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Purpose@#The alveolar ridge preservation (ARP) is widely conducted for implant placement. However, experimental results using deproteinized porcine bone mineral (DPBM) have been scarce. This retrospective study evaluated factors affecting the primary stability of implants in an area where ARP was performed using DPBM. @*Materials and Methods@#Thirty-eight patients were divided into two groups based on the primary stability, with torque value of 30 Ncm as borderline. To determine the factors that affect the primary stability of implants, we collected data from patients’ medical records including age, sex, reentry time, socket location, remaining bone wall at the time of extraction, and type of collagen membrane, as well as from radiographs and histomorphometric analysis.Result: The results showed statistically significant difference for the remaining extraction socket wall (P=0.014), residual graft (P=0.029), and fibrovascular tissue (P=0.02) between the two groups. There was an insignificant tendency toward the time of reentry surgery (P=0.052) and location (P=0.077). All implants placed in sites using DPBM functioned well up to 3 years. @*Conclusion@#Within the limitations of the present study, extraction socket wall, residual graft, and fibrovascular tissue can affect the primary stability at the time of implant placement on grafted sites using DPBM and collagen membranes. In addition, reentry time and locations can be considered. In future studies, comparative experiments in quantified models will be required to supporting the findings.
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Purpose@#As the aging of society progresses, the proportion of extremely older lung cancer patients has also increased; However, studies of these patients with non–small cell lung cancer are limited. Therefore, we investigated the initial treatment modalities and survival outcomes for patients aged 80 years or over. @*Materials and Methods@#We included a multicenter retrospective cohort from the Korean Association for Lung Cancer Registry, which surveys 10% of the newly diagnosed lung cancer patients across 52 hospitals in Korea. We analyzed and compared the 2014–2016 data of the non–small cell lung cancer patients aged ≥ 80 years and those aged < 80 years. @*Results@#Of the 6,576 patients reviewed, 780 patients were aged ≥ 80 years, and 5,796 patients were aged < 80 years. In the patients aged ≥ 80 years, surgery and radiation therapy resulted in longer patient survival among those with a resectable tumor (stage I–II) than the best supportive care (median survival, not reached [surgery] vs. 32.2 months [radiation therapy] vs. 11.43 months [best supportive care]). The duration of survival in patients with advanced-stage (IV) lung cancers was higher after chemotherapy than after the best supportive care (median survival, 8.63 months vs. 2.5 months). Patients with stage IV adenocarcinoma who received targeted therapy had better survival than those who did not (median survival, 9.0 months vs. 4.3 months). @*Conclusion@#Even in extremely older patients, active treatments, such as surgery, radiation therapy, and chemotherapy, can result in better survival outcomes than the best supportive care.
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Pericardial effusion is a common disease seen by echocardiography, and it is found in 3–9% of annual echocardiograms. Although moderate pericardial effusion has been reported in some cases, it is usually asymptomatic and is rarely accompanied by cardiac tamponade. A large pericardial effusion may be due to various causes, including idiopathic causes, tuberculosis, cancer, connective tissue disease, infection, and hypothyroidism. Recent advances in analytic and imaging techniques have increased our ability to diagnose the cause of pericardial effusion accurately. This information is important for determining the proper treatment based on each case’s clinical characteristics. We report a case of large, recurrent pericardial effusion accompanied by hypothyroidism with initial increased levels of tumor markers, including cancer antigen 125, carcinoembryonic antigen, and alpha-fetoprotein. The patient was treated with thyroid hormone only. In follow-up images, the pericardial effusion was resolved and all of the tumor markers were normalized.
