• 제목/요약/키워드: Poor-grade

검색결과 511건 처리시간 0.027초

Prognostic Factors and Treatment Outcomes in 93 Patients with Uterine Sarcoma from 4 Centers in Turkey

  • Durnali, Ayse;Tokluoglu, Saadet;Ozdemir, Nuriye;Inanc, Mevlude;Alkis, Necati;Zengin, Nurullah;Sonmez, Ozlem Uysal;Kucukoner, Mehmet;Anatolian Society of Medical Oncology (ASMO), Anatolian Society of Medical Oncology (ASMO)
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.1935-1941
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    • 2012
  • Introduction: Uterine sarcomas are a group of heterogenous and rare malignancies of the female genital tract and there is a lack of consensus on prognostic factors and optimal treatment. Objective and Methodology: To perform a retrospective evaluation of clinicopathological characteristics, prognostic factors and treatment outcomes of 93 patients with uterine sarcomas who were diagnosed and treated at 4 different centers from November 2000 to October 2010. Results: Of the 93 patients, 58.0% had leiomyosarcomas, 26.9% malignant mixed Mullerian tumors, 9.7% endometrial stromal sarcomas, and 5.4% other histological types. According to the last International Federation of Gynecology and Obstetrics (FIGO) staging, 43.0% were stage I, 20.4% were stage II, 22.6% were stage III and 14.0 % were stage IV. Median relapse free survival (RFS) was 20 months (95% confidence interval (CI), 12.4-27.6 months), RFS after 1, 2, 5 years were 66.6%, 44.1%, 16.5% respectively. Median overall survival (OS) was 56 months (95% CI, 22.5-89.5 months), and OS after 1, 2, 5 years was 84.7%, 78%, 49.4% respectively. Multivariate analysis showed that age ${\geq}60$ years and high grade tumor were significantly associated with poor OS and RFS; patients administered adjuvant treatment with sequential chemotherapy and radiotherapy had longer RFS time. Among patients with leiomyosarcoma, in addition to age and grade, adjuvant treatment with sequential chemotherapy and radiotherapy after surgery had significant effects on OS. Conclusion: Uterine sarcomas have poor progrosis even at early stages. Prognostic factors affecting OS were found to be age and grade.

자궁경부암의 외부방사선 치료 성적 (Carcinoma of the Uterine Cervix Treated with External Beam Irradiation Alone)

  • 김미숙;하성환
    • Radiation Oncology Journal
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    • 제11권2호
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    • pp.363-367
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    • 1993
  • 자궁경부암의 방사선 치료중 외부방사선조사로만 치료한 환자에서 생존율, 합병증, 예후인자를 알아보기 위하여 본 연구를 시행하였다. 1979년 3월부터 1988년 12월까지 서울대학교병원 치료방사선과에서 근치적 방사선 치료를 시행받은 총 650명의 자궁경부암 환자 중 외부방사선 조사만 시행한 42명을 대상으로 후향적 분석을 실시하였다. 방사선치료는 45 Gy내지 50 Gy의 전골반 조사후 3 내지 2 조사야를 사용한 축소야로 12 Gy에서 22 Gy의 추가조사를 시행하였다. 외부방사선조사만 시행한 이유는 심한 종양괴사로 인한 경우 25예, vaginal vault가 좁은 경우 5예, 외부방사선 치료 중 자궁강의 파열 1예등 강내조사용기구삽입이 불가능한 경우(poor geometry) 31명, 내과적 문제 5명, 고령 2명, 환자의 거부 2명, 장관 유착과 골반질환이 각각 1명이었다. FIGO병기 IB, IIA, IIB, IIIA, IIIB, IVA의 환자수는 각각 1명, 3명, 12명, 1명, 20명, 5명이었다. 병기 IIA, IIB, IIIB, IVA에 따른 5년 국소치유율은 각각 $66.7\%,\;38.9\%,\;27.0\%,\;20.0\%$이었고 5년 생존률은 각각 $66.7\%,\;36.4\%,\;32.8\%,\;25.0\%$으며 1명씩의 IB와 IIIA의 환자는 무병생존했다. 방사선 치료가 끝난 후 치료반응 판정에서 완전관해와 부분관해를 보인 환자군이 그렇지 않은 환자군보다 5년 국소치유율은 의미있게 높았으나 $(45.3\%\;vs\;17.8\%\;p=0.04)$ 5년 생존률의 의미있는 차이는 없었다$(43.5\%\;vs\;23.1\%\;p=0.17)$. 방사선 치료후 1개월에서 완전관해와 부분관해를 보인 환자군은 그렇지 않은 환자군보다 5년 국소치유율 $(53.8\%\;vs\;0\%\;p=0.0002)$과 5년 생존률$(51.3\%\;vs\;1.0\% \;p=0.001)$이 의미있게 높았다. Grade 2와 Grade 3의 합병증은 각각 $12\%$$10\%$였다. 진행된 경우일수록 합병증의 빈도가 증가하는 경향이었다. 따라서 자궁경부암 환자의 방사선 치료에 가장 적합한 방법은 외부조사와 강내 치료를 병행하는 것이나 강내 치료가 불가능한 환자군에 대해서는 적극적 수술방법의 도입을 고려해야하겠다.

