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Primary Orbital Lymphoma : A Retrospective Analysis of Results of Radiation Therapy (원발성 안와 림프종의 방사선치료 성적에 관한 후향적 분석)

  • Kim Sussan;Ahn Seung Do;Chang Hyesook;Kim Kyoung Ju;Lee Sang-wook;Choi Eun Kyung;Kim Jong Hoon;Huh Jooryung;Suh Cheol Won;Kim Sung Bae
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.139-146
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    • 2002
  • Purpose : This study evaluated the treatment outcomes, patterns of failure, and treatment related complications of primary lymphoma patients who received definitive radiation therapy. Materials and Methods : A retrospective analysis was undertaken for 31 patients with primary orbital lymphoma at the Asan Medical Center between February 1991 and April 2001. There were 18 males and 13 females with ages ranging from 3 to 73 years (median, 44 years). The involved sites were 9 conjunctivae, 12 eyelids and 10 other orbits. The histological types were 28 MALT lymphomas (low-grade B-cell lymphoma of mucosa-associated lymphoid tissue type), 1 diffuse large B-cell lymphoma, 1 anaplastic large cell lymphoma and 1 lymphoblastic lymphoma. The Ann Arbor stages were all IE $(100\%)$. Ann Arbor stage III or IV patients were excluded from this study, Bilateral orbital involvement occurred in 6 cases. Radiation therapy was given with one anterior port of high energy electrons $(6\~16\;MeV)$ for the lesions located at the anterior structures like the conjunctivae or eyelids. Lesions with a posterior extension or other orbital lesions were treated with 4 or 6 MeV photons with appropriately arranged portals. In particular, lens blocks composed of lead alloy were used in conjunctival or eyelid lesions. Twelve patients received chemotherapy. The median follow-up period was 53 months. Results : The 5-year overall, cause-specific, and disease-free survival was $91\%,\;96\%,\;and\;80\%$, respectively. The complete response rate 6 months after radiation therapy was $100\%$. Local recurrences were observed in 2 patients at 16 and 18 months after completion of radiation treatment. They were salvaged with additional radiation therapy. Two patients developed distant metastases. A MALT lymphoma patient with a lung relapse was successfully salvaged with radiotherapy, but the other lymphoblastic lymphoma patient with bone marrow relapse expired. There were no severe complications but 5 patients developed radiation-induced cataracts and 2 patients developed dry eye. Conclusion : Most primary orbital lymphomas consisted of MALT lymphomas. Radiation therapy was a successful treatment modality for orbital lymphoma without any severe complications. In cases of local relapses, radiation therapy is also a very successful salvage treatment modality.

Radiotherapy in Supraglottic Carcinoma - With Respect to Locoregional Control and Survival - (성문상부암의 방사선치료 -국소종양 제어율과 생존율을 중심으로-)

