Purpose: This study comprehensively examined the experiences of breast cancer survivors' while accessing healthcare facilities for developing nursing intervention programs to enhance and maintain patients' health. Methods: As part of this qualitative study, focus group interviews were conducted with six breast cancer survivors from December 30, 2020, to April 30, 2021. Results Qualitative data analysis revealed four themes and nine sub-themes using a medical institution after diagnosis in breast cancer survivors. Four themes were ‘burden that individuals still have to bear’, ‘hospital situation that is not patient-centered’, ‘alternative ways to get information and support from the other resources’, and ‘the journey of long-term treatment and management’. Discussion: To improve the quality of life in breast cancer survivors, it is vital to establish medical services that consider the characteristics of each stage of the disease, in addition to support hospitals and social policy programs that can address the unmet needs of the survivors.

Purpose: This study aimed to provide a theoretical basis for career anchors of nurses by defining and organizing its concept. Methods: Using the Walker and Avant concept analysis, a total of 29 articles were analyzed through a literature search in this study. Results: The career anchors of nurses are individual career choice motives, a self-concept where in competency and values are harmonized, which act as a desire for growth and development in nursing, and are actions that maintain careers. Additionally, they indicate the direction for achieving individual career goals and act as a core value expected of nurses by nursing organizations, indicating continuous and integrated professional growth and development of the nursing profession. Conclusion The career anchors of nurses identified in the results contribute to securing patient safety, providing quality care through policies, institutionalizing bases for career development, preventing nurse turnover, and retaining skilled nurses.

OBJECTIVE: Antidepressants Modulate Neuronal Plasticity. Tianeptine, An Atypical Antidepressant, Might Be Involved In The Restoration Of Neuronal Plasticity; It Primarily Enhances The Synaptic Reuptake Of Serotonin. Ncam140 Is Involved In Neuronal Development Processes, Synaptogenesis And Synaptic Plasticity. We Investigated The Effect Of Tianeptine On The Expression Of Ncam140 And Its Downstream Signaling Molecule In The Human Neuroblastoma Cell Line Sh-sy5y. METHODS: NCAM protein expression was measured in human neuroblastoma SH-SY5Y cells that were cultivated in serum-free media and treated with 0, 10, or 20 microM tianeptine for 6, 24, or 72 hours. NCAM140 expression in the tianeptine treatment group was confirmed by Western blot, and quantified through measurement of band intensity by absorbance. CREB and pCREB expression was identified after treatment with 20 microM tianeptine for 6, 24, and 72 hours by Western blot. RESULTS: Compared to cells treated for 6 hours, cells treated with 0 or 10 microM tianeptine for 72 hours showed a significant increase in NCAM140 expression and cells treated with 20 microM tianeptine showed a significant increase after 24 and 72 hours. The pCREB level in cells treated with 20 microM tianeptine increased in time-dependent manner. CONCLUSION: Our findings indicated that the tianeptine antidepressant effect may occur by induction of NCAM140 expression and CREB phosphorylation.
Antidepressive Agents ; Blotting, Western ; Cell Line ; Culture Media, Serum-Free ; Humans ; Neural Cell Adhesion Molecules ; Neuroblastoma ; Neuronal Plasticity ; Neurons ; Phosphorylation ; Plastics ; Serotonin

Under the assumption that people go through stages in making dietary behavior change, this study was attempted to apply the stages of a change model for fat intake by examining the associations of social psychological variables with stages of change in dietary fat reduction. Derived from social psychological theories, 10 social psychological variables on motivational beliefs(6), social influence(3) and self-efficacy(1) related specifically to selecting every day diets low in fat were constructed. Fat and energy intakes were assessed by a short form semi-quantitative food frequency questionnaire. The associations of stages of change with motivational beliefs, social influence, and self-efficacy variables and energy and fat intakes were assessed in 333 female adults from large cities in Korea. Dietary stage groups differed significantly on most of the social psychological variables in ways predicted by theory. Motivational factors that lead to a psychological state of readiness to take action were important in the early stages of the dietary change process. Social influences were more important in the stages as people decide to take action. Self efficacy and motivational beliefs, particularly, reduction of perceived barriers were important in maintaining fat reduction behavior. The results of our study indicate differences in stages of change in fat reduction behavior in terms of nutrient intakes and social psychological correlates and suggests that adding a time dimension to social psychological models increases our understanding of dietary change, which assist us in designing nutrition education interventions that are more appropriately targeted by stage of change.
Adult* ; Diet ; Dietary Fats ; Education ; Female* ; Humans ; Korea ; Models, Psychological ; Psychological Theory ; Self Efficacy ; Surveys and Questionnaires

