• Title/Summary/Keyword: Guidelines

Search Result 9,939, Processing Time 0.057 seconds

Screening Examination of Breast Cancer: Review of the Recommended Guidelines (유방암 선별검사의 경계연령에 대한 고찰)

  • Shin, Myung-Ho;Hwang, Mi-Soo;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
    • /
    • v.16 no.2
    • /
    • pp.342-346
    • /
    • 1999
  • Background: Delays in breast cancer diagnosis may occur in young women due to a low index of suspicion. The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest a reasonable guideline for breast cancer screening examination. Materials and Methods: Among 820 patients, 102 patients were under 35 years and 122 patients were above 60 years of age. We reviewed medical records, mammograms and/or ultrasonography of 49 patients under 35 years and 48 patients above 60 years of age with pathologically-proven breast cancer. Pathological reports were as follows Invasive ductal carcinoma(IDC) was present 61.2% of patients in the young age group and ductal carcinoma in situ(DCIS) in 16.3%. IDC was present in 66.6% of the patients in the old age group, and DCIS in 8.33%. We analyzed mammography and ultrasonography to evaluate their usefulness in detecting breast cancer in patients under 35 years and over 60 years of age. Results: The mammographic results are as follows : 1) detection rate of lesion: 83.8%(under 35yrs), 100%(over 60yrs) 2) sensitivity of cancer: 67.6%(under 35yrs), 91.2%(over 60yrs) The ultrasonographic results are as follows : 1) detection rate of lesion: 100% 2) sensitivity of cancer: 87.2%(under 35yrs), 96.7%(over 60yrs) The breast cancer detection rate in women under 35 years old was comparable to that of women above 60 years old in our study. Conclusion: A striking histologic finding in the two groups was a higher incidence of nuclear Grade II and III tumors. This finding correlates with the reported increased incidence of high grade tumors in young women and may correlate with the poorer prognosis of breast cancer in young patients. We conclude that early screening examination is helpful for early detection of breast cancer in women under age 35.

  • PDF

Oxidative Stress Induced Damage to Paternal Genome and Impact of Meditation and Yoga - Can it Reduce Incidence of Childhood Cancer?

  • Dada, Rima;Kumar, Shiv Basant;Chawla, Bhavna;Bisht, Shilpa;Khan, Saima
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.9
    • /
    • pp.4517-4525
    • /
    • 2016
  • Background: Sperm DNA damage is underlying aetiology of poor implantation and pregnancy rates but also affects health of offspring and may also result in denovo mutations in germ line and post fertilization. This may result in complex diseases, polygenic disorders and childhood cancers. Childhood cancer like retinoblastoma (RB) is more prevalent in developing countries and the incidence of RB has increased more than three fold in India in the last decade. Recent studies have documented increased incidence of cancers in children born to fathers who consume alcohol in excess and tobacco or who were conceived by assisted conception. The aetiology of childhood cancer and increased disease burden in these children is lin ked to oxidative stress (OS) and oxidative DNA damage( ODD) in sperm of their fathers. Though several antioxidants are in use to combat oxidative stress, the effect of majority of these formulations on DNA is not known. Yoga and meditation cause significant decline in OS and ODD and aid in regulating OS levels such that reactive oxygen speues meditated signal transduction, gene expression and several other physiological functions are not disrupted. Thus, this study aimed to analyze sperm ODD as a possible etiological factor in childhood cancer and role of simple life style interventions like yoga and meditation in significantly decreasing seminal oxidative stress and oxidative DNA damage and thereby decreasing incidence of childhood cancers. Materials and Methods: A total of 131 fathers of children with RB (non-familial sporadic heritable) and 50 controls (fathers of healthy children) were recruited at a tertiary center in India. Sperm parameters as per WHO 2010 guidelines and reactive oxygen species (ROS), DNA fragmentation index (DFI), 8-hydroxy-2'-deoxy guanosine (8-OHdG) and telomere length were estimated at day 0, and after 3 and 6 months of intervention. We also examined the compliance with yoga and meditation practice and smoking status at each follow-up. Results: The seminal mean ROS levels (p<0.05), sperm DFI (p<0.001), 8-OHdG (p<0.01) levels were significantly higher in fathers of children with RB, as compared to controls and the relative mean telomere length in the sperm was shorter. Levels of ROS were significantly reduced in tobacco users (p<0.05) as well as in alcoholics (p<0.05) after intervention. DFI reduced significantly (p<0.05) after 6 months of yoga and meditation practice in all groups. The levels of oxidative DNA damage marker 8-OHdG were reduced significantly after 3 months (p<0.05) and 6 months (p<0.05) of practice. Conclusions: Our results suggest that OS and ODD DNA may contribute to the development of childhood cancer. This may be due to accumulation of oxidized mutagenic base 8OHdG, and elevated MDA levels which results in MDA dimers which are also mutagenic, aberrant methylation pattern, altered gene expression which affect cell proliferation and survival through activation of transcription factors. Increased mt DNA mutations and aberrant repair of mt and nuclear DNA due to highly truncatred DNA repair mechanisms all contribute to sperm genome hypermutability and persistant oxidative DNA damage. Oxidative stress is also associated with genome wide hypomethylation, telomere shortening and mitochondrial dysfunction leading to genome hypermutability and instability. To the best of our knowledge, this is the first study to report decline in OS and ODD and improvement in sperm DNA integrity following adoption of meditation and yoga based life style modification.This may reduce disease burden in next generation and reduce incidence of childhood cancers.

