• Title/Summary/Keyword: 기관암

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Diagnostic Role of Tc-99m MIBI Scintimammography in Suspected Breast Cancer Patients: Results of Unicenter Trial (유방암이 의심되는 환자에서 Tc-99m MIBI 유방스캔의 진단적 역할: 단일기관의 결과)

  • Kim, Seong-Jang;Kim, In-Ju;Kim, Yong-Ki;Bae, Young-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.234-242
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    • 2000
  • Purpose: Tc-99m MIBI scintimammography has been validated as an useful non-invasive diagnostic tool for the primary breast cancer. But most studies have included small population of patients. We have experienced a large study population and investigated the diagnostic usefulness of Tc-99m MIBI scintimammography in detection of primary breast cancer and axillary lymph node metastasis. Materials and Methods: This study included 305 patients who underwent scintimammogtaphy for palpable breast masses or abnormal radiologic findings. Tc-99m MIBI scintimammography was performed 10 minutes after intravenous injection of 925 MBq of Tc-99m MIBI. If the early image revealed abnormal finding, 3 hour delayed image was also acquired. We calculated early and delayed lesion to non-lesion ratios (L/N). The pathologic diagnosis was obtained from surgical operation or FNAB and compared with the results of Tc-99m MIBI scintimammography. Results: Malignant breast diseases were 155 and benign ones were 150. Tc-99m MIBI scintimammography revealed 132 true positive, 23 false negative, 10 false positive, and 140 true negative cases. The sensitivity, specificity, positive predictive value and negative predictive value for the primary breast cancer detection were 85.2%, 93.4%, 92.9%, and 85.9%, respectively. The sensitivity, specificity, positive predictive and negative predictive values of Tc-99m MIBI scintimammography in detecting metastatic axillary lymph node involvement were 22%, 90.4%, 61.9% and 62.3%, respectively. Early L/N of malignant breast disease was significantly higher than that of benign one ($2.44{\pm}0.97\;vs\;1.94{\pm}0.78$, p=0.01). Delayed L/N had no significant difference between malignant and benign breast diseases ($1.94{\pm}0.52\;vs\;1.91{\pm}0.73$, p=0.43). Conclusion: Our study revealed that Tc-99m MIBI scintimammography was an useful diagnostic tool for the diagnosis of breast cancer. And early L/N ratio might provide complementary role in the detection of breast cancer. But the Tc-99m MIBI scintimammography had limited value in the detection of small breast cancer (less than 1 cm) and axillary lymph node metastasis.

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Current Status and Challenge of Hospice.Palliative Care in Korea (한국 호스피스.완화의료 기관 현황 및 과제)

  • Lee, Kun-Sei;Joo, Ji-Soo;Kim, Jung-Hoe;Kim, Keon-Yeop
    • Journal of Hospice and Palliative Care
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    • v.11 no.4
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    • pp.196-205
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    • 2008
  • Purpose: The purpose of this study was to evaluate the current status of hospice palliative care facilities, and to identify problems and improve hospice palliative care in Korea. Methods: The questionnaire survey was implemented from October to December, 2007. It was consisted of general characteristics of organization, health manpower, facilities & equipments, service programs, and so on. Sixty two (79.5%) out of 78 hospice palliative care facilities returned the questionnaires. Results: They were 42 hospital-based hospice palliative care hospitals and 9 clinics, and most of them are located at central metropolitan areas (Seoul and Gyeonggi Province). more than 80% of hospitals met with the requirements (one doctor per 10 patients and one nurse per 1.5 patients), whereas 42.9% of clinics met the requirements. Approximately 22% of them met the requirement of sick room (4 patients for 1 room). Most of them provided various hospice palliative care programs. The proportion of giving regular education programs to hospice palliative care personnels were about half (41.9%). Thirty two (51.6%) facilities provided home visiting hospice palliative care service. Conclusion: There were lack of enough health manpower, rooms, and programmes and they varied among facilities. It is necessary to increase the number of hospice palliative care facilities with consideration of regional fair distribution and standardization of programmes.

