• Title/Summary/Keyword: Standard of Care

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Detection of Circulating Tumor Cells in Breast Cancer Patients: Prognostic Predictive Role

  • Turker, Ibrahim;Uyeturk, Ummugul;Sonmez, Ozlem Uysal;Oksuzoglu, Berna;Helvaci, Kaan;Arslan, Ulku Yalcintas;Budakoglu, Burcin;Alkis, Necati;Aksoy, Sercan;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1601-1607
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    • 2013
  • A determination of circulating tumor cell (CTC) effectiveness for prediction of progression-free survival (PFS) and overall survival (OS) was conducted as an adjunct to standard treatment of care in breast cancer management. Between November 2008 and March 2009, 22 metastatic and 12 early stage breast carcinoma patients, admitted to Ankara Oncology Training and Research Hospital, were included in this prospective trial. Patients' characteristics, treatment schedules and survival data were evaluated. CTC was detected twice by CellSearch method before and 9-12 weeks after the initiation of chemotherapy. A cut-off value equal or greater than 5 cells per 7.5 ml blood sample was considered positive. All patients were female. Median ages were 48.0 (range: 29-65) and 52.5 (range: 35-66) in early stage and metastatic subgroups, respectively. CTC was positive in 3 (13.6%) patients before chemotherapy and 6 (27.3%) patients during chemotherapy in the metastatic subgroup whereas positive in only one patient in the early stage subgroup before and during chemotherapy. The median follow-up was 22.0 (range: 21-23) and 19.0 (range: 5-23) months in the early stage and metastatic groups, respectively. In the metastatic group, both median PFS and OS were significantly shorter in any time CTC positive patients compared to CTC negative patients (PFS: 4.0 vs 14.0 months, Log-Rank p=0.013; and OS: 8.0 months vs. 20.5 months, Log-Rank p<0.001). OS was affected from multiple visceral metastatic sites (p=0.055) and higher grade (p=0.044) besides CTC positivity (log rank p<0.001). Radiological response of chemotherapy was also correlated with better survival (p<0.001). As a result, CTC positivity was confirmed as a prospective marker even in a small patient population, in this single center study. Measurement of CTC by CellSearch method in metastatic breast carcinoma cases may allow indications of early risk of relapse or death with even as few as two measurements during a chemotherapy program, but this finding should be confirmed with prospective trials in larger study populations.

Fathers' Awareness and Practice of Picture Book Reading with Toddlers (영아-아버지 그림책 읽기에 대한 아버지의 인식과 참여 실태)

  • Kim, Myoungsoon;Pae, Sunyoung;Kim, Jiyeon
    • Korean Journal of Childcare and Education
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    • v.9 no.5
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    • pp.277-297
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    • 2013
  • The present study was designed to examine fathers' awareness and practice of picture book reading with toddlers. The subjects were 221 fathers who have toddlers, and the data collected by questionnaires were analysed by mean and standard deviation, and frequency analysis. As a result, approximately 59% of fathers stated that it is essential to read to their children who are 12 month old or less, and 36% of fathers answered that they read books as much as their children wanted. The majority considered the emotional aspect of picture book reading as being significant. Also, nearly half (46%) of the fathers read books to their children 1-2 times per week, and 37% of them spent 6-10 minutes at a time reading books. While reading books, 60% of the fathers explained text and pictures to their children and a fourth of the fathers answered their children's questions. Also, while reading books, fathers tried to accept their toddlers' responses positively. However, they did not have much time to read books to their children and had little knowledge on how to read books to infants. Further research and education programs on picture book reading for fathers are needed.

