• Title/Summary/Keyword: cancer severity

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A Survey of Patient Satisfaction with the use of Aloe Vera Mist for Skin Care during Radiation Therapy for Breast Cancer (유방암 방사선치료 중 피부 관리를 위한 알로에 베라 미스트 사용에 대한 환자 만족도 조사)

  • Han-A Yun;Hyo-Young Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.2
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    • pp.231-242
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    • 2023
  • 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.

Evaluation of Efficacy and Safety of Nivolumab and Pembrolizumab in Elderly Cancer Patients (고령 암환자에서의 nivolumab과 pembrolizumab의 유효성과 안전성 평가)

  • Kim, Hye Sung;Jeong, HyoKeun;Shim, Mi Kyong
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.1
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    • pp.11-18
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    • 2020
  • 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.

Treatment Process and Outcomes of Brain Injuried ER Patients (응급실 내원 뇌 손상 환자의 진료과정과 결과)

  • Hong, Hye-Ryeon;Jin, Ki-Nam;Lee, Dong-Woo;Kim, Jae-Su
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.481-489
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    • 1998
  • 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.

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A Case of Pyloric Obstruction Developed after Upper GI Barium Study in Patients with Caustic Injury on Gastrointestinal Tract (부식제에 의한 위장관 손상 환자에서 상부 위장관 조영술 후 발생한 위유문부 폐쇄 1례)

  • 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
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    • pp.51-55
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    • 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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Dose-response Effects of Bleomycin on Inflammation and Pulmonary Fibrosis in Mice

  • Kim, Soo-Nam;Lee, Jin-Soo;Yang, Hyo-Seon;Cho, Jae-Woo;Kwon, Soon-Jin;Kim, Young-Beom;Her, Jeong-Doo;Cho, Kyu-Hyuk;Song, Chang-Woo;Lee, Kyu-Hong
    • Toxicological Research
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    • v.26 no.3
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    • pp.217-222
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    • 2010
  • Many studies have reported that bleomycin, anti-cancer drug, induces pulmonary fibrosis as a side effect. However, few investigations have focused on the dose-response effects of bleomycin on pulmonary fibrosis. Therefore, in the present study, we investigated the effects of different doses of bleomycin in male mice. ICR mice were given 3 consecutive doses of bleomycin: 1, 2, or 4 mg/kg in bleomycin-treated (BT) groups and saline only in vehicle control (VC) groups. The animals were sacrificed at 7 and 24 days postinstillation. The severity of pulmonary fibrosis was evaluated according to inflammatory cell count and lactate dehydrogenase (LDH) activity in the broncho alveolar lavage fluid (BALF), and lung tissues were histologically evaluated after hematoxylin and eosin (H&E), and Masson's trichrome staining. BT groups exhibited changed cellular profiles in BAL fluid compared to the VC group, which had an increased number of total cells, neutrophils, and lymphocytes and a modest increase in the number of macrophages at 7 days post-bleomycin instillation. Moreover, BT groups showed a dose-dependent increase in LDH levels and inflammatory cell counts. However, at 24 days after treatment, collagen deposition, interstitial thickening, and granulomatous lesions were observed in the alveolar spaces in addition to a decrease in inflammatory cells. These results indicate that pulmonary fibrosis induced by 4 mg/kg bleomycin was more severe than that induced by 1 or 2 mg/kg. These data will be utilized in experimental animal models and as basic data to evaluate therapeutic candidates through non-invasive monitoring using the pulmonary fibrosis mouse model established in this study.

