• Archives of Reconstructive Microsurgery
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• v.21 no.2
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• pp.118-130
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• 2012

Background: Women receiving mastectomy usually prefer a single-stage surgical procedure without the need for additional surgery. Hence, nipple sparing mastectomy was introduced, and the follow-up data on the aesthetic outcome and recurrence of breast cancer were investigated in this study. Materials and Methods: The study subjects comprised 22 patients who received nipple-sparing mastectomy and immediate breast reconstruction using the free transverse abdominal rectus abdominis myocutaneous flap between June of 2007 and June of 2012. The patients' aesthetic outcomes were measured with 2 methods for the objective result: Breast size measurements and breast volume calculation both at preoperative phase and postoperative 1 years phase. Also, the patients' satisfaction was evaluated at postoperative 1 year with the self-assessment questionnaire. Follow up check for assessing cancer recurrence was performed for an average period of postoperative 1063 days. Results: First, in objective aesthetic outcome, there were no significant differences between the preoperative and postoperative results on both the breast size and the volume. Second, the patient satisfaction analysis scores were graded as very good in 15 patients (68.2%), and as good in 6 patient (27.3%). Most of the patients were very satisfied with our surgery method. Last, there was no local or distant recurrence in these 22 patients during the follow-up period. Conclusion: In this study, the nipple-sparing mastectomy achieved satisfactory results for the breast scar and shape with a single-stage surgical procedure, and the cancer recurrence rate was not significantly different from that of the conventional mastectomy. Besides, the nipple-sparing mastectomy is more cost-effective than the conventional mastectomy since it reduces the need for additional procedures. However, we think that it is necessary to determine the long-term outcomes about the recurrence rate.

• Medical Lasers
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• v.10 no.1
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• pp.31-36
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• 2021

Background and Objectives Several predicted optimal parameters for laser treatment have been suggested, making the settings subject to variation. Thus, picosecond lasers may require more data and studies to optimize the laser parameters, increase the efficacy of each session, and minimize the total number of sessions. This study evaluated the results of picosecond laser tattoo removal in variable locations, focusing on the aesthetic outcome, number of procedures, and adverse effects. Materials and Methods Nine patients who underwent picosecond laser treatment from February 2014 to July 2020 were enrolled. Before the procedures, the required number of sessions was estimated using the Kirby-Desai scale. At the end of the treatment, the patients assessed their satisfaction. The patient and two plastic surgeons assessed the clearance of the tattoo. Results The mean of the clearance was 86.6% in both the patient and investigators assessment. The patients reported satisfaction for an average score of 5.1 ± 0.78 for the aesthetic outcome, 4.5 ± 0.78 for pain, 4.1 ± 0.92 for the number of procedures, and 4.7 ± 0.97 for adverse effects. The average number of actual procedures was 6.7 ± 1.20. The average Kirby-Desai score was 7.1 ± 1.45. Their correlation coefficient was 0.803, which is considered a strong positive correlation. Conclusion Picosecond lasers have a remarkable ability to degrade smaller tattoo pigments through a photoacoustic effect. Moreover, a picosecond laser treatment for tattoo removal can be a safe and effective method. Picosecond lasers are a promising technology with the potential to optimize the treatment of tattoos.

• Journal of Gastric Cancer
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• v.23 no.2
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• pp.275-288
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• 2023

Purpose: This study aimed to examine the effects of 4 main types of gastrectomy for proximal gastric cancer on postoperative symptoms, living status, and quality of life (QOL) using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Materials and Methods: We surveyed 1,685 patients with upper one-third gastric cancer who underwent total gastrectomy (TG; n=1,020), proximal gastrectomy (PG; n=518), TG with jejunal pouch reconstruction (TGJP; n=93), or small remnant distal gastrectomy (SRDG; n=54). The 19 main outcome measures (MOMs) of the PGSAS-45 were compared using the analysis of means (ANOM), and the general QOL score was calculated for each gastrectomy type. Results: Patients who underwent TG experienced the lowest postoperative QOL. ANOM showed that 10 MOMs were worse in patients with TG. Four MOMs improved in patients with PG, while 1 worsened. One MOM was improved in patients with TGJP versus 8 MOMs in patients with SRDG. The general QOL scores were as follows: SRDG (+39 points), TGJP (+6 points), PG (+3 points), and TG (-1 point). Conclusions: The TG group experienced the greatest decline in postoperative QOL. SRDG and PG, which preserve part of the stomach without compromising curability, and TGJP, which is used when TG is required, enhance the postoperative QOL of patients with proximal gastric cancer. When selecting the optimal gastrectomy method, it is essential to understand the characteristics of each and actively incorporate guidance to improve postoperative QOL.

• The Journal of Korean Medicine
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• v.40 no.2
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• pp.119-132
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• 2019

Purpose: This study was conducted to collect and analyze real world data to evaluate the effectiveness and safety of comprehensive traditional Korean Medicine treatment on quality of life, anorexia and cachexia of cancer patients. Methods: We analyzed medical records of 62 cancer patients admitted to O-I Dang Korean Medicine Hospital from February 2018 to February 2019. The primary outcome was a change score in the Anorexia/Cachexia Subscale of Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes were Functional Assessment of Cancer Therapy-General (FACT-G), Trial Outcome Index(TOI) of FAACT, 11 point Pain Intensity Numeric Rating Score (11 PI-NRS) and Patient Global Impression of Change (PGIC) and adverse event. Results: Cachexia and quality of life in cancer patients assessed by FAACT, increased by $5.59{\pm}14.83$ (p=0.004) after treatment. PI-NRS was reduced by $2.10{\pm}1.81$ (p<0.001) and TOI and FACT-G total scores were increased by $5.17{\pm}11.70$ (p=0.001) and $3.59{\pm}10.94$ (p=0.012), respectively. These results were also clinically meaningful assessed via minimal clinically important difference (MCID). There was no severe adverse event. Conclusion: These findings suggest that comprehensive traditional Korean Medicine treatment might be effective and safe strategy for improving quality of life, anorexia, cachexia and pain of cancer patients. Further advanced studies with controlled group and more participants with rigorous design are needed to ensure these findings.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.414-424
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• 2013

