• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5709-5714
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• 2014

Background: An association between alcohol/tobacco use and risk of metastasis in breast cancer has been clearly shown. Materials and Methods: The present study explored, in 48 samples of tissue from mammary ductal carcinoma (taken from Mexican women with an average age of $58.2{\pm}10.9$ years), the association of risk of metastasis with the status of hormonal receptors and the c-erbB2 protein (by immunohistochemistry) as well as clinical, histopathological and sociodemographic factors. Results: Of 48 patients, 41.6% (20/48) presented with metastasis, 43.8% were positive for the estrogen receptor (RE+), 31.3% for the progesterone receptor (RP+) and 47.7% for c-erbB2 (c-erbB2+). The following combinations were found: RE+/RP+/c-erbB2+ 8.3%, RE+/RP+ 22.9%, RE+/RP- 20.8%, RE-/RP+ 8.3%, RE-/RP-/c-erbB2- 22.9% and RE-/RP- 47.8%. There were 12 patients who used alcohol/tobacco, of which 91.6% did not present metastasis and 81.9% were RE-/RP-. Compared to the RE-/RP-/c-erbB2+, the RE+/RP+/c-erbB2+ group had a 15-fold greater risk for metastasis (95%CI, 0.9-228.8, p=0.05). The carriers of the double negative hormonal receptors had a 4.7 fold greater probability of being (or having been) smokers or drinkers (95%CI, 1.0-20.4, p = 0.03). Conclusions: There was a clear protective effect of using alcohol and/or tobacco, in the cases included in the present study of mammary ductal carcinoma, associated with double negative hormonal receptors. However, this association could be due to a protective factor not measured (Neyman bias) or to a bias inherent in the rate of hospitalization (Berkson fallacy). This question should be explored in a broad prospective longitudinal study.

• Korean Circulation Journal
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• 제52권3호
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• pp.205-217
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• 2022

Background and Objectives: The prognostic value of left atrial (LA) function in terms of long-term clinical outcomes after mitral regurgitation (MR) surgery remains unclear. Therefore, we investigated the impact of preoperative LA global longitudinal strain (LAGLS) on the long-term postoperative clinical outcomes in chronic severe MR patients who underwent mitral valve (MV) repair surgery. Methods: From January 2012 to December 2017, we analyzed 338 patients (mean age, 51.9±12.5 years; 218 males [64.5%]) treated with MV repair surgery for severe MR. The primary outcome was cardiovascular events, defined as the composite of all-cause death, newly developed atrial fibrillation (AF), and re-hospitalization for cardiovascular causes. Results: During a median follow-up of 45 months (interquartile range, 26-65), 30 (8.9%) cardiovascular events, 5 (1.5%) all-cause death, 8 (2.4%) newly developed AF, and 26 (7.7%) re-hospitalizations occurred. On multivariable analysis, baseline LAGLS was an independent predictor of cardiovascular events (adjusted hazard ratio [HR], 0.91; 95% confidential interval [CI], 0.85-0.97; p=0.004) and re-hospitalization (adjusted HR, 0.93; 95% CI, 0.86-1.00; p=0.037). According to the optimal cutoff value of LAGLS, patients with low LAGLS (<23.6%) had a significantly higher risk of cardiovascular events (adjusted HR, 2.70; 95% CI, 1.04-7.00; p=0.041) than those with high LAGLS (≥23.6%). In a subgroup analysis, patients with high LAGLS had better clinical outcomes regardless of whether the patient had a LA volume index <60 mL/m². Conclusions: In patients with chronic severe MR who received successful MV repair surgery, preoperative LAGLS is an independent predictor of long-term postoperative outcomes.

• 대한족부족관절학회지
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• 제16권2호
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• pp.108-115
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• 2012

Purpose: To evaluate several risk factors related to re-ulceration of diabetic foot including psychosocial aspects such as familial support and degree of independence of patients' activity. Materials and Methods: We reviewed medical records and performed telephone interview with eighty-five patients who had a history of hospitalization in our hospital due to diabetic foot ulceration from year 2002 to 2010. Based on the collected data, we analyzed several factors such as age, gender, prevalence duration, accompanying diseases, HbA1c level, degree of independence and familial support. Results: The mean age was 61.4 years and most common in the 4th decade. There were 57 cases (67%) of recurrence, predominance of male. Eleven patients with recurrent diabetic foot ulceration had undergone major amputations. Psychosocial problems such as depression, insufficient familial support and mortality were more frequently observed in recurrent group. Conclusion: This study shows that psychosocial factor such as familial support for patient with diabetic foot could be important to reduce the recurrence rate of diabetic foot ulceration. Therefore, we should pay attention to strategic plans for prevention, screening, treatment, and aftercare through the prospective studies including psychosocial risk factor in diabetic foot ulceration.

