• 제목/요약/키워드: cancer diagnosis

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영양 불량 입원 환자에서 영양소 섭취 변화 분석 (Changes in Nutrient Intake in Patients at Nutritional Risk)

  • 이호선;신경훈;라선영;정문재;송시영;송승은;함혜진;김형미
    • 대한영양사협회학술지
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    • 제20권4호
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    • pp.285-295
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    • 2014
  • The purpose of this study was to examine changes in nutrient intake in patients at nutritional risk. We included 106 malnourished patients who were admitted to Severance Hospital from March to September 2014. The average age was $59.0{\pm}11.6$ years old and 59 patients were male (59.7%). The majority of diagnosis was cancer (94.3%). We evaluated patients' nutritional status by scored patient-generated subjective global assessment (PG-SGA), anthropometric measurement (height, weight, body composition by Bioelectrical impedance analysis), hand grip strength, biochemical and dietary assessment. The patients' daily intakes of energy and protein ($1,019.5{\pm}706.4kcal$, $40.4{\pm}27.7g$) during hospitalization were significantly lower than their usual intakes ($1,382.0{\pm}499.8kcal$, $54.4{\pm}25.1g$, P<0.001). Serum levels of albumin, cholesterol, and total lymphocytes were significantly reduced during hospital stay. The negatively influencing factors for reduced dietary intake were anorexia (42.5%), abdominal distention (14.2%), pain (13.2%), and others. The results of this study could be used to establish baseline data for developing new strategies for nutritional intervention in malnourished patients.

진료의뢰센터 운영이 전원환자의 재원일수에 미치는 영향 - 일개 3차 의료기관 진료의뢰센터 경유 환자를 중심으로 - (The effect of operating the referral center on the Length of stay of transferred inpatients in a tertiary medical center)

  • 조상옥;박은철;손태용;강희정;유승흠
    • 한국병원경영학회지
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    • 제10권3호
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    • pp.67-84
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    • 2005
  • To compare differences of LOS between the group of inpatients via referral centers(the referral group) and the group of inpatients via different routes (the general group) and analyze factors which determine the difference. The 9,484 cases of newly inpatients of Mar., Jun., Sep., Dec. of year 2003 were used for the data. We calculate the Case-mix index of length of stay($CMI_{LOS}$) to compare LOS adjusted with the disease as the ratio of a patient' LOS to all patients' average LOS by 21 classification diagnosis group. We conducted t-test to compare differences of $CMI_{LOS}$ between two groups and multiple regression to analyze factors determining the difference. $CMI_{LOS}$ was 0.94 in the referral group, which was smaller than 1.01 in the general group. LOS was 7.5days in the referral group, which was 0.6day shorter than that in the general group. Multiple regression also showed that $CMI_{LOS}$ was smaller in the referral group than in the general group after controlling patients' general characteristics, diagnostic information variables. The referral centers can be said to playa role in decreasing LOS. We suggest that variety of depth studies on referral centers should be continued at the strategic level of hospital management using additional medical informations.

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한번의 말초정맥주사로 유발되어 파국적으로 진행된 Trousseau증후군 1예 (A Case of Trousseau's Syndrome with Catastrophic Course Triggered by an Intravenous Injection)

  • 문지용;김사일;곽현정;송순영;김인순;김상헌;김태형;손장원;윤호주;신동호;박성수
    • Tuberculosis and Respiratory Diseases
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    • 제71권2호
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    • pp.134-138
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    • 2011
  • Trousseau's syndrome is an unexplained thrombotic event that precedes the diagnosis of an occult visceral malignancy or appears concomitantly with the tumor. Upper extremity deep vein thrombosis is prevalent in patients with a central venous catheter. Furthermore, a peripheral intravenous injection may cause upper extremity deep vein thrombosis as well. However, a deep vein thrombosis has not been reported in the form of Trousseau's syndrome with a catastrophic clinical course triggered by a single peripheral intravenous injection. A 48-year-old man presented with a swollen left arm on which he was given intravenous fluid at a local clinic due to flu symptoms. Contrast computed tomgraphy scans showed thromboses from the left distal brachial to the innominate vein. The patient developed multiple cerebral infarctions despite anticoagulation treatment. He was diagnosed with stomach cancer by endoscopic biopsy to evaluate melena and had a persistently positive lupus anticoagulant. After recurrent and multiple thromboembolic events occurred with treatment, he died on day 20.

