• Title/Summary/Keyword: 치료 순응도

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A Prospective Randomized Trial Comparing the Seciuence of Adiuvant Chemotherapy and Radiotherapy following Curative Resection of Stage II, III Rectal Cancer (직장암의 근치적 수술 루 방사선치료와 화학요법의 순서에 대한 고찰 -전향적 무작위 3상 임상연구 중간 결과 보고-)

  • Kim Kyoung Ju;Kim Jong Hoon;Choi Eun Kyung;Chang Hyesook;Ahn Seung Do;Lee Je Hwan;Kim Jin Cheon;Yu Chang Sik
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.17-25
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    • 2000
  • Purpose : To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and III rectal cancer who had undergone curative resection were randomized to 'early radiotherapy group (arm I)' or' late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. Materials and Methods . From January 1996 to March 1999, 313 patients with curatively resected stages II and III rectal cancer have been randomized to' early' or' late' radiation therapy group and received combined chemotherapy (5-FU 375 mg/m$^{2}$/day, ieucovorin 20 mg/m$^{2}$, IV bolus daily Dl-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/s weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was peformed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. Results :Local recurrence occurred in 11 patients (9.7$\%$) for arm I and 9 patients (8$\%$) for arm 11. There was no significant difference between both groups ( p=0.64). However, distant metastasis was found in 22 patients (19.5$\%$) for arm I and 35 patients (31.0$\%$) for arm II and which showed statistically significant difference between the two groups ( p=0.046). And neither 3-year disease-free survival (70.2$\%$ vs 59.2$\%$, p=0.2) nor overall survival (89.4$\%$ vs 88.0$\%$, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3$\%$ and 79.9$\%$ respectively but leukopenia more than RTOG grade 3 was only 2.1$\%$ and 6.0$\%$ respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2$\%$ vs 41.6$\%$, p=0.02) but this complication was controlled with supportive cares. Conclusion : Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy after curative resection for rectal cancer, local recurrence rate was low with combined chemoradlotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.

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The Correlation between Sensory Process Type and Interpersonal Problems, Adult Attachment on University Students (대학생의 감각처리 유형과 대인관계문제 및 성인애착의 관계)

  • Yoon, Su-Jeong;Lee, Chun-Yeop;Kim, Hee-Jung;Jung, Hye-Rim
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.2
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    • pp.9-18
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    • 2017
  • Objective : This study was to find out the level of sensory process type, adult attachment and interpersonal problems on university students and then to investigate the correlation. Methods : For this study, 169 students who don't know about the evaluation tool in university students of K area in Korea were participated. To execute evaluation, Adolescents/Adults Sensory Profile (AASP) was used for the sensory process type, Short Form of the Korean Inventory of Interpersonal Problems Circumplex Scale (KIIP-SC) was used for interpersonal problems, and Experiences in Close Relationships Scale-Revised (ECR-R) was used for the adult attachment. The correlation between sensory process type and interpersonal problems, adult attachment was analyzed by using pearson correlation analysis. Results : Sensory process type of university students appeared that sensory seeking was lower than general people, and the rest of items showed similar results with general people. For interpersonal problems, there was a lot of difficulty in self-sacrificing and overly accommodating, whereas there was a little difficulty in vindictive and domineering / controlling. For adult attachment, attachment avoiding was more stable than attachment anxiety. Also, low registration and sensory sensitivity all showed positive correlation with interpersonal problems and adult attachment. Among interpersonal problems, self-sacrificing and intrusive showed positive correlation with sensory seeking whereas cold, socially inhibited, nonassertive, and overly accommodating showed positive correlation with sensory avoiding. Thus, sensory seeking and sensory avoiding showed different results (p<.05). Conclusion : In occupational therapy clinic, not only the disabled but non-disabled people that experience issue of interpersonal problems and attachment could be helped with managing high quality social activity if they execute intervention according to sensory process type.

