• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1115-1118
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• 2016

Background: There is controversy about ablation efficacy of low or high doses of radioiodine-131 (RAI) in patients with differentiated thyroid cancers (DTC). The purpose of this prospective study was to determine efficacy of 30 mCi and 100 mCi of RAI to achieve successful ablation in patients with low to intermediate risk DTC. Materials and Methods: This prospective cross sectional study was conducted from April 2013 to November 2015. Inclusion criteria were patients of either gender, 18 years or older, having low to intermediate risk papillary and follicular thyroid cancers with T1-3, N0/N1/Nx but no evidence of distant metastasis. Thirty-nine patients were administered 30 mCi of RAI while 61 patients were given 100 mCi. Informed consent was acquired from all patients and counseling was done by nuclear physicians regarding benefits and possible side effects of RAI. After an average of 6 months (range 6-16 months; 2-3 weeks after thyroxin withdrawal), these patients were followed up for stimulated TSH, thyroglobulin (sTg) and thyroglobulin antibodies, ultrasound neck (U/S) and a diagnostic whole body iodine scan (WBIS) for ablation outcome. Successful ablation was concluded with stimulated Tg< 2ng/ml with negative antibodies, negative U/S and a negative diagnostic WBIS (triple negative criteria). ROC curve analysis was used to find diagnostic strength of baseline sTg to predict successful ablation. Results: Successful ablation based upon triple negative criteria was 56% in the low dose and 57% in the high dose group (non-significant difference). Based on a single criterion (follow-up sTg<2 ng/ml), values were 82% and 77% (again non-significant). The ROC curve revealed that a baseline sTg level ${\leq}7.4ng/ml$ had the highest diagnostic strength to predict successful ablation in all patients. Conclusions: We conclude that 30 mCi of RAI has similar ablation success to 100 mCi dose in patients with low to intermediate risk DTC. A baseline $sTg{\leq}7.4ng/ml$ is a strong predictor of successful ablation in all patients. Low dose RAI is safer, more cost effective and more convenient for patients and healthcare providers.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.945-952
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• 2016

Purpose: To assess knowledge, attitudes and cervical cancer screening behavior of Bangkok Metropolitan women. Materials and Methods: Thai women, aged 25-to-65 years old, having lived in Bangkok for 5 years or more were invited to participate in the study. After signing informed consent, all women were asked to complete a self-questionnaire (Thai language) with literate assistance if needed. The questionnaire was divided into 3 parts: (I) demographic data; (II) knowledge about cervical cancer screening; and (III) behavior and attitudes, towards cervical cancer screening. Adequate screening was defined as women who had ${\geq}$two cervical cancer screening tests except women aged 25-30 years who may have only one screening, and the last screen was within 5 year or had had regular screening. Results: Of 4,339 women, there were 1,857 (42.8%) with adequate screening and 2,482 (57.2%) with inadequate screening. Significant factors associated with inadequate screening included age < 45 years, pre-menopausal status, family monthly income <625 USD, no reported sexual intercourse, nulliparous, no knowledge, lack of awareness and poor attitudes. Three major reasons provided by women for inadequate screening were no symptoms (54.4%), fear of pain (33.2%), and embarrassment (34.6%). Conclusions: Personal features, knowledge, and attitudes influence screening behavior of Bangkok Metropolitan women. The three most common reasons of women for not undergoinging screening are no symptoms, fear of pain, and embarrassment. These factors should be the focus of attention to improve coverage of cervical cancer screening in Bangkok.

• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.209-219
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• 2009

Purpose: This study was to testify the effects on self esteem and spiritual well-being of holistic hospice nursing intervention program ("Rainbow program") for inpatients of hospice palliative care unit. This was designed as a preliminary experimental study with one-group pre-post test. Methods: A total of 27 patients who were over 18 years old, and admitted in hospice palliative care unit of S hospital in P city, submitted informed consent for this study, participated in holistic hospice nursing intervention program(total 10 sessions and 1,200 minutes for 2 weeks) from April 6, 2004 to April 20, 2005. To test the effects of this intervention, Self Esteem Questionnaire (SEQ) and Spiritual Well-being Questionnaire were used. The collected data were analyzed by Paired t-test with SPSS/WIN 12.0 program. Results: (1) Hypothesis No. 1 "The experimental group which received Rainbow program will have a higher degree of self esteem than before" was supported (t=11.554, P<0.001). (2) Hypothesis No. 2 "The experimental group which received Rainbow program will have a higher degree of spiritual well-being than before" was also supported (t=6.387, P<0.001). Conclusion: This Holistic Hospice Nursing Intervention Program was effective in increasing self-esteem and spiritual well-being of patients in hospice palliative care unit. Therefore, it can actively be used and also applied to hospice palliative care practice, research, and education as a useful model of interdisciplinary team approach by hospice professionals.

