• Journal of Chest Surgery
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• v.56 no.1
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• pp.25-32
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• 2023

Background: We reviewed the clinical outcomes of patients with oligometastatic (OM) non-small cell lung cancer (NSCLC) who received multimodal therapy including lung surgery. Methods: We retrospectively analyzed 117 patients with OM NSCLC who underwent complete resection of the primary tumor from 2014 to 2017. Results: The median follow-up duration was 2.91 years (95% confidence interval, 1.48-5.84 years). The patients included 73 men (62.4%), and 76 patients (64.9%) were under the age of 65 years. Based on histology, 97 adenocarcinomas and 14 squamous cell carcinomas were included. Biomarker analysis revealed that 53 patients tested positive for epidermal growth factor receptor, anaplastic lymphoma kinase, or ROS1 mutations, while 36 patients tested negative. Metastases were detected in the brain in 74 patients, the adrenal glands in 12 patients, bone in 5 patients, vertebrae in 4 patients, and other locations in 12 patients. Radiation therapy for organ metastasis was performed in 81 patients and surgical resection in 27 patients. The 1-year overall survival (OS) rate in these patients was 82.8%, and the 3- and 5-year OS rates were 52.6% and 37.2%, respectively. Patients with positive biomarker test results had 1-, 3-, and 5-year OS rates of 98%, 64%, and 42.7%, respectively. These patients had better OS than those with negative biomarker test results (p=0.031). Patients aged ≤65 years and those with pT1-2 cancers also showed better survival (both p=0.008). Conclusion: Surgical resection of primary lung cancer is a viable treatment option for selected patients with OM NSCLC in the context of multimodal therapy.

• Journal of Biomedical Engineering Research
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• v.44 no.1
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• pp.11-18
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• 2023

Currently, studies to predict the risk of rectal cancer surgery select MRI image slices based on the clinical experience of surgeons. The purpose of this study is to semi-automatically select and classify 2D MRI image slides to predict the risk of rectal cancer surgery using biomarkers. The data used were retrospectively collected MRI imaging data of 50 patients who underwent laparoscopic surgery for rectal cancer at Gachon University Gil Medical Center. Expert-selected MRI image slices and non-selected slices were screened and radiomics was used to extract a total of 102 features. A total of 16 approaches were used, combining 4 classifiers and 4 feature selection methods. The combination of Random Forest and Ridge performed with a sensitivity of 0.83, a specificity of 0.88, an accuracy of 0.85, and an AUC of 0.89±0.09. Differences between expert-selected MRI image slices and non-selected slices were analyzed by extracting the top five significant features. Selected quantitative features help expedite decision making and improve efficiency in studies to predict risk of rectal cancer surgery.

• Journal of Korean Academy of Nursing
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• v.5 no.1
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• pp.93-111
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• 1975

