Lee, Wei Ching;Yusof, Mastura Md.;Lau, Fen Nee;Ee Phua, Vincent Chee
Asian Pacific Journal of Cancer Prevention
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v.14
no.6
/
pp.3941-3944
/
2013
Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.13
no.2
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pp.139-144
/
2002
Background and objectives : The various voice-conserving treatments are used for Tla staged glottic cancer. Especially, Tla staged glottic cancer has been shown excellent treatment result after laser cordectomy or radiotherapy. To evaluate which treatment results better voice after treatment made it valuable to define the exact indication and recommending treatment modality on the Tla staged glottic cancer patients. Method : The medical records of 75 patients with glottic TlaN0 cancer diagnosed at Asan medical center, University of Ulsan college of medicine form May, 1989 to July,2001 were retrospectively reviewed on the point of voice quality and oncology including 5-year survival rate and local control rate. Results : Laser cordectomy and radiotherapy showed 100% and 94.0% 5-year survival rate, respectively. And laser cordectomy had 94.3% local control rate while radiotherapy got 87.6% local control rate. Voice analysis of pretreatment and posttreatment were used to compare each result. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum confortable phonation time(MPT) and vocal efficiency(VE) were used for parameters for voice analysis. Only in shimmer and MPT, we could find significant posttreatment difference between two therapies. In addition, we reviewed the total expenses for each therapy. Conclusion : On the basis of the oncologic result, both the laser cordectomy and radiotherapy had the similar results. Laser cordectomy showed the relatively acceptable voice as radiotherapy did. Laser cordectomy cost less than radiotherapy did. Laser cordectomy can be used for treatment about Tla staged glottic cancer.
Pyo Hong Ryull;Seong Jin Sil;Shin Hyun Soo;Lee Hyung Sik;Kim Gwi Eon;Suh Chang Ok;Loh John Juhn Kyu;Kim Woo Cheol
Radiation Oncology Journal
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v.11
no.1
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pp.103-108
/
1993
Among the patients with rectal cancer who entered Yonsei University Hospital for management from Jan. 1980 to Dec. 1990, we selected 23 subjects who were received surgical resection of tumor in rectum, and who proved to have liver metastasis during the diagnostic work-up, at the time of the operation, or within 3 months after starting definitive treatment. With those subjects, we investigated the role of radiation therapy by comparison of the treatment results of the patients without radiation therapy (S group) with those of the patients with radiation therapy to the primary site (S+R group). The local control rates of S group and S+R group were $64{\%}$ and $89{\%}$, and 2-year survival rates were $50{\%}$ and $78{\%}$, respectively. Although there was not statistically meaningful difference, local control rate and 2-year survival rate were higher in the group with radiation therapy to primary site than that without radiation therapy. The 2-year survival rates of the case with resection of the liver and the case without it were $63.6{\%}$ and $58.3{\%}$ respectively, which was not statistically significant. Also, the 2-year survival rate of the case with sustained local control was higher than that of the case with local failure, which was statistically significant ($76.5{\%}$ and $16.7{\%}$, p<0.005). From the above results, it is thought that radiation therapy to the primary site might improve the local control rate even in the patients with liver metastasis, which seems to be correlated to the higher survival rate.
Purpose: The purpose of this study was to discern the effects of music therapy on the patients' level of anxiety and operative satisfaction during cataract surgery under local anesthesia. Method: The subjects for this study were fifty patients. Half of the subjects were categorized as an experimental group and the other half as a control group. All of the subjects were admitted to one hospital in Seoul for cataract surgery. This study was conducted from September 7 to October 2, 2002. The level of anxiety determined by self-reporting anxiety, pulse rate, systolic blood pressure, and diastolic blood pressure, was measured before and after the music therapy. The satisfaction degree was measured after the surgery. The tools for this study were Spilberger's state anxiety inventory and Patient Care Management System. Each patient in the experimental group chose the music used in his/her surgery and it was played through an audio system in the operating room. The data analysis was performed using the SAS/pc+(version 8.0). Results: 1. The anxiety of the experimental group decreased significantly compared to the control group. 2. The pulse rate of the experimental group decreased more than the control group. 3. The blood pressure of the experimental group decreased more than the control group. 4. The operative satisfaction of the experimental group was higher than the control group. Conclusion: According to the previous results, music therapy turned out to be a very efficient way to increase the satisfaction of a cataract patient after surgery by reducing the anxiety and the pulse rate of the patient during an operation with local anesthesia.
Kim, Doosoo;Lee, Sangho;Lee, Nanyoung;Jih, Myeongkwan;Ahn, Jihye
Journal of the korean academy of Pediatric Dentistry
/
v.48
no.1
/
pp.95-104
/
2021
The purpose of this study was to evaluate the effect of virtual reality distraction on pain and anxiety in children during local anesthesia. Local anesthesia was administered to 3 groups: a control group without distraction, a group watching TV, and a group using a virtual reality device. The pulse rate and oxygen saturation rate were measured before and at the time of local anesthesia to assess the patients' pain and anxiety, and the Wong-Baker Faces Pain Rating Scale was completed after local anesthesia. The group using the virtual reality device had a significantly lower heart rate change and lower Wong-Baker Faces Pain Rating Scale score than those in the control group and the group watching TV (p < 0.05). The greatest difference in heart rate change and Wong-Baker Faces Pain Rating Scale score, between the control and virtual reality distraction groups, was seen in 5 - 7-year-olds and a Frankl's behavior rating scale grade of 3. The virtual reality device alleviated pain and reduced anxiety in children during local anesthesia.
