• Tuberculosis and Respiratory Diseases
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• v.65 no.3
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• pp.183-190
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• 2008

Background: The control of active pulmonary tuberculosis is still an issue in community medicine. But there are also considerable needs for supportive management of symptomatic patients with post-tuberculous destroyed lung. Few studies have evaluated clinical characteristics and health-related quality of life in patients with post-tuberculous destroyed lung. Methods: We evaluated lung function, exercise tolerance, HRCT and health-related quality of life measurements using the Korean version of St. George's Respiratory Questionnaire (SGRQ) in 22 patients with parenchymal damage to more than a half of one lung due to pulmonary tuberculosis. Results: In the pulmonary function test, mixed defects and obstructive defects were observed in 10 (45.0%) and 9 (40.9%) of patients, respectively. In the cardiopulmonary exercise test, the mean $VO_2max%$ predicted ($39.0%{\pm}10.9%$) and $O_2$ pulse% predicted ($61.3%{\pm}13.6%$) were markedly decreased. In the SGRQ, the impact score (mean $27.8{\pm}18.5$) was significantly lower than the symptom score (mean $53.9{\pm}20.9$) or activity score (mean $50.8{\pm}27.3$) (p<0.05, p<0.01). Cronbach's alpha coefficient value for reliability was more than 0.7 for each subscale and total score. The total score showed a significant negative correlation with $FEV_1%$ predicted (r=-0.46, p<0.05) and $SaO_2$ (r=-0.60, p<0.05). On HRCT, a median of 9 (range 5~15) bronchopulmonary segments were destroyed by less than half, which significantly correlated with SGRQ total score (r=-0.52, p=0.02). Conclusion: The reliability and validity of the Korean version of the SGRQ was acceptable for the measurement of health-related quality of life in patients with post-tuberculous destroyed lung.

• Radiation Oncology Journal
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• v.27 no.4
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• pp.189-193
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• 2009

Purpose: To report on the changes in the patterns of care and survival over time for esthesioneuroblastoma. Materials and Methods: We retrospectively analyzed 42 previously untreated and histologically confirmed esthesioneuroblastoma patients seen between March 1989 and June 2007. According to Kadish's classification, 3 patients (7%) were stage A, 6 (14%) at stage B, and 33 (79%) at stage C. Of the 33 Kadish C patients, 19 and 14 patients were treated from 1989 through 2000 and from 2001 through 2007, respectively. Treatment included surgical resection, radiotherapy, chemotherapy, or a combination of these methods. Chemotherapy was administered to 8 of 19 patients (42%) seen from 1989 through 2000, whereas all of the 14 patients seen from 2001 through 2007 received chemotherapy (p<0.001). No patient was treated by three-dimensional conformal radiotherapy (3D-CRT) from 1989 through 2000, however 8 of 14 patients (67%) seen from 2001 through 2007 underwent 3D-CRT (p<0.001). The median follow-up time for surviving patients was 6.5 years (range, 2.2~15.8 years). Results: The 5-year overall survival (OS) and progression-free survival (PFS) rates for the entire cohort were 53% and 39%, respectively. The 5-year OS was 100% for Kadish stages A or B and 39% for stage C (p=0.007). For patients with stage C disease who were treated from 1989 to 2000 and from 2001 to 2007, the 5-year OS rate was 26% and 59% (p=0.029), respectively and the corresponding 5-year PFS rate was 16% and 46% (p=0.001), respectively. Intraorbital extension and treatment era (1989~2000 vs. 2001~2007) were found as independent factors for OS and PFS in a multivariate analyses. Conclusion: The results of this study suggest that treatment era, which features a distinction in treatment modality and technique with the introduction of 3D-CRT, may be the cause of improved OS and PFS in Kadish stage C patients. To achieve better outcomes for patients with Kadish stage C, combined chemoradiotherapy, especially 3D-CRT, is recommended in addition to surgery.

