• 농촌의학ㆍ지역보건
• /
• 제6권1호
• /
• pp.33-41
• /
• 1981

To investigate the status of medical accident attack rate and medicare utilization during last 27months from 1st Oct., 1977 to 31st Dec. 1979 in the area under Sam Wha Medicare Insurance Union, the study was carried out through analyzing the medicare records of patients who were enrolled. "The medical accident" in this study was used as the meaning of the state that the people who have been treated morbid condition with insurance money. For the study, 2 doctors and one nurse were mobilized and the results are as follows: 1) The total number of the Medicare Insurance Union members among the 37,044 total population of the study area, (Hea-mi, Unsan, Eumam Myun) were 57, 35 composed of 3,000 males (52.3%) and 27, 35 females (47.7%) in 1977, 3,383 composed of 2,006 males (59.3%) 1,377 females (40.7%) in 1978, 2,573 composed of 1,437 males and 1,336 females (44.2%) in 1979. 2) Total number of medical accident attack cases were 6,774 case (partially overlapped the number of the 1977 with that of the 1978) and average annual medical accident attack rate per 1,000 population was 700.9. 3) Five major disease group in the past three years were disease of the respiratory system (177.7), disease of the digestive system (165.8), disease of the skin and subcutaneous(64.9), symptoms, signs and ill-defined conditions (64.6), any injury and poisoning (51.9). Mental disorders (32.6) was the 6th order disease group. 4) The order of the medical accident attack rate of age group per 1,000 population per year was the year group of 0~4(877.8), 45~64(832.6), 25~44(810.3), 5~14(495.1) 15~24(494.7) 65 and over (460.7). 5) Medical accident attack rate of age group per 1,000 population in the 5 major disease groups were the year group of 45~64 (100.0) in the mental disorders 0~4(525.1) in the disease of the respiratory system 45~64 (328.5) in the disease of the digestive system 0~4 (202.8) in the disease of the skin and subcutanous tissue, 25~44 (98.3) in the accidents and poisoning. 6) Monthly medical accidents attack rate were 87.0 in the winter (Dsc., Jan., Feb.) and 86.2 in the summer (Jun., July, Aug.). So the trend of the medical accidents attack rate during the year was bimount figure. 7) Monthly medical accidents attack rate in the major disease group were highest in Jan., Apr., (31.1) in the disease of the respiratory system, in Jan., Feb., Mar. (24.9) in the disease of the digestive system, in Jan., Jun., Aug. (9.8) in the injury and poisoning. 8) Duration of the treatment of the 93.1% of the total cases were within 5 days. 9) 299 cases (4.5%) of the total number of cases, 6,587 cases were referred to secondary and tertiary medicare facilities. 10) The order of the major 10 kinds of diagnosis of the disease, 6,587 cases during 27 months, were URI and chillness (1,063 cases, 16.1%), gastritis(830 cases, 12. 6%) dermatitis(360 cases, 5.5%), bronchitis(291 cases, 4.4%), neurosis (284 cases, 4.3%), contusion (165 cases, 2.5%), tooth extraction (157 cases, 2.4%), tonsillitis (109 cases, 0.7%), laceration (107 cases, 1.6%), neuralgia (105 cases, 1.6%), arthritis (104 cases, 1.6%), otitis media and mastoiditis (103 cases, 1.6%), so total case were 3,678 cases (55.9%).