Phytoncide Extracted from Pinecone Decreases LPS-Induced Inflammatory Responses in Bovine Mammary Epithelial Cells

  • Kang, Sukyung;Lee, Jae Sung;Lee, Hai Chon;Petriello, Michael C.;Kim, Bae Yong;Do, Jeong Tae;Lim, Dae-Seog;Lee, Hong Gu;Han, Sung Gu
    • Journal of Microbiology and Biotechnology
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    • v.26 no.3
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    • pp.579-587
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    • 2016
  • Mastitis is a prevalent inflammatory disease that remains one of the main causes of poor quality of milk. Phytoncides are naturally occurring anti-inflammatory compounds derived from plants and trees. To determine if treatment with phytoncide could decrease the severity of lipopolysaccharide (LPS)-induced inflammatory responses, mammary alveolar epithelial cells (MAC-T) were pretreated with phytoncide (0.02% and 0.04% (v/v)) followed by LPS treatment (1 and 25 μg/ml). The results demonstrated that phytoncide downregulated LPS-induced pro-inflammatory cyclooxygenase-2 (COX-2) expression. Additionally, LPS-induced activation of ERK1/2, p38, and Akt was attenuated by phytoncide. Treatment of cells with known pharmacological inhibitors of ERK1/2 (PD98059), p38 (SB203580), and Akt (LY294002) confirmed the association of these signaling pathways with the observed alterations in COX-2 expression. Moreover, phytoncide attenuated LPS-induced NF-κB activation and superoxide production, and, finally, treatment with phytoncide increased Nrf2 activation. Results suggest that phytoncide can decrease LPS-induced inflammation in MAC-T cells.

Factors related to Continuous Participation in the Pap Smear Screening among Korean Women: using a Structural Model (한국여성의 Pap 도말검사 지속적 참여행위에 관한 설명모델)

  • 박소미
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.160-170
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    • 2000
  • The purpose of this study was to develop an explanatory model to predict factors related to continuous participation in the Pap smear screening among Korean women. A hypothetical model was constructed on the basis of Health Belief Model and extensive review of literature on the Pap smear screening. Exogeneous variables included in this model were knowledge, perceived sensitivity, perceived severity, negative and positive emotional responses and professional support from physicians and nurses. Endogeneous variables were threat to cervical cancer, perceived benefit of the Pap smear screening, perceived barrier, and the final outcome variable was continuous participation in the Pap smear screening. The hypothetical model was tested with an empirical study. The data was collected from 623 married women whose age range was 24 - 83 using a self-reported survey questionnaire which was developed by the researcher. It's Cronbach's alpha score ranged from .6478 to .9118. Data was collected at different locations in Seoul; a university hospital, a local health center, and apartment complexes. Data analysis was done using SPSS 7.5 WIN Program for descriptive statistics and LISREL 8.12a WIN Program for covariance structural analysis. In conclusion, threat, perceived benefit, perceived barrier, positive emotion and professional support had a significant direct effect on continuous participation in the Pap smear screening among Korean women. The results of this study also showed that perceived barrier had the most significant direct effect on continuous participation in the Pap smear screening while negative emotional response had the most significant direct effect on perceived barrier. It can be suggested that decreasing perceived barrier by reducing negative emotional responses may be the most effective strategies for increasing continuous participation in the Pap smear screening among married Korean women.

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Surgical Invasiveness is Important for Determining Severity of Postoperative Pain after Oral & Maxillofacial Surgery (구강악안면 수술의 침습도 및 술 후 통증의 정도와의 상관성)

  • Shin, Teo-Jeon;Park, Yun-Ki;Seo, Kwang-Suk;Han, Hyo-Jo;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.1
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    • pp.9-15
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    • 2011
  • 배경: 술 후 통증은 술 후 합병증의 발생가능성을 증가시키며 생체기능의 회복을 방해한다. 술 후 통증을 효과적으로 조절하기 위해선 통증의 정도를 객관적으로 평가하는 것이 필요하다. 술 후 통증은 수술의 침습도와 관련이 높을 가능성이 많다. 본 연구에서는 수술 침습도의 정도와 술 후 통증의 정도 사이의 상관관계를 확인하고자 한다. 방법: 총 153명의 환자를 수술의 침습도에 따라 4개의 그룹으로 나누었다(그룹 1: 악성종양 수술 (malignancy surgery), 그룹 2: 양악수술(bimaxillary surgery), 그룹 3: 양성 종양수술(benign cancer surgery) 그룹 4: 임플란트 & 골절 수술(implant & frature)) 수술이 끝나갈 무렵 fentanyl 700 ${\mu}g$, ketorolac 1,500 mg (총 용적 120 ml)가 포함된 자가통증조절장치를 정맥로에 연결하였다. 술 후 통증의 정도는 시각통증등급(visual analogue scale)을 이용하여 측정하였고 자가통증조절장치의 총 사용시간, 투여된 진통제의 양, bolus 투여 총 횟수를 측정하였다. 결과: 술 후 시각통증등급은 술 후 1일부터 3일까지 그룹 1, 2 군에서 유의하게 높았다. 또한 시각통증등급 3점 이상의 통증을 호소하는 환자의 비율 역시 그룹 1, 2 군에서 유의하게 높았다. 진통제 총 투여용량 및 자가로 주입한 진통제의 양 역시 그룹 1, 2군에서 3, 4 군에 비해 유의하게 높은 것을 확인하였다. 결론: 본 연구결과 외과적 수술의 침습도가 술 후 통증의 정도를 결정하는데 있어 중요한 요소임 을 확인하였다.

