Background: Uterine sarcoma is a group of rare gynecologic tumors with various natures, and different lines of treatment. Most have a poor treatment outcome. This study targeted clinical characteristics, treatment, overall survival (OS), progression-free survival (PFS), and prognostic factors in uterine sarcoma patients in one tertiary center for cancer care. Materials and Methods: Uterine sarcoma patients who were treated at the Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital between January 1994 and December 2014 were identified. Clinico-pathological data were analyzed. Prognostic outcomes were examined by Kaplan-Meier curves and Cox regression analysis. Results: We identified 46 uterine sarcoma patients: 25 carcinosarcoma (CS) (54.3%), 15 leiomyosarcoma (LMS) (32.6%), and 6 undifferentiated uterine sarcoma (UUS) (13.1%) cases. Mean age was $54.0{\pm}11.9years$ (range 25-82 years). Abnormal uterine bleeding was the most common presenting symptom (63.0%). Among 33 patients (71.7%) who had pre-operative tissue collected, diagnosis of malignancy was correct in 29 (87.9%). All patients received primary surgery and retroperitoneal lymph nodes were resected in 34 (73.9%). After surgery, 5 (10.9%) had gross residual tumors. Stage I disease was most commonly found (56.5%). Adjuvant treatment was given to 27 (58.7%), most commonly chemotherapy. After a median follow-up of 16.0 months (range 0.8-187.4 months), recurrence was encountered in 22 patients (47.8%). Median time to recurrence was 5.8 months (range1.0-105.5 months). Distant metastasis was more common than local or locoregional failure. The 2-year PFS was 45.2% (95% confidence interval [CI], 30.6%-59.7%) and the 2-year OS was 48.3% (95% CI, 33.3%-60.7%). Multivariable analyses found residual disease after surgery as a significant factor only for PFS. Conclusions: Uterine sarcoma is a rare tumor entity. Even with multimodalities of treatment, the prognosis is still poor. Successful cytoreductive surgery is a key factor for a good survival outcome.
The purpose of this study is to investigate the cause analysis according to the difference between the pre exposure tube voltage and actual exposure tube voltage in mammography in connection with breast pressure thickness, breast size and body mass index and to find the improvement. The study tracked 377 women age 40 and older among the mammography examiners conducted by the National Health Insurance Corporation. It was analyzed that breast pressure thickness, breast size and body mass index according to the difference between the pre exposure tube voltage and actual exposure tube voltage among the parameters of dose report been sent to the picture archiving communication system with reference to the image with cranio-caudal projection in mammography. As are result, it shows that the thicker the breast thickness, smaller the breast size and lower body mass index, the higher the difference of tube voltage. In conclusion, the minimum tube voltage of mammography machine should be reset in order to set the tube voltage according to breast pressure thickness and breast size that are suitable for our country in mammography, in addition, it was considered that radiologist should make an effort to reduce radiation exposure and make a good quality image with reducing the difference of mammography condition by making a correct exposure condition in case of examining the patients with thin breast pressure and small breast size.
Older adults in the hospice care experience difficulties in expressing their emotional and psychological issues, which has detrimental effect in their well-being. The purpose of this study is to examine how music can be used to facilitate self-expression both verbally and nonverbally in order to decrease negative influences of self-concealment. Four cases were referred from hospice personnel at the hospital, and received music therapy sessions for four month. The total number of session varied from 9 to 11 depending on the conditions of each case. Both qualitative and quantitative data were collected from pre and post test of Self-Concealment Scale and Personal Descriptive Essays. The results indicated that the use of music, especially programed songs were effective in evoking emotional responses with various life-related issues and themes. The posttest indicated that the level of self-concealment has decreased, and also the Personal Descriptive Essays involved increased statements of emotional content after music therapy implementation. The study indicates that music can be used as an significant communicative and expressive medium when working with older adults in the hospice or palliative care, since they experience many difficulties to be engaged in the active expression. Music provide both passive and active experience through listening and participating, and programed music therapy intervention will increase the quality of life through expressive music activities.
