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LINAC-based Stereotactic Radiosurgery for Meningiomas (수막종에 대한 선형가속기형 정위방사선수술)

  • Shin Seong Soo;Kim Dae Yong;Ahn Yong Chan;Lee Jung Il;Nam Do-Hyun;Lim Do Hoon;Huh Seung Jae;Yeo Inhwan J;Shin Hyung Jin;Park Kwan;Kim BoKyoung;Kim Jong Hyun
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.87-94
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    • 2001
  • Purpose : To evaluate the role of LINAC-based stereotactic radiosurgery (SRS) in the management of meningiomas, we reviewed clinical response, image response, neurological deficits for patients treated at our institution. Methods and materials : Between February 1995 and December 1999, twenty-six patients were treated with SRS. Seven patients had undergone prior resection. Nineteen patients received SRS as the initial treatment. There were 7 male and 19 female patients. The median age was 51 years (range, $14\~67\;years$). At least one clinical symptom presented at the time of SRS in 17 patients and cranial neuropathy was seen in 7 patients. The median tumor volume was $4.7\;cm^3\;(range,\;0.7\~16.5\;m^3)$. The mean marginal dose was 15 Gy (range, $10\~20\;Gy$), delivered to the $80\%$ isodose surface (range, $46\~90\%$). The median clinical and imaging follow-up periods were 27 months (range, 1-71 months) and 25 months (range, $1\~52\;months$), respectively. Results : Of 14 patients who had clinical follow-up of one year or longer, thirteen patients $(93\%)$ were improved clinically at follow-up examination. Clinical symptom worsened in one patient at 4 months after SRS as a result of intratumoral edema, who underwent surgical resection at 7 months. OF 14 patients who had radiologic follow-up of one year or longer, tumor volume decreased in 7 patients $(50\%)$ at a median of 11 months (range, $6\~25\;months$), remained stable in 6 patients $(43\%)$, and increased in one patient $(7\%)$, who underwent surgical resection at 44 months. New radiation-induced neurological deficits developed in six patients $(23\%)$. Five patients $(19\%)$ had transient neurological deficits, completely resolved by conservative treatment including steroid therapy. Radiation-induced brain necrosis developed in one patient $(3.8\%)$ at 9 months after SRS who followed by surgical resection of tumor and necrotic tissue. Conclusions : LINAC-based SRS proves to be an effective and safe management strategy for small to moderate sized meningiomas, inoperable, residual, and recurrent, but long-term follow-up will be necessary to fully evaluate its efficacy. To reduce the radiation-induced neurological deficit for large size meningioma and/or in the proximity of critical and neural structure, more delicate treatment planning and optimal decision of radiation dose will be necessary.

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Reversal of Multidrug Resistance with KR-30035: Evaluated with Biodistribution of Tc-99m MIBI in Nude Mice Bearing Human Tumor Xenografts (이종이식된 인체종양에서 KR-30035가 Tc-99m MIBI체내 분포에 미치는 영향으로 평가한 다약제내성 역전가능성)

  • Kim, Jung-Kyun;Lee, Byung-Ho;Choi, Sang-Woon;Yoo, Sung-Eun;Lee, Sang-Woo;Chun, Kyung-Ah;Ahn, Byeong-Cheol;Park, Jae-Young;Suh, Jang-Soo;Lee, Kyu-Bo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.168-184
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    • 2001
  • Purpose: KR-30035 (KR), a new MDR reversing agent, has been found to produce a similar degree of increased Tc-99m MIBI uptake in cultured tumor cells over-expressing mdr1 mRNA compared to verapamil (VP), with less cardiovascular effects. We assessed the MDR-reversing ability of KR in vivo, and effects of various doses of KR on MIBI uptake un nude mice hearing P-glycoprotein (P-gp) positive (+) and P-gp negative (-) human tumor xenografts. Methods: P-gp (+) HCT15/CL02 colorectal and P-gp (-) A549 non-small cell cancer cells were inoculated in each flank of 120 nude mice (20 mice ${\times}$ 6 groups). Group 1 (Gr1) mice received 10mg/kg KR i.p. 3 times $({\times}3)$; Gr2, 10mg/kg VP i.p. ${\times}3$; Gr3, 10mg/kg KR i.p. ${\times}2$ + 25mg/kg KR i.p. ${\times}1$; Gr4, 10mg/kg KR i.p. ${\times}2$ + 50mg/kg i.p. ${\times}1$; Gr5, 10mg/kg KR i.p. ${\times}2$ + 25mg/kg KR i.v. ${\times}1$, GrC, controls. The mice were then injected with Tc-99m MIBI and sacrificed after 10 min, 30 min, 90 min and 240 min. Tumor uptake of MIBI (TU) in each group was compared. Results: TU in P-gp (+) and (-) tumors were both higher in Gr1 than Gr2. Washout rate between the 10 min and 4 hours was lower in Gr5 of P-gp (+) cell(0.93) than the control. Percentage increases in TU were higher in P-gp (+) than P-gp (-) tumors with all KR doses. Pgp (+) TU were highest at 10 mon (173% of GrC) and persisted up to 240 min (144%) in Gr3. Larger doses of KR resulted in a lesser degree of increase in P-gp (+) TU at 10 min (130% in Gr4 and 117% un Gr5) and 30 min (178%, 129%), but TU increased by time up to 240 min (177%, 196%). Heart and lung uptakes were markedly increased in Gr4 and Gr5 at 10 and 30 min, likely due to cardiovascular effects. No mice died. Conclusion: These data further suggest that KR that has significantly lower cardiovascular toxicity than verapamil can be used as an active inhibitor of MDR. Even a relatively low dose of KR significantly increased Tc-99m MIBI uptake in P-gp (+) tumors in vivo.

