• Journal of Gastric Cancer
• /
• 제15권1호
• /
• pp.10-18
• /
• 2015

The purpose of this study was to determine if international guidelines differ in their recommendations concerning additive therapy for advanced, but potentially curable, gastric cancer. A systematic search of the English and German literature was conducted in the databases Medline, Cochrane Database, Embase, and PubMed. The search terms used were 'guidelines gastric cancer,' 'guidelines stomach cancer,' and 'Leitlinien Magenkarzinom.' Six different guidelines published after January 1, 2010, in which the tumors were classified according to the seventh edition of the TNM system (2010), were identified. Although the examined guidelines were based on the same study results, their recommendations concerning accompanying therapy for gastric cancer differ considerably. While perioperative chemotherapy is recommended in Germany, Great Britain, and large parts of Europe, postoperative adjuvant radiochemotherapy or perioperative chemotherapy is recommended in the USA and Canada. In Japan, postoperative adjuvant chemotherapy is recommended. The results of identical studies were interpreted differently in different countries. Since considerable effort is required for each country to separately test relevant studies for their validity and suitability, an international cooperation could simplify the creation of a common basis for guidelines and contribute to improved comparability of international guidelines.

• 대한수의학회지
• /
• 제62권2호
• /
• pp.1.1-1.8
• /
• 2022

Rehabilitation treatments after orthopedic surgery promote postoperative healing in humans. In veterinary medicine, there is increased interest in rehabilitation treatments because they are potentially beneficial to animals in the post-operation period. This study examined the effectiveness of rehabilitation treatment in dogs that underwent orthopedic surgeries, including femoral head & neck ostectomy (FHNO) and medial patellar luxation treatment (MPLT). The group that received the rehabilitation treatment after FHNO (1.88 weeks) showed a significantly shorter recovery length of 6.62 weeks compared to those that did not receive the treatment (8.50 weeks). The other group that received the rehabilitation treatment after MPLT (4.38 weeks) showed a significantly shorter recovery length of 5.01 weeks compared to those that did not receive the treatment (9.39 weeks). For the qualitative evaluation, the types and frequencies of rehabilitation treatments were monitored. The rehabilitation programs used frequently were heat therapy, laser therapy, passive range of motion, exercise therapy, and aquatic therapy. A standard rehabilitation program after hindlimb surgery was suggested based on the quantitative and qualitative investigation. The results add additional evidence that showed the beneficial effects of rehabilitation treatments in dogs.

• Radiation Oncology Journal
• /
• 제27권1호
• /
• pp.10-14
• /
• 2009

목적: 식도암에서 수술 후 방사선치료 및 방사선 단독 치료의 효과를 검증하고 예후 인자를 알아보고자 하였다. 대상 및 방법: 1989년부터 2006년까지 방사선치료를 받은 132명의 환자를 후향적으로 분석하였다. 35명은 제2병기 88명은 제3병기 9명은 제4병기 환자였다. 상부 식도암이 18명, 하부 식도암이 33명이었으며 중등부 식도암이 81명이었다. 60명에서는 방사선 단독 치료를 시행하였고 72명은 수술 후 방사선치료를 받았다. 8명에서는 40 Gy 이하를 조사하였으며 78명에서는 40내지 50 Gy를 조사하였다. 나머지 46명은 50내지 60 Gy를 조사 받았으며 수술 후 방사선치료를 받은 대부분의 환자는 45 Gy를 조사받았다. 결과: 전체 환자의 2년 및 5년 생존율은 24% 및 5%이었고 중앙 생존기간은 11개월이었다. 수술 후 방사선치료군의 2년 및 5년 생존율은 19% 및 8%, 방사선 단독치료군의 2년 및 5년 생존율은 18% 및 2%이었다. 제2병기, 제3 병기 및 제4병기 환자의 2년 및 5년 생존율은 각각 43% 및 15, 22% 및 2, 0% 및 0% 이었으며 이는 통계적으로 유의하였다. 상부, 중등부, 하부 식도암의 2년 생존율은 각각 19, 29, 22%이었으며 통계적으로 유의한 차이는 나타나지 않았다. 방사선 단독치료군에서 13명(22%)은 완전관해를, 40명(67%)은 부분관해를 보였고 7명(12%)은 반응을 보이지 않았다. 완전관해를 보인 환자군이 부분관해를 보인 환자군보다 더 나은 2년 생존율을 나타내었다(31% vs 17%). 결론: 식도암에서 방사선치료는 효과적이고 유용한 치료 방법이었으며 병기 및 방사선치료에의 반응 정도가 유의한 예후인자이었다. 그러나 식도암의 장기 생존율 및 예후가 만족스럽지 못하므로 더욱 효과적인 치료 방법의 개발이 향후 필요하리라 사료된다.

