• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.421-427
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• 2005

Complete surgical resection is the most effective treatment for pT1/2N1 non-small cell lung cancer, however 5 year survival rate of these patients is about $40\%$ and the major cause of death is recurrent disease. We intended to clarify the risk factors of recurrence in completely resected pT1/2N1 non-small cell lung cancer. Material and Method: From Jan. f990 to Jul. 2003, total of 117 patients were operated for pT1/2N1 non-small cell lung cancer. The risk of recurrence according to patients characteristics, histopathologic findings, type of resection, pattern of lymph node metastasis, postoperative adjuvant treatment were evaluated retrospectively. Result: Mean age of patients was 59.3 years. There were 14 patients with T1N1 and 103 patients with T2N1 disease. Median follow-up time was 27.5 months and overall 5 year suwival rate was $41.3\%$. 5 year freedom-from recurrence rate was $54.1\%$. Recurrence was observed in $44 (37.6\%)$ patients and distant recurrence developed in 40 patients. 5 year survival rate of patients with recurence was $3.3\%$, which was significantly lower than patients without recurrence $(61.3\%,\;p=0.000).$ In multi-variate analysis of risk factors for freedom-from recurrence rate, multi-station N1 $(hazard\;ratio=1.997,\;p=0.047)$ was a poor prognostic factor. Conclusion: Multi-station N1 is the risk factor for recurrence in completely resected pT1/2N1 non-small cell lung cancer.

• Clinical and Experimental Pediatrics
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• v.52 no.4
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• pp.494-498
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• 2009

Purpose : Applicability of transcatheter closure of atrial septal defect (ASD) has been expanded by accumulation of clinical experiences and evolutions of the device. This study was performed to evaluate the safety and efficacy of transcatheter closure of ASD with Amplatzer septal occluder (ASO) in young children less than 3 years of age. Methods : From May 2003 to December 2005, 295 patients underwent transcatheter closure of ASD with ASO in the Severance Cardiovascular Hospital, Yonsei University Health System. Among them, 51 patients less than 3 years of age were enrolled in this study. We investigated procedural success rate, rate of residual shunt, frequency of complications, procedure/fluoroscopy time, and need of modified techniques for device implantation. Results : The median age was 2.1 years and median body weight was 12 kg. Implantation of device was successful in 50 patients (98%). Seven patients (15%) showed a small residual shunt 1 day after the procedure, but complete occlusion had been documented at 6 month follow-up in all patients (100%). The pulmonary to systemic flow ratio (Qp/Qs), peak systolic pulmonary artery pressure, and peak systolic right ventricular pressure had decreased significantly after closure of ASD. There were 2 complications including device embolization (1, 2%) and temporary groin hematoma (1, 2%). Conclusion : Transcatheter closure of ASD with ASO can be performed with satisfactory results and acceptable risk even in young children less than 3 years of age. We could suggest that even in very young children with ASD, there is no need to wait until they grow to a sufficient size for the transcatheter closure.

• Journal of Radiation Protection and Research
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• v.41 no.1
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• pp.49-55
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• 2016

Background: For the purpose of baseline data collection and enhancement of environmental monitoring the distribution studies of $^{137}Cs$ and $^{90}Sr$ in the soil of Uljin province was performed and the relation between surface soil activities and soil properties (pH, TOC and median of the surface soil) was analyzed. Materials and Methods: For 14 spots within 10 km from the NPP surface soil samples were collected and soils for depth profile were sampled for 3 spots in April 2011. Using ${\gamma}$-ray spectrometry with HPGe detector, the concentrations of $^{137}Cs$ were determined and the concentrations of $^{90}Sr$ were measured by counting ${\beta}$-activity of $^{90}Y$ (in equilibrium with $^{90}Sr$) in a gas flow proportional counter. Results and Discussion: The concentration ranges of $^{137}Cs$ and $^{90}Sr$ were $<0.479-39.6Bq{\cdot}(kg-dry)^{-1}$ (avg. $7.51Bq{\cdot}(kg-dry)^{-1}$) and $0.209-1.85Bq{\cdot}(kg-dry)^{-1}$ (avg. $0.74Bq{\cdot}(kg-dry)^{-1}$) which were similar to the reported values from other regions in Korea. The activity ratio of $^{137}Cs$ to $^{90}Sr$ in surface soils was around 9.67, which is much bigger than the initial value of 1.75 for worldwide fallouts because of faster downward movement of $^{90}Sr$ after fallout than that of $^{137}Cs$. For depth profile studies soils were collected down to 40 cm depth for the locations of Deokgu, Hujeong and Maehwa. The $^{137}Cs$ concentration distribution of the first two showed maximum values at top soils and decreased rapidly in exponential manner, while $^{90}Sr$ showed two local maximum values for soils near top and about 30 cm depth. Through linear fittings between the $^{137}Cs$ and $^{90}Sr$ concentrations of surface soil and pH, TOC and median of the surface soil, the only probable relationship obtained was between $^{137}Cs$ and TOC (determination coefficient $R^2=0.6$). Conclusion: The concentration ranges of $^{137}Cs$ and $^{90}Sr$ in Uljin were similar to the reported values from other regions in Korea. The only probable relationship obtained between activities and soil properties was between $^{137}Cs$ and TOC.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.219-225
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• 1992

