• Tuberculosis and Respiratory Diseases
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• 제68권5호
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• pp.286-289
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• 2010

A 55-year old woman with advanced stage non-small cell lung cancer was admitted to hospital for the management of severe chest pain, which measured 7 out of 10 on a numerical rating scale (NRS). Despite palliative radiation and the application of multiple epidural blocks, she continued to experience severe cancer pain. We gradually increased the dose of transdermal fentanyl patches from $500{\mu}g/hr$ to $3,650{\mu}g/hr$, for 3 months without any significant side effects. Concomitantly, adjuvant therapy with antidepressants and anticonvulsants were added, decreasing the patient's pain to NRS 3~4 down from 7. After being transferred to a hospice clinic, her chest pain was well-controlled below NRS 4 by means of strong opioid medications, including the highest dose of transdermal fentanyl $4,050{\mu}g/hr$ for more than 16 months.

• Journal of Chest Surgery
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• 제43권2호
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• pp.217-220
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• 2010

소위 다형선종이라 불리는 혼합종은 주로 침샘에 기원하며 폐에서 발생한 예는 세계적으로 보고된 예가 극히 드물다. 이 신생물은 저악성도를 나타내기도 하나 재발이나 원격전이와 같은 공격적인 성향을 보이는 경우도 있다. 우리는 종양의 완전 절제후 병리학적으로 폐의 일차성 악성 다형선종임을 확인하였고 술 후 다발성 전이와 같은 악성 신생물의 소견을 보이는 증례를 경험하여 이를 보고하는 바이다.

• 성인간호학회지
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• 제23권5호
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• pp.460-471
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• 2011

Purpose: This study was designed to investigate the levels of anxiety, depression, physical symptoms, and supportive care needs in patients with hematologic malignancy and to identify predictive factors of supportive care needs. Methods: The data were collected from 100 subjects undergoing treatments during 2010 in Korea. The questionnaires included the Hospital Anxiety-Depression Scale, the M. D. Anderson Symptom Inventory, and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regression. Results: Forty percent of the subjects had anxiety and 58% had depression. Thirty-eight percent of the subjects reported to have moderate-to-severe levels of physical symptoms. The most severe physical symptom was lack of appetite, followed by fatigue and pain. In terms of supportive care needs, the health system and information domain showed the highest among all domains. Supportive care needs had a significant positive correlation with anxiety, depression, and physical symptoms. And its predictive factors were identified as anxiety, physical symptoms and marital status, with the explanatory power of 48.9%. Conclusion: These findings demonstrate that anxiety and physical symptoms should be assessed and treated to meet the supportive care needs of patients with hematologic malignancies.

• 성인간호학회지
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• 제25권1호
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• pp.95-104
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• 2013

Purpose: The purpose of this study was to investigate the level of resilience, family support, anxiety and depression in patients with hematologic malignancy, and to determine modifiable psychosocial factors that affect their resilience. Methods: Data were collected from 104 patients undergoing curative therapy at 'S' hospital in Seoul. The data were collected from April to May, 2012. The questionnaires included Korean Version of Connor-Davidson Resilience Scale, Family Support Scale and Hospital Anxiety-Depression Scale. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation and stepwise multiple regression. Results: Resilience had statistically significant correlation with family support (r=.43, p<.001), anxiety (r=-.49, p<.001) and depression (r=-.52, p<.001). Factors influencing resilience were depression, family support, anxiety and time since diagnosis with R-sq. value of 36%. Conclusion: The results of the study show that family support, anxiety and depression have important influences on resilience of patients with hematologic malignancy. Thus, family support needs to be reinforced when developing and implementing nursing intervention, and nurses need to intervene to reduce anxiety and depression of patients with hematologic malignancy.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.79-82
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• 2010

Purpose: Carcinosarcomas are rare neoplasms in which both malignant epithelial and mesenchymal elements are identified. We have found only twenty one cases of primary cutaneous carcinosarcoma in the English language literature. Therefore it has been difficult to diagnosis because its unclear etiology and low frequency. Methods: A 31-year-old young man with a protruding mass on his ankle dorsum was examined. The tumor was $7{\times}6{\times}3\;cm$ sized and arose from a burn scar. The mass was wide excised and applied split thickness skin graft. Characteristic pathologic finding was a mixture of squamous cell carcinoma and malignant fibrous histiocytoma. Results: Three months after the operation, the patient died of multiple metastasis to the liver, lung and finally of sepsis despite adjuvant chemotherapy and adjuvant radiotherapy. Conclusion: If a metastatic cutaneous carcinosarcoma is diagnosed, wide excision is required. There should be more aggressive management to minimize the risk of recurrence. Further research into the etiology and pathophysiology of the disease and a more careful differential diagnosis may allow improvement in treatment.

