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Radiation Therapy in Recurrence of Carcinoma of the Uterine Cervix after Primary Surgery (자궁경부암으로 수술 후 재발암의 방사선치료)

  • Kim, Jin-Hee;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.143-148
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    • 2003
  • Purpose: The purpose of this study was to evaluate treatment results in terms of the survival and failure patterns subsequent to radiation therapy in recurrent cervical cancer, fellowing primary surgery. Material and Methods: Between January 1990 and December 1999, 27 patients, with recurrent cervical cancer following primary surgery, were subsequently treated with radiation in the Department of Radiation Oncology, at the Keimyung University Dongsan Medical Center. Their median age was 48, ranging from 31 to 70 years old. With regard to the Initial FIGO stage on presentation, 20 and 7 patients were stages I and II, respectively. Twenty three patients had squamous cell carcinomas and 4 had adenocarcinomas. The time interval from the primary surgery to the recurrence ranged from 2 to 90 months with a median of 29 months. The recurrent sites were the vaginal cuff alone, the pelvic cavity and combined recurrence in 14, 9 and 4 patients, respectively. Radiation was peformed, with external and vaginal intracavitary radiation in 13 patients, external radiation alone in 13 and vaginal intracavitary radiation alone in another one. The median follow-up period was 55 months, ranging from 6 to 128 months. Results: The five year disease free survival (5y DFS) and five year overall survival (5y OS) rates were 68.2 and 71.9$\%$, respectively. There was a marginal statistically significant difference in the 5y DFS in relation to the recurrent site (5y DFS, 85.7$\%$ in vaginal cuff recurrence alone, 53.3$\%$ in pelvic cavity recurrence, p=0.09). There was no difference in the survival according to the time interval between the primary surgery and a recurrence. There was only a 7$\%$ local failure rate in the patients with a vaginal cuff recurrence. The major failure patterns were local failure in the patients with pelvic cavity recurrence, and distant failure in the patients with a combined recurrence. There were no complications above grade 3 after the radiation therapy. Conclusion: Radiation therapy was safe and effective treatment for a recurrent carcinoma of the uterine cervix following primary surgery, especially the external beam radiation and vaginal intracavitary irradiation achieved the best results in the patients with a vaginal cuff recurrence following primary surgery.

Symptom Prevalence During Terminal Cancer Patients' Last 48 Hours of Life (말기 암 환자에서 임종 전 48시간 동안 나타나는 신체적 증상 빈도)

  • Jung, Soo-Jin;Lee, Bok-Ki;Choi, Kyung-Hi;Youn, Bang-Bu;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.5 no.1
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    • pp.17-23
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    • 2002
  • Purpose : The prevalence of symptoms in patients with terminal cancer varies considerably and these symptoms are very difficult to control. However, patients can spend their last days or hours of life without suffering pain with appropriate care. One of the major concerns during last days of life is to predict the time of death. We would like to investigate symptom prevalence during terminal cancer patients' last 48 hours in Korea, and therefore contribute to predict the time of death and to help to determine appropriate treatments. Methods : The data for this study was recorded from 92 of 132 patients who died with terminal cancer at the hospital between February 1 and October 31, 2000. We investigated the symptom prevalence during the last 48 hours through medical obligation record and analyzed the changes of symptom prevalence at the admission, $48{\sim}24$ hours and $24{\sim}0$ hours before death. Results : The predominant symptom prevalence was pain (57.6%), followed by confusion (55.4%), dyspnea (48.9%), voiding difficulty (42.4%) in the last 48 hours before death. From the statistical analysis for the changes of symptom prevalence in time, pain, nausea and vomiting were decreased but noisy and moist breathing, sweating, groan, restlessness and agitation, and loss of consciousness were increased (P<0.05). Conclusion : The results from this study show the tendency to increase of prevalence of noisy and moist breathing, sweating, groan, restlessness and agitation as well as loss of consciousness in 48 hours before death. Therefore the symptoms above can be used for the important indicators to predict the imminent death.

