• 대한방사선치료학회지
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• 제18권2호
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• pp.113-117
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• 2006

목 적: 유방암으로 진단 받고 변형 근치적 유방절제술(Modified Radical Mastectomy)후 흉벽에 방사선치료를 시행 받고 있는 환자를 대상으로 볼루스(Bolus) 적용에 따른 흉벽(흉터, 수술봉합부위)의 피부선량 변화를 분석 하여 적절한 볼루스 적용횟수를 얻고자 한다. 대상 및 방법: 유방암으로 진단받고 변형 근치적 유방절제술 후 방사선치료를 받고 있는 4명의 여성 환자(우측 2명 좌측 2명)를 대상으로 하였다. 흉벽 방사선조사는 4 MV광자선으로 매일 2 Gy씩 주 5회, 접선조사로 치료하였고, 총 조사선량은 50 Gy였는데 동측 내유방림프절은 포함하지 않았다. 치료 계획을 위한 전산화단층촬영에서 흉터 부위의 위치 확인을 위해 방사선비투과성물질인 Angio-catheter를 흉터 위에 위치시켰다. 획득한 영상을 이용하여 치료계획을 세웠고, 전산화치료계획장치에서 흉터부위 좌우 2 cm 영역을 포함하는 두께 0.5 cm, 넓이 6 cm의 볼루스를 적용시켰다. 계획한 내용을 바탕으로 볼루스를 적용하지 않은 경우와 볼루스를 적용한 경우에 대하여 선량분포 변화와 피부선량을 비교 분석하였고 열형광선량계 (Thermoluminescent dosimetry: TLD, Harshaw, USA)를 이용하여 관심 부위(흉터 부위 3 지점, 흉터 좌측 1 cm 3지점, 흉터 우측 1 cm 3지점) 9개 지점의 선량을 실측하였다. 결 과: 전산화치료계획장치에서 얻어진 선량분포를 통해 분석한 결과, 볼루스를 적용하지 않은 경우와 볼루스를 적용한 경우 모두에서 흉벽 부위에 $95{\sim}100%$ 선량이 감싸고 있었으나, 흉터 주위 피부선량에 있어서는 볼루스를 적용하지 않은 경우($50{\sim}75%$)와 볼루스를 적용한 경우($100{\sim}105%$)가 큰 차이를 보였다. 선량분포를 통한 관심지점의 피부선량은 볼루스를 적용하지 않은 경우에 비해 볼루스를 적용한 경우에서 환자 1번 23.3%, 환자 2번 35.6%, 환자 3번 34.9%, 환자 4번 41.7%의 선량 증가를 보였다. 볼루스를 적용하지 않은 경우와 볼루스를 적용한 경우의 TLD 평균 측정치는 환자 1번 161.1 cGy 209.3 cGy 환자 2번 150.2 cGy, 200 cGy, 환자 3번 150.5 cGy, 211.4 cGy, 환자 4번 155.5 cGy 198.6 cGy의 결과를 얻었다. 결 론: 본 원에서 변형 근치적 유방절제술 후 흉벽 방사선치료의 가장 적절한 볼루스 적용 횟수는 전 치료횟수의 $50{\sim}60%$ 적용이다.

• Radiation Oncology Journal
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• 제22권3호
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• pp.177-183
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• 2004

목적: 초기 병기 비강 natural killer/T-ceil 림프종에 대한 CHOP 항암화학요법과 국소 방사선치료의 순차적 적용 결과를 보고하고자 한다. 대상 및 방법: 1995년 3월부터 1999년 12월 사이에 성균관의대 삼성서울병원 종양센타에 비강 I/II 병기natural killer/T-cell 림프종으로 등록된 17명의 환자들 중 14명의 환자들에 대하여 순차적 항암화학요법과 방사선치료를 적용하였고 이들에 대한 분석을 시행하였다. 치료방침은 우선 CHOP 항암화학요법을 3주 간격으로 3~4회 시행한 후 5주간에 걸쳐 육안적 병변과 인접한 림프절 부위에 대한 국소 방사선치료를 추가하는 것이었다. 결과: 방사선치료의 시작 전에 시행한 국소종양의 항암화학요법에 대한 반응평가는 50%의 환자들에서 양호한 반응(완전관해 5명+부분관해 2명)을 보였고 나머지 50%의 환자들에서는 병변이 진행하였다. 5명의 환자에서 국소재발이 나타났는데 이들 중 2명은 원격전이를 동반하였고, 영역 림프절 재발을 수반한 경우는 없었다. 3년 생존율과 무병생존율은 50.0%와 42.9%였으며, 모든 사망과 재발사례는 치료개시 후 13개월 이내에 발생하였다. 예후인자의 단변량 분석에서 'B' 증상이 없는 경우, 항암화학요법과 전체 치료방침에 양호한 반응을 보인 경우, 국제예후지표상 저위험군 등이 양호한 생존율과 관련이 있었다. 결론: 본 연구의 치료방침에 의한 결과는 과거의 방사선치료 단독 또는 방사선치료 후 항암화학요법 추가에 따르는 결과들과 비교해 볼 때 재발양상과 생존율의 측면에서 유리한 점이 없었다. 따라서 방사선치료와 항암화학요법을 새로운 병용방법에 관한 연구개발이 요망된다.

