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Comparison of Concurrent Chemoradiotherapy with Conventional Radiotherapy in Advanced Non-smal Cell Lung Cancer (진행된 비소세포 폐암 환자에서 Concurrent Chemoradiotherapy와 Conventional Radiotherapy의 비교)

  • Kim, Hui-Jung;Lee, Dong-Soo;Song, So-Hyang;Jung, Su-Mi;Kim, Young-Kyoon;Yoon, Se-Chul;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.493-504
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    • 1997
  • Background : Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stageIII non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it has at most only a modest effect on survival. Recently, cisplatin(cis-diamminedichloroplatinum) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and Method : Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given to times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 times, in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. Results : There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p < 0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p < 0.05) In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. Conclusion : There was no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.

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Blood Pressure Cuff Bladders Tailored For Koreans (한국인 맞춤형 혈압계 커프 블래더)

  • Hwang, Lark Hoon;Park, Woo Sung;Na, Seung Kwon
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.38C no.9
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    • pp.822-829
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    • 2013
  • Hypertension is one of the most common clinical diseases, with an increasing prevalence globally. Hypertension triggers various harmful consequences and affects multiple organs. Life-long care may be required in some cases. According to the Korea Center for Disease Control and Prevention, the prevalence of hypertension is gradually increasing. A 2011 survey revealed that 28.9% of Korean adults had hypertension. The prevalence rates were slightly higher among men than women. Accurate measurement of blood pressure(BP) is crucial to classify patients, to identify BP-related risks, and to inform correct treatment. For accurate blood pressure measurement, the use of a cuff bladder size appropriate for the mid-upper arm circumference(MUAC) is essential. Incorrect sized cuff bladder is one of the main causes of equipment error affecting sphygmomanometer accuracy. When commercial sphygmomanometers were examined, the cuff bladders differed from the dimensions specified in the ISO 81060-1:2007 standards. Undercuffing is responsible for a spurious overestimation of BP in patients with large arms leading to overdiagnosis of hypertension, whereas overcuffing (that is, use of relatively large cuffs with small arms), may be responsible for an opposite problem, leading to erroneous underestimation of BP levels. The cuff bladder sizes recommended by the American Heart Association(AHA) are an arm circumference(AC) of 17-25 cm for small-sized adults, AC of 24-32 cm for adults, AC of 32-42 cm for normal-sized adults, and AC of 42-50 cm for obese adults. In contrast, the AC of Korean adults ranges from 23-31 cm, belonging to a single type of adult bladder. Three types of bladders are necessary for Korean adults with an AC of 23-31cm. Hospitals often use one or two differently-sized Western cuffs for adult patients, which can yield inaccurate BP determinations. Cuff bladders with dimensions based on anthropometric reference data obtained from Koreans will aid hospitals to measure BP more accurately.

The Role of Radiotherapy in the Treatment of Extrahepatic Bile Duct Carcinoma (간외담도종양에서 방사선치료의 역할)

  • Shin Hyun Soo;Kim Gwi Eon;Lee Hyung Sik;Suh Chang Ok;Loh John JK;Lee Jong Tae
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.253-263
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    • 1991
  • Twenty-seven patients with unresectable extrahepatic bile duct carcinoma (n=21) or with microscopic evidence of tumor rest after aggressive surgery for extrahepatic bile duct carcinoma (n=6) between 1985 and 1990 were given radiotherapy consisting intentionally external radiotherapy and/or intraluminal therapy using Gamma-Med 12i (192-Ir) high dose rate (HDR) remote control afterloading system following bile drainage procedures and Gianturco stent insertion. The objectives of this study has been to assess the feasibility and effects on survival of a combination of external radiotherapy and brachytherapy with which we hope to achieve optimal loco-regional control for patients with unresectable extrahepatic bile duct tumors. Sixteen patients were men and eleven were women, and the mean age was 58 years (34-70). 10MV X-ray was used for radiation therapy, with the total dose ranging from 45 Gy to 55 Gy, and intraluminal brachytherapy performed after external radiotherapy, with the dose of total 15 Gy. The minimum follow up was 12 months. Failure were predominantly local-regional, without distant failure. Median survival was 10 months; 2-year actuarial survival rates was $21\%$. Median survival for common hepatic duct (CHD) cancer was 9 months; for common bile duct (CBD) cancer, was 16 months. And median survival for incomplete surgery/external radiotherapy group and external/intraluminal radiotherapy group was 10 months; for external radiotherapy alone group, was 6 months. Use of chemotherapy and/or hyperthermia were not affected in survival. Therefore, our result is that the survival rates in the group of external/intraluminal radiotherapy were comparable with ones in the group of incomplete resection/external radiotherapy, and so we believe that the aggressive local and regional radiotherapy can improve the quality of life and the survival length.

