• Korean Journal of Psychosomatic Medicine
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• v.15 no.2
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• pp.100-106
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• 2007

Objectives : The objective of the present study was to investigate alexithymia in major depressive disorder(MDD) and subclinical depression(SCD). Methods : Three hundred eighty-six community-dwelling adults(238 females and 148 males, age 19-79; mean age $43.0{\pm}13.9$) were recruited. Structured clinical Interview for DSM-IV(SCID) was conducted for the diagnosis of MDD or other Axis I psychiatric disorders. The Center for Epidemiological Studies for Depression Scale(CES-D) and the Totonto Alexithymia Scale(TAS) were administered to assess depressive symptom and alexithymia, respectively. Among subjects without MDD, those who had minor depressive disorder on the SCID or high scores(i.e. over 16) on the CES-D were defined as subjects with SCD. TAS total score and factor I, II, III scores of TAS in MDD, SCD, and non-depressive controls were compared. Results : Among 386 subjects, 38 subjects(9.8%) were diagnosed as MDD by DSM-IV criteria, while 57 subjects(14.8%) were classified into SCD group. There were significant differences between 3 groups(MDD, SCD and non-depressive controls) in total score($F_{2,383}=14.0$, p<0.01), factor I(difficulty in identifying feeling)($F_{2,383}=23.4$, p<0.01) and factor II(difficulty in describing feeling)($F_{2,383}=7.8$, p<0.01), but not factor III(external oriented thinking)($F_{2,383}=1.8$, p=0.16) of TAS. In post-hoc analysis, both MDD subjects and SCD subjects had higher scores in TAS total, factor I and factor II, compared to non-depressive controls(all p<0.01). In contrast, there were no significant differences between MDD subjects and SCD subjects in any TAS factor. Conclusion : In this study, both MDD subjects and SCD subjects were more alexithymic than non-depressive control subjects. These findings suggest that SCD, as well as MDD, is also related to alexithymia.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.141-145
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• 1999

Purpose : Granisetron is a potent, the most selective 5-HT3 receptor antagonist and is reported to b effective in treatment of radiation-induced emesis. The antiemetic efficacy and safety of oral granisteron was evaluated in patients with receiving highly emetogenic treatment by conventional fractionated irradiation. Materials and Methods : Patients with various cancers who were being treated with irradiation were accrued into the present study. The intensity of nausea was evaluated on first 24 hours and on day-7 by patients according to the degree of interference with normal daily life as followings; a) none; b) present but no interference with normal daily life (mild): c) interference with normal daily life (moderate): and d) bedridden because of nausea (severe). Non or mild state was considered to indicate successful treatment. The efficacy of antiemetic treatment was graded as follows; a) complete response; no vomiting, no worse than mild nausea and receive no rescue antiemetic therapy over the 24h period, b) major response; either one episode of vomiting or moderate/severe nausea or had received rescue medication over 24h period, or any combination of these, c) minor response; two to four episodes of vomiting over the 24h period, regardless of nausea and rescue medication, d) failure; more than four medication. The score of the most symptom was recorded and the total score over 24 hours was summarized. The complete or major response was considered to indicate successful treatment. Results : A total of 10 patients were enrolled into this study, and all were assessable for efficacy analysis. Total nausea control was achieved in 90$\%$ (9/10:none=60$\%$ plus mild=30$\%$) of total patients after 7 days. The control of vomiting by granisteron was noted in seven patients (70$\%$) of complete response and three (30$\%$) of major response with a hundred-percent successful treatment over 7 days. The minor response or treatment failure were not observed. No significant adverse events or toxicities from granisetron were recorded in patient receiving granisetron. Conclusion : We concluded that granisetron is a highly effective antiemetic agent in controlling radiotherapy-induced nausea or vomiting with a minimal toxicity profile.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.504-509
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• 2005

