Purpose: To investigate the role of radiotherapy for squamous cell carcinomas of the external auditory canal and middle ear. Materials and Methods: A series of 35 patients who were treated at a single institution from 1981 through 2007 were retrospectively analyzed. Thirteen patients were treated by radiotherapy alone; four by surgery only and 18 by a combination of surgery and radiotherapy. The total radiation dose ranged from 39~70 Gy (median, 66 Gy) in 13~35 fractions for radiotherapy alone and 44~70 Gy (median, 61.2 Gy) in 22~37 fractions for the combined therapy. Clinical end-points were the cause of specific survival (CSS) and local relapse-free survival (LRFS). The median follow-up time was 2.8 years (range, 0.2~14.6 years). Results: The 3-year CSS and LRFS rate was 80% and 63%, respectively. Based on a univariate analysis, performance status and residual disease after treatment had a significant impact on CSS; performance status and histologic grade for LRFS. Patients treated by radiotherapy alone had more residual disease following the course of treatment compared to patients treated with the combined therapy; 69% vs. 28%, respectively. Conclusion: Our results suggest that radiation alone was not an inferior treatment modality for CSS compared to the combined therapy for squamous cell carcinoma of the external auditory canal and middle ear. However, local failure after radiotherapy is the main issue that will require further improvement to gain optimal local control.
Purpose: To examine the effect of suboptimal chemotherapy in patients undergoing preoperative chemoradiotherapy for the treatment of rectal cancer. Materials and Methods: The medical records of 43 patients who received preoperative concurrent chemoradiotherapy, followed by radical surgery for the treatment of pathologically proven adenocarcinoma of the rectum from April 2003 to April 2006 were retrospectively reviewed. The delivered radiation dose ranged from 41.4 to 50.4 Gy. The standard group consisted of patients receiving two cycles of a 5-FU bolus injection for three days on the first and fifth week of radiotherapy or twice daily with capecitabine. The standard group included six patients for each regimen. The non-standard group consisted of patients receiving one cycle of 5-FU bolus injection for three days on the first week of radiotherapy. The non-standard group included 31 patients. Radical surgery was performed at a median of 58 days after the end of radiotherapy. A low anterior resection was performed in 36 patients, whereas an abdominoperineal resection was performed in 7 patients. Results: No significant difference was observed between the groups with respect to pathologic responses ranging from grades 3 to 5 (83.3% vs. 67.7%, p=0.456), downstaging (75.0% vs. 67.7%, p=0.727), and a radial resection margin greater than 2 mm (66.7% vs. 83.9%, p=0.237). The sphincter-saving surgery rate in low-lying rectal cancers was lower in the non-standard group (100% vs. 75%, p=0.068). There was no grade 3 or higher toxicity observed in all patients. Conclusion: Considering that the sphincter-saving surgery rate in low-lying rectal cancer was marginally lower for patients treated with non-standard, suboptimal chemotherapy, and that toxicity higher than grade 2 was not observed in the both groups, suboptimal chemotherapy should be avoided in this setting.
Journal of the Korean Society for Library and Information Science
/
v.46
no.3
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pp.271-295
/
2012
This study aims to extract and analyze the bibliotherapeutic values/situations of Korean folk-tales for multi-cultural families in Korea. By analyzing 27 stories in the Korean folk-tale picture book written in two languages(Korean & English), we can find out 5 kinds of situational analysis as follows: (1) There are more men than women by the biological sex factor, whereas there are more adults than younger persons by the biological age discrimination. (2) For the space concept, there are a lot of socially related stories in their surroundings. (3) In the vertical relationship, there are more conflict elements than in the horizontal one. (4) There are more helpers from the outside than in the inside circle for the solution of their problems. (5) As a story theme, greed, wisdom, belief and family component elements are greatly involved in the stories. Among their beliefs, there are a lot of wisdom and greed themes, while piety and royalty to parents and conflict against stepmothers are among the family components. All of these would be an archetype of Korean culture, which can play an important role not only to understand Korean lifestyle for the multi-cultural families, but also to learn and practice bibliotherapeutic values.