• Korean Journal of Clinical Pharmacy
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• v.30 no.1
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• pp.36-43
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• 2020

Background: Tacrolimus, a calcineurin inhibitor, is an immunosuppressant used in post-transplantation maintenance therapy. The drug has a narrow therapeutic range and requires periodic therapeutic drug monitoring. Although many studies have reported the effects of intrapatient variability of tacrolimus on survival, rejection, and complications in renal transplant recipients, very few studies have reported these effects in liver transplant recipients. The purpose of this study was to evaluate the effect of intrapatient variability of tacrolimus on clinical outcomes after liver transplantation. Methods: Intrapatient variability was calculated using individual, averaged tacrolimus concentrations. Patients were divided into two groups according to their median variability value: high-variability and low-variability groups. The rate of deviation from the therapeutic range, incidence of acute rejection, post-transplant diabetes, incidence of infection, and estimated glomerular filtration rate (eGFR) after transplantation were compared between the groups. Results: Of the total patients (n=82), the high-variability group (n=41) exhibited significantly greater deviation from the therapeutic range (65.92% vs. 56.84%; p<0.001). There was no significant difference in acute rejection or post-transplantation diabetes incidence or eGFR; however, the number of infection in the first 6 months was significantly lower in the low-variability group (0.4 vs. 0.9 times; p=0.039). Multiple linear regression analysis showed that the number of infection significantly increased as intrapatient variability increased (p=0.015). Conclusion: High intrapatient variability in tacrolimus concentrations was strongly associated with an increased frequency of deviation from the suggested therapeutic range and an increased number of infection.

• Radiation Oncology Journal
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• v.33 no.3
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• pp.198-206
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• 2015

Purpose: We evaluated the prognostic factors and clinical outcomes of 56 patients with vulvar cancer treated with curative radiotherapy (RT) or concurrent chemoradiotherapy. Materials and Methods: Overall survival (OS) and disease-free survival (DFS) were assessed retrospectively. Prognostic factors evaluated included age, International Federation of Gynecology and Obstetrics (FIGO) stage, TNM classification, tumor size, treatment modality, RT duration, and RT field. The association between the tumor human papillomavirus (HPV) status and survival was analyzed in 35 patients. Results: During the median follow-up of 2.8 years (range, 0.3 to 18.9 years), 21 patients (37.5%) experienced treatment failure. Fifteen patients (27%) had local failure: nine (16%) local failure only, three (5%) locoregional failure, two (4%) local and distant failure, and one (2%) locoregional and distant failure. Of 56 patients, seven (13%) had persistent disease at the first follow-up at 2 months and all but one died within a year after completing RT. The 5-year OS and DFS were 51.6% and 44.0%, respectively. In multivariate analysis, clinical size ${\geq}3$ cm predicted a poor prognostic factor for DFS (p = 0.040) and age (${\geq}70years$) was poor prognostic for DFS (p = 0.032) and OS (p = 0.048). Patients with HPV-positive tumors tended to have better 5-year OS and DFS, but the differences were not significant statistically. Conclusion: Clinical size ${\geq}3$ cm was a significant prognostic factor for DFS. However, age was the most important prognostic factor for DFS and OS in patients treated with curative RT. Further studies are needed to determine which treatment should be considered for old age ${\geq}70years$.

• Korean Journal of Community Nutrition
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• v.20 no.5
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• pp.351-361
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• 2015

Objectives: The purpose of this study was to investigate the relations between diabetic dietary compliance and dietary intake, physical activity and prevalence of metabolic syndrome (MS) in type 2 diabetic patients. Methods: Seventy five subjects diagnosed with type 2 diabetes visiting the D hospital in Dongducheon from May 2014 to Dec 2014 were included in this study. The subjects were divided into two groups according to their diabetic dietary compliance score (median 39); low diabetic dietary compliance (LDDC) group (n=44) and high diabetic dietary compliance (HDDC) group (n=31). Survey data collection was carried out by direct interview method. The nutrient intake, food intake and KDDS (Korean's dietary diversity score), DVS (dietary variety score) and GMVDF (grain, meat, vegetable, dairy and fruit) were analyzed using data from the 24-recall method. Metabolic parameters were obtained from the hospital records. Data was analyzed using Chi-square test and general linear model adjusted for sex. Results: The prevalence of MS was 59.7% in the participating diabetic patients. The prevalence of MS of the HDDC (39.3%) was significantly lower than that of the LDDC (72.7%). The distribution of physical activity showed a significant difference between the groups (p=0.006). The intakes of seeds and nuts of the HDDC were significantly lower than those of the LDDC. Fat and vegetable fat intakes and % fat of energy in the HDDC were significantly lower than those in the LDDC. But, carbohydrate (CHO) and potassium intake and %CHO of energy in the HDDC were significantly higher than those in the LDDC. KDDS and GMVDF showed significant differences between groups (p=0.033; p=0.012). Conclusions: Continuous intervention by specialized nutritionists for long-term self-regulation is needed for diabetic patients, and the high compliance to diabetic diet and increasing physical activity may be effective in the prevention of metabolic syndrome.