Comparison of Antidepressants Tolerability in Cancer Patients Referred for Psychiatric Consultation (정신건강의학과 자문 의뢰된 암 환자의 항우울제 내약성 비교 연구)

  • Ko, Eunmi;Park, Jin-Seong;Ha, Juwon;Lim, Sewon;Kim, Tae-Suk;Ha, Jee Hyun;Paik, Jong-Woo;Lee, Boung Chul;Choe, Byeong Moo;Lee, Kang-Joon;Kim, Sung-Wan;Yang, Jong-Chul;Ko, Young-Hoon;Oh, Kang-Seob
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.3-10
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    • 2013
  • Objectives : Many patients diagnosed with cancer suffer from various psychiatric symptoms such as depression, anxiety and insomnia as well as cancer itself. Patients with cancer are more vulnerable to possible adverse events of psychotropic medications. Although antidepressants are widely used among cancer patients, there is little information about tolerability of antidepressants. This study was conducted to compare tolerability of antidepressants in cancer patients referred for psychiatric consultation. Methods : The participants were cancer patients who had been referred to psychiatrist for their psychiatric symptoms. We retrospectively analyzed the data of patients diagnosed with cancer from 9 general hospitals in Korea. The discontinuation rate for a 6 months period after treatment initiation for three antidepressants(Escitalopram, Mirtazapine, Paroxetine) were compared. Results : Antidepressants were prescribed for 96.3% of subjects and Escitalopram 150(47.2%), Mirtazapine 92(28.9%) and Paroxetine 76(23.9%) were prescribed frequently in order There were no significant differences in discontinuation rates among the three antidepressants during the 6 month period after initiation of pharmacotherapy. But there was a difference in discontinuation rates between inpatients versus outpatients(p<0.0001). Conclusions : In a naturalistic setting for the antidepressant treatment for cancer patients, it seems that there are no differences in discontinuation rates among these three antidepressants. It is therefore essential that such interactions are carefully considered when treating patients of antidepressants who already have cancer.

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Helicobacter pylori reinfection rate by a 13C-urea breath test and endoscopic biopsy tests in Korean children (한국 소아에서 Helicobacter pylori 박멸 후 13C-요소 호기 검사와 내시경적 생검을 이용한 재감염률 연구)

  • Shim, Jeong Ok;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.268-272
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    • 2006
  • Purpose : The reinfection rate of H. pylori reported before $^{13}C$-urea breath test($^{13}C$-UBT) era was higher than that of the post $^{13}C$-UBT era. Children are usually reluctant to receive invasive endoscopic evaluation for the reinfection of H. pylori, particularly when they are asymptomatic. The aim of the study is to discover the reinfection rate by different diagnostic tests, and to find out what causes the difference. Methods : Children confirmed to be eradicated from H. pylori were included in the study. Reinfection was evaluated by endoscopic biopsy based tests(n=34, mean age $11.5{\pm}3.7$ years) and/or a $^{13}C$-UBT(n=38, mean age $10.0{\pm}3.6$ years) at the time of 18 months after eradication. At first visit, H. pylori infection had been diagnosed by positive results from a rapid urease test, Giemsa stain and Warthin-Starry stain and/or a positive culture. Eradication was defined as negative results from all above tests 1-3 months after eradication therapy. Results : Reinfection rate by endoscopic biopsy based tests was 35.3 percent(12/34). All patients had abdominal symptoms(P=0.000). Reinfection rate was 13.2 percent(5/38) by a $^{13}C$-UBT. Reinfection rate was higher in children with abdominal symptoms(P=0.008). There was no evidence that reinfection rate depended on the sex(P=0.694), age(P=0.827), diseases(peptic ulcers vs gastritis, P=0.730) and eradication regimen(P=0.087). Conclusion : Helocibacter pylori reinfection rate in Korean children was 13.2 percent per 18 months by a non-invasive test or $^{13}C$-UBT. Accurate determinations of the reinfection rate in children is affected by the compliance of the diagnostic tests. Non-invasive tests should be considered to investigate the reinfection rate in children.