• 대한방사성의약품학회지
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• 제7권1호
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• pp.50-55
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• 2021

Low-dose radiotherapy has been known to have anti-inflammatory activity and been used for treatment of pneumonia together with anti-serum and sulfanilamide. However, it rapidly discontinued after the development of various antibiotics showing outstanding effect. Recently, it was re-considered to treat COVID-19 which has very limited treatment such as remdesivir and dexamethasone. So, several studies of COVID-19 therapy using low-dose radiation were reported very recently. They showed that low-dose radiation of 0.5~1.5 Gy were useful for decreasing the oxygen consumption and hospitalization period of COVID-19 patients without adverse reaction. Radiopharmaceuticals such as [⁹⁹mTc]Tc-macroaggregated albumin (MAA) also might be used for low-dose radiotherapy. Administration of vitamin D having anti-inflammatory effect would also be helpful for therapy with synergistic effect.

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.55-57
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• 2017

A 64-year-old man was admitted due to jaundice for 2 weeks. Radiologic findings revealed biliary stricture at the hepatic hilum with intrahepatic duct dilation suggesting Bismuth type IV Klatskin tumor. Jaundice improved spontaneously several days after hospitalization. Surgical treatment was considered but he only wanted to observe without specific treatment. Ten months later, he was re-admitted due to the recurrence of jaundice. Computed tomography (CT) showed no significant difference compared to previous results. Serum cancer antigen 19-9 and Immunoglobulin G4 were normal. Endoscopic forcep biopsy during endoscopic retrograde cholagiopancreatography (ERCP) revealed chronic inflammation. After steroid use under possible diagnosis of IgG4 related cholangiopathy, biliary stricture improved slightly. Four years later, he was hospitalized with the occurrence of acute cholangitis. Endoscopic retrograde biliary drainage was performed following endobiliary forcep biopsy. Pathology revealed well-differentiated adenocarcinoma at this time. Combined chemotherapy based on gemcitabine and cisplatin was performed. Six months later, CT revealed partial response.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제29권2호
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• pp.39-48
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• 2023

Purpose: In Korea, the increase rate of the number of mentally ill patients increases, and the hospitalization period for severely mentally ill patients to stay in acute wards is long and the re-hospitalization rate is high. In order to improve the dignity of patients with acute mental illness and to plan a therapeutic environment for this, this study attempted to present a basic framework of spacial planning for establishing guidelines for psychiatric acute ward in general hospitals. Methods: By analyzing the acute psychiatric ward guidelines of the UK, Australia, and the US., this study analyzed the areas and required rooms of psychiatric acute ward in general hospitals, as well as the net floor area of each room, and the connection between the rooms. Results: As a result of the study, the basic framework for the ward areas and the required rooms, the net floor areas of the rooms, and the connection between the rooms were presented for the establishment of guidelines for the psychiatric acute ward in general hospitals. Implication: The results of the study will be used as a basic framework of space planning for establishing of guidelines for the psychiatric acute ward in general hospitals and will contribute to the establishment of detailed guidelines based on the space configuration through surveys and analysis of space use status, operation status, and expert interviews in Korea.

• 대한한의학회지
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• 제44권2호
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• pp.20-33
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• 2023

Objectives: This study is designed to statistically analyze the features of patients who visited to Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital for 3 years. Methods: This study retrospectively analyzed the medical records of patients at Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital using IBM SPSS ver. 27.0 for Windows. Results: 1. In the analysis of the total number of patients, those in their 30s accounted for the highest percentage, male patients had a higher rate. 2. In the analysis of KCD-8 code, spinal stenosis and fractures in areas other than the spine were the most common in the 70s and older, and cervical sprains were the most common in other. 3. In the analysis of the number of hospitalizations, patients classified as illness or higher age had more re-hospitalization than patients classified as injury or lower age in first-time care. 4. In the analysis of hospitalization duration, patients classified as illness, female or higher age had longer hospitalization duration than patients classified as accident, male or lower age in first-time care. Conclusion: We expect that the results of this study would be used as reference materials for analyzing medical consumption condition of Department of Acupuncture and Moxibustion.

