Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.
Background : Open lung biopsy(OLB) has conventionally been regarded as the gold standard for the diagnosis in interstitial lung disease. With recent advances in diagnostic technique such as high resolution computed tomography(HRCT), and transbronchial lung biopsy(TBLB) which provide relatively accurate diagnosis of ILD, it is necessary to reevaluate the role of these methods in the diagnosis of ILD. Methods: We carried out a retrospective analysis of nineteen patients who underwent OLB at Dankook University Hospital for the diagnosis of acute and chronic ILD, between May 1995 and June 1998. By reviewing the medical records, the demographic findings, underlying conditions, HRCT and TBLB findings, OLB diagnosis, therapy after OLB, and complication of OLB were evaluated. Results: Thirteen patients(68.4%) had chronic ILD(symptom duration over 2 weeks prior to OLB), and six patients(31.6%) had acute ILD(symptom duration less than 2 weeks). Specific diagnosis were reached in 92%(12/13) of chronic ILD(5 bronchiolitis obliterans organizing pneumonia(BOOP), 2 constrictive bronchiolitis, 3 usual interstitial pneumonia, 1 hypersensitivity pneumonitis, 1 eosinophilic pneumonia), and in all patients of acute ILD(5 acute interstitial pneumonia, 1 pneumocystis carinii pneumonia). HRCT were performed in all patients and a correct first choice diagnosis rate of HRCT was 42%(5/12) in chronic ILD. In chronic ILD patients, 62%(8/13) received specific therapy(steroid therapy in 7 patients and moving in one patient), after OLB, but in acute ILD, all patients received specific therapy(steroid therapy in 5 patients and steroid and antibiotic therapy in one patient) after OLB. The in-hospital mortality after OLB was 5.3%(1/19). Conclusion: OLB is an excellent diagnostic technique with relatively low complications in patients with ILD. Therefore OLB should be considered in patients with ILD when the specific diagnosis is important for the treatment, especially in patients with acute ILD.
Park, Jae-Seuk;Chun, Yong;Choi, Eun-Kyung;Jee, Young-Koo;Lee, Kye-Young;Kim, Keum-Youl
Tuberculosis and Respiratory Diseases
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v.46
no.1
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pp.17-24
/
1999
Background : A sizable percentage of tuberculous pleurisy patients are known to have residual pleural thickening(RPT) despite adequate anti-tuberculous chemotherapy. But, the predictive factors related to the development of RPT is not well known. Therefore, we studied to determine which factors are related to the development of RPT after completion of therapy. Methods: By retrospective review of medical records, fifty-eight patients initially diagnosed as having tuberculous pleurisy between March 1995 and January 1998 were separated into two groups : 27 patients in group 1 had RPT on simple chest radiography, while 31 patients in group 2 had no RPT after 6 month of anti-tuberculous chemotherapy. The clinical characteristics, radiologic findings and pleural fluid findings of the two group were compared at the time of diagnosis and during the course of therapy. Results: 47% of patients had RPT after 6 month of chemotherapy, and RPT was more common in man than in women(54% vs 29%, p=0.092). In group 2 patients, complete resorption of pleural lesion occurred rather late stage of therapy(1-2 month: 26%, 3-4 month: 29%, 5-6 month: 45%). Group 1 patients had increased percentage of loculated pleural lesion(26 % vs 19%) and increased white blood cell and lymphocyte count, lactate dehydrogenase level in pleural fluid ($3527\pm5652$ vs $2467\pm2201$/ml, $2066\pm2022$ vs $1698\pm1835$/ml and $1636\pm1143$ vs $1441\pm923$IU/mL respectively) than group 2 at the time of diagnosis, but statistically insignificant. Duration of symptom prior to treatment, size of pleural effusion, presence of parenchymal lung lesion, level of total protein, glucose and adenosine deaminase(ADA)activity in pleural fluid were similar in both group. Conclusion: 53% of tuberculous pleurisy patients showed slow but complete resorption of pleural lesion after 6 month of chemotherapy. But, no clinical, radiological and pleural fluid findings are predictive for the development of RPT.
