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Radiosensitization of Cis-Platimum in the Treatment of Advanced Head and Neck Squamous Cell Carcinoma (국소 진행된 두경부편평 상피암에 대한 CIS-PLATINUM과 방사선치료의 동시 병행요법)

  • Chang, Hye-Sook
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.27-34
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    • 1992
  • Cis-Platinum (DDP) was utilized as a radiosensitizer in a pilot study for stage III and IV squamous cell carcinoma between 1984-1987, and DDP 20 mg/M2/day was administered for 4 days at 3 week interval with concurrent radiotherapy. This study consisted of three phases: cytoreduction phase, eradicative treatment phase and adjuvant phase. Total 59 patients were subjected to evaluate a tumor response and its toxicity. During the eradicative phase,27 patients underwent surgery (group I ), 29 patients were treated with radiotherapy only (group II) and 3 patients did not complete the second phase of therapy. At the cytoreduction phase, 95% response rate with complete response (CR) 47.5% and partial response (PR) 47.5% was observed. Complete tumor clearance (CTC) rate following 2nd phase of therapy was 84% (47/56) with 26/27(96%) in group I achieved CTC with surgery and 21/29 (72%) patients In group II achieved CTC following 2nd phase. 67% of primary lesions and 70% of nodal diseases in group I showed no tumor in the surgical specimen. 34% of patiets who achieved CTC at 2nd phase developed recurrence and median time to recur was 8 months. Actuarial disease free survival at 4 years was 59% and 51%(24/27) of patients who achieved CTC at 2nd phase were alive without any evidence of disease at median follow-up 31 months (range, 10-48 months). There was no significant difference in overall and disease free survival between group I and II between CR and PR group following 1st Phase. Only significant Prognostic factor in this study was the complete tumor clearance following 2nd phase theapy. In general, toxicity was not excessive. Author concludes that this study confirmed the significant radiosensitizing effect of DDP with the acceptable toxicity and warrant the prospective study to determine optimum scheduling for DDP and radiotherapy which maximizes the therapeutic gain.

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THE DISTRIBUTIONS AND TRENDS IN MALOCCLUSION PATIENTS - A 10 year study of 2155 patients from YDSH (연세대학교 영동세브란스병원 교정과에 내원한 부정교합 환자의 분포 및 경향에 관한 연구)

  • Baik, Hyoung-Seon;Kim, Kyung-Ho;Park, Yul
    • The korean journal of orthodontics
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    • v.25 no.1 s.48
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    • pp.87-100
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    • 1995
  • Distributions and trends were examined in 2155 malocclusion patients who had been examined and diagnosed at Deparment of Orthodontics in Youngdong Severance Hospital over a 10 year-period from 1984 to 1993. The results were as follows ; 1. The number of patients per you had nearly quadrupled during the 10 year-period, with females(58.3%) outnumbering males (41.7%). 2. Age distribution had shown 7-12 year-old group being the largest(53.3%), but percentages of 7-12 year-old and 13-18 year-old groups had been decreasing while that of above-19 patients had gradually incresed. 3. Distributions in the types of malocclusion according to the Angle's Classification had shown 27.8% for Class I, 22.6% for Class II division 1, 7.9% for Class II division 2, and 41.6% for Class III. Percentages of Class I patients had decreased while percentages of Class II and III patients had increased. 4. Non-extraction cases (75.4%) had outnumbered extraction cases (24.6%), with a general trend toward fewer extraction cases over the 10 year period. 5. Patients who had orthognathic surgery had been increasing, with Class I, II, and III cases comprising 8.8%,16.9%and74.3%, respectively. There had been three times as newly 2-jaw operations as 1-jaw operations. 6. Nearly 4% of the subjects had facial asymmetries, with Class III cases being the most frequent. 7. Patients with TMD symptoms comprised 4.6%, with an increasing trend. The symptoms had occurred more frequently in older patients and in females. 8. Geograpic distributions showed majority (3/4) of patients from the nearby areas, namely Gangnam-gu, Seocho-gu and Songpa-gu.

