Seong Jin Sil;Juhn Juhn Kyu;Suh Chang Ok;Kim Gwi Eon;Han Kwang Hyub;Lee Sang In;Roh Jae Kyung;Choi Heung Jai;Kim Byung Soo
Radiation Oncology Journal
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v.7
no.2
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pp.247-257
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1989
Thirty patients with nonresectable hepatocellular carcinoma (HCC) due to either locally advanced lesion or association with liver cirrhosis, treated with combined radiotherapy and hyperthermia between April 1988 and July 1988, at Dept. of Radiation Oncology, Yonsei university College of medicine, were analysed. External radiotherapy of a total dose of 3060cGy/3.5 wks was given. Hyperthermia was given twice a week with a total of 6 treatment sessions using 8MHz radiofrequency capacitive type heating device, i.e., Thermotron RF-8 and Cancermia. In all cases hyperthermia was given within 30 minutes after radiotherapy for 30~60min. Temperature was measured by inserting thermocouple into the tumor mass under the ultrasonographic guidance only for those who had not bleeding tendency. As a result, partial response (PR) was achieved in 12 patients (40%), and symptomatic improvement was observed in 22 patients (78.6%) among 28 patients who had suffered from abdominal pain. The most significant factor affecting the tumor response rate was the type of tumor (single massive: 10/14, 71.4%; diffuse infiltrative: 2/10, 20%; multinodular:0/6, 0%; p<0.005). There were not any significant side effects relating to combined treatment. The overall 1 year survival rate was 34%, with 50% in the PR group and 22% in the no response group (NR), respectively. Median survival was 6.5 months and longer for those of PR than of NR (11 mos. vs 5, p<0.05). In conclusion, combined radiotherapy and hyperthermia appeared to be effective in local control and symptomatic palliation of HCC. Further study including a larger number of the patients to confirm its effect in survival and detrimental side effect should be urged.
Purpose: A dedifferentiated chondrosarcoma is a rare lethal tumor characterized by a low grade chondrosarcoma juxtaposed with a high grade dedifferentiated sarcoma, such as osteosarcoma, fibrosarcoma. The aim of our study was to document the clinical manifestation and oncologic outcomes of a dedifferentiated chondrosarcoma. Materials and Methods: This study identified 11 patients who were diagnosed and treated for dedifferentiated chondrosarcoma between January 2007 and December 2016. The identified cohort was then reviewed regarding age, sex, symptom onset, tumor location, magnetic resonance imagings (MRIs), surgical margin, and pathologic diagnosis. The time to local recurrence and/or metastasis, follow-up duration, and the patients' final status were analyzed. Results: The patients were comprised of 7 males and 4 females with a mean age of 54 years (range, 33-80 years). The location of the tumor was in the femur in 6 cases, pelvis in 4 cases, and metatarsal in 1 case. The average tumor diameter was 12.7 cm (range, 6.0-26.1 cm). At the time of diagnosis, 2 patients showed pathologic fracture; 1 patient was Enecking stage IIA, 9 patients were stage IIB, and 1 patient was stage III. Eight patients were classified as a primary dedifferentiated chondrosarcoma and 3 patients were secondary. One of the primary lesions was misinterpreted initially as a low grade chondroid lesion by MRI and underwent curettage. Local recurrence occurred in 8 cases and distant metastasis occurred in 10 cases with a mean duration of 8 months (range, 2-23 months) and 7 months (range, 1-32 months), respectively. The three-year overall survival of patients with dedifferentiated chondrosarcoma was 18%, and 10 patients died due to disease progression. Conclusion: Dedifferentiated chondrosarcoma developed lung metastases in the early period of the clinical courses and the prognosis was dismal.
Depression is the most common and widespread mood disorder. About 20% of the population might suffer a major, incapacitating episode of depression during their lifetime. This disorder can be classified into two types: major depressive disorders and bipolar disorder. Since pharmaceutical treatments are different according to types of depression disorders, correct and fast classification is quite critical for depression patients. Yet, classical statistical method, such as minnesota multiphasic personality inventory (MMPI), have some difficulties in applying to depression patients, because the patients suffer from concentration. We used electroencephalogram (EEG) analysis method fer classification of depression. We extracted nonlinearity of information flows between channels and estimated approximate entropy (ApEn) for the EEG at each channel. Using these attributes, we applied two types of data mining classification methods: decision tree and possibilistic support vector machines (PSVM). We found that decision tree showed 85.19% accuracy and PSVM exhibited 77.78% accuracy for classification of depression, 30 patients with major depressive disorder and 24 patients having bipolar disorder.