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Effects of Supplementary Multiple Probiotics or Single Probiotics on the Performance, Intestinal Microflora, Immune Response of Laying Hens and Broilers (혼합 또는 단일 생균제가 산란계와 육계의 생산성, 소장내 미생물 균총 및 면역 체계에 미치는 영향)

  • Kim, Chan-Ho;Woo, Kyung-Chun;Kim, Geun-Bae;Park, Yong-Ha;Paik, In-Kee
    • Korean Journal of Poultry Science
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    • v.37 no.1
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    • pp.51-62
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    • 2010
  • This study was conducted to investigate the effects of dietary supplementation of multiple probiotics on the performance, small intestinal microflora and immune response in laying hens and broilers. In Exp.1, a total of 800, 82 wk old Hy-line Brown$^{(R)}$ laying hens were assigned to one of the following five dietary treatment; Control, Antibiotics (avilamycin 6 ppm), Probiotics; PB-M (Micro-ferm$^{(R)}$ 0.2%), PB-L (Lacto-sacc$^{(R)}$ 0.1%), PB-Y (Y University probiotics 0.2%). Each treatment was replicated eight times with 20 birds in each replicate and two birds were housed in each cage. Twenty birds units were arranged according to completely randomized block design. Feeding trial lasted 6 wk under 16 h lighting regimen. The Exp. 2, was conducted with a total of 1,000 broilers chicks (Ross$^{(R)}$). They were divided into five treatments, same as those of Exp. 1. Birds were fed starter (0~3 wk) and grower (4~5 wk) diets. Each treatment was replicated four times with 50 birds per pen comprising of deep litter. In Exp. 1, egg production parameters, such as hen-day and hen-house egg production, egg weight, broken and soft shell egg production, feed intake and feed conversion were not significantly different among treatments. However, strength and thickness of eggshell were significantly (P<0.05) different. Among the probiotics, PB-Y showed the highest strength and thickness of eggshell. Eggshell color, egg yolk color and Haugh unit were not significantly influenced. In Exp. 2, overall weight gain (0~5 wk) and mortality were not significantly different among treatments. However, weight gain of birds from PB-Y treatment during starter (0~3 wk) was significantly lower than the birds from Control and Antibiotic treatment. During the whole period (0~5 wk), birds from Antibiotics treatment had higher feed intake and Production Index (PI) and lower feed conversion than birds from Control treatment. Probiotics treatments were not significantly different from the Control on feed intake and feed conversion. In Exp.1, there were significant (P<0.05) differences in leukocytes parameters, such as white blood cell (WBC), hetrophil (HE), lymphocytes (LY), monocyte (MO), eosinophil (EO) and stress index (SI; HE/LY) in the blood of layers. Birds from Antibiotics and probiotics treatments tended to increase these parameters. In Exp. 2, however, only SI was significantly (P<0.05) decreased in Antibiotics treatments. Concentration of serum immunoglobulin (IgG) were higher (P<0.05) in PB-M and PB-Y treatments when compared with Control treatment in Exp. 1. The population of E. coli significantly (P<0.05) decreased in birds from Antibiotics, PB-L and PB-Y treatments when compared with birds from Control treatment in Exp. 1. Metalbolizability of crude fat decreased significantly (P<0.05) in birds from probiotic treatments in Exp. 2. It was concluded that the response of probiotics on the productivity of layers and broilers were different. Probiotics increased strength and thickness of eggshell in layers, and decreased feed conversion and increased PI in broilers. Leukocytes and IgG tended to increase by supplementation of antibiotics and probiotics in layers. Intestinal E. coli tended to decrease in layers. Digestibility of crude fat of diet decreased in probiotics treatments broilers. Parameters of blood and microbial were more sensitive in layers than broilers.

