이 연구는 마음챙김을 기반으로 한 명상 프로그램을 말기 암 환자에게 실시하여 마음챙김의 주의 자각이 환자들의 죽음에 대한 불안감 감소에 미치는 효과를 검증하고자 하였다. 연구방법은 단일집단 사전-사후검사 설계를 바탕으로, 부산 소재 D병원에서 항암과 방사선 치료를 받고 있는 말기 암 환자들에게 마음챙김 명상 프로그램을 주 1회 1시간 30분씩 5 회기를 실시하였으며, 효과성에 대한 검증을 살펴보기 위해 비모수 검정 인 Wilcoxon Signed-Test로 분석하였다. 연구의 결과 마음챙김 명상 프로그램이 연구 참여자들의 주의 자각을 향상시킴으로써 참여자들의 죽 음에 대한 불안감을 감소시키는데 효과가 있음이 입증되었다. 결론 및 제언으로 마음챙김 명상 훈련을 통해 말기 암 환자들의 죽음에 대한 불 안감을 감소시킬 수 있다는 본 연구의 결과를 바탕으로 말기 암 환자들 의 불안감 감소가 지속적으로 유지될 수 있는 시스템의 구축과 꾸준히 마음챙김 명상 프로그램을 활용한 연구가 진행되기를 제언하였다.

To develop customized food products for gastric cancer patients, it is crucial to understand their dietary characteristics and changes in their perception of smell and taste due to their condition. This study conducted in-depth interviews and administered olfactory and gustatory tests on 20 patients with gastric cancer. A control group of 20 healthy, gender and age matched individuals, was included for comparison. Patients reported difficulties in sustaining their appetite, particularly during chemotherapy. This could be attributed to gastrointestinal discomfort and an altered perception of smell and taste. The olfactory test revealed that cancer patients were significantly less sensitive than the control group. Also, a smaller number of participants in the cancer group were reported to have a normal taste function, which enabled them to perceive umami, one of the five basic taste compared to those in the control group. These findings demonstrated that gastric cancer patients experience post-surgical digestive issues, chemotherapy-induced changes in smell and taste, and appetite loss. To improve the quality of life of these patients and the efficacy of the treatment, it is necessary to consider not only their nutritional requirements but also other factors such as appetite loss and discomfort when developing meals specifically for them.

유방암수술은 환자의 생존율을 높이지만 환자의 수술부위 통증, 상지근육의 변 화나 불균형 등의 체형변화뿐 아니라 재발에 대한 두려움, 자아존중감 저하와 우 울, 불안, 분노, 스트레스 등의 심리적 증상마저 유발할 수 있다. 그래서 유방암환 자를 위한 심신중재 프로그램의 개발이 필요하다. 이 프로그램의 1~3회기에는 단 축되거나 긴장된 부위의 자각훈련과 호흡훈련으로 구성되는 경견완부위 통증유발 점 스트레칭 요가체위가 실시된다. 4~8회기에는 통증유발점의 긴장부위를 자각하 는 훈련과 체형유지를 위한 주요근육을 강화하는 요가체위가 실시된다. 유도된 심 상 프로그램의 1~3회기에는 호흡과 신체자각, 심장박동소리듣기, 빛 명상이 실시 되고, 4~7회기에는 통증부위 빛 명상이 심화되며, 마지막 8회기는 임종명상으로 마무리된다. 유방암환자의 몸통 및 상지근육의 변화와 그에 동반되는 통증을 경감 시킬 수 있는 요가와 유도된 심상법으로 구성되는 자연치유요가 심신중재 프로그 램 개발을 위한 본 논문의 사례연구는 고유수용감각 훈련과 내수용감각 훈련을 설계하는 데 유용하다. 유방암수술을 받고 이 프로그램에 참가한 환자의 목과 어깨통증은 경감되었고 근육 밸런스는 회복되었으며 수술 후 방사선치료 등을 받으 며 느낀 공포와 불안감은 감소되었고 삶의 질이 향상되었으며 죽음에 대한 인식 도 변했다.

