• 제목/요약/키워드: Patients with cancer

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Therapeutic Results of Radiotherapy in Nonsmall Cell Lung Cancers (비소세포성 폐암의 방사선치료 성적)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.72-81
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    • 1994
  • Total 55 patients with nonsmall cell lung cancer treated with radiation therapy at Department of Therapeutic Radiology, Yeungnam University Hospital, between May-1 1986 and April-30 1993 were retrospectively analyzed by clinical characteristics, failure patterns, follow up duration and survival ratio according to prognostic factors. Obtained results were as follows : 1. Male to female ratio was 17.3 2. Sixth and seventh decades were predominant age group. 3. The patients were 8 in stage I-II, 34 in stage IIIA, 13 in stage IIIb, respectively. 4. Forty five patients out of 55 were squamous cell carcinoma. 5. Primary tumor were originated from upper lobe bronchi predominantly. 6. The size of the primary tumor, lymph node involvement and the degree of differentiation were important in evaluation of prognosis. 7. In conclusion, for patients with poor prognostic factors systemic chemotherapy and multidisciplinary approach were recommended for better treatment outcome and improvement of survival.

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Is $^{99m}Tc$-MDP Mammoscintigraphy Useful in Patients with Breast Mass Lesions? ($^{99m}Tc$-MDP 유방 스캔은 유방 종괴의 감별진단에 임상적인 유용성이 있는가?)

  • Park, Seok-Gun;Lee, Yeon-Hee;Rhyu, Jin-Woo;You, Sun-Mee
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.2
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    • pp.151-160
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    • 1998
  • Purpose: Piccolo et al. advocated the usefulness of $^{99m}Tc$-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied $^{99m}Tc$-MDP uptake pattern and lesion/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of $^{99m}Tc$-MDP scan. Materials and Methods: Total 34 patients were studied with physical examination, mammo-gram and $^{99m}Tc$-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq $^{99m}Tc$-MDP. Breast uptake pattern of $^{99m}Tc$-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammogram. Results: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of $^{99m}Tc$-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 217, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. Conclusion: $^{99m}Tc$-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.

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The error analysis of field size variation in pelvis region by using immobilization device (고정기구의 사용이 골반부위 방사선조사영역의 변화에 미치는 오차분석)

  • Kim, Ki-Hwan;Kang, No-Hyun;Bim, Dong-Wuk;Kim, Jun-Sang;Jang, Ji-Young;Kim, Yong-Eun;Kim, Jae-Sung;Cho, Moon-June
    • Journal of Radiation Protection and Research
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    • v.25 no.1
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    • pp.31-36
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    • 2000
  • In radiotherapy, it may happen to radiate surrounding normal tissue because of inconsistent field size by changing patient position during treatment. We are going to analyze errors reduced by using immobilization device with Electonic portal imaging device(EPID) in this study. We had treated the twenty-one patients in pelvic region with 10 MV X-ray from Aug. 1998 to Aug. 1999 at Chungnam National University Hospital. All patients were treated at supine position during treatment. They were separated to two groups, 11 patients without device and 10 patients with immobilization device. We used styrofoam for immobilization device and measured the errors of anterior direction for x, y axis and lateral direction for z, y axis from simulation film to EPID image using matching technique. For no immobilization device group, the mean deviation values of x axis and y axis are 0.19 mm. 0.48 mm, respectively and the standard deviations of systematic deviation are 2.38 mm, 2.19 mm, respectively and of random deviation for x axis and y axis are 1.92 mm. 1.29 mm, respectively. The mean deviation values of z axis and y axis are -3.61 mm. 2.07 mm, respectively and the standard deviations of systematic deviation are 3.20 mm, 2.29 mm, respectively and of random deviation for z axis and y axis are 2.73 mm. 1.62 mm, respectively. For immobilization device group, the mean deviation values of x axis and y axis are 0.71 mm. -1.07 mm, respectively and the standard deviations of systematic deviation are 1.80 mm, 2.26 mm, respectively and of random deviation for x axis and y axis are 1.56 mm. 1.27 mm, respectively. The mean deviation values of z axis and y axis are -1.76 mm. 1.08 mm, respectively and the standard deviations of systematic deviation are 1.87 mm, 2.83 mm, respectively and of random deviation for x axis and y axis are 1.68 mm, 1.65 mm, respectively. Because of reducing random and systematic error using immobilization device, we had obtained good reproducibility of patient setup during treatment so that we recommend the use of immobilization device in pelvic region of radiation treatment.

