PURPOSE: This study was conducted to compare the levels of pain intensity and pain relief between cancer patients and nursing records, and to compare the barriers to pain control between cancer patients and their nurses. METHODS: Data were collected from 90 cancer patients who were admitted to three oncology wards and 90 oncology nurses in the same three wards at C University Hospital in G City from July to September, 2012. RESULTS: The most severe pain intensity reported by cancer patients was 6.59 points on the first day of analgesic treatment, while that of their nursing records was 3.98 points on the first day. There were significant changes in pain intensity over time between two groups (F=142.07, p<.001). The highest level of pain relief reported by patients was 2.87 points on the third day, while that of nursing records was 1.67 points on the first day. The score for the social system area of barriers to pain control among the nurses was higher than that of cancer patients (t=-3.69, p=.021). CONCLUSION: Nurses need to frequently check and to be sensitive to cancer pain. Furthermore, the administrative procedures of narcotic analgesics need to be simplified.
Comprehension ; Humans ; Narcotics ; Nursing Records

PURPOSE: To evaluate the effect of Imatinib which is tyrosine kinase inhibitor used for the treatment of chronic myelogenous leukemia on the proliferation of the lens epithelial cells and the activities of growth factors. METHODS: In the experimental group I, the cells were exposed to Imatinib for 3, 5 min with various concentration. In the experimental group II, the cells were cultured with PDGF, bFGF, TGF-beta2. In the experimental group III, the cells were exposed to Imatinib for 3, 5 min with the various concentration in the presence of each growth factor. The cell viability was assessed by MTT assay. And the cell proliferation were evaluated by BrdU staining. The phosphorylation of ERK (Extracellular-signal regulated kinase) and the amount of collagen type I produced by TGF-beta2 were analyzed with western blot. RESULTS: MTT assay showed that the viability of lens epithelial cells was decreased about 50% at the concentration above Imatinib 30 micro M for 5 mins exposure in group I. Both PDGF and bFFG induced significantly increased cell viability in group II. The group III that was treated with both PDGF and bFGF showed the decrease of cell viability after being exposed to Imatinib. As the concentration of Imatinib increased, BrdU incorporation of experimental group I was decreased compared with control group. It also found that The BrdU incorporation of experimental group III was also decreased compared with experimental group II. The phosphorylation of ERK 1/2 and the amount of collagen type I production was significantly decreased in addition of Imatinib 20 to 30 micro M for 3 mins exposure. CONCLUSIONS: The proliferation of lens epithelial cells could be inhibited by Imatinib. And the activities of PDGF, bFGF, TGF-beta2 were also inhibited by Imatinib.
Blotting, Western ; Bromodeoxyuridine ; Cell Proliferation ; Cell Survival ; Collagen Type I ; Epithelial Cells* ; Intercellular Signaling Peptides and Proteins* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Phosphorylation ; Protein-Tyrosine Kinases ; Transforming Growth Factor beta2 ; Imatinib Mesylate

OBJECTIVE: Acute ischemic stroke (AIS) requires time-dependent reperfusion therapy, and early recognition of AIS is important to patient outcomes. This study was conducted to identify the clinical features and risk factors of AIS patients that are missed during the early stages of diagnosis. METHODS: We retrospectively reviewed AIS patients admitted to a hospital through the emergency department. AIS patients were defined as ischemic stroke patients who visited the emergency department within 6 hours of symptom onset. Patients were classified into two groups: an activation group (A group), in which patients were identified as AIS and the stroke team was activated, and a non-activation group (NA group), for whom the stroke team was not activated. RESULTS: The stroke team was activated for 213 of a total of 262 AIS patients (81.3%), while it was not activated for the remaining 49 (18.7%). The NA group was found to be younger, have lower initial National Institutes of Health Stroke Scale scores, lower incidence of previous hypertension, and a greater incidence of cerebellum and cardio-embolic infarcts than the A group. The chief complaints in the A group were traditional stroke symptoms, side weakness (61.0%), and speech disturbance (17.8%), whereas the NA group had non-traditional symptoms, dizziness (32.7%), and decreased levels of consciousness (22.4%). Independent factors associated with missed stroke team activation were nystagmus, nausea/vomiting, dizziness, gait disturbance, and general weakness. CONCLUSION: A high index of AIS suspicion is required to identify such patients with these findings. Education on focused neurological examinations and the development of clinical decision tools that could differentiate non-stroke and stroke are needed.
Cerebellum ; Consciousness ; Diagnosis ; Dizziness ; Education ; Emergencies* ; Emergency Service, Hospital* ; Gait ; Humans ; Hypertension ; Incidence ; National Institutes of Health (U.S.) ; Neurologic Examination ; Reperfusion ; Retrospective Studies ; Risk Factors* ; Stroke*

