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Cancer of the Hypopharynx (하인두암)

  • Seel David John;Chung Sung-Min;Park Yoon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.65-70
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    • 1987
  • 하인두암은 거의 대부분 이상동(Pyriform Sinus) 에서 발생하며 상당한 정도 진행 시까지 별다른 증상을 나타내지 않는다. 저자들은 1966년부터 1985년까지 만 20년간 하인두에서 발생된 암환자 63명을 중심으로 임상 관찰 및 문헌고찰과 함께 발표하는바이다. 원발병소로는 전체 중 58명에서 이상동, 하인두벽(hypopharyngeal wall) 3명, Postcricoid hypopharynx 와 pharyngopalatine fold 에서 각각 1명씩의 발생빈도를 보였다. 저자들은 설저(base of tongue)암, supraglottic Ca. 및 경부 식도(cervical esophagus)암 경우는 모두 제외시켰다. 임상증상으로서는 경부 종괴(lump)가 33 예로써 가장 현저했으며 또한 첫증상으로써 연하곤란(dysphagia) 또는 sore throat를 나타낸 경우는 32 예 이었다. 그 외에 hoarseness 가 20 예, bloody sputum 4 례 및 호흡곤란 2 예의 순이었다. 내원까지의 증상기간은 대부분 $4{\sim}6$ 개월 이었다. 흡연관계는 1일 1값 이상의 중등도 흡연 경우는 전체의 58% 이었으며 흡연 사실이 있었던 경우는 전체의 88% 이었다. 연령별 발생빈도는 50대$\sim$60대에서 48명으로서 현저히 높았다. 완치 목적의 수술적 치료는 24명에서 시행하였으며 치료 거절은 16명이었다. 치료 거절하였던 환자들 중 81% 가 임상적 제 4 병기였으며 보조적 치료 요법을 실시한 환자들의 78% 에서 제 4 병기였다. 또한 완치 목적의 치료 실시 경우의 67% 에서 제 4 병기였다. 수술요법은 일반적으로 "후두 인두 적출술 및 양측 경정맥 임파군 곽청술"(laryngopharyngectomy with bilateral jugular dissection) 또는 후두 인두 적출술 및 동측의 표준 광범위 경부 곽청술(standard radical neck dissection) 과 반대측의 경정맥 임파군 곽청술을 시행하였다. 3 년 이내와 3 년 이상무병 상태(free of disease) 경우가 각각 4명씩이었다. 마지막 예후 추적 조사시까지 무병 상태였던 환자를 포함하여 예후 추적 조사기간 중 추적 실패 경우는 7명이었다. 확정된 3 년 생존율(determinate 3-year survival rate) 은 31% 이었다. 수술 사망이 1명 있었으며 재발경우는 9 명이었다. 재발부위로는 원발병소 재발이 7명, 경부 재발 1명 및 원격전이가 1명 이었으며, 저자들은 이에 대한 실패 원인을 규명코져 하였다.

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The Use and Understanding of Keyword Searching in SELIS Online Public Access Catalogs (SELIS OPAC에 있어서 키워드탐색의 이용과 이해)

  • Koo Bon-Young
    • Journal of the Korean Society for Library and Information Science
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    • v.33 no.2
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    • pp.119-139
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    • 1999
  • It Is the purpose of this research to analyse users' understanding how keyword and boolean search work in SELIS(SEoul Women's University Library and Information System) OPAC. Results of analyses of the subject, SELIS OPAC system processing, are: comprehension percentage of keyword extraction is $67(22.48\%)$ out of total 298 persons, no comprehension is $231(77.52\%)$ understanding of boolean OR In keyword search appears $115(22.48\%)$ out of 297, no understanding does $182(77.52\%)$ : comprehension of boolean AND is $98(33.11\%)$ out of 296, no understanding appears $198(66.89\%)$ understanding of using boolean and symbols is $109(36.49\%)$ out of 285, no understanding is $181(63.51\%)$ which Is lower percentage generally. And in SELIS OPAC system, in Intentional analyses to see any difference in understanding of keyword search between experience of keyword search or no, It shows no difference in interrelation $5\%$ level of significance, but In boolean search it does in interrelation $5\%$ level of significance.

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Named Entity and Event Annotation Tool for Cultural Heritage Information Corpus Construction (문화유산정보 말뭉치 구축을 위한 개체명 및 이벤트 부착 도구)

  • Choi, Ji-Ye;Kim, Myung-Keun;Park, So-Young
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.9
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    • pp.29-38
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    • 2012
  • In this paper, we propose a named entity and event annotation tool for cultural heritage information corpus construction. Focusing on time, location, person, and event suitable for cultural heritage information management, the annotator writes the named entities and events with the proposed tool. In order to easily annotate the named entities and the events, the proposed tool automatically annotates the location information such as the line number or the word number, and shows the corresponding string, formatted as both bold and italic, in the raw text. For the purpose of reducing the costs of the manual annotation, the proposed tool utilizes the patterns to automatically recognize the named entities. Considering the very little training corpus, the proposed tool extracts simple rule patterns. To avoid error propagation, the proposed patterns are extracted from the raw text without any additional process. Experimental results show that the proposed tool reduces more than half of the manual annotation costs.