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Nursing research issues and trends : views from Korea (우리나라 간호연구의 현황과 문제)

  • Oh, Kasil;Sin, Hee-Sun;Kim, Hee-Soon
    • The Korean Nurse
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    • v.31 no.3
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    • pp.76-87
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    • 1992
  • The purposes of study was: 1. To identify the direction and scope of research activities in Korean Nursing. 2. To discuss the unique problems present in Korea that warrant nursing research. 3. To delineate the factors that facilitate and/or hinder nursing research in Korea. This study was conducted at six colleges of nursing in Korea. The schools which were selected had doctoral programs at the time, the data were collected in 1990. Four of the schools were located in the metropolitan area of the capital city, Seoul, and two were in two other cities similar in size. The total population of the study was 283 nurses. The instrument for the research was the English version of Research Profile Questionnaire which was translated into Korean by the researchers and was validated in its translation by two professors. A pretest procedure was done before the data collection process. Of the population of 283, 210 subjects received the questionnaire and 150 subjects responded(71.4%). Excluding incomplete questionnaires, 141 questionnaires were utilized for data analysis. Data were analyzed using descriptive statistics. Responses to open-ended questions were content analyzed for themes and categories. Results of the study were as follows : Respondents currently , involved in nursing research numbered 108(76.6%), but 33(23.4%) did not have any research experience. The inexperienced respondenLs tended to be younger than the experienced subjects and most( 60.6%) were employed in hospitals, while 82.4 percent of the experienced nurses were employed in nursing schools. Among the respondents with research experience, 68.5 percent were involved in one to three projects and 31.5 percent were engaged in four or more projects. The experienced nurses indicated that nursing research in Korea is active. On the other hand, the responses of the inexperienced were that nursing research is not active. The most frequently selected research subjects were patients(76.9%, 83 respondents) followed by nurses, healthy persons and nursing students. The relatively high percentage of healthy persons as study subjects, could be explained as a concern of nurses for healthy persons as well as for ill patients. The aforememioned literature review showed a dramatic change in the kinds of study subjects; approximately 33 percent were patients but 25 percent were healthy subjects of various ages. The hospital was the prevailing research setting(67.6%) but at the same time various community settings were used. This is a changing phenomena in nursing research of Korea. Current research designed to build on previous studies amounted to 75 percent; about 39.8 percem were theory and hypothesis generated. Over 65 recommended additional research focusing on hypothesis-testing 0:' theory building. The previously quoted literature review found that only 4.0 percent of the study quescions were developed from a theoretical framework. The most frequently listed current major focus of nursmg research was stress and adaptation. Patients with cancer, pain, social support and care of the elderly were the next most frequently reported. These concerns may reflect problems associated with a technological and industrializing societyl. The most frequently identified problem was lack of clinical research. The need for replication research and research that contributes to the accumulation of nursing knowledge were found to be rare in Korean research. A need for theory testing and theory construction research was also identified. Although advanced statistical methods were often utilized in nursing research, the results were frequently considered by the interviewers not to be applicable in practice, and readers had difficulty in comprehending the findings. Even though the number of clinical nurses involved in research is increasing, it is still considered inadequate. Among 108 respondents, 83(76.9%) gave lack of time as a barrier to conducting nursing research. Over fifty percent of the respondents reported lack of funding or, personally, low confidence in research skills as barriers. The respondents offered 183 suggestions for future emphasis in nursing research. Among the 51 areas of emphasis, clinical research received the highest number and nursing intervention was next. The findings suggested that nursing research should be based on theory, be related to practice and relevant to the situation of a unique Korean culture.

