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Large Cell Carcinoma of the Lung - An analysis of clinical features and survival (대세포 폐암의 임상적 양상과 생존률에 대한 분석)

  • Yang Jin Yeong;Lee Hyung Sik;Moon Sun Rock;Kim Gwi Eon;Suh Chang Ok;Loh Jojn J.K;Oh Won Yong;Whang In Soon
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.219-223
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    • 1990
  • This is a retrospective review of 33 patients with large cell lung carcinoma treated at Yonsei University Cancer Center between Jan.1985 and Dec.1989. Of the thirty-three patients, twenty eight were men and five women. Median age was 59 years. Large cell undifferentiated carcinoma was the most common pathologic type, $78.8\%$. Twenty one of thirty three patients had far advanced diseases, stage IIIB-IV at the time of initial diagnosis. Pleural effusion was initially presented in 12 patients, and SVC syndrome appeared in 5 patients. As to location of the primary tumor,19($57.6\%$) appeared in the right lung and 14 ($42.4\%$) in the left. Patients with a centrally located primary tumor mass were nearly the same as those peripherally located (17 vs.16). Fifteen of thirty three patients developed metastasis involving not only bone, brain, the opposite lung, adrenal gland but also soft tissue, skin, pancreas and appendix. Treatment was individualized with 19 treated radically and 14 palliatively. After treatment, only two patients showed a complete response. Long term survival was observed in 4 patients: 1 (24 mo.),2 (41 mo.) and 1 (54 mo.). The overall 2 year survival rate was $14.3\%$ while the median survival time was 6.0 months. Through the analysis of the various factors affecting survival, we observed that pleural effusion-absent group and complete response group had a statistical significant better survival rate (p<0.01).

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Study of Absorbed Dose and Effective Dose for Prostate Cancer Image Guided Radiation Therapy using kV Cone Beam Computed Tomography (kV Cone Beam Computed Tomography (CBCT)를 이용한 전립선암 영상유도방사선치료 시 흡수선량 및 유효선량에 관한 고찰)

  • Na, Jong-Eok;Lee, Do-Geun;Kim, Jin-Soo;Baek, Geum-Mun;Kwon, Kyung-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.2
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    • pp.67-74
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    • 2009
  • Purpose: To evaluate the results of absorbed and effective doses using two different modes, standard mode (A-mode) and low-dose mode (B-mode) settings for prostate cancer IGRT from CBCT. Materials and Methods: This experimental study was obtained using Clinac iX integrated with On Board Imager (OBI) System and CBCT. CT images were obtained using a GE Light Speed scanner. Absorbed dose to organs from ICRP recommendations and effective doses to body was performed using A-mode and B-mode CBCT. Measurements were performed using a Anderson rando phantom with TLD-100 (Thermoluminescent dosimeters). TLD-100 were widely used to estimate absorbed dose and effective dose from CBCT with TLD System 4000 HAWSHAW. TLD-100 were calibrated to know sensitivity values using photon beam. The measurements were repeated three times for prostate center. Then, Evaluations of effective dose and absorbed dose were performed among the A-mode and B-mode CBCT. Results: The prostate absorbed dose from A-mode and B mode CBCT were 5.5 cGy 1.1 cGy per scan. Respectively Effective doses to body from A mode and B-mode CBCT were 19.1 mSv, 4.4 mSv per scan. Effective dose from A-mode CBCT were approximately 4 times lower than B-mode CBCT. Conclusion: We have shown that it is possible to reduce the effective dose considerably by low dose mode(B-mode) or lower mAs CBCT settings for prostate cancer IGRT. Therefore, we should try to select B-mode or low condition setting to decrease extra patient dose during the IGRT for prostate cancer as possible.

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Burden, Job Satisfaction and Quality of Life of Nurses Caring for Cancer Patients (암 환자를 돌보는 간호사의 부담감, 직무 만족도 및 삶의 질)

  • Park, Mi-Sun;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.8-17
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    • 2005
  • Purpose: This study was performed to investigate burden, job satisfaction and quality of life of nurses who take care of cancer patients. Methods: The subjects were 237 nurses working at the oncology unit of hospitals with over 500 beds in Seoul and Gyeonggi-do. Data were collected using questionnaire from the February to March, 2005. Data were analyzed through t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression using SAS. Results: 1. The item that showed the highest level of burden was 'I feel limited even if I make efforts to reduce patients' pain. 'Burden was high in those group both who were younger than 35 years old and who had clinical experiences caring cancer patients for $3{\sim}4$ years. 2. The item that showed the lowest level of job satisfaction was 'the possibility of promotion'. Job satisfaction was high in those group both who had a spouse and were head nurses or incharge nurses. 3. The item that showed the lowest level of quality of life was 'I am physically exhausted'. Over 35 years old who had a spouse, and over 2,000,000 won monthly income made a high score in the quality of life. 4. There were negative correlations among burden, iob satisfaction and the quality of life. 5. The major factor affecting the quality of life was burden. Conclusion: The results of this study are expected to be utilized as basic data for developing support system to improve nurses' work conditions and quality of life.

