The assessment of patient status in palliative medicine is essential for determining treatments and for clinical outcomes. The objective of assessment tools is to raise the quality of care for individual patients and their families. There are a number of tools available to assess pain, non-pain symptoms and quality of life. The tools are either uni-dimensional or multi-dimensional measures. Unfortunately, however, no single tool is recommended to be a superior to others in symptoms or quality of life assessment. Therefore, to select an appropriate assessment tool, one should consider the time frame and unique characteristics of tools depending on purpose and setting. The combination of prognostic index is highly recommended in prognostication, and web-based prognostic tools are available. Recently, a new objective prognostic score has been constructed through multicenter study in Korea. It does not include clinicalestimates of survival, but includes new objective prognostic factors, therefore, anyone can easily use it. For beginners in palliative medicine, relatively easy-to-use tools would be convenient. We recommend Eastern Cooperative Oncology Group performance status to assess functional status, numeric rating scale for pain assessment and the Korean version of brief pain inventory for initial pain assessment. Asking directly with numeric rating scale or the Korean version of MD Anderson Symptom Inventory would be desirable to assess various symptoms together. We think that European Organization Research and Treatment Quality of Life Questionnaire Core 15 for Palliative Care is good to assess the quality of life, while Objective Prognostic Score is convenient as prognostic index for beginners.
Brief Psychiatric Rating Scale ; Humans ; Korea ; Pain Measurement ; Palliative Care ; Quality of Life ; Surveys and Questionnaires

BACKGROUND: The growth of Korean adolescents' average height has slowed over the past 10 years. The objective of this study was to investigate the association between height and mental health in Korean male adolescents.METHODS: This study used data from the 2015 Korea Youth Risk Behavior Web-based Survey (34,152 male school students). The male adolescents were divided into the below-average height and above-average height groups according to age. The association between height and mental health was analyzed by multivariate logistic regression.RESULTS: The above-average height group had significantly higher subjective health (P=0.003) and significantly lower depression than the belowaverage height group (P=0.031). In multivariate logistic regression, the odds ratio of subjective health wass 1.13 (P=0.043), but no significant difference in subjective happiness, depression, stress and suicidal ideation (P>0.05) at both group.CONCLUSION: It was confirmed that height is associated with subjective health in Korean male adolescents.
Adolescent ; Depression ; Diagnostic Self Evaluation ; Happiness ; Humans ; Korea ; Logistic Models ; Male ; Mental Health ; Odds Ratio ; Risk-Taking ; Suicidal Ideation

BACKGROUND: Breast cancer is the second most common cancer in Korean women. As survival years increase, health-related quality of life has become an important issue in breast cancer patients. Sleep problems are common and cause significant disruption in quality of life in breast cancer patients. However, cancer-related sleep disturbance has received little attention. The purpose of this study was to determine the prevalence of poor sleep quality and factors which are associated with poor sleep quality in the breast cancer patients receiving chemotherapy in the outpatients setting. METHODS: One hundred and twenty-seven breast cancer patients receiving chemotherapy in a tertiary hospital outpatient were surveyed between February 2009 and July 2009. Among them, 94 (72.8%) patients were finally included in the study. The sleep quality was assessed by the Pittsburg Sleep Quality Index (PSQI). PSQI > 5 indicates clinically significant poor sleep quality. Also the independent factors of sleep quality were assessed using univariable analysis and multiple logistic regression analysis. RESULTS: Seventy-two (76.6%) patients of 94 breast cancer patients undergoing chemotherapy have poor sleep quality. Among of them, 11 (15.3%) patients were actually consulted with doctors. Average PSQI score was 8.8 (+/- 4.1). Anxiety and employment status were associated with poor sleep quality. CONCLUSION: A high proportion of breast cancer patients receiving chemotherapy even in the outpatient settings had poor sleep quality. But only small proportion of them consulted doctor. Poor sleep quality during chemotherapy in breast cancer patient was associated with anxiety and employment status. Considering the high prevalence of sleep problem and inadequate management, more adequate attention is needed to manage the sleep problem of breast cancer patients receiving chemotherapy.
Anxiety ; Breast ; Breast Neoplasms ; Employment ; Female ; Humans ; Logistic Models ; Outpatients ; Prevalence ; Quality of Life ; Tertiary Care Centers