As the hospitalized patients will be facing new stress situation due to change of his environment from home to hospital it will be very important to understand the psychological stress experienced by hospital patients not only for helping patients in the process of recovery from illness but also fulfil1ing the objective of comprehensive nursing care by understanding the needs of the patients. There is no doubt that it would be very helpful for treatment of patients as well as for improvement of nursing care if we know more about psychological needs of patients and give them adequate support to meet these needs. The study to find out the causes and degree of stress events experienced by hospitalized patients, with the objective of instituting improvement of nursing care program based on the needs of patients, was conducted during the month of September 1974 with 60 patients randomly selected from those admitted to medical and surgical wards at Yonsei Medical Center in that period The questionnaire form included 36 questions which are considered to be stress events for hospital patients, and was devide into five areas namely, such events related to 1) disease itself, 2) hospital environment, 3) nursing care and treatment, 4) communication and human relations, and 5) family and economic problems. The results of the study were as follows: 1. It was confirmed that hospitalization considered to be a stress producing factor and most patients perceived the admission to hospital as a stress factor. 2. According to the rating scale, it was found that degree of perceived stress shows a variation according to the source of stress producing event. 3. No significant differences in the mean values were observed statistically with the perceived stress levels according to demographic and other variables of patients related to hospitalization. 4. Among the questions related to disease itself, "Admission for surgery" was perceived most frequently as a stress event (97.14%) by patients. 5. With regard to the questions related to hospital environment, "death of the patient room-mate" was the most serious stress event perceived by patients (90%) and "living with hospital regulations"was considered to be less serious stress event (23.33%). 6. As for the questions related to nursing care and treatment, "limitation of freedom" was perceived as a stress factor most frequently (70.91%) by the patients and "worry for wrong treatment" turned out to be less frequent stress event (50.0%). 7. As for the questions related to communication and human relations, "difficulty to meet doctors when wanted"appeared to be the most frequent stress event by the respondents (75.86%) , followed by "no explanation about treatment or examination"(75.0%) and "no explanation about nursing care procedures"(71.66%). 8. With regard 111 tile questions related to family and economic problems, "inadequate finances for family living due to hospitalization"and "high cost of hospitalization" were the most frequent cause of stress mentioned by the patients. (80.0%). 9. As a result of application of the stepwise regression analysis, it was found that about 89% was explained by those events associated with disease itself, hospital environment and family and economic problems. By adding those events related to "nursing care and treatment" and "communication and human relation", 100% of stress associated with hospitalization was explained.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8259-8263
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• 2014

Aims: To determine the clinical characteristics, pathological features, local and distant failure patterns in patients with carcinoma of major salivary glands treated with surgery and postoperative radiotherapy (PORT). Materials and Methods: We retrospectively reviewed 106 cases of major salivary gland tumor seen at our centre (1998-2008). Sixty five cases of major salivary gland carcinoma were selected for analysis (exclusions: benign, palliative, non-carcinomas). The patient population treated by surgery and PORT was divided into two groups: 1) Patients who underwent surgery and immediate PORT (Primary PORT); 2) Patients with recurrent carcinoma who underwent at least two surgeries and received PORT in the immediate post-operative period of the last performed surgery (Recurrent PORT). Recurrence free survival (RFS) was assessed using the Kaplan-Meier method. Results: Median age was 35 years with a male: female ratio of 1.3:1. The majority of cancers were located in the parotid gland (86.2%) and the most common histology was mucoepidermoid carcinoma (43%). Thirty nine cases (60%) were primary while 26 (40%) were recurrent. Optimal surgery was performed in 59/65 patients (90.8%). 43 patients (66.2%) underwent neck dissection, of which 14 (32.5%) had nodal metastasis. Overall, 61 (93.8%) patients complied with the prescribed radiotherapy. Median dose of PORT was 60 Gy. Median follow-up was 13.1 months (range 2-70). Relapse free survival was 50.4% at 60 months. Some 12 cases (18.5%) recurred with a median time to recurrence of 16.9 months. Conclusions: Surgery and PORT is an effective treatment for major salivary gland carcinoma with over 90% compliance and <20% recurrence. Early treatment with postoperative radiotherapy may increase the survival rate in major salivary gland carcinoma patients.

• The Journal of Advanced Prosthodontics
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• v.9 no.3
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• pp.224-231
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• 2017

PURPOSE. This study was designed to evaluate the teeth and dental implants during dental maintenance therapy over 3 years in different conditions after periodontal and dental prosthetic treatment. MATERIALS AND METHODS. 166 patients received maintenance therapy. 59 patients were treated with 2% minocycline-HCl ointment as local drug delivery (LDD) (L group) and 107 patients were treated without LDD (NL group). Clinical data was collected in maintenance period for evaluation. Patients were classified into groups depending on the application of LDD with maintenance therapy, the type of dental treatment before maintenance period (Pre-Tx), the frequency (F-MT), and regularity (R-MT) of maintenance therapy. RESULTS. The numbers of lost teeth (N-teeth, P=.003) and newly placed dental implants (N-implants, P=.022) are significantly different according to Pre-Tx. F-MT among patients who received surgical dental treatment before maintenance period showed statistical differences in N-teeth (P=.041), but not in N-implants (P=.564). All of the patients in L group showed high F-MT (F-MT1). In NL group, there were no statistical differences in N-teeth or N-implants according to F-MT or R-MT. In F-MT1 group, application of LDD made N-teeth significantly different from both Pre-Tx groups while no significant difference could be found in N-implant. Independent t-test and one-way ANOVA were selected for statistical analysis. CONCLUSION. The regular maintenance therapy and LDD can be effective for teeth during maintenance period. It is not only pharmacological efficacy in decreasing bacterial species that makes LDD a useful adjunct. Application of LDD also motivates patients to take adequate check-ups in the aspects of both frequency and regularity.