• Radiation Oncology Journal
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• v.35 no.3
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• pp.217-226
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• 2017

Purpose: Hematotoxicity following anti-cancer treatment is known to be related to treatment efficacy in several malignancies. The purpose of this study was to examine the hematologic parameters related to the tumor response and survival in patients treated with curative surgery following preoperative chemoradiotherapy (CRT) for rectal cancer. Materials and Methods: Four hundred eighteen patients with rectal cancer who underwent preoperative CRT and curative surgery were analyzed, retrospectively. The main clinical factors and blood cell counts before and after CRT were investigated with respect to their relationships with tumor downstaging and patient survival. Results: The post-CRT leukocyte count was significantly different between the tumor downstaging group and the non-downstaging group (median, 4740/uL vs. 5130/uL; p = 0.013). Multivariate analysis showed that histological grade, circumferential extent, and post-CRT leukocyte count were related to tumor downstaging. In addition, histological grade, post-CRT leukocyte count, and tumor downstaging were related to disease-free survival. The 5-year disease-free survival and overall survival in patients with post-CRT leukocyte count ${\leq}3730/uL$, which is the cut-off value derived from the receiver operation characteristic (ROC) curve analysis, were significantly higher than those with higher counts (88.0% vs. 71.6%, p = 0.001; 94.4% vs. 84.1%, p = 0.024). Conclusion: Post-CRT leukocyte count of ${\leq}3730/uL$ could be regarded as a good prognostic factor for tumor response and survival in rectal cancer patients treated with preoperative CRT.

• Women's Health Nursing
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• v.2 no.1
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• pp.138-157
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• 1996

Recently, there has been increase perception of health promotion with development of the economic state and science. Individual's responsibility and psychosocial factors have impacted on the individual's lifestyle. Health promotion can be maintained or improved through changes of lifestyle of individuals. Also, there has been supported results of health behavior health has been focused on menopausal symptom and reproductive organ. Until recently, little research has been available on the health or health care of midlife women. The purpose of this study was to explain relationship between health promoting lifestyle and hardiness, gender role characteristics. A total of 254 items of data were obtained from randomly selected subjects. The data collected from the interviews were analyzed using SPSS, yielding frequency, mean. t-test, ANOVA, Pearson Correlation, Stepwise multiple regression. The result of this study are as follows : 1) For the health promoting lifestyle, the mean score was 116.3, the highest score was nutrition(3.30) and interpersonal support(2.86), the lowest score was exercise(1.68). The highest subscale for the hardiness was committment(2.44). Also for the gender role characteristics was higher than median score(37.8). 2) There was a statistically difference the demographic variables. A total health promotion lifestyle was predicted by income and marriage satisfaction, hardiness was predicted by education, income, marriage satisfaction, support person and gender role characteristics was predicted by education. 3) With regard to the relationship among health promoting lifestyle, hardiness, gender role characteristics, the correlation coefficient between health promoting lifestyle and hardiness was r=-.48, p<.001. Also there were significant correlation between health promoting lifestyle and gender role characteristics(r=.22, p<.01), hardiness and gender role characteristics(r=-.39, p<.001). 4) A stepwise multiple regression analysis was done on the total health promoting lifestyle score using the demographic variables, hardiness subscale and gender role characteristics for independent variables. A total of 25% of the variance was explained inthe total health promoting lifestyle by the control, challenge and marriage satisfaction. In conclusion, hardiness and gender role characteristics were engaged in health promoting activity in midlife women. This study also provides new information about the health practices that midlife women report they practice. Therefore, nursing intervention to increase women's health have to be planed program that consider on the basis the results of this study.

• Journal of Environmental Health Sciences
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• v.37 no.6
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• pp.440-449
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• 2011

