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Surgery and Postoperative Immunochemotherapy for Thoracic Esophageal Cancer (흉부식도암의 수술 면역화학요법)

  • 김광택
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.214-218
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    • 1993
  • Extensive lymphnode dissection combined with thoracic esophagectomy improved prognosis of esophageal cancer, but there is still high postoperative recurrence rate. The immunologic capacity of esophageal cancer patients is compromised by surgery and adjuvant chemotherapy. Therefore immunological therapy for esophageal cancer patients seems rational. We have adopted postoperative immunochemotherapy since 1988. From 1988 to 1992, 31 patients with thoracic esophageal cancer underwent esophagectomy and radical lymphnode dissection, and selected patient with early esophageal cancer and unfit for thoracotomy underwent transhiatal esophagectomy in Korea University Hospital. Mean age of patients was 56 years. There were 28 squamous cell cancers, 2 adenocarcinomas and one mixed tumor. There were 4 stage I, 3 stage II, 18 stage III, and 6 stage IV cases. There were no opeartive death. Postoperative complications included anastomotic leakage in 9%, pneumonia 3 %, cylothorax 3%, recurrent laryngeal neve paresis in 3% of all patients. Curative resection group[n=19] received immunotherapy. Noncurative resection group[n=12] received postoperative immunochemotherapy, including PS-K, CDDP, and 5-FU. Operative survivors were followed from 4 months to 5 years. There were 3 lost of follow-up. Actuarial survival rate is 79% to one year, 54% to two years and 27% to five years.In conclusion, an transthoracic esophagectomy combined with systematic lymph node dissection and postoperative immunochemotherapy could improve survival rate for esophageal cancer.

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The Relationship Between Maturity of Christian Faith and Anxiety of Patients with Cancer (암환자의 기독교신앙성숙과 불안과의 관계 연구)

  • Min, Soon
    • Journal of Korean Academy of Nursing
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    • v.19 no.1
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    • pp.118-126
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    • 1989
  • The purpose of this study was to determine the relationship between the maturity of Christian faith and anxiety. Nurses are concerned with the spiritual dimension of clients' experience. The subjects of this study were patients with cancer in Y. University Hospital in Seoul Subjects were selected who knew their diagnosis, were aged 20 or older and agreed to the interview. A total of 35 patients were interviewed from August 1 to September 15, 1988. The instruments used in this study were the maturity of Christian faith scale developed by H.S. Choi and modified by the investigator, and an anxiety scale developed by the investigator. Data were analyzed by statistical methods including Frequency, ANOVA, and Pearson Correlation Coefficient. Results included the following : Hypothesis, “That as the degree of maturity of Christian faith of the patients increases, the degree of state anxiety will decreases”, was supported (${\gamma}$=-.8061, p<.001). According to this study, maturity of Christian faith is significantly related to on the reduction of anxiety of patients with cancer. In a holistic approach to their clients, nurses may have confidence that the maturity of Christian faith of their clients will contribute to the reduction of anxiety.

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Instrument Development for Patient Respect (환자 존중 측정도구 개발)

  • Yoo, Myoung-Ran;Hyeon, Jin-Suk;Choi, Yun-Jung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.13 no.2
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    • pp.162-168
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    • 2007
  • Purpose: Patients hope to receive 'respected nursing' which guarantees the right of privacy and treatment as a human being in hospitals. However, no specific tool has been developed to measure patients' perceived respect from nurses while staying in hospitals. This study was conducted to develop a tool to measure the respect that they experience in hospital. Method: A basic questionnaire was made based on research literature, pilot studies, and collected data via patients' interviews. The questionnaire was verified by 5 members of an expert group, a chief nurse in the clinical area and 10 patients. We distributed the questionnaires to 266 randomly selected inpatients and carried out analyses of factors and content to evaluate the validity and reliability of the questionnaire. Result: According to the results of factor analyses, three factors such as 'cordial treatment', 'consideration', and 'recognition' were extracted, which took up to 61 percent from all variants. Final questionnaires has 30 questions on a 4-point scale. Conclusion: The questionnaire which was designed through the study showed a high reliability and validity. We anticipate that this questionnaire will contribute to fostering nursing care with respect for patients.