The Effect of Aroma Inhalation on the Preoperative Pain and Anxiety of the Elderly Preparing to Undergo Spine Surgery (척추 수술 전 노인환자에게 적용한 아로마 향흡입요법이 통증 및 불안에 미치는 효과)

  • Park, Sohwi;Kim, Bokyoung;Park, Kyungsook
    • Journal of Digital Convergence
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    • v.17 no.12
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    • pp.523-533
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    • 2019
  • This study's purpose is to determine the effects of aroma inhalation on preoperative pain and anxiety of the elderly preparing to undergo a spine surgery. A Quasi-experimental design, with non-equivalent control group non-synchronized design was used in this study. Blended essential oils with frankincense, marjoram and mandarin were inhaled twice in the experimental group (n=30). The control group (n=30) was treated with the standard preoperative care. Pain, state anxiety, and vital sign were measured twice (before and after). The results of this study showed that pain (t=-1.223, p=.226), systolic blood pressure (t=-0.211, p=.833), diastolic blood pressure (t=0.638, p=.526), and respiration rate (t=0.734, p=.466) were not statistically significant in the experimental and the control group. There were significant differences in state anxiety (t=-3.202, p=.002) and pulse rate (t=-0.213, p=.037) in the experimental group compared to the control group. According to the results, aroma inhalation is an effective nursing intervention for relieving anxiety in surgical patients.

A Study on Analysis of Depression, Cognition, Communication, and Quantitative Electroencephalogram in Hearing Impaired Elderly (난청 고령자의 우울정도, 인지기능, 의사소통능력 및 정량뇌파 분석 연구)

  • Kim, Hyoung Jae;Weon, Hee Wook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.4
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    • pp.430-440
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    • 2021
  • The purpose of this study was to analyze the degree of depression, cognitive function, communication ability, and the quantitative electroencephalogram (EEG) in elderly individuals with hearing loss and to investigate their inter-relationship. Hearing-impaired elderly participants, aged 60 years or older (37 men and 26 women) who visited the S Hearing Rehabilitation Center in Y City from June 20, 2020, to September 3, 2020, participated voluntarily after a recruitment announcement.The participants' overall characteristics, depression, and cognitive functions were evaluated with a structured questionnaire. The Word Recognition Score (WRS) was evaluated with an audiometer using the Korean Standard Monosyllabic Word Lists for Adults (KS-MWL-A). The quantitative EEG was measured with dry electrodes using a 2-channel EEG on the frontal lobes Fp1 and Fp2. The results are summarized as follows: Communication ability showed a positive correlation with the left-right symmetry of the frontal lobes (**p<.01) and a negative correlation with right-brain mental distraction and stress (*p<.05). In the difference WRS test for each group, the left-right symmetry of the frontal lobes (**p<.01) showed the greatest correlation with communication ability. Our results suggest that the left-right symmetry of the frontal lobes can be a biomarker indicative of the communication ability of older people with hearing impairments.

Performance Measurement of Diagnostic X Ray System (진단용 X선 발생장치의 성능 측정)

  • You, Ingyu;Lim, Cheonghwan;Lee, Sangho;Lee, Mankoo
    • Journal of the Korean Society of Radiology
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    • v.6 no.6
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    • pp.447-454
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    • 2012
  • To examine the performance of a diagnostic X-ray system, we tested a linearity, reproducibility, and Half Value Layer(HVL). The linearity was examined 4 times of irradiation with a given condition, and we recorded a level of radiation. We then calculated the mR/mAs. And the measured value should not be more than 0.1. If the measured value was more than 0.1, we could know that the linearity was decreased. The reproducibility was analyzed 10 times of irradiations at 80kVp, 200mA, 20mAs and 120kVp, 300mA, 8mAs. The values from these analyses were integrated into CV equation, and we could get outputs. The reproducibility was good if the output was lower than 0.05. HVL was measured 3 times of irradiation without a filter, and we inserted additional HLV filters with 0, 1, 2, 4 mm of thickness. We tested the values until we get the measured value less than a half of the value measured without additional filter. We tested the linearity, the reproducibility, and HVL of 5 diagnostic X-ray generators in this facilities. The linearity of No. 1 and No. 5 generator didn't satisfy the standard for radiation safety around 300mA~400mA and 100mA~200mA, respectively. HVL of No.1 generator was not satisfied at 80kVp. The outputs were higher in the three-phase equipment than the single-phase equipment. The old generators need to maintain and exchange of components based on the these results. Then, we could contribute to getting more exact diagnosis increasing a quality of the image and decreasing an expose dose of radiation.

