The purpose of this study was to test the effects of foot reflexology on pain and mood in patients who have just had a mastectomy. The research design was a nonequivalent control group, non-synchronized design. The participants for this study were 28 patients with breast cancer on first or second day after mastectomy surgery. The first 12 patients were assigned to the control group and the second 16 to the experimental group. The study was conducted from October 28, 2001 to December 22, 2001 on a surgical unit of Y Medical Center in Seoul, Korea. Pain intensity, blood pressure, pulse rate and mood were measured as dependent variables. The instrument used for pain intensity and mood was a 10 cm visual analogue scale. Cronbach alpha for this study was .70. For the experimental group pre and post tests were done immediately before and 15 minutes after completion of foot reflexology. Foot reflexology was performed once for 20 minutes. After the pretest, patients in the control group were instructed to have a quiet time for a 35 minute period and then the post-test was done. The number of participants was small so the data were analyzed by Mann-Whitney U test, and Wilcoxon signed ranks test. The results of this study are as follow : 1. In the experimental group there were significant decreases between the pre and post tests for pain intensity (z=-3.47, p<.001), diastolic blood pressure (z=-2.67, p<.01) and pulse rate (z=-3.44, p<.001) but there was no difference between the two groups on the post test. 2. The systolic blood pressure, diastolic blood pressure and pulse rate were also not significantly different between the experimental group and the control group on the post test. 3. The mood score was significantly improved after foot reflexology(z=-3.52, p=.000) and the difference between the two groups was also significant (u=49.0, p=.03). In conclusion, there was a statistically significant difference in mood between the two groups, but no difference for pain intensity, blood pressure, or pulse rate. However, there were significant differences between the pretest and post-test for pain intensity, diastolic blood pressure and pulse rate in the experimental group. On the basis of the above findings, this study suggests that foot reflexology can be an effective method of relieving pain and improving mood in clinical practice in women who have had mastectomy surgery.
Kim, Il-Kug;Lee, Jun-Ho;Kim, Yong-Ha;Kim, Tae-Gon;Lee, Soo-Jung;Kang, Soo-Hwan
Archives of Plastic Surgery
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v.38
no.6
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pp.808-814
/
2011
Purpose: Despite wide clinical use of breast implants, there is continued concern about the lifespan of these devices. The causes of explantation were infection, deflation of implant and patient's want. The deflation of saline-filled breast implant was related to strength and durability of implant shell. The purpose of this study is to evaluate the clinical durability of saline-filled breast implant through the analysis of duration until deflation occurred, causes, incidence and influencing factors. Methods: Retrospective analyses were conducted on clinical records for 19 cases of deflation of saline-filled breast implant from 201 cases of breast reconstruction with saline-filled implant between May 1995 and June 2011. The authors had been analyzed the causes of deflation, survival duration, symptom, sign, nipple excision, volume of implant, saline filling, method of reoperation, breast cancer stage and combined capsular contracture. Results: The causes of deflation were attributed to the cases that cannot be evaluated the causes in 15 cases, fall down in 1 case, mammography in 2 cases, accidental needle injury in 1 case. Mean survival duration was 4 years and 5 months. The duration of survival was less than 1 year for 5 cases, 1 year to 10 years for 10 cases, more than 10 years for 4 cases. The volume between 201 and 250 cc of deflated breast implant was rated as high by 14.0 percent. The deflation rate of underfilled implants was 11.4 percent, adequate filled implants was 9.3 percent. None of overfilled implant was deflated. The deflation of smooth surface implant was 5 of 152 cases. Textured implant was 14 of 49 cases. The capsular contracture of non-deflated breast implant was 28 of 182 cases and that of deflated breast implant was 6 of 19 cases. Conclusion: The patients who underwent saline-filled breast implant implantation should be informed that their implant could deflate. The analysis of clinical durability and causes of deflation in breast implant was important for the prediction and prevention of reopeation. The authors could suppose the causes of deflation of saline-filled breast implant through history, duration of survival, inspection of the shell of implant.
