• Title/Summary/Keyword: Stage of disease

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A Case of Lung Cancer: Postop Minimal Residual Disease at Pleura (폐암 수술 후 흉막 내 미세잔류병변 판정사례)

  • Jang, JoungSoon
    • Korean journal of aerospace and environmental medicine
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    • v.31 no.2
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    • pp.57-59
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    • 2021
  • For nonsmall cell lung cancer (NSCLC), surgery is indicated only for stage 3 as a curative measure. Even so, there is a high risk of recurrence following stage 3 lung cancer surgery, a third (33.9%) of patients experienced a cancer recurrence mostly within 2 years after surgery. The median survival time for all stages reaches only 21.9 months. For people undergoing surgery for stage 3A NSCLC, a pre-operative course of (neoadjuvant chemotherapy) can improve survival times, by improving the resectability and lowering the risk of recurrence. Pleural metastases are frequently associated with tumors of the lung and breast. Chest radiographs and computed tomography scans of pleural metastases can present as an effusion or smooth or nodular pleural thickening. In the absence of irregular or nodular pleural thickening, it is difficult to distinguish a benign from a malignant pleural effusion. To treat lung cancer, tyrosine kinase inhibitors (TKIs) recently have been used to cope with genetic mutations, apart from cytotoxic anticancer drugs. Compared to cytotoxic drugs, they are effective, have fewer side effects, and are easy to administer. Airman must have no cancer disease to apply for Class-I medical certification. Specifically, if previously operated on cancer, the cancer should not remain in the body at present, and the disease free state should persist at least one year after all kinds of anti-cancer treatments including adjuvant chemotherapy are completed. Here, this case deals with a 41-year-old pilot who has ATP license who had stage 3A NSCLC. The pilot underwent curative lung cancer surgery (lobectomy) a year ago and showed suspicious pleural metastasis at the time of his application for certification and was still using an unauthorized TKI agent alectinib (Alecensa; Roche, Basel, Switzerland).

Study on Knowledge Levels of Pre-dialysis, Chronic Renal Failure Patients at Glomerular Filtration Rates (GFRs) and Their Educational Demands (사구체 여과율에 따른 투석 전 만성 신부전 환자의 질병 관련 지식 정도와 교육 요구도 조사)

  • Kim, Hye-Won;ChoiKwon, S-Mi
    • Journal of Korean Biological Nursing Science
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    • v.12 no.2
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    • pp.114-126
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    • 2010
  • Purpose: To examine the levels of the disease-related knowledge and educational demands of pre-dialysis, chronic renal failure patients at different GFRs and stages. Methods: This study used a cross-sectional survey and aimed at 116 pre-dialysis, chronic renal failure patients, who were registered and received regular treatment from December 1 to December 31, 2009 at the nephrology departments of tertiary medical centers in Seoul. Stages were classified into Stage 3, 4 and 5 depending on GFR ranges. To measure the levels of knowledge and educational demands, the tool, which were first invented by Young Ae Lim (1996) and then modified by Hyo Sun Lim (2005) to adjust the knowledge and educational demands measuring tool for hemodialysis patients to pre-dialysis patients with chronic renal failure, was used. Collected data was analyzed with the SPSS WIN 12.0 program (average, standard deviation, Pearson's correlation coefficient, t-test and ANOVA). Results: There was a significant difference in the disease-related knowledge levels of the subjects at each stage (F=24.41, p=.000). The Scheffe post hoc test confirmed that patients at higher stages had higher levels of knowledge of their disease. Also, although the results showed that patients at higher stages had higher educational demands, there was no significant difference among the groups (F=1.259, p=.288). Conclusion: As patients have different levels of knowledge of the disease and educational demands depending on their stages, it is important to develop and use a systematic education program that reflects the demands and levels of patients at each stage in order to help pre-dialysis patients with chronic renal failure with self-management and improve their quality of life.

