• Title/Summary/Keyword: Day surgery

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The Effect of Increased Dilution Volume and Prolonged Infusion Time of Vancomycin on Incidence of Adverse Reactions through Peripheral Venous Cannulae (말초정맥을 통한 반코마이신희석과 주입시간연장이 부작용발생에 미치는 영향)

  • Oh, Myeong Ju;Kim, Mae Ja
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.196-208
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    • 2000
  • The purpose of the study was to explore the effect of 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hour on the frequency of "red man syndrome", phlebitis and length of peripheral catheter placement of infected patients, in order to provide safe infusion method for reducing vancomycinin-duced RMS and phlebitis. The subjects of the study consisted of 16 hospitalized patients; 3 oncology and gastro-intestinal patients, 1 neurological patient, 6 thoracic surgical patients and 6 orthopedic patients, who had received vancomycin from July to October in 1999 at S-hospital. The dependent variables were the incidence of RMS, phlebitis and the length of peripheral catheter placement. The incidence of RMS was checked by an inspector at the first night whenever the infusion method of vancomycin was changed. RMS was observed every 15 minutes during an hour for symptoms of RMS such as itching, erythema, chest pain and systolic blood pressure. Incidence of phlebitis was assessed by inspector twice a day from the insertion of peripheral catheter to the removal of the catheter. The data were analyzed by percentage, mean, $X^2$-test, t-test, repeated ANOVA, and logistic regression analysis using the SPSSWIN program. The results are summarized as follows; 1. No significant difference was identified in frequency of RMS between the experimental group and control group. 2. There was no significant difference in the change of systolic blood pressure as the time goes on between the experimental group and control group. 3. The incidence of phlebitis was significantly lower in the experimental group than in the control group. 4. The length of peripheral catheter placement was significantly longer in the experimental group than in the control group. 5. Other drugs administrated with vancomycin didn't influence the occurrence of phlebitis. However, the infusion method of vancomycin influenced the occurrence of phlebitis. The results suggest that 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hours may decrease the incidence of phlebitis and increase the length of peripheral catheter placement compared to 1 hour infusion of vancomycin(1g) in 100ml of isotonic saline every 12 hours. However, it does not reduce the incidence of RMS.

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Modified Docetaxel and Cisplatin in Combination with Capecitabine (DCX) as a First-Line Treatment in HER2-Negative Advanced Gastric Cancer

  • Bilici, Ahmet;Selcukbiricik, Fatih;Demir, Nazan;Ustaalioglu, Bala Basak Oven;Dikilitas, Mustafa;Yildiz, Ozcan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8661-8666
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    • 2014
  • Background: Docetaxel and cisplatin in combination with fluorouracil (DCF) regimen is accepted to be one of the standard regimens in the treatment of advanced gastric cancer. However, substantial toxicity has limited its use in daily clinical practice. Therefore, modification of DCF regimens, including introduction of capecitabine has been investigated to improve the safety profiles. In the present study, the efficacy and toxicity of a regimen with a modified dose of docetaxel and cisplatin in combination with oral capecitabine (DCX) was evaluated in untreated patients with HER2-negative advanced gastric cancer. Materials and Methods: Fifty-four patients with HER2-negative locally advanced or metastatic gastric cancer were included in this cohort. Patients received docetaxel $60mg/m^2$ plus cisplatin $60mg/m^2$ (day 1) combined with capecitabine $1650mg/m^2$ (days 1-14) every 3 weeks. Treatment response, survival, and toxicity were retrospectively analyzed. Results: The median age was 54 years (range: 24-76). The majority of patients (70%) had metastatic disease, while 11 patients (21%) had recurrent disease and underwent curative gastrectomy, and 5 patients (9%) had locally advanced disease (LAD). The median number of DCX cycles was 4. There were 28 partial responses and 11 complete responses, with an overall response rate of 72%. Curative surgery could be performed in four patients among five with LAD. At the median follow-up of 10 months, the median progression-free survival (PFS) and overall survival (OS) of the entire cohort of patients were 7.4 and 12.1 months, respectively. Dose modification was done in 12 patients due to toxicity in 8 and noncompliance in 4 patients. The most common hematological toxicity was neutropenia, which occurred at grade 3-4 intensity in 10 of 54 patients (27.7%). Febrile neutropenia was diagnosed only in two cases. Conclusions: DCX regimen offers prominent anti-tumor activity and considered to be effective first-line treatment with manageable toxicity for patients with HER2-negative advanced gastric cancer.