This study is to investigate the effect of music therapy Program on Problem Behaviors and Social Skills Children with ADHD. The participants of the study were first and second graders in B elementary school in J city. They were observed in unsuitable behavioral patterns in school life by their homeroom teachers. Fifteen participants were divided into control and experimental group: The control group was eight and the experimental group was seven. Group music therapy was conducted two times a week for seven-week period. It took 35-40 minutes per therapy after school. Child Behavior Checklist-Korean, Social Skills Rating System, Social Acceptance were administered in pre- and post-stages. For the analysis of the data, Mann-Whitney U test was used. The findings from the research are summarized as follows: 1) The experimental group who was treated in music therapy showed a positive effect on problem behaviors. That is to say, the participants in the experimental group improved in emotional and cognitive stability while they significantly decreased attack behaviors; 2) The experimental group statistically showed significant improvement in their social behaviors compared to the control group. The music therapy group significantly increased social skills such as cooperation, self-assertion, and self-control. However, they did not improve responsibility as social skills in a significant manner; and 3) The experimental group showed higher degree of social acceptance than the control group. However, the result did not show a significant difference between the groups. In conclusion, the study proved positive effects of music therapy on ADHD children's uncarefulness, attack behaviors, and social skills for seven-week experimental period.
Purpose: To estimate the long-term therapeutic efficacy and safety of adefovir dipivoxil in children and adolescents with chronic hepatitis B who have developed lamivudine resistance. Methods: Sixteen patients (12 boys and 4 girls; ages 4.3~20.9 years; mean age 14.2 years) with chronic hepatitis B infection resistant to lamivudine therapy received adefovir (0.3 mg/kg/day, maximal dose 10 mg) orally for at least 9 months between March 2004 and April 2008. Each patient was followed up for a mean period of 27 months (range 9~49 months) until April 2008 at Kyungpook National University Hospital in Korea. Therapeutic responses to adefovir were evaluated at 12, 24, 36, and 48 months from the initiation of therapy using the Kaplan-Meier method. Response measurements included ALT normalization, HBV DNA negativization, 2 $log_{10}$ IU/mL decrement of HBeAg titer, HBeAg loss, and HBeAg/Ab seroconversion rate. Results: Three (18.8%) of the 16 patients treated with adefovir showed HBeAg/Ab seroconversion. Kaplan-Meier estimates of cumulative ALT normalization were 12.5% (12 months), 43.8% (24 months), 63.5% (36 months), and 92.7% (48 months), respectively. Cumulative HBV DNA negativization was 6.7%, 30.0%, 45.6%, and 78.2% at 12, 24, 36, and 48 months, respectively. Cumulative 2 $log_{10}$ copies/mL decrement of HBeAg titer was 12.5%, 43.8%, 56.3%, and 86.9% at 12, 24, 36, and 48 months, respectively. Cumulative HBeAg loss and HBeAg/Ab seroconversion were 6.7% (12 months) and 22.2% (24 months), respectively. Conclusion: The long-term therapeutic efficacy of adefovir dipivoxil was favorable in children and adolescents with chronic hepatitis B who had developed lamivudine resistance. The long-term use of adefovir should be safe in children.
Purpose: Three-dimensional conformal radiation therapy (3DCRT) and intensity-modulated radiation therapy (IMRT) were found to reduce the incidence of acute and late rectal toxicity compared with conventional radiation therapy (RT), although acute and late urinary toxicities were not reduced significantly. Acute urinary toxicity, even at a low-grade, not only has an impact on a patient's quality of life, but also can be used as a predictor for chronic urinary toxicity. With bladder filling, part of the bladder moves away from the radiation field, resulting in a small irradiated bladder volume; hence, urinary toxicity can be decreased. The purpose of this study is to evaluate the impact of bladder volume on acute urinary toxicity during RT in patients with prostate cancer. Materials and Methods: Forty two patients diagnosed with prostate cancer were treated by 3DCRT and of these, 21 patients made up a control group treated without any instruction to control the bladder volume. The remaining 21 patients in the experimental group were treated with a full bladder after drinking 450 mL of water an hour before treatment. We measured the bladder volume by CT and ultrasound at simulation to validate the accuracy of ultrasound. During the treatment period, we measured bladder volume weekly by ultrasound, for the experimental group, to evaluate the variation of the bladder volume. Results: A significant correlation between the bladder volume measured by CT and ultrasound was observed. The bladder volume in the experimental group varied with each patient despite drinking the same amount of water. Although weekly variations of the bladder volume were very high, larger initial CT volumes were associated with larger mean weekly bladder volumes. The mean bladder volume was $299{\pm}155\;mL$ in the experimental group, as opposed to $187{\pm}155\;mL$ in the control group. Patients in experimental group experienced less acute urinary toxicities than in control group, but the difference was not statistically significant. A trend of reduced toxicity was observed with the increase of CT bladder volume. In patients with bladder volumes greater than 150 mL at simulation, toxicity rates of all grades were significantly lower than in patients with bladder volume less than 150 mL. Also, patients with a mean bladder volume larger than 100 mL during treatment showed a slightly reduced Grade 1 urinary toxicity rate compared to patients with a mean bladder volume smaller than 100 mL. Conclusion: Despite the large variability in bladder volume during the treatment period, treating patients with a full bladder reduced acute urinary toxicities in patients with prostate cancer. We recommend that patients with prostate cancer undergo treatment with a full bladder.
