• Title/Summary/Keyword: 4P Strategy

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Management of Regional Lymph Nodes in Localized Vulvar Carcinoma (국소 외음부 암에서 영역 림프절의 치료)

  • Jang, Won-Il;Wu, Hong-Gyun;Park, Charn-Il;Ha, Sung-Whan;Lee, Hyo-Pyo;Kang, Soon-Beom;Song, Yong-Sang
    • Radiation Oncology Journal
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    • v.26 no.1
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    • pp.1-9
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    • 2008
  • Purpose: To evaluate the impact of postoperative radiotherapy on loco-regional failure in patients with vulvar carcinoma and to determine the treatment strategy for inguinal lymph nodes. Materials and Methods: Sixty-six patients who received treatment for primary vulvar carcinoma at Seoul National University Hospital, from October 1979 through June 2004, were retrospectively analyzed. Sixteen patients were excluded from the analysis due to the following reasons: distant metastases in two patients; palliative intent for six patients; previous radiotherapy given to the pelvis in three patients; follow-up loss after surgery for four patient; insufficient medical records for one patient. Of 50 eligible patients, 35 were treated with surgery alone(S), ten were treated with surgery followed by radiotherapy(S+RT), and five were treated with radiotherapy alone. Results: The 5-year overall survival(OS) and disease-free survival(DFS) rates of all patients were 91% and 78%, respectively. Twelve patients(26%) experienced treatment failures and the sites of initial failure were as follows: a primary site in eight patients; regional lymph nodes in three patients; the lung in one patient. Although risk factors for failure were more common in the S+RT group than the S group of patients(p<0.05), the DFS rates were similar for the two groups(5-year DFS rates, 78% vs. 83%, p=0.66). The incidences of occult lymph node metastases was 10%. Ten of 31 patients with clinically negative lymph nodes did not received inguinal lymph node dissection, but no patient experienced regional failure. Conclusion: Postoperative radiotherapy may have a potential benefit for patients with risk factors for failure. The omission of inguinal dissection or elective radiotherapy to the inguinal lymph nodes may be considered in low-risk patients with clinically negative lymph nodes.

Preliminary Environmental Impact Assessments on Fish Compositions and the Ecological Health of Jeokbyeok River on the Road Construction of Muju-Geumsan Region (무주-금산간 도로건설에 따른 적벽강의 어류 종 조성 분석 및 생태건강도 사전환경성평가)

  • Lee, Sang-Jae;Park, Hee-Sung;An, Kwang-Guk
    • Journal of Environmental Impact Assessment
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    • v.26 no.1
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    • pp.27-43
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    • 2017
  • The objectives of the study were to evaluate fish compositions, endangered species, community structure, physical habitat, and general water quality for a preliminary environmental impact assessment of Jeokbyeok River on the road construction between two regions. Total number of species and total number of individuals, based on CPUE, were 23 and 1186, respectively. The endangered species (I, II) as the legal protection species were Pseudopungtungia nigra (79 samples) Gobiobotia brevibarba) (5) Gobiobotia macrocephala (2), indicating a requiring of endangered species conservation. In the meantime, exotic species and ecological disturbing species such as Micropterus salmoides and Lepomis macrochirus, were not present, indicating a well conserved area. According to fish community analysis, values of species diversity index were high (range: 0.788 - 1.030), and the dominance index were low (range: 0.097 - 0.183), indicating that the fish community in this area was maintained well without high dominacne by specific species. Also, fish analysis on tolerance guilds and trophic guilds showed that the proportions of sensitive species were largely exceeded the proportions of the tolerant species, while the proportions of insectivore species were largely exceeded the proportions of the omnivore species. This outcome suggests that the ecosystem was well maintained in terms of tolerance and trophic compositions (food chain). Ecological health, based on the multi-metric fish model of Fish Assessment Integrity (FAI), reflected those fish conditions. In other words, values of FAI model averaged 82.4, which means a "good condition" in the criteria of ecological health by the Minstry of Environment, Korea. In addition, general water quality and physical habitat analyses showed that the system was in good condition. Under these conditions, if the road constructions between the two regions happen in the future, inorganic suspended solids may increase in the waterbody, and this may result in indirect or direct influences on the physical habitats and food chain as well as fish compositions, so the ecological protections and prevention strategy from the soil erosion are required in the system.