• Journal of Korean society of Dental Hygiene
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• v.13 no.5
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• pp.901-908
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• 2013

Objectives : The purpose of this study was to evaluate the bleaching effect of 3% hydrogen peroxide containing strip with primer in vivo. Methods : 22 female subjects aged from 20 to 39 years old were recruited after informed consent. They were divided into two groups with control and experimental group. Experimental group was bleached with 3% HP strip with primer, and control group received placebo for 14 days. Color changes were measured with Shade Eye-NCC (Shade Eye-NCC, SHOFU Co., Japan), Shade guide (VITA classical shade guide, $VIDENT^{TM}$, CA, USA) and digital camera image. All collected data were analyzed using SPSS 18.0. Results : At baseline, $L^*$ was $71.75{\pm}3.2$ and $b^*$ was $14.90{\pm}3.6$ in control, and $L^*$ was $71.3{\pm}3.4$ and $b^*$ was $15.61{\pm}3.7$ in experimental group. At day 14, $L^*$ was $71.35{\pm}3.2$ and $b^*$ was $13.97{\pm}4.3$ in control, and $L^*$ was $73.51{\pm}2.0$, $b^*$ was $9.10{\pm}3.0$ in experimental group. ${\Delta}E^*$ of all teeth were statistically significant between the two groups. Final ${\Delta}E^*$ was $7.15{\pm}2.09$ at experimental group and $2.78{\pm}2.93$ at control group, and the difference was significant (p<0.005). Color changes using shade guide also significantly decreased at 14th day compared with baseline at experimental group (p<0.005). Conclusions : 3% hydrogen peroxide strip with primer revealed effective enough to bleaching the human enamel during 14 days without any soft and hard tissue irritations.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.217-226
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• 2016

Objectives : To investigate changes in, and predictors of, metabolic syndrome(MetS) status over a 5-year period in chronic schizophrenic patients and to identify factors associated with the prevention of or recovery from MetS. Methods : In total, 107 patients, all of whom provided written informed consent, were followed from 2011 to 2016 at Naju National Hospital for this study. MetS was defined according to the revised National Cholesterol Education Program-Adult Treatment Panel III guidelines. Results : During follow-up period, 22(20.5%) patients were newly diagnosed to MetS, 14(13.1%) were disappeared, 77(66.4%) were not changed[MetS : 34(31.8%), No MetS 37(34.6%)]. Common significant factors in the two changed groups were triglyceride and waist circumference, not dose and type of antipsychotic medication. Multiple logistic regression analysis revealed that female gender(odds ratio[OR]=2.846, 95% confidence interval[CI] : 1.020-7.942), attending two or more outpatient visits per month(OR=3.155, 95% CI : 1.188-8.379) and taking antidepressant medication(OR=3.991, 95% CI : 1.048-15.205) were significantly associated with MetS after controlling for other confounding variables. Type and dose of antipsychotic medication were not significantly associated with MetS. Conclusions : Triglyceride and waist circumference were important manageable indicator of MetS. Adoption of a healthy lifestyle is more important than adjusting the dose or type of antipsychotic medication in the treatment of chronic schizophrenia patients with MetS.

• Sleep Medicine and Psychophysiology
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• v.23 no.2
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• pp.68-76
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• 2016

Objectives: To find evidence that sleep is necessary for normal brain function, thus indicating that declines in both sleep quality and quantity are related to worse performance of many daily tasks and deteriorated physical functions. The present study investigates the relationships of balance control and reaction time with sleep quality. Methods: 58 healthy (male 20, female 38) volunteers with informed consent participated in this study. The Self-reported Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality and relevant factors, and the subjects were divided into groups A (PSQI < 5) and B ($PSQI{\geq}5$) based on this index. Static balance control and reaction time to visual stimuli were conducted to assess their relationship with sleep quality. Results: Group B exhibited excessive daytime sleepiness significantly more often compared to group A. Static balance control did not markedly change relative to sleep quality, but reaction time and error to visual stimuli were significantly increased in group B compared to group A. Conclusion: These findings indicate that a decline in sleep quality can result in delayed reactions, as well as decreased accuracy of these reactions. They also suggest that low sleep quality may be associated with changes in physical functions, including balance control through reduced selective attention.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1145-1150
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• 2015

