• Title/Summary/Keyword: Short-term therapy

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A Pychoeducational Group Intervention for Women with Primary Breast Carcinoma (유방암 환자에 대한 심리교육 집단개입의 효과)

  • Hwang, Sook-Yeon;Lee, In-Soo;Park, Byeong-Woo
    • Korean Journal of Social Welfare
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    • v.51
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    • pp.93-118
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    • 2002
  • The objective of this study was to determine the effect of a psycho-educational group intervention in reducing psychologic distress and enhancing coping in Korean breast cancer patients. The patient selection criteria were age younger than 70 years, having any postoperative adjuvant therapy, and surgery undergone within the previous 12 months as of the start of the study and there were 70 patients eligible for this criteria. They were randomized into three groups; experimental group(24 patients), wait-list control group(24 patients) and wait-list group(36 patients). We conducted a 8-week, structured, psychosocial group intervention, which used psycho-educational strategies combining education and psychological support. Subjects were assessed for psychological distress and coping by administering the Beck Depression Inventory(BDI) and the Ways of Coping Checklist-Revised(WCCL-R) at the baseline and after 8 weeks. Forty eight patients were participated and thirty five patients completed the study. The experimental group had significantly lower scores than the controls for depression on the BDI(p=.012) after 8-week intervention. However, coping did not show a significant difference on WCCL-R after the intervention. Despite of some limitations, the results of this study suggest that a short term psychosocial group intervention produces a significant improvement in the quality of life of patients with primary breast carcinoma in Korea in terms of managing depression.

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The Clinical Study of Tongue Change in Diabetes Mellitus Patients as Oriental Diagnostic Method (糖尿환자의 27例의 舌診에 關한 臨床 硏究)

  • Seo, Gan-soo;Kim, Dong-woung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.12 no.2
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    • pp.212-221
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    • 1999
  • Tongue examination is the most unique and important diagnostic method of oriental medicine. It reveals patients condition and give some information about direction of therapy and background of disease as well as produces clue of duration of disease changing that grasps it from outside. The aims of this study show that results of tongue examination is related to somewhat special pattern. we study 27 patients(age of means: 63.01 years old, male: 14, female: 13) who come to Wonkwang University Oriental-Medicine Hospital at Chonju with diabetes mellitus or diabetes mellitus complications. Tongue colors of this study result in pale-red 8 cases, pale 6 cases, red 6 cases, crimson 5 cases, blue-green-purple 2 cases and tongue fur of this study result in white-fur 16 cases, yellow-fur 7 cases, black-fur 1 case, none-fur 3 cases. And the condition of tongue fur with grimy and thin result in thin-white-fur 12 cases, white-grimy-fur 4 cases, thin-yellow-fur 5 cases, grimy-yellow-fur 2 cases, black-fur 1 case. Means level of fasting glucose during 7 days was $223.24{\pm}32.l7mg/dl$ and postprandial 2hours was $286.37{\pm}24.54mg/dl$ There were no changes in tongue body and tongue color but changes occur in tongue fur with 9cases in this period. 5 cases of patient make a difference between FBS(fasting blood glucose) and postprandial blood glucose level more than l00mg/dl (2 cases of patient with thin-white-fur gradually turned to slight-yellow-fur. There were no changes in 2 cases of patient with crimson-none-fur and pale-white-fur. 1 case of patient with slimy-yellow-fur turned to black fur.) 11 cases of patient had lesser than $10\%$ hemoglobin $A_lC$ and tongue color of these patient were pale-red 5cases, pale 2 cases, red 2 cases, crimson 2 cases. 16 cases of patient had more than $10\%$ Hemoglobin $A_1C$ and tongue color of these patients were pale-red 3 cases, pale 4 cases, red 4 cases, crimson 3 cases, blue 2 cases. This result shows that quantity of Hemoglobin $A_1C$ make a somewhat role in tongue color. The above results show that tongue color, fur color, condition and change of fur in diabetes mellitus patients is various in pale-red, pale, crimson, none-fur. So it is difficult to give an exact diagnosis on pathology of diabetes mellitus only with tongue examination because there are a little matches between blood glucose level, prevalence-period, short-term blood glucose regulation and tongue and fur colors.

