• The Journal of Korean Society for Radiation Therapy
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• v.14 no.1
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• pp.187-199
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• 2002

This descriptive study was undertaken to measure quality of life score and investigate the correlation between the demographic characteristics, the diagnostic related characteristics, physical symptom and quality of life of breast cancer patients undergoing radiation therapy as on attempt to provide basic data to help them attain better qualify of life. The subjects for this study were 74 out-patients undergoing radiation therapy at C University hospital in Gwangju, from June, 1998 to July, 2000. The data were obtained using a convenient sampling technique. The tool of this study was the quality of life scale developed by Ro Yoo Ja. The data were analyzed using the SAS program for percentage, mean, standard deviation, Pearson Correlation Coefficient, GLM. The results were as follows: 1. The total average score for quality of life of the subjects was 137.22 and the range was from 38 to 227, item mean score(range 1-5) was 3.15. For each factor in qualify of life of life score, the mean scores(range 1-5) were as follows; family relationship 3.69, relationship with neighbors factor 3.40, self esteem 3.10, physical state and function 2.95, economic life 2.91, emotional fate 2.88. 2. The incidence of physical symptoms was seen fatigue($82.4\%$), skin change($43.2\%$), alopecia($41.9\%$), pain($41.9\%$), anorexia($39.2\%$), anemia($39.2\%$), and headache($31.1\%$) in that order. 3. The result of the analysis of the relationships between the quality of life scores and demogaphic characteristics were as follows : there were significant differences, between age(F=3.44, p=0.013), educational level(F=3.84, p=0.007), duration of marriage((F=5.06, p=0.003) and monthly income(F=4.72, p=0.005). 4. The result of the analysis of the relationships between quality of life scores and diagnostic related characteristics was as follows: there was a significant difference between incidence durations(F=5.02, p=0.003). 5. The correlation of emotional state, economic life, self esteem, physical sate & function, relationship with neighbors, relationship with family in quality of life of cancer patients revealed a positive correlation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.456-465
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• 2018

This study was conducted to investigate the relationships among self-efficacy, family support, and self-care performance of gastric cancer surgery patients. The study was conducted from 11 October to 15 November 2013. Data were collected by self-report questionnaires from 121 patients who were diagnosed with stomach cancer and had undergone surgery at D university hospital in B city and were in follow-up care for 3 months to 5 years after surgery. Data were analyzed using SPSS/PC WIN 18.0 to obtain the percentage, average, mean rating, and standard deviation. In addition, t-test, ANOVA, Scheffe's test, Pearson's correlation and stepwise multiple regression were conducted. The degree of self-care performance in research targets showed significant differences by sex (t=-2.25, ｐ=0.027), religion (F=3.67, ｐ=0.028) and profession (F=4.17, ｐ=0.008). Self-care performance was positively correlated (r=0.60, ｐ<0.001) with the degree of specific self-efficacy. There was a significant difference in self-care performance by specific self-efficacy, religion and gender. The total explanatory power was 37.9% and the explanatory power of the degree of specific self-efficacy (${\beta}=0.53$) was greater than that of other factors. Therefore, it is necessary to provide interventions that improve specific self-efficacy to help patients with gastric cancer patients conduct self-care performance, and practical measures should be made with respect to religion and gender.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.328-333
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• 2012

Objective : The aim of this study is to determine the association between the cerebrospinal fluid (CSF) biomarkers and inflammation, and the predictive value of these CSF biomarkers for subsequent shunt associated infection. Methods : We obtained CSF samples from the patients with hydrocephalus during ventriculoperitoneal (VP) shunt operations. Twenty-two patients were enrolled for this study and divided into 3 groups: subarachnoid hemorrhage (SAH)-induced hydrocephalus, idiopathic normal pressure hydrocephalus (INPH) and hydrocephalus with a subsequent shunt infection. We analyzed the transforming growth factor-${\beta}1$, tumor necrosis factor-${\alpha}$, vascular endothelial growth factor (VEGF) and total tau in the CSF by performing enzyme-linked immunosorbent assay. The subsequent development of shunt infection was confirmed by the clinical presentations, the CSF parameters and CSF culture from the shunt devices. Results : The mean VEGF concentration (${\pm}$standard deviation) in the CSF of the SAH-induced hydrocephalus, INPH and shunt infection groups was $236{\pm}138$, $237{\pm}80$ and $627{\pm}391$ pg/mL, respectively. There was a significant difference among the three groups (p=0.01). Between the SAH-induced hydrocephalus and infection groups and between the INPH and infection groups, there was a significant difference of the VEGF levels (p<0.01). However, the other marker levels did not differ among them. Conclusion : The present study showed that only the CSF VEGF levels are associated with the subsequent development of shunt infection. Our results suggest that increased CSF VEGF could provide a good condition for bacteria that are introduced at the time of surgery to grow in the brain, rather than reflecting a sequel of bacterial infection before VP shunt.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2505-2510
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• 2014

