Dignity therapy for terminally ill patients in end-of-life care helps improve their psychological and spiritual well-being. In this study, the effectiveness and feasibility of dignity therapy in terminally ill patients were analyzed by reviewing previous studies. The review’s findings show that dignity therapy alleviates psychological distress and improves patients' spiritual well-being and dignity. In addition, many patients and their families found emotional support in generativity documents created through dignity therapy. Finally, the possibility of applying dignity therapy to palliative care in Korea in the future was explored. The findings indicate the influence of Eastern culture on recognizing death in patients who receive dignity therapy. Thus, dignity therapy shows promise as a contribution to improving palliative care; however, additional studies are needed to implement effective dignity therapy in the Korean context.

Entrapment syndrome of suprascapular nerve by a ganglion has been reported not frequently. We experienced a case of suprascapular nerve entrapment by ganglion which was treated with non-operative treatment, and report it with literature.
Ganglion Cysts* ; Nerve Compression Syndromes*

OBJECTIVE: To evaluate the effectiveness of doxycycline as monotherapy for the treatment of acute pelvic inflammatory disease (AcPID) resistant with traditional combined regimen (TCR). METHODS: 128 patients were selected, who were diagnosed as AcPID from January 2003 to June 2004 and prescribed with medical treatment. Initially, TCR by cephalosporin, metronidazole, and aminoglycoside antibiotics was applied to all patients. 2-3 days later, the level of subjective pain or tenderness on pelvic examination was evaluated. If it is 30% or less than initial symptoms and signs, original regimen was prescribed (group I). If it is 30% more than initial symptoms and signs, we judged AcPID resistant with TCR and changed the antibiotic regimen with doxycycline (group II). Cure of AcPID was defined by no pain or tenderness. In this study, retrospective review about the result of medical treatment and clinical characteristics between two groups was done. RESULTS: Of the 128 patients, 94 (73.4%) was group I (46 inpatient and 48 outpatient) and 34 (26.6%) was group II (20 and 14). There were no significant differences in clinical characteristics except initial blood WBC count between group I and II. Initial blood WBC count was 11153+/-4393/microliter in group I and 9112+/-3483/microliter in group II (p<0.05). Positive rate of Chlamydia trachomatis using PCR was 9.4% (12/128) in all patients (group I:0%, II:35.3%). All patients of two groups were cured with TCR and doxycycline. CONCLUSION: Our data shows that doxycycline as monotherapy is effective to patients who are resistant with TCR for medical treatment of AcPID.
Anti-Bacterial Agents ; Chlamydia trachomatis ; Doxycycline* ; Female ; Gynecological Examination ; Humans ; Inpatients ; Metronidazole ; Pelvic Inflammatory Disease* ; Polymerase Chain Reaction ; Retrospective Studies

OBJECTIVE: Preterm birth is an important cause of infant death and morbidity but its pathophysiology still remains to be clear. The associations between preterm birth and the polymorphism of interleukin-1beta gene and interleukin-1 receptor antagonist gene have been suspected. And ethnic variations in the polymorphism of the genes were also reported. We decided to study polymorphisms of interleukin-1beta+3953 and interleukin-1 receptor antagonist in Korean pregnant women. METHODS: Patients were divided into 2 groups. Group 1 is the control group of 33 subjects with uncomplicated term delivery : group 2 is the case group of patients who had spontaneous preterm delivery. Polymorphisms were determined by polymerase chain reaction and restriction fragment length polymorphism analysis. RESULTS: There were significant differences in gestational age and birth weight between two groups (P<0.001). No significant differences were found in genotypic frequencies and allelic frequencies in interleukin-1beta+3953 between two groups. Interleukin-1 receptor antagonist gene had 5 alleles and the most frequent allele was IL1RN*1 (410bp), 66.7% in control group and 77.8% in case group. And significant differences were not found in genotypic frequencies and allelic frequencies between two groups, too. CONCLUSION: There were no significant differences in polymorphisms in interleukin-1beta +3953 and interleukin-1 receptor antagonist between term delivery group and preterm birth group.
Alleles ; Birth Weight ; Female ; Gestational Age ; Humans ; Infant ; Interleukin-1* ; Interleukin-1beta* ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Pregnant Women ; Premature Birth*