Compliance with Respiratory Infection Preventive Behaviors and Its related Factors in Older Adults using a Senior Center

  • Park, Yeon-Hwan;Lee, Seong Hyeon;Yi, Yu Mi;Lee, Chi Young;Lee, Min Hye
    • 지역사회간호학회지
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    • 제29권3호
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    • pp.322-334
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    • 2018
  • Purpose: The purpose of this study is to identify factors related to compliance with respiratory infection preventive behaviors including hand washing, cough etiquette, and oral hygiene of older adults. Methods: A cross-sectional study was conducted with a convenience sample of 100 older adults (mean age: $76.11{\pm}6.35$ years, female: 86.0%). Data were collected from a community senior center through face to face interviews by using instruments including measuring knowledge, perceived threat, self-efficacy, compliance with respiratory infection preventive behaviors. Results: The mean score of knowledge was 7.52 out of 13 in total. The compliance with hand washing with soap was 6.0% for 8 or more times per day. Among the participants, 12.0% adhered to the cough etiquette. Sixty-two older adults (62.0%) didn't use interdental brushes or floss at all. The stepwise linear regression indicated that age and self-efficacy for respiratory infection preventive behaviors were significant factors and explained 24.0% of the compliance with hand washing and the cough etiquette. Education level, cancer diagnosis, and self-efficacy for respiratory infection preventive behaviors were significant predictors of oral hygiene. The factor with the greatest effect was self-efficacy in the two models. Conclusion: The findings suggest that it is necessary to improve compliance with respiratory infection preventive behaviors among older adults using senior centers. In order to enhance the compliance, it is necessary to develop nursing programs based on the self-efficacy for respiratory infection preventive behaviors in the senior centers.

구강편평세포암종에서 임상적 N0 경부의 경부 곽청술 후 병리학적인 비교 (NECK DISSECTION OF CLINICALLY NO NECK OF ORAL SQUAMOUS CELL CARCINOMA & PATHOLOGIC COMPARISON)

  • 강진한;안강민;이상우;명훈;이종호;김명진
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권6호
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    • pp.591-596
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    • 2007
  • Neck node metastasis of oral cancer can be diagnosed by bimanual palpation, CT, MRI and neck sonography and the final diagnosis can be confirmed by pathologic evaluation of the neck nodes after elective neck dissection. When we meet clinically negative neck node(N0 neck) of oral squamous cell carcinoma, the treatment modality of the neck nodes with the primary lesions are so controversial. The usually used methods are various from close observation to elective radiation and elective neck dissection. The methods can be chosen by the primary size of the carcinoma, site of the lesions and the expected percentage of the occult metastasis to the neck. We reviewed the 86 patients from 1996 to 2006 who were diagnosed as oral squamous cell carcinoma, whose necks were diagnosed negative in radiographically and clinically. According to TNM stage, the patients were in the states of N0 and treated by surgery using mass excision and elective neck dissection. We compared the differences between the clinical diagnoses and pathologic reports and would discuss the needs for elective neck dissection.

유전성 췌장염 - 1가계보고 - (Hereditary Pancreatitis - Report of a Kindred -)

  • 김형란;정재희;송영택;윤원재;류지곤;김용태
    • Advances in pediatric surgery
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    • 제12권1호
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    • pp.24-31
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    • 2006
  • 저자들은 만성췌장염으로 췌관결석이 합병되어 Puestow-Gillesby 췌관 공장 측측변형 문합술을 시행 받은 14 세 환아와 합병증이 발생하지 않은 만성췌장염을 앓고 있는 13세의 환아의 여자형제, 췌장암으로 사망한 외삼촌과 만성췌장염으로 배액술을 받은 26세 사촌언니를 가진 유전성 췌장염한 가계를 경험하였다. 또한 이들을 대상으로 유전자를 검사하여 R122H 변이를 관찰하였기에 보고하는 바이다.

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다량의 늑막삼출을 동반한 늑막횡문근육종 1예 (A Case of Rhabdomyosarcoma Arising at the Pleura)

  • 이진구;최경묵;신상원;인광호;강경호;김준석;유세화;원남희;이윤석
    • Tuberculosis and Respiratory Diseases
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    • 제40권3호
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    • pp.308-313
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    • 1993
  • 원발성 늑막횡문근육종은 세계적으로 그 예가 드문 희귀한 질환으로, 저자등은 호흡곤란을 주소로 내원한 15세 남자 환아의 늑막조직검사에서 진단되고, 항암화학요법에 좋은 반응을 보인 원발성 늑막횡문근육종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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A Case of Locally Advanced Well-Differentiated Fetal Adenocarcinoma of the Lung Treated with Concurrent Chemoradiation Therapy

