• Korean Journal of Adult Nursing
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• v.17 no.2
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• pp.298-309
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• 2005

Purpose: The purpose of this study was to investigate the effect of a comprehensive rehabilitation program on grip strength, pinch strength, the shoulder joint function, flexibility, and fatigue in mastectomy patients. Method: The subjects were fifty-five women with breast cancer (27 in the control group and 28 in the experimental group). The subjects in the experimental group participated in a comprehensive rehabilitation program for 10 weeks, which was composed of education, stress management, exercise, and peer support group activity. Results: The results revealed that the increase in grip strength, key pinch, the shoulder joint function, and flexibility (Back & Reach test, Standing & Bending reach test) of the operated extremity, and the decrease in fatigue were significantly higher in the experimental group than in the control group. However, the results revealed that tip strength and palmar pinch of the experimental group increased but there was no significant difference from that of the control group. Conclusions: The 10-week comprehensive rehabilitation program showed much affirmative effect on physical function, and fatigue of breast cancer patients after mastectomy.

• Asian Oncology Nursing
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• v.2 no.1
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• pp.72-82
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• 2002

Purpose : To observe changes in side effects and fatigue of the cancer patients receiving radiation therapy on the head/neck and the chest over a period from the start to the end of the therapy, and to analyze correlation between side effects and fatigue. Method : Twenty seven patients receiving radiation therapy 5 days per week for longer than 6 weeks participated in the present study. Fatigue was measured for when healthy, before-, and after-therapy. Side effects was surveyed by structured questionnaire on the last day of each therapy. Result : The results of this study were as follows. 1. Major side effects of the head/neck patients were skin irritation, change of taste, sore throat and xerostomia, while the chest patients experienced fatigue, skin irritation, anorexia, difficulty swallowing and cough increased with therapy. 2. Although fatigue was significantly changed for when healthy and before-therapy (F=60.25, p <.05) and also for before- and after-therapy, no statistical significance was demonstrated in fatigue of both the chest head/neck patients (p> .05). 3. Fatigue and side effects showed high correlation form the 4-th week with after the therapy Conclusion : The present results could be of great use to develop systematic intervention technique, leading to practical help for patients, since side effects and fatigue change to a large degree depending on the disease and the timing and technique of the therapy.

• Journal of the Korean Data and Information Science Society
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• v.26 no.6
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• pp.1327-1334
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• 2015

Cancer pain is a very important factor in cancer patients refractory to drop the quality of life of cancer patients. The worldwide trend is an integrated effort by both the western medicine and korean traditional medicine of treatment increases to reduce cancer pain. There are many studies related to cancer pain through an integrated medicine approach. Many study was reported that acupuncture treatment is effective for fatigue, xerostomia, insomnia, anxiety and quality of life. However, despite the practical clinical effects and various case reports of acupuncture, many still disagree about the significance of an integrated treatment of pain reduction with acupuncture. Therefore, we has identified that reduce effect of comprehensive and integrative treatment using acupuncture for cancer pain through publication review. And we evaluated effect of comprehensive and integrative treatment using acupuncture through summary of values in each publication.

• Proceedings of the Korean Journal of Food and Nutrition Conference
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• 1997.06b
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• pp.8-10
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• 1997

