• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.239-247
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• 1993

Differentiating the various causes of hydronephrosis from that of obstruction can be very difficult. The decision-making process for those instances of urinary tract dilatation that require surgical correction and those that do not is based in part on the findings of diuresis renography. The methodology for performing this test has differed among nuclear medicine practitioners and the surgical findings are occasionally discrepant from the diuretic renogram interpretation. Consequently we made an automatic computer software program that calculates the slope of the response curve. The quantitative indices, such as the injection and response t1/2 by linear-fitting and monoexponential-fitting, were compared with the visual assessment of the diuretic cinerenography and clinical outcome in 50 children (62 kidneys) with ureteropelvic junction obstruction. Pooled diuresis renogram data indicated that: (1) Visual evaluation of the diuretic cinerenography is a sensitive (87%, 54/62) tool to differentiate obstruction in suspected ureteropelvic junction obstruction. (2) The cut-off value (maximum washout t1/2 with non-obstruction) of injection and response t1/2 by linear-fitting were 40 min. (3) The sensitivity and specificity using injection and response t1/2 by linear-fitting for obstruction were 89%(23/26) and 100%(30/30), respectively. (4) Response t1/2 as well as injection t1/2 by monoexponential-fitting do not stratify children with possible ureteropelivic junction obstruction. In conclusion, quantitative assessment of diuretic renography as well as visual assessment of diuretic cinerenography correlate well with surgical and clinical outcome of suspected ureteropelvic junction obstruction.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.755-759
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• 2002

A 64-year-old man was admitted for gross hematuria. Preoperative study revealed right renal cell carcinoma with inferior vena cava(IVC) tumor thrombus. Right radical nephrectomy was performed, and deep hypothermic circulatory arrest(DHCA) with retrograde cerebral perfusion(RCP) was used for extraction of tumor thrombus in the IVC. The thrombus originated from the right kidney, which extended the orifice of the gonadal vein in the left renal vein laterally, the hepatic vein superiorly, and 3cm below the right renal vein inferiorly. The thrombus was removed completely without caval wall injury under DHCA with RCP, and the postoperative course was uneventful. He received immunotherapy with interferon, and followed up without any surgical problem.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.8
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• pp.276-282
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• 2018

This study was conducted to improve the quality of home-based cancer management programs through a survey of satisfaction and needs of the program provided by a regional cancer center. From March 2015 to October 2015, we conducted face to face surveys of patients and caregivers enrolled in home-based cancer management. A total of 101 patients, 59 patients and 41 caregivers, were enrolled. Breast cancer was the main cancer and 51 (86%) patients and 36 (85%) caregivers were satisfied with the number of visits for home-based cancer management. For the service application route, 22 patients (37.29%) obtained information through the cancer center publicity paper and 11 caregivers (26.19%) received recommendations from acquaintances. Except for treatment provided directly to the patients, psychological counseling was the most preferred, and satisfaction regarding picnic and cancer education were also high. Satisfaction with the program provided by regional cancer center was relatively high ($4.14{\pm}1.21$ on a 5-point scale). Additionally, satisfaction of the patients was higher than that of the caregivers, but this difference was not significant ($4.29{\pm}1.11$, $3.93{\pm}1.31$, p = 0.141). Self-esteem was higher among caregivers than patients, but this difference was not significant. To improve the quality of life of cancer patients and caregivers, it is necessary to develop customized programs considering patients' economic situations and need for psychological counseling.

• Women's Health Nursing
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• v.8 no.4
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• pp.529-537
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• 2002

The purpose of this study was to investigate the prevalence, relative factor and the effects that overactive bladder or urinary incontinence have on women's lives. Data was gathered through an internet survey. The subjects included 3,372 women ranging from 20 years old to 49 years of age. The questionnaire included general characteristics (age, parity, family history, and history of UTI), overactive bladder symptoms (urgency, frequency, nocturia, urgent incontinence), urinary incontinence, discomfort in ADL and sexual activity. The data was analyzed by the SPSS/PC+ program using frequency, $x^2$ test, and multivariate logistic regression. The results were as follows; 1. The prevalence was 12.7 % in overactive bladder and 21.0% in urinary incontinence. 2. 19.2% of the subject have urge incontinence, 5% of them have coped with the use of a pad. 3. The significant factors to overactive bladder were age($x^2$=6.6, p<0.05), history of urinary tract infection ($x^2$=50.8, p<0.01) and family history ($x^2$=26.1, p<0.01). The significant factors to urinary incontinence were age ($x^2$=6.2, p<0.05), occupation ($x^2$=11.0, p<0.05), history of urinary tract infection($x^2$=20.2, p<0.01), parity ($x^2$=8.6, p<0.01), and family history ($x^2$=4.9, p<0.05). 4. Overactive bladder impacts on individual daily life was 5.0 times, urinary incontinence was 2.9 times higher than in non-symptoms. Also, overactive bladder impacts on their sexual activity disturbance was 4.3 times, urinary incontinence has 3.9 times higher than in non-symptoms. In conclusion, overactive bladder symptoms and urinary incontinence were health problems that disturbed women's lives. Also the most problem among overactive bladder may be urgency in Korean. Intervention based on these results needs to be provided for these women.