Purpose: influence of benzodiazepine (midazolam)or cholinergic inhibitor (atropine or glycopyrrlate) on intra-operative body temperature remains unclear and controversial. This study compares intra-operative body temperature in 50 abdominal surgical patients under general anesthesia between the administration of midazolam and glycopyrrolate in combination, or glycopyrrolate alone. Methods: Patients who underwent abdominal surgery were recruited from September 2008 through October 2009 at Gachon University Gil hospital in incheon. Core body temperature was measured in the right ear using a tympanic membrane thermometer at induction of general anesthesia and at 1 hr, 2 hr, and 3 hr after induction. Results: There were no differences in core body temperature at any measurement point between either patient group (F=1.08, $p$=.377). Core body temperature decreased throughout the 3 hr after induction in both groups (F=9.22, $p$ <.001). Specially, core temperatures at induction of general anesthesia (p<.001), 1 hr (p<.001), 2 hr ($p$ <.001), and 3 hr ($p$ <.001) after induction were lower than before administration of midazolam and glycopyrrolate, or glycopyrrolate alone. Conclusion: We conclude that a cholinergic inhibitor (glycopyrrolate, 0.1 mg) therefore seems not to affect intra-operative body temperature of patients given a benzodiazepine (midazolam, 0.04 mg $kg^{-1}$), and not to increase body temperature in patients not given a benzodiazepine during the 3 hr after the induction of general anesthesia. Intra-operative warming therefore is needed to prevent hypothermia in surgical patients who receive pre-operative administration of midazolam and/or glycopyrrolate.
Purpose: study of the mutual influence of the individual anatomical regions damage in patients associated with falls from heights. Methods: 561 medical reports of patients associated with falls from heights admitted to Republican Research Center of Emergency Medicine (RRCEM), in period of 2010-2013 yy, were analyzed retrospectively. Patient's age range was from 15 to 89. Treatment of these patients held in three stages: period of acute disorders of vital functions; relative stabilization period; stabilization of vital functions. The scope and content of medical diagnostic procedures performed on pre-hospital and intensive care stages. The severity of each injury was scored according to the AIS scale, the total severity of lesions was scored by points due to ISS. Digital material is treated by methods of mathematical statistics. Results: Falls from heights leads to associated injuries for 4 times more than isolated trauma, and increases according to height of fall and falling surface. Patients with TBI+chest trauma, are most serious contingent that has highest mortality and complications (36.8%). TBI+musculoskeletal system trauma are characterized by high blood loss, traumatic shock and fat embolism, forming a vicious circle. Conclusion: in patients associated with falls from heights clinical manifestations of injuries mutual aggravation syndrome will be seen. TBI leads to complication of chest trauma, delayed diagnostics of abdominal and chest trauma, aggravation of coma condition. Developing of high blood loss and fat embolism in musculoskeletal system trauma leads to shock and pulmonary embolism, which increases probability of death in the presence of abdominal or chest trauma, but abdominal trauma or chest trauma has no significant effect on the severity of the musculoskeletal system trauma.
Purpose: This study was to examine the effect of a taping therapy on pain relief and the improvement of daily living for elderly having degenerative knee arthritis. Method: This study was conducted with a non-equivalent control-group pre-test and post-test design. Data were collected conveniently with 63 elderly who had having(a) pain due to degenerative knee arthritis, and (b) inconvenience in daily life(30 for an experimental group and 33 for a control group). The subjects were recruited from the elderly, participating in welfare programs held in a welfare organization and day-care facilities. The experimental group received an intervention of taping therapy offered twice a week, for 4 weeks. The data collection from the experimental group was done from the beginning of the therapy throughout two weeks later after the end of the therapy. Results: For the experimental group, pain scores came to more decreased significantly, as the periods in which taping therapy was conducted were getting longer. Physical function scores became also more decreased at significantly level, as taping therapy was more conducted. However, compared to the control group, the score change for the experimental was not significantly showed in physical function after the therapy ended. That is, there was no longer-lasting effect on physical function improvement. Conclusion: This study found that this therapy could be a useful self-management method that the elderly with degenerative knee arthritis can use easily at home. Because of insignificant result in longer-lasting effect, this taping therapy would be applied properly with the interval of 2~3days.