The Study of Incidence Disease Categories on Breast Medical Examination in Some Area (일부지역 유방검사의 질환별 발생 빈도에 관한 연구)

  • Kwak, Byung-Joon;Im, In-Chul;Ji, Tae-Jeong
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.357-363
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    • 2007
  • The breast cancer occurrence have been increase yearly. Consequently the effort for early discovery or prevention is necessary. The study investigated the age distribution rate and a disease distribution occurrence rate in the breast medical examination of Ulsan city area. Breast medical examination distribution ratio it preferred the breast ultrasound with mamography 38.8% breast-ultrasonogrphy 61.2% to be investigated. The disease categories distribution was various from breast-ultrasound medical examination and it was investigated with becomes ramification. The reading find was many most infiltrating duct carcinoma from 40 age stage. The ductal carcinoma in situ was many from 50 age stage. The most many disease was investigated HP(Heterogenous dense nodule or mass parenchyma pattern) with 29.2%. Also the breast abscess or mastitis disease is confirmed only the breast-ultrasonography examination, even from the outside disease it was investigated with the fact that the breast-ultrasound raises the discrimination.

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Efficacy by Application Schedule of Fungicides before Harvest Stage for Control of Strawberry Powdery Mildew (딸기 흰가루병 방제를 위한 수확전 약제 처리 시기)

  • Nam, Myeong-Hyeon;Jung, Suck-Kee;Jang, Chang-Soon;Song, Jeong-Young;Kim, Hong-Gi
    • Research in Plant Disease
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    • v.11 no.1
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    • pp.39-42
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    • 2005
  • Powdery mildew, caused by Sphaerotheca aphanis var. aphanis, is an economically significant disease of strawberry in Korea. When powdery mildew is not controlled adequately, it often spreads rapidly through strawberry plants and damage is associated with reduced yields. Proper timing of fungicide applications is, therefore, essential for effective disease control. This study evaluated the efficacy by application schedule of fungicides before harvest stage for preventing powdery mildew in 2001-2003. The systemic fungicides, azoxystrobin, kresoxim-methyl, and cupper fungicide DBEDC were applied preventively during the first part of the cultivating season. Preventative applications of DBEDC by dipping treatment before transplanting and kresoxim-methyl by foliar spray before blooming stage were one of the most effective control schedule tested to prevent and manage this disease. This research demonstrated the significance of application time to control of powdery mildew, particularly provided elimination unnecessary sprays of agrochemicals and reduction costs for strawberry growers.

TOAST Distribution of Ischemic Stroke Patients Admitted to Oriental Hospitals (한방 의료기관에 입원한 허혈성 뇌졸중 환자의 아형 분포)

  • Lee, Jung-Sup;Ko, Mi-Mi;Lee, Ju-Ah;Kang, Byoung-Kab;Cha, Min-Ho;Oh, Dal-Seok;Bang, Ok-Sun
    • The Journal of Korean Medicine
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    • v.31 no.5
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    • pp.82-89
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    • 2010
  • Objectives: The aim of this study was to determine distribution patterns of TOAST subtypes of ischemic stroke patients admitted to oriental hospitals and to get a better understanding of present conditions in oriental medicine by comparing with the Korea stroke registry (KSR), the largest and representative data. Methods: Clinical data were collected from acute ischemic stoke patients. MRI studies including vascular images were performed in all cases. TOAST criteria were used to determine subtypes of ischemic stroke patients. According to the duration from disease onset to hospital admission time, patients were assigned to 3 groups (Group I0 to 3 d, Group II4 to 7 d, Group III8 to 28 d) and the distribution of TOAST subtypes were compared among these three groups. Results: We collected 514 sets of clinical data from 10 oriental hospitals between May 2007 and September 2009. Small vessel occlusion (SVO) subtype was the most common (57.62%), followed by large artery atherosclerosis (LAA, 29.98%). Compared with TOAST distribution of KSR, the proportion of ischemic stroke patients with SVO subtype was higher than that of KSR. On the other hand the proportion of patients with stroke of undetermined etiology (SUE) was lower. Distributions of SVO, LAA and cardioembolism (CE) in group were I 66.4%, 23.8% and 8.9%, respectively; those in group IIIwere 51.03%, 34.71% and 11.57%, respectively. Conclusions: In oriental hospitals, the proportion of ischemic stroke patients diagnosed as SVO type was higher than that of KSR. At early stage (from onset to 2 d) proportion of SVO was very high, however after 7 days from onset it decreased with concomitant increases in proportions of LAA and CE. These phenomena may be due to the facts that 1) at early stage emergency treatments are limited in oriental hospitals, 2) after early stage many patients prefer oriental treatments, including rehabilitation.

