• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2159-2165
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• 2013

Cancer registries help to establish and maintain cancer incidence reporting system, serve as a resource for investigation of cancer and its causes, and provide information for planning and evaluation of preventive and control programs. However, their wider role in directly enhancing oncology drug access has not been fully explored. We examined the value of cancer registries in oncology drug access in the Asia-Pacific region on three levels: (1) specific registry variable types; (2) macroscopic strategies on the national level; and (3) a regional cancer registry network. Using literature search and proceedings from an expert forum, this paper covers recent cancer registry developments in eight economies in the Asia-Pacific region - Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand - and the ways they can contribute to oncology drug access. Specific registry variables relating to demographics, tumor characteristics, initial treatment plans, prognostic markers, risk factors, and mortality help to anticipate drug needs, identify high-priority research area and design access programs. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes. Concurrent efforts should also be channeled into developing and implementing data integrity and stewardship policies, and providing clear avenues to make data available. Less mature registry systems can employ modeling techniques and ad-hoc surveys while increasing coverage. Beyond local settings, a cancer registry network for the Asia-Pacific region would offer cross-learning and research opportunities that can exert leverage through the experiences and capabilities of a highly diverse region.

• Journal of Korean Neurosurgical Society
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• v.30 no.11
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• pp.1263-1270
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• 2001

Objective : To analyze the radiosurgical results of intracranial meningiomas after Gamma Knife radiosurgery (GKS) and to assess the possible factors related to the outcome and complications in treating meningiomas. Patients and Methods : We retrospectively reviewed the clinical and radiological data in 179 patients(194 lesions) treated with GKS for intracranial meningiomas between May 1992 and October 2000. Radiosurgical responses were categorized as shrinkage, stasis and enlargement, and we defined the shrunken and static group as a radio-logical control. A Cox proportional hazards model was used to evaluate the correlation between the radiosurgical outcomes and various factors such as location and size of tumor, age and gender of patients, relation to venous sinus, pre-GKS degree of edema, treatment modality, radiosurgical parameters, and pathologic findings. Results : Patients were grouped into skull base meningiomas(57.7%), non-skull base tumor including convexity, parasagittal, and falx meningiomas(37.1%), and others(5.2%) according to the location of tumors. The mean maximum dose and the margin dose of tumor was 30.0Gy(19-45Gy) and 15.1Gy(9.5-24.5Gy), respectively. The mean volume of the tumors was 9.4cc(0.003-45.0cc). The radiologic control rate was 97.1%. The radiation induced imaging change with or without neurologic deficit was the most common complication(23.6%). There were seen mostly in convexity, parasagittal, and falx meningiomas which were deeply embedded in cortex. Conclusion : GKS for intracranial meningioma seems to be safe and effective treatments. However, GKS should be considered very cautiously in non-skull base tumor such as convexity, parasagittal, or falx meningiomas with regards to patient's age and general condition, size and location of tumor, pattern of embedding into cortex, presenting symptoms and patient's preference.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.675-680
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• 2010

Background: The aim of this study was to identify the distinguishing clinicoradiologic findings of traumatic tracheobronchial injury. Material and Method: Between January 2003 and December 2009, six patients who underwent surgical repair for traumatic tracheobronchial injury due to blunt trauma were included in this study. We evaluated the mechanism of the injury, the coexisting injuries, the time until the making diagnosis and treatment, the diagnostic methods, the anatomic location of the injury and the surgical outcomes. Result: The mechanisms of injury were traffic accident and crushing forces. The frequent symptoms were subcutaneous emphysema, dyspnea and pain, and the common radiologic findings were pneumothorax, mediastinal emphysema, rib fracture and lung contusion. Only 2 patients were diagnosed by chest CT and the others were not diagnosed preoperatively. The location of injury was the trachea in 2 patients and the bronchial tree in 4 patients. There was no postoperative mortality or anastomotic leak; however, vocal cord palsy occurred in one patient. The most distinguishing sign was persistent lung collapse even though the chest tube was connected with negative pressure. Conclusion: Although it was not easy to diagnose traumatic tracheobronchial injury without a clinical suspicion, the distinguishing clinical symptoms and CT findings could help to make an early diagnosis without performing bronchoscopy.

