Lee, Ji Sun;Oh, Eui Geum;Lee, Hyang Kyu;Kim, Sang Hee
The Journal of the Korea Contents Association
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v.17
no.12
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pp.357-367
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2017
The study investigated information about the effects of message framing on colorectal cancer(CRC) screening related health beliefs and compliance with the CRC screening test within the theoretical framework of the prospect theory and the Health belief model (HBM). This study was using a non-randomized controlled quasi-experimental design. One hundred and sixty-four in the industrial workers who were currently nonadherent to guidelines for receiving screening were assigned to one of three experimental conditions: (a) gain-framed message, (b) loss-framed message, and (c) general-framed message. CRC screening-related health beliefs was self-reported after the intervention. And the immunoassay Fecal Occult Blood Test (iFOBT) kit was collected at 1 week. The research finding were analyzed by $x^2$ test and one-way ANOVA using SPSS 21.0. The loss-framed message group had higher perceived susceptibility, severity and benefit than the gain-framed message and general message. The participation rate for the immunoassay Fecal Occult Blood Test(iFOBT) was highest in the loss-framed message group. The loss framed messages more effective to enhance screening behavior. The present results provide a theoretical basis for developing educational guidelines for CRC testing and could be used for performing comprehensive approach by predicting and suggesting the practical effects according to message type in advance.
To determine the relationship between comorbidity and outcome after radical cystectomy in Chinese patients by using the Adult Comorbidity Evaluation (ACE)-27 index. Two-hundred-and-forty-six patients treated with radical cystectomy at the Second Xiangya Hospital of Central South University, Hunan Province, China between 2000 and 2010 were retrospectively analyzed. Medical records were reviewed for age, gender, delayed time of radical cystectomy, urinary diversion type, pelvic lymphadenectomy status, TNM stage, and pathological grade. Comorbidity information was assessed by the ACE-27 index. The outcome measurement was overall survival. Univariate and multivariate Cox proportional hazards regression analyses were used to determine the association between comorbidity and outcome. The study population consisted of 215 (87.40%) males and 31 (12.60%) females with a mean age of $62{\pm}11$ years. Median duration of follow-up was $47{\pm}31$ months. A total of 151 (61.38%) patents died during follow-up. Of those, 118 (47.97%) had at least one comorbidity. According to the ACE-27 scores, 128 (52.03%) patients had no comorbidity, 79 (32.11%) had mild, 33 (13.41%) had moderate, and 6 (2.45%) had severe comorbidities. Multivariate analysis indicated that moderate (p=0.002) and severe (p<0.001) comorbidity was significantly associated with decreased overall survival. In addition, age ${\geq}70$ years (p=0.002), delayed time of radical cystectomy >12 weeks (p=0.044), pelvic lymphadenectomy status (p=0.014), and TNM stage >T3 (p<0.001) were determined to be independent risk factors of overall survival. Increasing severity of comorbidity statistically correlated with decreased overall survival after radical cystectomy.
Five hundred and fifty patients treated for carcinoma of the uterine cervix at the Department of Therapeutic Radiology, Seoul National University Hospital from 1979 to 1986, were analyzed retrospectively for late bladder complications. Of them,468 patients received primary radiotherapy for the cervix cancer in intact uterus, and the other 82 patients were treated postoperatively. The cumulative incidence of radiation induced bladder complication of grade 2 or 3 was $2.5\%$ at five years. The mean bladder dose for the group of patients with complication was higher than that of the group without complication, and the difference was statistically significant (p<0.01). But relationship between mean bladder dose and severity of complication was not found. The frequency of complication (grade I, II, III) increased as a function of radiation dose to bladder from $5.0\%$ for patients with bladder dose less than 6,500 cGy to $27.7\%$ for patients with bladder dose higher than 8,000 cGy. Among various factors, the age of patient and the distance between ovoids turned out to have significant effect on the complication.
Journal of Physiology & Pathology in Korean Medicine
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v.20
no.6
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pp.1678-1727
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2006
This study was perfromed to develop the assessment guideline and endpoints for clinical trial with anticancer herbal medicine. The botanical products used to humans for long time may be applied to phase 3 clinical trial after submitting the evidences for safety and efficacy of them or completion of basic requirement of phase 1 and phase 2 for safety confirmation and dose determination. Syndrome improvement was chiefly evaluated by Zubrod and karnofsky(%) methods. We suggest the general clinical trial assessment with botanical products, by following assessment points, that is, tumor size for 50 points, survival fate for 10 points, major syndromes for 40 points. It is recommendable that the each symptom of Qi deficiency syndrome, blood deficiency syndrome and Qi stagnation syndrome was allocated by assessment points, Similarly, the each symptom was given the assessment points according to the severity of symptom, for example, slight for 3 points, moderate for 2 points and severe for 1 point in hepatocelluar carcinoma and lung cancer. Then, the efficacy of botanical products was evaluated by the difference between pre-treatment and post-treatment. Asking the neoplastic patients of questionnaire on physical, emotional, cognitive, social and role subjects availability, three more syndromes (Fatigue, Pain and Nausea/Vomit), quality of life(QOL) will be evaluated by GLM statistics. In addition, in case of lung cancer, 13 questions will be asked by the EORTC QLQ-C13 forms. As the assessment of endpoints for efficacy to reduce side effects induced by chemotherapy and radiotherapy, the data of image scanning and hemato-urinalysis can be usefully applied on immune response, weight loss, indigestion, hemopoietic damage and injury of liver and kidney, while the changes of syndromes of side effect can be evaluated by differentiation methods of Qi and blood and five viscera. However, it is still necessary to determine the ratio between scientific analytical method and Oriental differentiation method as well as confirm the Oriental assessment endpoints by clinical trial. In addition, we suggest the continuous development of assessment endpoints on other carcinomas except of hepatocelluar carcinoma and lung cancer in future.
