• Title/Summary/Keyword: 무작위성

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The Study of Normal Tissue Complication Probability(NTCP) for Radiation Pneumonitis by Effective Volume Method (유효체적 방법과 임상분석을 통한 방사선에 의한 정상 폐조직의 부작용 확률에 관한 연구)

  • Ahn Seung Do;Choi Eun Kyung;Yi Byong Yong;Chang Hyesook
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.243-249
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    • 1997
  • Purpose : In radiation therapy, NTCF is very importart indicator of selecting the optimal treatment plan. In our study, we tried to find out usefullness of NTCP in lung cancer by comparng the incidence of radiation pneumonitis with NTCP. Materials and Methods : From August 1993 to December 1994, thirty six patients with locally advanced non=small cell lung cancer were treated by concurrent chemoradiation therapy. Total dose of radiation therapy was 6480cGy (120cGy, bid) and chemotherapeutlc agents were mitomycin C. vinblastion, cisplatin (2 cycles, 4 weeks interval). We evaluated the development of raniation pneumonitis by CT scan, chest x-rar and clinical symptoms. We used grading system of South Western Oncology Group (SWOG) for radiation pneumanitis. Dose Volume Histograms (DVH) were analyzed for ipsilateral and whole lung, Non uniform DVH was translated to uniform DVH by effective volume method. With these data, we calculated NTCP for ipsilateral and whole lung. Finally we compared the clinical results to NTCP. Results : Eight of thrity six patients developed radiation pneumonitis. Of these 8 patients , 6 had grade I severity and 2 had grade II. The average NTCP value cf the patients who showed radiation pneumonitis was significantly higher than that uf the patients without pneumonitis $(66\%\;vs.\;26.4\%)$. But the results of pulmonary function test was not correlated with NTCP. Conclusion : NTCP of lung is very good indicator for selecting rival treatment planning in lung cancer. According to the results of NTCP, it may be possible to adjust target volume and optimize target dose. In the near future, we are going to anaiyze the effect of hyperfractionation and concurrent chemotherapy in addition to NTCP.

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Quality and Affecting Factor of Care for Patients Hospitalized with Pneumonia (폐렴 입원환자 진료과정의 질적 수준과 이에 영향을 미치는 요인: 임상질지표를 중심으로)

  • Moon, Sangjun;Lee, Jin-Seok;Kim, Yoon;You, Sun-Ju;Choi, Yun-Kyoung;Suh, Soo Kyung;Kim, Yong-Ik
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.300-308
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    • 2009
  • Background: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. Methods: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. Results: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. Conclusion: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

Clinical Efficacy of Belotecan (CKD-602), Newly Developed Camptothecin Analog, in the 2nd Line Treatment of Relapsed Small Cell Lung Cancer (재발된 소세포폐암환자에서 이차 약제로 사용되는 Belotecan (CKD-602)의 임상적 효용성)

  • Ban, Hee-Jung;Oh, In-Jae;Kim, Kyu-Sik;Ju, Jin-Yung;Kwon, Yong-Soo;Kim, Yu-Il;Lim, Sung-Chul;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.2
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    • pp.93-97
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    • 2009
  • Background: Belotecan (Camtobell, CKD-602, Chongkundang Pharm., Korea), a camptothecin derivative, has anticancer effects by inhibiting topoisomerase I such as topotecan. This study observed the response, survival and toxicity of belotecan monotherapy after the failure of etoposide and platinum (EP). Methods: Forty nine small cell lung cancer (SCLC) patients (M/F=41/8; age, 64.5${\pm}$7.6 (mean${\pm}$SD) years), who failed in their first line chemotherapy were enrolled in this study. Twenty one SCLC patients showed relapsed lung cancer more than 90 days after their priorEP chemotherapy (sensitive relapse group, SR) and 28 patients relapsed within 90 days (refractory relapse group, RR). Results: The response rate was 25%. Eleven patients showed partial responses and 5 patients could not be checked. The response rate of the SR and RR patients was similar. The relative dose intensity was lower in the responders (78${\pm}$15%) than non-responders (83${\pm}$13%, p=0.03). The median survival time (MST) was 10.3 months (290 days). The MST of the non-responders and responders was 186 days (95% CI; 67-305) and 401 days (95% CI; 234-568, p=0.07), respectively. The median progression free survival (MPFS) was similar in the SR (79 days) and RR (67 days) patients. Grade 3-4 neutropenia, anemia, and thrombocytopenia were observed in 59.6%, 12.8% and 23.4% of patients, respectively. Conclusion: The efficacy and survival were demonstrated in the second-line setting. However, a randomized comparative trial with topotecan will be needed.

