• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.510-516
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• 2005

Backgroud : Lung cancer is the leading cause of cancer deaths in Korea and the number of lung cancer deaths is increasing. The higher response rates, decreased toxicity and improved performance status of the first-line treatments have resulted in an increased number of patients becoming candidates for second-line therapy. Several new antineoplastic agents, including gemcitabine, docetaxel and paclitaxel, have recently demonstrated second-line activity. This phase II study evaluated the efficacy and toxicity of gemcitabine and vinorelbine as combination chemotherapy for Korean patients with NSCLC as a second-line treatment. Methods : Sixty response-evaluable patients were enrolled from December 2000 to July 2003. We conducted a phase II study of a combination gemcitabine and vinorelbine chemotherapy for patients with histologically confirmed NSCLC that was stage IIIB and IV disease at the time of diagnosis, and the disease had progressed onward or the patients had relapsed after first-line platinum-based chemotherapy. They were treated with intravenous gemcitabine $1000mg/m^2$ and intravenous vinorelbine $25mg/m^2$ on days 1 and 8. This chemotherapy regimen was repeated every 3 weeks. Results : A total of 215 cycles of treatment were given and the mean number of cycles was 3.6 cycles. All the patients were evaluable for the toxicity profile. The response rate was 10% according to the WHO criteria. The median progression free survival was 3.8 months and the median survival time was 10.1 months. The 1-year survival rate was 32.9%. Grade III and IV neutropenia were seen in 20 (33.3%) and 7 (11.7%) patients, respectively. Conclusion : The combination of gemcitabine and vinorelbine is active and well tolerated as a second-line therapy for patients with advanced nonsmall cell lung carcinoma.

• Korean Parent-Child Health Journal
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• v.3 no.1
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• pp.1-14
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• 2000

The Low Birth Weight infant birth rate in this country is a little more than 15 percent and is being increased. The survival rate of Low Birth Weight infant is over 90 percent and recently the rate runs is getting. However, because of the high risk of Low Birth Weight infant for handicap in growth, a preventive nursing intervention program for Low Birth Weight infant and their mother is considered to be necessary. Touch and massage, thus sensory stimulation has been considered to be important ensuring a normal growth of Low Birth Weight infant During the past decades sensory stimulation program has been used for premature and Low Birth Weight infants. Recently a study on the sensory stimulation for Low Birth Weight infants has bee n done in this country. Mother and infant relationship has a great influence on child's development. Especially, mother and infant interaction during one year after birth plays important role in child's social. affective and cognitive developments. But in the study of Low Birth Weight infants, the mother and infant interaction has been rare yet. However, there was no study effectiveness of the sensory stimulation on mother and infant interaction. In this respect, this study based on the importance of the nursing intervention, is intended to measure the effectiveness of the massage therapy in the aspects of weight, daily feeding amount, cortisolurine stress hormone and mother and infant interactions. This study has been conducted on the nonequivalent control group pretestposttest design in quasi experimental basis and Low Birth Weight infants from NICU of two Medical University Hospitals located in Taegu Metropolitan were selected in experimental group of 21 infants and control group of 20 infants. Data has been collected from May 1, 1999 to September 5, 2000. For the experimental group Field's sensory stimulation(tactile and kinesthetic stimulation) was applied 2 times a day for 10 days(10:00 - 11:00 hours in the morning and 19:00 - 20:00 in the afternoon) by nurse and mother. The electronic indicator scale (Cas Co. Korea) was used to measure infant's body weight. To determine urine cortisol concentration level under stress, rad immuno assay method was used. And to determine mother and infant interactions during feeding, tools developed by Kim Mi-Ye (1999) were used. Collected data were analyzed with SAS program using x-test, t-test, paired t-test and repeated measures ANOVA. Findings were as follows : 1. For the daily mean weight gain, the experimental group showed little higher than the control group, even though, there was no Statistically significant differences between two groups. 2. For the amount of daily mean feeding, the experimental group showed little higher than the control group, while there was no Statistically significant differences between two groups. 3. The level of wine cortisol concentration was increased in both groups, while no Statistical significance was shown between the two groups. 4. Mothers in experimental group were more likely to have higher mean scores in mother and infant interaction during feeding than mothers in the control group. Statistical significance was shown between the two groups(t= 5.78, P=.001). In conclusion, the massage therapy in this study showed with regard to even though through there was no statistically significance in the weight gain and urine stress hormone concentration. there was Statistical significantly higher in the mother and infant interaction during feeding. Based on the result of this study, it is considered that the massage therapy should be applied clinical practice and home to help a developmental growth and interaction of Low Birth Weight infants and mothers during the period of recovery.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.152-157
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• 1997