• 종양간호연구
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• 제4권2호
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• pp.110-123
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• 2004

The purpose of this study was to develop a clinical pathway for the allogeneic bone marrow transplantation donor. For this study, a conceptual framework was developed through a review of the literature including six steps which are using in Jones Hopkins Hospital. USA. The researcher reviewed 129 medical re-cords of donor who had bone marrow donation between January 2002 to January 2004, to identify the overall service contents required by these patients and to make a preliminary clinical pathway. A content validity test was done for the preliminary clinical pathway, a professional group screened 51 medical re-cords and adopted with 3 hospitalization days as the clinical pathway framework. In the fifth step, clinical pathway test was also done to 7 donors from April 28th to July, 2004. After these processes the final clinical pathway was developed. The results of this study are as follows: 1. The vertical axis of the clinical pathway Includes the following 9 items: vital signs, nursing assessment, activity, diet, intervention, medication, test, consultation and patient teaching. The duration of the horizontal axis was 3days from admission to discharge 2. Analysis of the 129 medical records indicated that the average length of stay was 3 4 days. The medical performance according to the vertical axis in the preliminary clinical pathway consisted of 51 items After clinical validity test, it steel consisted of 51 items in the final form. 3. Clinical Validity test was done to 7 bone marrow donors. During these process, The first patient was deleted because he was out of the criteria the investigate set and 6 patients were used, finally The result of this study indicated all of 7 donors were discharged on expected day. 4. Clinical pathway enables to improve the quality of care, multidisciplinary team work It also helps nursing bone marrow donor, effective education to donor or medical member. The results of this study suggest that clinical pathway may be able to improve the quality of nursing care for bone marrow transplantation donors.

• Archives of Plastic Surgery
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• 제42권5호
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• pp.608-613
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• 2015

Background The purpose of this study was to compare postoperative morbidities and functional outcomes of pectoralis major myocutaneous (PMMC) flap and cutaneous free flap reconstruction approaches in hypopharyngeal squamous cell carcinoma patients. Methods We retrospectively reviewed records from 99 patients who underwent hypopharyngeal reconstruction with a cutaneous free flap (n=85) or PMMC flap (n=14) between 1995 and 2013. Morbidity was classified into hospitalization, medical, or flap-related complications. Functional outcomes were classified into oral re-alimentation and decannulation time. Results The overall flap-related complication rate was higher in the PMMC flap group (n=8, 57.1%; P=0.019), but the medical morbidity rate was higher in the cutaneous free flap group (n=68, 80%; P=0.006). The rate of pneumonia was higher in the cutaneous free flap group (n=48, 56.5%; P=0.020). Pulmonary premorbidity was the variable most significantly associated with pneumonia (odds ratio=3.012, P=0.012). There was no statistically significant difference in oral re-alimentation and decannulation time between the two groups. Conclusions Although the functional superiority of free flaps has been reported in many studies, our results do not support this hypothesis. One limitation of our study is the relatively smaller flap size and fewer PMMC flap cases compared with the cutaneous free flap group. The low postoperative medical morbidity incidence rate in the PMMC flap group was clinically significant; however, the free flap group had more flap-related complications. Thus, PMMC flaps should be considered a viable option, especially for patients with pulmonary premorbidities.

• 정신신체의학
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• 제29권1호
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• pp.34-41
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• 2021

연구목적 본 연구는 우울 증상으로 정신건강의학과에 자문 의뢰된 환자들의 임상적 특징과 자문 의뢰 형태, 재협진 여부에 따른 차이를 알아봄으로써, 종합병원 입원환자의 우울장애의 특징을 조사하고자 하였다. 방 법 2005년 8월부터 2011년 12월까지 정신건강의학과에 자문 의뢰된 입원환자를 대상으로 하였고, 이중 우울증상으로 의뢰된 환자들의 의무기록을 후향적으로 분석하였다. 결 과 우울 증상으로 의뢰된 환자는 총 647명으로 전체 협진 중 13.82%에 해당하였다. 우울 증상으로 의뢰된 환자의 평균 나이는 58.6세로 전체 정신건강의학과에 협진 의뢰된 환자군의 평균 56.4세보다 높았으며, 3형 의뢰 형태(입원 이후 새롭게 발생한 정신건강의학과적 증상을 위한 협진 의뢰)가 가장 많았다. 이중 재협진 의뢰된 환자는 275명으로 전체의 42.5%였으며, 재협진군과 비재협진군을 비교해 보았을 때 통계적으로 유의미한 차이는 없었다. 그러나 자문 의뢰 형태에서 두 군의 산술적 차이가 있었는데, 재협진군은 3형(보수형)-2형(병렬형)-1형(상호보완형)의 빈도순을 보였고 반면, 비 재협진군은 2형(병렬형)-3형(보수형)-1형(상호보완형)의 빈도순을 보였다. 결 론 종합병원에서 우울 증상으로 의뢰된 환자군은 전체 정신건강의학과 협진 의뢰 환자 군에 비해 고령의 비율이 높았고, 그중 재협진군은 비재협진군에 비해 입원 이후 새롭게 증상이 발생하여 협진 의뢰된 비율이 높았다. 따라서 각 과 주치의들과 정신건강의학과 의사들은 입원환자들의 우울 증상에 주의를 기울이고, 적극적으로 치료계획을 논의함으로써 의료 서비스의 질을 향상시키고 위험 요인을 파악하여 필요하면 조기 개입할 수 있도록 노력해야 할 것이다.