This study intends to identify the characteristics of cancer in-patients and those of cancer patients who defected to other medical institutions based on the summary of hospital discharge information of a university hospital for the purpose of improving work efficiency and maximizing the number of patients. The study used data on cancer patients registered in the database of C University Hospital in Gyeonggi Province for a period of one year between January 1 and December 31. The analysis results suggest that the commonalities of the cancer patients who defected to other medical institutions include no specific job, old age, and hospitalization through emergency room. In conclusion, hospitals need to identify the characteristics of cancer patients classified as patients who are prone to defect and the defection factors through this prediction model.
Osteoporosis in gastric cancer patients is often overlooked or even neglected despite its high prevalence in these patients. Considering that old age, malnutrition, chronic disease, chemotherapy, decreased body mass index and gastrectomy are independent risk factors for osteoporosis, it is reasonable that the prevalence of osteoporosis in gastric cancer patients would be high. Many surviving patients suffer from back pain and pathological fractures, which are related to osteoporosis. Fractures have obvious associated morbidities, negative impact on quality of life, and impose both direct and indirect costs. In the era of a >55.6% 5-year survival rate of gastric cancer and increased longevity in gastric cancer patients, it is very important to eliminate common sequelae such as osteoporosis. Fortunately, the diagnosis of osteoporosis is well established and many therapeutic agents have been shown to be effective and safe not only in postmenopausal females but also in elderly males. Recently, effective treatments of gastric cancer patients with osteoporosis using bisphosphonates, which are commonly used in postmenopausal woman, were reported.
Purpose: This study aimed to examine factors influencing health-related quality of life (HRQOL) and compare them between young-aged and old-aged patients with cancer. Methods: Data of 291 patients (young-aged: 168, old-aged: 123) were obtained from the 10th wave of the 2015 Korea Health Panel Survey. The HRQOL was measured using the Korean version of Euro-QoL-5D. Independent t-test, analysis of variance, and multiple regression analysis were performed to identify factors influencing HRQOL. Results: The average HRQOL score was 0.87±0.10 and 0.82±0.15 among young-aged and old-aged, respectively. The factors differed partially between the two groups. For young-aged, the influencing factors were activity restriction, subjectively perceived health status, and smoking. For old-aged, the influencing factors were activity restriction, subjective health status, and unmet healthcare needs. Conclusion: Strategies to improve the HRQOL of elderly adults need to be developed considering the age group. Additionally, studies that include clinical factors such as symptoms are required to prepare need-based practical approaches for better quality of life of such patients.
Between September 1973 and December 1983, 61 patients with carcinoma of the esophagus were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among 61 patients, male patients were 51 cases, female 10 cases and the age ranged from 21 years old to 72 years old with the average of 54.6 years old. Min symptoms of esophageal cancer were dysphagia (91.5%), weight loss (40.4%), pain(27.6%), and the average symptom duration was 3.85 months. The anatomical locations of esophageal cancer in preoperative esophagogram revealed 41.7% in middle 1/3, 8.3% in esophagograstic junction or cardia. Among 61 cases, 9 cases were managed by feeding gastrostomy due to inoperability, 8 cases by exploratory thoracotomy or lapatotomy only without curative or palliative resection, and 44 cases by curative or palliative resection with reconstruction. Among 52 cases of exploration, 44 cases were managed with curative or palliative resection of cancer and the resectability revealed 84.6% in operated cases. Among palliative or curative resected group, the esophagogastrostomy was performed in 40 cases (90.9%), esophagojejunostomy in 3 cases(6.8%), esophagectomy only in 1 case(2.3%). Postoperative complications were noticed in 12 cases, such as anastomotic leakage in 7 cases(15.6%), empyema in 2 cases (4.4%), respiratory failure in 2 cases (4.4%), anastomotic stricture in 1 case (2.2%). among 7 postoperative anastomotic leakage, 2 patients died as a result of that complication and the operative mortality revealed 4.3%. During follow-up work, the mean survival period was 19.3 months in patients who discharged hospital alive, and the 2 year survival rate was 34.6%.