Eating Traits and General Psychopathology of Korean Males Who Show High Score on the Korean Version of Eating Attitudes Test-26 (한국판(韓國版) 식사태도(食事態度) 검사(檢査)-26에서 고득점(高得點)을 보인 한국(韓國) 일반(一般) 남성군(男性群)의 식사특성(食事特性)과 일반정신병리(一般精神病理))

  • Han, Ki-Seok;Lee, Young-Ho;Rhee, Min-Kyu;Park, Se-Hyun;Sohn, Chang-Ho;Chung, Young-Cho;Hong, Sung-Kook;Lee, Byung-Kwan;Chang, Phi-Lip;Yoon, A-Rhee
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.87-102
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    • 1999
  • Objectives : The purposes of this study were to estimate the prevalence rate of eating disorders in Korean males and to clarify their characteristics in sociodemograhic data, the eating traits, and general psychopathology through the comparison with those of female high scored group on the Korean version of Eating Attitudes Test-26(KEAT-26). Methods : Using a multi-stage questionnaire sampling method including area sampling, proportionated stratified sampling, and quota sampling, we surveyed a total of 4,400 Korean adults over 18 in a nationwide area(9 kus, 10 middle or small cities, and 17 kuns), obtaining usable responses on 3,896. Of the 3,062 subjects(1249 males and 1813 females) who were available for analysis, we ascertained 52 males and 208 females who had high score($\geq$ cutoff point 21) on the KEAT-26. Results : 1) The proportion of this high score group was 1.7% in male and 6.8% in female with a sex ratio(male versus female) of 1 : 4. 2) The mean age was higher in the male group than in the female group, although it was not statistically significant(p=0.0514). Mean Body Mass Index(BMI) of the male group was significantly higher than that of female group, and the number of male subjects with below 20 of BMI was also significantly lower than in the female group. 3) There were no significant difference in past history of physical illness between two groups. However, frequency of smoking and alcohol use, and mean amount of alcohol consumption per month were significantly higher in the male group than in the female group. There were no significant differences between the two groups on various socio-demographic correlates such as economic status, total duration of education, number of family, marital status, religious status, and area of residence, but the exception of being occupational status. 4) The 'Eating Habits Scale' score and score of 'preference for vegetables and fish, and dislike for sweet-tasting food' of the male group were significantly lower than those of the female group. Although there was no significant difference between the two groups in total scores of the KEAT-26, the mean score on 'pursuit of thinness' subscale was higher in the female group than in the male group, while scores of 'food preoccupation' and 'self-control' subscales were higher in the male group than in the female group. 5) Scores on 'psychoticism' was significantly higher in the male group than in the female group, although there were no significant differences between the two groups on 'locus of control for weight', 'depression' and 'hypochondriasis'. Conclusion : These results support a possibility of a high prevalence of eating disorders in Korean males. These results suggest that eating related characteristics of high scorer on the EAT are different by sex in spite of the same high score on the EAT, and also suggest that male patients with eating disorders have more serious personality pathology than female patients with eating disorders.

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Vitamin $B_{12}$ Contents in Some Korean Fermented Foods and Edible Seaweeds (한국의 장류, 김치 및 식용 해조류를 중심으로 하는 일부 상용 식품의 비타민 $B_{12}$ 함량 분석 연구)

