PURPOSE: The aim of this study was to explore the significant factors that influence quality of life in elderly patients with colorectal cancer. METHODS: A total of 107 patients with colorectal cancer completed the self-reported MD Anderson Symptom Inventory (MDASI-GI), Patient Generated Subjective Global Assessment (PG-SGA), self-care, and Functional Assesment of Illness Therapy-Colorectal (FACT-C). RESULTS: The mean scores were 87.20±19.84 for QOL, 2.80±2.25 for symptom experience, 6.84±0.58 for nutritional status, and 3.81±0.62 for self-care. The highest score was emotional well-being whereas the lowest score was social/family well-being. Factors affecting quality of life were analyzed by hierarchical multiple regression. As a result, self-care (β=.36, p<.001), symptom experience (β=-.34, p<.001), and nutritional status (β=-.25, p=.001) were identified as factors affecting quality of life. The explanation power of this regression model was 52.0% and it was statistically significant (F=23.55, p<.001). CONCLUSION: The quality of life can be improved by evaluating the comprehensive symptoms experienced by the elderly patients after colorectal cancer treatment, helping self-care, and maintaining proper nutritional status.
Aged ; Colorectal Neoplasms ; Equidae ; Humans ; Nutritional Status ; Quality of Life ; Self Care

A ruptured brain arteriovenous malformation (bAVM) presenting with a hematoma may have unseen parts of the shunts in diagnostic angiography in the acute phase, which may lead to innate incomplete evaluation for the whole angioarchitecture of the bAVM. Even though it is generally accepted that the nidus of a ruptured bAVM may be underestimated in angiography during the acute phase due to hematoma compression, documentation of the underestimated parts has not been described in the literature. The authors report 2 cases of ruptured bAVMs in which the obscured segments were cast with liquid embolic material, which suggests a potential presence of obscured segments in bAVMs.

PURPOSE: To understand the essentials of rearing conflict experience by three shift nurses in advanced general hospitals. METHODS: The design was a qualitative research of phenomenology. Participants were 7 shift nurses working in advanced general hospitals who were rearing young children. Data were collected individually through in-depth interview on their life experiences. Data were analyzed by Colaizzi's phenomenological methodology. RESULTS: Eighteen themes were drawn from 256 meaningful experiences and these themes were integrated to six theme clusters. The most influencing themes were ‘Regret that I cannot satisfy even the slightest wish’, ‘Fail to care for kids’, and ‘Mutual feeling to care giver between appreciation and inconvenience’. Other themes were as follows: ‘Body and mind are broken’, ‘The need for a three-shift system to support nurses who are rearing children’, ‘Doing my best for work and child rearing’. CONCLUSION: The nature of three-shift nurses working in advanced hospital and caring kids is explained as ‘lives with conflict’ between work and home. This study suggests it is necessary to establish a 24-hour care center for 3-shift nurses to keep working while rearing their children.
Caregivers ; Child ; Hospitals, General ; Humans ; Life Change Events ; Qualitative Research

Objective: Evidence for the association between circadian rhythm delay and depression is accumulating. Genetic studies have shown that certain polymorphisms in circadian genes are potential genetic markers of diurnal preference. Along with circadian genes, there is a growing interest in other genetic effects on circadian rhythms. This study evaluated whether the HTR2A rs6311 (-1438C/T) polymorphism is associated with diurnal preference in a Korean population. Methods: A total of 510 healthy subjects were included in this study. All subjects were genotyped for the HTR2A rs6311 polymorphism and they completed the Korean version of the composite scale of morningness (CSM). Results: The C allele carriers (C/C+C/T) showed significantly higher CSM scores compared to C allele non-carriers (T/T) (t=2.22, p= 0.03), suggesting the existence of a morning chronotype tendency in C allele carriers. In other words, the T/T genotype may be associated with the evening chronotype. Conclusion These results suggest that the HTR2A rs6311 polymorphism may be associated with diurnal preference in a healthy Korean population. The absence of the C allele may be responsible for the increasing susceptibility to eveningness in the Korean population. Further studies on HTR2A polymorphisms that evaluate their interactions with various candidate genes and differences in phenotypic expression of polymorphisms according to ethnic groups are warranted to fully understand their association with diurnal preference.