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Purpose@#This study investigated the difficulties in end-of-life care and end-of-life care competency in nurses who take care of cancer patients. @*Methods@#In the mixed method, a structured questionnaire on end-of-life care stress and competency was conducted on 115 nurses caring for cancer patients, and 19 were interviewed for qualitative research. For the collected quantitative data, descriptive statistics were used. For the qualitative study, the contents of the interview were summarized and systematized using the content analysis method to derive the main themes. @*Results@#The mean end-of-life care stress was 4.08 points (out of 5) and the mean end-of-life care competency was 3.43 points (out of 5). Four themes and 11 sub-themes for the difficulties in end-of-life care were identified, and the four themes are as follows: (1) regret over limited end-of-life nursing, (2) different aspects of persistent emotional distress, (3) overloaded duty at the end-of-life (4) conflicts encountered in decision-making for life-sustaining treatment. Four themes and eight sub-themes for end-of-life care competency were identified, and the four themes are as follows: (1) empathy and listening skills, (2) communication skills, (3) clinical nursing experience and education, (4) clinical nursing competency. @*Conclusion@#It was confirmed that nurses caring for cancer patients had a high level of end-of-life care stress, and it is necessary to develop a program to reduce difficulties in end-of-life care and increase end-of-life care competency.
ABSTRACT
Pericardial effusion is a common disease seen by echocardiography, and it is found in 3–9% of annual echocardiograms. Although moderate pericardial effusion has been reported in some cases, it is usually asymptomatic and is rarely accompanied by cardiac tamponade. A large pericardial effusion may be due to various causes, including idiopathic causes, tuberculosis, cancer, connective tissue disease, infection, and hypothyroidism. Recent advances in analytic and imaging techniques have increased our ability to diagnose the cause of pericardial effusion accurately. This information is important for determining the proper treatment based on each case’s clinical characteristics. We report a case of large, recurrent pericardial effusion accompanied by hypothyroidism with initial increased levels of tumor markers, including cancer antigen 125, carcinoembryonic antigen, and alpha-fetoprotein. The patient was treated with thyroid hormone only. In follow-up images, the pericardial effusion was resolved and all of the tumor markers were normalized.
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Purpose@#This study investigated the difficulties in end-of-life care and end-of-life care competency in nurses who take care of cancer patients. @*Methods@#In the mixed method, a structured questionnaire on end-of-life care stress and competency was conducted on 115 nurses caring for cancer patients, and 19 were interviewed for qualitative research. For the collected quantitative data, descriptive statistics were used. For the qualitative study, the contents of the interview were summarized and systematized using the content analysis method to derive the main themes. @*Results@#The mean end-of-life care stress was 4.08 points (out of 5) and the mean end-of-life care competency was 3.43 points (out of 5). Four themes and 11 sub-themes for the difficulties in end-of-life care were identified, and the four themes are as follows: (1) regret over limited end-of-life nursing, (2) different aspects of persistent emotional distress, (3) overloaded duty at the end-of-life (4) conflicts encountered in decision-making for life-sustaining treatment. Four themes and eight sub-themes for end-of-life care competency were identified, and the four themes are as follows: (1) empathy and listening skills, (2) communication skills, (3) clinical nursing experience and education, (4) clinical nursing competency. @*Conclusion@#It was confirmed that nurses caring for cancer patients had a high level of end-of-life care stress, and it is necessary to develop a program to reduce difficulties in end-of-life care and increase end-of-life care competency.
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Purpose@#This study aimed to identify the factors that influence the wellness of bus drivers by examining the relationships between job stress, physical activity, subjective happiness, and wellness. @*Methods@#Self-report questionnaires were distributed during October 2017. @*Results@#Based on a multiple regression analysis, the significant factors found to affect the wellness of bus drivers were physical activity (β=.48,p<.001), subjective happiness (β=.25, p=.001), and job stress (β=-.17, p=.025). The total explanatory power of the study variables for wellness was 45.7% (F=33.04, p<.001). @*Conclusion@#These findings highlight a need to develop workplace wellness programs to reduce job stress and improve physical activity and subjective happiness among bus drivers.