Analysis of Image Distortion on Magnetic Resonance Diffusion Weighted Imaging

  • Cho, Ah Rang;Lee, Hae Kag;Yoo, Heung Joon;Park, Cheol-Soo
    • Journal of Magnetics
    • /
    • v.20 no.4
    • /
    • pp.381-386
    • /
    • 2015
  • The purpose of this study is to improve diagnostic efficiency of clinical study by setting up guidelines for more precise examination with a comparative analysis of signal intensity and image distortion depending on the location of X axial of object when performing magnetic resonance diffusion weighted imaging (MR DWI) examination. We arranged the self-produced phantom with a 45 mm of interval from the core of 44 regent bottles that have a 16 mm of external diameter and 55 mm of height, and were placed in 4 rows and 11 columns in an acrylic box. We also filled up water and margarine to portrait the fat. We used 3T Skyra and 18 Channel Body array coil. We also obtained the coronal image with the direction of RL (right to left) by using scan slice thinkness 3 mm, slice gap: 0mm, field of view (FOV): $450{\times}450mm^2$, repetition time (TR): 5000 ms, echo time (TE): 73/118 ms, Matrix: $126{\times}126$, slice number: 15, scan time: 9 min 45sec, number of excitations (NEX): 3, phase encoding as a diffusion-weighted imaging parameter. In order to scan, we set b-value to $0s/mm^2$, $400s/mm^2$, and $1,400s/mm^2$, and obtained T2 fat saturation image. Then we did a comparative analysis on the differences between image distortion and signal intensity depending on the location of X axial based on iso-center of patient's table. We used "Image J" as a comparative analysis programme, and used SPSS v18.0 as a statistic programme. There was not much difference between image distortion and signal intensity on fat and water from T2 fat saturation image. But, the average value depends on the location of X axial was statistically significant (p < 0.05). From DWI image, when b-value was 0 and 400, there was no significant difference up to $2^{nd}$ columns right to left from the core of patient's table, however, there was a decline in signal intensity and image distortion from the $3^{rd}$ columns and they started to decrease rapidly at the $4^{th}$ columns. When b-value was 1,400, there was not much difference between the $1^{st}$ row right to left from the core of patient's table, however, image distortion started to appear from the $2^{nd}$ columns with no change in signal intensity, the signal was getting decreased from the $3^{rd}$ columns, and both signal intensity and image distortion started to get decreased rapidly. At this moment, the reagent bottles from outside out of 11 reagent bottles were not verified from the image, and only 9 reagent bottles were verified. However, it was not possible to verify anything from the $5^{th}$ columns. But, the average value depends on the location of X axial was statistically significant. On T2 FS image, there was a significant decline in image distortion and signal intensity over 180mm from the core of patient's table. On diffusion-weighted image, there was a significant decline in image distortion and signal intensity over 90 mm, and they became unverifiable over 180 mm. Therefore, we should make an image that has a diagnostic value from examinations that are hard to locate patient's position.

