• Radiation Oncology Journal
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• v.13 no.1
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• pp.41-48
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• 1995

Purpose : The adjuvant postoperative radiotherapy has been usually applied to the patients with unfavorable prognostic factors after radical operation in early cervical cancer. We focused on the evaluation of the survival status and failure patterns of the patients with postoperative radiotherapy. Materials and Methods : We retrospectively analyzed ninety patients with FIGO stage IB and IIA cervix cancer who received postoperative pelvic irradiation at Chonnam University Hospital between August 1985 and December 1988, Seventy-eight patients had adequate follow-up information for survival analysis. Median follow-up time of these patients was 64 months. Results : The 5 year overall and disease free survival rate of ninety patients was $80.0\%$ and $80.2\%$, respectively. The prognostic significance to the survival was determined by multivariate analysis. Adequacy of resection margin(p=0.005) and lymph node status(p=0.005) appeared to be independent prognostic factors. Recurrence occurred in 13 patients, 5 in the pelvis and 8 at distant sites. The median time to recurrence was 19 months(range:3-39 months). The pelvic recurrence was more prevalent in the group of patients with adenocarcinoma, depth of stromal invasion more than 10mm and use of chemotherapy. The distant failure was more prevalent in the group of positive resection margin or positive lymph node with statistical significance. Conclusion : Patients with pelvic lymph node or surgical margin involvement clearly constitute a high risk group in this analysis and should be considered as candidates for some form of adjuvant therapy.

• Korean Journal of Food Science and Technology
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• v.29 no.2
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• pp.362-368
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• 1997

As a preliminary study for the development of cancer-preventing functional food using Korean mistletoe, the cytotoxic effects of Korean mistletoe on between non-tumorigenic A3l cell and tumorigenic MSV cell derived from mouse 3T3 fibroblast cell line were investigated. While the raw extract, of which $ID_{50}$, value was $3.94\;{\mu}g/mL$, showed strong cytotoxic effect, its heat-treated extract was not cytotoxic up to $30\;{\mu}g/mL$. On the other hand, the heat-treated extract with law concentration showed an accelerative effect on the proliferation of non-tumorigenic A3l cell and an inhibitory effect on that of tumorigenic MSV cell. In addition, the influences of the addition of carbohydrates, such as galactose, lactose, glucose, mannose, fructose, sucrose and starch, to mistletoe extract were studied. There were not any significant changes with raw extract plus carbohydrate treatment, but the accelerative and inhibitory effects of heat-treated extract on each A3l and MSV cell were increased further by the treatment with sugars such as lactose, galactose, glucose, fructose. In order to investigate the changes of cytotoxicity of fermented Korean mistletoe according to fermentation periods, the raw and heat-treated extract were inoculated with Lactobacillus plantarum. During 1, 3, 5 and 7 fermentation days, the fermented raw mistletoe extract showed gradual accelerative effect on A31 cell proliferation without any changes of cytotoxicity on MSV cell. In case of the fermented heat-treated extract, however, the accelerative effect of heat-treated extract on A31 cell proliferation in early stage was disappeared during the fermentation.

• Journal of the Korean Society of Radiology
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• v.9 no.4
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• pp.205-211
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• 2015

At a recent medical imaging technology, the major issue of X-ray diagnosis in breast cancer is the early detection of breast cancer and low patient's exposure dose. As one of studies to acquire a monochromatic X-ray, Technologies using multilayer mirror had been preceded. However, a uniform multilayer mirror that consists of uniform thin-film thickness can acquire a monochromatic X-ray only in the partial area corresponds to angle of incidence of white X-ray, so there are limits for X-ray imaging technology applications. In this study, we designed laterally graded multilayer mirror(below GML) that reflects same monochromatic X-ray over the entire area of thin-film mirror, which have the the thickness of the linear gradient that correspond to angle of incidence of white X-ray. By using ion-beam sputtering system added the mask control system we fabricated a GML which has size of $100{\times}100mm^2$. The GML is designed to achieve the monochromatic X-ray of 17.5kev energy and has thin-film thickness change from 4.62nm to 6.57nm(3.87nm at center). It reflects the monochromatic X-ray with reflectivity of more than 60 percent, FWHM of below 2.6keV and X-ray beam width of about 3mm. The monochromatic X-ray corresponded to 17.5keV using GML would have wide application in development of mammography system with high contrast and low dose.

