• Journal of the Korean Society of Radiology
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• v.5 no.1
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• pp.37-49
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• 2011

To examine the possible changes in the SNRs, CNRs, and ADC values for lumbar spines with metastasis based on the DW images before and after contrast agent injection taken from metastatic spinal cancer patients using a 1.5 T MR machine. The quantitative analysis revealed that in case of spinal cancer subjects, both SNRs and CNRs at all of those assessed locations significantly increased on the DWI after contrast agent injection compared to before, while on the ADC map images, SNRs significantly decreased. On the other hand, significantly decreased ADC values at all the assessed locations were found on the ADC map images. With reference to the normal group, significantly increased SNRs were found at all of the assessed locations on the DWI image after injection compared to before, while significantly decreased SNRs were found on the ADC map images. Also, significantly decreased ADC values at all the assessed locations were found on the ADC map images. For the qualitative analysis, after contrast agent injection, significantly increased signal intensities were found at the locations with spinal cancer on the DWI. In contrast, significantly decreased signal intensities were found on the ADC map images. The implication from the results showing that SNR and CNR significantly increased while ADC value significantly decreased at, above, and below the location of metastatic spinal cancer on DWI after contrast agent injection is that DWI obtained after contrast agent injection can be made available for wider application to vertebral disorders.

• Journal of Chest Surgery
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• v.36 no.2
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• pp.91-97
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• 2003

With the advent of stage-adapted multimodal regiments for esophageal malignancy, accurate staging has become of utmost importance. Endoscopic ultrasono graphy(EUS) i.: a diagnostic method for the local staging of esophageal cancer, in particular for T and N evaluation. The aim of this study was to examine the diagnostic efficacy of the EUS and to evaluate the relation between prognosis and EUS findings. Material and Method : We reexamined the cases of 88 consecuitive patients who underwent transthroacic esophagectomy and cervical esophagogastrostomy for esophageal cancer from January 1991 to July 2001 We compared EUS findings, histological results and outcomes. Result : There were 83 male(94.3%) and 5 female. Median age was 61.3 years old. Overall staging accuracy were 59.0% for T staging and 76.0% for N staging, In early T staging group, the accuracy was 74.9% except 74 stage. However significant differences were not found in the ability of EUS-determined T-stage and N-Stage to predict survival. Multivariate analysis showed EUS-stage to predict survival. Conclusion : EUS provides a high degree of accuracy in assessing both T and N parameters in staging esophagal cancer. EUS should be performed in all patients with esophageal cancer, not only for staging before therapy, but also as a valuable method of determining prognosis.

• The Korean Journal of Nuclear Medicine
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• v.33 no.1
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• pp.40-48
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• 1999

Purpose: The sensitivity of ST-depression in the electrocardiogram during exercise is influenced by the level of efforts. However, unlike the prevalence of ST-depression on exercise ECG, the degree of exercise is reported to do not influence the diagnostic ability of myocardial perfusion scan. Furthermore, the relation between the prevalence of myocardial ischemia and effort is still controversial. We evaluated the effect of the degree of exercise on the ability of SPECT imaging to detect coronary artery stenosis. Materials and Methods: The patient population was comprised of 111 patients (73 men and 38 women, mean age 56 years) who underwent an exercise test in conjunction with Tc-99m MIBI and cardiac catheterization within 3 months apart each other. The degree of exercise was classified into four groups according to the percentage of maximal predicted heart rate. The sensitivity and specificity was compared between each group. Results: The overall diagnostic sensitivity was significantly higher with Tc-99m MIBI SPECT than exercise ECG. The specificity was not significantly different between two tests. Sensitivity and specificity of Tc-99m MIBI was not different between four groups. Sensitivity for individual coronary stenosis seemed to be lower in subjects who had premature termination of exercise due to early appearance of ST depression. Conclusion: These results suggest that the overall diagnostic sensitivity of Tc-99m MIBI myocardial perfusion SPECT is not significantly affected by the degree of exercise in stable patients undergoing symptom-limited treadmill exercise testing. Myocardial perfusion SPECT imaging should be added to routine exercise stress testing for the detection of coronary artery disease.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.359-366
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• 2002

