• 여성건강간호학회지
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• 제28권4호
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• pp.296-306
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• 2022

Purpose: This study investigated the effects of peripheral neuropathy symptoms, self-care ability, and disturbances to daily life on quality of life (QoL) among gynecological cancer patients undergoing chemotherapy. Methods: The participants included 144 patients with gynecological cancer undergoing anticancer chemotherapy at a tertiary hospital in Seoul, South Korea, from December 1, 2021 to January 28, 2022. Convenience sampling was used to recruit patients who had received 4 or more cycles of chemotherapy using a paclitaxel-platinum regimen, and a self-reported questionnaire was used to collect data. Descriptive statistics, the t-test, analysis of variance, Scheffé test, Pearson correlation coefficients, and multiple regression analysis were performed. Results: Most of the participants had ovarian cancer (70.1%) or endometrial cancer (14.6%), and the most common number of treatment cycles was 6 to 10 (29.2%). The mean QoL (60.83±19.89) was greater than the midpoint. The regression model analyzing the patients' QoL was statistically significant (F=15.38, p<.001) with an explanatory power of 56.7%. Self-care ability (β=.39, p<.001), disturbances to daily life (β=-.38, p<.001), the duration of peripheral neuropathy symptoms (β=2.14, p=.034), and regular exercise (β=-2.12, p=.036) were found to significantly affect QoL. Conclusion: Efforts to improve the self-care ability of gynecological cancer patients who have experienced peripheral neuropathy after receiving chemotherapy and mitigate disturbances to their daily life can improve their QoL. Healthcare professionals should identify peripheral neuropathy symptoms and examine the effects of the symptoms on patients' daily lives. Improving the self-care ability of patients and alleviating their limitations in daily life may improve QoL.

• Journal of Chest Surgery
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• 제56권6호
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• pp.403-411
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• 2023

Background: The concept of oligo-recurrence has not been generally applied in esophageal cancer. This study aimed to determine the prognostic significance of the number of recurrences in esophageal cancer. Methods: Patients with squamous cell carcinoma who underwent curative esophagectomy with R0 or R1 resection and who experienced a confirmed recurrence were included. The study included 321 eligible participants from March 2001 to December 2019. The relationship between the number of recurrences and post-recurrence survival was investigated. Results: The mean age was 63.8±8.1 years, and the majority of the participants (97.5%) were men. The median time to recurrence was 10.7 months, and the median survival time after recurrence was 8.8 months. Multiple recurrences with simultaneous local, regional, and distant locations were common (38%). In terms of the number of recurrences, single recurrences were the most common (38.3%) and had the best post-recurrence survival rate (median, 17.1 months; p<0.001). Patients with 2 or 3 recurrences showed equivalent survival to each other and longer survival than those with 4 or more (median, 9.4 months; p<0.001). In the multivariable analysis, the significant predictors of post-recurrence survival were body mass index, minimally invasive esophagectomy, N stage, R0 resection, post-recurrence treatment, and the number of recurrences (p<0.05). Conclusion: After esophagectomy, the number of recurrences was the most significant risk factor influencing post-recurrence survival in patients with esophageal cancer. In esophageal cancer, oligo-recurrence can be defined as a recurrence with three or fewer metastases. More intensive treatment might be recommended if oligo-recurrence occurs.

• Journal of Gastric Cancer
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• 제23권4호
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• pp.598-608
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• 2023

