Objectives: Sleep disturbance in the elderly is associated with cognitive decline. Sleep quality is known to deteriorate with age, and prospective studies seldom have examined the relationship between sleep quality and cognitive function. This study investigates the relationship between early sleep quality and cognitive function based on six-year follow-up data of community individuals older than 60 years. Methods: The participants included 622 community elderly people older than 60 years from Jinju-Si. The final analysis comprised 322 elderly people. Pittsburgh sleep quality index (PSQI) and the Korean version of Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) were used to assess early sleep quality and cognitive function after six years. Multiple linear regression analysis was performed to investigate the association between early sleep quality and cognitive function in the elderly. Results: Early sleep quality (PSQI) was significantly associated with the results of the digit span test, clock drawing test (clox 1), and word recall test after six years. Sleep quality (PSQI) decreased significantly after six years, and lower quality of sleep (PSQI) score was associated with higher digit span test score (β = -0.167, p = 0.026) and higher clock drawing test score (β = -0.157, p = 0.031). Lower quality of sleep (PSQI) score was associated with higher word recall test (β = -0.140, p = 0.039). Conclusion: The digit span test, word recall test, and clock drawing task (CLOX 1) shown to be significantly associated to sleep quality can be performed fast and easily in clinical practice. It is important to assess early cognitive function in the elderly with poor sleep quality, and further studies could suggest that these tests may be useful screening tests for early dementia in elderly with poor sleep quality.
Purpose : To confirm the reproducibility of in vivo transmission dosimetry system and the accuracy of the a1gorithms for the estimation of transmission dose in head and neck radiation therapy patients. Materials and Methods : From September 5 to 18, 2001, transmission dose measurements were peformed when radiotherapy was given to brain or head and neck cancer patients. The data of 35 patients who were treated more than three times and whose central axis of the beam was not blocked were analyzed in this study. To confirm the reproducibility of this system, transmission dose was measured before dally treatment and then repetitively every hour during the treatment time, with a field size of 10$\times$10 cm$^{2}$ and a delivery of 100 MU. The accuracy of the transmission dose calculation algorithms was confirmed by comparing estimated dose with measured dose. To accurately estimate transmission dose, tissue inhomogeneity correction was done. Results : The measurement variations during a day were within $\pm$0.5$\%$ and the dally variations in the checked period were within $\pm$ 1.0$\%$, which were acceptable for system reproducibility. The mean errors between estimated and measured doses were within $\pm$5.0$\%$ in Patients treated to the brain, $\pm$2.5$\%$ in head, and $\pm$ 5.0%$\%$in neck. Conclusion : The results of this study confirmed the reproducibility of our system and its usefulness and accuracy for dally treatment. We also found that tissue inhomogeneity correction was necessary for the accurate estimation of transmission dose in patients treated to the head and neck.
Song Si Yeol;Lee Sang-wook;Yu Eunsil;Cho Kyung-Ja;Park Jin-hong;Kim Sang Yoon;Nam Soon Yuhl;Lee Bong-Jae;Kim Sung Bae;Choi Seung-Ho;Ahn Seung Do;Shin Seong Soo;Choi Eun Kyung
Radiation Oncology Journal
/
v.23
no.1
/
pp.1-8
/
2005
Purpose : The objective of this study was to determine whether the expressions of the two components of DNA-dependent protein kinase, Ku70 and DNA-PKcs, influence the response to radiotherapy (RT) and outcome of treatment of non-disseminated nasopharyngeal carcinoma (NPC) in patients who received definitive RT. Materials and Methods : Sixty-six patients with NPC who were treated with radiotherapy alone or with concurrent chemotherapy between June 1995 and December 2001 were divided into groups based on the levels of immunoreactivity for Ku70 and DNA-PKcs in pretreatment biopsy specimens. The over-expression of Ku70 or DNA-PKcs groups Included patients whose biopsy specimens showed at least 50% immunopositive tumor cells; patients in which less than 50% of the tumor cells in the biopsy tissues were immunopositive were placed in the low Ku70 and DNA-PKcs groups. The immunoreactivities for Ku70 and DNA-PKcs were retrospectively compared with the sensitivity of the tumor to radiation and the patterns of therapy failure. Univariate analyses were peformed to determine the prognostic factors that influenced locoregional control of NPC. Results : The five-year locoregional control rate was significantly higher in the low Ku70 group (Ku(-)) (85%) than in the high Ku70 group (Ku(+)) (42%) (p=0.0042). However, there were no differences in the metastases-free survival rates between the two groups (Ku70 (+), 82%; Ku70 (-), 78%; p=0.8672). Univariate analysis indicated that the over-expression of Ku70 surpassed other well-known predictive clinocopathologic parameters as an Independent prognostic factor for locoregionai control. Eighteen of 22 patients who had locoregional recurrences of the tumor displayed an over-expression of Ku70. No significant association was found between the level of DNA-PKcs expression and the clinical outcome. Conclusion : Our data suggest that the level of Ku70 expression can be used as a molecular marker to predict the response to RT and the locoregional control after RT and concurrent chemotherapy in patients with non-disseminated NPC.