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The Effects of Yongin-Emotional Management Training Program on the Improvement of Life Care in Patients with Chronic Schizophrenia (만성 조현병 환자의 라이프케어 증진을 위해 용인 정서관리 훈련 프로그램이 미치는 영향)

  • Lee, Eun-Young;Jin, Myung-Ja;Kim, Young-Woon
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.4
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    • pp.385-400
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    • 2019
  • We reviewed existing studies and proposed future research on the sustainability of short-term effects, and of the Yongin Emotion Management Training program (Y-EMT). In this study, we conducted Y-EMT to verify its effectiveness in relation to affective disorders associated with chronic schizophrenia. Thirty-five patients were assigned to the experimental group, and 35 to the control group. First, results of repeated-measures analysis supported the effectiveness of Y-EMT. Comparisons of the results on the pre-test with those for the 5-month and 1-year post-training tests showed significant differences in mean scores between the experimental and control groups. Furthermore, these differences persisted at the 2-year follow-up. Second, in the experimental group, interactions between emotional behavior and expression, self-efficacy, and changes in interpersonal relationships showed significant effects at 5 months after the program ended, and these effects continued to increase up to 1 year post-training. Taken together, the findings indicate that, to maintain the effects of therapy in patients with chronic schizophrenia, patients should undergo Y-EMT along with cognitive rehabilitation training and social skills training. Human relations training such as Y-EMT is most helpful for rehabilitation when it is paired with high levels of medication.

Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer (조기유방암에서 유방보존치료와 유방전절제술의 치료결과 및 실패양상 비교)

  • Kim Yeon-Sil;Yoon Sei-Chul;Chung Su-Mi;Ryu Mi-Ryeong;Jung Sang-Sul;Choi Ihl-Bohng
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.115-123
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    • 2004
  • Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

Permanent Brachytherapy of Localized Prostate Cancer: Preliminary Results (국소 전립선암의 영구적 근접치료: 조기 결과)

  • Park, Hye-Li;Chang, Sei-Kyung;Kim, Ja-Young;Lee, Bo-Mi;Ko, Seong-Young;Kim, Sung-Joon;Shin, Hyun-Soo
    • Radiation Oncology Journal
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    • v.29 no.2
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    • pp.71-82
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    • 2011
  • Purpose: To evaluate the biochemical control rate and the rate of side effects after performing permanent brachytherapy of localized prostate cancer. Materials and Methods: 67 patients with localized prostate cancer were treated with brachytherapy between April 2007 and December 2008. Of these, 43 patients who were followed up and did not receive external radiotherapy were evaluated for the change in prostate specific antigen (PSA) level and the occurrence of side effects. In total, 18 patients were classified as low risk, 19 patients as intermediate risk, and 6 patients as high risk. The prescription dose was 145 Gy. Results: A PSA increase greater than 2 ng/mL occurred in 2 patients (4.7%). Radiation Therapy Oncology Group (RTOG) grade 1 and 2 acute urologic complications (UC) occurred in 40 and 3 patients, respectively. Further, 5 patients had RTOG grade 1 acute rectal complication (RC). The numbers of RTOG grade 1, 2, and 3 chronic UC were 1, 4, and 1, respectively. The numbers of RTOG grade 1, 2, and 4 chronic RC were 5, 10, and 3, respectively. The statistically significant risk factors (RF) of acute RC were the minimal dose in the most irradiated 0.1 cc volume ($D_{0.1cc}$, p=0.041) and absolute volume receiving 150% of the prescribed dose ($V_{150cc}$, p=0.038) in the entire rectum (ER). The percentage ($V_{100%}$, p=0.019) and absolute volume ($V_{100cc}$, p=0.047) in the involved rectum (IR) were also statistically significant. The RF of chronic RC were $V_{100%}$ (p=0.011) in the ER and the $D_{0.1cc}$ (p=0.049), $V_{100cc}$ (p=0.023) in the IR. The number of used seeds were related with acute UC (p=0.028). Conclusion: Permanent brachytherpy of localized prostate cancer showed a favorable short term biochemical control rate. As such, selective intermediate and high risk patients can be managed with permanent brachytherapy. The effort to reduce rectal complication is also necessary.