Purpose: Lymph node (LN) metastasis is a crucial factor in the prognosis of patients with gastric cancer (GC) and is known to occur more frequently in cases with an advanced T stage. This study aimed to analyze the survival data of patients with advanced LN metastasis in T1 GC. Materials and Methods: From January 2008 to June 2018, 677 patients with pathological stage II GC who underwent radical gastrectomy were divided into an early GC group (EG: T1N2 and T1N3a, n=103) and an advanced GC (AGC) group (AG: T2N1, T2N2, T3N0, T3N1, and T4aN0, n=574). Short- and long-term survival rates were compared between the 2 groups. Results: A total of 80.6% (n=83) of the patients in the EG group and 52.8% (n=303) in the AG group had stage IIA AGC. The extent of LN dissection, number of retrieved LNs, and short-term morbidity and mortality rates did not differ between the 2 groups. The 5-year relapse-free survival (RFS) of all patients was 87.8% and the overall survival was 84.0%. RFS was lower in the EG group than in the AG group (82.2% vs. 88.7%, P=0.047). This difference was more pronounced among patients with stage IIA (82.4% vs. 92.9%, P=0.003). Conclusions: T1 GC with multiple LN metastases seems to have a worse prognosis compared to tumors with higher T-stages at the same level. Adjuvant chemotherapy is highly recommended for these patients, and future staging systems may require upstaging T1N2-stage tumors.

• Clinical and Experimental Vaccine Research
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• 제12권4호
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• pp.319-327
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• 2023

Purpose: Patients with hematological malignancies are at an increased risk of severe infection with coronavirus disease 2019 (COVID-19). However, developing an adequate immune response after vaccination is difficult, especially in patients with lymphoid neoplasms. Since the long-term effects of the BNT162b2 vaccine are unclear, the humoral immune response 5 months after the two vaccinations in patients with hematological disorders was analyzed. Materials and Methods: Samples were collected from 96 patients vaccinated twice with BNT162b2 and treated with at least one line of an antitumor or immunosuppressive drug in our hospital from November 2021 to February 2022. Serum anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) spike (S) antibody titers were analyzed. Patients were age- and sex-matched using propensity matching and compared with a healthy control group. Patients with serum anti-SARS-CoV-2 S antibodies were defined as 'responder' if >50 U/mL. The patients had B-cell non-Hodgkin lymphoma (B-NHL), multiple myeloma, chronic myeloid leukemia, etc. Results: Patients had significantly low antibody levels (median, 55.3 U/mL vs. 809.8 U/mL; p<0.001) and a significantly low response rate (p<0.001). Multivariate analysis showed that patients with B-NHL, aged >72 years, were associated with a low response to vaccination. There were no significant differences between patients with chronic myeloid leukemia and healthy controls. Conclusion: Our study shows that patients with hematological disorders are at risk of developing severe COVID-19 infections because of low responsiveness to vaccination. Moreover, the rate of antibody positivity differed between the disease groups. Further studies are warranted to determine an appropriate preventive method for these patients, especially those with B-NHL.

• 한국간담췌외과학회지
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• 제27권3호
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• pp.277-286
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• 2023

Backgrounds/Aims: To study histopathological changes in gall bladder mucosa in cholelithiasis patients, and analyse their relation to the number and size of gallstones. These findings were evaluated in the context of age distribution of the study population. Methods: One hundred cases of cholecystectomy were part of the study, which was conducted in collaboration with the pathology department. The time period of the study was January 2020 to June 2021. Results: Maximum cases had multiple stones (69.0%), while one third cases (31.0%) had solitary stones. While initial univariate analysis showed age (odds ratio [OR], 6.882; p = 0.043), gallstone number (OR, 9.1; p = 0.050), gallstone size (OR, 17.111; p = 0.013), and duration of symptom (OR, 34.125; p = 0.001) to be significant risk factors associated with gallbladder carcinoma, multivariate analysis found none of these variables to be significant. However, conditional multivariate analysis for the duration of symptom (p = 0.008; OR, 21.118) yielded significant p-value. With histopathological diagnoses, 5% of cases had gallbladder cancer. Conclusions: This study shed light on the rising incidence of cholelithiasis in the young population and the high rate of gallbladder carcinoma in Punjab, India. Although gall stone characteristics (size, number) and patient age appeared to be significant risk factors when their individual relation with gallbladder carcinoma was studied, multivariate analysis, could not prove that. Conditional multivariate analysis showed the duration of symptom to be the only significant risk factor associated with gallbladder carcinoma. Further research with larger sample size is needed to study the rising incidence of gallbladder carcinoma, and the risk factors associated with it.