Phase II Study on Pemetrexed-based Chemotherapy in Treating Patients with Metastatic Gastric Cancer not Responding to Prior Palliative Chemotherapy

  • Wei, Guo-Li;Huang, Xin-En;Huo, Jie-Ge;Wang, Xiao-Ning;Tang, Jin-Hai
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2703-2706
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    • 2013
  • Purpose: This study was to determine the efficacy and safety of pemetrexed based chemotherapy in treating patients with metastatic gastric cancer who failed to respond to first and (or) second line chemotherapy. Patients and Methods: Metastatic gastric cancer patients who failed first and (or) second line chemotherapy, were enrolled. All patients were recruited from Jiangsu Cancer Hospital & Research Institute, and were treated with pemetrexed $500mg/m2$ (intravenous; on day 1), and a platinum (or irinotecan) every 3 weeks until disease progression, or intolerable toxicity. Evaluation on efficacy was conducted after two cycles of chemotherapy using the Response Evaluation Criteria for Solid Tumors. Toxicity was recorded according to National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Results: From Jun 2011 to May 2013, 23 patients were enrolled. All eligible 23 patients completed at least 2 cycles of chemotherapy with pemetrexed based chemotherapy, and were evaluable. Their median age was 55 years (range 40 to 78 years). Seventeen patients were male and 6 female. Three patients (13%) achieved partial response, five patients (22%) stable, 15 patients (65%) with disease progression, and none with complete response. Grade 2 neutrophil suppression occurred in 4.3%, grade 3 in 13% of patients, and no grade 4 was reported. Thrombocytopenia was encountered as follows: 4.3% grade 2, 4.3% grade 3 and 4.3% grade 4. Incidence of anemia was 34.8% in grade 2, 8.7% grade 3 and 0% grade 4. Only 4.3% of patients required packed red blood cell infusion. Elevated transaminase were 4.3% in grade 2 and 0% in grade 3 or 4. Other toxicity included oral mucositis. Conclusions: Pemetrexed based chemotherapy is mildly effective in treating patients with metastatic gastric cancer with tolerable toxicity.

Annual Financial Impact of Thyroidectomies for Nodular Thyroid Disease in China

  • Liu, Xiao-Yun;Zhu, Li-Jun;Cui, Dai;Wang, Zhi-Xiao;Chen, Huan-Huan;Duan, Yu;Shen, Mei-Ping;Zhang, Zhi-Hong;Wang, Xiao-Dong;Chen, Jia-Wei;Alexander, Erik Karl;Yang, Tao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5921-5926
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    • 2014
  • A large proportion of patients with thyroid nodules in China undergo thyroidectomy in order to get confirmatory histology diagnosis. The financial impact of this modality remains to be investigated. To evaluate rationality of performing thyroidectomy without a routine FNA preoperatively from the economic perspective, we conducted a retrospective, observational study of all archival thyroidectomies with records of cost per stay (CPS), cost per day (CPD) and length of stay (LOS) from 2008 to 2013 in the First Affiliated Hospital of Nanjing Medical University. We compared all the parameters between cancer and non-cancer thyroidectomies. We recruited 6, 140 thyroidectomies with valid records of CPS, CPD and LOS in this period. The CPS of cancer thyroidectomy was significantly higher than non-cancer thyroidectomy. The percentage of cancer thyroidectomy increased from 26.5% to 41.6%. The percentage of annual cost of cancer thyroidectomies rose from 30.2% to 45.2%. The LOS for cancer and non-cancer thyroidectomy decreased while the CPD increased in the past six years. The estimated national cost in 2012 for all thyroidectomies would be USD 1.86 billion with USD 1.09 billion for non-cancer thyroidectomies. We have witnessed great improvement in the healthcare for patients with thyroid nodules in China. However, given limited healthcare resources, currently thyroid FNA for more precise preoperative diagnosis may help to curb the rapidly increasing demand in healthcare costs in the future for nodular thyroid disease in China.