• Journal of Chest Surgery
• /
• 제26권3호
• /
• pp.214-218
• /
• 1993

Extensive lymphnode dissection combined with thoracic esophagectomy improved prognosis of esophageal cancer, but there is still high postoperative recurrence rate. The immunologic capacity of esophageal cancer patients is compromised by surgery and adjuvant chemotherapy. Therefore immunological therapy for esophageal cancer patients seems rational. We have adopted postoperative immunochemotherapy since 1988. From 1988 to 1992, 31 patients with thoracic esophageal cancer underwent esophagectomy and radical lymphnode dissection, and selected patient with early esophageal cancer and unfit for thoracotomy underwent transhiatal esophagectomy in Korea University Hospital. Mean age of patients was 56 years. There were 28 squamous cell cancers, 2 adenocarcinomas and one mixed tumor. There were 4 stage I, 3 stage II, 18 stage III, and 6 stage IV cases. There were no opeartive death. Postoperative complications included anastomotic leakage in 9%, pneumonia 3 %, cylothorax 3%, recurrent laryngeal neve paresis in 3% of all patients. Curative resection group[n=19] received immunotherapy. Noncurative resection group[n=12] received postoperative immunochemotherapy, including PS-K, CDDP, and 5-FU. Operative survivors were followed from 4 months to 5 years. There were 3 lost of follow-up. Actuarial survival rate is 79% to one year, 54% to two years and 27% to five years.In conclusion, an transthoracic esophagectomy combined with systematic lymph node dissection and postoperative immunochemotherapy could improve survival rate for esophageal cancer.

• 기본간호학회지
• /
• 제7권2호
• /
• pp.222-238
• /
• 2000

The purpose of this study was to demonstrate the effect of music therapy as a nursing intervention on changes in recovery of consciousness and vital signs for postoperative patients in the recovery room. The subject for this study were fifty three of postoperative patients who were transferred from the OR to the RR at Kwangju Christian Hospital in Kwangju City. Thirty of them were assigned to the experimental group, and twenty three, to the control group. The age of the subject was between twenty and sixty years of age. The subject had a general anesthesia without any special complications, and they were not completely awake. The data were collected for six months from July 1999 to February 2000. The method used was to compare the condition of the subjects in each group at the beginning and at certain times repeatedly. The features observed were the level of consciousness, the frequency of complaints of pain, and vital signs of the subject before and 15 minutes, 30 minutes, and 60 minutes after hearing their favorite music for 30 minutes. The results are as follows 1. The recovery of consciousness was revealed through significant changes in facial expression, facial color, and grip strength in the experimental group more strongly than in the control group. No significant changes were shown in verbal order. The differences in recovery of consciousness in the pre-post music therapy between the two groups was not significant in verbal order, facial expression, or grip strength. However, significant changes were seen in facial color. 2. There were no significant differences between the two groups in changes in the frequency of pain complaints after music therapy. However, a significant difference was shown in the pre-post music therapy scres. 3. Vital signs did not show a significant difference between the two groups. However, the $SPO_2$ of the experimental group was significantly elevated after 60 minutes. The difference pre-post to the music therapy in the vital signs between two groups was significant only in body temperature. This study showed that the effect of music therapy given to postoperative patients is that it promotes changes in facial expression, facial color, and grip strength helping recovery of consciousness, stabilizing vital signs, elevating levels of $SPO_2$. and reducing complaints of pain. It is recommended that if the patient wants it music therapy be given right after surgery in the recovery room as a nursing intervention.

