• Journal of Chest Surgery
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• 제45권6호
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• pp.396-400
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• 2012

Background: Surgery has been the classical treatment of pectus carinatum (PC), though compressive orthotic braces have shown successful results in recent years. We propose a non-operative approach using a lightweight, patient-controlled dynamic chest-bracing device. Materials and Methods: Eighteen patients with PC were treated between July 2008 and June 2009. The treatment involved fitting of the brace, which was worn for at least 20 hours per day for 6 months. Their degree of satisfaction (1, no correction; 4, remarkable correction) was measured at 12 months after the initiation of the treatment. Results: Thirteen (72.2%) patients completed the treatment (mean time, $4.9{\pm}1.4$ months). In patients who completed the treatment, the mean overall satisfaction score was $3.73{\pm}0.39$. The mean satisfaction score was 4, and there was no recurrence of pectus carinatum in patients who underwent the treatment for at least 6 months. Minimal recurrence of pectus carinatum after removal of the compressive brace occurred in 5 (38.5%) patients who stopped wearing the compressive brace at 4 months. Conclusion: Compressive bracing results in a significant improvement in PC appearance in patients with an immature skeleton. However, patient compliance and diligent follow-up appear to be paramount for the success of this method of treatment. We currently offer this approach as a first-line treatment for PC.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.4031-4035
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• 2016

Background: In the adjuvant treatment of breast cancer, anthracycline and taxane based regimens can be used concomitantly or sequentially. The best order in the sequential regimens has yet to be well established. This study evaluated the feasibility of 4 cycles of adjuvant taxotere ($100mg/m^2$) every 3 weeks followed by 4 cycles of doxorubicin ($60mg/m^2$) and cyclophosphamide ($600mg/m^2$) every 3 weeks. The primary outcome was the safety profile. Secondary outcomes were disease free survival (DFS) and overall survival (OS). Materials and Methods: This non-randomize prospective phase II stud was performed at Jordan University of Science and Technology and its affiliated King Abdulla Teaching Hospital between July 2009 and August 2010. Data collection was closed on May $31^{th}$, 2015 giving a median follow up period of 62 months. The study was approved by the institutional review board and a written informed consent was obtained for each patient. Results: Fifty patients were enrolled. The median age was 53.1 years (range 34-76). One patient (2%) had stage I disease, 17 (34%) stage II, and 32 (64.0%) stage III. Forty-six patients were evaluable for efficacy analysis. The completion rate was 95.7%. No dose modifications were needed. The incidences of grade 3-4 neutropenia and febrile neutropenia were 14 % and 10%. No grade 3-4 non-hematological adverse events were encountered. At a median follow up time of 62 months the OS and the DFS rates were 76.1% and 56.5%. Those for stages I and II combined were 100% and 75%. Conclusions: Taxotere first followed by doxorubicin-cyclophosphamide appears a feasible regimen as evidenced by an acceptable completion rate, a satisfactory safety profile, and an OS and DFS rates comparable to other studies.

• 대한간호학회지
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• 제22권4호
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• pp.421-443
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• 1992

The purpose of this study was to identify patients' perceptions of health professionals' unkind behavior and the effects of this unkind behavior using a Phenomenological research methodology. Understanding of this phenomena should enlighten nurses to interaction and relationship problems between patient and health professionals and thus lead to further research toward enhancing these interaction and relationships. The subjects were 40 adult patients hospitalized in a university hospital in Seoul. They were from 20 to 65 yews old and hospitalized at IM, GS, OS, NS, OB /GY ward. Their hospital days were from 4 to 72. Data were collected from July 29 to August 9, 1991 and from January 6 to 17, 1992. The research questions were “What behavior on the part of health professionals you perceive as unkind and what effect does such behavior have in you\ulcorner”. Responses to the non-structured open-ended questions were audio-recorded during the interviews done by two nurses researchers. Data were analyzed using the phenomenological method of Colazzi. The validity was enhanced by confirmation of the analysis by two nursing clinical researchers, and professor of psychology, and philosophy, all knowledgable of phenomenological research. From the protocols, 146 significant statements about unkind behavior were organized into 38 formulating meanings which were then grouped into six clusters of themes. Patients' Perceived health professional' unkind behavior as being cold, insincere, unconcerned, disregardful, lacking in technical skill, and failing to provide a therapeutic environment. From the protocols, 65 significant statements about the influence of such behavior on patient care were organized into 18 formulating meanings which were then grouped into four clusters of themes. Patients perceived these unkind behavior influencing then emotionally, physically and having negative effects on their compliance with medical and nursing care. The study points to the need for health professionals to understand how their behavior may be perceived by their patients as unkind behavior. Patients perceptions of health professionals' unkind behavior may suggest the opposite desire, that professionals have exellent medical knowledge and skill and that they be sincere, concerned, respectful and warm emotionally toward their patients.