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Background/Aims@#Although acute pulmonary embolism (PE) adversely impacts survival and should be treated regardless of cancer, the treatment rate of cancer-related PE is relatively low. We aimed to compare clinical characteristics and long term prognosis of PE in patients with or without cancer. @*Methods@#From March 2010 to December 2013, patients with newly diagnosed PE were analyzed. Baseline demographics, comorbidities, cancer status and clinical manifestations of PE were recorded. We defined primary composite outcome as recurrent venous thromboembolism (VTE) and death from PE. @*Results@#Among a total of 976 patients with PE, the 703 (72.0%) had cancer-related PE. Cancer-related PE group was more frequently asymptomatic (54.5% vs. 13.2%, p < 0.001), less extensive (involvement of bilateral pulmonary arteries: 42.8% vs. 51.3%, p = 0.017; lung infarction: 5.3% vs. 10.3%, p = 0.005) and less likely to accompany right ventricular dysfunction (10.3% vs. 27.2%, p < 0.001) compared with the non-cancer PE group. Anticoagulation was less frequently underwent in patients with cancer-related PE than those without cancer (62.0% vs. 81.7%, p < 0.001). A composite of recurrent VTE and death from PE was significantly higher in the cancer-related PE group (14.4% vs. 6.6%, p = 0.001). @*Conclusions@#Although PE in cancer patients were seem to be less aggressive initially, compared to those without cancer, they had significantly poor prognosis. Given a high rate of recurrent VTE and relatively similar risk of anticoagulation associated bleeding events in cancer patients, more active treatment of PE is warranted in cancer patients.
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Purpose@#This study investigated the complications and patterns of implants that confronted with the extruded natural teeth. @*Materials and Methods@#Among patients who received implant treatment between 2006 and 2018 at Chosun University Dental Hos-pital, only implants that had a maintenance period of at least 5 years and that both implants and confronting natural teeth could bemeasured and compared on a radiograph were selected. They were divided into two groups. Group 1, experimental group consisted of Implants confronting the extruded natural posterior teeth (n = 167: maxilla (Group 1max ) = 92, mandible (Group 1man ) = 75) and Group 2, control group consisted of Implants confronting the normal natural posterior teeth (n = 656: maxilla (Group 2max ) = 272, mandible (Group 2man ) = 384). @*Results@#The incidence of complications between Group 1 and Group 2 was statistically significant. In particular, there was a statistically significant difference between the frequency of marginal bone loss and the amount of marginalbone loss. @*Conclusion@#The extruded natural tooth may cause more frequent complications including bone resorption in the oppos-ing implant.
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Purpose@#This study investigated the complications and patterns of implants that confronted with the extruded natural teeth. @*Materials and Methods@#Among patients who received implant treatment between 2006 and 2018 at Chosun University Dental Hos-pital, only implants that had a maintenance period of at least 5 years and that both implants and confronting natural teeth could bemeasured and compared on a radiograph were selected. They were divided into two groups. Group 1, experimental group consisted of Implants confronting the extruded natural posterior teeth (n = 167: maxilla (Group 1max ) = 92, mandible (Group 1man ) = 75) and Group 2, control group consisted of Implants confronting the normal natural posterior teeth (n = 656: maxilla (Group 2max ) = 272, mandible (Group 2man ) = 384). @*Results@#The incidence of complications between Group 1 and Group 2 was statistically significant. In particular, there was a statistically significant difference between the frequency of marginal bone loss and the amount of marginalbone loss. @*Conclusion@#The extruded natural tooth may cause more frequent complications including bone resorption in the oppos-ing implant.
