• Radiation Oncology Journal
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• v.35 no.1
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• pp.1-15
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• 2017

Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection. Reirradiation with or without combined chemotherapy is an appropriate option for unresectable recurrence. Reirradiation is carefully considered with a case-by-case basis. Reirradiation protocol enrollment is highly encouraged prior to committing patient to an aggressive therapy. Radiation doses greater than 60 Gy are usually recommended for successful salvage. Despite recent technical improvement in intensity-modulated radiotherapy (IMRT), the use of concurrent chemotherapy, and the emergence of molecularly targeted agents, careful patient selection remain as the most paramount factor in reirradiation. Tumors that recur or persist despite aggressive prior chemoradiation therapy imply the presence of chemoradio-resistant clonogens. Treatment protocols that combine novel targeted radiosensitizing agents with conformal high precision radiation are required to overcome the resistance while minimizing toxicity. Recent large number of data showed that IMRT may provide better locoregional control with acceptable acute or chronic morbidities. However, additional prospective studies are required before a definitive conclusion can be drawn on safety and effectiveness of IMRT.

• The Korean Journal of Health Service Management
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• v.14 no.1
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• pp.161-176
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• 2020

Objectives: The purpose of this study was to investigate the effects of health status and health behaviors on health-related quality of life in Korean adults. Methods: The study was based on the 2017 National Health and Nutrition Survey. Of the total 8,127 people, 5,780 (71.1%) participated: 2,553 (44.2%) were male and 3,227 (55.8%) were female. The variables for this study were demographic factors, disease count, subjective health status, health behaviors, and health-related quality of life (measured by the EQ-5D Index). Results: After analysis, the statistically significant factors associated with health-related quality of life were gender, age, income, education, daytime health status, number of comorbidities (6 or more) and stress. Conclusions: Seven demographic factors have been identified as having a significant impact on health-related quality of life, categorized by model, gender, age and income. Therefore, it is possible that quality of life can be improved through proactive management and by improving subjective health status and health behaviors while in considering of demographic and sociological factors by providing indicators as per gender and age.

• CELLMED
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• v.5 no.2
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• pp.8.1-8.22
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• 2015

Medicinal uses of edible and other plants for prevention and cure of obesity and overweight associated metabolic and mental health problems have since long been known to scholars and practitioners of Ayurvedic and other traditionally known system of medicine. Modernized versions of numerous edible plant derived formulations mentioned in ancient Ayurvedic texts are at present some of the most popular, or best selling, herbal remedies in India and numerous other countries suffering from double burden of diseases caused by malnutrition and obesity. Preclinical and clinical information now available on edible plants and their bioactive constituents justify traditionally known medicinal uses of products derived from them for prevention and cure of obesity associated type-2 diabetes, psychopathologies and other health problems. Such information now available on a few edible Ayurvedic plants and their formulations and suggesting that their stress response regulating effects are involved in their broad spectrums of bioactivity profiles are summarized in this communication. Implications of recent physiological and pharmacological observations made with numerous phytochemicals isolated from edible plants for better understanding of traditionally known medicinal uses of herbal remedies are also pointed out.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.23-28
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• 2011

Diagnosis of early esophageal cancer has become more frequent as a result of improved endoscopic technology, surveillance programmes, and increasing experience and awareness on the part of endoscopists. In early esophageal cancer, squamous cell carcinoma and early adenocarcinoma must be managed differently because they have different origins, pathogenesis. and clinical characteristics. The current treatment options vary widely, from extended resection with lymphadenectomy to endoscopic mucosal resection (EMR) or ablation. None of these treatment options can be recommended universally. Instead, an individualized strategy should be based on the depth of tumor infiltration into the mucosa or submucosa, the presence or absence of lymph node metastases, the multicentricity of tumor growth, the length of the segment of intestinal metaplasia, and comorbidities of the patient. EMR has become increasingly important, both as a diagnostic tool for the staging of esophageal carcinomas and as a method of carrying out definitive treatment when the cancer meets certain criteria in which the risk of lymph-node metastasis is negligible. EMR may be sufficient in a subset of patients who have m1 or m2 squamous cell carcinoma and in patients who have isolated foci of high-grade intraepithelial neoplasia or mucosal cancer.