• 여성건강간호학회지
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• 제29권4호
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• pp.317-327
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• 2023

Purpose: This study investigated the influence of cervical cancer knowledge, human papillomavirus (HPV) knowledge, self-efficacy, and uncertainty on the intention to engage in cervical cancer preventive behavior in HPV-infected women. Methods: This descriptive correlational study was conducted among 129 adult women aged 20 to 65 years who received positive HPV results at a general hospital in Changwon, Korea. The dataset was analyzed using descriptive statistics, the independent t-test, analysis of variance, the Pearson correlation coefficient, and multiple regression. Results: The mean score for the intention to engage in cervical cancer preventive behavior was high (4.43±0.65). This intention was significantly different according to age at first sexual intercourse (F=7.38, p=.001), HPV type (F=4.79, p=.010), vaccination (t=3.19, p=.002), and condom use (t=3.03, p=.003). The intention to engage in cervical cancer preventive behavior showed significant, weak-to-moderate positive correlations with HPV knowledge (r=.22, p=.012) and self-efficacy (r=.42, p<.001). Self-efficacy (β=.46, p<.001), first sexual intercourse at <20 years (β=.45, p<.001), first sexual intercourse at 20-24 years (β=.29, p=. 018), HPV high- and low-risk group infection (β=.26, p=.019), HPV high-risk group infection (β=.26, p=.026), and vaccination (β=.21, p=.007) significantly influenced the intention to engage in cervical cancer preventive behavior. These variables explained 34.6% of variance in intention. Conclusion: Study findings support the need to develop a program that effectively conveys accurate information about cervical cancer prevention to HPV-infected women and helps them enhance self-efficacy to boost the intention to engage in cervical cancer preventive behavior.

• Korean Journal of Radiology
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• 제1권1호
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• pp.38-42
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• 2000

Objective: The purpose of this study was to determine the utility of preoperative CT in predicting early recurrence of hepatocellular carcinoma after partial hepatic resection. Materials and Methods: Preoperative three-phase helical CT scans in 53 patients with hepatocellular carcinoma were retrospectively reviewed by two radiologists. In 27 patients (group I), HCC had recurred within six months, while 26 (group II) had remained disease free for at least two years. In each group, preoperative CT findings were evaluated in each group for the tumor size and number, the presence or absence of capsule, distinctness of tumor margin, perinodular extension, and the presence or absence of portal vein thrombosis. Results: In group I, a tumor capsule of tumor was seen in five of 27 patients (19%), and in group II, in 16 of 26 (62%) (p = .001). The tumor margin was distinct in eight patients (30%) in group I and in 20 (77%) in group II (p = .001). Multiple tumors, perinodular extension, and portal vein thrombosis were more frequently seen in group I but the differences were not statistically significant (p > .05). Tumor size was similar in each group (p > .05). Conclusion: Preoperative CT findings that may help predict the early recurrence of hepatocellular carcinoma after surgical resection are an absence of capsule of tumors and an indistinct margin. Reference to these findings during preoperative CT can guide clinicians in their choice of treatment.

• 임상간호연구
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• 제30권2호
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• pp.147-156
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• 2024

Purpose: The purpose of this study is to confirm the effect of resilience, family support, and spiritual well-being on posttraumatic growth(PTG) in lung cancer patients undergoing chemotherapy. Methods: The study collected data from January 20 to July 6, 2023 on 124 lung cancer patients who were admitted to hospital of C university in Seoul and received chemotherapy treatment. Patients were asked to complete a questionnaire consisting of general characteristics, disease characteristics, resilience, family support, spiritual well-being and PTG. Data were analyzed using t-tests, One-way ANOVA, Pearson's correlation and multiple regression analysis. Results: The mean score for PTG in lung cancer patients was 55.17, resilience was 72.46, family support was 49.00, and spiritual well-being was 53.50. Significant positive correlations were found for PTG with resilience (r=.62, p<.001), family support (r=.40, p<.001) and spiritual well-being (r=.47, p<.001). Factors contributing to PTG of lung cancer patients were resilience (β=.50, p<.001), spiritual well-being (β=.20, p=.008), and gender (β =.14, p=.043). Conclusion: This study aims to provide basic data for the PTG intervention program by identifying factors affecting the PTG of lung cancer patients. It is necessary to develop new nursing intervention programs to improve PTG for patients with lung cancer based on strategies to enhance resilience and spiritual well-being.

