• Journal of Korean Academy of Nursing
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• v.12 no.2
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• pp.80-90
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• 1982

This study was undertaken to determine the influence of a chronic disease on body image, and to show that body image is directly related to one's self concept. Body image is the concept of one's own body based on present and past perception, and is elated to one's self concept. Body image is a dynamic concept constantly changing throughout the life cycle but it changes greatly in illness, surgery, and accident. The child with a chronic disease experiences pain and immobilization due to illness and he/she experiences a strange environment in the hospital. illness often brings feeling of frustration and loss of self-esteem. Therefore this study was done to compare the body image of a child with a chronic disease（Asthma), with that of a normal healthy child, and to determine the relationship between the body image and self concept. The subjects in this study were 36 children being treated for asthma at the allergy clinic of Y University Hospital in Seoul (patient group) and 44 children attending elementary school in Kwanak Ku Seoul (normal healthy group). For the measurement of the body image, the researcher used Secord & Jourard's Body Cathexis Scale, and another scale which was constructed after reading about Osgood's Semantic Differential Method. For the measurement of the self concept, the researcher used Jacox & Stewart's Health Self Concept. The period for data collection was from October 7th to October 27th, 1982. The analysis of data was done by use of Percentage, t-test, Chi-square test, Pearson Correlation Coefficient and ANOVA, The results of the study were as follows: 1. The first hypothesis,“That the chronically ill (Asthma) child will have a more negative body image than the normal healthy child.”was supported. 2. The second hypothesis,“The more negative the body image, the lower the self concept.”was also supported. 3. The researcher failed to obtain statistically significant results in the analysis of the general characteristics which affect the body image except in the case of the older child as compare to the younger Child having a mole positive body image (r=.2751, r=.2481, p<.05). However it was found that, 1) Boy's have a more positive body image than girls (Mean=〔37.81, 141.09〕,〔37.00, 126.54〕), 2) The child who has been hospitalized has a more negative body image than the child who has never been hospitalized (Mean=〔33.25, 122.45〕,〔35.68, 129.93〕). 3) The younger the child when the disease is discovered and diagnosed, the more negative the body image (Onset of illness: Mean=〔31.44, 117.33〕,〔34.00, 103.50〕, 〔35.75, 140.38〕,〔36.33, 130.00〕, Time of Diagnosis: Mean=〔29.00, 117.33〕,〔33.89, 115.00〕,〔33.36, 124.93〕,〔37.10, 139. 20〕). In conclusion the chronically ill(.Asthma) child has a more negative body image than the normal healthy child, and the more negative the body image the lower the self concept. Therefore the concept of body image is useful in understanding the influences of chronic disease on body' image and self concept.

• Journal of Digital Contents Society
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• v.13 no.3
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• pp.421-429
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• 2012

Lately, the number of interventional radiology is increased by the extension of procedure in medical radiation, and radiation exposure may be appeared differently by interventional radiologists, it is caused increase of radiation dose for radiation worker, patient, and radiologists. This study has done a comparative analysis characteristic of radiation exposure for five radiologists who executed interventional cardiology for 303 patients in S university hospital of Gyeong-Buk from Nov. 1, 2011 to Jan. 31, 2011. The average exposure time of five radiologists was 697.95sec. The average of cumulative DAP(exp) for patients was $52,730mGycm^2$ and the average of total DAP for patients was $104,875.14mGycm^2$. The average of frames for image was 855.52 frames in acquired images, and the average of frames for images was 802.2 frames in exposure images. They were statistically significant differences (p<0.05). Exposure time, cumulative DAP(fluro), cumulative DAP(exp), total DAP, acquired image, and exposure image were high correlation except cumulative DAP(exp), and acquired runs in x-ray exposure characteristics of machine. Exposure time was a great influence on radiologist. It signified that the more exposure time lead to the more radiation dose for radiologist. Radiation dose is related to ability, experience, difficulty, and precision of procedures in interventional procedure. The number of angiography and exposure time is difficult to control by radiologists. Therefore, it is in need of reasonable system which was evaluated the real dose of medical teams in interventional proceedings. We think that self education and training are required to reduce radiation dose for radiologists and radiation workers.

