The purpose of this study was to determine an effect of the health camp program on self-efficacy, sick-role behavioral compliance and glucose metabolism in juvenile diabetes mellitus patients. The quasi -experimental study was designed using a nonequivalent control group pre-posttest design with the framework of Bandura's self-efficacy theory. Forty-two juvenile diabetes mellitus patients participating in this study were selected from outpatients. Of these, twenty-one were assigned to the experimental group and twenty-one to the control group. The period of data collection was from August 8 to December 9 in 1994. The health camp program for the experimental group was carried out over 6 days and the control group did not participate in the program. Collection data was analyzed by means of chi - square test, t - test, ANCOVA, Pearson correlation with SPSS /PC+. The result were summarized as follows: 1. The health camp program was effective in in-creasing the scores of self-efficacy for juven-ile diabetes mellitus patients. 2. The health camp program was effective in increasing the scores of sick - role behavioral compliance for juvenile diabetes mellitus patients. 3. The health camp program was not effective in decreasing the levels of glucose metabolism. 4. The more self-efficacy increased, the more sick - role behavioral compliance increased. 5. Boys showed the higher self-efficacy than girls and the group with diabetes patients whose family members are also patients, showed the higher self-efficacy and sick-role behavioral compliance than the group without diabetic patient among the family members. Thus, it can be concluded that the health camp program was a useful health intervention for juvenile diabetes mellitus patients.
Purpose: Lymph node (LN) metastasis is the best prognostic indicator in non-distant metastatic advanced gastric cancer. This study aimed to assess the prognostic value of various clinicopathologic factors in node-negative advanced gastric cancer. Materials and Methods: We retrospectively analyzed the clinical records of 254 patients with primary node-negative stage T2~4 gastric cancer. These patients were selected from a pool of 1,890 patients who underwent radical resection at Memorial Jin-Pok Kim Korea Gastric Cancer Center, Inje University Seoul Paik Hospital between 1998 and 2008. Results: Of the 254 patients, 128 patients (50.4%), 88 patients (34.6%), 37 patients (14.6%), and 1 patient (0.4%) had T2, T3, T4a, and T4b tumors, respectively. In a univariate analysis, operation type, T-stage, venous invasion, tumor size, and less than 15 LNs significantly correlated with tumor recurrence and cumulative overall survival. In a multivariate logistic regression analysis, tumor size, venous invasion, and less than 15 LNs significantly and independently correlated with recurrence. In a multivariate Cox proportional hazards analysis, tumor size (hazard ratio [HR]: 2.926; 95% confidence interval [CI]: 1.173~7.300; P=0.021), venous invasion (HR: 3.985; 95% CI: 1.401~11.338; P=0.010), and less than 15 LNs (HR: 0.092; 95% CI: 0.029~0.290; P<0.001) significantly correlated with overall survival. Conclusions: Node-negative gastric cancers recurred in 8.3% of the patients in our study. Tumor size, venous invasion, and less than 15 LNs reliably predicted recurrence as well as survival. Aggressive postoperative treatments and timely follow-ups should be considered in cases with these characteristics.
Kim, Jae Hoon;Song, Jin Woo;Park, Sung Wan;Oh, Won Suk;Lee, Joo Heon
Archives of Plastic Surgery
/
v.41
no.1
/
pp.3-11
/
2014
Background This study aimed at overcoming the disadvantages of septal extension grafts and keeping the nasal tip as natural as possible by using different forms of the graft and additional supporting methods depending on the case. Methods Among 458 patients who received a septal extension graft from March 2008 to September 2011, 107 patients were selected who underwent at least a 6-month follow-up. Patients were categorized according to the primary objective of the operation; an upturned tip correction or tip lengthening, tip lengthening with tip projection, or retracted columella correction. Each group of patients received a different type of septal extension graft out of 3 different types of grafts based on the purpose of the operation. The evaluation of the results was made from by comparing preoperative and postoperative photographs of the tip angle, projection, and nasolabial angle. Results The average tip angle for the patients in the upturned tip correction group was reduced to 98.3 from 124.9 degrees. For the patients in the tip lengthening with tip projection group, the average tip angle was reduced to 96.8 from 122.4 degrees and the average tip projection was increased to 27.5 from 23.2 mm. The average nasolabial angle for the patients in the retracted columella correction group was increased to 94.6 from 74.8 degrees. Conclusions Sufficient nasal tip lengthening and projection could be achieved by applying a septal extension graft using the graft best suited for the group of patients categorized by surgical objective.
