PURPOSE: The purpose of this study was to determine the relationships of pain cognition, performance status, and hope with health-related quality of life. METHODS: Patients(n=149) with various cancer diagnoses completed the SF-36 standard Korean Version and the Herth Hope Index. The Perceived Meanings of Cancer Pain Inventory was used to measure the cognition dimension of pain, whereas the Brief Pain Inventory Korean version was used to represent the sensory dimension of pain. RESULTS: The patients in the pain group had significant differences in the three dimensions(loss, threat, spiritual awareness) of pain cognition. There were statistically significant negative correlations between the three dimensions(loss, threat, and spiritual awareness) of pain cognitions and SF-36 dimension, and the positive correlations between challenge dimension and SF-36 dimension. Hope had the positive correlation with SF-36 dimensions. CONCLUSION: Pain has a negative impact on health-related quality of life, especially on physical health. However, patients who ascribed more positive meaning to their pain, tended to have a higher quality of life. Therefore, nursing intervention to reinforce the positive aspects of pain cognition is to empower patients to create a sense of control and assume an active role in pain management and quality of life.
Cognition* ; Diagnosis ; Hope* ; Humans ; Nursing ; Pain Management ; Quality of Life*

Purpose: This study was conducted to develop and examine the effects of a nursing education program using virtual reality to enhance clinical decision-making ability in respiratory disease nursing care by assessing students’ confidence in performance, clinical decision-making ability, practice flow, class evaluations, and simulation design evaluations. Methods: This study was developed based on the Jeffries simulation model and 5E learning cycle model, blending a virtual reality simulation and high-fidelity simulation. The participants were 41 third-year nursing students with no virtual reality and simulation education experience. The experimental group (n=21) received the virtual reality program, while the control group (n=20) received traditional simulation education. Data were collected from March 8 to May 28, 2021 and analyzed using SPSS version 27 for Windows. Results: Statistically significant differences were found between the experimental group and the control group post-intervention in confidence in performance (F=4.88, p=.33) and clinical decision-making ability (F=18.68, p＜.001). The experimental group showed significant increases in practice flow (t=2.34, p=.024) and class evaluations (t=2.99, p=.005) compared to the control group. Conclusion Nursing education programs using virtual reality to enhance clinical decision-making ability in respiratory disease nursing care can be an effective educational strategy in the clinical context.

PURPOSE: To evaluate the treatment results and prognostic factors after radiotherapy in stage IIB uterine cervix cancer. MATERIALS AND METHODS: We retrospectively analyzed the records of 90 patients with stage IIB uterine cervix cancer who received radiotherapy between 9/94 and 12/99. Age was ranged from 28 to 79 years (median 57). Tumor size was > or = 4 cm in 64 patients. Preteatment SCC level was measured in 76 patients. Twenty nine patients received conventional radiotherapy (QD) and the others received modified hyperfractionated radiotherapy (BID). Only 7 patients in BID had tumor size <4 cm. All patients received high dose rate brachytherapy (4 Gy x 7 or 5 Gy x 6). No patient received concurrent chemotherapy during radiotherapy. Follow up period was ranging from 9 to 76 months (median 38). RESULTS: The 5-year overall and disease free survival rates were 73.4% and 71.6%, respectively. Local recurrences occurred in 10% of patients, and distant metastasis in 18.9%. There was a significant correlation between OS/DFS and tumor size (<4 cm; OS 95.2%, DFS 91.4%, > or = 4 cm; OS 63.4%, DFS 63.4%). Pretreatment SCC level was one of prognostic factors only in univariate analysis. CONCLUSION: With modified hyperfractionated radiotherapy, there was very low local recurrence rate (6.6%) and high 5-year overall and disease free survival rate (75.4% and 70.5%), which is comparable to results after concurrent chemoradiotherapy in bulky, locally advanced stage IIB uterine cervix cancer.
Brachytherapy ; Cervix Uteri* ; Chemoradiotherapy ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Radiotherapy* ; Recurrence ; Retrospective Studies

