• Title/Summary/Keyword: 고경

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Levels of Barriers to Pain Management of Cancer Patients and their Nurses (암 환자와 간호사의 통증관리 장애정도)

  • Yoo, Yang-Sook;Lee, Won-Hee;Cho, Ok-Hee;Lee, So-Woo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.224-233
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    • 2005
  • Purpose: This study was conducted to provide basic data for developing an effective strategy for cancer pain management by comparing the levels of barriers to pain management of metastatic or advanced cancer patient and their nurses. Methods: The subject of this study were 155 patients who were treated for metastatic or advanced cancer at one of three hospitals in Seoul from January 2004 to January 2005, and 153 nurses who take care of those patients. The levels of barriers to pain management were measured using a tool developed by Gunnarsdottir et al. (2002), 27 questions on a six point scale. The levels of stresses were measured using a tool modified from a stress response measurement reported by Goh Gyung-bong et al. (2000), 27 questions on a five point scale. The levels of barriers in cancer patients were analyzed using t-test and ANOVA, while the data obtained from patients and nurses were compared by t-test. Results: Higher levels of barriers to pain management were found in three groups: 'less than middle school,' 'not treated with anti-cancer chemotherapy,' and 'ECOG of 2.' The level (2.55) of barriers to pain management in the patient group was higher than that (1.76) of the nurse group. Both of the two groups had high levels of barriers in two variables: 'There is a danger of becoming addicted to pain medicine.' and 'Using pain medicine blocks your ability to know if you have any new pain.' There was not a significant difference in the levels of stresses between the two groups. Conclusion: It was found that, for effective cancer pain management practices, it would be necessary to provide cancer patients and their nurses with education and training about pain management and related barriers.

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Helicobacter pylori Infection and Gastroduodenal Pathology in Children with Upper Gastrointestinal Symptoms (상부 위장관 증세가 있는 소아의 위십이지장병변 및 Helicobacter pylori 감염)

  • Yoon, Young-Ran;Kim, Mi-Ryeung;Lim, Jae-Young;Choi, Myoung-Bum;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang;Ko, Gyung-Hyuck;Kang, Hyung-Lyun;Baik, Seung-Chul;Lee, Woo-Kon;Cho, Myung-Je;Rhee, Kwang-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.103-111
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    • 2003
  • Purpose: This study was undertaken to evaluate the gastroduodenal pathology and Helicobacter pylori infection in children with upper gastrointestinal symptoms. Methods: One hundred and seven pediatric patients with upper gastrointestinal symptoms were undergone endoscopy at the Gyeongsang National University Hospital from June 1990 to April 1991. Histopathologic examination was done by H & E staining of gastric antral biopsy specimen and gastritis was defined according to the Sydney System. Tissue H. pylori status was evaluated with the urease test using Christensen's urea broth and H & E or Warthin-Starry silver staining of gastric antral biopsy specimen. IgG Immunoblotting were also performed to detect specific anti-H. pylori antibody in these patients. Results: The reasons for endoscopy were recurrent abdominal pain, acute abdominal pain, sallow face, hunger pain, and frequent nausea. Variable degrees of gastric mucosal hyperemia were found in most of the patients. Gastric hemorrhagic spots, gastric ulcer, duodenal ulcer, duodenal erosion, and hemorrhagic duodenitis were rare endoscopic findings. Histologic chronic gastritis was found in 88% of 107 patients. Histologic chronic duodenitis was observed in all 99 patients whose tissue were available. Gastric tissue H. pylori was positive in 57% of 107 patients by one of the ureasetest, H & E staining and Warthin-Starry silver staining. However, gastric tissue H. pylori detection rate was lower in the younger age groups. Anti-H. pylori IgG antibodies were detectable in 96% of 107 patients. Conclusion: Chronic gastroduodenitis and anti-H. pylori IgG antibody were ubiquitous in children with upper gastrointestinal symptoms.

