• 대한간호학회지
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• 제47권6호
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• pp.731-743
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• 2017

Purpose: Chemotherapy-induced nausea and vomiting (CINV) can cause severe malnutrition. However, relationships between CINV levels, non-pharmacological coping methods, and nutritional status of female cancer patients have rarely been investigated. Therefore, this study aimed to analyze their relationships in gynecologic cancer patients. Methods: Participants receiving a highly and moderately emetogenic chemotherapy were recruited. The level of CINV was assessed using a numeric rating scale. Coping methods were determined using multiple-choice self-report questionnaires and categorized into seven types for statistical analysis. Nutritional status was evaluated using biochemical and anthropometric parameters. Results: Among all the 485 patients, 200 eligible inpatients were included. Despite the administration of prophylactic antiemetics, 157 patients (78.5%) still experienced CINV, and several used nonmedically recommended coping methods, such as just enduring the symptom or rejecting food intake. A total of 181 patients (90.5%) had nutritional disorders. Although the level of CINV was indirectly related to the occurrence of nutritional disorders, patients who rejected food (${\beta}=1.57$, p=.023) and did not use physical measures (${\beta}=-1.23$, p=.041) as coping methods were under the high risk of nutritional disorders. Conclusion: Korean gynecologic cancer patients had high levels of CINV and were at high risk of nutritional disorders, which may be related to the use of nonscientific coping methods, possibly due to cultural backgrounds and lack of proper nutritional program. Therefore, developing a culturally appropriate educational program for the cancer patients with CINV is urgently needed.

• Archives of Plastic Surgery
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• 제45권3호
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• pp.239-245
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• 2018

Background Breast reconstruction has become more common as mastectomy has become more frequent. In Korea, the National Health Insurance Service (NHIS) began covering breast reconstruction in April 2015. This study aimed to investigate trends in mastectomy and breast reconstruction over the past 10 years and to evaluate the impact of NHIS coverage on breast reconstruction. Methods Nationwide data regarding mastectomy and breast reconstruction were collected from the Korean Breast Cancer Society registry database. Multiple variables were analyzed in the records of patients who underwent breast reconstruction from January 2005 to March 2017 at a single institution. Results At Seoul National University Hospital, the total number of reconstruction cases increased 13-fold from 2005 to 2016. The proportion of immediate breast reconstruction (IBR) cases out of all cases of total mastectomy increased from 4% in 2005 to 52.0% in 2016. The proportion of delayed breast reconstruction (DBR) cases out of all cases of breast reconstruction and the overall number of DBR cases increased from 8.8% (20 cases) in 2012 to 18.3% (76 cases) in 2016. After NHIS coverage was initiated, the proportions of IBR and DBR showed statistically significant increases (P<0.05). Among the IBR cases, the percentage of prosthesis-based reconstructions increased significantly (P<0.05), but this trend was not found with DBR. Total mastectomy became significantly more common after the expansion of NHIS coverage (P<0.05). Conclusions Over the last decade, there has been an increase in mastectomy and breast reconstruction, and the pace of increase accelerated after the expansion of NHIS coverage. It is expected that breast reconstruction will be a routine option for patients with breast cancer under the NHIS.

• Journal of Chest Surgery
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• 제39권4호
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• pp.335-339
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• 2006

양성 전이성 근종은 조직학적으로는 양성 종양의 소견을 보이는 자궁근종에서 폐로 전이되어, 임상적으로는 악성 종양의 성질을 지닌 매우 드문 질환이다. 저자들은 자궁근종으로 자궁 절제술을 계획하고 있는 환자에서 다발성 폐 결절이 발견되어, 폐절제술과 자궁절제술을 동시에 시행하였다. 수술후 조직병리 검사에서 폐 결절에서 호르몬 수용체 존재를 확인하여 양성 전이성 근종으로 확진할 수 있었으며, 환자는 수술 후 특별한 치료 없이 외래 추적 관찰 중이다.

