• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4289-4294
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• 2013

Background: The purpose of this study was to assess the predictive effect of preoperative CEA and CA 19-9 levels on the prognosis of colorectal and gastric cancer patients. Materials and Methods: CEA and CA 19-9 were evaluated preoperatively in patients undergoing surgery for colorectal cancer (n=116) and gastric cancer (n=49). Patients with CEA levels <5 ng/mL were classified as CEA Group 1, 5-30 ng/mL as CEA Group 2 and >30 ng/mL were classified as CEA Group 3. Similarly the patients with a CA 19-9 level <35 U/mL were classified as CA 19-9 Group 1, with 35-100 U/mL as Group 2 and with >100 U/mL as Group and 3. TNM stages and histologic grades were noted according to histopathological reports. Patients with a TNM grade 0 or 1 were classified as Group A, TNM grade 2 patients constituted Group B and TNM grade 3 and 4 patients constituted Group C. Demographic characteristics, tumor locations and blood types of the patients were all recorded and these data were compared with the preoperative CEA and CA19-9 values. Results: A significant correlation between CA 19-9 levels (>100 U/mL) and TNM stage (in advanced stages) was determined. We also determined a significant correlation between TNM stages and positive vlaues for both CEA and CA 19-9 in colorectal and gastric cancer patients. In comparison between CEA and CA 19-9 levels and age, gender, tumor location, ABO blood group, and tumor histologic grade, no significant correlation was found. Conclusions: Positive levels of both CEA and CA 19-9 can be considered to indicate an advanced stage in colorectal and gastric cancer patients.

• Radiation Oncology Journal
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• 제11권2호
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• pp.303-309
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• 1993

Between November 1983 and December 1992, 121 patients with non-small cell lung cancer were treated with radiotherapy alone or combined with chemotherapy in Inje University, Seoul Paik Hospital. Of these,97 patients were evaluable and analyzed retrospectively. Group 1 (n=62)was treated with radiotherapy alone and group 2 (n=35) combined with chemotherapy. There were 7 patients, 1 patient with stage I and II ,20 patients, 11 patients with stage IIIA,28 patients, 20 patients with stage IIIB, and 6 patients, 3 patients with stage IV, respectively. Ninety percent of patients received more than 5000 cGy of radiaton. Median survival of patients in group 1 was 9 months, group 2 was 15 months. Overall 2 year survival rates of group 1 and 2 were $37\%\;and\;27\%$, respectively. Relapse free survival rates at 2 year were $27\%\;and\;15\%$, respectively. Overall survival rates at 5 year for group 1 and 2 were $15\%\;and\;11\%$, and relapse free survival rates were $16\%\;and\;6\%,$ respectively. Median survival of complete and partial responders was 47 months in group 1,18 months in group 2, and those of stable or progression was 6 months,11 months, respectively. The proportion of locoregional relapse and distant metastasis was not significantly different between group 1 and 2. The majority of relapse developed within 2 years. Although 2 cases of severe esophagitis and myelosuppression were noted in group 2, the treatment related toxicity was relatively acceptable. Our analysis showed no statistically significant differences between the two treatment groups in terms of response rate, survival, and sites of relapse.

• Korean Journal of Hospice Care
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• 제4권2호
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• pp.1-8
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• 2004

Purpose: This research aims to assess the effect of group education of hospice and palliative care program on recognition of home hospice care for terminal cancer patients and their family members. Methods: The terminal cancer patients or their family members who have visited Sam Anyang Hospital from January to September in 2004 participated in group education of hospice and palliative care program on one time a week. Of those, 32 patients or family members who were called education group has participated in group education more than 4 times and responded to a questionnaire. Sixty three patients or family members who were called non-education group have never participated in group education of hospice and palliative care program during the same period. Data were collected and done comparative analysis about both group. Results: A knowledge difference on definition of hospice and palliative care come out 29 people(91%) in education group and 26 people(41%) in non-education group. The recognition of home hospice care in education group(32 people, 100%) was significantly higher than non-education group(15 people,24%). A intention to home hospice care in education group(23 people, 72%) was significantly higher than non-education group(10 people,16%) and practically number of home hospice care was 15 people(50%) in education group and 8(13%) in non-education group. The recognition about cancer of patients was not significant differences in both group. People that the response to the question about 'Did you let your patient know to be the terminal cancer patient?' is 'yes' was 12 people(38%) in education group and 13(21%) in non-education group. Patients in education group had insight about terminal cancer significantly higher than non-education group. Conclusion: If we educated effective hospice and palliative care program in terminal cancer patients or their family members, we think the recognition of cancer and hospice and palliative care improve, and the home hospice care be activated more and more.