A STUDY ON THE BONDING OF COMPOMER TO DECIDUOUS DENTIN (컴포머와 유치 상아질의 결합에 관한 연구)

  • Kim, Jee-Tae;Kim, Yong-Kee;Kim, Jong-Soo;Kwon, Soon-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.509-518
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    • 2002
  • The purpose of this study was to evaluate the bonding of compomer to deciduous dentin which is known to have been developed to improve the weak properties of glass ionomer cement and composite resin. 120 sound primary molars were used for the shear bond strength test and another 24 for the scanning electron microscopic evaluation. Each material was ailed into polyethylene mold attached to exposed dentinal surface($3{\times}4mm$ in diameter) of sample blocks. Shearbond strength was measured using Universal testing machine and data were analyzed statistically with Oneway-ANOVA and Scheffe test. Scanning electron microscopic observation was performed in order to evaluate the pattern of distribution and penetration of resin tags and hybrid layer. Compomer groups(II-V) showed significantly higher bond strength values than glass ionomer group(I)(p<.05). Etching-compomer groups(III, V) showed the significantly higher bond strength than non-etching compomer groups(II, IV)(p<.05), but slightly lower values than composite resin group(VI) with no statistically significant difference(p>.05). No significantly different bond strength was found between compomer groups of different bonding system(p>.05). Scanning electron micrographs showed more irregular distribution of short and thin resin tags in non-etching compomer groups(II, IV) whereas the more regular and intimate distribution of long and thick tags in etching compomer groups(III, V) and composite resin group(VI). The evaluation of hybrid layer also showed more regular formation of thicker layer in etching compomer groups(III, V). Based on the results of present study, the use of compomer as an esthetic restorative material for primary molars might be justified.

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A STUDY OF ADDITIONAL VIBRATION EFFECT ON DENTIN BOND STRENGTH (진동이 상아질 결합력에 미치는 영향에 관한 연구)

  • Lee, Jin;Kim, Jung-Wook;Lee, Sang-Hoon;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.4
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    • pp.632-640
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    • 2002
  • The objective of the study was to apply the vibration technique to reduce the viscosity of bonding adhesives and thereby compare the bond strength and resin penetration into dentinal tubules achieved with those gained using the conventional technique. Eighty-eight noncarious extracted human permanent molar teeth were sectioned to remove the coronal enamel and were embedded in 1-inch PVC pipe with acrylic resin. The occlusal surfaces were placed so that the tooth and the embedding medium were at the same level to form one flat surface, and the samples were subsequently polished with silicon carbide abrasive papers. The samples were randomly assigned to 4 groups(n=22). On Group 1 and 2, Single Bond(3M-ESPE, St. Paul, USA) was used, and on Group 3 and 4, One-Step(Bisco Inc., Schaumburg, USA) was used, and each was applied according to its manufacturer's instructions. For Group 2 and Group 4, vibration was applied with ultrasonic scaler for 10 seconds, and the adhesive was light-cured for 10 seconds. Resin composite was condensed on to the prepared surface in two increments using a mold kit(Ultradent Products Inc., USA) and each was light-cured for 40 seconds. After 24 hours in tap water at room temperature the specimens were thermocycled, and shear bond strengths were measured with a universal testing machine(Instron 4465, Canton, USA). To investigate infiltration patterns of the adhesive materials, the surface of specimen was examined with scanning electron microscope. The results were as follows. 1. The shear bond strengths of vibration groups(Group 2, Group 4) were significantly greater than those of the non-vibration groups(Group 1, Group 3)(p<0.05). 2. The shear bond strengths of Single Bond and One-Step were not significantly different (p>0.05). 3. The vibration groups showed greater number of resin tags in tubules and lateral branches under SEM.