Purpose: To date, there are no promising treatments for gastric carcinoma with peritoneal metastasis. Some researchers have suggested a survival benefit of gastrectomy in select patients. This study investigated the survival of gastric carcinoma patients with stand-alone peritoneal metastasis according to the type of treatment modality. Materials and Methods: We reviewed the data of 132 patients with gastric carcinoma and stand-alone peritoneal metastasis. We performed gastrectomy when the primary tumor was deemed resectable and systemic chemotherapy was administered. We analyzed patient survival according to the type of treatment, and the prognostic value of gastrectomy was evaluated in univariate and multivariate models. Results: Among all patients, 70 underwent gastrectomy plus chemotherapy, 20 underwent gastrectomy alone, 36 underwent chemotherapy alone, and 6 received supportive care.The median patient survival was 13 months. Patients who underwent gastrectomy had significantly longer survival than those who did not undergo gastrectomy (14 vs. 8 months, P<0.001). Patients who received chemotherapy showed significantly longer survival than those who did not (13 vs. 7 months, P=0.032). Patients who underwent gastrectomy plus chemotherapy showed better survival than those who underwent other treatments. In multivariate analysis, gastrectomy was found to be an independent prognostic factor (hazard ratio, 0.52; 95% confidence interval, 0.33–0.82) in addition to chemotherapy. Conclusions Our study showed that patients who underwent gastrectomy plus chemotherapy had the best survival. Although the survival benefit of gastrectomy remains uncertain, it is a favorable prognostic indicator in patients with stand-alone peritoneal metastasis.

Purpose: The numeric N stage has replaced the topographic N stage in the current tumor node metastasis (TNM) staging in gastric carcinoma. However, the usefulness of the topographic N stage in the current TNM staging system is uncertain. We aimed to investigate the prognostic value of the topographic N stage in the current TNM staging system. Materials and Methods: We reviewed the data of 3350 patients with gastric cancer who underwent curative gastrectomy. The anatomic regions of the metastatic lymph nodes (MLNs) were classified into 2 groups: perigastric and extra-perigastric. The prognostic value of the anatomic region was analyzed using a multivariate prognostic model with adjustments for the TNM stage. Results: In patients with lymph node metastasis, extra-perigastric metastasis demonstrated significantly worse survival than perigastric metastasis alone (5-year survival rate, 39.6% vs. 73.1%, respectively, P<0.001). Extra-perigastric metastasis demonstrated significantly worse survival within the same pN stage; the multivariate analysis indicated that extra-perigastric metastasis was an independent poor prognostic factor (hazard ratio=1.33; 95% confidence interval=1.01–1.75). The anatomic region of the MLNs improved the goodness-of-fit (likelihood ratio statistics, 4.57; P=0.033) of the prognostic model using the TNM stage. Conclusions The anatomic region of MLNs has an independent prognostic value in the numeric N stage in the current TNM staging of gastric carcinoma.

Purpose: This study aimed to investigate the impact of different types of complications on long-term survival following total gastrectomy for gastric cancer. Materials and Methods: A total of 926 patients who underwent total gastrectomy between 2008 and 2016 were included. Patients were divided into the morbidity and no-morbidity groups, and long-term survival was compared between the 2 groups. The prognostic impact of postoperative morbidity was assessed using a multivariate Cox proportional hazard model, which accounted for other prognostic factors. In the multivariate model, the effects of each complication on survival were analyzed. Results: A total of 229 patients (24.7%) developed postoperative complications. Patients with postoperative morbidity showed significantly worse overall survival (OS) (5-year, 65.0% vs. 76.7%, P<0.001) and cancer-specific survival (CSS) (5-year, 74.2% vs. 83.1%, P=0.002) compared to those without morbidity. Multivariate analysis adjusting for other prognostic factors showed that postoperative morbidity remained an independent prognostic factor for OS (hazard ratio [HR], 1.442; 95% confidence interval [CI], 1.136–1.831) and CSS (HR, 1.463; 95% CI, 1.063–2.013). There was no significant difference in survival according to the severity of complications. The following complications showed a significant association with unfavorable long-term survival: ascites (HR, 1.868 for OS, HR, 2.052 for CSS), wound complications (HR, 2.653 for OS, HR, 2.847 for CSS), and pulmonary complications (HR, 2.031 for OS, HR, 1.915 for CSS). Conclusions Postoperative morbidity adversely impacted survival following total gastrectomy for gastric cancer. Among the different types of complications, ascites, wound complications, and pulmonary complications exhibited significant associations with longterm survival.