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One Case of Esophageal Cancer Treated with High Dose Rate ICR (고 선량률 강내 치료기를 이용한 식도암 치험 1례)

  • Kim, Kyeung-Ae;Kim, Sung-Kyu;Shin, Sai-One;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.147-151
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    • 1988
  • Esophageal cancers are highly malignant neoplasms. Prognosis of esophageal cancer treated by external irradiation alone is rather poor because of local recurrence and distant metastasis. Recently intracavitary irradiation has been used as a boost therapy after external irradation to optain better local control. One case of esophageal cancer has been treated by high dose rate remote-controlled afterloading unit as boost therapy after external irradiation. The result was excellent in short term follow up esophagogram but esophageal bleeding and esophagotracheal fistula were noted in further follow up examination after inappropriate posttreatment management including insufficient chemotherapy due to poor general condition. We reviewed possible causes of esophageal bleeding and esophagotracheal fistula after external irradiation and high dose rate ICR.

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Childhood Brain Tumors (소아 뇌종양 - 항암화학요법을 중심으로 -)

  • Ghim, Thad T.
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1055-1058
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    • 2002
  • 뇌종양 치료성적은 점차 향상되고 있지만 백혈병 등 다른 소아암에 비해 향상 속도가 느리다. 하지만, 근래 MRI, PET scan 등 neuro-imaging 기술의 발달, 뇌종양의 분자유전학적 연구, 외과 수술 방법의 진전, 치료방사선요법의 다양화 등 많은 분야에서 꾸준한 발전을 보이고 있다. 그리고 여러 가지 신약개발에 의한 제 1, 제 2상의 약제시험, antiangiogenesis 약제의 임상시험, gene therapy 등의 연구가 활발하게 진행되고 있으므로, 이에 따른 환자의 치료 성적도 향상될 것으로 기대하고 있다. 외국에서는 여러 대학이 함께 참여하여 작성한 공동의 치료 protocol에 의한 치료가 활발하게 진행되어 생존율을 높이는데 반해, 우리나라에서는 아직까지 각 기관의 협조체제가 구축되지 못한 형편이다. 하지만 금년에 처음으로 여러 대학에서 임상각과가 참석하는 한국소아 뇌종양연구회가 탄생되어 우리나라 뇌종양 환아들의 치료 protocol 개발에 기여할 것을 기대하고 있다. 뇌종양 치료 후 생존하는 아이들을 위한 정밀한 추적관찰이 필수사항인데 여기에 소아과 의사들의 역할은 클 것으로 사료된다. 지능장애, 부적절한 대인관계, 사회적응의 어려움, 치료 후 발생한 내분비계통의 후유증 그리고 2차 암의 발생 등의 정확한 진단 및 치료가 소아과 의사들의 몫으로 남는다. 또한, 이러한 장애가 있는 환아들이 사회에 잘 적응하도록 하기 위해서는 재활교육에 대한 사회적인 관심과 그에 적절한 지원제도의 확립이 절실히 요구된다. 이 점에 있어서도 소아과 의사들의 관심과 지원이 필요하다.

A Case of Bronchoesophageal Fistula Treated by Bronchial Stent Insertion and Endoscopic Histoacryl Injection (기관 스텐트 삽입과 히스토아크릴 주입법으로 치료한 식도 누공 1례)

  • Dong Joon Oh;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.2 no.1
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    • pp.21-23
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    • 2014
  • We report a bronchoesophageal fistula that treat with bronchial stent insertion and histoacryl injection. A 52-year-old man with esophagel cancer was transferred for dysphagia management. At the CT scan that underwent on admission, esophageal cancer with multiple lymph node metastasis was observed. At the gastroduodenoscopy and contrast study, bronchoesophageal fistula was observed. Recurrent stent insertion treatment was failed, and then, By the broncoscopy, covered stent was inserted to right bronchus, and By the endoscopy, fibrin glue and histoacryl was injected in the fistula opening. At the contrast study, contrast leakage was not observed, and the patient was discharged. But, at the 14 days after discharge, the patient was admitted to the emerency room because of cough symptom whenever he eat food. The patient was diagnosed with aspiration pneumonia, we were determined that it is unable to oral intake. The patient received a jejunostomy and antibiotic treatment for aspiration pneumonia. He was discharged after symptomatic improvement.