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A Correlation Study on Spiritual Wellbeing, Hope and Perceived Health Status of the Elderly (노인의 영적안녕, 희망 및 지각된 건강상태에 관한 연구)

  • Sung, Mi-Soon;Kim, Chung-Nam
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.53-69
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    • 1999
  • A descriptive correlation study was done to provide a basic data for comprehensive nursing care by analyzing the relationship between spiritual wellbeing, hope and perceived health status of the elderly. 195 respondents who lived at their homes and 148 respondents who lived at the facilities for elders such as nursing homes and elder's rehabilitation centers were selected and their age was over 60 years old. Paloutzian and Ellison(1982)'s spiritual wellbeing scale, Nowotny(1989)'s hope scale and Northern Illinois University's health self rating scale was used. From August 10th to August 25th, 1998, ready made questionnaires were handed out by researcher to those who can fill it out and for those who cannot fill out the questionnaires alone, the researcher read it and finished by interview. This study used Pearson's correlation coefficient for the hypothetic test and the average point and standard deviation of spiritual wellbeing, hope, and perceived health status were checked. To find out the difference between spiritual wellbeing, hope, and perceived health status by general characteristics ANOVA and Tukey test were used. The results are as follows : 1. The mean score for spiritual wellbeing of the elders was 42.27(SD±9.67) in a possible range of 20-80. The average point of spiritual wellbeing was 2.11(SD±0.97) point to 4 point full marks. The mean score of religious wellbeing was 21.37(SD±7.02) and that of existential wellbeing was 20.90(SD±4.63) in a possible range of 10 - 40. The average point of religious wellbeing was 2.14(SD±0.70)points and existential wellbeing was 2.09(SD±0.46) points to 4 point full marks. 2. The mean score for hope was 67.16(SD±12.28) in a possible range of 29-116. The average point of hope was 2.31(SD±0.42) points to 4 point full marks. 3. The mean score for perceived health status was 8.72(SD±2.49) in a possible range of 4-14. 4. In testing the hypothesis concerning the relationship between spiritual wellbeing and hope, there was a statistically positive correlation(r=0.5209, p=0.0001). 5. In testing the hypothesis concerning the relationship between spiritual wellbeing and perceived health status, there was a statistically positive correlation(r=0.1427, p=0.0081). 6. In testing the hypothesis concerning the relationship between hope and perceived health status, there was a statistically positive correlation(r=0.2797, p=0.0001). 7. There were significant differences in spiritual wellbeing according to sex, religion, and present occupation. 8. There were significant differences in hope according to residential places, age, religion, educational level, family status, average monthly pocket money. 9. There were significant differences in perceived health status according to residential places, sex, age, educational level, present occupation and family status. From the above results it can be concluded that: There was a positive correlation between spiritual wellbeing and hope, spiritual wellbeing and perceived health status, hope and perceived health status. When the nurse implicate the nursing intervention which can be promote the spiritual wellbeing and hope, elder's perceived health status also can be improved.

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Effect of TNF-α Gene Transfer to Respiratory Cancer Cell Lines on Sensitivity to Anticancer drugs (호흡기계암세포주에서 TNF-α 유전자의 이입이 항암제 감수성에 미치는 효과)

  • Mo, Eun-Kyung;Lee, Jae-Ho;Lee, Kye-Young;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Choi, Hyung-Seok
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.302-313
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    • 1995
  • Background: Tumor necrosis factor(TNF) showed antitumor cytolytic effects on sensitive tumor cells in numerous in vivo and in vitro studies. But it could not be administered systemically to human because of severe systemic adverse effects at effective concentrations against tumor cells. Many studies showed that a high concentrations of TNF in the local milieu may evoke in vivo TNF-responsive mechanisms sufficient to suppress tumor growth. Recently developed technique of TNF gene transfer to tumor cells using retrovirus vector could be a good candidate for local TNF administration. TNF is also known to synergistically enhance in vitro cytotoxicity of chemotherapeutic drugs targeted to DNA topoisomerase II against TNF-sensitive tumor cell lines. In this study the in vitro chemosensitivity against DNA topoisomerase II targeted chemotherapeutic drugs was evaluated using some respiratory cancer cell lines to which TNF gene had been transferred. Method: NCI-H2058, a human mesothelioma cell line, A549, a human lung adenocarcinoma cell line and WEHI 164 cell line, a murine fibrosarcoma cell line were treated with etoposide and doxorubicin, which are typical topoisomerase II - targeted chemotherapeutic agents, at different concentration. The resultant cytotoxicity was measured by MIT assay. Then the cytotoxicity of the same chemotherapeutic agents was measured after TNF-α gene-transfer and the two results were compared. Results: The cytotoxicity was not increased significantly in WEHI164 cell line and A549 cell line but statistically significant increase was observed in H2058 cell line when TNF-α gene was transferred(p<0.05). Conclusion: These findings show that TNF-α gene transfer to respiratory cancer cell lines results in variable effects on chemosensitivity against topoisomerase II inhibitor among different cell lines in vitro and can be additively cytotoxic in certain selective tumor cell lines.