Kim, Hye-Ok;Kim, Min-Ji;Yeon, Myeong-Jin;Cha, Sun-Wha;Koong, Mi-Kyoung;Song, In-Ok
Clinical and Experimental Reproductive Medicine
/
v.35
no.3
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pp.213-221
/
2008
Objective: To evaluate predictor of IVF outcomes following single embryo transfer in patients with decreased ovarian reserve. Methods: A retrospective review was performed in 919 IVF cycles with elevated basal serum FSH (${\geq}12\;mIU/mL$), the number of retrieved oocytes ${\geq}4$ and serum $E_2$ concentration on hCG day <500 pg/ml between Jan. 1996 and Dec. 2006. Two hundred thirty five IVF cycles following single embryo transfer were included. Pregnancy rates and live birth rates was evaluated according to maternal age, serum $E_2$ on hCG day, basal FSH level, the number of blastomere on day 3 ET, stimulation protocol, the number of cycles of ET. Statistical analysis was used SPSS 12.0 program. Results: OPU cancellation rates were 25.6% (235 cycles), OPU failure rates were 18.5% (170 cycles), embryo transfer cancellation rates were 14.0% (129 cycles). Pregnancy rates following single embryo transfer was 8.1% (19 cycles) and live birth rates was 4.7% (11 cycles). Pregnancy rates and live birth rates of women under 35 years old was statistically higher than those of women above 35 years old (20% vs. 3.5% (p<0.0001), 12.3% vs. 1.8%, (p=0.002)). There was no difference in basal FSH, serum $E_2$ on hCG day, and the number of blastomere on ET, and stimulation protocol. Cumulative pregnancy rates according to the number of cycles of ET were $1^{st}$ 8.1%, $2^{nd}$ 9.2%, $3^{rd}$ 9.7%, $4^{th}$ 9.0%, and $5^{th}$ 9.5%. Conclusion: Pregnancy rates and live birth rates of IVF-ET cycles following single embryo transfer in patients with decreased ovarian reserve are statistically increased in women under 35 yrs old. There is no difference in cumulative pregnancy rates. These data may be helpful for counseling women with decreased ovarian reserve in attempting IVF with their own eggs or when choosing donor oocytes.
This study was attempted to look into relation between job stress and job satisfaction perceived by clinical dental hygienists and the influencing factors for providing fundamental data to increase their job satisfaction. For this, mailed correspondence examination was conducted with questionnaire for dental hygienists who are engaged in dental hygiene duties at dental clinics in Seoul between June 19 and July 24, 2008. Total 180 questionnaires were distributed, and among these, 156 questionnaires were included in analysis except for 24 questionnaires having incomplete answers. The findings of this study are as follows: 1. The total mean of dental hygienists' job stress was found to be 3.46 points out of 5 points, and that of their job satisfaction to be 2.99. 2. For relation between general characteristics and job stress of dental hygienists, significant difference was found just in the motive to select dental hygienist (p < 0.001) and the expected period of engagement in dental hygienist duties (p < 0.05). 3. For relation between general characteristics and job satisfaction of dental hygienists, significant difference was found just in job experience(p < 0.05), current position (p < 0.05), average salary (p < 0.001), and the expected period of engagement in dental hygienist duties (p < 0.01). 4. For correlation between job stress and job satisfaction, negative correlation was shown generally (r=-0.222), such that the more was job stress, the less was job satisfaction. 5. As a result of multiple regression analysis to look into the job stress factors influencing dental hygienists' job satisfaction, it was found that the factors of excessive workload(p < 0.05) and improper treatment(p < 0.01) most influenced job satisfaction, and the descriptive power on the job stress factors influencing their job satisfaction was found to be 24.1%.
