• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.69-79
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• 2023

Purpose: This study aimed to investigate the involvement of patients who died from hematologic neoplasms in the decision-making process surrounding the withdrawal of life-sustaining treatment (LST). Methods: A total of 255 patients diagnosed with hematologic neoplasms who ultimately died following decisions related to LST during their end-of-life period at a university hospital were included in the study. Data were retrospectively obtained from electronic medical records and analyzed utilizing the chi-square test, independent t-test, and logistic regression. Results: In total, 42.0% of patients participated in the decision-making process regarding LST for their hematologic neoplasms, while 58.0% of decisions were made with family involvement. Among these patients, 65.1% died in general wards and 34.9% in intensive care units (ICUs) as a result of decisions such as the suspension of LST. The period from the LST decision to death was longer when the decision was made by the patient (average, 27.15 days) than when it was made by the family (average, 7.48 days). Most decisions were made by doctors and family members in the ICU, where only 20.6% of patients exercised their right to make decisions regarding LST, a rate considerably lower than 79.4% observed in general wards. Decisions to withhold or withdraw LST were more commonly made by patients themselves than by their families. Conclusion: The key to discussing the decision to suspend hospice care and LST is respecting the patient's self-determination. If a patient is lucid prior to admission to the ICU, considerations about suspending LST should involve the patient input.

• Journal of Korean Academy of Nursing
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• v.41 no.5
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• pp.603-612
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• 2011

Purpose: The purpose of this study was to describe the experience process of adolescents with hematologic malignancies. The question for the study was "What is the experience of adolescents with hematologic malignancies like?" Methods: The grounded theory methodology was used for this study. The data were collected through in-depth interview from 10 adolescents with hematologic malignancies. Data collection was done from January to June 2007. Theoretical sampling was used until the data reached saturation. Results: As a result of the analysis, "Reconstructing self-image from deviated and suspended life" was identified as the core category. And 11 subcategories were identified and they were integrated to the core category. 'Establishment of expanded and matured self' was identified as the consequence. Conclusion: The results of the study provide a frame for effective individualized nursing intervention strategies in helping adjustment of the adolescents with hematologic malignancies.

• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.195-201
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• 2022

Background: The aim of this study was to evaluate the long-term (5-year) clinical outcomes of patients who received intensive care unit (ICU) treatment using Korean nationwide data. Methods: All patients aged >18 years with ICU admission according to Korean claims data from January 2008 to December 2010 were enrolled. These enrolled patients were followed up until December 2015. The primary outcome was ICU mortality. Results: Among all critically ill patients admitted to the ICU (n=323,765), patients with cancer showed higher ICU mortality (18.6%) than those without cancer (13.2%, p<0.001). However, there was no significant difference in ICU mortality at day 28 among patients without cancer (14.5%) and those with cancer (lung cancer or hematologic malignancies) (14.3%). Compared to patients without cancer, hazard ratios of those with cancer for ICU mortality at 5 years were: 1.90 (1.87-1.94) for lung cancer; 1.44 (1.43-1.46) for other solid cancers; and 3.05 (2.95-3.16) for hematologic malignancies. Conclusion: This study showed that the long-term survival rate of patients with cancer was significantly worse than that of general critically ill patients. However, short term outcomes of critically ill patients with cancer were not significantly different from those of general patients, except for those with lung cancer or hematologic malignancies.

• Korean Journal of Adult Nursing
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• v.25 no.1
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• pp.95-104
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• 2013

Purpose: The purpose of this study was to investigate the level of resilience, family support, anxiety and depression in patients with hematologic malignancy, and to determine modifiable psychosocial factors that affect their resilience. Methods: Data were collected from 104 patients undergoing curative therapy at 'S' hospital in Seoul. The data were collected from April to May, 2012. The questionnaires included Korean Version of Connor-Davidson Resilience Scale, Family Support Scale and Hospital Anxiety-Depression Scale. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation and stepwise multiple regression. Results: Resilience had statistically significant correlation with family support (r=.43, p<.001), anxiety (r=-.49, p<.001) and depression (r=-.52, p<.001). Factors influencing resilience were depression, family support, anxiety and time since diagnosis with R-sq. value of 36%. Conclusion: The results of the study show that family support, anxiety and depression have important influences on resilience of patients with hematologic malignancy. Thus, family support needs to be reinforced when developing and implementing nursing intervention, and nurses need to intervene to reduce anxiety and depression of patients with hematologic malignancy.

• Korean Journal of Adult Nursing
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• v.23 no.5
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• pp.460-471
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• 2011

Purpose: This study was designed to investigate the levels of anxiety, depression, physical symptoms, and supportive care needs in patients with hematologic malignancy and to identify predictive factors of supportive care needs. Methods: The data were collected from 100 subjects undergoing treatments during 2010 in Korea. The questionnaires included the Hospital Anxiety-Depression Scale, the M. D. Anderson Symptom Inventory, and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regression. Results: Forty percent of the subjects had anxiety and 58% had depression. Thirty-eight percent of the subjects reported to have moderate-to-severe levels of physical symptoms. The most severe physical symptom was lack of appetite, followed by fatigue and pain. In terms of supportive care needs, the health system and information domain showed the highest among all domains. Supportive care needs had a significant positive correlation with anxiety, depression, and physical symptoms. And its predictive factors were identified as anxiety, physical symptoms and marital status, with the explanatory power of 48.9%. Conclusion: These findings demonstrate that anxiety and physical symptoms should be assessed and treated to meet the supportive care needs of patients with hematologic malignancies.