• Tuberculosis and Respiratory Diseases
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• 제81권1호
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• pp.42-48
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• 2018

Background: The diffusing capacity of the lung is influenced by multiple factors such as age, sex, height, weight, ethnicity and smoking status. Although a prediction equation for the diffusing capacity of Korea was proposed in the mid-1980s, this equation is not used currently. The aim of this study was to develop a new prediction equation for the diffusing capacity for Koreans. Methods: Using the data of the Korean National Health and Nutrition Examination Survey, a total of 140 nonsmokers with normal chest X-rays were enrolled in this study. Results: Using linear regression analysis, a new predicting equation for diffusing capacity was developed. For men, the following new equations were developed: carbon monoxide diffusing capacity (DLco)=-10.4433-0.1434${\times}$age (year)+0.2482${\times}$heights (cm); DLco/alveolar volume (VA)=6.01507-0.02374${\times}$age (year)-0.00233${\times}$heights (cm). For women the prediction equations were described as followed: DLco=-12.8895-0.0532${\times}$age (year)+0.2145${\times}$heights (cm) and DLco/VA=7.69516-0.02219${\times}$age (year)-0.01377${\times}$heights (cm). All equations were internally validated by k-fold cross validation method. Conclusion: In this study, we developed new prediction equations for the diffusing capacity of the lungs of Koreans. A further study is needed to validate the new predicting equation for diffusing capacity.

• 보건행정학회지
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• 제20권4호
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• pp.58-73
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• 2010

Background : Cancer is a disease that not only places a significant burden on patients clinically but also requires significant expense for diagnosis and treatment. Although the cancer coverage of health insurance has recently been expended, the need for financial assistance among cancer patients and their families is still expected to be significant. In this study, cancer patients' need for financial assistance in Korea was examined and its influence factors were analyzed. Methods : Target study subjects were those who are over 18 years of age and were diagnosed with cancer more than four months prior at the National Cancer Center and 9 Regional Cancer Centers in Korea during the period from July to August of 2008. Quarter sampling was conducted according to the ratio of the type of each cancer. A face to face interview survey was conducted. A total of 2,661 cancer patients finished the survey. Medical charts were reviewed in order to obtain the cancer type and SEER stage of cancer patients. An ordered logistic regression model was used to examine the level of need for financial assistance according to the demographical, clinical, and socio-economic variables of cancer patients. Result : The percentage of cancer patients who needed financial assistance was 69.0%, and 36.9% needed significant financial assistance. The need for financial assistance was perceived to be greater in males, younger age group, low income group, low education group, medical aid recipients, those who were diagnosed recently, those with a low level of quality of life measured through EQ5D, and those with decreased income after cancer diagnosis. Conclusion : In spite of the current policy to increase health insurance coverage, the majority of cancer patients and their families in Korea still need financial assistance due to cancer. In particular, there were more vulnerable groups, such as the low income, or low education group. In the future, policies that focus on the disadvantaged, which strengthen social security, should be considered for achievement of a substantially better quality of life for cancer patients and their families.

• 대한치과교정학회지
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• 제52권1호
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• pp.66-74
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• 2022

Objective: To investigate demographic and skeletodental characteristics of one-jaw (1J-OGS) and two-jaw orthognathic surgery (2J-OGS) in patients with skeletal Class III malocclusion. Methods: 750 skeletal Class III patients who underwent OGS at 10 university hospitals in Korea between 2015 and 2019 were investigated; after dividing them into the 1J-OGS (n = 186) and 2J-OGS groups (n = 564), demographic and skeletodental characteristics were statistically analyzed. Results: 2J-OGS was more frequently performed than 1J-OGS (75.2 vs. 24.8%), despite regional differences (capital area vs. provinces, 86.6 vs. 30.7%, p < 0.001). Males outnumbered females, and their mean operation age was older in both groups. Regarding dental patterns, the most frequent maxillary arch length discrepancy (ALD) was crowding in the 1J-OGS group (52.7%, p < 0.001) and spacing in the 2J-OGS group (40.4%, p < 0.001). However, the distribution of skeletal pattern was not significantly different between the two groups (all p > 0.05). The most prevalent skeletal patterns in both groups were hyper-divergent pattern (50.0 and 54.4%, respectively) and left-side chin point deviation (both 49.5%). Maxillary spacing (odds ratio [OR], 3.645; p < 0.001) increased the probability of 2J-OGS, while maxillary crowding (OR, 0.672; p < 0.05) and normo-divergent pattern (OR, 0.615; p < 0.05) decreased the probability of 2J-OGS. Conclusions: In both groups, males outnumbered females, and their mean operation age was older. The most frequent ALD was crowding in the 1J-OGS group, and spacing in the 2J-OGS group, while skeletal characteristics were not significantly different between the two groups.

