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Treatment Results in Anal Cancer : Non-operative Treatment Versus Operative Treatment (항문암의 치료성적 : 비수술적방법과 수술적방법의 결과 비교)

  • Chie Eui Kyu;Ha Sung Whan;Park Jae-Gahb;Bang Yung-Jue;Heo Dae Seog;Kim Noe Kyeong
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.62-67
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    • 2002
  • Purpose : This study was undertaken to analyze the efficacy and sphincter preservation rate of platinum based neoadjuvant chemotherapy Plus radiotherapy versus abdominoperineal resection and Postoperative radiotherapy for anal cancer. Materials and Methods : Data of forty-two patients with anal cancer were retrospectively analyzed. Among thirty-eight patients with epidermoid histology, four patients received radiotherapy, and nineteen patients received abdominoperineal resection and adjuvant radiotherapy with or without chemotherapy $(APR+RT{\pm}CT)$, and fifteen patients received neoadjuvant chemotherapy and radiotherapy (CRT). The CRT regimen was composed of three cycles of 5-fluorouracil $(1,000\;mg/m^2\;bolus\;on\;D1\~5)$ and cisplatin $(60\;mg/m^2\;bolus\;on\;D1)$ followed by 50.4 Gy to the tumor bed and regional lymphatics over 5.5 weeks. Both inguinal lymphatics were treated with an identical dose schedule. Residual disease was treated with an additional three cycles of identical adjuvant chemotherapy. An identical dose schedule was used for post-operative radiotherapy. Median follow-up period was eighty-five months. Results : Overall five-year survival rates were $80.3\%$, 88.9 and $79.4\%$ for entire patients, $APR+RT{\pm}CT$ group, and the CRT group, respectively. No significant difference was found between the two groups (p=0.49). Anus preservation rate for the CRT group was $86.7\%$. Age (0=0.0164) and performance status (p=0.0007) were found to be significant prognostic factors by univariate analysis. Age (p=0.0426), performance status (p=0.0008), and inguinal lymph node metastasis (e=0.0093) were statistically significant prognostic factors by multivariate analysis. No case of RTOG grade 3 complication or higher was reported. Conclusion : This and other recent studies have shown that combined chemotherapy plus radiotherapy for anal cancer results in a high rate of anal sphincter preservation as well as local control and survival. Furthermore, neoadjuvant use of chemotherapy with a cisplatin based regimen rather than a concurrent regimen may lead to a decrease in complications.

Effects of different sizes of Hydroxyapatite/$\beta$-Tricalcium phosphate particles on vertical bone augmentation (수직골 증대술에서 $\beta$-Tricalciumphosphate/Hydroxyapatite 골 이식재 입자 크기의 영향)

  • Huh, Jung-Bo;Jung, Dong-Hee;Kim, Ji-Sun;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.4
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    • pp.259-265
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    • 2010
  • Purpose: This study was aimed to evaluate the effect of different sizes of $\beta$-TCP/ HA particles on vertical bone augmentation using titanium mesh in the cranium of rabbits. Materials and methods: Six white rabbits weighing 5kg were used. Four circular grooves of 6mm diameter were made by trephine, and five small holes were drilled in the inner surface of each circular gooves. Different sizes of grafts (small 0.3 - 0.5 mm, medium 0.5 - 1.0, large 1.0 - 2.0 mm) were placed respectively in the experimental groups. Titanium mesh (height 3 mm, width 6 mm) was placed. After 8weeks healing period, the rabbits were euthanized, and the specimens were prepared for histological findings. New bone formation and remaining graft area were measured to calculate the ratio of areas occupying the inner space of titanium mesh. Mann-Whitney U-test and Wilcoxon signed rank-test were used for statistical analysis ($\alpha$ = .05). Results: The experimental groups with $\beta$-TCP/HA graft showed a significantly higher new bone formation (P = .003). Comparing different sizes of $\beta$-TCP/HA, there was no statistical difference in terms of new bone formation. The vertical bone formation (i.e. new bone and graft area) was significantly greater in $\beta$-TCP/HA groups (P = .001). In comparison between different sizes of $\beta$-TCP/HA, medium size group had significantly greater area than large particle size group (P = .039). Conclusion: The use of $\beta$-TCP/HA with titanium mesh showed a higher vertical bone formation, particularly the medium sized $\beta$-TCP/HA particles (0.5 - 1.0 mm) produced better results in vertical bone augmentation.

