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The Results of Hyperfractionated Radiotherapy on Locally Advanced Non-Small Cell Lung Cancer (국소적으로 진행된 비소세포 폐암에 대한 과분할 방사선 치료의 성적)

  • Hur, Won-Joo;Lee, Hyung-Sik;Kim, Jeong-Ki;Choi, Young-Min;Lee, Ho-Jun;Youn-Seon-Min;Kim, Jae-seok;Kim, Hyo-Jin;Woo-Jong-Soo;Choi, Pill-Jo;Lee, Ki-Nam
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.275-282
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    • 1998
  • Purpose : The effect of hyperfractionated radiotherapy on locally advanced non-small lung cancer was studied by a retrospective analysis. Materials & Methods : We analyzed sixty one patients of biopsy-confirmed, IIIA and IIIB non-small cell lung cancer. Using the ECOG performance scale, all the patients were scored less than 2. They were treated by curative hyperfractionated radiotherapy alone from Oct. 1992 to Oct. 1995 at the Department of Radiation Oncology. All the patients received 120cGy b.i.d with more than 6 hours interval between each fraction. The total dose of radiation was reached up to 6400-7080 cGy with a mean dose of 6934 cGy. The results were analyzed retrospectively. Results : The overall survival rate was 53 1$\%$ in 1 year, 9.9$\%$ in 2 years with a median survival time (MST) of 13.9 months. The progression free survival (PFS) rate was 37.0$\%$ in 1 year, 8.9$\%$ in 2 years. Twenty two Patients were classified as complete responders to this treatment and their MST was 19.5 months When this was compared with that of partial responders (MST: 11 7months), it was statistically significant (p=0.0003). Twenty nine patients of stage IIIA showed a better overall survival rate (1yr 63.3$\%$, 2yr 16.8$\%$) than IIIB patients (1yr 43.3$\%$, 2yr 3.6$\%$), which was also statistically significant (p=0.003). Patients with adenocarcinoma showed a better survival rate (1yr 64.3$\%$, 2yr 21.4$\%$) than that of squamous cell counterpart (1yr 49.4$\%$, 2yr 7.4$\%$), although this was not significant statistically (p=0.61). Two patients developed fatal radiation-induced pneumonia right after the completion of the treatment which progressed rapidly and they all died within 2 months. One patient developed radiation-induced fibrosis after 13 months. He refused further treatment and died soon after the development of fibrosis. Conclusion : Among locally advanced NSCLC, hyperfractionated radiotherapy was effective on stage IIIA patients by increasing MST with acceptable toxicities. Acute radiation-induced pneumonia should be carefully monitored and must be avoided during or after this treatment.

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Role, Change, Job Satisfaction and Obstacles in Carrying out the Role of Public Health Nurses in Health Center (보건소 보건간호사의 역할변화, 역할수행의 장애요인과 만족도)

  • Ahn, Kyeong-Sook;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.1-13
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    • 1995
  • Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.

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Effects of Wood Particles and Steel Wire Compositions on Physical and Mechanical Properties of the Boards (목재(木材)파아티클과 철선(鐵線) 복합체(複合體)가 보오드의 물리적(物理的) 및 기계적(機械的) 성질(性質)에 미치는 영향(影響))

  • Park, Heon;Lee, Pill-Woo
    • Journal of the Korean Wood Science and Technology
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    • v.14 no.1
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    • pp.3-44
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    • 1986
  • In order to obtain the basic physical and mechanical properties of steel wire reinforced particleboard, particleboards were formed with large particles through 2.11 mm (12 meshes) and retained on 1.27mm (20 meshes) sieves and small particles through 1.27mm (20 meshes) and retained on 0.42mm (60 meshes) sieves from the plywood mill wastes of meranti (Shorea spp.) in the form of pallmanchips, applying urea-formaldehyde resin as an adhesive on the particle surface in 10 percent on the oven dried weight of particles, and arranging steel wires of 1mm in diameter 5,10,15,20, and 25mm in longitudinal and transverse direction with crossing in the mid of the board depth in single layer boards, 10mm in longitudinal or transverse direction without crossing in two layers and 10mm in longitudinal and transverse directions with and without crossing in three steel wire layers boards. The stepwise 9-minutes-multi-pressing schedule in 5 minutes at 35 kgf/$cm^2$, 2.5 minutes at 25 kgf/$cm^2$. and 1.5 minutes at 15 kgf/$cm^2$ was applied for $300{\times}200{\times}13$mm board at the temperature of 160$^{\circ}C$ in a hot press. Specific gravity, thickness swelling, bending properties of modulus of rupture (MOR), modulus of elasticity(MOE), work to proportional limit, and work to ultimate load, internal bond (IB), and screw holding power(SHP) of the reinforced boards were analyzed on the wire openings and wire layers. The results obtained are summarized as follows; 1) In specific gravity, particleboards with large particles and small particles had higher value with more steel wire placements and more steel layers composition, 2) Particleboards with large particles in accordance with more steel wire liners composition gave very poor thickness swelling. 3) The mechanical properties of particleboards formed with large or small particles were reinforced with more steel wire layers. Therefore, bending strength was improved in modulus of rupture, modulus of elasticity, and work to ultimate load. Especiallv, particleboards with two or three steel wire layers showed the tension lamination effect when the steels in lower steel wire layer were oriented parallel to the board length. 4) The modulus of rupture, modulus of elasticity, and work to ultimate load in bending varied with opening area, distance of lengthwise wires multipled by distance of transverse wires. Particleboards formed with large particles resulted in higher value in modulus of rupture with 1.5-3 $cm^2$ opening area, 1-2cm distance between transverse wires, and 1.5-2.5cm distance between lengthwise wires. Particle boards formed with small particles showed higher value with 0.5-1.5$cm^2$ or 3.75-6.25 $cm^2$ opening area, 0.5 or 2.5cm distance between transverse wires. 5) In modulus of elasticity, particleboards formed with large particles with one steel wire layer suggested higher value with 5-3$cm^2$ opening area, 1-2.5cm distance between transverse wires and also 1-2.5 cm distance between lengthwise wires. Particleboards formed with small particles showed higher value with 0.75-1.25$cm^2$ or 3-6.25$cm^2$ opening area and 0.5 or 2.5cm distance between transverse wires. 6) Particleboards formed with large particles gaved higher value in work to ultimate load with 1-3$cm^2$ opening area. Particleboards formed with small particles showed increasing tendancy with decreasing opening area. 7) In internal bond and screw holding power, particleboards formed with large particles had increasing value in two and three steel wire layers compositions, but particleboards formed with small particles showed no difference. Particleboards formed with large particles containing one steel wire layer showed no difference in internal bond and screw holding power, and particleboards formed with small panicles containing one steel wire layer resulted in increasing value in internal bond and decreasing value in screw holding power in accordance with increase in opening area.

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