  • Kwak, Chung-Shil;Hwang, Jin-Yong;Watanabe, Fumio;Park, Sang-Chul
    • Journal of Nutrition and Health
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    • v.41 no.5
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    • pp.439-447
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    • 2008
  • There is a limitation to estimate vitamin $B_{12}$ intake due to lack of data on vitamin $B_{12}$ content in many Korean foods. In this study, vitamin $B_{12}$ content was determined in some soybean or vegetable-fermented foods, edible seaweeds and other frequently consumed foods in Korea by microbioassay using Lactobacillus delbruecki ATCC 7830. The traditional type of Doenjang and Chungkookjang contained 1.85 ${\mu}g/100$ g and 0.69 ${\mu}g/100$ g of vitamin $B_{12}$, respectively, while the factory-type of Doenjang and Chungkookjang contained 0.04-0.86 ${\mu}g/100$ g and 0.06-0.15 ${\mu}g/100$ g. Vitamin $B_{12}$ was not detected in steamed soybeans and Tofu which is a not-fermented soybean product, indicating that vitamin $B_{12}$ in Doenjang and Chungkookjang might be produced during the fermentation process. The Korean-style soy sauce contained 0.04 ${\mu}g$ vitamin $B_{12}$/100 mL, but vitamin $B_{12}$ was not detected in Japanese-style soy sauce and white miso. Commercial Kimchi, a representative Korean vegetable- fermented food, made of Korean cabbage, Yeolmu, or Mustard leaves contained 0.013-0.03 ${\mu}g$ vitamin $B_{12}$/100 g, while Kimchi without red pepper and fermented fish sauce (White Kimchi) did not. Vitamin $B_{12}$ content was very high in some edible seaweeds such as laver (66.76 ${\mu}g/100$ g dry weight) and sea lettuce (84.74 ${\mu}g/100$ g dry weight), and it was 17.12 ${\mu}g/100$ g of dried small anchovy, 1.07 ${\mu}g/100$ g of whole egg, and 0.02 ${\mu}g/100$ g of coffee mix. From these results, it is assumed that Koreans take substantial amount of vitamin $B_{12}$ from plant-origin foods. And, with these data, we will be able to calculate dietary vitamin $B_{12}$ content more correctly than before. In conclusion, soybean-fermented foods, Kimchi, laver and sea lettuce are recommendable as good sources of vitamin $B_{12}$ for vegetarians or Korean elderly on grain and vegetable based diet.

Individualized Determination of Lower Margin in Pelvic Radiation Field after Low Anterior Resection for Rectal Cancer Resulted in Equivalent Local Control and Radiation Volume Reduction Compared with Traditional Method (하전방 절제술을 시행한 직장암 환자에서 방사선조사 영역 하연의 개별화)

  • Park Suk Won;Ahn Yong Chan;Huh Seung Jae;Chun Ho Kyung;Kang Won Ki;Kim Dae Yong;Lim Do Hoon;Noh Young Ju;Lee Jung Eun
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.194-199
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    • 2000
  • Purpose : Then determining the lower margin of post-operative pelvic radiation therapy field according to the traditional method (recommended by Gunderson), the organs located in the low pelvic cavity and the perineum are vulnerable to unnecessary radiation. This study evaluated the effect of individualized determination of the lower margin at 2 cm to 3 cm below the anastomotic site on the failure patterns. Materials and Methods . Authors included ぉ patients with modified Astler-Coiler (MAC) stages from B2 through C3, who received low anterior resection and post-operative pelvic radiation therapy from Sept. 1994 to May 1998 at Samsung Medical Center, Sungkyunkwan University. The numbers of male and female patients were 44 and 44, and the median age was 57 years (range: 32-81 years). Three field technique (posterior-anterior and bilateral portals) by 6, 10, 15 MV X-rays was used to deliver 4,500 cGy to the whole pelvis followed by Sn cGy's small field boost to the tumor bed over 5.5 weeks. Sixteen patients received radiation therapy by traditional field margin determination, and the lower margin was set either at the low margin of the obturator foramen or at 2 cm to 3 cm below the anastomotic site, whichever is lower. In 72 patients, the lower margin was set at 2 cm to 3 cm below the anastomotic site, irrespectively of the obturator foramen, by which the reduction of radiation volume was possible in 55 patients ($76\%$). Authors evaluated and compared survival, local control, and disease-free survival rates of these two groups. Results : The median follow-up period was 27 months (range : 7-58 months). MAC stages B2 in 32($36\%$), B3 in 2 ($2\%$), Cl in 2 ($2\%$), C2 in 50 ($57\%$), and C3 in 2 ($2\%$) Patients, respectively. The entire patients' overall survival rates at 2 and 4 years were $94\%$ and $68\%$, respectively, and disease-free survival rates at 2 and 4 years were $86\%$ and $58\%$, respectively. The first failure sites were local only in 4, distant only in 14, and combined local and distant in 1 patient, respectively. There was no significant difference with respect to local control and disease-free survival rates ( p=0.42, p=0.68) between two groups of different lower margin determination policies. Conclusion : The new concept in the individualized determination of the lower margin depending on the anastomotic site has led to the equivalent local control and disease-free survival rates, and is expected to contribute to the reduction of unnecessary radiation-related morbidity by reduction of radiation volume, compared with the traditional method of lower margin determination.

