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Analysis of Radiotherapy Associated Factors in Stage IIb Carcinoma of Uterine Cervix (자궁 경부암 처지)

  • Moon, Chang-Woo;Jeung, Tae-Sig;Yum, Ha-Yong
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.241-253
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    • 1990
  • 331 patients of stage IIb uterine cervix cancer trated by radiation alone at Kosin Medical Center between June 1980 and Dec. 1985 were analysed to determine parameters of radiotherapy associated to disease states. Survival rate was highest among the reported ($82.8{\%}$ for crude and $82.4{\%}$ for disease free survival). Pelvic control rate in 6 weeks after the end of radiotherapy was $93.6{\%}$ in the patients treated with ICR following total pelvic radiation and $71.6{\%}$ with small field additional external irradiation. 5 year survival rate in those who achieved pelvic control was $98.9{\%}$ and $12.9{\%}$ in those who had pelvic failure and/or metastasis after radiation. The survival rate figured maximal $88.5{\%}$ with dosage of $7500{\~}8500$ cGy to point A with acceptable incidence of complications ($4.9{\%}$) but without increasing survival above it and minimal $74.1{\%}$ with dosage of less than 6500 cGy. The treatment failure was counted $18.7{\%}$ (62 of 331 patients): Local failure $72.6{\%}$ (45 of 62 patients), locoregional failure $3.2{\%}$ (2 of 62 patients) and distant failure $24{\%}$ (15 of 62 patients). Late complications were found in 50 patients ($15.1{\%}$) and $42{\%}$ of them was rectal bleeding and stenosis. The dose of 8500 cGy to point A was found to be critical for complication and $70{\%}$ of complications occurred above it and was more serious one such as fistula. Rectal complications were developed above rectal dose 6500 cGy and bladder complication above bladder dose 7500 cGy. Major cause of death was cachexia due to locoregional failure ($73.7{\%}$ of death), next was due to metastasis to lung, liver and bone, and only 3 patients died of complication of intestinal perforations and obstruction. In conclusion higher external radiation dose for a bulky uterine cervix and barrel shaped uterus was essential for local control.

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Radiation Results and Survival Rate of Small Cell Lung Cancer (소세포폐암의 방사선치료 성적 및 생존율)

  • Oh, Won-Yong;Song, Mi-Hee;Whang, In-Soon
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.105-113
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    • 1996
  • Purpose : To improve treatment modality and results by analysis of clinical characteristics, local control, survival and recurrence rate in limited stage small cell lung cancer. Materials and Methods : patients with limited stage small cell lung cancer were treated with combined radiation and chemotherapy from Feb. 1986 to Dec. 1992 at the National Medical Center We followed up on 21 patients ($81\%$), who were mostly irradiated with 4,000-5.000cGy ($75\%$ of all Patients) in the results by the analysis retrospectively. Survival rate was evaluated by the Kaplan-Meier method Results : Mean survival of irradiated patients with limited small cell lung cancer was 12 months. 1-rear and 2-rear survival rate were $65.3\%$ and $15.4\%$ Tumor response rate and median survival after combined chemotherapy and irradiation were the following: $50\%$ and 15 months of complete response, and $23\%$ and 11 months of partial response respectively. Response rates by radiation dose were $66\%$ for below 4,000cGy $69\%$ for between 4,000-5,000cGy and $86\%$ for above 5,000cGy. 21 of all patients showed treatment failure($81\%$) which as appeared 9 of local failure.9 of distant failure and 3 of local and distant failure. Conclusion : Local response rate after induction chemotherapy alone in limited stage of small cell lung cancer was $54\%$. Furthermore it was increased to $73\%$ after adding of radiation. We have to increase radiation dose above 5,000cGy and need to try new effective chemotherapy agents for the improvement of local control and survival rate and also will try concurrent chemoradiotherapy in near time.

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Analysis of Telephone Counseling Service on Child Health (전화 아기건강상담을 통해 나타난 우리나라 어머니들의 육아문제 분석)

  • Song Ji-Ho;Han Kyung-Ja;Oh Ka-Sil;Cho Kyoul-Ja;Lee Ja-Hyung;Park Eun-Sook;Cho Kap-Chul;Tak Young-Nan;Ahn Young-Mee
    • Child Health Nursing Research
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    • v.7 no.2
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    • pp.245-257
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    • 2001
  • This study analyzed the services as operated by the Child Health Telephone Service Center. The Center is a toll free service operated as part of the community services of the Korean Academic Society of Child Health Nursing. The aim of the study was to describe the concerns of child caregivers regarding child health care as discussed during telephone counseling. Specific objectives were as follows: 1. To analyze the activities of the Center. 2. To describe the characteristics of caregivers who made phone calls for counseling services and also the characteristics of their children. 3. To analyze the content of the counseling sessions. 4. To analyze counseling content according to the characteristics of the caregivers and their children. Data used for the study were obtained from the counseling records for the period from Sept. to Dec. 1999, as kept by the three counselors at the Center. The total number of calls was 8,261 and that consisted of 15,150 questions. The total questions were merged into 13,236 by eliminating those questions which overlapped or were of similar content. The final 13,236 questions were used for the final analyses. Almost of the callers (98.4%) were mothers. Among them 89.6% were between 25 and 35 years of age. Geographical distribution of the callers covered the whole nation. The largest numbers who made the calls were from the Seoul metropolitan area (36%), followed by 28% from Kyung Gi Province, and 20% were from the Kyung Sang area. Among 8,261 callers, 72.8% were first users. Sex of the babies and children in question for counseling was about even for males and females and ages ranged from one month to six years. The largest group (62.5%) was the less than six month age group. The finalized 13,236 questions/problems were categorized into 11 problem areas. They were in order of frequency, physical problems, feedings and nutrient concerns, information on child rearing, growth and development, guidance on utilization of child care facilities, elimination problems, sleeping concerns, immunization related concerns, behavior problems, injury and accidents, and safety measures. The most frequent problems for counseling were physical signs and symptoms (27.3%), followed by feeding and nutrients, information on child rearing, and growth and development. Of physical problems, abnormal gastrointestinal signs and symptoms were the most frequent concern and skin problems were next at 25% and 23.3% respectively. Loose bowels, vomiting and constipation were the most frequent gastrointestinal problems. Atopic dermatitis had the highest frequency at 53.3% with diaper rash being the second highest among the skin problems. About 80% of the growth and developmental category were physical development concerns related to physiological, body growth, and motor and sensory development. This study constitutes the activity report for the first year of the Center. The findings correspond with literature reports on child health problems and parents educational needs. One recommendation from this study is that since the services of the Center are carried out only by telephone, the psychology of the counselees and the counselor relationship must be considered for better services.

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A Study on Clinical Progress of the Metastatic Adenocarcinoma of Pleura (전이성 흉막선암의 임상 경과에 관한 연구)

  • Yang, Seong-Wook;Lee, Tae-Kwan;Lee, Tae-Heon;Cho, Deok-Su;Baek, Hyeon-Seon;Kim, Ji-Young;Lee, Hye-Kyung;Kim, Kwi-Wan
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.156-164
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    • 1995
  • Background: We had undergone this study to investigate clinical progress of this disease and to decide the role of aggressive diagnostic approaches, the efficacy of treatments and prognoses. Methods: A retrospective study was done on 113 patients who had been diagnosed to metastatic adenocarcinoma of pleura by pleural fluid cytology(106 cases) or pleural needle biopsy(22 cases), at Presbyterian Medical Center, from Jan. 1990 to Dec. 1994. Results: 1) The patients were composed of 59 males(52.2%) and 54 females(47.8%), and the mean age distribution was $57.4{\pm}12.1$ years. 2) The site of origin was lung cancer 46.9%(53/113), stomach cancer 20.4%(23/113), breast cancer 11.5%(13/113), and unknown primary site 6.2%(7/113 cases), as a whole. In male, lung cancer was 55.9%(33/59), stomach cancer was 28.8%(17/59), and in female, lung cancer was 37%(20/54), breast cancer was 24.1%(13/54) of cases. 3) The cardinal symptoms were dyspnea(69%), cough(61%), chest pain(50%), weight loss(50%), anorexia(49%), sputum(43%), malaise(30%). 4) The pleural fluid findings were exudative in 94.4%(102/108), serosanguinous or bloody in 36~53%, unilateral involvement in 74.3%(84/113) of cases, and lymphocyte predominance($71{\pm}27%$) in differential count of WBC. 5) CEA levels in pleural fluid or plasma were over 10ng/ml in 60.6%(40/66), and ADA levels in pleural fluid were under 40U/L in 95%(57/60) of cases. 6) The patients were managed by various methods, but the efficacy of treatment was uncertain. 7) The mean survival time was $12.7{\pm}13.5$ weeks. Conclusion: It seems to be no effective treatment methods yet and the prognosis was very poor in this disease, so the objectives of diagnostic approaches and treatment methods should be directed to early diagnosis, treatment and prevention of curable disease. And we must make our best endeavors to lengthen the survival time and improve the quality of patients' life.

