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Predicting Risk Factors for Pressure Sores in Patients Undergoing Operations ; A Prospective Study (수술환자의 욕창예측변수에 관한 연구)

  • Pak Soon-Mi;Jun Seong-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.2
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    • pp.267-276
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    • 1999
  • The purpose of this study was to identify risk factors predictive of alterations in skin integrity during the intraoperative period. The predictive risk factors were studied for intraoperative pressure sores from December 1998 through January 1999. A sample of 220 patients was selected from the operating room schedule of a University Hospital in Pusan. There were two criteria in including patients : the operation lasted longer than 2 hours and the absence of skin break-down according to NPUAP criteria. The data were analized by SPSS/PC, Stepwise multiple logistic regression was used to identify the variables which were predictive of alterations in skin integrity. Of the 220 patients studied, 41 patients (18.6%) developed stage 1 pressure sores in the immediate postoperative period. In relation to skin changes, three independent variables emerged from the stepwise multiple logistic regression as being significant (p<0.05). Factors predictive of pressure sore formation included low serum albumin(p=0.000), prone position while undergoing surgery(p=0.0004), time on the operating table(p=0.0165). Among the intrinsic factors, serum albumin was the most significant causal factor in pressure sores development in the intra-operative period. Pressure and shearing force were the most significant extrinsic factors in pressure sores development. From the results of this study we concluded that the primary nursing goal is the maintenance of the proper patient' position during the intraoperative period. Also imperative for sore prevention is the reduction of surgery time and improving preoperative nutritional status.

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A CLINICAL STUDY ON THE INTRAORAL SQUAMOUS CELL CARCINOMA (구강내(口腔內) 편평상피암(扁平上皮癌)에 관(關)한 임상적(臨床的) 연구(硏究))

  • Kim, Jae-Seung;Chung, Bong-Hee;Kim, Yong-Kack
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.3
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    • pp.23-33
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    • 1990
  • A clinical study of selected patients with intraoral squamous cell carcinoma which were managed in the Department of Oral Oncology of Korea Cancer Center Hospital from January 1982 to August 1989 was done. And following results were obtained. 1. Males were involved more than females by intraoral squamous cell carcinoma in a ratio of 4:1. and most of the cases occurred in the 7th and 6th decades (69%). 79% of total patients and 92.5% of males were. 2. The mean duration of symptomatic period was 5.9 months. 3. The common symptoms were swelling (63%), pain (40%), ulceration (33%), and trismus (23%) 4. In the histologic findings, well differentiation comprised 58.0%. 5. The primary sites were the upper alveolar mucosa (32%), the floor of the mouth (21%), the lower alveolar mucosa (19%), tongue (14%), retromolar trigone (8%), palate (7%) and buccal mucosa (3%). 6. According to TNM system, Stage I, Stage II, Stage III, and Stage IV comprised 4%, 15%, 32%, and 49% respectively. 7. In the management of intraoral squamous cell carcinoma, surgeries were done in the 32 cases, 23 cases of which were managed by radiation therapy or chemotherapy concurrently. And radiation therapy alone was received in 35 cases. 8. Overall 3 and 5-year survival rates without regarding to stage were 27.6% and 21.4%. 9. 3-year survival rate of female patients was 47.2% and that of male patients was 22.6%. 10. 5-year survival rate was 53.9% for "early" cancer (stage I and II) and 15.6% for "advanced"cancer (stage III and IV). Survival rate of patients in the early stages of cancer appeared to be higher than that of patients with stage III and IV(p<0.05).