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Comparison of longitudinal treatment effects with facemask and chincup therapy followed by fixed orthodontic treatment on Class III malocclusion (상악전방견인장치와 이모장치 및 고정식 교정장치 치료를 받은 III급 부정교합 환자의 치료효과에 대한 종단적 비교)

  • Lee, Nam-Ki;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.39 no.6
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    • pp.362-371
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    • 2009
  • Objective: The purpose of this study was to compare the longitudinal treatment effects of facemask with rapid maxillary expansion (FM/RME) and chincup (CC) therapy followed by fixed orthodontic treatment (FOT) in Class III malocclusion (CIII) patients. Methods: The samples consisted of twenty-one CIII patients who had similar skeletal and dental characteristics before FM/RME or CC therapy and good retention results (Class I molar/canine relationship and positive overbite/overjet) after FOT (Group 1, FM/RME, n = 11; Group 2, CC, n = 10). Lateral cephalograms were taken before (T0) and after FM/RME or CC therapy (T1), and after FOT and retention (T2). Skeletal and dental variables were measured. Mann-Whitney U-test and Wilcoxon signed-rank test were used for statistical analysis. Results: During T0-T1, FM/RME therapy induced forward movement of point A, and labioversion of the upper incisors. Both groups showed posterior repositioning of the mandible. FM/RME resulted in increase of the vertical dimension; however, CC caused an increase in articular angle and decrease in gonial angle. During T1-T2, both groups exhibited forward growth of point A. Group 1 showed forward growth and counterclockwise rotation of the mandible and increase of IMPA; however, Group 2, showed increase of ANS-Me/N-Me and decrease of overbite. Conclusions: The key factor for successful FM/RME and CC therapy and good retention results might be a harmonized forward growth of the maxilla that could keep pace with the growth and rotation of the mandible.

THE STUDY ABOUT THE CHANGES OF MASTICATORY SYSTEM SUBSEQUENT TO RANDOMLY INCREASING THE VERTICAL DIMENSION (교합고경의 인위적인 증가에 따른 저작계의 반응에 관한 연구)

  • Kim, Nam-Jung;Lee, Sung-Bok;Choi, Dae-Gyun;Park, Nam-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.33 no.4
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    • pp.731-752
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    • 1995
  • This study was performed to research the changes of masticatory system subsequent to randomly increasing the vertical dimension. The subjects were twenty seven persons, twenty two men and five women, with a mean age of 24.3(age ranged from 22 to 26). The subjects had a complete or almost complete set of natural teeth and reported no subjected symptoms of pain or dysfunction in the masticatory system. The occlusal splint increased vertical dimension was made on semiadjustable articulator. The subjects were randomly divided to three groups according to the vertical dimension, at which the occlusal splint was made. Group I occlusal splints were made at 2mm form the occlusal vertical dimension, group II occlusal splints at 5mm, group III occlusal splints at 8mm. The occlusal splints were almost weared for 2 weeks except meal-time. Clinical examination, muscle activity, changes of free-way space, movement of mandible and articular condyle were recorded and analyzed by means of biopak system(Bioresearch Inc, Millwakee Wisconsin.) and radiograph. 1. In clinical examination, various symptoms were reported by all subjects immediately after the placement of occlusal splint. At the end of experiment, symptoms were lasted by 1 subject in Group I, 2 subjects in Group II, 6 subjects in Group III. At the other subjects, the most of symptoms were disappered within 2-4 days after the placement of occlusal splints. 2. The average free-way space before the startof experiment was 1.77mm in all twenty seven subjects. Immediately after the placement of occlusal splints, 0.67mm at Group I, 0.49mm at Group II, 0.41mm at Group III, At 2 weeks after the placement of occlusal splint 0.93mm, 0.79mm, 0.78mm each other, 1.94mm, 1.77mm, 2.3 mm at immediately after the removal of occlual splint. At 1 week after the removal of occlusal splint, free-way space was recovered to the pre-experimental state 3. In cephalometric radiograph, following either the placement or the removal of the occlusal splints, the movements of mandible in an antero-posterior direction were not statistically significant(p>0.05). 4. In transcranial radiograghs of TMJ, 1 week after the placement of occlusal splint the movement of most superior position on condyle in all group shoed antero-inferior position than before the experiment(p<0.001) and also showed antero-inferior position in mandibular postural rest position than in certric occlusion(p<0.001). Following either the placement or the removal of the splints, the amount of movement of most superior position on condyle was group III. group II and group I in order(p<0.001). 5. In anterior temporal and superficial masseter muscle, muscle activity at postural rest position decreased at 2 weeks after the placement of occlusal splint in group I and group II (p>0.05), but significantly increased in group III(p<0.001). At 1 week after the removal of the occdusal splint, muscle activity at postural rest position was recovered preconditional state 6. In anterior temporal and superficail masseter muscle, muscle activity at clenching in all group was significantly decreased after placement of the occlusal splint, slightly increased during experimental period and recovered to the original state at 1 week after removal of the occlusal splint. But was not statistically significat(p>0.05)s.