Yoon, Wan Ki;Heo, Mi Jung;Lee, Ok Sang;Lim, Sung Cil
Korean Journal of Clinical Pharmacy
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v.22
no.4
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pp.356-366
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2012
Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.
Oh Young Taek;Kim Juree;Kang Haejin;Sohn Jeong Hye;Kang Seung Hee;Chun Mison
Radiation Oncology Journal
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v.15
no.2
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pp.137-143
/
1997
Purpose : Radiation pneumonitis is one of the complications caused by radiation therapy that includes a Portion of the lung tissue. The severity of radiation induced pulmonary dysfunction depends on the irradiated lung volume, total dose, dose rate and underlying Pulmonary function. It also depends on whether chemotherapy is done or not. The irradiated lung volume is the most important factor to predict the pulmonary dysfunction in breast cancer Patients following radiation therapy. There are some data that show the irradiated lung volume measured from CT scans as a part of treatment Planning with the tangential beams. But such data have not been reported in Korea. We planned to evaluate the irradiated lung volume quantitatively using CT scans for the breast tangential field and search for useful factors that could Predict the irradiated lung volume Materials and Methods : The lung volume was measured for 25 patients with breast cancer irradiated with tangential field from Jan.1995 to Aug.1996. Parameters that can predict the irradiated lung volume included; (1) the peruendicular distance from the Posterior tangential edge to the posterior part of the anterior chest wall at the center of the field (CLD) ; (2) the maximum perpendicular distance from the posterior tangential field edge to the posterior Part of the anterior chest wall (MLD) ; (3) the greatest perpendicular distance from the Posterior tangential edge to the posterior part of anterior chest wall on CT image at the center of the longitudinal field (GPD) ; (4) the length of the longitudinal field (L). The irradiated lung volume(RV), the entire both lung volume(EV) and the ipsilateral lung volume(IV) were measured using dose volume histogram. The relationship between the irradiated lung volume and predictors was evaluated by regression analysis. Results :The RV is 61-279cc (mean 170cc), the RV/EV is $2.9-13.0\%\;(mean\;5.8\%)$ and the RV/IV is $4.9-29.0\%\;(mean\;12.2\%)$. The CLD, the MLD and the GPD ave 1.9-3.3cm, 1.9-3.3cm and 1.4-3.1cm respectively. The significant relations between the irradiated lung volume such as RV. RV/EV, RV/IV and parameters such as CLD, MLD, GPO, L. $CLD\timesL,\;MLD\timesL\;and\;GPD\timesL$ are not found with little variances in parameters. The RV/IV of the left breast irradiation is significantly larger than that of the right but the RV/EVS do not show the differences. There is no symptomatic radiation pneumonitis at least during 6 months follow up. Conclusion : The significant relationship between the irradiated lung volume and predictors is not found with little variation on parameters. The irradiated lung volume in the tangential held is liss than $10\%$ of entire lung volume when CLO is less than 3cm. The RV/IV of the left tangential field is larger than that of the right but there was no significant differences in RV/EVS. Symptomatic radiation pneumonitis has not occurred during minimum 6 months follow up.
