The purpose of this study was to identify the relationships of symptom clusters, compliance with the patient’s role behavior, and dialysis adequacy with quality of life among hemodialysis patients. Methods: Structured surveys were used to collect data from 132 patients who were receiving hemodialysis as outpatients at two hemodialysis units using the Dialysis Symptom Index, tools to assess compliance with the patient’s role behavior and dialysis adequacy, and the Korean version of the World Health Organization BREF index for quality of life. Results: Quality of life was negatively correlated with the emotional-gastrointestinal symptom cluster (r=-.20, p=.021), the disturbance related-worrying symptom cluster (r=-.40, p<.001), and the sexual symptom cluster (r=-.23, p=.007), and positively correlated with compliance with the patient’s sick role (r=.43, p<.001). Conclusion: Nursing interventions for hemodialysis patients targeting each symptom cluster are expected to improve their quality of life, as well as applying educational programs and nursing interventions to strengthen patient role performance.

BACKGROUND: The purpose of this study was to identify role ambiguity of comprehensive nursing care unit nurses. METHODS: A concept analysis method by Walker and Avant was used to understand role ambiguity of comprehensive nursing care unit nurses. RESULTS: The antecedents of role ambiguity of nurses at comprehensive nursing units were shortage of nurses, unclear admission criteria, and demands for customized nursing care according to severity. Attributes include ambiguity in role delegation, patient placement ambiguity, and professional ambiguity among nursing staff. The consequences were diminished job satisfaction due to excessive workload, difficulty in resolving role ambiguity due to the lack of work analysis studies, and poor outcome of nursing indicators. CONCLUSION Improvement of nationwide awareness for comprehensive nursing care unit is required. Clear division at scope of practice for nursing staff in accordance of each medical institution's characteristics is essential. Nurses at comprehensive nursing care unit should understand nature of role ambiguity that occurs as they work in large groups. Nurses should promote communications between nursing staff and they must have volition to improve status quo. An additional research of comprehensive nursing care on the causes of role ambiguity in the practice of nursing care for ward nurses is needed, and management measures should be sought at the organizational level.

BACKGROUND/AIMS: Erlotinib and gemcitabine combined chemotherapy is becoming the treatment of choice in advanced pancreatic cancer. We evaluated the effectiveness of treatment with erlotinib plus gemcitabine and the prognostic factors for chemotherapeutic response in Korean pancreatic cancer patients. METHODS: Sixty-nine patients with advanced pancreatic cancer who were treated with daily erlotinib 100 mg orally and gemcitabine 1,000 mg/m2/30 min intravenous infusion on days 1, 8, and 15 of each 4-week cycle from 2006 to 2009 were included in this study. This study was a phase II single-center trial. RESULTS: All 69 patients with advanced pancreatic cancer were chemotherapy-naive. The objective response rate was 18.8%, and the overall tumor-stabilization rate was 49.2%. The median overall survival was 7.7 months (95% confidence interval [CI], 6.0 to 9.4 months). The median progression-free survival was 1.9 months (95% CI, 1.4 to 2.5 months). Prognostic factors for good chemotherapeutic response were good performance status and the presence of skin rash during chemotherapy. Patients with lower performance scores showed worse chemotherapeutic responses (odds ratio [OR], 7.6; 95% CI, 2.4 to 24.8). Poor responses were predicted by the absence of skin rash during chemotherapy (OR, 3.0; 95% CI, 1.4 to 6.3). CONCLUSIONS: Erlotinib and gemcitabine chemotherapy is a tolerable treatment regimen and has a favorable therapeutic effect in Korean patients with advanced pancreatic cancer.
Deoxycytidine ; Disease-Free Survival ; Exanthema ; Humans ; Infusions, Intravenous ; Pancreatic Neoplasms ; Quinazolines