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The Knowledge, Attitude, and Utilization Experience of Community Health Practitioners on Complementary Therapies (보완요법에 대한 보건진료원의 지식, 태도와 활용 경험)

  • Hwang, Sung-Ho;Park, Jae-Yong;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.87-105
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    • 2002
  • In order to find out the knowledge, attitude, and experience of community health practitioners(CHP) on complementary therapy, 393 community health practitioners who provide primary health care service in Busan, Kyeongnam, and Daegu, Gyeongbuk regions were interviewed or surveyed by mail from February 1st to March 31st, 2002. In terms of interest of CHPs toward 11 different hinds of complementary therapy, the rate of interest for soojichim was the highest with 75.3%. Aroma therapy had the interest of 71.0% of the CHPs, oriental medicine had 67.4%, and massage had 67.4%. The interest for shiatsu was 64.6%, while homeopath had the lowest rate of interest of 18.1%. In terms of reliance on the treatment results, oriental medicine scored the highest with 92.6%, and soojichim, massage, and shiatsu followed with 85.5%, 83.7%, and 81.7% respectively. Homeopath had the lowest reliance of 18.1%. The 65.1% of the CHPs had the experience of recommending oriental medicine to patients. 50.4% indicated that they had recommended soojichim, and 44.8% had recommended massage before. Shiatsu and aromatherapy followed with 34.4% and Homeopath had the lowest rate of 2.80%. When CHPs were asked if they had received any training in complementary therapy, 33.1% indicated that they had studied soojichim and 13.2%stated that they had learned oriental medicine. Aromatherapy, massage, and shiatsu followed with 11.2%, 8.4%, and 5.6% respectively On the other hand, none of the CHPs had received training in homeopath. In terms of using complementary therapy during the past 5 years, 23.9% had been treated with oriental medicine, and 18.896 had received soojichim. 5.9% had received aromatherapy, 5.3% had used massage, and 5.1% had experience with shiatsu. None of the practitioners had used homeopath during the past 5 years. Significantly many number of practitioners indicated that they had excellent treatment results with all hinds of complementary therapy, and there were rare cares of side effects. When they were asked if they wanted complementary therapy to become part of the curriculum during re-training or training for public service personnels, 78100 wanted soojichim, 69.2% wanted oriental medicine, and 67.9% wanted aroma therapy. 63.9% wanted shiatsu to be included, and 63.1% wanted massage. When CHPs were asked if they wanted to use complementary therapy during primary health care, 63.6% wanted to use soojichim, 52.9% wanted massage, and 51.9% wanted to use aroma therapy. Oriental medicine also showed a high rate of 50.1%. On the other hand, only a small percentage wanted to use chiropractic or homeopath with 17.0% and 12,2% respectively. Among the CHPs, there were some who had administered complementary therapy during the past 5 years. 84% had administered soojichim, 4.6% had administered oriental medicine, and 2.5% had administered massage 2.5% of the CHPs answered that they had administered aromatherapy. However, none of them had administered apitherapy or homeopath. Most of patients showed positive responses, and the rate of side effect was very low. As shown in the above results, although CHPs have a high rate of interest, reliance, and experience in recommending complementary therapy, only a low percentage of them had received any training in complementary therapy. In addition, since there were little side effects when they received or administered complementary therapy, they hoped complementary therapy, which can be beneficial to health, to be introduced to the curriculum. Therefore, in order to provide community members with complementary therapy and the correct information regarding the selection of complementary therapy that could be beneficial to health, a policy of continuous interest and support is needed so that CHPs can he provided with a systemic and rational curriculum of complementary therapy.