Hepatomegaly and liver dysfunction might develop in patients with diabetes mellitus due to glycogen deposition or nonalcoholic steatohepatitis. We experienced a case of hepatic glycogenosis in a patient with type 1 diabetes mellitus who presented with recurrent hypoglycemia, suggesting impairment of glycogenolysis and gluconeogenesis. A 10-year-old girl with a 4-year history of type 1 diabetes mellitus was admitted because of recurrent hypoglycemia and abdominal pain in the right upper quadrant. She had Cushingoid features and hepatomegaly that extended 6 cm below the right costal margin. Laboratory data and radiologic examination revealed elevated liver enzyme levels due to fatty liver. Periodic acid-Schiff (PAS) staining revealed intense glycogen deposition in the cytoplasm of the hepatocytes and PAS reactivity was lost with diastase treatment. At 2 months after administration of glucagon injection and uncooked cornstarch between meals and at bedtime, the hypoglycemic episodes and liver dysfunction improved. It is important to distinguish hepatic glycogenosis from steatohepatitis, because it is possible to prevent excessive hepatic glycogen storage in hepatic glycogenosis cases by strictly controlling blood glucose level and by glucagon administration. To prevent severe hypoglycemic symptoms accompanied by hepatic glycogenosis, we suggest that uncooked cornstarch, which is effective in maintaining blood glucose level, can also be administered.
Interstitial lung disease refers to a group of pulmonary disorders characterized by inflammation of the interstitium, derangements and loss of alveolar capillary units leading to disruption of alveolar gas exchange, which induces symptoms of restrictive lung disease. Cases of interstitial pneumonia in children are uncommon and mostly have unknown causes. We have experienced an 8-year old boy who had symptoms of cyanosis, dry cough, dyspnea and abrupt weight loss. He had not been exposed to organic dusts, allergens or any other systemic disease infections. Chest radiology showed diffuse ground glass opacity in both lung fields. High resolution computed tomography(HRCT) showed multiple small patchy areas of consolidation with an underlying ground glass appearance in both lungs. The pathologic findings of lung biopsy tissue showed patchy areas of interstitial fibrosis, alveolar obliteration and nodular fibrotic areas, strongly suggesting interstitial pneumonia. No specific finding of viral inclusion or any other evidence of infection was found under electromicroscopy. We used peak flow meters to compare functional improvement. Forced expiratory volume in one second ($FEV_1$) was decreased to 25 percent of predicted value. The boy was given treatment with prednisone and showed improvements in HRCT findings after two months. He was able to tolerate easy exercise in school and showed clinical improvements after one year of follow up.
Kim, Seog-Ju;Park, Young-Su;Lee, Hae-Won;Park, Sang-Min
Korean Journal of Psychosomatic Medicine
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v.20
no.1
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pp.32-39
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2012
Objective : Psychiatry in North Korea is believed to seem very different from psychiatry in South Korea. However, there is nearly no information regarding psychiatry in North Korea until now. Our study aimed to get information about North Korean psychiatry. Methods : Three North Korean defectors in South Korea, whose clinical experience as medical doctors in North Korea was over 10 years, were recruited. They underwent the semi-structured interview, content of which included the clinical experience with psychiatric patients, the details of psychiatry, the treatment of psychiatric patients, the stigma of mental illness, and the suicide, in North Korea. Results : In North Korea, psychiatric department was called as 49th(pronounced as Sahsip-gu-ho in Korean). Only patients with vivid psychotic symptoms came to psychiatric department. Non-psychotic depression or anxiety disorders usually were not dealt in psychiatry. The etiology of mental illness seemed to be confined to biological factors including genetic predisposition. Psychosocial or psychodynamic factors as etiology of mental illness appeared to be ignored. Psychiatry was apparently separated from political or ideological issues. The mainstay of psychiatric treatment is the inpatient admission and out-of-date therapy such as insulin coma therapy. Stigma over mental illness was common in North Korea. Suicide is considered as a betrayal to his/her nation, and has been reported to be very rare. Conclusion : The situation of psychiatry in North Korea is largely different from that of South Korea. Although some aspects of North Korean psychiatry are similar to psychiatry in former socialist countries, North Korean psychiatry is considered to have also its unique characteristics.
