Posterior reversible encephalopathy syndrome (PRES) is a transient condition characterized by altered mental status, seizure, headache, and visual disturbance with typical neuro-imaging findings in the bilateral parieto-occipital regions. Clinicians should be aware of this syndrome because delayed diagnosis and treatment result in irreversible neurologic deficits. We present the case of a 77-year-old male diagnosed with PRES in the setting of postoperative critical illness caused by small-bowel strangulation.
Aged ; Critical Illness* ; Delayed Diagnosis ; Headache ; Humans ; Intensive Care Units ; Male ; Neurologic Manifestations ; Posterior Leukoencephalopathy Syndrome* ; Postoperative Period ; Seizures

PURPOSE: This study was a latitudinal descriptive effort to understand the degree of quality of life of patients who had undergone a rectal cancer operation. METHODS: The Korean versions of European Orgaization for Research and Treatment of Cancer (EORTC)-Quality of life Questionnaire 30 (QLQ-C30) and Colorectal Cancer-specific Core Questionnaire (QLQ-CR38) were used to examine the degree of quality of life of patients who had undergone a rectal cancer operation. The subjects of this study were 155 patients who had been diagnosed as having rectal cancer and who had received an anterior resection (AR), a low anterior resection (LAR), or an abdominoperineal resection (APR). RESULTS: In our study, patients' responses were combined and converted to a 0-100 scale according to the guidelines provided by the EORTC Center. From these guidelines, high functional scores (0-100) represent good function and high symptom scores (100-0) signify more problems. The APR patients had their social and family life disrupted (social functioning) and were less able to get about and look after themselves (physical functioning), and they felt themselves to be less attractive (body image). In addition, the scores for stoma problems were worse than those for pain and for male sexual problems. The AR patients and the LAR patients, despite suffering diarrhea, symptoms of insomnia, and defecation problems, had better quality of life than the APR patients without anorectal function. CONCLUSION: If the quality of life of rectal cancer patients is to be maintained and their rate of survival is to be increased, an understanding of the patients' situation, education on self-management related to stoma, and active provision of support from medical teams to solve the discomfort caused by the operation are needed.
Defecation ; Diarrhea ; Humans ; Male ; Quality of Life ; Surveys and Questionnaires ; Rectal Neoplasms ; Self Care ; Sleep Initiation and Maintenance Disorders ; Stress, Psychological

PURPOSE: This research was conducted to explore the relationship between spiritual well being and life attitude among breast cancer patients who were operated, and to increase understanding for wholistic nursing care. METHOD: With spiritual well being from quality of life questionnaire in breast cancer survivors (QOL-BR 23) of Ferrell et al (1998) and Life attitude profile (LAP) of Recker & Peacock (1981), the data were collected by research assistant in a sample of 56 women with stage 1-stage 3 breast cancer at surgery OPD after follow-up care. RESULT: Mean spiritual wellbeing score of subject was 5.83 (0-10) and life attitude was 4.96 (1-7). There were significant differences in life attitude according to monthly income (F=3.22, p=.03), and in spiritual wellbeing according to monthly income (F=4.16, p=.01) and religion (t=-3.67, p=.001) among demographic characteristics. There was significant difference in spiritual wellbeing according to the period passed after operation (F=2.89, p=.04) among disease characteristics. From life attitude domain, the mean score of "will to meaning" was the highest (5.30) and "existential vacuum" was the lowest (4.58). There was a significant relationship between spiritual wellbeing and "will to meaning" subscale of life attitude (r=.521, p=.000). The correlation coefficient showed r=.513 between spiritual well being and life attitude. CONCLUSION: Nurses could promote positive life attitude for breast cancer patients by improving spiritual well being with the encouragement of having religion expecially for long term breast cancer survivors in the process of their rehabilitation.
Breast Neoplasms* ; Breast* ; Female ; Follow-Up Studies ; Humans ; Nursing Care ; Quality of Life ; Surveys and Questionnaires ; Rehabilitation ; Survivors