Stenotrophomonas maltophilia and Ventilator-Associated Pneumonia in Critically Ill Pediatric Patients: a Retrospective Analysis at a Single Center (소아 환자에서 Stenotrophomonas maltophilia와 인공 환기요법 관련 폐렴에 관한 연구)

  • Lee, Byung-Kee;Choi, Soo-Han;Kim, Soo Jin;Cho, Joong Bum;Ae, Hong;Yoo, So-young;Kim, Ji Hye;Lee, Nam Young;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.22 no.2
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    • pp.75-80
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    • 2015
  • Purpose: Ventilator-associated pneumonia (VAP) is a serious threat in critically ill pediatric patients. Data regarding Stenotrophomonas maltophilia VAP in pediatric population is limited. We evaluated the clinical data of S. maltophilia associated VAP in critically ill pediatric patients. Methods: A retrospective chart review was performed in pediatric patients 18 years old or younger who developed S. maltophilia associated VAP at Samsung Medical Center, Seoul Korea from January 2008 to December 2012. Results: A total of 31 patients were identified S. maltophilia associated VAP. Median age was 8 months (range, 0.5 month to 16.6 years) and 13 patients were male (40.6%). Underlying illnesses were cardiologic diseases (n=11, 34.4%), hematologic oncologic malignancies (n=7, 25%), neurologic diseases (n=4, 12.5%), pulmonary diseases (n=3, 9.4%), and others (n=4, 12.5%). The median duration of ventilator use before S. maltophilia VAP diagnosis was 14 days (range, 4-256 days). Overall mortality at 30 days was 12.5% (4/32). Conclusions: S. maltophilia should be also considered as a possible pathogen for VAP in critically ill pediatric patients. Empiric antibiotic choice should include agents that are active against S. maltophilia in patients who are deteriorating on broad spectrum beta-lactam antimicrobial agents.

Criteria of Evaluating Clothing and Web Service on Internet Shopping Mall Related to Consumer Involvement (인터넷 쇼핑몰 이용자의 소비자 관여에 따른 의류제품 및 웹 서비스 평가기준에 관한 연구)

  • Lee, Kyung-Hoon;Park, Jae-Ok
    • Journal of the Korean Society of Clothing and Textiles
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    • v.30 no.12 s.159
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    • pp.1747-1758
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    • 2006
  • Rapid development of the information technology has influenced on the changes in every sector of human environments. One prominent change in retail market is an increase of electronic stores, which has prompted practical and research interest in the product and store attributes that include consumer to purchase products from the electronic shopping. Therefore many marketers are paying much attention to the criteria of evaluating clothing and web service on internet shopping malls. The purpose of this study is to examine differences of clothing and web service criteria of consumer groups (High-Involvement & High-Ability, Low-Involvement & High-Ability, High-Involvement & Low-Ability, and Low-Involvement & Low-Ability) who are classified into consumer involvement and internet use ability. The subjects of this study were 305 people aged between 19 and 39s, living in Seoul and Gyeonggi-do area, and having experiences in buying products on the internet shopping. Statistical analyses used for this study were the frequency, percentage, factor analysis, ANOVA and Duncan test. The results of this study were as follows: Regarded on the criteria of evaluating clothing, the low different groups had significant differences in the esthetic, the quality performance and the extrinsic criterion. Both HIHA group and HILA group showed the similar results. They considered every criterion of evaluating clothing more important, compared with other groups. Regarded on the criteria of evaluating web service related to the low different groups, there were significant differences in the factors related to the shopping mall reliance, the product, the satisfaction after purchase, and the promotion and policy criterion. Both HIHA group and HILA group showed the similar results as well. They considered every criterion of evaluating web service more important, compared with other groups. In conclusion, HI groups perceive relatively more dangerous factors which can be occurred during internet shopping. Therefore, internet shopping malls need to provide clothing that can satisfy the HI groups as well as make efforts to remove the dangerous factors on the internet.