PURPOSE: Obstructive jaundice in patients with hepatocellular carcinoma (HCC) is uncommon (0.5-13%). Unlike other causes of obstructive jaundice, the role of endoscopic intervention in obstructive jaundice complicated by HCC has not been clearly defined. The aim of this study was to evaluate the clinical characteristics of obstructive jaundice caused by HCC and predictive factors for successful endoscopic intervention. MATERIALS AND METHODS: From 1999 to 2009, 54 patients with HCC who underwent endoscopic intervention to relieve obstructive jaundice were included. We defined endoscopic intervention as a clinical success when the obstructive jaundice was relieved within 4 weeks. RESULTS: Clinical success was achieved in 23 patients (42.6%). Patients in the clinical success group showed better Child-Pugh liver function (C-P grade A or B/C; 17/6 vs. 8/20), lower total bilirubin levels (8.1+/-5.3 mg/dL vs. 23.1+/-10.4 mg/dL) prior to the treatment, and no history of alcohol consumption. The only factor predictive of clinical success by multivariate analysis was low total bilirubin level at the time of endoscopic intervention, regardless of history of alcohol consumption [odds ratio 1.223 (95% confidence interval, 1.071-1.396), p=0.003]. The cut-off value of pre-endoscopic treatment total bilirubin level was 12.8 mg/dL for predicting the clinical prognosis. Median survival after endoscopic intervention in the clinical success group was notably longer than that in the clinical failure group (5.6 months vs. 1.5 months, p< or =0.001). CONCLUSION: Before endoscopic intervention, liver function, especially total bilirubin level, should be checked to achieve the best clinical outcome. Endoscopic intervention can be helpful to relieve jaundice in well selected patients with HCC.
Adult ; Aged ; Bilirubin/blood ; Carcinoma, Hepatocellular/*complications ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects ; Female ; Humans ; Jaundice, Obstructive/complications/*surgery ; Liver Function Tests ; Liver Neoplasms/*complications ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Palliative Care ; Treatment Outcome

The purpose of this study was to develop a multiplex PCR that can detect porcine endogenous retrovirus (PERV) proviral genes (pol, envA, envB, envC) and porcine mitochondrial DNA, using a dual priming oligonucleotide (DPO) system. The primer specifically detected the PERV proviral genes pol, envA, envB, envC, and porcine mitochondrial DNA only in samples of pig origin. The sensitivity of the primer was demonstrated by simultaneous amplification of all 5 target genes in as little as 10 pg of pig DNA containing PERV proviral genes and mitochondrial DNA. The multiplex PCR, when applied to field samples, simultaneously and successfully amplified PERV proviral genes from liver, blood and hair root samples. Thus, the multiplex PCR developed in the current study using DPO-based primers is a rapid, sensitive and specific assay for the detection and subtyping of PERV proviral genes.
Animals ; DNA Primers/genetics ; DNA, Mitochondrial/*genetics ; Gammaretrovirus/*genetics ; Polymerase Chain Reaction/*methods ; Proviruses/classification/*genetics ; Sensitivity and Specificity ; Sus scrofa/*genetics/*virology

Pulmonary choriocarcinoma is a very rare tumor in men. Herrein, the case of a pulmonary choriocarcinoma in 39-year-old man, and whether it had a primary nature, is reported. He denied any prior medical illness, but was admitted to our hospital with a history of a cough, and progressive dyspnea and hemoptysis 2 and 1 week duration, respectively. Chest radiographs on admission revealed a huge lung mass, 10 cm in diameter, in the left upper lung field, with left pleural effusion. Although biopsies using several diagnostic methods for the pathological confirmation were attempted, the pathology was not confirmed. Finally, the patient died after 2 months of regression. An autopsy of the lung was then performed.
Adult ; Autopsy ; Biopsy ; Choriocarcinoma* ; Cough ; Dyspnea ; Female ; Hemoptysis ; Humans ; Lung ; Male ; Pathology ; Pleural Effusion ; Pregnancy ; Radiography, Thoracic