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An Effect of Rhythmic Movement Therapy for Adaptation State in Mastectomy Patients (율동적 운동요법이 유방절제술 환자의 퇴원후 적응상태에 미치는 영향)

  • Lee Myung-Hwa
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.1
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    • pp.67-85
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    • 1995
  • The purpose of this study was to determine the effects of rhythmic movement therapy for adaptation state in mastectomy patients. The quasi-experimental study was designed using nonequivalent control group pretest-posttest design within the framework of Laszarus & Folkman's stress-adaptation model. The subjects of the study were composed thirty-two mastectomy patients, of these fifteen were assigned to the experimental group and seventeen to the control group. Rhythmic movement therapy was carried out twice a week for thirty-five, minutes or forty minutes for six weeks period from August 22 to September 30 in 1994. Data was collected before and after the experimentation. Collected data was analyzed by mens of chi-square test, t-test, two-way ANOVA, Pearson's correlation coefficient with $SPSS/PC^+$. The results were summarized as follows : 1. Physical symptom score in the experimental group and control group was not significant difference. 2. Joint Movement Parameter in the experimental group and control group was significant difference. 3. Depression score in the experimental group and contrl group was significant difference. 4. Body image score in the experimental group and control group was significant difference. 5. Stress perception score in the experimental group and control group was significant difference. 6. Social adjustment score in the experimental group and control group was significant difference. 7. Each adaptational level in the experimental group and control group according to type of Health Locus of Control were partially significant difference. Depression score and social adjustment score between the experimental group and control group according to others Health Locus of control were significant difference. This data suggest that rhythmic movement therapy was more effective in the group of Others health Locus of Control. 8. Each adaptational level between the experimental group and control group according to amount of spouse support were not significant difference. 9. The significant positive correlation between physical symptom score and body image, between body image and social adjustment, were observed. The significant negative correlation between stress perception score and social adjustment, between depression and body image, between depression and social adjustment, were observed. This data suggest that the more physical symptom score increased, the more body image increased and the more body image, the more social adjustment. And then the more stress perception score decreased, the more social adjustment increasded and the more depression score, the more body image and social adjustment. Thus it is concluded that the rhythmic movement therapy was a useful nursing intervention for adaptation of mastectomy patients.

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Dental Hygienists Work on the Impact of Factors Associated with Musculoskeletal Pain (치과위생사 작업과 관련된 근골격계 통증의 영향요인)

  • Kim, Min A;Seo, Hwa Jeong
    • Journal of dental hygiene science
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    • v.12 no.6
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    • pp.558-565
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    • 2012
  • The purpose of this study was to work related musculoskeletal disorders are a major. Occupational disease of the dental care profession is no exception. The survey was self-reported questionars of 300 dental hygienists that 268 dental hygienists reply to self-reported survey. This study results are as follows: Subjects of research analyzing the degree of physical musculoskeletal disorders pain, shoulder 90.3%, neck 89.2%, leg 83.6%, 81.7% back, hand/wrist/fingers 75.7%, arm/elbow, according to 52.8%. Therefore the work province of the research object people the musculoskeletal disorders appeared different. Generally characteristic was taller dental hygienists lower back pain and were out of less weight, study subjects had neck and arm pain. 29~33 year-old age the shoulder, over the age of 34 the arm/elbow to be high (p<0.05). Working environment to become a career, the more hand/wrist/fingers and the pain increased (p<0.05). The neck, shoulders (p<0.05), arm (p<0.01), waist high in the 3~4 years experience. And leg/foot was in the 1~2 years experience. This increase in working hours had increased pain in the neck but the hand/wrist/finger pain in the small hours of experience in the high pain(p<0.01). Conclusion of the musculoskeletal disorders of the dental hygienists often than the average for this risk is recognized. When it occurs early in treatment can be simple, but time is left to revert to normal when you do not already. Therefore, maintaining proper posture and dental hygienists, pain or fatigue appeared to accumulate immediately treated continued efforts are needed.

Association between Risk of Obstructive Sleep Apnea and Subjective Health and Health-Related Quality of Life of the Korean Middle-Aged and Elderly Population (한국 중고령층의 폐쇄성 수면무호흡증 위험과 주관적 건강 및 건강 관련 삶의 질 간의 연관성)

  • Nu-Ri Jun;Min-Soo Kim;Jeong-Min Yang;Jae-Hyun Kim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.141-155
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    • 2024
  • Background: This study aimed to identified the relationship between the risk of obstructive sleep apnea, subjective health, and health-related quality of life among the middle-aged and elderly population in Korea. Methods: Adults aged 40 or older were extracted from the total 22,559 respondents to the 2019-2020 Korea National Health and Nutrition Examination Survey VIII, and secondary analysis was conducted on a total of 6,659 middle-aged and elderly people with no missing values. Logistic regression analysis and multiple regression analysis were conducted to examine the relationship between obstructive sleep apnea risk factors and subjective health as well as quality of life. Results: The subjective health status decline in the high-risk group compared to the non-risk group for obstructive sleep apnea was statistically significantly higher, with an odds ratio of 1.84 (p<0.001). The health-related quality of life was also statistically significantly lower by 0.02 points (β, -0.02; p<0.001). As a result of subgroup analysis on specific variables, the association between the risk of obstructive sleep apnea and subjective health and health-related quality of life was statistically significant depending on gender, sleep time, presence of depression, household income, and number of household members. Based on the obstructive sleep apnea risk group, women had a higher correlation with low subjective health and lower health-related quality of life scores than men. Sleeping time of more than 8 hours or less than 6 hours was more associated with low subjective health and lower health-related quality of life score than sleeping time of 6-8 hours. Patients with depression were more likely to have low subjective health than those without depression. The lower the household income level and the smaller the number of household members, the higher the association with low subjective health and the lower the health-related quality of life score. Conclusion: It is essential to recognize that the risk of obstructive sleep apnea not only directly affects sleep disorders but also impacts individuals' subjective health and quality of life. Consequently, social support and education should be provided to raise awareness of this issue. Particularly, programs for preventing and managing obstructive sleep apnea should target vulnerable groups such as women, individuals in single-person households, low household income, and those with depression, aiming to improve their subjective health and quality of life.

Study about Vaccination of Patients Diagnosed by Antimeasles Antibody in Measles Out break between 2000 and 2001 (2000~2001년 홍역 유행시 홍역 항체 유무로 진단된 환아의 홍역백신 접종 여부에 관한 연구)

  • Kang, Kye Wool;Yoon, Hwa Jun;Park, Seok Won;Kim, Hwang Min;Kim, Jong Soo
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.67-73
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    • 2002
  • Purpose : Despite of the appropriate measles vaccination programs, epidemics occur every 2~3 years and especially occurred in large group in late of 2000 and early of 2001. To evaluate the effect of the vaccination, needs for revaccination and to determine the optimal age for revaccination, we examined measles specific IgG and IgM in mealses patients and investigated different antibody appearance according to vaccination history. Methods : Anti-measles antibodies were checked in sera of 201 patients(male : 117, female : 84) that are responsible for Criteria for Disease Control among 298 patients that are suspicious of measles including inpatients and outpatients in Wonju Christian Hospital from June in 2000 to June in 2001. They were checked by immunofluorescent assay. Then we classified them according to sex, month, distribution of age due to vaccination and appearance of measles antibody. Results : The ratio of male and female was 1.4 : 1. The maximum incidence was 38 cases(18.9%) in May in 2001. Incidence was increased from November in 2000 to January in 2001 and decreased in February and March in 2001. Thereafter it was increased from April in 2001 again and decreased from June. There were 93 cases(46.3%) in vaccinated group and 108 cases(53.7%) in unvaccinated group. In the distribution according to age in vaccinated group, there were 54 cases(58.1%) in more than 10 years old, 15 cases(16.0%) between 7 and 10 years old, 12 cases(12.9%) between 15 months and 3 years old, 6 cases (6.5%) between 4 and 6 years old and 6 cases(6.5%) between 6 months and 14 months old. In the distribution according to age in unvaccinated group, there were 88 cases(81.5%) between 6 months and 14 months old, 9 cases(8.3%) between 15 months and 3 years old, 7 cases(6.5%) less than 6 months old, 3 cases(2.8%) more than 10 years old and 1 case(0.9%) between 7 and 10 years old. In the distribution of measles specific IgG and IgM, 78 cas (87.6%) were IgG(+), IgM(+) and 11 cases(12.4%) are IgG(+), IgM(-) in vaccinated group. In unvaccinated group, there were 69 cases(63.9%) of IgG(+), IgM(+) and 39 cases (36.1%) of IgG(-), IgM(+). Con c lu s i on s : We thought that measles incidence was peaked between 6 months and 14 months old in unvaccinated group because of maximum decrement of transplacental matenal antibody and was peaked in more than 10 years old in vaccinated group because of maximum decrement of measles specific IgG. We think that measles revaccination as well as vaccination and especially optimal age for revaccination is very important to prevent measles successfully.

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The Spatial Disparity of Opportunity Potentials in Korea (한국 도시의 경제 $\cdot$ 문화 $\cdot$ 사회 복지적 기회 잠재력의 지역적 격차)

  • Choi, Yoon-Jeong;Lee, Keumsook
    • Journal of the Economic Geographical Society of Korea
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    • v.8 no.1
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    • pp.91-105
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    • 2005
  • The assessment (or the evaluation) of spatial disparity is the main concern for the study of spatial disparities or spatial inequalities. In order to evaluate the spatial disparity, the regional differences have to be counted quantitatively. Several measurements have been introduced for evaluating the development potentials of each region. Most of them are the composite indices of the socio-economic variables rather than the real potentials of the region. This study attempts to investigate the spatial disparity in Korea. For the purpose, the levels of opportunity potentials of the cities have been calculated by the Potential Model redefined by Lee(1995). The opportunity potentials have been calculated for the educational, cultural, medical service, environmental sectors, income, and consumption sectors, and the spatial patterns of various opportunity potentials have been analyzed. The spatial patterns of opportunity potentials show the severe concentration on the Metropolitan Seoul area through all sectors. The next level concentration appears at the other end of the Keuyng-Bu axis. And the cities relatively high opportunity potential values are distributed along the Keuyng-Bu axis. Remain parts of the country show quietly low opportunity potential values. In particular, the southern-west and the northern-east parts show relatively very low values. This pattern appears for all sectors except for the opportunity potential of the environmental sector. It means that the spatial disparity in Korea have been promoted and enhanced by the national development policies concentrated the investment on the large cities along the Keuyng-Bu axis during the last 40 years.

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Clinical Characteristics and Heart Rate Variability of Foreign Domestic Violence Victims in Korea (국내 거주 외국인 가정폭력 피해 여성의 임상적 특징 및 심박변이도)

  • Kim, Kyu-Lee;Choi, Jin-Sook;Jang, Yong-Lee;Lee, Hae-Woo;Sim, Hyun-Bo
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.46-54
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    • 2017
  • Objectives: Domestic violence is related to many psychiatric diseases, such as depression, anxiety disorder, and PTSD. Heart rate variability (HRV) is an index of autonomic control of the heart and is related to cardiovascular and emotional disorders. Although there have been some studies on the effects of domestic violence on women's mental health, relatively little information is available on HRV in this population. The aim of this study is to investigate demographic data, psychological features, and HRV in female victims of domestic violence and difference between Korean and foreign female victims. Methods: A total of 210 female victims of domestic violence (166 Korean women and 44 foreign women) were recruited for this study. Psychological symptoms were measured using the Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Impact of Event Scale-Revised (IES-R). HRV measures were assessed by time-domain and frequency-domain analyses. Results: The mean score of HAM-A was 13.81, that of HAM-D was 12.92, and that of IES-R was 33.61 ; there were no significant differences between Korean and foreign women in these measures. In HRV time domain analyses, approximate entropy (ApEn) was significantly increased in foreign women compared to the Korean women. The square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) was significantly decreased in foreign women compared to Korean women. There were no significant differences in the other HRV variables between Korean and foreign women. Conclusion: Female victims of domestic violence in Korea are associated with depression, anxiety, and PTSD symptoms. The physiologic factors of a female victim's nationality could be related to higher ApEn and lower RMSSD in foreign female victims. These findings have important implications for future study to study the relationships among ethnic and environmental factors and HRV variables.

