Objective: Clinical practice guidelines (CPGs) are systematically developed statements aimed at helping optimal care of the patient in a given clinical circumstance. Because of the increasing evidence that active implementation of CPGs improve health outcomes, there is a growing awareness of the importance of guideline development and dissemination. The objective of this study was to investigate the status of CPG development and availability of the CPGs in Korea. Method: We searched in the Web sites of 180 organizations to identify CPGs which were developed and/or published in Korea until 1 July 2014. The data of titles, published year, publisher, distributer, and accessibility at the internet web of all CPGs were collected and analyzed. Results: A total of 172 CPGs were developed and 80% had been released since 2009. Most (51.2%) were developed for management of 4 diseases: 28 for digestive system disease; 27 for infectious disease; 18 for endocrine and metabolic diseases; and 15 for neoplasms. Of the 172 CPGs, 150 CPGs were publicly available. Among the 150 CPGs, 78.7% (118/150) were developed by only one organization. Conclusion: To ensure the production of high-quality CPGs, it is necessary to collaborate with other relevant professional societies in guideline development process. In addition, stronger efforts on wider dissemination of CPGs must be employed at the country levels to promote implementation of CPGs in clinical settings.
Cytokines influence the overall cancer immune cycle by triggering tumor antigen expression, antigen presenting, immune cell priming and activation, effector immune cell recruitment and infiltration to cancer, and cancer killing in the tumor microenvironment (TME). Therefore, cytokines have been considered potential anti-cancer immunotherapy, and cytokine-based anti-cancer therapies continue to be an active area of research and development in the field of cancer immunotherapy, with ongoing clinical trials exploring new strategies to improve efficacy and safety. In this review, we examine past and present clinical developments for major anticancer cytokines, including interleukins (IL-2, IL-15, IL-12, IL-21), interferons, TGF-beta, and GM-CSF. We identify the current status and changes in the technology platform being applied to cytokine-based immune anti-cancer therapeutics. Through this, we discuss the opportunities and challenges of cytokine-based immune anti-cancer treatments in the current immunotherapy market and suggest development directions to enhance the clinical use of cytokines as immuno-anticancer drugs in the future.
To assess the nutritional and health status of the elderly, anthropometric measurements and blood test for analyzing biochemical indices were carried out from August to September in 1996. Data on the incidence of a specific disease and clinical symptoms were also collected by interviews with a questionnaire. Among the total of 169 free-living elderly interviewed(91 men, 78 women), 86 elderly(57 men, 29 women) participated in the anthropometric measurements, and 73 elderly(52 men, 21 women) in blood tests. Average heights and weights were much lower than the standards established in the Korean Recommended Dietary Allowances. While average triceps skinfold thickness of men and women were above the 50 percentile of the reference data, mid-arm muscle circumferences were lower than the 50 percentile. Prevalences of anemia, assessed by hemoglobin using WHO definition, were 38.5% for men and 33.3% for women. Blood levels of total protein and albumin were above the normal limit for all participants. Mean blood cholesterol levels of men and women were 163.9mg/dl and 185.8mg/dl, and triglyceride levels were 138.2mg/dl and 161.9mg/dl, respectively. Women older than 75 years generally had high levels of BMI, total cholesterol and triglyceride. Health status assessed by clinical symptoms generally showed no significant difference by age, and their smoking, and drinking habits. Males and the elderly who exercised regularly had better health status. It was suggested that exercise was a good way to improve health status. (Korean J Community Nutrition 2(4) : 568-577, 1997)
Purpose: The purpose of this study was to investigate the relationships of activity status, anxiety, depression, social support, symptom experience, and functional status in patients with lung cancer based on the theory of unpleasant symptoms. Methods: The participants for this study were 101 lung cancer patients who visited the out-patient department for treatment or follow-up at one hospital in Seoul. Data were collected from January 1 to February 8, 2013 using self-reported questionnaires and clinical records. To measure variables, the functional scale and symptom scale of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30, EORTC QLQ-Lung Cancer 13, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, and Multidimensional Scale of Perceived Social Support were used in this study. The data were analyzed using SPSS 19.0 software for Windows. Results: The symptom experience showed more severity in patients with lower activity status, higher anxiety and depression. With lower activity status and social support, functional status was lower. When anxiety, depression, and symptom experience were higher, functional status was also lower. The significant factors predicting symptom experience were depression, anxiety, activity status, and social support, which explained 57.8% of the variance. Conclusion: These results suggest that psychological factors such as anxiety and depression had a negative influence on the symptom experience of lung cancer patients. Therefore, providing emotional support based on the patients' needs prior to providing symptom management could be a useful strategy for improving symptom experience and functional status.
