PURPOSE: This study was to compare and analyze sleep patterns, satisfaction of sleep, and sleep enhancement behaviors between hospitalized and non-hospitalized elderly. METHODS: Subjects were 201 older adults, who were hospitalized patients or living in U-city, Gyung-gi province. Data was collected from June 10 to August 25, 2007, and was analyzed by the SAS program. RESULTS: 1) Non-hospitalized elderly had better sleep patterns than hospitalized elderly patients. 2) There was a strong positive correlation between sleep patterns and satisfaction of sleep in both groups. 3) In hospitalized elderly, there were significant differences in sleep patterns and satisfaction of sleep by month. 4) In non-hospitalized elderly, there was a significant difference in sleep patterns by presence or absence of spouses. There was a significant difference in satisfaction of sleep by those living with others. There were significant differences in sleep enhancement behaviors by age, religion, length of time, and sponsors. CONCLUSION: To relieve sleep disturbances of elderly, comprehension of sleep of the aged by nursing care givers should be obtained. Also, improving environments and elder's selfesteem with religious consideration and preparation of financial conditions are needed to promote the sleep of hospitalized and non-hospitalized elderly.
Aged ; Aged, 80 and over ; *Behavior ; Data Interpretation, Statistical ; Female ; Humans ; Inpatients/*psychology ; Interviews as Topic ; Male ; Outpatients/*psychology ; Patient Satisfaction ; *Sleep ; Sleep Initiation and Maintenance Disorders/*psychology

PURPOSE: We performed nerve-sparing robot-assisted radical cystectomy (nsRARC) and compared the operative outcomes of nsRARC and open radical cystectomy (ORC). MATERIALS AND METHODS: The data of 38 patients that underwent ORC or nsRARC for bladder cancer between July 2009 and April 2014 (23 ORC and 15 RARC) were retrospectively analyzed. Data were collected on patient demographics, pathologic stages, perioperative outcomes, and oncologic outcomes as well as on erectile function. Five-year overall survival and cancer-specific survival were analyzed using the Kaplan-Meier method. Erection function recovery was defined as the ability to achieve penetration ≥50% of the time and to maintain an erection sufficient enough for penetration ≥50% of the time at 12 months after surgery. RESULTS: No significant differences were found between the nsRARC and ORC groups in terms of age, sex, body mass index, American Society of Anesthesiologists physical status, or clinical stage. Mean estimated blood loss was significantly less in the nsRARC group (205.3 mL vs. 394 mL, p=0.011), but mean operative time was significantly greater (520.3 minutes vs. 415.0 minutes, p=0.004). Five-year overall survival and cancer-specific survival were 86.7% and 86.7%, respectively, for nsRARC, and 77.7% and 86.7% for ORC. With respect to erectile function, the overall postoperative potency rate at 12 months was 40.0% in the RARC group and 9.5% in the ORC group, and this difference was significant (p=0.021). CONCLUSIONS: Our clinical experiences indicate nsRARC in selected patients is a feasible procedure in terms of oncologic outcome and that it preserves erectile function relatively effectively.
Body Mass Index ; Cystectomy ; Demography ; Humans ; Methods ; Operative Time ; Recovery of Function ; Retrospective Studies ; Urinary Bladder Neoplasms

Medical education in Je Joong Won was proposed and initiated by Dr. HN Allen. In his proposal of building a new hospital, submitted to the king in 1885, he expressed his wish to teach Western medicine to young Koreans at the hospital. The king welcomed his proposal and the plan was soon realized. Je Joon Won, the first modern hospital in Korea, opened on April 10th, 1885. The following year, on March 29th, Dr. Allen began medical school attached to the hospital. Many applicants were recruited by the government and 16 students were selected through the entrance examination. At first, they were taught English and finally 12 students out of them were selected after three months of teaching. The selected students were taught arithmetic, physics, chemistry, anatomy and physiology. The medical education at this period cannot be evaluated entirely successful since none of the 12 students was presumed to have worked as a practitioner.
Education, Medical/*history ; English Abstract ; History of Medicine, 19th Cent. ; History of Medicine, 20th Cent. ; Hospitals/history ; Korea ; Mentors/*history ; Missions and Missionaries/*history ; United States ; Western World