Associations of GSTT1, GSTM1 and CYP1A1 gene variants with risk of developing oral cancer were evaluated in this study. A case-control study was conducted in Pashtun population of Khyber Pakhtunkhwa province of Pakistan in which 200 hospital based oral cancer cases and 151 population based healthy controls exposed to similar environmental conditions were included. Sociodemographic data were obtained and blood samples were collected with informed consent for analysis. GSTM1 and GSTT1 were analysed through conventional PCR method while specific RT-PCR method was used to detect CYP1A1 polymorphisms. Results were analyzed for conditional logistic regression model by SPSS version 20. The study shows that patients with either GSTM1 or GSTT1 null genotypes have significantly higher risk of oral cancer (adjusted odds (OR): (3.019 (1.861-4.898) and 3.011(1.865-4.862), respectively), which further increased when either one or both null genes were present in combination (adjusted odds (OR): (3.627 (1.981-6.642 and 9.261 (4.495-19.079), respectively). CYP1A1 rs4646903 gene variants individually showed weak association OR: 1.121 (0.717-1.752); however, in the presence of GSTM1 and/or GSTT1 null genotypes further increasing the association (adjusted odds (ORs): 4.576 (2.038-10.273), 5.593 (2.530-12.362) and 16.10 (3.854-67.260 for GSTM/GSTT null and CYP1A1 wild type, GSTM/GSTT either null and CYP1A1 variant alleles, and all 3 gene polymorphisms combinations, respectively). Our findings suggest that presence of GSTM1 and/or GSTT1 null genotypes along with variant alleles of CYP1A1 may be the risk alleles for oral cancer susceptibility in Pashtun population.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.103-128
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• 2023

According to the current act of Decision-Marking in Life-Sustaining Medicine, the decision to withhold or discontinue life-sustaining treatment is primarily based on the wishes of a patient in the dying process. Decision-making regarding life-sustaining treatment for these patients is made by the patient, if he or she is conscious, directly expressing his/her intention for life-sustaining treatment in writing or verbally or by writing an advance medical directive and physician orders for life-sustaining treatment. It can be exercised. On the other hand, if the patient has not written an advance medical directive or physician orders for life-sustaining treatment, the patient's intention can be confirmed with a statement from the patient's family, or a decision to discontinue life-sustaining treatment can be made with the consent of all members of the patient's family. However, in the case of an unrelated patient who has no family or whose family is unknown, if an advance medical directive or physician orders for life-sustaining treatment are not written before hospitalization and a medical condition prevents the patient from expressing his or her opinion, the patient's will cannot be known and the patient cannot be informed. A situation arises where a decision must be made as to whether to continue or discontinue life-sustaining treatment. This study reviewed discussions and measures for unbefriended patients under the current law in order to suggest policy measures for deciding on life-sustaining treatment in the case of unbefriended patients. First, we looked at the application of the adult guardian system, but although an adult guardian can replace consent for medical treatment that infringes on the body, permission from the family court is required in cases where death may occur as a direct result of medical treatment. It cannot be said to be an appropriate solution for patients in the process of dying. Second, in accordance with Article 14 of the Life-Sustaining Treatment Decision Act, we looked at the deliberation of medical institution ethics committees on decisions to discontinue life-sustaining treatment for patients without family ties.Under the current law, the medical institution ethics committee cannot make decisions on discontinuation of life-sustaining treatment for unbefriended patients, so through revision, matters regarding decisions on discontinuation of life-sustaining treatment for unbefriended patients are reflected in Article 14 of the same Act or separate provisions for unbefriended patients are made. It is necessary to establish and amend new provisions. In addition, the medical institution ethics committee must make a decision on unbefriended patients, but if the medical institution cannot make such a decision, there is a need to revise the law so that the public ethics committee can make decisions, such as discontinuing life-sustaining treatment for unbefriended patients.

