This study investigated the effect of spouse attitude of psychiatric patients on relapse. The research was based on the concept that spouses' attitudes toward mental illness influences relapse, mediated by marital relationship and social adaptation. Data were collected from 102 of the psychiatrically disordered who were married, and analyzed through Structural Equation Modelling to validate causal paths and mediator effects of the variables. The marital relationship was shown to act as a mediator between spouse attitude and social adaptation, while social adaptation showed a complete mediation effect between marital relationship and relapse. Thus, spouse attitude towards mental illness was shown to have a statistically meaningful effect on relapse indirectly and through sequential mediation effect of marital relationship and social adaptation. This study proposes the facilitation of counseling and training programs to improve the marital relationships of psychiatric patients. The emphasis is on the educational program for the spouses to improve their knowledge of mental illness.
This research purposes to investigate parameters which effect on the relapse of alcoholism, to understand psychological factors for stress control and drinking anticipation which lead to the relapse of female alcoholism and to seek practical ways in social welfare for alcoholism, focusing on the traumatic experiences and post traumatic stress symptoms of female alcoholics experienced physical, sexual abuses. The main results of this research can be summarized as follows. First, the characteristic related with physical, sexual traumatic experiences of subjects is that physical, sexual abuses by acquaintances under 18 is more common than that experiences over 18. Second, the 8 pathes among 10 direct pathes are statistically significant. Third, as the result of verification of indirect effects through parameters, in the model, 4 out of 6 indirect pathes parameterized as post traumatic stress symptoms, problem focused coping, and drinking anticipation are significant. Based on these results, the practical implications for the warning of relapse of female alcoholics had been discussed.
Uterine cervical cancer is the most common malignancy in korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications can not be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analized to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that our treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.
Jun Hyuk Son;Jae Woo Lee;Dong Kee Jang;Sang Hyub Lee;Ji Kon Ryu;Yong-Tae Kim
Journal of Digestive Cancer Research
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v.3
no.2
/
pp.105-107
/
2015
Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.
In Sub Han;Geun Am Song;Kwang Ha Kim;Bong Eun Lee;Dong Hoon Baek;Seong Jun Lee;Moon Won Lee;Sung Yong Han
Journal of Digestive Cancer Research
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v.4
no.1
/
pp.32-35
/
2016
Pseudomyxoma peritonei (PMP) is a rare clinical syndrome characterized by profuse jelatinous materials in the abdominal cavity and pelvis with mucinous implants on the peritoneal surface. There are some studies for serum tumor markers, including carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125), to assess the risk of recurrence following cytoreductive surgery and intraperitoneal chemotherapy. However, rare cases were reported about recurrence with increasing serum CEA levels. Herein, we report a case of recurrence of PMP according to serially elevated serum CEA.
Purpose : To evaluate the outcome of early stage non-small cell lung cancer patients who were treated with radiation therapy alone and define the optimal radiotherapeutic regimen for these patients. Materials and Methods : A retrospective review was peformed on patients with sage I or II non-small cell carcinoma of the lung that were treated at our institution between June, 1987 and May, 2000. A total of 21 patients treated definitively with radiation therapy alone were included in this study. The age of the patients ranged from 53 to 81 years with a median of 66 years. All the patients were male. The medical reasons for inoperability were lack of pulmonary reserve, cardiovascular disease, poor performance status, old age, and patient refusal in the decreasing order. Pathological evidence was not adequate to characterize the non-small cell subtype in two patients. Of the remaining 19 patients, 16 had squamous cell carcinoma and 3 had adenocarcinoma. Treatment was given with conventional fractionation, once a day, five times a week. The doses to the primary site ranged from 56 Gy to 59 Gy. No patients were lost to follow-up. Results : The overall survival rates for the entire group at 2, 3 and 5 years were 41, 30 and $21\%$, respectively. The cause specific survivals at 2, 3 and 5 years were 55, 36 and $25\%$, respectively. An intercurrent disease was the cause of death in two patients. The cumulative local failure rate at 5 years was $43\%$. Nine of the 21 patients had treatment failures after the curative radiotherapy was attempted. Local recurrences as the first site of failure were documented in 7 patients. Therefore, local failure alone represented $78\%$ of the total failures. Those patients whose tumor sizes were less than 4 cm had a significantly better 5 year disease free survival than those with tumors greater than 4 cm $(0\%\;vs\;36\%)$. Those patients with a Karnofsky performance status less than 70 did not differ significantly with respect to actuarial survival when compared to those with a status greater than 70 $(25\%\;vs\;26\%,\;p>0.05)$. Conclusion : Radiation therapy 리one is an effective and safe treatment for early stage non-small ceil lung cancer patients who are medically inoperable or refuse surgery. Also we believe that a higher radiation dose to the primary site could improve the local control rate, and ultimately the overall survival rate.