• Journal of Gastric Cancer
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• v.11 no.4
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• pp.206-211
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• 2011

Purpose: Laparoscopic total gastrectomy (LTG) for gastric cancer is still uncommon because of technical difficulties, especially in esophagojejunostomy (EJ). There are many reports for various laparoscopic procedures of EJ using linear or circular staplers. On the other hands, there has been no report for hand-sewn anastomosis. We report successfully performed intracorporeally hand-sewn EJ after LTG. Materials and Methods: The clinicopathologic data and short-term surgical outcomes of 6 patients who underwent totally laparoscopic total gastrectomy for upper gastric cancer from December 2010 and July 2011 were retrospectively reviewed. Results: The mean age was 66.5 years and mean body mass index (kg/$m^2$) was 24.6. All patients had medical comorbidities. The mean patient ASA score was 2.17. Among the 6 patients, previous abdominal operation was performed for 2 patients and combined operation was performed for 3 patients. The mean blood loss, operation time, and EJ anastomosis time was 130 ml, 379.7 minutes, and 81.5 minutes, respectively. The mean time to first flatus, first oral intake, and postoperative hospital stay was 3.0, 3.0, and 12.5 days, respectively. There was no 30-day mortality case. Postoperative aspiration pneumonia and multiple periventricular lacunar infarctions developed in 1 patient. There were no anastomosis-related complications and other major surgical complications. Conclusions: When the intracorporeal anastomotic technique becomes popular in LTG the intracorporeally hand-sewn EJ may be accepted as one method among the various laparoscopic procedures of EJ.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.3
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• pp.169-175
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• 2018

Background: The objective of this study was to compare hemodynamic and recovery characteristics of total intravenous anesthesia using propofol target-controlled infusion (TCI) versus sevoflurane for extraction of four third molar teeth. Methods: One hundred patients undergoing extraction of four third molar teeth under general anesthesia were randomized to one of two groups. Group 1 received propofol TCI-oxygen for induction and propofol TCI-oxygen-air for maintenance. Group II received a propofol bolus of 2 mg/kg for induction and sevoflurane-oxygen-air for maintenance. Heart rate, mean arterial pressure (MAP), operating time, time to emergence, nausea and vomiting, and sedation and pain scores were measured in each group. Results: Demographic data, including age, gender, weight, and height, were not significantly different between the two groups. The MAP was significantly higher after intubation (P = 0.007) and injection of anesthesia (P = 0.004) in the propofol group than in the sevoflurane group, with significant reflex bradycardia (P = 0.028). The mean time to emergence from anesthesia using propofol was 25 s shorter than that of sevoflurane (P = 0.02). Postoperatively, the propofol group was less sedated than the sevoflurane group at 30 min (0.02 versus 0.12), but this difference was not significant (P = 0.065). Conclusion: Both propofol TCI and sevoflurane are good alternatives for induction and maintenance of anesthesia for short day-case surgery. However, propofol TCI does not blunt the hemodynamic response to sudden, severe stimuli as strongly as sevoflurane, and this limitation may be a cause for concern in patients with cardiac comorbidities.