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Serum Human Leukocyte Antigen-G and Soluble Interleukin 2 Receptor Levels in Acute Lymphoblastic Leukemic Pediatric Patients

  • Motawi, Tarek M.K.;Zakhary, Nadia I.;Salman, Tarek M.;Tadros, Samer A.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5399-5403
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    • 2012
  • Aims and Background: Human leukocyte antigen-G and interleukin-2 receptor play pivotal roles in the proliferation of lymphocytes, and thus generation of immune responses. Their overexpression has been evidenced in different malignant hematopoietic diseases. This study aimed to validate serum soluble human leukocyte antigen-G (sHLA-G) and serum soluble interleukin-2 receptor (sIL-2R) as an additional tool for the diagnosis and follow up of acute lymphoblastic leukemia (ALL). Subjects and Methods: Both markers were determined by ELISA in the serum of 33 ALL pediatric patients before treatment and after intensification phase of chemotherapy as well as in the serum of 14 healthy donors that were selected as a control group. Results: ALL patients showed abnormal CBC and high serum lactate dehydrogenase, which were improved after chemotherapy. Also, there was a non-significant increase in serum sHLA-G in ALL patients compared with the control group. However, after chemotherapy, sHLA-G was increased significantly compared with before treatment. On the other hand, serum sIL-2R in ALL patients was increased significantly compared with the control group. After chemotherapy, sIL-2R decreased significantly compared with before treatment. Conclusions: From these results it could be suggested that measurement of serum sHLA-G might be helpful in diagnosis of ALL, while sIL-2R might be useful in diagnosis and follow-up of ALL in pediatric patients.

Association of Chemotherapy-induced Leucopenia with Treatment Outcomes in Advanced Non-small-cell lung Cancer Cases Receiving the NP Regimen

  • Huang, Cheng-Suo;Liu, Lin;Liu, Jie;Chen, Zhen;Guo, Jun;Li, Chang-Zheng;Zhou, Deng-Guang;Wang, Zhe-Hai
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4481-4485
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    • 2012
  • Background: Chemotherapy induced leutropenia has been shown to be associated with improved treatment outcomes in selected solid tumors. We studied the association of chemotherapy induced leutropenia with treatment related outcomes in advanced non-small-cell lung cancer. Methods: This is a prospective analysis of patients receiving chemotherapy for advanced NSCLC at the Shandong Cancer Hospital from 2005-07.The chemotherapy included cisplatin $35mg/m^2$, IV on $d_{1,2}$ and vinorelbine $25mg/m^2$ IV on $d_{1,8}$ every 21 days. Patients were stratified into three groups (A) those experiencing grades 0 leucopenia, group (B) grades 1-2 and group (C) grades 3-4. The outcomes studied were response rate (RR), disease control rate (DCR), and time to progression (TTP). Results: 128 patients were studied. The RRs in groups A, B and C were 30.8%, 56.8% and 71.4%, respectively, p=0.010. The DCRs were 61.5%, 83.8% and 92.9%, respectively, p=0.009 and the median TTPs were 150 days (95%CI: 91-209), 189 days (95%CI: 181-197) and 207 days (95%CI: 172-242), p=0.009. The differences in RR and TTP were significant. In patients whose CIL kept on 10 days at least, the TTP was significantly prolonged, p=0.0213, and the same was the case for those experiencing grades 1-2 leucopenia and ECOG 0, p=0.0412. Conclusions: Occurrence of CIL correlated with RR and TTP in patients with advanced NSCLC receiving cisplatin and vinorelbine chemotherapy, especially in patients experiencing grades 1-2 leucopenia and ECOG 0, and the same for those with CIL persisting for 10 days at least. CIL could be a biological measure of drug activity and a marker of efficacy.

Effects of Comorbid Sleep Disorders on Cardiovascular Complications of Hypertension Among Patients With Newly-diagnosed Hypertension: An Analysis of the Korean National Health Insurance Service-National Sample Cohort

  • Kang, Jeongmook;Park, Yoon-Hyung;Yang, Kwang Ik;Cruz, Jose Rene Bagani;Hwangbo, Young
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.1
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    • pp.37-44
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    • 2020
  • Objectives: This study investigated the effects of comorbid sleep disorders (SD) on the incidence of cardiovascular complications among newly-diagnosed hypertension (HTN) patients. Methods: As study population, 124 057 newly-diagnosed essential HTN patients aged 30 or older, without cardiovascular complications at diagnosis with HTN, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid SD at HTN diagnosis was calculated. Results: Over 10 years, 32 275 patients (26.0%) developed cardiovascular complications. In HTN patients with comorbid SD at diagnosis of HTN, the incidence of cardiovascular complications (78.3/1000 person-years; 95% confidence interval [CI], 75.8 to 80.9) was higher than in those without comorbid SD (58.6/1000 person-years; 95% CI, 57.9 to 59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17 to 1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid SD at diagnosis of HTN for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69 to 2.44). Conclusions: Newly-diagnosed essential HTN patients aged 30 or older who had comorbid SD at the time of their HTN diagnosis had a higher incidence of cardiovascular complications than those without comorbid SD. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of SD.