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Effect of Neutrophil Elastase Inhibitor, lei 200,355, on Interleukin-1 Induced Acute Lung Injury in Rats (Interleukin-1으로 유도된 흰쥐 급성폐손상에서 neutrophil elastase 억제제인 ICI 200,355의 효과)

  • Chung, Jin-Hong;Mun, Yeung-Chul;Park, Hye-Jung;Shin, Kyeong-Cheol;Lee, Kwan-Ho
    • Journal of Yeungnam Medical Science
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    • v.19 no.1
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    • pp.55-62
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    • 2002
  • Background: Interleukin-1(IL-1) and neutrophil appear to contribute to the pathogenesis of acute respiratory distress syndrome(ARDS). Elastase, as well as reactive oxygen species released from activated neutrophil, are thought to play pivotal roles in the experimental models of acute lung leak. This study investigated whether ICI 200,355, a synthetic elastase inhibitor, can attenuate acute lung injury induced by IL-1 in rats. Materials and Methods: We intratracheally instilled either saline or IL-1 with and without treatment of ICI 200,355 in rats. Lung lavage neutrophils, lung lavage cytokine-induced neutrophil chemoattractant(CINC) concentration, lung lavage protein concentration, lung myeloperoxidase(MPO) activity and lung leak index were measured at 5 hours of intratracheal treatment. Results: In rats given IL-1 intratracheally, lung lavage neutrophils, lung lavage CINC concentration, lung lavage protein concentration, lung MPO activity and lung leak index were higher. Intratracheal ICI 200,355 administration decreased lung lavage neutrophils, lung MFO activity and lung leak index, respectively, but did not decrease lung lavage CINC concentration. Conclusion: These results suggest that ICI 200,355 decreases lung inflammation and leak without decreasing lung lavage CINC concentration in rats given IL-1 intratracheally.

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The efficacy of optimal doses of intramuscular ketamine and midazolam injections for procedural sedation in laceration repair of children (소아 열상 처치에서 적절한 용량의 ketamine과 midazolam 병용 근육주사의 진정효과)

  • You, Je Sung;Cho, Young Soon;Choi, Young Hwan;Kim, Seung Hwan;Lee, Hahn Shick;Lee, Jin Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.726-731
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    • 2006
  • Purpose : We reported previously that intramuscular ketamine with adjunctive midazolam is more effective than ketamine alone in pediatric procedural sedation, but with limited satisfactory sedation by suboptimal ketamine dose. The optimal dose of intramuscular ketamine in children has never been studied in Korea. In this study, we investigated the effectiveness and adverse events of ketamine 4mg/kg with adjunctive midazolam in pediatric laceration repair. Methods : From Jan. 2005 to July 2005, we enrolled 60 children, aged 3 months-7 years, who needed laceration repair under sedation. After verbal consent from parents, patients were randomly assigned to KMA group(IM ketamine 4 mg/kg+atropine 0.01 mg/kg+intramuscular midazolam 0.05 mg/kg) or KA group(without midazolam). We compared both groups with the induction time, recovery time, total sedation time, efficacy of sedation, adverse effects, and the satisfaction score of treating physicians. Results : Potentially confounding variables, age, weight, injury site and anxiety score, were similar between groups. The induction time, recovery time and total sedation time were not different statistically. In KMA group, 90.9 percent of patients showed satisfactory sedation compared to 66.7 percent of KA group(P=0.02) and the occurrence rate of significant adverse effect was 0.0 percent and 37.0 percent respectively. Conclusion : We found adjunctive midazolam with ketamine doses of 4 mg/kg IM produced more effective, satisfactory sedation and less adverse effect than without midazolam in pediatric laceration repair. The emergence phenomenon(agitation during recovery) only occurred in 9 KA group patients. In spite of adverse effect, all patients recovered, were discharged and there were no reported delayed events.

