Factors Influencing Oncology Nurses’ Pain Management of Cancer Patients

Purpose@#The purpose of this study is to investigate the factors influencing oncology unit nurses’ pain management of cancer patients. @*Methods@#This study was a designed descriptive correlation study. The participants of this study were nurses working in an oncology unit at a university hospital. A total of 135 nurses participated and data were collected between October 10 and October 31, 2018. Measures used for this study assessed nurses’ knowledge of cancer pain management, compassion competence, and the performance of cancer pain management. The data were analyzed using independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple linear regression analysis. @*Results@#Performance of cancer pain management was significantly correlated with compassion competence (r=0.37, p<.001) and difference according to the experience of cancer by the participants or family members (t=2.22, p=.028). Performance of cancer pain management was influenced by compassion competence (β=.36,p<.001) and the experience of cancer by the participants or family members (β=.17, p=.041). The explanatory power of this model was 14.4%. @*Conclusion@#These results suggest the need for cancer pain management education based on compassion empowerment. The findings shows that continuous cancer pain management education is required in consideration of the oncology nurses’ career and work characteristics.

Cranioplasty Results after the Use of a Polyester Urethane Dural Substitute (Neuro-Patch®) as an Adhesion Prevention Material in Traumatic Decompressive Craniectomy

PURPOSE@#This study was conducted to investigate the usefulness of a polyester urethane dural substitute (Neuro-Patch®, B. Braun, Boulogne, France) as an anti-adhesion agent in subsequent cranioplasty by analyzing the use of Neuro-Patch® during decompressive craniectomy in traumatic brain injury patients.@*METHODS@#We retrospectively analyzed patients with traumatic brain injury who underwent decompressive craniectomy followed by cranioplasty from January 2015 to December 2018. Patients were analyzed according to whether they received treatment with Neuro-Patch® or not (Neuro-Patch® group, n=71; control group, n=55). Patients' baseline characteristics were analyzed to identify factors that could affect cranioplasty results, including age, sex, hypertension, diabetes mellitus, use of antiplatelet agents or anticoagulant medication, the interval between craniectomy and cranioplasty, and the type of bone used in cranioplasty. The cranioplasty results were analyzed according to the following factors: operation time, blood loss, postoperative hospitalization period, surgical site infection, and revision surgery due to extra-axial hematoma.@*RESULTS@#No significant difference was found between the two groups regarding patients' baseline characteristics. For the cranioplasty procedures, the operation time (155 vs. 190 minutes, p=0.003), intraoperative blood loss (350 vs. 450 mL, p=0.012), and number of surgical site infections (4 vs. 11 cases, p=0.024) were significantly lower in the Neuro-Patch® group than in the control group.@*CONCLUSIONS@#The use of Neuro-Patch® was associated with a shorter operation time, less blood loss, and a lower number of surgical site infections in subsequent cranioplasties. These results may provide a rationale for prospective studies investigating the efficacy of Neuro-Patch®.

An experimental study on the therapeutic effect of ABNOBAviscum. on oral squamous cell carcinoma xenografted in nude mice

Application of False Discovery Rate Control in the Assessment of Decrease of FDG Uptake in Early Alzheimer Dementia / 대한핵의학회잡지

PURPOSE: Determining an appropriate thresholding is crucial for PDG PET analysis since strong control of Type I error could fail to find pathological differences between early Alzheimer' disease (AD) patients and healthy normal controls. We compared the SPM results on FDG PET imaging of early AD using uncorrected p-value, random-field based corrected p-value and false discovery rate (FDR) control. MATERIALS AND METHODS: Twenty-eight patients (66+/-7 years old) with early AD and 18 age-matched normal controls (68+/-6 years old) underwent FDG brain PET. To identify brain regions with hypo-metabolism in group or individual patient compared to normal controls, group images or each patient's image was compared with normal controls using the same fixed p-value of 0.001 on uncorrected thresholding, random-field based corrected thresholding and FDR control. RESULTS: The number of hypo-metabolic voxels was smallest in corrected p-value method, largest in uncorrected p-value method and intermediate in FDG thresholding in group analysis. Three types of result pattern were found. The first was that corrected p-value did not yield any voxel positive but FDR gave a few significantly hypometabolic voxels (8/28, 29%). The second was that both corrected p-value and FDR did not yield any positive region but numerous positive voxels were found with the threshold of uncorrected p-values (6/28, 21%). The last was that FDR was detected as many positive voxels as uncorrected p-value method (14/28, 50%). CONCLUSIONS: FDR control could identify hypo-metabolic areas in group or individual patients with early AD. We recommend FDR control instead of uncorrected or random-field corrected thresholding method to find the areas showing hypometabolism especially in small group or individual analysis of FDG PET.