The Associated Factors of Health Examinations Behaviors among Some Elderly Persons in Urban and Rural Areas (일부 도시·농촌지역 고령자의 건강검진 수진행동에 관련된 요인)

  • Kim, Yong-Ik;Cho, Young-Chae
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.1-14
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    • 2004
  • Objectives: We investigated the factors related to health examination behaviors, sociodemographic aspects and lifestyles of elderly persons with different social backgrounds, and compared sexual and regional differences in urban and rural elderlies. Methods: The total study subjects(464 individuals) from urban(236) and rural areas(228), recruited by a stratified cluster random sampling were interviewed and examined about their sociodemographic profiles, daily lifestyles, subjective health status, conditions concerning use of medical resources, hearing acuity, visual acuity and ADL(activity of daily living), and whether they receive health examination or not. For statistical analysis, Chi-square test was used for sexual and regional comparisons among the groups who have been given a health examination and the one who have not. Results: In urban areas, the rate of having underwent health examination was 54.5% in men and 46.9% in women, and in rural areas, it was 59.8% in men and 42.7% in women, showing its higher rate in men than in women in both areas. For regional differences between the group who have taken a health examination and the one who have not, there was a significant difference in terms of age, family pattern, current job, monthly household income, owning a house, drinking status, eating habit, subjective health status, whether they have taken outpatient medical service for the recent 3 months or not, anxiety for the health, and IADL conditions according to whether the community is rural or urban. In multiple regressions, the influential factors on the health examination behaviors were selected such as having their own house, their family doctor, amnesia, urinary incontinence and chronic disease in urban districts. But in rural districts, the variables were selected such as having or not of their family doctor, urinary incontinence, anxiety for the health, educational level, their own house and chronic disease. Conclusions: It is suggested that the approach to the health examination of an older patient requires substantial consideration of highly variable individual sociodemographic characteristics involving regional attributes as well as their daily life styles, subjective health status, status of performing health examination, physical health status and ADL conditions.

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Study on Absorbed Dose Determination of Electron Beam Quality for Cross-calibration with Plane-parallel Ionization Chamber (평행평판형이온함의 교차교정 시 전자선 선질에 따른 흡수선량 결정에 대한 연구)

  • Rah, Jeong-Eun;Shin, Dong-Oh;Park, So-Hyun;Jeong, Ho-Jin;Hwang, Ui-Jung;Ahn, Sung-Hwan;Lim, Young-Kyung;Kim, Dong-Wook;Yoon, Myong-Geun;Shin, Dong-Ho;Lee, Se-Byeong;Suh, Tae-Suk;Park, Sung-Yong
    • Progress in Medical Physics
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    • v.20 no.2
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    • pp.97-105
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    • 2009
  • Absorbed dose to water based protocols recommended that plane-parallel chambers be calibrated against calibrated cylindrical chambers in a high energy electron beam with $R_{50}$>7 $g/cm^2$ (E${\gtrsim}$16 MeV). However, such high-energy electron beams are not available at all radiotherapy centers. In this study, we are compared the absorbed dose to water determined according to cross-calibration method in a high energy electron beam of 16 MeV and in electron beam energies of 12 MeV below the cross-calibration quality remark. Absorbed dose were performed for PTW 30013, Wellhofer FC65G Farmer type cylindrical chamber and for PTW 34001, Wellhofer PPC40 Roos type plane-parallel chamber. The cylindrical and the plane-parallel chamber to be calibrated are compared by alternately positioning each at reference depth, $Z_{ret}=0.6R_{50}-0.1$ in water phantom. The $D_W$ of plane-parallel chamber are derived using across-calibration method at high-energy electron beams of 16, 20 MeV. Then a good agreement is obtained the $D_W$ of plane-parallel chamber in 12 MeV. The agreement between 20 MeV and 12 MeV are within 0.2% for IAEA TRS-398.

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