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Use of Discriminant Analysis to Identify Soil Quality Variation by Land Use (판별분석을 이용한 토지이용별 토양 특성 변화 연구)

  • Ko Kyung-Seok;Kim Jae Gon;Lee Jin-Soo;Kim Tack Hyun;Lee Gyoo Ho;Cho Choon Hee;Oh In Suk;Cheong Young Wook
    • Economic and Environmental Geology
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    • v.38 no.3 s.172
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    • pp.207-219
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    • 2005
  • The physical and chemical characteristics of soils in a small watershed were investigated and the effect of geology and land use on soil quality were examined by using multivariate statistical methods, principal components analysis and discriminant analysis. The soil developed from andesite had finer texture and higher contents of water extractable inorganic components, clay, and mafic minerals than the soil developed from granite. It is considered that the accumulation of salts in the farmland soils indicated by electrical conductivity, contents of cations and anions and pH was caused by fertilizer input during cultivation. The low contents of organic matter in the farmland soils was due to the enhanced oxidation of organic matter by tillage and by the harvest of crops. The contents of inorganic components are increased as following order: upland > orchard > paddy field > forest. The high contents of water soluble $SO_4\;^{2-}$ of paddy soils is due to the oxidation of sulfides mineral formed during the flooding period during the air-dry and extraction. The results of principal components analysis show the difference of soil quality was controlled by geology and land use. PCI indicate the input of fertilizer, mineral weathering and ion exchange reaction by application of nitrogenous fertilizers. The results of two discriminant analyses using water extractable inorganic components and their ratios by land use were also clearly classified by discriminant function 1 and 2. In discriminant analysis by components, discriminant function 1 indicated the effect of fertilizer application and increased as following order: upland > orchard > paddy field > forest soil. The investigated and predicted data for land use from discriminant analysis showed similar results. The discriminant analysis can be used as a useful method certifying the change of land use.

MR Evaluation of Tendinous Portions in the Subscapularis Muscle (견갑하근의 건 부분에 대한 자기공명영상을 이용한 분석)

  • Shon, Min-Soo;Koh, Kyoung-Hwan;Lee, Sung-Sahn;Yoo, Jae-Chul
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.35-45
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    • 2011
  • Purpose: The purpose of this study was to document the structural features of the tendinous portions within the non-pathologic subscapularis muscle by performing high resolution MR imaging of the shoulder. Materials and Methods: Between April 2007 and May 2010, we retrospectively obtained the MR scans of 88 consecutive young patients (88 shoulders) who were in their twenties. MRI and MR arthrography were performed using a 3.0-T system for the evaluation of glenohumeral instability and nonspecific shoulder pain. None of the patient in this study had any evidence of injury to the tendon or muscle belly of the subscapularis. On MR images, we recorded the transverse length of a stout tendinous band and the total tendinous portion of the subscapularis. In addition, we recorded the number of intramuscular tendinous slips of the susbscapularis. Results: The mean transverse length of the tendinous band was 15.0 mm (range: 8 to 20 mm). The mean transverse length of the total tendinous portion was 48.9 mm (range: 40 to 60 mm). The number of intramuscular tendinous slips on the base of the glenoid fossa was 3 in 20 (22.72%), 4 in 45 (51.14%) and 5 in 23 shoulders (26.14%). On the lateral portion, the intramuscular tendinous slips became gradually rounder and thicker and they gave converge in the superior direction. Conclusion: In this study, the structural features of the tendinous portions of the subscapularis on the MR scans were identified. This will in return give good justification for the lines to be pulled during biomechanical stimulation and also for the surgical approach to restore the biomechanical function.