PURPOSE: To evaluate the efficacy of interferon alpha therapy with or without prednisolone in children with chronic hepatitis B. METHODS: Twenty-eight children (22 boys, 6 girls, mean age 130 months) had seropositive results for HBsAg, HBeAg and HBV DNA; 11 had chronic persistent hepatitis and 17 had chronic active hepatitis. The patients were divided into two groups depending upon their inflammatory activity on liver biopsy, pretreatment serum ALT levels and HBV DNA levels. Fourteen children (group 1: chronic active hepatitis, ALT > or = 100 IU/L and HBV DNA < or = 100 pg/300 microliter) received interferon alpha 2a 5 MU/m2 of body surface three times weekly for 6 months. Fourteen children (group 2: chronic persistent hepatitis or chronic active hepatitis with ALT < 100 IU/L or HBV DNA > 100 pg/300 microliter) received prednisolone in decreasing daily doses of 60 mg/m2, 40 mg/m2, and 20 mg/m2, each for 2 weeks, followed after 2 weeks by interferon alpha 2a on the same schedule. At the end of therapy, 3 end points were analyzed: HBeAg seroconversion, serum ALT normalization rate and clearance of serum HBV DNA. RESULTS: At the end of treatment, HBe antigen-to antibody seroconversion was higher but not more significant in group 1 than group 2 (71.4% vs. 50.0%). Only one patient in group 2 who lost HBeAg, also cleared HBsAg. ALT normalization was similar in both groups (64.3% in group 1 vs. 55.6% in group 2). Clearance of serum HBV DNA was observed in 78.6% of patients in group 1 and 64.3% in group 2, but no significant differences. Complete response was similarly achieved in both groups (57.1% in group 1 vs. 50.0% in group 2). Interferon alpha therapy with prednisolone priming was well tolerated and all children finished therapy. CONCLUSION: The combined therapy with prednisolone followed by interferon alpha may be safe and effective in inducing a serological and biochemical remission of the disease in approximately 50% of children with chronic hepatitis B and with a high level of viral replication and less active disease. However, a controlled study should be performed to confirm these results.
Appointments and Schedules ; Biopsy ; Child* ; DNA ; Female ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons ; Liver ; Prednisolone*

No abstract available.
Diagnosis* ; Polycystic Kidney Diseases*

PURPOSE: To evaluate characteristic CT features of twisted ovarian tumors and to assess the diagnostic value of the existence of twisted vascular pedicle in torsion of ovarian tumors. MATERIALS AND METHODS: Weretrospectively reviewed the clinical and CT findings in eleven patients with ovarian tumor torsion confirmed bysurgery. Pre- and post-contrast CT were available in nine patients and post-contrast CT in two. All twisted ovaries, tubes, and tumors showed hemorrhagic infarction and necrosis. RESULTS: All patients had twisted vascular pedicle of the ovarian tumor evaluated by CT. Eight patients with left ovarian tumor had twisted vascular pedicleon the left side of the tumor, and three patients with right ovarian tumor on the right side of the tumor. Themorphologic characteristics of twisted vascular pedicle were coiled target appearance (4 cases), beak appearance(3 cases), doughnut appearance (3 cases), and mass with irregular margin (1 case). High density on precontrast CT scan was present in the pedicle in four cases and linear contrast enhancement was seen in the peripheral portionof the pedicle in four cases. The shape, density and location of ovarian tumors were inconsistent, however, contrast enhancement was not seen in all patients. Other findings were uterine deviation, loss of fat plane andpelvic fluid. CONCLUSION: Detection of twisted vascular pedicle by CT may be useful for the diagnosis of ovariantumor torsion.
Animals ; Beak ; Diagnosis ; Humans ; Infarction ; Necrosis

BACKGROUND: The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib. METHODS: We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method. RESULTS: Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib. CONCLUSION: Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Male ; Multivariate Analysis ; Protein-Tyrosine Kinases ; Quinazolines ; Receptor, Epidermal Growth Factor ; Erlotinib Hydrochloride

The purpose of this study was to assess dental hygienists' awareness of medical technician jurisprudence. The study was conducted over a 2-month period from March 1 to May 1, 2016. A self-reported questionnaire was completed by 201 dental hygienists in Seoul, Gyeonggi, and Incheon province. The questionnaire consisted of items on the awareness of the jurisprudence pertaining to medical technician jurisprudence. Data were analyzed using the IBM SPSS Statistics ver. 19.0 program. We found that 32.8% of the respondents were aware of medical technician jurisprudence. Low awareness that result was due to “insufficient public relations efforts.” The respondents thought that medical technician jurisprudence are inefficient in clinical settings. Of the dental hygienists, 75.9% replied that task distribution was unclear and 40.0% lacked awareness of the distribution of dentists' duties (40.0%). A total of 59.8% of respondents showed intention to participate in medical jurisprudence seminars. Of the dental hygienists, 77.0% agreed with the insert dental hygienists under medical jurisprudence category. In conclusion, dental hygienists' awareness of medical technician jurisprudence should be improved. In addition, the dental hygienist jurisprudence need to be revised regarding job status.
Dental Hygienists ; Gyeonggi-do ; Humans ; Incheon ; Intention ; Jurisprudence* ; Public Relations ; Seoul ; Surveys and Questionnaires