External Beam Radiotherapy for Carcinoma of the Extrahepatic Biliary System (담낭 및 간외 담도계암의 방사선 치료성적)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.129-136
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    • 1996
  • Purpose : To evaluate the effectiveness and tolerance of patients of external beam radiotherapy for carcinoma of the extrahepatic biliary system (EHBS) including gall bladder (GB) and extrahepatic bile ducts (EHBD) and to define the role of radiotherapy for these tumors. Methods and Materials : We retrospectively analyzed the records of 43 patients with carcinoma of the EHBS treated with external beam radiotherapy at our institution between April, 1986 and Julr, 1994. Twenty three patients had GB cancers and remaining 20 patients did EHBD cancers. Of those 23 GB cancers, 2 had Stage II, 12 did Stage III and 9 did Stage IV disease, respectively. Male to female ratio was 11 to 12. Fifteen patients underwent radical surgery with curative intent and 8 patients did biopsy and bypass surgery alone All of the patients except for 3 patients were treated with 4500 cGy or higher doses postoperatively Follow up periods ranged from 11 to 82 months. Of those 20 EHBD cancers, one had Stage I, 2 did Stage II, 10 did Stage III and 7 did Stage IV disease, respectively. Male to female ratio was 16 to 4 Sixteen patients underwent Whipple's procedure or resection and drainage with curative aim and remaining 4 patients did bypass surgery alone Postoperatively 16 patients were irradiated with 4500 cGy or higher doses and 4 patients with 3180 to 4140 cGy Follow up periods ranged from 8 to 34 months. Results : Overall median survival time of patients with GB cancer was 11 months. Median survival time for Patients with Stage III and IV disease were 14 months and 5 months, respectively. Corresponding two rear survival rates were $36\%$(4/11) and $13\%$(1/8), respectively Those who underwent surgery with curative intent showed significantly better survival at 12 months than those who underwent bypass surgery alone($67\%$ vs $13\%$). None of the patients died of treatment related complications Median survival time for entire group of 20 EHBD patients was 10 months Median survivals of 10 Stage III and 7 Stage IV disease were 10 and 8 months, respectively. Two patients who underwent Whipple's procedure had 11 and 14 month survival and those treated with resection and drainage showed median survival of 10 month. Conclusion : Postoperative external beam radiotherapy for carcinoma of the extrahepatic biliary system is well tolerated and might improve survival of patients, especially those with resectable lesions with microscopic or gross residual disease after surgery.

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Novel Directions in Adjuvant Chemotherapy for Early Stage Epithelial Ovarian Cancer

  • Sakarya, Derya Kilic;Yetimalar, M Hakan;Ozbasar, Demir
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4157-4160
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    • 2015
  • Treatment of early stage ovarian cancer remains controversial despite advances in chemotherapeutic options. Over the past 30 years, molecular and clinicopathologic studies accelerated and treatment of ovarian cancer has undoubtedly improved although there is a debate as to whether this impacts outcome or not. More recently, the introduction of targeted therapy started a new era. Probably it is because early stage disease comprises a small portion of the epithelial ovarian cancer, studies have mostly ignored this group and still there is no clear consensus regarding systemic treatment of early-stage lesions. However this group of patients has the best chance of cure. In this review, we focus on current developments in the treatment of early stage ovarian cancer and query the options.

Survival of Stage IIIA NSCLC Patients with Changes in N Stage after Neoadjuvant Chemoradiotherapy (IIIA기 비소세포 폐암환자에서 신보조 항암방사선치료 후 N병기의 변화에 따른 생존률 비교)