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Surgical Outcome of Patients with Ischemic Cardiomyopathy Selected by the Results of Myocardial Viability by Preoperative F-18 FDG PET (F-18 FDG 양전자단층촬영을 이용한 생존심근 평가 후 수술한 허혈성 심근병증 환자의 수술 결과)

  • Kim, Jae-Sung;Lee, Dong-Soo;Hong, Suk-Keun;Lee, Young-Tak;Kim, Yu-Kyeong;Kim, Youn-Jung;Moon, Keon-Sik;Won, Tae-Kyoung;Hwang, Hweung-Kon
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.4
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    • pp.276-284
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    • 2000
  • Purpose: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Materials and Methods: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. Results: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. Conclusion: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.

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Influences of Unilateral Mandibular Block Anesthesia on Motor Speech Abilities (편측 하악전달마취가 운동구어능력에 미치는 영향)

  • Yang, Seung-Jae;Seo, In-Hyo;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.31 no.1
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    • pp.59-67
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    • 2006
  • There exist patients complaining speech problem due to dysesthesia or anesthesia following dental surgical procedure accompanied by local anesthesia in clinical setting. However, it is not clear whether sensory problems in orofacial region may have an influence on motor speech abilities. The purpose of this study was to investigate whether transitory sensory impairment of mandibular nerve by local anesthesia may influence on the motor speech abilities and thus to evaluate possibility of distorted motor speech abilities due to dysesthesia of mandibular nerve. The subjects in this study consisted of 7 men and 3 women, whose right inferior alveolar nerve, lingual nerve and long buccal nerve was anesthetized by 1.8 mL lidocaine containing 1:100,000 epinephrine. All the subjects were instructed to self estimate degree of anesthesia on the affected region and speech discomfort with VAS before anesthesia, 30 seconds, 30, 60, 90, 120 and 150 minutes after anesthesia. In order to evaluate speech problems objectively, the words and sentences suggested to be read for testing speech speed, diadochokinetic rate, intonation, tremor and articulation were recorded according to the time and evaluated using a Computerized Speech $Lab^{(R)}$. Articulation was evaluated by a speech language clinician. The results of this study indicated that subjective discomfort of speech and depth of anesthesia was increased with time until 60 minutes after anesthesia and then decreased. Degree of subjective speech discomfort was correlated with depth of anesthesia self estimated by each subject. On the while, there was no significant difference in objective assessment item including speech speed, diadochokinetic rate, intonation and tremor. There was no change in articulation related with anesthesia. Based on the results of this study, it is not thought that sensory impairment of unilateral mandibular nerve deteriorates motor speech abilities in spite of individual's complaint of speech discomfort.

Illness Experiences and Palliative Care Needs in Community Dwelling Persons with Cardiometabolic Diseases (심혈관대사질환이 있는 지역사회 거주 환자의 질환경험 및 완화의료 요구)

  • Cha, EunSeok;Lee, JaeHwan;Lee, KangWook;Hwang, Yujin
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.8-18
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    • 2019
  • Purpose: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. Methods: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. Results: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. Conclusion: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.

