Background: Differences in clinicopathological characteristics of gastric cancer (GC) between young and older patients are controversial and a matter of debate. Determining the statistical significance of clinicopathological information with respect to age might provide clues for better management and treatment ofGC. Materials and Methods: A total ofl03 Indiao GC patients were enrolled for study and specimens were classified according to the AjCC-TNM system. Patients were grouped into two age-wise categories, young patients (<40 years; n=13) and older patients (${\geq}40$ years, n=90). The clinicopathological features of both groups were retrospectively examined and compared. p53 alterations were analyzed by polymerase chain reaction-single strand conformational polymorphism and immunohistochemistry methods at gene and protein levels respectively. The cases were considered p53 over-expressed if it was present in more than 25% of the tumor cells and p53 alterations was correlated with the clinicopathological characteristics of the patients as well as etiological factors for GC in both groups. Results: We found significant association of young patients with cancer stage (p=0.01), and very strong association with histology grade (p=0.064) and poorly differentiated (p=0.051) state of GC. However, neither young nor elderly patients showed associations with location, gender, etiological factors and p53 expression and alteration. Overall the male-to-female ratio of GC patients was 3.12 and the value was higher in the young (5.5) than in the older group (2.91). Conclusions: Clinicopathological features of GC like caocer stage, cell differentiation and histological grades were significantly different among young and old age cohorts. We observed a male predominance among the young group that decreased significantly with advancing age. More awareness of GC onset is required to detect cancer at an early stage for successful treatment.
Background: To verify whether serum tumor abnormal protein (TAP) would correlate with the responsiveness of palliative chemotherapy in patients with advanced gastric cancer, and the variation of conventional serum tumor markers e.g., carcinoembryonic antigen (CEA), antigen 125 (CA125),carbohydrate antigen19-9 (CA19-9) of adjuvant chemotherapy in patients with early gastric cancer. Materials and Methods: Patients with histologically confirmed gastric cancer and treated with chemotherapy were enrolled into this study. TAP values of these patients were determined by detecting abnormal sugar chain glycoprotein in serum, combined with the area of agglomerated particles. For patients with advanced gastric cancer, responsiveness of palliative chemotherapy was compared with variation of TAP and the relation between variation of TAP and tumor markers in patients with early gastric cancer was analyzed. Results: Totally 82 gastric cancer patients were enrolled into this study. The value of TAP is more closely related to responsiveness of palliative chemotherapy for patients with advanced gastric cancer. The correlation between TAP and responsiveness to palliative chemotherapy is stronger than the correlation between several conventional serum tumor markers (CEA, CA125 and CA199). The variation of TAP was also positively correlated with the trend of CA125 in adjuvant chemotherapy. Conclusions: TAP is sensitive in monitoring the responsiveness to palliative chemotherapy in patients with advanced gastric cancer. But this result should be confirmed by randomized clinical trials for patients with gastric cancer.
Kim, K.W.;Choe, K.O.;Park, C.Y.;Lee, H.;Son, H.Y.;Huh, K.B.;Ryu, K.J.
The Korean Journal of Nuclear Medicine
/
v.13
no.1_2
/
pp.37-43
/
1979
This is an analysis of 39 patients studied at the Yonsei Medical Center from January, 1976 to March 1979. Of these35 patient were suspected of having hypothalamic insufficiency and subjected to the L-Dopa stimulation test to observe growth hormone sceretory function while four acromegaly patient received the glucose loading test and L-Dopa stimulation test. The results are as follows: 1. The basal level of GH in the various disease was as follows: a. The basal level was lower than the control level but was not statistically significant b. In diabetes the mean value tended to be higher than the control level but was not significant statistically c. In all four acromegaly patients the GH level was significantly higher than the control level 2. Of 13 patients with diabetes, nine had diabetic retinopathy, and of those nine, sir showed increased L-Dopa response. However, of the four non retinopathic DM patients, only one showed increased response to L-Dopa. 3. Two patients out of ten with Sheehan's syndrome responded to L-Dopa stimulation. 4. One Patient of eight with pituitary chromophobe adenoma responded to L-Dopa stimulation. 5. Four acromegaly patients revealed 3 acidophilic adenoma and one chromophobe adenoma histologically. Of patients receiving the L-Dopa stimulation test. Two showed a paradoxical response. Two patients who received the glucose loading test showed supressed response. 6. Of two craniopharyngioma patients, one showed increased GH response after L-Dopa stimulation. Increased response of GH after L-Dopa stimulation was seen in one of two craniopharyngioma patients and also in one of two patients with
