• Title/Summary/Keyword: 임상통계

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Genotoxicity of Therapeutic Dose of $^{131}I$ Analyzed by Micronuclei Test in the Mouse Bone Marrow (생쥐골수세포 미소핵검사에 의한 치료용량 방사성옥소($^{131}I$)의 유전독성 평가)

  • Bom, Hee-Seung;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.112-117
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    • 1993
  • Background Radioiodine ($^{131}I$), a major component of nuclear fallout and a valuable therapeutic agent for thyrotoxicosis and thyroid cancer, has been regarded as a mutagen or a carcinogen without any convincing evidence. To evaluate the genotoxicity of radioiodine ($^{131}I$) we performed a micronuclei test in mice bone marrow. Materials and methods : Mice (ICR strain, $25{\sim}30 g$) were divided to 4 groups: control, group 1 (0.17 mCi/kg, usual therapeutic dose for thyrotoxicosis), group 2 (1.67 mCi/kg, usual therapeutic dose for thyroid cancer), and group 3 (16.67 mCi/kg, usual accumulated dose causing bone marrow suppression). $^{131}I$ was administered intraperitoneally. Ten mice of each group were sacrificed at days 1 and 3. Bone marrow were smeared and stained with May-Grunwald Giemsa method. One thou-sand polychromatic erythrocytes (PCE) and normochromatic erythrocytes (NCE) were counted under the light microscope, and the number of micronucleated PCEs were recorded. Results : The frequency of micronuclei in PCE (and NCE in parenthesis) in the control group was $0.25{\pm}0.07$ ($0.23{\pm}0.07$)% in day 1 and $0.24{\pm}0.07$ ($0.21{\pm}0.07$)% in day 3. Those in group 1 was $0.27{\pm}0.1$ ($0.23{\pm}0.09$)% in day 1 and $0.28{\pm}0.07$ ($0.25{\pm}0.06$)% in day 3. Micronuclei was noted in $0.29{\pm}0.08$ ($0.26{\pm}0.09$)% in day 1 and $0.31{\pm}0.05$ ($0.29{\pm}0.06$)% in day 3 in group 2, and in $0.32{\pm}0.06$ ($0.25{\pm}0.09$)% in day 1 and $0.33{\pm}0.08$ ($0.3{\pm}0.06$)% in day 3 in group 3. There was no difference in the frequency of micronuclei between each groups (p> 0.05). Conclusion : Radioiodine ($^{131}I$) did not cause any genotoxicity in mice bone marrow even at the large dose (16.67 mCi/kg).

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Usefulness of F-18 FDG PET/CT in Adrenal Incidentaloma: Differential Diagnosis of Adrenal Metastasis in Oncologic Patients (부신 우연종에서 F-18 FDG PET/CT의 유용성: 악성 종양 환자에서 부신 전이의 감별진단)

  • Lee, Hong-Je;Song, Bong-Il;Kang, Sung-Min;Jeong, Shin-Young;Seo, Ji-Hyoung;Lee, Sang-Woo;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.5
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    • pp.421-428
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    • 2009
  • Purpose: We have evaluated characteristics of adrenal masses incidentally observed in nonenhanced F-18 FDG PET/CT of the oncologic patients and the diagnostic ability of F-18 FDG PET/CT to differentiate malignant from benign adrenal masses. Materials and Methods: Between Mar 2005 and Aug 2008, 75 oncologic patients (46 men, 29 women; mean age, $60.8{\pm}10.2$ years; range, 35-87 years) with 89 adrenal masses incidentally found in PET/CT were enrolled in this study. For quantitative analysis, size (cm), Hounsfield unit (HU), maximum standardized uptake value (SUVmax), SUVratio of all 89 adrenal masses were measured. SUVmax of the adrenal mass divided by SUVliver, which is SUVmax of the segment 8, was defined as SUVratio. The final diagnosis of adrenal masses was based on pathologic confirmation, radiologic evaluation (HU<0 : benign), and clinical decision. Results: Size, HU, SUVmax, and SUVratio were all significantly different between benign and malignant adrenal masses.(P < 0.05) And, SUVratio was the most accurate parameter. A cut-off value of 1.0 for SUVratio provided 90.9% sensitivity and 75.6% specificity. In small adrenal masses (1.5 cm or less), only SUVratio had statistically significant difference between benign and malignant adrenal masses. Similarly a cut-off value of 1.0 for SUVratio provided 80.0% sensitivity and 86.4% specificity. Conclusion: F-18 FDG PET/CT can offer more accurate information with quantitative analysis in differentiating malignant from benign adrenal masses incidentally observed in oncologic patients, compared to nonenhanced CT.