• 한방안이비인후피부과학회지
• /
• 제18권3호
• /
• pp.84-94
• /
• 2005

Objective: In order to help clinical approach on OME patient in progress observation and decision on improvement by clinical research results using tympanometry. Methods: Data was collected from 163 ears of 96 patients who were treated in Dept. of Oriental Medical Ophthalmology & Otolaryngology & Dermatology, Kyung-Hee Medical Center from 2001-2-12 to 2005-4-29 for Otitis Media with Effusion(OME). Tympanometry was applied to all patients and the test result was used to evaluate progress and improvement. F/U cases below 3 times were excluded. Results & conclusion: 1. Age and sex distribution was as follows: Mean Age 5.5years old(Standard deviation: 2.1), age distribution 2-61years old, below 10years old 151cases(92.6%) and above 10years old 12cases(7.4%). Male and female ratio was 1.81:1. 2. There were 67people(69.8%) with bilateral affected ear. Unilateral was 29people(30.2%). Affected ear distribution according to sex came out similarly. 3. Affected period distribution was as follows: over 12weeks 71cases(43.6%), under 12weeks 92cases(56.4%). Out of under 12weeks cases, 2-4weeks was 34cases(20.9%), 0-1weeks and 5-8weeks 20cases(12.3%), 9-12weeks 18cases(11.0%). There was evident difference about affected period between male and female. 4. All patients who served previous Tx in medical clinic(118 cases) took antibiotics. Only 6cases took tube insertion. The period of Taking antibiotics was as fellows: over 6weeks 42cases(35.6%), under 5weeks 37cases(31.4%). unknown 25cases(21.2%), jntermittent 14cases(11.9%). 5. In Period of Tx distribution, 5-6weeks showed 40cases(24.5%) which was highest number. In Improved cases(85cases), 3-4weeks and 5-6weeks each 22cases(25.9%) which was highest number. 1-2weeks 3cases(3.5%), 7-8weeks 12cases(14.1%), 9-10weeks 9cases(10.6%), 11-12weeks 10cases(11.8%), over 12weeks 7cases(8.2%). 6. The cases which have gastrointestinal Sx were 71cases(43.6%), the others 92cases(56.4%). Details of gastrointestinal Sx were as follows: Sx associated with appetite 47cases(47.5%), constipation 15cases(15.2%), abdominal pain and diarrhea 14cases(14.1%), frequent vomitting Teases(7.1%), etc 4cases(4.0%). 7. The cases which have accompanying disease were 116case(71.2%), the other 47cases(28.8%). Details a accompanying disease were as follows: sinusitis 57cases(35%), rhinitis 55cases(3.7%), allergic rhinitis 20cases(12.3%), atopic dermatitis 19cases(1.7%), urticaria 4cases(2.5%), asthma 3cases(1.8%), nasal polyp and conjunctivitis 2cases(1.2%) each, laryngitis 1case(0.6%).

• 한방안이비인후피부과학회지
• /
• 제14권2호
• /
• pp.173-182
• /
• 2001

This Study is attempted in order to observe a clinical analysis from Constitution medical view point about allergic rhinitis. We studied 71 patients who had visited Dept. surgery, opthalmology & otolaryngology, col1ege of Oriental Medicine, Kyungsan University, Pohang, Korea and were treated by medications of Sasang Constitution and Constitution-Acupunture with allergic rhinitis from March 1, 2000 to February 28, 2001. The results were as follows: 1. The sex distribution was 71 males($69\%$), 22 femail($31\%$), In age distribution, the average was 29.6. The peak age was thirties($36.7\%$), teen-ager was $23.9\%,\;fortieth\;was\;15.5\%,\;under\;10\;years\;old\;was\;9.9\%,\;twenties\;was\;7\%,\;fifties\;was\;5.6\%,\;sixtisth\;was\;1.41\%$. 2. In the age of onset, thirties was $29.6\%$, teen-ager was $19.7\%$, twenties was $18.3\%$, under 10 years old and fortieth was $14.1\%$, fifties was $3.8\%$, sixtisth was $1.41\%$. 3 In monthly distribution. september was $25.8\%$, january was $14.1\%$, october was $11.3\%$. november and august was $8.5\%$, april was $7\%$, febuary and may were $5.6\%$, june, july. December were each $4.2\%$, In the distribution of season. the peak season was fall from september to November. 4. In the duration of the disease, 1-3 years was $26.8\%$, 3-5 years was $19.7\%$, 6 months - 1 year $16.9\%$, 5-10 years was $14.1\%$, under 6 months was $11.3\%$, over 10years and over 15 years were each $5.6\%$. 5. In the three main symptom, hydrorrhoea was $71.8\%$, nasal obstruction was $67.6\%$, sneezing was $64.8\%$. In others, fatique was $25.6\%$, headache was $14.1\%$, itching and cough was $11.3\%$, laryngopharyngeal discomfort and red eye were $4.2\%,\;infirmity\;was\;2.8\%$. 6. Patients whose families have allergic disease account for 26 cases($36.6\%$). 7. There was no past history in 37 cases($52.l\%$). In past history distribution, digestive tract disease was $12.7\%$, paranasal sinusitis was $8.5\%$, allergic dermatitis was $7\%$, common cold was $4.2\%$. otitis media, bronchitis, asthma, tonsillitis were $2.8\%$. 8. Sasang Constitution classification was Soyanggin in 52 cases($73.2\%$), Taeumgin in 12 cases($16.9\%$). Soumgin in 7 cases($9.9\%$). 9. In the duration of treatment, it was 1-2 weeks in 26 cases($36.6\%$), 2-4 weeks was $21.1\%$, under 1weeks was $14.1\%$, 4-6 weeks was $11.3\%$, 6-8 weeks was $8.5\%$, 8-10 weeks was $5.6\%$, over 10 weeks was $2.8\%$. 10. We had a follow-up survey the effect of treatment in the 60 cases. there was fair in 25 cases($41.7\%$), good in 21cases($35\%$), excellent in 3cases($5\%$)로 total rate of treatment was $81.7\%$. The case of no change was $16.7\%$, the case of poor was $1.6\%$.