The Study of Standardization of Temperature Distribution of Interstitial Hyperthermia -In Phantoms and Living cat's brain tissue (Normal Tissue)- (915 MHz 극초단파 자입온열시 온도분포 적정화에 관한 연구 -조직등가물 및 가묘대뇌를 대상으로-)

  • Kyoung Hwan Koh;Cho Chul Koo;Park Young Hwan;Yoo Seong Yul;Kim Jong Hyun;Lee Seung Hoon
    • Radiation Oncology Journal
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    • v.8 no.1
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    • pp.7-15
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    • 1990
  • The ultimate objective of our experiment is to obtain the precise distribution of temperature in malignant tumors occurring in cerebral parenchyme of human beings when we will carry out interstitial hyperthermia in the near future. To achieve this purpose, first of all, it is necessary to make an attempt at performing interstitial hyperthermia in vivo under the similar condition of human beings. Therefore, we chose cats as materials much alike tissue characteristics of human beings. Moreover, it is also necessary to get the basic data from dynamic phantom in order to standardize and compare results obtained from interstitial hyperthermia carried out in cats. By having performed these experiments we got the following results. 1) On doing interstitial hyperthermia with 915 MHz microwave, the possible treated volume was 2 cm by 2 cm by 6 cm according to $50\%$ specific absorption rate (SAR). 2) The distribution of temperature within non-circulated static phantom was much the same as power density in air, but we observed that the temperature, within $5\~10$ minutes, rose to more higher than $55^{\circ}C$ not measured with Ga-As fiberoptic thermistor which was not impeded by microwave after performing interstitial hyperthermia. 3) Within dynamic phantom in which normal saline was circulating, temperature reached steady state which was maintained for more than 45 minutes through transit period in 5 minutes after starting interstitial hyperthermia. 4) When we interrupted circulation in the dynamic phantom, we observed that temperature rose to the same level as in the static phantom. 5) We could carry out interstitial hyperthermia safely when we used the generating power below 5 watts. Abrupt interruption of circulation caused a rapid increase in temperature. Times taking to rise to maximum $55^{\circ}C$ were 15.2 minutes (SE 0.4),9.7 minutes (SE 0.3), and 6.3 min-utes (SE 0.4) respectively with generating powers of 5,10, and 15 watts.

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Primary Radiation Therapy of Malignant Salivary Gland Tumors by Conventional Megavoltage Irradiation -Korea Cancer Center Hospital- (악성 타액선 종양의 방사선 치료 성적에 대하여 -원자력 병원의 10년 경험 ($1975.1{\sim}1984.12$)-)

  • Cho Chul Koo;Koh Kyoung Hwan;Yoo Seong Yul;Park Young Hwan;Park Woo Yoon;Shim Young Sang;Oh Kyung Kyoon
    • Radiation Oncology Journal
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    • v.8 no.1
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    • pp.35-43
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    • 1990
  • Retrospective analysis of survival rates was undertaken in the patients of 58 cases treated with conventional radiation therapy for malignant salivary gland tumors between January 1975 and December 1984 in Korea Cancer Center Hospital (KCCH). They were patients whose long-term follow-up was possible and who had refused surgery or had had recurrences postoperatively. Out of 58 patients, 25 patients ($43.1\%$) had mucoepidermoid carcinomas and 24 patients ($41.3\%$) adenoid cystic carcinoma. Total actuarial survival rates at 5 years and 10 years were $68.2\%\;and\;31.8\%$ respectively, but disease-free survival rates, $43.2\%\;and\;13.0\%$, respectively. According to TNM stage, the survival rates at 5 years were $86.5\%$ in $T_1,\;40.0\%\;in\;T_2+T_3,\;and\;0\%\;in\;T_4$. In terms of histologic types, 5 years disease-free survival rate of adenoid cystic carcinomas ($40.1\%$) was lower than that of mucoepidermoid carcinomas ($49.8\%$) but overall survival rate ($77.3\%$) was much higher than that of mucoepidermoid carcinomas ($51.5\%$). There-fore, we concluded that the patients, who had had disease after failure of treatment, could survive during a certain period of time and their alive times were 2 years on the average. There was a difference in survival rates in the mucoepidermoid carcinomas in terms of histological grade of differentiation and it was a arbiter in prognosis: 5 YSR of low-grade was $78.8\%$ and higher 2 times than that of high-grade. There was no difference in survival rates according to location and sex. The number of patients having minor salivary gland tumors was 6 cases and their actuarial 5 YSR was $32.3\%$. Consequently, prognostic factors which influence the survival rates of patients with malignant salivary gland tumors are thought to be 1) histological subtypes 2) T and N staging (AJCC) 3) histological grade, especially in mucoepidermoids.