$^{18}F$-FDG PET/CT in Patients with Initially Diagnosed Adenoid Cystic Carcinoma of the Head and Neck: Clinicoplathologic Correlation (처음 진단된 두경부 선양낭성암종에서 $^{18}F$-FDG PET/CT: 임상상 및 병리소견과의 상관성)

  • Lee, Ji-Young;Choi, Joon-Young;Ko, Young-Hyeh;Baek, Chung-Hwan;Son, Young-Ik;Cho, Suk-Kyong;Cheon, Mi-Ju;Lee, Kyung-Han;Kim, Byung-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.5
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    • pp.395-401
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    • 2009
  • Purpose: We evaluated $^{18}F$-FDG PET/CT findings in initially diagnosed adenoid cystic carcinoma (ACC) of the head and neck in association with pathological subtype, staging, uptake comparison with squamous cell carcinoma (SqCC) and prognosis. Materials and Methods: The subjects were 16 patients with initially diagnosed ACC of head and neck who underwent pretreatment $^{18}F$-FDG PET/CT. Histological subtype (solid pattern vs. tubular/cribriform pattern), $SUV_{max}$ of size-matched SqCC of the head and neck as control group, disease-free survival (DFS) were compared with the $SUV_{max}$ of ACC of the head and neck. Results: Of total 16 patients, 6 had solid pattern and the remaining 10 had tubular/cribriform pattern. The $SUV_{max}$ were significantly higher in solid pattern group than in tubular/cribriform pattern group ($6.7{\pm}3.2$ vs. $4.2{\pm}0.9$, p=0.03). PET/CT found unexpected distant metastasis in 18.7% of patients (3/16) and changed the therapeutic plan in those patients. The $SUV_{max}$ of ACC was significantly lower than that of size-matched SqCC ($5.1{\pm}2.4$ vs. $13.6{\pm}6.0$, p<0.001). DFS was not significantly different according to the histological subtype. In contrast, patients with high $^{18}F$-FDG uptake ($SUV_{max}$ ${\geq}$6.0) had significantly shorter DFS than those with low $^{18}F$-FDG uptake ($SUV_{max}$ <6.0). Conclusion: $^{18}F$-FDG uptake of ACC of the head and neck is significantly associated with histological subtype and DFS. $^{18}F$-FDG PET/CT may be useful for detecting unexpected metastasis. Since $^{18}F$-FDG uptake of tubular/cribriform ACC compared with SqCC is relatively low, it is necessary to interpret PET images carefully in patients without alleged ACC.

Efficacy of Nutritional Therapy in Children with Crohn Disease (소아 크론병에서 영양 치료의 효과)

  • Suh, Hyun Ah;Kim, Sung Eun;Jang, Joo Young;Kim, Bong Jin;Kim, Joon Sung;Lee, Sun Youn;Chang, Soo Hee;Kim, Kyung Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.210-217
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    • 2006
  • Purpose: Crohn disease (CD) in children is frequently complicated by malnutrition and growth retardation. Conventional treatment with corticosteroid may also affect the growth of children, which may be alleviated by nutritional therapy. Therefore, we performed this study to evaluate the role of nutritional therapy in the treatment of CD in children. Methods: The study cohort consisted of thirty children under the age of 17 years, admitted to the Asan Medical Center from 2001 to 2005. While 11 children received nutritional therapy (NT) with an elemental diet, 19 received conventional corticosteroid therapy (ST). Comparative analysis was performed for the rate of the induction of remission, recurrence, disease activity index of pre and post-treatment, and changes of the growth using mean standard deviation score for weight (zW) and height (zH). Results: Ten of 11 children with NT and 18 of 19 children with ST completed the therapy. Two of them were lost to follow-up during the treatment. All 10 children with NT and 15 of 18 children with ST achieved remission. While there was no recurrence in children with NT, 7 with ST showed recurrence within 1 year. Pre- and post treatment Pediatric Crohn disease Activity Index (PCDAI) did not show a difference between the two groups. There were no differences in zW and zH between the two groups after 1 year of follow-up. Conclusion: This study showed that nutritional therapy could be considered instead of steroid therapy for treatment of children with CD. However, a long-term study will be needed to determine the long-term efficacy.

