Journal of the Korea Society of Computer and Information
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v.29
no.6
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pp.167-173
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2024
In this paper, we propse a quantitative research by investigating the subcutaneous tissue elasticity by using ultrasonography in lymphedema patients after breast cancer surgery. Lymphedema patients who took breast cancer operation were included. Thickness of subcutaneous tissue was assessed at two spots; 10cm below elbow (forearm) and 10cm above elbow (upper arm), not only in affected side but also in sound side. By using probe attached to real-time pressure sensor, stress-strain curves were obtained. We defined tissue elasticity as slope of that curve at range of 7.5~15% of strain to avoid toe region. By comparing the elasticity of normal side and that of affected side, lymphedema tissues were classified into 'softer' and 'harder' tissues. Overall 30 cases of lymphedema tissues and 30 cases of sound tissues were checked. The difference of the elasticity between normal and affected side ranged from -3.98 N/m2 to 1.40 N/m2. The lymphedema tissues were classified into 17 softer tissues and 13 harder tissues. No demographic and clinical values, including clinical stage of lymphedema, showed statistically meaningful differences between two groups. Evaluation of subcutaneous tissue elasticity with ultrasonography and real-time pressure sensor could be one of the useful tools for investigation of lymphedema tissue characteristics.
Journal of agricultural medicine and community health
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v.49
no.2
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pp.102-110
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2024
Objective: This study evaluated the health behavior level of urological cancer survivors after surgery. Understand the experience of change and identify the factors that affect it for health. Selection of the best intervention steps and effective intervention adopt a lifestyle. It is intended to contribute to the creation of basic data for development of guidelines. Methods: The study was conducted with patients diagnosed with urological cancer at a hospital in Seoul. Study data were obtained by having 100 patients who agreed to the study self-fill out a questionnaire through interviews, and the 2018 World Cancer Research Fund and American Institute for Cancer Research Score (2018 WCRF/AICR SCORE) was used to estimate the level of health behavior. Results: The study examines health behavior among urolgical cancer survivors based on the 2018 WCRF/AICR SCORE. Higher household income and younger age were associated with better health behavior scores, with those under 60 and earning over 3 million won being more likely to have higher scores. Conclusion: Based on these results, this study requires comprehensive data collection considering the missing variables, suggesting that high household income and young age can positively affect healthy behavior. In addition, we conclude that education for cancer survivors and development of strategies to bridge the health gap for low-income and elderly populations are necessary.
Brain injury causes persistent disability in survivors, and epidural hematoma(EDH) and subdural hematoma (SDH) resulting from cerebral hemorrhage can be considered one of the major clinical diseases. In this study, we attempted to automatically segment and hematomas due to cerebral hemorrhage in three dimensions based on computed tomography(CT) images. An improved GVF(gradient vector flow) algorithm was implemented for automatic segmentation of hematoma. After calculating and repeating the gradient vector from the image, automatic segmentation was performed and a 3D model was created using the segmentation coordinates. As a result of the experiment, accurate segmentation of the boundaries of the hematoma was successful. The results were found to be good even in border areas and thin hematoma areas, and the intensity, direction of spread, and area of the hematoma could be known in various directions through the 3D model. It is believed that the planar information and 3D model of the cerebral hemorrhage area developed in this study can be used as auxiliary diagnostic data for medical staff.
Purpose : Radiotherapy is effective in local treatment for retinoblastoma. However, asymmetric facial hypoplasia after radiation is a serious late effect. This study was performed to investigate the effects of enucleation and chemotherapy with or without radiotherapy in advanced intraocular and intraorbital retinoblastoma. Methods : Between 1985 October and 2006 December, the records of thirty five patients who were diagnosed as retinoblastoma at Yeungnam University Hospital were reviewed. Advanced intraocular and intraorbital retinoblastoma patients classified as Reese-Ellsworth group III, IV, and V and Grabowski- Abramson class II were selected for the study. Results : Eighteen patients were enrolled in this study. All patients were enucleated and had received chemotherapy. Nine patients received radiotherapy and nine patients didn't receive radiotherapy. Tumor cells were found on resection margin of optic nerve in five of nine patients who received radiotherapy, but none of nine who didn't receive radiotherapy. Chemotherapy included vincristine, adriamycin, cyclophosphamide, VM-26, cisplatin before 2001, and vincristine, etoposide, and carboplatin after 2001. There were no recurrences or metastases in nine patients who didn't receive radiotherapy. But two of nine patients who received radiotherapy had metastases to brain. However, all survivors who received radiotherapy had significant facial asymmetry. Conclusion : In advanced intraocular and intraorbital retinoblastoma without tumor cell on resection margin of optic nerve, enucleation and chemotherapy without local radiotherapy appears to be safe for long-term survival. However, in those with tumor cells on resection margin of optic nerve, enucleation and chemotherapy with local radiotherapy seems to be necessary to improve survival.
