• The Korean Journal of Pain
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• 제32권3호
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• pp.178-186
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• 2019

Background: Epidural steroid injections (ESIs) have been widely used in managing spinal pain. Dexamethasone has recently emerged as a useful drug in this setting, relative to particulate steroids, although the associated systemic effects have not been fully elucidated. This study aimed to investigate the incidences and types of systemic effects after fluoroscopically guided ESI with dexamethasone. Methods: This retrospective study included 888 ESIs with dexamethasone (fluoroscopically guided at the cervical and lumbosacral levels) performed on 825 patients during January to June 2017. Data regarding systemic effects were collected via telephone interviews using a standardized questionnaire at 2 weeks after the procedure. Data on patient demographic, clinical, and procedural characteristics were collected and analyzed to identify factors that were associated with systemic effects. All statistical analyses were performed using the chi-squared test. Results: Among the 825 patients, 40 patients (4.8%) experienced systemic effects during the 2-week follow-up period. The most common systemic effect was facial flushing (12 patients, 1.5%), which was followed by urticaria (7 patients, 0.8%) and insomnia (7 patients, 0.8%). A history of spine surgery was significantly associated with the occurrence of systemic effects (P = 0.036). Systemic effects were significantly more common for injections at the cervical level than at the lumbar level (P = 0.019). Conclusions: Approximately 4.8% of the patients who underwent ESI with dexamethasone experienced minor and transient systemic effects. These effects were more common in patients who had undergone a previous spine surgery or received a cervical ESI.

• 임상간호연구
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• 제24권1호
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• pp.113-126
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• 2018

Purpose: The purpose of this study was to revise the KPCS-1 and to standardize the three patient classification systems for general ward, ICU and NICU. The actual utilization of the KPCS-1 score and each nursing activity was evaluated and the relationships between KPCS-1 score and nursing related variables were reviewed. Methods: The 47,711 KPCS-1 scores of 6,931 patients who discharged from $1^{st}$ to $30^{th}$ April 2017 were analyzed and the statistical significance between KPCS-1 score and nursing related variables was reviewed by Generalized Estimating Equation. The revision of the KPCS-1 was carried out by Partial Least Square model. The 3 patient classification systems (KPCS-1,KPCSC and KPCSN) were standardized by professional reviews. Results: KPCS-1 was a valid instrument to express nursing condition adequately and was revised as a new version which has 34 nursing activity items. The names and terminologies of pre-existing 3 patient classification systems developed by KHNA were standardized as KPCS-GW, KPCS-ICU, KPCS-NICU. Conclusion: KPCS-1 was a valid instrument to represent diverse nursing conditions precisely and was revised as a 34-item KPCS-GW. The terminologies of the other patient classification systems by KHNA were standardized as KPCS-ICU and KPCS-NICU.

• 대한방사선기술학회지:방사선기술과학
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• 제41권6호
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• pp.553-560
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• 2018

PET-CT and PET-MRI which integrates CT using ionized radiation and MRI using phenomena of magnetic resonance are determined to have the limitation to apply the semi-quantitative index, standardized uptake value (SUV), with the same level due to the fundamental differences of image capturing principle and reorganization, hence, their correlations were analyzed to provide their clinical information. To 30 study subjects maintaining pre-treatment, $^{18}F-FDG$ (5.18 MBq/㎏) was injected and they were scanned continuously without delaying time using $Biograph^{TM}$ mMR 3T (Siemens, Munich) and Biograph mCT 64 (Siemens, Germany), which is an integral type, under the optimized condition except the structural differences of both scanners. Upon the measurement results of $SUV_{max}$ setting volume region of interest with evenly distributed radioactive pharmaceuticals by captured images, $SUV_{max}$ mean values of PET-CT and PET-MRI were $2.94{\pm}0.55$ and $2.45{\pm}0.52$, respectively, and the value of PET-MRI was measured lower by $-20.85{\pm}7.26%$ than that of PET-CT. Also, there was a statistically significant difference in SUVs between two scanners (P<0.001), hence, SUV of PET-CT and PET-MRI cannot express the clinical meanings in the same level. Therefore, in case of the patients who undergo cross follow-up tests with PET-CT and PET-MRI, diagnostic information should be analyzed considering the conditions of SUV differences in both scanners.