Management of Vocal Cord Palsy during Thyroid Surgery (갑상선 수술 시의 성대마비의 처치)

  • Choi Hong-Shik;Kim Se-Heon;Park Kuk-Jin;Kim Kwang-Moon;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.27-34
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    • 1998
  • Objectives, Materials & Methods: To prevent deterioration of postoperative voice due to iatrogenic transection of the recurrent laryngeal nerve during the thyroid surgery, intraoperative medialization of the membranous vocal cord by type I thyroplasty together with direct epineurial neurorraphy was done on 2 cases of benign thyroid lesion. To improve the quality of voice together with complete removal of advanced thyroid carcinoma, intraoperative vocal cord medialization on the lesion side together with total thyroidectomy was done by type I thyroplasty in 2 cases and combined procedure by arytenoid adduction and type I thyroplasty in another 2 cases. Results: The resultant voice of the iatrogenic injury cases was relatively tolerable. The voice of the combined procedure was better than that of type I thyroplasty cases for the intraoperative rehabilitation cases. Not only for the preoperative evaluation of the severity of the nerve lesion but also the prognosis will be expected by use of laryngeal EMG in the cases of thyroid cacer with vocal cord palsy. Conclusion: Intraoperative simultaneous rehabilitation for the vocal cord palsy during thyroid surgery is beneficial for the patients.

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The Analysis of Surgical Results to the Lumbar Spinal Disorders of Aged Persons (노령인구의 요추질환에 대한 수술적 치료결과의 분석)

  • Lee, Sei-Young;Youn, Seung-Hwan;Cho, Joon;Moon, Chang-Taek;Chang, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1612-1619
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    • 2000
  • Objective : To retrospectively analyse the surgical outcome and efficacy of the lumbar spinal surgery in sixty to older patients who failed to conservative treatments. Methods : Between July 1990 and November 1996, the authors retrospectively investigated the medical records of 46 patients who over 60 years of age at the time of surgery. The clinical severity was assessed with Prolo's grade(economic and functional). Questionnaire was sent to each patient regarding long-term effect, satisfaction, and side effects. Results : In 46 patients, 2 patients(1 case died of lung cancer, 1 case lost in follow-up) were lost. Among 44 patients (28 men, 16 women ; mean age 64 years), 22 patients underwent partial or total laminectomy, 17 spinal fusion with instruments, 2 chemonucleolysis, 2 adhesiolysis for failed back surgery syndrome, and 1 automated percutaneous lumbar discectomy. Although postoperative complications were observed in 5 patients, they were successfully managed. No deaths were documented in the perioperative periods. The average Prolo's economic and functional grade improved from 2.98 to 3.48 and 2.81 to 3.75, respectively. Conclusion : In overall, the favorable surgical outcome was obtained. This results indicated that with appropriate preoperative selections and indications, careful intraoperative monitoring, and attentive postoperative care, the surgical treatment of eldery patients for the lumbar spinal disorders, significant improvement with acceptable levels of morbidity and mortality can be achived.

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