• Journal of Korean Biological Nursing Science
• /
• v.3 no.1
• /
• pp.29-40
• /
• 2001

The purpose of this study was to investigate the effect of exercise training on work capacity, psychologic functions and quality of life in hemodialysis patients. Forteen hemodialysis patients, 3 males, 11 females, age ranged from $23{\sim}58$ years($42.3{\pm}0.4$) were selected and assessed using a modified Bruce protocol on a treadmill. The 3 months supervised exercise training consisted of 60 minites session thrice weekly on the treadmill, bicycle and arm ergometer at $40{\sim}60%$ of maximum $O_2$ consumption. The changes of maximum $O_2$ consumption, psychologic test and quality of life questionnaire in 14 patients before and after 3 months exercise training have been measured. The mean maximum $O_2$ consumption($VO_2$ max) of exercises increased by 23% after training(pre-and postexercise $26.3{\pm}4.6ml$/kg/min vs $29.8{\pm}4.9ml$/kg/min, p=0.013). There was significant reduction in anxiety score(p=0.004) and significant improvement in quality of life score(p=0.031) after training. The result of this study indicated that a structured exercise training for hemodialysis patients provides many benefits. These result suggest the exercise training can improve the work capacity, psychologic functions and quality of life outcomes in hemodialysis patients.

• Journal of Chest Surgery
• /
• v.44 no.1
• /
• pp.51-57
• /
• 2011

Background: Up to now, lobectomy, bilobectomy and pneumonectomy combined with extensive lymph node dissection have been regarded as the standard procedures for non-small cell lung cancer (NSCLC). In high-risk patients, however, limited resection (LR) has been attempted as a salvage procedure, and, recently, indication for LR has been extended to selected cases with early-stage NSCLC. Material and Methods: Among the 773 patients who underwent surgical procedures for NSCLC in Seoul National University Bundang Hospital from May 2003 to December 2008, 43 patients received LR. Medical records of these patients were retrospectively reviewed. Results: Mean age at operation was $66.0{\pm}12.4$ years, and there were 30 males. Twenty-five patients underwent conservative limited resection (CLR) and 18 underwent intentional limited resection (ILR). Indications for CLR were multiple primary lung cancer in 9 (9/25, 36%) and severe concomitant diseases in 5 (5/25, 20%). Of these, 6 patients underwent segmentectomy and 19 received wedge resection. During the follow-up period of $28.0{\pm}17.8$ months, 15 patient developed recurrent lung cancer. ILR was selectively performed in lesions almost purely composed of ground glass opacity (${\geq}$95%), or in small solid lesions (${\leq}$2 cm). Of these, 11 patients underwent segmentectomy and 7 underwent wedge resection. During the follow-up period of $31.7{\pm}11.6$ months, no patient developed recurrence. Conclusion: Intermediate-term outcome of LR for early-stage lung cancer is comparable to that of standard operation. For the delineation of the indications and appropriate surgical techniques for LR, prospective randomized multi-institutional study may be expedient.

• Health Policy and Management
• /
• v.20 no.4
• /
• pp.1-18
• /
• 2010

Much policy attention has been directed to the concentration of patients in large hospitals, especially in tertiary care hospitals. In order to address the problem, the government has enforced referral requirement for accessing care in tertiary care hospitals by denying insurance benefits to the patients who do not observe the requirement. This approach somehow has failed to produce expected effects although it still exists in theory. The concentration of patients in a certain type of providers results in the distortion of functional differentiation among various types of providers and vice versa. Thus the approaches for the alleviation of the problem should be directed to both patients and providers. However, policy approaches has so far focused on ways of directly affecting patients' choice of a provider neglecting the effects of providers. Based upon the observation, this paper has reviewed selected issues that should be considered in agenda setting for policies concerned with the concentration of patients in large hospitals or the distortion of functional differentiation among health care providers. A brief discussion of each of the issues suggests three general guidelines for the formulation and implementation of policies intended to address the problem. First, attention should be directed to both patients and providers. Secondly, it is necessary to employ diverse measures including regulation, incentives and administrative supports. Thirdly, some of the approaches should be planned from a long range perspective, for it often takes a long time to change some aspects of health care utilization and provision.