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Structural analysis of the Social Support, Career Capability, Career Decision-making Self-Efficacy and Career Adaptability for the Reemployment Women (재취업여성이 지각한 사회적지지, 진로역량 진로결정자기효능감 및 진로적응성 간의 구조적 관계 분석)

  • Shin, Su-Jeong;Lee, In-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.8
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    • pp.422-432
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    • 2018
  • This study is designed to find out the causal relation between social support, career capability, career decision-making self-efficacy and career adaptability for the career interrupted women. For this purposes the scales of social support, career capability, career decision related self efficacy and career adaptability were used. For this study, the questionnaires were distributed from Mar. 2, 2018 to Apr. 6, 2018 to 960 to the career interrupted women who had the experience of getting training at the vocational school, beauty school and women's centers located in Seoul and Gyeonggi area (composed of married women in their 30s and 50s who were receiving the education of beauty care for more than 1-9 months). 920 questionnaires got responded from the women and they were used for the final analysis with Cronbach's ${\alpha}$, exploratory factor analysis, factor analysis, frequency analysis and correlation analysis performed with SPSS program and the structural equation performed with AMOS program. The findings from the analysis are as follows; First, it was found that the structural model between career capability, social support, career decision related self efficacy and career adaptability are proper. Second, the path coefficient of the structural model was found to be statistically significant with respect to all of career capability, social support, career decision related self efficacy and career adaptability. Third, it was found that in the relation between career capability, social support and career adaptability, the career decision related self efficacy has the mediating effect. These results show that if the level of career adaptability is to be enhanced for the caber interrupted women, the career decision related self efficacy can make the critical role in addition to the career capability and social support. So, this study tries to offer the basic data required for the preparation of career and the development of future career for the success of career interrupted women going back to the workplace.

The Relationship between Perceived Stress and Coping Strategies in Patients with Chronic Low Back Pain (만성요통 환자들에서 스트레스지각과 대응전략 간의 관계)

  • Shin, Yoon-Sik;Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.18-26
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    • 2002
  • Objectives : The object of this study was to investigate the relationship between coping strategies and perceived stress or pain discomfort in patients with chronic low back pain. 80 patients with chronic low back pain and 100 normal controls participated in this study. Methods: Global assessment of recent stress (GARS) scale and Stress Response Inventory (SRI) were used to measure perception for stressors and stress responses. Coping scale and pain discomfort scale were used to measure coping strategies and pain perception. Results : Scores of perceived stress related to work or job, interpersonal relationship, changes in relationship, sickness or illness and the total scores on the GARS scale were significantly higher in those with chronic low back pain than normal controls. Scores of the SRI fatigue subscale scored significantly higher in those with chronic low back pain than normal controls. No significant difference was found on total scores of the pain discomfort scale between those with chronic low back pain and normal controls. The patients with chronic low back pain scored significantly higher on planful problem solving and positive reappraisal than normal controls. In the patient group, pain perception had significant positive correlations with total scores of the SRI and scores of stress perception related to illness or injury. The extent of escape-avoidance showed significant negative correlations with age, whereas the extent of distancing or escape-avoidance had significant negative correlations with the level of education. Significant difference was also found in accepting responsibilities between male subjects and females. However, no significant correlations were found between coping strategies and perceived stressors, stress responses or pain perception. Conclusion : The results suggest that patients with chronic low back pain were more likely to use more active coping strategies than normal controls, though the former had more perception for stressors than the latter. It was also found that coping strategies used by the patients were associated with sociodemographic factors, but that they were not associated with perceived stressors, stress responses or pain perception.