SOCS3, a suppressor of cytokine signaling 3, is known as a negative regulator of various cytokines and a tumor suppressor gene in human tumors. This study aimed to investigate the role of SOCS3 in oral squamous cell carcinoma (OSCC) and its impact on epithelial-mesenchymal transition (EMT) in OSCC cells. Although SOCS3 is recognized as a negative regulator of various cytokines and a tumor suppressor gene in human tumors, its specific effects on OSCC remain poorly understood. For the assessment of SOCS3 expression in OSCC, the UALCAN website and TCGA data were used to evaluate its expression in head and neck cancer. Additionally, immunohistochemical staining was conducted to determine the SOCS3 expression specifically in OSCC. The findings indicated a significant decrease in SOCS3 expression in tumor tissue compared to that in normal tissues. To investigate the enhancement of SOCS3 expression in OSCC cancer cell lines, IL6 treatment was administered to MC3 cells. However, no significant differences were observed in cell viability, wound healing assay, and invasion assay. Conversely, the transfection of SOCS3 siRNA into OSCC cells led to a notable increase in cell viability and statistically significant increases in wound healing and invasion assays. These results suggest that SOCS3 plays a crucial role in cell viability and EMT in OSCC, thereby contributing to oral carcinogenesis. Further research is necessary to elucidate the precise role of SOCS3 in OSCC.

Purpose: The aims of the study were to explore caregiving burden and quality of life (QOL) and to identify factors affecting QOL of family members of terminal cancer patients from hospice palliative care center. Methods: Survey was performed using structured questionnaires measuring caregiving burden and QOL. To collect data, family members from 6 hospice palliative care facilities were recruited from July to September 2018. During that period, survey questionnaires were distributed and collected and total 140 study respondents participated in the survey. Collected data were analyzed using SPSS WIN 23.0 and descriptive statistics, t-test, ANOVA, correlation coefficient, stepwise multiple regression analysis were performed as appropriate. Results: Caregiving burden and QOL score were 2.83 and 3.23 out of 5 point respectively. Factors affecting QOL were emotional burden (β = -0.35, p <.001), perceived health status (β = 0.23, p <.001), family support (β = 0.23, p <.001), age (β = -0.19, p <.003), economic burden (β = -0.16, p <.020), education (β=0.13 p<.033). Conclusion: Study results suggest that the lower caregiving burden, the higher QOL level of family members of terminal cancer patients. Since QOL of family members was affected by various factors, efforts to promote QOL through alleviating caregiving burden are required.

Background: The Functional Assessment of Chronic Illness Therapy (FACIT) for Dyspnea was developed to assess multidimensional dyspnea using two subscales (experience of dyspnea and functional limitation) and a total score. Objects: This study aimed to assess the reliability and validity of the Korean version of the FACIT-dyspnea 10-item short form questionnaire (FACIT-dyspnea-K). Methods: Subjects were 163 patients with cancer. Dyspnea-related scales (modified Medical Research Council scale [mMRC], European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 [EORTC QLQ-C30], Hospital Anxiety and Depression [HAD], and WHO Performance Scale) were used to validate the FACIT-dyspnea-K. Results: Internal consistency was confirmed by Cronbach’s alpha values of 0.90 and 0.95 in factors 1 and 2, respectively. Convergence validity was determined by comparing the two factors and total score of the FACIT-dyspnea-K with conceptually related assessment tools measuring the physical and emotional effects of dyspnea, with which correlations ranged from 0.364 to 0.567. Criterion validity was established by significant differences in the FACITdyspnea- K score between groups when the patients were classified by performance status as assessed by the WHO performance scale. Furthermore, the FACIT-dyspnea-K showed notable correlations with other dyspnea scales (mMRC, EORTC QLQ-C30, and HAD) for cancer patients (r = 0.28 to 0.54). The test-retest reliability of the two factors and total score of the FACITdyspnea- K appeared to be excellent (Cronbach’s alpha = 0.96 to 0.97). Conclusion: This study supports FACIT-dyspnea-K as a valid and reliable instrument to assess the dyspnea experience of cancer patients in clinical settings.