CONSTRUCTION OF HNGF-$\beta$ RECOMBINANT ADENOVIRUS & SCREENING OF ITS EXPRESSION AFTER TRANSFECTION INTO VARIOUS CELL LINES (말초신경재생을 위한 hNGF-$\beta$ recombinant Adenovirus의 제작 및 수종세포주에서 신경성장인자의 발현)

  • Gao, En-Feng;Chung, Hun-Jong;Ahn, Kang-Min;Kim, Yoon-Tae;Park, Hee-Jung;Sung, Mi-Ae;Kim, Nam-Yeol;Yoo, Sang-Bae;Myoung, Hoon;Hwang, Soon-Jung;Kim, Myung-Jin;Kim, Sung-Min;Jang, Jeong-Won;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.5
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    • pp.446-456
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    • 2005
  • Nerve growth factor(NGF) has a critical role in peripheral nerve regeneration. The aim of this study is to construct a well-functioning hNGF-$\beta$ recombinat adenovirus for the ultimate development of improved method to promote peripheral nerve regeneration with adenovirus mediated hNGF-$\beta$ gene transfection into Schwann cells. First PCR associated cloning of GFP-tagged hNGF-$\beta$ which was ligated into E1/E3 deleted adenoviral vector was performed and tranfected into E. coli to construct hNGF-$\beta$ recombinant adenovirus. After production of recombinat adenovirus in a large scale, its transfection efficiency, expression, and function were evaluated using cell lines or primarily cultured cells of HEK293 cells, Schwann cells, fibroblast(NIH3T3) and myocyte(CRH cells). GFP expression was observed in 90% of infected cells compared to uninfected cells. Total mRNA isolated from hNGF-$\beta$ recombinat adenoviru infected cells showed strong RT-PCR band, however, LacZ recombinant adenovirus infected or uninfected cells did not. NGF quantification by ELISA showed a maximal release of 18.865 +/- 0.31ng/mL at 4th day. PC-12 cells exposed to media with hNGF-$\beta$ recombinant adenovirus infected Schwann cell demonstrated higher levels of differentiation compared with controls. We generated hNGF-$\beta$ recombinant adenovirus and induced over expression of NGF successfully in nonneuronal and neuronal cells. Following these result, it is expected to develop an improved treatment strategy peripheral nerve regeneration using the hNGF-$\beta$ gene transfected cells.

Correlation Between Knowledge and Educational Needs Related to Recurrent in Coronary Artery bypass graft patients (관상동맥 우회술환자의 수술 후 재발 관련 지식과 교육요구도와의 상관관계)

  • 김희승;박민정
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.549-559
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    • 2000
  • The purpose of this study was to investigate the correlation between the knowledge and educational needs related to recurrent in coronary artery bypass graft patients as a basis to provide an individual nursing education for the population. The subjects consisted of 110 patients who had coronary artery bypass graft(CABG) at Asan Medical Center in Seoul and Sechong hospital in Buchon. Data was obtained from a knowledge questionnaire and a learning needs questionnaire between November 1998 and February 1999. Data were analyzed using SAS program for Wilcoxon rank sum test and Spearman correlation coefficient. The results were as follows : 1. With regard to the 18 items to measure knowledge, the mean (median) of items 'don't know' was 4.9(4) items. The mean (median) of items answered wrong was 3.2(3) items. The number of items answered 'don't know' tend to show higher in those who had less education, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension 2. With regard to the level of knowledge by questionnaire about CABG, The most "I dont know" (59.1%) highly response was 'He has to be treated with anticoagulant drug to prevent revasculized vessel from obstructing.' The seond highest response (56.4%) was 'If you were hypotensive, the coronary attack would collapse. 'During the hospitalized day, the patient has complete bedrest.' The highest error probability was cholesterol has not to intake.', 'After surgery, the sexual life is need controlled for 1 year. 3. The mean of educational needs was 3.38. With regard to the level of learning needs by sentence about CABG, 'Food that benefit heart disease', 'Recurrence possibility of heart disease', 'Management method of operation site', 'Risk symptom that visit hospital or report immediately' were higher than other sentenses. With regard to the level of learning needs by factor 'food(5 items)', 'disease(9 items)' and 'exercise(3 items)' showed the highest than other factors. The educational needs by patients characteristics tend to show higher in males, under the age of 49, middle or high school degree, previous experience of admission with coronary artery disease, history of myocardial infarction, expierience of PTCA, history of cerebro-vascular accident, previous expierience of smoking than in their counter parts. 4. The number of items answered 'don't know', wrong and correct weren't correlated with the level educational needs. As the results, the number of items answered 'don't know' tend to show higher in those who had less educated, blue color jobs and myocardiac infarction history than in their counter parts. There were higher frequency of items answered 'don't know' in those who had no hypertension .There were higher frequency of items answered 'don't know' on anti-thrombolitic theraphy, hypotension and pain relief. Also there were higher frequency of items answered wrong on bed rest period, cholesterol intake, and sexual life. Educational needs were higher in young age group, had previous experience of procesure and history of other disease. And when we educate CABG patients, education for diet, recurrence possibility of disease, management methods of operation site and risk symptom should be emphasized.