Acute renal failure caused by rifampin typically occurs on intermittent administration or reintroduction of the drug. However, acute kidney injury (AKI) due to rifampin has been rarely reported to occur in patients receiving a continuous rifampin therapy. We have experienced a case of acute interstitial nephritis during the first course of standard anti-tuberculous therapy, including continuous rifampin therapy in daily dose. Forty-five-year-old male, who had been being treated with anti-tuberculous medication including rifampin (600 mg/day), was admitted to our hospital because of generalized edema and dyspnea by acute renal failure. His past medical history was unremarkable. Since the creatinine level was still elevated in 10 days after cessation of rifampin, we performed renal biopsy. The renal pathologic findings revealed acute interstitial nephritis. After that, the patient symptom was relieved and serum creatinine level was decreased without specific therapy. The renal function was recovered at 1 month after withdrawal of rifampin. We report a case of acute interstitial nephritis complicated with the first daily rifampin therapy, along with the review of literature.
Acute Kidney Injury ; Biopsy ; Creatinine ; Dyspnea ; Edema ; Humans ; Male ; Nephritis, Interstitial ; Renal Insufficiency ; Rifampin

PURPOSE: The potential therapeutic application of the tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), in the treatment of multiple myeloma (MM), was recently proposed. However, there have been some problems with the use of TRAIL, due to the appearance of TRAIL-resistant cells in MM. The effect of arsenic trioxide (As2O3) on the rate of apoptosis induced by TRAIL was evaluated in MM cells. MATERIALS AND METHODS: Using TRAIL-sensitive (RPMI- 8226) and TRAIL-resistant (ARH-77 and IM-9) MM cell lines, the cell viability, induction of apoptosis, and change in the caspases were examined after treatment with TRAIL alone, or in combination with various concentrations of As2O3. RESULTS: Incubating the cell lines with As2O3 augmented the TRAIL-induced apoptosis in the MM cell lines, according to the As2O3 concentration. Apoptosis was mediated through caspase activation. When TRAIL was used alone, caspase8 was activated in the RPMI-8226 cell lines, but not in the ARH-77 and IM-9 cell lines. When As2O3 was added to TRAIL, caspase-9 was activated in the ARH-77 and IM-9 cells. CONCLUSION: The use of As2O3, in combination with TRAIL, would help enhance the level of TRAIL-induced apoptosis, and overcome the TRAIL-resistance, in MM cells.
Apoptosis* ; Arsenic* ; Caspase 9 ; Caspases ; Cell Line* ; Cell Survival ; Multiple Myeloma* ; Necrosis*

Major peritoneal catheter-related complications include pericatheter leaks, outflow failure, and infection of the exit site or tunnel. We experienced a rare spontaneous fracture of a silicone peritoneal catheter. A 39-year-old man undergoing continuous ambulatory peritoneal dialysis (CAPD) developed peripheral edema and peritoneal outflow failure. He had no signs of exit-site infection, trauma, or peritonitis. The kidney-ureter-bladder radiograph suggested a fractured peritoneal catheter. We removed the catheter in an emergency operation and inserted a new peritoneal catheter. No obvious reason could explain why the catheter had broken, although the patient's nephew was known to frequently jump on his abdomen Based on this case, mechanical stress should be avoided in CAPD patients with increased intra-abdominal pressure.
Abdomen ; Adult ; Catheters ; Edema ; Emergencies ; Fractures, Spontaneous ; Humans ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Silicones ; Stress, Mechanical

