• Journal of Hospice and Palliative Care
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• v.10 no.4
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• pp.184-189
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• 2007

Purpose: This study was to explore barriers to effective pain management in general population. Methods: Total 163 Participants completed the Barrier Questionnaire-II (BQ-II), a 27-item on a six point scale, from May to June in 2007. BQ-II consisted of four subscales which were 1) physical effects (PE) addressing beliefs that side effects of analgesics are inevitable and concerns about tolerance, fatalism (Fa) addressing fatalistic beliefs about cancer pain and its management, Communication (Co) addressing the beliefs of 'good patient' and concerns of distracting physician from underlying disease, and harmful effects (HE) addressing fear of addiction and harmful effect to immune system of pain medicine. Results: The BQ-II total had an internal consistency of 0.877 in this study. HE was the biggest barrier (3.03) followed by PE (2.73), Fa (2.15), and Co (1.71). Items appeared as great concerns were 'there is a danger of becoming addicted to pain medication'(3.58), 'using pain medicine blocks your ability to know if you have any new pain' (3.18), 'pain medicine is very addictive' (3.09), 'when you use pain medicine your body becomes used to its effects and pretty soon it won't work any more' (3.09), and 'drowsiness from pain medicine is difficult to control' (3.09). Only 12 respondents (7.4%) reported that they took any type of pain education, however, those who took pain education represented significantly lower barriers to pain management than who did not (P=.029). Conclusion: This result suggests the strategies for public education to surmount cancer pain.

• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.205-215
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• 2013

Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

• Pediatric Infection and Vaccine
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• v.13 no.2
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• pp.155-162
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• 2006

Purpose : Appropriate use of antimicrobials is an essential factor to treat infectious diseases and prevent acquisition of antimicrobial resistant pathogens. This study was undertaken to search that application of computerized management program for restriction of antimicrobials use in a hospital is helpful to decrease antimicrobial use density. Methods : Antibiotics utilization committee decided to restrict the use of 16 antimicrobials(14 expensive drugs having fear of drug resistance by pathogens and additional two drugs with inappropriate using tendency). Retrospective evaluation of antimicrobial user numbers between May and July of 2004 and 2005(study group) was conducted to compare with previous use density during same period of 2002 and 2003(control group). Results : Inpatients number of control group($823.5{\pm}37.1$ persons) was more than study group($809.2{\pm}39.3$ persons, P<0.001), but, outpatients number and hospitalized duration were equal in two groups. Antimicrobial user number/100 inpatients per day of glycopeptides and antifungal agents was equal in two groups, and study group was significantly higher density than control group in the use of carbapenems, piperacillin-tazobactam and quinolones(P<0.001). But study group was significantly lower density than control group in the use of drugs with inappropriately using tendency and expensive cephalosporins having broad antimicrobial spectrum(P<0.001). Conclusion : Application of computerized management program for restriction of antimicrobials use in a hospital is effective to decrease the use density of antimicrobials with inappropriately using tendency, but it is an insufficient measures for the restricted use of other antimicrobials on the whole.

• Journal of radiological science and technology
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• v.33 no.2
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• pp.127-132
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• 2010

The purpose of this study is to measure scattered ray which is occurred except for Z-axis range of the detector in MDCT's iso-center and present the basic data about the standard for reduction of scattered ray. The development of MDCT brings out the enlargement of beam thickness to the patient's Z-axis, which distributes to the increase in exposure dose according to the rise of scattered ray. Also MDCT brings out the increase of scattered ray about 4times more than SDCT. To evaluate scattered ray according to the change of beam thickness on MDCT, we measured scattered ray of MDCT's Z-axis beam thickness by using one 16-slice CTs and two 64-slice CTs. We used the ionization chamber 60ml 2026C as the equipment of measurement. In our results, we found out that the change of scattered ray according to the beam thickness in the same kVp has increase of scattered ray. Secondly we found out the increase of scattered ray according to the increase of kVp. Lastly we found out the decrease of scattered ray according to the increase of the distance from the ionization chamber.