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The Comparison between High Dose and Low Dose Morphine in Terminal Cancer Patients During the Last 1 Week to Death (고용량과 저용량의 몰핀을 쓰는 말기 암 환자에서 임종 1주일동안 비교)

  • Cho, Doo-Yeoun;Cha, Kyu-Jin;Yoon, Bang-Boo;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.5 no.1
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    • pp.24-30
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    • 2002
  • Background : Pain is one of the most feared consequences of cancer. $65{\sim}85%$ of cancer patients experienced severe pain, and sometimes high dose morphine is used to these patients. But many doctors still have 'opioid-phobia' and hesitate to use high dose morphine. We investigated the morphine therapy in terminal cancer patients during the last 1 week to death, and found any differences according to the morphine dosage. Methods : 93 patients admitted to National Health Insurance Corporation Ilsan Hospital, department of family medicine for hospice care between September 2000 and the end of October 2001 and lived more than 1 week entered in the study. We investigated the demographic data, laboratory tests and sufficient dosage of morphine for pain control. According to the calculated dosage by OME(oral morphine equivalent), patients were divided into low dosage group (${\leq}150mg/day$) and high dosage group (>150 mg/day). The chi-squared test were used to evaluate the influence of age, gender, tumor sites, metastasis and adverse effects of morphine. Results : Mean age was $65.0{\pm}13.1year$ in low dosage group and $59.9{\pm}11.6year$ in high dosage group. 32 men (50.0%) and 32 women (50.0%) were included in low dosage group and 15 men (51.7%) and 14 women (48.3%) in high dosage group. Stomach was the most frequent tumor site and lung was the next. Metastasis were found 58 (90.6%) in low dosage group and 28 (96.6%) in high dosage group. In other palliative radiotherapy and adverse effects, there were no differences in both group. Conclusion : During the last 1 week to death in cancer patients, there were no difference according to the morphine dosage. So we don't have to have 'opioid-phobia' in treating the terminal cancer patients.

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Retrospective study on survival rate of 2158 osseointegrated implants placed in 770 patients in Sanbon dental hospital of Wonkwang University (원광대학교 산본치과병원에서 770명의 환자에 식립한 2158개의 골유착성 임플란트의 보철 전 초기 생존율에 관한 후향적 연구)

  • Seon, Hwa-Gyeong;Chee, Young-Deok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.4
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    • pp.278-288
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    • 2014
  • Purpose: The aim of the study was to evaluate preprosthetic initial survival rate and factors associated with survival of osseointegrated implants placed in edentulous area of maxilla and mandible and to suspect the possible causes leading to failure. Materials and Methods: A total of 2158 endosseous implants that had been inserted between 2004 through 2013 were placed in 770 patients. The clinical comparisons were performed to evaluate implant loss in relation to age and gender of patients, position, system, length and diameter of implant, and bone graft technique. Results: According to position, the survival rates were 98.23% in maxillary anterior site, 96.98% in maxillary posterior site, 97.85% in mandibular anterior site and 98.76% in mandibular posterior site (P < 0.05). According to diameter of implant, the survival rates were 100% under 3.0 mm, 97.09% between 3.0 to 3.5 mm, 98.19% between 3.5 to 4.0 mm and 98.29% between 4.0 to 4.5 mm but relatively lower survival rate was 75% in 5.0 mm-over (P < 0.05). The survival rates of implants were 89.51%, 98.28%, 98.34% and 99.27% in the group with isolated sinus graft, with isolated GBR, with sinus graft and GBR simultaneously and without bone graft, especially (P < 0.05). Conclusion: This study establishes a relationship between survival rate of implant and position, diameter of implant system and bone graft technique. In conclusion, there were low survival rates in maxillary posterior site, in dental implants with wide diameter of 5 mm-over, and in the group with isolated sinus graft.