Comparison of total body irradiation-based or non-total body irradiation-based conditioning regimens for allogeneic stem cell transplantation in pediatric leukemia patients (소아 백혈병 환자의 동종 조혈모세포이식 전처치로서 전신방사선 조사 포함군과 비포함군의 비교)

  • Kim, Sang-Jeong;Han, Dong-Kyun;Baek, Hee-Jo;Kim, Dong-Yeon;Nam, Taek-Keun;Hwang, Tai-Ju;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.538-547
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    • 2010
  • Purpose : This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children. Methods : We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen, engraftment kinetics, development of graft-versus-host disease (GVHD), complications, cause of deaths, overall survival (OS), and event-free survival (EFS) were compared between the 2 groups. Results : Among 34 patients with acute lymphoblastic leukemia (ALL), 28 (82.4%) were in the TBI group, while 72.7% (24/33) of patients with myeloid leukemia were in the non-TBI group. Although the 5-year EFS of the 2 groups was similar for all patients (62% vs 63%), the TBI group showed a better 5-year EFS than the non-TBI group when only ALL patients were analyzed (65% vs 17%; $P$=0.005). In acute myelogenous leukemia patients, the non-TBI group had better survival tendency (73% vs 38%; $P$=0.089). The incidence of GVHD, engraftment, survival, cause of death, and late complications was not different between the 2 groups. Conclusion : The TBI and non-TBI groups showed comparable results, but the TBI group showed a significantly higher 5-year EFS than the non-TBI group in ALL patients. Further prospective, randomized controlled studies involving larger number of patients are needed to assess the late-onset complications and to compare the socioeconomic quality of life.

Preliminary Study on the Standardization of Korean Version of Type D Personality Scale 14 : Internal Consistency and Construct Validity (D형 인격 척도의 표준화 예비연구 : 내적일치도 및 구성타당도)

  • Lee, Moon-Soo;Park, Young-Min;Lim, Hong-Euy;Song, Woo-Hyuk;Ahn, Jung-Chun;Kim, Seong-Hwan;Lee, Bun-Hee;Han, Chang-Su;Kim, Yong-Ku;Joe, Sook-Haeng;Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.2
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    • pp.81-87
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    • 2007
  • Objectives : The distressed personality (type-D) pattern, consisting of negative affectivity and social inhibition, has been shown by Denollet et al. For measuring the Type D characteristics, Denollet has devised the 14 item Type D scale (DS14). In the present study, this instrument was translated into Korean. The reliability and validity of the Korean DS14 was pilot tested. Methods : Preliminary version of the total 17-item DS14 scale was translated into Korean. 372 controls that did not have any coronary heart diseases (CHD) were randomly sampled in Seoul and Gyeonggi province. Preliminary Korean version was applied to controls and 14 items were finally selected to maximize reliability of the scale. We compared the distribution of type-D personality among the normal controls, hypertensive patients, and the CHD patients. Results : 7 of 10 items in social inhibition were selected and final 14-item version was made. The internal consistency of negative affectivity (0.817) and social inhibition (0.797) were high. In addition, the prevalence of type-D personality in the CHD patients group was significantly higher than normal controls. Conclusion : These findings suggest that Korean version of DS14 is a valid tool for measuring the type D characteristics. Type-D characteristics can be suggested to predict adverse prognosis in patients with CHD.

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The Effect of Green Coffee Bean Extract Supplementation on Body Fat Reduction in Overweight/Obese Women (과체중 여성에서 생커피두 엑기스의 섭취가 체지방 개선에 미치는 영향)

  • Park, Ju-Yeon;Kim, Ji-Young;Lee, Sung-Pyo;Lee, Jong-Ho
    • Journal of Nutrition and Health
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    • v.43 no.4
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    • pp.374-381
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    • 2010
  • This study was performed to examine the diet effect of green coffee bean extract on body fat reduction. Overweight/obese women (body mass index > $23\;kg/m^2$ or body fat > 27%) who were not diagnosed any type of disease were included in this study and subjects were randomly assigned to green coffee bean extract group (n = 23) or placebo group (n = 20). We measured anthropometric parameters, abdominal fat distribution by computed tomography and blood components before and after the 8-weeks intervention period. After supplementation, green coffee bean extract group showed a significant reduction of body weight (p < 0.01), body fat percent (p < 0.01), total fat area at L1 vertebra (-4.8%, p < 0.05) and visceral fat area at L4 vertebra was(-4.7%, p < 0.05). In addition, total fat area and visceral fat area at L1 vertebra decreased significantly in green coffee bean extract group compared with placebo group (p < 0.05, p < 0.05 respectively). The result of present study demonstrated that the supplementation of green coffee bean extract for 8 weeks can give beneficial effects on body fat reduction and visceral fat accumulation.