PURPOSE: This study was to identify behaviors preventing the recurrence of breast cancer and the level of quality of life. METHODS: This descriptive study was conducted using a structured questionnaire from November 1, 2006 to December 25, 2006 . One hundred and twenty two women breast cancer survivors were recruited by convenience sampling. RESULTS: The most frequent behavior for preventing recurrence of the breast cancer was dietary treatment (90.9%) and exercise (86.8%) was the second behavior. In addition, most of them perceived these behaviors as 'very effective' (82.8%). The degree of the quality of life of a breast cancer survivor was 5.34 point indicating a 'medium level'. CONCLUSION: Breast cancer survivors pursued various behaviors for preventing recurrence of breast cancer. Therefore, the nursing interventions should be focused on a systematic educational approach considering healthy behaviors to prevent breast cancer recurrence for breast cancer survivors.
Adaptation, Psychological ; Adult ; Aged ; Breast Neoplasms/prevention & control/*psychology/therapy ; Data Interpretation, Statistical ; Demography ; Dietary Supplements ; Exercise Therapy ; Female ; *Health Behavior ; Humans ; Life Style ; Middle Aged ; Neoplasm Recurrence, Local/*prevention & control ; *Quality of Life ; Questionnaires ; Recurrence ; Survivors/*psychology

No abstract available.
Catheters* ; Peritoneal Dialysis, Continuous Ambulatory*

BACKGROUND: Weaning from mechanical ventilation is difficult in the intensive care unit (ICU). Many controversial questions remain unanswered concerning the predictors of weaning failure. This study investigates patient characteristics and delayed weaning after lung transplantation. METHODS: This study retrospectively reviewed the medical records of 17 lung transplantation patients from October 2012 to December 2013. Patients able to be weaned from mechanical ventilation within 8 days after surgery were assigned to an early group (n = 9), and the rest of the patients were assigned to the delayed group (n=8). Patients' intraoperative and postoperative characteristics were collected and analyzed, and conventional weaning predictors, including rapid shallow breathing index (RSBI), were also assessed. RESULTS: The results of the early group showed a significantly shorter ICU stay in addition to a shorter hospitalization overall. Notably, the early group had a higher body mass index (BMI) than the delayed group (20.7 vs. 16.9, p = 0.004). In addition, reopening occurred more frequently in the delayed group (1/9 vs. 5/8, p = 0.05). During spontaneous breathing trials, tidal volume (TV) and arterial oxygen tension were significantly higher in the early group compared to the delayed weaning group, but differences in RSBI and respiratory rate (RR) between groups were not statistically significant. CONCLUSIONS: Low BMI might be associated with delayed ventilator weaning in lung transplantation patients. In addition, instead of the traditional weaning predictors of RSBI and RR, TV might be a better predictor for ventilator weaning after lung transplantation.
Body Mass Index* ; Hospitalization ; Humans ; Intensive Care Units ; Lung Transplantation* ; Medical Records ; Oxygen ; Respiration ; Respiration, Artificial ; Respiratory Rate ; Retrospective Studies ; Tidal Volume ; Ventilator Weaning* ; Weaning

PURPOSE: The effects of neoadjuvant chemoradiation therapy (NCRT) in cases of locally advanced rectal cancer include tumor downstaging with respect to a curative resection and a decreasing incidence of local recurrence. The aim of this study is to evaluate the oncologic results according to the tumor regression grade (TRG) after NCRT and radical surgical resection in cases of locally advanced rectal cancer. METHODS: From 1999 to 2003, 140 consecutive patients, who suffered from locally advanced rectal cancer (T3 or T4, or lymph node positive) were enrolled in this study. They all received neoadjuvant chemoradiation therapy and a radical resection. Chemotherapy was based on 5-fluorouracil (5-FU), and the total radiation dose was 5,040 cGy over 6 weeks. A radical surgical resection, including a total mesorectal excision, was done 6 to 8 weeks after the completion of NCRT. We classified patients into subgroups by using the TRG; then, we investigated the overall and the disease-free survival rates and the local recurrence and the distant metastasis rates. RESULTS: One hundred twenty-six (126, 90%) patients responded to radiation therapy. According to the TRG, the numbers of non- responders (Grade I, NR), partial responders (Grade II, PR), and patients who went into complete remission (Grade III, CR) were 14 (10%), 98 (70%), and 28 (20%), respectively. The overall survival (OS) and the disease-free survival (DFS) rates for 3 years (n=140) were 91.43% and 74.29%, and the rates for 5 years (n=117) were 81.20% and 67.52%, respectively. While there was no significant difference in the 3-year OS or DFS between the three groups stratified by TRG (P=0.1136, P=0.1215), the 5-year OS and DFS showed a statistical difference (P=0.0485, P=0.0458). Furthermore, the 3-year OS and DFS rates (P=0.0451, P=0.0458), as well as the 5-year OS and DFS rates (P=0.0139, P=0.0131) were significantly better for patients in the CR group than for the other patients. Still, no statistical significance differences existed between the CR group and the non-CR groups or between the TRG groups in terms of the local recurrence and the distant metastasis rates (P=0.447, P=0.271). CONCLUSIONS: Any tumor response group that shows complete Rremission after NCRT and radical surgical resection has an oncologic benefit in overall survival and disease- free survival in our study.
Disease-Free Survival ; Fluorouracil ; Humans ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Rectal Neoplasms ; Recurrence