• Radiation Oncology Journal
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• v.21 no.4
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• pp.291-298
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• 2003

Purpose: We report upon a web-based system for Patterns of Care Study (PCS) devised for Korean radiation oncology. This PCS was designed to establish standard tools for clinical quality assurance, to determine basic parameters for radiation oncology processes, to offer a solid system for cooperative clinical studies and a useful standard database for comparisons with other national databases. Materials and Methods: The system consisted of a main server with two back-ups in other locations. The program uses a Linux operating system and a MySQL database. Cancers with high frequencies in radiotherapy departments in Korea from 1998 to 1999 were chosen to have a developmental priority. Results: The web-based clinical PCS .system for radiotherapy in www.pcs.re.kr was developed in early 2003 for cancers of the breast, rectum, esophagus, larynx and lung, and for brain metastasis. The total number of PCS study items exceeded one thousand. Our PCS system features user-friendliness, double entry checking, data security, encryption, hard disc mirroring, double back-up, and statistical analysis. Alphanumeric data can be input as well as image data. In addition, programs were constructed for IRB submission, random sampling of data, and departmental structure. Conclusion: For the first time in the field of PCS, we have developed a web-based system and associated working programs. With this system, we can gather sample data in a short period and thus save, cost, effort and time. Data audits should be peformed to validate input data. We propose that this system should be considered as a standard method for PCS or similar types of data collection systems.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.3
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• pp.245-253
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• 2000

The development and progression of oral cancer is associated with an accumulation of multiple genetic alterations through the multistep processes. Comparative genomic hybridization(CGH), newly developed cytogenetic and molecular biologic technique, has been widely accepted as a useful method to allow the detection of genetic imbalance in solid tumors and the screening for chromosome sites frequently affected by gains or losses in DNA copy number. The authors examined 19 primary oral squamous cell carcinomas using CGH to identify altered chromosome regions that might contain novel oncogenes and tumor suppressor genes. Interrelationship between these genetic aberrations detected and major oncogenes and tumor suppressor genes previously recognized in carcinogenesis of oral cancers was studied. 1. Changes in DNA copy number were detected in 14 of 19 oral cancers (78.9%, mean: 5.58, range: $3{\sim}13$). High level amplification was present in 4 cases at 9p23, $12p21.1{\sim}q13.1$, 3q and $8q24{\sim}24.3$. Fourteen cases(78.9%, mean: 3.00, range: $1{\sim}8$) showed gains of DNA copy number and 12 cases(70.5%, mean: 2.58, range: $1{\sim}9$) revealed losses of DNA copy number. 2. The most common gains were detected on 3q(52.6%), 5p(21.0%), 8q(21.0%), 9p(21.0%), and 11q(21.0%). The losses of DNA copy number were frequently occurred at 9p(36.8%), 17q(36.8%), 13q(26.3%), 4p(21.0%) and 9p(21.0%). 3. The minimal common regions of gains were repeatedly observed at $3q24{\sim}26.7$, $3q27{\sim}29$, $1q22{\sim}31$, $5p12{\sim}13.3$, $8q23{\sim}24$, and 11q13.1-13.3. The minimal common regions of losses were detected at $9q11{\sim}21.3$, 17p31, $13q22{\sim}34$, and 14p16. 4. In comparison of CGH results with tumor stages, the lower stage group showed more frequent gain at 3q, 5q, 9p, and 14q, whereas gains at 1q($1q22{\sim}31$) and 11q($11q13.1{\sim}13.3$) were mainly detected in higher stage group. The loss at $13q22{\sim}34$ was exclusively detected in higher stage. The results indicate that the most frequent genetic alterations in the development of oral cancers were gains at $3q24{\sim}26.3$, $1q22{\sim}31$, and $5p12{\sim}13.3$ and losses at $9q11{\sim}21.3$, 17p31, and 13q. It is suggested that genetic alterations manifested as gains at $3q24{\sim}26.3$, $3q27{\sim}29$, $5p12{\sim}13.3$ and 5p are associated with the early progression of oral cancer. Gains at $1q22{\sim}31$ and $11q13.1{\sim}13.3$ and loss at 13q22-34 could be involved in the late progression of oral cancers.