Prognostic Value of MAC30 Expression in Human Pure Squamous Cell Carcinomas of the Lung

  • Ding, Hui;Gui, Xian-Hua;Lin, Xu-Bo;Chen, Ru-Hua;Cai, Hou-Rong;Fen, Yan;Sheng, Yun-Lu
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2705-2710
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    • 2016
  • Recent evidence haas indicated that meningioma-associate protein (MAC30) exhibits different expression patterns in various tumors. However, little is known about the value of MAC30 in human squamous cell carcinoma of lung (SQCLC). The purpose of our study was to investigate the expression of MAC30 and to explore its clinical significance in SQCLC patients. A total of 156 Chinese patients diagnosed with SQCLC were selected for this study. The expression of MAC30 in all tissues was confirmed by immunohistochemical staining. Quantitative real-time PCR was performed to analyze MAC30 mRNA expression in 32 cases of SQCLC patients with corresponding non-tumor lung tissues. We observed enhanced mRNA expression of MAC30 in SQCLC as compared to control samples. Further, elevated MAC30 protein expression was strongly associated with poor tumor differentiation, TNM stage, and lymph node metastasis. In addition, we observed that patients with increased MAC30 expression demonstrated poor overall survival. Multivariate analysis explicated that increased MAC30 expression was a valuable independent predictable factor for poor tumor differentiation and short survival in SQCLC patients. Our present study suggests that MAC30 may serve as a biomarker for poor tumor differentiation and outcomes of patients with SQCLC.

The effect of atropine in preventing catheter-related pain and discomfort in patients undergoing transurethral resection due to bladder tumor; prospective randomized, controlled study

  • Sahiner, Yeliz;Yagan, Ozgur;Ekici, Arzu Akdagli;Ekici, Musa;Demir, Emre
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.176-182
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    • 2020
  • Background: Catheter-related bladder discomfort (CRBD) has been observed in many patients undergoing a urethral catheterization. CRBD may be so severe that the patients require additional analgesics. Muscarinic receptors are involved in the mechanism of CRBD. The aim of this study is to determine the effects of the antimuscarinic properties of atropine, which is frequently used in current practice on CRBD, by comparing it with sugammadex which has no antimuscarinic effects. Methods: Sixty patients selected for transurethral resection due to bladder tumors were randomized into 2 groups: an atropine group and a sugammadex group, with no antimuscarinic effect. The patients were given rocuronium (0.6 mg/kg) as a neuromuscular-blocker. In addition to the frequency and severity of CRBD postoperatively at 0, 1, 6, 12, and 24 hours, postoperative numeric rating scale (NRS) scores, and postoperative nausea and vomiting were examined. Results: The incidence of CRBD was significantly lower in the atropine group in all postoperative measurements. The score was found to be significantly lower in the atropine group when NRS measurements were performed at all time periods (P < 0.01). There was no difference between the groups in terms of nausea and vomiting (P > 0.05). Conclusions: Atropine is a cheap, easy-to-access, safe-to-use drug for reducing CRBD symptoms, without any observed adverse effects. Since it not only reduces CRBD symptoms but also has a positive effect on postoperative pain, it can be used safely to increase patient comfort in patients receiving general anesthesia and a urinary catheter.