Therapeutic Effect of Prednisolone in Tuberculous Pleurisy -A prospective study for the prevention of the pleural adhesion- (결핵성 흉막염에서 프레드니솔론의 치료효과 -흉막유착 발생에 대한 전향적 연구-)

  • Lee, Byoung-Hoon;Jee, Hyun-Suk;Choi, Jae-Chul;Park, Yong-Bum;An, Chang-Hyeok;Kim, Jae-Yeol;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.481-488
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    • 1999
  • Background: The routine application of the combined regimen of corticosteroid-antituberculosis therapy to the tuberculous pleurisy remains controversial. Steroid therapy to tuberculous pleurisy could be effective on the acceleration of absorption of pleural effusion and symptom improvement, but there has been debate about the effect of prednisolone on the prevention of pleural adhesion. So we studied the efficacy of combined regimen of prednisolone-antituberculosis therapy on the absorption of pleural effusion and prevention of pleural adhesion. Method: A prospective, randomized study was performed in 82 patients, 50 patients(non-steroid group) were treated with only antituberculosis regimen for 6 months and in 32 patients(steroid group) prednisolone(30mg/day) were administered in addition to antituberculosis regimen for one months and tapered for another month. The amount of pleural effusion was compared at the beginning of treatment, 2nd month, 6th month and final visit with chest X-ray findings which were graded from grade 0(complete absorption) to grade 6(near total haziness). Results: The amount of pleural effusion of steroid group at 2nd month, 6th month and final visit was lesser than that of non-steroid group(P<0.05). The incidence of the complete absorption of the pleural effusion was 3/32(9.4%) in steroid group, 1/50(2%) in non-steroid group at 2nd month after treatment; and 12/32(37.5%) in steroid group, 6/50(12%) in non-steroid group at 6th month after treatment(P<0.05). At final observation, the incidence of residual pleural thickening was 15/32(47%) in steroid group and 37/50(74%) in non-steroid group(P<0.05). No serious side effects were noted during the treatment with prednisolone. Conclusion: The administration of prednisolone in conjunction with antituberculosis chemotherapy improved the absorption of pleural effusion and decreased the residual pleural thickening.

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Bone Conduction Loss in Chronic Otitis Media (만성중이염에서의 골도장애)

  • 김종선;김시영
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.3.2-3
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    • 1979
  • Bone conduction loss is one of the most common complication in chronic otitis media, and is mostly high frequency loss. Of 233 tympanomastoidectomy ears, 187 ears were considered eligible for this study. A histopathological change was examined in the natural otitis media of guinea pigs. It is our intention to analyze the pattern of bone conduction loss in chronic otitis media, and to correlate this findings with clinical and pathological changes in human and animal otitis media. l) In unilateral cases, a significant difference in bone conduction threshold was observed between normal and diseased ears, and between each frequency with significant interaction between 2KHz and 4KHz (p 0.01). 2) Using one way analysis of variance, mean bone conduction was compared with the duration of disease. We observed a significant difference (p 0.05) between each group of duration, except between 11-15 and 15-20 years group. 3) A comparison of bone conduction between stapes loss group and intact stapes group revealed significant t ratio (p 0.01) at each frequency. The effect of stapes loss on each frequency was evaluated, using one way analysis of variance. there were significant difference(p 0.05) between 250Hz and 500Hz. and between 2KHz and 4KHz. 4) A comparison of bone conduction between round window obliteration and nonobliteration group revealed significant t ratio (p 0.01) at each frequency. Using one way analysis of variance. the effect of round window obliteration was evaluated in each frequency. We observed significant difference (p 0.05) between 250Hz and 500Hz. and between 2KHz and 4KHz. 5) A comparison of bone conduction between cholesteatoma and non -cholesteatoma group revealed significant t ratio (p 0.01) only in 2KHz and 4KHz. No significant differency was observed in mean bone conduction. 6) In a histopathological study of natural otitis media in guinea pig, we observed inflammatory infiltration of the round window membrane, serofibrinous precipitate in the scala tympani, and degeneration of the organ of Corti most significant near the basal turn. These changes would explain high tone bone conduction loss in the process of chronic otitis media.