Background: The standard radiotherapy (RT) fractionation practiced in India and worldwide is 50Gy in 25 fractions over 5 weeks to the chest wall or whole breast followed by tumour bed boost in case of breast conservation (BCS). A body of validated data exists regarding hypofractionation in breast cancer. We here report initial results for 135 patients treated at our center with the START-B type of fractionation. Materials and Methods: From May 2011 till July 2012, women with all stages of breast cancer (excluding metastatic), who had undergone BCS or mastectomy were planned for 40Gy in 15 fractions over 3weeks to chest wall/whole breast and supraclavicular fossa (where indicated) followed by tumour bed boost in BCS patients. Planning was done using Casebow's technique. The primary end point was to assess the acute toxicity and the cosmetic outcomes. Using cosmetic scales; patients were assessed during radiotherapy and at subsequent follow up visits with the radiation oncologist. Results: Of the 135 patients, 62 had undergone BCS and 73 mastectomy. Median age of the population was 52 years. Some 80% were T1&T2 tumours in BCS whereas most patients in mastectomy group were T3&T4 tumours (60%). 45% were node negative in BCS group whilst it was 23% in the mastectomy group. Average NPI scores were 3.9 and 4.9, respectively. Most frequently reported histopathology report was infiltrating ductal carcinoma (87%), grade III being most common (58%), and 69% were ER positive tumours, and 30% were Her 2 Neu positive. Triple negative tumours accounted for 13% and their mean age was young (43 yrs.) The maximum acute skin toxicity at the end of treatment was Grade 1 in 94% of the mastectomy grouppatients and 71% in BCS patients. Grade 2 toxicity was 6% in mast group and 23% in BCS group. Grade 3 was 6% in BCS group, no grade 3 toxicity in mastectomy patients and there was no grade 4 skin toxicity in any case. Post RT at 1 month; 39% of BCS patients had persisting Grade I skin reaction which was only 2% in mastectomy patients. At 3 months post RT, 18% patients had persisting hyperpigmentation. At 6 months 8% patients had persisting erythema in the BCS group only. Some 3% BCS and 8% mastectomy patients had lymph edema till the date of evaluation. Cosmetic outcome in BCS patients remained good to excellent 6 months post surgery and radiotherapy. 1 patient of BCS and 3 patients of mast had developed metastatic disease at the time of evaluation. Conclusions: Hypofractionated RT is well tolerated in Indian population with reduced acute skin toxicity and good cosmetic outcome. Regimens such as these should be encouraged in other centers to increase machine output time. The study is on-going to assess long term results.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7607-7611
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• 2013

Background: Cervical cancer continues to be a major problem in Bangladesh with approximately 18,000 new cases annually of which over 10,000 women die from it. Visual inspection of the cervix after 3-5% acetic acid (VIA) application is a simple and easy to learn method for cervical cancer screening, although cytology-based screening is more often applied in developed countries where it has successfully reduced the prevalence of cervical cancer. Objective: To compare the efficacy of VIA and cytology-based primary methods for cervical cancer screening in Bangladesh. Materials and Methods: This hospital based comparative study was conducted at the VIA centre and Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from October 2008 to October 2010. Results: Among 650 women, 74 (11.4%) were VIA+ve and 8 (1.2%) had abnormalities in their Pap smear reports. During colposcopy, 38 (7.7%) women had different grades of CIN and 4 (0.6%) had cervical cancer. The gold standard histology findings proved 20 women had CIN I, 14 had CIN II/II and 4 had cervical cancer. Among the 38 histology diagnosed abnormalities, VIA test could identify 30 abnormalities including two cervical cancers. However, Pap smear could detect only 8 cases of histological abnormalities (2 low grade and 6 had high grade lesion) and it missed all the cervical cancer cases. The sensitivity and specificity of VIA were 88.9% and 52.1%. The positive predictive value (PPV) and negative predictive value (NPV) were 41.0%, and 92.6% respectively. Moreover, the sensitivity, specificity, PPV and NPV of Pap smear were 33.3%, 95.8%, 75.0% and 79.3%, respectively. Conclusions: VIA test should be used as the primary screening tool even with its low sensitivity and specificity in low resource countries like Bangladesh. False positive results may be greater, but overtreatment can be minimized by colposcopy evaluation of the VIA positive women.