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.116-119
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• 2013

A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

• Quality Improvement in Health Care
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• v.1 no.1
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• pp.110-118
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• 1994

As the first step to improve the medical recording for the hospitalized patients, we tried to identify problems of completion rate of the medical recording and made the completion rate of the medical recording within due date known to the public in the hospital and commended the best Department and resident officially. The results were as follows: 1. The average number of the medical recordings per a recorder by years of residency(average number to quorum) was 293.3(398.8) in 1st year, 82.5(68.1) in 2nd year, 21.2(8.3) in 3rd year, and 20.5(1.9) in 4th year-residents. There was only 2 residents who prepared the medical recordings more than the average of 125.6 recordings per a resident. 2. Among 13 Departments, the medical recording was wholly put in charge of the 1st year-resident in 6 Departments. The duty was shared with the 2nd year-resident in 5 Departments and the 3rd year-resident in 1 and the 4th year-resident in Only 1 Department. 3. The more the cases requiring the medical recording, the lower the completion rate(80% less than 100 recordings, 70% in 100-299, 60% in 300-399 and 33.3% in more than 400). 4. There was no difference in the completion rate of the medical recording before(1991) and after(1993) a public nitice(1992). However, 4 Departments showed improvement of 21-45% in the completion rate, and no case was found where billing for medical assurance was postponed due to delayed completion of the medical recording. 5. The completion rate was relatively low(72-78%) from January to March. The main reasons were shortage of men power due to preparation of board examination, attendance to military duty, and lack of training in the medical recording for the new 1st year-residents. 6. The official commendation of the best Department and resident by letters did not improve the completion rate of the medical recording. In conclusion, The main reason of the low completion rate of the medical recording was the fact that the 1st year-residents were almost exclusively responsible for the medical recording. Hence, it is mandotory that this practice gets staffs' attention to improve the completion rate. Public notice of the completion rate of the medical recording shows prompt improvement of the completion rate. Prize money rather than commendation by a letter for the best Department would also be more effective to improve the quality of medical recording.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.130-145
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• 1996

Purpose : the management of University Hospital is being challenged in maintenance of reasonable level of income and high ranked reputation by domestic competition with each other and emergence of enterprised owned hospitals. It is imperative that University Hospitals have to make management for patient satisfaction. Furthermore, increased patient's requirement for qualified hospital services (quality assurance) and low-estimated service fee also repress the hospital management condition as well as medical markets open following with Urguay Connection. Due to these unforable conditions surrounding hospital management, -University Hospitals are being pressed to seek improved management strategies. To develope the strategies, we need to have basic understanding about the problems on hospital management and detail information for various patient's requirement. Methods: For this study, we have analysed out-patients from five different University Hospitals located in Seoul, Korea. To obtain the data, we have carried out personal interviews with patients who patients who visit the Out-Patient Clinics of five different University Hospitals using a previously prepared questionnaire. Result: Around 65.7 percent of the visits to University Hospitals were indwelt in the vicinity of 1 hour and motuvation of visiting University Hospital was expending high wuality medical csre in 49.3 percent. The 79.3 percent of the patients have experienced inconvenience during medical care in University Hospital. The most inconvenient condition was waiting for doctors. The 57.2 percent of total patient have experienced rudness. The most rudness condition was registration and receipt desk in 44.4 percent. Patient expect that doctors working in University Hospitals as professors have high and updated medical knowledge(50.4%) and University Hospitals have a high quality medical care system(79.4%). The patient satisfaction was relatively low in 61.1 percent of total patient and revealed high frequency of again visit University Hospital in satisfaction group. Comparison of interhospital analytical study showed quite difference on various problems. Conclusion: Almost patients who visit to Out-Patient Clinic of University Hospital havevisiting motivation to high quality medical care. University Hospitals have several different unsatisfactorial factors and revealed different degree of patient satisfaction. In a future day, University Hospitals have to make use of another University Hospital's merits for approach of Benchmarking and also should be studied decision factors of patient satisfaction and interhospital difference of them.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.7
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• pp.200-206
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• 2018