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Effects of Higher Dietary Cation with or without Protected Fat and Niacin on the Milk Yield and Thermoregulatory Ability in Holsteins During Summer Heat Stress (여름철 고온스트레스 기간에 고 양이온 사료와 반추위 보호지방과 나이아신의 추가공급시 착유우의 유생산 및 체온조절에 미치는 영향)

  • 김현섭;이왕식;이현준;기광석;백광수;안병석;아주말 칸
    • Journal of Animal Science and Technology
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    • v.48 no.4
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    • pp.555-562
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    • 2006
  • The objective of this study was to evaluate the effects of dietary cation-anion difference (DCAD) with or without ruminally protected fat and niacin on the thermoregulatory ability, milk yield and milk composition of lactating dairy cows during summer in Korea. Thirty mid-lactating Holstein cows (134±12.4 DIM and 23.4±2.3kg/d of milk yield) were divided into three groups (10 animals/group). Cows were housed in a free-stall barn and were provided with forced- air ventilation (wind velocity = 4 m/s) using 41 cm diameter fans. Diet one was formulated to contain low DCAD (+15 DCAD) while the remaining two diets were higher in DCAD (+30 DCAD). One higher DCAD diet was formulated to contain by-pass fat and the second higher DCAD diet contained the niacin along with by-pass fat. The maximum ambient temperature during July was 28.5℃ which could be seen as a period of mild heat stress. As summer progressed, August was characterized as a severe heat stress condition with maximum ambient temperature (32.4℃) and THI (74.0). Dry matter, crude protein and total digestible nutrients intake was not affected by the DCAD level and supplementation of ruminally protected fat or niacin. Milk production was higher in cows fed diets supplemented with fat and niacin than those fed un-supplemented diet. No difference in milk yield was observed in cows fed diets supplemented with fat or niacin plus fat. Milk fat and rectal temperature were not affected by the DCAD level and supplementation of ruminally protected fat or niacin. However, respiration rate was decreased in cows fed diets supplemented with either fat or fat and niacin compared to those fed. The results of the present study indicated that higher DCAD (+30) and supplementation of fat along with niacin can somehow mitigate the negative effects of heat stress on milk yield and physiology of lactating Holsteins during July and August in Korea. In present study reduced respiration rate and increased milk yield in lactating cows may be attributed to the cooling effect of supplemented fat along with vasodilatory functions of niacin. (Key Words: DCAD, Heat stress, THI, milk yield, Milk fat, Holstein)

Review on Usefulness of EPID (Electronic Portal Imaging Device) (EPID (Electronic Portal Imaging Device)의 유용성에 관한 고찰)

  • Lee, Choong Won;Park, Do Keun;Choi, A Hyun;Ahn, Jong Ho;Song, Ki Weon
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.1
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    • pp.57-67
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    • 2013
  • Purpose: Replacing the film which used to be used for checking the set-up of the patient and dosimetry during radiation therapy, more and more EPID equipped devices are in use at present. Accordingly, this article tried to evaluated the accuracy of the position check-up and the usefulness of dosimetry during the use of an electronic portal imaging device. Materials and Methods: On 50 materials acquired with the search of Korea Society Radiotherapeutic Technology, The Korean Society for Radiation Oncology, and Pubmed using "EPID", "Portal dosimetry", "Portal image", "Dose verification", "Quality control", "Cine mode", "Quality - assurance", and "In vivo dosimetry" as indexes, the usefulness of EPID was analyzed by classifying them as history of EPID and dosimetry, set-up verification and characteristics of EPID. Results: EPID is developed from the first generation of Liquid-filled ionization chamber, through the second generation of Camera-based fluoroscopy, and to the third generation of Amorphous-silicon EPID imaging modes can be divided into EPID mode, Cine mode and Integrated mode. When evaluating absolute dose accuracy of films and EPID, it was found that EPID showed within 1% and EDR2 film showed within 3% errors. It was confirmed that EPID is better in error measurement accuracy than film. When gamma analyzing the dose distribution of the base exposure plane which was calculated from therapy planning system, and planes calculated by EDR2 film and EPID, both film and EPID showed less than 2% of pixels which exceeded 1 at gamma values (r%>1) with in the thresholds such as 3%/3 mm and 2%/2 mm respectively. For the time needed for full course QA in IMRT to compare loads, EDR2 film recorded approximately 110 minutes, and EPID recorded approximately 55 minutes. Conclusion: EPID could easily replace conventional complicated and troublesome film and ionization chamber which used to be used for dosimetry and set-up verification, and it was proved to be very efficient and accurate dosimetry device in quality assurance of IMRT (intensity modulated radiation therapy). As cine mode imaging using EPID allows locating tumors in real-time without additional dose in lung and liver which are mobile according to movements of diaphragm and in rectal cancer patients who have unstable position, it may help to implement the most optimal radiotherapy for patients.

