• Title/Summary/Keyword: gynecology

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Differences of Blood Oxygen Saturation between 20s and 60s due to Amount of Highly Concentrated Oxygen Administration (고농도 산소 공급량에 따른 20대와 60대의 혈중 산소 포화도의 차이)

  • Choi, Mi-Hyun;Kim, Ji-Hye;Lee, Su-Jeong;Yang, Jae-Woong;Yi, Jeong-Han;Jun, Jae-Hoon;Kim, Hyun-Jun;Lee, Tae-Soo;Chung, Soon-Cheol
    • Science of Emotion and Sensibility
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    • v.13 no.1
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    • pp.41-46
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    • 2010
  • The purpose of this study was to examine differences between 20s and 60s in blood oxygen saturation due to 93% oxygen administration of the three levels(1L/min, 3L/min, 5L/min). Ten 20s male($25.0{\pm}1.8$ years), ten 20s female($23.7{\pm}1.9$ years), ten 60s male($68.0{\pm}2.6$ years), and ten 60s female($65.5{\pm}3.1$ years) were selected as the subjects for this study. The oxygen supply equipment(OXUS Co.) provided oxygen by supply rate(i.e., 1L/min, 3L/min, and 5L/min) at a constant rate of 93% oxygen. The experiment consisted of three phases, i.e., Prehyperoxia(5min), Hyperoxia(10min), and Post-hyperoxia(5min). Blood oxygen saturation were measured throughoutthe three phases. By increasing the amount of highly concentrated oxygen administration, blood oxygen saturation was increased. Blood oxygen saturation of 20s was higher than 60s. Blood oxygen saturation was greater during Hyperoxia than during Pre- and Post-hyperoxia. However, rising rate of blood oxygen saturation of 60s by oxygen administration was higher than 20s.

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Early and Late Bowel Complication Following Irradiation of Cancer of the Uterine Cervix (자궁경부암의 고선량 치료후의 장관 합병증)

  • Kim Myung Se;Kim Kyung Ae;Kim Sung Kyu;Shin Sei One;Lee Sung Ho;Chang Jae Chun
    • Radiation Oncology Journal
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    • v.7 no.1
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    • pp.59-70
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    • 1989
  • Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still $44\%$ of patient will develop recurrent cancer. This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen Which is $5500\~1000 CGy$ higher than Other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was $46\%$, but only 1 patient $(1\%)$ had operative treatment because of incomplete obstruction of small bowel. Most symptoms appeared within 12 months and most common complaints were frequent bowel movement. Barium enema and sigmoidoscopy were performed for persistent symptomatic patients. Only one patient had abnormal finding in barium enema which showed inefficiency of this method for detecting bowel complication. Patient's age, total tumor dose, total TDF, rectal dose were not significant risk factors for complication, but boost dose, previous history of operation had some relationship with complication risk. Even though dose of point A and rectum is $500\~1,000cGy$ higher than other institution, such a low rate of severe complications may suggest that fear of complications should not be overestimated than cure rate and the possibility of more aggressive treatment for better local control should not be underestimated.

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Radiotherapy Results in Stage IIB Uterine Cervix Cancer (자궁경부암 병기 IIB의 방사선치료결과)

  • Kil Whoon Jong;Chun Mison;Kang Seunghee;Oh Young Taek;Ryu Hee Sug;Ju Hee Jae;Lee Eun Ju
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.345-352
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    • 2001
  • Purpose : To evaluate the treatment results and prognostic factors after radiotherapy in stage IIB uterine cervix cancer. Materials and methods : We retrospectively analyzed the records of 90 patients with stage IIB uterine cervix cancer who received radiotherapy between 9/94 and 12/99. Age was ranged from 28 to 79 years (median 57). Tumor size was $\geq4\;cm$ in 64 patients. Preteatment SCC level was measured in 75 patients. Twenty nine patients received conventional radiotherapy (QD) and the others received modified hyper-fractionated radiotherapy (BID). Only 7 patients in BID had tumor size <4 cm. All patients received high dose rate brachytherapy $(4\;Gy\times7\;or\;5\;Gy\times6)$. No Patient received concurrent chemotherapy during radiotherapy. Follow up period was ranging from 9 to 76 months (median 38). Results : The 5-year overall and disease free survival rates were $73.4\%\;and\;71.6\%$, respectively. Local recurrences occurred in $10\%$ of patients, and distant metastasis in $18.9\%$. There was a significant correlation between OS/DFS and tumor size $(<4cm;\;OS\;95.2\%,\;DFS\;91.4\%,\;\geq4cm;\;OS\;63.4\%,\;DFS\;63.4\%)$. Pretreatment SCC level was one of prognostic factors only in univariate analysis. Conclusion : With modified hyperfractionated radiotherapy, there was very low local recurrence rate $(6.6\%)$ and high 5-year overall and disease free survival rate $(75.4\%\;and\;70.5\%)$, which is comparable to results after concurrent chemoradiotherapy in bulky, locally advanced stage IIB uterine cervix cancer.