  • Bae, Chi-Hoon;Park, Seung-Il;Kim, Yong-Hee;Kim, Dong-Kwan
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.586-590
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    • 2008
  • Background: Non-small cell lung cancer (NSCLC) patients histologically proven to have stage N2 disease by media-stinoscope or thoracoscope underwent subsequent neoadjuvant chemoradiotherapy. This study was designed to find out if there were any differences in survival or recurrence rates between N2 positive and N2 negative patients. Material and Method: Between January 1998 and December 2005, we retrospectively analyzed 69 patients who were divided into three groups. Group A consisted of patients whose N stage was downstaged, group B of patients whose N stage was the same, and Group C of patients who could not undergo surgery because of disease progression during neoadjuvant chemoradiotherapy. We analyzed and compared the mean survival, three-year survival, mean disease-free survival, and three-year disease-free survival rates for the three groups. Result: There were no demographic differences among the groups. The mean survival was 58, 47, and 21 months for groups A, B, and C, respectively. The mean survival was longest in group A, but no statistically significant difference was found on A-B or B-C group comparison (p>0.05). However, a significant difference was noted between group A and group C (p : 0.01). Three-year survival rates were 67%, 41%, and 21.6% for groups A, B, and C, respectively, with a statistical difference similar to that seen in mean survival. The mean disease-free survival was 44 months in group A and 45 months in group B, with no statistically significant difference noted. No significant differences were noted in the three-year disease-free survival rates (55.1%, 46.8%). Conclusion: There were no significant differences in survival or recurrence rates with changes in N stage after neoadjuvant chemoradiotherapy. However, mean survival, three-year survival, and three-year disease-free survival rates tended to be higher in downstaged patients. Nevertheless, the difference was statistically insignificant, and therefore further studies with more patients and longer follow-up are necessary to clarify the positive effects on the survival and prognosis of downstaged patients.

Features Related to Smoking and Psychological Characteristics of Coronary Artery Patients Associated with the Stage of Change in Smoking Cessation (금연변화단계에 따른 관상동맥질환자들의 흡연관련 특성과 심리적 특성)

  • Kim, Hwa Soon
    • Korean Journal of Adult Nursing
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    • v.17 no.4
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    • pp.592-601
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    • 2005
  • Purpose: The purpose of this study was to investigate differences in smoking related characteristics and psychological features of coronary artery patients by the stages of change in smoking cessation behaviors. Method: Subjects for this survey were 97 patients who were smoking when doctors diagnosed them to have coronary artery diseases. Result: Subjects were distributed 21.6% in precontemplation stage, 24.7% in contemplation stage, 17.5% in preparation stage, 19.6% in action stage, and 16.5% in maintenance stage respectively. The numbers of previous attempts to quit smoking of subjects in precontemplation stage(mean=3.00, SD=3.71) and contemplation stage(mean=2.63, SD=2.32) were significantly lower than that of subjects in preparation stage(mean=5.82, SD=6.20). Benefit scores of subjects in maintenance stage were significantly greater than those of subjects in precontemplation stage. Self-efficacy, barriers, seriousness, and nicotine dependency were not significantly different by the stages of change. Number of signs and symptoms related to smoking which subjects were experiencing were not significant by the stages of change too. Conclusion: Future intervention programs for smoking cessation should be focused on the strategies to enhance the realization of health benefits that patients might acquire from smoking cessation.

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Pretreatment prognostic Factors in Early Stage Caricinoma of the Uterine Cervix (초기 자궁 경부암에서 치료전 예후 인자)

  • Kim, Mi-Sook;Hua, Sung-Whan
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.59-67
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    • 1992
  • From March 1979 through December 1986, 124 patients with early stage carcinoma of the uterine cervix received curative radiation therapy. According to FIGO classification, 35 patients were stage IB and 89 were stge II A. In stage IB, five year locoregional control, five year disease free survival, and five year overall survival was $79.0\%$, $76.4\%$ and $81.8\%$, respectively. In stage II A, five year locoregional control, five year disease free survival, and five year overall survival were $78.0\%$, $66.8\%$, and $72.1\%$, respectively. To identify prognostic factors, pretreatment parameters including age, ECOG performance status, number of pregnancies, history of diabetes mellitus and hypertension, histology, size and shape of primary tumor, CT findings and blood parameters were retrospectively analyzed in terms of locoregional control, disease free survival and overall survival using univariate analysis and multivariate analysis. In univariate analysis, tumor size on physicai examination and rectal invasion on CT significantly affected locoregional control, disease free survival and overall survival. Parametrial involvement on CT was a significant prognostic factor on locoregional control and disease free survival. Hemoglobin level affected disease free survival and overall survival. Histology and age were significant prognostic factors on locoregional control. In multivariate analysis excluding CT finding, tumor size on physical examination was a significant factor in terms of locoregioal control and overall survival. Hemoglobin level was significant in terms of disease free survival. In multivariate analysis including CT, histology was a prognostic factor on locoregional control and disease free survival. Hemoglobin level and rectal invasion on CT were significant factors on locoregional control.

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