• Title, Summary, Keyword: patient factors

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The Cumulative Recurrence Rate of Colonic Adenomatous Polyps After Colon Polypectomy in a Single University Hospital Health Check-up Examinees (일개 대학병원 건강검진 수진자를 대상으로 한 선종성 대장용종절제술 후 대장용종의 누적재발률)

  • Hwang, Hye-Lim;Jung, Woo-Geun;Kim, Yun-Jin;Lee, Sang-Yeoup;Cho, Byung-Mann;Yi, Yu-Hyeon;Cho, Young-Hye;Tak, Young-Jin;Jeong, Dong-Wook;Lee, Jeong-Gyu
    • Journal of agricultural medicine and community health
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    • v.39 no.3
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    • pp.137-145
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    • 2014
  • Objectives: Colonoscopy is a popular tool for screening for colon cancer throughout the world. The incidence of polypectomy and follow-up colonoscopy are persistently increasing but the studies about follow-up test after polypectomy are still lack of its domestic sources. This study is designed to look into the recurrence rate of colon polyps and risk factors after polypectomy. Methods: This is a retrospective study by reviewing medical charts of 147 patients who underwent polypectomy and follow-up colonoscopy from Jan. 2000 to Mar. 2008. The Kudo classification was used to describe the polyps found in the colonoscopy. The follow-up period was defined as the term between polypectomy and the first colonoscopy follow up. Results: Seventy six point two percent of the enrolled patient were male and the mean age was $56.5{\pm}8.1$. Mean follow-up period was $24.9{\pm}13.7$ (6 - 65) months. The cumulative recurrence rate of 1 year was 11.6%. The rate of 2 years was 36.7% and that of 3 years was 55.8%. The number of polyps was the factor which statistically showed significant relation of its recurrence rate. The histological morphology characteristic of polyps could be one independent factor which may be associated to the recurrence of polyps. Conclusions: The importance of colonoscopy follow up after polypectomy was clearly emphasized through the cumulative recurrence rate of 55.8%. Therefore, there is a need for more domestic studies with a large number of patients about the recurrence of polyps after polypectomy.

Relationship between Vitamin D Level and Survival in Terminally III Cancer Patients (말기암환자에서 혈중 비타민 D 농도와 생존기간과의 관련성)

  • Choi, Sun Young;Choi, Youn Seon;Hwang, In Cheol;Lee, June Young
    • The Korean Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.120-127
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    • 2015
  • Purpose: We aimed to investigate how serum vitamin D levels are related to survival of terminally ill cancer patients. Methods: From May 2012 through June 2013, a retrospective chart review was performed on 96 hospice patients. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with severe vitamin D deficiency and Coxcy and Coxional hazard analyses were used to evaluate effects on survival. Results: The mean vitamin D level in patients was $8.60{\pm}7.16ng/ml$. Vitamin D was severely deficient (<10 ng/ml) in 75 patients (78.2%), deficient (10~20 ng/ml) in 13 patients (13.5%), relatively insufficient (21~29 ng/ml) in five patients (8.3%) and sufficient ((t ng/ml) in three patients (3.1%). Hyperbilirubinemia (${\geq}1.2g/dl$) was the only factor associated with severe vitamin D deficiency according to the multiple logistic regression analysis (Odds ratio, OR=18.48, P<0.05). Although hyperbilirubinemia showed a strong association with survival (Hazard ratio, HR=2.25, P<0.01), no association was found between severe vitamin D deficiency and survival (HR=1.15, P>0.05) in Cox's proportional hazard analysis. Conclusion: Although serum vitamin D levels were severely low in terminally ill cancer patients, we found no association between severe vitamin D deficiency and patient survival.

Evaluation of Dose Change by Using the Deformable Image Registration (DIR) on the Intensity Modulated Radiation Therapy (IMRT) with Glottis Cancer (성문암 세기조절 방사선치료에서 변형영상정합을 이용한 선량변화 평가)

