• Clinical Endoscopy
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• 제57권1호
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• pp.122-127
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• 2024

Benign biliary stricture (BBS) is a complication of chronic pancreatitis (CP). Despite endoscopic biliary stenting, some patients do not respond to treatment, and they experience recurrent cholangitis. We report two cases of CP with refractory BBS treated using endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) fistula creation. A 50-year-old woman and a 60-year-old man both presented with obstructive jaundice secondary to BBS due to alcoholic CP. They underwent repeated placement of a fully covered self-expandable metal stent for biliary strictures. However, the strictures persisted, causing repeated episodes of cholangitis. Therefore, an EUS-CDS was performed. The stents were eventually removed and the patients became stent-free. These fistulas have remained patent without cholangitis for more than 2.5 years. Fistula creation using EUS-CDS is an effective treatment option for BBS.

• Journal of Gastric Cancer
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• 제19권2호
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• pp.157-164
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• 2019

Purpose: Although standard radical gastrectomy is recommended after noncurative resection of endoscopic submucosal dissection (ESD) for early gastric cancer in most cases, residual tumor and lymph node metastasis have not been identified after surgery. The aim of this study is to evaluate the feasibility of sentinel node navigation surgery after noncurative ESD. Materials and Methods: This trial is an investigator-initiated, multicenter prospective phase II trial. Patients who underwent ESD for clinical stage T1N0M0 gastric cancer with noncurative resections were eligible. Qualified investigators who completed the prior phase III trial (SENORITA 1) are exclusively allowed to participate. In this study, 2 detection methods will be used: 1) intraoperative endoscopic submucosal injection of dual tracer, including radioisotope and indocyanine green (ICG) with sentinel basins detected using gamma-probe; 2) endoscopic injection of ICG, with sentinel basins detected using a fluorescence imaging system. Standard laparoscopic gastrectomy with lymphadenectomy will be performed. Sample size is calculated based on the inferior confidence interval of the detection rate of 95%, and the calculated accrual is 237 patients. The primary endpoint is detection rate, and the secondary endpoints are sensitivity and postoperative complications. Conclusions: This study is expected to clarify the feasibility of laparoscopic sentinel basin dissection after noncurative ESD. If the feasibility is demonstrated, a multicenter phase III trial will be initiated to compare laparoscopic sentinel node navigation surgery versus laparoscopic standard gastrectomy in early gastric cancer after endoscopic resection.

• Journal of Chest Surgery
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• 제48권6호
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• pp.387-392
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• 2015

Background: The aim of this study was to evaluate the feasibility of single-port video-assisted thoracic surgery (VATS) in the treatment of secondary spontaneous pneumothorax (SSP). Methods: Twenty-four patients who were scheduled to undergo single-port VATS for SSP were studied. The medical records of the patients were retrospectively reviewed. The mean follow-up duration was $26.1{\pm}19.8$ months. In order to evaluate the feasibility of single-port VATS for SSP, the postoperative results of single-port VATS (n=15) in patients with emphysema were compared with those of emphysematous patients who underwent three-port VATS (n=15) during the study period. Results: Single-port VATS was feasible in 19 of 24 patients (79.2%), while an additional port was needed in five patients. In the single-port VATS patients, the median operation time, duration of chest tube drainage, and hospital stay were 84.0 minutes, one day, and two days, respectively. Postoperative complications included prolonged chest tube drainage for more than five days (n=1), wound infection (n=1), and vocal fold palsy (n=1). No recurrence of pneumothorax was observed during the follow-up period. The median operation time, duration of chest tube drainage, and hospital stay of the emphysematous patients who underwent single-port VATS were shorter than those who underwent three-port VATS group (p<0.05 for all parameters). Conclusion: Single-port VATS proved to be a feasible procedure in the treatment of patients with secondary spontaneous pneumothorax.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1159-1164
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• 2015

Background: The prevalence of smoking among secondary school children continues to remain unchanged over the last 3 decades even though awareness regarding the health effects of smoking is increasing. Common misconceptions about smoking and parental influence could be factors influencing future intentions to smoke among these students. Hence, we looked at the common misconceptions as well as student perceptions about their future intention to smoke among Form 4 students in Shah Alam, Malaysia. Materials and Methods: This study was conducted by distribution of a questionnaire developed as part of the Global Youth Tobacco Survey to Form 4 student in 3 schools at Shah Alam. Results: Prevalence of smoking (current smokers) was 7.5%. Almost half of the children came from families where one or both parents smoked and a third of the parents had no discussion regarding consequences of smoking with them. A large number of students were classified as "triers" as they had tried smoking and were unsure of whether they would not be smoking in the future. Contrary to our expectations, students generally felt smoking did make one feel more uncomfortable and helped one to reduce body weight. Most students seemed to be aware of the ill-effects of smoking on health. They felt they had received adequate information from school regarding the effects on smoking on health. Conclusions: Our study showed that even though Form 4 students in Shah Alam were knowledgeable about ill-effects of smoking and were taught so as part of their school curriculum, the prevalence of smoking was still high. Students in the "trier group" represent a potential group of future smokers and strategies targeting tobacco control may be aimed at tackling these vulnerable individuals. Efforts are also needed to help educate secondary school children about common misconceptions and dispel myths associated with cigarette smoking.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.75-79
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• 2009

Purpose: The transverse rectus abdominis musculocutaneous(TRAM) flap is the most commonly used autogenous tissue flap for breast reconstruction. Postoperatively, partial flap loss or fat necrosis are relatively common and it may result in a smaller breast volume with marked contour irregularities. These defects are not easy to reconstruct with local tissue rearrangement or with breast implants. The current authors present the results of 2 patients who underwent Latissimus dorsi(LD) flap reconstruction to correct partial flap or fat necrosis that developed after TRAM flap breast reconstruction. Method: Case1: A 50 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively partial flap necrosis was developed. Secondary breast reconstruction using LD flap was done. Case2: A 51 - year - old woman with left breast cancer visited for breast reconstruction after radical mastectomy. Initially, breast reconstruction with pedicled TRAM was performed. Postoperatively fat necrosis was developed. Secondary breast reconstruction using LD flap was done. Results: Secondary breast reconstruction using LD flap survived completely and produce successful reconstruction. There was no significant complication in both patients. Conclusion: LD flap provides sufficient, vascularized skin and soft tissue. The flap can be molded easily to replace deficient tissue in all areas of the breast. These attributes make it an ideal candidate for salvage of the partially failed TRAM flap breast reconstructio.