• Radiation Oncology Journal
• /
• 제6권2호
• /
• pp.195-201
• /
• 1988

최근 폐암의 발생빈도는 높아지고 있으나, 아직까지 만족할 만한 치료 성적은 제시되시 많고 있으며, 현재로서는 가능한 한 초기에 발견하여 수술을 시행후 국소재발 위험군의 경우 방사선 치료를 시행하는 것이 최선의 방법으로 알려져있다. 이에 저자들은 1979년 3월부터 1986년 2월까지 서울대학교 병원에서 비소세포성 폐암 진단하에 근치적 절제수술 시행후 방사선 치료를 받은 60명의 환자를 대상으로 수술후 방사선 치료의 효과 및 예후인자에 대한 분석을 시행하여 다음과 같은 결과를 얻었다. 전체 환자 60명중 방사선 치료를 불완전하게 시행한 5명을 제외한 55명을 분석한 결과 전체 환자의 5년 생존율은 $39\%$였으며 무병생존율은 $29\%$였다. 환자의 예후를 결정하는 주요인자로서는 병기 및 국소 임파절 전이 여부였고, 1병기와 병리조직학적 분류 및 나이, 성별, 방사선 조사선량과 수술시 절제면의 종양 침범 여부는 예후에 큰 영향을 미치지 못하였다. 수술 시행후 방사선 치료를 받은 환자 군의 생존율은, 문헌상에 나타난 수술 단독 시행 환자군의 생존율과 비교해 볼 때 국소 임파절 전이가 있는 환자군에서 더 높은 결과를 보였으며, 임파절 전이가 없는 환자군에서는 큰 차이를 발견할 수 없었다. 국소 재발율도 임파절 전이가 있는 환자군에서는 수술 단독 시행 환자군보다 현저히 낮은 결과를 보여 수술후 방사선 치료가 임파절 전이가 있는 환자에게는 생존율의 증가 및 국소재발 억제의 효과를 나타냄을 관찰할 수 있었다.

• Radiation Oncology Journal
• /
• 제19권4호
• /
• pp.312-318
• /
• 2001

목적 : 고위험 유방암 환자의 수술 후 방사선치료 후 국소 재발율, 생존율 및 예후인자를 후향적 분석하여 방사선치료의 역할을 규명하고자 하였다. 대상 및 방법 : 1984년부터 1995년까지 유방암으로 변형 근치적 유방절제술 후 종양의 크기가 4 cm 이상이거나, 4 cm 미만이나 액와 림프절의 전이가 있는 환자 중 방사선치료를 완료한 48명을 대상으로 하였다. 중앙 연령은 47세 ($31\~79$세)이었으며, 종양의 크기가 2 cm미만 1명, $2\~5\;cm$ 15명, 5 cm이상이 32명이었다. 액와림프절에 전이된 환자는 32명이었다. 흉벽과 국소림프절에 방사선치료받은 환자는 42명, 흉벽만 받은 환자는 6명이었으며 방사선량은 1일 1회(1.8 Gy)로 총 선량은 50.4 Gy이었다. 48명 중 18명$(38\%)$은 5-FU를 기본으로 하는 항암화학요법을 방사선치료 전 혹은 후에 투여하였다. 중앙 추적기간은 61개월이었다. 결과 : 국소 재발율은 $8\%$, 원격전이율은 $14\%$이었다. 전체환자의 5년 생존율은 $63\%$, 무병생존율은 $62\%$이었으며 중앙생존기간은 67개월이었다. 병기에 따른 5년 생존율은 IIB는 $70\%$, IIIA는 $58\%$이었으며, 생존율에 미치는 예후인자는 병기이었다(p=0.0076). 결론 : 고 위험군의 유방암 환자의 수술 후 방사선치료는 국소재발율은 감소시키고 생존율을 향상시킬 수 있으며, 생존율에 영향을 주는 인자는 병기이었다.

