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Factors Related to Substantial Pain in Terminally Ill Cancer Patients

  • Suh, Sang-Yeon;Song, Kyung-Po;Choi, Sung-Eun;Ahn, Hong-Yup;Choi, Youn-Seon;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.14 no.4
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    • pp.197-203
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    • 2011
  • Purpose: Pain is the most common and influential symptom in cancer patients. Few studies concerning pain intensity in the terminally ill cancer patients have been done. This study aimed to identify factors related with more than moderate pain. Methods: This study used secondary data of 162 terminal cancer inpatients at the palliative ward of six training hospitals in Korea. Physician-assessed pain assessment was by 10 point numeric rating scale. Substantial pain was defined more than moderate intensity by the Korean National Guideline for cancer pain. The Korean version of the MD Anderson Symptom Inventory was self-administered to assess symptoms. Survival prediction was estimated by the attending physicians at the time of admission. Results: Less than six weeks of predicted survival and more than numeric rating of six for worst drowsiness in the previous 24 h were significantly related to substantial pain (P=0.012 and P=0.046, respectively). The dose of opioid analgesics was positively related to substantial pain (P=0.004). Conclusion: Factors positively related to substantial pain were less than six weeks of predicted survival and considerable drowsiness. Careful monitoring and active preparation for pain are required in terminal cancer patients having those factors.

Optimization of Flip Angle at Head & Neck MR Angiography using Gadoteridol (Gadoteridol을 이용한 Head & Neck MR Angiography에서의 적정 Flip Angle)

  • Jeong, Hyunkeun;Kim, Mingi;Song, Jaejun;Nam, Kichang;Choi, Hyunsung;Jeong, Hyundo;Kim, Hochul
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.3
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    • pp.151-159
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    • 2016
  • In this research, we tried to suggest moderate FA(Flip Angle) for CE(Contrast Enhnaced)-Head&Neck MR Angiography with Gadoteridol. For this study, we did test MR phantom and clinical study according to FA change. After that, quantitative analysis was progressed. The results of MR phantom study were as follow: RSP(Reaction Starting Point)was recorded within 300~400 mmol. MPSI(Max Peak Signal Intensity) was 2,086, 3,705, 5,109, 6,194, 7.096, 7,192 [a.u]. MPP(Max Peak Point) was shown at 30, 50, 50, 40, 50, 40 mmol. IRMPSI(Increase Rate of MPSI) was 77.6%, 37.9%, 21.2%, 14.6%, 1.4% as increasing of FA. The results of clinical study were as follow SICB(Signal Intensity of Carotid artery Bifurcation) was recorded respectively 392.5, 4165.2, 4270, 3502.2, 3263.7, 3119.6 [a.u]. ORA(Occurence Rate of Artifact) was increased as 0, 0, 20, 40, 50, 70%. According to this research, we are not only able to assure that increase of FA can be effect on H1 spin's SI(Signal Intensity) which was combined with gadolinium agent, but also be effect on artifact rate in blood vessel. In clinical field, we expect that CE-Head&Neck MR Angiography can be performed in a practical way with this research.

Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

  • Kim, Min Sun;Lee, Jihye;Sim, Jin-Ah;Kwon, Jung Hye;Kang, Eun Joo;Kim, Yu Jung;Lee, Junglim;Song, Eun-Kee;Kang, Jung Hun;Nam, Eun Mi;Kim, Si-Young;Yun, Hwan-Jung;Jung, Kyung Hae;Park, June Dong;Yun, Young Ho
    • Journal of Korean Medical Science
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    • v.33 no.49
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    • pp.327.1-327.10
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    • 2018
  • Background: It is difficult to decide whether to inform the child of the incurable illness. We investigated attitudes of the general population and physicians toward prognosis disclosure to children and associated factors in Korea. Methods: Physicians working in one of 13 university hospitals or the National Cancer Center and members of the general public responded to the questionnaire. The questionnaire consisted of the age appropriate for informing children about the prognosis and the reason why children should not be informed. This survey was conducted as part of research to identify perceptions of physicians and general public on the end-of-life care in Korea. Results: A total of 928 physicians and 1,241 members of the general public in Korea completed the questionnaire. Whereas 92.7% of physicians said that children should be informed of their incurable illness, only 50.7% of the general population agreed. Physicians were also more likely to think that younger children should know about their poor prognosis compared with the general population. Physicians who opposed incurable illness disclosure suggested that children might not understand the situation, whereas the general public was primarily concerned that disclosure would exacerbate the disease. Physicians who were women or religious were more likely to want to inform children of their poor prognosis. In the general population, gender, education, comorbidity, and caregiver experience were related to attitude toward poor prognosis disclosure to children. Conclusion: Our findings indicate that physicians and the general public in Korea differ in their perceptions about informing children of poor prognosis.