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Characteristics of Tuberculosis Detected during Chemotherapy for a Solid Tumor (고형암에 대한 항암화학요법 치료 중 병발한 결핵의 특성)

  • Kim, Deog Kyeom;Lee, Sei Won;Kang, Young Ae;Yoon, Young Soon;Yoo, Chul-Gyoo;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yim, Jae-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.285-290
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    • 2005
  • Background : Some malignancies including lymphoma, head and neck cancer, and lung cancer are believed to be associated with the reactivation of tuberculosis (TB) because cyclic anti-cancer chemotherapy can induce the leukopenia or immunological deterioration. This report describes the clinical characteristics and treatment response of TB that developed during cyclic anti-cancer chemotherapy in patients with a solid tumor. Materials and Methods : From January 1 2000 to July 31 2004, patients with TB diagnosed microbiologically, pathologically, or clinically during anti-cancer chemotherapy in a tertiary hospital were enrolled, and their medical records were reviewed. Patients with the known risk factors for the reactivation of TB were excluded. Results : Twenty-two patients were enrolled and their mean age was 56.5 years (range 21-78). The male to female ratio was 3.4:1 and pulmonary TB was the main variant (20 patients, 90.9%). Gastric cancer (10 patients, 45.4%) and lymphoma (4 patients, 18.2%) were the leading underlying malignancies. The other malignancies included lung cancer, head and neck cancer, breast cancer, cervix cancer, and ovary cancer. Fifteen patients (68.2%) had a healed scar on a simple chest radiograph suggesting a previous TB infection. Among these patients, new TB lesions involved the same lobe or the ipsilateral pleura in 13 patients (87.6%). An isoniazid and rifampicin based regimen were started in all the subjects except for one patient with a hepatic dysfunction. The mean duration of medication was 9.9±2.4 months and no adverse events resulting in a regimen change were observed. With the exception of 5 patients who died of the progression of the underlying malignancy, 70.6% (12/17) completed the anti-TB treatment. Conclusion : The clinical characteristics and response to anti-TB treatment for TB that developed during anticancer chemotherapy for a solid tumor were not different from those of patients who developed TB in the general population.

The Effects of Object Size and Reaching Distance on Upper Extremity Movement (물체 크기와 뻗기 거리가 상지 움직임에 미치는 영향)

  • Bae, Su-Young;Kim, Tae-Hoon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.1
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    • pp.51-61
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    • 2020
  • Objectives : The purpose of this study is to investigate the effect of object size and reaching distance on kinematic factors of the upper limb while performing arm reaching for normal subjects. Methods : The subjects of this study were 30 university students who were in D university in Busan, and the measuring tool was CMS-70P(Zebris Medizintechnik Gmbh, Germany), a three-dimensional motion analyzer. The task had six conditions. The average velocity of motion, average acceleration, maximum velocity, and the velocity definite number of movements were measured according to changes in object size(2cm, 10cm) and reaching distance(15%, 37.5%, 60%) when they performed arm reaching. The general characteristics of the subject were technical statistics. One-way ANOVA measurement was used to compare variables when the arm reaching task was performed from two object sizes to three reaching distance, and the post-test was conducted with Tukey test. In addition, an independent t-test was used to analyze the kinematic differences according to the two object sizes at three reaching distances. A two-way ANOVA measurement (3×2 Two-way ANOVA measurement) was performed to identify the interaction of the reaching distance(15%, 37.5%, 60%) and the object size(2cm, 10cm). The statistical significance level α was set to .05. Results : When the size of the object increased, the velocity and maximum velocity also increased, but the definite number of velocity decreased. When the reaching distance increased, the velocity and maximum velocity increased, whereas the definite number of velocity decreased. Conclusion : The clinical significance of this study could be utilized as the baseline data for grading object size and reaching distances when the reaching training is implemented for patients whose central nervous system was damaged.