Background: Gastric cancer (GC) is the fifth most common cancer worldwide. Since development is usually asymptomatic, it is generally diagnosed at an advanced stage. The value of screening in patients with nonspecific symptoms for GC is controversial. Aim: The study aimed to evaluate whether hematological parameters (platelet count (PC), mean platelet volume (MPV), MPV/PC ratio, red blood cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR)) are useful markers to differentiate between gastric cancer patients and healthy individuals. Materials and Methods: Sixty-one patients with gastric cancer and sixty-one healthy individuals were enrolled to the survey and retrospective analysis of selected blood parameters were performed. Results: The mean values of PC, MPV, RDW, NLR, and PLR were significantly higher in GC patients compared to the control group. No statistical differences were observed in MPV/PC ratios. Likewise, no significant statistical differences were revealed in values of blood parameters among TNM stage groups. The RDW showed the highest diagnostic specificity and sensitivity. Conclusions: Hematological parameters: PC, MPV, RDW, NLR, PLR have diagnostic power and can discriminate patients with gastric cancer from patients without cancer. Blood parameters compared with clinical symptoms might alert physicians and patients and lead to performancce of upper gastrointestinal endoscopy, the gold standard in gastric cancer screening and therebly increase the early detection of cancer.
Seo, Yejin;Geum, Min Jung;Lee, Kyung Ah;Kim, Jae Song;Son, Eun Sun;Yu, Yun Mi
Korean Journal of Clinical Pharmacy
/
v.30
no.3
/
pp.149-160
/
2020
Background: Basiliximab is used as an alternative to tacrolimus in patients with decreased renal function. However, studies on basiliximab as a maintenance immunosuppressant, particularly in patients with lung transplantation, are limited. Therefore, here, we investigated the efficacy and safety of basiliximab in patients with lung transplantation. Methods: Adult patients with acute kidney injury (AKI) who received lung transplantation at a single general hospital between July 1, 2014 and June 30, 2018, were selected and classified in tacrolimus and basiliximab groups. Both groups received a triple-drug regimen (tacrolimus, mycophenolate mofetil, and steroids). However, tacrolimus was discontinued in the basiliximab group when AKI occurred, and two or more repeat basiliximab doses were administered within 3 months after transplantation. The electronic medical records were analyzed retrospectively. Results: Of the 85 patients who met the selection criteria, 61 and 24 were assigned to the tacrolimus and basiliximab groups, respectively. Significant improvement in renal function was observed in the basiliximab group (p <0.001). However, there were no differences in acute and chronic rejection rates in both the groups. No difference was observed in the incidence rate of complications between the groups, except for chronic kidney disease, which showed higher incidence in the basiliximab group (25.0% vs. 4.9%; p =0.013). Conclusions: We suggest the use of basiliximab as an immunosuppressant alternative to tacrolimus in patients with acute renal failure after lung transplantation. Basiliximab demonstrated effectiveness as an immunosuppressant and improved renal function. Therefore, basiliximab can be used in patients with decreased renal function.
Background: Systemic chemotherapy for patients with metastatic gastric cancer (MGC) is generally palliative, although some patients experience long-term survival after treatment. Thus, we identified clinical characteristics that are associated with long-term survival of patients with MGC after palliative chemotherapy. Materials and Methods: We retrospectively reviewed 514 MGC patients who received systemic chemotherapy at our institution from 2001 to 2008. To identify clinical predictors of survival beyond 2 years, multivariate logistic regression analyses were performed, and 5-year survival rates were estimated among MGC patients following chemotherapy. Results: Among 514 patients, 96 (19%) and 16 (3%) survived beyond 2 and 5 years, respectively, and performance status of 0 or 1 (odds ratio [OR]=3.39; p=0.01), previous gastrectomy (OR=1.86; p=0.01), single metastatic site (OR=1.80; p=0.03), and normal alkaline phosphatase levels (OR=2.81; p<0.01) were identified as independent predictors of long-term survival. Of the 16 5-year survivors, six were alive at the end of the study and showed no evidence of disease despite cessation of chemotherapy. Conclusions: The present data demonstrate distinct clinical characteristics that are associated with long-term survival of MGC patients, and indicated that palliative chemotherapy can be curative in highly selected patients.