Rhee, Chin Kook;Joo, Young Bin;Kim, Seok Chan;Park, Sung Hak;Lee, Sook Young;Koh, Yoon Seok;Kim, Young Kyoon
Tuberculosis and Respiratory Diseases
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v.62
no.5
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pp.389-397
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2007
Background B-type natriuretic peptide (BNP) has been shown to be strong mortality predictors in a wide variety of cardiovascular syndromes. Little is known about BNP in patients with acute respiratory distress syndrome (ARDS). We studied whether BNP can predict mortality in patients with ARDS. Method Echocardiographic study was done to all patients with ARDS, and we excluded patient with low ejection fraction (less than 50%) or showing any features of diastolic dysfunction. 47 patients were enrolled between December, 2003 and February, 2006. Parameters including BNP were obtained within 24h hours at the time of enrollment. Result Mean BNP concentrations and APACHE II scores differed between the survivors and nonsurvivors (BNP, $219.5{\pm}57.7pg/mL$ vs $492.3{\pm}88.8pg/mL$; p=0.013, APACHE II score, $17.4{\pm}1.6$ vs $23.1{\pm}1.3$, p=0.009, respectively). With the use of the threshold value for BNP of 585 pg/mL, the specificity for the prediction of mortality was 94%. The threshold value for APACHE II of 15.5 showed sensitivity of 87%. 'APACHE II + $11{\times}logBNP$' showed sensitivity 63%, and specificity 82%, using threshold value for 46.14. Conclusion BNP concentrations and APCHE II scores were more elevated in nonsurvivors than survivors in patients with ARDS who have normal ejection fraction. BNP can predict mortality. Further study should be done.
Jang, Gi Young;Kim, Sun Young;Moon, Joo Ryung;Huh, Joon;Kang, I-Seok;Park, Seung Woo;Jun, Tae Gook;Park, Pyo Won;Lee, Heung Jae
Clinical and Experimental Pediatrics
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v.46
no.7
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pp.661-667
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2003
Purpose : This study was performed to find the chief clinical problems associated with the ages of adult patients of tetralogy of Fallot(TOF) who had undergone total correction. Methods : Of the 30 patients who were registered at the Grown-Up Congenital Heart Disease (GUCH) Clinic of Samsung Medical Center for TOF, a retrospective investigation was carried out on 28 patients who underwent total correction. Results : Mean age at retrospective study was 30.8(range : 16-53) years old. Age at total correction was 15.8(range : 2-49) years old. Problems after corrective surgery were assessed. They were arrhythmia, pulmonary valve regurgitation, left pulmonary artery stenosis, residual ventricular septal defect, mitral valve regurgitation, tricuspid valve regurgitation, right ventricle outflow tract obstruction, aortic valve regurgitation, infective endocarditis and protein losing enteropathy. After repair of TOF, such arrhythmias as atrial arrhythmia and AV conduction disturbances were observed in some patients. Cardiomegaly was found significantly in the subjects with arrhythmia(P<0.05), and arrhythmia was less observed in patients who underwent surgery at a young age. Eight patients required a reoperation; the main indications were residual ventricular septal defect, right ventricle outflow tract obstruction and peripheral pulmonary artery stenosis. Conclusion : The majority of the patients seemed to live normal lives after Tetralogy of Fallot repair. However, as residual anatomic and functional abnormalities exist postoperatively, continued careful follow-up is needed to detect and correct structural and functional abnormalities.