Purpose: The post-operative quality of life (QoL) is a significant concern for patients undergoing gastrectomy. Unlike subtotal gastrectomy, the detailed aspects of QoL involving the ability to perform everyday activities that reflect physical, psychological, and social well-being; and satisfaction with levels of functioning and control of the disease after total gastrectomy remain poorly investigated. Materials and Methods: We enrolled 170 patients who underwent total gastrectomy for gastric carcinoma and completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life questionnaires (QLQ) C30 and STO22 preoperatively and post-operatively at 1, 6, and 12 months. We investigated the QoL change in terms of the minimally important difference (MID), which refers to a score change patients would perceive as clinically important (effect size >0.5). Results: At 1-month post-surgery, MID in global health, physical, social, role, emotional, and cognitive functions was observed at 44.0%, 68.0%, 42.7%, 38.7%, 32.0%, and 16.0% respectively. Of QLQ-C30 symptoms, MID was frequently observed in appetite (52.9%). Of the QLQ-STO22 symptoms, MID was frequently observed in eating restrictions (74.1%), dysphagia (63.5%), pain (51.8%), and anxiety (50.6%). At 12 months post-surgery, MID in global health, physical, role, cognitive, social, and emotional functions was 32.9%, 58.8%, 42.4%, 40.0%, 36.5%, and 17.6%, respectively. Of QLQ-C30 symptoms, MID was frequently observed in diarrhea (52.9%). Of the QLQ-STO22 symptoms, MID was frequently observed in eating restrictions (63.5%), dysphagia (52.9%), body image (55.3%), pain (55.3%), and anxiety (51.8%). Male sex, comorbidity, D2 lymphadenectomy, and post-operative morbidity were associated with MID in global health at 12 months post-surgery. Conclusion This study provides information about the detailed aspects of impairment in various functions and symptoms of QoL after total gastrectomy. This information can be used to develop a tailor-made management plan for QoL.

PURPOSE: This study was conducted to compare the recovery state of 6 month between s-ICH and s-SAH patients. The patients' recovery state was measured with 2 dimensions: functional and cognitive. METHODS: Non-experimental prospective design was adopted by including 108 hemorrhagic stroke patients(s-ICH: 52 vs s-SAH: 56) admitted to Intensive Care Unit of one university hospital. RESULTS: The study results showed that overall functional recovery state of s-SAH patients was better than that of s-ICH patients, and s-SAH patients also showed better recovery states in all of the sub-dimensions of functional recovery, such as feeding, grooming, and toileting, than those of s-ICH in 6 month. On the contrary, the study results showed that overall cognitive recovery states of 6 month between two groups were not significantly different. However, according to the results comparing the sub-dimensions of cognitive recovery, s-SAH patients' recovery states on attention, communication and memory were significantly better than those of s-ICH patients, while recovery states on problem solving, safety behavior, and social behavior between 2 groups were not significantly different. CONCLUSION: From the study results, it was noted that s-SAH patients showed better recovery states in cognitive dimension as well as in functional dimension compared with s-ICH patients.
Animals ; Cerebral Hemorrhage ; Grooming ; Humans ; Intensive Care Units ; Memory ; Problem Solving ; Prospective Studies ; Social Behavior ; Stroke ; Subarachnoid Hemorrhage

We report a case of pulmonary edema developed in a 33-year-old female who underwent two-stage bilateral carotid body tumor excision. About 1 month ago, she had undergone a left carotid body tumor excision. After the operation, her tongue was deviated to left side. Bilateral hypoglossal nerve injury was suspected. These injuries should be carefully monitored in patients who will undergo a similar procedure on both sides because a bilateral deficit of the hypoglossal nerve is poorly tolerated, resulting potentially serious pulmonary edema. In recovery room, she became pale and SpO2 was fall down. We reintubated her immediately and the pulmonary edema was treated using a supportive management. She was discharged without any signs of dyspnea or airway obstruction, but hypoglossal nerve injury remained. We discuss the possible etiology of the upper airway obstruction after the neck surgery and review the literatures associated with the pulmonary edema following upper airway obstruction.
Adult ; Airway Obstruction ; Carotid Body Tumor* ; Carotid Body* ; Dyspnea ; Female ; Humans ; Hypoglossal Nerve ; Hypoglossal Nerve Diseases ; Hypoglossal Nerve Injuries ; Neck ; Pulmonary Edema* ; Recovery Room ; Tongue