Kim, Woo-Chul;Kim, Hun-Jung;Park, Jeong-Hoon;Huh, Hyun-Do;Choi, Sang-Huoun
Radiation Oncology Journal
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v.29
no.1
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pp.28-35
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2011
Purpose: Recently, the use of radiosurgery as a local therapy in patients with early stage non-small cell lung cancer has become favored over surgical resection. To evaluate the efficacy of radiosurgery, we analyzed the results of stereotactic body radiosurgery in patients with primary or recurrent non-small cell lung cancer. Materials and Methods: We reviewed medical records retrospectively of total 24 patients (28 lesions) with non-small cell lung cancer (NSCLC) who received stereotactic body radiosurgery (SBRT) at Inha University Hospital. Among the 24 patients, 19 had primary NSCLC and five exhibited recurrent disease, with three at previously treated areas. Four patients with primary NSCLC received SBRT after conventional radiation therapy as a boost treatment. The initial stages were IA in 7, IB in 3, IIA in 2, IIB in 2, IIIA in 3, IIIB in 1, and IV in 6. The T stages at SBRT were T1 lesion in 13, T2 lesion in 12, and T3 lesion in 3. 6MV X-ray treatment was used for SBRT, and the prescribed dose was 15~60 Gy (median: 50 Gy) for PTV1 in 3~5 fractions. Median follow up time was 469 days. Results: The median GTV was 22.9 mL (range, 0.7 to 108.7 mL) and median PTV1 was 65.4 mL (range, 5.3 to 184.8 mL). The response rate at 3 months was complete response (CR) in 14 lesions, partial response (PR) in 11 lesions, and stable disease (SD) in 3 lesions, whereas the response rate at the time of the last follow up was CR in 13 lesions, PR in 9 lesions, SD in 2 lesions, and progressive disease (PD) in 4 lesions. Of the 10 patients in stage 1, one patient died due to pneumonia, and local failure was identified in one patient. Of the 10 patients in stages III-IV, three patients died, local and loco-regional failure was identified in one patient, and regional failure in 2 patients. Total local control rate was 85.8% (4/28). Local recurrence was recorded in three out of the eight lesions that received below biologically equivalent dose 100 $Gy_{10}$. Among 20 lesions that received above 100 $Gy_{10}$, only one lesion failed locally. There was a higher recurrence rate in patients with centrally located tumors and T2 or above staged tumors. Conclusion: SBRT using a CyberKnife was proven to be an effective treatment modality for early stage patients with NSCLC based on high local control rate without severe complications. SBRT above total 100 $Gy_{10}$ for peripheral T1 stage patients with NSCLC is recommended.
In Joseon dynasty, Gongsin-Gyoseo(Royal Edicts rewarding meritorious vassals) was issued for the reward of the contribution to the specific event of the nation. The family decided as vassals succeeded this Gongsin-Gyoseo as the family treasure to later generations. When one happened to lose this caused by an unavoidable situation such as war in this process, there were a few cases of reissuing of Gongsin-gyoseo by the nation. The confirmative reissued Gongsin-gyoseo among Gongsin-gyoseo that descended down by now are three pieces which is Park dongnyang Hoseong Gongsin-Gyoseo, Gu goeng Jeongsa Gongsin-Gyoseo, and Park jung Jeongsa Gongsin-Gyoseo. This research considered the form and mounting about these three pieces. It was indicated that the reissued Gongsin-Gyoseo was produced following the same form with the original Gongsin-Gyoseo, that is pyeongchul(moving to next lines) and daedu (writing one or two letters ahead compared to the first letter) and so on. But, it was indicated that the change of the position of the vassals in the reissued time was reflected compared to position of the original Gongsin-Gyoseo. In case of Jeonsa Gongsin-Gyoseo, it was indicated that it was 'Wonjongdaewang-whi' since the original Gongsin-Gyoseo was 'Jeongwongun-bu' and the reissued time he became the father of King Injo. Also, it was confirmed that the case of deprivation because of conspiracy such as 'Kim jajeom, Kim ryeon, Sim kiwon, Sim kisung' was produced as the original document and deleted with black ink stick. It was newly confirmed while the original Gongsin-Gyoseo was produced by a designated writer from the nation, the reissuance was written by a writer from the family of the vassals. Since the mounting of Gongsin-Gyoseo could be changed according to the favor and technique of the craftsman participated in the practical production such as Baezeopjang and economical situation of the country supplying the material, the mounting of these three Gongsin-Gyoseo should be different from the original mounting, especially because of the loss of the original by the Manchu war of 1636. The comparison result of Gongsin-Gyoseo produced in the same period with the original issued one in the record of the related Uigwe (a collection of documents from the Joseon Dynasty), the reissued one seems to be larger in the form or ratio of the mounting compared to the first issued one. First of all, the width of Byunah was expanded as twice bigger, center and both side Hoejang also was bigger as over 2cm, and the below Hoejang was expanded as 10cm, and the ratio of the upper Hoejang and the below Hoejang was wider as 1.5 times and the reissuance was 1:1 ratio. The bisect of upper shaft in Park dongnyang Hoseong Gongsin-Gyoseo is assumed as the form of an equilateral triangle, not a half-moon shape of the present, and Gu goeng and Park jung Jeongsa Gongsin-Gyoseo will be the form whose bisection form is same but the size is smaller. Chuksu is confirmed that the size is not changed significantly. Osaekdahoe can be assumed that the width was smaller compared to the first issued one. The 3 pieces of the reissued versions provide the clue of the verification for the form of the mounting of Bosa Gongsin-Gyoseo in the same production period. In the situation that the mounting of the production time was not confirmed among the currently descended Bosa Gongsin-Gyoseo, they can be very important materials.
