• Advances in pediatric surgery
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• 제12권2호
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• pp.167-174
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• 2006

Central venous catheter (CVC) for long-term venous access is indispensable for various reasons including hyperalimentation, frequent blood sampling, frequent IV drug use in pediatric patients. We report clinical experience of surgical neonates in whom CVC was inserted primarily via great saphenous vein into suprarenal inferior vena cava. From March 2004 to March 2006, we performed CVC insertion via saphenous vein - contralateral side to main wound - into suprarenal inferior vena cava in surgeries of neonates. 2.7Fr or 4.2Fr, single lumen, tunneled Broviac catheters (Bard Access system, Inc, Salt Lake City, Utah) were used. Skin exit site of tunneled catheter was located in ipsilateral flank area just below edge lower rib. At the end of the procedure, location of the catheter tip was confirmed by plain radiography of abdomen. We retrospectively reviewed the admission records of the patients including nursing staff charts. Nine (50.0 %) patients were male and nine (50.0%) were female. Median gestational age was 38 weeks (range, 29-42 weeks) and median birth weight was 3,105 gm (range, 1,040-3,720 gm). Median age at catheter insertion was 38.5 days (range, 1-236 days). The purpose of CVC insertion was short-and long-term hyperalimentation in nine (50.0 %) patients. CVC insertion was performed in operation room under general anesthesia in sixteen (88.9 %) patients (in these cases, CVC insertion was performed just prior to concurrent operation) and neonatal intensive care unit (NICU) under local anesthesia with adequate sedation in two (11.2%). During the admission period (total catheter-indwelling time: 553 days), CVC functioned well without any significant side effects. Transient swelling of the ipsilateral leg (n=1, 5.6 %) and transient migration of catheter tip (n=1, 5.6 %) were noted, which did not affect function of the indwelled CVC. Mean catheter-indwelling time was 30.7days (range, 3-72 days). All catheters were removed electively except two mortality case. Complications, such as thrombosis, infection, kinking or extravasation of drugs, were not observed in our study period. Tunneled trans-great saphenous vein inferior vena cava catheters are not only comparable to cervical CVCs in terms of function and complication rates, but also very beneficial in selected patients, especially those in whom cervical approach is technically impossible or contraindicated.

• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5385-5388
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• 2015

Background: Gastric cancer is the most common gastrointestinal cancer and a leading cause of cancer mortality in Nepal. Survival of gastric cancer patients depends on the stage at which diagnosis is made. The aim of this study was to analyze the presentation and outcomes of gastric cancer patients treated at a tertiary care hospital in Nepal. Materials and Methods: A retrospective analysis of 140 consecutive histologically proven gastric adenocarcinoma cases managed at the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal for the period of January 2009 to December 2013 was carried out. Results: One hundred forty out of the total 186 patients with histologically proven gastric adenocarcinoma, were admitted for surgery. The mean age was $59.6{\pm}12.4yrs$ (range 29 to 78 yrs) and the male: female ratio was 2:1. Sixty three (45%) patients featured Tibeto-Burman descent though this ethnic group accounts for only 18% of the Nepalese population. Two-thirds or more patients presented with abdominal pain, anorexia, weight loss and/or vomiting. In 86 (61.5%) of the patients the tumor was located in the lower $3^{rd}$ of the stomach and in only 15% of the patients the tumor was located at the upper $3^{rd}$. Early gastric cancer was diagnosed postoperatively in only 4%. In 54%, the disease was locally advanced and metastatic lesions were found in 14% of the patients. Subtotal (73) or total (11) curative gastrectomies (D1, D1+ or D2) were performed in 84 (60%) patients with average lymph node retrieval of $16.6{\pm}8.2$. Palliative gastrectomies or procedures were performed in 23% of the patients and no intervention (open & close/biopsy) was employed in 15% of the patients. Perioperative morbidity was seen in 10% and mortality in 4%. Three, four and five year survival rates up to the recent follow-up were 17.9%, 11.9% and 8.3%, respectively. Conclusions: Gastric cancer in Nepal is usually diagnosed at an advanced stage and has a poor prognosis. Thus, early detection is the key to improve the survival of gastric cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4577-4581
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• 2013

