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Korean parents' perceptions of the challenges and needs on school re-entry during or after childhood and adolescent cancer: a multi-institutional survey by Korean Society of Pediatric Hematology and Oncology

  • Lee, Jun Ah;Lee, Jae Min;Park, Hyeon Jin;Park, Meerim;Park, Byung Kiu;Ju, Hee Young;Kim, Ji Yoon;Park, Sang Kyu;Lee, Young Ho;Shim, Ye Jee;Kim, Heung Sik;Park, Kyung Duk;Lim, Yeon-Jung;Chueh, Hee Won;Park, Ji Kyoung;Kim, Soon Ki;Choi, Hyoung Soo;Ahn, Hyo Seop;Hah, Jeong Ok;Kang, Hyoung Jin;Shin, Hee Young;Lee, Mee Jeong
    • Clinical and Experimental Pediatrics
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    • v.63 no.4
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    • pp.141-145
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    • 2020
  • Background: For children and adolescents with cancer, going back to school is a key milestone in returning to "normal life." Purpose: To identify the support vital for a successful transition, we evaluated the parents' needs and the challenges they face when their children return to school. Methods: This multi-institutional study was conducted by the Korean Society of Pediatric Hematology and Oncology. The written survey comprised 24 questions and was completed by 210 parents without an interviewer. Results: Most parents (165 of 206) reported that their children experienced difficulties with physical status (n=60), peer relationships (n=30), academic performance (n=27), emotional/behavioral issues (n=11), and relationships with teachers (n=4) on reentering school. Parents wanted to be kept informed about and remain involved in their children's school lives and reported good parent-teacher communication (88 of 209, 42.1%). Parents reported that 83.1% and 44.9% of teachers and peers, respectively, displayed an adequate understanding of their children's condition. Most parents (197 of 208) answered that a special program is necessary to facilitate return to school after cancer therapy that offers emotional support (n=85), facilitates social adaptation (n=61), and provides tutoring to accelerate catch up (n=56), and continued health care by hospital outreach and school personnel (n=50). Conclusion: In addition to scholastic aptitude-oriented programs, emotional and psychosocial support is necessary for a successful return to school. Pediatric oncologists should actively improve oncology practices to better integrate individualized school plans and educate peers and teachers to improve health literacy to aid them in understanding the needs of children with cancer.

Utility Estimation of the Manufactured Stereotactic Body Radiotherapy Immobilization (자체 제작한 정위적체부방사선치료(Stereotactic Body Radiotherapy) 고정용구의 유용성 평가)

  • Lee, Dong-Hoon;Ahn, Jong-Ho;Seo, Jeong-Min;Shin, Eun-Hyeok;Choi, Byeong-Gi;Song, Gi-Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.1-6
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    • 2011
  • Purpose: Immobilizations used in order to maintain the reproducibility of a patient set-up and the stable posture for a long period are important more than anything else for the accurate treatment when the stereotactic body radiotherapy is underway. So the purpose of this study is to adapt the optimum immobilizations for the stereotactic body radiotherapy by comparing two commercial immobilizations with the self-manufactured immobilizations. Materials and Methods: Five people were selected for the experiment and three different immobilizations (A: Wing-board, B: BodyFix system, C: Arm up holder with vac-lock) were used to each target. After deciding on the target's most stable respiratory cycles, the targets were asked to wear a goggle monitor and maintain their respiration regularly for thirty minutes to obtain the respiratory signals. To analyze the respiratory signal, the standard deviation and the variation value of the peak value and the valley value of the respiratory signal were separated by time zone with the self-developed program at the hospital and each tie-downs were compared for the estimation by calculating a comparative index using the above. Results: The stability of each immobilizations were measured in consideration of deviation changes studied in each respiratory time lapse. Comparative indexes of each immobilizations of each experimenter are shown to be A: 11.20, B: 4.87, C: 1.63 / A: 3.94, B: 0.67, C: 0.13 / A: 2.41, B: 0.29, C: 0.04 / A: 0.16, B: 0.19, C: 0.007 / A: 35.70, B: 2.37, C: 1.86. And when all five experimenters wore the immobilizations C, the test proved the most stable value while four people wearing A and one man wearing D expressed relatively the most unstable respiratory outcomes. Conclusion: The self-developed immobilizations, so called the arm up holder vac-lock for the stereotactic body radiotherapy is expected to improve the effect of the treatment by decreasing the intra-fraction organ motions because it keeps the respiration more stable than other two immobilizations. Particularly in case of the stereotactic body therapy which requires the maintenance of set-up state for a long time, the self-developed immobilizations is thought to more useful for stereotactic body radiotherapy rather than the rest two immobilizations with instable respiratory cycle as time passes.