Journal of agricultural medicine and community health
/
v.39
no.3
/
pp.137-145
/
2014
Objectives: Colonoscopy is a popular tool for screening for colon cancer throughout the world. The incidence of polypectomy and follow-up colonoscopy are persistently increasing but the studies about follow-up test after polypectomy are still lack of its domestic sources. This study is designed to look into the recurrence rate of colon polyps and risk factors after polypectomy. Methods: This is a retrospective study by reviewing medical charts of 147 patients who underwent polypectomy and follow-up colonoscopy from Jan. 2000 to Mar. 2008. The Kudo classification was used to describe the polyps found in the colonoscopy. The follow-up period was defined as the term between polypectomy and the first colonoscopy follow up. Results: Seventy six point two percent of the enrolled patient were male and the mean age was $56.5{\pm}8.1$. Mean follow-up period was $24.9{\pm}13.7$ (6 - 65) months. The cumulative recurrence rate of 1 year was 11.6%. The rate of 2 years was 36.7% and that of 3 years was 55.8%. The number of polyps was the factor which statistically showed significant relation of its recurrence rate. The histological morphology characteristic of polyps could be one independent factor which may be associated to the recurrence of polyps. Conclusions: The importance of colonoscopy follow up after polypectomy was clearly emphasized through the cumulative recurrence rate of 55.8%. Therefore, there is a need for more domestic studies with a large number of patients about the recurrence of polyps after polypectomy.
Ninety five patients of rectal cancer treated with surgery with or without adjuvant radiation therapy since January 1982 to December 1990 at the Chonnam University Hospital were analysed retrospectively regarding local failure. Of these 95 patients 72 patients were treated with surgery alone and remaining 23 patients received postoperative radiation therapy to pelvis. There were 45 men and 50 women with 53 years of median age. Minimum follow-up period was 19 months and median was47 months (range, 19-125 months). Kaplan-Meier method was used to calculate actuarial risk of local recurrence and survival rate. Comparison between two groups was evaluated by Log rank test. Of total 95 patients twenty seven patients ($28.4\%$) developed local recurrence and 13 patients ($17.3\%$) developed local and distant metastasis concomitantly. Eighty nine percent (24/27) of patients developed local recurrence within 24 months. Pelvic organ adjacent to the primary tumor area was the most common site of initial local recurrence. Of 72 patients treated with surgery alone local recurrence developed in 24 patients. Of 17 patients with stage A and 81 (Gunderson-Sosin modification of Dukes' staging system) 6 patients experienced local recurrence ($31.2\%$). The local recurrence rate of B2 and B3 group was $29.9\%$ (7/33) and that of C2 and C3 was $54.7\%$ (11/19), respectively. There was statistically significant difference between two groups (p<0.05). Of 23 patients treated with definitive surgery and radiation therapy $10\%$ (1/10) recurred in B2 and B3 patients. This was slightly lower than C2 and C3 patients ($22.2\%$, 2/10) of similar policy, but revealed no statistically significant difference (p>0.05). In the patients of B2+3 local failure rate decreased when radiation therapy was added ($29.9\%$ vs $10\%$, p>0.05) and also similar results in C2+3 group ($34.7\%$ vs $22.2\%$, p<0.05). The local failure rate in relation to distance from the anal verge had no statistically significant difference.
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