Chemotherapy-induced Peripheral Neuropathy and Depression in Cancer Patients

PURPOSE: The purpose of this study was to assess chemotherapy induced peripheral neuropathy (CIPN) and to examine the relationship between CIPN and depression. METHODS: A purposive sample of 105 patients treated with chemotherapy were recruited in the cross-sectional survey design. Data were collected using self-report questionnaires. The instruments used were the Chemotherapy Induced Peripheral Neuropathy Assessment Tool (CIPNAT) and Hospital Anxiety Depression Scale (HADS). RESULTS: The most frequent suffering symptom of CIPN was 'tingling feeling in the hand and foot'. Of the motor symptoms, 'muscle weakness' was the most frequent symptom and 'muscle or joint aches' was the strongest suffering symptom of CIPN. The mean score for suffering of CIPN was 4.1. The mean score was 1.04 for depression and the prevalence was 48.5%. CIPN was significantly positively correlated with depression (r=.38, p<.001). The result of simple regression analysis revealed that CIPN was predictive of depression (R2=.136, p<.001). CONCLUSION: Based on the findings of this study, nursing intervention programs focusing on CIPN management and alleviating depression are recommended.

Disturbance in ADL from Chemotherapy-induced Peripheral Neuropathy and Quality of Life in Cancer Patients: The Mediating Effect of Psychological Distress

PURPOSE: The purpose of this study was to examine the mediation of psychological distress in the relationship between disturbance in ADL from chemotherapy induced peripheral neuropathy and quality of life in order to provide a basis for planning nursing interventions to improve the quality of life in cancer patients. METHODS: A purposive sample of 130 patients treated with chemotherapy were recruited in the cross-sectional survey design. Data were collected using self-report questionnaires. The instruments were the Chemotherapy Induced Peripheral Neuropathy Assessment Tool (CIPNAT), Hospital Anxiety Depression Scale (HADS), and Functional Assessment of Cancer Therapy-General (FACT-G). RESULTS: The mean score for disturbance in ADL from chemotherapy induced peripheral neuropathy was 3.30. Overall quality of life was 2.48. The mean score was 1.04 for psychological distress. The prevalence was 35.4% for anxiety and 47.7% for depression. There were significant correlations among the three variables, disturbance in ADL from chemotherapy induced peripheral neuropathy, psychosocial distress, and quality of life. Psychosocial distress had a complete mediating effect (beta= -.74, p <.001) in the relationship between disturbance in ADL from chemotherapy induced peripheral neuropathy and quality of life (Sobel test: Z= -6.11, p <.001). CONCLUSION: Based on the findings of this study, nursing intervention programs focusing on disturbance of ADL management, and decrease of psychological distress are highly recommended to improve quality of life in cancer patients.

Salivary Duct Carcinoma with Unusual Clinical Course of Sialolithiasis / 대한이비인후과학회지

Salivary duct carcinoma is a high-grade malignant tumor that is histologically similar to ductal carcinoma of the breast. It accounts for less than 1-3% of salivary gland tumors and 63-100% of cases arise in the parotid gland. Swelling, pain, facial palsy and mass in the salivary gland are clinical features suggestive of salivary duct carcinoma. CT and MR imaging findings are nonspecific. However, a few reports suggest that ill-defined heterogenous mass containing calcification observed on CT scans may be useful for diagnosis. Although salivary duct carcinoma can show calcifications on CT images (33-50%), it can be confused with sialolithiasis. The authors report two cases of salivary duct carcinoma, which was complicated with sialolithiasis in the submandibular gland (in a 25-year-old man with recurrent distal submandibular duct stone, and a 50-year-old man with intraglandular stone). It is suggested that unusual cases of sialolithiasis should be carefully examined to exclude the suspicion of malignancy before surgery.

Porous Polyurethane Scaffold as a Tracheal Prosthesis Material / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to confirm the usefulness of the porous polyurethane scaffold as a tracheal prosthesis for repair of partial tracheal defect. SUBJECTS AND METHOD: A porous polyurethane (PU) scaffold was manufactured by salt-leaching method. Polyethylene glycol (PEG) was grafted onto the surface of the PU scaffold following surface ozonation treatment. Scanning electro-microscopy (SEM) was then performed to evaluate the morphklogy. For the biocompatibility evaluation, a 5x5 mm sized PU scaffold was implanted into the rabbit's ear. A histological examination was performed with the tissue one month later. Polymerase chain reaction for tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, procollagen, fibromodulin, fibronectin, and actin was also performed. The tensile strength was measured and compared with beagle's trachea to evaluate the mechanical property of the prosthesis. RESULTS: The effect of ozonation and surface grafting with PEG was on the porous scaffold was confirmed by SEM and X-ray photoelectron spectroscopy. The histological examination showed a large amount of fibrous tissue and capillary had grown through the pores of the porous scaffold. The inflammatory reaction was not so severe. TNF-alpha and IL-6 were slightly elevated in the PU scaffold transplanted tissue. However, the concentration levels of the other cytokines were similar between transplanted tissue and normal tissue. The tensile strength was very similar with the beagle's normal trachea. CONCLUSION: The polyethylene grafted polyurethane scaffold is a good candidate prosthesis for tracheal reconstruction.