Background: To evaluate the risk factor and long-term result of arterial switch operation , a retrospective study was done. Material and Method: A retrospective analysis was done to evaluate the early and long-term results on 58 patients who underwent an arterial switch operation(ASO) for transposition of the great arteries(TGA) with intact ventricular septum, between January 1988 and December 1996. Beforesurgery, 36 patients(62.1%) underwent balloon atrial septostomy, 32 patients(51.7%) received PGE1 infusion, and preparatory banding of pulmonary artery was performed on 6 patients(mean LV/RV pressure ratio 0.53$\pm$0.11). Result: The age at operation ranged from 1 to 137 days(mean 24$\pm$26 days) and the weights ranged from 1.8 to 6.8 kg (mean 3.5$\pm$0.8 kg). There were 14 early deaths(24.1%), but of the last 24 patients operated on since 1994, there were only 2 early deaths(8.3%). In the risk factor analysis, the date of operation was the only risk factor for early death(p-value < 0.01). Eight of the 14 early deaths were due to acute myocardial failure(mainly inadequate coronary blood flow). The length of follow-up ranged from 2 months to 8 years, average of 36$\pm$27 months. The follow-up included sequential noninvasive evaluations and 21 catheterizations and angiographic studies performed 5 to 32 months postoperatively with particular attention to the great vessel and coronary anastomosis, ventricular function, valvular competence, and cardiac rhythm. There were 5 late deaths(11.4%), one of thesedeaths was related to the late coronary problems, two to aspiration, one to uncontrolled chronic mediastinitis, and one to progressive aortic insufficiency and heart failure. The most frequent postoperative hemodynamic abnormality was supravalvular stenosis and the degree of pulmonary or aortic obstruction had slowly progressed in some cases, however there were no children who had to undergo a reoperation for supravalvular pulmonary or aortic stenosis. Aortic regurgitation was identified in 9 patients, which was mild in 7 and moderate in 2 and had progressed in some cases. Two patients who had an unremarkable perioperative course were identified as having coronary artery obstructions. The other late survivors were in good condition, were in sinus rhythm, and had normal LV functions. Actuarial survival rate at 8 years was 68.8%. Conclusion: We concluded that anatomic correction will be established as the optimal approach to the TGA with intact ventricular septum, though further long-term evaluations are needed.
Purpose: The purpose of this study was to evaluate the impact of the use of external radiation therapy (ERT) in terms of survival and compliance in patients with anaplastic thyroid carcinoma. Materials and Methods: The medical records of 17 patients with anaplastic thyroid carcinoma treated with ERT between 1993 and 2002 were retrospectively reviewed. ERT was administered after surgery in 14 patients and after a biopsy in three patients. Among the 14 patients who had undergone surgery, nine underwent a curative resection and five underwent a palliative resection. Six patients had associated well-differentiated thyroid carcinomas and 14 patients were diagnosed with a tumor size exceeding 5 cm. The radiation dose ranged from $6{\sim}70\;Gy$ (median dose, 37.5 Gy). Eleven patients completed the planned course of ERT, whereas six patients did not. The follow-up period ranged from $1{\sim}104$ months (median, 5 months; mean, 20 months). Results: Five patients started the ERT without the presence of a gross mass and all of the patients competed ERT without a re-growth of tumor. Twelve patients (four patients after a curative resection, five patients after a palliative resection and three patients after a biopsy) started ERT with a gross mass present and only six patients were able to complete the planned course of ERT. Among the six patients who completed ERT, two patients showed a marked regression of the tumor mass, whereas two patients showed slight regression and two patients showed no response. The median survival was five months (range, $1{\sim}104$ months) and the mean survival was 21 months. The overall survival was 41% at 1-year, 24% at 2-years and 12% at 5-years. Significant prognostic factors included the number of primary tumors present, tumor size, whether surgery was performed and completion of ERT as planned. Long-term survivors showed a tendency of having smaller sized initial tumors and smaller sized pre-ERT tumors than the short-term survivors. Conclusion: This study suggests that patients with a small initial tumor (${\leq}5\;cm$), which was treated by surgery (curative resection or palliative resection) before ERT, and without rapid re-growth of the mass seen at the surgical site at the beginning of the ERT course, would be the best candidates for postoperative ERT. In contrast, patients with a large initial tumor (>5 cm) and did not undergo surgery before ERT or that rapid re-growth of the mass was observed at the surgical site are likely to have a short survival time, along with the interruption of ERT. In these cases, the role of ERT is very limited and the omission of ERT could be considered.
