• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7167-7170
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• 2015

Background: Although 3D image based brachytherapy is currently the standard of treatment in cervical cancer, most of the centres in developing countries still practice orthogonal intracavitary brachytherapy due to financial constraints. The quest for optimum dose and fractionation schedule in high dose rate (HDR) intracavitary brachytherapy (ICBT) is still ongoing. While the American Brachytherapy Society recommends four to eight fractions of each less than 7.5 Gy, there are some studies demonstrating similar efficacy and comparable toxicity with higher doses per fraction. Objective: To assess the treatment efficacy and late complications of HDR ICBT with 9 Gy per fraction in two fractions. Materials and Methods: This is a prospective institutional study in Southern India carried on from $1^{st}$ June 2012 to $31^{st}$ July 2014. In this period, 76 patients of cervical cancer satisfying our inclusion criteria were treated with concurrent chemo-radiation following ICBT with 9 Gy per fraction in two fractions, five to seven days apart. Results: The median follow-up period in the study was 24 months (range 10.6 - 31.2 months). The 2 year actuarial local control rate, disease-free survival and overall survival were 88.1%, 84.2% and 81.8% respectively. Although 38.2% patients suffered from late toxicity, only 3 patients had grade III late toxicity. Conclusions: In our experience, HDR brachytherapy with 9 Gy per fraction in two fractions is an effective dose fractionation for the treatment of cervical cancer with acceptable toxicity.

• 한국산학기술학회논문지
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• 제21권10호
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• pp.299-307
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• 2020

연구목적: 본 연구는 암 환자의 삶의 질에 영향을 미치는 재정 관련 어려움 요인을 찾고자 수행하였다. 방법: 연구대상은 항암, 방사선 치료 경험이 있는 암 환자이며, 종속변수는 삶의 질, 독립변인은 인구사회학적 요소, 의료적 상황, 재정관련 어려움(암 치료비로 인한 물질적 상황, 심리적 반응, 대처행동)을 변인으로 하여 모형을 구성하였다. 자료수집은 자기기입식 설문지를 활용, 5개 요양병원에서 수집하였으며, 422부의 설문지를 분석에 사용하였다. 분석방법은 인구사회학적, 의료적 변인과 함께, 세 유형으로 분류한 재정관련 어려움 변인을 각각 단계적으로 투입하여 5단계로 위계적 다중 회귀분석 하였다. 결과: 삶의 질에 가장 영향력이 큰 요인은 평소처럼 일할 수 없거나, 가계에 도움이 될 수 없다는 좌절감이었으며, 신체활동수행정도가 나쁠수록, 동반질환이 있는 경우, 여자인 경우, 암 치료비에 대한 심리적 부담감이 클 경우, 치료비용에 대한 의료진과 의사소통 만족도가 낮을 경우, 경제적 상황에 대해 잘 관리되고 있다고 느끼지 못하는 경우, 삶의 질이 나쁜 것으로 나타났다. 결론: 본 연구결과가 암 환자 삶의 질 향상을 위한 실천 현장의 중재 프로그램 개발, 임상적 개입방안 및 관련 정책 방안 마련을 위한 근거로 활용되길 기대한다.

• 한국잡초학회지
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• 제13권4호
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• pp.195-202
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• 1993

The benefits of pesticides in improving the food quantity and quality requirements for an increasing world population are significant, and they can be described in agronomic, economic and social terms. The risks are assessed from the hazards which are likely to occur in practice ; the hazards are defined by the toxicity of the pesticide to non-target organisms at various exposure levels. There are ways of reducing the risks (mainly by reducing exposure in practice) and improving the benefits of pesticides ; these are known as risk management and benefit management respectively. The overall risk-benefit assessment is facilitated if each component can be expressed in financial terms, but it must be made nationally or locally on a sound technical basis against the prevailing agronomic, socio-economic and political circumstances. Paraquat is used to illustrate the risk-benefit assessment process in general terms, and the conclusion is that the benefits greatly outweigh the risks. It is important to keep the risks of pesticides in perspective with those associated with other naturally occurring chemicals in our diet and with other everyday aspects of life. In an overall context, the pesticide risk is small.

• Journal of Preventive Medicine and Public Health
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• 제54권5호
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• pp.376-379
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• 2021

Elemental mercury exposure can result in significant toxicity. Source decontamination and remediation are often required after larger elemental mercury exposures, but the details of these processes are infrequently reported. In the case described herein, a 64-year-old woman and her husband were exposed to elemental mercury in their home after the husband purchased it online for the purpose of recreational barometer calibration. After the mercury reportedly spilled during the calibration process, a vacuum cleaner was used to decontaminate the affected surface; this led to extensive mercury contamination of the home. The couple was relocated from the home while remediation occurred over the course of several weeks. Vacuum cleaning of an elemental mercury spill can lead to extensive volatilization and recirculation of mercury vapor. For smaller mercury spills, careful removal of visible mercury beads by using an eyedropper, cardboard, and masking tape is recommended. Larger spills require professional decontamination and remediation and may necessitate involvement of governmental resources. Vacuum cleaning should not be used as an initial method of decontamination after elemental mercury exposure. Careful attention to source decontamination can reduce the emotional and financial costs associated with extensive remediation after elemental mercury exposure.