Park, Seong-sik;Choi, Jae-young;Chung, Min-suk;Kim, Yi-suk;Lee, Je-man;Lee, Kyung-ae;Cho, Gyu-seon;Lee, Ji-young;Park, Eun-kyung
Journal of Sasang Constitutional Medicine
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v.10
no.1
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pp.81-99
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1998
1. Background : Sasang Constitutional Medicine divides mankind into Taeyangin(太陽人), Taeumin(太陰人), Soyangin(少陽人) and Soeumin(少陰人) according to appearance, moral nature and characteristic of constitutional symptoms, and it is a medical science to study about different treatment for each constitution. In Sasang Constitutional Medicine, diagnosis of constitution was so important that we had the necessity of studying constitutional diagnostic method which had presented wholly and intuitively in Dongyi Soose Bowon(東醫壽世保元) with objective and analytic thinking. There were several attempts to classify Sasang Constitutional Types through morphological investigation of each parts of body. The one of them was to use measuring the body. In this study, we purposed to make clear whether the analysis of fingerprints and palm, one of the physical anthropologic methods would be helpful to classify Sasang Constitution. 2. Method : After practicing Questionnaire I and QSCC(Questionnaire of Sasang Constitution) II from 347 healthy Korean adults(242 males and 106 females), we analyzed fingerprints and palm prints of 208 people(142 males and 66 females) who were classified same constitution from two questionnaires. We analyzed the types of fingerprints according to the number of triradius and counted the number of dermal ridges from fingerprint center to triradius. We found triradius in the lower part of each finger and analyzed the courses of dermal ridges and counted the number of dermal ridges between each triradius. We mesured angle atd, and then researched relationship between fingerprints, palm prints and Sasang Constitution. 3. Result and Conclusion : The results of Sasang Constitution analysis of 208 Korean adults showed 76 Taeumin(36.5%), 81 Soeumin(39.0%) and 51 Soyangin(24.5%). The analytic results of fingerprints and palm prints are as follows : The types of fingerprints were helpful to sort Taeumin and the types of palm prints were helpful to sort Soyangin and Soeumin especially. In addition, the number of dermal ridges in fingerprints and palm prints were helpful to sort Soyangin. Fingerprints and palm prints have characteristic in each constitutions, so the investigation of fingerprints and palm prints seems to helpful to classify Sasang Constitution. We are planning to report fingerprints and palm prints of more subjects.
The purpose of this study was to examine dental personnels' concern for health, their personal protection manner, and whether or not they were inoculated against hepatitis B and made an inquiry of patients about that. It's ultimately meant to serve as a basis for the preparation of an anti-infection guide for the protection of dental personnels against all sorts of infectious diseases. After a survey was conducted from March 29 through May 9, 2001, the following findings were obtained: (1) The dental personnel group that had worked for 5 to less than 7 years took health examination the most, with 71.4%, before joining the hospital, and 61.5% of those who had served for 9 years or more, the greatest percentage, took medical checkup after joining the hospital(P<0.05). (2) The largest percentage of being inoculated against the anti-B type hepatitis after employment was 71.4% of the dental personnels over 35, and 57.7% of those with 9-year or more working experiences. Therefore, their age and service term made a significant difference(P<0.05). (3) There was no significant gap in personal protection practices between the dental hygienists and nurse aids(P>0.05). But the use of safety goggles for treatment was not properly done, with just 1.48 on the basis of 3 points, whereas the use of mask was scored 2.40 and the use of gloves was scored 1.96. (4) After a narcotic was used once, the leftovers were wasted by 89.7% of the dental hygienists and 70.0% of the nurse aids. More dental hygienists wasted them(P<0.05). (5) For hand washing, antibiotic liquid soap was used by 19.3% of the dental hygienists and 10.0% of the nurse aids, which were both very low percentage. And just 37.2% of the dental hygienists utilized a disposable paper towel to dry their hands, and only 36.0% of the nurse aids used the same(P<0.05).