Fifty patients with carcinoma of the uterine cervix received curative radiotherapy by external irradiation of the whole pelvis and intracavitary radiation at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital from September, 1983 to October, 1986. External beam whole pelvic irradiation was done first up to 4500-5940 cGy in 5 weeks to 6.5 weeks, followed by an intracavitary radiation. Total dose of radiation to point A varied from 6500 cGy to 11344 cGy (average 6764 cGy). Of the 50 patients, one patient was lost to follow up and follow up period of the remaining 49 patients ranged from 3 months to 93 months (median 32 months). According to FIGO classification, 6 ($12.2\%$) were in stage Ib, 6 ($12.2\%$) in stage IIa, 25 ($51\%$) in stage IIb, 7 ($14\%$) in stage III, and 5 ($10.2\%$) in stage IV. Age of the patients ranged from 33 to 76 years (median 60 years). Pathologically, fourty six ($94\%$) patients had squamous cell carcinoma, 2 ($4\%$) had adenocarcinoma, and 1 ($2\%$) had adenosquamous cell carcinoma. Overall response rate was $84\%$. 5-year survival rate was $49\%$ for entire group ($75\%$ for stage Ib, $83\%$ for Stage IIa, $42.5\%$ for stage IIb, $25\%$ for stage III, $40\%$ for stage IV). Complications were observed in 11 ($22.4\%$) patients, who revealed rectal complications with most common frequency. Others were self limiting trifle ones such as wet desquamation, fatigue, mild leukopenia, etc. The correlation of the survival rate with various factors (age, dose, Hb level, pelvic lymph node status, performance status, local recurrence) was evaluated but showed no statistical significance except the age and local recurrence in this series; survival of patients less than 50 years of age was worse than that of the older, and the presence of local recurrence had worse prognosis (p<0.05).

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.277-283
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• 2017

Background: Smoking cessation is the most powerful intervention to modify progress of chronic obstructive pulmonary disease (COPD), and nicotine dependence is one of the most important determinants of success or failure in smoking cessation. We evaluated nicotine dependence status and investigated factors associated with moderate to high nicotine dependence in patients with COPD. Methods: We included 53 current smokers with COPD in the Korean Obstructive Lung Disease II cohort enrolled between January 2014 and March 2016. Nicotine dependence was measured by using Fagerstrom test for nicotine dependence (FTND). Cognitive function was assessed by Korean version of Montreal Cognitive Assessment. Results: The median FTND score was 3, and 32 patients (60%) had moderate to high nicotine dependence. The median smoking amount was 44 pack-years, which was not related to nicotine dependence. Multiple logistic regression analysis revealed that high education status (odds ratio, 1.286; 95% confidence interval, 1.036-1.596; p=0.023), age <70 (odds ratio, 6.407; 95% confidence interval, 1.376-29.830; p=0.018), and mild to moderate airflow obstruction (odds ratio, 6.969; 95% confidence interval, 1.388-34.998; p=0.018) were related to moderate to high nicotine dependence. Conclusion: Nicotine dependence does not correlate with smoking amount, but with education level, age, and severity of airflow obstruction. Physicians should provide different strategies of smoking cessation intervention for current smokers with COPD according to their education levels, age, and severity of airflow obstruction.