• Journal of Home Health Care Nursing
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• v.3
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• pp.53-66
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• 1996

Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.42-49
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• 1995

Background: Hemoptysis always merits thorough investigation because even minimal bleeding may be an early indicator of the presence of significant bronchopulmonary disease. But in patients with hemoptysis & a normal chest roentgenogram, there are no clear guidelines for a diagnostic approach, including the indications of bronchoscopy. Methods: Eighty patients with hemoptysis and a normal chest roentgenogram were involved in this study. We evaluated the cause of hemoptysis in these patients by bronchoscopy and/or bronchogram or high-resolution CT of the lung and we analyzed the relationship of clinical features, such as age, sex, smoking and properties of hemoptysis, to the cause of hemoptysis. Results: 1) They were 34 men and 46 women, with the mean age of 46.7 and 41.8 years old, respectively. 2) Initial bronchoscopy provided a diagnosis in 8 patients - bronchogenic carcinoma in 3 patients (3.8%), metastatic cancer in 1 patient(1.3%) and endobronchial tuberculosis in 4 patients(5.0%). 3) Two clinical findings of patients over 50 years and/or with more than 30 pack-year smoking history were associated with bronchogenic carcinoma, and among these two factors, a more than 30 pack-year smoking history was the best predictor for diagnosis of bronchogenic cancer. 4) The 72 patients in whom no specific cause of hemoptysis was identified by initial bronchoscopy underwent bronchogram and/or high resolutional CT of the lung. Then, 6 patients were diagnosed as bronchiectasis and 5 patients rebleeded in the follow up period of 9 to 90 weeks. Of the remaining 66 patients, 33 were followed for 7 to 80 weeks. Among these patients, only 5 patients had recurrent episodes of hemoptysis & they were diagnosed as bronchiectasis in 1 patient, tuberculosis in 2 patients and catamenial hemoptysis in 2 patients. Conclusion: We conclude that patients with hemoptysis and a normal chest roentgenogram who are more than 50 years old or have more than 30 pack-year smoking history should undergo bronchoscopy to exclude possible bronchogenic carcinoma. In patients without these clinical features, a conservative approach with observation appears justified. If hemoptysis recurs to these patients, bronchogram or high-resolutional CT of the lung with sputum examination are necessary.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7825-7829
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• 2015

Background: Egypt has the highest prevalence of HCV infection in the world (~14.7%). Around 10-15% of HCV-infected persons will advance to cirrhosis within the first 20 years. The incidence of HCC is expected to grow in the next two decades, largely due to HCV related cirrhosis, and detection of HCC at an early stage is critical for a favorable clinical outcome. No simple reliable non-invasive marker has been available till now. B2M, a non-glycosylated polypeptide composed of 99 amino acids, is one of the components of HLA class I molecules on the surfaces of all nucleated cells. It has been reported that the level of serum B2M is elevated in patients with chronic hepatitis C and HCV-related HCC when compared to HCV-negative patients or healthy donors. Determining the clinical utility of serum B2M as a marker for disease progression in Egyptian patients with HCV related chronic hepatitis, cirrhosis and hepatocellular carcinoma was the aim of the present study. Materials and Methods: In this analytical cross sectional study 92 participants were included in 4 equal groups: Group (1) non cirrhotic chronic HCV; Group (2) HCV related liver cirrhosis; Group (3) HCC on top of HCV,; and Group (4) healthy controls. History taking, clinical examination, routine labs and abdominal ultrasound were conducted for all patients, PCR and Metavir scores for group (1) patients, and triphasic CT abdomen and AFP for Group (3) patients. B2M levels were measured in serum with a fully-automated IMX system. Results: The mean serum B2M level of Group (1) was $4.25{\pm}1.48{\mu}g/ml$., Group (2) was $7.48{\pm}3.04$, Group (3) was $6.62{\pm}2.49$ and Group (4) was $1.62{\pm}0.63$. Serum B2M levels were significantly higher in diseased than control group (p<0.01) being significantly higher in cirrhosis ($7.48{\pm}3.04$) and HCC groups ($6.62{\pm}2.49$) than the HCV group ($4.25{\pm}1.48$) (p<0.01). There was a significant correlation between B2M Level and ALK, total and direct bilirubin and INR (p<0.05), and a significant inverse correlation between B2M level and albumin, total proteins, HB andWBCS values (p<0.05). There was no significant correlation between B2M level and viral load or Metavir score, largest tumour size or AFP (p>0.05). The best B2M cut-off for HCV diagnosis was 2.6 with a sensitivity of 100%, a specificity of 92%, a positive predictive value (PPV) of 97% and a negative predictive value (NPV) of 100%. The best B2M cut-off for HCC diagnosis was 4.55 which yielded sensitivity, specificity, positive predictive value, negative predictive values of 74%, 62%, 39.5, 87.8% respectively (p-value <0.01) while best cut-off for cirrhosis was 4.9, with sensitivity 74 % and specificity 74%.The sensitivity for HCC diagnosis increased upon B2M and AFP combined estimation to 91%, specificity to 79%, NPV to 95% and accuracy to 83%. Conclusions: Serum B2M level is elevated in HCV related chronic liver diseases and may be used as a marker for HCV disease progression towards cirrhosis and carcinoma.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.24-27
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• 2010