Despite recent advances in the management of a wide variety of solid tumors, the outcomes for patients with advanced urothelial carcinoma remain relatively poor. Cisplatin-based combination chemotherapy remains the standard of care for first-line systemic treatment of advanced urothelial carcinoma and for more than 10 years there have been no other Korean health insurance system-approved treatment options available for these patients. In this review article, we summarize the current state of chemotherapeutic agents, used either alone or in combination with other chemotherapy in advanced urothelial carcinoma. Our discussion focuses on the new agents for the cisplatin ineligible patients, including carboplatin, gemcitabine, paclitaxel, docetaxel and pemetrexed. Moreover, we addressed that neoadjuvant chemotherapy was supported in the patients planning radical cystectomy as an optimal treatment option by qualified studies.
Carboplatin ; Carcinoma, Transitional Cell ; Cisplatin ; Cystectomy ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Insurance, Health ; Paclitaxel ; Pemetrexed ; Standard of Care

PURPOSE: This study was a descriptive survey research to compare and to examine the levels of health status, depression, and quality of life between the elderly living with family and the elderly living alone, the relations among the factors. METHODS: Subjects were the 441 elderly over 65 years old(243 elderly living with family; 198 elderly living alone) in Seoul and Gyung-gi province. Data were collected from January to March, 2007. Collected data were analyzed through SAS/PC 11.0 version. RESULTS: First, the health status and quality of life in the elderly living with family were higher than them in the elderly living alone. Also depression in the elderly living with family was lower than that in the elderly living alone. Second, in all elderly there was positive correlation between health status and depression. There were negative correlations between health status and quality of life, and between depression and quality of life. Third, the economic environments in all elderly did effect to the health status, depression, and quality of life. CONCLUSION: In conclusion, it's requested a special attention of the current job level or interpersonal relationship of older people.
Aged ; Depression ; Humans ; Quality of Life

PURPOSE: This study examined the effects of individual reminiscence therapy on older adults' depression, morale, and the quality of life. METHODS: The design was a single-group pre-test and post-test study. Subjects consisted of 31 older adults from two senior centers and a welfare center in Seoul. Individual reminiscence therapy was applied to study subjects four times, once a week for an hour at each time. Measurement tools were the Geriatric Depression Scale Short Form Korea (GDSSF-K) for depression, Mun Ae-ri's (1996) scale for morale, and Medical Outcomes Study Short Form 36 (SF-36) for the quality of life. Data was analyzed using descriptive statistics, paired t-test, and pearson correlation. RESULTS: The application of individual reminiscence therapy reduced older adults' depression (t=-5.65, p=.000), and enhanced older adults' morale (t=4.65, p=.000). The application of individual reminiscence therapy improved older adults' quality of life (t=5.00, p=.000). CONCLUSION: Findings of the study suggest that individual reminiscence therapy may be applied as a nursing intervention that contributesto the improvement of older adults' quality of life, reduces their depression, and enhances their morale.
Aged ; Aged, 80 and over ; Depression/psychology/*therapy ; Female ; Humans ; Male ; *Mental Recall ; *Morale ; Psychotherapy/*methods ; *Quality of Life