• Journal of Hospice and Palliative Care
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• v.19 no.3
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• pp.201-210
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• 2016

Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

• Journal of Hospice and Palliative Care
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• v.17 no.2
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• pp.57-65
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• 2014

Purpose: Since most terminally ill cancer patients die of multiple organ failure, plasma endotoxin concentration levels may be used to predict the life expectancy. This study was performed to evaluate the clinical significance of endotoxin level in plasma as a prognostic factor for survival in patients with terminal cancer. Methods: This study was conducted with 56 terminally ill cancer patients, above 20 years old, from April 2009 through October 2009. Demographic characteristics, Karnofsky performance status, and survival time were evaluated. We analyzed blood levels of white blood cell hemoglobin, hematocrit, aspartate aminotransferase, alanine aminotransferase, c-reactive protein, total bilirubin and endotoxin in each patient. Results: We considered following variable for univariate analysis: plasma endotoxin level, sex, age, WBC, hemoglobin, hematocrit, AST, ALT, total bilirubin, CRP and severity of pain. Univariate analysis did not show a significant association between plasma endotoxin level and survival time. However, in a multivariate analysis with factors that were found to be significantly associated with survival sex, WBC count and total bilirubin level in univariate analysis, high levels of plasma endotoxin and short survival time were significantly related. Conclusion: Plasma endotoxin level could be used as a prognostic factor to predict the life expectancy of terminally ill cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8911-8916
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• 2014

Background: The aim of the present study was to determine the predictive/prognostic value of the secreted protein, acidic and rich in cysteine (SPARC) in cases of unresectable, locally advanced, non-small cell lung cancer. Materials and Methods: The study included 84 patients with Stage IIIA-B non-small cell lung cancer, undergoing simultaneous chemoradiotherapy including radiotherapy at a dose of 66 Gy and weekly docataxel ($20mg/m^2$) and cisplatin ($20mg/m^2$). SPARC expression was studied in biopsy material by immunohistochemical methods and correlations with treatment responses or survival were evaluated. Results: Median overall survival was $16{\pm}2.73$ (11.55-20.46) months for low expression vs $7{\pm}1.79$ months (7.92-16.08) months for high expression (p=0.039), while median local control was $13{\pm}2.31$ (8.48-17.5) months for low expression vs $6{\pm}0.85$ (4.34-7.66) months for high expression (p=0.045) and median progression-free survival was $10{\pm}2.31$ (5.48-14.5) months for low expression vs $6{\pm}1.10$ (3.85-8.15) months for high expression (p=0.022). In both univariate and multivariate analyses, high SPARC expression was associated with significantly shorter overall survival (p=0.003, p=0.007, respectively), local control (p=0.008, p=0.036) and progression-free survival (p=0.004, p=0.029) when compared to low SPARC expression. No significant difference was detected between high and low SPARC expression groups regarding age, sex, T stage, N stage, histopathology and stage-related patient characteristics. Conclusions: High SPARC expression was identified as a poor prognostic factor in cases with locally advanced NSCLC treated with concurrent chemoradiotherapy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.985-989
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• 2015