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Combined Effects of Gamma-irradiation and Hyperthermia on the Human Cell Lines for Various Temperatures and Time Sequences (감마선과 온열치료 병용시 세포 치사 능력 증강에 관한 실험적 연구)

  • Koh Kyung Hwan;Cho Chul Koo;Park Woo Yoon;Yoo Seong Yul;Yun Hyong Geun;Shim Jae Won;Lee Mi Jung
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.51-58
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    • 1993
  • We tried to establish the theoretical basis of clinical use of combined modality of hyperthermia and radiation therapy. For this purpose, we made an in vitro experiment in order to get the synergistic and/or additive effects on the cell killing of hyperthermia combined with radiation therapy by using the microwave-hyperthermia machine already installed at our department. In our experiment, we use two human cell lines: MKN-45 (adenocarcinoma of stomach) and K-562 (leukemia cell lines). In cases of combined treatments of hyperthermia and gamma-irradiation, the therapeutic effect was the highest in the simultaneous trial. Hyperthermia after gamma irradiation showed slightly higher therapeutic effect than that before irradiation without significant difference, but its effect was the same in the interval of 6 hours between hyperthermia and irradiation. The higher temperature and the longer treatment time were applied, the higher therapeutic effects were observed. We could observe the thermoresistance by time elapse at $43^{\circ}C$. When hyperthermia was done for 30 minutes at the same temperature, thermal enhancement ratio (TER) at DO. 01 (dose required surviving fraction of 0.01) were $2.5{\pm}0.08,\;3.75{\pm}0.18$, and $5.0{\pm}0.15\;at\;436{\circ}C,\;44^{\circ}C,\;and\;45^{\circ}C$ respectively in K-562 leukemia cell lines. Our experimental data showed that more cell killing effect can be obtained in the leukemia cell lines, although they usually are known to be radiosensitive, when treated with combined hyperthermia and radiation therapy. Furthermore, our data show that leukemia cell lines may have various intrinsic radiosensitivity, especially in vitro experiments. The magnitude of cell killing effect, however, will be less than that of MKN-45.

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Frequency of Micronuclei in Lymphocytes Following Gamma and Fast-neutron Irradiations (방사선 조사량에 따른 인체 정상 림파구의 미세핵 발생빈도)

  • Kim Sung-Ho;Cho Chul-Koo;Kim Tae-Hwan;Chung In-Yong;Yoo Seong-Yul;Koh Kyoung-Hwan;Yun Hyong-Geun
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.35-42
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    • 1993
  • The dose response of the number of micronuclei in cytokinesis-blocked (CB) lymphocytes after in vitro irradiation with $\gamma$-rays and neutrons in the 5 dose ranges was studied for a heterogeneous population of 4 donors. One thousand binucleated cells were systematically scored for micronuclei. Measurements performed after irradiation showed a dose-dependent increase in micronuclei (MN) frequency in each of the donors studied. The dose-response curves were analyzed by a linear-quadratic model, frequencies per 1000 CB cells were ($0.31{\pm}0.049$)D+($0.0022{\pm}0.0002)D^2+(13.19{\pm}1.854) (r^2=1.000,\;X^2=0.7074,\;p=0.95$) following $\gamma$ irradiation, and ($0.99{\pm}0.528$)\;D+(0.0093{\pm}0.0047)\;D^2+(13.31{\pm}7.309)\;(r^2=0.996,\;X^2=7.6834,\;p=0.11) following neutrons irradiation (D is irradiation dose in cGy). The relative biological effectiveness (RBE) of neutrons compared with $\gamma$-rays was estimated by best fitting linear-quadratic model. In the micronuclei frequency between 0.05 and 0.8 per cell, the RBE of neutrons was $2.37{\pm}0.17$. Since the MN assay is simple and rapid, it may be a good tool for evaluating the $\gamma$-ray and neutron response.

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