Evaluation of a Community-Based Cancer Patient Management Program: Collaboration between a Hospice Center and Public Health Centers (병원 호스피스센터-보건소 연계를 통한 지역사회 재가암환자 관리 프로그램 평가)

  • Lee, Hae-Sook;Park, Sun-Hee;Chung, Young-Soon;Lee, Boo-Kyung;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
    • /
    • v.13 no.4
    • /
    • pp.216-224
    • /
    • 2010
  • Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

Perceptions of Caregivers and Medical Staff toward DNR and AD (Do Not Resuscitate (DNR)와 Advance Directives (AD)에 대한 환자 보호자와 의료인의 인식)

  • Lee, Sun Ra;Shin, Dong-Soo;Choi, Yong-Jun
    • Journal of Hospice and Palliative Care
    • /
    • v.17 no.2
    • /
    • pp.66-74
    • /
    • 2014
  • Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

Annual Increase in Carbon and Nitrogen Stocks of Trees and Soils in a 'Niitaka' Pear Orchard Following Standard Fertilization Recommendations (표준 시비에 따른 '신고'배 수체 및 재배지 토양의 탄소 및 질소 저장량 변화)

  • Ro, Hee-Myong;Choi, Jin-Ho;Lee, Seo-Yeon;Lee, Tae-Kyu;Kim, Jong-Sung;Park, Ji-Suk;Choi, Jang-Jeon;Lee, Min-Jin
    • Horticultural Science & Technology
    • /
    • v.33 no.4
    • /
    • pp.591-597
    • /
    • 2015
  • We determined the total C and N stocks in trees and soils after 1 year of fertilization in an experimental orchard with 16-year-old 'Niitaka' pear (Pyrus pyrifolia Nakai cv. Niitaka) trees planted at $5.0m{\times}3.0m$ spacing on a Tatura trellis system. Pear trees were fertilized at the rate of 200 kg N, 130 kg P and $180kg\;K\;ha^{-1}$. At the sampling time (August 2013), trees were uprooted, separated into six fractions [trunk, main branches, lateral branches (including shoots), leaves, fruit, and roots] and analyzed for their total C and N concentrations and dry masses. Soil samples were collected from 0 to 0.6 m in 0.1 m intervals at 0.5 m from the trunk, air-dried, passed through a 2-mm sieve, and analyzed for total C and N concentrations. Undisturbed soil core samples were also taken to determine the bulk density. Dry mass per tree was 5.6 kg for trunk, 12.0 kg f or m ain branches, 15.7 kg for lateral branches, 5.7 kg for leaves, 9.8 kg for fruits, and 10.5 kg for roots. Total amounts of C and N per tree were respectively 2.6 and 0.02 kg for trunk, 5.5 and 0.04 kg for main branches, 7.2 and 0.07 kg for lateral branches, 2.6 and 0.11 kg for leaves, 4.0 and 0.03 kg for fruit, and 4.8 and 0.05 kg for roots. Carbon and N stocks stored in the soil per hectare were 155.7 and 14.0 Mg, respectively, while those contained in pear trees were 17.8 and $0.2Mg{\cdot}ha^{-1}$ based on a tree density of 667 trees/ha. Overall, C and N stocks per hectare stored in the pear orchard were 173.6 and 14.2 Mg, respectively. Compared with results obtained in 2012, the amounts of C stocks have increased by $17.7Mg{\cdot}ha^{-1}$, while those of N stocks remained virtually unchanged ($0.66Mg{\cdot}ha^{-1}$).