• Radiation Oncology Journal
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• 제35권4호
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• pp.325-331
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• 2017

Purpose: There is controversy regarding the cosmetic outcome after accelerated partial breast radiation (APBR). We report the cosmetic outcome from a single-arm prospective clinical trial of APBR delivered using intensity-modulated radiation therapy (IMRT) in elderly patients with stage I breast cancer (BC), using a novel fractionation schedule. Materials and Methods: Forty-two patients aged ${\geq}65$, with Stage I BC who underwent breast-conserving surgery were enrolled in a phase I/II study evaluating a 2-week course of APBR. Thirty eligible patients received 40 Gy in 4 Gy daily fractions. Cosmetic outcome was assessed subjectively by physician/patient and objectively by using a computer program (BCCT.core) before APBR, during, and after completion of the treatment. Results: The median age was 72 years, the median tumor size was 0.8 cm, and the median follow-up was 50.5 months. The 5-year locoregional control in this cohort was 97% and overall survival 87%. At the last follow-up, patients and physicians rated cosmesis as 'excellent' or 'good' in 100% and 91 %, respectively. The BCCT.core program scored the cosmesis as 'excellent' or 'good' in 87% of the patients at baseline and 81% at the last follow-up. The median $V_{50}$ (20 Gy) of the whole breast volume (WBV) was 37.2%, with the median WBV $V_{100}$ (40 Gy) of 10.9%. Conclusion: An excellent rate of tumor control was observed in this prospective trial. By using multiple assessment techniques, we are showing acceptable cosmesis, supporting the use of IMRT planned APBR with daily schedule in elderly patients with early stage BC.

• Journal of Preventive Medicine and Public Health
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• 제43권3호
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• pp.222-234
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• 2010

Objectives: Limited research has investigated the specific needs of patients with cancer. This study was performed to explore patients needs and the related factors. Methods: The data were collected by 1 National Cancer Center and 9 regional cancer centers in Korea. An interview survey was performed with using a structured questionnaire for the subjects(2661 patients who gave written informed consent to particiate) survey 4 months after diagnosis and review of medical records. Data were analyzed using t-test, ANOVA and multiple regression analysis. Results: When comparing the relating factors related with patient needs to the sociodemographic characteristics, the female group showed a higher level of recognition for physical symptoms, social support needs. The younger group showed a significantly higher level of recognition for health care staff, psychological problems, information and education, social support, hospital services needs. In addition, the higher educated group showed a higher level of recognition for health care staff, physical symptoms, social support needs. The higher income and office workers group showed a higher level of recognition for hospital services needs. When comparing the relating factors related with patient needs to the cancer, the breast cancer group showed a higher level of recognition for all needs excluding physical symptoms, accessibility and financial support needs. The combined radiotherapy with surgery and chemotherapy group showed a higher level of recognition for psychological problems, information and education, social support needs. Conclusions: This study showed that needs on patient with cancer was significantly influenced by female, higher educagion, lower income, having religion, office worker, liver cancer, breast cancer, colon cancer, chemotherapy, and combined therapy.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.534-539
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• 2017

Objective : Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. Methods : From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results. Results : The most common diagnosis of hematological malignancy was multiple myeloma (96 patients, 49.7%), followed by chronic myeloid leukemia (30, 15.2%), acute myeloid leukemia (22, 11.2%), and lymphoma (15, 7.56%). The major presenting symptoms were mechanical axial pain (132, 67.7%) resulting from pathologic fractures, and followed by radiating pain (49, 25.1%). Progressive neurologic deficits were noted in 15 patients (7.7%), which revealed as cord compression by epidural mass or compressive myelopathy combined with pathologic fractures. Reconstructive surgery for neurologic compromise was done in 16 patients. Even though surgical intervention was useful for early paralysis (Frankel grade D or E), neurologic recovery was not satisfactory for the progressed paralysis (Frankel grade A or B). Conclusion : Hematological malignancies may cause various spinal problems related to disease progression or consequences of treatments. Conservative and palliative treatments are mainstay for these lesions. However, timely surgical interventions should be considered for the cases of pathologic fractures with progressive neurologic compromise.

