Journal of Information Technology Applications and Management
/
v.31
no.2
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pp.1-13
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2024
The purpose of this study is to identify the quality of life (QOL) and factors influencing the QOL in middle-aged and elderly cancer patients. Among the 2019 data of the Korea Health Panel, data from 498 adults over the age of 40 who were diagnosed with cancer by doctors were analyzed. As a result of the study, the mean QOL of middle-aged cancer patients was 0.90 (±0.09) and that of elderly cancer patients was 0.86 (±0.12). The QOL of middle-aged cancer patients was significantly higher than that of elderly cancer patients. Factors influencing the QOL of middle-aged cancer patients were subjective health status, anxiety, suicidal ideation, and bedridden status. Factors influencing the QOL of elderly cancer patients were subjective health status, bedridden status, economic activity, education level, regular physical activity, stress, and age. In order to improve the QOL of middle-aged and elderly cancer patients, along with interest in the QOL of middle-aged and elderly cancer patients, it is necessary to develop an age-specific intervention program, such as reducing anxiety and suicidal ideation for middle-aged cancer patients, and improving regular physical activity and reducing stress for elderly cancer patients.
Background: Gastric cancer, the fifth most common malignancy in the world, usually affects older individuals but can occur in younger age groups. In this study we compared the clinicopathological profile of young patients of gastric cancer with that of older patients. Materials and Methods: It is a prospective study of gastric cancer patients treated over three year period (January 2012 to December 2014). Data of patients were obtained from the medical record. Clinical and pathological characters of younger patients (age 40 years or less) were compared with older patients (age more than 40 years). Results: There were total of 152 patients treated during the study period. Twenty patients (13.2%) were less than 40 years of age and 132 (86.8%) were older. The male to female ratio in younger patients was 1:1.5 whereas in older patients it was 1:0.6. In the younger age group 14 patients (70%) had poorly differentiated adenocarcinoma in contrast to 45% in the older age group (p<0.01). Some 55% of younger and 42% of older patients had stage IV disease at presentation and curative surgery was not possible. Palliative surgery for gastric outlet obstruction or bleeding from the tumor was performed on 25% and 21% respectively. Conclusions: Gastric cancer in young people aged less than 40 years has unique characters like female predominance, unfavorable tumor biology, and advanced stage at presentation. There should be a high index of suspicion of gastric cancer even in young patients.
Kim, Chong-Ho;Park, Seung-Taeck;Park, Seok-Tae;Kim, Jong-Ho;Kang, Young-Tae
Biomedical Science Letters
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v.16
no.1
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pp.19-24
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2010
We analyzed and compared the concentration of total cholesterol (CHOL), high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and triglyceride (TG) in serum and the serum protein electrophoresis fractions of thyroid disease patients. In comparison with the average of reference, our data showed that the average concentration of CHOL, LDL cholesterol and TG in hyperthyroidism patients were decreased significantly, but HDL cholesterol was increased significantly. In hypothyroidism patients, CHOL, HDL cholesterol, LDL cholesterol and TG were all increased significantly. In comparison of the concentration of lipids in each patient to reference range, 28.3% of hyperthyroidism patients showed abnormally low level of total cholesterol. In the patients with hypothyroidism, the percentage of patients showed abnormally high level of CHOL, HDL cholesterol, LDL cholesterol and TG were 37.7%, 10%, 68.8% and 49.1%, respectively. In our studies of serum protein electrophoresis, the average of ${\alpha}_2$-globulin and $\gamma$-globulin in hyperthyroidism patients were increased and $\beta$-globulin was decreased significantly. In hypothyroidism patients, the average of $\gamma$-globulin was increased and $\beta$-globulin was decreased significantly. In comparison of protein fractions of each patient to reference range, 38.3% and 50.0% of hyperthyroidism patients showed abnormally high levels of ${\alpha}_2$-globulin and $\gamma$-globulin, but 73.3% of patients showed abnormally low level of $\beta$-globulin. In hypothyroidism patients, 70.4% of patients were abnormally decreased in $\beta$-globulin and 63.9% of patients were abnormally increased in $\gamma$-globulin. These data suggest that the concentrations of CHOL, HDL cholesterol, LDL cholesterol and TG are not critical data for clinical interpretation of hyperthyroidism, but the levels of them are useful for interpretation of hypothyroidism patients. Our results of serum protein electrophoresis suggest that the concentration of serum protein electrophoresis fractions can be useful to understand the thyroid disease.
