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Surgical Outcomes and Survival Prognostic Factors for Palliative Gastrectomies in Stage IV Resectable Gastric Cancer Outlet Obstruction Patients

  • Choi, Won Yong;Kim, Hyun Il;Park, Seong Ho;Yeom, Jong Hoon;Jeon, Woo Jae;Kim, Min Gyu
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.421-430
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    • 2020
  • Purpose: Currently, there is no clear evidence to support any specific treatment as a principal therapy for stage IV gastric cancer outlet obstruction (GCOO) patients. This study evaluated the outcomes of palliative gastrectomies and survival prognostic factors in patients with stage IV resectable GCOO. Materials and Methods: We retrospectively reviewed the medical records of 48 stage IV GCOO patients who underwent palliative gastrectomies between June 2010 and December 2019. Palliative gastrectomies were performed only in patients with resectable disease. Early surgical outcomes and prognostic factors were analyzed using univariate and multivariate analyses. Results: There were no specific risk factors for postoperative complications, except for being underweight. Severe postoperative complications developed in five patients, and most of the patients underwent interventional procedures and received broad-spectrum antibiotics for intra-abdominal abscesses. The multivariate survival analysis showed that palliative chemotherapy is a positive prognostic factor, while the specific type of hematogenous and lymphatic metastasis is a negative prognostic factor. Conclusions: We recommend that the treatment method for stage IV GCOO should be selected according to each patient's physical condition and tumor characteristics. In addition, we suggest that palliative gastrectomies can be performed in stage IV resectable GCOO patients without unfavorable prognostic factors (types of hematogenous and lymphatic metastases).

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD): A Korean Chronic Kidney Disease Cohort

  • Oh, Kook-Hwan;Park, Sue K.;Kim, Jayoun;Ahn, Curie
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.4
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    • pp.313-320
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    • 2022
  • The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) was launched in 2011 with the support of the Korea Disease Control and Prevention Agency. The study was designed with the aim of exploring the various clinical features and characteristics of chronic kidney disease (CKD) in Koreans, and elucidating the risk factors for CKD progression and adverse outcomes of CKD. For the cohort study, nephrologists at 9 tertiary university-affiliated hospitals participated in patient recruitment and follow-up. Biostatisticians and epidemiologists also participated in the basic design and structuring of the study. From 2011 until 2016, the KNOW-CKD Phase I recruited 2238 adult patients with CKD from stages G1 to G5, who were not receiving renal replacement therapy. The KNOW-CKD Phase II recruitment was started in 2019, with an enrollment target of 1500 subjects, focused on diabetic nephropathy and hypertensive kidney diseases in patients with reduced kidney function who are presumed to be at a higher risk of adverse outcomes. As of 2021, the KNOW-CKD investigators have published articles in the fields of socioeconomics, quality of life, nutrition, physical activity, renal progression, cardiovascular disease and outcomes, anemia, mineral bone disease, serum and urine biomarkers, and international and inter-ethnic comparisons. The KNOW-CKD researchers will elaborate a prediction model for various outcomes of CKD such as the development of end-stage kidney disease, major adverse cardiovascular events, and death.

The Effect of Chain Exercise Types on the Exercise Performance Improvement in Lower Limb Exercise for the Life-Carement (라이프케어먼트를 위한 신체운동수행능력 향상에 사슬운동형태가 미치는 효과 연구)

  • Yang, Seung-Hoon
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.8
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    • pp.391-396
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    • 2020
  • This study was to examined the effect of chain types exercise of lower limbs on the motor performance differences for the life-carement. For this, twenty normal adult women participated and they were examined the differences of exercise effects about abdominal muscle activity and balance ability by applying two types of chain exercise. In order to identify the differences we let them conduct exercise for 4 weeks with each type of exercise. And we used paired t-test and Independent sample t-test for comparing the differences in the group and inter groups. There was a significant difference in the value of 0.05 to verify statistical significance. As a result of this research, it was found that closed chain exercise is more effective than open chain exercise in muscle activity and balance function. Therefore, in the clinical therapeutic environment, if you apply chain exercise for patient to improve lower limb motor performance, we would recommend the close kinematic chain exercise.