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BACKGROUND@#Hyaluronic acid (HA) has been applied as a primary biomaterial for temporary soft tissue augmentation and as a carrier for cells and the delivery of growth factors to promote tissue regeneration. Although HA derivatives are the most versatile soft tissue fillers on the market, they are resorbed early, within 3 to 12 months. To overcome their short duration, they can be combined with cells or growth factors. The purpose of this study was to investigate the stimulating effects of human fibroblasts and basic fibroblast growth factors (bFGF) on collagen synthesis during soft tissue augmentation by HA hydrogels and to compare these with the effects of a commercial HA derivative (Restylane®).@*METHODS@#The hydrogel group included four conditions. The first condition consisted of hydrogel (H) alone as a negative control, and the other three conditions were bFGF-containing hydrogel (HB), human fibroblast-containing hydrogel (HF), and human fibroblast/bFGF-containing hydrogel (HBF). In the Restylane® group (HGF), the hydrogel was replaced with Restylane® (R, RB, RF, RBF). The gels were implanted subdermally into the back of each nude mouse at four separate sites. Twelve nude mice were used for the hydrogel (n = 6) and Restylane® groups (n = 6). The specimens were harvested 8 weeks after implantation and assessed histomorphometrically, and collagen synthesis was evaluated by RT-PCR.@*RESULTS@#The hydrogel group showed good biocompatibility with the surrounding tissues and stimulated the formation of a fibrous matrix. HBF and HF showed significantly higher soft tissue synthesis compared to H (p < 0.05), and human collagen type I was well expressed in HB, HF, and HBF; HBF showed the strongest expression. The Restylane® filler was surrounded by a fibrous capsule without any soft tissue infiltration from the neighboring tissue, and collagen synthesis within the Restylane® filler could not be observed, even though no inflammatory reactions were observed.@*CONCLUSION@#This study revealed that HA-based hydrogel alone or hydrogel combined with fibroblasts and/or bFGF can be effectively used for soft tissue augmentation.
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PURPOSE: The purpose of this study was to compare depression and quality of life (QOL) according to nutritional status of elderly cancer patients receiving chemotherapy. METHODS: A sample of 144 elderly cancer patients receiving chemotherapy was recruited for the cross-sectional survey design. The instruments were the Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Depression Scale Short Form-Korea (GDSSF-K), European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ ELD14. Data were analyzed using the SPSS/WIN program. RESULTS: Nutrition had mean of 10.17 points out of 14 and depression had mean of 6.72 points (out of 15). In quality of life, global health status/QoL was 50.06 points, 66.68 for the functional scale, and 29.77 for the symptom scale based on 100 points. The quality of life of elderly cancer patients was 36.52~70.14. There was a significant difference between the well-nourished and malnourished group in depression and QoL. There were significant correlations among the variables, nutritional status, depression and quality of life. CONCLUSION: We found that patients with cancer of the elderly receiving chemotherapy had poor nutritional status, depression, and poor QoL. It is necessary to evaluate the nutritional status of elderly cancer patients receiving chemotherapy and to develop interventions.
Subject(s)
Aged , Humans , Cross-Sectional Studies , Depression , Drug Therapy , Global Health , Nutritional Status , Quality of LifeABSTRACT
OBJECTIVE: Despite the increasing number of North Korean defectors, research on their mental health conditions and suicidal thoughts and behaviors has not been conducted systematically. We examined the prevalence and risk factors of suicidal thoughts and behaviors in North Korean defectors. METHODS: This study focused on 300 North Korean defectors recruited from regional resettlement centers in South Korea. In-person interviews based on the North Korean version of the Composite International Diagnostic Interview were conducted to diagnose mental disorders and assess suicidal thoughts and behaviors. Logistic regression analyses were performed to evaluate the association between suicidal thoughts and behaviors and socio-demographic variables, and DSM-IV mental disorders. RESULTS: Lifetime prevalence of suicidal ideation, plans, and attempts were 28.3, 13.3, and 17.3%, respectively. Female sex (OR: 2.0, 95% CI: 1.0–3.9), presence of health problems in the past year (2.6, 95% CI: 1.4–4.6), and absence of both South Korean acquaintances (1.9, 95% CI: 1.0–3.4) and North Korean family (1.7, 95% CI: 1.0–2.9) were associated with higher odds of suicidal thoughts and behaviors, after adjusting for participant age, sex, and education. Presence of a mental disorder was associated with a significantly increased odd of suicide ideation, plan, and attempt. Of all mental disorder categories, agoraphobia had the strongest association with suicidal ideation (6.5, 95% CI: 2.0–21.6), plans (7.7, 95% CI: 2.5–23.2) and attempts (12.0, 95% CI: 3.5–40.8). CONCLUSION: Suicidal thoughts and behaviors among North Korean defectors are higher than the general population in South Korea, especially show high rates in transit countries. Further study should focus on the changes in suicidal thoughts and behaviors according to the settlement process and early prevention.