• Tuberculosis and Respiratory Diseases
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• v.66 no.2
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• pp.93-97
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• 2009

Background: Belotecan (Camtobell, CKD-602, Chongkundang Pharm., Korea), a camptothecin derivative, has anticancer effects by inhibiting topoisomerase I such as topotecan. This study observed the response, survival and toxicity of belotecan monotherapy after the failure of etoposide and platinum (EP). Methods: Forty nine small cell lung cancer (SCLC) patients (M/F=41/8; age, 64.5${\pm}$7.6 (mean${\pm}$SD) years), who failed in their first line chemotherapy were enrolled in this study. Twenty one SCLC patients showed relapsed lung cancer more than 90 days after their priorEP chemotherapy (sensitive relapse group, SR) and 28 patients relapsed within 90 days (refractory relapse group, RR). Results: The response rate was 25%. Eleven patients showed partial responses and 5 patients could not be checked. The response rate of the SR and RR patients was similar. The relative dose intensity was lower in the responders (78${\pm}$15%) than non-responders (83${\pm}$13%, p=0.03). The median survival time (MST) was 10.3 months (290 days). The MST of the non-responders and responders was 186 days (95% CI; 67-305) and 401 days (95% CI; 234-568, p=0.07), respectively. The median progression free survival (MPFS) was similar in the SR (79 days) and RR (67 days) patients. Grade 3-4 neutropenia, anemia, and thrombocytopenia were observed in 59.6%, 12.8% and 23.4% of patients, respectively. Conclusion: The efficacy and survival were demonstrated in the second-line setting. However, a randomized comparative trial with topotecan will be needed.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.206-212
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• 2007

Purpose: Heterotopic ossification is a well-known postoperative and post-traumatic complication of the elbow. We reviewed the treatment outcome for the use of low-dose radiation after surgical intervention of the elbow to prevent recurrence of heterotopic ossification (HO). Materials and Methods: Forty-five patients with HO underwent surgical intervention and postoperative radiotherapy of the elbow. The median age of the patients was 29 years ($16{\sim}75$ years), and 27 of the patients were men and 18 were women. The occurrence of HO was mainly due to surgery after fracture (24/45) and traumatic injury (21/45). Limitation of the range of motion (ROM) was the most common symptom of the patients. Thirty-four patients received postoperative radiotherapy with a dose of 8 Gy in 2 fractions; 5 patients received a dose of 10 Gy in 5 fractions and 6 patients received a dose of 7 Gy in 1 fraction. Postoperative radiotherapy was given on the first two postoperative days for most of the patients. Sixteen patients were not given anti-inflammatory medication and 29 patients were given NSAIDs for $1{\sim}8$ months. Results: After a median follow-up period of 18 months (range $6{\sim}72$ months), 41 patients showed clinical improvement and two patients did not show improvement. Assessment of the ROM showed a mean improvement from $0{\sim}135^{\circ}$ to $60{\sim}145^{\circ}$ (p=0.028), and assessment of the functional outcome according to MEPI was from ($15{\sim}95$) to ($80{\sim}100$) (p<0.0001). Two of the 34 patients that were followed-up with radiography had mild radiological recurrence of heterotopic ossification. No complications were observed after the radiotherapy. Conclusion: These results suggested that low-dose radiation administered after surgical intervention is safe and effective to prevent the recurrence of HO in the elbow.

• Journal of dental hygiene science
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• v.16 no.2
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• pp.111-117
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• 2016

The purpose of this study was to assess the relationship that adolescent stress perception level has with dietary habits and oral health behaviors in high school students. A survey of high school students in some areas of the Jeollabuk-do province of South Korea was conducted. Five hundred fourteen survey responses were used in the final analysis. As a result of the questionnaire survey, the following conclusions were obtained. The highest stress type was indicated to be academic stress (mean${\pm}$standard deviation [SD], $3.09{\pm}0.89$). The next was shown to be home (family) stress (mean${\pm}$SD, $2.85{\pm}0.84$). The possibility of using a dental clinic was indicated to be less in girls than boys (p<0.001). Regarding subjective oral health behavior, the possibility of visiting a dental clinic was low in those who thought that their own oral health condition was not good or moderate (p<0.05). Also, it was shown that the higher stress led to the higher possibility of visiting a dental clinic (p<0.01). Students with higher grades had a in the upper ranks were indicated to have high possibility of having a regular meal (p<0.01). Higher stress led to the significantly higher possibility of eating cariogenic food (p<0.01). Students with median grades had a high possibility of eating cariogenic food (p<0.01), while students with higher grades had a low possibility of eating cariogenic food (p<0.05). These resultss show that stress perception level influences dietary habits and oral health behaviors. Thus, there is a need to develop a program in high scholls to promote the physical and mental health of students to relieve stress. Substantial and systematic oral health education is thought to be likely needed to develop desirable dietary habits.