Validity and Reliability of the Korean Version of the Global Assessment of Recent Stress Scale (전반적인 스트레스평가 척도 한국판의 타당도 및 신뢰도)

  • Koh, Kyung-Bong;Park, Joong-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.201-211
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    • 2000
  • Objectives : The purpose of this study was to determine the validity and reliablity of the Korean version of the Global Assessment of Recent Stress(GARS) Scale developed for assessing the severity of current perceived stressors, and then to use the scale in clinical practice. Methods : The questionnaire was completed by 215 healthy subjects. A comparison was made regarding the perception of stressors among 242 patients(71 with anxiety disorder, 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Factor analysis was done using oblique rotation after maximum-likelihood factor analysis. Results : Factor analysis yielded 1 subscale. Reliability was computed by administering the GARS Scale to 69 healthy subjects during a 2-week interval. Test-retest reliability for 8 items and the total score was significantly high, ranging between 0.85-.95. Internal consistency was significant(Cronbach's a for 7 items : .86). Convergent validity was computed by correlating the 8 items and the total score with the total score of the stress response inventory(SRI), the perceived stress questionnaire(PSQ), and the somatization, anxiety, depression, hostility subscales and general indices of the symptom checklist-90-revised(SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the 8 item scores of the patient and control groups. Significant differences were found in area relevant to sickness or illness and the overill global area. The patients with anxiety disorder were significantly higher in area relevant to sickness or illness than the healthy group, whereas the patients with depressive disorder was significantly higher in the overall global score than healthy group. The depressive disorder group was the highest in overall global score of the GARS scale among 4 patient groups, and showed a significant higher scores in interpersonal relationship and overall global area than the psychosomatic disorder group. Conclusions : These results indicate that the Korean version of the GARS scale is highly reliable and valid, and that it can be utilized as an effective measure of perceived stressors for research in stress-related fields. It is suggested that depressive disorder patients are more likely to perceive recent stressors than psychosomatic disorder patients.

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Current status of meal and snack service in elementary care classes in Gyeonggi area (경기도 지역 초등돌봄교실의 급·간식 운영 현황)

  • Yang, Hee Soon;Park, Haeryun;Song, Kyunghee;Ahn, Yoonjin;Choi, Daeun;Jin, Juntai;Lee, Youngmi
    • Journal of Nutrition and Health
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    • v.51 no.3
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    • pp.264-274
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    • 2018
  • Purpose: This study aimed to investigate the current status of food service management in elementary care classes. Methods: A focus group interview with seven care class managers and a survey with 101 care class managers using a self-administered questionnaire in Gyeonggi province were conducted. Results: In the focus group interview, purchased meals and snacks were evaluated as low quality by the care class managers. Frequent use of frozen or processed food and products with low prices were also reported as problems. Care class managers were in charge of meal and snack planning without any guidelines or expert advices. The results of the survey show that most schools serve purchased snacks and meals. The average unit costs of one meal and snack were 4,062 and 1,463 Won, respectively. The average unit costs of snacks during semester (p = 0.015) and vacation (p = 0.039) were significantly lower in rural than urban areas. The percentages of schools that prepared nutrition standards for meal and snack planning in elementary care classes were only 7.4% and 10.9%, respectively. The meal menus were mostly provided by catering service companies, and the snack menus were planned mostly by the care class managers. Menu planning by the care class managers was more usual in rural than urban areas (p = 0.054 for meal planning and p = 0.008 for snack planning). Just 33.7% of schools introduced safety standards for food service in elementary care classes, and more than half of the respondents (56.4%) did not do a regular medical check-up. Only 33.7% of the respondents received education for food safety. Conclusion: These results show the necessity for establishment of detailed guidelines for food service in elementary care classes and for the introduction of a food safety and nutrition education program customized for care class managers.