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Palliative Irradiation Using Helical Tomotherapy in Recurrent Pelvic Tumors with Prior Radiotherapy (방사선치료 후 재발한 골반암에서 토모테라피를 이용한 고식적 재치료)

  • Kay, Chul-Seung;Yoo, Eun-Jung;Kim, Ji-Hoon;Ro, Duck-Young;Kim, Ki-Jun
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.133-140
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    • 2010
  • Purpose: We retrospectively investigated the effect of irradiation using helical tomotherapy in recurrent pelvic tumors that underwent prior irradiation. Materials and Methods: Fourteen patients with recurrent pelvic tumors consisting of rectal cancer (57.1%), cervical cancer (35.7%) and cancer with an unknown origin (7.1%) were treated with tomotherapy. At the time of irradiation, median tumor size was 3.5 cm and 7 patients complained of pain originating from a recurrent tumor. The median radiation dose delivered to the gross tumor volume, clinical target volume, and planning target volume was 50 Gy, 47.8 Gy and 45 Gy, respectively and delivered at 5 fractions per week over the course of 4 to 5 weeks. Treatment response and duration of local disease control were evaluated using the Response Evaluation Criteria in Solid Tumors (ver. 1.0) and the Kaplan-Meyer method. Treatment-related toxicities were assessed through Common Terminology Criteria for Adverse Events (ver. 3.0). Results: The median follow-up time was 17.3 months, while the response rate was 64.3%. Symptomatic improvement appeared in 6 patients (85.7%). The median duration time of local disease control was 25.8 months. The rates of local failure, distant failure, and synchronous local and distant failure were 57.1%, 21.4%, and 7.1%, respectively. Acute toxicities were limited in grade I or II toxicities, except for one patient. No treatment related death or late toxicity was observed. Conclusion: Helical tomotherapy could be suggested as a feasible palliative option in recurrent pelvic tumors with prior radiotherapy. However, to increase treatment effect and overcome the limitation of this outcome, a large clinical study should be performed.

A Study on the Degree of Need of Human Structure and Function Knowledge in Clinical Nurses (기초간호자연과학의 인체구조와 기능 내용별 필요도에 대한 연구)

