• Title/Summary/Keyword: Patients' Evaluation

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Comparison of Metabolic and Anatomic Response to Chemotherapy Based on PERCIST and RECIST in Patients with Advanced Stage Non-small Cell Lung Cancer

  • Ordu, Cetin;Selcuk, Nalan A.;Akosman, Cengiz;Eren, Orhan Onder;Altunok, Elif C.;Toklu, Turkay;Oyan, Basak
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.321-326
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    • 2015
  • Background: The aim of this study was to explore the prognostic role of metabolic response to chemotherapy, determined by FDG-PET, in patients with metastatic non-small-cell lung cancer (NSCLC). Materials and Methods: Thirty patients with metastatic NSCLC were analyzed for prognostic factors related to overall survival (OS) and progression free survival (PFS). Disease evaluation was conducted with FDG-PET/CT and contrast-enhanced CT prior to and at the end of first-line chemotherapy. Response evaluation of 19 of 30 patients was also performed after 2-3 cycles of chemotherapy. Morphological and metabolic responses were assessed according to RECIST and PERCIST, respectively. Results: The median OS and PFS were 11 months and 6.2 months, respectively. At the end of first-line chemotherapy, 10 patients achieved metabolic and anatomic responses. Of the 19 patients who had an interim response analysis after 2-3 cycles of chemotherapy, 3 achieved an anatomic response, while 9 achieved a metabolic response. In univariate analyses, favorable prognostic factors for OS were number of cycles of first-line chemotherapy, and achieving a response to chemotherapy at completion of therapy according to the PERCIST and RECIST. The OS of patients with a metabolic response after 2-3 cycles of chemotherapy was also significantly extended. Anatomic response at interim analysis did not predict OS, probably due to few patients with anatomic response. In multivariate analyses, metabolic response after completion of therapy was an independent prognostic factor for OS. Conclusions: Metabolic response is at least as effective as anatomic response in predicting survival. Metabolic response may be an earlier predictive factor for treatment response and OS in NSCLC patients.

Level and Evaluation of Tumor Marker CA-125 in Ovarian Cancer Patients in Khyber Pakhtunkhwa, Pakistan

  • Ahmad, Bashir;Nawaz, Seema;Ali, Sajid;Bashir, Shumaila;Mahmood, Nourin;Gul, Bushra
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.185-189
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    • 2015
  • Background: Due to the increase in morbidity and mortality rate, cancer has become an alarming threat to the human population worldwide. Since cancer is a progressive disorder, timely diagnosis is necessary to prevent/stop cancer from progressing to a severe stage. In Khyber Paktunkhwa, Pakistan, many tumors are diagnosed with endoscopy and biopsy; rare studies exist regarding the diagnosis and evaluation of ovarian cancer, based on tumor markers like CA-125. Objectives: The objectives of this study were to investigate and evaluate levels of CA-125 in hospitalized ovarian cancer patients. Materials and Methods: In this study, a total of 63 admitted patients having ovarian cancer by biopsy were included. The level of CA-125 was determined in the blood of these patients using ELISA technique. Results: Out of 63 patients, the level of CA-125 was high in 52%. The affected individuals were more in the group of 40-60 and the level of CA-125 was comparatively higher in patients having moderately differentiated histology than those having well differentiated and poorly differentiated tumor histology. Moreover, the highest level of CA-125 was present among the patients having serous subtype of carcinoma and the common stage of carcinoma was stage II followed by stage III, I and IV. Conclusions: CA-125 level was high in more than 50% of the total patients. Moreover, CA-125 elevation was more common in serous subtype and stage II cancer patients.

Effects of Web-Based Nutrition Counseling on Dietary Behavior and Food Intake in Hyperlipidemic Patients (고지혈증 환자의 식행동 및 식품섭취에 웹기반 영양상담의 영향)

  • Kim, Jong-Suk;Han, Ji-Suk
    • Journal of the Korean Dietetic Association
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    • v.11 no.4
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    • pp.418-429
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    • 2005
  • The purpose of this study was to investigate the effect of the web-based nutrition counseling on the dietary behavior and food intake of hyperlipidemic patients and to evaluate the web-based nutrition counseling program. Forty hyperlipidemic patients, twenty of them were hypercholesterolemia and the other twenty were hypertriglyceridemia, participated in the web-based nutrition counseling program. At the first nutrition counseling, the patients were interviewed and then follow-up nutrition counselings were accomplished four times during eight weeks through a web-based internet program. The web-based nutrition counseling program was consisted of diet management, nutrition education and nutritional assessment and the follow-up counseling program. The dietary behavior score increased significantly in both groups after the nutrition counseling program(p<0.01). The diet therapy knowledge score also increased significantly (p<0.01). For food frequency, vegetable (p<0.01), fruit (p<0.05) and seaweed (p<0.01) consumption increased significantly, while meat (p<0.01), egg (p<0.01), snack (p<0.01) and instant food (p<0.01) intake decreased significantly in both groups after the nutrition counseling program. The evaluation of the web-based nutrition counseling program by the patients showed above average in all domains, specially the evaluation scores of younger aged patients habituated to practice computer were better than those of older aged patients. Therefore, this study shows that the web-based nutrition counseling program is effective for improving dietary behavior and food consumption the patients. In addition, these results indicate that internet presents us with potential as a new medium for nutrition counseling in informationized society.

