Journal of Korean Academy of Nursing Administration
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v.13
no.1
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pp.74-81
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2007
Purpose: This study focuses on doctors' role expectation and patients satisfaction with the referral centers to get necessary basic Method: There were 495 subjects in this study. 245 of them were doctors working in the 397 clinics and hospitals which have made contracts with the referral center in Y General Hospital located in J city, and 250 were patients who had been treated in it. The data were collected from Sep. 25 to Oct. 21, in 2006. Data analysis was processed with SPSS/WIN 14.0 electronically. Results: Concluding cooperative treaties with other clinics and hospitals, doctors expect the following effects: First, the improvement of the treatment quality of patients. The patients satisfaction ranking order for using referral centers is as follows: kindness of the staff, treatment reservation, doctor's satisfying explanation. providing one-stop service, reduction of waiting time for treatment, evasion of repetitive tests. Conclusion: Referral centers should provide various services totally and actively which reflect the role expectation and satisfaction of doctors and patients altogether.
Background: The efficacy of erlotinib is controversial in patients with unknown EGFR mutational status. The aim of this study was to identify the clinicopathological factors that are predictive of erlotinob treatment outcomes for NSCLC patients with unknown EGFR mutational status. Materials and Methods: A retrospective analysis of 109 patients with advanced NSCLC who had previously failed at least one line of chemotherapy and received subsequent treatment with erlotinib (150 mg/day orally) was performed. A Cox proportional hazard model for univariate and multivariate analyses was used to identify the baseline clinical parameters correlating with treatment outcome, expressed in terms of hazard ratios (HRs) and 95% confidence intervals. Results: The median treatment duration was 15 weeks (range, 4-184). The disease control rate was 55%, including disease stability for ${\geq}3$ months for 40% of the patients. Median progression-free survival and median overall survival (OS) were 4.2 and 8.5 months, respectively. The Cox model indicated that an Eastern Cooperative Oncology Group performance status (ECOG PS) ${\geq}2$ (HR 3.82; p<0.001), presence of intra-abdominal metastasis (HR 3.42; p=0.002), 2 or more prior chemotherapy regimens (HR 2.29; p=0.021), and weight loss >5% (HR 2.05; p=0.034) were independent adverse prognostic factors for OS in NSCLC patients treated with erlotinib. Conclusions: This study suggests that NSCLC patients should be enrolled in erlotinib treatment after a first round of unsuccessful chemotherapy to improve treatment success, during which they should be monitored for intra-abdominal metastasis and weight loss.
Objectives: To report the improvement of chemotherapy-induced peripheral neuropathy and pantalgia with integrative cancer treatment on adverse effects of chemotherapy in a breast cancer patient. Methods: A 63-year-old female patient who has been diagnosed with breast cancer got treated for 103 days with integrative cancer treatment including acupuncture, moxibustion, herbal medicine, physiotherapies, hand and foot bath to decrease side effects of chemotherapy. The patient was also treated Western immunotherapies like Thymosin, Viscum album. Paclitaxel, Carboplatin, Doxorubicin, Cyclophosphamide was applied and chemotherapy-induced peripheral neuropathy(CIPN), pantalgia and nausea occured. The efficacy of treatment was measured by a numeric rating scale(NRS) of symptoms, National Cancer Institute Common Terminology Criteria for Adverse Event(NCI-CTCAE) and Eastern Cooperative Oncology Group(ECOG) Performance Status Scale. Results: The NRS scroes for CIPN, pantalgia, nausea were improved. There was no adverse effects of 3 or higher assessed by the NCI-CTCAE. The ECOG grade improved from grade 2 to 1. Conclusions: This study suggests that integrative cancer treatment could improve CIPN, pantalgia after chemotherapy in breast cancer.