Prevalence of Metabolic Syndrome and Related Risk Factors of Elderly Residents in Andong Rural Area 1. Based on the Anthropometric Measurements and Health Behaviors (안동 농촌지역 중년 및 노인 주민의 대사증후군 유병율과 관련 위험요인 분석 1. 신체계측결과와 건강습관을 중심으로)

  • Lee, Hye-Sang;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.4
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    • pp.511-517
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    • 2010
  • This study was performed to estimate the prevalence and the risk factors of metabolic syndrome in Andong rural area. A total of 1,431 people (533 males, 898 females) aged over 45 years participated in this study in 2003. The prevalence of metabolic syndrome was 38.2% (male 23.5%, female 46.9%, p<0.001). As age increased, the prevalence of the metabolic syndrome increased in female, but not in male. The major underlying components of metabolic syndrome were high blood pressure (67.1%), low HDL-cholesterol (60.6%), and abdominal obesity (39.9%). The distinctive component for male was high blood pressure (70.1%), and for female, low HDL-cholesterol (73.6%), high blood pressure (65.3%), and abdominal obesity (54.5%). Subjects having more than one component were 94.7%. The risk factors for metabolic syndrome were analyzed using the multiple logistic regression method according to gender and expressed as age-adjusted odds ratio (OR). The results of comparing female to male (OR=2.953), and of comparing obese by % body fat (M: OR=5.786, F: OR=13.498) or BMI (M: OR=3.782, F: OR=13.301) to normal body weight showed significantly higher risk for metabolic syndrome (p<0.001). Health related habits, such as smoking, alcohol drinking, and exercise, didn't show any effect on metabolic syndrome. This study revealed that the prevalence of metabolic syndrome was significantly higher in female subjects compared to both male and female, and high blood pressure was the main cause of metabolic syndrome. We suggest that the strategy for prevention or reducing the prevalence of metabolic syndrome in this area should be concentrated on reducing high blood pressure through lowering obesity and abdominal obesity.

Perception and Preference for Tangpyeongchae by Chinese and American University Students (중국인 및 미국인 유학생의 탕평채에 대한 인식 및 기호도)

  • Lee, Kyong Ae;Kim, Bo Ram;Choe, Eunok;Kim, Jung In
    • Korean journal of food and cookery science
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    • v.29 no.3
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    • pp.301-308
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    • 2013
  • This study investigated the recognition and preference of foreign students to Tangpyeongchae, in order to suggest strategy for developing Tangpyeongchae acceptable for them. Questionnaires translating in Chinese and English were given to 75 Chinese and American university students in Chungnam province. A total of 70 questionnaires were analyzed using SPSS software(version 12.0). The students were asked about impression, recognition, preference and factors for improving acceptability of Tangpyeongchae. The respondents consisted 51(72.9%) Chinese and 19(27.1%) Americans. This research was conducted from May 11 to May 18, 2012. The results of this study were as follows : Impression after eating Tangpyeongchae got better scores than first impression by Chinese students, whereas there were no significant differences in Americans' impression. The main reason for good impression after eating it was 'good taste'. The Chinese and Americans' mean overall acceptance scores of Tangpyeongchae were 4.06 and 3.86 on 5-point scale, respectively, showing that they had high acceptance for Tangpyeongchae. Most of the Chinese students chose 'taste' as the most important factor for enhancing the popularity for Tangpyeongchae. It proposed that the control of taste may be a main factor, and then need to develop the sauce and seasonings which is suitable for Chinese taste for developing Chinese favorite Tangpyeongchae. Most of American students answered the texture should be improved for Americans' preference.

Analysis of Urine Iodine Excretion Decrease by Two-Week Stringent Low Iodine Diet for Remnant Thyroid Ablation with Radioactive Iodine in Korean Patients with Thyroid Cancer; Prospective Study (한국 갑상선암 환자들에서 잔여갑상선 제거를 위한 방사성요오드 치료 전 2주간의 엄격한 저요오드식이에 의한 소변 내 요오드량 감소 분석; 전향적 연구)

  • Choi, Joon-Hyuk;Kim, Hoon-Il;Park, Jang-Won;Song, Eun-Hoon;Ko, Bong-Jin;Cheon, Gi-Jeong;Kim, Byung-Il
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.5
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    • pp.375-382
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    • 2008
  • A low iodine diet (LID) is the recommended preparation for radioactive iodine treatment. However, the recommended duration and stringency of LID are different among each recommendation. More stringent LID is expected in Korea because Korea is a iodine-rich region. We investigated the decrement of urine iodine excretion by two-week stringent LID for remnant thyroid ablation with radioactive iodine in Korean patients with thyroid cancer, prospectively. Material and Method: From November 2006, patients who referred to our hospital for remnant ablation after total thyroidectomy were included in this study. To decrease total body iodine, our protocol included three strategies. First, we checked medication which could inhibit the radioactive iodine uptake. Second, the date of 1-131 treatment was scheduled at least 3 months later if contrast agent had been used. The last strategy was two-week stringent LID education by specialized nutritionist. Before and after two-week stringent LID, 24hr-urine iodine was analyzed respectively. 24hr-urine creatinine was also analyzed for determining more valid 24hr urine sampling subgroup. Results: Total 51 patients were finally enrolled. Average of 24hr-urine iodine excretion was significantly lowered ($787{\pm}2242\;{\rightarrow}\;85{\pm}85\;{\mu}g/d$, p=0.03) after LID and 74.4% of patients reached below the recommended urine iodine excretion level ($<100\;{\mu}g/d$). In subgroup (n=14), similar results was showed ($505{\pm}666\;{\rightarrow}\;99{\pm}116\;{\mu}g/d$, p=0.05) and 78.6% of patients met the criteria. Conclusion: Most patients could reach below the recommended urine iodine level after two-week stringent LID. Therefore, in our opinion, at least two-week stringent LID should be recommended in Korea.

Anti-inflammatory and Antioxidant Effects of Spiraea prunifolia Sieb. et Zucc. var. simpliciflora Nakai in RAW 264.7 Cells (조팝나무 뿌리 열수 추출물이 RAW264.7 세포에서 미치는 항산화 및 항염증 활성)

  • Sim, Mi-Ok;Lee, Hyun Joo;Jang, Ji Hun;Lee, Hyo Eun;Jung, Ho-Kyung;Kim, Tae-Muk;No, Jong hyun;Jung, Jakyun;Jung, Da Eun;Cho, Hyun-Woo
    • Korean Journal of Plant Resources
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    • v.30 no.4
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    • pp.335-342
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    • 2017
  • Spiraea prunifolia Sieb. et Zucc. var. simpliciflora Nakai (SSN) has been used for the anti-inflammation in traditional folk medicine. To compare water and methanol extracts of SSN, we analyzed major components using LC IT TOF MS. The major components of hot water extract were identified as caffeic acid and p-coumaric acid, but methanol extract was not well established. However, methanol extract was detected with less polarity compounds compared to hot water extract. Next, we investigated the inhibitory effects of SSN water extract on the lipopolysaccharide (LPS)-induced inflammatory response or $H_2O_2-induced$ oxidative stress in Raw 264.7 macrophage cells. SSN strongly suppressed the production of nitric oxide in LPS-induced inflammatory response without cytotoxcity. The SSN possessed free radical scavenging activities such as DPPH ($IC_{50}=320.2{\mu}g/m{\ell}$), ABTS ($IC_{50}=124.0{\mu}g/m{\ell}$), and superoxide anion radical ($IC_{50}=122.6{\mu}g/m{\ell}$). The total phenol and flavonoid content of SSN was 56.7 mg/g, and 15.1 mg/g, respectively. Furthermore, SSN decreased the $H_2O_2-induced$ cytotoxicity by enhancing the cell viability, and SSN significantly reduced the intracellular reactive oxygen species (ROS) level. Therefore, SSN may be recommended as an effective strategy to prevent and/or treat various inflammation and ROS-induced diseases.

Comparative Analysis of Fracture Angulation between Parallel Pinning and Plate Fixation Techniques in the Management of 5th Metacarpal Fractures (제 5 수지 중수골 골절에서 평행 핀 또는 플레이트 고정술 이후 골절각 변화에 대한 비교 연구)

  • Lee, Myungchul;Shin, Hyojung;Choi, Hyungon;Kim, Jeenam;Shin, Donghyeok
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.230-238
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    • 2018
  • Purpose: Metacarpal fractures are common injuries of the hand. They are treated using closed reduction (CR) or open reduction (OR) techniques. The management strategy depends on fracture site characteristic and fixation methods. In this study, we evaluated pre- and postoperative fracture angulation, when metacarpal fractures bad been treated using two different techniques: CR with parallel transverse pinning and OR with plate fixation. Methods: Forty-six patients undergoing anatomic reduction to treat extra-articular metacarpal fractures were recruited. They were included in one of two therapeutic groups: Group 1, CR with parallel transverse pinning (n=21); Group 2, OR with plate fixation (n=25). Fracture angulation values have been measured on pre- and postoperative radiologic images. Values were compared between pre- and postoperative states, and between corresponding measurements of each group. Results: All extra-articular metacarpal fractures were successfully treated without wound related complications or the limit of joint motion. Both groups demonstrated adequate reduction at immediate postoperative period (postoperative angulation of group 1, $20^{\circ}{\pm}7^{\circ}$; group 2, $19^{\circ}{\pm}5^{\circ}$). During the observation at follow-up period, Group 1 exhibited slight recurrence (follow-up angulation of group 1, $24^{\circ}{\pm}10^{\circ}$). Nonetheless, Group 2 showed adequate reduction state in both immediate postoperative and long-term follow-up periods (follow-up angulation of group 2, $18^{\circ}{\pm}6^{\circ}$). Conclusion: Extra-articular metacarpal fractures were successfully restored without functional complications. CR with parallel transverse pinning method exhibited recurrence after pin removal, which necessitates cautious postoperative exercise and monitoring.

A Cohort Study on Risk Factors for Chronic Liver Disease: Analytic Strategies Excluding Potentially Incident Subjects (만성간질환 위험요인에 대한 코호트연구: 잠재적 발병자 집단을 감안한 분석전략)

  • Kim, Dae-Sung;Kim, Dong-Hyun;Bae, Jong-Myun;Shin, Myung-Hee;Ahn, Yoon-Ok;Lee, Moo-Song
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.452-458
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    • 1999
  • Objectives: The authors conducted the study to evaluate bias when potentially diseased subjects were included in cohort members while analyzing risk factors of chronic liver diseases. Methods: Total of 14,529 subjects were followed up for the incidence of liver diseases from January 1993 to June 1997. We have used databases of insurance company with medical records, cancer registry, and death certificate data to identify 102 incident cases. The cohort members were classified into potentially diseased group(n=2,217) when they were HBsAg positive, serum GPT levels higher than 40 units, or had or has liver diseases in baseline surveys. Cox's model were used for potentially diseased group, other members, and total subjects, respectively. Results: The risk factors profiles were similar for total and potentially diseased subjects: HBsAg positivity, history of acute liver disease, and recent quittance of smoking or drinking increased the risk. while intake of pork and coffee decreased it. For the potentially diseased, obesity showed marginally significant protective effect. Analysis of subjects excluding the potentially diseased showed distinct profiles: obesity increased the risk, while quitting smoking or drinking had no association. For these intake of raw liver or processed fish or soybean paste stew increased risk; HBsAg positivity, higher levels of liver enzymes and history of acute liver diseases increased the risk. Conclusions: The results suggested the potential bias in risk ratio estimates when potentially diseased subjects were included in cohort study on chronic liver diseases, especially for lifestyles possibly modified after disease onset. The analytic strategy excluding potentially diseased subjects was considered appropriate for identifying risk factors for chronic liver diseases.

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Review of the Radiation Risk and Clinical Efficacy Associated with Computed Tomography Cancer Screening (암의 조기발견을 위한 CT촬영에서의 임상적 효능과 방사선위해에 대한 고찰)

  • Kim, Hyun Ja
    • Journal of Radiation Protection and Research
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    • v.38 no.4
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    • pp.214-227
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    • 2013
  • Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

Attitudes to Safety of Genetically Modified Foods in Korea -Focus on Consumers- (유전자재조합 식품의 안전성에 대한 기본인식 조사 -일반 소비자를 중심으로 _)

  • 김영찬;박경진;김성조;강은영;김동연
    • Journal of Food Hygiene and Safety
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    • v.16 no.1
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    • pp.66-75
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    • 2001
  • A survey was conducted to investigate consumers'attitudes toward the foods developed by gene recombination techniques from December, 1999 to April, 2000. The questionnaires were mailed to 1,500 people, and the 1,101 people responded. The consumers were asked about knowledge, acceptance, intention of purchasing, and labeling information. Although the portion of the consumers (88.8%) knowing the genetically modified floods (GMF) was lower than that of the flood expert group (98.7%), many consumers had some knowledge on the GMF, which may be influenced by news released from mass media. Seventy-nine percent of the consumers responded that gene recombination technology is necessary in food production, which is similar to the findings on the survey of the expert group. The portion of the consumers responding that these foods are potentially hazard was 88.1%, which is a little higher than the data (80.9%) from the expert group. The consumers having greater knowledge less worried about a potential hazard of the gene recombinant foods (p<0.01). Although 62.9% of the consumers responded to be willing to purchase those foods, only 16.2% of them responded to purchase the foods with no conditions, which is lower to that from the expert group (23.5%). There was no statistically significant relationship between the knowledge and the intention of purchasing. The ninety point three percent of the consumers wanted the information on gene recombination to be labeled on the foods. The data from this survey suggest that knowledge of the consumers on the GMF are not accurate, so proper strategy for consumer education may need to be developed. In addition, it is necessary to improve safety assessment system and analytical techniques for genetically modified foods (GMF) and to build pre- and post-market surveillance system fur efficient implementation of the GMF labeling.

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