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A Study on Job Stress and Job Satisfaction of Dental Hygienists Working in Dental Clinics (치과의원에 근무하는 치과위생사의 직무 스트레스와 직무만족에 관한 연구)

  • Jung, Jung-Ock;Song, Kwui-Sook
    • Journal of dental hygiene science
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    • v.8 no.4
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    • pp.305-312
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    • 2008
  • This study was attempted to look into relation between job stress and job satisfaction perceived by clinical dental hygienists and the influencing factors for providing fundamental data to increase their job satisfaction. For this, mailed correspondence examination was conducted with questionnaire for dental hygienists who are engaged in dental hygiene duties at dental clinics in Seoul between June 19 and July 24, 2008. Total 180 questionnaires were distributed, and among these, 156 questionnaires were included in analysis except for 24 questionnaires having incomplete answers. The findings of this study are as follows: 1. The total mean of dental hygienists' job stress was found to be 3.46 points out of 5 points, and that of their job satisfaction to be 2.99. 2. For relation between general characteristics and job stress of dental hygienists, significant difference was found just in the motive to select dental hygienist (p < 0.001) and the expected period of engagement in dental hygienist duties (p < 0.05). 3. For relation between general characteristics and job satisfaction of dental hygienists, significant difference was found just in job experience(p < 0.05), current position (p < 0.05), average salary (p < 0.001), and the expected period of engagement in dental hygienist duties (p < 0.01). 4. For correlation between job stress and job satisfaction, negative correlation was shown generally (r=-0.222), such that the more was job stress, the less was job satisfaction. 5. As a result of multiple regression analysis to look into the job stress factors influencing dental hygienists' job satisfaction, it was found that the factors of excessive workload(p < 0.05) and improper treatment(p < 0.01) most influenced job satisfaction, and the descriptive power on the job stress factors influencing their job satisfaction was found to be 24.1%.

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Analysis of Prognostic Factors in Glioblastoma Multiforme (다형성 교모세포증 환자의 예후인자 분석)

  • Chang Sei Kyung;Suh Chang Ok;Lee Sang Wook;Keum Ki Chang;Kim Gwi Eon;Kim Woo Cheol
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.181-189
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    • 1996
  • Purpose : To find the more effective treatment methods that improving the survival of patients with glioblastoma multiforme(GBM), we analyze the prognostic factors and the outcome of therapy in patients with GBM. Materials and Methods : One hundred twently-one patients with a diagnosis of GBM treated at Severance Hospital between 1973 and 1993 were analyzed for survival with respect to patients characteristics, that is, duration of symptom, age, and Karnofsky performance status, as well as treatment related variables such as extent of surgery and radiotherapy. Results : The median survival time(MST) and 2-year overall survival rate (OSR) of the patients with GBM were 13 months and $20.8\%$, respectively. Duration of symptom, age, Karnofsky performance status(KPS), radiotherapy, and extent of surgical resection were associated with improved survial in a univariate analysis. Patients whose duration of symptom was longer than 3 months, had the 2-year OSR of $47.2\%$(p=0.0082), who were younger than age 50, $32.9\%$(p=0.0003) In patients with a KPS of 80 or higher, the 2-rear OSR was $36.9\%$(p=0.0422). Patients undergoing radiotherapy had the 2-year OSR of $22.9\%$(p=0.0030), and surgical resection of $23.3\%$ (p<0.000). A Cox regression model confirmed a significant correlation of duration of symptom, age, radiotherapy, and extent of surgical resection with survival, excluding KPS(P=0.8823). The 2-year OSR were $22.3\%$ and $19.4\%$, combined with chemotherapy or without, respectively(p=0.6028). The duration of symptom of 3 months or shorter, 50 years of age or older, and undergoing stereotactic biopsy only were considered as risk factors, then patients without any risk factors had the MST of 29 months and 2-year OSR of $53.9\%$ compared to 4 months and $0\%$ for Patients who had all 3 risk factors. Most of all treatment failures occurred in the primary tumor site($80.4\%$). Conclusion : The duration of symptom, age, radiotherapy, and extent of surgical resection were a prognostically significant indeuendent variables. To get a better survival, it seems to be reasonable that the study design which improves the local control rates is warranted.

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