• Journal of Chest Surgery
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• v.46 no.6
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• pp.426-432
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• 2013

Background: Heart transplantation has become a widely accepted surgical option for end-stage heart failure in Korea since its first success in 1992. We reviewed early postoperative complications and mortality in 239 patients who underwent heart transplantation using bicaval technique in Asan Medical Center. Methods: Between January 1999 and December 2011, a total of 247 patients aged over 17 received heart transplantation using bicaval technique in Asan Medical Center. After excluding four patients with concomitant kidney transplantation and four with heart-lung transplantation, 239 patients were enrolled in this study. We evaluated their early postoperative complications and mortality. Postoperative complications included primary graft failure, cerebrovascular accident, mediastinal bleeding, renal failure, low cardiac output syndrome requiring intra-aortic balloon pump or extracorporeal membrane oxygenation insertion, pericardial effusion, and inguinal lymphocele. Follow-up was 100% complete with a mean follow-up duration of $58.4{\pm}43.6$ months. Results: Early death occurred in three patients (1.3%). The most common complications were pericardial effusion (61.5%) followed by arrhythmia (41.8%) and mediastinal bleeding (8.4%). Among the patients complicated with pericardial effusion, only 13 (5.4%) required window operation. The incidence of other significant complications was less than 5%: stroke (1.3%), low cardiac output syndrome (2.5%), renal failure requiring renal replacement (3.8%), sternal wound infection (2.0%), and inguinal lymphocele (4.6%). Most of complications did not result in the extended length of hospital stay except mediastinal bleeding (p=0.034). Conclusion: Heart transplantation is a widely accepted option of surgical treatment for end-stage heart failure with good early outcomes and relatively low catastrophic complications.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7315-7319
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• 2015

Objectives: The study analyzed and compared the long term outcome in locally advanced rectal cancer treated with preoperative and postoperative concurrent chemoradiation (CCRT). Materials and Methods: A retrospective review of 105 patients with stage T3-T4 or regional lymph node positive adenocarcinoma of rectum treated with preoperative or postoperative CCRT at Ramathibodi Hospital during 2005 to 2010 was performed. The results of treatment were reported with 5-year overall survival (OS), 5-year locoregional recurrence free survival (LRFS), and toxicity according to preoperative versus postoperative concurrent chemoradiation (CCRT) groups. Results: Among 105 patients, 34 (32%) were treated with preoperative CCRT and 71 (68%) with postoperative CCRT. At the median follow-up time of 50.5 months (range 2-114 months), five-year OS and LRFS of all patients were 87% and 91.6%, respectively. The study found no difference in 5-year OS (81.7% vs 89.2 %) or LRFS (83.4% vs 95.1%) between preoperative versus postoperative CCRT. Seven cases of loco-regional recurrence were diagnosed, 4 (11.8%) after preoperative CCRT and 3 (4.2%) after postoperative CCRT. The recurrent sites were anastomosis in all patients. There was no significant factor associated with outcome after univariate and multivariate testing. Grade 3 or 4 acute and late complications were low in both preoperative and postoperative CCRT groups. Conclusions: Locally advanced rectum cancer patients experience good results with surgery and adjuvant concurrent chemoradiation.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3941-3944
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• 2013