Serum ghrelin and leptin concentrations in children with cancer : comparisons with normal children (소아 종양 환아의 혈중 Ghrelin과 Leptin의 농도: 정상 소아와 비교)

  • Park, So Hyun;Jung, Min Ho;Chung, Nac Gyun;Suh, Byung-Kyu;Lee, Byung Churl
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.905-911
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    • 2007
  • Purpose : Ghrelin, being secreted from the stomach, stimulates growth hormone secretion and controls energy homeostasis by increasing appetite. Leptin, being secreted from the adipocytes, controls weight and energy homeostasis by decreasing appetite. Leptin concentration is reported to increase after childhood cancer therapy. This study was aimed to compare ghrelin and leptin concentrations in normal children and children who received cancer therapy. Methods : We enrolled forty-three patients who were diagnosed with cancer and received radiotherapy or chemotherapy during Dec. 2004 through Dec. 2005 in St. Marys hospital and Kangnam St. Marys hospital. Forty-five healthy children were selected as a control group whose age, gender, weight and height were similar to those of cancer group. The serum leptin and ghrelin concentrations were also measured by radioimmunoassay. Results : The cancer group showed higher BMI and leptin concentrations. The control group showed higher concentrations of ghrelin. Both control and cancer groups revealed positive correlations between leptin concentrations and BMI. Ghrelin concentrations in the control group showed negative correlations with age, height, weight and BMI but no significant correlation was found in the cancer group. All the parameters in the group treated with chemotherapy only were not different from those in the group treated with chemotherapy and irradiation. But the level of ghrelin in the acute myeloid leukemia group was much higher than those in the acute lymphoblastic leukemia group. Conclusion : Patients with pediatric cancer treatment have presented higher BMI and leptin concentrations but lower ghrelin concentrations than those in healthy children. Because of the relatively short duration and cross sectional method of the study, however, further long term and prospective study will be required in the future.

Phenotype-genotype correlations and the efficacy of growth hormone treatment in Korean children with Prader-Willi syndrome (프래더 윌리 증후군의 유전학적 발병 기전에 따른 표현형 및 성장 호르몬 치료 효과에 관한 연구)

  • Bae, Keun Wook;Ko, Jung Min;Yoo, Han Wook
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.315-322
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    • 2008
  • Purpose : Prader-Willi syndrome (PWS) is a complex genetic disorder, caused by the deletion of the paternally derived 15q11-13 region or the maternal uniparental disomy of chromosome 15 (mUPD(15)). In this study, we compared phenotypic differences between those patients whose disease was caused by microdeletion and those caused by mUPD(15). In addition, a comparison of the efficacy of growth hormone (GH) therapy between these two PWS genotypes was analyzed. Methods : Fifty-three patients were diagnosed as having PWS based on molecular and cytogenetic analyses and clinical features. Data that included maternal age, birth weight, a feeding problem in the neonatal period, cryptorchidism, developmental delay or mental retardation, short stature, hypopigmentation, changes in height, weight, and body mass indexes (BMI) before and after GH treatment were obtained by a retrospective review of medical records. The data from the patients with microdeletion were compared with those from the patients with mUPD(15). Results : Of the 53 patients with genetically confirmed PWS, 39 cases had microdeletion and 14 mUPD(15). Maternal ages were significantly higher in the mUPD(15) group, and hypopigmentation and a feeding problem in the neonatal period were more frequent in the microdeletion group. Growth hormone was administered to 20 patients [14 with microdeletion, 6 with mUPD(15)]. There were no differences between the two groups in height velocity, weight and height SDS, and BMI after GH therapy. Conclusion : Phenotype and genotype correlations were observed in Korean PWS patients, such as more advanced maternal ages in the mUPD(15) group and more feeding problems and hypopigmentations in the microdeletion group. Further long-term prospective studies are needed to correlate other aspects of the phenotypes.

Outcome of patients with neuroblastoma aged less than 1 year at diagnosis (진단 시 1세 이하인 신경모세포종 환자의 치료성적)

  • Suh, Jung Min;Lee, Sang Goo;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe;Kim, Ju Youn;Cho, Eun Joo;Lee, Suk Koo;Kim, Jhingook;Lim, Do Hoon
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.93-98
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    • 2009
  • Purpose : The purpose of this study was to evaluate the clinical characteristics and outcomes of patients with neuroblastoma aged less than 1 year. Methods : From January 1997 to December 2007, 41 patients aged less than 1 year were diagnosed with neuroblastoma. Patients were divided into 3 risk groups according to the stage of the disease and N-myc amplification. Low-risk patients underwent surgery with (stage 2) or without (stage 1) short-term chemotherapy. Intermediate-risk patients underwent chemotherapy and surgery with or without local radiation therapy. High-risk patients underwent chemotherapy, surgery, radiation therapy, and high-dose chemotherapy/autologous stem cell rescue (HDCT/ASCR). Results : While tumor relapse occurred in only 1 patient, 7 patients died of treatment-related toxicities. Causes of treatment- related death included infection during conventional chemotherapy in 5 patients and acute myocarditis during HDCT/ASCR in 2 patients. The overall 5-year survival (${\pm}$ standard error) and 5-year event-free survival (EFS) rates after diagnosis for all 41 patients were $82.8{\pm}5.9%$ and $80.0{\pm}$6.3%$, respectively, with a median follow-up of 58 (9-137) months. The 5-year EFS rates for low-risk, intermediate-risk, and high-risk patients were 100%, $68.4{\pm}10.8%$, and $66.7{\pm}19.3%$, respectively. Conclusion : Increased efforts to reduce infection-associated toxicity deaths during conventional chemotherapy are needed to further improve the survival of patients with neuroblastoma aged less than 1 year.