Background: Docetaxel, cisplatin, 5-fluorouracil (DCF) given every three weeks is an effective, but palliative regimen and significantly toxic especially in patients who have a low performance score. Here, we aimed to evaluate the efficacy and tolerability of a weekly formulation of DCF in locally advanced and metastatic gastric cancer patients. Materials and Methods: 64 gastric cancer patients (13 locally advanced and 51 metastatic) whose ECOG (Eastern Cooperative Oncology Group) performance status (PS) was 1-2 and who were treated with at least two cycles of weekly DCF protocol as first-line treatment were included retrospectively. The weekly DCF protocol included $25mg/m^2$ docetaxel, $25mg/m^2$ cisplatin, and 24 hours infusion of $750mg/m^2$ 5-fluorouracil, repeated every week. Disease and patient characteristics, prognostic factors, treatment response, grade 3-4 toxicity related to treatment, progression free survival (PFS) and overall survival (OS) were evaluated. Results: Of the patients, 41 were male and 23 were female; the median age was 63 (29-82) years. Forty-one patients were ECOG-1 and 23 were ECOG-2. Of the total, 81.2% received at least three cycles of chemotherapy. Partial response was observed in 28.1% and stabilization in 29.7%. Overall, the disease was controlled in 57.8% whereas progression was noted in 42.2%. The median time to progression was 4 months (95%CI, 2.8-5.2 months) and median overall survival was 12 months (95%CI, 9.2-14.8 months). The evaluation of patients for grade 3-4 toxicity revealed that 10.9% had anemia, 7.8% had thrombocytopenia and 10.9% had neutropenia. Non-hematologic toxicity included renal toxicity (7.8%) and thrombosis (1.6%). Conclusions: In patients with locally advanced or metastatic gastric cancer who were not candidates for DCF administered every-3-weeks, a weekly formulation of DCF demonstrated modest activity with minimal hematologic toxicity, suggesting that weekly DCF is a reasonable treatment option for such patients.

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.21-27
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• 2014

Objective : Infectious spinal disease is regarded as an infection by a specific organism that affects the vertebral body, intervertebral disc and adjacent perivertebral soft tissue. Its incidence seems to be increasing as a result of larger proportion of the older patients with chronic debilitating disease, the rise of intravenous drug abuser, and the increase in spinal procedure and surgery. In Korea, studies assessing infectious spinal disease are rare and have not been addressed in recent times. The objectives of this study are to describe the epidemiology of all kind of spinal infectious disease and their clinical and microbiological characteristics as well as to assess the diagnostic methodology and the parameters related to the outcomes. Methods : A retrospective study was performed in all infectious spinal disease cases presenting from January 2005 to April 2010 to three tertiary teaching hospitals within a city of 1.5 million in Korea. Patient demographics, risk factors, clinical features, and outcomes were assessed. Risk factors entailed the presence of diabetes, chronic renal failure, liver cirrhosis, immunosuppressants, remote infection, underlying malignancy and previous spinal surgery or procedure. We comparatively analyzed the results between the groups of pyogenic and tuberculous spinal infection. SPSS version 14 statistical software was used to perform the analyses of the data. The threshold for statistical significance was established at p<0.05. Results : Ninety-two cases fulfilled the inclusion criteria and were reviewed. Overall, patients of tuberculous spinal infection (TSI) and pyogenic spinal infection (PSI) entailed 20 (21.7%) and 72 (78.3%) cases, respectively. A previous spinal surgery or procedure was the most commonly noted risk factor (39.1%), followed by diabetes (15.2%). The occurrence of both pyogenic and tuberculous spondylitis was predominant in the lumbar spine. Discs are more easily invaded in PSI. At initial presentation, white cell blood count and C-reactive protein levels were higher in PSI compared to TSI (p<0.05). Etiological agents were identified in 53.3%, and the most effective method for identification of etiological agents was tissue culture (50.0%). Staphyococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis, followed by E. coli. Surgical treatment was performed in 31.5% of pyogenic spondylitis and in 35.0% of tuberculous spondylitis cases. Conclusion : Many previous studies in Korea usually reported that tuberculous spondylitis is the predominant infection. However, in our study, the number of pyogenic infection was 3 times greater than that of tuberculous spinal disease. Etiological agents were identified in a half of all infectious spinal disease. For better outcomes, we should try to identify the causative microorganism before antibiotic therapy and make every effort to improve the result of culture and biopsy.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.4
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• pp.463-470
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• 2020