  • Kim, Woo Chul;Min, Chul Kee;Lee, Suk;Choi, Sang Hyoun;Cho, Kwang Hwan;Jung, Jae Hong;Kim, Eun Seog;Yeo, Seung-Gu;Kwon, Soo-Il;Lee, Kil-Dong
    • Progress in Medical Physics
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    • v.25 no.3
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    • pp.167-175
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    • 2014
  • The purpose of this study is to evaluate the variation of the dose which is delivered to the patients with glottis cancer under IMRT (intensity modulated radiation therapy) by using the 3D registration with CBCT (cone beam CT) images and the DIR (deformable image registration) techniques. The CBCT images which were obtained at a one-week interval were reconstructed by using B-spline algorithm in DIR system, and doses were recalculated based on the newly obtained CBCT images. The dose distributions to the tumor and the critical organs were compared with reference. For the change of volume depending on weight at 3 to 5 weeks, there was increased of 1.38~2.04 kg on average. For the body surface depending on weight, there was decreased of 2.1 mm. The dose with transmitted to the carotid since three weeks was increased compared be more than 8.76% planned, and the thyroid gland was decreased to 26.4%. For the physical evaluation factors of the tumor, PITV, TCI, rDHI, mDHI, and CN were decreased to 4.32%, 5.78%, 44.54%, 12.32%, and 7.11%, respectively. Moreover, $D_{max}$, $D_{mean}$, $V_{67.50}$, and $D_{95}$ for PTV were increased or decreased to 2.99%, 1.52%, 5.78%, and 11.94%, respectively. Although there was no change of volume depending on weight, the change of body types occurred, and IMRT with the narrow composure margin sensitively responded to such a changing. For the glottis IMRT, the patient's weight changes should be observed and recorded to evaluate the actual dose distribution by using the DIR techniques, and more the adaptive treatment planning during the treatment course is needed to deliver the accurate dose to the patients.

An Analysis of Factors That Affect Image Quality Deterioration in The Potable X-ray Examination on using Digital Wireless Detector (디지털 무선 검출기를 이용한 이동형 X선검사에서 영상품질 저하의 요인분석)

  • Yu, Young-Eun;Lim, Cheong-Hwan;Ko, Joo-Young
    • Journal of radiological science and technology
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    • v.37 no.2
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    • pp.93-100
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    • 2014
  • Recently the development of portable digital wireless imaging system, which acquires digital radiation images by using wireless LAN telecommunications function in an easy and fast way, provides lots of convenience for people. Considering the characteristics of portable imaging tests on emergency and critical patients, this study aims to suggest guidelines for Digital wireless detector by evaluating the effect of de-centering of focus-grid and displacement of subject in detector on the quality of image. The equipments used for this study were Elmo-T6 Digital Mobile X-ray system (SIMAZU Corp.), el' Tor ($14{\times}17$ "Wireless detector), Grid (10:1) and Chest & head phantom. After acquiring post-processing image according to dose increase and de-centering image of grid-focus and head phantom displacement image, this study compared, analyzed and evaluated these images by using a digital image analysis program by Image J. In the change of images based on dose increase, images were rough in the dose of 0.5 mAs, while there was no difference among images in the proper dose of 1~2 mAs and, especially from 2.5 mAs, average value of pixels radically decreased, affecting contrast. Over 3 mAs, contrast dropped due to saturation phenomenon of lungs. As the result of analysis using Image J program, with the increase of displacement between focus-grid and head phantom, the frequency of low pixel value also increase, causing the outline of surface image to disappear, which in turn affects contrast. For better quality imaging, a radiographer must be aware before the time of test that the image quality can be changed based on the critical patient's posture, movement, respiration, displacement of X-ray tube and distance of imaging.

Comparison of the Awareness and Knowledge of Scrub Typhus between Case and Control Groups (쯔쯔가무시증 환자군과 대조군의 인지도와 지식 비교)

  • Lee, Kwan;Park, Byeong-Chan;Lim, Hyun-Sul;Kweon, Sun-Seog;Choi, Jin-Su;Kim, Jang-Rak;Kim, Keon-Yeop;Ryu, So-Yeon
    • Journal of agricultural medicine and community health
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    • v.37 no.1
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    • pp.1-11
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    • 2012
  • Objectives: To survey the awareness of patient to scrub typhus to provide data for education and communication concerning scrub typhus. Methods: Patients with scrub typhus (case group, n=299) and people without scrub typhus within the previous 2 years (control group, n=598) were matched for age (within 5 years), gender, and occupation (farmer or non-farmer). The participants were recruited from 15 study areas between October and December 2006. Results: The awareness rate of scrub typhus was 75.1%, and was significantly higher than in the case group (79.4% vs. 66.6%, respectively; p<0.01). The major routes of awareness were from 'past history of scrub typhus in family members or neighbors' (54.9%), 'television' (28.3%), and their past history of scrub typhus (5.5%). The average correct rate of scrub typhus was 48.4%, and the correct response rate of cases was significantly higher than controls (p<0.01). Especially, the correct rate of etiology, incubation period, route of transmission, and acquired immunity was <40%. Through conditional logistic regression test, the factor significantly associated with awareness in case group was age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94-0.98). And the factors associated with awareness in control group were female (OR, 1.56; 95% CI, 1.03-2.36) age (OR, 0.98; 95% CI, 0.96-0.99), family history of scrub typhus (OR, 10.18; 95% CI, 1.37-75.99), history of receiving prevention education (OR, 8.47; 95% CI, 1.14-63.00). Conclusions: The rate of awareness was relatively low in study population. Thus, effective working guidelines and educational program to prevent scrub typhus must be developed, and publicity activities about the prevention of scrub typhus are needed for high-risk groups.