Objective: Previous studies have suggested various causes of restless legs syndrome (RLS), including iron and dopamine concentrations in the brain. Genetic influences have also been reported in many studies. There is also a possibility that circadian clock genes may be involved because symptoms of RLS worsen at night. We investigated whether CLOCK and NPAS2 gene polymorphisms were associated with RLS. Methods: A total of 227 patients with RLS and 229 non-RLS matched controls were assessed according to the International Restless Legs Syndrome Study Group diagnostic criteria. Genotyping was performed using reverse transcription polymerase chain reaction and high-resolution melting curve analyses. Results: Although the genotype distributions of the CLOCK variants (rs1801260 and rs2412646) were not significantly different between patients with RLS and non-RLS controls, the allele frequencies of CLOCK rs1801260 showed marginally significant differences between the two groups (X2 =2.98, p=0.085). Furthermore, there was a significant difference in the distribution of CLOCK haplotypes (rs1801260-rs2412646) between patients with RLS and non-RLS controls (p=0.013). The distributions of allelic, genotypic, and haplotypic variants of NPAS2 (rs2305160 and rs6725296) were not significantly different between the two groups. Conclusion Our results suggest that CLOCK variants may be associated with decreased susceptibility to RLS.

Quadriplegia is a serious or complete loss of motor function of all four limbs that is commonly caused by spinal cord injuries secondary to damage to the cervical spine. In this situation, there is a higher risk of pneumonia due to paralysis of the respiratory muscles. Tracheostomy is preferred over endotracheal intubation for the effective elimination of sticky bronchial secretion. The safest technique for a tracheostomy is to carry it out under general anesthesia with endotracheal intubation. However, endotracheal intubation may be difficult and cause other complications in patients with laryngotracheal stenosis caused by repeated tracheostomy and a limitation of neck movement as a result of the fixation of the cervical vertebral bodies due to the cervical spine fracture. We report a case of a tracheostomy performed sucessfully under intravenous anesthesia using a laryngeal mask airway without muscle relaxants in a patient with quadriplegia caused by a cervical spine injury.
Anesthesia, General ; Anesthesia, Intravenous ; Constriction, Pathologic ; Extremities ; Humans ; Intubation, Intratracheal ; Laryngeal Masks ; Muscles ; Neck ; Paralysis ; Pneumonia ; Quadriplegia ; Respiratory Muscles ; Spinal Cord Injuries ; Spine ; Tracheostomy

The purpose of this study was to investigate the difference of nutritional status according to metabolic syndrome in colorectal cancer patients. The subjects were divided into 2 groups (metabolic syndrome group and normal group) according to the presence or absence of metabolic syndrome in 143 patients diagnosed with colorectal cancer, and their lifestyle and nutritional status were analyzed. Recall method was used for the dietary survey, and metabolic syndrome was defined as the presence of 3 or more of waist circumference, fasting blood glucose, triglyceride, high-density lipoprotein (HDL)-cholesterol, and blood pressure. This study showed that the metabolic syndrome group had a low age, a high body mass index (BMI), and a high drinking rate. The intake of energy, protein, fat, calcium, and phosphorus was significantly higher in the metabolic syndrome group than in the normal group, and the intake of β-carotene, vitamin C, and folic acid was significantly low. The intake of cholesterol, fatty acid, saturated fatty acid, and polyunsaturated fatty acid was also higher in the metabolic syndrome group. Higher BMI, alcohol consumption, intake of fat, total fatty acid or saturated fatty acid increased the risk of metabolic syndrome, but fiber, vitamin C, or folic acid intake lowered the risk.Weight management and balanced nutritional intake should be emphasized to prevent metabolic syndrome and to improve the condition in patients with colorectal cancer.
Alcohol Drinking ; Ascorbic Acid ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Calcium ; Cholesterol ; Colorectal Neoplasms* ; Diet ; Drinking ; Fasting ; Folic Acid ; Humans ; Life Style ; Lipoproteins ; Methods ; Nutritional Status ; Phosphorus ; Triglycerides ; Waist Circumference