This study was conducted to aid in the development of an infection control educational program for nurses, by assessing the knowledge and educational demand of nurses for MDRO infection control. Totally, 115 nurses participated in the study. Data were collected from November 15-30, 2019, using structured questionnaires. Descriptive statistics, t-test, and ANOVA were applied for analyzing the data. Experience of caring for MDRO patients was reported by 86.1% nurses, whereas 67.8% nurses had received training on MDROs. The average score for knowledge on MDROs was 25.51 out of 27 points, with minimal correct answers given for the query on level of disinfection for medical equipment used by patients, criteria for the preemptive precaution, patient management in the cohort, and timing for removing personal protective equipment. The educational demand was highest for assignment to the precaution, criteria for screening examination, and management of outbreak. Also, educational needs differed with respect to the general educational characteristics and position of the individual. We propose the need to differentiate the educational status according to the career when developing the MDROs program, and the necessity to execute education of MDROs for new nurses and career nurses.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1179-1184
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• 2008

Purpose : Pulmonary interstitial emphysema (PIE) primarily occurs in preterm infants suffering from respiratory distress syndrome (RDS) and kept under mechanical ventilator care. Therefore, this study aimed to examine various risk factors for PIE, to identify conditions that can decrease the possibility of PIE development. Methods : PIE classification was conducted for 183 patients diagnosed to have RDS and receiving mechanical ventilator care with pulmonary surfactant between March 2000 and February 2007. The characteristics of each patient were analyzed through retrospective examination of their medical histories. Results : Among 183 patients, 17 had PIE; all factors, including birth weight, gestational age, RDS grade III or above, chorioamnionitis, and premature rupture of membranes, were statistically significant (P<0.05). The period of mechanical ventilator use was statistically significant, but the peak mean airway pressure and peak partial pressure of inspired oxygen were not. PIE mainly occurred on the right side or both sides rather than the left side and mostly developed within 72 h. The PIE group showed higher mortality rate than the control group, and the major cause of mortality was pneumothorax. Conclusion : Risk factors for PIE in infants suffering from RDS and kept under mechanical ventilator care include low gestational age, low birth weight, chorioamnionitis, and premature rupture of membranes. If any risk factors are noted, the infant must be observed closely for at least 72 h after birth.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.6
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• pp.558-566
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• 2020

Purpose: Progressive familial intrahepatic cholestasis (PFIC) is a rare genetic autosomal recessive disease caused by mutations in ATP8B1, ABCB11 or ABCB4. Mutational analysis of these genes is a reliable approach to identify the disorder. Methods: We collected and analyzed relevant data related to clinical diagnosis, biological investigation, and molecular determination in nine children carrying these gene mutations, who were from unrelated families in South China. Results: Of the nine patients (five males, four females) with PFIC, one case of PFIC1, four cases of PFIC2, and four cases of PFIC3 were diagnosed. Except in patient no. 8, jaundice and severe pruritus were the major clinical signs in all forms. γ-glutamyl transpeptidase was low in patients with PFIC1/PFIC2, and remained mildly elevated in patients with PFIC3. We identified 15 different mutations, including nine novel mutations (p.R470HfsX8, p.Q794X and p.I1170T of ABCB11 gene mutations, p.G319R, p.A1047P, p.G1074R, p.T830NfsX11, p.A1047PfsX8 and p.N1048TfsX of ABCB4 gene mutations) and six known mutations (p.G446R and p.F529del of ATP8B1 gene mutations, p.A588V, p.G1004D and p.R1057X of ABCB11 gene mutations, p.P479L of ABCB4 gene mutations). The results showed that compared with other regions, these three types of PFIC genes had different mutational spectrum in China. Conclusion: The study expands the genotypic spectrum of PFIC. We identified nine novel mutations of PFIC and our findings could help in the diagnosis and treatment of this disease.