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Clinical Meaning of Hallucinatory Experience among PTSD Patients (외상 후 스트레스 장애 환자에서 발생한 환각 경험의 임상적 의미)

  • Park, Ji Hoon;Yi, Jung Seo;Lee, Hong Seock
    • Anxiety and mood
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    • v.9 no.2
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    • pp.113-120
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    • 2013
  • Objectives : The aim of this study was to investigate clinical meaning of hallucination among patients with posttraumatic stress disorder (PTSD). Methods : PTSD patients with hallucination (n=50) were selected and matched with the PTSD patients without hallucination (n=50) by age and sex. The patients were evaluated in two different aspects, pathologic aspects which can develop after traumatic event, and positive/adaptive aspects which are concerned in positive psychology. In addition to these, temperament and character features between two groups were also evaluated using the Temperament and Character Inventory (TCI). Results : Except for the total score of DES (Dissociative Experience Scale) and the score of re-experience subscale of CAPS (Clinician Administered PTSD Scale), clinical characteristics did not show any significant difference between the two groups. Among the comparison of seven higher dimensions in TCI profiles, only Self-transcendence showed significant difference between the two groups. Conclusion : The two groups did not show significant differences in pathologic aspects except for factors that may contribute to development of hallucination. Furthermore, authors could not find any differences in positive/adaptive aspects.

A study of the effects of Cheongsimyeonjatang (CYT) on ECG in comparing before and after CYT medication: Case study of hospitalized Taeumin patients (청심연자탕(淸心蓮子湯)이 심전도(心電圖) 변화(變化)에 미치는 영향(影響)에 관한 연구(硏究))

  • Bae, Young-Chun;Lee, Sang-Min;Kim, Kyung-Yo;Kim, Hyoung-Soon
    • Journal of Sasang Constitutional Medicine
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    • v.15 no.3
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    • pp.147-157
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    • 2003
  • The purpose of this study is to examine the effects of Sasang constitutional herbal extracts, Cheongsimyeonjatang(CYT) on ECG(electrocardiogram). For this purpose, Ten hospitalized Taeumin patients were selected and changes of the ECG was investigated. The researcher also measured and observed ECG changes before and after CYT medication. The following is the summarized results of study. 1. The RV5+SV1 voltage was decreased in LVH patients. 2. The S-T voltage was decrease in the previous S-T elevated patients. 3. The heart rate was increased in the patients of lower heart rate than normal. 4. There was no remarkable change after medication on T-inversion and bundle branch block. From the above results, it is concluded that Cheongsimyeonjatang(CYT) have influenced on ECG.

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The Results of Yangdorak(良導絡) and D.I.T.I,, according to Deficiency or Excess(虛實) of Acne Patients (여드름 환자의 허실(虛實)에 따른 양도락(良導絡) 및 적외선체열진단 결과 분석)

  • Jung, Min-Young;Kim, Dae-Su;Park, Su-Yeon;Kim, Jong-Han;Choi, Jeong-Hwa;Park, Yong-Ho
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.20 no.2 s.33
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    • pp.171-178
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    • 2007
  • Objective : The aim of this study was to evaluate Yangdorak and D.I.T.I. for analysis of Symptom-complexes. Method : This study was selected 26 acne patients in Dongshin University Oriental Medical Hospital. We used Yangdorak (SME5800N, Sord Medicom Co., Korea) and D.I.T.I. (Digital Infrared Thermal Imaging 256, Dorex Inc, Orange CA, USA) and investigated the results of Yangdorak and D.I.T.I.. We made a comparison according to Deficiency or Excess(虛實) of acne patients. Result : In comparing Yangdorak results according to Deficiency or Excess(虛實) of acne patients, Triple-energizer(三焦), Intestine(大腸), Liver(肝), Stomach(胃) meridian in Excess group are higher than Deficiency group, and Kidney(腎) meridian in Deficiency group are lower than Excess group. D.I.T.I. reveald hyperthemia of face and chest on acne patients. The temperature of face and chest on Excess group is higher than Deficiency group. There is no statistically significant value compared with data of other group.

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Relationship Between Plantar Foot Pressures and Plantar Ulceration in Patients With Hansen's Disease (한센병 환자의 족저궤양과 최대 족저압력과의 관계)

  • Jung, Do-Young;Park, Kyoung-Hee;Lee, Kang-Sung
    • Physical Therapy Korea
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    • v.9 no.1
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    • pp.63-68
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    • 2002
  • Foot ulceration results in substantial morbidity in patients with peripheral neuropathy. The purpose of this study was to find the relationship of plantar foot pressures during walking to plantar ulceration in patients with Hansen's disease. The subjects were recuruited from two Welfare Clinic for Hansen's disease in Wonju and Uiwang city. Ten subjects (5 females, 5 males) with plantar ulceration and a mean age of 63 years were evaluated in this study. The mean duration of Hansen's disease in these subjects was 30 years. Plantar pressures were measured during self-selected comfortable walking speed by using MatScan system. Three subjects had plantar ulceration under the first metatarsal head. Five subjects had plantar ulceration under the second and third metatarsal head. Two subjects had plantar ulcers under the fifth metatarsal head. Eight of 10 subjects had plantar ulceration at highest pressure point that measured during walking. This result suggests that the abnormal high plantar pressure could be related factor to plantar ulceration in patients with Hansen's disease. Also the foot pressure measurement may be useful to evaluate the risk of plantar ulceration in patients with Hansen's disease.