  • Choe, Myoung-Ae;Byun, Young-Soon;Seo, Young-Sook;Hwang, Ae-Ran;Kim, Hee-Seung;Hong, Hae-Sook;Park, Mi-Jung;Choi, Smi;Lee, Kyung-Sook;Seo, Wha-Sook;Shin, Gi-Soo
    • Journal of Korean Biological Nursing Science
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    • v.1 no.1
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    • pp.1-24
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    • 1999
  • The purpose of this study was to define the content of requisite human structure and function knowledge needed for clinical knowledge of nursing practice. Subjects of human structure and function were divided into 10 units, and each unit was further divided into 21 subunits, resulting in a total of 90 items. Contents of knowledge of human structure and function were constructed from syllabus of basic nursing subjects in 4 college of nursing, and textbooks published by nurse scholars prepared with basic nursing sciences. The degree of need of 90 items was measured with a 4 point scale. The subjects of this study were college graduated 136 nurses from seven university hospitals in Seoul and three university hospitals located in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, hospice ward, and their working period was mostly under 5 years. The results were as follows: 1. The highest scored items of human structure and function knowledge necessary for nursing practice were electrolyte balance, blood clotting mechanism and anticoagulation mechanism, hematopoietic function, body fluid balance, function of plasma, and anatomical terminology in the order of importance. The lowest scored items of human structure and function knowledge necessary for nursing practice was sexual factors of genetic mutation. 2. The highest order of need according to unit was membrane transport in the living unit, anatomical terminology in movement and exercise unit, mechanism of hormone function in regulation and integration unit, component and function of blood in oxygenation function unit, structure and function of digestive system in digestive and energy metabolism unit, temperature regulation in temperature regulation unit electrolyte balance in body fluid and electrolyte unit, concept of immunity in body resistance unit, and genetics terminology in genetics unit. The highest order of importance according to subunit was membrane transportation in cell subunit, classification of tissues in tissue unit, function of skin and skin in skin subunit, anatomical derivatives of the skeleton subunit, classification of joints in joint subunit, an effect of exercise on muscles in muscle subunit, function of brain in nervous system subunit, special sense in sensory subunit mechanism of hormone function in endocrine subunit, structure and function of female reproductive system in reproductive system unit, structure and function of blood in blood unit, structure of heart, electrical and mechanical function in cardiovascular system unit, structure of respiratory system in respiratory system subunit, structure and function of digestive system in digestive system subunit, hormonal regulation of metabolism in nutrition and metabolism subunit, function of kidney in urologic system subunit, electolyte balance in body fluid, electolyte and acid-base balance subunit. 3. The common content of human structure and function knowledge need for all clinical areas in nursing was structure and function of blood, hematopoietic function, function of plasm, coagulation mechanism and anticoagulation mechanism, body fluid, electrolyte balance, and acid-base balance. However, the degree of need of each human structure and function knowledge was different depending on clinical areas. 4. Significant differences in human structure and function knowledge necessary for nursing practice such as skin and derivatives of the skin, growth and development of bone, classification of joint, classification of muscle, structure of muscle, function of muscle, function of spinal cord, peripheral nerve, structure and function of pancrease, component and function of blood, function of plasma, structure and function of blood, hemodynamics, respiratory dynamics, gas transport, regulation of respiration, chemical digestion of foods, absorption of foods, characteristics of nutrients, metabolism and hormonal regulation, body energy balance were demonstrated according to the duration of work. 5. Significant differences in human structure and function knowledge necessary for nursing practice such as classification of tissue, classification of muscles, function of muscles, muscle metabolism, classification of skeletal muscles, classification of nervous system, neurotransmitters, mechanism of hormone function, pituitary and pituitary hormone, structure and function of male reproductive organ, structure and function of female reproductive organ, component and function of blood, function of plasma, coagulation mechanism and anticoagulation mechanism, gas exchange, gas transport, regulation of respiration, characteristics of nutrients, energy balance, function of kidney, concept of immunity, classification and function of immunity were shown according to the work area. Based on these findings, all the 90 items constructed by Korean Academic Society of Basic Nursing Science should be included as contents of human structure and function knowledge.

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The Impact of Delayed Interval Delivery on Neonatal Mortality and Morbidity (지연 분만이 신생아의 사망률과 이환율에 미치는 영향)

  • Lee, Eun-Hee;Sohn, Jin-A;Lee, Ju-Young;Choi, Eun-Jin;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Jun, Jong-Kwan;Kim, Byeong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.111-116
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    • 2011
  • Purpose: To evaluate the impact of delayed interval delivery on neonatal outcomes. Methods: This was a retrospective study of infants who were born at Seoul National University Hospital by delayed interval delivery from June 2005 to July 2010. Outcomes (neonatal mortality and morbidity) of later babies were compared to those of the first babies and the control group whose gestational ages and birth weights were similar to them. Results: There were 4 twin and 5 triplet pregnancies. The first babies (group 1, n=9) were delivered at $22^{+6}$ to $27^{+5}$ weeks of gestational age, and the later babies (group 2, n=14) were born at $24^{+6}$ to $28^{+0}$ weeks. The mean interval between the first and later deliveries was 10 days, and there was no delay between the second and third deliveries in all triplet pregnancies. There were more small for gestational age (SGA) infants in group 1 than group 2 (66.7% and 21.4% respectively, P=0.03). Two of three babies who died in group 1 were born before 24 weeks of gestational age and expired within a week after birth. The mortality rate of group 2 (7.1%) was lower than group 1 (33.3%), but not significantly (P=0.106). The control group matched to group 2 consisted of 28 infants. There were no significant differences in neonatal mortality and morbidity between the two groups. Conclusion: Although there is a limitation to the number of infants in this study, it suggested that delayed delivery in a multiple pregnancy could decrease the incidence of SGA of the remaining fetuses and that prolonged gestation would not be harmful to those fetuses after birth.