Time Series Analysis on Outcomes of Tuberculosis Control and Prevention Program between Small Areas in Korea - with Patient Registry Data of 234 City.County.District Public Health Centers - (소규모 지역간 결핵관리사업 성과에 대한 시계열분석 - 전국 234개 시.군.구 보건소의 환자등록자료를 중심으로 -)

  • Kim, Chun-Bae;Choe, Heon;Shin, Kye-Chul;Park, Jong-Ku;Ham, Soo-Keun;Kim, Eun-Mi
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.837-852
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    • 2000
  • Backgrounds : Today, tuberculosis cannot only be cured medically, but also controlled by public health. Despite the overall worldwide decline in tuberculosis, the disease continues to be a significant problem among developing countries and in the slums of large cities in some industrialized countries. Particularly, this communicable disease has come into the public health spotlight because of its resurgence in the 1990's. our country has been operating the Korean National Tuberculosis Control Program since 1962, focusing around public health centers. Therefore, this study aims to compare the effectiveness of tuberculosis control activities, one of the major public health activities in Korea, by producing indexes, such as the yearly registration rate per 100,000 population and treatment compliance of tuberculosis on in small areas (communities). Methods : This work was accomplished by constructing a time-series analytic model using data from "1980~2000: the Yearly Statistical Report" with patient registry data of 234 City. County. District public health centers and by identifying the factors influencing the tuberculosis indexes. Results : The trends of pulmonary tuberculosis positive point prevalence and pulmonary tuberculosis negative point prevalence on X-ray screening have declined steadily, beginning in 1981 and continuing to 1998 by region (city, county, district). Although the tuberculosis mortality rate steadily shows a declining trend by year and region, but Korea still ranks first among 29 OECD countries in 1998, with a tuberculosis mortality rate of 7.1 per 100,000 persons, according to the time-series analysis for fatal diseases. Conclusion : The results of the study will form the fundamental basis of future regional health care planning and the Korean Tuberculosis Surveillance System on 2000. Since the implementation of local autonomy through the Local Health Act of 1995, it has now become vita1 for each city, county, district public health centers to determine its own priorities for relevant health care management, including budget allocation and program goals.

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Prospective Study of Helicobacter pylori Reinfection Rate and Its Related Factors (전향적 연구에 의한 Helicobacter pylori 재감염률 및 관련요인)

  • Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Chang-Yoon
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.79-92
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    • 2003
  • Objectives: To investigate the reinfection rate of Helicobacter pylori and the factors related to reinfection of H. pylori, 86 persons were examined in April 2000 after 1 year follow-up period and 77 persons were examined in October 2001 after two and a half-year follow-up period in Gyeongju-si, Gyeongsangbuk-do, Korea. Methods: The subjects were confirmed as H. pylori negative by urea breath test(UBT), and asked to answer the questionnaire regarding demographic characteristics, dyspepsia symptoms, health-related behaviors and family history. Results: The reinfection rate on the first year of the eradication of H. pylori was 15.6%, when the 77 subjects have finished follow-up observation for one year. In the urea breath test performed after two and a half year, 13 out of 77 were positive, with the reinfection rate of 16.9%. Age, sex, socio-economical status, educational level and family history were not associated with the reinfection, while there was significant association between the reinfection and postprandial fullness and epigastric bloating in subjective dyspepsia that the subjects who were determined to be negative in the urea breath test for the following year. The treatment compliance and drinking were significant variables in univariate analysis. Meanwhile, the cases in which the dyspepsia symptom scores for the recent year were 2 to 3 points served as the only statistically significant variable in multiple logistic regression analysis, with the odds ratio of 4.5. The cases in which salt intake during meals was exceeded were 8.7 in the odds ratio, but statistically insignificant. Conclusions: Conclusively, the first-year reinfection rate was 15.6%, and the second-year reinfection rate was 16.9%. Thecomplaints of subjective dyspeptic symptoms and the treatment compliance, as the basis for predicting the H. pylori reinfection in communities, can be used as the basis to screen the subjects for follow-up examination to find out H. pylori infection.

