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표준화된 수술 전 교육이 위암수술 후 환자의 자가간호지식, 수행 및 신체회복에 미치는 효과
윤민아(Yun, Min Ah),김소선(Kim, So Sun),김상희(Kim, SangHee),노성훈(Noh, Sung Hoon3) 대한종양간호학회 2016 Asian Oncology Nursing Vol.16 No.2
Purpose: The purpose of this study was to identify the effects of a standardized preoperative education program on self-care knowledge, performance, satisfaction, and physical recovery in the stomach cancer patients undergoing gastrectomy. Methods: A nonequivalent control group non-synchronized design was utilized and 63 participants who underwent gastrectomy (31 for experimental group, 32 for control group) were recruited at a university hospital from May to August 2015. Results: There were significant differences between the groups in self-care knowledge (F=17.63, p<.001), performance (F=-9.25, p<.001) and satisfaction (F=-6.91, p<.001). Although the pain levels (F=974.57, p<.001) showed significant differences in each group and 3 time intervals (F=18.26, p<.001), there was no interaction of group and time (F=0.09, p=.917). The highest body temperature at 48 hours after surgery (F=1.32, p=.192), as well as presence of atelectasis (F=2.23, p=.213) indicating a chance of pulmonary complications, and the time of first gas pass (F=-1.05, p=.299), presence of paralytic ileus (F=0.13, p=.719) were not significantly differ. Conclusion: The preoperative education program developed in this study can be utilized as a part of nursing interventions and be beneficial to patients who undergo stomach cancer surgery for their thorough understanding.
위암에서 Collagen-4 및 Type-4 Collagenase의 발현과 예후인자로서 임상적 응용
노성훈(Sung Hoon Noh),이종인(Chong In Lee),정현철(Hyun Cheol Chung),박준오(Joon Oh Park),조재용(Jae Yong Cho),라선영(Sun Young Ra),유내춘(Nae Chun Yoo),김주항(Joo Hang Kim),노재경(Jae Kyung Roh),민진식(Jin Sik Min),김병수(Byung Soo K 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1
N/A Background/Aims: In Korea, gastric cancer is the commonest cancer and the leading cause of cancer-related death. Though the most effective treatment for gastric cancer is radical resection, there are many patients with gastric cancer inoperable at the time of diagnosis. Collagen-IV, one of the major intrinsic components of the basement membrane, has cell adhesion function and it is known to be associated with tumor invasion or penetration. Type- IV collagenase, a metallo- proteinase purified from highly metastatic tumor cells, has been implicated in the process of invasion of epithelial and endothelial basement membranes in several steps of tumor invasion and metastasis. Methods: We retrospectively reviewed the clinical records of SO patients with histologically proven gastric cancer who had been treated in Yonsei University Medical Center and Yonsei Cancer Center between June l985 and June 1990. We perfonned immunohistochemical staining of surgically resected specimens of stomach cancers to investigate the expression rate and clinical relevance of collagen-lV and type-IV collagenase as prognostic niarkers. Results: Collagen- IV expression rate was 50% in 40 gastric cancers and type-IV collagenas expression rate was 76% in 50 gastric cancers. Six cases(30%) recurred in 20 collagen-IV positivc cases and six cases(30/c) recurred in 20 collagen-IV negative cases(p=1.00000). Eleven cases(29%) recurred in 38 type-P' collagenase positive cases and four cases(33%) recurred in 12 type-IV collagenase negative cases(p=0.77255). In the collagen-IV positive and negative group, 5-ye.ar disease-free survival rate was 607c and 67%, respectively(p=0.6725), and 5-year overal] survival rate was 71% and 827o, respectively(p=0.3953). In the type-IV collagenase positive and negative group, 5-year disease-free survival rate was 63% and 60%, respectively(p=0.6407), and 5-year ovevall survival rate was 78% and 60%, respectively (p=0.3822). Conclusions: Collagen-IV and type-lV collagenase were found in gastric tissues. However, together with recurrence rate and survival rat:, expressions of collagen- IV and type-IV collagenase were not significantly correlated with T state, nodal status, TNM stage and histologic differentiation of gastric cancer. Further studies to define the biological role of collagen-IV and type-IV collagenase is required. (Korean J Gastroenlerol 1996;28:1 - 10)