• 한국방사선학회논문지
• /
• 제8권4호
• /
• pp.171-180
• /
• 2014

본 연구는 양성자 치료를 시행하고 있는 수모세포종 환자의 양성자 치료 시 환자들의 Skin에서 홍반이나 피부염이 발생하는 경우가 빈번하여 Phantom에서 실제 환자와 동일한 치료계획 후 생체 내 선량측정 검출기(In-vivo dosimetry)로 사용되는 열 형광선량계(Thermo-luminescence Dosimeter, TLD)와 EBT3 Film으로 실제선량을 조사 측정한다. 측정된 선량값을 치료계획 된 피부선량과 비교 분석하여 양성자 치료 시 임상적으로 피부선량 측정 사용에 유용성이 있는지 알아보고자 한다. Phantom을 수모세포종의 전뇌척수치료(Cranio-spinal irradiation, CSI) Set-up position으로 위치하여 Brain에서 부터 Pelvis까지 CT촬영하고 양성자 치료계획 후 치료실에서 디지털 영상 포지셔닝 시스템(Digital Imaging Positioning System, DIPS)을 이용하여 정확하게 치료 Isocenter지점을 맞춘다. 양성자 빔이 들어가는 5부위의 치료 Isocenter 지점과 CT촬영 시 Phantom에 표시한 Marker 2부위, 모두 7지점에 미리 교정을 마친 열 형광선량계와 EBT3 Film을 교차해가면서 위치하여 붙이고 치료 계획된 양성자 빔을 각각 10회씩 조사한다. 10회 반복 측정하여 얻은 값을 평균산출하여 치료계획 시스템 에서 측정된 Skin Dose와 비교 분석한 결과, 측정위치의 어려움이 있는 정확한 측정이 결여된 한 지점을 제외한 나머지 6지점의 측정 선량값은 열 형광선량계와 EBT3 Film 모두 절대 선량값과 ${\pm}2%$이내의 분포를 보였다. 결론적으로, 본 연구에서는 국내 최초의 양성자 치료에서 Enterance skin dose 측정을 위한 In-vivo dosimetry로 열 형광선량계와 EBT3 Film의 임상적인 유용성을 확인하였다.