Background: The objective of this study was to determine the practice of skin cancer prevention among Malaysian road traffic police officers. Materials and Methods: This cross-sectional study involved 202 Malaysian Road Police Traffic officers. Inclusion criteria were those officers who work wearing white uniform regulating traffic. The survey took place at the Police Traffic Station, Jln Tun H.S. Lee, Kuala Lumpur, the main Head Quarters of Malaysian's Traffic Department where almost 600 police traffic officers are employed. The police traffic officers are given the task to take care of the traffic from the main office of the police station, then, according to the task, the officers drive to their given location for their duty. Each task is approved by the Chief Traffic Inspector of Kuala Lumpur. Data collected in this study were analyzed using SPSS 13, with the T-test for univariate analysis and multiple linear regression for multivariate analysis. Results: A total of 202 road traffic police officers participated. The majority were older than 30 years of age, male, Malay, married, with secondary education, with monthly income more than 2000 Ringgit Malaysia (66.3%, 91.1%, 86.6%, 84.7%, 96%, 66.3%; respectively). Regarding the practice of skin cancer prevention, 84.6% of the study participants were found to wear hats, 68.9% sunglasses and 85.6% clothing that covering most of the body but only 16.9% used a sunscreen when they were outdoors. When analysis of the factors that influenced the practice of skin cancer prevention was performed, univariate analysis revealed that gender, age and monthly income significantly influenced the practice of skin cancer prevention. For multivariate analysis, gender, monthly income and race significantly influenced the practice of using sunscreen among road traffic police officers (p<0.001, p=0.019, p=0.027; respectively). Conclusions: The practice of skin cancer prevention among the traffic police officers showed good practices in terms of wearinga hat, sun glasses and clothing that covers most of the body. However, the study revealed a poor practice of the use of sunscreen. The factors that influence the practice of sunscreen use were found to be gender, income, and race. The study suggests that more awareness campaign among traffic police officers is needed. Providing sunscreen for free for police traffic officers should be considered by the Police authorities.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.11-15
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• 2016

Gastrointestinal cancers remain the most prevalent cancers in many developing countries such as Iran. The aim of this study was to estimate incidence, prevalence and mortality, as well as time trends for gastrointestinal cancers in Isfahan province of Iran for the period 2001 to 2010 and to project these estimates to the year 2020. Estimates were driven by applying the MIAMOD method (a backward calculation approach using mortality and relative survival rates). Mortality data were obtained from the Ministry of Health and the relative survival rate for all gastrointestinal cancers combined was derived from the Eurocare 3 study. Results indicated that there were clear upward trends in age adjusted incidence (males 22.9 to 74.2 and females 14.9 to 44.2), prevalence (males 52.6 to 177.7 and females 38.3 to 111.03), and mortality (males 14.6 to 47.2 and females 9.6 to 28.2) rates per 100,000 for the period of 2001 to 2010 and this upward state would persist for the projected period. For the entire period, the male to female ratio increased slightly for all parameters (incidence rate increased from 1.5 to 1.7, prevalence from 1.4 to 1.6, and mortality from 1.5 to 1.7). In males, totals of 2,179 incident cases, 5,097 prevalent cases and 1,398 mortality cases were predicated to occur during the study period. For females the predicted figures were 1,379, 3,190 and 891, respectively. It was concluded that the upward trend of incidence alongside increase in survival rates would induce a high burden on the health care infrastructure in the province of Isfahan in the future.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3465-3468
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• 2016

Background: Fluorodeoxyglucose ($^{18}FDG$) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body $^{18}F$-FDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital. Materials and Methods: This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG was injected at 3 MBq/Kg and a low dose, non-enhanced CT protocol (LD-NECT) was used. Diagnostic CT studies of specific regions were subsequently performed if required. Effective dose imparted by 18FDG (internal exposure) was calculated by using multiplying injected dose in MBq with coefficient $1.9{\times}10^{-2}mSv/MBq$ according to ICRP publication 106. Effective dose imparted by CT was calculated by multiplying DLP (mGy.cm) with ICRP conversion coefficient "k" 0.015 [mSv / (mG. cm)]. Results: Mean age of patients was $49{\pm}18$ years with a male to female ratio of 35:28 (56%:44%). Median dose of 18FDG given was 194 MBq (range: 139-293). Median CTDIvol was 3.25 (2.4-6.2) and median DLP was 334.95 (246.70 - 576.70). Estimated median effective dose imparted by $^{18}FDG$ was 3.69 mSv (range: 2.85-5.57). Similarly the estimated median effective dose by low dose (non-diagnostic) CT examination was 4.93 mSv (range: 2.14 -10.49). Median total effective dose by whole body 18FDG PET plus low dose non-diagnostic CT study was 8.85 mSv (range: 5.56-13.00). Conclusions: We conclude that the median effective dose from a whole body 18FDG PET/CT in our patients was significantly low. We suggest adhering to recently published dose reducing strategies, use of ToF scanner with CT dose reducing option to achieve the lower if not the lowest effective dose. This would certainly reduce the risk of second primary malignancy in younger patients with higher odds of cure from first primary cancer.