Objective: To investigate the effects of secondary left-sided portal hypertension (LSPH) on the radical operation rate of patients with pancreatic cancer and systemically evaluate the prognosis of patients with LSPH secondary to pancreatic cancer after radical surgery. Materials and Methods: The data of patients with pancreatic cancer who underwent laparotomy over a 15-year period in Department of Hepatobiliary Surgery of Chinese PLA Air Force General Hospital from Jan. 1, 1997, to Jun. 30, 2012 was retrospectively reviewed. Results: A total of 362 patients with pancreatic cancer after laparotomy were selected, including 73 with LSPH and 289 without LSPH. Thirty-five patients with LSPH (47.9%) and 147 without non-LSPH (50.9%) respectively underwent radical operations. No significant difference was found between these two groups regarding the total resection rate and stratified radical resection rate according to different pathological types and cancer locations. The mean and median survival time of patients after radical operation in LSPH group were $13.9{\pm}1.3$ months and 14.8 months, respectively, while those in non-LSPH group were $22.6{\pm}1.4$ months and 18.4 months, respectively(P<0.05). Conclusions: Radical operations for pancreatic cancer and secondary LSPH are safe and effective. Because high-grade malignancy and poor prognosis are closely associated, the decision for radical surgery should be made more meticulously for the patients with pancreatic cancer.
Background: The optimal surgical strategy for the treatment of synchronous resectable gastric cancer liver metastases remains controversial. The aims of this study were to analyze the outcome and overall survival of patients presenting with gastric cancer and liver metastases treated by simultaneous resection. Materials and Methods: Between January 1990 and June 2009, 35 patients diagnosed with synchronous hepatic metastases from gastric carcinoma received simultaneous resection of both primary gastric cancer and synchronous hepatic metastases. The clinicopathologic features and the surgical results of the 35 patients were retrospectively analyzed. Results: The 5-year overall survival rate after surgery was 14.3%. Five patients survived for more than 5 years after surgery. No mortality has occurred within 30 days after resection, although two patients (5.7%) developed complications during the peri-operative course. Univariate analysis revealed that patients with the presence of lymphovascular invasion of the primary tumor, bilateral liver metastasis and multiple liver metastases suffered poor survival. Lymphovascular invasion by the primary lesion and multiple liver metastases were significant prognostic factors that influenced survival in the multivariate analysis (p=0.02, p=0.001, respectively). Conclusions: The presence of lymphovascular invasion of the primary tumor and multiple liver metastases are significant prognostic determinants of survival. Gastric cancer patients without lymphovascular invasion and with a solitary synchronous liver metastasis may be good candidates for hepatic resection. Simultaneous resection of both primary gastric cancer and synchronous hepatic metastases may effectively prolong survival in strictly selected patients.
Background: Predictor factors determining complete response to treatment are still not clearly defined. We aimed to evaluate clinicopathological features, risk factors, treatment responses, and survival analysis of patient with advanced nonseminomatous GCTs (NSGCTs). Materials and Methods: Between November 1999 and September 2011, 140 patients with stage II and III NSGCTs were referred to our institutions and 125 patients with complete clinical data were included in this retrospective study. Four cycles of BEP regimen were applied as a first-line treatment. Salvage chemotherapy and/or high-dose chemotherapy (HDCT) with autologous stem cell transplantation were given in patients who progressed after BEP chemotherapy. Post-chemotherapy surgery was performed in selected patients with incomplete radiographic response and normal tumor markers. Results: The median age was 28 years. For the good, intermediate and poor risk groups, compete response rates (CRR) were, 84.6%, 67.9% and 59.4%, respectively. Extragonadal tumors, stage 3 disease, intermediate and poor risk factors, rete testis invasion were associated with worse outcomes. There were 32 patients (25.6%) with non-CR who were treated with salvage treatment. Thirty-one patients died from GCTs and 94% of them had stage III disease. Conclusions: Even though response rates are high, some patients with GCTs still need salvage treatment and cure cannot be achieved. Non-complete response to platinium-based first-line treatment is a negative prognostic factor. Our study confirmed the need for a prognostic and predictive model and more effective salvage approaches.
Kwon, H.;Kim, K.;Kim, J.M.;Lee, Y.H.;Kim, T.E.;Lim, H.K.;Park, Y.K.;Ko, Y.G.;Chung, N.
Progress in Superconductivity
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v.8
no.1
/
pp.46-53
/
2006
Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool for the detection of cardiac electrical abnormality associated with myocardial ischemia. In our previous study, we have proposed a new classification method of MCG parameters, based on the different populations of the parameters between coronary artery disease(CAD) patients, symptomatic patients and healthy volunteers. We used four parameters, representing the directional changes of the electrical activity in the period of an R-ST-T interval. In patients with chest pain and without ST-segment elevation, who were selected consecutively from all patients admitted to the hospital in 2004, the patients with CAD could be classified with a higher sensitivity than conventional methods, showing that the proposed method can be useful for the diagnosis of CAD with MCG. In this study, we examined the validity of the algorithm with the prior probability distribution in diagnosis of new patients admitted to the hospital in 2005. In the results, presence of CAD could be found with sensitivity and specificity of 81.3% and 71.4%, respectively, in patients with chest pain and non-diagnostic ECG findings.
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