• Journal of Korean Neurosurgical Society
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• 제43권1호
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• pp.16-20
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• 2008

Objective : Rapid increase in aged population and westernization of lifestyle have modified epidemiological status of stroke. The purpose of this study is to analyze changing trends of stroke epidemiology in South Korea. Methods : We reviewed retrospectively medical records of 1,124 cases diagnosed as stroke among 54,534 patients who visited the Emergency Medical Center at our hospital from January 1994 to December 1996 (Group A). Also, we evaluated 1,705 cases diagnosed as stroke among 55,381 patients who visited to the same hospital from January 2003 to December 2005 (Group B). The variable features of stroke, such as age, sex, seasonal variation and distribution of stroke subtypes were studied by comparing group A with B. Results : In group A, hemorrhagic stroke (67.9%) was more prevalent than ischemic stroke (32.1%). However, group B showed that the ratio of hemorrhagic stroke (40.3%) to ischemic stroke (59.6%) has been reversed. The highest incidence of stroke was noted in their sixties and seventies of age in group B, which was older than that of group A. In group A, male ischemic stroke (IS) patients outnumbered female patients (1.26:1). Moreover, this gender disproportion became higher in group B (1.53:1). In group A, the number of male intracerebral hermorrhage (ICH) patients were similar to that of female patients (0.97:1). However, male ICH patients outnumbered female patients in group B (1.23:1). As for subarachnoid hemorrhage (SAH), female patients outnumbered male patients more than two-fold in both groups. Both groups showed that the occurrence of ischemic stroke was highest in summer, but that of hemorrhagic stroke was the highest in winter. Conclusion : This study showed the changing trends of stroke in its distribution of subtypes. Multicenter prospective study using stroke registry would be required for the determination of national epidemiologic trends.

• Journal of the Korean Dietetic Association
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• 제10권4호
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• pp.442-451
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• 2004

Protein-calories malnutrition is common among patients in the hospital. In particular, elderly patients with neurologic disorders has more risk of nutritional deficiency due to swallowing difficulty. Enteral tube feeding is more economical, physiological and immunological than parenteral nutrition for patients who have adequate gastrointestinal function. This study was conducted patients with neurologic disorders who received enteral nutrition at Asan Medical Center from February 1 to October 10, 2002. The control group (48 patients) were given traditional feeding methods 4 times a day while the treatment group (45 patients) were given improved feeding methods 3 times a day. We assessed nutritional status of patients and compared to both groups. We investigated body weight, serum albumin, hemoglobin, total lymphocyte count by means of nutrition markers. The objectives of this study is to reduce the time needed for nutritional requirement of patients without an increase in gastrointestinal intolerances. The results of this study are as follows: 1. Nutritional status of many patients in both groups were either malnourished or at risk for malnutrition. 2. The time to arrive to the nutritional requirements were 6.21 $\pm$ 0.35 days for the control group and 4.24 $\pm$ 0.52 days for the treatment group. The treatment group showed a significantly shorter amount of time. 3. The changes of the nutritional marker in the control group showed a significant drop in body weight, serum albumin and serum hemoglobin while the treatment group experienced a significant increase in body weight, serum albumin and total lymphocyte count. 4. Feeding intolerane such as diarrhea, high residual volume, ileus, nausea and vomiting were investigated. Diarrhea found in 25.1% (12 patients) of the control group and 22.2% (10 patients) of the treatment group and these findings are not significant.

• Journal of Chest Surgery
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• 제42권4호
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• pp.480-486
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• 2009