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Rapid Loc 기기를 이용한 관절경적 반월상 연골판 봉합술 (Arthroscopic Meniscal Repair with Rapid Loc Device)

  • 권덕주;이기병;정웅교;이병택;박상욱
    • 대한관절경학회지
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    • 제9권2호
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    • pp.180-185
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    • 2005
  • 목적: 본 논문의 목적은 Rapid Loc 기기를 이용한 관절경적 연골판 봉합술의 임상적, 방사선학적 결과를 평가하고자 하였다. 대상 및 방법: 44례를 대상으로 후향적으로 결과를 분석하였다. 퇴행성 병변이 동반되지 않은 단순 종파열로 진단되어 관절내시경하에서 Rapid Loc 기기를 이용하여 연골판을 봉합한후 평균 6개월이상의 추시가 가능하였던 환자 군을 대상으로 하였다. Orthopaedische Arbeitsgemeinschaft Knie (OAK) 평가 지표와 자기 공명 영상 촬영을 이용하여 임상적 방사선학적 결과를 평가하였다. 관절연 압통, 관절내 부종, McMurray 검사에서 양성인 경우는 임상적 실패로 간주하였다. 결과: 평균 연령은 33.4세 평균 추시기간은 15개월이었다. 임상결과는 우수 15례(34.1%), 좋음 20례 (45.5%), 양호 7례(15.9%), 불량 2례(4.5%) 였다. MRI상 Reicher 분류를 이용한 방사선학적 평가에서 grade 1 15례(33.3%), grade II 21례(50%), grade III 7례(16.7%)였으며, 임상적 실패는 8례(18%)였다. 술후 합병증은 1례에서 발생되었다. 결론: Rapid Loc 기기는 연골판 봉합술에 있어서 매우 우수한 결과를 보였으며, 삽입물이 유연하여 연골 손상이 적고, 사용이 간편하고 파열 부위의 압박 정도를 조절 할 수 있는 등 많은 장점이 있는 기법이라 사료된다.

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족근통(足根通)에 봉약침료법(蜂藥針療法)이 미치는 영향(影響) (The Effect of Bee-venom Acupuncture on Heel Pain)