The aim of this study was to evaluate the effect of Ropivacaine on pain following laparoscopic surgery. Between March 2015 and June 2017, all 97 patients with renal mass who elected to receive laparoscopic nephrectomy were reviewed, retrospectively. Normal saline (0.9%) was used as a control in 45 patients while Ropivacaine was used for local anesthesia in the instillation group (n=52). Pain score (visual analog scale) of the shoulder and upper abdominal area between the two groups was significantly different between recovery time and 24 h (p<0.05), with no significant differences between 48 and 72 h (both p>0.05). In the instillation group, pain score of shoulder and abdominal pain in the two groups according to the amount of CO2 used was not significantly different between recovery time and 24, 48, and 72 h (all p>0.05). Ropivacaine reduced shoulder and upper abdominal pain that occurred within 24 h after surgery. Effective pain control with Ropivacaine is needed in the early postoperative period when a large amount of CO2 is used in laparoscopic surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10217-10223
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• 2015

Hyperactivated ${\alpha}2$-6-sialylation on N-glycans due to overexpression of the Golgi enzyme ${\beta}$-galactoside: ${\alpha}2$-6-sialyltransferase (ST6Gal-I) often correlates with cancer progression, metastasis, and poor prognosis. This study was aimed to determine the association between ST6Gal-I expression and the risk of recurrence and survival of patients with localized clear-cell renal cell carcinoma (ccRCC) following surgery. We retrospectively enrolled 391 patients (265 in training cohort and 126 in validation cohort) with localized ccRCC underwent nephrectomy at a single center. Tissue microarrays were constructed for immunostaining of ST6Gal-I. Prognostic value and clinical outcomes were evaluated. High ST6Gal-I expression was associated with Fuhrman grade (p<0.001 and p=0.016, respectively) and the University of California Los-Angeles Integrated Staging System (UISS) score (p=0.004 and p=0.017, respectively) in both cohorts. Patients with high ST6Gal-I expression had significantly worse overall survival (OS) (p<0.001 and p<0.001, respectively) and recurrence free survival (RFS) (p<0.001 and p=0.002, respectively) than those with low expression in both cohorts. On multivariate analysis, ST6Gal-I expression remained associated with OS and RFS even after adjusting for the UISS score. Stratified analysis suggested that the association is more pronounced among patients with low and intermediate-risk disease defined by the UISS score. High ST6Gal-I expression is a potential independent adverse predictor of survival and recurrence in ccRCC patients, and the prognostic value is most prominent in those with low and intermediate-risk disease defined by the UISS score.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2597-2604
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• 2012

Methylenetetrahydrofolate reductase (MTHFR) is an essential enzyme involved in folate metabolism; a single nucleotide polymorphism (SNP) C677T has been reported to be linked with altered incidences of several diseases. We here conducted a meta-analysis of 15 published epidemiological studies with a total of 7306 cases and 8062 controls to evaluate its association with prostate cancer risk with overall and subgroup analyses. No statistical relationship was found overall with any genetic model (TT vs. CC: OR = 0.80, 95%CI = [0.62, 1.04], P = 0.094; CT vs. CC: OR = 0.97, 95%CI = [0.84; 1.12], P = 0.667; Dominant: OR = 0.94, 95%CI = [0.82; 1.07], P = 0.343; Recessive: OR = 0.81, 95%CI = [0.64; 1.04], P = 0.104), but after the exclusion of several studies, we could observe the homozygote TT to confer less susceptibility to prostate cancer in carriers; moreover, different effects of the polymorphism on prostate cancer risk was detected from subgroup analysis stratified by participants' residential region: significant reduced prostate cancer risk was found to be associated with the polymorphism from Asian studies (TT vs. CC: OR = 0.47, 95%CI = [0.33; 0.67], P < 0.001; CT vs. CC: OR = 0.73, 95%CI = [0.60; 0.90], P = 0.002; Dominant: OR = 0.67, 95%CI = [0.56; 0.82], P < 0.001; Recessive: OR = 0.55, 95%CI = [0.40; 0.76], P < 0.001) while studies from Europe indicated a slight increased risk under dominant model with marginal significance (OR = 1.14, 95%CI = [0.99; 1.30], P = 0.064). Moreover, the protective effect of the polymorphism against prostate cancer was also shown by studies performed in yellow Asians (TT vs. CC: OR = 0.48, 95%CI = [0.31; 0.75], P = 0.001; CT vs. CC: OR = 0.68, 95%CI = [0.51; 0.90], P = 0.006; Dominant: OR = 0.63, 95%CI = [0.48; 0.82], P < 0.001; Recessive: OR = 0.57, 95%CI = [0.39; 0.84], P = 0.004). We propose that these phenomena should be viewed with the consideration of folate metabolism profile and different gene background as well as living habits of different populations, and more relevant studies should be conducted to confirm our hypothesis and provide a comprehensive and clear picture concerning this topic.