요로감염 환아에서 방광요관 역류를 예측할 수 있는 인자에 대한 연구
이승현,노성훈,오정은,김민선,이대열,Lee, Seung-Hyun,Noh, Sung-Hoon,Oh, Jeung-Eun,Kim, Min-Sun,Lee, Dae-Yeol 대한소아신장학회 2008 Childhood kidney diseases Vol.12 No.1
목적 : 배뇨성 방광요도 조영술은 초회 열성 요로감염이 있는 환아에게서 선천성 신장 질환이나 동반된 방광요관 역류를 확인하기 위해 시행한다. 그러나 이 시술은 요로 감염에서 방광 천공까지 다양한 합병증 등이 초래될 수 있으므로 본 연구는 배뇨성 방광요도 조영술 이외에 방광요관 역류의 존재를 예측할 수 있는 인자를 알아보고자 하였다. 방법 : 1998년 5월부터 2005년 11월까지 약 7년간 전북대학교 병원 소아청소년과에 입원하여 소변 배양 검사상 확진된 요로 감염 환아를 대상으로 후향적으로 분석하였다. 각각의 환아들에게서 연령, 성별, 발열, 위장관 증상, 뇨 검사 및 뇨 배양, 말초혈액 백혈구수, ESR, CRP, BUN, 혈청 creatinine과 요로계 초음파 및 DMSA 신스캔 결과와 방관요관 역류의 정도를 표준화된 형식을 통해 기록하였다. 결과 : 총 410명의 환아 중, 방광요관 역류가 없는 그룹은 273명이었고 역류가 있는 그룹은 137명 이었다. 방광요관 역류 존재 유무에 따른 두 그룹 간에는 발열, 농뇨, 말초백혈구수, ESR, CRP의 P 값이 0.001 이하의 의미있는 차이를 나타냈다. 그러나, 방광요관 역류 정도에 따른 비교분석 결과 방광요관 역류가 낮은 군(I-II)과 높은 군(III-V) 사이에는 농뇨, 발열, 말초백혈구수, C-반응단백(CRP) 등에서 의미있는 차이를 보이지 않았다(P<0.05). 역류의 유무에 따른 영상의학적 소견의 차이를 보면, 신장 초음파는 민감도 33%, 특이도 73%를 보였으며 DMSA 신스캔은 민감도 76%, 특이도 65%를 나타내었다. 또한 역류가 심할수록 신장 초음파와 DMSA 신스캔 모두 양성률이 높았다. 결론 : 초회 요로감염 환아 중 발열, 농뇨 및 높은 적혈구 침강속도, C-반응단백를 보이는 경우와 DMSA 신스캔상 이상 소견을 보이는 경우는 방광요관 역류가 있을 가능성이 높으므로, 이 경우에는 반드시 배뇨성 방광요도 조영술을 시행하는 것이 좋을 것으로 사료된다. Purpose: The most concerning issue in children with urinary tract infection(UTI) is the probability of underlying genitourinary anomalies and vesicoureteral reflux (VUR), which is frequently associated with renal scarring and eventually end-stage renal disease. Therefore, voiding cystourethrography(VCUG) is usually recommended at the earliest convenient time for children with UTI. However, VCUG is an invasive procedure that requires catheterization and exposure to X-ray. In this study, we aimed to determine the predictability of clinical, laboratory and imaging parameters for VUR in children with UTI. Methods: Data of children with bacteriologically proven UTI who underwent VCUG were evaluated retrospectively for clinical(age, gender, fever), laboratory(leukocytosis, ESR, CRP, pyuria, blood urea nitrogen, serum creatinine) and imaging(renal ultrasound and DMSA renal scan) findings. First, children with UTI were divided into two groups according to the presence of VUR as non-VUR group and with VUR group, and clinical, laboratory variables were compared between these groups. Second, patients who had VUR were reclassified as low-grade VUR(grade I-II) group and high-grade(grade III-V) VUR group according to grading of VUR, and clinical, laboratory and imaging variables were compared between these groups. Results: Among 410 children with UTI, 137 had VUR and 78 high-grade VUR. Fever, leukocytosis, ESR, CRP, pyuria were associated with VUR. In addition, abnormal findings of ultrasonography and DMSA renal scan were closely related to VUR. However, these clinical and laboratory variable in patients with high grade VUR were not different significantly, compared to those with low-grade VUR group. Conclusion: Fever, leukocytosis, ESR, CRP seems to be potentially useful predictors of VUR in pediatric patients with UTI. In addition, renal ultrasonography and DMSA renal scan findings supported the presence of VUR. Further study of these findings could limit unnecessary VCUG in patients with UTI.