Meal kit purchasing behavior and relationship with the nutrition quotient of young adults in Chungnam (충남 일부지역 젊은 성인의 밀키트 구매행태 및 영양지수와의 관련성)

  • Lee, Eun-Young;Kim, Yu-Mi;Choi, Mi-Kyeong
    • Journal of Nutrition and Health
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    • v.54 no.5
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    • pp.534-546
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    • 2021
  • Purpose: This study aimed at understanding meal kit purchasing behavior and investigating its relationship with the Nutrition Quotient (NQ) of young adults. Methods: We conducted a survey on adults in their 20s and 30s covering their meal kit purchase experience, satisfaction, recognition, and purchase intention, and examined the relationship between the meal kit purchase and their NQ from February to March 2021. Results: Among the 404 subjects, 37.9% of males and 48.0% of females had experience in purchasing a meal kit (p < 0.001). The highest response indicated that the purchase cost of meal kits was 10,000-20,000 Won at a time, and the frequency of purchase was less than once a month. The convenience of cooking was the main reason for the purchase of meal kits, which were consumed mainly in the evening with family. The satisfaction with the purchase experience of a meal kit was rated 3.6 points for males and 3.7 points for females out of 5 points, and the satisfaction experienced by women was significantly higher than men in terms of freshness of ingredients, packaging design, and adequacy of the quantity of content (p < 0.05). Recognition of the meal kit was rated 3.5 points for males and 3.7 points for females out of 5 points. The purchase intention of the meal kit was rated 3.8 points for those with prior purchase experience, 3.2 points for the non-experienced, 3.3 points for males, and 3.6 points for females out of 5 points each (p < 0.001). The NQ score of dietary behavior in females with experience of meal kit purchases was significantly higher than non-experience (p < 0.05). Conclusions: The dietary behavior of female showed a significant difference by the meal kit purchase experience. It is necessary to understand the consumers' meal kit purchasing behavior to enable the development of various health-oriented meal kit products.

The Effect of YouTube Creator's Characteristics on Content Involvement, user Attitude, and user Attitude on Subscription Intentions - Focusing on the Mediated Effect of Content Involvement - (유튜브 크리에이터의 특성이 콘텐츠관여도와 사용자태도에 그리고 사용자태도가 구독의도에 미치는 영향 - 콘텐츠관여도의 매개효과를 중심으로 -)

  • Eun, Chang-Ik
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.4
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    • pp.55-72
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    • 2021
  • This study aims to research the influences of the discrimination of internet media and one-person media environment, especially, the one-person media creators leading the mobile media that could be accessed and viewed anywhere, on the user attitude and continuous subscription intention. Especially, this study aimed to understand the current situation of one-person media market represented as YouTube, to explore the relationship and ecology between each subject and elements composing the media market, and also to understand the mediating effects of the characteristics of YouTube creators on the relation between contents involvement and user attitude, and the relation between user attitude and subscription intention, and the mediating effects of contents involvement on the relation between characteristics of creators and user attitude. As research methods, first, for the theoretical establishment, this study collected, conducted, and organized the published domestic/foreign theses/journal papers. For the objective validity and verification of the established research model, a survey was conducted targeting adult men and women currently watching YouTube, and then the empirical analysis was performed through the final effective samples. And the results of this study are as follows. First, the playfulness and reliability on the relation between characteristics of creators and contents involvement were not significant while the professionalism was significant. Second, the professionalism on the relation between characteristics of creators and user attitude was not significant while the playfulness and reliability were significant. Third, the relation between contents involvement and user attitude was significant. Fourth, the relation between user attitude and subscription intention was also significant. Also, in the results of verifying the mediating effects of contents involvement, the contents involvement completely mediated the relation between characteristics(playfulness, reliability, and professionalism) of creators and user attitude. And in the conclusion, this study presented the implications and suggestions for further researches in the future.