Utility of Serum Albumin for Predicting Incident Metabolic Syndrome According to Hyperuricemia

  • Lee, You-Bin;Jun, Ji Eun;Lee, Seung-Eun;Ahn, Jiyeon;Kim, Gyuri;Jee, Jae Hwan;Bae, Ji Cheol;Jin, Sang-Man;Kim, Jae Hyeon
    • Diabetes and Metabolism Journal
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    • v.42 no.6
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    • pp.529-537
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    • 2018
  • Background: Serum albumin and uric acid have been positively linked to metabolic syndrome (MetS). However, the association of MetS incidence with the combination of uric acid and albumin levels has not been investigated. We explored the association of albumin and uric acid with the risk of incident MetS in populations divided according to the levels of these two parameters. Methods: In this retrospective longitudinal study, 11,613 non-MetS participants were enrolled among 24,185 individuals who had undergone at least four annual check-ups between 2006 and 2012. The risk of incident MetS was analyzed according to four groups categorized by the sex-specific medians of serum albumin and uric acid. Results: During 55,407 person-years of follow-up, 2,439 cases of MetS developed. The risk of incident MetS increased as the uric acid category advanced in individuals with lower or higher serum albumin categories with hazard ratios (HRs) of 1.386 (95% confidence interval [CI], 1.236 to 1.554) or 1.314 (95% CI, 1.167 to 1.480). However, the incidence of MetS increased with higher albumin levels only in participants in the lower uric acid category with a HR of 1.143 (95% CI, 1.010 to 1.294). Conclusion: Higher levels of albumin were associated with an increased risk of incident MetS only in individuals with lower uric acid whereas higher levels of uric acid were positively linked to risk of incident MetS regardless of albumin level.

A Study on the Forecasting Trend of Apartment Prices: Focusing on Government Policy, Economy, Supply and Demand Characteristics (아파트 매매가 추이 예측에 관한 연구: 정부 정책, 경제, 수요·공급 속성을 중심으로)

  • Lee, Jung-Mok;Choi, Su An;Yu, Su-Han;Kim, Seonghun;Kim, Tae-Jun;Yu, Jong-Pil
    • The Journal of Bigdata
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    • v.6 no.1
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    • pp.91-113
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    • 2021
  • Despite the influence of real estate in the Korean asset market, it is not easy to predict market trends, and among them, apartments are not easy to predict because they are both residential spaces and contain investment properties. Factors affecting apartment prices vary and regional characteristics should also be considered. This study was conducted to compare the factors and characteristics that affect apartment prices in Seoul as a whole, 3 Gangnam districts, Nowon, Dobong, Gangbuk, Geumcheon, Gwanak and Guro districts and to understand the possibility of price prediction based on this. The analysis used machine learning algorithms such as neural networks, CHAID, linear regression, and random forests. The most important factor affecting the average selling price of all apartments in Seoul was the government's policy element, and easing policies such as easing transaction regulations and easing financial regulations were highly influential. In the case of the three Gangnam districts, the policy influence was low, and in the case of Gangnam-gu District, housing supply was the most important factor. On the other hand, 6 mid-lower-level districts saw government policies act as important variables and were commonly influenced by financial regulatory policies.

Hospice Music Therapy in Korea (한국의 호스피스 음악치료)

  • Kim, Eun Jung
    • Journal of Hospice and Palliative Care
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    • v.21 no.4
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    • pp.109-114
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    • 2018
  • The objective of this paper is to suggest plans to properly establish and promote the use of hospice music therapy by examining its necessity and how it is being used in Korea. Hospice music therapy is a clinical and evidence-based use of music interventions administered by a professional to alleviate total pains suffered by hospice patients and their families. While the effects of hospice music therapy have been reported by many studies, its meaning and value are still poorly understood in Korea, which explains the lack of related institutions in the nation. Recently policy-wise and legislative efforts have been made to promote hospice and palliative care, which in turn will likely fuel demand for hospice music therapy. Therefore, the meaning and role of hospice music therapy should be defined by major hospice and palliative care institutions and societies, followed by institutional and academic efforts as follows. First, a set of qualification criteria for hospice music therapists should be established to provide proven music therapy interventions to patients and their families. Second, a systematic program offering both theoretical and practical trainings needs to be developed to foster hospice music therapists. Last but not least, clinical studies should be promoted with development of a research road map for hospice music therapy and a standard protocol.

Low-Tube-Voltage CT Urography Using Low-Concentration-Iodine Contrast Media and Iterative Reconstruction: A Multi-Institutional Randomized Controlled Trial for Comparison with Conventional CT Urography