• Journal of Trauma and Injury
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• v.29 no.4
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• pp.99-104
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• 2016

Purpose: There are many patients visited to ED in an alcohol intoxicated state. For these patients, it is difficult to predict by only clinical examination whether he/she would have brain lesion. The purpose of this study is to research whether it is possible to predict brain lesion by only clinical examination findings, with comparing patients with/without actual brain lesions. Methods: A retrospective study was performed at a university hospital for the period 11 months with the medical records. As for the inclusion group, head trauma patients with objectively proved drunk, judging by their blood ethanol concentration, and performed the brain CT were selected. In terms of medical record, Glasgow coma scale (GCS), the presence of neurologic abnormalities, the presence of lesion on brain CT of the patients, were examined. From laboratory results, blood ethanol concentration, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT) and glucose concentration were identified. Results: For this study, there were total 80 patients of inclusion group. There was no statistically significant difference in terms of GCS score and neurological examination abnormalities, between the group with brain lesion and the group without brain lesion on brain CT. Conclusion: Alcohol intoxicated patient with head trauma visits the ED, it is not possible to distinguish or determine whether brain lesion exists or not by only clinical findings. In order to check the lesion existence, the image examination, therefore, should be considered and performed.

• Korean Journal of Adult Nursing
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• v.14 no.1
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• pp.93-101
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• 2002

Using the APCHE III tool, this study was about the factors related to the death of ICU-patients. From 1999. 12. 1 to 2000. 9. 30, the 284 patients admitted to ICU at P university who were over 15 years of age were selected for the subjets. The data was analyzed through SPSS WIN program for frequency, percentile, $x^2$-test, t-test and logistic regression. The results are summarized as follows: 1) Of the 284 patients, 88died. The mortality is 31.0 percent. The average APACHE III point was $48.62{\pm}32.32$. The average point of non-survivors was higher than that of survivors. 2) There are the significant difference between APACHE III marks and mortality. The mortality rate were over 50 percent 60 points of the mark. When the marks were over 100 points, the mortality were over 90 percent. Below 40 points, the mortality was below 10 percent. Among the variables in the APACHE III, the most significant variables in explaining death were neurologic abnormalities, pulse, $PaO_2$/$AaDO_2$, creatinine, sodium, glucose, chronic health state and age. According to the variables, the models explained the 42.43 percent of the variance in patient's death. In conclusion, the APACHE III tool can be used to predict the progress of ICU patients, and can also be used for the selection of patients for ICU admission/discharge criteria.

• Journal of Pharmacopuncture
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• v.17 no.4
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• pp.22-26
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• 2014

Objectives: This study was performed to estimate the effectiveness of burning acupuncture therapy (Hwachim) and sweet bee venom pharmacopuncture (S-BV pharmacopuncture) in treating lateral epicondylitis of elbow. Methods: We selected 33 patients at first, but 13 patients were excluded due to unclear medical records. Finally, a total of 20 patients who had received treatment from January 2012 to December 2013 were included in this study; all 20 patients had undergone Hwachim for the treatment of lateral epicondylitis of elbow, and 19 of the 20 had been treated with S-BV pharmacopuncture (Korea Pharmacopuncture Institute, KPI) and transcutaneous electrical nerve stimulation (TENS) as an ancillary treatment method. The degrees of pain of the 20 patients were evaluated by using the visual analogue scale (VAS) score at their first and final visits. The Wilcoxon signed rank test and the Kruskal-Wallis test were used to compare the VAS scores statistically. Results: The VAS score had decreased significantly from $10.00{\pm}0.00$ to $4.00{\pm}2.47$ (P = 0.000) by the end of the treatment. No significant changes were observed based on the number of treatments (P = 0.246), the age of the patients (P = 0.810), the duration of the illness (P = 0.705), and the location of the lesion (P = 0.076). Conclusion: This study suggests Hwachim and S-BV pharmacopuncture are very effective for treating lateral epicondylitis of the elbow.