• 간호행정학회지
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• 제8권2호
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• pp.239-248
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• 2002

Purpose: The actual nursing processes have been performed by individual nurses' judgment without any supporting programs in Korea. It is not easy for novice nurses to make accurate diagnoses and provide proper nursing interventions to patients. Therefore, we propose a computerized program for nursing diagnosis and intervention linked to medical diagnosis. Method: For the program, we have linked standardized nursing diagnosis and intervention classifications with medical diagnosis. It is premised that the program is connected to order communication system(OCS) in hospitals. Result: We provide a nursing information system with standardized database for nursing diagnosis and interventions so that nurses can make more accurate diagnosis and perform more adequate interventions. Conclusion: It is expected that the program will help the nurses perform their nursing processes more efficiently. And we expect the system can be used in many hospitals efficiently in the future after pilot operations are completed in some hospitals.

• 한방비만학회지
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• 제19권2호
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• pp.113-118
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• 2019

A counseling manual for the standardized management of obesity in Korean Medicine was developed. Four specialist for obesity and ten advisors participated in the development. The development process was conducted in order to investigate the needs of clinical doctors for obesity, search for related books and references, determine the contents of the manual, produce the manual, and review of the advisors. The contents of the manual were written in order of goal of obesity counseling, assessment of obesity and health risk factors, assessment of obesity-related lifestyles, counseling for weight management, and counseling for Korean Medical treatment. This manual is the first standardized counseling manual developed, and it is meaningful to provide a counseling method for comprehensive Korean Medicine obesity care. Although there were various limitations in the review of the advisory committee, it is expected that this study will be used as a basic data for the establishment of obesity-related health care policy. We hope that obesity counseling of Korean Medicine will be settled as one of the certified korean medical treatment.

• The Korean Journal of Pain
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• 제9권2호
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• pp.354-362
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• 1996

Background: We started postoperative pain management service using an intravenous patient-controlled analgesia (IV-PCA, PCA), which is known as convenient and effective analgesic method. In this report, we describe the efficacy and safety of PCA and the experience of developing an acute pain service to treat postoperative pain using a PCA. Methods: Practices of an acute pain service were started at a ward for general surgery after preparation of the standardized protocols for PCA. In each patient, PCA was connected following administration of initial loading doses of analgesics at recovery room after operation. All patients were checked by acute pain service team once or twice daily. The scope of acute pain service was gradually spread to other departments such as orthopedic, thoracic, obstetric and gynecologic departments by requests of patients or surgeons. We managed 1,590 patients during first 22 months. among them, nine hundred seventy two cases were prospectively evaluated for their analgesis efficacy and side effects of PCA. Results: The number of patients was increased day by day. the most common type of operation was gastrectomy (21.6%). Commonly used analgesics were nalbuphine (59%) and morphine (37%). The mean duration of PCA attachment was 3.3 days. The degree of analgesia on operation day was good in 44.8% and tolerable in 52.6% of patients. Only 3.9% of patients complained severe pain during their postoperative periods. One elderly patient experienced respiratory depression (0.06%) owing to accidental misuse of PCA by his relatives. Overall patient's satisfaction was over 93%. Conclusion: According to our experiences, we conclude that PCA is an effective, relatively safe and highly satisfactory method for postoperative pain management. Because of these advantages of PCA, the creation of our acute pain service using a PCA was successful and expanded rapidly.

• Journal of Gastric Cancer
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• 제11권2호
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• pp.69-77
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• 2011

Purpose: In an effort to examine the clinicopathological characteristics of GC and the status of its surgical treatment, the Korean Gastric Cancer Association (KGCA) conducted a nationwide survey targeting surgically-treated gastric cancer patients in 2009. Materials and Methods: A standardized electrical case report was sent to every member institution of the KGCA via E-mail with detailed instructions regarding the survey data. Completed data forms were retrieved from each institution and analyzed by the KGCA information committee. Results: Data on 14,658 patients was collected from 59 institutions. The mean patient age was $59.2{\pm}11.9$ years with a male to female ratio of 2.05 : 1. Lower third cancer (56.0%) was the most common among all gastric cancers. The histological type revealed poorly differentiated adenocarcinoma (34.1%) to be the most common, and the Lauren classification revealed the intestinal type (50.0%) to be the most prevalent. Curative surgery was performed in 92.4% of patients with laparoscopic surgery in 25.8% of patients. A Billroth I reconstruction was performed most frequently after a distal gastrectomy (63.4% of distal gastrectomy). T1 cancers accounted for 57.6% of all cases, and 62.6% of patients showed no lymph node metastasis. Compared to previous reports, it was found that patients are becoming older, laparoscopic surgery is being performed increasingly, and the proportion of T1 cancer is increasing with time. Conclusions: This survey presented the clinicopathological characteristics and current status of the surgical treatment of gastric cancer in Korea. This survey is expected aid research studies as well as planning and evaluation programs targeting cancer control.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.4103-4107
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• 2015