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The study on the entry of dental technicians in the public health center for a manpower supply and demand plane (Centering around a denture insurance policy in 2012) (인력수급 대책을 위한 치과기공사의 보건지소 진출에 관한 연구 - 2012년 틀니보험화 정책을 중심으로 -)

  • Lee, Jong-Do;Kim, Jeong-Sook;Park, Kwang-Sig
    • Journal of Technologic Dentistry
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    • v.32 no.4
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    • pp.417-433
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    • 2010
  • Purpose: This study evaluated the manpower planning of dental technicians. Methods: Methods : Survey was conducted regarding subject's general characteristics, characteristics of dental technician's occupational view and working conditions, and reason to enter into branches of the public health enter. The survey sample consisted of 323 dental technicians (221 male/ 102 female). Survey was conducted for one month from August 1 to September 1 in 2010. Following results were obtained. Results: 1. Regarding general characteristics of the subjects, there was a slight male predilection with 68.4%. Subjects in their 40s occupied the highest proportion of 32.2%. Majority of subjects worked in the big cities (71.5%). Favored working places were dental laboratory (57.6%) and dental hospital or dental clinic (19.5%). Although no position is available in the public sector such as public health center or health care civil servant, 9.3% preferred working in the public health center. Public sector is more favored than 2-year technical colleges or dental supply and equipment companies. In respect to education, 57% of the subjects graduated college. 67.8% were married. Subjects who specialize in the porcelain or all-ceramic were 57.9%. With regard to current position, head of the dental laboratory was most common. 2. Following occupation characteristics were found. Economic reason took the highest proportion when deciding their occupation (39.9%) followed by gaining social experience (36.5%). Majority of the subjects (76.5%) wanted to work as dental technicians until their retirement. 71.5% pursuit to become a manager of the dental laboratory. 76.1% agreed on opening a dental technician position in the public health center. Regarding an authority to lead developing the dental technician position in the public sector, majority of the subject chose ministry of health and welfare (35.6%) and Korean dental technologist association (34.7%). Employment (average, 30%) and turnover rate (average, 36.5%) of dental technology college graduates ranged from 40% to 60%. Most important factors for the employment were practical experience (41.2%) and competency (34.4%). With regard to job satisfaction, so-so as 46.7% and satisfactory was 42.7% 3. In respect to the reason for opening a position in the public health center, 'It is needed to continue denture rogram for elderly patients' obtained the highest score (4.14 point). 'Institutional devices are required to open a position for dental technicians as a public healthcare provider' received high score (4.11 point). 4. Concerning the working conditions, 'professional knowledge is required' received the highest score (4.23) followed by 'too short maternity and parental leave' (4.21). 5. Relationship between general characteristics of the subjects and favor of working in the public health center was investigated. Significant differences were found according to the current and favored working area, favored occupation, education level, marital status, and specialty. Working in the public health center was favored by following subjects: working in mid- or small-sized cities (4.16 point, p<0.05); PhD degree-holder (4.59 point, p<0.01). 6. Among general characteristics of the subjects, significant difference of working conditions was found in the following factors: gender; working areas; favored working areas; favored working positions, and education level. Majority of subjects favored working in big cities and currently work in big cities although satisfaction was comparatively low (3.75 score). 7. Future plan to work in public health center was evaluated according to occupational characteristics. Subject's intention to work in the public healthcare center was significantly affected by opening of dental technician position, leading authority, average turnover rate, and factors affecting employment. Working in the public health care center was favored by the following subjects: Dental technicians who actively supported opening of the dental technician position (4.34 point, p<0.001); subjects who thought the Korean dental technologist association is responsible for the opening of positions in the public sector (4.26 point, p<0.001); and subjects who thought that attitude and character are important for the employment (p<0.001). 8. Concerning difference of working conditions according to the occupational characteristics, significant difference was demonstrated by factors such as a reason to choose to be a dental technician, work plan, pursuing position, responsible authority, average employment rate, and job satisfaction. High standard of working conditions was required in subjects who selected to be a dental technician for the leisure time after work (s.05 point, p<0.01), who planted to work until their marriage (4.25 point, p<0.001), and who pursuit to be a manager (3.98, p<0.05). 9. In respect to influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.068 and age affected the working condition with significant difference according to the pvalue. 10. Regarding influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.335 and work plan, opening of dental technician position in the public sector, and responsible authority had significant influence over the subject's intention to work in the public health center according to the p-value. 11. With regard to the influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.091 and reason to choose to be a dental technician, work plan, and responsible authority significantly affected subject's working conditions. Conclusion: Korean society is becoming a super-aged society according to several statistics. As aged population is rapidly increasing, national health insurance plans to cover denture for senior citizen over 75 years old from 2012. Therefore, dental technicians are urgently needed in the public health centers all over the nation. Many subjects in this study planed to work until their retirement and recognized dental technician's expertise. Ministry of health and welfare and Korean dental technologist association should co-operate each other to prepare foundation and institutional devices for dental technicians to advance into the public health center. This will improve oral health of the population. This study showed urgency of medical facilities and services which meets increasing number of aged population and welfare of the population.