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Case Study of New Employee Mentoring Program at Hospital A (의료기관 신입직원 멘토링프로그램 사례연구: A병원을 중심으로)

  • Jiyoung Han;Jongil Choi
    • Korea Journal of Hospital Management
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    • v.29 no.1
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    • pp.19-31
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    • 2024
  • Purposes: The purpose of this study is to analyze cases of development and operation of a mentoring program that provides psychological support to new employees and helps them adapt to work, thereby applying it to actual work and laying the foundation for follow-up research. Methodology: We explored the development and application process of A Hospital mentoring program by applying the mentoring program model developed according to the procedures of the ADDIE model, and confirmed the perceptions of participants who participated in the training course through analysis of activity logs and in-depth interviews. Findings: The main results of the case analysis are as follows. First, the curriculum was developed according to the stages of analysis, design, development, implementation, and evaluation. As a result of activity log and in-depth interview analysis, participants recognized that the mentoring program was helpful in forming social relationships, organizational adaptation, and preventing job turnover, and recognized difficulties in communication. Participants mentioned supplementing the operating system. Practical Implication: The results of a systematic review of the application and effectiveness of mentoring programs for new employees can serve as reference material for practical program design.

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A study on Quality Control of Mammography Equipment in the Gwang-Ju (일부지역 유방 촬영 장비의 정도관리 실태조사 연구)

  • Shin, Ji-Yun;Lee, Sang-Bock;Jin, Gye-Hwan;Lee, Sam-Yeol;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.2 no.4
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    • pp.11-25
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    • 2008
  • As breast cancer shows the highest incidence among women's cancers, the use of mammography is also increasing as a screening test. Mammography should produce high-quality images for accurate diagnosis. For this, it is necessary to manage the performance and image quality of mammography. Thus, in order to investigate quality control, the present study conducted a questionnaire survey of 37 hospitals registered as breast cancer medical examination centers in Gwang-Ju, concerning their quality control of mammography. In the results of surveying the characteristics of apparatus use for mammography, many respondents did not know about the equipment that they were using. Of the hospitals, 19 (49%) were using film, 19 (49%) CR, and 1 DR. In the results of asking how to do quality control, only 38% answered that they inspected according to the manual. In addition, all the surveyed hospitals had specialized agencies do quality control for them. As to the reason for using agencies, 65% mentioned limitations in personnel, time, distance, etc, and 44% mentioned the absence of machines and materials. These results suggest that quality control is being performed perfunctorily, as well as passively and indifferently as it relies on specialized agencies. Accordingly, it is necessary to provide regular education for enhancing people's perception of quality control and to perform quality control adequately in the presence of Radiologist.

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CLINICO-STATISTICAL STUDY OF PATIENTS WITH HOARSENESS (사성환자의 임상통계적 관찰)

  • 문영일;박연아;김영주;조은아
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.15.2-16
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    • 1987
  • 사성이란 후두의 발생기능에 장애가 있을 때 생기는 후두질환의 가장 대표적인 주증상으로 인간 문화의 발달에 병행되어서 대화에 의한 전달수단이 중요시되고 또한 암에 대한 인식이 높아져 사성을 호소하는 환자들이 많아지는 경향이 있다. 이에 저자는 1980년 1월부터 1984년 12월까지 이화여자대학교 의과대학 부속병원 이비인후과 외래에 내원한 신외래환자 총 24,949명 중 사성을 주소로 한 800명의 환자에 대하여 병력지를 기준하여 각 질환을 통계적으로 분석 검토하여 다음과 같은 성적을 얻었다. 1) 이비인후과 외래환자 총 24,949명중 사성환자는 800명으로 약 3.2%이었다. 2) 외래사성환자 800명중 남자 336명, 여자 464명으로 남녀비는 약 1 : 1.4이었다. 3) 질환별로는 급성 후두염 248예(31.0%), 만성 후두염 186예(23.3%), 성대결절 160예(20.0%), 성대폴립 90예(11.3%), 성대마비 56예(7.0%), 후두 유두종 12예(1.5%), 후두암 9예(1.1%)이었다. 4) 연령별로는 30대가 213예(26.6%), 20대가 190예(23.8%), 40대가 179예(22.4%)의 순이었다. 5) 각 질환별 최다연령은 급성 후두염 30대 73예(29.4%), 만성 후두염 30대 53예(28.5%), 성대결절 30대 52예(32.5%), 성대폴립 40대 26예(28.9%), 성대마비 40대 14예(25.0%), 후두암 50대 6예(66.7%)이었다. 6) 발병부터 초진까지의 기간은 10일 이내가 153예(19.1%)로 제일 많았고 1개월∼3개월 138예(17.3%), 11일∼l개월 119예(14.9%)의 순이었다. 7) 각 질환에 따른 발병부터 초진까지의 기간의 최다분포는 급성 후두염은 10일 이내가 117예(47.2%), 만성 후두염은 3개월∼6개월이 44예(23.7%), 성대결절은 3개월∼6개월이 40예(25.0%), 성대폴립은 6개월∼1년이 20예(22.2%), 성대마비는 10일이내가 12예(21.4%)이었다. 8) 질환별 동반증상 분포는 사성만을 호소한 경우가 394예(41.4%)로 가장 많았고 동반증상으로는 인두통, 이물감, 객담, 기침, 연하장애, 호흡곤란의 순이었다. 9) 저자의 연도별 사성환자의 평균발생빈도(3.2%)를 문(1981)의 1975년 1월부터 1979년 12월(만 5년간)까지의 평균발생빈도(2.9%)와 비교할 때 증가하였다.