• Korean Journal of Head & Neck Oncology
• /
• v.34 no.2
• /
• pp.17-21
• /
• 2018

Background/Objectives: Cancers of the abdominal or pelvic organ rarely metastasize to the cervical lymph nodes. Although it indicates distant metastasis, perceivable prolongation of survival or cure may be possible in selected cases. We sought to identify patients with cervical metastasis from cancers below the diaphragm and identify patients who may benefit from aggressive treatment. Materials & Methods: From 2009 to 2017, patients with pathologically confirmed metastatic cervical lymph nodes originating from below the diaphragm were included for analysis. Patient demographics, cancer characteristics, treatment course, and clinical outcomes were analyzed. Results: 208 patients were identified. Left supraclavicular node (Virchow's node) was the most frequently involved. Irrespective of treatment, survival for uterine cervical and ovarian cancers was significantly longer than that of other primaries. Patients with isolated cervical metastasis (oligometastasis) had significantly longer median survival compared to patients with concomitant bone, lung, brain, and mediastinal metastases. Conclusion: Although cervical metastasis from cancers of the abdominal and pelvic organ represent distant metastasis, patients with uterine cervix and ovary primary and oligometastatic lesions may benefit from aggressive treatment. Prudent patient selection and further investigation is warranted.

• The Korean Journal of Pain
• /
• v.32 no.2
• /
• pp.113-119
• /
• 2019

Background: Discogenic pain is a common cause of disability and is assumed to be a major cause of non-specific low back pain. Various treatment methods have been used for the treatment of discogenic pain. This study was conducted to compare the therapeutic success of radiofrequency (an intradiscal procedure) and laser annuloplasty (both an intradiscal and extradiscal procedure). Methods: This single-center study included 80 patients and followed them for 6 months. Transforaminal laser annuloplasty (TFLA, 37 patients) or intradiscal radiofrequency annuloplasty (IDRA, 43 patients) was performed. The main outcomes included pain scores, determined by the numeric rating scale (NRS), and Oswestry disability index (ODI), at pre-treatment and at post-treatment months 1 and 6. Results: The patients were grouped according to procedure. In all procedures, NRS and ODI scores were significantly decreased over time. Mean post-treatment pain scores at months 1 and 6 were significantly lower (P < 0.01) in both groups, and between-group differences were not significant. The ODI score was also significantly decreased compared with baseline. Among patients undergoing TFLA, 70.3% (n = 26) reported pain relief (NRS scores < 50% of baseline) at post-treatment 6 months, vs. 58.1% (n = 25) of those undergoing IDRA. There were no statistically significant differences between the groups in ODI reduction of > 40%. Conclusions: Our results indicate that annuloplasty is a reasonable treatment option for carefully selected patients with lower back and radicular pain of discogenic origin, and TFLA might be superior to IDRA in patients with discogenic low back pain.

• Korean Journal of Applied Biomechanics
• /
• v.29 no.1
• /
• pp.23-32
• /
• 2019

Objective: The aim of this study was to provide kinematic data on the characteristics of spinal disease patients by comparing and analyzing kinematic variables related to foot balance and gait pattern of spinal disease. Method: The subjects of the study included 40 adult men and 60 adult women who visited the hospital in Busan. Patients who were diagnosed with spinal disease by a physician through X-ray examination were selected as subjects for the diagnosis of vertebral disc herniation, spinal stenosis, spinal disease diagnosed with spinal disease and the general public. Left and right foot pressure and contact area were checked by Gaitview pro meter. X-ray photographs were taken with a Zen-2090 mobile fluoroscopy under physicians' direct participation. One-way ANOVA was performed to compare the differences between the kinematic variables and post-hoc was performed by the Duncan method. Results: The difference in contact area between the left foot and the right foot was $115.30{\pm}14.15cm^2$ in the left side and $124.25{\pm}13.65cm^2$ in the left side in the spinal disease patients. The difference in pressure between the left and right side of the spinal disease patients was wider than that of the general people. Especially, the right side of the spinal disease patients showed a larger area of left foot contact than the general population. Conclusion: Spinal disease patients have wider contact area of the left foot than those of the general population. In the case of right spinal disease, the left foot support area is widened due to pain. In the gait, women showed slightly more posterior body center than men, and the upper body muscle imbalance and immobilization due to the spinal disease caused imbalance of the muscles moving to the lower limb, It was analyzed to inhibit movement.

• Journal of Family Relations
• /
• v.22 no.4
• /
• pp.223-238
• /
• 2018

Objectives: The purpose of this study was a) to examine the effect of positive family relationships on post-traumatic growth in cancer patients, and b) to verify the moderating effect of spiritual sensitivity. Methods: The subjects were cancer patients, both outpatients and inpatients selected from major hospitals specialized in cancer treatment using judgement sampling. A self-administered questionnaire survey was given to cancer patients, and a total of 208 cases were collected but only 201 cases were used in the final analysis due to seven unclear and inadequate questionnaires. We performed descriptive statistics to identify the prevalence for each variable, and the moderating effect was verified through multiple regression analysis. Results: The main results are as follows. First, the average post-traumatic growth of the subjects was 3.01 (0-5 points). Second, the positive family relations of the subjects were 2.58 (0-5 points) and the average of spiritual sensitivity was 2.93 (1-5 points). Third, positive family relationship of cancer patients was positively correlated to post-traumatic growth, and spiritual sensitivity was verified as a moderator to positive family relationship enhancing the post -traumatic growth. Conclusion: These findings imply the importance of post-traumatic growth in cancer patients as a key intervention point to overcome pain and frustration from cancer. We suggest to develop family therapy programs and services aimed at fostering positive family relationships and meeting the needs of spiritual sensitivity for cancer patients and their families. This study also provides ways to promote post-traumatic growth in social welfare facilities in medical institutions and religious foundations.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.21 no.6
• /
• pp.527-545
• /
• 2021