This study aims to provide basic data to reduce the incidence of radiation dermatitis and improve patient satisfaction by investigating the management status and satisfaction level of radiation dermatitis in patients undergoing radiation therapy. From October 28, 2022, to April 4, 2023, a survey was conducted on 137 breast cancer patients who received radiation therapy at G Hospital in Busan. The Radiation Therapy Oncology Group (RTOG) cutaneous acute radiotherapy toxicity score was used as the standard for measuring skin reactions, and the association between cancer stage and RTOG was analyzed. SPSS program (ver. 18.0) was used for statistical analysis. The frequency of radiation dermatitis occurrence was relatively low, with 73% in the RTOG 0-1 group and 27% in the 2-3 group. Patient satisfaction after radiation therapy varied significantly depending on the RTOG group, with lower levels of dermatitis resulting in higher satisfaction and higher levels resulting in dissatisfaction (p=0.001). Although there was no statistically significant difference in RTOG group and skin satisfaction depending on the frequency of aloe mist use (p=0.065), the group that used it 1-2 times a day (69.3%) showed a higher satisfaction level. The perceived effects of aloe mist use were statistically significant for decreasing heat sensation (p=0.001), pain (p=0.033), itching (p=0.001), and psychological stability (p=0.027), especially in the higher RTOG groups. Additionally, as cancer stage increased, the severity of radiation dermatitis also increased, which was statistically significant (p=0.001). In conclusion, radiation dermatitis is the most common side effect of radiation therapy, and it can appear in various forms depending on individual skin sensitivity and external factors during treatment. Adequate education before treatment and the use of MD Cream and aloe vera mist are recommended to reduce the incidence and manage radiation dermatitis effectively.
Background: Nivolumab and pembrolizumab are antagonists of the programmed death-ligand 1 (PD-L1) receptor that function as immuno-oncological agents. This study aimed to evaluate the safety and efficacy of nivolumab and pembrolizumab in elderly patients in outpatient settings. Methods: The safety and efficacy of nivolumab and pembrolizumab were compared retrospectively among patients at the Veterans Health Service (VHS) Medical Center in Seoul, South Korea, from September 1, 2017 to August 25, 2018. Results: Eighty-seven patients were selected for the study. The median progression-free survival was 63 days for nivolumab (95% confidence interval (CI), [14 to 282]) vs. 243 days for pembrolizumab (95% CI, [22 to 348]) (p =0.04). The objective response rate (ORR) was 0% in the nivolumab group vs 5.6% in the pembrolizumab group (p =0.310). All the patients exhibited treatment-related adverse effects. More than 89% of the patients exhibited diseases of the gastrointestinal (GI) tract. Pneumonia, of grades three or higher, was the most common adverse effect, followed by weakness and anorexia. Conclusions: There was no statistically significant difference between the nivolumab group and the pembrolizumab group with respect to the ORR. The incidence and severity of the adverse effects in this study were higher than those of previous studies; however, these adverse effects are generally manageable in a real-world clinical setting. Further randomized controlled studies will be necessary to confirm these results in elderly patients.
Injuries and infectious diseases have been the most important public health problems since the beginning of human life. Injuries result in death of about 30,000 people each year in South Korea. In terms of years of life lost, injuries are considerably more costly than either heart disease or cancer. In terms of cost - both the direct costs of care and the indirect costs to individuals, families, and societies of a diminished life-injuries are among the most expensive of all social problems. The main purposes of this study are (1) to describe the outcomes as well as treatment process of brain injured patients and (2) to identify the factors impacting on length of stay during hospitalization and hospital fees. The research method used in this study was to review the medical records of five hundreds brain injured cases using systemic random sampling. The multiple logistic regression was administered to identify the factors impacting on the outcomes. The results are as follow : (1) the consultation .ate was found to be 72.9% while referral rate was 11.2%; (2) nearly 30% of the respondents were hospitalized over 30 days; (3) multiple logistic regression analyses revealed that the determinants influencing LOS were number of consultations, number of lab tests, and surgery; (4) the determinants of hospital fee were severity of brain injury, gender of patients, number of consultations, number of lab tests, and surgery.
Kim, Jeong-Goo;Cho, Hye-Jin;Lee, Seung-Hee;Kim, Pum-Soo;Roh, Hyung-Keun
Journal of The Korean Society of Clinical Toxicology
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v.1
no.1
/
pp.51-55
/
2003
Caustic ingestion can produce a progressive and devastating injury to the esophagus and stomach, In the acute stage, perforation and necrosis may occur. Long-term complications include esophageal stricture, antral stenosis and the development of esophageal cancer. Endoscopy should be performed as soon as possible in all cases to evaluate the extent and severity of damage, unless there is evidence of perforation. Endoscopy is the diagnostic procedure of choice. However, when the endoscopy cannot be passed through due to esophageal stricture, upper GI barium studies may be useful as a follow-up measure and in the evaluation of complications. A 44-year-old man visited our hospital complaining frequent vomiting 1 hour after ingestion of unknown amount of hydrochloric acid. At the time of arrival, the patient's oral cavity was slightly swollen and erythematous. On the endoscopic examination fourteen hour after the caustic ingestion, marked swelling of the arytenoids and circumferential ulceration with brown and black pigmentation at the upper esophagus were observed. Four weeks after the caustic injury, upper esophageal narrowing was observed and then the scope could not be advanced to the stomach. Upper GI barium study performed at that time revealed diffuse luminal narrowing of the esophagus and concentric luminal narrowing from prepyloric antrum to pylorus with disturbance of barium passage. At a week after the Upper GI study, through endoscopic examination after bougie dilatation of the esophagus, barium impaction in the stomach and the pylorus was noticed.
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