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Injury Characteristics of Self-injury Patients Who Visit the Emergency Department (응급실로 내원한 자의 손상 환자의 특징)

  • Kwak, Young Soo;Lee, Kang Hyun;Shin, Hyung Jin;Park, Kyung Hye;Choi, Han Joo;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.65-70
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    • 2009
  • Purpose: Many studies have addressed a psychiatric analysis of self-injury patients who have self-injurious behavior and who have attempted suicide. Few studies on the injury characteristics of self-injury related trauma patients have been conducted. We analyzed the injury characteristics of self-injury patients. Methods: A retrospective review of the medical records extracted from the injury surveillance system of Wonju Christian Hospital for the period from August 2006 to February 2008 was conducted. Of the 121 cases extracted, 103 were included in this study. We analyzed the sex ratio, age group, place of injury, injury mechanism, location of injury, management results, injury severity, and relation with drinking. Results: One hundred three cases were included (sex ratio: 1.06), and the mean age was $33.9{\pm}14.2$ years old. Fifty-six patients (54.4%) were discharged from the emergency department (ED) on the day of injury after primary care, and 9 patients (8.7%) were discharged, because they refused treatment. Seven patients (6.8%) died. Of these, 4 patients (3.9%) died after attempted cardio-pulmonary resuscitation in the ED, 1 patient (1%) was dead on arrival, and 2 patients (1.9%) died after admission. Sixteen patients (15.5%) were admitted to the hospital, including 2 patients (1.9%) needing emergency surgery. Sixteen patients (15.5%) were transferred to other hospitals. Sixty-one cases (59.2%) involved drinking, and 31 (30.1%) did not; for 11 cases (10.7%), the involvement of drinking was unknown. The mean revised trauma score (RTS) was $11.26{\pm}2.52$, and 88 cases (85.4%) hat a RTS of 12. The mean injury severity score (ISS) was $5.80{\pm}14.56$, and 9 (8.7%) severely injured patients had scores of more than 15. Conclusion: Most self-injuries were mild traumas related to drinking and occurred at a young age. Most cases were not so severe, and the patients were discharged from the ED, but some patients needed hospitalization. Other patients had injuries so severe that they died.

Renal Cell Carcinoma in a Pekingese Dog (페키니즈견에서 신장세포암종)

  • Lee Ki-chang;Jung Joo-hyun;Byeon Ye-eun;Oh Sun-kyung;Seo Eun-jung;Song Kyung-jin;Kweon Oh-kyeong;Yoon Jung-hee;Choi Min-cheol
    • Journal of Veterinary Clinics
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    • v.22 no.2
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    • pp.148-152
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    • 2005
  • An intact female, 5-year-old, Pekingese, weighing 3.5kg with a history of a palpated abdominal mass was referred to Veterinary Medical Teaching Hospital, Seoul National University. In laboratory examination, there were no remarkable abnormalities. Radiographic findings included a left mid-abdominal mass with ill-defined margin, serosal detail loss of peritoneal space, non-uniform opacity of retroperitoneal space, and a radiopaque cystic calculus. On abdominal ultrasonography, a heterogeneous parenchymal mass with irregular contour in the left renal region was found. Computed tomographic findings showed a tumor embolus within the caudal vena cava and an invasion into mesentery, small bowel loops, spleen and pancreas around the large left renal mass. Unilateral nephroureterectomy was performed. Histopathologic examination of the resected mass confirmed the diagnosis of renal cell carcinoma. The dog died one day after surgery. Although ultrasonography could give diagnostic information about mass characteristics, computed tomography (CT) can provide key imaging features of mass characteristics.