This paper analyzes the religious circuit of suicidal concept based on verbal expression and ritual acts, which are found in the suicide discourse of Korean Catholic Church and Protestant Church. In the relationship of suicide and religion, it is easily overlooked the religious circuit and its construction that forms the concept of suicide among the religious laymen. It is assumed that the belief system of traditional religions prohibits suicide and the laymen accordingly construct a perception or concept of suicide along with this belief system. Various studies on this subject have proved it. However, in order to understand the religious way of constructing the concept of suicide on a personal level, it is necessary to pay attention to the religious environment in which the concepts and emotions of suicide circulate. The laymen do not passively and perfectly accept the finely established suicide concept provided by the doctrine or the theology. Rather, the laymen tend to collect the pieces of concept over the suicide that are drifting in the religious environment of his/her daily routine life and to make an concept of suicide in an incomplete form. We can find the unstable and imperfect traits of such a suicide concept through the experience of suicide survivors who have a religious background. For the suicide survivors with religious beliefs, they resist the formal doctrinal and theological provisions to suicide, or try to understand the notion of suicide in their own contexts. In terms of linguistic expressions and ritual acts relating to suicide, the attentions are differently directed in the public and the private domain among the religious groups. Considering on the high rates of suicide in Korean society, the Korean Catholic Churches are increasingly tolerant over the suicide and accept it in the public sphere. It is unlikely when comparing to the negative attitudes of the suicide in the past. However, such tolerance does not go beyond the doctrinal and ethical judgment that defines suicide as a serious sin. The once-committed lay believer's speech and gestures usually contain the various emotions, such as sadness, grief, anxiety, regretfulness, eagerness, and pain in the private spheres. The language and gestures with these emotions have been activated in the religious circuits of suicide, being extended to the religious apparatus for the person who died of suicide. In case of Protestantism, the institutional organizations, such as the particular denominations and the individual-churchism of the Korean Protestant Churches, and their own interpretations of the Bible have in the private sphere strongly effected on the linguistic expressions and the rituals related to the suicide. The religious-ethical judgment of the suicide is varied how the suicide is interpreted by the theologians and the pastors. And the ritual acts for healing the complex feelings and the psychological wounds of the suicide survivors are not actively explored and adopted yet. It makes harder to approach and heal the protestant followers since they emphasize the innermost belief and the salvation assurance faith.
The study was to provide basic data and to examine the effect of combined exercise for 12 months on functional fitness and bone mineral density (BMD) in breast cancer survivors. The subjects of this study were 40 to 60-year-old married women (N=24) who finished their treatments chemotherapy and radiation therapy. They were divided into two groups that exercise group and exercise with alendronate group. Eighteen (T-score=$-2.2{\pm}0.8$) of the 24 women who were diagnosed osteopenia (N=15) and osteoporosis (N=3), participated in combined exercise (EG). The other six (T-score=$-4.6{\pm}0.9$) women who were diagnosed as osteoporosis (EDG), participated in the combined exercise program with osteoporosis drug (Alendronate 70 mg/w). The result of the analysis was as follows: Twelve months after, the participants (N=24) had a significant increase of the items such as sit and reach ups, grip strength (R and L) and sit ups test of functional fitness in the periods. In body composition, FM (fat mass) had significant decrease in periods. In the comparison of BMD, EG (N=18) had no change, while EDG (N=6) had significant improvement in L1, T12 and T-score after 12months. Consequently, complex exercise program (Hatha yoga, elastic band, gym ball) had positive effect on functional fitness and bone mineral density. We suggest that complex exercise program can be applied as recovery program after breast cancer surgery. Further research needs various and repetitive studies from more different targets or methods in the exercise program for its improvement.
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