Purpose: This study was done to identify the experience of stress and burn-out in caregivers of patients with senile dementia. Method: To evaluate the degree of stress and burn-out in caregivers of patients with senile dementia, 64 caregivers and matched to 64 patients with senile dementia at a Primary Health Care Post in South Kyung Sung Province were selected. The study was carried out from March 6 to March 30, 2001. Data on the degree of dementia in the patients was measured by the MMSE-K (Mini-Mental State Examination-Korea) and caregiver characteristics such as, sex, age, marital status, educational level, job, socioeconomic status, religion, number in family, relationship with patient, duration of care, and chronic disease in caregiver were collected by direct interview with a questionnaire. Results: Of 64 patients with senile dementia, 15.6% were classified as mild dementia (MMSE score 20-24) and 84.4%, as severe dementia. There were no significant characteristics of caregivers associated with the degree of stress and burn-out experience. The degree of burn-out in these caregivers of patients with severe dementia (mean value 94.3) was significantly higher than the 81.4 for those caring for patients with mild dementia (p<0.05). However, the degree of stress was not significantly related with the degree of dementia. The proportion experiencing severe burn-out (above score 4) was 54.7% in the physical domain, 90.6% in the emotional domain, and 73.4% in psychiatric domain, respectively. Conclusion: The above findings suggest that the degree of stress and burn-out experienced by caregivers of patients with senile dementia are high. Also the degree of burn-out experienced by in caregivers of patients with severe dementia was higher than for those caring for patients with mild dementia.
One hundred and one patients with tetralogy of Fallot who were older than 16 years of age underwent a total correction of the anomaly between May, 1964 and July, 1987. This group comprised 14.9% of the 679 consecutive patients who had repair of the tetralogy at our institution during the same period. Of the 101 patients, 8 had a previous shunt procedure for palliation. The preoperative mean hemoglobin value was 16.9*1.0% and the mean systemic oxygen saturation, 84.4*0.9%. In 76 patients[75.2%], a type II ventricular septal defect was seen whereas in 14 patients[13.9%], the defect was type I. In 72 patients[71.3%], other cardiac anomalies were present which included patent foramen ovale in 37.6%, atrial septal defect in 8.99b, vegetations in 6.9%, right sided aortic arch in 5.9% and coronary artery anomaly in 5.0%. The right ventricular outflow obstruction was caused most commonly by combination of infundibular and valvular stenosis[74.3%], followed by isolated infundibular stenosis[19.8%] and valvular stenosis [5.9%] alone in order. The preoperative mean diameter of the pulmonary valve ring size was 10.2*0.5 mm in diameter. A transannular patch enlargement of the right ventricular outflow tract was performed in 28 patients and, in 12 a pericardial monocusp was utilized. Major anomalous aorto-pulmonary vessels were encountered in 5 patients which were detected before or during the operation. In 3 patients, they were ligated beforehand to control the flooding of the operative field. Postoperatively, the mean systolic pressure gradient between the right ventricle and the main pulmonary artery was 16.2*2.3 mmHg and the mean systolic pressure- ratio between the right and the left ventricle was 45.3*2.0%. Perioperative complications including bleeding in 8.9%, pleural effusion in 7.9%, dysrrhythmia in 4.9%, and residual VSD in 4.0%. Operative mortality was 8.9%. There has been no operative death in the recent 65 cases since 1981. There were 2 late deaths, 68 and 113 months after surgery. There were 2 late detachment of the VSD patch during the follow-up period. Of the 6 patients with patch detachment found during the postoperative period, 3 had subacute bacterial endocarditis before or after the operation indicating The serious nature of this complication. Two of these patients subsequently underwent a successful reoperation.
Hongrye Kim;Mou Seop Lee;Su Young Yoon;Jonghee Han;Jin Young Lee;Junepill Seok
Journal of Trauma and Injury
/
v.37
no.2
/
pp.114-123
/
2024
Purpose: Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients. Methods: Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma. Results: In total, 1,038 patients were divided into two groups: those with complications (822 patients, 79.2%) and those with no complications (216 patients, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P<0.001). The proportion of head trauma patients was higher (58.3% vs. 24.6%, P<0.001) and the Glasgow Coma Scale score was worse (median [interquartile range], 12 [6.5-15] vs. 15 [14-15]; P<0.001) in the complications group. The number of rib fractures, the degree of rib fracture displacement, and the severity of pulmonary contusions were also higher in the complications group. In the area under the ROC curve analysis, the TTSS showed the highest predictive value for the entire group (0.731), head trauma group (0.715), and no head trauma group (0.730), while RibScore had the poorest performance (0.643, 0.622, and 0.622, respectively) Conclusions: Early injury severity detection and grading are crucial for patients with blunt chest trauma. The chest trauma scoring systems introduced to date, including the TTSS, are not acceptable for clinical use, especially in polytrauma patients with traumatic brain injury. Therefore, further revisions and analyses of chest trauma scoring systems are recommended.