  • 안광현;김기현;황현서;송호섭;권순정;이성노;변임정;강미숙
    • Journal of Acupuncture Research
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    • 제19권5호
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    • pp.149-160
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    • 2002
  • Objetive : To evaluate the effect of treatment for Heel Pain by using Bee-venom Acupuncture that is well known for anti-inflamatory effect and function of activating immunine system. Methods : We investigated 32 cases of patient with Heel Pain. From 1th November 2001 to 30th June 2002, 32 cases of patient with Heel Pain treated at the Department of Acupuncture & Moxibustion of Kyung-won University Oriental Hospital were selected for two group. One group was treated by Bee-venom Acupuncture therapy (Bee-venom Acupuncture Group : BAG), the other group was treated by Common Acupuncture therapy (None Bee-venom Acupuncture Group : NBAG). Both group were composed of 16 patients. After treatment, we evaluated the effects per each group. Results : 1. In the distribution by sex & age : 5 cases were male, 11 cases were female in BAG. 10 cases were male, 6 cases were female in NBGA. Forty aged cases were the most in BAG. Thirty aged cases were the most in NBAG. 2. Assessment of treatment by therapeutic frequency : 14 cases(87.5%) were above "Fair" within 6 times in BAG, 7 cases(43.8%) were above "Fair" beyond 10 times. 3. Assessment of treatment : Excellent were 9 cases, Good 5 cases, Fair 2 cases in BAG, Excellent were 2 cases, Good 7 cases, Fair 2 cases, Poor 5 cases in NBAG. Therapeutic effect above "Fair" were 16 cases(100%) in BAG, 11 cases(68.8%) in NBAG. 4. Comparing BAG with NBAG by therapeutic frequency and assessment in Grade II state : 11 cases(91.7%) were above "Good" within 6 times in BGA, 3 cases (57.1%) above "Fair" beyond 10 times. 5. About average frequency of treatment in the distribution of Grade : Grade III was 5.3 times, Grade II 4.0 times in BGA, whereas Grade III 16.0 times, Grade II 8.4 times in NBGA. Conclusions : In the treatment of Heel Pain, the Bee-venom Acupuncture can be regarded as more useful method in the clinical practice, because it has comparatively shorter duration of treatment and is more effective.

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Conventional Radiotherapy with Concurrent Weekly Cisplatin in Locally Advanced Head and Neck Cancers of Squamous Cell Origin - a Single Institution Experience

  • Dimri, Kislay;Pandey, Awadhesh Kumar;Trehan, Romeeta;Rai, Bhavana;Kumar, Anup
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6883-6888
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    • 2013
  • Background: Platinum based concurrent chemo-radiation is the de-facto standard of care in the non-surgical management of locally-advanced head and neck cancer of squamous origin. Three-weekly single agent cisplatin at 100 $mg/m^2$ concurrent with radical radiotherapy has demonstrated consistent improvement in loco-regional control and survival. This improvement is however at the cost of considerable hematologic toxicity and poor overall compliance. The routine use of this regime is improbable in developing countries with limited resources. We therefore aimed to determine the safety and efficacy of an alternative regime of weekly cisplatin and concurrent radiotherapy in such patients. Materials and Methods: January-05 and April-12, 188 patients of locally-advanced head and neck cancer of squamous origin were treated with concurrent weekly-cisplatin at $35mg/m^2$ and conventional radiotherapy 60-66Gy/30-33 fractions/5days per week. Results: Overall, 95% patients received planned doses of RT while 74% completed within the stipulated overall treatment time of <50 days. Eighty-two percent received at-least 5 weekly cycles. Grade-III/IV mucositis was seen in 58%/9% respectively, which resulted in mean weight loss of 9.2% from a pre-treatment mean of 54.5 kg. Grade-III hematologic toxicity-0.5%; grade II nephrotoxicity-2.5% and grade III emesis-3% were also seen. Grade-III/IV subcutaneous toxicity-10%/1% and grade-III/IV xerostomia-10%/0% were observed. Complete responses at the primary site, regional nodes and overall disease were seen in 86%, 89% and 83% patients respectively. The median and 5-years disease-free survival were 26 months and 39.4% respectively, while the median and overall survival were 27 months and 41.8% respectively. Conclusions: Weekly-cisplatin at 35 $mg/m^2$ when delivered concurrently with conventional radical RT (at-least 66y/33 fractions) in locally-advanced head and neck cancer is well tolerated with minimal hematologic and neprologic toxicity and can be routinely delivered on an out-patient basis. It is an effective alternative to the standard 3-weekly cisplatin especially in the context of developing countries.