• 한국콘텐츠학회논문지
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• 제11권2호
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• pp.215-228
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• 2011

수천년을 거쳐 온 역사 속에서 '아버지'라는 인물은 가족의 건강과 마음을 챙겨주는 대상 이외에도 사회적으로 가족을 대표하고 부양하는 능력을 가진 존재로 그려지고 있다. 19세기에 편중된 서구의 가부장적 전통과 더불어 한국 사회에서의 아버지 역시 한국 전통의 유교문화를 바탕으로 가부장적 부성성을 띠고 있다. 1960년대부터 산업화를 이루어 결국 21세기에는 가족중심주의 대신 개인중심주의로, 서열화 대신 평등성을 강조하며 상호존중과 자율성을 바탕으로 하는 근대적 가치에 중심을 두게 되었다. (2005, 한국가족문화원, 21세기 한국 가족) 하지만 짧은 기간 동안 이루어진 급작스런 근대화로 인해 실제로는 아직 한국사회에 전통적 가족문화 현상이 남아있는 것이 사실이다. 결국 이러한 한국 특유의 가족문화를 바탕으로 가족 내에서 한국의 아버지는 가부장적 남성중심적 사고를 가지고 가족의 생계와 안전을 책임지며 감정보다는 이성에, 부드러움 보다는 무뚝뚝함에 더 중심을 두는 것이 남자, 그리고 아버지로서의 역할이라고 여기게 된다. 이러한 아버지의 모습에 대한 사회적 이데올로기는 미디어를 통해 표현되는데, TV나 영화에서 보여지는 가부장적 아버지의 이미지가 그 예이다. 본고는 그러한 한국의 아버지가 묘사된 영화 분석을 위해 선정한 영화 두 편을 통해 한국 영화 속에서 표현되는 아버지의 역할이 어떠한지를 메츠의 통합체, 계열체분석과 그레마스 분석 방법을 이용하여 기호학적 의미에서 살펴보도록 하겠다. 사례분석을 위해 선정된 영화로는, 한국형 가장으로서의 아버지가 표현된 영화 '플라이 대디'와 한국형 기러기 아빠가 등장하는 '우아한 세계'가 있다. 위의 영화들은 영화 속의 가부장적 부성성과 그 배경이 된 한국 전통의 이데올로기가 미디어를 통해 투영된다는 것을 보여주는 좋은 예이다.

• 한국산학기술학회논문지
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• 제18권10호
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• pp.471-479
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• 2017

본 연구는 대상자들(35명)이 제주곶자왈 산림을 방문하기 전과 후의 타액cortisol 함량의 변화를 조사하는 것이 목적이었다. 방문 전후에 타액을 채취하여 항혈청면역법으로 분석을 하였다. 연구기간은 2017년 5월 1일부터 6월 30일 4 주간에 실시하였다. 대조군의 사전과 사후의 측정 cortisol 평균치는 유의성이 없었다. 실험군의 평균치는 사전보다 사후에는 감소하는 경향을 보였으나 유의하지는 않았다. Cortisol 함량의 차이는 대조군과 실험군은 사전에는 유의한 차이를 보이지 않았으나, 사후에는 대조군보다 실험군이 낮게 나타나서 유의한 차이를 보였다. Cortisol 평균값은 남자의 경우에 대조군보다 실험군이 낮았다. 여자의 경우에 대조군보다 실험군이 낮아서 남자가 여자보다 2배 이상 큰 변화를 보이었다. 사후의 측정치는 대조군보다 실험군의 cortisol함량이 낮게 나타나 유의한 차이를 보였다. 사후의 성별 및 대조군과 실험군 별 분석에서는 성별, 집단, 성별과 집단의 결합효과 간에 유의하게 나타났다. 즉 성별과 집단에 따른 cortisol 수치의 차이가 있음을 알 수 있다. 본 연구는 삼림욕의 효과를 나타내는 기본 자료를 제공하고 있다.

• 대한간호학회지
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• 제30권2호
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• pp.514-526
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• 2000