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Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center

  • Lee, Min A;Lee, Seung Hwan;Choi, Kang Kook;Park, Youngeun;Lee, Gil Jae;Yu, Byungchul
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.177-182
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    • 2021
  • Purpose: Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods: We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients' demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results: A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions: For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient's hemodynamic status. NOM can be performed without mortality in appropriately selected cases.

Onlay patch augmentation in rotator cuff repair for moderate to large tears in elderly patients: clinical and radiologic outcomes

  • Sung-Yup Hong;Seung-Jin Lee;Hee-Bum Hahm;Ji-Woo Chang;Yoon-Suk Hyun
    • Clinics in Shoulder and Elbow
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    • v.26 no.1
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    • pp.71-81
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    • 2023
  • Background: This study evaluated the clinical and radiologic outcomes of onlay patch augmentation in rotator cuff repair for moderate-to-large tears in elderly patients. Methods: We reviewed 24 patients who underwent onlay augmentation with dermal allograft after arthroscopic rotator cuff repair from January 2017 to March 2020. Inclusion criteria were patients aged >65 years with tears >2.5 cm, who were followed for >12 months after surgery, and patients who could raise their arms above 90° preoperatively. American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, pain visual analog scale (VAS), and VAS for satisfaction were used as clinical outcomes. For the evaluation of cuff integrity, magnetic resonance imaging scans were performed every 3 months after surgery. The results were compared before and after surgery in all patients and between the retear and intact groups. Results: The average follow-up period was 16.38 months, and the mean age of patients was 71.05 years. All patients showed significant improvement in ASES score, Constant-Murley score, and pain VAS at the last evaluation. The average value of satisfaction VAS was 7.27/10. The retear rate was 25% (6/24) if Sugaya type 3 was categorized in the retear group, otherwise 16.7% (4/24), if Sugaya type 3 was categorized into the intact group. Irrespective of Sugaya type 3 being included in the retear group, there was no significant difference in outcome variables between the intact and retear groups during follow-up. Conclusions: In moderate-to-large rotator cuff tear in elderly patients, onlay patch augmentation improved clinical outcomes. Retear did not adversely affect clinical outcomes.

Clinical review of four patients of acute purulent pericarditis (급성 화농성 심낭염의 외과적 고찰)

  • Kim, Su-Seong;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.263-268
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    • 1984
  • Four patients of acute purulent pericarditis were seen at the Jeonbug National University Hospital between January, 1979 and December 1983. All patients were proven to have acute purulent pericarditis by clinical evaluation, bacterial study, and biopsy. Three patients were male and one female. The three patients were in pediatric age. The primary focuses were meningitis, Rt. coxitis, lobar pneumonia, and gastro-enteritis. The causative organisms were staphylococcus aureus in two patients. In the other two patients, organisms were not cultured from the pericardial pus. The reason why the causative organisms were not cultured in pericardial pus was probably due to massive antimicrobial treatment before pus collection. All patients were treated with systemic antibiotic therapy and pericardiostomy with normal saline irrigation. The three patients were treated without specific complication. The one patient developed the chronic constrictive pericarditis. In this patient, pericardiectomy was performed.

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Surgical treatment of vascular ring: a report of 6 cases (혈관륜의 수술체험6례 보)

  • 김원곤
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.205-211
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    • 1984
  • Developmental anomalies of the aortic arch, commonly known as vascular rings, are relatively rare congenital vascular anomalies which can compress the trachea and esophagus. We have presented six patients with surgically treated vascular rings at Seoul National University Hospital during the period June 1970 through May 1984. Two patients had double aortic arches and four patients had right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum. Four patients had symptoms relating vascular ring and two patients were detected incidentally during diagnostic evaluation of symptomatic intracardiac defects. Associated congenital malformations were seen in four patients. The operative approach was through left thoracotomy in three patients and median sternotomy in remaining three patients associated with congenital cardiac defects. There were no postoperative deaths with excellent result in preoperative symptomatic patients. To our knowledge, successful surgical repair of vascular ring has been reported only once in the Korean literature.