• Radiation Oncology Journal
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• v.15 no.4
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• pp.339-348
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• 1997

Purpose : To evaluate the role of postoperative radiation therapy after curative resection of sigmoid colon cancer Materials and Methods : From 1988 to 1993, a total of 93 Patients with curative resectable sigmoid colon cancer of modified Astler-Coiler (MAC) stage B2, B3, C2, C3 was divided into two groups on the basis of those who received radiation treatment and those who did not. Forty-three patients who treated by surgery alone were classified as postop RT (-) group The remaining 50 patients who underwent postoperative radiotherapy were classified as postop RT (+) group. In all patients in Postop RT (+) group. radiation therapy was delivered using 4 or 10 MV linear accelerators to treat the tumor bed with approximately 5cm margin to a total dose 50.4-61Gy(median 54Gy) in 1.8Gy per fraction. Thirty-two patients were treated. with 5-Fluorouracil based adjuvant chemotherapy at least 3 cycles. but these was no significant difference between two groups. Treatment failure Pattern, 5-year local failure-free survival rates (LFFS), and 5-year disease-free survival rates (DFS) were compared between two groups. Result : Five year LFFS and DFS were $85.1\%,\;68.5\%$, respectively, In Postop RT (-) group, LFFS was $76.2\%$ compared with $91.7\%$ in Postop RT (+) group. Improved LFFS and DFS were seen for patients with stage C3 sigmoid colon carcinoma with postoperative radiation therapy compared with postop RT (-) group (P=0.01, p=0.06 respectively), in stage B3, LFFS washigher in postop RT (+) group than that in Postop RT (-) group. although itwas not significant. Especially, local control was higher in stage 74 inpostop RT (+) group than that in postop RT (-) group, Conclusion : This studv showed significantly improved LFFS and DFS in MAC Stage C3 and improved tendency of LFFS and DFS in MAC Stage B3 disease. Large scale prospective study is required to verify the role of adjuvant radiation therapy in resectable sigmoid colon cancer.

• Journal of the Korean Society of Radiology
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• v.1 no.1
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• pp.17-23
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• 2007

Background: Cerebrovascular diseases are known to show different patterns of incidence among regions and races. Therefore, it is very important to determine the incidence pattern of a specific area in order to diagnose, treat and prevent cerebrovascular diseases. The objective of the present study is to analyze quantitatively the incidence ratios of hemorrhagic and ischemic cerebrovascular diseases by season, by gender and by age. Methods: The subjects of this study were 1603 patients hospitalized for hemorrhagic or ischemic cerebrovascular diseases at the Department of Neurosurgery or the Department of Neurology of a University Hospital. Statistical analysis of data used Excel 2003 of Microsoft, and t-test was conducted using ORIGIN 6.0 of MICROCAL. Results: In the subjects, the incidence ratios of hemorrhagic and ischemic cerebrovascular diseases for four years, the period of this research, were 38.55% and 61.45%, respectively. The mean and standard deviation of age when hemorrhagic cerebrovascular diseases occurred were 58.20 and 12.60, respectively, and the percentages of subjects in their 40s, 50s, 60s and 70s were all around 20%. On the contrary, the mean and standard deviation of age when ischemic cerebrovascular diseases occurred were 65.01 and 13.59, respectively. The average age of patients with ischemic cerebrovascular diseases was older than that of patients with hemorrhagic brain diseases, and the percentages of those in their 60s, 70s and 80s were 15.53%, 37.06% and 27.72%, respectively. The season when hemorrhagic cerebrovascular diseases appeared most frequently was winter, which was followed by summer, spring and autumn. The season when hemorrhagic cerebrovascular diseases appeared most frequently was spring, which was followed by summer, winter and autumn. Conclusions: In this study, the incidence rates of hemorrhagic and ischemic cerebrovascular diseases were 38.55% and 61.45%, showing the rising percentage of ischemic cerebrovascular diseases. For making adequate prevention and disease control plans, it is considered necessary to make a long-term epidemiological investigation of cerebrovascular diseases.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.1
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• pp.1-12
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• 2018

Purpose: Disorders of organic acid metabolism have various clinical manifestations and it may be life-threatening. The prognoses of affected children are dependent on early diagnosis and treatment. We report this study to find out detection rate of referred samples, clinical manifestations and age distribution after introduction of neonatal screening test using tandem mass spectrometry in Hallym University Chuncheon Sacred Heart Hospital during 8 years and 9 months. Methods: The 2,794 patients referred from Jan. 2007 to Sep. 2015 were divided into four groups according to age. We conducted organic acid analysis of urine samples of patients and analyzed clinical manifestations and distributions of age at the diagnosis. For patients with ambiguous results, reanalysis of urine organic acid after diet restriction, protein loading and restriction, has been done. Results: A total of 626 patients with 20 disorders were diagnosed. Mitochondrial disorders (482 patients) were the most common diagnosis, followed by ketolytic defects (67), 3-hydroxyisobutyric aciduria (32), EPEMA syndrome (8), 3-methylcrotonyl glycinuria (7), glutaric aciduria type II (6) and type I (4), methylmalonic aciduria (3), isovaleric aciduria (3) and medium chain acyl-CoA dehydrogenase deficiency (3). Conclusion: As neonatal screening test using tandem mass spectrometry is increasingly common and medical environment is changed, detection rate of disorders of organic acid metabolism in this study has decreased compared to previous report. Because the deterioration can be prevented by early diagnosis and treatment, many pediatricians have to pay special attention to possibility of the disorders and make an effort for early diagnosis in clinical setting.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.49-55
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• 2005