The aim of this systematic review was to determine the success rate of nitrous oxide-oxygen procedural sedation (NOIS) in dentistry. A systematic digital search was conducted for publications or reports of randomized controlled trials evaluating the clinical performance of NOIS. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who met the inclusion and exclusion criteria accordingly. The quality of the studies was assessed using the revised Cochrane risk-of-bias tool (RoB 2). A total of 19 articles (eight randomized clinical trials with parallel intervention groups and 11 crossover trials), published between May 1988 and August 2019, were finally selected for this review. The studies followed 1293 patients reporting NOIS success rates, with a cumulative mean value of 94.9% (95% CI: 88.8-98.9%). Thirteen trials were conducted on pediatric populations (1098 patients), and the remaining six were conducted on adults (195 patients), with cumulative efficacy rates of 91.9% (95% CI: 82.5-98.1%) and 99.9% (95% CI: 97.7-100.0%), respectively. The difference was statistically significant (P = 0.002). Completion of treatment and Section IV of the Houpt scale were the most used efficacy criteria. Within the limitations of this systematic review, the present study provides important information on the efficacy rate of NOIS. However, further well-designed and well-documented clinical trials are required and there is a need to develop guidelines for standardization of criteria and definition of success in procedural sedation. Currently, completion of treatment is the most used parameter in clinical practice, though many others also do exist at the same time. To maximize NOIS efficacy, clinicians should strictly consider appropriate indications for the procedure.

• Journal of Oriental Neuropsychiatry
• /
• v.33 no.4
• /
• pp.401-424
• /
• 2022

Objectives: As effective treatments for dementia are lacking in Western medicine, complementary and alternative medicine (CAM) is considered a useful option. While the quality of life (QoL) is a vital outcome for patients with dementia, the QoL of patients receiving CAM for dementia remains ambiguous. This study aimed to determine the effect of CAM on QoL outcomes in dementia patients. Methods: A search was performed using the keywords "dementia," "Alzheimer's," "cognitive impairment," "Chinese," "Korean," "oriental," "herbal," "acupuncture," and "quality of life". All quantitative data were synthesized using R version 4.1.1. Results: Twenty-five randomized controlled trials (RCTs), 16 pre-post trials, and two cohort studies were selected for the systematic review. QoL in Alzheimer's disease (QOL-AD) (n=11, 25.6%) and geriatric QoL in dementia (GQOL-D, n=9, 20.9%) were the most utilized QoL instruments. Significant benefits in QoL were observed after receiving mind, body, combined mind and body, nursing, oriental medicine, and acupuncture therapies. In the meta-analysis, the combined effect was shown to significantly increase QOL-AD compared to before CAM interventions (standardized mean difference, SMD: 0.507; 95% confidence interval (CI), 0.191~0.824; p<0.01). The overall synthesized estimates in the GQOL-D showed a significantly improved QoL (SMD: 0.537, 95% CI: 0.238~0.837 p<0.01; one group; SMD: 1.465, 95% CI: 0.934~1.996, p<0.01). The seven studies assessing the cost-effectiveness of CAM reported uncertain outcomes. Conclusions: This study showed that CAM interventions benefited patients with dementia by improving their QoL. While additional standardized research is required, CAMs are suggested as effective clinical management for patients with dementia. They are also suggested as complementing therapies for these patients.

• Journal of Korean Traditional Oncology
• /
• v.27 no.1
• /
• pp.13-23
• /
• 2022

Objective: The purpose of this review is to analyze the clinical studies on tongue diagnosis in cancer patients. Methods: Domestic and foreign databases were used, such as Pubmed, google scholar, Wanfang med online, Scopus, and OASIS. Searching keywords were tongue diagnosis, tongue color, tongue fur, tongue inspection, cancer, tumor, neoplasm, carcinoma, etc. Studies on tongue diagnosis in cancer patients were included. The published year was limited from 2000 to June 2022. Results: Thirteen studies were enrolled. All selected studies were cross-sectional studies. Cancer patients tend to have a dark and blue-purple tongue, thick fur, yellow fur, fissure tongue, and red dots on the tongue compared with non-cancer patients. With the aggravation of cancer, the rate of patients having dark or blue, or purple tongues increased, and the patients' sublingual veins became wide and tortuous. Conclusion: This study suggests that cancer patients tend to have distinct features of tongue diagnosis. Further researches are warranted.