배경/목적: 췌장암은 일반적으로 불량한 예후를 보이며, 조기 진단이 어렵다는 점이 이에 영향을 미칠 것으로 생각되고 있다. 본 연구는 한국인 췌장암 환자에 있어서 혈장내 대사체 분석을 시행하여 건강 자원자의 대사체 프로파일과 비교 하였다. 방법: 각 10명으로 비한국인들을 대상으로 이루어진 기존 연구에 비하여 대상자 수가 매우 적지만 검진으로 시행한 복부 CT상 췌장 질환의 증거가 없는 건강한 자원자를 모집하였으며, 이는 췌장암의 조기 진단이 어렵다는 점을 감안할 때 기존 연구에 비한 장점이 될 수 있겠다. 결과: 혈장내 대사체 비교 분석상 췌장암 환자에서 L -lysine의 혈장 농도는 1.36배 높고 L -leucine은 0.63배, palmitic acid는 0.93배 낮은 것으로 나타나 이 세 가지의 대사체 프로파일의 조합이 건강자원자와 췌장암 환자를 가장 잘 구분해 주는 것으로 나타났다. 결론: 앞으로 췌장암의 조기 진단 혹은 발생 역학의 규명을 위하여 대사체 분석에 대한 연구가 더 필요하겠다.

배경/목적: 담도암에서 플라스틱 스텐트 너비에 따른 스텐트 생존 차이에 대한 데이터는 부족하다. 이번 연구의 목적은 담도암에서 7-프렌치와 10-프렌치 플라스틱 스텐트의 생존 차이를 보고 어떤 인자가 개방성에 영향을 미치는지 확인하고자 한다. 방법: 2010년 1월부터 2014년 10월까지 연세대학교 원주세 브란스기독병원에서 담도암으로 담도가 막힌 환자들을 등록 하였다. 결과: 총 215명(7-프렌치:10-프렌치 = 89명:126명)의 환자 를 후향적으로 등록하였다. 암의 위치는 총담관(111명), 간문 부 담관(45명), 바터팽대부(59명)였다. 스텐트 이동이나 폐쇄는 두 군 간에 통계적 차이가 없었다. 중앙 스텐트 생존은 7-프렌치의 경우 3.3개월이었고 10-프렌치의 경우 5.9개월이었다 (p = 0.543). 플라스틱 스텐트 너비는 스텐트 생존에 영향을 미치지 않았다(Hazard Ratio: 1.11, 95% CI 0.71-1.73, p = 0.649). 결론: 담도암 치료에 있어 7-프렌치와 10-프렌치 플라스틱 스텐트는 스텐트 이동이나 폐쇄 차이가 없었고 스텐트 생존에 있어 7-프렌치 플라스틱 스텐트가 10-프렌치에 비해 열등하지 않았다

본 연구는 암 환자의 심신을 다스리는 아로마테라피에 대해 사례고찰을 통해 연구하고 자 했다. 그리고 본 연구를 토대로 실제 임상에서 아로마를 사용하는 것이 암환자에게 긍정적이라는 것을 밝히는 것이 목적이다. 사례고찰에서 아로마테라피의 처방 및 환자소 감을 통해서 환자의 임상적 치료에 대한 결과는 사례 1의 폐암환자는 호잎 5방울, 라벤 더 10방울, 프랑킨센스(유황) 2방울, 로즈마리 3방울, 스위트 아몬드 오일 100ml, 1% 농 도 아로마 트리트먼트 오일로서 말기암의 심신고통을 완화하고 QOL이 향상되었다. 사례 2의 난소함 환자는 사이프레스 7방울과 라벤더 10방울 유칼립투스 3방울, 스위트 아몬드 오일 100ml, 1%농도 아로마 트리트먼트 오일로 손뿐만 아니라 얼굴이 핑크빛으로 되고 눈동자가 빛났다. 사례 3의 대장암환자는 라벤더 10방울, 유칼립투스 4방울, 로즈마리 4 방울, 페파민트 2방울, 스위트 아몬드 오일 100ml, 1% 농도 아로마 트리트먼트 오일로 환자의 QOL 전체를 높여 행복한 나날을 갖게 하였다. 그러므로 본 연구의 결과에 따라 아로마테라피는 암환자의 심신을 다스리는 것에 효과가 있음을 확인하였다.

Branch duct intraductal papillary mucinous neoplasms of the pancreas (BD-IPMN) without malignant features rarely developed into invasive cancer. However, invasive cancer is aggressive once an invasive change occurs. We report three cases of invasive cancers which developed in patients with BD-IPMN and they showed grave clinical courses. All patients were diagnosed with BD-IPMN < 3 cm without malignant features on imaging. Invasive cancer was detected at 2.5 years, 3.0 years, and 4.0 years after BD-IPMN detection in each patient. The intervals of invasive cancer and the last follow-up were 9 months, 3 years, and 1.5 years in the three patients, respectively. All patients were diagnosed with locally advanced pancreas invasive cancers and were treated with palliative chemotherapy or conservative management. The patients died at 3 months, 9 months, and 10 months after the diagnosis of invasive cancers, respectively. We report three cases of invasive cancer developed in BD-IPMN patients and followed fatal courses.