Water-Blooms (Green-Tide) Dynamics of Algae Alert System and Rainfall-Hydrological Effects in Daecheong Reservoir, Korea (대청호 조류경보제의 녹조현상 동태와 강우-수문학적 영향)

  • Shin, Jae-Ki;Kang, Bok-Gyoo;Hwang, Soon-Jin
    • Korean Journal of Ecology and Environment
    • /
    • v.49 no.3
    • /
    • pp.153-175
    • /
    • 2016
  • Daecheong Reservoir has suffered eutrophication and water-blooms by blue-green algae from initial impoundment, and algae alert system (AAS) was introduced in 1997. The purpose of this study was to investigate the effect of rainfall and hydrological factors in increase or decrease variability of green-tide and prolonged AAS, studied and analyzed the current situation of AAS has been operating for 19 years (1997~2015) in Daecheong Reservoir. The total issued number of AAS was 46 times, the most frequent period in August and September were 22 times (752 days) and 16 times (431 days), respectively, it accounted for 82.6%. Many number and frequency during this period were significantly associated with rainfall, various discharge and water level. Rainfall and hydrological events are associated with the rainy season of monsoon-Changma and the typhoon, it was concentrated in June~September, total rainfall in this period accounted for 69.9% of the annual rainfall. An increase in inflows was dependent on the intensity, frequency and the amount of rainfall. Accounted for 68.4% of the total annual inflow, it was a time when the most rapidly changing hydrological variability in the reservoir. The total outflow was closely related to rainfall, and compared the distinctive characteristics of hydropower generation and watergate-spillway discharge. In addition, the upreservoir zone of Daecheong Reservoir could be vulnerable to green-tide by regulating discharge of the upstream dam. The issue of AAS was strongly related to the with and without of watergate-spillway discharge. The watergate-spillway discharge had a total of 25 times, it was maximum 17 days from July to September in the year. And the opening times and each duration of the watergate were 1~4 times and the range of 3~37 days, respectively. When the watergate opened, the issue of AAS was maintained to 13 years and the movement of water bodies and green-tide was great about five times than that of non-open, had a profound effect on prolonged AAS within reservoir. In Daecheong Reservoir, Chusori (CHU) area of the So-ok Stream was still showing serious symptoms green-tide levels in the summer, but Janggye (JAN) waters of the main reservoir was pointed out that more important. AAS will be operated by an absolutely consider the rainfall and hydrological effects around the watergate-spillway discharge. The measures of green-tide will be included in the limnological studies more suited to the characteristics of the watershed and reservoir of the our country. Finally, from now on, we will prepare the systematic management and guidelines for vulnerable zone water-blooms that are the source within the reservoir before the monsoon rather than waiting for the arrival of green-tide on the operating stations of AAS.

A Research on the Development Initiative for Public Practices of Local Governmentsin Korea - Focused on the Local Adaptation Planning in Ecosystem Sector - (지자체 기후변화 적응실무 발전방향 연구 - 생태계 분야 기후변화 적응 시행계획 수립 및 이행을 중심으로 -)

  • Yeo, Inae;Hong, Seungbum
    • Journal of Environmental Impact Assessment
    • /
    • v.29 no.2
    • /
    • pp.79-92
    • /
    • 2020
  • This study aimed at analyzing the current status and further needs of ecological information which is provided with the civil servants in the process of climate change adaptation planning in ecosystem sector and at providing suggestions for future development of ecological knowledge on climate change. Therefore, we conducted a questionary survey titled as "the knowledge-base and information needs for climate change adaptation in ecosystem sector" with the civil servants who are engaged with adaptation practices in the ecology related divisions in 17 regional local governments (RLG) and the affiliated basic local governments (BLG) in Korea. As a result, the characteristics of ecological information which is applied in public practices was analyzed and strategies for improved utilization was suggested. 75% of the respondents (RLG 85% and BLG 72%) were aware of the relativeness between the existence and utilization of ecological information and the execution of climate adaptation practices in ecosystem sector. They were agreed with the necessity of ecological information not only in adaptation practices but also overall affairs in the ecological related division in the local government (RLG 82% and BLG 72%). The current situation of utilizing ecological information which is produced from central orlocal government to civil affairs were only represented as 64 persons (28%) in RLG and 42 persons (18%) in BLG. One of the major obstacles that the respondents confront with when applying ecological information to public practices was deficit of prior knowledge on the ecological information itself, such as awareness of the characteristics of ecological information and the link with public affairs for adaptation plans. Therefore, delivering current knowledge and ecological information on climate change by educational and promotional method is an urgent priority to the civil servant. The future needs on ecological information for local government servants were deduced as basic information on local ecosystem and applied knowledge on local development to meet the biodiversity conservation and ecosystem services at the same time. The respondents expected not only the specific guidelines for using ecological information to apply on the adaptation plans in the relevant divisions of the local governments but also the institution where the usage activation of ecological information would be operated and managed to enhance the information utilizing structure in the local government. In the nation-wide, the capacity of local governments should be enhanced with adaptation knowledge and the application of appropriate information to the public practices by central government's aiding with the better quality of information, its public promotion, and the applicability to civil affairs.