• Radiation Oncology Journal
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• v.29 no.1
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• pp.11-19
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• 2011

Purpose: To evaluate the pathological and clinical effects of preoperative chemoradiation (CCRT) in cases of locally advanced rectal cancer and to determine the predictive factors for tumor downstaging. Materials and Methods: From March 2004 to August 2008, 33 patients with locally advanced rectal cancer were treated with preoperative CCRT. Twenty-eight patients (84.8%) were treated using a concomitant boost technique while five (15.2%) patients were treated using a cone down boost technique. All patients received 50.4 Gy of irradiation and concurrent chemotherapy with 5-fluorouracil. The median follow-up duration was 24.2 months (range, 9.8 to 64.7 months). Results: Thirty-one (93.9%) patients underwent surgery. Twenty-four patients (72.7%) underwent anal sphincter-preserving surgery. The 3-year disease free survival (DFS) and overall survival rates were 63.4% and 78.8%, respectively. Post-operative factors were more important for DFS. Pathologic N stage, margin status, and pathologic differentiation were significant prognostic factors (p=0.001, 0.029, 0.030). Tumor size and lymphovascular invasion were also associated with marginal significance (p=0.081, 0.073). However, only pre-treatment T stage was a significant pre-operative factor (p=0.018). The complete pathological response rate was 9.1 %. T-downstaging was observed in ten (30.3%) patients, whereas N-downstaging was found in 24 (72.7%) patients. Pre-treatment T stage and the interval between CCRT and operation were the predictive factors for downstaging in a univariate analysis (p=0.029, 0.027). Pre-treatment carcinoembryogenic antigen was also associated with marginal significance (p=0.068). Conclusion: The survival of rectal cancer patients can be better determined based on post-operative findings. Therefore, pre-operative CCRT for downstaging of the tumor seems to be important. Pre-treatment T stage and the interval between CCRT and operation can be used to predict downstaging.

• Pediatric Infection and Vaccine
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• v.21 no.3
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• pp.181-190
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• 2014

Purpose: This study was performed to investigate the epidemiological trend of rotavirus acute gastroenteritis (RV-AGE) in children. Methods: A retrospective review was performed in patients (1 month to 18 years of age) with acute gastroenteritis at KEPCO Medical Center from September 2004 to August 2013. Comparative analyses were performed based on periods: pre-vaccine (2004-2006) and post-vaccine (2008-2012) in all patients; 2004-2006 (period A), 2007-2009 (period B) and 2010-2012 (period C) in patients under 5 years of age. Results: Proportion of RV-AGE decreased from 25.0% (337/1,346) in pre-vaccine period to 20.8% (459/2,210) in post-vaccine period (rate ratio (RR), 0.83 [95% CI, 0.73-0.93]; P=0.0029). The median age of patients with RV-AGE in post-vaccine period (2.6 years) was significantly (P<0.0001) higher than that in pre-vaccine period (1.6 years). In patients hospitalized with AGE, proportion of RV-AGE was significantly reduced in patients 6 to 23 months old (RR, 0.62 [95% CI, 0.51-0.75]; P<0.0001). Significant decline in proportion of RV-AGE was observed in patients under 5 years of age: period A, 26.9% (308/1,144); period B, 22.7% (295/1,299); period C, 20.6% (186/902) (P =0.0007). After the introduction of rotavirus vaccine, a significant decreasing trend of RV-AGE proportion was observed in patients 6 to 11 months old (P =0.0018) and 12 to 23 months old (P =0.0152). Conclusion: Decrease in RV-AGE proportion and increase in age of patients with RV-AGE were observed after the introduction of rotavirus vaccine in this single center study. Continued and systematic surveillance is needed to assess the impact of rotavirus vaccine.