This study aimed to compare the characteristics of breast cancer surgery and shoulder surgery patients on the shoulder range of motion (ROM), degree of pain and dysfunction, and scapular position. This study was carried out with a total of 90 women: a breast cancer surgery group (BS, n1=30), a shoulder surgery group (SS, n2=30) and a control group (n3=30). Shoulder ROM, the Quadruple Visual Analogue Scale (QVAS), the Shoulder Pain and Disability Index (SPADI), and the Scapular Index (SI) were used to assess shoulder function. Statistical analyses were performed using a one-way analysis of variance, crosstab test, and independent sample t-test. Post-hoc testing was carried out with Bonferroni test. There were significant differences in shoulder ROM when the BS and the SS were compared with the control group. However, there was no significant difference in ROM between the BS and SS. Furthermore, there was a significant difference in shoulder pain between both surgery groups, and there was greater shoulder dysfunction in the SS than in the BS. There was also a significant difference in upper extremity posture when the BS and the SS were compared to the control group. Finally, there was no significant difference in upper extremity posture between the BS and the SS. This study compared shoulder ROM, pain, dysfunction, and upper extremity postures between the BS and SS. While there were no significant differences in shoulder ROM, pain, and upper extremity posture between both surgery groups, the level of dysfunction was found to be significantly different. Therefore, health professionals managing for breast cancer surgery or shoulder surgery patients should consider these outcomes.

Oral squamous cell carcinoma (OSCC), is the most common malignancy of oral cavity, and the sixth most frequently diagnosed cancer worldwide. This tumor type is associated with poor prognosis, and most OSCC patients are diagnosed after the cancer has reached an advanced stage. The over expression of NF-κB p65 has been associated with OSCC progression and lymph node metastasis. Hence, the present study analyzed the expression of NF-κB p65 in OSCC from Korean patients. Immunohistochemistry for NF-κB p65 was performed using 12 normal oral mucosas (NOM), 16 oral leukoplakia (with/without dysplasia), and 58 OSCC patients samples. Immunoreactivity was semi-quantitatively scored and the correlation between the expression of NF-κB p65 and clinicopathological parameters of OSCC patients was analyzed. Immunohistochemical staining revealed that NF-κB p65 expression level increased in oral leukoplakia with dysplasia and OSCC. Moreover, the immunoexpression of NF-κB p65 appeared to be associated with age, recurrence, TNM stage, and lymph node metastasis in OSCC patients (p<0.05). These results indicated that NF-κB p65 can play a role as oncogene in OSCC. Moreover, NF-κB p65 may play an important role in both oral carcinogenesis and OSCC patient outcome. It may be considered as another new malignant biomarker of OSCC.

The purpose of this study is to evaluate salivary flow rate, salivary pH, and cariogenic activity using unstimulated saliva of the head and neck cancer patients. Twenty three cancer patients (19 males, 4 females) who had undergone chemotherapy and radiation therapy and twenty four healthy volunteers (14 males, 10 females) as a control were included. Salivary flow rate, salivary pH, and cariogenic activity using unstimulated saliva were examined. Compared to saliva of the control group, salivary flow rate (p<0.001) and salivary pH (p<0.001) were significantly lower in head and neck cancer patients. The colony counts of Lactobacilli was higher in head and neck cancer patients (p<0.05) than in control group. These salivary factors and cariogenic activity can increase the prevalence of dental caries in head and neck cancer patients.