Purpose : The purpose of the present study was to analyze and evaluate prior studies published in Korea on the cancer-related quality of life, in order to make recommendations for further research. Materials and Methods : A total of 31 studies were selected from three different databases. The selected studies were analyzed according to 11 criteria, such as site of cancer, domain, independent variable, research design, self/proxy rating, single/battery instrument, translation/back translation, reliability, validity, scoring, and findings. Results : Of the 31 studies, approximately half of them were conducted using a mixed cancer group of patients. Many of the studies asserted that the concept of quality of life had a multidimensional attribute. Approximately 30% were longitudinal design studies giving information about the changes in quality of life. In all studies, except one, patients directly rated their level of quality of life. With respect to the questionnaires used for measuring the quality of life, most studies did not consider whether or not their reliability and validity had been established. In addition, when using questionnaires developed in other languages, no studies employed a translation/ back-translation technique. All studies used sum or total scoring methods when calculating the level of quality of life. The types of variables tested for their influence on qualify of life were quite limited. Conclusion : It is recommended that longitudinal design studies be peformed, using methods of data collection whose validity and reliability has been confirmed, and that studies be conducted to identify new variables having an influence on the quality of life.

• Journal of Chest Surgery
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• v.40 no.8
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• pp.546-551
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• 2007

Background: The radial artery is gaining widespread acceptance as complementary arterial conduits for surgical myocardial revascularization, but there have been limited reports about its angiographic patency compared with that of internal thoracic artery or saphenous vein. We tried to evaluate angiographic patency of radial artery graft and to compare that of radial artery and other gratis with retrospective manner. Material and Method: From January 2001 to Jure 2006, totally 132 patients (male 92, female 40) who underwent coronary artery bypass graft using radial artery were re-admitted to our hospital for follow up angiographic examination. Mean age was 58.2+8.87 and mean follow up duration was 32 month ($2{\sim}110$ month). Off pump and on pump bypass surgery were performed 74 and 58 patients respectively. Along with radial artery, left internal thoracic arteries were used in 57 cases, concomitant left internal thoracic artery and saphenous veins were used in 47 cases and bilateral internal thoracic arteries were used in 20 cases. Result: Totally 412 distal anastomosis were performed and 376 anastomosis remained patent (91.2%). Left internal thoracic artery showed the most excellent patency in all of the conduits (98.5%). Radial artery graft patency was 90.8% (169/186). There was no statistical difference of the patency by conduit between on-pump and off-pump group. But radial artery showed more higher patency rate (98/110, 89%) in the severe stenotic lesion that preoperatively revealed more than 90% stenosis than in the lesser severe (<90%) stenotic lesion (60/76, 78%)(p < 0.005). Radial artery conduit represented the worst result when it was grafted in the right coronary system. But when it was positioned in the left heart especially diagonal or obtuse marginal area, patency was comparable with left internal thoracic artery. Conclusion: Radial artery graft showed good midterm patency when it was used in the severe stenotic lesion more than 90% and left coronary system. But great notice should be taken when it is grafted in the right coronary system or less severe stenotic lesion.

• Journal of Hospice and Palliative Care
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• v.22 no.4
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• pp.145-155
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• 2019

Purpose: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment. Methods: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed. Results: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting. Conclusion: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.

• Journal of Hospice and Palliative Care
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• v.22 no.4
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• pp.185-197
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• 2019

Purpose: Hospice volunteers are serving an invisible yet pivotal role in the hospice and palliative care team. This study investigated how effectively a continuing education program could enhance hospice volunteers' competency. Methods: A total of 20 hours (four hours per week) of training was provided to 30 hospice volunteers who participated in the continuing education for hospice volunteers. Efficiency of the education was analyzed with an exploratory mixed-methods design. For quantitative analysis, the volunteers were asked, before and after the training, about their attitudes towards hospice care, what makes a meaningful life, self-efficacy and satisfaction with their volunteer service. Descriptive statistics, paired t-tests, and Wilcoxon signed-rank test were performed using SPSS Window 20.0. For qualitative research, participants were placed in three groups for a focus group interview, and data were analyzed by content analysis. Results: A quantitative study result shows that this training can significantly affect hospice volunteers' attitudes and improve their self-efficacy. A qualitative study result shows that participants wanted to receive continuous education from the physical/psychosocial/spiritual aspects to better serve end-of-life patients and their family members even though they have to spare significant time for the volunteer service. They wanted to know how to take good care of patients without getting themselves injured and how to provide spiritual care. Conclusion: The continuing education program reflecting volunteers' requests is strongly needed to improve their competency. An effective continuing education requires continuous training and support in areas where hospice volunteers are interested in. A good alternative is to combine web-based and hands-on training, thereby allowing hospice volunteers freely take training that suits their interest.