Background : Endobronchial tumors cause life-threatening dyspnea and can lower the quality of life due to central airway obstruction. In those cases with an intraluminal tumor, various bronchoscopic techniques are available for tumor debulking. The therapeutic effect of bronchoscopic electrocautery for palliation in patients with a symptomatic tumor obstruction was studied. Method : Nineteen patients with bronchogenic carcinomas (n=15) and metastatic tumors affecting the bronchi (n=4), between March 2002 and March 2005, were enrolled in this study. Electrocautery was performed under local anesthesia using an electroprobe and diathermic snare. Using flexible bronchoscopy, a follow-up bronchoscopic examination was performed 3-4 days later. Symptom improvement was evaluated by $FEV_1$, FVC and dyspnea score (Modified Borg Category Scale (0~10)), both before and after the electrocautery. Results : The success rate of electrocautery on the follow up examination was 84%. Patients with endoluminal airway lesions had a mean overall decrease in the size of the obstruction to $47.8{\pm}15.7%$. The mean Improvement in the dyspnea score immediately after the endobronchial tumor debulking was $2.78{\pm}1.42$. The average improvements in the $FEV_1$ and FVC after electrocautery were $0.32{\pm}0.19L$ and $0.5{\pm}0.22L$, respectively. There were 2 cases of complications related with electrocautery (one each of pneumothorax and pneumonia). Conclusion : Electrocautery using an electroprobe and diathermic snare was an effective and safe palliative treatment for a symptomatic endoluminal airway obstruction in lung cancer.

• Journal of Home Health Care Nursing
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• v.8 no.1
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• pp.5-24
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• 2001

The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.493-504
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• 1997

Background : Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stageIII non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it has at most only a modest effect on survival. Recently, cisplatin(cis-diamminedichloroplatinum) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and Method : Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given to times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 times, in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. Results : There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p < 0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p < 0.05) In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. Conclusion : There was no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.

• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.137-144
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• 2002

Background: Hemoptysis is an often alarming presenting symptom and VEGF is a major regulator of both normal and abnormal angiogenesis, including many inflarrunatory diseases. In this report the clinical significance of the serum VEGF level in patients with hemoptysis was investigated. Methods: Thirty-two patients with hemoptysis were evaluated. The estimated amount of hemoptysis, etiology and serum VEGF level was examined at admission and bronchial angiography was performed in 22 patients. In order to objectify the neovascularization status, one point for the presence of the A-V shunt, hypervascularity, vascular tortuosity was designated for a total of 0-3 points. Results: Mean quantity of hemoptysis was $172.4{\pm}270.4ml$. The mean angiographic neovascularization score was $1.23{\pm}0.75$. The serum VEGF level correlated with the quantity of hemoptysis(r=0.524, p=0.002) and with the angiographic neovascularization score(r=0.441, p=0.04). Using the standard diagnostic criterion for massive hemoptysis, the serum VEGF level of patients with massive hemoptysis($642.4{\pm}545.6$ pg/ml, n=13) was found to be higher than that of patients with non-massive hemoptysis($394.6{\pm}225.8$ pg/ml, n=19) (p=0.069). Conclusion: Regardless of the etiology, the serum VEGF may contribute to abnormal neovascularization in patients with hemoptysis. Therefore, it is suggested that serum VEGF measurements may help in predicting a massive hemoptysis.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.115-123
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• 2003

Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.389-398
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• 1998