• 기본간호학회지
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• 제18권2호
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• pp.247-257
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• 2011

Purpose: This study was conducted to identify communication principles for nurses in cancer units according to Grice's theory. Method: This study was a secondary analysis of qualitative research using conversational analysis. Results: The principles consisted of four maxims: Quality, quantity, relevance and manner and 14 strategies. For the quality maxim, 'asking what you believe to be true' and 'saying the facts you know' strategies were identified. In the quantity maxim, the strategies were 'asking single questions', 'asking open questions' and 'asking optimistic questions'. In the relevance maxim, 'asking about the same theme' and 'giving relevant explanations' strategies were identified. In manner maxim, the strategies were 'using clear expressions in asking questions', 'asking in an orderly way', 'verifying answers', 'using clear expressions in explanations', 'explaining in an orderly way' and 'verifying understanding'. Conclusion: It is expected that these strategies will help and increase the degree of cooperation for nurses in effectively communication with cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.5097-5105
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• 2014

Knowledge of health and community psychology in health professionals influences psychosocial and community determinants of health and promoting participation in disease prevention at the community level. This paper appraises the potential of knowledge on psychology in health care professionals and its contribution to community empowerment through individual behavior change and health practice. The authors proposed a schematic model for the use of psychological knowledge in health professionals to promote participation in health interventions/disease prevention programs in developing countries. By implication, the paper provides a vision on policies towards supporting breast cancer secondary prevention efforts for community health development in Asian countries.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8127-8133
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• 2016

Background: The objective of this study was to evaluate the effect of back massage on the anxiety state, cortisol level, systolic/diastolic blood pressure, pulse rate, and sleep quality in family caregivers of patients with cancer. Materials and Methods: Forty-four family caregivers were randomly assigned to either the experimental or control group (22 interventions, 22 controls) after they were matched on age and gender. The intervention consisted of back massage for 15 minutes per day for a week. Main research outcomes were measured at baseline (day I) and follow-up (day 7). Unpaired t-test, paired t test and chi-square test were used to analyse data. Results: The majority of the caregivers were women, married, secondary school educated and housewife. State anxiety (p<0.001), cortisol level (p<0.05), systolic/diastolic blood pressure (p<0.001, p<0.01 respectively), and pulse rate (p<0.01) were significantly decreased, and sleep quality (p<0.001) increased after back massage intervention. Conclusions: The study results show that family caregivers for patients with cancer can benefit from back massage to improve state anxiety, cortisol level, blood pressure and heart rate, and sleep quality. Oncology nurses can take advantage of back massage, which is non-pharmacologic and easily implemented method, as an independent nursing action to support caregivers for patients with cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1571-1578
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• 2013

Cancer is a leading cause of death worldwide. Recently, the demand for more effective and safer therapeutic agents for the chemoprevention of human cancer has increased. As a white rot fungus, Inonotus obliquus is valued as an edible and medicinal resource. Chemical investigations have shown that I. obliquus produces a diverse range of secondary metabolites, including phenolic compounds, melanins, and lanostane-type triterpenoids. Among these are active components for antioxidant, antitumoral, and antiviral activities and for improving human immunity against infection of pathogenic microbes. Importantly, their anticancer activities have become a hot recently, but with relatively little knowledge of their modes of action. Some compounds extracted from I. obliquus arrest cancer cells in the G0/G1 phase and then induce cell apoptosis or differentiation, whereas some examples directly participate in the cell apoptosis pathway. In other cases, polysaccharides from I. obliquus can indirectly be involved in anticancer processes mainly via stimulating the immune system. Furthermore, the antioxidative ability of I. obliquus extracts can prevent generation of cancer cells. In this review, we highlight recent findings regarding mechanisms underlying the anticancer influence of I. obliquus, to provide a comprehensive landscape view of the actions of this mushroom in preventing cancer.

• 대한간호학회지
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• 제49권6호
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• pp.713-723
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• 2019

Purpose: The purpose of this study was to identify the impact of cigarette smoking and alcohol consumption on the incidence of colon cancer in adults with metabolic syndrome. Methods: This study employed a longitudinal study design and utilized secondary data drawn from the Korean Genome and Epidemiology Study (KoGES). The data of a sample of 2,327 adults with metabolic syndrome tracked every two years from 2001 to 2014 were used in this study. Statistical data analyses of the frequency, number of cases per 100,000 person-years, log-rank test, Kaplan-Meier curve, and Cox's proportional hazards regression were performed using IBM SPSS statistics version 24. Results: During the observation period, the number of colon cancer cases was 46, and the total person-years were 252,444. The incidence of colon cancer was higher in current, over 10 pack-year smokers when compared to non-smokers (hazard ratio=3.38, 95% confidence interval=1.09~8.42). Conclusion: Excessive and long-term smoking should be avoided to prevent colon cancer, especially in adults with metabolic syndrome, since it might exacerbate the risk factors of colon cancer. Particularly, health professionals need to provide individualized smoking cessation interventions to those at high risk of colon cancer.