Clinical Study on the Survival Rate and Marginal Bone Resorption of Short Implants (짧은 임플란트의 생존율과 변연골 흡수량에 관한 임상적 연구)

  • Myung, Tae-Soo;Jung, Seung-Hyun;Kim, Tae-Young;Kim, Yu-Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.1
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    • pp.1-13
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    • 2012
  • Short implants are used in parts which have anatomical structures like maxillary sinus, inferior alveolar nerve and limited alveolar height due to severe alveolar bone resorption. In these case, there are no need of additional bone augmentation so there are advantages like reduced entire treatment time, reduced patient's discomfort and protection of important anatomical structures. The aim of this study is, in implants whose length is less than 10mm, to analyze the impact of implant length, diameter, location of implant placement, presence of bone graft, presence of prosthesis splinting on survival rates and marginal bone resorption. The samples used in this study were 227 implants, less than 10mm, placed in 137 patients in Wonkwang university dental hospital implant center. From dental charts the information about implant length, diameter, location of implant placement, presence of bone graft, presence of prosthesis splinting were obtained. Emago advanced v5.6(Oral diagnostic systems, Amsterdam, The Netherlands)program was used to measure the amount of marginal bone resorption. Out of total 227 implants, resulting in 96.5 % of survival rate. There was a tendency toward higher failure rates for the maxilla and bone graft site. No significant difference in marginal bone resorption was found associated with length of implants(p>0.05) and neither with the diameter of implants. Among the risk factors examined, more failure rates of short implants can be attributed to poor bone quality in the maxilla and presence of bone graft. At implants under 10mm, length, diameter, location of implant placement, bone graft and splinting of prosthesis didn't affect marginal bone loss.

Effect of Work Improvement for Promotion of Outpatient Satisfaction on CT scan (CT 외래환자의 만족도 향상을 위한 업무개선 연구)

  • Han, Man-Seok;Lee, Seung-Youl;Lee, Myeong-Goo;Jeon, Min-Cheol;Cho, Jae-Hwan;Kim, Tae-Hyung
    • Journal of radiological science and technology
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    • v.35 no.1
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    • pp.45-50
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    • 2012
  • Nowadays, most of the hospital serves "one stop service" for CT scan. The patients could be taken the CT scan in the day they register for scan. On the contrary to the time convenience, patients are not satisfied with long waiting time and unkindness of staff. The objective of this study is to improve the patient's satisfaction for the CT scan, by analyzing inconvenience factors and improving the service qualities. From April 1 to August 30 in 2011, we investigated the satisfaction of patients who did examined abdomen CT scan with contrast media. We analyzed the 89 questionnaires before and after the service improvements from them. The worker's kindness, the environment of CT room and understanding about CT scan were answered by questionnaire and the waiting time of a day CT scan was drawn by medical information statistics. Also, the period before improvement was from April to June and the period after improvement was from July to September. And these questionnaire was analyzed through SPSS V. 15.0. In this study, kindness of staff, environment of CT room, intelligibility for CT scan and waiting time was explored and analyzed by SPSS V.15.0. The score of kindness was improved by 32%, satisfaction level of the environment was improved by 52.54%. The understanding level about CT scan was improved by 52.36% and the wating time of a day CT was shortened by 21% through our service enhancement programs. Consequentially, it is considered that these efforts would contribute to increase the revenue of hospital.