The assessment and rehabilitation of patients with cognitive dysfunction is a field that currently requires assistive technology. While the paper-and-pencil test, such as the line tracing test (LTT), is one of the most commonly used assessment methods for cognitive dysfunction, it has become time-consuming due to its manual characteristic. The aim of this study was therefore to establish a computer-based real-time assessment system for patients without compromising the usefulness of the conventional paper-and-pencil based user tools. A digital pen-based assessment and rehabilitation system, the ePen System, could eliminate the time required for manual assessment while maintaining the measurement accuracy. The proposed system may assist rehabilitation specialists to assess and diagnose patients with unilateral visual neglect. This system can be applied to a range of assessment and rehabilitation modalities based on pen and paper. It can also be used for various patients such as those with Parkinson's disease, stroke, or different forms of brain lesions.
Purpose: The purpose of this study was to provide basic data for the effectiveness and the necessity of home visiting physical therapy through examining performance ability and functional changes in daily life activities by investigating the life of disabled persons living at home. Methods: After selecting 100 people with physical disabilities greater than level 3 and brain damage related disabilities living in Youngam-Gun, we conducted mobility tests according to a Modified Bathel Index (MBI), the Berg Balance Scale (BBS), and floor and bed movements? for Activities of Daily Living evaluation. We did this before the experiment and after doing home visiting physical therapy for 90 minutes at a time, once a week for 6 months Results: 1) Persons who live in a bed are higher than those who live in a floor. There was a significant difference between persons who live in a floor and those who live in a bed in the change in MBI and BBS scores after home visiting physical therapy. 2) Those with a musculoskeletal disorder had a significantly different change in MBI and BBS according to the type of disease and kind of disability. Those with neuropathy had a significantly different change in MBI. Those with physical disabilities showed a significant difference in MBI and BBS. Conclusion: A home visiting physical therapist can cause an improved performance ability and lead to the ability of disabled persons living at home to carry out activities of daily livingin a large part and the study for brain lesion disabilities except physical disabilities and stroke which occupy large proportion of disabled persons should be done.
The purpose of this study as a research of experience of sexual offenders who are in confinement in prisons and forensic facilities is to theoretically investigate fundamental structures of their experiences and to practically construct basic data to present intervention programs of sexual offenders. This study was conducted by hermeneutical and phenomenological methods invoked of the analytic framework of Van-Manen (1990) about seven sexual offenders. The data were collected through in-depth interviews, and the results of the interpretation are shown as perception that they were victims of public opinion, the mark of Cain, loss of opportunity of examination caused by show window, collective differentiation through distinction, expression of metaphysical being that wants to slip out of the skin, counterplot of scientific management techniques, undifferentiation from the Imaginary, sexual acts shown as inverted communication, discovering dominant domain as forming reaction to being controlled, not being free from capitalistic attributes in which even children's sex is commercialized, distortion in socialization of sexual identity, paternity stamped as embodiment of suppressed desire, recovery of lost virginity of mother through children, and family as a name broken to pieces.
Dong Hyeon Kim;Ji Hae Lee;Myeong Ja Jeong;Soung Hee Kim;Ji-Young Kim;Soo Hyun Kim;Mi-Jin Kang
Journal of the Korean Society of Radiology
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v.84
no.3
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pp.726-730
/
2023
The accessory tendon of the extensor hallucis longus is a common type of extensor hallucis longus variation. This is a case of a 38-year-old female patient who initially considered conservative treatment for a suspected partial rupture, but finally underwent surgery after being diagnosed with a complete rupture of the main tendon and accessory tendon medial to the main tendon on MRI scan.
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