• The Korean Journal of Pain
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• v.29 no.4
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• pp.249-254
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• 2016

Background: This study aimed to investigate the effect of strenuous exercise on ${\beta}$-endorphine (${\beta}$-END) level in fibromyalgia (FM) patients compared to healthy subjects. Methods: We enrolled 30 FM patients and 15 healthy individuals. All study participants underwent a treadmill exercise test using modified Bruce protocol (M.Bruce). The goal of the test was achieving at least 70% of the predicted maximal heart rate (HRMax). The serum levels of ${\beta}$-END were measured before and after the exercise program. Measurements were done while heart rate was at least 70% of its predicted maximum. Results: The mean ${\pm}$ the standard deviation (SD) of exercise duration in the FM and control groups were $24.26{\pm}5.29$ and $29.06{\pm}3.26$ minutes, respectively, indicating a shorter time to achieve the goal heart rate in FM patients (P < 0.003). Most FM patients attained 70% HRMax at lower stages (stage 2 and 3) of M.Bruce compared to the control group (70% versus 6.6%, respectively; P < 0.0001). Compared to healthy subjects, FM patients had lower serum ${\beta}$-END levels both in baseline and post-exercise status ($Mean{\pm}SD$: $122.07{\pm}28.56{\mu}g/ml$ and $246.55{\pm}29.57{\mu}g/ml$ in the control group versus $90.12{\pm}20.91{\mu}g/ml$ and $179.80{\pm}28.57{\mu}g/ml$ in FM patients, respectively; P < 0.001). Conclusions: We found that FM patients had lower levels of ${\beta}$-END in both basal and post-exercise status. Exercise increased serum the ${\beta}$-END level in both groups but the average increase in ${\beta}$-END in FM patients was significantly lower than in the control group.

• The Korean Journal of Pain
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• v.30 no.1
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• pp.3-17
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• 2017

Background: Postherpetic neuralgia (PHN) is a common and painful complication of acute herpes zoster. In some cases, it is refractory to medical treatment. Preventing its occurrence is an important issue. We hypothesized that applying nerve blocks during the acute phase of herpes zoster could reduce PHN incidence by attenuating central sensitization and minimizing nerve damage and the anti-inflammatory effects of local anesthetics and steroids. Methods: This systematic review and meta-analysis evaluates the efficacy of using nerve blocks to prevent PHN. We searched the MEDLINE, EMBASE, Cochrane Library, ClinicalTrials.gov and KoreaMed databases without language restrictions on April, 30 2014. We included all randomized controlled trials performed within 3 weeks after the onset of herpes zoster in order to compare nerve blocks vs active placebo and standard therapy. Results: Nine trials were included in this systematic review and meta-analysis. Nerve blocks reduced the duration of herpes zoster-related pain and PHN incidence of at 3, 6, and 12 months after final intervention. Stellate ganglion block and single epidural injection did not achieve positive outcomes, but administering paravertebral blockage and continuous/repeated epidural blocks reduced PHN incidence at 3 months. None of the included trials reported clinically meaningful serious adverse events. Conclusions: Applying nerve blocks during the acute phase of the herpes zoster shortens the duration of zoster-related pain, and somatic blocks (including paravertebral and repeated/continuous epidural blocks) are recommended to prevent PHN. In future studies, consensus-based PHN definitions, clinical cutoff points that define successful treatment outcomes and standardized outcome-assessment tools will be needed.