Prolapse of the aortic valve is the main cause of insufficiency of the aortic valve as a complication of ventricular septal defect. Aortic insufficiency gets worse by the progress of prolapse of aortic valve due to lack of support of the valve and the hemodynamic effect of blood flow through the ventricular septal defect. This produces typical clinical picture, that may be serious and threatening when it is untreated. Type and timing for the surgical treatment of the ventricular septal defect with aortic insufficiency is considered. Among 113 ventricular septal defect, 9 patients of ventricular septal defect with associated aortic insufficiency were experienced from June. 1983 to June 1988 at the Department of Thoracic and Cardiovascular Surgery, Chon-Buk University Hospital. Male was 6 patients and female was 3 patients. Ages were from 7 years to 24years. 5 patients were from 10 to 19 years age. 3 patients were below 10 years age. The ratio of pulmonary blood flow to systemic f low [Qp/Qs] was 1.53 and in pulmonary vascular resistance, normal or slight increase was 7 patients, moderate 1 patient, and severe 1 patient. Ventricular septal defect was subpulmonic in 5 patients and infracristal in 4 patients. Prolapse of right coronary cusp was 7 patients, right and non coronary cusp 1 patient and non coronary cusp 1 patient. Teflon patch closure of ventricular septal defect was undertaken in 3 patients and primary closure in 1 patient. Among the 4 patients of defect closure alone, one patient performed valve replacement 7 months later due to progressive regurgitation and cardiac failure and the result was good. The other 3 patients were good result. Closure of ventricular septal defect and aortic valvuloplasty performed in 4 patients. 2 patients of these required valve replacement for the sudden intractable cardiac failure and died due to low cardiac output. The cause of intractable cardiac failure was tearing of repaired valve at the fixed site. The other 2 patients were good result. Closure of ventricular septal defect and valve replacement performed in 1 patient with good result.
The aim of this study is to present the basic reference data of age and specific gait parameters for comparisons of the gait characteristics depended on amputation length of the Unilateral Trans-Tibial Prostheses. The basic gait parameters were extracted from 10 Adult, and 20 below knee(B/K) patients, 50 to 60 years of age using VICON 512 Motion Analyzer. The results were as follows; 1. The mean Cadence of the above knee(A/K) patients and below knee(B/K) patients were $87.77{\pm}8.64$ steps/min, to $99.84{\pm}11.14$ steps/min.(p<0.05) 2. The mean Walking Speed of the above knee(A/K) patients and below knee(B/K) patients were $0.84{\pm}0.15$ m/s, to $0.96{\pm}0.25$ m/s.(p>0.05) 3. The mean Stride Length of the above knee(A/K) patients and below knee(B/K) patients were $1.14{\pm}0.14\;m$, to $1.14{\pm}0.22m$.(p>0.05) 4. The mean maximal angles of joint on the hip flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $34.75{\pm}10.18_{\circ}$, to $32.32{\pm}6.34_{\circ}$.(p>0.05) 5. The mean maximal angles of joint on the knee flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $66.97{\pm}15.08_{\circ}$, to $52.65{\pm}9.21_{\circ}$. (p<0.05) 6. The mean maximal angles of joint on the ankle dorsi-flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $14.41{\pm}4.82_{\circ}$, to $10.04{\pm}3.49_{\circ}$.(p>0.05) 7. The mean maximal angles of joint on the ankle plantar-flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $5.77{\pm}3.17_{\circ}$, to $2.75{\pm}4.49_{\circ}$.(p>0.05)
Lee, Sung Hyun;Yie, Kilsoo;Lee, Jong Hyun;Kang, Jae Gul;Lee, Min Koo;Kwon, Oh Sang;Chon, Soon-Ho
Journal of Trauma and Injury
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v.30
no.2
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pp.33-40
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2017
Purpose: The role for minimally invasive surgery in chest trauma is vague, one that recently is more frequently performed, and one attractive option to be considered. Thoracoscopic surgery may improve morbidity, mortality, hasten recovery and shorten hospital stay. Methods: A total of 31 patients underwent video assisted thoracoscopic surgery for the treatment of blunt and penetrating chest trauma from June 9th, 2013 to March 21st, 2016 in Jeju, South Korea. Results: Twenty-three patients were males and eight patients were females. Their ages ranged from 23 to 81 years. The cause of injury was due to traffic accident in 17 patients, fall down in 5 patients, bicycle accident in 2 patients, battery in 2 patients, crushing injury in 2 patients, and slip down, kicked by horse, and stab wound in one patient each. Video assisted thoracoscopic exploration was performed in the 18 patients with flail chest or greater than 3 displaced ribs. The thoracoscopic procedures done were hematoma evacuation in 13 patients, partial rib fragment excision in 9 patients, lung suture in 5 patients, bleeding control (ligation or electrocautery) in 3 patients with massive hemothorax, diaphragmatic repair in two patients, wedge resection in two patients and decortication in 1 patient. There was only one patient with conversion to open thoracotomy. Conclusion: There is a broad range of procedures that can be done by thoracoscopic surgery and a painful thoracotomy incision can be avoided. Thoracoscopic surgery can be done safely and swiftly in the trauma patient.