During the period of 4 years from August 1975 to August 1979 one hundred and forty seven cases of lung cancer were seen at Paik Foundation Hospital in Seoul, Korea. Among these 147 cases, 104 patients had primary carcinoma of the lung and the remainder was metastatic carcinoma to the lung. Among these 104 primary carcinoma patients, 73 cases were proven histologically as primary carcinoma of the lung. There were three cases of alveolar cell carcinoma [Table 1 ]. This clinical observation is based on those 73 cases including three case reports of the alveolar cell carcinoma. 1. Peak incidence was observed in the 5th decade of life. Male to female ratio was 2 to 1 [Fig. 1]. 2. Pathological classifications were as follows: epidermoid carcinoma, 24 cases [32.9%]; undifferentiated carcinoma, 20 cases [27.4%]; adenocarcinoma, 15 cases [20.5%]; bronchioloalveolar carcinoma [5.5%] and positive cytology, 10 cases [13.7%] [Fig. 2]. 3. Evidence of inoperability was observed in 55 patients [75% of the 73 cases] [Table 3]. 4. Among those 73 cases, operability was evaluated in 18 patients or 25%. One patient refused operation and 17 patients [23.6%] were explored. In 11 [15%] out of 17 patients, thoracotomies were performed. Six cases were pneumonectomies and 5 cases were lobectomies or bilobectomies [Fig. 3]. 5. First case of alveolar cell carcinoma was a 46 year-old housewife complaining of cough and hemoptysis for one year. The plain chest X-ray and bronchogram showed characteristic pictures as Figures 4 and 5. A pneumonectomy was carried out. Histologically, a beautiful alveolar carcinoma consisted of the characteristic tall columnar epithelial cells, which were lining the alveolar spaces as seen in Figures 6, 7, 8, and 20. 6. In the second case of 41 year old male, predominant clinical feature was single, well defined mass in the right lower lobe [Fig. 10 and 11] on chest X-ray. Bilobectomized specimen showed fragile, soft and hard tissue containing mucoid secretions and focal yellowish necrosis with pigmentation on cut surface [Fig. 12]. Slides showed tumor cells lined up along the alveolar septa with papillary projections [Fig. 13 and 14]. 7. Third case of alveolar cell carcinoma was a 50-year-old housewife with hemoptysis. An outstanding clinical picture was a round to lobulated mass in the right upper lobe [Fig. 16]. She is living now, 2 years and 1 month post-operatively, but has arrived at terminal stage with military nodular disseminations to the contralateral lung [Fig. 19].
A clinical study of 36 cases of pulmonary tuberculosis that had had a surgical resection during the period of 13 years from January 1979 to December 1992 was performed in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital The ratio between male and female was 3.5 1 and the age of peak incidence was in the 2nd and 3rd decades. The common prodromal symptoms were chest pain (38.9 %) and hemoptysis or blood tinged sputum (36.1 %). Preoperative diagnostic examination of sputum positivity for AFB stain despite antituberculosis chemotherapy was noticed in 22.8 oyo . Surgical indications were destroyed lobe or segment with or without cavity (58.3 oyo), mass unable to differentiate from lung cancer (16.7 %), total destroyed lung (13.9 %), bronchostenosis with atelectasis and distal bronchiectasis (11.1 %). Types of resection were pneumonectomy in 16.7%, lobec omy and segmentectomy 2.7%, lobectomy 50 %, segmentectomy 27.8%, and wedge resection 2.7%. Postoperatively, pulmonary function Improved compared to the preoperative examination, although these changes were not statistically significant. One patient died of ulcerative colitis due to drug hypersensitivity, and the postoperative complications were remnant dead space in 11.1 %, spreading of tuberculosis in 5.5%, and empyema with BPF in 5.5%.