종양은 아직 그 발생 원인과 기작이 정확히 밝혀져 있지 않으므로 정확한 정의를 내리는 것은 어려우나 일반적으로 종양이란 정상 세포가 갖고 있는 세포 분열의 특이성을 상실하여 일어나는 조직의 자율적인 과잉 성장을 말한다. 이와 같은 세포의 비정상적인 증식에 의한 종양을 임상 및 병리 형태학적으로 양서 종양과 악성종양으로 분류한다. 양성 종양을 일으키는 종양 세포는 정상 세포와 비슷할 뿐 아니라 그 주변 세포들과 확실한 경계를 이루고 있으며 증식도 느리며 다른 부위로의 전이가 없다. 이에 반해 악성종양은 일반적으로 증식도 빠르고 이형의 세포로서 주변의 조직으로 확산, 전이될 뿐만 아니라 최종적으로 숙주인 개체를 사망시킨다. 악성종양은 다시 상피 조직에서 유례한 암, 비상피 조직에서 유래된 육종, 백혈구에서 유래된 백혈병 등으로 구별하지만 그의 본질은 거의 같으며 모든 악성종양은 통속적으로 암이라고 불리운다. 종양의 발생원인으로 크게 3가지로 나눌 수 있는데 화학물질, 바이러스 및 유전적 요인에 의한 것으로 알려졌다. 최초의 발암물질로 알려진 benzopyrene에 의한 발암 등 연구에 의해 화학적 발암원들은 직접 발암 물질로 작용하는 것이 아니라, 일단 체내에서 대사된 후 이들 대사 산물일 DNA 등에 작용함으로써 발암이 유도 되는 것으로 밝혀졌다. 이와 같이 화학적 변화를 거친 후에야 DNA에 영향을 미치는 것외에 다른 화학물질들은 또 다른 기작을 통해 암을 유발하는데 쥐의 피부에 benzopyrene을 한 번 처리하면 암을 유발하지 않으나 여기에 phorbol ester를 처리하면 높은 빈도로 암이 형성된다. 여기서 benzopyrene과 같이 세포의 DNA에 돌연변이를 일으키는 작용을 하는 발암물질을 발암개시제라 하고 phorbol ester처럼 그 자체로는 발암능이 없으나 발암개시제에 노출된 세포에 영향을 미쳐 발암능을 크게 강화시켜 주는 것을 발암촉진제라고 한다. 암은 세포증식 제어계에 DNA가 이상을 일으킨 현상을 말하는 데 이와 같은 DNA의 변형된 유전정보에 의해 암과 관련된 단백질을 합성하므로 이 DNA를 암유전자라 부르며 바이러스에서 유래된 것을 V-one 그리고 세포에서 유래된 것을 c-one이라 한다. 암유전자는 본래 암을 형성하기 위한 것이 아니라 증식제어 유전자로서 변이나 비정상으로 활성화 됨으로써 암을 유발시키므로 proto-oncogene이라 부른다. 또한 고등동물의 유전자 중에는 세포성장을 억제하는 유전자들이 있으며 이들은 세포의 성장 생존 분화를 조절하는 것으로 생각되고 있다. 따라서 이들 유전자는 세포의 암변형을 억제하는 기능을 가지고 있다. 이들 유전자의 이상으로 세포성장 억제기능이 상실되면 세포의 과잉 성장이 초래되면 결과적으로 암으로 유발하는 것으로 추측되고 있다. 최근의 연구에 의하면 암세포에서 암억제 유전자의 이상과 암유전자의 활성화가 함께 발견 되면서 정상세포가 암으로 변형되는 과정에는 암억제 유전자의 이상과 암유전자의 활성화가 동시에 관여한 가능성이 높은 것으로 알려져 있다. 정상 세포가 암을 유발하기 위해서는 발암의 다단계설에서와 같이 여러 단계의 변과가 필요한데 여러 가지 요인에 의해 정상세포의 염색체가 변화되어 정상세포들이 가지고 있는 세포분열의 특이성을 상실하고 증식이 빠르고 저항력이 강한 세포가 선택 되어지고 비정상 서ㅔ포으 과잉 분여러에 의해 종양이 형성되며 이어서 혈관의 신생을 촉진하는 맥관형성, 전이 등이 과정을 거쳐 신체의 다른 부위로 전이된다. 20세기 초까지는 암은 노화와 함께 자연발생적으로 일어나는 피할 수 없는 질병으로 여겨졌으며 그 치료도 조기에 발견된 암환자에게 외과적인 치료를 하는 것이 최선의 방법 이었다. 그러나 현재에는 암환자의 80% 이상이 환경적 요인에 의해 암이 발생 된다고 믿어지고 있다. 과거 치료에 중점을 둔 것에서 점차 예방의 가능성과 그 방법의 모색에 관심을 갖게 되었으며 치료적인 면에서도 외과적 수술 이외에 방사선 치료, 항암제의 투여 등 약물요법, 면역요법의 이용 이외에 더 나아가 gene theraph 및 tumor vaccines 개발에 대한 관심도 증가되고 있다. 국제암연구협회에서는 인간에게 발암이 가능한 물질의 종류를 정기적으로 발표하고 있는데 지금까지 발암 가능성이 높다고 널리 알려진 위험요인을 크게 나누어 보면 다음과 같다. 흡연, 음주, 식이요인, 호르몬 및 기타 요인으로 약물, 자외선 등을 들 수 있는데 현재까지 이들 요인에 의한 발암 기작이 완전히 규명된 것은 아니지만 이들에 의한 발암의 확률이 높다는 것은 사실이므로 이 위험요인에 노출되는 것을 방지함으로써 암발생을 예방할 수 있을 것이다. 암발생의 예방법으로는 암발생 자체를 예방하는 것과 이미 발생한 암환자를 조기 발견하고 치료하는 방법이 있을 수 있다. 현재까지의 여러 연구 결과들을 보면 유전적인 요인을 제외한 대부분의 발암 위험인자들은 개개인의 생활습관과 밀접히 관련되어 있음을 알 수 있다. 이를 바탕으로 1992년 대한 암협회에서는 '암 예방 14개 권장 사항'을 발표하여 국민 홍보활동을 하고 있는데 그 내용의 반 이상이 식생활 습관과 관련되어 있을 정도이므로 암예방에 있어서의 식품의 역할이 매우 크다 할 수 있다. 따라서 건전한 생활습관과 더불어 적절한 식품의 섭취는 암예방을 위한 기본이 될 것이다.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.946-948
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• 2006