• 대한두경부종양학회지
• /
• 제13권2호
• /
• pp.221-227
• /
• 1997

The authors reviewed 106 cases of parotid gland tumor at Presbyterian Medical Center seen during the past 10 years between January, 1986 and December, 1995. The results were obtained as follows; 1) 86 cases(81.1%) were benign tumors and 20 cases(18.9%) were malignant tumors. 2) Overall male and female sex ratio was 1 : 1.4. 3) For benign tumors, the mean age was 47.9 and for malignant tumors, the mean age was 43.4. 4) Clinical manifestations in benign tumors were palpable mass in 86 cases(100%), pain in 6 cases(6.9%), facial nerve palsy in 2 cases(2.3%), lymphadenopathy in 1 case(1.2%); and in malignant tumors, palpable mass in 20 cases(100%), pain in 7 cases(35%), facial nerve palsy in 2 cases(10%) and lymphadenopathy in 3 cases(15%). Thus, the presence of pain, facial nerve palsy and lymphadenopathy suggest malignant tumors. 5) Operative procedures in benign tumors included superficial parotidectomy in 53 cases(61.6%), total parotidectomy in 10 cases(11.6%), local excision in 23 cases(26.7%); and in malignant tumors, superficial parotidectomy in 3 cases, total parotidectomy in 1 case, local excision in 1 case, superficial parotidectomy with supraomohyoid neck dissection in 6 cases, total parotidectomy with supraomohyoid neck dissection in 8 cases, total parotidectomy with radical neck dissection in 1 case. 6) Postoperative complications in benign tumors were transient facial nerve palsy in 14 cases, Frey's syndrome in 2 cases. In malignant tumors complications included transient facial nerve palsy in 3 cases and permanent facial nerve palsy in 1 case. 7) Pleomorphic adenoma was the most common benign parotid tumor and mucoepidermoid carcinoma was the most common malignant tumor. 8) In our review of 20 patients with malignant parotid tumors, all patients who received supraomohyoid neck dissection and postoperative radiation therapy remain alive from 1986 to 1995 years. Two deaths in this series were adenoid cystic carcinoma patients who failed to receive postoperative radiation therapy. These series of cases have been studied in order to determine whether supraomohyoid neck dissection and postoperative radiation therapy may have further therapeutic effect.