건축물 안전등급 산출을 위한 외관 조사 상태 평가 데이터 기반 DNN 모델 구축 (Development of a Building Safety Grade Calculation DNN Model based on Exterior Inspection Status Evaluation Data)

  • 이재민;김상용;김승호
    • 한국건축시공학회지
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    • 제21권6호
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    • pp.665-676
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    • 2021
  • 노후 건축물의 수가 증가함에 따라, 건물의 안전진단, 유지 보수에 대한 중요성이 증가하고 있다. 기존 외관 조사는 점검자의 주관적인 판단이 수반되어 평가 결과가 다르고 객관성과 신뢰성이 떨어진다. 따라서 본 연구는 기존 연구를 통해 기실시된 외관 조사 및 상태 평가 프로세스의 한계를 제시하였으며, UAV, Laser Scanner를 통해 3D Point Cloud 데이터를 수집하였다. 또한, Reverse Engineering 기술을 이용하여 3D 모델을 생성한 후 객관적인 상태평가 데이터를 취득하였다. 이후 기존의 정밀검사 데이터와 정밀 안전진단 데이터를 활용하여 DNN 구조를 생성하고, 고정밀도 측정 장치를 이용하여 얻은 상태평가 데이터를 적용하여 객관적인 건물안전등급을 산출하였다. 자동화된 프로세스는 20개의 노후된 건축물에 적용되며 동일 면적 건축물 기준 수작업으로 실시되는 안전진단의 시간에 비해 약 50% 감소하였다. 이후 본 연구에서는 안전등급 결과값과 기존값을 비교하여 안전등급 산출과정의 정확성을 검증하고 약 90%의 높은 정확도를 가진 DNN을 구축하였다. 이는 향후 노후 건물의 안전등급 산정의 신뢰성이 향상되고 비용과 시간을 절약해 경제성이 향상될 것으로 기대된다.

시력증진 프로그램이 초등학생의 시력에 미치는 효과 (Effects of vision care program for elementary school children)

  • 이정렬;유일영;이은숙
    • 보건교육건강증진학회지
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    • 제16권1호
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    • pp.137-148
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    • 1999
  • The necessity of school health promoting projects is well known to many researchers, however, there is a lack of research on the development of strategies for school health programs and the evaluation of the effectiveness of the programs. The results of our previous study in 1996 identified poor eyesight as one of the several health problems among elementary school children in urban areas. The main objective of this study is to develop, implement, and evaluate vision care for elementary school children. The research method utilized a quasi experimental design using non-equivalent group, pre-post comparison. The sample consisted of all second grade children in two elementary schools in Kyung-giProvince. In order to prevent a contamination effect of the vision care program, one school was selected as a control and the other school was selected as a treatment group. The experimental school had 467 children and the control school had 402 children. The visual acuity of children in both group was measured and a survey questionnaire was sent out to parents on the knowledge, attitude, and behavior related to vision care before the program was implemented. The children of the experimental school received the following programs; separate education on proper nutrition and care of eyesight for children and parents, daily eye exercises using video tape, and an essay and poster contest on healthy eyesight. The eye exercise program lasted from March, 1997 to November, 1997. On November, 1997, visual acuity was measured again from children in both schools. The data was analyzed by using SAS statistical package. The results indicate that the children in the experimental group had significantly (p〈0.001) better eyesight than the children in the control group. Also, some of the behavior highly related to the poor eyesight are poor maternal eyesight and watching TV from a short distance. In conclusion, one of the significance of this project is that the vision care program was developed after the need assessment. It will be encouraged in the future that more school health program should be developed after a need assessment. Also, inclusion of family members was important in health promoting projects within a school setting since healthy behavior needs to be reinforced at horne as well as at school.

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일부 중학생들의 자살생각 및 그의 관련요인 (Factors related to Suicide Ideation among Middle School Students)

  • 배상윤;윤현숙;조영채
    • 한국산학기술학회논문지
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    • 제16권1호
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    • pp.544-554
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    • 2015
  • 본 연구는 중학생들의 자살생각 및 그의 관련 요인간의 관련성을 파악하여 자살생각에 유의하게 영향을 미치는 요인들을 규명하고자 시도하였다. 조사대상은 경인 지역의 4개 중학교에서 임의로 선정된 재학생 975명으로 하였으며, 자료수집은 2013년 5월 1일부터 6월 30일까지의 기간 동안에 무기명 자기기입식 설문지(self-administrated questionnaire)를 통해 이루어졌다. 연구결과, 자살생각이 높은 위험 군으로는 여성 군, 흡연경험 군, 음주경험 군, 비만하다고 생각하는 군, 식사를 규칙적으로 하지 않는 군, 주관적 건강상태가 좋지 않다고 생각하는 군, 가정 분위기가 좋지 않은 군, 가정생활 만족도가 낮은 군, 학년이 낮은 군, 친구와 관계가 좋지 않은 군, 학교폭력을 경험한 군, 학교생활 만족도가 낮은 군, 절망감 수준이 높은 군, 사회심리적스트레스 수준이 높은 군, 우울수준이 높은 군이 선정되었다. 특히 이들 변수 중 절망감 수준은 자살생각에 크게 영향을 미치는 변수로 지적되었다.