Park, Ha Young;Sim, Min Seob;Song, Hyoung Gon;Song, Keun Jeong
Quality Improvement in Health Care
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v.12
no.1
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pp.114-123
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2006
Background : Patients who were discharged from the emergency department(ED) may revisit. These patients are divided into two groups; one is expected scheduled condition, the other is unexpected condition. These patients of inappropriate revisits to the ED would be unsatisfied, difficult to make rapport and take legal action as a result of additional medical charges. The purpose of this study was to reduce inappropriate revisits to the ED with a new method which was developed by analyzing inappropriate revisits in 2002. Methods : This study was conducted in a tertiary hospital consisting of 1,278 beds. The most common cause of inappropriate revisits was the medical team's lack of explanation about a disease. Thus we decided that the effective method was to offer full explanations to patients to understand the clinical pathway of a disease. We made four types of stickers to explain most common 4 diseases in 2003. An emergency physician completed 'discharge explanation report' and explained it to patients in 2004. Results : In 2002 inappropriate revisited patients were 164, patients with four diseases were 79. During the same period of 2003, inappropriate revisited patients were 56 (-65.9%), four disease patients were 6 (-92.4%) and in 2004 inappropriate revisited patients were 52, four disease patients were 19. Causes of revisits were lack of explanation about a disease in 35 patients (44.3%) in 2003, and 5 patients (83.3%) in 2003, and 16 patients (84.2%). Conclusions : Application of 'explanation stickers' at discharge reduced inappropriate revisits from 34.5% in 2002 to 15.9% in 2003. Application of 'Discharge explanation report' by emergency physician reduced inappropriate revisits from 15.9% in 2003 to 13.5% in 2004. Reduction of inappropriate revisits elevated the quality of medical treatment, and decreased patients' dissatisfaction in ED.
Between April 1986 and September 1990, 34 patients with a single or dominant right ventricle underwent modified Fontan procedure for definite palliation in Seoul National University Children`s Hospital. Their age at operation ranged from 8 months to 14 years [Mean 5.5 years]. The ventricular chamber was solitary and of indeterminate trabecular pattern in 6 patients. 28 patients had posteriorly located rudimentary chamber, all of which were trabecular pouches having no communication with outlet septum. The patterns of atrioventricular connection were common inlet[9], double inlet [11], left atrioventricular valve atresia [12] and right atrioventricular valve atresia with L-loop [2]. Pulmonary outflow tracts were atretic in 7 patients and stenotic in 26 patients. Major associated anomalies included anomalous systemic venous drainage [15], dextrocardia [12] and total anomalous pulmonary venous connection[3]. Shunt operations were previously performed in 13 patients and pulmonary artery banding and atrial septectomy in 1 patients. Surgery included intraatrial baffling in 26 patients, bidirectional cavopulmonary shunt in 13 patients, atrioventricular valve obliteration in 3 patients and atrioventricular valve replacement in 3 patients. Central venous pressure measured postoperatively at intensive care unit ranged from 18cm H2O to 28cm H2O [mean 23.2cm H2O]. Hospital mortality was 35.3% [12/34], all died out of low output syndrome. Suspected causes of low output syndrome include ventricular dysfunction [8], hypoplastic or tortuous pulmonary artery [2] and elevated pulmonary vascular resistance [2]. 19 patients had 31 major complications including low output syndrome [18], arrhythmia [4], acute renal failure [3] and respiratory failure [3]. Mortality rate was significantly higher in the groups receiving intraatrial baffling and AV valve replacement respectively [p<0.05]. 20 patients were followed up postoperatively with the mean follow-up period 15.0$\pm$11.6 months. There were no late death and follow-up catheterization was performed in 10 patients. Mean right atrial pressure was 15.4$\pm$6.8mmHg and ventricular contraction was reasonable in all but one case. Thus, Fontan principle can be applied successfully to all the patients with complex cardiac anomaly of single ventricle variety and better results can be anticipated with judicious selection of patient and improvement of postoperative care.