The patient was a 42-year-old female with breast cancer who had an implantable central venous catheter inserted percutaneously into left subclavian vein for chemotherapy. The postinsertion chest x ray revealed that there was no compressive sigh of catheter. Three months after insertion of the catheter, the patient was admitted to the hospital for 4th chemotherapy. The port was accessed but blood could not be aspirated and the catheter could not be flushed. A chest x ray revealed that the catheter was completely transected at the point where the catheter passed under the clavicle. Percutaneous removal of the distal fragment of the catheter was accomplished. The patient was discharged after successful removal of fragment of catheter.

• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.4
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• pp.165-178
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• 2018

Objectives: To determine the current status of the treatment of breast cancer patients by Korean Medicine doctors (KMDs) and to examine the need for clinical practice guidelines (CPGs) for the supportive care of these patients. Methods: This cross-sectional study used a self-administered questionnaire. Participants were asked about their experience in treating breast cancer patients; the number of breast cancer patients they currently treat; the main complaints expressed by, diagnoses of, and treatments used for such patients; and their opinions about Korean Medicine (KM) as the basis for providing supportive care for breast cancer. Results: The data for this study were collected from 322 respondents. 84 of whom reported having ever treated patients with breast cancer. Most breast cancer patients who visited the KM clinic were classified as stage I or II, and their major complaints were fatigue, general weakness and musculoskeletal pain. The major diagnostic strategies were syndrome differentiation and pulse diagnosis. The major treatments administered were herbal medicine, acupuncture, and moxibustion. KMDs cited a need for medical information, such as CPGs, as their most important concern with regard to the treatment of breast cancer patients. Conclusions: This survey determined the prevalence of the use of KM for Korean breast cancer patients. Our results underscore the need for clinical practice guidelines for using of KM as the basis of supportive care for breast cancer and for informing clinicians and patients about this approach.

• Journal of Korean Academy of Nursing
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• v.34 no.5
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• pp.809-819
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• 2004

Purpose: The purpose of this study was to investigate the effect of a comprehensive rehabilitation program on physical function, immune response, fatigue and quality of life in mastectomy patients. Method: The subjects included fifty-five patients with breast cancer (27 in the control group and 28 in the experimental group). The subjects in the experimental group participated in a comprehensive rehabilitation program for10 weeks, which was composed of 1 session of education, 2 sessions of stress management, 2 sessions of exercise, and 1 session of peer support group activity per week. Result: The results revealed anincrease in shoulder extension, abduction, external rotation, and internal rotation of the affectedupper extremity, and in shoulder extension and abduction of the healthy upper extremity. Also an increase in quality of life and a decrease in fatigue were significantly higher in the experimental group than the control group. However, the results revealed that the natural killer cell ratio of the experimental group increased but there was no significant difference from that of the control group. Conclusion: The 10-week comprehensive rehabilitation program showed a large affirmative effect on physical function, fatigue and quality of life of breast cancer patients after a mastectomy.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.65-71
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• 2018