The active treatment phase in preparation for bone marrow transplantation(BMT) of che- motherapy regimen and total body irradiation (TBI) containing regimen requires considerable teaching. There have been researches that are related to treatment onto BMT patients and to psychological change during BMT process. However, it was hard to find researches focused on learning needs of patients undergoing BMT. The purpose of this study was to provide the basic data for effective educational program about BMT by investigating the learning needs in patients undergoing BMT. The subjects consisted of 90 BMT patients have been admitted to the department of BMT at three university hospitals. Data were obtained from October 1998 to March 1999 and analyzed by SAS program for unpaired t-test, ANOVA, Duncan test. The results were as follows : 1. Learning needs related to demographic characteristics was identified as below. That of male was higher than that of female. That of under age 29, unmarried, religious and university graduated group was higher than that of opposite group but it didn't show significant difference. Learning needs of group of patients who were employed was significantly higher then that of unemployed patients. 2. According to types of diagnosis, learning needs of myelodysplastic syndrome(MDS) patients was the higher than that of others, but admission frequency was the least. Learning needs of unrelated matched BMT(UBMT) patients was higher than that of autologous BMT patients. However, it didn't show significant difference. With regard to learning needs according to process of BMT, learning needs of Pre- BMT period or Post-BMT period was significantly higher than that of BMT day. 3. Learning needs related to BMT was relatively high (total mean: 3.11 of 4.0). The order of the mean score of leaning needs was shown as follows : Restricted activities after discharge, Relapse symptom, Complications of BMT, Kinds of available drugs at home. Therefore the learning needs that is related to life after discharge and to relapse and complications after BMT was high. 4. Learning needs related to radiation therapy was high (total mean: 3.35 of 4.0). The learning needs in radiation therapy items was the Skin care of radiation therapy and Purpose of radiation therapy. 5. Learning needs related to graft versus host disease(GVHD) therapy was high (total mean: 3.55 of 4.0). The highest learning needs in GVHD therapy items was the Preventive method GVHD. less admission frequency and UBMT patients. It is necessary that education for BMT patients should be focused on life after discharge and on relapse and complications after BMT. Especially education for allogeneic BMT patients should be emphasized on GVHD. For all of these, it is necessary to develop systematic and concrete educational program.

• 대한한의학방제학회지
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• 제16권2호
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• pp.11-29
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• 2008

Objective : The aim of this study was to analyse the latest trend of medical science articles about Bojungikki-Tang published in Japan. Methods : We searched medical science articles published from 2003 to 2008 in Japan on the web site, CiNii and then these articles were reviewed and classified according to experimental subject and method. Results : Fifty-two articles, related to Bojungikki-Tang were searched and these were classified into three classes, pharmacological signaling studies, clinical case studies and the others. As a result of classification, clinical case studies were most abundant by 38 cases, pharmacological signaling studies were 10 and the others were 4. This result suggested that the study of Bojungikki-Tang was mainly focused on clinical study rather than experimental study. Among the clinical case studies, clinical studies related to immune disease took the most greatest number and number of other clinical studies were evenly distributed over the various disease. Immune intensification effect of Bojungikki-Tang can be thought continuous with reinforce the middle Jiao Qi in company with improvement effect on growth hormone failure and male infertility. A fact that the one prescription, Bojungikki-Tang could be used to treat various diseases reflects a viewpoint of Oriental medicine that is based on the respect for and understanding of individual constitution and disposition while paying attention to the gender difference and individuality. The clinical usefulness of Bojungikki-Tang on obstructive sleep apnea syndrome and visceroptosis concerns with ascend Yang and treat Qi sinking. Pharmacological signaling studies were mainly focused on diseases that were treated Bojungikki-Tang in clinic, however, there was one study that experimented on changes of numerous gene expression according to the treatment of Bojungikki-Tang using DNA array. Conclusion : The therapeutic system of Oriental medicine is different in various aspects form that of Western medicine and appropriate harmonization of east and west is expected to improve the quality of medical care. In this regard, continuous investigation and analysis about herbal medical science papers in Japan can also be useful to make progress in Korean traditional medicine.

• Clinical and Experimental Pediatrics
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• 제50권7호
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• pp.665-671
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• 2007

목 적 : 최근 신생아기에 심장 수술을 받은 환아들의 임상적 특징 및 수술 성적에 대해 알아보고자 하였다. 방 법 : 2000년 3월부터 2006년 2월까지 6년간 경북대학교 병원에서 신생아기에 수술을 받은 82명에 대해 이들의 수술 당시 나이 및 체중, 심기형의 종류, 수술 전 상태, 수술 내용 및 결과, 합병증 등을 검토하였다. 결 과 : 대상 환아 82명 중 남아는 41명이었으며 수술 당시 평균 나이는 12일, 평균 몸무게는 3,200 g이었다. 주된 심기형은 완전대혈관전위, 활로씨사징, 심실중격이 온전한 폐동맥판폐쇄, 기능적 단심실이 다수를 차지하였다. 수술 방법으로 인공심폐기를 사용한 경우가 57례였고, 54례에서 완전 교정수술이 시행되었다. 수술 종류로 완전 교정수술로는 동맥전환수술이, 고식 수술로는 변형 B-T 단락술이 가장 많이 시행되었다. 총 사망은 9례(10.9%)였으며 이 중 조기 사망은 6례, 만기 사망은 3례였다. 수술 후 합병증은 급성 신기능 부전, 지연 흉골 봉합, 상처감염, 수술 후 부정맥, 뇌실내 또는 뇌내출혈 등이 발생하여 내과적 치료를 필요로 하였다. 결 론 : 최근 6년간 본원에서 신생아기의 선천성 심장병에 대한 수술적 치료는 수술 전 처치, 수술 방법, 체외 순환법 그리고 수술 후 집중 치료의 발달을 통해서 많은 향상을 보였다.