Objective: To compare the mammogarphic appearance between breast cancer patients aged <40 and ${\geq}40$ years. Methods: Needle localization and biopsy of suspicious mammographic lesions identified 1,959 breast carcinomas in a single institution from Jun 2012 to Apr 2013. According to the age, we divided patients into two groups: <40 and ${\geq}40$ years old, and analyzed mammographic appearance separately. Results: Young patients had 44.2% foci with calcification, but old patients only had 39.4% (P<0.001). In younger group, the ratios of cases according to mass density were 41.8% or higher, 58.2% equivalent and lower. In older group, the ratios were 55.5 % and 44.5%, respectively. There were statistical differences between high density and others (P<0.05). The ratios of cases according to mass margin were 13.9% circumscribed and microlobulated, 86.1% indistinct and spiculated in the younger group, as compared to 6.5% and 93.5%, respectively, in the older group (P<0.05). Conclusions: Mammographic findings differ between young and old patients with breast cancer, for example regarding mass density, mass margin and microcalcification ratios.
Inferior mesenteric plexus block(IMPB) sa useful nerve block for the relief of intractable lower abdominal and pelvic pain caused by a lower abdominal visceral or a pelvic malignancy. IMPB has been performed in the prone position. But there are many patients who can't lie in the prone position, because ascites is frequently noticed in cancer patients and they also frequently received abdominal operations. We performed IMPB in the lateral position on two patients with lower abdominal pain, Case 1: A 77 year old female who had a right ovarian cancer with metastatic cancer of descending colon and rectum, experienced complete pain relief. Case 2: A 72 year old female who had a far advance pancreatic cancer with intestinal obstruction due to carcinomatosis received right and left celiac plexus block and right and left IMPB. The patient was satisfied with the result of these pain blocks. Conclusion; IMAPB performed in the lateral position on two patients with lower abdominal pain and their results were excellent for pain relief.
Purpose: The purpose of this study was to identify relationship of urinary symptom, urinary discomfort and quality of life among the bladder cancer patients and benign prostate hypertrophy patients, and to contribute health promotion of such patients and nursing intervention development based on this results. Method: Study sample recruited bladder cancer patents(n=49) and benign prostate hypertrophy patients who admitted Seoul National University Hospital from June, 2002 to June, 2003. Both group patients were operated, and prostate hypertrophy patients group (mean 67.8 years old) were older than bladder cancer patients group(60.82 years old). Instruments was composed of general characteristics, urinary symptom scale(19 items), urinary discomfort scale(19 items) and quality of life scale(21 items). Data was analysed SPSS PC + 10. using mean, standard deviation, pearson correlation coefficient. Result as follows: 1. There was a statistically significant difference in occupation between two groups (p=.027). Hypertrophy patients group's age was more older than bladder cancer patients group. 2. The prostate hypertrophy patients group had the significantly higher score in urinary symptom (p=000) and nighttime urination frequency. However, there was no significant difference in incontinence symptoms and the symptoms associated bladder cancer between two groups. 3. The prostate hypertrophy patients group had significantly higher score in urinary discomfort (p=000) than the bladder cancer patients group. However, there was no significant difference incontinence discomfort and the discomfort associated bladder cancer between two groups. 4. The prostate hypertrophy patients group suffered more urinary discomfort than the bladder cancer patients group did. The quality of life the prostate hypertrophy patients group was lower than the quality of life the bladder cancer patients group. Quality of life was no statistically significant difference between two groups (p=000). 5. There was a positive correlation between urinary symptoms and urinary discomfort. However, there was a negative correlation between the quality of life and urination symptoms and discomfort. Conclusions: The prostate hypertrophy patients group had significantly higher score in urinary symptom and urinary discomfort (p=000) than the bladder cancer patients group. The quality of life the prostate hypertrophy patients group was lower than the quality of life the bladder cancer patients group. This means that urinary symptom and urinary discomfort in prostate hypertrophy patient group is more important problem. So, prostate hypertrophy patient group need to control the symptom. Therefore, nurses will be provide the intervention program to improve the bladder function after prostate hypertrophy surgery.