• Journal of Digestive Cancer Research
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• v.10 no.2
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• pp.112-116
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• 2022

Idiopathic inflammatory myopathy (IIM) is known for its association with malignant diseases. Moreover, various solid organ malignancies, such as ovarian, breast, lung, esophageal, stomach, and colorectal cancers, have been reported to occur with IIM. Furthermore, its relationship with hematologic malignancies, including non-Hodgkin lymphoma, myeloma, and leukemia, has been reported. However, to date, IIM related to pancreatic cancer has scarcely been reported, particularly in patients with polymyositis (PM). Therefore, here we report a case of PM developed immediately after the diagnosis of pancreatic ductal adenocarcinoma.

• Journal of Chest Surgery
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• v.52 no.1
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• pp.25-31
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• 2019

Background: The primary goal of this study was to characterize the clinical outcomes of adult patients with hematologic malignancies (HM) who were treated with extracorporeal membrane oxygenation (ECMO) support when conventional treatments failed. Methods: In this retrospective, observational study at a tertiary medical center, we reviewed the clinical course of 23 consecutive patients with HM requiring ECMO who were admitted to the intensive care unit at Asan Medical Center from March 2010 to April 2015. Results: A total of 23 patients (8 female; median age, 44 years; range, 29-51 years) with HM and severe acute circulatory and/or respiratory failure received ECMO therapy during the study period. Fourteen patients received veno-arterial ECMO, while 9 patients received veno-venous ECMO. The median ECMO duration was 104.7 hours (range, 37.1-221 hours). Nine patients were successfully weaned from ECMO. The in-hospital mortality rate was 91.1% (21 of 23). There were complications in 3 patients (cannulation site bleeding, limb ischemia, and gastrointestinal bleeding). Conclusion: ECMO is a useful treatment for patients with circulatory and/or pulmonary failure. However, in patients with HM, the outcomes of ECMO treatment results were very poor, so it is advisable to carefully decide whether to apply ECMO to these patients.

• Nutrition Research and Practice
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• v.13 no.3
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• pp.214-221
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• 2019

BACKGROUNDS/OBJECTIVES: Cancer treatment may lead to significant body composition changes and affect growth and disease outcomes in pediatric cancer patients. This prospective study aimed to evaluate short- and long-term body compositions changes focused on body fat during the first year of cancer treatment in children. SUBJECTS/METHODS: A prospective study was conducted in 30 pediatric cancer patients (19 hematologic malignancies and 11 solid tumors) and 30 age- and sex-matched healthy controls. Anthropometric measurements and body composition analysis using whole body dual energy X-ray absorptiometry were performed at baseline and 1, 6, and 12 month(s) of cancer treatment. Kruskal-Wallis tests, Wilcoxon paired t tests, and generalized estimation equation (GEE) were applied for statistical analysis. RESULTS: At baseline, no differences in weight, height, body mass index, abdominal circumferences, body fat, and fat-free mass were observed between 30 controls and 30 pediatric cancer patients. Total fat mass (P < 0.001) and body fat percentage (P = 0.002) increased significantly during the first month, but no changes were observed from 1 to 12 months; however, no changes in the total mass were observed during the first year of cancer treatment. Meanwhile, the total fat-free mass decreased during the first month (P = 0.008) and recovered between 6 and 12 months of follow-up (P < 0.001). According to GEE analysis, there was a significant upward trend in body fat percentage during the first year, especially the first month, of cancer treatment in children with hematologic malignancies, but not in those with solid tumors. CONCLUSIONS: Our results indicate that cancer treatment is related to significant body composition changes and rapid body fat gain, particularly during the first month after initiating cancer treatment, in children with hematologic malignancies. Therefore, individualized dietary strategies to prevent excessive fat gain are needed in pediatric cancer patients for better outcomes.

• Journal of Oral Medicine and Pain
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• v.41 no.4
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• pp.200-204
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• 2016

Numb chin syndrome, or mental neuropathy is a rare sensory neuropathy characterized by abnormal sensation such as hypoesthesia, paresthesia, or dysesthesia in the chin and lower lip innervated by the mental nerve. Sensory neuropathy of mental nerve is somewhat familiar to dentists because it can occur following nerve damage by trauma or dental treatment such as implant surgery or third molar extraction. It can also result from dental causes including abscess or osteomyelitis. However, it can be the first sign of the systemic disease or malignancy if it is not related to dental causes. In this study, we present the case of a patient who present with hypoesthesia and pain in chin area without other symptoms and is later diagnosed with diffuse large B-cell lymphoma.

• Tuberculosis and Respiratory Diseases
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• v.72 no.3
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• pp.318-322
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• 2012

Sarcoidosis is an inflammatory disease involving multiple-organs with an unknown cause. The new onset of sarcoidosis associated with therapeutic agents has been observed in 3 clinical settings; tumor necrosis factor antagonists in autoimmune rheumatologic diseases, interferon alpha with or without ribavirin in patients with chronic hepatitis C or melanoma, and antineoplastic agent-associated sarcoidosis in patients with hematologic malignancies. Here, we report a female patient who developed sarcoidosis after capecitabine treatment as an adjuvant chemotherapy for sigmoid colon cancer. To our knowledge, this is the first report of a capecitabine-induced sarcoidosis.