Monitoring of the residues of some pesticides in mulberry leaves and their safety evaluation (뽕잎중 잔류농약의 monitoring 및 안전성 평가)

  • Lee, Jae-Koo;Kwon, Jeong-Wook;Ahn, Ki-Chang;Moon, Jae-Yu
    • The Korean Journal of Pesticide Science
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    • v.2 no.2
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    • pp.45-52
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    • 1998
  • In order to evaluate the safety of mulberry leaves for sericultural purpose to the contamination by pesticide residues, the analyses of dichlorvos, acephate, phenthoate, pyrazophos, deltamethrin, and cypermethrin were done for 24 samples collected in spring and fall over two consecutive years (1996 and 1997), each, from 8 provinces across the country, by selecting three representative farmhouses in each province. In spring samples of 1996, the residual amounts of dichlorvos, acephate, and phenthoate were $0.018{\sim}0.032$, $0.013{\sim}0.072$, and 0.051 ppm, respectively, whereas, pyrazophos was not detected, and the detection frequencies were 29, 58, and 4%, respectively. In fall samples, on the other hand, those of the above pesticides were $0.012{\sim}0.048$, $0.020{\sim}0.156$, and $0.018{\sim}0.050$ ppm, respectively, and pyrazophos was not detected either and the detection frequencies were 42, 17, and 13%, respectively. While in spring samples of 1997, the residual amounts of dichlorvos, acephate, and cypermethrin were $0.014{\sim}0.064$, $0.033{\sim}0.061$, and $0.019{\sim}0.068$ ppm, respectively, and deltamethrin was not detected. The detection frequencies were 75, 13, and 8%, respectively. In fall samples, on the other hand, those of the above pesticides were $0.013{\sim}0.062$, 0.015, and $0.009{\sim}0.013$ ppm, respectively, and deltamethrin was not detected either. The detection frequencies were 88, 4, and 17%, respectively. Almost all of the samples turned out to be non-toxic to silkworms, except that one sample (No. 10, spring 1997) contaminated by a high concentration of cypermethrin (0.068 ppm) was judged to do harm to silkworms. In the GC analyses, the selection of columns, the change in column temperature, and the use of MSD made the separation and identification of the vague compounds possible.

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A Study on the Necessary Number of Bolus Treatments in Radiotherapy after Modified Radical Mastectomy (변형 근치적 유방절제술 후 방사선치료에서 볼루스 적용횟수에 대한 고찰)

  • Hong, Chae-Seon;Kim, Jong-Sik;Kim, Young-Kon;Park, Young-Hwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.2
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    • pp.113-117
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    • 2006
  • Purpose: Post-mastectomy radiotherapy (PMR) is known to decrease loco-regional recurrence. Adequate skin and dermal dose are achieved by adding bolus. The more difficult clinical issue is determining the necessary number of bolus treatment, given the limits of normal skin tolerance. The aim of this study is to evaluate the necessary number of bolus treatment after PMR in patients with breast cancer. Materials and Methods: Four female breast cancer patients were included in the study. The median age was 53 years(range, $38{\sim}74$), tumor were left sided in 2 patients and right sided in 2patients. All patients were treated with postoperative radiotherapy after MRM. Radiotherapy was delivered to the chest wall (C.W) and supraclavicular lymph nodes (SCL) using 4 MV X-ray. The total dose was 50 Gy, in 2 Gy fractions (with 5 times a week). CT was peformed for treatment planning, treatment planning was peformed using $ADAC-Pinnacles^3$ (Phillips, USA) for all patients without and with bolus. Bolus treatment plans were generated using image tool (0.5 cm of thickness and 6 cm of width). Dose distribution was analyzed and the increased skin dose rate in the build-up region was computed and the skin dose using TLD-100 chips (Harshaw, USA) was measured. Results: No significant difference was found in dose distribution without and with bolus; C.W coverage was $95{\sim}100%$ of the prescribed dose in both. But, there was remarkable difference in the skin dose to the scar. The skin dose to the scar without and with bolus were $100{\sim}105%\;and\;50{\sim}75%$. The increased skin dose rates in the build-up region for Pt. 1, Pt. 2. Pt. 3 and Pt. 4 were 23.3%, 35.6%, 34.9%, and 41.7%. The results of measured skin dose using TLD-100 chips in the cases without and with bolus were 209.3 cGy and 161.1 cGy, 200 cGy and 150.2 cGy, 211.4 cGy and 160.5 cGy, 198.6 cGy and 155.5 cGy for Pt. 1, Pt. 2, Pt. 3, and Pt. 4. Conclusion: It was concludes through this analysis that the adequate number of bolus treatments is 50-60% of the treatment program. Further, clinical trial is needed to evaluate the benefit and toxicity associated with the use of bolus in PMR.