Comparison of the Effects of Three Interventions on Back Pain and Functional Improvement in Office Workers (사무직 근로자의 허리통증 및 기능 개선에 대한 3가지 중재의 효과 비교)

  • Huh, Jun;Jang, Woo-Jung;Kim, Myung-Chul
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.3
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    • pp.221-232
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    • 2022
  • Purpose : In this study, rectus abdominis relaxation intervention was administered to office workers who were experiencing low back pain due to sitting for extended periods of time in an incorrect posture. This study aimed to develop an effective treatment program for individuals who experience low back pain. This was done by verifying changes using the Korean Oswestry Disability Index (K-ODI) and considering kyphosis. Both factors are related to low back pain. Methods : This study included 39 office workers with low back pain. The participants were randomly assigned to three groups. 1) The functional massage and self-stretching (FAS) group (n=14). 2) The diaphragmatic breathing and self-stretching (DAS) group (n=13). 3) The self-stretching (S) group (n=12). All groups applied the intervention for 30 minutes a day, thrice a week for four weeks. All participants were evaluated using the K-ODI and thoracic kyphosis measurements before and after the intervention. Results : The findings of this study are as follows. All three groups had improved K-ODI scores after the intervention. The FAS and DAS groups showed a greater effect than the S group. However, there was no difference in effect between the FAS and DAS groups. Kyphosis was not improved in any of groups after the intervention, and there was no difference between the three groups. Conclusion : This study showed that the FAS, DAS, and S programs were effective relaxation interventions that improved the K-ODI for office workers with low back pain. The FAS and DAS programs were more effective than the S program. Therefore, it is recommended to combine relaxation and stretching of the rectus abdominis muscle for office workers who experience low back pain. Clinically, a relaxation intervention that is most appropriate for the patient, depending on his or her condition, should be.

The Effect of Lower Trapezius Resistance Exercises on Shoulder Alignment and Muscle Activity in Patient with Rounded Shoulder Posture (아래등세모근 저항운동이 둥근 어깨를 가진 성인의 어깨 정렬과 근활성도에 미치는 영향)

  • Young-Mi Kim;Ji-Won Han
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.4
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    • pp.41-50
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    • 2023
  • Purpose : The aim of study was to determine the effect of lower trapezius muscle strengthening exercises on the height of rounded shoulder posture and muscle activity in patients with rounded shoulder posture. Methods : Thirty-one subjects with rounded shoulders were selected and assigned, with the use of a random number table, to an experimental group (EG, n=16) that received resistance exercises of the trapezius (lower) muscles or a control group (CG, n=15) that received isometric exercises of the lower trapezius muscles. In the EG, with the subject in a prone position, both arms were abducted at the angles suggested for each posture (145 °, 45 ° abduction), with the hands holding dumbbells to assume a functional posture. The CG performed only isometric exercises without dumbbells in the same conditions. At the start signal, with the thumb raised, the arm was raised to the level of the ear. Both groups were assessed by the height of the rounded shoulder posture (RSP) and muscle activity (EMG). The intervention was performed three times a week. Results : The RSP significantly decreased during the intervention period in both the EG and CG (p<.05), and a significant difference was determined between the RSP of the two groups (p<.05). In the EG, the EMG significantly increased during the intervention period (p<.05), but the CG did not show any significant increase (p>.05). The final EMG was significantly higher in the EG than in the CG (p<.05). Conclusion : Both the EG and CG showed positive improvement in rounded shoulder posture during the intervention period. In particular, lower trapezius resistance exercise appears to reduce shoulder height and positively affects the activity of muscles around the shoulder.