BACKGROUND: Smoking is universally recognized as the foremost preventable cause of cancer. And smoking behavior causes many negative effects in cancer patients. Based on the mounting evidence that smoking affects cancer treatment outcomes and survival, we studied whether the cancer diagnosis affects smoking behavior. METHODS: During August 2007, 279 patients who were hospitalized with the diagnosis of cancer were surveyed by a questionnaire and a follow up survey was performed at 3 months and 7 months afterwards. Follow up survey was performed via telephone and finally 246 patients were enrolled. Questions in the survey included smoking history, nicotine dependence, stage of change and the reason for quit smoking or keep smoking. In the follow up survey at 7 month, we asked whether they needed smoking cessation interventions. RESULTS: At the end of the study, the subjects who kept smoking were 27 patients, but the degree of nicotine dependence was decreased compared to the preceding 2 surveys and contemplation as well as preparation stage turned out to be the most prevalent stage of change. The main reasons to keep smoking were behavioral habits and stress. Regardless of their smoking history, almost all cancer patients wanted smoking cessation interventions. CONCLUSION: Smoking is a critical variable that affects cancer treatment and outcome. We surely found there is a smoking subgroup after cancer diagnosis and we should advise them to quit smoking.
Follow-Up Studies ; Humans ; Smoke ; Smoking ; Smoking Cessation ; Telephone ; Tobacco Use Disorder

BACKGROUND AND OBJECTIVES: A fall refers to a sudden fall accident resulting in injury and hurt of the human body. In the hospital, fall accidents occur mainly in dizzy patients or elderly people, but can also occur even in young people who fail to adapt to the unfamiliar hospital environment. This study analyzed the incidence of fall accidents and its pattern in dizzy patients in a tertiary hospital in South Korea. SUBJECTS AND METHOD: This study was conducted using 477 fall accidents that occurred in a tertiary hospital in Korea from 2011 to 2015. Extensively investigated were related fall risk factors such as patient's sex, age, medical department, diagnosis, first witness, mental status, physical activity, patient risk factors, walking aids, medication use and treatment. RESULTS: Dizziness induced falls consisted of 20.5% of the total fall accidents. Sedative medications were frequently used in patients of dizziness induced falls (42.9%). Fall acidents were mainly detected by nurses 33%. The frequente sites of fall were the bed rooms (55%), the corridor (15%) or the bath rooms (8%). Types of physical damage were no damage (47%), abrasion or bruising (20%), laceration (10%), bath rooms (8%), fracture (3%), and head trauma (1%). In 532 treatments, observation was recommended for 68%, sterilization 15.2%, suture 4.7%, cast 1%, and surgery 1%. CONCLUSION: The study finds that the fall risk screening test and Multifactorial Fall Prevention Program should be performed for all high-risk patients of fall. About 20% of falls were associated with otologic dizziness, and otolaryngology doctors should pay attention to the fall problem and the medication related to dizziness, which may potentially increase the risk of falls.
Accident Prevention ; Accidental Falls ; Aged ; Baths ; Craniocerebral Trauma ; Diagnosis ; Dizziness ; Education ; Human Body ; Humans ; Incidence ; Korea* ; Lacerations ; Mass Screening ; Methods ; Motor Activity ; Otolaryngology ; Risk Factors ; Sterilization ; Sutures ; Tertiary Care Centers* ; Walking

BACKGROUND: Many epidemiological studies suggest the pathogenic role of serum uric acid level in development of hypertension. Several cross-sectional studies have shown the relationship between uric acid and development of hypertension in Korea. We investigated whether uric acid associates with the development of hypertension in a retrospective cohort study. METHODS: We included 2,353 people who did not have hypertension initially and underwent general medical examination between 1997 and 1998 and were re-examined after 10 years later. Study people divided into three groups according to serum uric acid level tertiles. RESULTS: The incidences of hypertension in tertile groups were 14.1% (108/764), 22.0% (175/769), and 24.3% (193/793) and they showed statistically significant difference. We performed multivariable logistic regression with serum uric acid and other risk factors of hypertension. The incidence of hypertension in second and third tertile group were significantly higher than first tertile group (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.11 to 2.10; P = 0.009 in second tertile group and OR, 1.66; 95% CI, 1.17 to 2.37; P = 0.005 in third tertile group). CONCLUSION: Serum uric acid level is associated with the development of hypertension.
Cohort Studies ; Epidemiologic Studies ; Hypertension ; Incidence ; Korea ; Logistic Models ; Retrospective Studies ; Risk Factors ; Uric Acid