The purpose of this study was to provide a basic data for developing and solutions to prevent verbal abuse and to determine the actual overall verbal abuse experience of dental hygienist. Participants were 289 dental hygienists who work in dental hospitals and clinics. The results of this study, 177 dental hygienists experienced verbal abuse. Perpetrators of verbal abuse experience became patient (67.9%), dentist (21.1%). The most common reason for verbal abuse were 'anger about the dental service' (17.0%), 'anger about physical and emotional suffering' (14.1%), 'consider the dental hygienists as subordinate not as colleague or practitioner' (12.6%). The types of verbal abuse were 'taking down' (21.7%), 'yelling' (16.3%), 'being sarcastic' (11.3%). The types of coping with verbal abuse were many aspects of passive coping in order of 'suppress' (12.3%), 'ignore' (8.2%). The result of verbal abuse experience according to working characteristics was significant different to clinical career, main duty, position. The result of self-esteem and job satisfaction according to verbal abuse experience, dental hygienist who had experienced verbal abuse was lower in job satisfaction. Therefore, it should be recognized that experience of verbal abuse in dental hygienist was serious and need to develop prevention programs and research.
Purpose: Various treatment techniques have been attempted for the radiotherapy of anal cancer because of acute side effects such as perineal skin reactions. This study was performed to investigate an optimal radiotherapy technique in anal cancer. Materials and Methods: The study subjects included 35 patients who underwent definitive concurrent chemoradiotherapy for anal cancer in Yonsei Cancer Center between 1990 and 2007. The patients' clinical data, including irradiation technique, were reviewed retrospectively. The primary lesion, regional lymph nodes, and both inguinal lymph nodes were irradiated by $41.4{\sim}45\;Gy$ with a conventional schedule, followed by a boost does to the primary lesion or metastatic lymph nodes. The radiotherapy technique was classified into four categories according to the irradiation field and number of portals. In turn, acute skin reactions associated with the treatment interruption period were investigated according to each of the four techniques. Results: 28 patients (80.0%) had grade 2 radiation dermatitis or greater, whereas 10 patients (28.6%) had grade 3 radiation dermatitis or greater during radiotherapy. Radiation dermatitis and the treatment interruption period were relatively lower in patients belonging to the posterior-right-left 3 x-ray field with inguinal electron boost and in patients belonging to electron thunderbird techniques. The interruption periods were $8.2{\pm}10.2$ and $5.7{\pm}7.7$ for the two technique groups, respectively. Twenty-seven patients (77.1%) went into complete remission at 1 month after radiotherapy and the overall 5 year survival rates were 67.7%. Conclusion: Field size and beam arrangement can affect patients' compliance in anal cancer radiotherapy, whereas a small x-ray field for the perineum seems to be helpful by decreasing severe radiation dermatitis.
Lee Kichang;Jung Joohyun;Oh Sunkyoung;Jeong Yucheol;Lim Changyun;Yoon Junghee;Choi Mincheol
Journal of Veterinary Clinics
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v.22
no.3
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pp.186-189
/
2005
For the assessment of the clinical application of histogram on internal parenchymal organs, ultrasonography with a multi-frequency transducer was taken. We scanned in the region of right cranial abdomen for both liver and right kidney, and left cranial abdomen for liver, spleen and left kidney in 9 normal Beagle dogs. The data from histogram examined in a region of interest centered on each picture element of B-mode images at the same depth were compared among liver, renal cortex, spleen, cortex and medulla of each kidney. The right renal cortex showed significantly lower echogenicity than parenchyma of liver by $15{\%}$. Spleen was more echogenic than the cortex of the left kidney by $23{\%}$, and liver was more echogenic than the left renal cortex by $30{\%}$. Renal cortex was more echogenic than medulla by $47{\%}$ and $65{\%}$ on the right and left side, respectively (p<0.05). The mean (${\pm}SD$) values calculated echogenicity were $46.2{\pm}12.3\;(95\%$ confidential interval (CI), 41.0 to 55.0) and $53.4{\pm}12.1\;(95\%$ CI, 47.0 to 55.1) in in the right renal cortex and liver parenchyma, $65.0{\pm}11.8\;(95\%$ CI, 57.9 to 71.0) and $51.0{\pm}16.9\;(95\%$ CI, 42.8 to 54.1) in splenic parenchyma and renal cortex. And the mean values calculated echogenicity were $65.0{\pm}10.15\;(95\%$ CI, 60.1 to 71.5) and $52.0{\pm}9.4\;(95\$ CI, 43.8 to 60.3) in liver parenchyma and the left renal cortex, $54.5{\pm}18.3\;(95\%$ CI, 40.1 to 62.8) and $35.0{\pm}16.2\;(95\%$ CI, 24.2 to 43.6) in the left renal cortex and medulla. And the mean values calculated echogenicity were $55.0{\pm}14.4\;(95\%$ CI, 47.3 to 61.7) and $40.0{\pm}13.2\;(95\%$ CI, 34.3 to 46.7) in the right renal cortex and medulla, respectively. In addition, the echogenicity ratios were $0.86{\pm}0.11$ between the right renal cortex and liver parenchyma, $1.37{\pm}0.47$ between spleenic parenchyma and the left renal cortex, $1.30{\pm}0.19$ between liver parenchyma and the left renal cortex. All the values measured showed significant different (p<0.05). Ultrasound histogram is simple, useful and feasible to evaluate the sonographic architecture of the internal organs such as liver, spleen and kidney, quantitatively.