• 기본간호학회지
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• 제25권3호
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• pp.176-184
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• 2018

Purpose: Purpose of this study was to investigate relationships and influence of peripheral neuropathy, sleep, and quality of life in patients with gastric cancer who are receiving chemotherapy. Methods: Participants were 131 patients with gastric cancer being treated at a chemotherapy outpatient clinic and receiving chemotherapy. Data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression analysis with the SPSS program. Results: Mean score for peripheral neuropathy was 24.66, for sleep, 6.71 and for quality of life, 67.69. Peripheral neuropathy had a significant positive correlation with sleep (r=.26, p=.003) and sleep had a significant negative correlation with quality of life (r=-.50, p<.001). The regression model explaining quality of patients'lives was significant (F=11.91, p<.001), peripheral neuropathy, sleep, and pain due to anticancer drugs and number ofneurotoxic anticancer drugs explained 25.1% of the variance in quality of life and sleep was the most important factor. Conclusion: To improve the quality of life for these patients, individualized nursing interventions for pain should be provided according to number of anticancer drugs in the chemotherapy. Also there is a need to identify ways to assess peripheral neuropathy and sleep disorders that are appropriate in the treatment and reduce side effects during treatment.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.114-120
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• 2018

Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a $1.5{\times}1.3cm$ homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a $0.5{\times}0.4cm$ round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

• Journal of Gastric Cancer
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• 제21권3호
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• pp.279-297
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• 2021

Purpose: Various changes in nutrition, metabolism, immunity, and psychological status occur through multiple mechanisms after gastrectomy. The purpose of this study was to predict disease status after gastrectomy by analyzing diseases pattern that occur or change after gastrectomy. Materials and Methods: A retrospective cohort study was conducted using nationwide claims data. Patients with gastric cancer who underwent gastrectomy or endoscopic resection were included in the study. Eighteen target diseases were selected and categorized based on their underlying mechanism. The incidence of each target disease was compared by dividing the study sample into those who underwent gastrectomy (cases) and those who underwent endoscopic resection for early gastric cancer (controls). The cases were matched with controls using propensity score matching. Thereafter, Cox proportional hazard models were used to evaluate intergroup differences in disease incidence after gastrectomy. Results: A total of 97,634 patients who underwent gastrectomy (84,830) or endoscopic resection (12,804) were included. The incidence of cholecystitis (P<0.0001), pancreatitis (P=0.034), acute kidney injury (P=0.0083), anemia (P<0.0001), and inguinal hernia (P=0.0007) were higher after gastrectomy, while incidence of dyslipidemia (P<0.0001), vascular diseases (ischemic heart disease, stroke, and atherosclerosis; P<0.0001, P<0.0001, and P=0.0005), and Parkinson's disease (P=0.0093) were lower after gastrectomy. Conclusions: This study identifies diseases that may occur after gastrectomy in patients with gastric cancer.

• 대한상부위장관⦁헬리코박터학회지
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• 제18권4호
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• pp.258-263
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• 2018

Follicular lymphoma is the most common form of low-grade B cell lymphoma. Follicular lymphoma occurs predominantly at lymph node sites and rarely in the gastrointestinal tract. Rare gastrointestinal follicular lymphoma is most commonly found in the small intestine, especially in the duodenum, and appears as multiple granules. However, gastric follicular lymphoma mostly appears as a subepithelial tumor. We observed two primary gastric follicular lymphomas that resembled subepithelial tumors located in the body of the stomach. Endoscopic ultrasound revealed hypoechoic lesions located in the submucosa layer. Since endoscopic forceps biopsies were inconclusive, we performed endoscopic submucosal dissection, which resulted in a final pathologic diagnosis of follicular lymphoma. Because of the indolent nature of gastrointestinal follicular lymphoma, the "watch and wait" strategy can be applied in the early phase. The identification of endoscopic characteristics of gastric follicular lymphoma can be helpful for differential diagnosis and decision of treatment strategy. Therefore, we report two cases of primary gastrointestinal follicular lymphoma diagnosed following endoscopic submucosal dissection.