Safety and Efficacy of Peripherally Inserted Central Catheters in Terminally Ill Cancer Patients: Single Institute Experience

  • Park, Kwonoh;Lim, Hyoung Gun;Hong, Ji Yeon;Song, Hunho
    • Journal of Hospice and Palliative Care
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    • v.17 no.3
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    • pp.179-184
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    • 2014
  • Purpose: We investigated the safety and efficacy of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. Methods: A retrospective review was conducted on patients who underwent PICC at the hospice-palliative division of KEPCO (Korea Electric Power Corporation) Medical Center between January 2013 and December 2013. All PICCs were inserted by an interventional radiologist. Results: A total of 30 terminally ill cancer patients received the PICC procedure during the study period. Including one patient who had had two PICC insertions during the period, we analyzed a total of 31 episodes of catheterization and 571 PICC days. The median catheter life span was 14.0 days (range, 1~90 days). In 25 cases, catheters were maintained until the intended time (discharge, transfer, or death), while they were removed prematurely in six other cases (19%; 10.5/1000 PICC days). Thus, the catheter maintenance success rate was 81%. Of those six premature PICC removal cases, self-removal due to delirium occurred in four cases (13%; 7.0/1000 PICC days), and catheter-related blood stream infection and thrombosis were reported in one case, each (3%; 1.8/1000 PICC days). Complication cases totaled eight (26%; 14.1/1000 PICC days). The time to complication development ranged from two to 14 days and the median was seven days. There was no PICC complication-related death. Conclusion: Considering characteristics of terminally ill cancer patients, such as a poor general condition, vulnerability to trivial damage, and a limited period of survival, PICC could be a safe intravenous procedure.

A Study on the Effects of BCG Vaccination against Tuberculosis (BCG의 결핵예방(結核豫防) 효과에 관(關)한 연구(硏究))

  • Kang, Pock-Soo;Lee, Sung-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.15 no.1
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    • pp.33-46
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    • 1982
  • In Korea BCG vaccination has been employed as the main control measure for tuberculosis since 1962. Recently, the protective efficacy of BCG against tuberculosis has been controversial worldwide. A case-control study was conducted to evaluate the efficacy of BCG in Korea which has a high prevalence of tuberculosis(2.5%). The study subjects were children under the age of 14 years who were hospitalized and diagnosed as tuberculosis in three general hospitals in Taegu City during last 6 years (19751980). Among 416 hospitalized tuberculous patients, 314 cases were confirmed as to the presence or absence of the BCG scar. A control group was selected from the same hospital patients of the same period as the cases. The control group was other than tuberculous patients whose distribution of age, sex and residence were the same as the cases. The results obtained are as follows: For all forms of tuberculosis, the relative risk and the protective efficacy of BCG were 3.5 and 71.8%. The efficacy was higher among female than among male (78.6% vs. 65.8%). The efficacy was higher among the one year and above than among less than 1 year of age. For tuberculous meningitis, the relative risk and the protective efficacy of BCG were 3.9 and 74.3 %. The efficacy was statistically significantly higher among female than among male (p<0.05). The relative risk and the protective efficacyt of BCG for uberculous meningitis combined with miliary tuberculosis and combined with pulmonary tuberculosis represented 6.9, 85.6%, and 7.4, 86.5%, respectively. On the other hand, the relative risk and the protective efficacy of BCG for miliary tuberculosis were 2.1 and 51.6%, and for pulmonary tuberculosis, 2.3 and 54.7%, respectively. From these results, it appears that BCG vaccination is an efficient preventive measure in Korea where tubercluosis is prevalent. Thus the routine BCG vaccination should be continued.