Association between Risk of Obstructive Sleep Apnea and Subjective Health and Health-Related Quality of Life of the Korean Middle-Aged and Elderly Population (한국 중고령층의 폐쇄성 수면무호흡증 위험과 주관적 건강 및 건강 관련 삶의 질 간의 연관성)

  • Nu-Ri Jun;Min-Soo Kim;Jeong-Min Yang;Jae-Hyun Kim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.141-155
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    • 2024
  • Background: This study aimed to identified the relationship between the risk of obstructive sleep apnea, subjective health, and health-related quality of life among the middle-aged and elderly population in Korea. Methods: Adults aged 40 or older were extracted from the total 22,559 respondents to the 2019-2020 Korea National Health and Nutrition Examination Survey VIII, and secondary analysis was conducted on a total of 6,659 middle-aged and elderly people with no missing values. Logistic regression analysis and multiple regression analysis were conducted to examine the relationship between obstructive sleep apnea risk factors and subjective health as well as quality of life. Results: The subjective health status decline in the high-risk group compared to the non-risk group for obstructive sleep apnea was statistically significantly higher, with an odds ratio of 1.84 (p<0.001). The health-related quality of life was also statistically significantly lower by 0.02 points (β, -0.02; p<0.001). As a result of subgroup analysis on specific variables, the association between the risk of obstructive sleep apnea and subjective health and health-related quality of life was statistically significant depending on gender, sleep time, presence of depression, household income, and number of household members. Based on the obstructive sleep apnea risk group, women had a higher correlation with low subjective health and lower health-related quality of life scores than men. Sleeping time of more than 8 hours or less than 6 hours was more associated with low subjective health and lower health-related quality of life score than sleeping time of 6-8 hours. Patients with depression were more likely to have low subjective health than those without depression. The lower the household income level and the smaller the number of household members, the higher the association with low subjective health and the lower the health-related quality of life score. Conclusion: It is essential to recognize that the risk of obstructive sleep apnea not only directly affects sleep disorders but also impacts individuals' subjective health and quality of life. Consequently, social support and education should be provided to raise awareness of this issue. Particularly, programs for preventing and managing obstructive sleep apnea should target vulnerable groups such as women, individuals in single-person households, low household income, and those with depression, aiming to improve their subjective health and quality of life.

Eros, Seduction for Redemption (에로스, 구원을 위한 유혹)

  • Jeeyoun Kim
    • Sim-seong Yeon-gu
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    • v.33 no.1
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    • pp.1-60
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    • 2018
  • The paper was inspired by Jung's words in the Red Book "just as Christ tormented the flesh through the spirit, the God of this time will torment the spirit through the flesh." I propose that the new form of torment in this era could be eroticism as a way of the individuation process because it seems to be one of a very few ways left to modern men to grasp the sense of permanence, the essence of the divine, without religion because of its peculiar nature of transcendence. I suppose that it is not only a man who is tortured but also god is in torment since the divine needs a man as a womb for his incarnation. Therefore I suggest that man and god are fated to seduce each other to be redeemed by each other. I imagine that Eros with numinous sexuality seduces a man who has potentials for the god's incarnation and who would be willing to give in to the god's demand. This god needs a man who desires his essence of perpetuity, the eternal water of life, in ecstasy. Thus the purpose of the divine's seduction is to make a man awake from unconsciousness to pursue god himself, namely the individuation process. I call such divine seduction "eroticism of god" There seem to be a certain type of people who are destined to live eroticism as a way of individuation process. Through investigations, a melancholic tendency appears to be suitable for this type of individuation. Melancholia is deeply related to the poignant awareness of impermanence as the existential condition, which is a precondition for seeking permanence through eroticism. Melancholia essentially causes deep longing for eternity that bears fulfillment, which exists in eroticism, so melancholic agony seems inevitable for eroticism as the path for individuation in that, without knowing about deficiency, we never seek what is lacking in us. It can also be viewed that while a lover is driven to seduce lost love, what actually waits to become seduced for redemption is the god of love itself behind the human beloved. Man and god are fated to seduce each other for redemption. I suppose that the initiation to Eros implies how to seduce Eros. In a woman's psyche, psychological virginity is one of the essential qualities that her ego needs to attain. To the male it is vital to live his sensuality thoroughly and to experience his own and his lover's emotions to their limit. It cannot be an easy task because it demands us to give up our egotism entirely. Through eroticism, unconsciousness seduces us to make us live life as a whole. The god of love brings powerful sexuality as a means of "spiritual crisis" to redeem our lukewarm soul. Only a few can withstand the experience since it requires a strong will to bear the brunt of the sword despite the keen awareness that it may leave us bleeding in pain.