Uterine myoma: Treatment modalities and patient preference / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to describe the clinical features of myoma, treatment options, patient preference and to identify the clinical features which affect the management of myoma. METHODS: We retrospectively analyzed medical records of 577 patients who were diagnosed as uterine myoma on ultrasound exam between January 2006 and December 2006. Patients' characteristics, treatment methods and questionnaires for patient preference were evaluated. RESULTS: The mean age was 42.3 years and 90.8% of the patients were premenopausal status. Common symptoms were pain (58.6%), bleeding (51.3%) and compression symptom (30.2%). In our study, 183 of 577 patients (31.7%) planned to have regular follow-up without treatment. Non-hormonal medical treatment was used in 27.1% and hormonal treatment was used in 41.9% of the patients. One hundred eighty-two patients underwent surgical treatment, including myomectomy (57.1%), subtotal hysterectomy (19.8%) and total hysterectomy (23.1%). Among the patients who underwent surgery, 50.6% of patients (88/174) had surgery due to compression symptom, 42.6% (126/296) due to bleeding, and 34.6% (117/338) due to pain. According to the 100 patients who answered the questionnaires, 78 patients preferred medical therapy initially, but 22 patients chose surgical treatment. When the patient was asked to choose between myomectomy and hysterectomy, 94 patients wanted myomectomy, but only 6 patients chose hysterectomy. CONCLUSIONS: Many patients diagnosed as myoma prefer medical treatment initially. Medical treatment for myoma may be considered as the first line treatment for pain and bleeding symptoms before proceeding to surgical treatment.

Ovarian hemangioma: A case report / 대한산부인과학회지

Hemangiomas of ovary are extremely rare tumors, although ovaries have a very rich vasculature. There are only approximately 50 cases of ovarian hemangioma reported in the literature. The most of ovarian hemangiomas are the cavernous type and may present either as isolated unilateral ovarian masses, which are discovered incidentally, or together with diffuse abdominopelvic hemangiomatosis. We report a case of a ovarian hemangioma discovered incidentally in a 35-year-old woman with brief review on this topic.

Three different approach to hysterectomy for benign uterine pathology / 대한산부인과학회지

OBJECTIVE: To evaluate the rates and clinical outcomes between abdominal hysterectomy (AH), laparoscopic hysterectomy (LH) and vaginal hysterectomy (VH). METHODS: Medical records of 236 patients who underwent hysterectomy (by one surgeon) for benign uterine pathology between march 2004 and april 2006 were reviewed. Primary outcome measure was the rate of each method of hysterectomy. Secondary outcome measures included perioperative and postoperative outcomes between groups. RESULTS: The mean age, weight, height, body mass index, and parity in three groups showed no difference. In two hundred and twenty two cases of hysterectomies, the rate of AH was 13.5%, LH 34.2%, and VH 52.3%. Perioperative outcomes of AH, LH and VH were as follows : operative time (83.2+/-27.1 min, 94.2+/-25.2 min, and 50.8+/-15.5 min, respectively), change in hemoglobin (2.3+/-1.5 g/dL, 2.0+/-0.9 g/dL, and 1.3+/-1.1 g/dL, respectively), duration of urinary catheterization (2.0+/-0.2 days, 1.0+/-0.0 days, and 1.0+/-0.4 days, respectively), postoperative hospitalization (5.7+/-1.2 days, 4.7+/-0.9 days, and 4.3+/-1.0 days, respectively), uterine weight (733+/-665 g, 340+/-213 g, and 300+/-156 g, respectively). Uterine weight in the AH group was significantly heavier than in the LH and VH. The benefits of LH versus AH were shorter duration of urinary catheterization and postoperative hospitalization (p<0.05). The benefits of VH versus AH were shorter operative time, a smaller drop in hemoglobin, shorter duration of urinary catheterization and postoperative hospitalization (p<0.05). The benefits of VH versus LH were shorter operative time, a smaller drop in hemoglobin, and postoperative hospitalization (p<0.05). There were no differences in complications of AH, LH and VH (13.3%, 10.5%, and 9.5%, respectively p=0.825). CONCLUSIONS: Eighty six point five percent of hysterectomy can be done vaginal or laparoscopic approach. When there is a concerted effort to increase laparoscopic or vaginal hysterectomy, abdominal hysterectomy can decrease without increasing complication rate.