From August 1986 until June 1995, single aortic valve replacement was performed in 65 patients at the Chonnam National University Hospital. worthy-eight were male and 17 were female patients, ranging from 19 to 68 years of age(median : 43 years). The causes of the valve lesions were rheumatic in 29 patients (44.6%), bicuspid aortic valve in 6 patients (6.2%), endocarditis in 6 patients(6.2%), unknown in others. Concomitant surgical procedures were performed in 10 patients : repair of congenital defect in 5, pericardiectomy in 1, coronary artery bypass grafting in 1, noncoronary sinus plication in 1, Valsalva sinus aneurysmectomy in 1, subaortic membrane resection in 1 Used valves were 51. Jude-Medical valve in 42, Duromedics valve in 22, Bjork-Shiley valve in 2, Carpentier-Edward valve in 1. There were 3 hospital deaths (4.6%), and 2 late deaths (3.2%). Follow-up was 95.2% complete. The 10-year acturlal survival rate was 85.3%. Postoperative complications were low cardiac utput in 8, arrythmia in 5, valve related hemolysis in 1, cerebral infarction in 1, and gastrointestinal bleeding in 2. Reoperation was performed in 4 for surgical bleeding, in 3 for paravalvular leak. The mean improvement in New York Heart Association functional class is from 2.79 $\pm$ 0.66 preoperatively to 1.25 $\pm$ 0.49 postoperatively(p < 0.001) The change of cardiothoracic ratio from preoperative to postoperative is 0.57 $\pm$ 0.06 to 0.54 $\pm$ 0.05 (p < 0.05). The left ventricular ejection fraction change is not significant perioperatively. There are no mechanical failures. This early and intermediate-term follow-up suggests that in adults in whom valve repair is not possible, the mechanical valve is a reliable and durable prosthesis with good hemodynamic function and a low rate of thromboembolic event.

• Radiation Oncology Journal
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• v.21 no.2
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• pp.149-157
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• 2003

Purpose: The purpose of this study was to determine if there were prognostic differences between BRCA related and BRCA non-related Korean patients with early-onset breast carcinomas. Materials and Methods: Sixty women who had developed breast cancers before the age of 40, and who were treated at the Soonchunhyang University Hospital, were studied independently of their family histories. The age range was 18 to 40 with a median of 34.5 years. Lymphocyte specimens from peripheral blood were studied for the heterozygous mutations of BRCA1 and BRCA2 using direct sequencing methods. Immunohistochemistry was peformed on the paraffin-embedded tissue blocks that were available. Results: Eleven deleterious mutations (18.3%, 6 in BRCA1 and 5 in BRCA2) and 7 missense mutations of unknown significance (11.7%), were found among the 60 patients. More than half of the mutation were novel, and were not reported in the database. Most of the BRCA-associated patients had no history of breast cancer. No treatment related failures were observed in the BRCA carriers, with the exception of one patient that had experienced a new primary tumor of the contralateral breast. The seven year relapse free survival rate were 50 and 79% In the BRCA carrier and BRCA negative patients, respectively. Although the expression of estrogen and progesterone receptors were less common, and histological features more aggressive, in the BRCA associated tumors, the outcome of the patients with BRCA mutations was not poorer than that on the patients without deleterious mutations. Conclusion.: Despite the BRCA mutation carriers having adverse prognostic features, the recurrence rate was relatively lower than that in the BRCA non-carrying Korean patients wi4h early-onset breast carcinomas. In addition, although the prevalence of the BRCA mutation in Korean patients was higher than that in white patients, the penetrance of the cancer seemed to be relatively low in Korean women carrying BRCA mutations. A large population based study of the BRCA mutation, with a long-term follow-up of the study patients will be required to confirm these results.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.19-26
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• 2004