PURPOSE: To evaluate the efficacy of bronchial and intercostal arterial embolization using a glue-lipiodol mixture in patients with hemoptysis. MATERIALS AND METHODS: Between October 1997 and June 1999, 24 patients underwent 30 sessions of bronchial and intercostal arterial embolization using a glue-lipiodol mixture. The cause of hemoptysis was tuberculosis (n=11), bronchiectasis (n=9) or aspergilloma (n=4). Particular attention was paid to the source of bleeding, type and rate of complication and rate of recurrence, and the cause of recurrence and the duration of the asymptomatic period after bronchial and intercostal arterial embolization in patients with recurrent hemoptysis were also analysed. In addition, the asymptomatic period after bronchial and intercostal arterial emboilzation was classified as 24 hours or less, 7 days or less, or 6months or less. RESULTS: In all 24 cases, hemoptysis ceased immediately after bronchial and intercostal arterial embolization. In 18 cases, the focus of bleeding was a bronchial artery arising from the aorta, and in three of these cases there was also intercostal artery bleeding. In the remaining cases, the focus of bleeding was the right bronchial artery arising from the bronchointercostal trunk (n=5), or the intercostal artery only (n=1). During six of 24 sessions (25%) hemoptysis recurred within six months, but there was no recurrence within 24 hours or 7 days. The causes of recurrence were bleeding from systemic collaterals (n=5) and from another nonembolized bronchial artery (n=1). Retrosternal burning sensation (n=13; 43%) and shoulder pain (n=2; 7%) were detected but no complications critical. CONCLUSION: Because it involves non-recanalization of embolized vessels, bronchial and intereostol arterial embolization with a glue-lipiodol mixture can effectively control hemoptysis.
Aorta ; Arteries ; Bronchial Arteries ; Bronchiectasis ; Burns ; Hemoptysis* ; Hemorrhage ; Humans ; Recurrence ; Sensation ; Shoulder Pain ; Tuberculosis

PURPOSE: Authors evaluated the effectiveness of pain relief of the femoral nerve block in multimodal pain control protocols for patients with total knee arthroplasty in early postoperative period. MATERIALS AND METHODS: Seventy-six patients who underwent TKA under general anesthesia were enrolled in this study. Preemptive analgesic medication, periarticular multimodal drug injection, and IV-PCA were used for pain control in all patients. This single-blind, randomized controlled trial included 43 patients in the nerve block group and 33 patients in the control group. In the former group, the femoral nerve block was done by one author with a nerve stimulator set using 0.5% bupivacaine 20 ml and 1% lidocaine 10 ml. Pain scale was measured at 6, 12, 24, 48, 72 hours and 7 days postoperatively. In addition, amount of IV-PCA consumption, numbers of using acute pain rescuer, range of motion, straight leg raising, first ambulation time, and complications related with drugs were evaluated. RESULTS: Pain scale and the amount of IV-PCA consumption were significantly lower in nerve block group until 48 hours (p=0.04, 0.03), and the range of motion was better compared to the control group (p< or =0.02). The number of pain rescue medicines was significantly low in nerve block group within the first 3 days postoperatively (1.36 vs 2.58). The ability to raise a straightened leg was recovered more rapidly in the control group than in the nerve block group; this difference was statistically significant (12 vs 27.9 hours, p=0.02). There were no differences in first ambulation time and incidence of complications between the 2 groups. CONCLUSION: Femoral nerve block in the early period after TKA under multimodal pain control protocols showed significant improvement in pain relief and in range of motion, as well as a significant decrease in the requirement of IV PCA and acute pain rescuers.
Acute Pain ; Anesthesia, General ; Arthroplasty ; Bupivacaine ; Femoral Nerve ; Humans ; Incidence ; Knee ; Leg ; Lidocaine ; Nerve Block ; Osteoarthritis ; Passive Cutaneous Anaphylaxis ; Range of Motion, Articular ; Walking