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Difficult Intubation in Patients Undergone Oromaxillary Surgery: Retrospective Study (전신마취를 시행한 구강외과 환자에서 어려운 기관내삽관: 후향적 연구)

  • Kwon, O-Seon;Kim, Cheul-Hong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.8 no.2
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    • pp.118-121
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    • 2008
  • Background: This retrospective study aims to describe the airway management and to search predictive parameter for difficult intubation in 700 patients undergoing oromaxillary surgery. Methods: The medical records of 700 patients undergone oromaxillary surgery were reviewed for airway management during perioperative period. The cases of difficult intubation were selected and those radiologic findings were reviewed. The mandibular depth (MD), mandibular length (ML), thyromental distance (TMD) were measured. Results: In 41 cases difficult intubation were recorded in anesthetic record. The grade of Cormack and Lehane was III in 36 patients and IV in 5 cases. The MD of difficult intubation cases was $4.2{\pm}3.2\;cm$. The ML of difficult intubation cases was $10.1{\pm}3.8\;cm$. The TMD of difficult intubation cases was $5.9{\pm}4.3\;cm$. Under the fiberoptic guided awake intubation was undertaken in 75 patient. In none of the cases was failed nasotracheal intubation. Conclusions: The patients undergoing oromaxillar surgery have a potentially difficult airway but, if managed properly during perioperative preiod, morbidity and mortality can be reduced or avoided. The radiologic findings were poor predict for difficult intubation. The fiberoptic guided awake intubation is a safe alternative to direct laryngoscopic intubation.

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Could immediate treatment change the management method of digital tendon musculotendinous junction avulsion?: a systematic review

  • Park, Sam-Guk
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.200-207
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    • 2017
  • Background: We conducted a systematic review of the literature to investigate the correlation between the interval to treatment and management of tendon avulsion ruptures in the musculotendinous junction (MTJ) of the forearm. Methods: A thorough literatures search for studies of tendon avulsion injuries at the forearm was conducted using PubMed, MEDLINE, CINAHL, and Cochrane databases in accordance with the PRISMA guidelines. In total, five case series and 15 case reports accounting for 87 injured tendons involving 60 patients were selected for the analysis. Results: Twenty-six patients had 44 tendon injuries associated with avulsion amputations, 31 patients had 38 tendon ruptures associated with closed avulsion injuries and three patients had five tendon ruptures associated with open avulsion injuries. Eighteen of the 49 (37%) patients were immediately treated for tendon ruptures and one of the 32 (3%) tendon ruptures treated via elective surgery was directly repaired. Additionally, 18 of the 30 (60%) tendons were directly repaired and 12 of the 30 (40%) tendons were transferred or side-to-side repaired in the immediately treated series. In contrast, one of the 28 (4%) tendon ruptures were directly repaired and 27 of the 28 (96%) tendons were transferred or side-to-side repaired in the electively treated series. Conclusion: In managing digital tendon avulsions at the MTJ, an immediate treatment could provide an opportunity to repair the ruptured tendon directly to the muscle.

How do Lung Cancer Patients Experience Stigma?: A Meta-synthesis of Qualitative Studies

  • Jeong, Ji Yeon;Jeong, Gyeonghui;So, Hyang Sook
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.116-126
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    • 2016
  • Purpose: Lung cancer patients are often stigmatized since lung cancer is closely associated with smoking, which is a self-administered life style. The stigma of lung cancer has been examined in some qualitative studies; however, their findings were diverse and not yet synthesized. Therefore, this meta-synthesis study aimed to explore how lung cancer patients experience stigma. Methods: A meta-synthesis method, as suggested by Sandelowski and Barroso in 2007, was applied by aggregating the findings after an evaluation according to consolidated criteria for reporting qualitative research (COREQ). Results: By synthesizing the findings of the selected seven papers, a synthesized theme was emerged as "experiencing external and internal distances, which mandates authentic and consistent supports." The four sub-themes included 'experiencing some distance from the surrounded world,' 'experiencing self-made distance between the disease and oneself,' 'the disease experience causes social isolation and loneliness,' and 'there is lack of supportive care for myself.' Conclusion: Health care providers should be more attentive to supporting lung cancer patients by providing more effective advocacy programs that improve patients' quality of life.