Background: The aims of this study are to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR), Material and Method: Fifteen patients operated on since 1985 were included in the study. The patients operated on before 1998 (n=9) showed heterogeneous properties with various surgical strategies and cardiopulmonary bypass techniques. However, six patients were operated on with the established surgical strategy since 1998; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery, 2) Coronary transfer by rolled-conduit made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not peformed. Result: Median age of the study group was 6 months (1 month to 34 years). The operative methods were left subclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 patients. The mean follow up period was 5.5<5.8 years (2 months 14 years), There were one early death (6.7%) and one late death. Overall 5-year survival rate was 85.6$\pm$9.6%. The Z-value of left ventricular end-diastolic and end-systolic dimensions were 6.4$\pm$3.0 and 5.1 $\pm$3.6 preoperatively, and decreased to 1.7$\pm$ 1.9 and 0.8$\pm$ 1.6 in 3 months (p<0.05). Significant preoperative MR was identified in 6 patients (40%) and all the patients showed immediate improvement of MR within f month postoperatively. There were 3 cases of reoperation due to coronary anastomosis site stenosis and recurrence of MR. However, there was no mortality nor late reoperation in the patients operated on after 1998. Conclusion: The surgical treatment of ALCAPA showed favorable survival and early recovery of ventricular dimensions and mitral valvular function. Although long-term reintervention was required in some cases of earlier period, all the cases after 1998 showed excellent surgical outcome without long-term problem.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.347-353
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• 2006

Background: Despite recent advances in surgical technique and perioperative care of total anomalous pulmonary venous return (TAPVR), post-repair pulmonary vein stenosis (PVS) remains as a serious complication. We thought that the most important factors of TAPVR repair to prevent PVS were good exposure, proper alignment, and sufficient stoma size. We analyzed our experience retrospectively. Material and Method: Between Jan. 1995 and Feb. 2005, we studied 74 patients diagnosed with TAPVR suitable for biventricular repair. Supra-cardiac type (n=41, 55.4%) was the most common. Mean CPB time, ACC time, and TCA (40.5%, 30/74) time were $92.1{\pm}25.9\;min,\;39.1{\pm}10.6\;min$, and $30.2{\pm}10.7\;min$, respectively. Mean follow-up duration was $41.4{\pm}29.1$ months and follow-up was possible in all patients. Result: The median age and body weight at operation were 28.5 days ($0{\sim}478$ days) and 3.4 kg $(1.4{\sim}9\;kg)$. Early mortality was 4.1% (3/74). Causes of death were pulmonary hypertensive crisis, sepsis, and sudden death. There was PR-PVS in 2 patients (early: 1, late: 1). Both patients were cardiac type TAPVR drained to coronary sinus. Re-operations were done but only one patient survived. Cumulative survival rate in 5 year and percent freedom from PVS were $94.5{\pm}2.7%\;and\;97.2{\pm}2.0%$, respectively. Conclusion: There was no PVS in patients who underwent extra-cardiac anatomosis between LA and CPVC. Therefore it could be said that our principle might be effective in preventing PR-PVS in patients suitable two-ventricle.

• Radiation Oncology Journal
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• v.6 no.1
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• pp.41-47
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• 1988

Thirty-five patients with locally advanced gastric carcinoma were treated with combined modalities of external radiation therapy (RT) and 5-FU based chemotherapy at the Division of Radiation Therapy, Department of Radiology, Kangnam 51. Mary's Hospital, Catholic University Medical College from May 1983 to May 1987. The purpose of this retrospective study is for the evaluation of the palliative response to RT. There were 25 men and 10 women. The age ranged from 38 to 80 years (median: 56 years). The pathologic classification showed $14(40\%)$ poorly differentiated, $12 (34\%)$ moderately differentiated, $3(9\%)$ well differentiated adenocarcinomas, 2 mucinous cystadenocarcinomas, 1 signet ring cell and 3 not specified ones. The time intervals from the initial surgicopathologic diagnosis to the starting day of RT was within 1 year for $18 (51\%)$, 1 to 2 years for $8 (23\%)$ and 2 to 3 years for $5 (14\%)$, respectively. The major symptoms to be treated were pain in $30 (80\%)$, mass for $29 (83\%)$, obstruction for $11 (31\%)$ and jaundice for $9 (20\%)$ patients. The response rate (patient number of positive response/total patient number) according to treated radiation doses were observed as follows; $14/16(88\%)$ for $40\~50Gy,\;8/10(80\%)$ for over $50Gy,6/8 (75\%)\;for\;30\~40Gy\;and\;8/10(53\%)\;for\;20\~30 Gy$ in decreasing order. The over ail survival was 3.0 months and that of 5FU+RT, FAM+RT and RT alone groups were 4.6 months, 3.7 months and 2.5 months respectively. Complications induced by RT were nausea and vomiting in $16(46\%)$, diarrhea in $7(20\%)$, leukopenia in $6(17\%)$ and anemia and intercurrent pneumonia in each $3(9\%)$ patients in decreasing order.