Background: The use of preoperative chemoirradiation is the commonest treatment strategy employed in Malaysia for locally advanced rectal cancer. We need to determine the local control and survival rates for comparison with established rates in the literature. Materials and Methods: This retrospective study analyzed all newly diagnosed patients with rectal adenocarcinoma who underwent long course preoperative radiotherapy (RT) at the Department of Radiotherapy and Oncology, Kuala Lumpur Hospital (HKL) between $1^{st}$ January 2004 and $31^{st}$ December 2010. The aim of the study was to determine the radiological response post radiotherapy, pathological response including circumferential resection margin (CRM) status, 3 years local control, 3 years overall survival (OS) and 3 years disease free survival (DFS). Statistical analysis was performed using the SPSS software. Kaplan-Meier and log rank analysis were used to determine survival outcomes. Results: A total of 507 patients with rectal cancer underwent RT at HKL. Sixty seven who underwent long course preoperative RT were eligible for this study. The median age at diagnosis was 60 years old with a range of 26-78 years. The median tumour location was 6 cm from the anal verge. Most patients had suspicion of mesorectum involvement (95.5%) while 28.4% of patients had enlarged pelvic nodes on staging CT scan. All patients underwent preoperative chemo-irradiation except for five who had preoperative RT alone. Only 38 patients underwent definitive surgery (56.7%). Five patients were deemed to be inoperable radiologically and 3 patients were found to have unresectable disease intraoperatively. The remaining 21 patients defaulted surgery (31.3%). The median time from completion of RT to surgery was 8 weeks (range 5.6 to 29.4 weeks). Fifteen patients (39.5%) had surgery more than 8 weeks after completion of RT. Complete pathological response was noted in 4 patients (10.5%). The pathological CRM positive rate after RT was 18.4%. With a median follow-up of 38.8 months, the 3 year local control rate was 67%. The 3 years rate for CRM positive (<2 mm), CRM clear (>2 mm) and pCR groups were 0%, 88.1% and 100% respectively (p-value of 0.007). The 3 year OS and DFS were 57.3% and 44.8% respectively. Conclusions: In conclusion, the approach of long course preoperative chemoirradiation for rectal cancer needs to be re-examined in our local setting. The high rate of local recurrence is worrying and is mainly due to patient defaulting post-preoperative chemoirradiation or delayed definitive surgery.

• PNF and Movement
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• v.16 no.2
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• pp.275-286
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• 2018

Purpose: This study aimed to investigate the effect of an intensive rehabilitation program on the pain, range of motion (ROM), muscle strength, function, quality of life (QoL), and depression of patients with traumatic rotator cuff injury caused by an industrial accident. Methods: Seventeen patients with traumatic rotator cuff injury caused by an industrial accident participated in this study. The 12-week treatment included 30 min of manual therapy and 30 min of exercise therapy twice a day, five times a week. The outcomes were measured for evaluating the pain, ROM, muscle strength, function, QoL, and depression before the commencement of the program and after 4, 8, and 12 weeks. Results: According to the time of applying the intensive rehabilitation program, the pain (p<0.01), ROM (p<0.01), muscle strength (p<0.01), function (p<0.01), and depression (p<0.05) significantly improved with time. However, QoL was not statistically significant. Conclusion: This study confirmed the excellent effect of an intensive rehabilitation program on the pain, ROM, muscle strength, function, and depression of patients with traumatic rotator cuff injury caused by an industrial accident. However, this study was limited by the absence of a control group. This pilot study highlights the need for more extensive research with a larger sample.

• Parasites, Hosts and Diseases
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• v.47 no.3
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• pp.299-302
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• 2009

The incidence of imported malaria has been increasing in Korea. Were viewed data retrospectively to evaluate the epidemiology, clinical features, and outcomes of imported malaria from 1995 to 2007 in a university hospital. All patients diagnosed with imported malaria were included. Imported malaria was defined as a positive smear for malaria that was acquired in a foreign country. A total of 49 patients (mean age, 35.7 year; M: F = 38 : 11)were enrolled. The predominant malarial species was Plasmodium falciparum (73.5%), and the most frequent area of acquisition was Africa (55.1%), followed by Southeast Asia (22.4%) and South Asia (18.4%). Fourteen-patients (30.6%) suffered from severe malaria caused by P. falciparum and 1 patient (2.0%) died of multiorgan failure. Most of the patients were treated with mefloquine (79.2%) or quinine (10.2%); other antimalarial agents had to be given in 13.2% treated with mefloquine and 44.4% with quinine due to adverse drug events (ADEs). P. falciparum was the most common cause of imported malaria, with the majority of cases acquired from Africa, and a significant number of patients had severe malaria. Alternative antimalarial agents with lower rates of ADEs might be considered for effective treatment instead of mefloquine and quinine.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.4
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• pp.293-300
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• 2009