Outcomes and Management of Fetal Infants with Birth Weight Below 500 g at a Tertiary Center (출생체중 500 g 미만의 태아영아 치료성적 및 치료의 실제)

  • Chang, Yun Sil;Kim, Yu Jin;Koo, Soo Hyun;Lee, Jang Hoon;Hwang, Jong Hee;Choi, Chang Won;Shim, Jae Won;Kim, Sung Shin;Ko, Sun Young;Lee, Eun Kyung;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.939-945
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    • 2005
  • Purpose : The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors. Methods : We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical Center(SMC), or transferred to neonatal intensive care unit(NICU) of SMC within 24 hrs after birth between 1994 and 2004. Data for all interventions and morbidity outcome were analyzed for infants who were admitted to the NICU and were compared between NICU survivors and deaths. Results : Among 53 infants with birth weights of 400 to 499 g who were born in SMC during the study period, 8(15.1%) infants were admitted to the NICU and one was transferred to NICU from other hospital. Overall, 4(44%) of 9 survived and were discharged from the NICU. The smallest infant who survived weighed 439 grams. The least gestational age was $23^{+3}$ among the survivors. Compared with NICU deaths, NICU survivors had larger gestational age($24^{+2}{\pm}1^{+3}$ vs. $25^{+4}{\pm}2^{+3}$) and birth weight($424{\pm}17$ vs. $453{\pm}19$)(P<0.05). Median survival duration of NICU deaths was 15 days. None of NICU survivors had severe IVH, but 3(75%) had laser therapy for retinopathy of prematurity and bronchopulmonary dysplasia, respectively. Conclusion : Fetal infants with birth weight below 500 g known as lower limit of viability survived successfully. Study for their long-term follow-up will be needed to define our limit of viability and indication for their active resuscitation.

The Short Term Efficacy of Entecavir Therapy in Chronic Hepatitis B (만성 B형 간염 환자에서 엔테카비어의 단기 치료 효과)

  • Kim, Hyun;Chae, Hee-Bok;Jeon, Won-Joong;Park, Seon-Mee;Youn, Sei-Jin;Eun, Jong-Ryul;Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.31-40
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    • 2008
  • Background/Aims : Entecavir is a synthetic nucleoside analogue, cyclopentyl guanine nucleoside, which has a potent antiviral effect and the least viral breakthrough in hepatitis B virus (HBV) replication. Entecavir has been available in Korea since 2007 but there are few reports on its effects. The aim of this study was to evaluate the virological response (VR) and biochemical response (BR) to entecavir in HBV patients at 3, 6 and 9 months after treatment with entecavir. Materials and Methods : Thirty-three chronic hepatitis B patients who took entecavir for at least 9 months were enrolled. We investigated VR and BR by retrospectively reviewing medical records. Patients who satisfied the following criteria were chosen: 1) initial alanine aminotransferase (ALT) levels = 1.5upper limit of normal (ULN) and 2) initial HBV DNA levels = $5\;log_{10}\;copies/ml$. We measured ALT levels every 3 months until month 9. HBV DNA was measured every 2 or 3 months by polymerase chain reaction (PCR) method. Results : Most patients taking entecavir showed good BR (ALT < 40 IU/L). The BR rates were 61%, 73% and 67% at months 3, 6 and 9, respectively. VR (HBV DNA < $5\;log_{10}\;copies/ml$ or 2 log lower than initial HBV DNA) rates were 82%, 91% and 91% at months 3, 6 and 9, respectively. Undetectable HBV DNA (HBV DNA < 4 log10 copies/ml) rates were 49%, 73% and 85% at months 3, 6 and 9, respectively. Two patients presented with virological breakthrough without adverse effects until month 9. Conclusions : Entecavir showed good BR and VR from month 3 and these effects continued through the 9-month observation period. This suggests that entecavir is also a good choice for the first line treatment of chronic hepatitis B (CHB). Further studies are needed to determine the long-term efficacy and drug resistance of entecavir in Korean CHB patients.

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