Objectives: This study was designed to determine the levels of polybrominated diphenyl ethers (PBDEs) in breast milk and to evaluate the relations with factors affecting these levels. Methods: The congener levels of PBDE in 22 samples of breast milk were analyzed using a high resolution gas chromatograph with a high resolution mass detector. In accordance with our standard operating procedures, the recoveries of internal standards had to range between 68% and 118%. Since the distribution of PBDE concentrations is close to log-normal, the data were logarithmically transformed before analysis. Test subjects were healthy primipara and multipara mothers with a mean age of 32 (SD = 2.7) in 2006. Results: Seven PBDE congeners (BDE-28, 47, 99, 100, 153, 154, and 183) were detected and identified in all of the pooled breast milk samples, indicating widespread contamination from PBDEs in the environment in Korea. Residue levels of total PBDEs (sum PBDEs from tri- to hepta-BDE) ranged from 0.84-13.1 ng/g lipid with median and geometric mean levels of 2.6 ng/g lipid and 2.74 ng/g lipid, respectively. PBDE congeners 47, 99 and 153 markedly predominated and accounted for about 75% of the amount of the PBDE congeners analyzed. BDE-47 was the dominant congener in most samples, whereas BDE-153 was predominant in a few (n = 7/22). BDE-47 was highly correlated with total PBDEs (r = 0.987, p < 0.01). In analyses of the differences of the means of log transformed breast milk PBDE levels for groups of potential covariates, only breast milk BDE-47 and BDE-99 levels were significantly associated with fish (p < 0.05) and meat consumption (p < 0.01). However, we did not find significant correlations between PBDE levels and maternal age, body mass index (BMI), parity, job presence and smoking status. Conclusions: Our findings are mainly limited due to the small sampling size and low doses of PBDEs exposure. Background and human exposure data of PBDEs is lacking, and longitudinal investigations into the environment and biota are encouraged to determine the health impact on future populations in Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2419-2423
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• 2015

Background: There are few choices for treatment of advanced cancer patients who do not respond to or tolerate conventional anti-cancer treatments. Therefore this study aimed to deploy the benefits and clinical efficacy of continuous dendritic cell-cytokine induced killer cell infusions in such patients. Materials and Methods: A total of 381 infusions (from 67 advanced cases recruited) were included in this study. All patients underwent peripheral blood mononuclear cell apheresis for the following cellular therapy and dendritic cells-cytokine induced killer cells were expanded in vitro. Peripheral blood T lymphocyte subsets were quantified through flow cytometry to address the cellular immunity status. Clinical efficacy and physical activities were evaluated by RECIST criteria and Eastern Cooperative Oncology Group scores respectively. Logistic regression model was used to estimate the association between cellular infusions and clinical benefits. Results: An average of $5.7{\pm}2.94{\times}10^9$ induced cells were infused each time and patients were exposed to 6 infusions. Cellular immunity was improved in that cytotoxic $CD8^+CD28^+$ T lymphocytes were increased by 74% and suppressive $CD8^+CD28^-$ T lymphocytes were elevated by 16% (p<0.05). Continuous infusion of dendritic cells-cytokine induced killer cells was associated with improvement of both patient status and cellular immunity. A median of six infusions were capable of reducing risk of progression by 70% (95%CI 0.10-0.91). Every elevation of one ECOG score corresponded to a 3.90-fold higher progression risk (p<0.05) and 1% increase of $CD8^+CD28^-$ T cell proportion reflecting a 5% higher risk of progression (p<0.05). Conclusions: In advanced cancer patients, continuous dendritic cell-cytokine induced killer cell infusions are capable of recovering cellular immunity, improving patient status and quality of life in those who are unresponsive to conventional cancer treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7101-7106
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• 2013

Background: The prognosis of patients with hepatocellular carcinoma (HCC) after curative resection varies greatly. Few studies had investigated the risk factors for early recurrence (recurrence-free time ${\leq}$ 1 year) of hepatitis B virus (HBV)-related HCCs meeting Milan criteria. Methods: A retrospective analysis was performed on the 224 patients with HCC meeting Milan criteria who underwent curative liver resection in our center between February 2007 and March 2012. The overall survival (OS) rate, recurrence-free survival (RFS) rate and risk factors for early recurrence were analyzed. Results: After a median follow-up of 33.3 months, HCC reoccurred in 105 of 224 patients and 32 died during the period. The 1-, 3- and 5-year OS rates were 97.3%, 81.6% and 75.6% respectively, and the 1-, 3- and 5-year RFS rates were 73.2%, 53.7% and 41.6%. Cox regression showed alpha-fetoprotein (AFP) > 800 ng/ml (HR 2.538, 95% CI 1.464-4.401, P=0.001), multiple tumors (HR 2.286, 95% CI 1.123-4.246, P=0.009) and microvascular invasion (HR 2.518, 95% CI 1.475-4.298, P=0.001) to be associated with early recurrence (recurrence-free time ${\leq}$ 1-year) of HCC meeting Milan criteria. Conclusions: AFP > 800 ng/ml, multiple tumors and microvascular invasion are independent risk factors affecting early postoperative recurrence of HCC. In addition resection appears capable of replacing liver transplantation in some situations with safety and a better outcome.