  • Kyung, Chanhee;Kim, Sang Young;Lim, Beom Jin;Cha, Jung-Joon;Kim, Hyung Jung;Ahn, Chul Min;Park, Heejin;Cho, Eun Na;Chang, Yoon Soo
    • Tuberculosis and Respiratory Diseases
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    • 제74권5호
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    • pp.226-230
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    • 2013
  • Fetal adenocarcinoma is a rare adenocarcinoma subtype of pulmonary blastoma. A 48-year-old male patient is being referred to our hospital due to progressive dyspnea. A chest X-ray showed a lung mass of unknown origin that was obstructing the right main bronchus. After relieving the airway obstruction with stent insertion via bronchoscopy, a diagnosis of fetal adenocarcinoma is being confirmed through thoracoscopic biopsy. Due to the locally advanced state of the lung cancer, it seemed to be inoperable, and concurrent chemo-radiation therapy was being administered with docetaxel. The stent was removed after improvements in the airway obstruction followed by a lung mass shrinkage. Comparing to other contexts which describe fetal adenocarcinoma as lower grade malignancy with low-associated mortality, herein, we describe a case of locally-advanced fetal adenocarcinoma (T4N3M0). This is the first documented case being treated with concurrent chemoradiation therapy. The followed-up image studies represent a partial response and the patient is currently under further observations.

중환자실 간호기록 표준화를 위한 간호초점 분석 (An analysis of nursing focuses for standardization of ICU nursing records)

  • 강영미;유지호;조용애;류성숙;조정구;성영희
    • 중환자간호학회지
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    • 제1권1호
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    • pp.73-83
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    • 2008
  • Purpose: Purpose of this study was to analyze the nursing focuses for standardization of ICU nursing records. Methods: The data were collected from 1,000days'nursing records of 197 ICU patients at a tertiary hospital in Seoul. Nursing focuses were unified at the consulting group meeting and they were cross-mapped with the NANDA nursing diagnoses. Results: The 62 nursing focuses in 7 NANDA categories were extracted from nursing record. Among total nursing focuses 41 correspond to the NANDA nursing diagnoses and 21 were added to ICU nursing focuses. The 10 most frequently used nursing focuses are 'Ineffective airway clearance', 'Impaired gas exchange', 'Ineffective tissue perfusion: cardiopulmonary', 'Ineffective breathing pattern', 'Ineffective tissue perfusion: renal', 'Ineffective infant feeding pattern', 'Risk for impaired skin integrity', 'Hyperthermia', 'Impaired skin integrity', 'Decreased cardiac output', Conclusion: Nursing focuses list of ICU was extracted from the result of this study. These nursing focuses might form a framework for development of research-based assessment guideline and care plans for ICU patients through standardization of nursing records.

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Analysis of Gene Expression in Carcinogen-induced Acute Hepatotoxicity

  • Oh, Jung-Hwa;Park, Han-Jin;Lee, Eun-Hee;Heo, Sun-Hee;Cho, Jae-Woo;Kim, Yong-Bum;Yoon, Seok-Joo
    • Molecular & Cellular Toxicology
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    • 제5권1호
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    • pp.58-66
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    • 2009
  • The 2-year rodent carcinogenicity test involves long-term, repetitive dosing of animals that is both time consuming and expensive. Alternative approaches have been attempted using specific transgenic or knockout mice or toxicogenomics to predict carcinogenicity without conducting a 2-year rodent test. In addition, toxicogenomic analysis of carcinogen-treated animals could also enhance our understanding of molecular mechanisms and aid in the diagnosis of acute toxicity induced by carcinogens. Therefore, we investigated transcription profiles after administering the carcinogens 4,4-dimethylformamide (DMF) and 4-biphenylamine (ABP). BALB/c male mice were treated once with DMF (650 mg/kg i.p.) or ABP (120 mg/kg p.o.). Standard blood biochemistry and histological changes were observed. Gene expression profiles in the livers of mice treated with either vehicle or the carcinogens were analyzed using the Affymetrix $GeneChip^{(R)}$ assay. In all, 1,474 differentially expressed genes in DMF- or ABP-treated mice were identified as being either up- or down-regulated over 1.5-fold (P< 0.01), and these genes were analyzed using hierarchical clustering and Ingenuity Pathways Analysis. Of these, 107 genes were consistently regulated in both carcinogen-treated groups. Genes associated with cancer were upregulated (Por, S100a10, Tes, Ctcf, Ddx21, Eapp, Nel, and Pa2g4) or downregulated (Cbs and Gch1). Toxicological function analysis also identified genes involved in organ toxicity, including hepatotoxicity. These data may help to identify molecular markers for acute hepatotoxicity induced by carcinogens.