• Journal of Chest Surgery
• /
• v.39 no.3 s.260
• /
• pp.255-259
• /
• 2006

The operation for esophageal cancer is both complex and challenging, and may be associated with significant morbidity and mortality compared to other oncologic surgeries. Minimally invasive surgeries have been applied on various kinds of surgery to enhance better recovery with minimal surgical complications. But for the esophageal cancer, it has not been actively applied yet. With improvement in instrumentations and increasing experience with endoscopic surgical techniques, minimally invasive surgical approaches to esophageal cancer are being explored to determine feasibility, results and potential advantages. We experienced eight cases of minimally invasive surgery for esophageal cancer and report here focusing on surgical techniques and tips.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.4
• /
• pp.514-520
• /
• 2000

Objective : Stereotactic psychosurgery is known as one of effective means of treating in some medically intractable psychiatric illness. However, it is unfamiliar and it's long-term clinical result has not reported in our country. The authors evaluated its long-term results of pscychosurgery and discussed its neuroanatomical basis. Methods : Since 1993, eight patients underwent stereotactic psychosurgery for medically intractable psychiatric illnesses. All were referred from psychiatrist of these disorders, one was aggressive behavior, five were obsessive-compulsive disorders(OCD), and two were depression with anxiety disorders. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior, and limbic leukotomy was done for OCD and depression with anxiety. The results of OCD were evaluated with with YBOCS(Yale-Brown obsessive compulsive scale) and VAS (visual analogue scale), CGI(clinical global impairment) in OCD, and OAS(overt aggression scale), MMS, WAIS were checked for the evaluation of aggressive behavior. Hamilton depression scale(HAMD) was used for evaluation of depression. Ventriculography was used in the first five patients and MR-guided stereotaxy was used in recent three cases for localization of target. The lesions were made with radiofrequency lesion generator. Results : With long-term follow up(mean 45 months) in five OCDs, mean YBOCS declined from 34 to 3(n=5). All returned to previous social life. In OAS scores of aggressive behavior during six-year follow up, scores declined from 8 to 2 with clinical improvement. In two patients with depression with anxiety, HAMD declined from 28.5 to 16.5(n=2). There was no operative mortality and no significant morbidity except one case of mild transient urinary incontinence. Conclusion : With these long-term results, authors assumed that stereotactic psychosurgery could be one of safe and effective mtherapeutic methods in several medically intractable psychiatric illness.

• Journal of the Korean Society of School Health
• /
• v.27 no.1
• /
• pp.7-21
• /
• 2014

Purpose: This study aims to evaluate the effects of school-based education programmes to prevent unintentional injuries in 7~19 years old. Methods: To perform a systematic literature survey, the researchers searched three databases - MEDLINE (PubMed), EMBASE and THE COCHRANE LIBRARY - for literature relevant to 'safety accidents in school' (published up to October 2013). The term 'school-based unintentional injuries' was used to sort out studies on injuries. This study adopted a pretest-posttest comparative design and the participants were children and adolescents aged 7 to 19 years. Results: The search yielded 9,553 records, of which eight studies were included in the review. The eight studies examined the effect of school-based education programmes to prevent unintentional injuries. The research revealed that education programmes had a significant impact on knowledge improvement and behavior change. Although two studies of the total eight showed a difference in attitude scores between the experimental group and the control group, the difference was not statistically significant. Conclusion: Despite the changes in education and public policy, trauma-related injuries continue to result in an unacceptably high morbidity and mortality, particularly among young people. More effective school health programs, policies and programmatic interventions are needed to reduce safety accidents and improve health among youth.