A study on the temperature inside clothing as fundamental data for development of the heat energy harvesting clothing (인체 전력에너지 수확의류 개발을 위한 의복내 온도 측정의 기초적 고찰)

  • Yang, Jin-Hee;Cho, Hyun-Seung;Park, Sun-Hyung;Lee, Joo-Hyeon
    • Science of Emotion and Sensibility
    • /
    • v.16 no.1
    • /
    • pp.125-132
    • /
    • 2013
  • Recently, the consciousness of energy crisis is rapidly growing and sustainable eco-friendly energy sources are becoming issue. Therefore the portable electronic device requires new energy sources for providing continuous power supply and the power energy harvesting system of the human body that enables the power-harvesting research requests anytime, anywhere. One of the sources for energy harvesting is heat energy, which is the difference in temperature of the body and the surrounding environment. We tried to analyze the temperature difference between the environmental temperature and the temperature inside clothing according to the structure of the closed portion. And we examined the temperature difference between the environmental temperature and the temperature inside clothing according to the material of the clothing. The analysis showed that we have been able to get different results at parts of the body in the temperature inside clothing according to the structure of clothing. In upper torso of the chest and back, the temperature inside clothing of 'closed structure' was higher than the temperature inside clothing of 'opened structure'. In the section of arm and leg, it was reduced the difference of temperature inside clothing between 'closed structure' and 'opened structure'. It was particularly noticeable in the section of leg. The results of analysis of the difference between the environmental temperature and the temperature inside clothing according to the material of the clothing, in both cases of the two materials, 'closed structure' was higher than the 'opened structure' in the difference value between the environmental temperature and the temperature inside clothing. There was a difference according to the material in the section of leg. In this study, we outlined the basic guidelines for developing heat energy harvesting clothing by exploring the structure and material of clothing suitable for the heat energy harvesting.

  • PDF

The Effect of Long-term Steroid Therapy Combined with Azathioprine in Henoch-$Sch{\ddot{o}}nlein$ Nephritis (Henoch-$Sch{\ddot{o}}nlein$(HS) 신염에서 장기 스테로이드와 Azathioprine의 병합치료 효과)

  • Moon, Kyoung-Sang;Jin, So-Young;Kim, Eun-Mi
    • Childhood Kidney Diseases
    • /
    • v.2 no.2
    • /
    • pp.118-124
    • /
    • 1998
  • Purpose : There is no specific treatment guidelines for Henoch-$Sch{\ddot{o}}nlein$(HS) nephritis. Therefore we performed this study to observe the effect of long term steroid therapy combined with azathioprine Methods : Treatment protocols; 1) Steroid pulse therapy: methylprednisolon 30 mg/kg/dose, maximum 1 gm, intravenolisly 6 times for alternate day. 2) Oral steroid was given 2 mg/kg/day for 1 month, 1 mg/kg/day for following 1 month and alternate day oral steroid combined with azathioprine 2 mg/kg/day for 2 years. Results : Time period from HSP to onset of HS nephritis was between 2 weeks to 5 months with mean $7.4{\pm}7.4$ weeks. Clinical remission were seen in 4 cases out of 5 ($80\%$). Mean time period with disappearance of proteinuria and microscopic hematuria were $5{\pm}2.4$ month and $13.3{\pm}2.9$ month respectively. On pathologic findings by ISKDC, 3 cases were grade IIIb, 2 cases were grade IV in first kidney biopsies and showed pathologic improvement in follow up tidneybiopsiesafterlyearstreatment. Conclusion : As there is no definitive treatment for HS nephritis so far, our study of long term oral steroid therapy with azathioprine was effective in clinical and histologic aspect. Therefore further study in HS nephritis with in a large group will be needed in the future.

  • PDF