PURPOSE: The main purpose of this study was to develop a substantive theory on the process of the spiritual experience in Christian terminal cancer patients in the context of Korean society and culture. The question for the study was 'What is the spiritual process in Christian terminal cancer patients?'. METHOD: The research method used was the Grounded Theory Method developed by Strauss and Corbin (1998). Participants for this study in total were 9 Christian terminal cancer patients. Data was collected using in-depth interviews during April 2003 to March. 2004. Data collection and analysis were carried out at the same time. RESULT: From the analysis 58 concepts and 20 categories emerged. The categories were presented into a paradigm, which consisted of condition-actions/ interactions-consequences. The theoretical scheme was described by organizing categories. In total, 4 stages were developed from the condition-actions/ interactions-consequences. Throughout these stages, the 'overcoming process of unbalanced interconnectedness' was the core category discovered. CONCLUSION: This study provides a framework for the development of individualized care interventions in the 'overcoming process of unbalanced interconnectedness' for Christian terminal cancer patients.
Christianity ; Humans ; Neoplasms/*psychology ; *Spirituality ; Terminally Ill/*psychology

BACKGROUND: Investigating the blood usage and blood wastage in Korea hospitals national wide, and including all types of medical institutes, has not been sufficient with the only study having been carried out by the KCDC thorough an Academic Research Contract in 2007. Yet that study was limited due to lack of participation from hospitals. Our study tried to establish a fundamental database for blood transfusion management by investigating the current status of blood products usage, under the KCDC's supervision, to improve participation from medical institutes. METHODS: From January to December in 2008, the Blood Bank, Red Cross of the Republic of Korea looked into the blood product supply of all the medical institutes and we conducted a national survey using questionnaires distributed via the local public health centers on the blood use, blood waste, the reasons for waste and the inventory of the remaining blood. The supply, as compared to the actual use of blood products in the same period, was analyzed by the Korean Red Cross. RESULTS: The total amount of blood products distributed by the Korean Red Cross to medical institutes in 2008 increased by 13.8% for platelets, 11.5% for RBC products, 8.4% for apheresis products and 2% for FFPs, as compared with that of 2006. A total of 2,500 institutions participated in the questionnaire and 60.7% (1,517 out of 2,500 institutes) of the institutes sent feed-back. The total amount of blood use was 3,483,636 units and 52% of the consumption was focused in metropolitan areas like Seoul, Geong-Ki and Busan. The total wastage rate for blood was 1.2% and it was 4.8% for institutes with admitting capacities of 100 beds or less, with expiration of the storage date being the main reason for wastage, while the wastage rate was 1.1% for general hospitals with admitting capacities of 500 beds or more, with an improving patient status or death being the main reason. CONCLUSION: The results of this study were similar to those of 2007, but the participation rate from medical institutes was much increased. Establishment of an investigational system for the use of blood products in medical institutes on a national level is needed to secure data for dealing with the increased projected demand of blood/blood products in the future.
Academies and Institutes ; Blood Banks ; Blood Component Removal ; Blood Platelets ; Blood Transfusion ; Contracts ; Hospitals, General ; Humans ; Korea ; Organization and Administration ; Public Health ; Red Cross ; Republic of Korea ; Surveys and Questionnaires

Malignant duodenocolic fistula is a rare complication of colon cancer, and this usually develops as the right-side colon cancer that invades the duodenal bulb. The fistula often results in watery diarrhea, weight loss and feculent vomiting. A barium enema or duodenography have been the most useful diagnostic procedures, and the fistula is directly confirmed by an endoscopic examination. Curative resection is not possible in many cases due to metastasis or local invasion, so a palliative operation can be performed to relieve symptoms, but it cannot completely prevent the vomiting or diarrhea. Seven Korean cases of malignant duodenocolic fistula have been previously reported on, and an operation was performed in six cases. We report here on a case of duodenocolic fistula with intestinal obstruction that arouse from a right-side colon cancer, and this was successfully managed by placing covered metallic stents at the duodenum and hepatic flexure.
Barium ; Colonic Neoplasms ; Diarrhea ; Duodenum ; Enema ; Fistula ; Intestinal Obstruction ; Neoplasm Metastasis ; Stents ; Vomiting ; Weight Loss

Colorectal varix (CRV) is a rare cause of lower gastrointestinal bleeding and usually associated with portal hypertension from liver cirrhosis or portal venous obstruction. Idiopathic CRV have no identifiable underlying cause and can only be diagnosed after the cause of portal or mesenteric vein circulation have been excluded. We report a case of idioipathic CRV presented with rectal bleeding for a week. Colonoscopy revealed markedly dilatated tortuous, and bluish veins in the rectum as well as coexistent adenomatous polyp and internal hemorrhoid. Despite extensive investigation, there was no evidence of portal hypertension or any other cause. Family history was also negative. Although blood transfusions were required, the patient remained asymptomatic without further rectal bleeding.
Adenomatous Polyps ; Blood Transfusion ; Colonoscopy ; Hemorrhage ; Hemorrhoids ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Mesenteric Veins ; Rectum ; Varicose Veins* ; Veins