• 대한수의학회지
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• 제56권4호
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• pp.273-276
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• 2016

Pericardial mesothelioma is a rare neoplasm in dogs. This report describes a case of pericardial mesothelioma in a 13-year-old Shih Tzu that presented with a clinical history of dyspnea. Hemorrhagic pericardial effusion and chylous pleural effusion with reactive mesothelial cells were identified by radiograph and cytology. Necropsy revealed multiple round nodules throughout the pericardium and regional lymph nodes in addition to chylothorax. Histopathology revealed invasive neoplasm on the pericardial surface with metastasis to the lymph nodes. The neoplastic cells were immunopositive to both cytokeratin and vimentin. Diagnosis of pericardial mesothelioma with regional lymph node metastasis was made.

• Archives of Plastic Surgery
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• 제41권5호
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• pp.584-587
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• 2014

In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

• Journal of Gastric Cancer
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• 제11권4호
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• pp.206-211
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• 2011

Purpose: Laparoscopic total gastrectomy (LTG) for gastric cancer is still uncommon because of technical difficulties, especially in esophagojejunostomy (EJ). There are many reports for various laparoscopic procedures of EJ using linear or circular staplers. On the other hands, there has been no report for hand-sewn anastomosis. We report successfully performed intracorporeally hand-sewn EJ after LTG. Materials and Methods: The clinicopathologic data and short-term surgical outcomes of 6 patients who underwent totally laparoscopic total gastrectomy for upper gastric cancer from December 2010 and July 2011 were retrospectively reviewed. Results: The mean age was 66.5 years and mean body mass index (kg/$m^2$) was 24.6. All patients had medical comorbidities. The mean patient ASA score was 2.17. Among the 6 patients, previous abdominal operation was performed for 2 patients and combined operation was performed for 3 patients. The mean blood loss, operation time, and EJ anastomosis time was 130 ml, 379.7 minutes, and 81.5 minutes, respectively. The mean time to first flatus, first oral intake, and postoperative hospital stay was 3.0, 3.0, and 12.5 days, respectively. There was no 30-day mortality case. Postoperative aspiration pneumonia and multiple periventricular lacunar infarctions developed in 1 patient. There were no anastomosis-related complications and other major surgical complications. Conclusions: When the intracorporeal anastomotic technique becomes popular in LTG the intracorporeally hand-sewn EJ may be accepted as one method among the various laparoscopic procedures of EJ.

• 대한두개안면성형외과학회지
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• 제21권3호
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• pp.202-205
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• 2020

Trichoepithelioma is a benign hair follicle tumor that can undergo malignant transformation into basal cell carcinoma in rare cases. Due to the similar clinical and histological features of trichoepithelioma and basal cell carcinoma, distinguishing between these types of tumors can be a diagnostic challenge. Punch biopsy obtains only a small sample of the entire lesion, and thus inherently involves a risk of misdiagnosis between histologically similar diseases. Therefore, if the possibility of misdiagnosis can reasonably be suspected, clinicians should conduct an excisional biopsy or immunohistochemical staining (e.g., CD10 and Bcl-2) to ensure an exact diagnosis. Although trichoepithelioma is benign, the surgical excision of solitary trichoepithelioma should be considered in order to avoid the possibility of malignant transformation, which has occasionally been documented for multiple familial trichoepitheliomas. Herein, we report a case that was initially misdiagnosed as trichoepithelioma before ultimately being diagnosed as basal cell carcinoma through excision and immunohistochemical staining.

• 대한간호학회지
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• 제48권2호
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• pp.241-253
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• 2018

Purpose: The purpose of this study was to test the mediating effect of social support and resilience on the relationship between symptom distress and coping in young Korean breast cancer survivors. Methods: A purposive sample of 209 young breast-cancer survivors (mean age 39.9) was recruited for a cross-sectional survey, and the data were collected between June and October 2015. The instruments used in this study were the Memorial Symptom Assessment Scale-Short Form, the Multidimensional Scale of Perceived Social Support, 10-item Connor-Davidson Resilience Scale, and Cancer Coping Questionnaire. The collected data were then analyzed using the SPSS 23.0 and AMOS 23.0 programs. Results: Symptom distress was found to have a significant indirect effect on coping (beta=-.32, p=.002), but not a significant direct effect (beta=.06, p=.577). Additionally, based on the values obtained for the squared multiple correlation, symptom distress, social support, and resilience were found to explain 46.4% of the total variance of coping. Conclusion: Based on the results of this study, it can be suggested that in order to enhance young breast cancer survivors' ability to cope with the distress they commonly feel, intervention methods that strengthen resilience and provide social support should be developed and made available to them.