Purpose: The purpose of this study was to examine the effects of aroma hand massage on anxiety and immune function in patients who had gynecology surgery under local anesthesia. Methods: The research design was a nonequivalent control group with pre-and posttest design. Data were collected from June 5 to October 6, 2010. Participants included 20 patients in the aroma hand massage group, 20 patients in a hand massage group, and 20 in a control group. As an experimental treatment, hand massage was carried out following the hand massage protocol. Measures consisted of the State Trait Anxiety, Numeric Rating Scale (NRS) for anxiety, vital signs (systolic and diastolic blood pressure, pulse rate), and salivary cortisol for anxiety, and immunoglobulin A for immune function. Results: Aroma hand massage and hand massage group showed lower levels in NRS for anxiety, systolic and diastolic blood pressure, and pulse rate (p<.001) compared to controls. No group differences were found for state anxiety, salivary cortisol and immunoglobulin A. Conclusion: The results indicate that aroma hand massage and hand massage are effective in reducing anxiety and can be complementary alternative interventions for women having gynecology surgery under local anesthesia.
Journal of the Korean Operations Research and Management Science Society
/
v.36
no.1
/
pp.39-55
/
2011
Process monitoring has been emphasized for the monitoring of complex system such as chemical processing industries to achieve the efficiency enhancement, quality management, safety improvement. Recently, ICA (Independent Component Analysis) based MSPC (Multivariate Statistical Process Control) was widely used in process monitoring approaches. Moreover, DICA (Dynamic ICA) has been introduced to consider the system dynamics. However, the existing approaches show the limitation that their performances are strongly dependent on the statistical distributions of control variables. To improve the limitation, we propose a novel approach for process monitoring by integrating DICA and LOF (Local Outlier Factor). In this paper, we aim to improve the fault detection rate with the proposed method. LOF detects local outliers by using density of surrounding space so that its performance is regardless of data distribution. Therefore, the proposed method not only can consider the system dynamics but can also assure robust performance regardless of the statistical distributions of control variables. Comparison experiments were conducted on the widely used benchmark dataset, Tennessee Eastman process (TE process), and showed the improved performance than existing approaches.
Objective: To analyze the treatment-related parameters after the radiotherapy of T1N0 squamous cell carcinoma of the glottic larynx. Materials and Methods: Between October 1989 and August 2000, 54 patients with histologically proven T1N0 squamous cell carcinoma of the glottic larynx who received definitive radiation therapy in Department of Radiation Oncology, Asan Medical Center were analyzed. They were all males with age ranged from 31 to 80 years (median 61 years). 1997 AJCC stages were 31 T1a, 23 T1b. Patients were treated with 4-MV X-rays with a parallel-opposed two-field technique. Ten patients received 66.0-68.4Gy at 1.2Gy per fraction twice daily, 21 patients received 64.8-66.6Gy at 1.8Gy per fraction once daily, and 23 patients received 66.0Gy at 2.0Gy per fraction once daily. Follow-up period was 16-119 months (median 56 months). Results: 5-year overall survival and local control rates for patients with T1 lesions were 87.0% and 88.5%, respectively. 5-year local control with larynx preservation rate was 90.5%. Host and tumor-related prognostic factors including age, stage, anterior commissure involvement and tumor bulk proved not to be significant. Only shorter overall treatment time among treatment-related factors had correlation with imporved local control. Conclusion: Comparable high local control rate with organ preservation was achieved with primary radiation therapy and salvage surgery. Shortening of overall treatment time is related to improved local control rate. To determine the optimal fractionation scheme, randomized trial is mandatory.
Since year 2000, French housing and rent prices rose at a rapid rate and the housing market has been overheated. Face to this phenomena, the French government enacted a new law Alur which is a legislatif tool to control the private housing rent price for the cities, where the tension of the housing market is very high. This new law has impacted the housing market in two major ways. First, for the 38 cities designated by this law, the rent price's increase rate can not rise above the IRL, which is the rent reference index. Secondly, this law also permits local authorities to control the housing rent's price following the concrete price guidance. Especially in Paris, the city applicated this method for private rental housing since 2015. This city classified its own area by 14 zones. Based on the market surveys of each sector, local authority made a guidance for private housing rent's price. The guideline is consisted of average prices, maxima and minima price by types, which is classified by the construction year, number of rooms and furnished or not. Therefore, this study aims to understand french housing rent's price control system and draw implementation for korean housing rent policies. This research is meaningful for it introduces recent foreign regislations which could be helpful to control the housing market in Korea.
Objectives : In $CO_2$ laser surgery for supraglottic cancer, neck dissection is generally done in second stage. We investigated simultaneous neck dissection with primary resection could be available in laser supraglottic surgery. Material and Methods : We analyzed 13 patients with supraglottic cancer who were treated with transoral supraglottic laryngectomy and simultaneous neck dissection from 2001 to 2007. Tumor stage, extent of laser surgery, histological results, survival rate, local control rate, complications, and functional results were reviewed. Results : 5-year local control rate, survival rate and disease specific survival rate from the neck was 100%, 69.9%, 100% respectively. Tracheotomy was done in all 13 cases. One patient had a long tracheotomy indwelling (191 days). In the rest of 12 patients average decanulation time was 7.4 days(1-22 days). Nasogastric tube was inserted in 5 cases, and average oral intake was possible in 3.5 days(1-16 days). Average hospital days was 29.7 days. There was no serious complication associated with neck dissection. Conclusion : Simultaneous neck dissection with primary laser resection for supraglottic cancer is oncologic sound and can be performed without significant surgical morbidity.
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