• Radiation Oncology Journal
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• v.12 no.3
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• pp.337-347
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• 1994

Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation in 1991 and treated one hundred and fourty patients during the next three years. Purpose : To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five Patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results : Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven Patients were N0 and 27 patients were Nl. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occured at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation pneumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer is Proven to be safe and comfortable treatment method without any major complication. Long-term follow up is needed to evaluate our treatment results in terms of loco-regional control rate, survival rate, and cosmetic effect.

• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.754-759
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• 1998

Background : Lung cancer is an important public health problem because of rapidly increasing malignancy in both sexes in relation with high smoking rate in Korea. Despite advances in therapeutic modalities and supportive cares, 5-year survival rate has improved only marginally during the past 2 decades. Therefore, the early detection of lung cancer is strongly needed for better prognosis and we conducted this study to review the clinical factors resulting in delayed diagnosis of lung cancer. Method: The clinical data such as presenting symptoms, duration for diagnosis, disease entities causing misdiagnosis or delayed diagnosis, were analyzed retrospectively in 154 patients with primary lung cancer diagnosed at Chungnam National university hospital from January to December in 1995. Results : 63 patients(40.9%) out of 154 patients were delayed diagnosed with the duration of 6.3 months compared with 3.6 months in patients diagnosed without delay. In delayed diagnosed group, Cough & sputum and dyspnea as presenting symptom were more critical than hemoptysis and chest pain, and doctor's delay was more critical than patient's delay. Tuberculosis(30/63) was most frequent disease entity causing delayed diagnosis, followed by pneumorua(9/63), COPD(6/63), heart diseases(5/63), etc.. Conclusion: It should be emphasized that any respiratory symptom be checked with chest X-ray to differentiate lung cancer and periodic check of chest X-ray be also needed for the longterm patients with any disease, especially with high risk group.

• Journal of Korean Society of Forest Science
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• v.81 no.2
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• pp.156-163
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• 1992

Pinus koraiensis (Pk), P. rigida (Pr) and P. rigida ${\times}$ P. taeda (Pr. t) seedlings in a bare-rooted nursery were artificially inoculated with Pisolithus tinctorius (Pt) and Thelephora terrestris (Tt) to test long term effects of ectomycorrhizal inoculation on host growth. Mycelial inocula of Pt and Tt were mass-cultured in vermiculite-peatmoss mixture and introduced into fumigated nursery soil before seed sowing. Bare-rooted, inoculated seedlings at one to four years of age were outplanted to the field with $P_2O_5$ content of 25 ppm in soil. At the time of outplanting, Pk seedlings(4 years old), Pr seedlings(2 years old), and Pr.t seedlings(1 year old) all infected by Pt were significantly taller by 28%. 26%, and 77%, respectively, than controlled seedlings infected by natural population of mycorrhizal fungi in the non-fumigated plot. Ten years after inoculation or six to nine years after outplanting, Pk seedlings inoculated with Pt were significantly taller by 9% Pr.t seedlings significantly taller by 18%, and Pr slightly Caller by 2%(not significant) than controlled seedlings, suggesting that the stimulatory effect of Pt on host growth gradually declined or became minimal after outplanting. Tt failed to stimulate host growth either in the nursery or in the field, and the survival rate of outplanted seedlings was not different among fungal treatments. Considerable loss of the infected root system during lifting the seedlings for outplanting would be the primary cause of the reduced effect of Pt in the field. Pt infected more than 90% of the fine roots in the fumigated nursery during the first growing season, but Pt assumed to fail to compete successfully with natural population of ectomycorrhizal fungi in the field. It is necessary to select other mycorrhizal fungi which adapt well in both nursery and field.