Purpose : Standardized pillow may not support patient's individual cervical spine thoroughly when head and neck radiation therapy with $Tomotherapy^{(R)}$. Therefore, the purpose of this study was to make a comparative analysis for the difference of using standardized pillow only and using customized cervical spine immobilizer with standardized pillow. Materials and Methos : The head and neck cancer patients who are treated image-guided radiation therapy(IGRT) with $Tomotherapy^{(R)}$ were divided into two groups, 20 patients using standardized pillow only, and 20 patients using customized cervical spine immobilizer with standardized pillow. We achieved 20 mega-voltage computed tomography(MVCT) image per patient, compared curvature of the cervical spine in MVCT with curvature of the cervical spine in CT-simulation. Results : Results of comparative analysis were curvature consistency 95.9 %, maximum error of distance 41.9 mm, average distance error per fractionation 19.4 mm, average standard deviation 1.34 mm in case of using standardized pillow only, curvature consistency 98.9 %, maximum error of distance 12.9 mm, average distance error per fractionation 5.8 mm, average standard deviation 0.59 mm in case of using customized cervical spine immobilizer with standardized pillow. Conclusion : Using customized cervical spine immobilizer shows higher reproducibility and low distance error, therefore customized cervical spine immobilizer could be useful for head and neck cancer patients who need radiation therapy.

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.216-222
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• 2014

Purpose: This study was performed to identify the symptoms and care needs of home-based cancer patients in Korea and to add to the scarce literature on this topic. Methods: Data were collected from patients who subscribed to home-based cancer care services in Jinju. Assessments were performed by nurses at the local public health center. The Edmonton Symptom Assessment System with a numeric rating scale (NRS) was used to identify symptoms, and a four-point Likert scale was used to assess psychological, social, and spiritual needs. Results: Cross-sectional data were collected in October 2013. A total of 209 patients participated and their median age was 65 years (range, 17~89 years). Most patients were diagnosed in the early stage of cancer (n=188); only 19 patients were diagnosed in the advanced stage. More than half the patients lived alone (n=115, 55.0%) and took care of themselves (n=128, 61.2%). Anorexia and fatigue were the most common symptoms (median NRS, 5 and 4, respectively). Patients needed economic support the most, whereas spiritual care was least needed (n=138 [67.3%] vs. n=128 [62.1%], respectively). Conclusion: Patients who signed up for home-based cancer care services in Jinju are struggling with a financial issue and physical symptoms. A customized approach is needed to improve the quality of the home-based care services.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.131-136
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• 2013

Purpose: Quantitative comparative evaluation of the difference in eye lens absorbed dose when measured by MVCT and kV-CBCT, though such a dose was not included in the original IMRT treatment plan for the nasopharyngeal cancer patient. Materials and Methods: We used CT (Lightspeed Ultra 16, General Electric, USA) against an Anderson rando phantom (Alderson Research Laboratories Inc, USA) and established the plan for tomotherapy treatment (Tomotherapy, Inc, USA) and linear accelerator treatment (Pinnacle 8.0, Philips Medicle System) for the achieved CT images on the same condition with the nasopharyngeal cancer patient treatment plan. Then, align the ther-moluminescence dosimeter (TLD100 Harshaw, USA) with the eye lens, shot the lens with Tomotherapy MVCT under 3 conditions (Fine, Normal, and Coarse), and shot both lenses with kV-CBCT under 2 conditions (Low Dose Head and Standard Dose Head) 3 times each. Results: When we analyzed the eye lens absorbed dose according to MVCT and kV-CBCT images by using both Tomotherapy and Pinacle 8.0, we achieved the following result; According to Tomotherapy MVCT, RT 0.8257 cGy in the Coarse mode, LT 0.8137 cGy, RT 1.089 cGy and LT 1.188 cGy in the Normal mode, and RT 2.154 cGy and LT 2.082 cGy in the Fine mode. According to Pinacle 8.0 kV-CBCT, RT 0.2875 cGy and LT 0.1676 cGy in the Standard Dose mode and RT 0.1648 cGy and LT 0.1212 cGy in the Low-Dose mode. In short, the MVCT result was significantly different from that of kV-CBCT, up to 20 times. Conclusion: We think kV-CBCT is more effective for reducing the amount of radiation which a patient is receiving during intensity modulated radiation treatment for other purposes than treatment than MVCT, when we consider the absorbed dose only from the viewpoint of image-guided radiation therapy. Besides, we understood the amount of radiation is too sensitive to the shooting condition, even when we use the same equipment.