BACKGROUND: Waldenstrom macroglobulinemia (WM) is a lymphoproliferative disorder characterized by monoclonal IgM. Its rarity makes it difficult to know the clinical manifestations and outcomes of patients with WM. METHODS: The clinical records of 13 patients diagnosed with WM between 1983 and 2003 were reviewed, and 12 patients were eligible. RESULTS: The median age was 57 years (range, 40 to 85), and the male to female ratio was 2. B symptoms and hyperviscosity requiring plasmapheresis existed in 5 and 4 patients, respectively, at the time of diagnosis. Hepatomegaly and splenomegaly were detected in 5 and 3 patients, respectively. Sites of extranodal involvement were bone (3) and lung (1) in 3 patients. The peripheral neuropathy was complicated in 3 patients. (Ed note: check this sentence.) Cryoglobulin was checked in 6 patients and it was detected in 3 of them. The median concentration of serum IgM was 4.2 g/dL (0.7~6.2). The median albumin, hemoglobin, WBC, and platelet levels were 2.8 g/dL, 8 g/dL, 5, 400/micro L, and 138, 000/micro L, respectively. One patient had transitional cell carcinoma concomitantly, and one patient developed small cell lung cancer. Of the 11 patients receiving chemotherapy (7-chlorambucil, 2-melphalan, 1-cyclophosphamide, 1-CHOP), 4 patients showed the objective responses including 2 complete remissions, but they all ultimately relapsed. The response rate of second-line therapy was 14% (1/7). After a median follow-up of 20 months, 3 patients were still alive with disease. The median overall and progression-free survival were 24 months (95% confidence interval (CI) : 5-43) and 24 months (95% CI: 8-40), respectively. CONCLUSION: The initial high levels of serum IgM and severe anemia reflect a lack of suspicion of WM at the early stage. Careful suspicion and proper diagnostic approaches will allow more patients to show an improved outcome.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Immunoglobulin M/blood ; Korea ; Male ; Middle Aged ; Retrospective Studies ; Waldenstrom Macroglobulinemia/blood/*diagnosis

OBJECTIVE: To understand the correlation between leptin in cord blood and parameters indicating fetal growth and to investigate the relationship between leptin and growth hormone. METHODS: We measured leptin and growth hormone levels in the cord blood of 46 healthy neonates by radioimmunoassay (RIA), and analyzed the correlation of leptin with growth hormone, birth weight, gestational age, sex, birth height, body mass index, maternal body mass index (BMI), and Ponderal Index by Pearson correlation coefficients. RESULTS: Leptin concentration of cord blood was 5.16 g/l in median value; concentration in female cord blood was significantly higher than in male's (P=0.005). Growth hormone concentration was 28.60 g/l; there was no significant difference between female and male (P=0.584). There were significant correlations between leptin and birth weight, birth height, and BMI at birth, with correlation coefficients 0.56 (P=0.0001), 0.35 (P=0.017), and 0.35 (P=0.017), respectively. Growth hormone was correlated with leptin but statistically insignificant (P=0.085). And growth hormone was not correlated with gestational age, Ponderal Index or maternal BMI. CONCLUSION: Leptin is significantly correlated with fetal growth, and growth hormone is potentially correlated with fetal growth.
Birth Weight ; Body Height ; Body Mass Index ; Female ; Fetal Blood* ; Fetal Development* ; Gestational Age ; Growth Hormone* ; Humans ; Infant, Newborn* ; Leptin* ; Male ; Parturition ; Radioimmunoassay

Transient osteoporosis of the hip (TOH) associated with pregnancy is a rare, self- limiting skeletal disorder affecting women, usually in the third trimester, which resolves spontaneously within several months postpartum. Magnetic resonance imaging (MRI) is used primarily for early diagnosis and monitoring the disease progression. Early differentiation from more aggressive conditions such as avascular osteonecrosis, septic coxitis, arthritis, osteomyelitis with long-term sequela is essential to avoid unnecessary treatment. Unilateral involvement of TOH is common. To our knowledge, there has been no case with bilateral involvement of TOH during pregnancy in Korea. We report a rare case with bilateral TOH associated with pregnancy.
Arthritis ; Disease Progression ; Early Diagnosis ; Female ; Hip ; Humans ; Korea ; Magnetic Resonance Imaging ; Osteomyelitis ; Osteonecrosis ; Osteoporosis ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, Third