Objectives: This study was conducted to reflect the public's perspective when developing Korean Medicine (KM) Clinical Practice Guideline (CPG) for nausea and vomiting of pregnancy (NVP). Methods: 317 respondents who had experienced nausea and vomiting during current or past pregnancy completed the questionnaire online, and we analyzed their answers. Results: 1. 24% of all respondents had received KM treatment. The most common reason for choosing KM treatment was "it would be relatively safe for pregnant women and fetuses", and the reason for not choosing KM treatment was "they did not know much about it". 2. Respondents who had experienced KM treatment for NVP had felt the effects of KM treatment (79%), and chose herbal medicine as the most effective and preferred treatment. 3. 64.1% of respondents who had not experienced KM treatment for NVP preferred cooperative treatment with Western medicine. They answered that herbal medicine would be the most effective treatment, but preferred acupuncture. 4. The most important factor when treating NVP was "the safety of treatments". 59% of all respondents perceived KM treatment is safe for NVP. The treatments perceived as safest were herbal medicine and acupuncture, while the treatments with the least safety information were pharmacopuncture and electro-acupuncture. 5. Treatments that medical consumers were comprehensively interested in were acupuncture, KM treatment & Fluid, herbal medicine, moxibustion, and acupressure, in order. Conclusions: This study revealed the public's experience of using medical care, preference and perception of KM treatment for NVP. Therefore we would reflect the patients' clinical needs in the CPG.
Park, Hyeong-Jun;An, Ji-Hye;Lee, Jin-Soo;Jung, Yee-Hong;Lee, Sang-Hun;Cheon, Seong-Ha;Jung, Hyun-Sik;Kim, Kyung-Suk;Choi, Won-Cheol
Journal of Korean Traditional Oncology
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v.15
no.1
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pp.71-77
/
2010
This case report documents a case in which the administration of an herbal product, an extract of the lacquer tree, Rhus verniciflua Stokes was related with a prolonged survival in a elderly advanced non-small cell lung cancer(NSCLC) patient. A 79-year-old man who had been diagnosed with advanced NSCLC refused conventional therapy and treatment with the allergen-removed Rhus verniciflua Stokes(aRVS) had continued from September 2007 to July 2010. He had survived for 35 months after the administration of aRVS and maintained good performance status with European Cooperative Oncology Group performance status(ECOG PS) of 1. This case suggests that aRVS be alternative treatment for the elderly advanced NSCLC patients.
Objectives: This survey was performed to investigate attitudes of western medicine doctors (WMD) and Korean medicine doctors (KMD) toward Korean medicine education (KME) to provide basic data for developing effective KME programs. Methods: We selected study objects in western medicine (WM) - Korean medicine (KM) collaborative institutions and structured questionnaires were administered to both WMD and KMD for comparison. The data from 167 WMD and 135 KMD were analyzed statistically by frequency, ${\chi}^2$ test and T-test analysis. Results: 61.1% of WMD have never experienced KME and 15% were not interested in cooperative practices and research. Most KME was done in medical schools (45%) and only 5% in residency education. WMD interested or experienced in cooperation have had more KME than the uninterested and inexperienced groups. Intentions of WMD to cooperative practices and research made a difference on the willingness to take KME, while relevant experiences didn't. WMD and KMD differed in ideas about major KME topics; WMD put the greatest emphasis on the herb-drug interaction, while KMD did on KM diagnosis and treatment. They also have different views on the optimal KME course load. Conclusions: For successful collaboration, more continuing KME and motivation for cooperation is required for WMD. Improvements are also needed in the form and contents of KME to meet the demands of learners.
Purpose: The purpose of this study is to understand currently active Korean paramedics' disaster response abilities, including immediate response, severity classification, patient treatment, and patient transfer, in a disaster situation with multiple casualties. Methods: A structured questionnaire consisting of a total of 25 questions was used, including 5 questions on the subject's general characteristics and 20 questions on disaster-related emergency response abilities. Results: Among the disaster response abilities of the participants, the patient transport ability scores were high and the cooperative support ability scores were low. In terms of general characteristics, there was a significant difference in age, and it was high in the 40s, and there was a significant positive correlation between each competency. Conclusion: These results suggest that there is an urgent need to develop a systematic and specialized educational system with components inside and outside fire departments related to multiple casualty disasters to improve overall abilities.
