• Journal of Chest Surgery
• /
• 제48권3호
• /
• pp.193-198
• /
• 2015

Background: Patients on dialysis undergoing surgery belong to a high-risk group. Only a few studies have evaluated the outcome of major thoracic surgical procedures in dialysis patients. We evaluated the outcomes of pulmonary resection for non-small cell lung cancer (NSCLC) in patients on hemodialysis (HD). Methods: Between 2008 and 2013, seven patients on HD underwent pulmonary resection for NSCLC at our institution. We retrospectively reviewed their surgical outcomes and prognoses. Results: The median duration of HD before surgery was 55.0 months. Five patients underwent lobectomy and two patients underwent wedge resection. Postoperative morbidity occurred in three patients, including pulmonary edema combined with pneumonia, cerebral infarction, and delirium. There were no instances of in-hospital mortality, although one patient died of intracranial bleeding 15 days after discharge. During follow-up, three patients (one patient with pathologic stage IIB NSCLC and two patients with pathologic stage IIIA NSCLC) experienced recurrence and died as a result of the progression of the cancer, while the remaining three patients (with pathologic stage I NSCLC) are alive with no evidence of disease. Conclusion: Surgery for NSCLC in HD patients can be performed with acceptable perioperative morbidity. Good medium-term survival in patients with pathologic stage I NSCLC can also be expected. Pulmonary resection seems to be the proper treatment option for dialysis patients with stage I NSCLC.

• 동의신경정신과학회지
• /
• 제26권4호
• /
• pp.365-382
• /
• 2015

Objectives: Interpersonal stress is a major cause and aggravating factor of Hwabyung. The purpose of this study was to compare communication type and stress coping style between the Hwabyung patients group and non-Hwabyung patients group. Methods: The total number of study participants was 101. Based on the Hwabyung symptom scale, the study participants were divided into Hwabyung patients group (30 patients) and non-Hwabyung patients group (43 patients; control group), and the others were excluded from the study . All included patients were administered the Virginia Satir’s communication type questionnaire and stress coping scale based on Folkman & Lazarus’s theory. The independent t-test was used to determine the statistical significance between the features of communication types and stress coping styles in each group. In addition, Spearman correlation analysis was used to identify the relationship between communication types and stress coping styles. Results and Conclusions: 1. Communication types differed significantly between the Hwabyung patients group and non-Hwabyung patients group. 2. Hwabyung patients scored significantly higher in each dysfunctional communication type than functional communication type. Scores of placating stance and super-reasonable stance, which were subtypes of dysfunctional communication type, were high in the Hwabyung patients group. The non-Hwabyung patients group scored the highest in Congruent stance, classified as functional communication type. 3. Stress coping style was not significantly different between the two groups.

• 보건행정학회지
• /
• 제16권4호
• /
• pp.128-146
• /
• 2006

The objective of this paper is to examine the proportion and characteristics of non-emergent patients at emergency departments. The observational survey was conducted using a structured form used by emergency medicine specialists or senior residents on June 7-20, 2005. 1,526 patients at ten emergency centers took part in this study. The structural form contained type of insurance, route and means of emergency department (ED) visit, triage based on the Manchester Triage Scale(MTS)-modified criteria, emergency level based on the government defined rule, type of emergency centers (Regional Emergency Medical Center; REMC, Local Emergency Medical Center; LEMC, Local Emergency Agency; LEA), as well as patient's general information. Data were analyzed using SAS statistical program(V.8.2). Descriptive analysis was performed to describe the magnitude of non-emergent patients. ${\chi}^2-analysis$ and logistic regression analysis was performed to identify the nonurgent patients' characteristics. In the MTS-modified criteria, we found a 15.3% rate of non-emergent patients. This rate differed from that of non-emergent patients obtained using government's rule. In particular, there were inaccuracies in the definition of government rule on non-emergent patients, so it is necessary to apply the new government rule regarding classification of non-emergent patients. There were significant differences in the rate of non-emergent patients according to type of ED, means of ED visit, time to visit, and insurance. Non-emergent patients are more likely to visit a D-type ED(LEA having less than 20,000 patients annually), not to use ambulance, to have 'Automobile Insurance, Industrial Accident Compensation Insurance, or pay out-of-pocket'. Non-emergent patients tend to visit ED due to illness rather than injury. Further studies on the development' of triage scale and reexamination of the government's rule on emergency visits are required for future policy in this area.