Pseudomyxoma peritonei may result from implantation of benign or malignant tumor in peritoneal cavity and is filled with gelatinous material (termed "Jelly Belly") in abdominal cavity. Its origin is usually an appendiceal or ovarian mucinous adenoma or cystadenocarcinoma, but other primary origin such as uterus, intestine, pancreas and stomach umor have been reported. Generally, pseudomyxoma peritonei is slowly progressive and has low grade malignant potential. This report presents a unusual long term survival after evacuation of 15,000 cc of gelatinous material from abdominal cavity which was the low grade mucinous adenocarcinoma and a review of the current literature, management and new its concept. The origin of pseudomyxoma peritonei of this case was most likely from appendiceal mvcinous adenocarcinoma.
Abdominal Cavity ; Adenocarcinoma ; Adenocarcinoma, Mucinous ; Adenoma ; Butyrates ; Colitis* ; Cystadenocarcinoma ; Gelatin ; Intestines ; Mucins ; Pancreas ; Peritoneal Cavity ; Pseudomyxoma Peritonei ; Stomach ; Uterus

OBJECTIVE: After drawing and stacking contour of structures, which are identifed in the serially sectioned images, three-dimensional (3D) images can be made by surface reconstruction. The 3D images can be selected and rotated in a real time. The purpose of this research is to compose software of automatic surface reconstruction for making 3D images. METHODS: Contours of 55 structures in the 613 magnetic resonance images of whole body were drawn to make segmented images. We composed automatic software for stacking contours of a structure, for converting the contours into polygons, and for connecting vertices of the neighboring polygons to fill gaps between polygons with triangular surfaces. The surface reconstruction software was excuted to make 3D images of 55 structures. RESULTS: Virtual dissection software, on which 3D images could be selected and rotated, was composed. CONCLUSION: For other research, this like program can be composed for automatic surface reconstruction; several kinds of commercial software can be used for manual or automatic surface reconstruction. Investigators might choose one of the methods in consideration of their only circumstances.
Humans ; Imaging, Three-Dimensional ; Research Personnel

The aim of this study was to assess the feasibility and efficacy of laparoscopic myomectomy (LM) for large myomas. A subpopulation of 51 patients with myomas 8 cm or larger in diameter was selected from 155 patients who underwent LM at Kangbuk Samsung Hospital from July 2003 to November 2006. The mean age of the patients was 34.9+/-5.6 yr, mean parity was 0.6+/-0.9, and 8 patients had a previous operative history. The most common operative indication was a palpable abdominal mass (24 patients, 47%). The mean operating time was 85.6+/-38.9 min, and the mean diameter of the largest myoma was 9.3+/-1.8 cm. The mean change in hemoglobin concentration was 2.1+/-1.2 g/dL. Histopathological diagnosis included 49 patients of leiomyoma (96.1%) and 2 patients of leiomyoma with adenomyosis (3.9%). Postoperatively, a transfusion was done in 7 patients, and a case of subcutaneous emphysema was noted. None of the operations was switched to laparotomy. With the newly-developed screw and the port placement system that was modified from the Choi's 4-trocar method to obtain better surgical vision, LM of large myomas proved to be one of the efficient and feasible methods.
Adult ; Feasibility Studies ; Female ; Humans ; Laparoscopy/adverse effects/*methods ; Leiomyoma/pathology/*surgery ; Length of Stay ; Postoperative Complications/etiology ; Reproducibility of Results ; Subcutaneous Emphysema/etiology ; Treatment Outcome ; Uterine Neoplasms/pathology/*surgery