OBJECTIVE: To investigate the changes of causes, clinical features, and functional outcomes in childhood strokes. METHOD: This study included 152 patients, aged from 1 to 18 years, who were diagnosed with stroke and admitted to a tertiary hospital between January 2000 and April 2004. All medical records and neurologic images of the patients were reviewed. A parental questionnaire was used to investigate patients' functional outcomes. These results were compared with those of the previous study performed in the same hospital in 2001. RESULTS: The number of hemorrhagic stroke was 78 (51.3%) and that of ischemic stroke was 74 (48.7%). When compared to the previous study, the incidence of hemorrhagic stroke especially above the age of 10 years decreased and that of ischemic stroke below the age of 10 years increased. The causes of stroke were arteriovenous malformation (AVM, 42.8%), Moyamoya disease (37.5%), vasculitis (5.3%), cardiac disease (3.9%), hematologic disease (2.0%), and undetermined (8.5%). Common clinical features were headache (53.8%), vomiting (43.6%) and loss of consciousness (28.2%) in the hemorrhagic stroke, and hemiparesis (94.6%), headache (35.1%) and speech disorder (31.1%) in the ischemic stroke. 86.0% of the hemorrhagic and 64.8% of the ischemic stroke patients were categorized in the 'good' outcome group. CONCLUSION: The incidence of ischemic stroke increased to the similar level of hemorrhagic stroke. The most common causes were AVM in the hemorrhagic and Moyamoya disease in the ischemic stroke. Most of these patients showed good functional outcome, regardless of the causes of stroke.
Aged ; Arteriovenous Malformations ; Child ; Headache ; Heart Diseases ; Hematologic Diseases ; Humans ; Incidence ; Medical Records ; Moyamoya Disease ; Parents ; Paresis ; Surveys and Questionnaires ; Stroke ; Tertiary Care Centers ; Unconsciousness ; Vasculitis ; Vomiting

BACKGROUND/AIMS: In patients with chronic obstructive pulmonary disease (COPD), left ventricular (LV) systolic dysfunction and structural changes are rare, while right ventricular (RV) dysfunction and structural alteration and/or LV diastolic dysfunction are common. We evaluated the cardiac structure and function in patients with COPD using echocardiography. METHODS: Echocardiography examinations were performed in 69 patients with clinically stable COPD and without a history of heart disease; 22 control subjects with normal lung function were enrolled for comparison. Echocardiography parameters of the COPD patients were compared with those of the controls, and assessed according to the COPD stage classified using the Global initiative for chronic Obstructive Lung Disease (GOLD) criteria. RESULTS: Patients with COPD had significantly lower body weight (p=0.001) and higher pack-years of smoking than did the controls (p=0.002). The echocardiogram showed that LV end diastolic diameter (p<0.001), LV end systolic diameter (p=0.020), left atrial (LA) diameter (p=0.026), and LV mass in the COPD patients were significantly decreased compared to the controls (p=0.003). However, there were no differences between the COPD patients and controls in the parameters reflecting LV diastolic function and mean RV systolic pressure (RVSP). According to the COPD stage, body weight (p<0.001), body mass index (BMI) (p<0.001), and LV mass were significantly different (p=0.011). In patients with COPD, LV mass (r=0.432) (p<0.001) and BMI were significantly correlated with FEV1% predicted (r=0.600) (p<0.001). CONCLUSIONS: Patients with COPD had lower LV mass and LA and LV diameters than did the controls, even though both groups had normal LV function. In particular, the LV mass appeared to correlate with the lung function in the patients with COPD.
Blood Pressure ; Body Mass Index ; Body Weight ; Echocardiography ; Heart ; Humans ; Hypertension ; Lung ; Lung Diseases ; Pulmonary Disease, Chronic Obstructive ; Smoke ; Smoking