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Association of total dietary antioxidant capacity with oxidative stress and metabolic markers among patients with metabolic syndrome (대사증후군 환자 및 위험군의 식사 내 총 항산화능과 산화스트레스 및 대사 지표의 연관성)

  • Ham, Dongwoo;Jun, Shinyoung;Kang, Minji;Shin, Sangah;Wie, Gyung-Ah;Baik, Hyun Wook;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.50 no.3
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    • pp.246-256
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    • 2017
  • Purpose: This study aimed to investigate the association of total dietary antioxidant capacity (TAC) with oxidative stress and metabolic markers among patients with metabolic syndrome according to gender. Methods: A total of 346 subjects aged 30~59 years with two or more risk factors of metabolic syndrome were recruited from a general hospital near Seoul in South Korea between 2010 and 2012 based on data from the medical checkup. Biochemical indices for oxidative stress and metabolic markers were measured. Food consumption data from 3-day food records were linked with the antioxidant capacity database for commonly consumed Korean foods to estimate individual's TAC. Results: Average dietary TAC of the study subjects was 132.0 mg VCE/d/1,000 kcal in men and 196.4 mg VCE/d/1,000 kcal in women. Levels of ${\gamma}$-glutamyltransferase (GGT), systolic blood pressure, diastolic blood pressure, and blood triglycerides were reduced significantly according to increasing TAC in men, but there was no significant trend in women. Intakes of total flavonoids and carotenoids were significantly negatively correlated with GGT (p < 0.05) and d-ROMs (p < 0.01) in men, whereas those of ${\alpha}$-tocopherol (p < 0.05) and ${\gamma}$-tocopherol (p < 0.05) were positively correlated with biological antioxidant potential (BAP) in women. The odds ratio of high oxidative stress indices and abnormal metabolic markers according to TAC level were not significant in either men or women. Conclusion: The results show that dietary TAC was partially associated with oxidative stress and metabolic markers among patients with metabolic syndrome. Further research is required for elucidating the association between dietary TAC and incidence of metabolic syndrome and chronic diseases within a large population in prospective studies.

Clinical Features of Pulmonary Tuberculosis In The Elderly (노인 폐결핵의 임상적 특정)

  • Lee, Jae-Ho;HwangBo, Bin;Yoo, Chul-Gyu;Lee, Chun-Taek;Kim, Yeong-Hwan;Han, Sung-Koo;Shim, Young-Soo;Chung, Hee-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.334-345
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    • 2001
  • Background : Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). Methods : The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. Results : Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT > $37^{\circ}C$, 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. Conclusion : Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.

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Clinical Appilication of Endobornchial Cryoablation That's Performed through Flexible Bronchoscope for Treating Tracheobronchial Ostruction (기관 및 기관지 폐색환자에서 굴곡형 기관지내시경을 이용한 냉동수술의 임상적용)

  • Lee, Sung-Ho;Kim, Kwang-Taik;Chung, Jae-Ho;Chung, Won-Jae;Kang, Moon-Chul;Kang, Eun-Hae;Lee, Eun-Joo;In, Kwang-Ho
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.457-462
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    • 2008
  • Background: Emergency airway access is essential when a patient has dyspnea that's due to tracheal or bronchial obstruction. Such methods as laser therapy and PDT are now being used for the treatment of tracheal obstruction that's due to benign diseases or nonsurgical malignant diseases. Cryotherapy is a method that uses extreme hypothermia for freezing a tumor to cause necrosis. In this study, we have evaluated the clinical effectiveness of performing endobronchial cryoablation through a flexible bronchoscope. Material and Method: 10 patients with tracheal obstruction that was due to endotracheal tumors were evaluated between May 2005 and May 2007. Eight were male and the mean age of the 10 patients was $59.4{\pm}18.4$ years. Three cases of tracheal obstruction were due to benign tumors and 7 were due to malignant tumors. The obstruction sites were 3 at the trachea, 3 at the carina and 4 at the bronchus. A flexible bronchoscope was inserted and the tumor was eliminated using a flexible cryoprobe. Follow up bronchoscopy was performed at 1 week and 1 month after cryoablation, and then we evaluated the decrease of dyspnea, the improvement of the performance and the complications of the procedures. Result: Complete remission was achieved in 4 patients and partial remission was achieved in 6 patients. Complications such as hemoptysis (100%), and cough (50%) were noted. Hemoptysis was spontaneously resolved in 3 to 8 days (mean: 4.9 days). A decrease in dyspnea and improvement in the performance was noted in all patients. Conclusion: Endobronchial stenosis plays a detrimental role in the life quality of a terminal cancer patient. Due to its simplicity and effectiveness for controlling bleeding, endobronchial cryoablation is considered to be a safe method that is clinically applicable to a wide range of tumors, including the removal of large tumors. We concluded that endobronchial cryoablation through a flexible bronchoscope is a safe, effective method for treating tracheobroncheal obstructions.