Cause-specific Analysis of Risk Factors in Completely Resected Pathologic Stage Ia Non-small Cell Lung Cancer (병리학적 병기 Ia기 비소세포폐암 환자에서 완전절제술 후 사망의 원인에 따른 위험인자 분석)

  • Park, Seong-Yong;Park, In-Kyu;Byun, Chun-Sung;Lee, Chang-Young;Bae, Mi-Kyung;Kim, Dae-Joon;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.725-731
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    • 2009
  • Background: Lobectomy and more extended anatomic resection are regarded as standard treatment for stage Ia non-small cell lung cancer, but approximately 15~40% of patients suffer from treatment failures such as cancer recurrence or death. The authors analyzed types and causes of treatment failures in surgically treated cases of stage Ia non small cell lung cancer. Material and Method: We retrospectively reviewed the medical records of 156 patients who had undergone complete resection for stage Ia NSCLC between Jan 1992 and Aug 2005. Patients were divided into two different treatment failure groups: cancer-related deaths and non-cancer-related deaths. Risk factors were analyzed in each group by the Kaplan-Meyer survival method and the Cox proportional hazard model. Result: Among the 156 patients, 93 were males; the mean age was 61. The median follow-up period was 33.8 months. The 5 year survival rate was 87.6%. Microscopic lympho-vascular permeation was reported in 10 patients. Recurrence was reported in 19 patients and 12 patients died due to recurrent lung cancer. Noncancer related deaths occurred in 16 patients. Risk factors for cancer recurrence and cancer related death were microscopic lympho-vascular permeation (HR=6.81, p=0.007, HR=7.81, p<0.001); for non-cancer related death, risk factors were pneumonectomy (HR=25.92, p=0.001) and postoperative cardiopulmonary complications (HR=29.67, p=0.002). Conclusion: After complete resection of stage Ia non small cell lung cancer patients, mortality includes not only cancer related deaths but also cancer unrelated deaths. Adjuvant chemotherapy is advised for patients who show microscopic lympho-vascular permeation, which is a risk factor for recurrence and for cancer related death. Patients who had pneumonectomy or who suffered from cardiac or respiratory complications need meticulous care in order to reduce comorbidity-induced death.

Comparative studies in Perception of Patient safety culture of Nurses and Dental hygienist (간호사와 치위생사의 환자안전문화 인식수준 비교연구)

  • Kim, Mi-Young;Kim, Young-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5196-5205
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    • 2012
  • Purpose: The Purpose of this study were to compare the level of perception and to identify factors associated with perception on patient safety culture by nurses and hygienists. Method: The data were collected from september to December, 2010 using Hospital survey on patient safety culture questionnaires. The subjects were 399 Nurses, hygienists, recruited from the hospital in Busan & Kyungnam. The collected data were analyzed using SPSS descriptive statistics, mean and standard deviation, t-test and ANOVA, Spearman rank coefficient. Result: The perception level of nurses on patient safety culture was 3.48. In case of hygienists, the level was 3.51. Compared to nurses, hygienists showed a significantly difference on the items "Staff arrangement"(t=2.841, p<.01) and "Administator attitude"(t=-2.471, p<.05), "Feedback and communication in accident"(t=-3.356, p<.01). Nurses and hygienists' age and career, working hour per week were identified as factor associated with patient safety culture. Conclusion: The perception level of hospital health providers on patient safety culture was moderate. and identified factors associated with patient safety culture were age and career, working hour per week.