• Journal of Nutrition and Health
• /
• 제52권6호
• /
• pp.559-568
• /
• 2019

서울시 일부 아동 대상의 식품알레르기 유병률과 위험 요인 및 다른 알레르기 질환과의 연관성 조사결과 식품알레르기 의사 진단 유병률은 14.2%, 알레르기 증상을 한번이라도 경험한 아동의 유병률은 20.4%, 최근 12개월 내 증상 경험 유병률은 17.4%이었다. 식품알레르기를 한번이라도 경험한 아동 612명을 대상으로 알레르기 경험 특성을 도출한 결과 대부분 식품 경구 섭취를 통해 발생하였고 증상 유발식품은 난류, 복숭아, 우유, 땅콩, 새우 등이 있었다. 식품알레르기 증상 경험 유병과 12개월 내 주요 알레르기 유발 의심식품 섭취의 위험요인으로는 곡류, 감자류, 패스트푸드, 견과류, 우유 등이 유의한 영향이 있었다. 식품 섭취의 경우 식품알레르기 증상을 경험한 아동일 경우 견과류, 우유 및 유제품, 난류의 섭취 빈도가 낮을수록 위험도가 유의하게 증가하였다. 환경적 위험요인으로 연령, 부모의 알레르기 질환력, 항생제 복용요인이 도출되었으며, 기타 알레르기 질환과도 관련이 있었다. 최근 식품 알레르기의 또 다른 환경적 위험요인으로 다른 연구들에서도 언급되는 요인이기에 이와 관련한 지속적인 연구가 필요할 것이다. 결과적으로 식품알레르기의 경험이 있는 아동은 다른 알레르기 질환으로 이환될 가능성이 상대적으로 높으며, 이에 따라 규칙적인 식품 섭취와 조기진단을 통하여 유발식품을 명확히 알고 제한할 수 있어야 할 것이다. 궁극적으로 이 연구 결과를 통해 서울에 거주하는 아동의 유병률과 증상경험의 특성을 파악하여 효과적인 중재방안을 도출할 기초자료로의 의미가 있을 것이다.

• 농업생명과학연구
• /
• 제45권2호
• /
• pp.43-50
• /
• 2011

본 시험은 무궁화과에 속하는 초본 식물인 Kenaf (Hibiscus cannabinus L.)를 경상대학교 시험농장에서 2010년 6월 1일 파종하여 같은 해 11월 18일 수확하여 건조 한 후, 꽃 (HCME-F)과 잎 (HCME-L)에서 추출한 메탄올 추출물을 이용하여, 세포 독성 시험 및 주요 병원균에 대한 항균효과를 규명하였다. 항균효과에 사용된 균주는 가축에서 피부 질환, 유방염 및 소화기질병을 유발하는 그람양성균인 St. aureus 와 Str. epidermidis, 그람음성균인 S. typhimurium 과 E. coli 균을 공시균주로 사용하였다. 추출물의 안전성을 평가하기 위해 두 추출물 HCME-F과 HCME-L을 0, 25, 50, 100 및 $200{\mu}g/ml$ 농도로 첨가한 배지에서 RAW 264.7 세포와 24시간 반응 후 세포 독성을 측정해 본 결과, 세포 독성이 인정되지 않았으며, 항균효과 시험결과 그람양성균인 St. aureus와 Str. epidermidis 균에 대하여 1, 50 및 $100{\mu}g/ml$의 추출물 농도 및 반응시간 경과에 따라 항균 효과가 증가되었으나, 그람음성균인 S. typhimurium 과 E. coli 에서는 항균효과가 인정되지 않았다. 종합적으로 Kenaf의 꽃과 잎에서 추출한 메탄올 추출물이 세포에 대한 안전성이 입증되었고, 가축과 사람의 피부 질환 및 유방염의 대표적 그람양성균인 St. aureus와 Str. epidermidis 균에 대한 항균효과를 보여, Kenaf의 꽃과 잎을 이용한 선택적 그람양성균 치료제 및 사료첨가제 개발이 가능할 것으로 판단된다.

• Journal of the Korean Wood Science and Technology
• /
• 제49권1호
• /
• pp.23-43
• /
• 2021