Hyperthyroidism Caused by a Mutation in the Thyrotropin Receptor Gene in Two Brothers (형제에서 발생한 갑상선 자극호르몬 수용체 유전자 돌연변이에 의한 갑상선 항진증 2례)

  • Kim, Jae Hyun;Lee, Sung Soo;Lim, Jung Sup;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.337-341
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    • 2005
  • Thyrotropin receptor(TSHR) mutations must be considered when congenital hyperthyroidism has persisted, but there has been no evidence for autoimmunity. TSHR mutations leading to constitutive activation of the thyroid gland were identified as the molecular cause of autosomal dominant nonautoimmune hyperthyroidism and sporadic congenital hyperthyroidism. We report two cases of hyperthyroidism caused by germline TSHR mutation who presented with exessive sweating and no evidence of autoimmune thyroid disease. They were brothers and their mother had undergone thyroidectomy because of hyperthyroidism. Direct sequencing of the polymerase chain reaction-amplified exon 10 of the TSHR genomic DNA revealed a transition of GCT to GTT, resulting in an exchange of alanine 627 to valine in the patients and their mother. This might be a novel mutation or polymorphism, but we did not perform any functional gene study. But considering the clinical profiles, we can conclude that hyperthyroidism of these two brothers might come from the point mutation described above.

Inhibitory Effect of Artemisiae Annuae Herba Extracts on Melanin Synthesis, Tyrosinase Activities and Production Levels of Tyrosinase, MMP-1 and MMP-9 in SK-MEL-2 Cells (SK-MEL-2 세포에서 청호(靑蒿) 추출물의 Melanin 생성, Tyrosinase 활성과 생성, MMP-1 및 MMP-9 생성 억제 효과)

  • Lee, Eun-Kyu;Kim, Soo-Hyeon;Park, Kyung-Mi;Yang, Seung-Jeong;Cho, Seong-Hee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.2
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    • pp.37-48
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    • 2017
  • Objectives: Artemisiae Annuae Herba is the dried aerial part of Artemisia annua L. (AAL). In Oriental medicine, Artemisiae Annuae Herba (AAH) is traditionally used to treat fever. AAH clears summerheat or damp-Heat, clears deficiency fevers, cools the blood and stops bleeding, stops malarial disorders and relieves heat, clears liver heat and brightens the eyes. Recently, there were many studies about effects of AAH on anti-oxidative, anti-inflammatory, anti-cancer, hair growth and plasma lipid composition. So, we expected AAH has an availability that can effect on skin whitening and elasticity. Methods: The present study was designed to investigate the effects of AAH on skin whitening and elasticity in SK-MEL-2 cells. In this experiment, the effects of AAH on proliferation rates, melanin synthesis, tyrosinase activities and production levels of tyrosinase, MMP-1 and MMP-9 in vitro were examined. Results: AAH did not affect viability of SK-MEL-2 cells and inhibited melanin synthesis induced by ${\alpha}$-Melanocyte-stimulating hormone (${\alpha}$-MSH) significantly. In addition, AAH also inhibited tyrosinase activity and lowered tyrosinase level in SK-MEL-2 cells. Finally, AAH inhibited productions of Matrix metalloproteinase-1 (MMP-1) and Matrix metalloproteinase-9 (MMP-9). Conclusions: These data suggest that AAH can be used to treat patients with skin diseases such as freckled face and also used as skin whitening agent.

A Case of Chronic Necrotizing Pulmonary Aspergillosis Obscured by Cavitary Pulmonary Tuberculosis (공동성 폐결핵으로 오인된 만성 괴사성 폐 아스페르길루스증 1예)

  • Min, Joo-Won;Yoon, Young Soon;Park, Jong Sun;Kim, Hye-Ryoun;Rhee, Ji young;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yim, Jae-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.368-371
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    • 2007
  • Pulmonary cavities are caused by bacterial pneumonia, fungal diseases, lung cancer, and tuberculosis (TB). However, in Korea, patients with cavitary lung lesions are generally considered to have pulmonary TB, where the incidence of TB is approximately 70/100,000 per year. We report a case of chronic necrotizing pulmonary aspergillosis that was obscured by multidrug-resistant pulmonary TB.