Chronic inflammation has long been considered as an important contributing factor to the development of malignant tumors in various tissues. In this study, we aimed to investigate a potential association between chronic periodontitis, a representative inflammatory disease in the oral cavity, and oral squamous cell carcinoma (OSCC), the most common form of malignant tumors in the oral cavity. A retrospective study was designed to include the cases and controls, each of which consisted of patients first diagnosed with OSCC and temporomandibular disorders, respectively. The existence or a history of periodontal disease was quantitatively estimated based upon the level of alveolar bone loss (ABL) from panoramic radiographs in these groups. Unlike other covariates, including LDH, WBC count and hemoglobin, the levels of ABL measured at three independent regions (second premolar and first/second molar) were significantly higher in the OSCC group, regardless of the patients’age in most cases. Our results thus support the hypothesis that chronic periodontitis, represented by significant ABL, is an important and clinically relevant factor potentially associated with the development of OSCC.

The presence of distinct bacterial species is found to be dependent on age, diet, and disease. We compared the detection rate of several oral bacterial strains in a cohort of 36 subjects including healthy volunteers, periodontal patients, and oral cancer patients. Gargling samples were obtained from these subjects from which DNA was then extracted. Specific primers for 29 bacterial species were used for PCR detection. In the oral cancer patients, Capnocytophaga ochracea, Gemella morbillorum, and Streptococcus salivarius were detected more frequently compared with the healthy volunteers and periodontitis patients. Fusobacterium nucleatum/ polymorphym and Prevotella nigrescens were significantly less prevalent in oral cancer patients than the other groups. In periodontitis patients, Porphyromonas gingivalis and Treponema denticola were more frequently found compared with the healthy volunteers. In the healthy volunteer group, Peptostreptococcus anaerobius was more frequently found than the other groups. The detection rate of several oral bacterial species was thus found to differ between healthy volunteers, periodontitis patients and oral cancer patients.

암과 같이 생명을 위협하는 질환을 진단받은 환자들은 여러 신체적인 변화와 불안 및 우울증 등의 정서적인 고통에 의해 심리적 상태가 매우 불안해지게 되고 이에 따라 극심한 정서적 혼란상태가 이어지게 되어 전체적인 삶의 질에 영향을 주게 된다. 암 생존자들은 재활 과정에서 필요한 건강관련 정보에 대한 요구도가 매우 높으며, 암 치료 과정 중 발생하는 여러가지 부작용 및 신체적 어려움은 심리적인 측면에도 많은 문제를 일으켜 암 환자의 삶의 질을 낮추는 요인이 되고 있다. 암 환자를 위한 재활에서 작업치료자의 역할은 암 환자가 일상생활에서 개인적, 신체적, 심리적으로 최대한 기능적으로 수행할 수 있도록 도와주는 것이며, 암 환자의 삶의 질을 향상시키기 위해 심리 사회적인 중재와 목적 있는 활동을 제공하는 것이다. 삶의 질은 환자중심 접근법을 적용하였을 때 향상될 수 있으며, 환자를 존중하고 환자와 협력하는 치료적 접근법을 통하여 환자에게 주도적으로 치료 상황에 참여하고 의미있는 작업을 스스로 선택하도록 할 수 있을 때 긍정적인 치료 효과를 기대할 수 있을 것이다. 일생동안 관리가 필요한 암이라는 질환을 겪고 있는 환자들의 삶의 질 향상을 위해서는 신체적, 정신적, 사회적인 각 영역들에 특화된 작업의 중요성을 인식시킴과 동시에 사회적인 영역에서 통합적인 서비스를 제공하여야 할 것이다.

This study examined the effects of a physical therapy program on quality of life (QOL), and neck and shoulder disability in head and neck cancer patients. The program included neck and shoulder range of motion (ROM) exercises, massage, progressive strengthening exercises, and stretching exercises. Sixteen patients who were assigned to an experimental group performed physical therapy for 40 minutes three times a week for eight weeks. Fifteen other patients were assigned to a control group who did not performed the physical therapy program. The European organization for research and treatment of cancer (EORTC QLQ-C30) and head and neck (EORTC QLQ-H&N) instruments, and the Neck Disability Index (NDI) were assessed before and after the rehabilitation program. The 40-minute program consisted of a 10-minute ROM exercise for the neck and shoulder, a 10-minute massage and 15-minute of progressive resistance exercises, followed by a five-minute stretching exercises. Statistically significant differences were noted for changes in global health, physical function in the EORTC QLQ-C30 and cancer related symptoms in the EORTC QLQ-H&N35 (p<.05). The NDI also showed significant differences (p<.05). Physical therapy may therefore benefit the physical aspects and QOL and improve neck and shoulder disability in patients with head and neck cancer.