The purposes of this study was to determine the effect of exercise in stroke patients and to define to strategy to promote their activity of daily living, decrease to their depression. The experiemental design was designed nonequivalent control group non-synchronized design. The study method had been done by investigating the experimental group and control group through the questionaire on 60 patients who had been in patient department in D University hospital and K University hospital in Busan from November 5th, 2000 to the end of February 28th, 2001. Exercise was conducted by the researcher and was carried out experimental group once per day for 20 minutes for daily fourteen days. ADL check List tool by Kang and Center of Epideilogic Studies-Depression (CES-D) were used for measurement in this study. The data was analyzed by means of freqency, percentage, $mean{\pm}SD$, t-test, chi-square test and ANOVA with SPSS/PC. The results were summarized as follow; 1. The experimental group which received exercise should be higher in activity of daily living than the control group was supported (t=2.70, P=.009). 2. The experimental group which received exercise should be lower in depression than the control group was not support(t=-1.120, P=.267) but experimental group post-pre depression score support(t=7.247, P=.000). 3. Factors influencing the activity of daily living measured are payer of medical expenses (F=3.98, P=.018) and complications(t=3.97, P=.056). 4. Factors influencing the depression measured are economic status(F=5.71, P=.009) and caregivers (F=3.09, P=.045). In conclusion, the exercise incresed the activity of daily living and effect on depression of stroke patiens. Based upon these results, it is recommended that the nurses who take care of stroke patients such as exercise.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.27
no.3
/
pp.79-87
/
2021
Objective: To compare the effects of lumbar dysfunction and balance when office workers with chronic back pain performed the abdominal drawing-in maneuver. Methods: A total of 16 office workers with chronic low back pain were included in this study. The participants were randomly divided into two groups: the general and abdominal drawing-in maneuver groups. The intervention was applied for 6 weeks, 3 times a week, 70 min per day. Participants in the general exercise group(n=8) performed the general physical therapy and lumbar flexibility exercise, whereas those in the abdominal drawing-in maneuver group(n=8) performed the general physical therapy and lumbar stabilization exercise using abdominal drawing-in maneuver(3 times/week for 6 weeks). All tests, were the Korean Oswestry disability index (KODI) and balance ability, were completed pre and post-intervention. Results: Significant improvements in the KODI and balance ability test were observed in the abdominal drawing-in exercise group (p<.05), whereas no significant changes (p>.05) were observed in the general exercise group. Conclusion: This study revealed that abdominal drawing-in maneuver can effectively improve the lumbar dysfunction and balance ability of office workers with chronic back pain.
Purpose: This study aims to identify the effects of mobile web-based COVID-19 isolation hospitalization management training on patient's uncertainty, anxiety, and nursing education satisfaction. Methods: Patients hospitalized with COVID-19 isolation rooms from August to October 2021, in Medical Center B which is an infectious disease dedicated hospital located in metropolitan city B were included. The total number of subjects was 142, of which 71 were the experimental group and 71 the control group. As an experimental treatment, a total of 5 minutes and 35 seconds of mobile web-based education were provided to the experimental group three times, including the day of, the first day of, and the second day of hospitalization. Existing training conducted on the control group was provided by the nurses in charge of the ward through oral explanation using printed materials. The data were analysed using the IBM SPSS/WIN 26.0 program. Results: Significant differences were observed between the two groups in pre-and post-assessment of uncertainty scores (t=-22.92, p<.001), anxiety scores (t=-15.03, p<.001) and nursing education satisfaction score (t=11.61, p<.001). Conclusion: As a result of the above, mobile web-based education can be used as an effective educational medium in nursing practice to improve the work efficiency and quality of nursing care and contribute to improving the patient's educational satisfaction.
Objectives: In the health care industry, the influence of online reviews is growing. As medical services are provided mainly by providers, those services have been managed by hospitals and clinics. However, direct promotions of medical services by providers are legally forbidden. Due to this reason, consumers, like patients and clients, search a lot of reviews on the Internet to get any information about hospitals, treatments, prices, etc. It can be determined that online reviews indicate the quality of hospitals, and that analysis should be done for sustainable hospital marketing. Method: Using a Python-based crawler, we collected reviews, written by real patients, who had experienced Korean medicine, about more than 14,000 reviews. To extract the most representative words, reviews were divided by positive and negative; after that reviews were pre-processed to get only nouns and adjectives to get TF(Term Frequency), DF(Document Frequency), and TF-IDF(Term Frequency - Inverse Document Frequency). Finally, to get some topics about reviews, aggregations of extracted words were analyzed by using LDA(Latent Dirichlet Allocation) methods. To avoid overlap, the number of topics is set by Davis visualization. Results and Conclusions: 6 and 3 topics extracted in each positive/negative review, analyzed by LDA Topic Model. The main factors, consisting of topics were 1) Response to patients and customers. 2) Customized treatment (consultation) and management. 3) Hospital/Clinic's environments.
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