ABSTRACT
PURPOSE: This study was done to identify the relationship between nurses' compliance with safety guidelines for the use of antineoplastic agents, observable symptoms, and stress from occupational exposure. METHODS: The participants were 172 nurses from six general hospitals in a metropolitan area. They had administered antineoplastic agents at least three months prior to the study. Data were collected using self-report questionnaires, and then analyzed using SPSS/WIN 23.0 for descriptive statistics, t-test, one-way ANOVA, Scheffé method, and Pearson correlation coefficient. RESULTS: The average score on the guideline for safety compliance was 87.75 points out of a total of 100. The average score for observable symptoms of exposure to antineoplastic agents was 30.12 (28~56) points, and that for mean stress was 33.52 (15~60) points. Observable symptoms and stress from occupational exposure showed a statistically significant positive correlation (r=0.34, p < .001). CONCLUSION: To increase the degree of compliance with safety guidelines for antineoplastic agents, hospitals should lower the chance of exposure to antineoplastic agents, as well as minimize the observable symptoms and stress from occupational exposure. Periodic education and policy support are needed to improve compliance with safety guidelines for antineoplastic agent use.
Subject(s)
Antineoplastic Agents , Compliance , Education , Hospitals, General , Methods , Occupational ExposureABSTRACT
Isoniazid is one of the most commonly used antituberculosis drug. Acute into xication is characterized by repetitious convulsions, high anion gap metabolic a cidosis and coma. The basis of theraphy consists of parental pyridoxine admi nistration in a dose equivalent to that of isoniazid ingested. Here we present a case of seizure and metabolic acidosis due to only renal adjustment dosage of Isoniazid in an elderly woman.
Subject(s)
Aged , Female , Humans , Acid-Base Equilibrium , Acidosis , Coma , Isoniazid , Parents , Pyridoxine , SeizuresABSTRACT
Since Wands et al. reported for the first time in 1975 the reactivation of the hepatitis B virus in hematologic disease patients who had been receiving chemotherapy, the efficacy of chemotherapy and immunosuppressants has improved. As a result, the frequency of the reactivation of hepatitis B is increasing. Reported herein is a case of a non-Hodgkin lymphoma patient in her 70s who was suspected to have had HBsAg negative/anti-HBs negative occult HBV infection. The patient experienced fulminant hepatitis caused by the reactivation of hepatitis B, and died three months after the R-CHOP regimen was completed. In the HBsAg negative plus HBV DNA-negative case, there were few instances of viral activation of HBV. In this case, antiviral therapy was needed when the patient was confirmed to have become HBV DNA positive through regular monitoring, but its necessity is often overlooked, unlike the preemptive antiviral treatment in the HBsAg positive cases.
Subject(s)
Humans , DNA , Drug Therapy , Hematologic Diseases , Hepatitis B Surface Antigens , Hepatitis B virus , Hepatitis B , Hepatitis , Immunosuppression Therapy , Immunosuppressive Agents , Lymphoma , Lymphoma, Non-Hodgkin , Virus Activation , RituximabABSTRACT
Hereditary non-polyposis colorectal cancer (HNPCC) is an autosomal dominant disease characterized by early manifestation of colorectal cancer (CRC), occurrence of multiple colorectal tumors and high frequencies of extracolonic malignancies. Evaluation of clinical findings in concert with a well-documented and extended pedigree and genetic studies of colorectal cancer can identify person who are at high risk and who thereby might benefit from targeted early detection and primary prevention programs. Here we report 4 cases of HNPCC including 2 cases with synchronous gastric cancers.
Subject(s)
Humans , Colorectal Neoplasms , Pedigree , Primary Prevention , Stomach Neoplasms , StomachABSTRACT
Familial adenomatous polyposis (FAP) includes early development of up to thousands of colorectal adenoma and of colonic adenocarcinoma in all untreated cases. Moreover, a variety of extracolonic manifestation are seen. Several reports have demontrated a high incidence of papillry carcinoma of thyroid. We experienced a case of familial adenomatous polyposis, presenting with thyoid papillry carcinoma, and reported with a brief review of literatures.
Subject(s)
Adenocarcinoma , Adenoma , Adenomatous Polyposis Coli , Carcinoma, Papillary , Colon , Incidence , Thyroid Gland , Thyroid NeoplasmsABSTRACT
BACKGROUND: In the United States, the Centers for Disease Control and Prevention recorded a 20-fold increase in the incidence of vancomycin-resistant enterococci (VRE) associated with nosocomial infections between 1989 and 1991. Although VRE has been reported in Korea since 1992, infections caused by these organisms are still extremely rare in Pusan, Korea. Therefore, a point prevalence culture survey was carried out to investigate the prevalence of intestinal colonization with VRE among patients admitted to Kosin Medical Center, which can predict the appearance of clinical infections with VRE. METHODS: Between July 1997 and August 1997, stool specimens were obtained from 303 patients. Specimens were placed in bile esculin azide broth containing vancomycin (64 microgram/mL) and aatreonam (60 microgram/mL). Cultures were done for 48 hours at 37degrees C, and turbid solutions were subcultured on blood agar. Minimal inhibitory concentrations (MIC) of vancomycin and teicoplanin to Enterococcus isolates were determined by Etest on Mueller-Hinton agar. For amplification of the vanA, vanB, and vanC genes, polymerase chain reactions were performed. RESULTS: VRE isolates were isolated from 6 of the patients (2%). Four of them were identified as E. faecium, and 1 was identified as E. avium, and 1 was identified as Enterococcus spp. All of them were highly resistant to vancomycin (MICs >256 microgram/mL), and they were also resistant to teicoplanin (MICs 32-->256 microgram/mL). All of 6 VRE strains carried vanA gene. CONCLUSION: The colonization of VRE was not infrequent among the patients of a university hospital in Pusan, Korea. Moreover, a large proportion of the colonizing VRE was revealed Enterococcus faecium with vanA gene, which implies quite a possibility of a sudden rising of infections by this organism in the near future. So we propose that the vancomycin susceptibility test should be done for every enterococcal isolate from clinical specimens and the intestinal colonization rate of VRE should be closely monitored at regular intervals for the purpose of surveillance 50 that proper establishment of plans for the prevention of this troublesome pathogen's spread can be promptly made.