Background: The Fogarty thromboembolectomy catheter technique was devised to extract distal arterial emboli and it represents a milestone for the treatment of patients with acute arterial occlusion since the 1960s. The major causes of arterial occlusion have changed from emboli of a heart origin to atherosclerosis over the past 30 years. Accordingly, questions have been raised about the effectiveness of simple Fogarty thromboembolectomy. Material and Method: During the period from March 1990 through August 2008, 156 patients who requiring Fogarty thromboembolectomy were analyzed. The patients were divided into two groups: those with simple Fogarty thromboembolectomy (Group 1, 79 patients) and those with additional vascular bypass graft surgery (Group 2, 77 patients). The duration of symptoms, the cause of thrombi, admission via the emergency room, a history of acupuncture or misdiagnosis, combined diseases, the anatomic occlusion site and the cause of death were analyzed using T-tests, cross tab tests, Chi square tests and Kaplan-Meier tests, respectively. Result: The mean age was 64$\pm$10 years in the 2 groups. The duration of symptoms (pain) in Group 1 vs Group 2 was 12$\pm$4 days vs 71$\pm$14 days (p=0.001). 50 (63%) patients in Group 1 were admitted via the emergency room vs 18 (23%) patients in Group 2 (p=0.005). Misdiagnosis and the treatment for herniated intervertebral disc or acupuncture were given to, 20 (25%) patients in Group 1 vs 30 (39%) patients in Group 2. Anticoagulation treatment before admission was performed in 22 (28%) patients in Group 1 vs 11 (14%) patients in Group 2. The causes of thrombi were heart disease in, 24 (30%) patients in Group 1 vs 6 (8%) patients in Group 2 (p=0.001), atherosclerosis in 46 (58%) patients in Group 1 vs 67 (87%) patients in Group 2 (p=0.001) and trauma in 9 (11%) patients in Group 1 vs 6 (8%) patients in Group 2. The combined diseases were cerebrovascular accident, hypertension and diabetes mellitus in 22 $\sim$ 37% of the total patients. The occlusion sites were mainly in the iliac and femoral arteries. Endarterectomy was performed in 7 (9%) patients in Group 1 vs 18 (23%) patients in Group 2 (p=0.012). Treatment was successful in 27 (34%) patients in Group 1 and in 40 (52%) patients in Group 2 (p=0.019). Reocclusion occurred in 37(47%) patients in Group 1 vs 20 (26%) patients in Group 2 (p=0.000), Amputation was done in 4 (5%) patients in Group 1 vs 12 (16%) patients in Group 2 (p=0.012) and death occurred in 10 (13%) patients (Group 1) vs 3(4%) patients (Group 2) (p=0.044). Conclusion: The recent past has shown a decline in the effectiveness of simple Fogarty thromboembolectomy with a changing pattern of acute arterial occlusion from a rheumatic heart origin to atherosclerosis. Additional bypass procedures play a role for the treatment of arterial occlusion instead of always performing simple Fogarty thromboembolectomy.

• Journal of Korean Academy of Fundamentals of Nursing
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• 제3권1호
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• pp.68-80
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• 1996

Long-term hemodialysis(HD) patients manifest various signs of protein and caloric malutrition due to poor intake of nutrients and other causes. Poor nutritional status increases the mortality and morbidity rates in HD patients. Thus, mataintnance of adequate nutritional status has been a major task in taking care of patients receiving HD. This study was to evaluate the nutritional status of HD patients and to clarify the degree of nutritional deficit based on usual dietary intake, anthropometric and biochemical indicators. Sixty HD patients comprised a HD group, while the control group consisted of 60 healthy adults whose age and sex matched those of the HD group. Nutritional status was evaluated by dietrary intake using instant nutritional scale, anthropometric measures, serum protein concentrations and the number of lymphocytes. The data were analyzed by using Chi-square test and unpaired t-test. The results are as follows. 1. Regarding usual dietary intake of HD group. 1) Estimated caloric intake was significantly lower than the recommended daily allowance(RDA) and among them, 35% were taking calories less than 85% of the RDA. 2) Estimated protein intake was significantly higher than the RDA and among them 40% were taking protein more than 115% of the RDA. 3) Estimated fat intake was lower than the RDA. 4) Vitamin A, B, $B_1,\;B_2$, C and niacin in take was lower than the RDA respectively. 5) Estimated ferrous intake was within the normal limit the RDA while estimated calcium intake was higher than the RDA. 6) Both calorie and protein intake were higher for the 10 patients who had been under continuous ambulatory peritoneal dialysis than for the patients under HD from the beginning. 2. Regarding anthropometric measures : 1) Body mass index(BMI), midarm circumference(MAC), and triceps skinfold thickness(TSF) were lower in the HD group than in the control group. 2) Among HD group, 47.1% were within the normal limit of BMI, while 86.7% were within the same limit in the control group. 3) Among HD group, 35.0% were within the normal limit of MAC, while 83.3% were within the same limit in the control group. 4) Among HD group, only 8.3% were normal, 30.3% were mild deficit status of TSF, while 50% were normal and 48.3% were mild deficit status in the control group. 3. Regarding biochemical laboratory tests 1) Albumin, transferrin concentrations and the number of lymphocytes were lower in HD group than in the control group. 2) Among HD group, 98.3% were within the normal limit of albumin concentration and all were within the same limit in the control group. 3) Among HD group, only 11.7% were within the normal limit of transferrin concentration, while 81.7% were within the same limit in the control group. 4) Among HD group, 25% were within the normal limit, while 93.3% were within the same limit in the control group. The above findings suggest that HD patients were in nutritional deficit status. Adequate diet therapy and periodical evaluation of the nutritional status in HD patients are needed. Accordingly, it turned out that anthropometric measures were very reliable parameters and easy to use to evaluate nutritional status. So nurses are encouraged to adopt anthropometric measures to examine nutritional deficit status of HD patients.