  • Nam Taek-Keun;Chung Woong-Ki;Cho Jae-Shik;Ahn Sung-Ja;Nah Byung-Sik;Oh Yoon-Kyeong
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.108-115
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    • 2002
  • Purpose : A retrospective study was undertaken to determine the role of conventional radiotherapy with or without surgery for treating a supraglottic carcinoma in terms of the local control and survival. Materials and Methods : From Jan. 1986 to Oct. 1996, a total of 134 patients were treated for a supraglottic carcinoma by radiotherapy with or without surgery. Of them, 117 patients who had completed the radiotherapy formed the base of this study. The patients were redistributed according to the revised AJCC staging system (1997). The number of patients of stage I, II, III, IVA, IVB were $6\;(5\%),\;16\;(14\%),\;53\;(45\%),\;32\;(27\%),\;10\;(9\%)$, respectively. Eighty patients were treated by radical radiotherapy in the range of $61.2\~79.2\;Gy$ (mean : 69.2 Gy) to the primary tumor and $45.0\~93.6\;Gy$ (mean : 54.0 Gy) to regional lymphatics. All patients with stage I and IVB were treated by radiotherapy alone. Thirty-seven patients underwent surgery plus postoperative radiotherapy in the range of $45.0\~68.4\;Gy$ (mean : 56.1 Gy) to the primary tumor bed and $45.0\~59.4\;Gy$ (mean : 47.2 Gy) to the regional lymphatics. Of them, 33 patients received a total laryngectomy (${\pm}lymph$ node dissection), three had a supraglottic horizontal laryngectomy (${\pm}lymph$ node dissection), and one had a primary excision alone. Results : The 5-year survival rate (5YSR) of all patients was $43\%$. The 5YSRs of the patients with stage I+II, III+IV were $49.9\%,\;41.2\%$, respectively (p=0.27). However, the disease-specific survival rate of the patients with stage I (n=6) was $100\%$. The 5YSRs of patients who underwent surgery plus radiotherapy (S+RT) vs radiotherapy alone (RT) in stage II, III, IVA were $100\%\;vs\;43\%$ (p=0.17), $62\%\;vs\;52\%$ (p=0.32), $58\%\;vs\;6\%$ (p<0.001), respectively. The 5-year actuarial locoregional control rate (5YLCR) of all the patients was $57\%$. The 5YLCR of the patients with stage I, II, III, IVA, IVB was $100\%,\;74\%,\;60\%,\;44\%,\;30\%$, respectively (p=0.008). The 5YLCR of the patients with S+RT vs RT in stage II, III, IVA was $100\%\;vs\;68\%$ (p=0.29), $67\%\;vs\;55\%$ (p=0.23), $81\%\;vs\;20\%$ (p<0.001), respectively. In the radiotherapy alone group, the 5YLCR of the patients with a complete, partial, and minimal response were $76\%,\;20\%,\;0\%$, respectively (p<0.001). In all patients, multivariate analysis showed that the N-stage, surgery or not, and age were significant factors affecting the survival rate and that the N-stage, surgery or not, and the ECOG performance index were significant factors affecting the locoregional control. In the radiotherapy alone group, multivariate analysis showed that the radiation response and N-stage were significant factors affecting the overall survival rate as well as locoregional control. Conclusion : In early stage supraglottic carcinoma, conventional radiotherapy alone is an equally effective modality compared to surgery plus radiotherapy and could preserve the laryngeal function. However, in the advanced stages, radiotherapy combined with concurrent chemotherapy for laryngeal preservation or surgery should be considered. In bulky neck disease, all the possible planned neck dissections after induction chemotherapy or before radiotherapy should be attempted.

Studies on Biology and Control of the Mulberry Small Weevil, Baris deplanata ROELOFS (Coleoptera: Curculionidae) (뽕나무애바구미의 생태 및 방제에 관한 연구)

  • 백현준;백운하
    • Journal of Sericultural and Entomological Science
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    • v.18 no.2
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    • pp.65-78
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    • 1976
  • The mulberry small weevil, Baris deplanata ROELOFS, has highly infested mulberry trees in Korea. As the damage caused by the mulberry small weevil in mulberry fields has been increased over the country since 1969, the authors has carried out a series of biological and controlling studies on the pest from 1971 to 1972. The results obtained are summarized as follows. 1. The adult weevil is elongate oval in shape with black in color and the probocis is long as usual in curculionidae. The size of adult female is 3.30${\pm}$0.04mm in length, 1.47${\pm}$0.04mm in width, and the length of proboscis is 1.25${\pm}$0.014mm, while adult male is 3.28${\pm}$0.06mm in length, 1.40${\pm}$0.04mm in width, and the length of proboscis is 1.30${\pm}$0.02mm. The antenna is geniculate consisting of 12 segments. The terminal sternite of the abdomen has a pointed tip in male but not in female. 2. The egg is long oval in shape, milky white in color, 0.51${\pm}$0.05mm in length and 0.32${\pm}$0.02mm in width. 3. The mature larva is cylindrical and light yellowow in color except the head of dark brown, and legless, 3.88${\pm}$0.06mm in length, 1.40${\pm}$0.02mm width, each segment bearing many wrinkless and short setae. 4. The pupa is long oval, milky white and exarate, 3.53${\pm}$0.09 in length, 1.40${\pm}$0.03mm in width. 5. Majority of the species has one generation through a year and overwinters as adult in xylem of withered branch and come out again from late April to early May in next year. But some of the female oviposit in the same year and the offsprings overwinter as larva (0.4%) or pupa (0.1%) 6. The eggs are mostly laid under the cork layer of withered branch and the number of eggs deposited by an adult female is 73.44${\pm}$8.74, the average egg-laying period is 33.88${\pm}$6.04 days. The incubation period is 11.69${\pm}$0.39 days, the larval period 45.04${\pm}$1.63 and the pupal period 11.05${\pm}$0.49 days. The period of adult's activity is 46.7${\pm}$5.90 days. 7. The larvae feed on the cambium under the bark and adults feed on the winter bud, the latent bud, the leaf stalk and the base of newly shoot. 8. An active period of adults was observed during the period of 4 months from April to July. However, the peak of adult-density occurred in the early May (in the fields of spring-prunning) and early to middle June(in the fields of summer-prunning). 9. There is a positive correlation between the density of larvae and diameter and length of the branches. 10. The pattern of distributions of the adult of mulberry small weevil is negative binomial distribution. 11. The chalcid fly was disclosed to be a natural enemy which was parasite on the larvae of mulberry small weevil and its parasitic ratio was 11.9%. 12. Phosvel D, Malix D, Salithion EC, DDVP EC, and Phosvel EC were effective for the control of adults and Satchukoto-S EC, and Salithio EC were effective for the control of larvae.

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Off Pump Total Arterial Myocardial Revascularization (동맥 도관만을 이용하여 체외심폐순환 없이 시행한 관상동맥우회술)

  • Youn Young Nam;Lee Kyo Joon;Lee Gy Jong;Joo Hyun Chul;Lim Sang Hyun;Kim Seung Ho;Kwak Young Lan;Yoo Kyung Jong
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.349-356
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    • 2005
  • Background: Arterial conduits using in coronary artery bypass grafting (CABG) have been known a great long term patency rates, and improved short and long term clinical outcomes. It has been reported that Off pump CABG has better clinical results than CABG using cardiopulmonary bypass. To evaluate the advantage of arterial conduits over venous conduits and to avoid the adverse effects of cardiopulmonary bypass, we performed total arterial Off pump CABG. Material and Method: From January 2001 to October 2004, Off pump CABG using only arterial conduits was performed on 325 patients with a mean age of $59.3\pm11.9$ years ($36\~83$). Mean ejection fraction was $55.4\pm14.0\%\;(15\~86).$ Angiography showed left main disease or triple-vessel disease in $81.9\%$ of the patients. Indications of using arterial conduits was stenosis $\ge50\%$ of left anterior descending artery, stenosis $\ge80\%$ of branches of left circumflex artery, and stenosis $\ge90\%$ of right coronary artery and its branches. Multi-slice computed tomography was performed on 194 patients to evaluate the short term patency rates. Result: A total of 928 distal anastomoses were performed and the average anastomoses per a patient were $2.86\pm0.78$. There was 1 operative mortality. Postoperative complications were mediastinitis in 6 patients ($1.8\%$), renal failure in 4 patients ($1.2\%$), perioperative myocardial infarction in 3 patients ($0.9\%$), reoperation for bleeding in 3 patients ($0.9\%$). There was no postoperative stroke. Patency rate of arterial conduits was $99.3\%$ (581/585). There were 4 stenoses or competitive flows in 2 radial arteries and 2 right internal mammary arteries. Conclusion: Total arterial Off pump CABG appears to be safe, showing a low surgical mortality and morbidity and excellent short term patency rates of arterial conduits.

The Influences of Perfusion Temperature on Inflammatory and Hematologic Responses during Cardiopulmonary Bypass (체외순환시 염증과 혈액학적 반응에 대한 관류온도의 영향)

  • 김상필;최석철;박동욱;한일용;이양행;조광현;황윤호
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.817-826
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    • 2004
  • Background: Several studies have demonstrated that conventional hypothermic cardiopulmonary bypass (CPB) causes cellular injury, abnormal responses in peripheral vascular beds and increased postoperative bleeding, whereas normothermic CPB provides protection of the hypothermic-induced effects and better cardiac recovery. The present study was prospectively performed to compare the effects of normothermic CPB to those of hypothermic CPB on the inflammatory and hematologic responses during cardiac surgery. Material and Method: Thirty-four adult patients scheduled for elective cardiac surgery were randomly assigned to hypothermic CPB (nasopharyngeal temperature $26~28^{\circ}C,$ n=17) or normothermic CPB (nasopharyngeal $temperature>35.5^{\circ}C,$ n=17) group. In both groups, cold $(4^{\circ}C)$ crystalloid cardioplegia was applied for myocardial protection. Blood samples were drawn from radial artery before (Pre-CPB), 10 minutes after starting (CPB-10) and immediately after ending (CPB-OFF) CPB. Total leukocyte and platelet counts, interleukin-6 (IL-6) level(expressed as percent to the baseline of Pre-CPB), D-dimer level, protein C and protein S activity were measured with the blood samples. The amount of bleeding for postoperative 24 hours and blood transfusion after operation were also assessed. All parameters were compared between the two groups. Result: The total leukocyte counts $(10,032\pm65/mm^3)$ and the increased ratio of IL-6 $(353\pm7.0%)$ at CPB-OFF in the normothermic group were higher than that $(7,254\pm48/mm^3$ and $298\pm7.3%)$ of the hypothermic group(p=0.02 and p=0.03). In the normothermic group, protein C activity $(32\pm3.8%)$ and protein S activity $(35\pm4.1%)$ at CPB-OFF were significantly lower than that $(45\pm4.3%$ and $51\pm3.8%)$ of the hypothermic group (p=0.04 and p=0.009). However, there were no differences in platelet counts and D-dimer concentration. In the normothermic group, the amount of bleeding for postoperative 24 hours $(850\pm23.2$ mL) and requirements for blood transfusion after operation such as packed cell $(1,402\pm20.5$ mL), fresh frozen plasma $(970\pm20.8$ mL) and platelet $(252\pm6.4$ mL) were higher than that $(530\pm21.5$ mL, $696\pm15.7$ mL, $603\pm18.2$ mL and $50\pm0.0$ mL) of the hypothermic group. Conclusion: These results indicate that normothermic CPB with cold crystalloid cardioplegia was associated with higher increase in inflammatory response, hemostatic abnormalities and postoperative bleeding problem than moderate hypothermic CPB.

Inhibition of Neointima Formation and Migration of Vascular Smooth Muscle Cells by Anti-vascular Endothelial Growth Factor Receptor-1 (Flt-4) Peptide in Diabetic Rats (당뇨병 쥐에서 혈관내피 성장인자 수용체-1 차단 펩타이드를 이용한 신내막 형성과 혈관평활근세포 이동의 억제)

  • Jo, Min-Seop;Yoo, Ki-Dong;Park, Chan-Beom;Cho, Deog-Gon;Cho, Kue-Do;Jin, Ung;Moon, Kun-Woong;Kim, Chul-Min;Wang, Young-Pil;Lee, Sun-Hee
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.264-272
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    • 2007
  • Background: Vascular endothelial growth factor (VEGF) plays an important role in angiogenesis, including stimulating the proliferation and migration of vascular smooth muscle cells (VSMCs). It has been known that diabetes is associated with accelerated cellular proliferation via VEGF, as compared to that under a normal glucose concentration. We investigated the effects of selective blockade of a VEGF receptor by using anti-Flt-1 peptide on the formation and hyperplasia of the neointima in balloon injured-carotid arteries of OLETF rats and also on the in vitro VSMCS' migration under high glucose conditions. Material and Method: The balloon-injury method was employed to induce neointima formation by VEGF. For f4 days beginning 2 days before the ballon injury, placebo or vascular endothelial growth factor receptor-1 (VEGFR-1) specific peptide (anti-Flt-1 peptide), was injected at a dose of 0.5mg/kg daily into the OLETF rats. At 14 days after balloon injury, the neointimal proliferation and vascular luminal stenosis were measured, and cellular proliferation was assessed by counting the proliferative cell nuclear antigen (PCNA) stained cells. To analyze the effect of VEGF and anti-Flt-1 peptide on the migration of VSMCs under a high glucose condition, transwell assay with a matrigel filter was performed. And finally, to determine the underlying mechanism of the effect of anti-Flt-1 peptide on the VEGF-induced VSMC migration in vitro, the expression of matrix metalloproteinase (MMP) was observed by performing reverse transcription-polymerase chain reaction (RT-PCR). Result: Both the neointimal area and luminal stenosis associated with neointimal proliferation were significantly decreased in the anti-Flt-1 peptide injected rats, ($0.15{\pm}0.04 mm^2$ and $ 36.03{\pm}3.78%$ compared to $0.24{\pm}0.03mm^2\;and\;61.85{\pm}5.11%$, respectively, in the placebo-injected rats (p<0.01, respectively). The ratio of PCNA(+) cells to the entire neointimal cells was also significantly decreased from $52.82{\pm}4.20%\;to\;38.11{\pm}6.89%$, by the injected anti-Flt-1 peptide (p<0.05). On the VSMC migration assay, anti-Flt-1 peptide significantly reduced the VEGF-induced VMSC migration by about 40% (p<0.01). Consistent with the effect of anti-Flt-1 peptide on VSMC migration, it also obviously attenuated the induction of the MMP-3 and MMP-9 mRNA expressions via VEGF in the VSMCS. Conclusion: Anti-Flt-1 peptide inhibits the formation and hyperplasia of the neointima in a balloon-injured carotid artery model of OLETF rats. Anti-Flt-1 peptide also inhibits the VSMCs' migration and the expressions of MMP-3 and MMP-9 mRNA induced by VEGF under a high glucose condition. Therefore, these results suggest that specific blockade of VEGFR-1 by anti-Flt-1 peptide may have therapeutic potential against the arterial stenosis of diabetes mellitus patients or that occurring under a high glucose condition.

The hydrodynamic characteristics of the canvas kite - 2. The characteristics of the triangular canvas kite - (캔버스 카이트의 유체역학적 특성에 관한 연구 - 2. 삼각형 캔버스 카이트의 특성 -)

  • Bae, Bong-Seong;Bae, Jae-Hyun;An, Heui-Chun;Lee, Ju-Hee;Shin, Jung-Wook
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.40 no.3
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    • pp.206-213
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    • 2004
  • As far as an opening device of fishing gears is concerned, applications of a kite are under development around the world. The typical examples are found in the opening device of the stow net on anchor and the buoyancy material of the trawl. While the stow net on anchor has proved its capability for the past 20 years, the trawl has not been wildly used since it has been first introduced for the commercial use only without sufficient studies and thus has revealed many drawbacks. Therefore, the fundamental hydrodynamics of the kite itself need to ne studied further. Models of plate and canvas kite were deployed in the circulating water tank for the mechanical test. For this situation lift and drag tests were performed considering a change in the shape of objects, which resulted in a different aspect ratio of rectangle and trapezoid. The results obtained from the above approaches are summarized as follows, where aspect ratio, attack angle, lift coefficient and maximum lift coefficient are denoted as A, B, $C_L$ and $C_{Lmax}$ respectively : 1. Given the triangular plate, $C_{Lmax}$ was produced as 1.26${\sim}$1.32 with A${\leq}$1 and 38$^{\circ}$B${\leq}$42$^{\circ}$. And when A${\geq}$1.5 and 20$^{\circ}$${\leq}$B${\leq}$50$^{\circ}$, $C_L$ was around 0.85. Given the inverted triangular plate, $C_{Lmax}$ was 1.46${\sim}$1.56 with A${\leq}$1 and 36$^{\circ}$B${\leq}$38$^{\circ}$. And When A${\geq}$1.5 and 22$^{\circ}$B${\leq}$26$^{\circ}$, $C_{Lmax}$ was 1.05${\sim}$1.21. Given the triangular kite, $C_{Lmax}$ was produced as 1.67${\sim}$1.77 with A${\leq}$1 and 46$^{\circ}$B${\leq}$48$^{\circ}$. And when A${\geq}$1.5 and 20$^{\circ}$B${\leq}$50$^{\circ}$, $C_L$ was around 1.10. Given the inverted triangular kite, $C_{Lmax}$ was 1.44${\sim}$1.68 with A${\leq}$1 and 28$^{\circ}$B${\leq}$32$^{\circ}$. And when A${\geq}$1.5 and 18$^{\circ}$B${\leq}$24$^{\circ}$, $C_{Lmax}$ was 1.03${\sim}$1.18. 2. For a model with A=1/2, an increase in B caused an increase in $C_L$ until $C_L$ has reached the maximum. Then there was a tendency of a very gradual decrease or no change in the value of $C_L$. For a model with A=2/3, the tendency of $C_L$ was similar to the case of a model with A=1/2. For a model with A=1, an increase in B caused an increase in $C_L$ until $C_L$ has reached the maximum. And the tendency of $C_L$ didn't change dramatically. For a model with A=1.5, the tendency of $C_L$ as a function of B was changed very small as 0.75${\sim}$1.22 with 20$^{\circ}$B${\leq}$50$^{\circ}$. For a model with A=2, the tendency of $C_L$ as a function of B was almost the same in the triangular model. There was no considerable change in the models with 20$^{\circ}$B${\leq}$50$^{\circ}$. 3. The inverted model's $C_L$ as a function of increase of B reached the maximum rapidly, then decreased gradually compared to the non-inverted models. Others were decreased dramatically. 4. The action point of dynamic pressure in accordance with the attack angle was close to the rear area of the model with small attack angle, and with large attack angle, the action point was close to the front part of the model. 5. There was camber vertex in the position in which the fluid pressure was generated, and the triangular canvas had large value of camber vertex when the aspect ratio was high, while the inverted triangular canvas was versa. 6. All canvas kite had larger camber ratio when the aspect ratio was high, and the triangular canvas had larger one when the attack angle was high, while the inverted triangluar canvas was versa.

Effect of Cryoprotectants on the Physico-chemical Characteristics of Chicken Breast Surimi Manufactured by pH Adjustment during Freezing Storage (냉동변성 방지제가 pH 조절법으로 제조한 닭가슴살 수리미의 냉동저장 중 이화학적 특성에 미치는 영향)

  • Jin, Sang-Keun;Kim, Il-Suk;Kim, Su-Jung;Jeong, Ki-Jong;Lee, Jae-Ryong;Choi, Yeung-Joon
    • Food Science of Animal Resources
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    • v.27 no.3
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    • pp.267-276
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    • 2007
  • This study was conducted to determine the effect of cryoprotectants (sugar, sorbitol, polyphosphate) on the physico-chemical characteristics of chicken breast surimi manufactured by pH adjustment (pH 11.0) during freezing storage. The final surimi was divided into experimental units to which the following treatments were randomly assigned: C (Alaska pollack surimi: two washings, 4% sugar +5% sorbitol ${\pounds}'$ 0.3% polyphosphate additive): T1 (chicken breast surimi: pH 11.0 adjusted, 0.3% polyphosphate additive): T2 (chicken breast surimi pH 11.0 adjusted, 5% sorbitol +0.3% polyphosphate additive); T3 (chicken breast surimi: pH 11.0 adjusted, 4% sugar +5% sorbitol +0.3% polyphosphate additive). The crude protein content of the control was higher than all treated samples, however the moisture, crude fat and crude ash of T3 were higher than the control (p<0.05). The pH, WHC and collagen content of the control were higher than all of the treated samples, and these values decreased with storage time for all treatments and the control (p<0.05). The cholesterol content of the control was lower than all treated samples, but the myofibrillar protein contents of all treated samples were higher than the control (p<0.05). The cooking loss of T2 was lower than the control and the other two treatments (p<0.05). The $L^*,\;a^*\;and\;b^*$ values of all treated samples were higher than those of the control during freezing storage (p<0.05). The W value of T3 at 1.5 and 3 months of freezing storage was higher than the control and T1 (p<0.05). The myoglobin and met-Mb contents of the control were similar to all treated samples, and the met-Mb content of the control and all treated samples increased with storage time (p<0.05). Immediately after freezing, the hardness of the control was higher than all treated samples, however it was lower after 1.5 and 3 months of frozen storage (p<0.05). The cohesiveness and gumminess of the control were higher than all treated samples immediately after freezing, however the values for T3 were higher than those of the control and the other two treatments during frozen storage for 1.5 and 3 months (p<0.05).

Clinical Characteristics and Adherence of Patients Who Were Prescribed Home Oxygen Therapy Due to Chronic Respiratory Failure in One University Hospital: Survey after National Health Insurance Coverage (한 대학병원에서 조사된 재택산소요법을 받고 있는 환자의 특성과 재택산소요법 처방에 대한 순응도: 건강보험급여전환 후 조사)

  • Koo, Ho-Seok;Song, Young Jin;Lee, Seung Heon;Lee, Young Min;Kim, Hyun Gook;Park, I-Nae;Jung, Hoon;Choi, Sang Bong;Lee, Sung-Soon;Hur, Jin-Won;Lee, Hyuk Pyo;Yum, Ho-Kee;Choi, Soo Jeon;Lee, Hyun-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.192-197
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    • 2009
  • Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

A study on the gratification of the patient in the Dental Hospital (치과병원 내원환자의 만족도 조사분석)

  • Kim, Min-Young;Lee, Keun-Woo;Moon, Hong-Suk;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.65-82
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    • 2008
  • Statement of problem : Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers ' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations' medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. Purpose : The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. Material and method : This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. Result : It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers 'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. Conclusion : The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients' satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.