Purpose: The purpose of this study was to evaluate the quality and problems of Web sites for management of childhood and adolescent obesity. Methods: We evaluated 203 Web sites identified from the search engine, Korean Yahoo, using the word of 'childhood and adolescent obesity'. 203 Web sites were classified according to medical institutions, health information Web sites, beauty shops. etc. We surveyed whether childhood and adolescent obesity distinguished with adult obesity was considered, or not. and researched the unique managements of childhood and adolescent obesity including the cardinal treatment. Results: Of the 203 Web sites, 157(77.3%) provided detailed information about treatment of obesity, 46(22.7%) provided only simple information about one. The sites providing detailed information were composed of 52.2% of oriental medicine clinics, 35.0% of clinic & hospitals including pediatric hospitals. Distribution of the sites about management of childhood and adolescent obesity distinguished with adult's one was only 23% of oriental medicine clinics, but 93% of childrens hospitals. Conclusion: Without considering the speciality of childhood obesity, inaccurate information are distributing on internet web sites. It is necessary for concern and development of advertizing system on the internet distributing accurate information about treatment of childhood obesity.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.169-180
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• 2010

Purpose: This study was to identify the death recognition, meaning in life, and death attitude of participants in the death education program. Methods: A survey was conducted, and 205 data were collected. Descriptive statistics, ${\chi}^2$-test, ANOVA, and Duncan test were used. Results: 1) The followings were the characteristics of death recognition shown by the participants. Over half of the participants said that they had given some thoughts on their deaths, that they had agreeable view on death acceptance, and that diseases and volunteer works made them think about their deaths. Moreover, suffering, parting with family and concerns for them, etc. were the most common reasons for the difficulty of accepting death. As for 'the person whom I discuss my death with', spouse, friend, and son/daughter were the most chosen in this order. Lastly, the funeral type that most of the participants desired was cremation. 2) The means of meaning in life and death attitude were $2.92{\pm}0.29$ and $2.47{\pm}0.25$, respectively. There were significant differences between health status, meaning in life and death attitude. 3) A significant positive corelationship was found between meaning in life and death attitude (r=0.190, P=0.001). Conclusion: For an effective death education program that would fit each individual's situation, an educational content that can make a person understand the meaning of his or her life and death, includes knowledge to lessen the fear and anxiety of death, and helps a person heal from the loss of a family member is absolutely necessary.

• Journal of Hospice and Palliative Care
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• v.16 no.1
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• pp.10-19
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• 2013

Purpose: Home-based care providers were surveyed to assess the effect of collaborative service between Gyeongnam Regional Cancer Center (GRCC) and public health centers (PHCs) in Gyeongnam province. Methods: Twenty home-based care providers who had previously participated in the GRCC-PHC care project were recruited from nine PHCs and were surveyed using a questionnaire developed by specialists. Questions were rated using the 5-point Likert scale ranging from "strongly disagree (-2)" to "strongly agree (+2)" and each score was multiplied by the corresponding number of respondents (n=20) with the maximum score of 40. Results: Between January 2008 and December 2011, 73 patients were registered to the collaborative service: 72 by GRCC and one by PHC. Home-based care providers marked the highest score (23 points) to "The collaborative service contributed to patients and their family's psychological stability" and the lowest score (11 points) to "The collaborative service was generally helpful for home-based cancer management." For possible suggestions to improve the service, the highest score (35 points) was given to "Simplification of the hospitalization process" followed by "Substantial benefits for patients at their visit to the hospital" (34 points). Conclusion: The results revealed several limitations of the GRCC-PHC collaborative care service for terminal cancer patients. The service could be further improved by developing measures to address the limitations and a service model tailored to region-specific needs.