This study sought to identify types of health behavior clusters among Korean adults and their related factors. A secondary analysis of 1,441 subjects, aged 19 to 64, in the 2009 Korean National Health and Nutrition Examination Survey (KNHANES IV-3) was conducted. A cluster analysis was used to identify types of clusters related to physical activity, smoking, and alcohol drinking. A complex samples chi square test and multivariate logistic regression were performed to analyze the associations between types of health behavior clusters and sample's characteristics using SPSS WIN 21. Five clusters were identified: health promotion, smoking, alcohol drinking, passive attitude, and risky behavior. The passive attitude cluster had the most subjects, with 47.7% of subjects as members. Socio-demographic factors, hypertension, and depressive symptoms were associated with membership in the alcohol drinking, smoking, passive attitude, or risky behavior cluster rather than the health promotion cluster. The findings of this study suggest that integrated health promotion programs incorporating multiple strategies need to be investigated. In addition, further studies should explore psychosocial factors that affect health behavior clusters, such as stress, self-efficacy, social support, and social networks.
Journal of agricultural medicine and community health
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v.20
no.2
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pp.149-156
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1995
This study was performed for 182 rural persons of patients who had admitted at National Masan Tuberculosis Hospital from 21th Feb to 18th Aug, 1994. We investigated diseased history based on the data according to the kind of occupation. The results were summarized as follows : The most common occupation was no occupation(35.2%). The most common age group was 5th decade(25.3%). By the age, the most common group in cases of no occupation was over 7th decade and under 5th decade, and agriculture was over 7th decade and 6th decade. Male(83.5%) were more than female, but wasn't significantly different. The most common group in the level of education was over the graduate of high school. The group that have ever drunken(p<0.05) and smoked(p<0.01) was significantly different in labour, service, agriculture, others. Family history, combined disease, symptom were no significantly different by occupation. Both lung fields on the chest X-ray was the most common site of invasion(82.4%). In the tests of AFB smear and culture, the differences according to the occupation were not. At the time of admission, the most common group in the state of treatment was initial treatment. The multi-drug resistance tuberculosis was no significantly different by occupation.
Kim, Dong Joo;Kim, Daeho;Lee, Jinbok;Kim, Yaeseul;Sohn, Sujin
Korean Journal of Psychosomatic Medicine
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v.28
no.1
/
pp.53-62
/
2020
Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.
The purpose of this study was to evaluate the association between oral health status and oral health-related quality of life (OHRQoL) by using the Oral Health Impact Profile-14 (OHIP-14) among adolescents in a metropolis of Korea. A total of 119 students in 1st grade in middle school and 1st grade in high school participated in this cross-sectional study. Oral examination was conducted by two trained dentists to collect in for mation about Decayed, Missing, and Filled Teeth (DMFT) and Community Periodontal Index (CPI). OHRQoL was evaluated by short-form of OHIP-14. Wilcoxon correlation, Kruskal-Wallis test and multiple regression analyses were performed to assess the association between oral health status and OHRQoL. All data was analyzed by SPSS 22.0 and the significance level was set at 0.05. The average of OHIP-14 score in adolescents having no dental caries ($17.88{\pm}5.13$) was higher than those having more than one DMFT index ($19.75{\pm}7.16$). The average of OHIP-14 score in adolescents having bleeding observed ($20.21{\pm}8.01$) was higher than those having more than calculus detected ($18.66{\pm}5.65$). The level of OHRQoL was higher in the participants perceiving better oral health condition compared to those perceiving poorer condition (p<0.05). The result of this study could provide the information that OHRQoL from adolescents positively associated with self-assessed oral health status than oral health with DMFT and CPI. Further studies are needed to well-designed follow-up studies.
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