PURPOSE: Smoothened(Smo) encodes a 1,024 amino acid transmembrane protein that acts as a transducer of the hedgehog(Hh) signal and maps to 7q31-q32 in humans. In the absence of Hh, Patched(Ptc) prevents Smo from signaling. When M-Hh-N binds to Ptc, however, Smo is free to upregulate downstream genes in the network. Activating mutations in Smo have been identified in sporadic basal cell carcinomas. This study was performed to evaluate the significance of Smo expression in humanzbladder cancer. MATERIALS AND METHODS: Tumor tissues were obtained from 140 patients with bladder cancer and normal bladder mucosa were acquired from 17 patients without bladder cancer as controls. Smo expression was assessed from paraffin sections of tissues using immunohistochemistry and graded on a scale of 0-12 according to the intensity and rate of staining. Differences of Smo expression between the bladder tumors and normal mucosa were compared. The relationships between their expression and the pathological or clinical characteristics such as tumor stage, grade, recurrence, and progression were also analyzed. RESULTS: There was no difference in the Smo expression in comparisons between the bladder cancers and the normal tissues(4.96+/-1.92 vs.4.52+/-0.87, p=0.111). Superficial bladder tumors had a higher Smo expression compared with normal tissues(0.005). Smo expression in the superficial and low-grade bladder tumors were higher than in the invasive and high-grade bladder tumors(p=0.002 and 0.001, respectively). The progression status was correlated with Smo expression but not the recurrence status(p=0.041 and 0.357, respectively). However, the Smo expression levels were not associated with the overall survival of patients(p=0.406). CONCLUSIONS: The results of this study showed that the enhanced expression of Smo was correlated with superficial, low-grade bladder cancer and tumors without progression. These results suggest that Smo is closely correlated with the differentiation and progression of bladder cancer and may, therefore, be useful as a prognostic marker for bladder cancer in the clinical setting.
Carcinoma, Basal Cell ; Humans* ; Immunohistochemistry ; Mucous Membrane ; Paraffin ; Recurrence ; Transducers ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: Urolithiasis develops more frequently in patients with a family history (FHx). However, little is known about risk factors in stone formers with a FHx. The aim of this study was to examine the clinico-metabolic characteristics of urinary stone formers according to FHx. MATERIALS AND METHODS: A database of 1,068 stone formers who underwent a complete metabolic evaluation was reviewed. The patients were divided into two groups on the basis of the presence of a FHx. Clinical factors and metabolic parameters were compared between the two groups. RESULTS: There were no significant differences in clinical characteristics, such as gender, age, body mass index, stone episodes, or multiple stones, between the two groups (p>0.05, respectively). Compared with stone formers without a FHx, however, serum calcium concentrations were more elevated in stone formers with a FHx. Also, the urinary excretion of calcium was higher in stone formers with a FHx than in those without a FHx. Other urinary metabolites showed no significant differences between the two groups (p>0.05, respectively). CONCLUSIONS: Our study revealed that stone formers with a FHx had increased urinary calcium excretion as well as elevated concentrations of serum calcium. This finding suggests that urolithiasis in stone formers with a FHx may be associated with calcium metabolic abnormalities.
Body Mass Index ; Calcium ; Family Characteristics ; Humans ; Risk Factors ; Urinary Calculi ; Urolithiasis

BACKGROUND: Outpatient surgery has recently grown at a substantial rate. The development and use of short acting anesthetic and analgesic agents have played a major role in the growth of outpatient surgery. This study was designed to evaluate the intraoperative hemodynamic responses and recovery characteristics, using propofol or isoflurane to maintain the anesthesia. METHODS: A total number of 30, ASA physical status I-II patients scheduled for outpatient surgery, all of whom were to undergo excision of breast mass. The patients were randomly allocated to receive either total intravenous anesthesia with propofol, or inhalation anesthesia with isoflurane after induction of anesthesia with propofol. All patients were ventilated via a laryngeal mask airway (LMA) using a mixture of oxygen and air so that the FiO2 would be 0.4. RESULTS: There were no significant differences in hemodynamic changes during anesthesia in recovery time, or in complications between the two groups. CONCLUSIONS: We conclude that both methods provide reasonably rapid and reliable recovery from anesthesia and are equally acceptable to the patients.
Ambulatory Surgical Procedures* ; Analgesics ; Anesthesia* ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Breast ; Hemodynamics ; Humans ; Isoflurane ; Laryngeal Masks ; Outpatients* ; Oxygen ; Propofol*

OBJECTIVES: We review the sleep problems of the alcohol dependence patients. Especially we are interested in the prevalence, the severity of symptoms, anxiety, depression, and sleep quality of restless legs syndrome (RLS) in the alcohol dependence patients. METHODS: We recruit 86 alcohol dependence patients who were admitted from October 6th, 2008 to October 17th, 2008. We interviewed each patient and evaluated sleep questionnaires such as the Sleep Disorder Questionnaire (SDQ), the Pittsburgh Sleep Quality Index (PSQI) and the International Restless Legs Syndrome Study Group (IRLSSG) rating scale. The presence of RLS and its severity were assessed using the IRLSSG diagnostic criteria and the IRLSSG severity scale, respectively. Depression and anxiety were evaluated by the Beck Depression Inventory (BDI) and the Beck anxiety inventory (BAI). RESULTS: Of all 86 patients, 59 patients have insomnia, 33 patients have RLS, 30 patients have Periodic limb movement disorder (PLMD), 29 patients have nightmare. RLS patients have more high score in the BAI (21.70+/-10.36 vs 14.67+/-11.98), and their sleep quality was poor in the PSQI (11.09+/-4.08 vs 7.92+/-3.91) than non-RLS patients. CONCLUSION: This study shows that alcohol dependence patients show many sleep problems such as insomnia and RLS. So we should notice that the sleep problems of alcohol dependence patients are important in clinical approach and treatment.
Alcoholism ; Anxiety ; Depression ; Dreams ; Humans ; Nocturnal Myoclonus Syndrome ; Prevalence ; Surveys and Questionnaires ; Restless Legs Syndrome ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders