Objectives : Many patients diagnosed with cancer suffer from various psychiatric symptoms such as depression, anxiety and insomnia as well as cancer itself. Patients with cancer are more vulnerable to possible adverse events of psychotropic medications. Although antidepressants are widely used among cancer patients, there is little information about tolerability of antidepressants. This study was conducted to compare tolerability of antidepressants in cancer patients referred for psychiatric consultation. Methods : The participants were cancer patients who had been referred to psychiatrist for their psychiatric symptoms. We retrospectively analyzed the data of patients diagnosed with cancer from 9 general hospitals in Korea. The discontinuation rate for a 6 months period after treatment initiation for three antidepressants(Escitalopram, Mirtazapine, Paroxetine) were compared. Results : Antidepressants were prescribed for 96.3% of subjects and Escitalopram 150(47.2%), Mirtazapine 92(28.9%) and Paroxetine 76(23.9%) were prescribed frequently in order There were no significant differences in discontinuation rates among the three antidepressants during the 6 month period after initiation of pharmacotherapy. But there was a difference in discontinuation rates between inpatients versus outpatients(p<0.0001). Conclusions : In a naturalistic setting for the antidepressant treatment for cancer patients, it seems that there are no differences in discontinuation rates among these three antidepressants. It is therefore essential that such interactions are carefully considered when treating patients of antidepressants who already have cancer.
Objectives : Although the Attention Network Test(ANT) has been widely used to assess selective attention including alerting, orienting, and conflict processing, data on its test-retest reliability are lacking for clinical population. The objective of the current study was to investigate test-retest reliability of the ANT in healthy controls and patients with schizophrenia. Methods : Fourteen patients with schizophrenia and 23 healthy controls participated in the study. They are tested with ANT twice with 1 week interval. Test-retest reliability was analyzed with Pearson and Intra-class correlations. Results : Patients with schizophrenia showed high test-retest correlations for mean reaction time, orienting effect, and conflict effect. Also, they showed moderate to high test-retest correlations for mean accuracy and moderate test-retest correlations for alerting effect and conflict error rate. On the other hand, healthy controls revealed high test-retest correlations for mean reaction time and moderate to high test-retest correlations for conflict error rate. In addition, they revealed moderate test-retest correlations for alert effect, orienting effect, and conflict effect. Conclusions : The mean reaction time, alerting effect, orienting effect, conflict effect, and conflict error rate of ANT showed acceptable test-retest reliabilities in healthy controls as well as patient with schizophrenia. Therefore, the analyses of these reliable measures of ANT are recommended for case-control studies in patients with schizophrenia.
Purpose : Recently, early surfactant replacement and tidal volume based gentle ventilation has been a fundamental treatment of respiratory distress syndrome(RDS). The aims of this study were to survey the changes in ventilator care duration and rate of complication in RDS groups. Methods : We performed a retrospective study of 255 newborn infants less than 1,500 g admitted to the neonatal intensive care unit(NICU) and discharged from January 1999 to December 2003. 141 of 255 newborn infants were RDS groups that required invasive management, such as endotracheal intubation, surfactant replacement and assisted ventilation. We analyzed epidemiologic data to study the changes in ventilator care duration and outcome of RDS groups. Results : Of 141 RDS groups, 135 were mild to moderate RDS groups and only 6 were severe RDS groups. 24(17.8%) of 135 mild to moderate RDS groups and 3(50%) of 6 severe RDS groups were antenatal no use of maternal dexamethasone. 127(90.1%) of 141 RDS groups underwent replacement of surfactant during 3 hours after birth. 121(85.9%) weaned within 48 hours. Conclusion : Our study shows a decreased frequency of severe RDS by a antenatal use of maternal dexamethasone and decreased duration of ventilator care by early surfactant replacement and gentle ventilation.
Kim, Bo Eun;Ha, Eun Ju;Bae, Keun Wook;Kim, Seon Guk;Im, Ho Joon;Seo, Jong Jin;Park, Seong Jong
Clinical and Experimental Pediatrics
/
v.52
no.10
/
pp.1153-1160
/
2009
Purpose:To evaluate the risk factors for mortality and prognostic factors in pediatric hemato-oncology patients admitted to the pediatric intensive care unit (PICU). Methods:We retrospectively reviewed the medical records of pediatric hemato-oncology patients admitted at the PICU of the Asan Medical Center between September 2005 and July 2008. Patients admitted at the PICU for perioperative or terminal care were excluded. Results:Total 88 patients were analyzed. Overall ICU mortality rate was 34.1%. Mean age at PICU admission was $7.0{\pm}5.7$ years and mean duration of PICU stay was $18.1{\pm}22.2$ days. Hematologic diseases contributed to 77.3% of all the primary diagnoses, and the primary cause of admission was respiratory failure (39.8%). The factors related to increased mortality were C-reactive protein level (P<0.01), ventilation or dialysis requirement (P<0.01), and hematopoietic stem cell transplantation (P<0.05). In all, 3 scoring systems were investigated [Number of Organ System Failures (OSF number), the Pediatric Risk of Mortality III (PRISM III) score, and the Sequential Organ Failure Assessment (SOFA) score]; higher score correlated with worse outcome (P<0.01). The Oncological Pediatric Risk of Mortality (O-PRISM) scores of the 21 patients who had received hematopoietic stem cell transplantation were higher among the non-survivors, but not statistically significant (P=0.203). Conclusion:The PRISM III and SOFA scores obtained within 24 hours of PICU admission were found to be useful as early mortality predictors. The highest OSF number during the PICU stay was closely related to poor outcome.
Joo, Chan Seong;Park, Su Yeon;Kim, JongSik;Choi, Byeong Gi;Chung, Yoonsun;Park, Won
The Journal of Korean Society for Radiation Therapy
/
v.27
no.2
/
pp.175-181
/
2015
Purpose : To evaluate Contralateral Breast Doses with Supine and Prone Positions for tangential Irradiation techniques for left-sided breast Cancer Materials and Methods : We performed measurements for contralateral doses using Human Phantom at each other three plans (conventional technique, Field-in-Field, IMRT, with prescription of 50 Gy/25fx). For the measurement of contralateral doses we used Glass dosimeters on the 4 points of Human Phantom surface (0 mm, 10 mm, 30 mm, 50 mm). For the position check at every measurements, we had taken portal images using EPID and denoted the incident points on the human phantom for checking the constancy of incident points. Results : The contralateral doses in supine position showed a little higher doses than those in prone position. In the planning study, contralateral doses in the prone position increased mean doses of 1.2% to 1.8% at each positions while those in the supine positions showed mean dose decreases of 0.8% to 0.9%. The measurements using glass dosimeters resulted in dose increases (mean: 2.7%, maximum: 4% of the prescribed dose) in the prone position. In addition, the delivery techniques of Field-in-field and IMRT showed mean doses of 3% higher than conventional technique. Conclusion : We evaluated contralateral breast doses depending on different positions of supine and prone for tangential irradiations. For the phantom simulation of set-up variation effects on contralateral dose evaluation, although we used humanoid phantom for planning and measurements comparisons, it would be more or less worse set-up constancy in a real patient. Therefore, more careful selection of determination of patient set-up for the breast tangential irradiation, especially in the left-sided breast, should be considered for unwanted dose increases to left lung and heart. In conclusion, intensive patient monitoring and improved patient set-up verification efforts should be necessary for the application of prone position for tangential irradiation of left-sided breast cancer.
Terrorism which became today's common phenomena over the world is one of the most serious threats the world confront. Although International society make and operate outstanding anti-terrorism system, terror would never end without solving fundamental problems. The main body of terrorism converts from nation to organization and from organization to cell, which makes it difficult for us to recognize the main body. Since the target of today's new terrorism is many and unspecified persons, terrorists will never hesitate to use mass destruction weapons such as nuclear, biological, chemical weapons, and also use cyber-technique or cyber-terrorism. So, effective counter-terrorism measures should be performed as follows. First, it must be better for international society should make long-time plan of solving fundamental problems of terrorism other than to operate directly on terror organization and its means. Second, preventive method should be made. The most effective method of eradicating terrorism is prevention. For this, it is necessary to remove environmental elements of terrorism and terrorist bases, and to stop inflow of money and mass destruction weapons to terrorists. Third, integrated anti-terror organization should be organized and operated for continuous counter-terrorism operations. Also international alliance for anti-terrorism should be maintained to share informations and measures. Fourth, concerned department in the government should prepare counter-terrorism plans in their own parts as follows and make efforts to integrate the plans. - Ministry of Government Administration and Home Affairs : conventional terror - Ministry of Health and Welfare : bio-terror - Ministry of Science and Technology : nuclear-terror Especially, they should convert their policy and operation from post-terror actions to pre-terror actions, designate terror as national disaster and organize integrated emergency response organization including civil, government, and military elements. In conclusion, pre-terror activities and remedy of fundamental causes is the best way to prevent terror. Also, strengthening of intelligence activities, international cooperations, and preventive and comprehensive counter-measures must not ignored.
Kim, Sun-hyung;Shin, Mi-ran;Kim, Dal-rae;Kwon, Ki-rok
Journal of Sasang Constitutional Medicine
/
v.12
no.1
/
pp.144-156
/
2000
Purpose of this study is to help classifying Sasang Constitution through correlation with Larynx waveform. This study was done it under the suppose that Sasang Constitution would be correlation with Larynx waveform. The following result were obtained about correlation between Erectroglottograph waveform and Sasang Constitution by analysis EGG program. 1. Taeumin was lower than Soyangin in Open Std Deviation, Contact Std Deviation of male/a/(0.5sec) 2. Soeyangin was high compared with the others in Pitch range of maie/a/(2.5sec) 3. Taeumin was higher than Soeumin in Pitch range, Soeyangin in pitch Maximum, and the others in Pitch Std Deviation of female/e/(0.5sec) 4. Taeumin was higher than Soeumin in Contact Maximum and lower than Soeumin in Contact Maximum of female/a/(2.5sec) 5. There was no significantly difference in male/e/(0.5sec), male/e/(2.5sce), female/a/(0.5sec), female/e/(2.5sec) 6. The percent of correctly classified in Soeoumin and Taeumin was high in CART Algolism. The risk estimate of Soyangin was relatively high. The study may be use on of the method to make objective diagnosis in Sasang constitution.
Objective ; The purpose of this study is to find out the constitutional symptomatic pattern of Soyangin and Taeumin through investigation of difference between two groups in stroke. Method ; 70 inpatients(Soyangin 31, Taeumin 39) in stroke, admitted into Kyung-Hee Oriental Hospital from 1. July. 1999 to 20. Sept. 1999, were investigated through questionnare which consists of 16 parts 155 questions, and the problems which have significant difference between Soyangin and Taeumin group were analyzed statistically. Result 1. The analysis of general characteristic difference between Soyangin and Taeumin group (1) The number of Soyangin patients is 31, Taeumin 39 and the number of Male patients 43, Female 27. (2) The mean weight of Taeumin group is heavier than that of Soyangin group and the degree of obesity of Taeumin group higher. (3) The number of patients who have smoking history is more at Soyangin group. (4) In neurological problem, dizziness is more complained of in Soyangin group. 2. The analysis about the result of Questionnare (1) In problems related with 'Sleeping', the time of going to bed and getting up and the duration of sleeping are more irregular in Taeumin group. (2) In problems related with 'Defecation', the shape of stool is more variable in Taeumin group. (3) In problems related with 'Urination', Soyangin group have more complaint. (4) In problems related with 'The condition of digestion', Taeumin group have a good appetite and more compalint in lower abdominal region, but on the contrary Soyangin group lose appetite and have more complaint in upper abdominal region. (5) In problems related with 'Head and Face', Soyangin group have more complaint. (6) In problems related with 'Eye, Ear and Nose', Soyangin group have more complaint at eye and ear. (7) In promlems related with 'Chest region', Soyangin group easily feel choked up and Taeumin group heart throbs. (8) In problems related with 'Skin', Taeumin group easily feel change of color tone at skin and Soyangin group dry.
Purpose : To improve treatment modality and results by analysis of clinical characteristics, local control, survival and recurrence rate in limited stage small cell lung cancer. Materials and Methods : patients with limited stage small cell lung cancer were treated with combined radiation and chemotherapy from Feb. 1986 to Dec. 1992 at the National Medical Center We followed up on 21 patients ($81\%$), who were mostly irradiated with 4,000-5.000cGy ($75\%$ of all Patients) in the results by the analysis retrospectively. Survival rate was evaluated by the Kaplan-Meier method Results : Mean survival of irradiated patients with limited small cell lung cancer was 12 months. 1-rear and 2-rear survival rate were $65.3\%$ and $15.4\%$ Tumor response rate and median survival after combined chemotherapy and irradiation were the following: $50\%$ and 15 months of complete response, and $23\%$ and 11 months of partial response respectively. Response rates by radiation dose were $66\%$ for below 4,000cGy $69\%$ for between 4,000-5,000cGy and $86\%$ for above 5,000cGy. 21 of all patients showed treatment failure($81\%$) which as appeared 9 of local failure.9 of distant failure and 3 of local and distant failure. Conclusion : Local response rate after induction chemotherapy alone in limited stage of small cell lung cancer was $54\%$. Furthermore it was increased to $73\%$ after adding of radiation. We have to increase radiation dose above 5,000cGy and need to try new effective chemotherapy agents for the improvement of local control and survival rate and also will try concurrent chemoradiotherapy in near time.
Purpose: We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by postoperative radiotherapy.Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months. Results: The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival. Conclusion: This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.
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