• Women's Health Nursing
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• v.7 no.3
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• pp.331-347
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• 2001

The purpose of this study was to compare the effects on labor pain and duration of delivery time for primipara women treated by Hob-Gog (LI-4) pressure. 1. The proposed hypothesis was that 'the score of labor pain could be lower in the group which had LI-4 pressure applied than in the control group'. 1-1. The sub hypothesis was that the score of subjective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 1-2. Another sub hypothesis was that the score of objective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 2. The proposed hypothesis was that 'the score of duration of delivery time could be shorter in the group which had LI-4 pressure applied than in the control group'. The design of this study was a nonequivalent control group non-synchronized post test only design to verify the effect on labor pain for primipara women treated by LI-4 pressure and to evaluate the benefits of using LI-4 pressure on some women and judging the degree of their labor pains in comparison with other primipara women not treated with LI-4 pressure. The subjects included 63 primipara women who underwent vaginal delivery, who were between 38-41 weeks intra uterine pregnancy; who did not have any complications; and who were under pitocin augmentation or induction. They were recruited with informed consent; 34 were in the control group and 29 were in the experimental group. The study was measured with a structured questionnaire consisting of general characteristics, knowledge related to delivery, subjective (Johnson, 1974) and objective(McLachlan, 1974) labor pain scale, data collection was done by research during the period from April, 2000 to July, 2000 and data was analyzed by descriptive statistics, $x^2$-test, and t-test. The results were as follows: 1. The scores of total labor pain in the group which had LI-4 pressure applied were lower($347.62{\pm}49.84$) than in the group($411.02{\pm}55.79$) which did not have LI-4 pressure applied; And these differences were statistically significant(t=4.7193, p=.000). 1-1. The scores of subjective labor pain in the group which had LI-4 pressure applied were lower($203.44${\pm}33.88$)$ than in the group ($$233.82{\pm}31.31$$) which did not have LI-4 pressure applied(t=3.6953, p=.000). 1-2. The scores of objective pain in the group which had LI-4 pressure applied were lower ($144.18{\pm}29.12$) than in the group which did not have LI-4 pressure applied($177.20{\pm}35.01$). but there were no statistically significant differences found in regard to the scores of objective pain(t=4.0271, p=.000). 3. The duration of delivery time in the group which had LI-4 pressure applied was shorter ($390.51min{\pm}111.91$) than in the group ($460.44min{\pm}190.78$)which did not have LI-4 pressure applied and the duration of delivery time in the experimental group was statistically more significant than that in the control group. therefore this thesis was adapted(t=1.734, p=.0879). It could be concluded that LI-4 pressure is effective in relation to labor pain and duration of delivery time for primipara women. Therefore it is necessary to increase the number of subjects to generalize this result.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.127-134
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• 2020

Purpose: The aims of this study were (1) to investigate the relationship between the characteristics of allogenic bone block and the compressive strength of an allogenic bone block measured by biomechanical experiments, and (2) to compare the maximum pressure load of allogenic bone block with the gap pressure measured at the high tibial opening osteotomy. Materials and Methods: Ten patients who provided informed consent for gap pressure measurements during opening wedge high tibial osteotomy (OWHTO) were included. The gap pressures were measured at 1 mm intervals while opening the osteotomy site from 8 mm to 14 mm. Seventeen U-shaped allogenous wedge bone blocks were made from the femur, tibia, and humerus. The height, width, cross-sectional area, and cortex thickness of the bone blocks were measured, along with the maximum compressive load just before breakage. The relationship between these characteristics and the maximum pressure load of the bone blocks was evaluated. The gap pressures measured in OWHTO were compared with the maximum pressure loads of the allogenous wedge bone blocks to evaluate the possibility of inserting allogenous wedge bone blocks into the osteotomy site without a distractor in OWHTO. Results: The OWHTO gap pressure increased with increasing osteotomy site opening. The mean gap pressure, which occurred at a 14-mm opening, was 282±93 N; the maximum pressure was 427 N. The maximum pressure load of the allografts was 13,379±6,469 N (minimum, 5,868; maximum, 29,130 N) and was correlated significantly with the cortical bone thickness (correlation coefficient=0.693, p=0.002) and cross-sectional area (correlation coefficient=0.826, p<0.001). Depending on the sterilization method, the maximum pressure loads for the bone blocks were 13,406±5,928 N for freeze-dried and 13,348±7,449 N for fresh frozen. The maximum compressive load of the allogenous wedge bone blocks was 13.7-times greater than that in OWHTO opened to 14 mm (5,868 N vs. 427 N). Conclusion: The compressive strength of allogenous wedge bone blocks was sufficiently greater than the gap pressure in OWHTO. Therefore, allogenous wedge bone blocks can be inserted safely into the osteotomy site without a distractor.