Jeung-pyun added to mulberry leaves powder was tested to prove in inorganic ingredients, physical function, chromaticity and rheometer. For cake, mulberry leaves powder were added to rice flour in the ratio of 0%, 1%, 2%, and 3% respectively. In inorganic ingredients test, the amounts of calcium, magnesium and potassium were increased according to adding levels of mulberry leaves powder. But the amounts of iron, copper and zinc, were not correlated with it. Calcium, magnesium and potassium are anti-hypertension inorganic substances. Thus, it is considered that food with plenty amountsz of inorganic ingredients is an effective diet for the patients who suffer from cardiovascular disease. In physical evalution test, the ratio of mulberry leaves powder was not correlated with the appearance of Jeung-pyun. The value of color decreased as the ratio of mulberry leaves powder increases. In texture, Jeung-pyun. The value of color decreased as the ratio of mulberry leaves power increase. In texture, Jeung-pyun added with 2% mulberry leaves powder had the highest value. In moisture, as the level of mulberry leaves powder was increased, the value was decreased. In rheometer test, Jeung-pyun 0% mulberry leaves powder had the highest value in hardness. While the ratio of mulberry leaves powder was not correlated with cohesiveness. Jeung-pyun added to 1% mulberry leaves powder had the highest value. In gummines and brittleness, 0% Jeung-pyun had the highest value, but the ratio was not correlate with cohesiveness.
Park, Yang-Hee;Kwon, In-Gak;Park, Kyei-Sook;Jang, Hae-Jung;Song, Mi-Ra;Kim, Hee-Jin
Quality Improvement in Health Care
/
v.19
no.2
/
pp.68-80
/
2013
Background: This study investigates improvements in non-value-added nursing activities in clinical work, in order to improve the efficiency and quality of nursing activities. Methods: The study was performed as a quality improvement project at a tertiary general hospital. The nursing activities that needed improvements were categories into admission care, discharge care, supply management, diagnostic work-up related activities, and others. The nursing time and frequency of non-value-added activities were compared across nine nursing units before and after implementation of the quality improvement program. Post-implementation patient and nurse satisfaction were subsequently analyzed. Result: Post-implementation, the time spent on non-value-added nursing activities was reduced and patients and nurses were satisfied with the improvements. Discussion: Reducing non-value-added activities in nursing can increase the work efficiency and ensure time for patient care, thus improving the quality of nursing care. For further study, accurate surveys on nursing activities based on nursing time are required.
To see the change of pulmonary arterial pressure after mitral valve replacement, postoperative cardiac catheterization and echocardiographies were performed in 12 patients of mitral valvular disease with pulmonary hypertension[systolic pulmonary arterial pressure>50 mm Hg]. The mean follow-up duration was 35.4[range: 15-47] months per patient. The following results were obtained. 1] Preoperative systolic pulmonary arterial pressure value of 66.17\ulcorner10.73mmHg decreased significantly to 29.17\ulcorner6.86mmHg postoperatively[p<0.01]. 2] Preoperative Pp/Ps value of 0.67\ulcorner0.13 decreased significantly to 0.28\ulcorner0.06 postoperatively[p<0.01]. 3] Preoperative PAWP value of 29.00\ulcorner4.02mmHg decreased significantly to 9.92\ulcorner4.27 mmHg postoperatively[p<0.01]. 4] Preoperative LAD value of 5.58\ulcorner1.20cm decreased significantly to 4.37\ulcorner0.67cm postoperatively [p<0.01]. In conclusion, pulmonary arterial hypertension secondary to mitral valvular disease could be reduced to normal range after successful mitral valve replacement.
The Journal of Korean Society for Radiation Therapy
/
v.11
no.1
/
pp.28-32
/
1999
Verifying the treatment value(Monitor Unit) unnecessarily involves too many simple and repetitive calculation processes, that is, individual computation process using the data(PDD value, Scp Factor, SSD Factor, Tray Factor) on the data book. We intend to minimize the time required to check the Monitor Unit through computerized calculation. Using $^{\ast}(multiplication)$, /(division), +(sum), if function, among others, which are present in the Excell program, MS office program, the Monitor Unit was obtainable through A/P value, Scp Factor and PDD value, Wedge Factor. From the verification of the computations of Monitor Unit for 60 patients previously treated, we were able to obtain an error rate of ${\pm}0.028MU$. Computerized calculation of the Monitor Unit could save the burden of Technologist.
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