• 대한물리치료과학회지
• /
• 제18권4호
• /
• pp.11-18
• /
• 2011

Purpose : This study attempts to assist stroke patients lead independent daily life movements by providing basic data for stroke patients' successful rehabilitation program and understanding the relationship between health beliefs of stroke patients and their guardians, and patients' rehabilitation performance level and daily life movement fulfillment ability. Methods : 23 stroke patients receiving treatments at rehabilitation specializing hospital after getting diagnosed with a stroke, along with 23 guardians were selected as research subjects, and health belief was measured by modifying supplementing Byun Young-Hee(2002)'s health belief measurement tool for leg movement disorder patients. Research findings revealed the following relationship between health beliefs of stroke patients and their guardians, and patients' rehabilitation performance and daily life movement fulfillment ability. Results : The patients group's initial MBI score was $33.13{\pm}3.46$, and measurement after four weeks was $38.43{\pm}3.47$. As health beliefs got stronger, MBI score increased significantly(p<.05). Correlation analyses of factors that affect rehabilitation attendance rate showed that perceived susceptibility, seriousness and usefulness were statistically significant, and perceived disability was not statistically significant(p<.05). Guardians' health belief index(susceptibility, seriousness, usefulness, disability) had no correlation with rehabilitation attendance rate. Conclusion : In order to increase daily life movement fulfillment ability of patients who are being treated with stroke, health beliefs must be raised to increase changes in daily life movement fulfillment ability. Therefore, it is believed that managing programs that can increase health beliefs of stroke patients can allow patients obtain positive health beliefs, further increase rehabilitation performance rate of stroke patients as well as independent daily life ability.

• Clinical and Experimental Reproductive Medicine
• /
• 제25권1호
• /
• pp.17-24
• /
• 1998

We have previously demonstrated that specific antigens involved in autoimmunity in endometriosis may be endometrial proteins with molecular weight (mw) of 71, 92, and 103 kilodalton (kDa). The purposes of this study were to determine the incidence of IgG antibodies against these endometrial antigens in peritoneal fluid of patients with endometriosis and to evaluate the antigenic differences between the endometria of patients with and without endometriosis. Forty peritoneal fluid (PF) from 24 patients with endometriosis and 16 patients without endometriosis (control patients) were tested against endometrial protein from patients (n=8) with endometriosis and from control patients (n=10) by western blot. Fifteen (62.5%) of 24 PF samples from patients with endometriosis had specific Immunoglobuiin (Ig) G antibodies against one of three endometrial proteins with mw of 71, 92 and 103 kDa but none of PF samples from control patients had these antibodies. The electrophoretic pattern of endometrial proteins from patients with endometriosis was similiar to that from control patients. Furthemore there was no significant difference in specific PF Immunoglobulin G binding to endometrial proteins regardless of origin of these proteins. Our data indicate that specific humoral immune response can be found in PF of patients with endometriosis and that specific antigens inducing this immune response are present in human endometrium and that there is no antigenic difference between the endometria of patients with and without endometriosis.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제17권4호
• /
• pp.271-280
• /
• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