Subject(s)
Female , Humans , Agoraphobia , Diagnostic and Statistical Manual of Mental Disorders , Education , Friends , Korea , Logistic Models , Mental Disorders , Mental Health , Prevalence , Risk Factors , Suicidal Ideation , SuicideABSTRACT
OBJECTIVE: Among the various psychiatric disorders, depression is a common comorbid condition in cancer patients. Due to the distinct and diverse nature of cancer, the prevalence of depression may be assumed to be affected by differences in primary cancer sites. In this study, we explored the prevalence rates of depression among the ten most prevalent cancers in South Korea using a national patient sample. METHODS: This was a 1-year cross-sectional study using a national patient sample provided by the South Korean National Health Insurance in 2011. We selected all patients who had received ICD-10 codes of the 10 most prevalent cancers and major depressive disorder. Afterwards, the cancer and depression groups were merged and analyzed. RESULTS: The MDD prevalence rate was highest in lung cancer (11.0%), followed by non-Hodgkin's lymphoma (9.2%), prostate (9.1%), bladder (8.8%), breast (7.8%), cervix (7.8%), colorectal (7.7%), stomach (6.9%), liver (6.5%), and thyroid cancer (5.6%). Within all cancer groups, patients with a MDD diagnosis were significantly older (p<0.05) than non-MDD patients. Colorectal, stomach, and thyroid cancer displayed a higher female proportion in the MDD group than the non-MDD group. In the subgroup analysis, the prevalence rate differed by age and sex. CONCLUSION: The prevalence of depression varied according to cancer types. Patients with lung cancer were the most prone to experience depression. Because clinical and psychological factors may influence MDD prevalence, these factors will need to be studied more closely in the future.
Subject(s)
Female , Humans , Breast , Cervix Uteri , Cross-Sectional Studies , Depression , Depressive Disorder, Major , Diagnosis , Epidemiology , International Classification of Diseases , Korea , Liver , Lung Neoplasms , Lymphoma, Non-Hodgkin , National Health Programs , Prevalence , Prostate , Psychology , Stomach , Thyroid Neoplasms , Urinary BladderABSTRACT
Delayed eruption disorders caused by systemic or local conditions are mostly found during childhood and can be treated with orthodontic forced eruption. When the disorder is not found nor treated during childhood, however, orthodontic eruption might become a difficult option while prosthodontic restoration can be considered as an another option. Considerations for the prosthodontic treatment plan include the extent of tooth loss, interdental mesio-distal space and interarch space, and age of the patient. In this case report, oral rehabilitation of the patient with delayed eruption disorder through zirconia partial fixed prostheses for both maxilla and mandible was performed.
Subject(s)
Humans , Mandible , Maxilla , Orthodontic Extrusion , Prostheses and Implants , Rehabilitation , Tooth LossABSTRACT
A spontaneous subcapsular hematoma of the liver is an unusual clinical phenomenon and is usually associated with trauma, surgery, tumor or pregnancy. We report a case of a recurrent spontaneous subcapsular hematoma of the liver without an identifiable cause. A 52-year-old female presented to the emergency room with acute abdominal pain localized in the right upper quadrant area. Diagnostic workup revealed a subcapsular hematoma in the segment 8 area. The laboratory evaluation was also normal. She was managed conservatively. However, two months later another episode of abdominal pain in the right upper quadrant recurred. Diagnostic workup showed recurrence of a subcapsular hematoma in the segment 6 area. Follow-up evaluation revealed resorption of the previous subcapsular hematomas, as well as a new lesion in the segment 1 area. Herein, we discuss potential causes of this spontaneous subcapsular hematoma of the liver.