Forest Fire in the safety of local residents aware analysis (산불피해지역 주민들의 안전성에 대한 인식분석)

  • Yeom, Chan-Ho;Lee, Si-Yeong;Gwon, Chun-Geun
    • Proceedings of the Korea Institute of Fire Science and Engineering Conference
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    • 2013.11a
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    • pp.105-105
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    • 2013
  • 본 연구는 산불피해 후 주민들의 시설물 안전성에 대한 인식을 분석하기 위하여 2013년 3월 9일부터 10일 이틀 동안 280ha의 산림 피해면적과 57동의 시설물 피해를 입은 울주산불지역과, 79ha의 산림피해와 111동의 시설물 피해를 입은 포항산불지역의 주민들을 대상으로 산불피해 후 시설물에 대한 안전성과 당시 격었던 심리상태를 알아보고자 울주 주민 60명, 포항 주민 60명 총 120명에 대하여 설문조사를 실시하였다. 조사항목은 일반현황, 산림 내 주요시설 및 주변 안전성 인식, 교육훈련에 대한 인식, 심리상태에 대해 4개의 항목으로 조사한바, 일반형황으로는 120명중 28명(23.3%)을 제외한 92(76.7%)명이 산불을 1~2회 이상 목격했으며, 24명(20%)이 산불 진화에 참여하였고, 41~60세가 66명(55%)으로 가장 많은 것으로 나타났다. 현재 거주하고 있는 건물은 콘크리트 가옥이 84명(70%)으로 가장 많았고, 현재 거주하고 있는 곳의 안전성에 대해서는 68명(56.7%)이 '안전하지 않다'고 인식하였다. 또한, 가옥주변 가연물질 관리 상태는 57명(47.5%)이 관리가 '잘 되어 있지 않다'고 인식하였다. 또한, 산불발생 대응 피난 및 교육훈련의 필요성에 대한 5점 척도 분석결과 4.2점으로 교육훈련이 필요하다고 인식하고 있었고, 필요한 교육훈련 과목으로는 산불피난대응훈련이 44명(36.7%)으로 가장 높은 비율을 나타냈다. 또한, 산불경험 후 심리적 불안에 대한 5점 척도 분석결과 4.0점으로 불안을 느끼고 있었고, 산불발생 후 느끼는 고통으로는 불면증, 불안감, 상실감, 혼란감, 신경과다 중 불안감이 89명(65.0%)으로 가장 높은 비율을 나타냈다.

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The Use of Analgesics in the Last 24 hours of Life of Patients with Advanced Cancer : A Comparison of Medical Physicians and Surgeons (말기 암 환자의 마지막 24시간 동안 진통제 사용의 분석 : 내과의사와 외과의사의 비교)

  • Choi, Youn-Seon;Kim, Jong-Min;Lee, Young-Mee;Lim, Jong-Kuk;Lee, Tai-Ho;Hong, Myung-Ho
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.47-55
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    • 1998
  • Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

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Radiotherapy in Incompletely Resected Gastric Cancers (불완전 절제된 위암의 방사선 치료)

  • Kim Jong Hoon;Choi Eun Kyung;Cho Jung Gil;Kim Byung Sik;Oh Sung Tae;Kim Dong Kwan;Chang Hyesook
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.17-25
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    • 1998
  • Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

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CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH PERVASIVE DEVELOPMENTAL DISORDER (입원한 전반적발달장애 소아청소년의 임상특성)

  • Pyo, Kyung-Sik;Bahn, Geon-Ho;Hong, Kang-E;Park, Tae-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.237-246
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    • 1998
  • Objectives and Methods:This study investigated clinical characteristics, treatment modality, outcome of 57 children and adolescent inpatients(male 53, female 4) who were diagnosed as pervasive developmental disorder(PDD) by DSM-Ⅳ criteria recent five years. Results:1) The mean age at admission was $96{\pm}28.2$ months, and the mean age at which they first visited treatment facility was $52{\pm}26.6$ months. The mean hospitalization period was $43.7{\pm}31.3$ days. 2) Diagnosis:Twenty-seven(47.4%) of subjects met DSM-Ⅳ criteria for PDD NOS. Fifteen (26.3%) met for autistic disorder, nine(15.8%) met for Asperger's syndrome, and two(3.5%) met for childhood disintegrative disorder. 3) Comorbid diagnosis:The most common comorbid dignosis was attention deficit hyperactivity disorder(23.8%). 4) IQ test:IQ test for twenty-eight subjects was possible. The Average of the subjects was $70{\pm}27.5$. Fifteen(53.6%) of the subjects were approximate or under 70. 5) Neurology Abnormality:EEG findings of eleven(21.2%) subjects were abnormal, brain CT or MRI findings of eight subjects(21.6%) were abnormal. 6) Family Hx:Depressive disorder were found in Eight mothers(14%). Familial loading was found in twenty families(35.1%), and familial loading of PDD was found in three(5.3%). Conclusion:The most important thing for the management of PDD is early detection and early treatment. To do so, multidisciplinary team approach should be emphasized.