Kim, Seo Yun;Myung, Jae Kyung;Kim, Hye-Ryoun;Na, Im Il;Koh, Jae Soo;Baek, Hee Jong;Kim, Cheol Hyeon
Tuberculosis and Respiratory Diseases
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v.82
no.1
/
pp.62-70
/
2019
Background: Epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancers have emerged as key predictive biomarkers in EGFR tyrosine kinase inhibitor (TKI) treatment. However, a few patients with wild-type EGFR also respond to EGFR TKIs. This study investigated the factors predicting successful EGFR TKI treatment in lung adenocarcinoma patients with wild-type EGFR. Methods: We examined 66 patients diagnosed with lung adenocarcinoma carrying wide-type EGFR who were treated with EGFR TKIs. The EGFR gene copy number was assessed by silver in situ hybridization (SISH). We evaluated the clinical factors and EGFR gene copy numbers that are associated with a favorable clinical response to EGFR TKIs. Results: The objective response rate was 12.1%, while the disease control rate was 40.9%. EGFR SISH analysis was feasible in 23 cases. Twelve patients tested EGFR SISH-positive, and 11 were EGFR SISH-negative, with no significant difference in tumor response and survival between EGFR SISH-positive and -negative patients. The overall median progression-free survival (PFS) and overall survival (OS) of 66 patients were 2.1 months and 9.7 months, respectively. Female sex and Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0-1 were independent predictors of PFS. ECOG PS 0-1 and a low tumor burden of extrathoracic metastasis were independent predictors of good OS. Conclusion: Factors such as good PS, female sex, and low tumor burden may predict favorable outcomes following EGFR TKI therapy in patients with EGFR wild-type lung adenocarcinoma. However, EGFR gene copy number was not predictive of survival.
Jung, Yooun Joong;Kim, Young Hwan;Kim, Tae Hyun;Keum, Min Ae;Ma, Dae Sung;Kyoung, Kyu Hyouck;Kim, Jung Jae;Hong, Suk-Kyung
Journal of Trauma and Injury
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v.25
no.4
/
pp.254-260
/
2012
Purpose: Ongoing treatment and care, as well as initial stabilization, are required for trauma patients. With increasing number of sickest trauma patients and shortage of surgeons, the need for advanced practice nurse to provide and coordinate trauma care has been greater. The purpose of this study is to analyze the effect of hiring a trauma clinical nurse specialist and its influence on the treatment of trauma patients. Methods: Based on the employment of the clinical nurse specialist in December 2010, the patients were divided into two groups: patients admitted from January 1, 2010 to November 30, 2010 and patients admitted from December 1, 2010 to December 31, 2011. Retrospectively, data were collected using electronic medical records. The general characteristics, clinical courses, and ICU re-admission rates, collaboration (transfers to other departments and collaborative surgery) were compared. Results: To have a clinical nurse specialist on the trauma team resulted in a statistically significant reductions in the length of general ward hospital stay (p<0.05), the ICU re-admission rate, (p<0.03), the lead-time before transfer to other departments (p<0.05). Conclusion: The clinical nurse specialist, as a professional practitioner, improved the quality of treatment through early detection and management of problems. In addition, as a coordinator, the clinical nurse specialist maintained a cooperative relationship with multi-disciplinary medical personnel. The trauma clinical nurse specialist contributed to the treatment of trauma patients positively through a decrease in ICU re-admission rate and length of hospital stay.
Journal of the Korean Society of Fashion and Beauty
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v.3
no.3
s.3
/
pp.41-47
/
2005
This study was conducted with 60 adult males who visited the Atomi Cooperative Clinic(Atomi Dermatology/Pediatrics/Oriental Clinic) in Seoul between May 2003 and December 2004; they were divided into three groups, each of which consisted of 20 persons, according to the level of erythma and then each group was subdivided to consist of ten according to whether they received skin treatment and care. The standard care provided to two groups involved topical steroids and oriental medicines prescribed by a dermatologist and a oriental doctor, respectively. 5th-grade topical steroid ointment was applied to the face and 3rd-grade to the limbs; a oriental medicine was administered in a lukewarm state half an hour after meals three times a day. To determine how special and systematic skin treatment and care was helpful in treating atopy, a skin treatment system was applied to the experimental group while the control group was provided with standard care alone. By using Mexameter(MX18) manufactured by ck-mpa as a measuring tool, the inflammation level was observed at the right antecubital space during each visit to the clinic. In view of the re suits, introduction of the systemic skin care for A. D to legitimate treatment provided by a medical institution is expected to be an appropriate supplementary treatment for adult patients who suffer from frequent recurrence of atopic dermatitis.
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