The purpose of this study was to compare food behaviors, nutrient intake, clinical symptoms, and hematological findings by smoking status. Among the third grade male students from a high school in Jinchun-kun, 31 smokers and 31 nonsmokers participated in this study. A self-administered questionnaire was used to investigate food behaviors and clinical symptoms. Nutrient intake data were collected by 24-hour recall method. Blood sample was drawn from each subject to determine the levels of hemoglobin, protein, triglyceride, cholesterol, etc. The major findings were as follows; First, smokers consumed every food group except fat & oil less frequently than nonsmokers, while they consumed instant food, coffee, alcoholic beverages more frequently than nonsmokers. Dietary habits of smokers such as regularity, balanced diet, skipping meals were worse than those of non-smokers. Second, intakes of energy, fat, carbohydrate, and β-carotene of smokers were lower than those of non-smokers. Third, smokers felt fatigue and other adverse symptoms more often than non-smokers. Fourth, the levels of hemoglobin, albumin and HDL-cholesterol were significantly lower in smokers than non-smokers. Fifth, Smoking history was negatively correlated with food behaviors, energy intake and clinical symptoms. These results suggest that food behaviors, nutrient intakes, hematological findings and clinical symptoms of male high school students were affected by smoking. Therefore, in order to decrease smoking rate of the students, the effect of smoking on nutritional and health status should be informed and nutrition education should be offered to the students.
Purpose: The purpose of this study was to investigate the degrees of assertiveness and depression in clinical nurses and identify the relationships between them. Method: The study included 261 clinical nurses working at one university hospital in the Kyunggi province. The assertiveness scale and a micro simple mental diagnosis test were used to assess the variables. Data were analyzed using SPSS. Results: The average assertiveness score was $3.04{\pm}0.38$ and an average depression score $1.23{\pm}0.71$. Statistically significant differences in assertiveness were identified with regards to marital status (p=.034), type of families (p=.005), number of counselling persons (p=.007), and subjective mental health status (p<.001). In addition, the assertiveness scores were statistically significant based on job position(p=.032), and the levels of satisfaction with nursing job (p=.015). There were significant negative correlations between assertiveness and depression of clinical nurses(r=-.237, p<.001). Conclusion: These findings suggest that assertiveness training for clinical nurses is necessary, especially for novice nurses, in order to decrease the level of depression.
Purpose: The purpose of this study was to examine job status and job satisfaction among clinical research coordinators. Method: Subjects were 91 clinical research coordinators participating in clinical trials at hospitals in Korea. Data were collected from July to August, 2008 using a structured questionnaire that include informed consent, and question as pertaining to, general characteristics, job related characteristics, and job satisfaction. The collected data were analyzed using SPSS 12.0 version. Result: Almost half of the subjects were called as nurse researcher. Major tasks included participant screening (100%), participant scheduling (100%), and obtaining informed consent from participants (98.9%). The most difficult aspect of work was salary (28.6%). The mean score on the job satisfaction was 80.21 (range: 54.00-109.00). Item related to promotion ranked lowest in job satisfaction. There were significant differences in job satisfaction according to the type of hospital (t=-3.640, p<.001), title (t=7.894, p=.001), and route for information of CRC (t=4.970, p=.001). Conclusions: Subjects feel poorly compensated, unrecognized, and perceive a limited career path. These factors are likely to diminish job satisfaction over time. Attention to these aspects through education program and criteria for clinical research coordinators could be helpful.