Golf activity after total knee arthroplasty (슬관절 전치환술 후 골프활동)

  • Kim, Hyung-Jun;Cha, Seung-Han;Nam, Kyoung-Mo;Kim, Dong-Heon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.51-56
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    • 2012
  • Purpose: Golf is a popular sports activity after total knee arthroplasty in old age patients. We evaluated golf and implant loosening through the radiologic method. We also evaluated correlation of patterns of golf activity and clinical outcome to suggest guidelines to the patients. Materials and Methods: We carried out a retrospective case-control study of 80 patients (80 knees) who underwent TKR between 2005 and 2008, and followed up more than 3 years. We divided patients who played golf after TKR as a study group and who did not participate sports activities as a control group. We calculated the sum of width of radiolucent line in 7 sections around femoral component, 7 sections around tibial components and 5 sections in patella component using American Knee Society Roentgenographic Evaluation and Scoring system respectively. The inclusion criteria, was BMI (body mass index) was between 25 and $30kg/m^2$, and UCLA activity-level rating System score was between 5 and 8. We also got the information of patients' patterns of golf activities such as 1. the interval from surgery to return to golf activity. 2. the frequency of golf activities 3. using spike or cart. We obtained the information from patient's questionnaire and telephone interview. We compared with the VAS (visual analogue scale) respectively. And handicaps and driving distance was evaluated as well. Results: The study group's mean sum of radiologic score was 0.84 mm and 0.69 mm in control group. This is not statistically significant (p=0.22). Too early returning to golf (p=0.01) and left knee replacement (p<0.01) were statistically significant factors affecting clinical outcomes of golf activities after total knee arthroplasty. Conclusion: We concluded that golf activities after total knee arthroplasty is not correlated with radiographic loosening, and we need to give an explanation to the patients about increased pain when returing to golf too early and left side arthroplasties.

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Clinical Evaluation of Implant-Supported Fixed Prostheses (임플란트-지지 고정성 보철물의 임상적 상태에 대한 평가)

  • Park, Chan-Yong;Yun, Mi-Jung;Huh, Jung-Bo;Jeong, Chang-Mo;Jeon, Yeong-Chan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.317-326
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    • 2013
  • This study was to compare the cumulative survival rate of implant-supported fixed prostheses and to analyze association between risk factors and cumulative survival rate of implant-supported fixed prostheses. In order to assess the clinical status of implant-supported fixed prostheses, individuals who treated in the Department of Prosthodontics, Pusan National University Dental Hospital, between 2000 to 2007 were examined. The results of this study were as follows: 1. Length of service of implant-supported fixed prostheses was $6.6{\pm}32.0$ years (mean), 11.7 years (median). 2. Age and sex of patient was found to have no statistically significant influence on longevity of implant-supported fixed prostheses (P>.05). 3. Reason of tooth extraction wax found to have statistically significant influence on implant-supported fixed prostheses (P<.05). The longevity of fixed prostheses was low in tooth extraction case due to periodontal disease (median:9.0 years). 4. Location of implant-supported fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longevity of fixed prostheses was low in molar region (median:8.8 years). 5. Number of units in implant-supported fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 6. Condition of opposing dentition was found to have no statistically significant influence on longevity of implant-supported fixed prostheses (P>.05). 7. Food impaction (40.5%), porcelain fracture (25.8%), screw loosening (23.6%) were frequent complications.

Analysis of Effect and Prognostic Factors Associated with Catheter Intervention on Ascites in Terminal Cancer Patient (복수가 있는 말기 암환자에서 복수 배액관 시술의 효과와 예후요인 분석)

  • Jang, Mungsun;Kim, Chul-Min;Yoon, Johi;Nah, Jung-Ran;Chang, Seung-Nam;Kim, Myung Ok;Lee, Ja Young
    • The Korean Journal of Hospice and Palliative Care
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    • v.19 no.4
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    • pp.303-309
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    • 2016
  • Purpose: Malignant ascites is a common complication in terminal cancer patients. Less-invasive pigtail catheter insertion is the most frequent procedure in patients who need repeated ascites drainage. This study investigated effects and adverse events associated with catheter insertion for ascites drainage and evaluated prognostic outcomes. Methods: We reviewed medical records between 2010 and 2013 of hospice and palliative care institutions in Seoul, South Korea. Among 2,608 inpatients, 67 patients received ascites pigtail catheter drainage. We reviewed demographic data, palliative performance scale, laboratory data, duration of catheter insertion, prevalence and type of complications, use and duration of antibiotics, and survival time. Univariate and multivariate Cox regression models were used to evaluate prognostic outcomes related with catheter insertion. Results: Ascites drainage was performed most commonly in hepatobiliary and gastric cancer patients. Ascites symptoms improved in 55 patients after the catheter drainage. Adverse events included pain (19.4%), leakage (14.9%), disconnection (7.5%), catheter occlusion (6%) and fever (4.5%). In Cox regression analysis, survival time from the catheter insertion was significantly associated with Palliative Performance Scale (PPS) (HR 0.73; P value 0.045) and serum sodium level (HR 2.77; P value 0.003) in a multivariate model. Conclusion: Patients' PPS and serum sodium level should be considered before making a decision of pigtail catheter insertion.