Previous studies concerning the usefulness of pleural fluid glucose levels in differentiating causes of pleural effusions have been conflicting. Gelenger and Wiggers (1949), Calnan et al(1951) and Barber et al(1957) concluded that the lower the level of pleural fluid glucose, the more likely was tuberculosis, and that tuberculosis was unlikely if the pleural fluid glucose level was more than 80 mg/100 ml. Light and Ball(1973), however, reported that in the great majority of tuberculous pleural fluids the glucose concentration was high rather than low, concluded that the pleural fluid glucose levels were not useful in the differential diagnosis of pleural effusion. In this study, pleural fluid glucose was determined in 46 pleural effusions from various causes to evaluate the usefulness in the differential diagnosis of pleural effusion. In addition, the protein concentration and the electrophoretic patterns of protein and amylases in pleural fluid was compared with that of serum. And the results were as follows. 1. The mean glucose concentration of pleural fluid was 80.8 mg/100 ml in 22 tuberculous origin, 92.5 mg/100 ml in 12 cancer patient and 70.4 mg/100 ml in 10 undiagnosed cases. In 2 cases of paragonimiasis the pleural fliud glucose levels were low (mean, 32.0 mg/100 ml). The percentage of pleural fluid protein to serum is about 75% in all disease groups and the protein level of tuberculous pleural fluid was significantly correlated with that of serum. 2. The disc eletrophoretic patterns of pleural fluid were almost similar with that of serum in all disease groups but the prealbumin fraction was not observed in pleural fluid. 3. With the isoelectric focusing, 4 to 7 isoamylase was observed in serum and the isoelectric point was ranged from pH 5.8 to 7.8 and isoelectic point of main fracticn is pH 7.2. The isoelectic focusing patterns of amylase of pleural fluid were identical to that of serum in all disease group. With the above results it is concluded that the pleural fluid is exudate of serum and that the glucose levels of pleural fluid are not useful in the differential diagnosis of pieural effusions.
The study was conducted targeting 25 patients who underwent the respiratory gated radiation therapy in the abdominal region at Radiation Oncology of a University Hospital from December 2013 to June 2014 and types of cancer included liver(64%), CBD(8%), gastric(8%), GB(8%), pancreas(8%), SMA(4%). The means of ITV and PTV volume are 471.44 cm3 and 425.48 cm3, showing an increase in volume. Normal tissue volume was also found to have increased due to the increase of the section selected from PTV section to ITV section. Right kidney showed a significant increase in differences between increase in normal tissue volume, increase in target volume and increase in therapy irradiation area and difference between the means of dose applied to normal tissue. There was no significant difference in the mean dose applied to normal tissue according to the respiratory average. Both kidneys showed a significant difference in the difference between mean doses of target moving and normal tissue. In this study, both therapy methods through PTV section and ITV section volume setting were appropriate for protection doses of normal tissue and distributed over 95% of the prescribed dose and therefore, it is considered to be okay to be optionally used depending on the patient's therapeutic purpose. But in order to minimize the unexpected side effect, the plan of PTV section and ITV section should be established and used by evaluating normal tissue protection dose.
Journal of the Korea Academia-Industrial cooperation Society
/
v.19
no.1
/
pp.497-505
/
2018
This study was conducted to investigate the characteristics of private health insurance subscribers and non-subscribers as they relate to severely ill patients, and to identify the factors of participation. The study was conducted using the National Health and Nutrition Examination Survey for 2015, and data were analyzed using SPSS ver. 23.0. The subjects were 417 patients with severe disease (cancer, heart disease, cerebrovascular disease) over 19 years of age. Crossover analysis was employed to identify differences between the state of private health insurance participation, while binary logistic regression analysis was used to confirm the factors affecting private health insurance subscription. Analysis of the effects of the subjects on the private health insurance participation rate revealed that the social and demographic characteristics were higher in younger individuals regardless of sex, residence, or marital status. Moreover, higher household income, regardless of the education level, was associated with a higher participation rate of health insurance target individuals compared to medical benefit target individuals. The private health insurance participation rate was low and the explaining power was 51.7%, regardless of subjective health awareness and walking practice. Therefore, efforts should be made to improve the living environment and support local governmental programs for the elderly, low income households, socially vulnerable groups with limited activities and groups with limited health behavior. It is also necessary to consider various health policies, such as providing government health education or programs to prevent severe illness.
Kim, Changsoo;Kang, Se-Sik;Kim, Jung-Hoon;Lee, Jin-Soo
The Journal of the Korea Contents Association
/
v.14
no.6
/
pp.247-254
/
2014
For the purpose of early diagnosis of the breast cancer, the attention on the screening mammography has been increasing-with supply of digital mammography day by day. Image quality is decided by target materials and filter combinations. Optimized selection by a glandular density and a thickness is needed, because these combinations change x-ray spectrum and effect to image quality. The purpose of this study is to find out optimized target and filter combinations through the evaluation of quantitative image quality and to suggest means which minimize patient dose through MCNPX. In results, spatial frequency resolution evaluation which is quantitative image quality evaluation method, MTF, NPS, DQE shows that we have to select Mo/Mo combinations or Mo/Rh combinations when compressed breast is thin. but in case of that when compressed breast is thick, we have to select Rh/Rh combinations or W /Rh combinations. In a comprehensive evaluation, W!Rh combinations which are not used in thin breasts in practice was superior to all image quality evaluation. This result is somewhat different-with clinical examination results. Secondary end point was organ dose evaluation, radiation dose of opposite breast was approximately 47 ~73% effectiveness when selecting standard breast. In conculsion, the most important point is that we have to select the optimal combinations-with considering dose evaluation and various thickness.