• Tuberculosis and Respiratory Diseases
• /
• v.84 no.4
• /
• pp.299-316
• /
• 2021

Background: The lack of effective medications for coronavirus disease 2019 (COVID-19) has led to a trend of drug repurposing such as the case of azithromycin which shows immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results. It is currently unclear whether the available evidence is in favor or against the use of azithromycin in COVID-19 patients. Thus, the aim of this study was to investigate the efficacy and safety of azithromycin in COVID-19 patients. Methods: Four independent reviewers selected relevant studies from PubMed, ScienceDirect, EBSCO, and ProQuest published prior to March 2021. The protocol used in this study has been registered in PROSPERO (CRD42020224967). Results: We included 17 studies and found that the mortality rate (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.76-1.19), need of respiratory support (OR, 1.30; 95% CI, 0.98-1.73), hospitalization rate (standardized mean difference, 0.12; 95% CI, -0.02 to 0.27), and intensive care unit transfer (OR, 1.21; 95% CI, 0.79-1.86) of azithromycin-treated group did not differ significantly (p>0.05) from those of the control group. Azithromycin treatment did not significantly increase the risk of getting secondary infection (OR, 1.23; 95% CI, 0.83-1.82), hypoglycemia (OR, 0.73; 95% CI, 0.38-1.40), gastrointestinal problems (OR, 1.03; 95% CI, 0.73-1.45) or electrocardiogram abnormalities (OR, 1.16; 95% CI, 0.94-1.42). The overall quality of evidence ranged from low to very low. Conclusion: Azithromycin did not result in a superior clinical improvement in COVID-19 patients, although it was well-tolerated and safe to use.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.24 no.6
• /
• pp.546-554
• /
• 2021

Purpose: Malnutrition is a significant issue for pediatric patients with cancer. We sought to evaluate the effectiveness and complication rate of percutaneous endoscopic gastrostomy (PEG) placement in pediatric oncology patients. Methods: A retrospective chart review was performed on 49 pediatric oncology patients undergoing PEG placement at Johns Hopkins All Children's Hospital between 2000 and 2016. Demographic and clinical characteristics, complications, absolute neutrophil count at time of PEG placement and at time of complications, length of stay, and mortality were identified. Weight-for-age Z-scores were evaluated at time of- and six months post-PEG placement. Results: The overall mean weight-for-age Z-score improved by 0.73 (p<0.0001) from pre- (-1.11) to post- (-0.38) PEG placement. Improvement in Z-score was seen in patients who were malnourished at time of PEG placement (1.14, p<0.0001), but not in those who were not malnourished (0.32, p=0.197). Site infections were seen in 12 (24%), buried bumper syndrome in five (10%), and tube dislodgement in one (2%) patient. One patient (2%) with fever was treated for possible peritonitis. There were no cases of other major complications, including gastric perforation, gastrocolic fistula, clinically significant bleeding, or PEG-related death documented. Conclusion: Consistent with previous studies, our data suggests a relationship between site complications (superficial wound infection, buried bumper syndrome) and neutropenia. Additionally, PEG placement appears to be an effective modality for improving nutritional status in malnourished pediatric oncology patients. However, larger prospective studies with appropriate controls and adjustment for potential confounders are warranted to confirm these findings.

• Journal of the Korea Convergence Society
• /
• v.10 no.6
• /
• pp.365-379
• /
• 2019

This review aimed to analyze characteristics and performances of patient and family-centered care interventions and evaluate the convergence effectiveness. Randomized controlled trials were searched, selected, data extracted and quality-assessed using the Risk of Bias in 15 databases. Characteristics suggested from 21 studies were provision of information, education, communication and family and friend participation. There were 89 measurement variables of performances. Patient outcome was measured by mortality, length of hospitalization, etc., indicated as significantly improved in 18 studies. This review has provided evidence that patient and family-centered care improved experience and performance of diverse patients, families and health-care providers. There is need to convergence adopt patient and family-centered care and conduct evidence-based studies for improvement of quality of healthcare and patient safety in the future.

• International Journal of Advanced Culture Technology
• /
• v.7 no.2
• /
• pp.28-33
• /
• 2019

Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.