Perinatal Factors Affecting Thyroid Stimulating Hormone(TSH) and Thyroid Hormone Levels in Cord Blood (제대혈 갑상선 자극호르몬과 갑상선 호르몬 농도에 영향을 주는 주산기 인자들)

  • Kim, Eun Young;Park, Sang Kee;Song, Chang Hun;LIm, Sung-Chul
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.143-147
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    • 2005
  • Purpose : The aim of the this study was to evaluate the effect of various perinatal conditions on TSH and thyroid hormone levels in cord blood. Methods : Cord blood samples were collected from 130 neonates immediately after birth. TSH, $T_3$, and free $T_4$ levels were measured by the radioimmunoassay(RIA) method. The effects of gestational age, sex, birth weight, delivery method, perinatal asphyxia, maternal diabetes mellitus(DM), and preeclampsia on TSH and thyroid hormone levels were assessed by ANOVA test, Student t-test, and multiple regression analysis. Results : Birth weight and sex did not affect TSH and thyroid hormone levels. TSH level increased according to gestational age(P<0.05). TSH level was $4.42{\pm}0.66{\mu}IU/mL$ in infants born vaginally, which was higher than that of cesarian section delivery($3.31{\pm}0.33{\mu}IU/mL$)(P<0.05). TSH level was $5.18{\pm}0.93{\mu}IU/mL$ in asphyxiated newborns and $2.97{\pm}0.84{\mu}IU/mL$ in non-asphyxiated newborns(P<0.05). TSH level in infants with maternal DM($8.911{\pm}1.25{\mu}IU/mL$) was higher than that of infants without maternal DM($4.32{\pm}0.42{\mu}IU/mL$)(P<0.05). TSH level was $5.28{\pm}0.42{\mu}IU/mL$ in infants with maternal preeclampsia and $3.65{\pm}0.46{\mu}IU/mL$ in infants without maternal preeclampsia(P<0.05). Thyroid hormones were lower in infants with perinatal asphyxia(P<0.05). In asphyxiated infants, $T_3$ level was $75.33{\pm}55.65ng/mL$ and free $T_4$ was $0.54{\pm}0.21ng/mL$. $T_3$ and free $T_4$ level was $109.85{\pm}41.77ng/mL$ and $0.76{\pm}0.22ng/mL$ each in infants without perinatal asphyxia. Among the perinatal factors, gestational age, 1 min Apgar score and maternal DM influenced TSH level independently. Conclusion : In our study, cord blood TSH and thyroid hormone levels were affected by perinatal stress events.

Cord blood IL-10, IL-12 in preterm newborns as predictors of respiratory distress syndrome and bronchopulmonary dysplasia (호흡곤란증후군과 기관지폐이형성증 예측 인자로서의 미숙아 제대혈 IL-10, IL-12)

  • Park, Jee Yoon;Kim, Ji Young;Cho, Soo Jin;Kim, Young Ju;Park, Hye Sook;Ha, Eun Hee;Park, Eun Ae
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.248-254
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    • 2007
  • Purpose : Inflammation plays a major role in the pathogenesis of RDS and BPD in the immature lung. We investigated the possible role of IL-10 and IL-12 in the cord blood of preterm newborns with RDS or BPD. Methods : Forty preterm newborns whose mothers received antenatal care at Ewha Womans University Mokdong Hospital between January 2003 to June 2005, and agreed to testing their cord blood samples were enrolled. The gestational ages were below 34 weeks. Cord blood level of IL-10 and IL-12 were determined by ELISA. We separated the patients into 2 groups (RDS group and non-RDS group, BPD group and non-BPD group) and compared the cytokine levels and clinical records of the groups. Results : Cord blood IL-10 level showed a significant inverse correlation with gestational age and birth weight (P=0.001, P=0.005). Preterm infants with RDS showed higher IL-10 level (1.0 vs 0.1 pg/mL; P=0.001) in the cord blood than those without RDS. The differences remained statistically significant after correction for the effect of gestational age between both preterm groups. Despite similar cord blood IL-10 levels, preterm infants with BPD showed no significant difference with those without BPD. Conclusion : Cord blood IL-10 levels are increased in preterm infants which may be due to the immuno-suppression occurring during pregnancy and to fetal immaturity because these levels are inversely correlated with the gestational age. So, Cord blood IL-10 level can be used as the predictor of RDS.