• Clinical Endoscopy
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• 제57권5호
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• pp.637-646
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• 2024

Background/Aims: During endoscopy, white spots (WS) are sometimes observed around benign or malignant colorectal tumors; however, few reports have investigated WS, and their significance remains unknown. Therefore, we investigated the significance of WS from clinical and pathological viewpoints and evaluated its usefulness in endoscopic diagnosis. Methods: Clinical data of patients with lesions diagnosed as epithelial tumors from January 1, 2019, to December 31, 2020, were analyzed (n=3,869). We also performed a clinicopathological analysis of adenomas or carcinomas treated with endoscopic resection (n=759). Subsequently, detailed pathological observations of the WS were performed. Results: The positivity rates for WS were 9.3% (3,869 lesions including advanced cancer and non-adenoma/carcinoma) and 25% (759 lesions limited to adenoma and early carcinoma). Analysis of 759 lesions showed that the WS-positive lesion group had a higher proportion of cancer cases and larger tumor diameters than the WS-negative group. Multiple logistic analysis revealed the following three statistically significant risk factors for carcinogenesis: positive WS, flat lesions, and tumor diameter ≥5 mm. Pathological analysis revealed that WS were macrophages that phagocytosed fat and mucus and were white primarily because of fat. Conclusions: WS are cancer-related findings and can become a new criterion for endoscopic resection in the future.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제13권2호
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• pp.154-163
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• 2010

목 적: 대장용종증은 소아에서는 드문 질환군으로 다수의 용종으로 인한 출혈, 복통, 장중첩증 등이 반복될 수 있고 용종의 악성화나 장외종양이 발생할 수 있으나 아직은 이에 관한 연구가 많지 않다. 본 연구에서는 소아 대장용종증의 임상 양상과 내시경적, 조직학적 특징을 살펴보고자 하였다. 방 법: 서울대병원 어린이병원에서 1987년부터 2009년까지 대장내시경을 시행 받은 2,956명의 소아 환자중에서 대장용종증으로 진단받은 37명의 환자를 대상으로 의무기록 분석을 시행하였다. 대장용종증 환자들의 진단 시 평균나이는 8세였다. 결 과: Peutz-Jeghers 증후군이 22예로 가장 많았으며 연소성 용종증 7예, 가족성 선종성 용종증 6예, 림프성용종증 2예이었다. 내원 시 가장 흔한 주소는 혈변이었다. 50% 이상의 환자에서 혈변과 복통이 동반되었고 일부에서 항문종괴, 설사, 변비가 동반되었다. 용종의 수와 크기는 다양하였고 위장과 소장에 용종이 동반된 환자는 각각 21명, 17명이었다. Peutz-Jeghers 증후군 환자에서는 주로 다엽성의 목이 있는 용종이 관찰되었다. 연소성 용종증 환자에서는 둥글고 목이 있는 용종이 대부분이었다. 가족성 선종성 용종증 환자에서는 작고 둥글며 목이 없는 용종이 관찰되었다. 림프성 용종증 환자에서는 목이 없는 용종이 관찰되었다. 모든 환자는 내시경적 용종절제술을 시행받았고 14명(38%)은 수술적 용종절제술을 시행받았다. 부분장절제술을 시행받은 환자는 13명(35%)이었고, 가족성 선종성 용종증 환자 4명은 전대장절제술을 시행받았다. Peutz-Jeghers 증후군 환자 중 일부에서 장외 종양이 발생하였으나 용종의 악성화는 없었다. 결 론: 소아의 대장용종증 환자는 출혈, 복통 등의 증상을 보이며 장중첩증 등의 합병증이 발생할 수 있어 조기 진단과 치료가 필요하며 정기적인 대장내시경 검사를 통해 합병증을 예방하고 용종의 악성화나 장외 종양 여부를 확인해야 한다.