• The Korean Journal of Pain
• /
• 제32권3호
• /
• pp.187-195
• /
• 2019

Background: Steroid injections are commonly used in pain clinics to relieve pain and treat inflammation. In Korea, these steroid injections are well known as 'ppyeojusa', which means to inject into the bone in Korean. Some patients often have a negative perception of this treatment method due to inaccurate information about the treatment and side effects of steroids. The purpose of this study is to investigate patients' perception and knowledge of ppyeojusa. Methods: A questionnaire about ppyeojusa was completed by patients who visited one of the pain clinics in nine university hospitals, from August 1 to September 10, 2017. Results: Three-hundred seventy-four patients completed the survey. Eighty-five percent of patients had had ppyeojusa, and 74% of the respondents had heard of ppyeojusa from the mass media, friends or relatives. Only 39% of the patients answered that this injection was safe without side effects if properly spaced. Of the patients surveyed, 21% responded that ppyeojusa are "injections into the bone"; while 15% responded that ppyeojusa are "terrible injections that melted 'the bone if used a lot'". Half of the patients did not know what the active constituent is in ppyeojusa. If steroid injections are advised by the pain specialists, 89% of the patients would consent. Conclusions: Most pain clinic patients have heard of ppyeojusa. Most patients obtained information about ppyeojusa from mass media, rather than their physicians. Therefore, it is likely that most patients have inaccurate knowledge.

• Journal of Gynecologic Oncology
• /
• 제29권6호
• /
• pp.90.1-90.12
• /
• 2018

Objective: We performed small-scale mutation and large genomic rearrangement (LGR) analysis of BRCA1/2 in ovarian cancer patients to determine the prevalence and the characteristics of the mutations. Methods: All ovarian cancer patients who visited a single institution between September 2015 and April 2017 were included. Sanger sequencing, multiplex ligation-dependent probe amplification (MLPA), and long-range polymerase chain reaction (PCR) were performed to comprehensively study BRCA1/2. The genetic risk models BRCAPRO, Myriad, and BOADICEA were used to evaluate the mutation analysis. Results: In total, 131 patients were enrolled. Of the 131 patients, Sanger sequencing identified 16 different BRCA1/2 small-scale mutations in 20 patients (15.3%). Two novel nonsense mutations were detected in 2 patients with a serous borderline tumor and a large-cell neuroendocrine carcinoma. MLPA analysis of BRCA1/2 in Sanger-negative patients revealed 2 LGRs. The LGRs accounted for 14.3% of all identified BRCA1 mutations, and the prevalence of LGRs identified in this study was 1.8% in 111 Sanger-negative patients. The genetic risk models showed statistically significant differences between mutation carriers and non-carriers. The 2 patients with LGRs had at least one blood relative with breast or ovarian cancer. Conclusion: Twenty-two (16.8%) of the unselected ovarian cancer patients had BRCA1/2 mutations that were detected through comprehensive BRCA1/2 genetic testing. Ovarian cancer patients with Sanger-negative results should be considered for LGR detection if they have one blood relative with breast or ovarian cancer. The detection of more BRCA1/2 mutations in patients is important for efforts to provide targeted therapy to ovarian cancer patients.

• 구강생물연구
• /
• 제42권4호
• /
• pp.228-234
• /
• 2018

The aim of this study was to determine the condition of supportive periodontal therapy (SPT) in implant patients and the effect of SPT on implant long-term survival. Implants placed at the Dept. of Periodontology, Chonnam National University Dental Hospital over a 5-year period, were traced for up to 8 years. Patients who had visited the hospital at least once a year were defined as regular SPT, and patients who were treated by active periodontal therapy were defined as patients with periodontitis. Kaplan-Meier survival analysis was performed based on the observation periods, and the effect of SPT and history of periodontitis on implant survival assessed by chisquare test. A total of 183 patients (age: 21-91, 98 males and 85 females), and 508 implants were used for this study. Three hundred eight implants were under SPT and 87 implants was under regular SPT. For the patients with periodontitis 136 implants were placed. The 5-year survival rate was 94.8%. The overall survival rate in patients who received SPT was 97.1% and 91.0% for those who did not (p=0.004). The survival rate in patients who received regular SPT was 97.7%, and 96.8% for patients received irregular SPT. The survival rate was 93.4% in patients with periodontitis and 95.2% in patients without periodontitis. Among patients with periodontitis, the survival rate was 100.0% in patients who received regular SPT and 89.2% for irregular SPT (p=0.012). These results suggest that regular SPT improves implant survival rate and is more effective in patients with periodontitis.

• Journal of Trauma and Injury
• /
• 제33권4호
• /
• pp.207-218
• /
• 2020

The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).