• 한국환경과학회지
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• 제19권12호
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• pp.1343-1354
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• 2010

The purpose of the study was to analyze the persistence of HCH in atmosphere, soil, sediment and water of the western and southern regions of Korea. The samples from the western region were collected from Anmyeon Island, and the samples from the southern region were collected from Kimhae and Busan. The concentration of HCH isomers in atmosphere showed the pattern of $\alpha$-HCH>$\gamma$-HCH>$\beta$-HCH. The regions with high HCH concentration in the atmosphere are the regions that have been highly exposed to HCH used in the past, and the areas that have been influenced by the long range transport. The HCH that persists in the soil, water and sediment evaporates into the atmosphere, showing the characteristics of Air-Surface exchange. When the regional concentration distributions are compared, the concentration of HCH was higher in the atmosphere of a plain and the cities near the plain, than the urban areas. In this study, the ratio of $\alpha/\beta$-HCH was used as an indicator for estimating the source of Technical HCH and Lindane. According to the result, the contribution of Lindane was high in Kimhae plain and Kimhae urban areas. However, in Busan, the contribution of Technical HCH was higher than Lindane. In case of Anmyeon Island, the western region of Korea had high contribution from Tehcnical HCH. In soil and sediment, $\beta$-HCH was dominant. In water, $\gamma$-HCH was dominant among other isomers. Such results are due to $\gamma$-HCH inLindane. Furthermore, the source of $\gamma$-HCH in urban areas is assumed to be the use of medicine, medical supplies and other living supplies. Based on the results of this study, the management of HCH, a newly list up emerging POPs, should be strengthened by further research on sources, fate, persistency, accumulation and exposures and etc. to the risk assessments.

• 한국응급구조학회지
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• 제3권1호
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• pp.65-76
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• 1999

Objectives: This study sought to examine the impact of alcohol use and misuse on mortality in korea during the 1991-l997. Methods: Alcohol-Related Disease Impact estimation software and Korea vital statistics data were used to calculate alcohol related-mortality, mortality rates, and YPLL(years of potential life lost). The major findings are as follows : An estimated 23,528 Korean died during 1997 from causes related to alcohol. Such deaths accounted for 17,052(12.60%) of all deaths for men and 6,206(5.88%) for women. Motor vehicle accidents were major contributors to the total estimated number of alcohol related deaths and years of potential life lost before age 65. Alcohol related mortality rates were significantly higher for men. For men, major causes of the deaths were motor vehicle accidents(4,147 deaths, 17.90 per 100,000 population), cancer of the stomach(1,467 deaths, 16.60 per 100,000 population) and chronic liver diseases and cirrhosis(1,233 deaths, 13.10). For women, the largest contributors to alcohol related mortality were motor vehicle accidents(1,509 deaths, 6.61), cerebrovascular diseases(1,114 deaths, 11.3) and cancer of the stomach(810 deaths, 8.24). Kleinman's method was used for obtaining on regional(Dongs, ups and Myons) differential of the alcohol related mortality in 1995. In general, The alcohol-related death rate for men was significantly higher than that for women, and the rate for ups and myons was significantly higher than that for dongs During 1997, approximately 356,667(male: 282, 510, female: 74, 157)YPLL to age 65 and 572,708(male:424,338, female:148,370)YPLL to life expectancy were attributable to alcohol related causes. Men accounted for 79% of the total YPLL to age 65 and 74% of the total YPLL to life expectancy The major contributors to these alcohol related years lost were the diagnostic categories of unintentional injuries. Particullary, In male, Motor vehicle accidents and accidental drowning-YPLL are considerably higher for other causes. Male-female YPLL differentials were greatest for mental disorder. Male-female mean-YPLL to age 65, accidental drowning(male;36.47, female;37.67) is higher for other causes. In both sexes, The YPLL and M-YPLL to life expectancy was significantly higher than the YPLL and M-YPLL to life expectancy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2707-2712
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• 2015