• Journal of Pharmaceutical Investigation
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• v.32 no.2
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• pp.119-125
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• 2002

A rapid, selective and reproducible high-performance liquid chromatographic method has been developed for the determination of terazocin in human plasma. Terazocin plus the internal standard, prazocin hydrochloride, were extracted from alkalified plasma with tert-butylmethyl ether, back-extracted into 0.05% phosphoric acid. Fifty ${\mu}l-portions$ of extract were injected onto a octadecylsilane column and eluted with a mixture of acetonitrile, water and triethylamine (30 : 70 : 0.1 v/v, adjusted to pH 5.0 with dilute phosphoric acid) at a flow rate of 1.0 ml/min. The fluorescence intensity of column eluents was monitored at excitation wavelength of 250 nm and emission wavelength of 370 nm. No interference peaks were observed. The practical limit of quantitation was 5 ng/ml for terazocin. The average intraday and interday coefficients of variation were 4.15 and 3.54%, respectively. Also intraday and interday precisions over the range $5{\sim}60\;ng/ml$ were $0.49{\sim}2.92\;and\;0.38{\sim}5.12%$, respectively. The bioequivalence of two terazosin tablets, the $Hytrine^{\circledR}$ (Il Yang Pharmaceutical Co., Ltd.) and the $Teratonin^{\circledR}$ (Sam-A Pharmaceutical Co., Ltd.), was evaluated according to the guideline of Korea Food and Drug Administration (KFDA). Sixteen healthy male volunteers $(24.6{\pm}2.0\;years\;old)$ were divided into two groups and a randomized $2{\times}2$ cross-over study was employed. After one tablet containing 2 mg of terazosin was orally administered, blood was taken at predetermined time intervals and the concentration of terazosin in plasma was determined with a HPLC method using spectrofluorometric detector. AUC was calculated by the linear trapezoidal method. $C_{max}\;and\;T_{max}$ were compiled from the plasma drug concentration-time data. Analysis of variance (ANOVA) was utilized for the statistical analysis of the parameters. The results showed that the differences in $AUC_t,\;C_{max}\;and\;T_{max}$ between the two preparations were 0.21 %, 5.53% and 8.82%, respectively. The powers $(1-{\beta})\;for\;AUC_t,\;C_{max}\;and\;T_{max}$ were >99%, 97.49%, and 33.26%, respectively. Minimum detectable differences $({\Delta},\;%)\;at\;{\alpha}=0.1\;and\;1-{\beta}=0.8$ and the 90% confidence intervals were all less than ${\pm}20%$ except for $T_{max}.\;AUC_t\;and\;C_{max}$ met the criteria of KDFA for bioequivalence, indicating that $Teratonin^{circledR}$ tablets are bioequivalent to $Hytrine^{circledR}$ tablets.

• Journal of Korean Physical Therapy Science
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• v.10 no.2
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• pp.62-72
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• 2003

The purpose of this study is to prove the efficacy of the Kaltenborn-Evjenth Orthopedic Manipulative Therapy and the Conventional Physical Therapy that influence changes in pain and range of motion when those therapies are applied to patients with temporomandibular pint movement restriction. The subjects of the study were 30 randomly selected patients who had been diagnosed with temporomandibular pint movement restriction and had endured pain for more than two weeks. These patients had visited one of three hospitals in Pyongchon 00 Hospital. The subjects were divided into two groups with 15 patients each. The Kaltenborn-Evjenth Orthopedic Manipulative Therapy was applied to one group and the Conventional Physical Therapy was applied to the other group, once a day for three days. Then, the pain perception degree was measured by using the Visual Analogue Scale(VAS) and a digital device(Absolute Digimatic) measured the range of motion for each group. The average and standard errors were calculated for each measured items and a paired t-test was used for identifying significance in the differences in the pain perception degree and the range of motion between the two groups according to therapy. The significant level was set as ${\alpha}=0.05$. The changes in the pain perception degree were statistically significant in both groups; however, the group that received Kaltenborn-Evjenth Orthopedic Manipulative Therapy(KE-Group) showed more significant changes in a decrease in the pain perception degree than did the group that received the Conventional Physical Therapy(CPT-Group). Both groups showed significant results regarding changes in the range of motion: however, the KE-Group showed more of a significant difference in the average of the range of motion than did the CPT-Group(p<0.001). Comparing the changes in the range of motion between the two groups, the KE-Group showed a significant result which means that the KE-Group had a higher therapy effect than did the CPT-Group(p<0.05). Based on the results of this study, we found that the Kaltenborn-Evjenth Orthopedic Manipulative Therapy decreased pain and increased the range of motion. With such findings, we expect that the Kartenborn-Evjenth Orthopedic Manipulative Therapy can be used as an effective treatment method for patients with tempomrnandibular pint movement restriction and that the treatment period can be reduced with this therapy as well.