Background In esthetic surgery, understanding the factors that influence patient satisfaction is important for successful practice. We hypothesize that the factors that influence patient satisfaction include not only aesthetic and functional outcomes, but also personal factors such as the level of familiarity with factors affecting wound healing and expectations regarding aesthetic outcome. Methods One hundred patients who underwent esthetic closure after thyroidectomy were included in this study. In order to evaluate the individual characteristics of the patients, a preoperative survey was administered to the patients. We estimated the patient satisfaction six months postoperatively and assessed the aesthetic and functional outcomes using the Patient and Observer Scar Assessment Scale. Results According to the results of correlation analysis, level of familiarity with wound healing factors had a positive correlation with satisfaction. High expectations, pain, itching, and high observer scale score had negative correlations with satisfaction. The factors that were correlated with satisfaction were included in the multiple regression analysis. Level of familiarity with wound healing factors was found to have a positive relationship with satisfaction, while itching and observer scale were found to have a negative relationship with satisfaction. After excluding 10 patients who had hypertrophic scars, only level of familiarity with wound healing factors and expectations affected satisfaction. Conclusions The level of familiarity with factors affecting wound healing and expectations were found to independently affect satisfaction. Improving patients' level of familiarity with wound healing factors and reducing their expectations by providing suitable preoperative education has the potential to improve patient satisfaction.

• YAKHAK HOEJI
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• v.54 no.6
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• pp.507-521
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• 2010

Training for asthma patients by professionals has been highly emphasized for patients' self-management. In the present study, three standardized training sessions targeting hospital pharmacists were performed. On the basis of the number of training sessions taken, a non-educated group (CG), an once-educated group (NG), and a twice more-educated group (IG) were allocated. The most frequent errors of using an inhalant were shaking before the use in MDI while taking breathe out before inhaling in the case of DPI, and the total average number of errors were the biggest for CG and the smallest in IG. On comparison in the number of the four symptoms of asthma according to the level of seriousness, it was revealed that the total average number was the biggest in CG and the smallest in IG. In the level of awareness regarding the contents of training for patients, patients over 50 tended to answer that they were aware of education contents, and particularly in mouth rinsing and the use before/after a meal, significant similarity was examined. Regular asthma patient training performed by hospital pharmacists appeared to reduce errors in the inhaler usage, increase the quality of life of an patient, and help a patient remember the contents of the training. Especially among patients over 50, it was found to be more effective and retraining of more than two sessions was requisite.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.10
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• pp.6495-6503
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• 2015

The purpose of the study was to evaluate patients' compliance with the hemodialysis and to investigate relationships between compliance, physiological parameters, and health-related quality of life. Data were collected from 220 patients at 27 local hemodialysis clinics. Compliance was measured with Sick-role Behavioral Compliance including interdialytic weight gain, serum potassium, and phosphorus. Health-related quality of life was assessed using Medical Outcomes Study Short Form-12. Data were analyzed using descriptive statistics, t-tests, ANOVA, and Pearson correlation. Total compliance scored 2.92 out of 4 points on average. Among fifteen items, 'I keep on my dialysis schedule(time and date)' was the highest score. There were differences in the scores for compliance according to age, marital status, and dialysis period. Statistically significant correlations were found between four compliance items(medication, infection control, sleep, eating vegetable and fruit) and health-related quality of life. The results of the study indicate that a patient-centered approach would be helpful to improve quality of life in patients with hemodialysis. Healthcare providers need to understand the patients' perspectives by identifying what is important to patients and taking patient values and priorities into account.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.3
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• pp.240-244
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• 2009

F-18 FDG PET is a metabolic imaging modality that is efficacious in staging and assessment of treatment response for variety of lymphomas. We report usefulness of F-18 FOG PET/Cl in evaluating severity of the disease and response to therapy in a patient with subcutaneous panniculitis- like T-cell lymphoma (SPTCL). Here we describe a case of SPTCL in 24-year-old man who had wide spread firm and tender nodular lesions with increased F-18 FOG uptake. After chemotherapy follow up F-18 FDG PET/CT image shows disseminated malignancy and then the patient died with hemophagocytic syndrome. This report suggests that F-18 FDG PET/CT may be useful in determining disease activity at the time of initial diagnosis, after treatment, and evaluating a suspected outcome of SPTCL.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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• pp.224-227
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• 2000

Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

• Journal of Korean Critical Care Nursing
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• v.3 no.1
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• pp.79-88
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• 2010

Optimal nutrition serves to maintain normal organ function and to preserve body energy stores to guarantee survival during times of shortage of food. Adequate nutrition of intensive care unit (ICU) patients improves outcome, while malnutrition is strongly associated with increased morbidity and mortality rates among critically ill patients. Previously published researches showed that trials of nutritional support in critical illness rarely fulfill basic quality requirements. Nutrition support plays a vital role in the prevention and treatment of nutritional deficiencies in at-risk, critically ill patients. This paper reviewed the challenges in determining critically ill patients' nutrition requirements including nutrition assessment, determination of caloric requirements then providing them with adequate nutrition support while in the ICU with the guidelines published by Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Nutrition support can be effectively enhanced by using the guidelines.