Background: Differences in clinicopathological characteristics of gastric cancer (GC) between young and older patients are controversial and a matter of debate. Determining the statistical significance of clinicopathological information with respect to age might provide clues for better management and treatment ofGC. Materials and Methods: A total ofl03 Indiao GC patients were enrolled for study and specimens were classified according to the AjCC-TNM system. Patients were grouped into two age-wise categories, young patients (<40 years; n=13) and older patients (${\geq}40$ years, n=90). The clinicopathological features of both groups were retrospectively examined and compared. p53 alterations were analyzed by polymerase chain reaction-single strand conformational polymorphism and immunohistochemistry methods at gene and protein levels respectively. The cases were considered p53 over-expressed if it was present in more than 25% of the tumor cells and p53 alterations was correlated with the clinicopathological characteristics of the patients as well as etiological factors for GC in both groups. Results: We found significant association of young patients with cancer stage (p=0.01), and very strong association with histology grade (p=0.064) and poorly differentiated (p=0.051) state of GC. However, neither young nor elderly patients showed associations with location, gender, etiological factors and p53 expression and alteration. Overall the male-to-female ratio of GC patients was 3.12 and the value was higher in the young (5.5) than in the older group (2.91). Conclusions: Clinicopathological features of GC like caocer stage, cell differentiation and histological grades were significantly different among young and old age cohorts. We observed a male predominance among the young group that decreased significantly with advancing age. More awareness of GC onset is required to detect cancer at an early stage for successful treatment.
Seo, Su-Han;Hur, Hoon;An, Chang-Wook;Yi, Xian;Kim, June-Young;Han, Sang-Uk;Cho, Yong-Kwan
Journal of Gastric Cancer
/
v.11
no.2
/
pp.116-121
/
2011
Purpose: Gastric cancer surgery is a common operation in East Asia, such as Korea and Japan, and there has been a significant increase in the need for this procedure due to the aging population. As a result, surgery for the treatment of gastric cancer for elderly patients is expected to increase. This study examined the effect of old age on gastric cancer surgery, and analyzed the operative risk factors for elderly patients. Materials and Methods: From November 2008 to August 2010, 590 patients, who underwent a curative resection for gastric cancers, were enrolled. Patients who underwent palliative or emergency surgery were excluded. A retrospective analysis of the correlation between surgical outcomes and age was performed. The elderly were defined as patients who were over the age of 65 years. Results: The mean age of all patients was 58.3 years, and complications occurred in 87 cases (14.7%). The most common complication was wound infection and severe complications requiring surgical, endoscopic, or radiologic intervention developed in 52 cases (8.8%). The rate of complications increased with increasing age of the patients. Univariate analysis revealed age, comorbidity, extent of resection, operation time, and combined resection to be associated with surgical complications. In particular, age over 75 years old, operation time, and comorbidity were predictive factors in multivariate analysis. In the elderly, only comorbidity was associated with surgical complications Conclusions: The patients' age is the most important factor for predicting surgical complications. Surgeons should pay an attention to the performance of gastric cancer surgery on elderly patients. In particular, it must be performed carefully for elderly patients with a comorbidity.
Purpose:It has been known that the prognosis of a young woman's breast cancer is Poorer than the other woman However, the effect of age on the prognosis is not well-defined We performed this study to investigate age as a prognostic factor of breast cancer. Materials and Methods : A retrospective study was conducted for 3209 breast cancer patients who underwent operations in Department of Surgery, Seoul National University Hospital from January 1981 to December 2000. Patients were divided into two groups, young age(≤35) and old age(>35) groups. And tumor stage, histopathologic characteristics(such as histology, nuclear grade, histologic grade, hormonal receptor, etc), overall survival and disease free survival rates were compared between age groups. Results . The age ranged from 17 to 88 years. 396 patients(12.3%) were included in young age group(median=32) and 2813 Patients(87.7%) in old age group(median=47).There are more advanced stages and poor nuclear grades in young age group(p=0.000, p=0.003), By log-rank test, the young age group had poorer overall survival and disease free survival rates(p<0.05, p=0.0002). Although, the young age group had more advanced TMN stages(p=0.000) and poorer nuclear grade than the old age group(p=0.003) in multi variate analysis, the age was not a significant independent prognostic factor. (P=0.642)Conclusion: Our study showed that the age was not a significant independent prognostic factor.
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