BACKGROUND: Since 1997, the annual case occurrence of vivax malaria in the Republic of Korea have exceeded 1,000 cases since 1997. The military is thought to be an important source of the current outbreak. We collected various informations about malaria cases (soldiers, veterans and civilians) which occurred in 2000, and analyzed the characteristics of the current outbreak. METHODS: Informations about malaria cases of soldiers, veterans and civilians, including name, age, sex, day of onset, region, etc., were collected through the National Institute of Health. RESULTS: Out of total 4,141 cases, 1,288 (31.1%) occurred in the military, 1,273 (30.7%) occurred among the veterans, and 1,580 (38.2%) occurred among civilians. The monthly case occurrence reached its peak in early August. Areas such as Cheolwon, Yeoncheon and Paju showed the highest prevalence. CONCLUSION: It is considered that the current malaria outbreak has escaped from the exponential growth phase, however, more attention should be paid to prevent further spreading of malaria infection.
Humans ; Malaria ; Malaria, Vivax* ; Military Personnel ; Prevalence ; Republic of Korea* ; United Nations ; Veterans

Purpose: There are many studies on sentinel lymph node (SLN) biopsy in thyroid carcinoma but SLN biopsy (SLNB) in papillary thyroid carcinoma (PTC) remains open to debate. Therefore in this retrospective study, the usefulness of SLNB in thyroid carcinoma patients who had micro-PTC without cervical lymphadenopathy was assessed. Methods: SLNB was performed in 114 patients who were diagnosed with micro-PTC in a single lobe without palpable or ultrasound-detected lymph node at the tertiary center between January 2012 and December 2013. After SLNB, all patients underwent total thyroidectomy and central neck dissection or thyroid lobectomy and central neck dissection of the single side. Results: SLNs were identified in 112 of 114 patients with 41 positive SLNs and 71 negative SLNs on intraoperative frozen sections. However, eight negative patients were found to be positive in the final pathology. Sentinel node identification rate and false negative value of SLNB were 98.2% and 11.3%, respectively. In the univariate analysis, higher lymph node metastasis was detected in men than in women. Higher detection number of SLN showed higher probability of lymph node metastasis. Conclusion SLNB may be helpful in papillary thyroid cancer, especially in male patients. Also, it is useful for the staging of nodal status and clearance of persistent disease.

Purpose: The balloon-stent technique (BST) has certain strengths as an assisted technique for the treatment of complex aneurysms. After Atlas release, the BST can be executed without an exchange maneuver of the balloon to the stent-delivery catheter. The purpose of this article is to share our experience with the BST using the Scepter-Atlas combination. Materials and Methods: Device inspection led us to a simple method to avoid failure in loading Atlas to the Scepter. From March 2018 to December 2019, 57 unruptured distal internal carotid artery (dICA) aneurysms were treated with coil embolization; among which, 25 aneurysms in 23 patients were treated with BST. Clinical and angiographic data were retrospectively collected and reviewed. Results: The technical success rate of the Scepter-Atlas combination increased from 50% to 100% after careful inspection. BST angiographic results were comparable to the stent-assisted coil (SAC) group treated during the immediately post-embolization same period (modified Raymond-Roy classification [MRRC] 1 & 2 84% in BST, 96.3% in SAC) and during short-term follow-up (MRRC 1 & 2 95.8% in BST, 88.4% in SAC). A small number of patients showed periprocedural complications, but none had clinical consequences. Conclusion BST using the Scepter-Atlas combination can provide an effective and safe method for the treatment of dICA aneurysms. Scepters can be used as delivery catheters for Atlas.