Nan Jing(Difficult Classic), as a catechism, describes in detail and deeply the ideas in Nei Jing(Huangdi's Internal Classic). The description of Nan Jing is focused on basic theories including theories about some disease and is excellent in identification and analysis. The contents of Nan Jing are as follows: 1-23 Nan-pulse and pulse condition, 24~29 Nan-channels and collaterals, 30~47 Nan-viscera and bowels(Zang Fu organs), 48~61 Nan-disease, 62~68 Nan-acupuncture points, 69~91 Nan-acupuncture. Especially, diagnosis techniques in Nan Jing make 'Only method of cunkou pulse taking' that is a technique for feeling the pulse widely applied in these days in Oriental medicine clear. Thus, this book adjusts the theory of pulse and pulse condition given in 1~23 Nan of 'The Study of Nan Jing' in order to enhance an understanding about the theory of pulse and pulse condition. The text of 1~23 Nan about pulse lore centers on all pulse of human body interconnected each other and cunkou, both ends of the pulse, and contrasts regular pulse with irregular pulse. 1. 10 Nan describes the theory about five kinds of evils and hardness and softness, and unique pulse condition of each bowels. 2. 13 Nan explains that the relative difficulty of medical treatment is determined by the degree of balance or unbalance among three factors-colors, pulse and pulse condition, flesh shape. 3. 14 Nan divides pulse and pulse condition into slow pulse and rapid pulse, and explains separately abnormality, great loss of semen, death caused by slow pulse, and abnormality, great loss of semen, death caused by rapid pulse. 4. 15 Nan about taut pulse(弦), full pulse(鉤), floating pulse(毛), deep pulse(石脈) describes that pulse and pulse condition differs according to four seasons. Therefore, Nan Jing establishes clearly techniques of feeling the pulse in 'Only method of cunkou pulse taking(獨取寸口)' and advances the theory of Nei Jing. Futhermore, Nan Jing is more valuable in that it suggests unique theory different with Nei Jing.
Kim, Joon-Young;Jeong, Soon-Wuk;Jeong, Man-Bok;Han, Hyun-Jung;Kim, Je-Sun
Journal of Veterinary Clinics
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v.20
no.1
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pp.26-32
/
2003
The clinical results of 10 consecutive total ear canal ablation combined with lateral bulla osteotomy (TECA-LBO) in six dogs with chronic otitis externa and media were evaluated by the postoperative recovery and long-term follow-up. All dogs were selected for TECA-LBO on the basis of following five clinical symptoms. First, medical treatment couldnt improve clinical signs at least for eve. 2 months. Second, tympanic membrane was completely disappeared. Third, radiopacity was increased in tympanic cavity. Forth, petrous temporal bone was sclerosed. Fifth, ear canal calcification was progressed. And all cases were satisfied all five clinical symptoms. At 14. days after operation, the preoperative symptoms of chronic otitis externa and media which were scratching ear, pain, and hardening ear canal were resolved, and postoperative swelling, erythema, head tilt, and exudate from Penrose drainage were not existed In all cases. Loss of eye blink was happened in 4 cases, but these were disappeared between 14 days a(ter operation except one case on 3 months. All dogs were discharged form hospital at 14 days after operation. Between 3.5 and 6.5 months after discharging from hospital, para-aural abscessation was happened only in all Cocker spaniels. But this complication was solved by ventral bulla osteotomy (VBO). The dogs which didn't show para-aural abscessation after TECA-LBO didn't show scratching, pain, hardening of ear and hearing ability was improved, at 7.5 months after TECA-LBO. And the dogs which showed para-aural abscessation after TECA-LBO also didn't show scratching, pain, hardening of ear and hearing ability was also improved, at 7.5 months after VBO. In conclusion, After TECA-LBO, all dogs were recovered well without complication within 2 weeks except Cocker spaniel. And loss of eye blink can be cured naturally within 2 weeks after surgery. And para-aural abscessation can be happened between 4 and 7 months after TECA-LBO, so surgeon must follow-up until 8 months.
Kim, Hyeun-Kyeung;Kim, Sung-Gon;Lee, Jin-Sung;Lee, Sang-Shin;Jung, Woo-Young;Han, Sang-Ik;Kim, Byung-Ju
Journal of Life Science
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v.23
no.5
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pp.698-702
/
2013
It is known that black sticky rice with giant embryo (BSRGB, Milyang 263) and giant embryo rice (GER) contains higher levels of GABA than rice. Therefore, feeding BSRGB, GER, or rice freely to C57BL/6 mice with two-hour alcohol intake for 16 days was investigated. For two-hour alcohol intake, a repeated measure ANOVA (three treatment groups repeated across 16 days; 8 two-day blocks) yielded a significant group by block interaction (df=16, F=3.109, p=0.004). The independent t-test showed that significant suppression of two-hour alcohol intake was observed when subjects were administered with BSRGB, compared with the rice alone across all the two-day blocks (p<0.05). The paired t-test revealed that a significant suppression of two-hour alcohol intake was observed starting 4 to 16 days after freely feeding with BSRGB compared to before feeding. However, there is no significant difference in the two-hour alcohol intake observed between the before and after administration of rice. A repeated measure ANOVA revealed no significant group by block interaction for 22-hour water intake and body weight. However, a repeated measure ANOVA revealed a significant grouping by block interaction for food intake. These results indicate a change of two-hour alcohol intake is presumably caused by GABA, which is found in higher levels in BSRGB than in rice.