Purpose : Though It has been known that the to tolerance of the liver to external beam irradiation depends on the irradiated volume and dose, few data exist which Quantify this dependence. However, recently, with the development of three dimensional (3-D) treatment planning, have the tools to Quantify the relationships between dose, volume, and normal tissue complications become available. The objective of this study is to investigate the relationships between normal tissue complication probabili쇼 (WCP) and the risk of radiation hepatitis for patients who received variant dose partial liver irradiation. Materials and Methods : From March 1992 to December 1994, 10 patients with hepatoma and 10 patients with bile duct cancer were included in this study. Eighteen patients had normal hepatic function, but 2 patients (prothrombin time 73$\%$, 68$\%$) had mild liver cirrhosis before irradiation. Radiation therapy was delivered with 10MV linear accelerator, 180$\~$200 cGy fraction per day. The total dose ranged from 3,960 cGy to 6,000 cGy (median dose 5,040 cGy). The normal tissue complication probability was calculated by using Lyman's model. Radiation hepatitis was defined as the development of anicteric elevation of alkaline phosphatase of at least two fold and non-malignant ascites in the absence of documented progressive. Results: The calculated NTCP ranged from 0.001 to 0.840 (median 0.05). Three of the 20 patients developed radiation hepatitis. The NTCP of the patients with radiation hepatitis were 0.390, 0.528, 0.844(median : 0.58$\pm$0.23), but that of the patients without radiation hepatitis ranged fro 0.001 to 0.308 (median .0.09$\pm$0.09). When the NTCP was calculated by using the volume factor of 0.32, a radiation hepatitis was observed only in patients with the NTCP value more than 0.39. By contrast, clinical results of evolving radiation hepatitis were not well correlated with NTCP value calculated when the volume factor of 0.69 was applied. On the basis of these observations, the volume factor of 0.32 was more correlated to predict a radiation hepatitis. Conclusion : The risk of radiation hepatitis was increased above the cut-off value. Therefore the NTCP seems to be used for predicting the radiation hepatitis.
Moon, Jin Soo;Lee, Soon Young;Eun, Baik-Lin;Kim, Seong Woo;Kim, Young Key;Shin, Son Moon;Lee, Hye Kyoung;Chung, Hee Jung
Clinical and Experimental Pediatrics
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v.53
no.3
/
pp.307-313
/
2010
Purpose : Results of the Korea National Health Screening Program for Infants and Children, which was launched in November 2007, were evaluated for future research and policy development. Methods : Data from a total of 2,729,340 cases were analyzed. Five visiting ages, such as 4, 9, 18, 30, and 60 months, were included. Several parameters such as stunting, obesity, and positive rate of developmental screening were also analyzed. Telephone survey was performed in 1,035 users. For the provider survey, 262 doctors participated in our study. Results : The overall participation rate of users was 35.3%. This participation rate showed a decrement tendency to old age and low income. Only 6.9% of users participated in oral screening. Health screening was performed mainly in private clinics (82.6%). The recall rate of 4 months program users at the age of 9 months was 57.3%. The positive rate of screening was 3.1%, and was higher in the low-income group. By telephone survey, users reported that questionnaires were not difficult (94%) and overall satisfaction was good (73%). Longer duration of counseling was related with more satisfied users. Counseling and health education were helpful to users (73.2%). Doctors agreed that this program was helpful to children (98.5%). Conclusion : Korea National Health Screening Program for Infants and Children was launched successfully. Participation rate should be improved, and a quality control program needs to be developed. More intensive support following this program for children of low-income families may lead to effective interventions in controlling health inequality. Periodic update of guidelines is also needed.
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