Effects of Concurrent Chemotherapy and Postoperative Prophylactic Paraaortic Irradiation for Cervical Cancer with Common Iliac Node Involvement (자궁경부암의 근치적 절제술 후 총장골동맥림프절 침범 시 동시항암화학치료와 예방적 대동맥주위림프절 방사선조사의 효과)

  • Han, Tae-Jin;Wu, Hong-Gyun;Kim, Hak-Jae;Ha, Sung-Whan;Kang, Soon-Beom;Song, Yong-Sang;Park, Noh-Hyun
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.125-132
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    • 2010
  • Purpose: To retrospectively assess the advantages and side effects of prophylactic Paraaortic irradiation in cervical cancer patients with common iliac nodal involvement, the results for survival, patterns of failure, and treatment-related toxicity. Materials and Methods: From May 1985 to October 2004, 909 patients with cervical carcinoma received postoperative radiotherapy at the Seoul National University Hospital. Among them, 54 patients with positive common iliac nodes on pathology and negative Paraaortic node were included in the study. In addition, 44 patients received standard pelvic irradiation delivered 50.4 Gy per 28 fractions (standard irradiation group), and chemotherapy was combined in 16 of them. The other 10 patients received pelvic irradiation at a dose of 50.4 Gy per 28 fractions in addition to Paraaortic irradiation at 45 Gy per 25 fractions (extended irradiation group). In addition, all of them received chemotherapy in combination with radiation. Follow-up times for pelvic and Paraaortic irradiation ranged from 6 to 201 months (median follow-up time, 58 months) and 21 to 58 months (median follow-up time, 47 months), respectively. Results: The 4-year overall survival, disease free survival, and distant metastasis free survival in the standard irradiation group and extended irradiation group were 67.2% vs. 90.0% (p=0.291), 59.0% vs. 70.0% (p=0.568) and 67.5% vs. 90.0% (p=0.196), respectively. The most common site of first failure for the standard irradiation group was the paraaortic lymph node, while no paraaortic failure was observed in the extended irradiation group. Relatively, hematologic toxicity grade 3 or greater was common in the extended irradiation group (2/10 extended vs. 2/44 standard), while gastrointestinal toxicity of grade 3 or greater was lower (2/10 extended vs. 6/44 standard), and urologic toxicity of grade 3 or greater was observed in the standard irradition group only (0/10 vs. 3/44). Conclusion: Concurrent chemotherapy and prophylactic Paraaortic irradiation in patients with common iliac nodal involvement showed slightly improved clinical outcomes aside from increased hematologic toxicity, which was statistically insignificant. Considering the relatively small number of patients and short follow-up times, additional studies are needed to obtain more conclusive outcomes.

A Study of The Medical Classics in the '$\bar{A}yurveda$' ('아유르베다'($\bar{A}yurveda$)의 의경(醫經)에 관한 연구)