Purpose: Early diagnosis of breast is of the utmost importance to improve prognosis. We have a limitation for mammography and sonography detecting small cancer. Clinical importance of Breast Specific Gamma Imaging (BSGI) has improved for that reason. So We studied performance evaluation test of count rate and resolution with high sensitivity to the low dose of BSGI. Materials and Methods: BSGI of Dilon 6800, point source of $^{99m}Tc$ from 1.85~148 MBq (0.05~4 mCi) at the intervals of 1.85~37 MBq (0.05~1 mCi) was used for the test. Performance evaluation method was performed for measuring deadtime for choosing at the 5 different point in the useful field of view (UFOV), acquired image for 60 seconds. Compared with reference of clinical uptake distribution of breast, activity increased according to the distance change 10, 20, 30, 40, 50 mm in the useful field of view. Results: Counting curve increased according to the activity from 1.85 MBq (0.05 mCi) to the 74 MBq (2 mCi), and it change flat shape over 74 MBq (2 mCi). The variation of the full width of half maximum (FWHM) to the distance is 4.05, 4.73, 5.77, 6.90, 8.00, 9.32 mm in 1.85 MBq (0.05 mCi), 4.30, 4.80, 5.90, 7.00, 8.10, 9.07 mm in 3.7 MBq (0.1 mCi), 4.90, 5.60, 6.20, 7.20, 8.20, 9.10 mm in 5.55 MBq (0.15 mCi), 5.30, 6.10, 6.60, 7.00, 7.90, 8.70 mm in 7.40 MBq (0.2 mCi). Conclusion: Distortions of image would be acquired because of the deadtime in BSGI. We found out the fact that specification of $^{99m}Tc$ reaction under 74 MBq (2 mCi) for BSGI. Second, FWHM distribution change from varied distance from the detector, clearly distinguished the location of the lesion.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.615-623
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• 2009

Background: We evaluated the feasibility and the efficacy of Video-Assisted Thoracic Surgery (VATS) lobectomy for treating patients with non-small cell lung cancer (NSCLC) and we compared the outcomes of VATS lobectomy with those of open lobectomy. Material and Method: From 2003 to March 2008, 133 NSCLC patients underwent VATS lobectomy. The patients were selected on the basis of having clinical stage I disease on the chest CT and PET scan. The outcomes of 202 patients who underwent open lobectomy (OL group) for clinical stage I NSCLC were evaluated to compare their results with those of the patients who underwent VATS lobectomy (the VL group). Result: The number of females and the number of patients with adenocarcinoma and stage IA disease were greater in VL group (p<0.05). There was no operative mortality or major complications in the VL group. Conversion to thoracotomy was needed in 8 cases (6%), which was mostly due to bleeding. The chest tube indwelling time and the length of the postoperative hospital stay were significantly shorter in the VL group (p<0.001). The number of dissected lymph nodes and the size of tumor were significantly smaller in the VL group (p<0.001). For the pathologic stage I patients, there was no significant difference in the three-year survival rates between the two groups (p=0.15). Conclusion: VATS lobectomy is a safe procedure with low operative mortality and morbidity. VATS lobectomy is feasible for early stage NSCLC and it provides outcomes that are comparable to those for open lobectomy. Further long-term data are needed.