From January 1, 2008 to March 31, 2010, 101 patients with stage II-III breast cancer were enrolled in this study and subjected to an anthracycline-based neoadjuvant chemotherapy regimen with or without docetaxel. Surgery was performed after 2-6 cycles of chemotherapy, and the clinical response was determined by pathological and histochemical assessments. The clinical response rate, as indicated by complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD), were 6.9, 52.5, 36.6, and 4.0%, respectively. A multivariable correlation analysis indicated that the overall clinical response rate correlated with the number of metastatic lymph nodes, number of chemotherapy cycles, and vessel invasion status. Importantly, the CR rate was only associated with the number of chemotherapy cycles. Nonparametric tests failed to detect a correlation between HER2 or Topo $II{\alpha}$ status and clinical response to neoadjuvant chemotherapy in these patients. When they were stratified by HER2 or HR status, for HER2-positive patients the CR rate was associated with vessel invasion and Topo $II{\alpha}$ status. Based on our findings, we propose that HR, HER-2 and Topo $II{\alpha}$ are not putative predictive biomarkers of chemotherapy outcome for breast cancer patients. Topo $II{\alpha}$ expression level was only inversely correlated with CR rate among HR-positive patients. Importantly, the achievement of CR was largely related to the number of chemotherapy cycles.
Iron deficiency is the most common nutritional problem that affects people of all ages in both industrialized and developing countries. Especially, college women are the target population for dietary iron deficiency. Recent study showed that the nutritional status of college women was poor because of insufficient food consumption and repeatabled weight reduction. The purpose of this study was to investigate the effects of nutrition counseling on the diet quality, nutritional status of iron and hematic parameters in college women who have self-recognized anemic symptoms. Anthropometric and dietary assessments as well as blood analysis, were carried out before and after the 8 weeks of nutrition counseling. During the experimental period, the 31 subjects were given nutrition education by a clinical dietitian. Nutrition counseling consisted of pathology of anemia, nutrition information for iron deficient anemia, diet information of balanced meals and menu choices for eating out. As a result, the frequencies of consumption of legumen and vegetables significantly increased after nutrition counseling(p<0.05). Daily intakes of protein, especially animal protein, vitamin E, niacin, heme iron, and zinc significantly increased(p<0.05). After nutrition counseling, some self-reported clinical symptoms such as 'dizziness', 'fatigue', 'short of breath', 'headache', 'sleeplessness', and 'beating heart' were significantly improved. Serum levels of transferrin(p<0.01) and total iron binding capacity levels(p<0.05) significantly increased. It could be concluded that the 8 weeks of nutrition counseling might be effective on quality of diet as well as iron status and it might also improve the some hematic parameters in college women who have self-recognized anemic symptoms.
Kim, Jin Kyu;Shin, Jun Jae;Park, Sang Keun;Hwang, Yong Soon;Kim, Tae Hong;Shin, Hyung Shik
Journal of Korean Neurosurgical Society
/
제54권4호
/
pp.296-301
/
2013
Objective : We conducted a retrospective study examining the outcomes of intracerebral hemorrhage (ICH) in patients with chronic kidney disease (CKD) to identify parameters associated with prognosis. Methods : From January 2001 to June 2008, we treated 32 ICH patients (21 men, 11 women; mean age, 62 years) with CKD. We surveyed patients age, sex, underlying disease, neurological status using Glasgow Coma Scale (GCS), ICH volume, hematoma location, accompanying intraventricular hemorrhage, anti-platelet agents, initial and 3rd day systolic blood pressure (SBP), clinical outcome using the modified Rankin Scale (mRS) and complications. The severity of renal functions was categorized using a modified glomerular filtration rate (mGFR). Multifactorial effects were identified by regression analysis. Results : The mean GCS score on admission was $9.4{\pm}4.4$ and the mean mRS was $4.3{\pm}1.8$. The overall clinical outcomes showed a significant relationship on initial neurological status, hematoma volume, and mGFR. Also, the outcomes of patients with a severe renal dysfunction were significantly different from those with mild/moderate renal dysfunction (p<0.05). Particularly, initial hematoma volume and sBP on the 3rd day after ICH onset were related with mortality (p<0.05). However, the other factors showed no correlation with clinical outcome. Conclusion : Neurological outcome was based on initial neurological status, renal function and the volume of the hematoma. In addition, hematoma volume and uncontrolled blood pressure were significantly related to mortality. Hence, the severity of renal function, initial neurological status, hematoma volume, and uncontrolled blood pressure emerged as significant prognostic factors in ICH patients with CKD.
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