Background: The human homologue of the mouse double minute 2 (MDM2) gene is a negative regulator of Tp53. MDM2-309T>G a functional promoter polymorphism was found to be associated with overexpression thereby attenuation of Tp53 stress response and increased cancer susceptibility. We have planned to evaluate the possible role of MDM2-309T>G polymorphism with risk and response to chemotherapy in AML. Materials and Methods: A total of 223 de novo AML cases and 304 age and sex matched healthy controls were genotyped for the MDM2-309T>G polymorphism through the tetra-primer amplification refractory mutation system (ARMS)-PCR method. In order to assess the functional relationship of -309T>G SNP with MDM2 expression level, we quantified MDM2 mRNA in 30 primary AML blood samples through quantitative RT-PCR. Both the (-309T>G) genotypes and the MDM2 expression were correlated with disease free survival (DFS) rates among patients who have achieved complete remission (CR) after first induction chemotherapy. Results: MDM2-309T>G polymorphism was significantly associated with AML development (p<0.0001). The presence of either GG genotype or G allele at MDM2-309 confered 1.79 (95% CI: 1.12-2.86; p<0.001) and 1.46 fold (95%CI: 1.14-1.86; p= 0.003) increased AML risk. Survival analysis revealed that CR+ve cases with GG genotype had significantly increased DFS rates (16months, p=0.05) compared to CR+ve TT (11 months) and TG (9 months) genotype groups. Further, MDM2 expression was also found to be significantly elevated in GG genotype patients (p=0.0039) and among CR+ve cases (p=0.0036). Conclusions: The MDM2-309T>G polymorphism might be involved in AML development and also serve as a good prognostic indicator.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.785-789
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• 2012

Background and Purpose: Cisplatin is the most common chemotherapeutic agent for loco-regionally advanced nasopharyngeal carcinoma (NPC); however, toxicity is a limiting factor for some patients. We retrospectively compared the efficacy and toxicity of weekly docetaxel-based and cisplatin-based concurrent chemoradiotherapy in loco-regionally advanced NPC. Methods and Materials: Eighty-four patients with Stage III and IVA-B NPCs, treated between 2007 and 2008, were retrospectively analyzed. Thirty received weekly docetaxel-based concurrent chemotherapy, and 43 were given weekly cisplatin-based concurrent chemotherapy. Radiotherapy was administered using a conventional technique (seven weeks, 2.0 Gy per fraction, total dose 70-74 Gy) with 6-8 Gy boosts for some patients with locally advanced disease. Results: Median follow-up time was 42.3 months (range, 8.6-50.8 months). There were no significant differences in the 3-year loco-regional failure-free survival (85.6% vs. 92.3%; p=0.264), distant failure-free survival (87.0% vs. 92.5%; p=0.171), progression-free survival (85.7% vs. 88.4%; p=0.411) or overall survival (86.5% vs. 92.5%, p=0.298) of patients treated concurrently with docetaxel or cisplatin. Severe toxicity was not common in either group. Conclusions: Weekly docetaxel-based concurrent chemoradiotherapy is potentially effective and has a tolerable toxicity; however, further investigations are required to determine if docetaxel is superior to cisplatin for advanced stage NPC.

• 대한예방한의학회지
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• 제21권3호
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• pp.11-18
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• 2017

Objectives : In an effort to suggest a developmental plan of Traditional Korean Medicine health promotion project(TKM-HPP), this study was conducted to identify the problems experienced by public health Traditional Korean Medicine(PH-TKM) doctors in duty and to analyze successful cases of the health promotion project. Methods : Two PH-TKM doctors in duty at the Public Health Centre branch and Public Health Centre respectively, and one TKM doctor in charge of Public Health Centre participated in the in-depth interview. The research procedure was as follows; 1) inform study objectives and interview questions to participants, 2) in-depth interview with semi-structured questions, and 3) post-confirmation and verification. The interview was recorded and transcripted. In-depth interview was composed of 6 subsections: 1) Introducing participants and share purpose of interview, 2) Confirmation of the job status and difficulty of public health centre, 3) Reflecting and sharing experiences of public health clinic job performance cases, 4) Current status and improvement needs of TKM-HPP, 5) Discussions on improvement of TKM-HPP in public health center, 6) Sharing and reconfirmation of interview results. Thematic analysis was conducted from the narratives. Results : The study showed that; 1) the support from the local government was critical for the successful TKM-HPP and participation of the PH-TKMs; 2) the major problems experienced by PH-TKMs were lack of training for TKM-HPP in the field and lack of knowledge at local government level; 3) the suggestions to provide PH-TKMs with manual to educate residents effectively and redefine roles of PH-TKMs in the project. It also suggests that TKM-HPP model should be developed by the district in a way of reflecting regional characteristics. Conclusions : Firstly, more efforts should be made on the projects rather than medical treatment in public health centers, except for areas where medical institutions are scarce. Secondly, in order to facilitate participation of PH-TKM doctors, each local office should reduce medical care and increase efforts related with projects. Thirdly, the institution has to develop feasible TKM-HPP plans that can be carried out by PH-TKMs by the manual. Lastly, pre-training should be provided to PH-TKMs to understand contents of TKM-HPP related to public health centre work before the placement.