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Relationship between job stress, health functional food selection attributes, and consumption values among workers for information technology in Gyeonggi area (경기지역 IT 분야 직장인의 직무스트레스, 건강기능식품 선택속성 및 소비가치의 관계)

  • Jung, Ji-Eun;Kim, Sung-Eun
    • Journal of Nutrition and Health
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    • v.53 no.1
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    • pp.54-67
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    • 2020
  • Purpose: This study examined the relationship between job stress, attributes of health functional food (HFF) selection, and consumption values for information technology (IT) workers, and analyzed the factors influencing the selection of HFF to improve health by making the right choice of HFFs. Methods: Three hundred forty IT workers in Gyeonggi area participated in the study. The participants were divided into low or high job stress group. The differences in participants' general characteristics, attributes of HFF selection, and HFF consumption values were investigated, and the mediating effects of HFF consumption values on the relationship between job stress levels and the HFF selection attributes were analyzed. Results: Job stress levels were high in those IT workers with a length of service < 5 years (p = 0.013). The group with lower job stress levels had a higher tendency to consider the ingredients contained in HFF products (p < 0.001), and their efficacy (p = 0.047). They also showed greater emotional value for a sense of security from consuming HFFs to stay healthy (p = 0.047). The group with higher job stress levels had greater epistemic value in that their choice of HFFs differentiated them from the other workers (p = 0.036). Higher job stress was associated with less consideration of the intrinsic attributes such as ingredients and efficacy of the HFF selection attributes (p = -0.113), emotional value of the HFF consumption values (p = -0.136), and the functional value such as practicality, price, and safety (p = -0.134). The job stress level influenced the intrinsic attributes through the functional and emotional values, demonstrating that the functional and emotional values had appropriate mediating effects on the relationship between job stress levels and intrinsic attributes. Conclusion: Education needs to be provided for workers to relieve job stress and improve the functional and emotional values, which contributes to choosing the appropriate HFFs.

A Study for Alexithymia in the Patients with Panic Disorder (공황장애환자에서 감정표현불능증에 대한 연구)

  • Choi, Young-Hee;Jang, Hyuck-Jin;Kim, Min-Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.1
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    • pp.53-61
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    • 2006
  • Objectives: This study was designed to evaluate difference of the alexithymia between panic patients and normal controls by examination of the relationships between different components of the alexithymia construct and level of anxiety and depression in panic patients and normal controls. Methods The subjects were 167 patients who met DSM-IV criteria for panic disorder and 110 normal controls. They drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorders Interview Schedule-Panic attack & Agoraphobia(ADIS-P & A), Korean version of Toronto Alexithymia Scale (TAS-20K), Spielberger State-Trait Anxiety Inventory-State & Trait (STAI-S & T), Beck Depression Inventory (BDI), and Revised Anxiety Sensitivity Index (ASI-R). For statistical analysis, we performed t-test to compare the sociodemographic characteristics and the scores of self reported scales between panic patients and normal controls. Pearson correlation was performed between TAS-20K and it's subfactors, STAI-S & T, ASI-R and BDI in panic patients and normal controls. And stepwise multiple regression analysis was preformed to explain results of correlation analysis for alexithymia. Results: The panic patients reported more significant alexithymic (p<0.001), more difficulty identifying feeling (p<0.001) and describing feeling (p=0.001) than normal controls. Futhermore, panic patients were more significant anxious, sensitive to anxious feeling and depressive than normal controls. Moreover, the alexithymia of panic patients was explained by trait-anxiety $({\Delta}R^2=0.255)$ and anxiety sensitivity $({\Delta}R^2=0.062)$, that of normal controls was predicted by depression $({\Delta}R^2=0.144)$ and anxiety sensitivity $({\Delta}R^2=0.033)$ Conclusion: The panic patients reported more anxious and sensitive to anxious feeling, and these symptoms predict alexithymia in panic patients. However, the alexithymia of normal controls was explained by depression more than anxiety sensitivity, and such a result isn't consistent with previous studies and this may be mainly due to difference of the homogeneity in object of the studies.

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Henoch-Scholein Purpura Presenting with Acute Abdominal Pain Preceding Skin Rash : Review of 23 Cases (급성 복통이 피부 발진에 선행한 Henoch-Schonlein Purpura 23례에 대한 고찰)

  • Chang, Ju Young;Kim, Yong Joo;Kim, Kyo Sun;Kim, Hee-Ju;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.576-584
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    • 2003
  • Purpose : For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. Methods : The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. Results : The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastrointestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum( 21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. Conclusion : The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.