Subject(s)
Female , Humans , Middle Aged , Pregnancy , Abdominal Pain , Emergency Service, Hospital , Follow-Up Studies , Hematoma , Liver , Recurrence , TamoxifenABSTRACT
OBJECTIVE: Korean American Elderly (KAE) have high rates of depression but underuse mental health services. The purpose of this study was to assess the meaning of depression and help seeking among KAE residing in the United States who have clinically significant depressive symptoms. METHODS: As a follow up to the Memory and Aging Study of Koreans (MASK; n=1,118), a descriptive epidemiological study which showed that only one in four of KAE with clinically significant depressive symptoms (Patient Health Questionnaire-9≥10) used mental health services, we conducted a qualitative study using semi-structured interviews with participants with clinically significant depressive symptoms regarding the meaning of depression and beliefs about help seeking. Ten participants with clinically significant depressive symptoms were approached and 8 were recruited for semi-structured interviews. RESULTS: KAE did not identify themselves as depressed though experiencing clinically significant depressive symptoms. They associated depression with social discrimination, social isolation, and suicide in the extreme circumstance. They attributed depression to not achieving social and material success in America and strained relationships with their children. Participants attempted to self-manage distress without telling others in their social network. However, KAE were willing to consult with mental health professionals if the services were bilingual, affordable, and confidential. CONCLUSION: KAE with clinically significant depressive symptoms are a vulnerable group with need and desire for linguistically and culturally relevant mental health services who are isolated due to a complex array of psychological and social factors.
Subject(s)
Aged , Child , Humans , Aging , Americas , Asian , Depression , Epidemiologic Studies , Follow-Up Studies , Memory , Mental Health , Mental Health Services , Qualitative Research , Social Discrimination , Social Isolation , Suicide , United StatesABSTRACT
OBJECTIVE: Lethality of the chosen method during a suicide attempt is a strong risk factor for completion of suicide. We examined whether annual changes in the pattern of suicide methods is related to annual changes in suicide rates among older adults in South Korea and Japan. METHODS: We analyzed annual the World Health Organization data on rates and methods of suicide from 2000 to 2011 in South Korea and Japan. RESULTS: For Korean older adults, there was a significant positive correlation between suicide rate and the rate of hanging or the rate of jumping, and a significant negative correlation between suicide rate and the rate of poisoning. Among older adults in Japan, annual changes in the suicide rate and the pattern of suicide methods were less conspicuous, and no correlation was found between them. CONCLUSION: The results of the present study suggest that the increasing use of lethal suicide methods has contributed to the rise in suicide rates among older adults in South Korea. Targeted efforts to reduce the social acceptability and accessibility of lethal suicide methods might lead to lower suicide rate among older adults in South Korea.
Subject(s)
Adult , Humans , Japan , Korea , Methods , Poisoning , Risk Factors , Suicide , World Health OrganizationABSTRACT
Crystalline nephropathy is a rare yet well-known condition associated with multiple myeloma and other light chain–secreting disorders. Paraproteins that are resistant to proteolysis crystallize within proximal tubular cells and cause light-chain proximal tubulopathy, which presents clinically as Fanconi syndrome. Podocytes are rarely affected, and the crystalline inclusions within podocytes are typically precipitated, yielding significant glomerular proteinuria. Here we report a case of extensive crystalline inclusions primarily within podocytes and proximal tubules that presented only with Fanconi syndrome and renal insufficiency. Despite the presence of extensive crystalline inclusions in podocytes and diffuse foot process effacement, the patient had no clinical evidence suggestive of podocyte injury.
Subject(s)
Humans , Crystallins , Fanconi Syndrome , Foot , Multiple Myeloma , Paraproteins , Podocytes , Proteinuria , Proteolysis , Renal InsufficiencyABSTRACT
Cardiac allograft vasculopathy is one of the most important causes of poor long-term survival after heart transplantation. The condition tends to be diffuse, usually affecting the mid-to-distal portions of the coronary artery. Reperfusion therapy is ineffective. Everolimus, an inhibitor of proliferation signaling, has been reported to prevent development of the condition; however, the efficacy thereof has not yet been fully accepted. The only definitive treatment for cardiac allograft vasculopathy is retransplantation. Herein, we describe the case of a 15-year-old boy who underwent heart retransplantation because of rapidly progressive cardiac allograft vasculopathy.