PURPOSE: The purpose of this study was to compare the clinical and functional outcomes in patients with primary base of tongue (BOT) cancer who received definitive radiotherapy (RT) or surgery followed by radiotherapy (SRT). MATERIALS AND METHODS: Between January 2002 and December 2016, 102 patients with stage I-IVB primary BOT cancer underwent either definitive RT (n=46) or SRT (n=56), and treatment outcomes were compared between two groups. The expression of p16 was also analyzed. RESULTS: The RT group had more patients with advanced T stage (T3-4) disease (58.7% vs. 35.7%, p=0.021) and who received chemotherapy (91.3% vs. 37.5%, p < 0.001) than the SRT group. At a median follow up of 36.9 months (range, 3.3 to 181.5 months), the 5-year overall survival (OS) and disease-free survival (DFS) were 75.5% and 68.7%, respectively. With respect to treatment group, the 5-year OS and DFS in the RT and SRT groups did not differ significantly (OS, 68.7% vs. 80.5%, p=0.601; DFS, 63.1% vs. 73.1%, p=0.653). In multivariate analysis, OS differed significantly according to p16 expression (p16-negative vs. p16-positive; hazard ratio [HR], 0.145; 95% confidence interval [CI], 0.025 to 0.853; p=0.033). Regarding DFS, p16 expression (p16-negative vs. p16-positive; HR, 0.164; 95% CI, 0.045 to 0.598; p=0.006) showed a significant effect in multivariate analysis. Functional defects (late grade ≥ 3 dysphagia or voice alteration) were more frequently reported in the SRT than in the RT group (16.1% vs. 2.2%, p=0.021). CONCLUSION: Despite advanced disease, patients in the RT group showed comparable survival outcomes and better functional preservation than those in the SRT group.
Chemoradiotherapy* ; Deglutition Disorders ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Organ Preservation ; Radiotherapy ; Radiotherapy, Adjuvant* ; Tongue Neoplasms* ; Tongue* ; Treatment Outcome ; Voice

Background and Objectives: We analyzed surgical outcomes, perioperative complications, and mortality in head and neck squamous cell carcinoma (HNSCC) in patients who underwent curative surgery following neoadjuvant immunotherapy.Subjects and Method The records of 36 HNSCC patients who underwent curative surgery with neoadjuvant immunotherapy and 69 HNSCC patients who received neoadjuvant chemotherapy were analyzed. Results: The average operation time was 315 minutes, and the average bleeding volume was 167 cc. The average length of hospital stay was 21 days. When evaluating surgical margin status, we found 24 patients (66.6%) who exhibited a negative margin. We found no case where surgery was impossible due to progression of the lesion during neoadjuvant immunotherapy. Compared to the neoadjuvant chemotherapy group, neoadjuvant immunotherapy group showed acceptable perioperative safety and complication profile. The postoperative complication rate was 19.4% in the neoadjuvant immunotherapy group and 13.0% in the neoadjuvant chemotherapy group (p=0.386). There were no serious complications during the recovery period after surgery or instances of death due to complications. Conclusion In HNSCC patients, there was no increase in the incidence of complications or mortality related to curative surgery after neoadjuvant immunotherapy.

Rifampin is one of the first line drugs for treating tuberculosis, but it might be associated with serious adverse effects, including renal failure. We report here on a case of a 57-year-old patient who developed Henoch-Shonlein purpura during antituberculosis therapy that included rifampin. The patient converted to negative on the AFB smear for tuberculosis two weeks after the initial administration of antituberculosis medication. After treatment for 60 days, this patient was diagnosed with Henoch-Shonlein purpura by the purpura lesion on the lower legs, the leukocytoclastic vasculitis, the renal impairment and the pathological examination. After stopping rifampin, the skin lesions disappeared in about 10 days and his renal function gradually improved. This case study showed that Henoch-Schonlein purpura can be caused by rifampin during antituberculosis therapy and we recommend that the use of rifampin should be restrained when clinical symptoms of Henoch-Shonlein purpura are observed.
Acute Kidney Injury ; Humans ; Leg ; Middle Aged ; Purpura ; Purpura, Schoenlein-Henoch ; Renal Insufficiency ; Rifampin ; Skin ; Tuberculosis ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous