• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2739-2742
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• 2013

Background: This survey aim was to evaluate the epidemiology and outcomes of neuroblastoma patients in one the most important children referral hospitals in Iran as a model from developing countries. Materials and Methods: This retrospective, non-randomized analytic study was conducted on 219 newly diagnosed neuroblastoma cases. Results: The age of patients ranged from 1-156 months with the average of $40.5{\pm}2.44$, with a male/female ratio of 1.9/1. Of the total, 172 (78.5%) were children and 47 (21.5%) were infants The adrenals were the most common primary site (60%). Stage 4 at diagnosis accounted for about 54% of all enrolled patients. Infants had significantly better cumulative survival ($85{\pm}8%$) than children ($33{\pm}7%$) during the follow up period and the survival rate improved from $33{\pm}7%$ in 1974-1994 to $58{\pm}9%$ in 1995-2005. Conclusions: This study indicates that our patient population with neuroblastomas tends to have more advanced disease, perhaps with poor biologic markers, but our analysis shows that the outcomes have improved over 32 years although the overall survival of Iranian neuroblastoma patients is still lower than developed countries. Late diagnosis, inability to determine risk group during the years of study and using single protocol for all enrolled patients can be the reasons of lower survival rate.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.385-392
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• 2023

Purpose: This study investigated the epidemiology, management, outcomes, and postoperative disabilities of degloving soft tissue injuries (DSTIs) treated at a tertiary care center in northern India. Methods: A prospective study of patients with DSTIs was conducted over 15 months. The type of degloving injury, the mechanism of injury, and any associated injuries were analyzed using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 along with the management, outcomes, and disabilities at a 3-month follow-up. Results: Among 75 patients with DSTIs, the average age was 27.5 years, 80.0% were male, and 76.0% had been injured in traffic accidents. The majority (93.3%) were open degloving injuries. Lower limbs were affected most often (62.7%), followed by upper limbs (32.0%). Fractures were the most commonly associated injuries (72.0%). Most patients required more than two procedures, including secondary debridement (41.3%), split skin grafting (80.0%), flap coverage (12.0%), or vacuum-assisted closure (24.0%), while five patients underwent conservative management for closed degloving injuries. Postoperative complications included surgical site infections (14.7%) and skin necrosis (10.7%). Two patients died due to septic shock and multiple organ dysfunction syndrome. The mean length of hospital stay was 11.5±8.1 days, with injuries affecting the lower limbs and perineum requiring longer hospital stays. The mean WHODAS 2.0 disability score at 3 months was 19. Most patients had mild disabilities. Time away from work depended largely upon the site and severity of the injury. Approximately 75% of patients resumed their previous job or study, 14% changed their job, and 8% stopped working completely due to residual disability. Conclusions: DSTIs are common injuries in trauma and management is challenging. Although open DSTI are clinically evident at secondary survey, closed degloving injuries may be missed in the primary survey, necessitating a high index of suspicion, thorough clinical examination, and protocol-based management. Primary preventive strategies (e.g., road safety protocols, preplacement training, and proper protective equipment in industries) are also needed to reduce the incidence of these injuries.

• Radiation Oncology Journal
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• 제11권2호
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• pp.355-361
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• 1993

본 연구는 1991년 5월부터 국소적으로 진행된 자궁경부암 (FIGO stage IIB~IVA) 환자를 대상으로 5-FU와 Cis-platinum을 방사선 치료와 동시에 투여하여 치료 독성, 치료의 적합성과 국소관해율을 평가하기 위해 시행되었다. 방사선 치료는 외부방사선 조사로 전골반부에 23회에 걸쳐 4140 cGy 시행후, 고선량 근접치료기로 강내조사를 6회 내지 7회 (A점에 $3000\~3500$ cGy) 시행하였으며, B점에 추가조사를 시행하여 IIB병기 환자는 6000 cGy까지 IIIB병기 환자는 6500 cGy가지 B점에 조사되도록 하였다. 첫 번째 항암화학요법은 외부방사선 치료 시행의 두번째 주에 5-FU는 $1000 mg/m^2/24hr$를 96시간 동안에 걸쳐 토여하고 Cis-platinum은 $20mg/m^2/day$를 3일 투여하였다. 두번째 항암화학요법은 처음과 동일한 방법으로 첫번째 고선량 근접 강내 치료가 시행될 때 투여 되었다. 1993년 8월까지 총 16명의 환자(10 IIB 병기, 4 IIIB병기, 2 IVA 병기)가 등록되었으며, 이중 2명은 외부방사선 2회 조사후 치료를 중단하였으며, 1명은 강내치료중 3등급의 비뇨기계독성으로 치료를 중단하였다. 2회의 항암화학 요법이 종료된 후 독성의 평가가 가능했던 14명의 환자중 5명이 3등급의 위장관독성이 발생하였으나, 4명은 치료종료후 평가에서 회복되었다. 1명은 병기 IIIB환자로 초기에 서혜부 임파절 전이가 있어 다량의 방사선이 조사되었는데, 치료종료 후에 위장관독성이 악화되었고, 1개월후 원격전이로 사망하였다. 치료후 치료전 체중의 $10\%$ 이상 감소된 환자는 2명이었고, 1명이 3등급의 백혈구 감소를 보였다. 환자의 평균 치료 기간은 75일(포준 치료 기간은 $70\pm7$일)이었고, 80일 이상인 환자는 3명 (84, 84, 89일)이었다. 추적관찰 가능했던 13명 환자중 8명이 완전관해를 보였고, 특히 IIB병기 환자의 경우 9명중 8명이 완전관해를 보였다. 본 연구결과 진전된 자궁 경부암에서 방사선과 항암화학요법 병행치료는 효과나 독성면에서 수용가능 하였으나 향후 근치적 방사선치료 단독으로 시행된 경우와의 전향적 비교연구가 필요할 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1431-1434
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• 2015

Background: Breast cancer is one of the most common cancers among women worldwide and the HER2 receptor plays an important role in its development and progression. This systematic review aimed to summarize the role of HER2 in brain metastasis in patients with breast cancer. Materials and Methods: We conducted a literature search by advanced search in title field using the Scopus, Pubmed, and Google scholar databases until the end of June 2014. With metastasis, metastatic, HER2, brain, and breast cancer, as terms of search we selected 31 articles, which were reviewed by two independent and blinded expert reviewers. The studies were first selected according to their titles and abstracts. Quality of the studies were then assessed using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) protocol for observational studies and CONSORT(Consolidation of Standards for Reporting Trials) protocol for clinical trials. For statistical analyses, we used STATA, version 11.0 software. Forest and funnel diagrams were drawn and for heterogeneity, index was also considered. Also we used meta regression analysis. Results: Finally, we reviewed 10 studies. The prevalence of brain metastasis in HER2-positive breast cancer patients was 24.9%. There was publication bias in the reviewed studies. Meta regression analysis showed that follow up time had no significant effect (p=0.396) on the prevalence of brain metastasis. Conclusions: The results showed a high prevalence of brain metastasis in HER2 positive breast cancer patients.

• 종양간호연구
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• 제5권2호
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• pp.107-115
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• 2005

Purpose: The present study was designed to identify cancer patients' needs when chemotherapy ends. Method: In-depth interview with focus questions was applied for the study. The participants were recruited from the patients receiving cancer chemotherapy in a university hospital. They were seven cancer patients with stomach cancer and two with liver cancer at the ending period of their chemotherapy protocol. Participants were interviewed on discharge date of last treatment and when they returned for the first outpatient follow-up. The focus question was 'what are your needs at this point?' The interviews were audio-taped and transcribed before analysis. The data were analyzed for common categories, special analytic categories, and conceptual categories. Results: Thirty two common categories, ten special analytic categories, and six conceptual categories were identified as patient's needs. The six conceptual categories were comfort needs, social needs, information needs, humanism needs, environmental needs, and self-efficacy needs. Conclusion: There were characteristic specific patients' needs when chemotherapy ends. There are needs to develop and to apply nursing intervention for cancer patients.

• Tuberculosis and Respiratory Diseases
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• 제83권2호
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• pp.141-146
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• 2020

Background: The burden of nontuberculous mycobacterial (NTM) pulmonary disease (PD) is increasing globally. To understand the treatment outcomes and prognosis of NTM-PD, a unified registry is needed. In this project, we aim to construct a multicenter prospective observational cohort with NTM-PD in South Korea (NTM-KOREA). Methods: The primary objective of this study is to analyze treatment outcomes according to the species. In addition, recurrence rate, adverse events, the impact of each drug on treatment outcomes as well as the impact of characteristics of mycobacteriology will be analyzed. The inclusion criteria for the study are as follows: fulfilling the criteria for NTM-PD having one of the following etiologic organisms: Mycobacterium avium complex, M. abscessus subspecies abscessus, M. abscessus subspecies massiliense, or M. kansasii; receiving the first treatment for NTM-PD after enrollment; age >20 years; and consenting to participate in the study. Seven institutions will participate in patient enrollment and about 500 patients are expected to be enrolled. Participants will be recruited from 1 March 2020 until 19 March 2024 and will be observed through 19 March 2029. During the follow-up period, participants' clinical course will be tracked and their clinical data as well as NTM isolates will be collected. Conclusion: NTM-KOREA will be the first nationwide observational cohort for NTM-PD in South Korea. It will provide the information to optimize treatment modalities and will contribute to deeper understanding of the treatment outcomes and long-term prognosis of patients with NTM-PD in South Korea.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권1_2호
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• pp.117-123
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• 1992

우측 협부의 종창과 압통을 주소로 내원한 59세의 여자 환자에서 방사선 소견상 우측 상악골의 광범위한 골파괴상이 나타났고 조직생검에서 MFH로 진단되었다. 치료는 술전과 술후에 SWOG외 CY-VA-DIC요법을 변형시킨 화학요법과 총 40Gy의 $^{60}Co$ 방사선요법 그리고 우측 상악골전적출술의 삼자병용요법을 시행하였다. 술후 2년이 경과된 현재까지 재발이나 전이 등의 소경은 관찰되지 않고 있으며 환자의 예후에 대하여 주의 깊은 관찰을 계속하고 있다.

• Archives of Plastic Surgery
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• 제48권1호
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• pp.98-106
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• 2021

Background Hand fractures can be treated using various operative or nonoperative methods. When an operative technique utilizing fixation is performed, early postoperative mobilization has been advocated. We implemented a protocol involving controlled active exercise in the early postoperative period and analyzed the outcomes. Methods Patients who were diagnosed with proximal phalangeal or metacarpal fractures of the second to fifth digits were included (n=37). Minimally invasive open reduction and internal fixation procedures were performed. At 3 weeks postoperatively, controlled active exercise was initiated, with stress applied against the direction of axial loading. The exercise involved pain-free active traction in three positions (supination, neutral, and pronation) between 3 and 5 weeks postoperatively. Postoperative radiographs and range of motion (ROM) in the interphalangeal and metacarpophalangeal joints were analyzed. Results Significant improvements in ROM were found between 6 and 12 weeks for both proximal phalangeal and metacarpal fractures (P<0.05). At 12 weeks, 26 patients achieved a total ROM of more than 230° in the affected finger. Postoperative radiographic images demonstrated union of the affected proximal phalangeal and metacarpal bones at a 20-week postoperative follow-up. Conclusions Minimally invasive open reduction and internal fixation minimized periosteal and peritendinous dissection in hand fractures. Controlled active exercise utilizing pain-free active traction in three different positions resulted in early functional exercise with an acceptable ROM.

• 대한토목학회논문집
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• 제31권4D호
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• pp.603-611
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• 2011

1997년 온실가스 감축을 위한 교토의정서가 채택된 이후 각 국가들은 대표적인 온실가스인 이산화탄소를 줄이기 위하여 전 산업에 걸쳐 다각적인 노력을 하고 있다. 건설산업에서도 온실가스 배출량을 고려한 Passive Design 이나, LCA기준에 의한 환경영향평가와 같은 소프트웨어적 기술의 개발 그리고 설비시스템의 조정이나 친환경 자재의 개발과 같은 하드웨어적 기술의 개발과 같이 두 가지 형태의 기술이 다양한 방법으로 개발됨으로써 이산화탄소 저감을 시도하고 있다. 그러나 건설산업에서 세부공정을 고려한 이산화탄소 배출과 관련한 연구는 전무하다. 본 연구에서는 철도노반공사 중에서 이산화탄소 배출량이 가장 많은 공정인 토공사를 대상으로 장비조합에 따른 이산화탄소 배출량을 산출하여 장비조합과 이산화탄소 배출량 그리고 공사기간의 상관성을 분석하였다.

• 재활치료과학
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• 제8권4호
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• pp.7-18
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• 2019

목적 : 경두개 직류 자극과 강제 유도 운동 치료의 결합된 중재를 적용한 뇌졸중 환자의 회복과 관련된 연구 동향을 알아보고, 중재 계획 시, 도움이 될 수 있는 정보 및 근거를 제시하는 데 목적이 있다. 연구방법 : 전자 데이터베이스 PubMed, NDSL 등을 이용하여 2009년 1월부터 2018년 12월까지 10년간 온라인 데이터에 등록된 논문을 검색하였다. 주요 검색어로 'Transcranial direct current stimulation' or 'tDCS', 'Constraint-induced movement therapy' or 'CIMT', 'Upper extremity function', 'Upper limb', 'Stroke'을 혼용하여 사용하여 본 연구의 선정기준과 배제기준에 부합하는 6편의 논문을 최종 선정하여 분석하였다. 결과 : 경두개 직류 자극의 적용 전류의 세기, 적용시간 등과 강제 유도 운동 치료의 프로토콜은 다양한 방법으로 이루어져 있었지만, 경두개 직류 자극 직 후 CIMT를 시행하는 중재 절차는 동일하게 시행되었다. 중재 효과를 알아보기 위해 상지기능, 일상생활동작, 대뇌피질 활성도 평가 등이 사용되었다. 경두개직류 자극과 강제 유도 운동 치료의 결합된 중재는 뇌졸중 환자의 상지기능과 일상생활동작 개선에 효과적인 것으로 나타났으며, 대뇌피질의 활성화에도 유의미한 효과가 있는 것으로 나타났다. 결론 : 본 연구를 통해 경두개 직류 자극과 강제 유도 운동 치료의 결합된 중재 적용에 필요한 정보 제공 및 근거를 마련하였다. 추후 연구를 통해, 경두개 직류 자극의 자극시간과 전류의 세기, 전극의 부착 위치 등에 대한 일반화가 필요할 것이며 가장 적절한 강제 유도 운동 치료 프로토콜을 사용하여 큰 모집단을 대상으로 장기간 추적 관찰을 포함한 무작위 대조군 실험연구가 필요하다.