Kim, Dong-Chan;Kim, Nam Doo;Kim, Sung In;Jang, Chul-Soo;Kweon, Chang Oh;Kim, Byung Weon;Ryu, Jae-Ki;Kim, Hyun-Kyung;Lee, Suk Jun;Lee, Seungho;Kim, Dongjin
Journal of Life Science
/
v.23
no.5
/
pp.609-615
/
2013
Glyceollin I has gained attention as a useful therapy for various dermatological diseases. However, the binding property of glyceollin I to the mammalian adenylyl cyclase (hereafter mAC), a critical target enzyme for the down-regulation of skin melanogenesis, has not been fully explored. To clarify the action mechanism between glyceollin I and mAC, we first investigated the molecular docking property of glyceollin I to mAC and compared with that of SQ22,536, a well-known mAC inhibitor, to mAC. Glyceollin I showed superiority by forming three hydrogen bonds with Asp 1018, Trp 1020, and Asn 1025, which exist in the catalytic site of mAC. However, SQ22,536 formed only two hydrogen bonds with Asp 1018 and Asn 1025. Secondly, we confirmed that glyceollin I effectively inhibits the formation of forskolin-induced cAMP and the phosphorylation of PKA from a cell-based assay. Long term treatment with glyceollin I had little effect on the cell viability. The findings of the present study also suggest that glyceollin I may be extended to be used as an effective inhibitor of hyperpigmentation.
Purpose : To see the relationship between the response to chemotherapy and the final outcome of neoadiuvant chemotherapy and radiotherapy in patients with mocanry advanced hypopharyngeal cancer. Methods and Materials :A retrospective analysis was done for thirty-two patients with locally advanced hypopharyngeal cancer treated in the Seoul National University Hospital with neoadiuvant chemotherapy and radiotherapy from August 1979 to July 1997. The patients were treated with Co-60 teletherapy unit or 4MV or 6MV photon beam produced by linear accelerator. Daily fractionation was 1.75 to 2 Gy, delivered five times a week. Total dose ranged from 60.8 Gy to 73.8 Gy. Twenty-nine patients received continuous infusion of cisplatin and 5-FU. Other patients were treated with cisplatin combined with bleomycin or vinblastin. Twenty-four (75$\%$) patients received all three prescribed cycles of chemotherapy delivered three weeks apart. Six patients received two cycles, and two patients received only one cycle. Results :The overall 2-year and 5-year survival rates are 65.6$\%$ and 43.0$\%$, respectively. 5-year local control rate is 34$\%$. Organ preservation for more than five years is achieved in 12 patients (38$\%$). After neoadjuvant chemotherapy, 24 patients achieved more than partial remission (PR): the response rate was 75$\%$ (24/32). Five patients had complete remission (CR), 19 patients PR, and 8 patients no response (NR). Among the 19 patients who had PR to chemotherapy, 8 patients achieved CR after radiotherapy. Among the 8 non-responders to chemotherapy, 2 patients achieved CR, and 6 patients achieved PR after radiotherapy. There was no non-responder after radiotherapy. The overall survival rates were 60$\%$ for CR to chemotherapy group, 35.1$\%$ for PR to chemotherapy group, and 50$\%$ for NR to chemotherapy group, respectively (p=0.93). There were significant difference in five-year overall survival rates between the patients with CR and PR after neoadjuvant chemotherapy and radiotherapy (73.3$\%$ vs. 14.7$\%$, p<0.01). The prognostic factor affecting overall survival was the response to overall treatment (CR vs. PR, p<0.01). Conclusion :In this study, there were only five patients who achieved CR after neoadiuvant chemotherapy. Therefore the difference of overall survival rates between CR and PR to chemotherapy group was not statistically significant. Only the response to chemo-radiotherapy was the most important prognostic factor. There needs to be more effort to improve CR rate of neoadjuvant chemotherapy and consideration for future use of concurrent chemoradiotherapy.
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