BACKGROUND/AIMS: Multidrug resistance 1 (MDR1) gene encodes P-glycoprotein in intestinal epithelium, which serves as a transmembrane efflux pump of various toxins. mdr1 knockout mice develop spontaneous colitis under specific pathogen free conditions. However, it is unclear that C3435T polymorphism of MDR1 is related to ulcerative colitis. Other studies suggest MDR1 may have an important role in colorectal carcinogenesis. Thus, we evaluated whether MDR1 C3435T polymorphism is present in Korean and it is associated with inflammatory bowel disease or colorectal cancer. METHODS: The genotype distributions of the C3435T polymorphism were investigated by PCR-RFLP method in 94 patients with ulcerative colitis, 24 patients with Crohn's disease, 64 patients with colorectal cancer and each of gender-matched controls with equal numbers. RESULTS: There was no significant difference in frequencies of 3435T allele and 3435TT genotype between patients with ulcerative colitis and controls (p=0.443, p=0.194). No significant difference was present in frequencies of 3435T allele and 3435TT genotype between patients with Crohn's disease and controls (p=0.378, p=1.000). There was neither significant difference in frequencies nor 3435T allele or 3435TT genotype between patients with colorectal cancer and controls (p=0.250, p=0.211). C3435T genotype was not associated with the age of onset or other clinical characteristics in patients with ulcerative colitis, Crohn's disease or colorectal cancer. CONCLUSIONS: MDR1 C3435T polymorphism is also present in Korean and the dominant allele is C. However, there is no evidence that C3435T polymorphism of MDRI is associated to inflammatory bowel disease or colorectal cancer in Korean.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms/*genetics/pathology ; Female ; Gene Frequency ; *Genes, MDR ; Genotype ; Humans ; Inflammatory Bowel Diseases/*genetics/pathology ; Male ; Middle Aged ; Polymerase Chain Reaction ; *Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

A 68-yr-old man complaining of sudden, postprandial chest pain visited the emergency room. His symptom had been aggravated during the preceding two days. Upper gastrointestinal contrast study with gastrographin showed leakage of dye from the epiphrenic diverticulum in the lower third of the esophagus. The primary repair was urgently carried out. Upper gastrointestinal contrast study 14 days after operation revealed an esophageal leakage which was small and confined. The patient was managed with conservative treatments such as intravenous hyperali-mentation and broad-spectrum antibiotics. Forty-two days after the operation, a gastrographin swallow study showed the absence of leaks. This is the first report-ed case of a perforated epiphrenic esophageal diverticulum repaired by delayed primary repair in Korea.
Aged ; Diverticulum, Esophageal/complications/*diagnosis/*surgery ; Esophageal Perforation/*diagnosis/etiology/*surgery ; Esophagectomy/*methods ; Humans ; Male ; Research Support, Non-U.S. Gov't ; Time Factors ; Treatment Outcome

Foreign bodies in the stomach and duodenum are usually accidentally swallowed by children, mentally ill patients, alcoholics, or persons with dentures. Swallowed foreign bodies are usually asymptomatic, and moved down the alimentary tract to be passed spontaneously without discomfort. There had been reported many kinds of foreign bodies, for example, metal fragments, fish bones and so on. A metal thread, which looks like a fishing hook in gastrointestinal tract as a foreign body, has never been reported in humans. A 62-year-old male patient was admitted due to abdominal discomfort for five days after eating raw fish. We performed gastroduodenoscopy and could find a thread penetrating to the anterior wall of duodenal bulb. It was removed by biopsy forcep. Herein, we report a case of a metal thread in duodenal bulb, which looked like a fishing hook.
Alcoholics ; Biopsy ; Child ; Dentures ; Duodenum ; Eating* ; Foreign Bodies ; Gastrointestinal Tract ; Humans ; Male ; Mentally Ill Persons ; Middle Aged ; Stomach ; Surgical Instruments

Cirrhotic patients with portal hypertension are often found to have changes in their colonic mucosa. Such mucosal changes are termed portal hypertensive colopathy. Most patients with portal hypertension remained asymptomatic but some may show massive bleeding. The mainstay of treatment for portal hypertensive gastropathy include non-surgical methods such as octreotide injection, endoscopic hemostasis, and interventional methods such as TIPS. However, treatment for portal hypertensive colopathy remained unresolved. The authors here report a case of a 41 year old male with liver cirrhosis admitted for fever and abdominal pain, who reported an episode of hematochezia in the course of admisssion period. Subsequent colonoscopy revealed angiodysplasia-like lesions throughout the entire colon. We observed that such lesions were the source of hematochezia and that direct clipping with octreotide injection was successful in controlling the bleeding.
Abdominal Pain ; Adult ; Colon ; Colonoscopy ; Fever ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis, Endoscopic ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Male ; Mucous Membrane ; Octreotide*