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The effect of using a Nursing Standards on the Quality of Nursing care in Musculo-skeletal Disorder Patients (간호표준 적용이 근${\cdot}$골격장애 환자의 간호질에 미치는 효과)

  • Choe, Sun-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.1
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    • pp.89-101
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    • 2003
  • Purpose : this study was to examine the effect of using a nursing standards for the quality of nursing care in musculo-skeletal patients. Method : The approach to nursing quality assurance evaluation was selected process-outcome framework. The subjects ware 100 case of musculo-skeletal patients in orthopedic surgery nursing care unit of E. university hospital in seoul. The data of a control group were collected from 23 December 2001 to 20 March 2002 and an experimental group were collected from 1 June to 25 August 2002. The instruments used for this study were a nursing care standards in musculo-skeletal disorder patients developed by the investigator and an evaluation tool for the quality of nursing care in orthopedic surgery patients developed by soon-ook Choi in 1995. It's reliability is Cronbach alpha=.8628. The data were analyzed by means of $x^1$-test, t-test, ANOVA with SPSS program. Results : This study are as fellows : 1. Scores of the quality of nursing care in standard 1 in the experimental group were higher than those of the control group with no significant difference(t=-8.793, p=.000), scores of the quality of nursing care in standard 2 in the experimental group were higher than those of the control group with significant difference(t=-8.793, p=.000) and standard 3 in the experimental group were higher than those of the control group with significant difference(t=-10.550, p=.000). scores of the quality of nursing care in standard 4 in the experimental group were higher than those of the control group with significant difference(t=-8.793, p=.000). scores of the quality of nursing care in standard 4 in the experimental group were higher than those of the control group with no significant difference(t=-1.833, p=.070). 2. Scores of the quality of nursing care in criteria 28 of 33 criteria in the experimental group were higher than those of the control group with significant difference in 12 criteria(p<.05 ). 3. Scores of the quality of nursing care in standard 1 to standard 4(process evaluation); the experimental group were higher than those of the control group with significant difference(t=-10.704, p=.000). scores of the quality of nursing care in standard 5(outcome evaluation); the experimental group were higher than those of the control group. but no significant difference(t=-1.833, p=.070). 4. Scores of the quality of nursing care in experimental group were higher than those of the control group with significant difference(t=-10.794, p=.000). Conclusion : Through this study, I'm sure that using a nursing care standards in musculo-skeletal disorder patients improve quality of nursing care and nursing care standards are effective nursing care.

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A CAOPI System Based on APACHE II for Predicting the Degree of Severity of Emergency Patients (응급환자의 중증도 예측을 위한 APACHE II 기반 CAOPI 시스템)

  • Lee, Young-Ho;Kang, Un-Gu;Jung, Eun-Young;Yoon, Eun-Sil;Park, Dong-Kyun
    • Journal of the Korea Society of Computer and Information
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    • v.16 no.1
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    • pp.175-182
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    • 2011
  • This study proposes CAOPI(Computer Aided Organ Prediction Index) system based on APACHE II(Acute Physiology And Chronic Health Evaluation) for classifying disease severity and predicting the conditions of patients' major organs. The existing ICU disease severity evaluation is mostly about calculating risk scores using patients' data at certain points, which has limitations on making precise treatments. CAOPI system is designed to provide personalized treatments by classifying accurate severity degrees of emergency patients, predicting patients' mortality rate and scoring the conditions of certain organs.

USEFULNESS OF $^{18}F$-FDG PET/CT IN THE EVALUATION OF CERVICAL LYMPH NODE METASTASIS IN PATIENTS WITH ORAL CANCER (구강암 환자에서 $^{18}F$ FDG-PET/CT의 경부 림프절 전이 평가 유용성)

  • Yu, Min-Gi;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.4
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    • pp.213-220
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    • 2009
  • Purpose: The present study was aimed to examine the usefulness of 18F-FDG PET/CT in the evaluation of cervical lymph node metastasis in patients with oral cancer. Materials and methods: Twenty-two patients who underwent neck dissection to treat oral cancer were subjected for examination. The cervical node metastasis was evaluated by means of clinical examination, CT scan, PET, and histologic examination. By comparing the results of each examination modality with those of histologic examination, it's sensitivity, specificity, positive predictive value, and negative predictive value were determined. Results: The oral cancer was more frequent in males with a ratio of 2.14:1. The sixth decade showed the highest incidence in age distribution with mean of $56{\pm}16$. Histologic findings showed that squamous cell carcinoma was the most common (15 patients), and mucoepidermoid carcinoma (3), malignant melanoma (2), and adenoid cystic carcinoma and ghost cell odontogenic carcinoma (1 each), in order. In most cases, wide surgical excision of the primary cancer and neck dissection was performed, followed by reconstruction with free flaps when necessary. When comparing the results of each examination modality with those of the histologic examination, clinical examination showed sensitivity, specificity, positive predictive value, and negative predictive value at 11%, 85%, 33%, and 58%, respectively. CT scans showed at 67%, 77%, 67%, and 77%, while $^{18}F$-FDG PET/CT at 78%, 77%, 70%, and 83%, respectively. Conclusions: These results suggest that PET is more useful, compared with clinical examination and CT scans, in the evaluation of cervical lymph node metastasis in patients with oral cancer.