Yu, Tosol;Kim, Hak Jae;Wu, Hong-Gyun;Ha, Sung Whan;Song, Yong-Sang;Park, Noh-Hyun;Kim, Jae-Won
Radiation Oncology Journal
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v.33
no.1
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pp.29-35
/
2015
Purpose: To analyze the prognostic factors for survivals and to evaluate the impact of postoperative whole pelvic radiotherapy (WPRT) on pelvic failure in patients with uterine sarcoma treated with radical surgery. Materials and Methods: We retrospectively analyzed 75 patients with uterine sarcoma who underwent radical surgery with (n = 22) or without (n = 53) radiotherapy between 1990 and 2010. There were 23 and 52 patients with carcinosarcoma and non-carcinosarcoma (leiomyosarcoma, 22; endometrial stromal sarcoma, 25; others, 5), respectively. The median follow-up period was 64 months (range, 17 to 269 months). Results: The 5-year overall survival (OS) and pelvic failure-free survival (PFFS) of total patients was 64.2% and 83.4%, respectively. Multivariate analysis revealed that mitotic count (p = 0.006) was a significant predictor of OS. However, factors were not found to be associated with PFFS. On analyzing each of the histologic subtypes separately, postoperative WPRT significantly reduced pelvic failure in patients with carcinosarcoma (10.0% vs. 53.7%; p = 0.046), but not in patients with non-carcinosarcoma (12.5% vs. 9.9%; p = 0.866). Among the patients with carcinosarcoma, 4 patients (17%) had recurrence within the pelvis and 3 patients (13%) had recurrence in other sites as an initial failure, whereas among the patients with non-carcinosarcoma, 3 patients (6%) experienced pelvic failure and 13 patients (25%) experienced distant failure. Conclusion: The most significant predictor of OS was mitotic count. Based on the improved PFFS after postoperative WPRT only in patients with carcinosarcoma and the difference in patterns of failure between histologic subtypes, optimal adjuvant treatment options should be offered to patients based on the risk of recurrence patterns.
Journal of The Korean Society of Clinical Toxicology
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v.10
no.2
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pp.91-96
/
2012
Purpose: A retrospective study with a literature review was conducted to identify the clinical characteristics and prognosis after the acute ingestion of glacial acetic acid. Methods: The medical records of 20 patients,who had presented to the emergency department of Ajou University Hospital complaining of the acute ingestion of glacial acetic acid between January 2006 and December 2011, were examined retrospectively. Results: Among the 172 patients admitted for caustics injury, 20 patients ingested glacial acetic acid. The mean age of the patients was $55{\pm}23.5$, and the mean volume of the acid was $84.5{\pm}71.3$ ml. The clinical features included 1) oral ulcers in 12 patients (63.2%), 2) respiratory difficulties in 11 patients (57.9%), 3) oliguria in 8 patients (42.1%), 4) renal toxicity in 7 patients (36.8%), 5) hepatic failure in 7 patients (36.8%), 6) disseminated intravascular boagulopathyin 7 patients (36.8%), 7) low blood pressure in 8 patients (42.1%), and 8) mental changes in 9 patients (47.4%). Ten patients required endotracheal intubation. Nine patients were admitted to the intensive care unit, and 5 patients expired. Conclusion: The ingestion of glacial acetic acid can cause severe symptoms, such as metabolic acidosis, multiple organ failure and upper airway swelling frequently and has a high mortality rate. Therefore, aggressive treatment, including endotracheal intubation, should be considered at the early stages.
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