The Effect of Virtual Reality Programs on Upper Extremity Function in Stroke Patients : A Meta-Analysis (뇌졸중 환자의 가상현실 프로그램이 상지기능에 미치는 영향 : 메타분석)

  • Cho, Sung-Hyoun;Choi, Ki-Bok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.429-439
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    • 2020
  • This study examined the effect size of virtual reality programs on the upper extremity function of stroke patients through a meta-analysis. Databases, such as the Research Information Sharing Service, the Korean Studies Information Service System, the National Library of Korea, the Korean Citation Index, and the National Digital Science Library, were used. Previous articles were surveyed for virtual reality programs between January 2010 and June 2019. A meta-analysis was performed by selecting the final 14 studies based on the PICO standard. The RoB and RoBANS tools were used as quality assessment tools for randomized and non-randomized control trials, respectively. The CMA 3.0 program was used to calculate the effect size of each study. Sub-group analysis, meta-regression analysis, and publication bias were performed. The total effect size of the virtual reality programs on the upper extremity function was Hedges's g=0.390 (95% CI: 0.192~0.587) (p<.05). The virtual reality program positively affects the upper extremity function of stroke patients. Therefore, the development of various virtual reality programs and industry-academia cooperation technology for stroke patients is required in accordance with the fourth industry. Randomized control trials and detailed upper extremity function studies for virtual reality programs will be needed in follow-up studies.

Uncertainty, Self-Efficacy & Coping in Parents′ of Children with Cancer (암환아 부모의 질병에 대한 불확실성, 자기효능감 및 대처정도)

  • Oh Won Oak;Park Eun Sook
    • Child Health Nursing Research
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    • v.4 no.2
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    • pp.274-285
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    • 1998
  • Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However the agrressiveness of therapy & uncertainty about prognosis are associated with many adverse effects, psychological as well as physical for both the child & family. The purpose of this study were to measure the degree of perceived uncertainty, self-efficacy & coping, and then to examine the relationship between the perceived uncertainty, self-efficacy & coping in parents of children cancer patients. The subjects of this study consist of 140 parents with pediatric cancer, registered at pediatric cancer ward & Out Patient Department. Data was collected from July 1st to August 15th 1998. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale (28 item, 4 likert scale), Shere's Self-Efficacy Scale (17 item, 5 likert scale) & Folkman & Lazarus Ways of Coping Checklist(34 items, 4 likert scale). Data was analyzed by t-test, Anova, Pearson Correlation coefficient. Results of this study are summerized as follows 1. Parents perceived their uncertainty to be slightly high(Mn 2.41). The degree of perceived uncertainty by the four components were followed as lack of clarity (2.60), unpredictability(2.59), ambiguity(2.51) & lack of information(1.90). The degree of perceived uncertainty of parents with pediatric cancer revealed to be influenced significantly by the family outcome, reliability about health care provider & perceived severity of illness. 2. The range of parents' self-efficacy was measured iron 35 to 85 point, so revealed slightly high. The degree of self-efficacy related to be Influenced signiicantly by the sequency of child birth, family religion & degree of perceived support. 3. The degree of parents' coping was measured slightly high (Mn 2.78). The degree of coping related to be influnced significantly by the sequency of child birth, number of sible & degree of perceived support. 4. parents' uncertainty was related inversely to the parents' self-efficacy(r=-.38, p<.001) & coping(r=-.26, p<.001). And also parents' self-efficacy was positively related to coping(r=.56, p<.001) From the above results, it can be concluded that predicting & controlling parents' uncertainty with children cancer are necessary to improve positive coping strategies. This information may be used as a foundation for developing nursing interventions to decrease perceived uncertainty & to foster self-efficacy & coping for parents with children cancer.