  • Kim, Ki-Wook;Park, Hyun-Kuk;Seo, Ji-Young
    • Journal of Korean Medical classics
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    • v.20 no.4
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    • pp.91-117
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    • 2007
  • Through a simple study of the medical classics in the '$\bar{A}yurveda$', we have summarized them as follows. 1) Traditional Indian medicine started in the Ganges river area at about 1500 B. C. E. and traces of medical science can be found in the "Rigveda" and "Atharvaveda". 2) The "Charaka" and "$Su\acute{s}hruta$(妙聞集)", ancient texts from India, are not the work of one person, but the result of the work and errors of different doctors and philosophers. Due to the lack of historical records, the time of Charaka or $Su\acute{s}hruta$(妙聞)s' lives are not exactly known. So the completion of the "Charaka" is estimated at 1st${\sim}$2nd century C. E. in northwestern India, and the "$Su\acute{s}hruta$" is estimated to have been completed in 3rd${\sim}$4th century C. E. in central India. Also, the "Charaka" contains details on internal medicine, while the "$Su\acute{s}hruta$" contains more details on surgery by comparison. 3) '$V\bar{a}gbhata$', one of the revered Vriddha Trayi(triad of the ancients, 三醫聖) of the '$\bar{A}yurveda$', lived and worked in about the 7th century and wrote the "$A\d{s}\d{t}\bar{a}nga$ $A\d{s}\d{t}\bar{a}nga$ $h\d{r}daya$ $sa\d{m}hit\bar{a}$ $samhit\bar{a}$(八支集)" and "$A\d{s}\d{t}\bar{a}nga$ Sangraha $samhit\bar{a}$(八心集)", where he tried to compromise and unify the "Charaka" and "$Su\acute{s}hruta$". The "$A\d{s}\d{t}\bar{a}nga$ Sangraha $samhit\bar{a}$" was translated into Tibetan and Arabic at about the 8th${\sim}$9th century, and if we generalize the medicinal plants recorded in each the "Charaka", "$Su\acute{s}hruta$" and the "$A\d{s}\d{t}\bar{a}nga$ Sangraha $samhit\bar{a}$", there are 240, 370, 240 types each. 4) The 'Madhava' focused on one of the subjects of Indian medicine, '$Nid\bar{a}na$' ie meaning "the cause of diseases(病因論)", and in one of the copies found by Bower in 4th century C. E. we can see that it uses prescriptions from the "BuHaLaJi(布哈拉集)", "Charaka", "$Su\acute{s}hruta$". 5) According to the "Charaka", there were 8 branches of ancient medicine in India : treatment of the body(kayacikitsa), special surgery(salakya), removal of alien substances(salyapahartka), treatment of poison or mis-combined medicines(visagaravairodhikaprasamana), the study of ghosts(bhutavidya), pediatrics(kaumarabhrtya), perennial youth and long life(rasayana), and the strengthening of the essence of the body(vajikarana). 6) The '$\bar{A}yurveda$', which originated from ancient experience, was recorded in Sanskrit, which was a theorization of knowledge, and also was written in verses to make memorizing easy, and made medicine the exclusive possession of the Brahmin. The first annotations were 1060 for the "Charaka", 1200 for the "$Su\acute{s}hruta$", 1150 for the "$A\d{s}\d{t}\bar{a}nga$ Sangraha $samhit\bar{a}$", and 1100 for the "$Nid\bar{a}na$", The use of various mineral medicines in the "Charaka" or the use of mercury as internal medicine in the "$A\d{s}\d{t}\bar{a}nga$ Sangraha $samhit\bar{a}$", and the palpation of the pulse for diagnosing in the '$\bar{A}yurveda$' and 'XiZhang(西藏)' medicine are similar to TCM's pulse diagnostics. The coexistence with Arabian 'Unani' medicine, compromise with western medicine and the reactionism trend restored the '$\bar{A}yurveda$' today. 7) The "Charaka" is a book inclined to internal medicine that investigates the origin of human disease which used the dualism of the 'Samkhya', the natural philosophy of the 'Vaisesika' and the logic of the 'Nyaya' in medical theories, and its structure has 16 syllables per line, 2 lines per poem and is recorded in poetry and prose. Also, the "Charaka" can be summarized into the introduction, cause, judgement, body, sensory organs, treatment, pharmaceuticals, and end, and can be seen as a work that strongly reflects the moral code of Brahmin and Aryans. 8) In extracting bloody pus, the "Charaka" introduces a 'sharp tool' bloodletting treatment, while the "$Su\scute{s}hruta$" introduces many surgical methods such as the use of gourd dippers, horns, sucking the blood with leeches. Also the "$Su\acute{s}hruta$" has 19 chapters specializing in ophthalmology, and shows 76 types of eye diseases and their treatments. 9) Since anatomy did not develop in Indian medicine, the inner structure of the human body was not well known. The only exception is 'GuXiangXue(骨相學)' which developed from 'Atharvaveda' times and the "$A\d{s}\d{t}\bar{a}nga$ Sangraha $samhit\bar{a}$". In the "$A\d{s}\d{t}\bar{a}nga$ Sangraha $samhit\bar{a}$"'s 'ShenTiLun(身體論)' there is a thorough listing of the development of a child from pregnancy to birth. The '$\bar{A}yurveda$' is not just an ancient traditional medical system but is being called alternative medicine in the west because of its ability to supplement western medicine and, as its effects are being proved scientifically it is gaining attention worldwide. We would like to say that what we have researched is just a small fragment and a limited view, and would like to correct and supplement any insufficient parts through more research of new records.

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