The Effects of Obstacle Height on the Stepping Over Gait in Parkinson's Patients (장애물 높이가 파킨슨 환자들의 장애물 보행에 미치는 영향)

  • Kim, Mi-Young;Lim, Bee-Oh
    • Korean Journal of Applied Biomechanics
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    • v.18 no.2
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    • pp.11-17
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    • 2008
  • Falls associated with tripping over an obstacle can be dangerous, yet little is known about the strategies used for stepping over obstacles by Parkinson's patients. The purpose of this study was to investigate stepping over gait characteristics according to obstacle height in Parkinson's patients. The gait of 7 Parkinson's patients was examined during a 5.0 m approach to, and while stepping over, obstacles of 0, 2.5, 5.2, and 15.2 cm. Only five Parkinson's patients were able to clear all obstacles successfully; as such, only their data were analyzed. A one-way ANOVA for repeated measures was employed for selected kinematic variables to analyze the differences of the height of four obstacles. The results showed significant differences between obstacle height and: approaching speed (AS), foot clearance from the obstacle(FC), and step width (SW). The results showed no significant differences between obstacle height and: crossing speed (CS), toe distance (TD), and heel distance (HD). This strategy tends to reduce the risk of toe contact with the obstacle. Parkinson's patients were stepping over the obstacle slowly, stably and inefficiently.

A Study on Pain and Anxiety of Burn Patients (화상환자가 지각하는 통증과 불안에 관한 연구)

  • Park Young Sook;Kim Eun Hee
    • Journal of Korean Public Health Nursing
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    • v.15 no.1
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    • pp.83-95
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    • 2001
  • The purpose of this study is to examine intensity of pain and anxiety of burn patients. This study selected 99 adult patients of 18 years old or older who have been hospitalized and treated for a second-degree burn at the surgery ward or burn ward of 3 university hospitals which are located in 2 metropolitan cities, and a university hospital in Seoul Special City from July 1 to October 20, 2000. This study used STAI(State-Trait Anxiety Inventory) developed by Spielberger, and translated by Kim, Jung Taek and Shin, Dong Kyun to examine the degree of anxiety and VAS to examine the pain. This study was carried out by interview and using SPSS 9.0 statistical program. Results were as follows : 1) As for general characteristics of the subjects, they were mostly male. 30s-40s, married, and high school graduates. 2) Forty-seven patients were burned by fire and $49.6\%$ of the patients had burn 10 to $20\%$ of BSA. seventy-nine percents of patients received one dressing change a day and $74.3\%$ received medication once or twice a day. 3) As for intensity of anxiety and pain. the mean intensity of pain was 6.41. The intensity of trait anxiety and the state anxiety were 39.76. and 51.81. 4) Subject's age was significantly different in their pain intensity and other variables were insignificant. Correlations between trait-anxiety and state-anxiety(r=.286, p=.004), and state-anxiety and VAS(r=.294, p=.003) showed weak correlation. There wasn't statistically any significance in trait- anxiety and VAS(r=.183, p=.070).

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A Comparative Study of the Time Use and Quality of life in Local Community and Convalescent Hospital of the Stroke Patient (거주 환경에 따른 뇌졸중 환자의 시간 사용과 삶의 질 비교 연구)

  • Kim, Hyeong-Min;Shim, Min-Kyu
    • The Journal of Korean society of community based occupational therapy
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    • v.4 no.1
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    • pp.1-10
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    • 2014
  • Objective : The purpose of this study was to comparatively analyze time use and quality of life in stroke patients who use Local community or convalescent Hospital environment. Methods : The study subjects were 74 stroke patients who were admitted to convalescent Hospital or who were being rehabilitated as outpatients. The Occupational Questionnaire(OQ)was used for measuring time use and the Stroke Specific Quality of Life(SS-QOL) utilized to measure Quality of life. Excluding 8 patients who did not fit selection criteria, 66 patients were selected and analyzed. Results : After comparatively analyzing time use in Local community and convalescent Hospital environment, significant differences were found in daily living(p<.05), resting(p<.05). In addition, in quality of life, significant differences were found in family(p<.05), self-management(p<.05), and social roles(p<.05). Conclusion : Local community patients used their time in daily living, resting more efficiently than convalescent Hospital patients, and also had a higher quality of life.

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