본 연구에서는 국내 자생식물 7종의 정유 중 우수한 항산화 효과가 있는 온주밀감, 육계나무 정유 2종을 선별하였고, 피부염을 유발하는 Candida albicans에 대한 항미생물 활성 평가를 통해 식물정유의 항미생물 활성성분을 구명하고자 하였다. 1,1-diphenyl-2-picrylhydrazyl (DPPH) 라디칼 소거활성 측정 결과 SC50값이 온주밀감 정유 0.010 mg/mL, 육계나무 정유 0.09 mg/mL을 나타냈으며, 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) 라디칼 소거활성 측정 결과 온주밀감 정유 0.09 mg/mL, 육계나무 정유 0.06 mg/mL로 높은 항산화 활성을 나타냈다. Minimum Inhibitory Concentration는 육계나무 정유 1.25 mg/mL, 온주밀감 정유 5 mg/mL 값으로 육계나무 정유에서 뛰어난 항미생물 활성이 나타났다. Thin layer chromatography (TLC) bioassay를 통해 2종 정유의 성분 분획에 따른 C. albicans에 대한 항미생물 활성을 평가하였고, preparative TLC (prep. TLC)를 통해 활성분획을 획득하고, 동일 Rf값을 가지는 성분들에 대해서 GC/MS 분석을 수행하여 항미생물 활성성분을 구명하였다. 그 결과 항산화 및 항미생물 활성을 나타내는 주성분은 각각 육계나무 정유의 경우 cinnamyl acetate, eucalyptol, linalool, citral 온주밀감 정유의 경우 linalool이었다. 2종 정유에 공통적으로 항산화 및 항미생물 활성을 나타낸 분획부 성분분석 결과 linalool은 항산화, cinnamyl acetate, eucalyptol, citral, geranyl acetate은 항산화와 항미생물 능력이 있다고 사료된다.

• 한국가금학회지
• /
• 제48권4호
• /
• pp.227-238
• /
• 2021

본 연구는 홰 종류 및 높이 설정에 따른 육계의 생산성, 혈액조성, 행동특성 및 계육품질에 미치는 영향에 대하여 조사하였다. 육계(Ross 308) 초생추(48.23±0.264 g) 수컷 912수를 공시하여 재질에 따른 홰 종류 3종(나무, 철제 및 플라스틱)과 높이 2수준(10→30 cm 변동, 10 cm 고정)의 3 × 2 요인으로 35일간 시험을 수행하였다. 체중 및 사료 섭취량은 개시일과 종료일에 측정하였다. 육계의 홰 이용도, 깔짚 품질, 발바닥피부염은 1, 3, 5주령에 측정하였으며, 혈청생화학 조성 및 계육품질은 35일령에 분석하였다. 체중, 사료요구율, AST를 제외한 혈청 생화학 성분은 처리구간 유의적인 차이를 보이지 않았으며, 5주령의 발바닥피부염 발생 정도는 플라스틱(1.65) 처리구가 나무(1.25)와 철제(1.30)에 보다 유의적으로 증가 하였다(P<0.05). 홰 이용성을 분석한 결과, 모든 주령에서 점등 및 소등구간에는 나무, 철재, 플라스틱 처리구 순으로 유의적으로 이용 횟수가 높았으며(P<0.05), 3주령과 5주령에는 홰의 높이 고정 처리구가 변동 처리구보다 이용 횟수가 높았다(P<0.05). 가슴육 품질 분석 결과, pH, 육색, 보수력은 홰 종류 및 높이 간 유의적인 차이를 나타내지 않았으나, 전단력은 나무, 철재, 플라스틱 순으로 유의적으로 높은 값을 나타내었다(P<0.05). 따라서 높이 설정에서는 10 cm 고정 처리구가 높은 이용도로 나타내었으며, 홰 재질은 다른 재질에 비해 나무 재질의 이용도가 높았고 AST 및 발바닥 피부염을 개선시키는 것으로 사료된다.