• Journal of the Korean Dietetic Association
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• v.5 no.1
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• pp.64-73
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• 1999

Carbohydrate(CHO) counting is a meal planning approach used with diabetic patients that focuses on carbohydrate as the primary nutrient affecting post-prandial glycemic response. However, it has not been used in meal management of diabetic patients in Korea. CHO counting can be used by clients with type 1 and 2 diabetes. The purpose of the study was to determine the barriers to utilize the CHO counting when three levels of CHO counting were educated to type 2 diabetic patients who started continuous subcutaneous insulin infusion (CSⅡ) therapy by nutrition lectures and counseling. And the CHO-to-insulin ratios were determined for the individual patients who followed the carbohydrate counting as a meal management, and the factors to influence the CHO-to-insulin ratios were selected through the stepwise regression analysis. Twenty- four subjects were received three lectures, and one or two nutritional counseling for a month. The average age of the subjects was 50.7 years, and the duration of diabetes was 9.4 years. Their body mass index (BMI) was 21.5 kg/$m^2$. The difficulties of using CHO counting were 1) confusing the CHO exchange system to diabetic food exchange system, 2) lack of basic nutrition and not distinguishing nutrients such as CHO, fat and calorie, and 3) lack of motivation to make effort to count and record the amount of carbohydrates eaten. Nutritional counseling replenished the nutrition education and made patients practice CHO counting. Average CHO-to-insulin ratios at breakfast, lunch and dinner were 4.1$\pm$3.3, 2.9$\pm$2.6 and 2.9$\pm$3.0units/23g of CHO, respectively. CHO-to-insulin ratios were influenced by gender, age, BMI, post-prandial blood glucose levels and post-prandial c-peptide levels. The effective education and nutritional counseling of CHO counting can make CHO counting applicable to type 2 diabetic patients as meal management for improving glycemic control with less hypoglycemic episode.

• Journal of Korean Academy of Nursing
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• v.27 no.4
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• pp.787-795
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• 1997

This descriptive study was conducted to ascertain whether the needs of patients with cancer, their caregivers and their nurses changed according to the illness phases and if the perceived needs of the three groups were different for three categories of nursing needs. At two hospitals in Seoul and Choongnam, three groups of subjects, -patients with cancer(79), caregivers(92), and nurses(72) - responded to a questionnaire consisting of items on educational need(11 items), physical need(8 items), emotional need(9 items) using a 4-point Likert scale. The patients and caregivers were selected according to the phase of the cancer (initial, intermediate or recurred, terminal phases). Finding revealed that the level of perception and degree of satisfaction of the needs were low, just around two points in patients and caregivers. Of the three categories of needs, physical needs were received the highest score and the degree of satisfaction of physical needs was also the highest. There was no significant difference between the level of perception and satisfaction of needs in patients and caregivers according to the phases of the illness and the degree of per reception and the satisfaction of the patients were not significantly different and caregivers showed the same result. There was a significant difference in the level of importance of the needs of nurses according to the phases of the cancer. They perceived emotional needs were the most important in first phase and second phase, physical needs in third phase and the educational needs were more important in the first phase than in any other phase. The degree of importance of needs was significantly lower than the degree to which needs were addressed, according to the nurses response. In a comparison of patient and caregiver's perceived degrees of need, and need satisfaction, and nurse's perceived degree of need provision, patient and caregiver scores were lower than the nurses.