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A Clinical Case Study of Common Peroneal Nerve Palsy(Foot Drop) Following Entrapment Neuropathy (압박성 신경병증에 의한 족하수(足下垂) 환자(患者) 1례(例)에 대한 임상적(臨床的) 고찰(考察))

  • Shin, Jeong-Cheol;Lee, Dong-Hyun;Wei, Tung-Shuen;Kim, Seon-Jong;Choe, Won-Hwak;Ryu, Chung-Ryul;Yun, Yeo-Choong;Cho, Myung-Rae;Che, Wu-Suk;Na, Gun-Ho
    • Journal of Acupuncture Research
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    • v.22 no.4
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    • pp.1-12
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    • 2005
  • Objectives : The Purpose of this study is to report in patient with common peroneal nerve palsy, who improved by oriental medical treatament. Methods : We Checked the temperature of a leg by Digital Infrared Thermal Imaging(DITI) at intervals of 10 days, angle of active dorsiflexion and range of active motion for estimating the improvement of symptoms. We used the Visual Analogue Scale(VAS) for estimating the degree of pain, too. Results : After 4 weeks treatment, the movement and power of ankle joint improved to nearly normal range. The degree of active dorsiflexion of the ankle increased from $-40^{\circ}\;to\;15^{\circ}$ and range of active motion increased from Gr III to Gr I. The difference of temperature between the both legs decreased remarkably. Conclusion : In this case we experienced improvement of symptoms by conservative oriental medical therapy, e.g acupuncture stimulation, herbal medication, physical therapy. It should be needed further investigation on common peroneal nerve palsy and its symptoms in order to set up a reasonable standard about a surgical operation.

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A Case of Obstructive Sleep Apnea Syndrome Associated with Primary Hypothyroidism and Dilated Cardiomyopathy (원발성 갑상선 기능저하증과 확장형 심근증이 동반된 폐쇄성 수면무호흡증후군 1예)

  • Yu, Sung-Keun;Park, Ji-Young;Pack, Jong-Hae;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.590-596
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    • 2001
  • The hallmarks of sleep apnea syndrome include daytime hypersomnolence, snoring, obesity, disturbed nocturnal sleep, and apneic episodes. Thyroid deficiency states are now a well recognized cause of sleep apnea. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A-33-yr-old man was admitted complaining of daytime hypersomnolence, snoring, sleep apnea and obesity. A polysomnogram showed obstructive pattern of sleep apnea syndrome. Physical examination and hormonal study revealed a narrowing of the upper airway and primary hypothyroidism. Dilated cardiomyopathy was diagnosed by echocardiogram. The poctients was treated for obstructive sleep apnea syndrome with nasal continuous positive airway pressure(CPAP) for 2 months and the underlying hypothyroidism with thyroid hormone therapy. This successfully controlled the snoring, sleep apnea, and other apnea-related symptoms. Here, we describe our experience of nasal CP AP and thyroid hormone therapy in a patient with primary hypothyroidism associated with obstructive sleep apnea syndrome and dilated cardiomyopathy with review of the relevant literature.

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Group Classification on Management Behavior of Diabetic Mellitus (당뇨 환자의 관리행태에 대한 군집 분류)

  • Kang, Sung-Hong;Choi, Soon-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.2
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    • pp.765-774
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    • 2011
  • The purpose of this study is to provide informative statistics which can be used for effective Diabetes Management Programs. We collected and analyzed the data of 666 diabetic people who had participated in Korean National Health and Nutrition Examination Survey in 2007 and 2008. Group classification on management behavior of Diabetic Mellitus is based on the K-means clustering method. The Decision Tree method and Multiple Regression Analysis were used to study factors of the management behavior of Diabetic Mellitus. Diabetic people were largely classified into three categories: Health Behavior Program Group, Focused Management Program Group, and Complication Test Program Group. First, Health Behavior Program Group means that even though drug therapy and complication test are being well performed, people should still need to improve their health behavior such as exercising regularly and avoid drinking and smoking. Second, Focused Management Program Group means that they show an uncooperative attitude about treatment and complication test and also take a passive action to improve their health behavior. Third, Complication Test Program Group means that they take a positive attitude about treatment and improving their health behavior but they pay no attention to complication test to detect acute and chronic disease early. The main factor for group classification was to prove whether they have hyperlipidemia or not. This varied widely with an individual's gender, income, age, occupation, and self rated health. To improve the rate of diabetic management, specialized diabetic management programs should be applied depending on each group's character.