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Optimal culture methods for plant regeneration via shoot organogenesis in the 'Fuji' apple (사과 '후지'의 기관형성을 통한 식물체 재생에 효율적인 배양방법)

  • Yoon Kyung Lee;Youngju Kwon;Yong Joon Yang
    • Journal of Plant Biotechnology
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    • v.50
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    • pp.176-182
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    • 2023
  • Plant regeneration protocols for adventitious shoot organogenesis from apple (Malus domestica 'Fuji') leaf explants were developed in the present study. The effects of dark incubation periods in the early stages of culture, pre-treatment methods, the number of explants per culture container, the type of culture containers, and the orientation of the explants on culture media were evaluated to determine the optimal shoot regeneration conditions for 'Fuji' apple leaf explants. Light incubation of explants produced minimal response. However, dark incubation of explants for 4 weeks during the initial culture period enhanced shoot regeneration frequency. Comparing the number of explants per container, a higher percentage of shoot regeneration was obtained with nine explants per container compared with four explants per container. Pre-treatment, before culture, by dipping explants in a liquid regeneration medium containing 40 g/L of sorbitol for 2 hours produced the highest shoot formation rate, and the time of shoot formation was accelerated. The percentage of shoot regeneration and number of shoots per regenerating explant reached a maximum of 87.5% and 4.7, respectively. The regenerated shoots were elongated and rooted on a rooting medium of 1/4 MS with 0.2 mg/L IBA. The plantlets were successfully acclimatized, and the regenerated plants produced normal phenotypes.

Prognostic Value of a Single Center Nutrition Screening Tool in Patients with Metastatic Cancer (전이암 환자에서 단일기관 영양검색 도구의 예후 가치)

  • Yoon, Sung Soo;Kim, Min Jin;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.24 no.2
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    • pp.1-11
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    • 2019
  • Objectives : We investigated whether a single center nutrition screening tool (Kyunghee Neo Nutrition Risk Screening, KNNRS) can predict survival in patients with metastatic cancer. Methods : We retrospectively reviewed data of inpatients with metastatic cancer from April 2016 to August 2019. Data on demographic and clinical parameters were collected from electronic medical records, and overall survival was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine factors associated with survival. Patients with a KNNRS score of 0 to 3 were classified as "no-risk", 4 to 10 as "low-risk", and 11 to 20 as "high-risk". Results : Total 105 patients were included in the study. According to nutritional screening at baseline, 25 patients (23.8%, median age 57.0) were classified as ""no risk"" group; 80 patients (76.2%, median age 68.5) as "low risk" group; No patients as "high risk" group. Predictors of survival were Eastern Cooperative Oncology Group Performance Status score of 3 or 4 (hazard ratio [HR] = 1.93; 95% confidence interval [CI] = 1.21-3.10), hemoglobin less than 10 g/dL (HR = 1.97; 95% CI = 1.25-3.10) and C-reactive protein more than 1.0 mg/dL (HR = 1.95; 95% CI = 1.21-3.13). Kaplan-Meier survival analysis showed significant differences in the survival between KNNRS groups: ""no risk"" group: 6.1 ± 1.4 months (95% CI = 3.37-8.83); ""low risk"" group: 3.4 ± 0.9 months (95% CI = 1.5-5.37). Conclusions : Nutritional status according to KNNRS wasn't significant predictor of survival for patients with metastatic cancer. Improvement of KNNRS score thresholds is needed.