BACKGROUND: Dietary supplements (DS) have been increasingly utilized as a way of the promoting health and complementary therapy. This study aimed to evaluate the patterns of dietary supplement use in Korean cancer patients and to examine the related factors. METHODS: Between April and May of 2008, 366 patients who were hospitalized for diagnosis and treatment of cancer in a university affiliated tertiary hospital were surveyed using a self-administered structured questionnaire after receiving written informed consent. Among them, 322 patients with adequate answers were fi nally included. RESULTS: Two hundred forty patients (72.3%) reported to have ever taken DS with the mean number of 3.6 +/- 2.98. Vitamins were the most frequently used, followed by ginseng steamed red, ginseng, and glucosamine. The most infl uential factor regarding DS use was the recommendation by family members or relatives. The main reason for DS use was for resolution of fatigue, followed by supplementation of therapy, and immune enhancement. Information concerning DS most eager to know about was the effect of DS (44.6%), followed by interaction of DS with therapeutics (33.2%). Doctor (74.4%) was the most preferred health care provider to be consulted concerning DS, but only 34% of DS users have actually consulted with a doctor. Multiple logistic regression analysis showed that increasing age, Catholicism, and higher educational level were associated with higher use of DS. CONCLUSION: DS use was very prevalent in cancer patients. In spite of the great need, only small proportion of cancer patients using DS has consulted with a doctor.
Catholicism ; Dietary Supplements ; Fatigue ; Glucosamine ; Health Personnel ; Humans ; Informed Consent ; Logistic Models ; Negotiating ; Panax ; Steam ; Tertiary Care Centers ; Vitamins

The purpose of this study was to develop a new ginseng (Panax ginseng) flower buds extract with the high concentration of ginsenoside Rg3, Rg5, Rk1, Rh1 and F4, the Red ginseng special component. Chemical transformation from the ginseng saponin glycosides to the prosapogenin was analyzed by the HPLC. The ginseng flower buds were processed at the several treatment conditions of the ultrasonication (Oscillator 600W, Vibrator 600W) and vinegar (about 14% acidity). The result of UVGFB-480 was the butanol fraction of ginseng flower buds that had been processed with ultrasonication and vinegar for 480 minutes gained the highest amount of ginsenoside Rg5 (3.548%), Rh1 (2.037%), Rk1 (1.821%), Rg3 (1.580%) and F4 (1.535%). The ginsenoside Rg5 of UVGFB-480 was found to contain 14.3 times as high as ginseng flower buds extracts (GFB, 0.249%).
Acetic Acid* ; Chromatography, High Pressure Liquid ; Flowers* ; Glycosides ; Panax* ; Saponins

Background: To date, there has been no practical guidelines for the prescription of antiepileptic drugs (AEDs) in brain tumor patients in Korea. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for AED usage in brain tumors since 2019. Methods: The Working Group was composed of 27 multidisciplinary medical experts in Korea.References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of the keywords. Results: The core contents are as follows. Prophylactic AED administration is not recommended in newly diagnosed brain tumor patients without previous seizure history. When AEDs are administered during peri/postoperative period, it may be tapered off according to the following recommendations. In seizure-naïve patients with no postoperative seizure, it is recommended to stop or reduce AED 1 week after surgery. In seizure-naïve patients with one early postoperative seizure (<1 week after surgery), it is advisable to maintain AED for at least 3 months before tapering. In seizure-naïve patients with ≥2 postoperative seizures or in patients with preoperative seizure history, it is recommended to maintain AEDs for more than 1 year. The possibility of drug interactions should be considered when selecting AEDs in brain tumor patients. Driving can be allowed in brain tumor patients when proven to be seizure-free for more than 1 year. Conclusion The KSNO suggests prescribing AEDs in patients with brain tumor based on the current guideline. This guideline will contribute to spreading evidence-based prescription of AEDs in brain tumor patients in Korea.

Background: There have been no guidelines for the management of adult patients with diffuse midline glioma (DMG), H3K27M-mutant in Korea since the 2016 revised WHO classification newly defined this disease entity. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for DMG since 2019. Methods: The Working Group was composed of 27 multidisciplinary medical experts in Korea.References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of keywords. As ‘diffuse midline glioma’ was recently defined, and there was no international guideline, trials and guidelines of ‘diffuse intrinsic pontine glioma’ or ‘brain stem glioma’ were thoroughly reviewed first. Results: The core contents are as follows. The DMG can be diagnosed when all of the following three criteria are satisfied: the presence of the H3K27M mutation, midline location, and infiltrating feature. Without identification of H3K27M mutation by diagnostic biopsy, DMG cannot be diagnosed. For the primary treatment, maximal safe resection should be considered for tumors when feasible. Radiotherapy is the primary option for tumors in case the total resection is not possible. A total dose of 54 Gy to 60 Gy with conventional fractionation prescribed at 1-2 cm plus gross tumor volume is recommended. Although no chemotherapy has proven to be effective in DMG, concurrent chemoradiotherapy (± maintenance chemotherapy) with temozolomide following WHO grade IV glioblastoma’s protocol is recommended. Conclusion The detection of H3K27M mutation is the most important diagnostic criteria for DMG. Combination of surgery (if amenable to surgery), radiotherapy, and chemotherapy based on comprehensive multidisciplinary discussion can be considered as the treatment options for DMG.