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An Epidemiologic Study of Kawasaki Disease(1987-2000) : Incidence of Coronary Artery Complication in the Acute Stage (가와사끼병의 역학적 연구(1987-2000년) : 관상 동맥 이상을 중심으로)

  • Lee, Kyung-Yil;Park, Min-Young;Han, Ji-Whan;Lee, Hyung-Shin;Choi, Jin;Whang, Kyung-Tai
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.783-789
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    • 2002
  • Purpose : We evaluated the epidemiologic characteristics and incidence of coronary artery sequele of children with KD according to treatment. Methods : We retrospectively analyzed 506 medical records of children with KD, who were admitted at Daejeon St. Mary's Hospital from Jan. 1987 to Dec. 2000. Results : The mean annual incidence was $36.1{\pm}11.1$ cases per year. There was a slightly higher occurrence in summer with no significant difference in monthly incidence. The mean age was $2.4{\pm}1.7$ years and 450 children(88.9%) were below four years of age. The male to female ratio was 1.7 : 1. When the 345 cases between 1987 and 1994 were divided into three groups according to treatment, incidences of the coronary abnormality(above grade II) of aspirin-treated(54 cases; 15.6%), divided-intravenous immunoglobulin(IVIG) treated($400-500mg/day{\times}4-5days$, 224 cases; 64.9%), and one-dose IVIG treated(2.0 g/day, 67 cases; 19.5%) groups were 8.3%, 6.0%, and 7.5%, respectively. Between 1995 and 2000, 143 cases were treated with only one-dose IVIG and 21 cases(14.7%) showed coronary artery abnormalities(grade I, 15 cases; grade II, two cases; and grade III, four cases). Among the 143 cases, 22 cases(15.1%) were retreated with IVIG and/or steroid pulse therapy. The incidence of coronary artery abnormality in this group was 50.0%. Incidences of cases in recurrence and among siblings were 0.6% and 0.4% respectively. There was no fatal case. Conclusion : In Daejeon, Korea, the epidemiologic feature of KD showed slight annual variations without monthly differences. The incidence of coronary abnormality with one-dose IVIG therapy was 14.7%. The nonresponse of this therapy was 15.1% with a coronary abnormality of 50.0%.

The alteration of the positive rate of cytomegalovirus IgG antibody among preschool period children (학령 전기 소아에서 거대세포바이러스 IgG 항체 양성률의 변동)

  • Seo, Se-Young;Park, Sang-Jun;Hwang, Ja-Young;Hahn, Seong-Hoon;Kim, So-Young;Kim, Hyun-Hee;Lee, Wonbae
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.51-55
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    • 2006
  • Purpose : In order to evaluate the time of disappearance of cytomegalovirus(CMV) IgG antibodies from mothers, and the alteration of the positive rate of CMV IgG antibodies among preschool period children, we investigated the positive rate of CMV antibodies among preschool children. Methods : We studied 391 children who visited the Department of Pediatrics from March, 2001 to February, 2004. We measured the serum CMV IgG of 217 children and the serum CMV IgM of 358 children. Results : The positive rate of CMV IgG antibodies is 83.9 percent(the number of positive IgG children is 182 out of 217). The alteration of the positive rate is 92.9 percent in 0-3 months, 75.0 percent in 4-6 months and the nadir was 20.0 percent in 7-9 months. Then, the positive rate increased to 83.9 percent in 22-24 months. After 22 months, the positive rate was 92.1 percent(the number of positive IgG children was 105 out of 114). The positive rate of CMV IgM antibody by age is 3.3 percent in 0-1 months, 3.6 percent in 1-2 months, 10.5 percent in 2-3 months, 14.3 percent in 3-4 months, 14.3 percent in 4-5 months, and then the results of five children among 148 children were positive. The distribution was one in 22-23 months, one in 25-26 months, one in 27-28 months, one in 28-29 months, one in 40-41 months. We discovered IgM positive children succesively from birth to 5 months, but sporadically after 5 months. Conclusion : The CMV IgG from mothers has decreased since birth and the time of nadir is 7-9 months. But it increases to a mean value of 83.9 percent at 22-24 months because of perinatal or postnatal infections.

Efficacy of Neoadjuvant Chemotherapy and Radiotherapy for the Histology-confirmed Intracranial Germinoma - Preliminary Report (조직학적으로 확진된 두개내 배아종의 전보조화학요법 후 방사선치료의 성적 - 예비적 결과)

  • Noh, Young-Ju;Kim, Hak-Jae;Heo, Dae-Seog;Shin, Hee-Yung;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.93-99
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    • 2002
  • Purpose : We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. Materials and Methods : Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. Results : The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia In 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. Conclusion : A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.