  • Kim, Sang Youn;Cho, Jeong Yeon;Lee, Joongyub;Hwang, Sung Il;Moon, Min Hoan;Lee, Eun Ju;Hong, Seong Sook;Kim, Chan Kyo;Kim, Kyeong Ah;Park, Sung Bin;Sung, Deuk Jae;Kim, Yongsoo;Kim, You Me;Jung, Sung Il;Rha, Sung Eun;Kim, Dong Won;Lee, Hyun;Shim, Youngsup;Hwang, Inpyeong;Woo, Sungmin;Choi, Hyuck Jae
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1119-1129
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    • 2018
  • Objective: To compare the image quality of low-tube-voltage and low-iodine-concentration-contrast-medium (LVLC) computed tomography urography (CTU) with iterative reconstruction (IR) with that of conventional CTU. Materials and Methods: This prospective, multi-institutional, randomized controlled trial was performed at 16 hospitals using CT scanners from various vendors. Patients were randomly assigned to the following groups: 1) the LVLC-CTU (80 kVp and 240 mgI/mL) with IR group and 2) the conventional CTU (120 kVp and 350 mgI/mL) with filtered-back projection group. The overall diagnostic acceptability, sharpness, and noise were assessed. Additionally, the mean attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) in the urinary tract were evaluated. Results: The study included 299 patients (LVLC-CTU group: 150 patients; conventional CTU group: 149 patients). The LVLC-CTU group had a significantly lower effective radiation dose ($5.73{\pm}4.04$ vs. $8.43{\pm}4.38mSv$) compared to the conventional CTU group. LVLC-CTU showed at least standard diagnostic acceptability (score ${\geq}3$), but it was non-inferior when compared to conventional CTU. The mean attenuation value, mean SNR, CNR, and FOM in all pre-defined segments of the urinary tract were significantly higher in the LVLC-CTU group than in the conventional CTU group. Conclusion: The diagnostic acceptability and quantitative image quality of LVLC-CTU with IR are not inferior to those of conventional CTU. Additionally, LVLC-CTU with IR is beneficial because both radiation exposure and total iodine load are reduced.

Korean physicians' attitudes toward the prenatal screening for fetal aneuploidy and implementation of non-invasive prenatal testing with cell-free fetal DNA

  • Kim, Soo Hyun;Kim, Kun Woo;Han, You Jung;Lee, Seung Mi;Lee, Mi-Young;Shim, Jae-Yoon;Cho, Geum Joon;Lee, Joon Ho;Oh, Soo-young;Kwon, Han-Sung;Cha, Dong Hyun;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • v.15 no.2
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    • pp.72-78
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    • 2018
  • Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

Status of Interchange of Medical Imaging in Korea: A Questionnaire Survey of Physicians (영상정보교류 실태 파악을 위한 의사 설문조사)

  • Choi, Moon Hyung;Jung, Seung Eun;Kim, Sungjun;Shin, Na-Young;Yong, Hwan Seok;Woo, Hyunsik;Jeong, Woo Kyoung;Jin, Kwang Nam;Choi, SeonHyeong
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.247-253
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    • 2018
  • The purpose of this study was to summarize the results of a survey for physicians with specialties other than radiology about imaging studies of patients referred from other institutions. The survey was promoted through individual contacts or social network service and physicians who voluntarily responded to the survey were the subjects of the study. The questionnaire consisted of 11 questions about basic information and referrals about medical imaging. A total of 160 physicians from 30 specialties participated in the survey and 95.6% of the respondents worked in tertiary care center or general hospital. Patients were frequently referred with outside medical images. The most frequently referred imaging modalities were computed tomography and magnetic resonance imaging. However, radiological reports from outside institutions were rarely referred. Most physicians thought that reinterpretation for outside imaging is necessary to acquire a secondary opinion. In conclusion, considering that outside radiological reports are frequently missing and there are high demands on reinterpretation for outside imaging, guidelines for referral of radiological reports with medical imaging, basic elements of radiological reports, and reinterpretation need to be developed.

Current Trends in the Treatment of Ankle Arthritis: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (족관절 관절염 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Byung-Ki;Cho, Jaeho;Gwak, Heui-Chul;Kim, Hak Jun;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.3
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    • pp.111-116
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    • 2021
  • Purpose: Variations in the preferred conservative and operative treatment methods for ankle arthritis may be observed in the practice of orthopedic surgeons. This study is based on the Korean Foot and Ankle Society (KFAS) member survey and aims to report the current trend and changes in the management of ankle arthritis over the last few decades. Materials and Methods: A web-based questionnaire containing 24 questions was sent to all KFAS members in July 2021. The questions were mainly related to the preferred techniques and clinical experience in osteotomy, arthrodesis, and total ankle arthroplasty (TAA) for patients with ankle arthritis. Results: Sixty-three out of 550 surgeons (11.5%) responded to the survey. The responses to 6 out of the total of 24 questions (25.0%) achieved the levels needed to reflect a tendency. Answers that showed a tendency were related to the following: a surgical approach for arthrodesis (anterior approach), use of auto-bone graft for arthrodesis (iliac bone), a nonunion rate of more than 10% following arthrodesis, main reason related to unsatisfactory results after arthrodesis (nonunion or delayed union), the main reason to change total ankle prosthesis (unstable supply of prosthesis), the unusualness of revision TAA and conversion of fusion to TAA. Diversity was found in several aspects of treatment (degree of experience and satisfaction in supramalleolar osteotomy, fixation method for arthrodesis, preferred TAA prosthesis and longevity, degree of experinece, annual number of TAA operation. Conclusion: This study proposes updated information with regard to the current trends in the management of ankle arthritis in Korea. Both consensus and variations in the approach to patients with ankle arthritis were identified through this survey. With an increasing preference for TAA, the need for the development of a prosthesis optimized for Koreans and a stable supply of prostheses were the suggestions made by the study.