Background: Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide. Transarterial chemoembolisation (TACE) is the standardized therapy for intermediate stage HCC. However, the prognosis for HCC patients treated by TACE greatly varies. Thus, there is a critical need for finding biomarkers to predict the prognosis of HCC patients. The amino acid transporter-2 (ASCT2) is involved in tumorigenesis and progression of many malignancies. This study aimed to evaluate the predictive role of two single nuclear polymorphisms (SNPs, rs3826793 and rs2070246) in the ASCT2 gene in HCC patients treated by TACE. Materials and Methods: Two functional SNPs (rs3826793 and rs2070246) in the ASCT2 gene were selected and genotyped using the Sequenom iPLEX genotyping system in a cohort of 448 unresectable Chinese HCC patients treated by TACE. Univariate and multivariate Cox proportional hazards models and Kaplan-Meier curves were used for the prognosis analyses. Results: There was no significant association between two SNPs (rs3826793 and rs2070246) in the ASCT2 gene and overall survival of TACE treated HCC patients. However, we demonstrated that patients with early stage HCC carrying T genotype in rs2070246 showed better OS than those carrying CC genotype (P=0.023). Conclusions: We demonstrated that patients with early stage HCC carrying T genotype in rs2070246 showed better OS than those carrying CC genotype.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6221-6225
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• 2012

Background: To determine the frequency of HER-2 overexpression in colorectal cancer (CRC) patients, and to explore the relationship between clinicopathological prognostic factors and their effects on survival, based on immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH) analysis. Materials and Methods: The study included 80 patients with a histologically proven diagnosis of CRC that received adjuvant FOLFOX-4 chemotherapy at our department between March 2006 and September 2010. Patient data were analyzed retrospectively. Results: The median follow-up period and age of the patients were 24 months and 59 years, respectively. In immunohistochemical staining, 3+ staining was found in 2 patients (2.5%) while 2+ was in 13 (16%). FISH for HER-2 was performed for all of these 15 patients; samples which were 3+ showed positivity but the ones with 2+ were negative. There was no significant correlation between HER-2 expression and age, gender, tumor localization, histological subtype, grade, lymphovascular and perineural invasion, or pTN stage (P>0.05), even when the patients with HER-2 overexpression were analyzed separately. There was also no significant relationship between progression-free survival (PFS) and overall survival (OS), and HER-2 expression, gender, tumor localization, obstruction-perforation, bleeding, histological type, grade, lymphovascular and perineural invasion, or pT staging (P>0.05); however, there was a significant relationship between lymph node involvement, and PFS and OS (P<0.05). Conclusions: Evaluation of HER-2 overexpression in a more comprehensive, multi-center, prospective trial with standardized methods will be an appropriate approach.

• Archives of Plastic Surgery
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• 제45권4호
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• pp.367-374
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• 2018

Background This analysis presents patient-reported outcomes of breast augmentation procedures performed in Singapore using an inframammary fold incision and the "5 Ps" best practice principles for breast augmentation. These data are the first of their kind in Southeast Asian patients. Methods Through a retrospective chart review, patients who underwent primary breast augmentation with anatomical form-stable silicone gel breast implants using an inframammary fold incision were followed for ${\geq}6$ months postoperatively. The BREAST-Q Augmentation Module (scores standardized to 0 [worst] - 100 [best]) and Patient and Observer Scar Assessment Scale (POSAS; 1 [normal skin] to 10 [worst scar imaginable]) were administered. Responses were summarized using descriptive statistics. Patient-reported events were collected. Results Twenty-two Southeast Asian patients (mean age, 35.1 years) completed ${\geq}1$ postoperative BREAST-Q and POSAS assessment and were assessed 11 months to 5.5 years postoperatively. The mean postoperative BREAST-Q satisfaction with breasts and psychosocial well-being scores were 69.2 and 84.0, respectively. The mean POSAS score for their overall opinion of the scar was 4.2; the mean scores for all scar characteristics ranged from 1.2 to 4.2. Over 90% of patients (20/22) said that they would recommend the procedure. Patient complaints following surgery included anisomastia (possibly pre-existing; n=2), sensory loss at the nipple (n=2) or around the nipple (n=3), scarring (n=4), and slight capsular contracture (n=1). No patients required reoperation. Conclusions Southeast Asian patients reported high long-term satisfaction scores on the BREAST-Q scale and with their scar characteristics following breast augmentation using an inframammary fold incision, and nearly all said they would recommend this procedure. No reoperations were necessary in patients assessed for up to 5.5 years postoperatively.