• Journal of Korean Neurosurgical Society
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• 제40권5호
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• pp.357-362
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• 2006

Objective : The incidence of aneurysmal subarachnoid hemorrhage has been increasing. At the same time, surgical results for elderly patients are unsatisfactory and no guidelines of treatment are available. We carried out a study comparing variable factors and surgical results between young and old age groups to find ways to improve prognosis. Methods : A retrospective study was carried out on 754 patients who were operated on between 1990 and 2004 by the same surgeon in our hospital. The patients were divided into seven groups according to age : 93 patients below 40 years of age [Group I], 419 patients aged $40{\sim}59$ [Group II], 115 patients aged $60{\sim}64$ [Group III], 82 patients aged $65{\sim}69$ [Group IV], 28 patients aged $70{\sim}74$ [Group V], 12 patients aged $75{\sim}79$ [Group VI] and 5 patients over the age of 80 [Group VII]. We then checked their medical history, Fisher's grade, Hunt-Hess grade, postoperative complications, and Glasgow Outcome Scale. Results : Age was not a statistically significant factor among patients below 70 years of age [P $value{\ge}0.05$]. But for those aged 70 and older, the age factor had a statistical value [P $value{\le}0.001$]. In addition, there was a close correlation between Hunt-Hess grade IV and V patients, and those with vasospasm, and hydrocephalus after surgery, with poor prognosis in elderly patients as well as young patients [P $value{\le}0.001$]. Conclusion : Advanced age [under the age of 70] dose not precluded adequate surgical treatment in patient with AN SAH, and we should be also alert to preventable causes of delayed neurological deterioration for improving the outcome in all elderly groups.

• Journal of Korean Neurosurgical Society
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• 제49권6호
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• pp.355-358
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• 2011

Objective : Subdural hygroma (SDG) is a complication occurring after head trauma that may occur secondary to decompressive craniectomy (DC). However, the mechanism underlying SDG formation is not fully understood. Also, the relationship between the operative technique of DC or the decompressive effect and the occurrence and pathophysiology of SDG has not been clarified. Purpose of this study was to investigate the risk factors of SDG after DC in our series. Methods : From January 2004 to December 2008, DC was performed in 85 patients who suffered from traumatic brain injury. We retrospectively reviewed the clinical and radiological features. For comparative analysis, we divided the patients into 2 groups : one group with SDG after craniectomy (19 patients; 28.4% of the total sample), the other group without SDG (48 patients; 71.6%). The risk factors for developing SDG were then analyzed. Results : The mean Glasgow Outcome Scale (GOS) scores at discharge of the groups with and without SDG were 2.8 and 3.1, respectively (p<0.0001). Analysis of radiological factors showed that a midline shift in excess of 5 mm on CT scans was present in 19 patients (100%) in the group with SDG and in 32 patients (66.7%) in the group without SDG (p<0.05). An accompanying subarachnoid hemorrhage (SAH) was seen in 17 patients (89.5%) in the group with SDG and in 29 patients (60.4%) in the group without SDG (p<0.05). Delayed hydrocephalus accompanied these findings in 10 patients (52.6%) in the group with SDG, versus 5 patients (10.4%) in the group without SDG (p<0.05). On CT, compression of basal cisterns was observed in 14 members (73.7%) in the group with SDG and in 18 members of the group without SDG (37.5%) (p<0.007). Furthermore, tearing of the arachnoid membrane, as observed on CT, was more common in all patients in the group with SDG (100%) than in the group without SDG (31 patients; 64.6%) (p<0.05). Conclusion : GOS showed statistically significant difference in the clinical risk factors for SDG between the group with SDG and the group without SDG. Analysis of radiological factors indicated that a midline shifting exceeding 5 mm, SAH, delayed hydrocephalus, compression of basal cisterns, and tearing of the arachnoid membrane were significantly more common in patients with SDG.

• Journal of International Academy of Physical Therapy Research
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• 제12권2호
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• pp.2370-2374
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• 2021

Background: Masticating is an activity that is free from temporal or spatial constraints, with an advantage that it can be combined easily with other treatment methods. While several studies have reported a positive effect of the intervention of chewing using the jaw on postural stability, only a few studies were conducted on stroke patients. Objectives: To investigated the effects of masticating chewing gum on the static and dynamic balancing of stroke patients. Design: Randomized cross-over study design. Methods: Nineteen stroke patients were randomly assigned to the chewing group or control group. BT4 was used to measure the static and dynamic balancing abilities. Pre-test measurements were taken before mastication of chewing gum, and post-test measurements were taken after 2 days. The stroke patients in the chewing group were guided to sit on a chair and chew gum for 3 min, and their balancing abilities were simultaneously measured. The balancing abilities of the control group patients were measured while they sat at rest without masticating chewing gum. Results: The chewing group showed significant increases in the measures of static balance (i.e., C90 area, trace length, X mean, and Y mean). In the between-group comparison, the measures of static balance were significantly higher in the chewing group than in the control group. Conclusion: These findings suggest that masticating chewing gum enhanced the static balancing ability of stroke patients. Thus, gum chewing should be considered a viable clinical intervention to control posture in stroke patients.