• 한국환경보건학회지
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• 제42권6호
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• pp.375-384
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• 2016

Objectives: This paper analyzes the intersection of tort law and environmental health in a recent court decision. Methods: This paper analyzes Supreme Court Decision 2011Da7437, Decided on September 4, 2014 and related lower court decisions. Results: The plaintiffs sought financial compensation from the defendants, arguing that air pollutants in gases emitted by vehicles produced by the defendants had caused them to acquire respiratory diseases. The district court highlighted the need to mitigate the burden of proof for the plaintiffs, but proceeded to review whether the plaintiffs proved the actual toxicity levels of the air pollutants, whether the defendant's vehicles were the main source of the emissions, the plaintiff's level of exposure to the pollutants, and causation between the emissions and the injury. By doing so, the district court required the plaintiffs to prove both indirect and direct facts of causation, increasing burden of proof for plaintiffs. The appellate court upheld the district court's decision, adding that the defendant's conduct did not constitute an illegal act because it did not violate the emissions standards set by environmental law. The Supreme Court upheld the appellate court's decision, reasoning that the epidemiological evidence cannot establish a direct causation for diseases that lack specificity. Conclusion: This case demonstrates that discussions in environmental health have significance in tort lawsuits. For each fact that the plaintiffs and defendants attempted to prove, environmental health research studies were offered as evidence. In addition, the courts decided the legality of the defendant's conduct based on emission standards set by environmental law.

• 한국양식학회지
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• 제11권3호
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• pp.285-294
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• 1998

When Cochlodinium polykrikoides came into the culture tanks through influent cultivated water during the red tides, hundred thousands of commercial flounders were concomitantly killed and many culturists suffered from a great deal of financial loss in the east coast of Korea. It is charactrized by high sinking rate after sunset and the formatino of clump which results in oxygen deficiency by its respiration at tank bottom under condition. We investigated the efficacy of hydrogen peroxide and chlorine dioxide, known to form radicals, for extermination of red tide organism C. polykrikoides. When C. polykrikoides seawater with a density of 6,000 cells/$m\ell$ was treated with 14, 28 and $42mg/\ell$ of hydrogen peroxide, its survival rate was markedly decreased to 9.8, 0.8 and 0.3% respectively immediately after 6 hours of treatments whereas when it was treated with 1.5, 2.1 and $3.0mg/\ell$ chlorine dioxide, its survival rate showed 87.7, 81.3 and 80.1 and 80.1% respectively at the same treatment time. Hydrogen peroxide was the effective agent since it has scarcely injured the cultured olive flounder when exposed to the tested concentration range of $14~28mg/\ell$ with the extermination of almost3 C. polykrikoides during the experimental period of 5 days and has shown the oxygen increase of approximately $1.23mg/\ell$ 2 hours immediately after the flounder by C. polykrikoides in the land-based culture tank is assumed to be not by the toxicity of itself but by oxygen dificiency from the rapid respiration of dinoflagellate clump sunken to the tank bottom.

• 한국산학기술학회논문지
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• 제20권7호
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• pp.281-290
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• 2019

본 연구에서는 의료현장에서 암 비용에 대한 환자와 가족, 전문가가 갖는 주관적 인식 유형을 탐색하고 분석하는 것을 목적으로 한다. 이를 위해 Q방법론을 활용하였으며, 문헌 조사, 인터넷 검색, 심층 면담 등을 통해 Q모집단을 수집하고, 최종 45개의 Q표본을 확정하였다. P표본은 암 환자와 가족, 전문가로 구성된 35명이며, 강제 정상분포방식에 따라 Q 진술문을 분류하도록 하였다. 수집된 자료는 PC QUANL Program을 이용하여 분석하였다. 분석 결과, 4개의 유형을 도출하고, 각 유형의 특성에 따라 암 비용에 대해 의심하고 막막해하며 불안해하는 '막막한 불안형', 암 비용을 크게 인지하고 부담스럽지만 어떻게든 마련해야하는 부담으로 여기는 '가족부담으로 수용형', 할수 있는 치료를 더 해야 한다고 생각하고 도전과제로 여기는 '적극 응전 대상형', 보험을 들 듯 개인적으로 준비하고 있어야 한다고 생각하는 '보험으로 대비형'으로 명명하였다. 본 연구결과는 의료, 간호, 사회복지 현장에서 암 환자와 가족을 위한 임상적 개입 방안과 정책 마련을 위한 근거로 활용될 수 있을 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4777-4781
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• 2012

Objective: To investigate the relationship between the efficacy and safety of different doses of thalidomide (Thal) plus dexamethasone (Dex) as the initial therapy in elderly patients with newly diagnosed multiple myeloma (MM). Methods: Clinical data of 28 elderly patients with newly diagnosed MM who underwent the TD regimen as the initial therapy were analyzed retrospectively. The patients were divided into two groups according to the maximal sustained dose of Thal: lower dose (group A) and higher dose (group B). The overall response rate (ORR), progression free survival (PFS), overall survival (OS), and adverse events (AES) were compared between the two groups. Results: A total of 28 patients were followed up with a median of 18 months. The ORR was 60.1%. The median response time and PFS were 2.0 and 17.0 months, respectively. The mean sustained dose of Thal in group B was significantly higher than group A (292.9 mg v 180.4 mg, P=0.01). There was no significantly difference in ORR (57.1% v 64.3%, P=1.00) and PFS (9.63months v 17.66 months, P=0.73) between groups A and B. During the follow up, only five patients died (<40%) and, therefore, median OS values were not available. It is estimated, however, that the mean survival time in the two groups was 35.6 and 33.4 months (P>0.05), respectively. All of the patients tolerated the treatment well. The incidence of AES in patients with a grading above 3 in group B was significantly higher than in group A (P=0.033). Conclusions: The TD regimen results in a high response rate and manageable AES as the initial therapy in elderly patients with MM. TD should be considered as the front line regimen for the treatment of elderly patients with MM in areas with financial constraints. The clinical response can be achieved at a low dose Thal with minimal toxicity.