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Crossed Cerebellar and Cerebral Cortical Diaschisis in Basal Ganglia Hemorrhage (기저핵 출혈에 의한 교차 소뇌 해리 현상)

  • Lim, Joon-Seok;Ryu, Young-Hoon;Kim, Hee-Joung;Lee, Byung-Hee;Kim, Byung-Moon;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.5
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    • pp.397-402
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    • 1998
  • Purpose: The purpose of this study was to evaluate the phenomenon of diaschisis in the cerebellum and cerebral cortex in patients with pure basal ganglia hemorrhage using cerebral blood flow SPECT. Materials and Methods: Twelve patients with pure basal ganglia hemorrhage were studied with Tc-99m ECD brain SPECT. Asymmetric index (AI) was calculated in the cerebellum and cerebral cortical regions as |CRCL/(CRCL)×200, where CRand CL are the mean reconstructed counts for the right and left ROIs, respectively. Hypoperfusion was considered to be present when AI was greater than mean +2 SD of 20 control subjects. Results: Mean AI of the cerebellum and cerebral cortical regions in patients with pure basal ganglia hemorrhage was significantly higher than normal controls (p<0.05): Cerebellum (18.68±8.94 vs 4.35±0.94, mean±SD), thalamus (31.91±10.61 vs 2.57±1.45), basal ganglia (35.94±16.15 vs 4.34±2.08), parietal (18.94±10.69 vs 3.24±0.87), frontal (13.60±10.5 vs 4.02±2.04) and temporal cortex (15.92±11.95 vs 5.13±1.69). Ten of the 12 patients had significant hypoperfusion in the contralateral cerebellum. Hypoperfusion was also shown in the ipsilateral thalamus (n=12), ipsilateral parietal (n=12), frontal (n=6) and temporal cortex (n=10). Conclusion: Crossed cerebellar diaschisis (CCD) and cortical diaschisis may frequently occur in patients with pure basal ganglia hemorrhage, suggesting that CCD can develop without the interruption of corticopontocerebellar pathway.

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Surgical Treatment of Loculated Empyema - Closed Rib Resectional Drainage (국소화 농흉의 외과적 치료 - 폐쇄식 늑골절제 배농술 -)

  • 허진필;이정철;정태은;이동협;한승세;선기남
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1063-1069
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    • 1998
  • Background: Multi-loculated empyema makes treatment difficult, and more so when thoracentesis or chest tube drainage fails. Materials and methods: From December 1991 to December 1997, we performed closed rib resectional drainage for 18 cases of loculated empyema on the fibrinopurulent or early chronic phase. Results: Surgery was performed on patients with loculated empyema complaining of persistent symptoms due to failure of treatment by thoracentesis(8 cases) or chest tube drainage(10 cases). Predisposing factors of empyema were pneumonia in 13 cases, clotted hemothorax in 3 cases, cholecystectomy, and tuberculous pleurisy in 1 case. Causal organisms were cultured in 8 cases(42.1%), and methicillin-resistant staphylococcus aureus was found in 3 cases, pseudomonas aeruginosa in 2 cases, and enterococcus aerogens, α-hemolytic streptococcus, and acinetobacter baumannii were found in 1 case. Size of loculations was various, and computed chest tomogram showed multiple loculations of empyema numbering 1∼4(mean 1.78±1.00). Operating time was relatively short, about 55∼140 mins(mean 102.8±30.8). All toxic symptoms including fever disappeared postopratively and general conditions improved very quickly in all patients. Length of chest tube indwelling time and hospital stay after surgery were 3∼42 days(mean 11.4±11.5) and 6∼36 days(mean 12.9±8.1), respectively. Complications of prolonged drainage occurred in 2 cases and no death occurred. There were no recurrences and chest x-rays taken 3∼6 months after surgery showed normal findings in 14 cases and slight pleural thickening in 4 cases. Conclusions: Closed rib resectional drainage requires very simple techniques and has excellent outcomes and little complications, therefore, we think that it is the choice of operation for patients with loculated empyema on the fibrinopurulent or early chronic phase.

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