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The Effects of Planned Discharge Nursing in Compliance, Knowledge, and Nursing Service Satisfaction for Patients having Video-Assisted Thoracoscopic Surgery (계획된 퇴원 간호 중재가 기흉 수술 환자의 약물복용 및 치료 지시 이행도, 질병에 대한 지식과 간호 만족도에 미치는 효과)

  • Lee, Won Jin;Bang, Yun Yi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.11
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    • pp.121-129
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    • 2019
  • This study aimed to develop a planned discharge nursing intervention guideline for patients with pneumothorax, and to examine its influence on drug compliance, knowledge about disease, compliance level with therapeutic regimen, and nursing satisfaction. Methods: The planned discharge nursing intervention guideline was developed based on comprehensive literature reviews and clinical experiences. Patients having video-assisted thoracoscopic surgery at a single general hospital were allocated to either intervention (n=30) or control group (n=29). Participants in the intervention group were administered planned discharge nursing intervention thrice, 30 minutes each, by a cardiovascular nurse. Standard care was provided to patients in the control group. Data were collected from March, 2010 to December, 2010. Results: Participants in the intervention group presented statistically significant improvement in drug compliance (t=-2.05, p=0.044), pill count (t=-2.61, p=0.011), knowledge about disease (t=-4.39, p=0.001), and nursing satisfaction (t=-4.13, p=0.001). No significant difference in compliance levels was observed with standard therapeutic regimen. Conclusion: Planned discharge nursing intervention can be successfully implemented for patients undergoing thoracoscopic surgery. Further research is required to evaluate long-term effects like complication or relapse.

Development of a novel combination tablet containing silodosin and solifenacin succinate for the treatment of urination disorder (배뇨 장애 치료를 위한 실로도신과 솔리페나신 숙신산염 함유한 새로운 복합 정제 개발)

  • Choi, Hyung-Joo;Lee, Jeong-Gyun;Kim, Kyeong Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.3
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    • pp.323-332
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    • 2021
  • This study was undertaken to develop a new combination tablet containing silodosin and solifenacin succinate for treating urination disorders, for which a simultaneous analytical method of silodosin and solifenacin succinate was established. The aqueous solubility of silodosin and solifenacin succinate was determined to be higher than 1 mg/ml in various buffers, and dissolution of the silodosin and solifenacin succinate commercial products was accomplished within 30 minutes. The drug-excipients compatibility test was subsequently evaluated using differential scanning calorimetry. Excipients without compatibility were selected, and various combination formulations were prepared applying the wet granulation method. Of these, the formulation comprising silodosin, solifenacin succinate, lactose hydrate, MCC PH101, sodium lauryl sulfate (SLS), Povidone K30, crospovidone and magnesium stearate, having a weight ratio of 8/10/56/112/2/6/6/2, respectively, showed equivalence comparative to the dissolution achieved with the commercial products of silodosin (Thrupas tab) and solifenacin succinate (Vesicare tab). Thus, we propose that compared to the currently available commercial products, this novel combination tablet containing silodosin and solifenacin succinate is an effective alternative for the treatment of urination disorders.