• 대한장애인치과학회지
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• 제14권1호
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• pp.31-35
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• 2018

부산대학교 치과병원 소아치과에 내원한 Shell teeth에 이환된 소아 환자를 전신마취 하에 치료하였다. 임상검사시 다수 치아의 치관 파괴와 치수 노출 및 상악 유전치 잔존치근이 관찰되었다. 방사선검사상 전반적인 유치열에서 정상보다 큰 크기의 치수강과 넓은 치근관 및 얇은 경조직 층이 존재했으며 발생중인 영구치 치배의 형태이상이 관찰되었다. 환자의 언니와 아버지를 포함한 부계 가족 구성원 일부에서 상아질형성부전증 병력이 조사되었다. 치료시 수복이 불가능한 치아는 발거하였고 보존 가능한 치아는 치수치료 및 기성금속관, 복합레진 수복치료를 시행하였다. 치료 결과 환자의 통증이 감소하였고 저작능력이 회복되었다. 주기적인 내원 및 경과관찰이 요구된다.

• 기본간호학회지
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• 제17권4호
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• pp.575-587
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• 2010

Purpose: The purpose of this study was to analyze the research on adherence for secondary prevention in patients with coronary artery disease (CAD) in Korea, and to identify the strategies for improvement that should be included in future studies. Methods: Electric literature searches were conducted for Pubmed, CINAHL, RISS4U, KISTI, DBpia, KoreaMed, National Assembly Library, and National Library of Korea. A total of forty two articles published between 1986 and 2009 were selected based on established inclusion criteria. Results: Forty research papers were related to nursing, and there was only one research paper focused 011 elderly people with CAD. There were no papers using concept analysis, qualitative study. or randomized controlled clinical trial. Almost all definitions of adherence were adopted from outdated compliance definitions with the attribute of 'paternalistic obligation', Measurement tools were not based on theoretical framework of adherence but borrowed from tools for measuring self-care, health behavior, or self-efficacy. Overall patient's adherence was analyzed in most studies, except for a few studies which focused on diet and exercise only. Educational strategy was the main strategy used in intervention studies. Conclusions: The concept of adherence and measurement tools need to be clarified, along with development of the specific adherence interventions according to the type of adherence in patients with CAD.

• 대한치과마취과학회지
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• 제14권4호
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• pp.205-211
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• 2014

Background: General anesthesia is a necessary method for successful dental treatment for children, compromised patients and the disabled who have difficulty in cooperation. The aim of this study was to assess dental treatment under general anesthesia at the department of pediatric dentistry, Ajou university hospital on children and the disabled. Methods: 217 general anesthesia from June 2010 to June 2014 were assessed for this study. Patient's distribution, treatment pattern, reasons for general anesthesia, distribution of combined operation, duration of anesthesia, treatment, frequency of general anesthesia and agents for general anesthesia were examined. Results: The proportion of male, the disabled were higher and above 19 years age group was the highest. Combined operation with otolaryngology was highest. Main reasons for general anesthesia were mental retardation for the disabled and uncooperative behavior for the non-disabled. Percentage of restorative treatment was the highest. Average anesthesia duration was 186 minutes and average treatment time was 143 minutes. Most of the airway was maintained by nasotracheal intubation and induction was done by sevoflurane. Conclusions: General anesthesia for dental treatment has been increasing for children, the disabled who have a difficulty of cooperation. The demand for dental treatment under general anesthesia is expected to continuously increase. Therefore, continuous research and studies should be done to establish efficiency and safety of general anesthesia and provide an enhanced environment for treatment.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2329-2336
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• 2016

Background: Despite the existence of established guidelines advocating the use and value of chemotherapy order templates, chemotherapy orders are still handwritten in many hospitals in Lebanon. This manuscript describes the implementation of standardized chemotherapy order templates (COT) in a Lebanese tertiary teaching hospital through multiple steps. Initial Assessment: An initial assessment was conducted through a retrospective appraisal of completeness of handwritten chemotherapy orders for 100 adult patients to serve as a baseline for the project and identify parameters that might afford improvement. Choice of solution: Development of over 300 standardized pre-printed COTs based on the National Comprehensive Cancer Network templates and adapted to the practice culture and patient population. Implementation: The COTs were implemented, using Kotter's 8-step model for leading change, by engaging health care providers, and identifying and removing barriers. Evaluation: Assessment of physicians' compliance with the new practice (122 orders assessed) was completed through two phases and allowed for the identification of areas of improvement. Lessons Learned: Overall, COT implementation showed an average improvement in order completion from 49.5% (handwritten orders) to 77.6% (phase 1-COT) to 87.6% (phase 2-COT) reflecting an increase of 38.1% between baseline and phase 2 and demonstrating that chemotherapy orders completeness was improved by pre-printed COT. As many of the hospitals in Lebanon are moving towards standardized COTs and computerized physician order entry (CPOE) in the next few years, this study provides a prototype for the successful implementation of COT and demonstrates their role in promoting quality improvement of cancer care.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2039-2043
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• 2012