Purpose : To evaluate the role of conventional postoperative adjuvant radiotherapy in the management of supratentorial malignant glioma and to determine favorable prognostic factors affecting survival. Materials and Methods : From Sep. 1985 to Mar. 1997, the number of eligible patients who received postoperative radiotherapy completely was 69. They ranged in age from 7 to 66 years (median, 47). Forty-two (61$\%$) patients were glioblastoma multiforme and the other 27 (39$\%$) were anaplastic astrocytoma. Twenty patients (29$\%$) had Karnofsky score equal or more than 80 preoperatively. Forty-three patients (62$\%$) had symptom duration equal or less than 3 months. Twenty-four patients (35$\%$) had gross total resection and forty patients(58$\%$) had partial resection, the remaining five patients (7$\%$) had biopsy only. Radiotherapy dose ranged from 50.4 Gy to 61.2 Gy (median, 55.8; mode, 59.4) with fraction size of 1 8 Gy-2.0 Gy for 33-83 days(median, 48) except three patients delivered 33, 36, 39 Gr, respectively with fraction size of 3.0 Gy due to poor postoperative performance status. Follow-up rate was 93$\%$ and median follow-up period was 14 months. Results : Overall survival rate at 2 and 3 years and median survival were 38$\%$, 20$\%$, and 16 months for entire patients; 67$\%$, 44$\%$, and 34 months for anaplastic astrocytoma; 18$\%$, 4$\%$, and 14 months for glioblastoma multiforme, respectively (p=0.0001). According to the extent of surgery, 3-year overall survival for gross total resection, partial resection, and biopsy only was 38$\%$, 11$\%$, and 0$\%$, respectively (p=0.02) The 3-year overall survival rates for patients age 40>, 40-59, and 60< were 52$\%$, 8$\%$, and 0$\%$, respectively (p=0.0007). For the variate of performance score 80< vs 80>, the 3-year survival rates were 53$\%$ and 9$\%$, respectively (p=0.008). On multivariate analysis including covariates of three surgical and age subgroups as above, pathology, extent of surgery and age were significant prognostic factors affecting overall survival. On another multivariate analysis with covariates of two surgical (total resection vs others) and two a9e (50> vs 50<) subgroups, then, pathology, extent of surgery and performance status were significant factors instead of age and 3-year cumulative survival rate for the five patients with these three favorable factors was 100$\%$ without serious sequela. Conclusion : We confirmed the role of postoperative conventional radiotherapy in the management of supratentorial malignant glioma by improving survival as compared with historical data of surgery only. Patients with anaplastic astrocytoma, good performance score, gross total resection and/or young age survived longest. Maximum surgical resection with acceptable preservation of neurologic function should be attempted in glioblastoma patients, especially in younger patients. But the survival of most globlastoma patients without favorable factors is still poor, so other active adjuvant treatment modalities should be tried or added rather than conventional radiation treatment alone in this subgroup.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.559-573
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• 1997

Background : Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway responsiveness to a variety of stimuli. Method : Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of "Global initiative for asthma, Global strategy for asthma management and prevention" (NHLBI/WHO) with PFR(%) larger than 80%, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/WHO, group 5 (long term control group) : patients who were controlled for more than 2 years by step 1 or 2 treatment of NHLBI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC20 and peripheral blood eosinophil count, pulmonary function test, steroid doses and aggrevation numbers after treatment. Results : On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and initial pulmonary function was better. The long term control group required lower amounts of oral steroid. had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control Atopy, allergic skin test, sputum and blood eosinophil, total IgE, nonspecific bronchial responsiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was $20.3{\pm}9.7$ months and relapse did not occur. Conclusion : Patients who had asthma of onset age younger, shorter symptom duration, better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.

• Journal of Nutrition and Health
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• v.42 no.6
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• pp.536-546
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• 2009

This study was done to investigate the effect of stress on appetite and eating habits, and other health-related behaviors. The subjects of this study consisted of 188 males and 224 females in Ulsan area. The results were as follows: When stressed, 56% (n = 231) of the subjects experienced a change in appetite and of these, 32% (n = 132) experienced an increased appetite. Stress-induced eating may be one factor contributing to the development of obesity. There was a gender-specific response to stress in which women are more likely to use food to deal with stress, whereas men are more likely to use alcohol consumption or smoking. It was found that types of stressors were individual (52.9%), social (50.7%), family relations (34.5%), work demands (34.2%) and physical environment (32.3%). Stress-induced symptoms of the subjects were anxiety (38.3%), headache (36.7%) and neck or shoulder aches (36.2%), and females experienced those symptoms more than males. Those older than 50 years had a higher eating habit score and lower stress score compared with younger subjects. There were significant differences between sex, age, occupation, family type, BMI, exercise, sleeping hours and eating habits or stress level. This study may be helpful in advancing findings in this area to better provide health professionals with appropriate counseling tools to improve the health of all individuals.