Estimation of Joint Risks for Developing Uterine Cervix Cancer in Korea / 예방의학회지

OBJECTIVE: This study was aiming at estimating the joint effects of various risk factors associated with uterine cervix cancer in Korea. METHODS: Data obtained from a case-control study were analyzed with a multiplicative model. RESULTS: After adjustment for age and husband's educational attainments, the family history of cervical cancer (OR=2.1, 95% CI=1.2-3.9), unstable marital status due to separation, by death or divorce, etc. (OR=2.8, 95% CI=1.7-4.6), and a large number of deliveries (> or = 3 vs. nulliparous OR=6.5, 95% CI=1.4-29.9) increased the risk of uterine cervix cancer. Conversely, first sexual intercourse at an older age (> or = 25 years vs. <19 years OR=0.4, 95% CI=0.2-0.6) and husband's circumcision (OR=0.7, 95% CI=0.5-1.0) decreased the risk. In the multiplicative model, the highest joint risk (OR=39.2, 95% CI 5.9-258.9) was observed in women with a family history of uterine cervical cancer, an unstable marital status, where the ex-husband was not circumcised, with 3 or more delivery experiences, and having her first sexual intercourse when younger than 19 years of age. However, women without a family history of uterine cervix cancer, married to a circumcised husband, having had her first sexual intercourse at 25 years or older, and nulliparous, showed the lowest joint effect (OR=0.3, 95% CI=0.1-0.5). CONCLUSION: As carcinogenesis is a complex action involving various factors, we consider a joint effects approach to be appropriate in an epidemiological study on risk factors for uterine cervix neoplasms.cervix neoplasm.

A Study On Clinical Use Of Hyperbaric Oxygen Theray Of The Oral And Maxillofacial Region

Hyperbaric oxygen therapy(HBO) is defined as breathing 100% oxygen while in an enclosed system pressurized to greater than on atmosphere(sea level). This increased oxygen delivery furthers your body's ability to kill germs and to increase healing. HBO is a supplemental therapy to be used in addition to the current medical and surgical therapy you are receiving. HBO typically is used to complement treatments of medical problems such as bone infections, complication of radiotherapy, and certain chronic, non-healing wounds. On an emergency basis, the chamber also is used to treat problems such as carbon monoxide poisoning and the decompression sickness. We analysed stastically cases which are treated by hyperbaric oxygen therapy in point of oral and maxillofacial region on the Kangnam General Hospital for aid in comprehension and application of this therapy. Total 760 patients were treated at Gangnam Gneral Hospital from July 1996 to September 1999. They were classifed by region to Decompression sickness(DCS), Carbon monoxide poisoning(CO), General surgery(GS), Orthopedics(OS), Oral and Maxillofacial surgery(OMFS), others. Patients of Oral and Maxillofacial surgery were divided by diseses to Osteomyelitis, Osteoradionecrosis, Reconstruction, Bone graft, Difficult wounds, others. The results were as follows. 1. This institute conducts HBO therapy for DCS which takes up 62% and 10.5% for OMF region. 2. In OMF region, Osteomyelitis is 40%, Osteoradionecrosis is next, Bone graft, and Reconstruction is a row. 3. According to our precious study, HBO has been frequently conducted in OMF region compared to past, however, it is less actively conducted in this area for reserch than other conturies. Therefore, We need further application to the clinical use.

Long-term Prognostic Value of Dipyridamole Stress Myocardial SPECT / 대한핵의학회잡지

PURPOSE: Dipyridamole stress myocardial perfusion SPECT could predict prognosis, however, long-term follow-up showed change of hazard ratio in patients with suspected coronary artery disease. We investigated how long normal SPECT could predict the benign prognosis on the long-term follow-up. MATERIALS AND METHODS: We followed up 1169 patients and divided these patients into groups in whom coronary angiography were performed and were not. Total cardiac event rate and hard event rate were predicted using clinical, angiographic and SPECT findings. Predictive values of normal and abnormal SPECT were examined using survival analysis with Mantel-Haenszel method, multivariate Cox proportional hazard model analysis and newly developed statistical method to test time-invariance of hazard rate and changing point of this rate. RESULTS: Reversible perfusion decrease on myocardial perfusion SPECT predicted higher total cardiac event rate independently and further to angiographic findings. However, myocardial SPECT showed independent but not incremental prognostic values for hard event rate. Hazard ratio of normal perfusion SPECT was changed significantly (p<0.001) and the changing point of hazard rate was 4.4 years of follow up. However, the ratio of abnormal SPECT was not. CONCLUSION: Dipyridamole stress myocardial perfusion SPECT provided independent prognostic information in patients with known and suspected coronary artery disease. Normal perfusion SPECT predicted least event rate for 4.4 years.

Cost-effectiveness of Myocardial Perfusion SPECT for Diagnosis of Coronary Artery Disease in Korea: Comparison with Exercise ECG and Coronary Angiography / 대한핵의학회잡지

PURPOSE: Cost-effectiveness of myocardial SPECT f'or the diagniosis of coronary artery disease was investigated considering the present and amended costs of myocardial SPECT and exercise ECG in Korea. MATERIALS AND METHODS: Four diagnostic tactics such as 1) coronary angiography (CAG) after exercise ECG, 2) CAG after myocardial SPECT, 3) direct CAG, and 4) CAG after myocardial SPECT following exercise ECG were chosen. Costs were calculated using the present costs of various tests and effects represented by Quality Adjusted Life Year (QALY) were estimated. Difference of QALY (deltaQALY) was calculated by subtracting QALY of diagnosed/treated cases from QALY of undiagnosed cases, Cost/delta QALY was calculated and compared between four different tactics according to pre-test probability, RESULTS: When pre-test probability was equal to or larger than 0.6, direct CAG was the most cost-effective. When pre-test probability was between 0.2 and 0.6, CAG after myocardial SPECT following exercise ECG was the most cost-effective. CAG after myocardial SPECT was the second most cost-effective. Cost-effectiveness was similar when the costs of exercise ECG were doubled or quadrupled. CAG after exercise ECG was always the least cost-effective, CONCLUSION: Myocardial SPECT with or without preceding exercise ECG was the most cost-effective method to diagnose coronary artery disease in the present or expected amended cost system.