EFFECT OF THE SOCIAL SKILL TRAINING IN ADHD CHILDREN (주의력 결핍 과잉운동장애 아동에서 사회기술훈련의 효과)

  • Park, Soon-Young;Kwack, Young-Sook;Kim, Mi-Koung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.154-164
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    • 1998
  • Medication is widely accepted as an effective method to reduce the problem of attention deficit, hyperactivity, impulsivity, resistance and violence of ADHD children. However, it does not provide us with the solution on the conflicting routinized behavioral patterns to gain a high level of self-control and acceptable behavior. As a way of replacing medication, this study applies the social skills training program for ADHD children and measures the level of improvement of social skills and the change of the behavioral patterns. The experiment is carried out on 16 children ranged from 6 to 13 years of age for 10 weeks. The patients are divided into three groups:a pure ADHD group, an ADHD group with conduct disorder, an ADHD group with mental retardation and other symptoms. The change of symptoms and the change of social skills are measured by the Child Behavior Checklist(CBCL), the ADD-H Comprehensive Teacher’s Rating Scale(ACTeRS) and the Social Skills Rating Scale(SSRS), and finally Mastson Evaluation of Social Skills for Youth(MESSY). Wilcoxon signed ranks test is used to evaluate the effect of the treatment, and Kruskal-Wallis test is also used to measure the change after the treatment in each of the three groups. In the ADHD group with conduct disorder, the examination of the effect of the treatment shows a significant reduction of violence in the area of behavior(p<.05), and a significant difference of activity and social skills in the area of social competent(p<.001). In the ADHD group with mental retardation and other symptoms, a significant rise of social skills is found in the area of social skills evaluation (p<.05). However, there is no significant difference of effect by the treatment among the three groups. In addition, the current examination shows that the social skills training program does not make a statistically significant contribution to the social skills of the ADHD children. On the other hand, the training helps some children, when it is suitable for the characteristics and accompanying symptoms of the children:it reduces the level of violence in the ADHD group with conduct disorder, and it raises the social skills in the ADHD group with mental retardation. In other words, the social skills training program will reduce the conduct disorder and helps peer relation for ADHD children.

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Phase II Study of Concurrent Chemotherapy with Etoposide and Cisplatin (EP) and Radiation Therapy for Unresectable Stage III Non-small Cell Lung Cancer (수술이 불가능한 제 III기 비소세포폐암에서 Cisplatin 및 Etoposide(EP)의 화학요법과 방사선요법의 병행요법(2상 임상연구))

  • Hur, Nam-Hyun;Lee, Choon-Taek;Kim, Jae-Hag;Jang, Jae-Jin;Nam, Seung-Mo;Park, Yeon-Hee;Ryoo, Baek-Yeol;Kim, Tae-You;Im, Young-Hyuck;Kang, Yoon-Koo;Kim, Mi-Sook;Yoo, Seong-Yul;Lee, Jhin-Oh;Kang, Tae-Woong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.776-784
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    • 1997
  • Background : Various combinations of treatment modalities have been reported in stage III non-small cell lung cancer (NSCLC). however, the standard treatment modality has not established yet. Recently, the efficacy of concurrent chemotherapy and radiation therapy has been reported in locally advanced lung cancer. We evaluate the response rate, toxicity, and survival of concurrent chemotherapy with etoposide and cisplatin(EP) and radiation therapy for unresectable stage III NSCLC. Method : Between October 1995 and December 1996, 32 patients with histologically proven unresectable stage III NSCLC without malignant pleural effusion were entered into this study. Twenty-nine patients were eligible for the response, survival, and toxicity analysis. Induction was two cycles of chemotherapy with etoposide and cisplatin plus concurrent chest RT to 4500cGy. Resection was attempted if the clinical response offered surgical resectability. Boost radiation therapy upto 5940cGy and one cycle of EP were performed if the disease were stable or responsive but still unresectable. Results : Of 29 eligible patients, 22(75.9%) showed partial response(PR). The progression free interval was 6.3months(range 1.1 to 19.5months). Surgical resection was performed in one patient. The median survival was 12.1months and one-year survival rate was 50.6%. The major toxicity was leukopenia($\geq$ grade 3, 46%). Thrombocytopenia over grade 3 was found in 11%. Radiation pneumonitis occurred in 13 patients(46%). Conclusion : Concurrent chemotherapy(EP) plus radiotherapy was effective and tolerable in the treatment of unresectable stage III NSCLC.

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