• Journal of Chest Surgery
• /
• 제18권4호
• /
• pp.679-691
• /
• 1985

Ninety patients underwent mitral valvular heart surgery associated with or without aortic valve surgery and subjected to a clinical study in relation to their control of postoperative atrial fibrillation. There were 26 males and 64 females ranged in age from 16 to 56 years with a mean of 35.2 years. Systemic arterial embolizations were observed in 11 patients [12.2%]. Four patients of them were in normal sinus rhythm and 7 in atrial fibrillation. Out of these, left atrial thrombi were found only in 2 at the operation. Intraoperatively confirmed left atrial thrombi were in 16 patients [17.7%] of all 90 patients: Eleven patients occurred at the age of more than 40 years, 14 were in atrial fibrillation and 2 only had previous episodes of systemic arterial embolization. Sixty three patients underwent isolated mitral valve surgery [OMC 28, MVR 35] and 27 patients associated with aortic valve surgery along with mitral valve [OMC+AVR 13, MVR+AVR 14]. Preoperatively, 44 patients [48.9%] were in normal sinus rhythm. Of them, 35 patients [79.5%] revealed normal sinus rhythm thoroughly after operation without any aid of digitalis or quinidine and 5 patients [11.4%] restored normal sinus rhythm with digitalization alone. Other 3 patients converted to normal sinus rhythm with the addition of quinidine, however, in 1 patient who was resistant to quinidine therapy, electrocardioversion was carried out on the postoperative third week showing normal sinus rhythm. Thus, the most atrial fibrillations that occurred for the first time in the postoperative period, were able to reverted to normal sinus rhythm responding well to antiarrhythmic therapy. Preoperatively, 46 patients [51.1%] were in atrial fibrillation. Of them, only 5 patients returned to sinus rhythm after operation without any aid of digitalis or quinidine and other 5 restored normal sinus rhythm with digitalization: namely 2 restored within early postoperative period and 3 after more than 3 months. Eight patients well responded to quinidine therapy showing normal Sinus rhythm. So far, 25 patients have remained in persistent atrial fibrillation on 6 to 36 months follow-up. In view of these, 17 patients [68%] were over 40 years of age, 22[80%] had long duration of symptom over 5 years and 10[40%] have had atrial thrombi before operation. Left atrial dimension were still more than 40mm in 21 patients on follow up M-mode echocardiogram. One month after operation, 87 hospital survivors were improved by at least one functional NYHA class. There were 3 operative deaths [3.3%, bleeding 1, LCOS 2] and 4 late deaths [LCOS 1, valve thrombosis 1, late bleeding 1, fulminant hepatitis 1] during follow-up period. According to our limited experience, we may conclude that better results will be expected with the addition of quinidine therapy judiciously in the cases of postoperative persistent atrial fibrillation who were aged or had longer history of symptom and left atrial thrombi.

• Radiation Oncology Journal
• /
• 제11권2호
• /
• pp.347-354
• /
• 1993

This is a retrospective analysis of 67 patients with histologically proven invasive carcinoma of uterine cervix treated with surgery followed by adjuvant radiotherapy at Inje University Seoul Paik Hospital between october 1983 and september 1991, Postoperative radiotherapy was carried out in patients with high risks of locoregional recurrence such as positive pelvic lymph node (38 pts), large tumor size more than 3 cm (22 pts), cervical stromal invasion more than 2/3 (46 pts), parametrial involvement (9 pts), positive resection margin (14 pts), endo/myometrial extension (10 pts), and angiolymphatic invasion (13 pts). Stage I A, I B, and IIA were 2 $(3\%),$ 39 $(58.2\%),\;and\;26\;(38.8\%),$ respectively. Median follow-up period was 48 months with ranges from 13 to 115 months. All 67 patients were treated externally with standard pelvic field with radiation dose ranging from 4080 to 6120 cGy in 4~6 weeks period of time. Of these, 45 patients received intracavitary radiotherapy. The overall survival rate and disease free survival rate at 5-year were $88.0\%\;and\;82.1\%,$ respectively. The survival rates by stage were $87.1\%$ in IB and $88.4\%$ in IIA. Local control rate was $80.6\%(58\;pts).$ The treatment failure was noted in 12 of 67 patients $(17.9\%):$ locoregional failure in $7(10.4\%),$ distant metastasis in 3 $(4.5\%),$ and locoregional and distant metastasis in $2(3\%),$ The univariate analysis of prognostic factors disclosed endo/myometrial extension as a significant factor of survival and recurrence $(70.0\%\;vs\;91.1\%\;P<0.05\;&\;30.0\%\;vs\;15.8\%,\;respectively).$ The complication of postoperative radiothrapy was not significant and all patient were well tolerated. In conclusion, postoperative radiotherapy in patients with high risks of locoreginal recurrence is relatively well tolerated and it gives significantly improved survival rate especially in patients with positive lymph nodes, bulky tumor size $(\geqq3\;cm),$ parametrial involvement, cervical stromal invasion more than 2/3, positive resection margin and angiolymphatic invasion.