Subject(s)
Humans , Agar , Bile , Colon , Cross Infection , Enterococcus , Enterococcus faecium , Esculin , Incidence , Korea , Polymerase Chain Reaction , Prevalence , Teicoplanin , United States , VancomycinABSTRACT
BACKGROUND: It is known that QT dispersion represents asynchronous repolarization of ventricle which is related to ventricular fibrillation. The incidence of ventricular arrhythmia is increased after acute myocardial infarction. So this study compared QT dispersion and other repolarization indexes for detection of asynchronous repolarization in acute myocardial infarction. We also investigated which portion of repolarization is the key portion of the asynchrony. METHODS: In 37 acute myocardial infarction patients and 38 angina patients dispersion of QT, JT, JTpeak and QTpeak were measured. We also measured maximum adjacent dispersion of same parameters in precordial leads. In 20 survived patients and 17 dead patients after acute myocardial infarction were also compared. We also investigated correlation of PVC's on Holter monitoring with these repolarization parameters. RESULTS: 1) All ventricular repolarization indexes(QT, QTc, JT, JTpeak, QT peak and TpeakTend dispersion) were significantly increased in acute myocardial infarction group than compared with those of angina group(p<0.05). 2) Maximal precordial dispersion(QT, QTc, JT, JTpeak and QTpeak) were also significantly increased in acute myocardial infarction group than angina group(p<0.05). 3) Dead patient group after myocardial infarction showed significantly increased QTc and TpeskTend dispersion compared with those of survived patient group(p<0.05). 4) Multivariate linear correlation showed that TpeakTend dispersion and JT dispersion was correlated with QT dispersion. CONCLUSIONS: There were asynchronous myocardial repolarization changes in acute myocardial infarction. Our study demonstrated that T wave change was major determinant of dispersion of myocardial repolarization.
Subject(s)
Humans , Arrhythmias, Cardiac , Electrocardiography, Ambulatory , Incidence , Myocardial Infarction , Ventricular FibrillationABSTRACT
PURPOSE: We have conducted this study to investigate the role of c-myc and AAT in gastric carcinoma progression and to see if clinical application of its expression in cancer tissue is of help for the diagnosis or in determining prognosis of gastric carcinoma. MATERIALS AND METHOD: The expression of c-Myc and AAT by immunohistochemical method applied to paraffin-embedded tissue sections of endoscopic biopsy materials of 71 cases of gastric carcinoma (24 early and 47 advanced) and immunoreactivities of antigens were correlated with histological differentiation of carcinoma, degree of tumor infiltration of mononuclear cells, serum levels of carcinoembryonic antigen (CEA) and presence of distant metastases. RESULTS: c-Myc in gastric carcinoma tissue was expressed in 24 cases (33.8%), and the rate of immunoreactivity of c-Myc was higher in the advanced carcinoma cases (38.2%) than early carcinoma cases (25.0%), but the difference was not stastistically significant. The elevated c-Myc expression correlated well with the elevation of serum CEA levels (P<0.05), with the presence of distant metastses (p<0.05), especially with peritoneal metastsis (p<0.05). AAT expression in gastric carcinoma was shown in 11 cases (14.1%), and the rate of immunoreactivity of AAT was significantly higher in advanced carcinoma cases (21.3%) than early carcinoma cases (4.2%) (p<0.05). The elevated expression of AAT correlated well with the elevation of serum CEA levels (p<0.05), and showed negative correlation with the degree of mononuclear cell infiltration in tumor area (p<0.05). The increased expression of c-Myc and AAT in gastric carcinoma correlated well (p=0.05, k= 0.31), which suggests the cooperative action of the two in gastric carcinoma progression. CONCLUSIONS: Our findings suggest that c-Myc expression may be a good marker of high grade malignancy in gastric carcinoma, and may be able to be used clinically in predicting distant metastases, especially for peritoneal dissemination. Our data also imply that c-myc, through its proliferative action, may play an important role in the progression of gastric carcinoma in cooperation with AAT which has immunosuppresive action.
Subject(s)
Biopsy , Carcinoembryonic Antigen , Diagnosis , Neoplasm Metastasis , PrognosisABSTRACT
The coexistence of adrenal cortical tumor and pheochromocytoma was extremely rare. A total of 25 reported cases showing evidence of hyperfuction of the adrenal cortex and pheochromocytoma were noted in the literature. Of those twenty cases were coexistence of pheochromocytoma and adrenocortical hyperplasia and only five cases were coincident pheochromocytoma and adreno-cortical adenoma. Recently, we experienced a case of adrenocortical adenoma associated with incidental pheochrmocytoma. A 55-year-old woman complained of progressive weight gain and epigastric discomfort. Hormonal and radiologic studies revealed Cushings syndrome with a left adrenal tumor. Adrenalectomy was performed and the gland actually had two nodules on its surface, one pheochromocytoma and the other cortical adenoma. This patient was the first case of pheochromocytoma with adrenocortical adenoma in Korea. We report the case with a review of literature.