Characteristics of Chaff Echoes Observed by X-band Dual Polarization Radar (X-밴드 이중편파레이더에서 관측된 채프에코의 특성)

  • Seo, Eun-Kyoung;Park, Sora;Nam, Kyung-Yeub;Heo, Sol-Ip
    • Journal of the Korean earth science society
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    • v.34 no.1
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    • pp.1-12
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    • 2013
  • To effectively remove chaff echoes, which are often misidentified as precipitation echoes on weather radars, this study examines the relationship between the radar reflectivity and each of dual polarimetric parameters. The dual polarimetric parameters are collected only for the echo areas identified as chaff echoes on the NIMR X-band dual polarization radar. Overall, the polarimetric parameters (i.e., reflectivity, differential reflectivity, cross correlation coefficient, standard deviation of differential reflectivity and specific differential phase) for chaff echoes have a wider range of values than those for precipitation echoes and the chaff filaments tend to be horizontally oriented to radar beams. There appears to be a considerable overlap in the cross correlation coefficient range of chaff and precipitation echoes since some precipitation echoes have cross correlation coefficient lower than 0.8. Therefore, although the cross correlation coefficient is known to be a good variable in identifying and separating chaff echoes from precipitation echoes, it is suggested that additional care should be taken when using the cross correlation coefficient solely in removing chaff echoes.

Development of a Spectrum Analysis Software for Multipurpose Gamma-ray Detectors (감마선 검출기를 위한 스펙트럼 분석 소프트웨어 개발)

  • Lee, Jong-Myung;Kim, Young-Kwon;Park, Kil-Soon;Kim, Jung-Min;Lee, Ki-Sung;Joung, Jin-Hun
    • Journal of radiological science and technology
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    • v.33 no.1
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    • pp.51-59
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    • 2010
  • We developed an analysis software that automatically detects incoming isotopes for multi-purpose gamma-ray detectors. The software is divided into three major parts; Network Interface Module (NIM), Spectrum Analysis Module (SAM), and Graphic User Interface Module (GUIM). The main part is SAM that extracts peak information of energy spectrum from the collected data through network and identifies the isotopes by comparing the peaks with pre-calibrated libraries. The proposed peak detection algorithm was utilized to construct libraries of standard isotopes with two peaks and to identify the unknown isotope with the constructed libraries. We tested the software by using GammaPro1410 detector developed by NuCare Medical Systems. The results showed that NIM performed 200K counts per seconds and the most isotopes tested were correctly recognized within 1% error range when only a single unknown isotope was used for detection test. The software is expected to be used for radiation monitoring in various applications such as hospitals, power plants, and research facilities etc.

Breast cancer screening rates-related factors Korea women ever considering area environmental characteristics: The fourth Korea National Health and Nutrition Examination Survey(KNHANES IV) (지역 환경적 요인이 한국 여성의 유방암 조기검진 수검률에 미치는 영향 : 국민건강영양조사 제 4기를 중심으로)

  • Lee, Mi-Hwa;Kim, Sang-Hyun
    • Journal of Digital Convergence
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    • v.12 no.11
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    • pp.437-449
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    • 2014
  • In this study, we analyzed an effect of area-environmental factor on breast cancer screening rates using multi-level analysis. It was intended for the KNHANES-IV. Total subjects were 14338. Among them, 4143 subjects met the inclusion criteria. When we applied only empty Model, a variance of breast cancer screening rates was 0.061 in each region. When we applied Model with individual level variables, the variance was 0.034. However, when we applied both Model with individual level variables and Model with area level variables, the variance was 0.023. We drew applied only individual level variables parallel applied 3 regional variances which could explain variance of inspection of breast cancer up to 18.04% compared with applied only individual level variables. Area level variables could reduce a variance of region. This means besides individual level variables. The group can share a same thing and can effect to breast cancer screening rates. We need to discover factors which area level variables and suggest that make a standard for inspection of breast cancer.