• Tuberculosis and Respiratory Diseases
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• v.59 no.4
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• pp.368-373
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• 2005

Background : Bronchial anthracofibrosis usually manifest as a form of obstructive airway disease, and can be accompanied by parenchymal diseases such as pneumonia, and pulmonary tuberculosis. This study investigated the ventilatory dynamics according to the severity of bronchial stenosis in patients with bronchial anthracofibrosis. Method : One hundred and thirteen patients with bronchial anthracofibrosis that was confirmed by bronchoscopy and who had undergone a pulmonary function test were enrolled in this study group. The correlation coefficients between the pulmonary functional parameters and the number of lobes with bronchial stenosis were investigated. Results : The incidence of ventilatory dysfunction was 56(49.6%) for obstructive, 8(7.1%) for restrictive, 2(1.8%) for mixed, and 47(41.6%) for a normal pattern. The $FEV_1/FVC$, $FEF_{25{\sim}75%}$, $FEF_{25%}$, $FEF_{50%}$, $FEF_{75%}$, and PEF showed a significant negative correlation (p<0.05) and the Raw had a significant positive correlation with the number of lobes with bronchial stenosis(p<0.001). Conclusion : These findings suggest that the most common abnormality of the ventilatory function in bronchial anthracofibrosis is an obstructive pattern with a small airway dysfunction according to the severity of bronchial stenosis.

• Clinical and Experimental Pediatrics
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• v.49 no.2
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• pp.181-186
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• 2006

Purpose : The hematologic change during the treatment of acute lymphoblastic leukemia(ALL) is critical as a prognostic determinant and a variable to determine the dose of chemotherapeutic agents. It is known that the dose of vincristine used in the maintenance phase of ALL is small enough to increase the count of platelet. To investigate the change of platelet count according to the vincristine administration in maintenance phase of ALL chemotherapy, we performed this study. Methods : Eleven patients eligible under the criteria of Children's Cancer Study Group(CCG)-1882 and who had completed chemotherapy were enrolled in this study. The count of platelets before vincristine administration was compared with those of vincristine administration 1, 2 and 3 weeks after the early and last periods of maintenance phases. The platelet count before vincristine administration was defined as 100 percent and that after vincristine were compared. In addition, we tentatively defined an enhancing effect of vincristine as positive when the relative count was more than 120 percent. Results : Platelet count did not differ according to the early and last periods of maintenance phase. Platelet count at first week after vincristine administration increased more significantly than that before vincristine in early and last periods. There was an enhancing effect in 10(90.9 percent) of 11 patients after 1 week vincristine administration both in the early and last periods of the maintenance phase. Conclusion : Vincristine, used in ALL maintenance phases as a low dose, increased platelet count 1 week after administration. The increased platelet count resumed to the previous level 2-3 weeks later. However, the thrombocytosis observed in the maintenance phase by vincristine was not high enough to induce thrombosis. In addition, vincristine is known to reduce the activity of platelets. Therefore, the risk of thrombosis in the maintenance phase of ALL chemotherapy would be low.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1219-1226
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• 2002

Purpose : To assess the clinical characteristics of the 2000-2001 measles outbreak in the Seoul metropolitan area, Korea, the clinical data of measles inpatients were analyzed. Methods : Three hundred and five children diagnosed with measles by clinical manifestation from July, 2000 to February, 2001, in Seoul, Ilsan and Ansan City were grouped according to their age and investigated for clinical manifestations, vaccination history and measles-specific IgM/IgG antibody positivity. Results : Thirty eight point seven percent of the subjects were less than 12 months of age, 27.5 % were 12-47 months of age and 33.8% were 48 months of age or older. There was no significant sexual difference(male : female=1.2 : 1). This epidemic started in June, 2000 and the number of patients increased abruptly in October, peaked in December and finally decreased after February, 2001. It started from the older age group and moved to the younger. Sixty five point two percent had a history of more than 1-dose vaccination and 13.6% of the patients equal or more than 48 months of age had a history of 2-dose vaccination. Primary vaccine failure rate was 59.4%(107/180) and secondary vaccine failure rate was 3.9%(7/180) in 1 dose vaccinees. Sixty one point six percent showed more than one complication and 38.4% had no complication. The most common complication was pneumonia(31.8 %), followed by bronchitis(11.5%) and acute otitis media(4.6%). Vaccination and dose were not related significantly with the occurrence of complications. Conclusion : Compared with previous outbreaks in Korea, clinical features showed no specific change in the 2000-2001 measles epidemic. However, primary vaccine failure rate was so high that the second vaccination at four to six years of age must be emphasized in Korea.