• 대한한의학회지
• /
• 제21권3호
• /
• pp.149-165
• /
• 2000

As recent developments of Immunology and Nuclear medicine, serum IgE and IgG values are helpful in the diagnosis and evaluation of the therapeutic effects of nasal allergies. But in Korea, air pollution and the increased use of food additives have become leading factors in nasal allergies, It seems to be induced by environmental change, especially industrialization and urbanization, so allergic rhinitis in our environment has changed in accordance with the changes made in the living environment. Therefore this study is attempted in order to observe a clinical analysis which places more importance on allergic rhinitis. We studied 200 patients who had visited Kyunghee Oriental Medical Center with allergic rhinitis from January 1, 1999 to December 31, 1999 The results were as follows: 1. The sex distribution was 114 males(57%) and 86 females(43%). In age distribution, the average age was 25. In males, ages ranged from 3 to 66 years old and the average was 23.81. In females, ages ranged from 4 to 67 years old and the average was 28.57. The peak age was 30～39 years old(24%); under 9 years old and 10～19 years old were each 18%; 20～29 years old was 22%; 40～49 years old was 11 %; over 50 years old 6.5%. The gulf between males and females showed a statistically significant difference(P<0.025). 2. In the age of onset, male' s maximum was 62.5, minimum was 0.25; female s maximum was 59.5, minimum was 0.2. Under 9 years old was the most with 34%(male 24%, female 10%), 10～19 years old was 18%, 20～29 years old was 22.5%, 30～39 years old was 13.50%, over 40 years old was 12%, The gulf between males and females were showed statistically significant difference.(p<0.014) 3. The average duration of the disease was 5.67 years. In male and female, the maximum was 30, the minimum was 0.05; under 5 years old was the most with 62%(male 34.50%, female 27.50%); 6～10 years old was 23%. So, under 10 years old was 85%. There was no statistically significant difference in the duration of disease. 4. Regarding type of residence, 47.50% of patients with allergic rhinitis lived in apartments, 52.50% lived in houses. In males, 29.50% lived in apartments, 27.50% lived in houses. In females, 18% lived in apartments, 25% lived in houses. There was no statistically significant difference in the residence by T-test and chi-test. 5. In the distribution of season, spring is the most with 29.5% of patients, winter 28%, fall 25.5%, and summer 17%. But there was no statistically significant difference. 6. After observing 200 patients with allergic rhinitis, classifying main symptoms into 5 types, sneezing was the main symptom in 177cases(88.50%), nasal obstruction in 176cases(88%), rhinorrhea in 169cases(84.5%), post nasal discharge in 87cases(43.50%), and itching in I04cases(52%). The Cumulus ration is 98.50% and symptoms overlapped with an average 3.57±0.1 times but in an analysis of variance of these symptoms, the gulf between males and females was not recognized as statistically significant by T-test and ANOVA. 7. Patients whose families have allergic diseases account for 90 cases(45%) : 49cases(24.50%) male and 41cases(20.50%) female. There were 4 cases (71.11 %) whose families have allergic rhinitis, 9cases(10%) of asthma, and 7.78% with allergic dermatitis. There were 61 (67.80%) cases of patients whose parents have allergic diseases; cases wherein the patient s child had allergic diseases numbered 13 (14.45%); and cases with a sibling with allergic diseases totalled 16cases (17.80%). There was no statistically significant difference in allergic disease regarding sex, parents, or siblings by chi-test. 8. Blood type: For males, type A is the most common, with 37cases(18.5%), followed by type B with 32cases(16%), type O 28cases(l4%) and type AB 13cases(6.5%). For females, type B is the most common, with 30cases(15%), followed by type O with 23cases(l1.5%), type A with 18cases(9%) and type AB with 13cases(6.5%). There was no statistically significant difference in blood type by chi-test. 9. In the selection of prefered food, most patients prefer cool food, with 98 such cases(49%), tepid food in 54cases(27%) and warm food in 48cases(24%). These showed a statistically significant difference in the selection of prefered food between males and females by chi-test(p<0.009). 10. The state of Past History was classified into II types. chronic hypertrophic rhinitis is the most common with 11cases (18.64%), tonsil and adenoid hypertrophy is 8cases(l3.56%), sinusitis is 6cases(10.17%), nasal septum deviation is 4cases, nasal polyp is 2cases, others are 10cases(l6.95%). No statistically significant difference in past history between males and females was shown, but a statistically significant difference was shown when males and females were compared with total cases by T-test(p<0.002, P<0.0008). 11. Regarding complications, 37 patients (28.91%) had sinusitis: 22cases(17.19%) in male, 15cases(11.72%) in female. Chronic hypertrophic rhinitis was found in 15cases(11.72%). Others are under 10%. There was no statistically significant difference in the type of complications between males and females, but a statistically significant difference was shown when males and females were compared with total cases by T-test(P<0.00l, P<0.007). 12. In the treatment, medication was used 1691 times, an average of 2.58 times. No.34 was used 370 times for 124 cases, an average of 2.98 times. No. 152 was used 318 times for 106 cases, an average of 3.00 times. No.151 was used 307 times for 97cases, an average of 3.16 times. No. 31 was used 117 times for 33 cases, an average of 3.55 times. No 25 was used 116 times for 33 cases, an average of 3.52 times. 13. In the duration of treatment, the most frequent is 1 week(69cases, 34.50%), the maximum is 20weeks, and the minimum is 1week. A treatment period of 2～3 weeks accounted for 32% of cases, a period of 4～5weeks accounted for 13.5%. The gulf between males and females showed a statistically significant difference in the duration of treatment.(p<0.01). There was a statistical significance when the males were compared with total cases by ANOVA(P<0.03). 14. A comparison between before-treatment and after-treatment showed a statistically significant difference in treatment by T-test (p<0.01) and F-test (p<0.0058).