• Journal of Korean Medicine for Obesity Research
• /
• v.19 no.1
• /
• pp.12-23
• /
• 2019

Objectives: Obesity is associated with a high mortality risk and impairment in health-related quality of life (HRQOL). The aim of this article is to examine the impact of weight loss on HRQOL and which questionnaires sensitively reflect weight loss effects on HRQOL. Methods: PubMed, Scopus, Research Information Sharing Service, and Korean Studies Information Service System were searched for the studies related to weight loss and HRQOL, published from 2009 to 2018. A total of 28 studies were eligible for inclusion. HRQOL results after weight loss from selected studies were classified and reported according to questionnaires. Results: Twenty-two studies reported statistically significant HRQOL improvements after weight loss and especially, all of studies with weight loss of more than 5% reported HRQOL improvements. HRQOL questionnaires were classified as generic, obesity-related and depression questionnaires. The most commonly used questionnaires were Short-Form health survey 36 (SF-36), Impact of Weight on Quality Life-Lite (IWQOL-Lite) and Beck Depression Inventory (BDI) respectively. SF-36 had a tendency to reflect physical health. IWQOL-Lite score was tended to be changed sensitively according to weight change. Depression questionnaires including BDI reported improvement of depression while mental aspects of SF-36 not changed in same studies. Conclusions: Improvements of HRQOL were noted in studies with weight loss of more than 5%. The main questionnaires for evaluating HRQOL were SF-36, IWQOL-Lite and BDI. It is suggested to use these questionnaires together for evaluating multiple aspects of impact of weight loss on HRQOL.

• Journal of Medicine and Life Science
• /
• v.15 no.2
• /
• pp.46-50
• /
• 2018

Cancer, a leading mortality disease following cardiovascular disease worldwide, has high incidence as one out of every four adults in Korea. It was known to be caused by several reasons including somatic mutation, activation of oncogene and chromosome aneuploidy. Cancer cells show a faster growth rate and have metastatic and heterogeneous cell populations compared to normal cells. Cancer stem cells, the most invested field in cancer biology, is a theory to explain heterogeneous cell populations of cancer cells among several characteristics of cancer cells, which is providing the theoretical background for incidence of cancer and treatment failure by drug resistance. Cancer stem cells initially explain heterogeneous cell populations of cancer cells based on the same markers of normal stem cells in cancer, in which only cancer stem cells showed heterogeneity of cancer cells and tumor initiating ability of leukemia. Based on these results, cancer stem cells were reported in various solid cancers such as breast cancer, liver cancer, and lung cancer. Breast cancer stem cells were first reported in solid cancer which had tumor initiating ability and further identified as anti-cancer drug resistance. There were several identification methods in breast cancer stem cells such as specific surface markers and culture methods. The discovery of cancer stem cells not only explains heterogeneity of cancer cells, but it also provides theoretical background for targeting cancer stem cells to complete elimination of cancer cells. Many institutes have been developing new anticancer drugs targeting cancer stem cells, but there have not been noticeable results yet. Many researchers also reported a necessity for improvement of current concepts and methods of research on cancer stem cells. Herein, we discuss the limitations and the perspectives of breast cancer stem cells based on the current concept and history.

• Journal of the Society of Disaster Information
• /
• v.19 no.3
• /
• pp.719-728
• /
• 2023

Purpose: Mobile cranes are machines that contribute to high mortality, and the High Risk Factor (SIF) information, which analyzed 2,574 accidental deaths in the construction industry in the past 6 years (2016~2021), resulted in a total of 61 mobile crane accidents. Despite safety measures in the field, it is not used properly. In this study, we present standard risk assessment indicators that contribute to accident prevention. Method: Through expert interviews, fatal accident case analysis, field analysis, and literature research, we present the standard risk assessment index method of the 4M risk assessment method. Result: As a result of analyzing the risk assessment of eight sites, it was concluded that it cannot make a significant contribution to disaster prevention and should be applied as an improvement measure of the Standard Risk Assessment Index Law. Conclusion: Switching to the standard risk assessment index method at construction sites has been proposed to make it easier for health and safety personnel and workers to use, contributing to the reduction of accidents.