Objective: This study was aimed to investigate whether uterine blood flow on the day of embryo transfer can be a predictor of pregnancy outcome in human IVF. Methods: Fifty-one patients undergoing IVF program were included in this study. Serum estradiol levels were measured on the day of hCG administration and uterine pulsatility index (PI) and resistance index (RI) was examined for at embryo transfer of day 3. Results: Of 51 cycles, 22 cycles were clinically pregnant (43.1%) and the implantation rate was 14.7%. Uterine PI and RI had a significant inverse correlation with serum estradiol levels (p<0.05). These uterine blood flows were not significantly different between pregnant and nonpregnant groups. The pregnancy rate was slightly higher in patients with PI more than 3.0 compared to those with PI of 3.0 or less, but there was no significant difference. Conclusion: These results suggest that uterine PI and RI at the day of embryo transfer could not be a good predictor of pregnancy in IVF treatment. But they had an inverse correlation with serum estradiol levels on the day of hCG administration.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.2
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• pp.243-254
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• 2004

Purpose: The purpose of this study was cross-mapping unique nursing statements which were identified in the nursing records of patients with six most common cancers in Korea with the standardized nursing languages of NANDA, NIC, NOC and ICNP. Method: The subjects were 72 nursing records which covered 1,502 admission days from August 1, 2003 to June 30, 2003. They were the records of the patients of six most common cancers who were treated at the six 3rd level general hospitals in Busan and Daegu. The unique nursing statements were identified by dividing the statements from the nursing records into the single statements according to their meanings. For cross-mapping, identified unique nursing statements were classified as 'Data(D)' for the subjective, objective data of the patients and the other data such as treatment, admission, discharge, and residence of patient, 'Problem(P)' for nursing problem or diagnosis defined by the nurse's decision, 'Intervention(I)' for nursing intervention for problem solving, and 'Outcome(O)' for patient reaction and results of the provided nursing interventions. Unique nursing statements classified to D, P, I, O were cross-napped by using Microsoft Excel 2000. The statements of D were cross-mapped with ICNP Nursing phenomena, P with NANDA nursing diagnosis and ICNP nursing phenomena, I with NIC and ICNP nursing intervention, and O with NOC and ICNP nursing phenomena Result: The results of this study were as follows. 1. Number of unique nursing statements were 506 in the records of lung cancer patients (18.12%), 480 in stomach cancer(17.19%), 458 in liver cancer(16.40%), 456 in colon cancer (16.33), 457 in breast cancer (16.36%) and 436 in cervix cancer (15.60%). 2. The range of percentage of cross-mapped unique nursing statements with the standardized nursing languages were as follows: P with NANDA nursing diagnosis $87.50{\sim}100%$, I with NIC $59.72{\sim}74.43$, O with NOC $61.05{\sim}72.64%$, and D, P, I and O with ICNP $60.92{\sim}69.95%$. 3. Number of the standardized nursing languages identified in this study were 21(12.66%) from 155 NANDA nursing diagnosis, 76(15.64%) from 486 NIC Nursing interventions, 54(17.47%) from 260 NOC nursing outcomes, and 343(13.03%) from ICNP 2,634. Conclusions: By the results of this study, NANDA, NIC, NOC and ICNP were found that they can be used as the language systems for nursing record and nursing information system for cancer patients. But, further study on the unique nursing statements which were not cross-mapped with the standardized nursing language systems will be necessary.