Effect of Isoflavone Supplementation on Bone Metabolism in Ovariectomized Rats at Different Ages (이소플라본 보충이 다른 나이에 난소를 절제한 흰쥐의 골대사에 미치는 영향)

  • Byun, Jae-Soon;Rho, Sook-Nyung;Park, Jong-Seong;Park, Hyoung-Moo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.9
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    • pp.1350-1356
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    • 2005
  • Osteoporosis that is associated with estrogen deficiency in menopause is by far the most common cause of age-related bone loss. Since isoflavone had been reported as a natural substance that minimizes bone loss, we have begun this study to examine the effect of the substance on bone metabolism in ovariectomized rats. Five week-old (n=22) and 25 week-old (n=22) Sprage-Dawley female rats were classified into young (Y) and adult (A) groups. Each group consisted of three subgroups : sham operated group (SH), ovariectomized group (OVX), and isoflavone supplemented group (OVX+ISO 80 mg/kg B.W.). They were fed chow for 9 weeks. The result showed that body weight gain was increased in YOVX in comparison to YSH group, (p<0.05) serum osteocalcin concentration and urinal deoxypyridinoline (DPD) excretion had significantly increased in YOVX more than in YSH group, and significantly decrease in OVX+ISO than in YOVX group (p<0.05). We concluded that soy isoflavones may decrease bone turnover in young rats. However, isoflavone supplement didn't show significant influence on bone metabolism of adult rats.

In Vitro Intrinsic Radiosensitivity Of Human Squamous Cell Carcinoma in Primary Culture (인체 상피 세포암의 일차 배양을 이용한 방사선 민감도 측정)

  • Choi Eun Kyung;Yang Kwang Mo;Yi Byong Yong;Chang Hyesook;Kim Sang-Yoon;Nam Joo-Hyun;Yu Eunsil;Lee Inchul
    • Radiation Oncology Journal
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    • v.12 no.1
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    • pp.27-31
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    • 1994
  • There are a number of reports suggesting that there may be a correlation between the clinical response to radiotherapy in various tumors and the clonogenic survival of cell lines derived from these tumors following exposure to 2 Gy(SF2). Authors conducted this study to determine SF2 for cells in primary culture from surgical specimens. The tumor tissues with squamous cell carcinoma of uterine cervix and head and neck were obtained. The tumor tissues were disaggregated to single cells by incubating with collagenase type w for 2 hours with constant stirring. Single cell suspensions were inoculated in four 24-well plates precoated with cell adhesive matrix. After 24 hours of incubation at 37$ ^{\circ}C $, rows of four wells were then irradiated, consisting of control set and five other sets each receiving doses of 1,2,3,4, and 6 Gy. After incubation for a total of 13 days, the cultures were stained with crystal violet and survival at each dose was determined by quantitative image analysis system, To determine whether cell growth was of epithelial origin, immunocytochemical staining with a mixture of cytokeratin and epithelial monoclonal antibodies were performed on cell cultures. During the period of this study, we received 5 squamous cell carcinoma specimens of head and neck and 20 of uterine cervical carcinoma. Of these, 15 yielded enough cells for radiosensitivity testing. This resulted an overall success rate of 60$ \% $. The mean SF2 value for 15 tumours was 0.55$\pm$0.17 ranging from 0.20 to 0.79. These results indicate that there is a broad range of sensitivities to radiation in same histologic type. So with a large patient population, we plan to determine whether a different SF2 value is associated with tumours that are controlled with radiotherapy than those that are not.

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