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Significance of tibial intra-tunnel fixation at Arthroscopic ACL Reconstruction with hamstring tendon (Second-look Arthroscopic Evalution) (자가 슬괵건을 이용한 전방 십자인대 재건술시 경골측 골 터널내 고정의 의의 (이차관절경 검사의 평가))

  • Kim, Young-Chang ;Seo, Seung-Suk;Jung, Kyung-Chil;Gwak, Hey-Chul;Kim, Yoon-Jun;Kim, Jin-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.165-172
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    • 2006
  • Purpose: The purpose of this study is to evaluate the effects of intratunnel fixation in the tibial side on the arthroscopic ACL reconstruction with quadruple hamstring tendon at the second look arthroscopy. Materials and Method: From Dec 1999 to May 2005, we arthroscopically reexamined 32 cases who had been done arthroscopic ACL reconstruction with quadruple hamstring tendons. Hamstring tendons of all cases were fixed at femoral side with RigidfixTM. At the tibial side hamstring tendons were fixed only Post-tie (Group I) or Post-tie combined with IntrafixTM (Group II). At the time of second look arthroscopy mean age of cases was 30 years and mean duration for second look arthroscopy was 21.3 months. We analyzed the results with IKDC score, KT-1000 arthrometer under anesthesia, Telos stress radiography, tibial tunnel widening on the radiography and second look arthroscopic findings. Results: Group II had more superior than group I at side to side differences with KT-1000 and Telos stress radiograph, IKDC score, but the differences were insignificant. At arthroscopic evaluation, Group ll also had more superior than group I at graft tension and graft appearance, graft synovialization, but the differences were insignificant. Tibial tunnel widening in the knee AP radiograph was 2.3 mm in Group I and 1.7 mm in Group II and the difference was significant. (P=0.042) Conclusions: Additional procedure of tibial intratunnel fixation in arthroscopic ACL reconstruction with autogenous hamstring tendon significantly prohibited from tibial tunnel widening but clinical results, radiologic joint stability, findings in second look arthroscopy were insignificantly different. We concluded that Post-tie itself induced satisfactory clinical results, joint stability and graft maturation and that tibial tunnel widening did not affect the results.

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A Study on the Effect of Cold Application Using a Sponge Bath in Healthy Adults (냉요법 적용방법에 따른 냉요법 효과에 관한 연구-건강한 성인 여성에서 스폰지 목욕방법을 중심으로)

  • Chung, Hyun-Sook;Kang, Kyu-Sook;Hwang, Ae-Ran
    • The Korean Nurse
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    • v.28 no.3
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    • pp.68-82
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    • 1989
  • This study was a quasi-experimental research study to test the characteristics of temperature regulation according to sponge bath methods of cold application. Thirteen volunteers were selected from among nursing college students according to an established criteria using a purposive sampling technique. Four different cold application methods were used: $\circled1$ tepid water sponge bath at $28^{\circ}C$, $\circled2$ 20% alcohol sponge bath at $28^{\circ}C$, $\circled3$ 40% alcohol sponge bath at $28^{\circ}C$ and $\circled4$ tepid water sponge bath at 28$^{\circ}$C plus an ice bag to the head. Changes in rectal temperature, mean skin temperature, mean body temperature, heat content change and thermal discomfort during the cold application were measured at 5 minute intervals over a 120 minute period. The data collection period was from Dec. 20, 1988 to Feb. 3, 1989. The data were analyzed using descriptive statistics, simple regression, ANOVA, Duncan's multiple range test and Pearson correlation coefficient using the SPSS-X Program. The results of the study are summarized as follows. Five general hypothesis were tested. Hypothesis 1 that "Change in heat content will be decreased for each cold application method according to the cold application time" was rejected. (tepid water sponge bath: after 10 minutes of cold application, 20% alcohol sponge bath: after 25 minutes of cold application: 40% alcohol sponge bath: after 45 minutes of cold application, tepid water sponge bath plus an ice bag to the head: after 80 minutes of cold application) Hypothesis 2 that "Thermal discomfort will be changed for each cold application method according to the cold application time" was rejected after 5minutes of cold application. Hypothesis 3 that "Change in heat content will differ among the cold application methods" was accepted except 0~5, 0~10, 0~65, 0~105 and 0~120 minute. This difference showed significance only between sponge bath methods and tepid water sponge bath plus an ice bag to the head. Hypothesis 4 that "Thermal discomfort will differ among the cold application methods" was accepted at 15, 20, 35, 45, 75, 80, 90, 95, 100, 105, 110, 115 and 120 minute of cold application time. This difference showed significance only between sponge bath methods and tepid water sponge bath plus an ice bag to the head. Hypothesis 5 that "The higher the change in heat content, the higher the thermal discomfort during the cold application time" was accepted for between 10~60 and 75 minute of cold application. In conclusion, this study showed that in sponge bath at $28^{\circ}C$, 10~80 minute was a effective cold application time in the view of heat loss through the skin. Concerning the effects of evaporation and thermal discomfort, it was found that there was no difference with regard to the solutions; tepid water sponge bath; 20% alcohol sponge bath or 40% alcohol sponge bath at a $28^{\circ}C$ controlled solution temperature. So it was thought that the type of solution itself did not have a big influence on the heat loss through skin. The combined effect of sponge bath with an ice bag to the head showed a significant difference and also showed a slight increase in thermal discomfort. On the basis of this research it can be concluded that cold application, for example, an ice bag to the head during a tepid water sponge bath is a good method as it increase heat loss through conduction, although fit can also cause a slight increase in thermal discomfort. The correlation between changes in heat content and thermal discomfort were not high. So factors other than change in heat content are considered to have an effect on the cognition of thermal discomfort.

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Species of Bacteria and Antimicrobial Susceptibility Isolated from Clinical Specimens in Jeon Buk Area (전북지역 임상가검물에서 분리된 세균의 종류와 항생제 감수성)

  • 황구연
    • Biomedical Science Letters
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    • v.3 no.1
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    • pp.55-67
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    • 1997
  • Considering many problems caused by the abuse of antibiotics recently, the appearance of antibiotic resistance bacteria is believed to help the cure of patients greatly. From Jan. 1st, 1996 to Dec. 31, 1996, 6135 strains were examined after being asked of and seperated from the clinical pathology departments of general hospitals, and the isolation frequency of identified bacteria and the susceptibility of antibiotics showed the following result. 1. The isolation frequency of strains was Escherichia coli, 1134 strains (18.4%), Pseudomonas aeruginosa, 856 strains (13.9%), coagulase negative Staphylococcus, 793 strains (12.89%), Staphylococcus aureus, 555 strains (9.02%), B. cepacia, 421 strains (6.84%), Enterobacter cloacae, 366 strains (5.95%), Enterobacter faecalis (4.86%), and Klebsiella pneumonia, 220 strains (3.85%). 2. The isolation rate of specimen was urine, 1, 969 strains, wound 1, 104 strains, sputum 701 strains, blood 643 strains, vaginal swab, 342 strains, and eye discharge, 192 strains, 40% of urine strains were E. coli 18% of wound strains were B. cepacia, 43.7% of sputum were P. aeruginosa, and in blood strains there were Enterobacter cloacae (25.8%), coagulase negative Staphylococcus (19.6%), and P. aeruginosa (8.7%). 3. The result of antibiotics susceptibility showed that, among gram negative bacilli, P. aeruginoas had resistance in almost all antibiotics except ceftazidme imipenem. But B. cepacia, the same glucose non-fermentation gram negative bacilli had more than 90% of sensitivity in aztreonam, ceftazidime, ciproflxacin, piperacillin, trimethoprim/sulfa and had resistance in the others. Enterococcus faecalis showed more than 85% of sensitivity in penicillin-G, ampicillin, ciprofloxacin. 4. In the case of specimen antibiotics susceptibility, Enterobacter cloacae was lower in specimen isolated from blood than in those isolated from others and p. aeruginosa was low in specimen isolated from urine, which showed that there was difference in specimen antibiotics susceptibility. The result of this study shows that there happen many resisitances in antibiotics used frequently and some countermeasure is necessary because many bacteria began to show new resistance. Also it is desirable that the choice of antibiotics for infection diagnosis and its cure should be made after the inspection of antibiotics.

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Effect of Sand Extraction on Meiobenthic Community of Jangbong-do in the Eastern Yellow Sea of Korea (서해 주문도 연안 사질 조하대에서의 해사채취가 중형저서동물 군집에 미치는 영향 연구)

  • Kang, Teawook;Min, Won-Gi;Hong, Jae-Sang;Kim, Dongsung
    • Korean Journal of Environmental Biology
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    • v.32 no.2
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    • pp.138-152
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    • 2014
  • The objective of the study survey was to determine the effect of marine sand extraction on community composition and rate of recolonization of the meiobenthos following cessation of mining activities. Because of meiobenthic distribution in nature, high abundance, intimate association with sediments, fast reproduction, benthic larva period, sensitivity to pollution and rapid life histories, meiobenthos are widely regarded as ideal organisms to study the potential ecological indicator of natural and anthropogenic stresses. The community structure of meiobenthos was studied at seven stations within sandy tidal and sub tidal zones in Jangbongdo in the Yellow Sea, Korea from Aug. 2006 to Dec. 2007. Meiobenthic samples were collected by three core samples, with a 3.6 cm in diameter, from each sediment sample taken with a Smith-McIntyre Grab. It was found that sand mining often causes complete removal of the sediment and the damage to the habitats of meiobenthos. This study in the effect showed that sand mining resulted in a reduction in total abundance and biomass of meiobenthos in mining area. The finding of this study further showed that initial restoration of abundance and biomass within one year of the cessation of sand mining.

Staphylococcal Scalded Skin Syndrome in Children : Comparison of the Clinical Features of That Isolated Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus (포도상 구균성 열상 피부 증후군의 임상적 고찰 : Methicillin 내성과 감수성 Staphylococcus aureus 예의 비교)

  • Lee, Seong Hun;Choi, Wu Kyung;Jung, Chang Hyn;Chung, Cheol Ju;Lee, Dong Jean
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.183-191
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    • 2004
  • Purpose : The purpose of this study was to compare the clinical features of staphylococcal scalded skin syndrome(SSSS) isolated methicillin-resistant Staphylococcal aureus(MRSA) with those of SSSS isolated methicillin-sensitive Staphylococcal aureus(MSSA) in children. Methods : We retrospectively reviewed the medical records and microbiological results of 36 cases of SSSS who were admitted to the Pediatric Department of Ulsan Dong-Kang General Hospital from Jan. 1999 to Dec. 2003. Results : Among 36 cases, there were 7 generalized types, 1 abortive type in MRSA group and 5 generalized types, 6 abortive types in MSSA group. The peak incidence of age was between 2 and 5 years in both groups. SSSS were diagnosed with increasing frequency. Most of MRSA group were diagnosed in 2003(6/8). The peak seasonal incidence was fall and winter in both groups. Facial lesion was observed in all cases followed by flexural lesion in both groups. Staphylococci were isolated from the skin and throat most frequently in both groups. Upper respiratory illness and conjunctivitis were most common preceding infections in both groups. Among 8 cases of MRSA group, 4 cases were treated completely with ampicillin-sulbactam. There was no significant difference of mean duration of admission between MRSA group and MSSA group. Conclusion : There was no significant difference of clinical features between MRSA group and MSSA group although generalized types of SSSS were more common in MRSA group than in MSSA group.

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The Causative Organisms of Neonatal and Pediatric Bacterial Meningitis in Korea(2000~2005) (국내 신생아와 소아 세균성 수막염의 원인균주(2000~2005))

  • Jeon, Yun Suk;Lee, Soo Young;Mok, Hye Rin;Lee, Jung Hyun;Kim, Jong Hyun;Hur, Je Kyun;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.130-136
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    • 2006
  • Purpose : The purpose of this study is to confirm the epidemiologic change of the causative organisms of neonatal and pediatric bacterial meningitis in Korea. And we tried to evaluate the risk factors correlated with prognosis which was available on the day of admission. Methods : Retrospectively, we reviewed the medical records of 57 patients admitted for bacterial meningitis at six hospitals affiliated with Catholic Medical Center for 6 years(Jan. 2000~Dec. 2005). Results : 22 cases(38.6%) of them were neonates under 28 days and 35 cases were infants and children ; 16 cases(28.1%), under 1 year ; 6 cases(10.5%), under 5 years ; 13 cases (22.8%), under 15 years. In neonates, 16 cases(72.7%) were caused by group B streptococcus (GBS). In infants and children, S. pneumoniae(25.7%), H. influenzae type b(Hib)(22.8%) and N. meningitidis(22.8%) were common cause of bacterial meningitis in order. In the informations available on the day of admission, weight deficit for age under 3 percentile, increased CRP level and decreased glucose level of CSF were related to poor prognosis(P<0.05). Conclusion : GBS became a leading cause of neonatal bacterial meningitis. Though, pneumoccocal, Hib and meningococcal meningitis were confirmed as major causes of bacterial meningitis. The routine immunization of pneumococcal and Hib vaccines will be considered, and it is necessary to introduce meningococcal vaccines to our country in the future.

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