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Validation of Food Intake Frequency from Food Frequency Questionnaire for Use as a Covariate in a Model to Estimate Usual Food Intake (식품의 일상섭취량 추정을 위한 식품섭취빈도의 활용가능성 및 타당도 연구)

  • Lee, Ja Yoon;Kim, Dong Woo
    • Culinary science and hospitality research
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    • v.23 no.2
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    • pp.64-73
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    • 2017
  • Although 24-hour recalls (24HR) capture detailed information on a person's food intake, this method suffers from difficulties in adequately measuring the usual intake of foods that are not consumed daily by most. Therefore, the purpose of this study is to investigate whether frequency of Food Frequency Questionnaire (FFQ) can be utilized in form of covariate when calculating usual intake of episodically-consumed foods and their distributions. Data used in this study was from the Korean National Healthy and Nutrition Examination Survey (KNHANES) 2012~2014 (3 years) and 10,945 subjects participated in this survey who performed both of 24HR and FFQ. In order to analyze the data, amount of intake in each food, which was reported in 24HR was recalculated according to 112 items in FFQ. We first assessed the relationship between FFQ frequency and the amount reported on 24HR. Second, we assessed the relationship between usual portion size of FFQ and the amount reported on 24HR. Our hypothesis was that people who reported high FFQ-reported frequency or FFQ-reported usual portion size would consume larger amounts of that food on 24HR than those with lower frequency or portion size of consumption of a food on the FFQ. For 59 of 112 individual foods (52.2%), there were statistically significant increasing relationships between FFQ frequency and consumption-day intake. Also, 102 of 112 individual foods (90.3%), there were statistically significant increasing relationships between FFQ usual portion size and consumption-day intake. For 10 of 13 food groups (grains, fruits, eggs, pulses, root and tuber crops, milk products, meat, beverage, alcoholic drink, vegetable, seaweeds and others), there were statistically significant increasing relationships between FFQ frequency and consumption-day intake. And there were statistically significant increasing relationships between FFQ usual portion size and consumption-day intake for all food groups. This study confirmed consistent correlation between reported FFQ frequency or usual portion size of food (group) consumption and consumption-day intake on 24HR. Therefore the frequency data may be utilized as important covariate when estimating usual intake of food or food groups.

A Study on the Recognition of Modern Cultural Heritage Value of Japanese-style Building Groups Using Q Methodology - Focusing on Huam-dong, Seoul - (Q 방법론을 이용한 일본식 건물군의 근대문화유산 가치에 관한 인식 연구 - 서울시 후암동을 중심으로 -)

  • Park, Han-Sol;Sung, Jong-Sang
    • Journal of the Korean Institute of Landscape Architecture
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    • v.47 no.6
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    • pp.115-128
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    • 2019
  • Huam-dong is a representative area from the Japanese colonial period and is the space where most Japanese-style buildings remain in Seoul. Interest in modern cultural heritage continues to increase, including the registration of cultural properties in 2001, building assets in 2015, and the registration of cultural property units in 2018. As the debate continues over the necessity of preserving cultural heritage that reminds us of the Japanese colonial, there is a need for research to grasp the perceptions of stakeholders along with the perceived value of such spaces. This study identified the subjective perception types of the stakeholders concerned with the Japanese-style building group in Huam-dong, analyzed characteristics by types, and debated the issues. For this purpose, Q methodology, which is a statistical technique for measuring human self-subjectivity and extracting common human perspectives, was used. A literature study on the values of Huam-dong and modern cultural heritage was conducted, and a Q questionnaire based on five aspects of modern cultural heritage values (historical, architectural, sociocultural, landscape, and economic) was applied. The results of the study depicted three types of cognition and showed different attitudes toward the Japanese building group. This study found a conflict comparing the perceptional differences between the types of cognition. This study is meaningful in that it provides an in-depth approach to the perspectives of the stakeholders concerned with the Japanese-style buildings clustered in central Seoul. It is also meant to present a theoretical framework that can be applied to the use area as sustainable cultural heritage through the establishment of preservation and utilization of Japanese-style areas and conflict resolution.