Kim, Jinsup;Lee, Na Hee;Lee, Soo Hyun;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe;Seo, Jeong-Meen;Lee, Suk-Koo
Clinical and Experimental Pediatrics
/
v.58
no.10
/
pp.386-391
/
2015
Purpose: To evaluate the outcomes and prognostic factors in children with extracranial germ cell tumors (GCTs) treated at a single institution. Methods: Sixty-six children diagnosed with extracranial GCTs between 1996 and 2012 were included in the study. Primary treatment was surgical excision, followed by six cycles of cisplatin-based chemotherapy. The survival rates were compared according to the International Germ Cell Cancer Cooperative Group classification used for GCTs in adults to validate the classification guidelines for GCTs in children. Results: The median patient age was 4.4 years. In 34 patients (51.5%), the primary tumor site was the gonad. Extragonadal GCTs were detected in 32 patients. The 5-year overall survival and event-free survival (EFS) were $92.0%{\pm}3.5%$ and $90.4%{\pm}3.7%$, respectively. In univariate analysis, tumor histology, metastasis, and elevated alpha-fetoprotein were not prognostic factors in children with extracranial GCTs. However, EFS was poorer in patients with mediastinal disease (n=12, $66.7%{\pm}13.6%$) than in those with nonmediastinal disease (n=54, $96.0%{\pm}2.8%$) (P=0.001). The 5-year EFS was lower in patients older than 10 years, (n=21, $80.0%{\pm}8.9%$) compared with those younger than 10 years (n=45, $95.2%{\pm}3.3%$) (P=0.04). Multivariate analysis identified the mediastinal tumor site as the only independent prognostic factor. Conclusion: The prognosis of children with extracranial GCTs was favorable. However, nongerminomatous mediastinal tumors were associated with poor survival in children. Further research is needed to improve the prognosis of children with malignant mediastinal GCTs.
Kim, Ji Hyun;Nam, Seung-Joo;Park, Sung Chul;Lee, Sang Hoon;Kim, Tae Suk;Lee, Minjong;Park, Jin Myung;Choi, Dae Hee;Kang, Chang Don;Lee, Sung Joon;Ryu, Young Joon;Lee, Kyungyul;Park, So Young
The Korean Journal of Physiology and Pharmacology
/
v.24
no.2
/
pp.185-191
/
2020
Interstitial cells of Cajal (ICC) are known as the pacemaker cells of gastrointestinal tract, and it has been reported that acute gastroenteritis induces intestinal dysmotility through antibody to vinculin, a cytoskeletal protein in gut, resulting in small intestinal bacterial overgrowth, so that anti-vinculin antibody can be used as a biomarker for irritable bowel syndrome. This study aimed to determine correlation between serum anti-vinculin antibody and ICC density in human stomach. Gastric specimens from 45 patients with gastric cancer who received gastric surgery at Kangwon National University Hospital from 2013 to 2017 were used. ICC in inner circular muscle, and myenteric plexus were counted. Corresponding patient's blood samples were used to determine the amount of anti-vinculin antibody by enzyme-linked immunosorbent assay. Analysis was done to determine correlation between anti-vinculin antibody and ICC numbers. Patients with elevated anti-vinculin antibody titer (above median value) had significantly lower number of ICC in inner circular muscle (71.0 vs. 240.5, p = 0.047), and myenteric plexus (12.0 vs. 68.5, p < 0.01) compared to patients with lower anti-vinculin antibody titer. Level of serum anti-vinculin antibody correlated significantly with density of ICC in myenteric plexus (r = -0.379, p = 0.01; Spearman correlation). Increased level of circulating anti-vinculin antibody was significantly correlated with decreased density of ICC in myenteric plexus of human stomach.
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