Objectives: Depression is common in cancer patients. However, only limited evidence is available for Asian populations. The authors therefore examine the prevalence of depression in Thai patients with cancer. In addition, associated factors were determined. Methods: This cross-sectional study was conducted in cancer patients admitted to a university hospital during December 2006 - December 2007. The Patient Health Questionnaire (PHQ-9) was used to assess all cancer patients. Suicidal risk was assessed by using the Mini-International Neuropsychiatric Interview (MINI) in the module of suicidal risk assessment. Results: Of 108 cancer patients, 29.6 % were diagnosed with a depressive disorder (mild, 14.8 %; moderate, 5.6 %; severe, 9.3 %). However, only 25.0 % of these were recognized as being depressed by the primary physician. According to the MINI., 28.1 % of these depressed cancer patients had a moderate to severe level of suicidal risk. In addition, the findings suggest that increased risk of depression is significantly associated with increased pain score, lower number of cancer treatments (< 2 methods), increased educational duration (>13 years), increased age (> 50 years old) and being female. Conclusions: The prevalence of depression is high in Thai cancer patients. However, depressive disorder in those patients is frequently undiagnosed. It is associated with several factors including pain, a number of cancer treatments, education duration, age and sex. To improve quality of life, increase compliance with treatments and prevent of suicide, screening for depressive disorders in this patient group is strongly recommended.

• 한국산학기술학회논문지
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• 제16권11호
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• pp.7838-7843
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• 2015

본 논문에서는 제 2형 당뇨병의 1차 선택약으로 사용되는 메트포르민 염산염이 통상적으로 1일 1000mg~2000mg의 고용량으로 투여되고 동시에 매우 높은 수성용해도를 가지므로 1일 1회 복용을 위한 약물방출제어시스템에 다량의 서방성 부형제를 필요로 하여 제형의 크기가 커져 복용이 어려운 문제점이 있다. 따라서 이를 개선하고자 상대적으로 수성용해도가 낮은 새로운 메트포르민 산부가염을 합성하여 서방성 정제에 적용하여 메트포르민의 방출을 확인하고자 하였다. 이를 위해 메트포르민 염산염을 원료로 하여 NaOH하에서 메트포르민 base를 만들고 여기에 산부가염을 반응시켜 6개의 새로운 메트포르민 산부가염들을 합성하였다. 또한 이들의 수성용해도를 측정하여 메트포르민 염산염에 비해 현저히 낮은 수성용해도를 가지는 메트포르민 스테아린산염을 확인하였고 메트포르민 서방성 제형에 적용하여 실제 약물의 방출제어에도 용출시험 결과, 12시간에서 약 2배의 약물방출제어 효과를 확인하였다. 결론적으로 새로운 메트포르민 산부가염을 통해 서방성 부형제의 양을 줄여 제형의 크기를 줄임으로써 보다 높은 환자의 복약순응도를 기대할 수 있을 것이다.

• 한방비만학회지
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• 제19권1호
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• pp.42-55
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• 2019

Objectives: Acceptability of patients towards obesity treatment program is associated with better weight loss outcomes. The purpose of this study was to review previously published study results of the predictive factors associated with patients' acceptability in obesity treatment. Methods: Authors searched for the articles related to acceptability reported as continuation, attendance and adherence, published from 2011 to 2018 found on Pubmed, Scopus, Research Information Sharing Service, and Koreanstudies Information Service System. A total of 23 articles were finally selected. From the study results, unchangeable and changeable predictors were extracted, and these predictors were examined according to detail categories. Results: Regarding the continuation of the treatment, unchangeable factors such as younger age, lower educational level, male sexuality and lower accessibility to physical activity predicted lower continuation. Furthermore, changeable factors such as early and half weight loss, better accessibility to the treatment and financial incentives for retention predicted higher continuation rate. Greater degree of attendance was predicted by unchangeable factors such as economical affordability, and changeable predictors such as half weight loss and proximity to the clinic. Main factors of adherence to the recommendation were unchangeable predictors such as weight loss experience, and changeable predictors such as more physical activity and appropriate dietary habits. Negative psychological state predicted lower continuation, attendance and adherence rate. Conclusions: Our review results suggest that unchangeable and changeable predictors of acceptability of patients should be carefully examined during treatments of obesity.