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Examinations on Applications of Manual Calculation Programs on Lung Cancer Radiation Therapy Using Analytical Anisotropic Algorithm (Analytical Anisotropic Algorithm을 사용한 폐암 치료 시 MU 검증 프로그램 적용에 관한 고찰)

  • Kim, Jong-Min;Kim, Dae-Sup;Hong, Dong-Ki;Back, Geum-Mun;Kwak, Jung-Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.23-30
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    • 2012
  • Purpose: There was a problem with using MU verification programs for the reasons that there were errors of MU when using MU verification programs based on Pencil Beam Convolution (PBC) Algorithm with radiation treatment plans around lung using Analytical Anisotropic Algorithm (AAA). On this study, we studied the methods that can verify the calculated treatment plans using AAA. Materials and Methods: Using Eclipse treatment planning system (Version 8.9, Varian, USA), for each 57 fields of 7 cases of Lung Stereotactic Body Radiation Therapy (SBRT), we have calculated using PBC and AAA with dose calculation algorithm. By developing MU of established plans, we compared and analyzed with MU of manual calculation programs. We have analyzed relationship between errors and 4 variables such as field size, lung path distance of radiation, Tumor path distance of radiation, effective depth that can affect on errors created from PBC algorithm and AAA using commonly used programs. Results: Errors of PBC algorithm have showned $0.2{\pm}1.0%$ and errors of AAA have showned $3.5{\pm}2.8%$. Moreover, as a result of analyzing 4 variables that can affect on errors, relationship in errors between lung path distance and MU, connection coefficient 0.648 (P=0.000) has been increased and we could calculate MU correction factor that is A.E=L.P 0.00903+0.02048 and as a result of replying for manual calculation program, errors of $3.5{\pm}2.8%$ before the application has been decreased within $0.4{\pm}2.0%$. Conclusion: On this study, we have learned that errors from manual calculation program have been increased as lung path distance of radiation increases and we could verified MU of AAA with a simple method that is called MU correction factor.

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The association of snack consumption, lifestyle factors, and pediatric obesity with dietary behavior patterns in male adolescents (남자 청소년의 식행동 패턴에 따른 간식 섭취, 생활 습관 요인 및 비만과의 연관성 연구)

  • Kim, Min-Ji;Song, SuJin;Park, So Hyun;Song, YoonJu
    • Journal of Nutrition and Health
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    • v.48 no.3
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    • pp.228-235
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    • 2015
  • Purpose: Along with the adaptation of a Western dietary pattern and low physical activity, pediatric obesity is increasing in Korea, especially for boys. The aim of this study was to identify dietary behavior patterns and examine the snack consumption, dietary habit, and pediatric obesity by pattern groups. Methods: Boys aged 15~19 years were recruited from one high school in Seoul. A questionnaire including dietary behaviors and lifestyle factors was administered and height and weight were measured. A total of 932 boys participated except boys who had missing or incomplete response (n = 30). Three dietary behavior patterns were identified by cluster analysis; 'Healthy pattern', 'Mixed pattern' and 'Unhealthy pattern'. Results: Snack consumption differed according to dietary behavior patterns group. The healthy and mixed patterns showed higher frequencies of white milk and fruit consumption while the unhealthy pattern as well as the mixed patterns showed higher frequencies of sweetened snack and ice cream consumption. Food availability at home of each food differed according to pattern groups but showed a similar trend with food consumption. Regarding dietary habits, the mixed pattern showed higher proportion of taking dietary supplement and eating dessert while the unhealthy pattern showed lower proportion of eating regular meals and appropriate amount of meals. When the healthy pattern was set as a reference group, the odds ratio of pediatric obesity was 1.11 (CI 0.65-1.87) in the mixed pattern group and 1.88 (CI 1.14-3.10) in the unhealthy pattern group. Conclusion: In conclusion, dietary behaviors including snack consumption and lifestyle factors were connected. Unbalanced diet and undesirable dietary practice are important determinants in pediatric obesity.

Study on the Characteristics and Non-point Source Pollution Loads in Stormwater Runoff of Shihwa Lake (시화호 유역 비점오염물질의 유출특성 및 부하량 연구)

  • Ra, Kong-Tae;Kim, Kyung-Tae;Kim, Joung-Keun;Bang, Jae-Hyun;Lee, Jung-Moo;Kim, Sung-Keun;Kim, Eun-Soo;Yun, Min-Sang;Cho, Sung-Rok
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.14 no.1
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    • pp.40-50
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    • 2011
  • We study the characteristic and total flux of non-point pollutants such as total suspended solids (TSS), chemical oxygen demand (COD), dissolved nutrients, total phosphorus (TP) and total nitrogen (TN) in the storm water runoff from urban streams and sewer outlets of Banweol Industrial Complex around Shihwa Lake. The concentrations of non-point pollutants were generally increased with increasing of the duration and intensity of rainfall. Mean TSS concentration of Ansan stream was higher than that of sewer outlets but mean concentrations of COD, TP and TN were approximately 2~5 times higher of sewer outlet than of urban stream. TSS showed statistically positive relationships with COD and TP but it had negative correlation with dissolved nutrients. There was a significant correlation between total flux of non-point pollutants in the storm water runoff and total basin area of each sewer outlet, showing that the highest runoff flux was observed at 3rd sewer outlet which represents the largest basin area from Banweol industrial complex. Total runoff fluxes for TSS, COD, TP and TN in this study were 187,536 kg, 17,118 kg, 922 kg, 13,519 kg, respectively. Given the basin area of sewer outlet in Banweol industrial complex which corresponds only 3% from total catchment area around Shihwa Lake, enormous amount of non-point pollutants will be entered into Shihwa Lake without any treatment. It is necessary to manage and reduce of various non-point sources and pollutants because the runoff of nonpoint pollutants during storm events should be deteriorating the water quality of Shihwa Lake. Our results provides useful informations on the development of best managements practices (BMPs) for effective implementation of total pollution loads management system of Shihwa Lake.

Technical Review of Target Volume Delineation on the Posterior Fossa Tumor : An Optimal Head and Neck Position (후두와 종양의 방사선치료 시 표적용적의 결정을 위한 적절한 치료자세 연구)

  • Yoon Sang Min;Lee Sang-wook;Ahn Seung Do;Kim Jong Hoon;YE Byong Yong;Ra Young Shin;Kim Tae Hyung;Choi Eun Kyung
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.94-99
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    • 2003
  • Purpose : To explore a 3D conformal radiotherapy technique for a posterior fossa boost, and the potential advantages of a prone position for such radiotherapy. Materials and Methods :A CT simulator and 3D conformal radiotherapy Planning system was used for the posterior fossa boost treatment on a 13-year-old medulloblastoma patient. He was placed In the prone position and Immobilized with an aquaplast mask and immobilization mold. CT scans were obtained of the brain from the top of the skull to the lower neck, with IV contrast enhancement. The target volume and normal structures were delineated on each slice, with treatment planning peformed using non-coplanar conformal beams. Results : The CT scans, and treatment In the prone position, were peformed successfully. In the prone position, the definition of the target volume was made easier due to the well enhanced tentorium, In audition, the posterior fossa was located anteriorly, and with the greater choice of beam arrangements, more accurate treatment planning was possible as the primary beams were not obstructed by the treatment table. Conclusion : .A posterior fossa boost, in the prone position, Is feasible in cooperating patients, but further evaluation is needed to define the optimal and most comfortable treatment positions.

Hepatic Detoxification activity and reduction of Serum Alcohol concentration of Hovenia dulcis $T_{HUNB}$ from Korea and China (중국산과 국내산 헛개 나무 열매의 체내 알콜 분해능 및 간 해독 작용)

  • Kim, Min-Hae;Chung, Yoo-Taek;Lee, Jin-Ha;Park, Young-Shik;Shin, Myung-Ki;Kim, Ho-Sang;Kim, Dong-Hoon;Lee, Hyeon-Yong
    • Korean Journal of Medicinal Crop Science
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    • v.8 no.3
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    • pp.225-233
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    • 2000
  • There was not noticeable differences in decreasing blood alcohol concentrations between Korea and China-produced Hovenia dulcis $T_{HUNB}$, showing only 1-2 % higher decreasing rate for Korea-produced seed extracts than those from China. It was also found that the blood alcohol decreasing ability was greatly enhanced by partitioning the crude extracts produced from both places. The both extracts (crude and partitioned) accelerated the reducing rate of blood alcohol concentrations down to 1-2 hours, compared to that of control (taking only ethanol). The crude extracts from imported seeds seemed to have slightly better effect on improving in vivo ADH and ALDH activities than domestic ones; however, not for partitioned extracts. It was interesting that the partitioned extracts from both countries enhanced ADH enzyme activity up to 60% than the crude, compared to the control, while ALDH activity was not much affected by the partitioned extracts. It was also confirmed that both ADH and ALDH activities were well balanced in controlling blood alcohol concentration maintaining 28-29% of enzyme activities in vivo. The extracts proved to have better effect on enhancing ALDH activity than ADH activity, which is one of possible explanation that Hovenia dulcis $T_{HUNB}$ can effectively relieve the hangover by fast decreasing acetaldehyde concentration in the liver and blood. GST activity was also increased in the range of 120 to 300% by adding crude or partitioned extracts from both countries; however, there was no difference in enhancing GST activity between the extracts from two countries. The extracts showed competitive inhibition with GST activity, showing the reduction of enzyme activity at higher than 0. 6 (g/L) of the imported extracts.

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The relationship between condyle position, morphology and chin deviation in skeletal Class III patients with facial asymmetry using cone-beam CT (안면비대칭을 동반한 골격성 III급 부정교합자에서 하악 과두의, 위치 형태와 이부 편위의 관계: cone-beam CT를 이용한 연구)

  • Lee, Bo-Ram;Kang, Dae-Keun;Son, Woo-Sung;Park, Soo-Byung;Kim, Seong-Sik;Kim, Yong-Il;Lee, Kyung-Min
    • The korean journal of orthodontics
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    • v.41 no.2
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    • pp.87-97
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    • 2011
  • Objective: Facial asymmetry is usually evaluated from the difference in length and angulation of the maxilla and mandible. However, asymmetric position or shape of the condyle can also affect the expression of asymmetry. The purpose of this study was to evaluate the correlation between condylar asymmetry and chin point deviation in facial asymmetry. Methods: Cone-beam CT images of fifty adult skeletal Class III patients were studied. Thirty patients who had more than 4 mm menton deviation were categorized in the asymmetric group. Twenty patients with less than 4 mm menton deviation were assigned to the symmetric group. Anteroposterior and transverse condyle positions were evaluated from the cranial base. The greatest mediolateral diameter (GMD) of the condyle in the axial plane and angulation to the coronal plane were measured. The height and volume of the condyles were evaluated. Results: The symmetric group had no statistical difference between both condyles in position, angulation, GMD, height and volume. In the asymmetric group, the non-deviated side condyle was larger in GMD, height and volume than the deviated side. There was no statistical difference in condyle position and angulation. The GMD, height difference and condylar volume ratio (non-deviated/deviated) were positively correlated with chin deviation. From the linear regression analysis, condylar volume ratio was a significant factor affecting chin deviation. Conclusions: These findings suggests that the non-deviated side condyle is larger than the deviated side. In addition, condylar asymmetry can affect the expression of facial asymmetry.

Effects of Stressful Life Events on Patients with Recurrent Ahthous Ulcer. (SRRS를 이용한 재발성 아프타성 구내궤양 환자의 생활변화에 관한 연구)

  • Ko, Myung-Yun;Kim, Young-Ae;Ok, Soo-Min;Heo, Jun-Young;Jeong, Sung-Hee;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.195-203
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    • 2012
  • Recurrent aphthous ulcer(RAU) is the most frequent form of oral ulceration with a prevalence in the general population ranging between 5% and 60%. The peak age of onset is between 10 and 19 years of age, and it can persist into adulthood and throughout the patient's lifespan, with no gender predilection. The disease is characterized clinically into three types: minor aphthous ulcer, major aphthous ulcer and herpeticform ulcers. The cause of RAU is unknown and thought to be multifactorial with many triggers or precipitating factors that include familial tendency or genetic predisposition, allergy, medications, hormones, stress or anxiety, and immunologic abnormalities. The need for consideration of psychological factors in the pathogenesis of oral disease has been increasingly acknowledged over the last decades and many studies have highlighted the psycho-social impact of oral conditions. In this study, we tried to evaluate the influence of emotional stress in RAU. There were thirty patients with a clinical diagnosis of RAU and other subjects who did not show any signs of systemic disorders include RAU. They are evaluated by using modified Holmes and Rahe's Social Readjustment Rating Scale (SRRS). As a result, a significantly higher level of stress was found in the RAU patients than the control group. Therefore it can be concluded that psychological stressors play an important role in the RAU.

Serum Tumor Marker Levels might have Little Significance in Evaluating Neoadjuvant Treatment Response in Locally Advanced Breast Cancer

  • Wang, Yu-Jie;Huang, Xiao-Yan;Mo, Miao;Li, Jian-Wei;Jia, Xiao-Qing;Shao, Zhi-Min;Shen, Zhen-Zhou;Wu, Jiong;Liu, Guang-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4603-4608
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    • 2015
  • Background: To determine the potential value of serum tumor markers in predicting pCR (pathological complete response) during neoadjuvant chemotherapy. Materials and Methods: We retrospectively monitored the pro-, mid-, and post-neoadjuvant treatment serum tumor marker concentrations in patients with locally advanced breast cancer (stage II-III) who accepted pre-surgical chemotherapy or chemotherapy in combination with targeted therapy at Fudan University Shanghai Cancer Center between September 2011 and January 2014 and investigated the association of serum tumor marker levels with therapeutic effect. Core needle biopsy samples were assessed using immunohistochemistry (IHC) prior to neoadjuvant treatment to determine hormone receptor, human epidermal growth factor receptor 2(HER2), and proliferation index Ki67 values. In our study, therapeutic response was evaluated by pCR, defined as the disappearance of all invasive cancer cells from excised tissue (including primary lesion and axillary lymph nodes) after completion of chemotherapy. Analysis of variance of repeated measures and receiver operating characteristic (ROC) curves were employed for statistical analysis of the data. Results: A total of 348 patients were recruited in our study after excluding patients with incomplete clinical information. Of these, 106 patients were observed to have acquired pCR status after treatment completion, accounting for approximately 30.5% of study individuals. In addition, 147patients were determined to be Her-2 positive, among whom the pCR rate was 45.6% (69 patients). General linear model analysis (repeated measures analysis of variance) showed that the concentration of cancer antigen (CA) 15-3 increased after neoadjuvant chemotherapy in both pCR and non-pCR groups, and that there were significant differences between the two groups (P=0.008). The areas under the ROC curves (AUCs) of pre-, mid-, and post-treatment CA15-3 concentrations demonstrated low-level predictive value (AUC=0.594, 0.644, 0.621, respectively). No significant differences in carcinoembryonic antigen (CEA) or CA12-5 serum levels were observed between the pCR and non-pCR groups (P=0.196 and 0.693, respectively). No efficient AUC of CEA or CA12-5 concentrations were observed to predict patient response toward neoadjuvant treatment (both less than 0.7), nor were differences between the two groups observed at different time points. We then analyzed the Her-2 positive subset of our cohort. Significant differences in CEA concentrations were identified between the pCR and non-pCR groups (P=0.039), but not in CA15-3 or CA12-5 levels (p=0.092 and 0.89, respectively). None of the ROC curves showed underlying prognostic value, as the AUCs of these three markers were less than 0.7. The ROC-AUCs for the CA12-5 concentrations of inter-and post-neoadjuvant chemotherapy in the estrogen receptor negative HER2 positive subgroup were 0.735 and 0.767, respectively. However, the specificity and sensitivity values were at odds with each other which meant that improving either the sensitivity or specificity would impair the efficiency of the other. Conclusions: Serum tumor markers CA15-3, CA12-5, and CEA might have little clinical significance in predicting neoadjuvant treatment response in locally advanced breast cancer.