• Radiation Oncology Journal
• /
• 제15권2호
• /
• pp.121-128
• /
• 1997

목적 : 국소 진행된 직장암 환자에서 근치적 절제술후 방사선치료와 항암화학요법과의 병용치료를 시항하여 치료에 따른 합병증, 국소재발 그리고 생존율에 대한 그 효과를 알아보고자 하였다. 방법 : 1992년 9월부터 1995년 9월까지 직장암으로 진단받고 근치적 절제술후 방사선치료와 항암화학요법과의 병용치료를 받은 28명의 환자를 대상으로 하였다. 방사선치료는 근치적 절제술 후 4주에서 6주이내에 시행하였으며 선형가속기 6MV와 15MV X-ray를 이용하여 주 5회, 1회 180cGy로 5-6주간 총조사선량은 5040cGy-5580cGy까지 조사하였다. 항암화학요법은 방사선치료 시작 1주와 5주째 처음 제1일부터 제4일까지 4일간 5-FU는 체표면적 $m^2$당 400mg씩 그리고 Leucovorin은 체표면적 $m^2$당 20mg씩을 정맥주사로 4주간격으로 2회 시행하였다. 추적관찰기관은 2개월에서 42개월이었으며 중앙값은 24개월이었다. 결과 : 전체환자의 2년 생존율과 무병생존율은 각각 $78.6\%,\;70.8\%$였다. 병기에 있어 2년 생존율과 무병생존율은 $B_{2+3}$에서는 $93.0\%$와 $79.4\%,\;C_{2+3}$에서는 $76.2\%$와 $69.2\%$였다. 치료실패 양상은 국소재발이 $10.7\%$(3128), 원격전이가 $3.6\%$(1/28), 국소재발과 원격전이가 동시에 발생한 경우는 $7.1\%$(2/28)로 궁극적인 국소재발율이 $17.9\%$(5/28)였다. 병기에 따른 국소재발율은 $B_{2+3}$와 $C_{2+3}$의 각각 $13.3\%$(2/15)와 $23.1\%$(3/13)였다. 치료에 따른 합병증으로는 방사선 피부염은 $28.6\%$(8/28)로 가장 많이 발생하였고 혈액학적 부작용으로 백혈구감소증이 $21.4\%$(6/28)에서 발생하였으나 보조적인 치료후 모두 회복되었고 치료와 관련되어 사망한 경우도 없었다. 생존율, 무병 생존과 국소재발율은,.영향을 미치는 단변수분석에서는 조직학적 분화도에 있어 잘 분화된 선암이 분화도가 나쁜 선암보다 통계학적 유의성이 있었고(p=0.04, 0.05, 0.04) 그외에서는 초기병기일수록, 종양의 크기가 5cm 이하에서 좋은 결과를 보였지만 통계학적 유의성은 없었다. 결론 : 국소적으로 진행된 직장암의 경우 근치적 절제술후 방사선치료와 항암화학요법과의 병용치료가 비교적 안전하고 효과적인 방법이였다. 그러나 본 연구에서는 직장암이 국소적으로 진행된 대상환자의 수효가 적어 향후 좀 더 환자를 모으고 장기적인 추적 결과를 살펴보아야 근치적 절제술후 방사선치료와 항암화학요법과의 병용치료의 효율성을 보다 명확히 확인할 수 있으리라 생각된다.