The Effect of Tai-Chi Exercise on the Function of Shoulder Joint, Heart Rate in Breast Cancer Patients (타이치(Tai-Chi) 운동이 유방암 수술환자의 어깨관절 가동범위와 심박동수 변화에 미치는 영향)

  • Kim, Cheol-Woo;Kwak, Yi-Sub;Kim, Yi-Soon;Kim, Kyung-Chul;Kim, Hee-Eun
    • Journal of Life Science
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    • v.20 no.3
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    • pp.345-349
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    • 2010
  • Good health-related quality of life is regarded as the goal of elderly residential care. Treatment for breast cancer produces side effects that diminish functional capacity and quality of life among survivors. Tai-Chi exercise offers the benefits of fitness and health. Tai-chi has been claimed to generate beneficial effects with respect to a wide range of diseases. The object of this research is to evaluate the effects of tai chi exercise on shoulder joint movement and cardiovascular function in elderly breast cancer patients. The subjects were 40 patients residing in B metropolitan city, who had undergone surgery for breast cancer within 2 months. They underwent post-operative radiotherapy and an anti-cancer chemical treatment. They practiced tai-chi exercise for 60 min a day, four times a week for 12 weeks under the direction of a special tai-chi instructor. Shoulder joint movement and heart rate, were measured before and after the experiment. The results were as follows; Shoulder joint movement, including flexion, extention, adduction and abduction, significantly increased (p<0.05) after treatment, and heart rates significantly decreased after treatment (p<0.05). From the results, Tai-Chi exercise was shown to be extremely effective in improving shoulder joint movement and heart rate in elderly breast cancer patients. Further study is needed in this area.

Suppression of Cocaine Intake by Acupuncture at HT7

  • Lee, Bong-Hyo;Kim, Sung-Hwan;Lim, Sung-Chul;Kim, Jae-Su;Lee, Yun-Kyu;Lee, Ji-Hye;Jung, Tae-Young;Yang, Chae-Ha;Yoon, Seong-Shoon;Han, Chang-Hyun;Lee, Kyung-Min
    • The Journal of Korean Medicine
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    • v.31 no.3
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    • pp.17-27
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    • 2010
  • Objectives: Cocaine has been well known as a representative drug of abuse for its strong reinforcing effect linked to the mesolimbic reward system including dopamine, and such reinforcement leads to the addiction. Acupuncture has been used widely in eastern Asia for the treatment of various diseases including mental disorders and psychiatric problems, and is gathering more interest as one of the complementary and alternative medicines in western countries. In a previous study, we demonstrated that acupuncture at HT7 could affect dopamine release in the mesolimbic system of rats sensitized to alcohol and morphine. This study was designed to investigate whether acupuncture at HT7 could attenuate cocaine intake or not. Material & Methods: Male Sprague-Dawley rats weighing 270-300 g at the start of experiment were trained to self-administer food pellets under a fixed ratio 1 schedule. After the success of acquisition of 100 pellets within 3 h for 3 consecutive days, animals were subjected to surgery whereby Silastic tubing was implanted into right jugular vein and secured with mesh under the anesthetization using pentobarbital injection (50 mg/kg, i.p.). Following recovery, rats were trained to self-administer cocaine (0.25 mg/kg) in daily 2 h sessions under fixed ratio 1 schedule over 10 days. Each treatment was performed on the next day of each establishment of baseline. Results: Results show that acupuncture at HT7, but not at control points, reduced cocaine intake significantly. Acupuncture at HT7 decreased selectively active lever response from $63.15{\pm}3.35$ to $51.46{\pm}3.99$ corresponding $82.12{\pm}5.31%$ compared to basal level. Also, it was demonstrated that the effect of acupuncture was mainly occurred at the half period. Nevertheless, acupuncture at HT7 did not influence the food taking behavior. Conclusions: From the results of this study, it may be suggested that acupuncture at HT7, at least in part, could contribute to the treatment of cocaine abuse.