• Radiation Oncology Journal
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• v.29 no.1
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• pp.1-10
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• 2011

Due to improved life spans, cancer incidence has increased with more aged patients presenting with cancer. Elderly cancer patients could have compromised organ function and/or comorbidities. Due to poor social support or lack of early diagnosis, treatment outcomes for elderly cancer patients are poor in general. However, with aggressive support during cancer management as well as careful selection, most elderly cancer patients can tolerate standard radiation therapy with good results based on published articles. Here, we reviewed existing articles regarding compliance and treatment results in elderly cancer patients based on tumor site.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.5
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• pp.388-393
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• 2021

At present, in Korea, due to developments in medicine and technology and an increasing mean lifespan, the expected lifetime for elderly people is increasing (at 70 years, the expected additional lifespan is 14.8 years for males and 18.3 years for females). However, among all causes of death, malignant neoplasm is ranked first for all ages. Further, the incidence rate of oral cancer tends to increase with age. Thus, oral and maxillofacial surgeons have increased opportunity to experience the 'oldest old' patients with oral cancer. Elderly patients commonly have several comorbidities, poor general condition, limited socioeconomic support, fear of various postoperative complications, and perception of short for the rest of their life. In this situation, the patient, caregiver, and surgeon often choose undergraded treatment rather than standard treatment for oral squamous cell carcinoma owing to patient age. In elderly patients with oral cancer, ablation of tumor or reconstructive surgery is challenging for surgeons. Oral and maxillofacial surgeons must evaluate carefully the patient's medical condition and make a decision regarding treatment plans after sufficient discussion with patient and caregivers. We review the literature to consider the factors involved for deciding on a treatment plan regarding surgery in elderly patients with oral cancer.

• Journal of Chest Surgery
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• v.54 no.4
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• pp.239-245
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• 2021

Video-assisted thoracoscopic surgery (VATS) has been established as the surgical approach of choice for lobectomy in patients with early-stage non-small cell lung cancer (NSCLC). Patients with clinical stage I NSCLC with no lymph node metastasis are considered candidates for VATS lobectomy. To rule out the presence of metastasis to lymph nodes or distant organs, patients should undergo meticulous clinical staging. Assessing patients' functional status is required to ensure that there are no medical contraindications, such as impaired pulmonary function or cardiac comorbidities. Although various combinations of the number, size, and location of ports are available, finding the best method of port placement for each surgeon is fundamental to maximize the efficiency of the surgical procedure. When conducting VATS lobectomy, it is always necessary to comply with the following oncological principles: (1) the vessels and bronchus of the target lobe should be individually divided, (2) systematic lymph node dissection is mandatory, and (3) touching the lymph node itself and rupturing the capsule of the lymph node should be minimized. Most surgeons conduct the procedure in the following sequence: (1) dissection along the hilar structure, (2) fissure division, (3) perivascular and peribronchial dissection, (4) individual division of the vessels and bronchus, (5) specimen retrieval, and (6) mediastinal lymph node dissection. Surgeons should obtain experience in enhancing the exposure of the dissection target and facilitating dissection. This review article provides the basic principles of the surgical techniques and practical maneuvers for performing VATS lobectomy easily, safely, and efficiently.

• Journal of Korean Public Health Nursing
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• v.35 no.1
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• pp.149-164
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• 2021

Purpose: To identify the factors associated with poor self-rated health in individuals with acquired visual impairment through classification of such individuals into severe and mild visual impairment groups. Methods: This descriptive, cross-sectional, survey-based study analyzed data from 563 individuals with visual impairment due to acquired causes who had been recruited in the 2017 Korean National Survey on Persons with Disabilities. Results: Individuals with severe visual impairment reported poorer self-rated health. Mild depression (p=.003), and low smartphone use (p=.045) were associated with poorer self-rated health in those with severe visual impairment. The factors associated with poor self-rated health in those with mild visual impairment were comorbidities, low smartphone use (p=.006), needed health information (p=.020), unbalanced diet (p<.001), low weight (p=.024), and lack of health checkups (p=.001). Conclusion: Depression was found to be a predictor of poor self-rated health in individuals with severe visual impairment, which highlights the need for nursing and related healthcare intervention to lower depression in this specific population. Further, promoting social network building and providing health information using smartphones may serve to encourage appropriate health behavior in people with severe visual impairment who have reduced mobility and health literacy.