PURPOSE: The aim of this study was to compare the measurements of diameter and volume of hepatic metastases from CT images with the overall survival and tumor response, in patients with unresectable liver metastases of colorectal cancer treated with a targeted agent. MATERIALS AND METHODS: We recruited 43 patients with unresectable liver metastases of colorectal cancer, in whom targeted therapy was used as the first-line treatment. Three-dimensional quantification of the volume of hepatic metastases was performed for each patient. An independent survival analysis using the Response Evaluation Criteria in Solid Tumors guidelines was performed and compared to the volumetric measurement. Overall survival was evaluated using the Kaplan-Meier analysis and compared to the Cox proportional hazard ratios (HRs) following univariate and multivariate analyses. RESULTS: In patients classified as non-progressing and progressing by the volumetric criteria, the median overall survival time was 21 months [95% confidence interval (CI): 491.25–768.75] and 11 months (95% CI: 0–949.42), respectively (p = 0.001). Using a multivariate analysis, we found that volumetric response (HR: 3.467; p = 0.002) was a significant factor affecting the overall survival in patients with liver metastases of colorectal cancer. CONCLUSION Volumetric assessment of liver metastases could be an alternative predictor of the overall survival of patients with liver metastases of colorectal cancer treated with a targeted agent.

PURPOSE: Hospice volunteers are serving an invisible yet pivotal role in the hospice and palliative care team. This study investigated how effectively a continuing education program could enhance hospice volunteers' competency.METHODS: A total of 20 hours (four hours per week) of training was provided to 30 hospice volunteers who participated in the continuing education for hospice volunteers. Efficiency of the education was analyzed with an exploratory mixed-methods design. For quantitative analysis, the volunteers were asked, before and after the training, about their attitudes towards hospice care, what makes a meaningful life, self-efficacy and satisfaction with their volunteer service. Descriptive statistics, paired t-tests, and Wilcoxon signed-rank test were performed using SPSS Window 20.0. For qualitative research, participants were placed in three groups for a focus group interview, and data were analyzed by content analysis.RESULTS: A quantitative study result shows that this training can significantly affect hospice volunteers' attitudes and improve their self-efficacy. A qualitative study result shows that participants wanted to receive continuous education from the physical/psychosocial/spiritual aspects to better serve end-of-life patients and their family members even though they have to spare significant time for the volunteer service. They wanted to know how to take good care of patients without getting themselves injured and how to provide spiritual care.CONCLUSION: The continuing education program reflecting volunteers' requests is strongly needed to improve their competency. An effective continuing education requires continuous training and support in areas where hospice volunteers are interested in. A good alternative is to combine web-based and hands-on training, thereby allowing hospice volunteers freely take training that suits their interest.
Education ; Education, Continuing ; Focus Groups ; Hospice Care ; Hospices ; Hospital Volunteers ; Humans ; Palliative Care ; Qualitative Research ; Volunteers

BACKGROUND: In the Republic of Korea, due to the low birth rate, blood donation is expected to decrease. However, the demand for blood is increasing as the proportion of elderly has increased. Korea Centers for Disease Control and Prevention operate the Korea Blood Inventory Monitoring System (KBIMs) for detection and response to the shortage of blood. The aim of this study was to show the trend of blood supply monitored by KBIMs. METHODS: This study analyzed the red blood cell inventory ratio, average daily usage, time-lag from blood donation to transfusion and from receipt to transfusion in blood banks monitored by KBIMs from 2009 to 2012. RESULTS: A total of 25 hospitals have participated in KBIMs since 2009. The average inventory ratio of blood banks was 5.3 days. By month, the inventory ratio was highest between November and February; and by week, highest on Fridays. Daily amount of RBC utilized in hospitals peaked on Thursday by week. Time-lag from blood donation to transfusion and from receipt to transfusion in blood banks was 12.2 and 6.4 days, respectively. The inventory ratio of type-A RBC was the lowest, because of the highest level of demand. In addition, time-lags from blood donation to transfusion and from receipt to transfusion were shortest in type-A RBC. CONCLUSION: The inventory ratio in blood banks monitored by KBIMs was stable throughout the years. However, due to higher level of demand, there is a risk of shortage of type-A RBC.
Aged ; Birth Rate ; Blood Banks ; Blood Donors ; Centers for Disease Control and Prevention (U.S.) ; Erythrocytes ; Humans ; Korea ; Republic of Korea

BACKGROUND: Diabetes is common among elderly, and low-income is associated with poor adherence to treatment and increased mortality. We evaluated whether comprehensive support using community networks improves glycemic control among low-income elderly patients with diabetes. METHODS: A total of 49 low-income elderly patients with type 2 diabetes, mean age 73 years, were enrolled. For 1 year, study subjects underwent various lifestyle modification programs provided by community networks. The biochemical data including glycemic markers and anthropometric data were obtained at the baseline and at the end of the study. Also, the patients were asked to complete a questionnaire about their quality of life, self-confidence and self-care behavior. RESULTS: After lifestyle modification program, overall changes of fasting plasma glucose, HbA1c, blood pressure, body weight, and other biochemical markers were not significantly different. In a subgroup analysis of 21 patients with poorly controlled diabetes (fasting glucose > 140 mg/dL or HbA1c > 7.5%), fasting plasma glucose was significantly reduced (P = 0.030). Among patients with baseline HbA1c level > or = 8%, HbA1c levels after intervention decreased from 9.33 +/- 1.07% to 8.27 +/- 1.15% (P = 0.092). The results of the questionnaires revealed significant increases in the scores of quality of life, self-confidence and self-care behavior (P < 0.05). CONCLUSION: Among low-income, elderly patients with type 2 diabetes, lifestyle modification through community networks showed no significant changes in glycemic control markers. More intensive and precise interventions using community networks are needed for the glycemic control of low-income, elderly patients with type 2 diabetes.
Aged ; Biomarkers ; Blood Pressure ; Body Weight ; Community Networks ; Fasting ; Glucose ; Humans ; Life Style ; Plasma ; Quality of Life ; Self Care ; Surveys and Questionnaires