High Expression of Forkhead Box Protein C2 is Related to Poor Prognosis in Human Gliomas

  • Wang, Yao-Wu;Yin, Chun-Li;Zhang, Hong-Yi;Hao, Jin-Min;Yang, Yue-Ye;Liao, Heng;Jiao, Bao-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권24호
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    • pp.10621-10625
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    • 2015
  • Background: Increasing evidence has indicated that high Forkhead box protein C2 (FOXC2) level is closely associated with the development, progression, and poor prognosis of a variety of tumors. However, the relationship between FOXC2 and the progression of human gliomas remains to be clarified. The aim of present study was to assess FOXC2 expression and to explore its contribution in human gliomas. Materials and Methods: Realtime quantitative PCR was performed to examine FOXC2 expression in 85 pairs of fresh frozen glioma tissues and corresponding non-neoplastic brain tissues. Associations of FOXC2 expression with clinicopathological factors and prognosis of glioma patients were statistically analyzed. Results: The relative mRNA expression of FOXC2 was significantly higher in glioma tissues than the corresponding non-neoplastic brain tissues (p<0.001). In addition, high FOXC2 expression was significantly associated with advanced pathological grade (P=0.005) and the low Karnofsky performance score (KPS) (p=0.003), correlating with poor survival (p<0.001). Furthermore, multivariate Cox regression analysis showed that high FOXC2 expression was an independent predictor of overall survival (p=0.006). Conclusions: FOXC2 may act as an oncogenic gene and represent a potential regulator of aggressive development and a candidate prognostic marker in human gliomas.

일개 치위생과 대학생의 인터넷 중독과 건강 관련성 (Relationship between internet addiction and health in dental hygiene students)

  • 강현주;이정화
    • 한국치위생학회지
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    • 제15권1호
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    • pp.91-99
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    • 2015
  • Objectives: The purpose of the study was to investigate the relationship between internet addiction and health in dental hygiene students. Methods: A self-reported questionnaire was completed by 216 dental hygiene students in Daegu from June 9 to 13, 2014. Data were analyzed by descriptive statistics, t-test, and ANOVA using SAS 9.2 program. The instruments included Korean internet addiction scale(K scale) and Korean version of the general health questionnaire. General characteristics consisted of grade, religion, residential types, economic condition, place of internet use, duration, purpose, and time of use. Physical characteristics consisted of subjective physical condition, smoking, alcohol drinking, exercise above twice per week, musculoskeletal disease, and location of physical symptoms. Psychiatric scale and 6 questions of physical characteristics were consulted by the statistician of preventive medicine department. Results: Internet users over 4 hours manifested the poor mental health, while those who uses internet under 2 hours showed good mental health(F = 1.41, p < 0.01). The students having good physical condition showed better mental health than those with poor physical condition(t = -2.81, p < 0.01). The students exercising at least twice a week showed better mental health than those who do not exercise(t = -3.10, p < 0.01). Those who having musculoskeletal symptoms showed higher index of internet addiction score than those who do not(t = 4.21, p < 0.01). Those who have no musculoskeletal symptoms tended to have better mental health than those who have musculoskeletal symptoms(t = 2.28, p < 0.05). The variables correlated to mental health were internet addiction, subjective physical condition, and exercise at least twice a week. The severity level of internet addiction leads to poor mental health(r = 0.26, p < 0.001). Conclusions: Internet addiction is closely related to mental health. So the students must know the danger of internet addiction. Proper health education is necessary for the prevention of addiction symptoms.