• Journal of Gastric Cancer
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• v.3 no.3
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• pp.122-127
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• 2003

Purpose: The incidence rate and the mortality rate of gastric cancer have decreased in developed countries over the last several decades. On the other hand, they remain high in far eastern countries such as Korea, Japan, China and in many developing countries. The cure of patients with gastric carcinomas can be achieved mostly through complete surgical resection, but most gastric cancer patients are in advanced stages when diagnosed and have poor prognoses. therefore, the development of an effective systemic therapy is essential for far advanced gastric cancer patients. Until recently, the most commonly used combination chemotherapy was based on 5-flurouracil or cisplatin, but the results were not satisfactory, so recently etoposide, adriamycin and cisplatin (EAP-II) combination chemotherapy was introduced in patients with advanced gastric cancer. Early studies showed a high response rate and the ability to convert unresectable cases to resectable ones, but later studies couldn't duplicate the result. the purpose of this study was to evaluate the relative efficacy & toxicity of EAP-II chemotherapy and ELF chemotherapy which is based on 5-flurouracil. Materials and Methods: Between July 1992 and July 2002, sixty-five patients with inoperable advanced gastric cancer were enrolled for this study. Thirty-seven patient received EAP-II chemotherapy:etoposide (20 mg/$m^{2}$ IV for $1\∼5 days$), adriamycin (20 mg/$m^{2}$ IV for $1\∼5 days$) and cisplatin (20 mg/$m^{2}$ IV for $1\∼5 days$) and Twenty-eight patients receieved ELF chemotherapy : etoposide (100 mg/$m^{2}$ IV for $1\∼3 days$), leucovorin (20 mg/$m^{2}$ IV for $1\∼5 days$) and 5-FU (500 mg/$m^{2}$ IV for $1\∼5 days$). Each treatment schedule for each group was repeated every four weeks: EAP-II means 3.4 cycles per patient..ELF means 4.1 cycles per patient Results: Total respones rates were $5.4\%$ in the ELF group and $3.6\%$ in the EAP group (P-value>0.05). The median times to progression were 144 days in the ELF group and 92 days in the EAP-II group (P-value<0.05), and themedian overall survival times were 189 days in the ELF group and 139 days in the EAP-II group (P-value>0.05). The difference in the survival curves for the two regimens was not statistically significant. Non-hematologic toxicitis & hematologic toxicitis were more frequently observed for the EAP-II regimen. Anemia: $27.6\%$ in ELF vs $54\%$ in EAP-II; Leukopenia: $8.5\%$ in ELF vs $19\%$ in EAP-II; nausea & vomiting: $45.9\%$ in ELF vs $67.8\%$ in EAP-II. Conclusion: EAP-II regimen is not superior to ELF regimen in the tratment of inoperable advanced gastric cancer (J Korean Gastric Cancer Assoc 2003;3:122-127)

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• Sijohaknonchong
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• v.22
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• pp.27-55
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• 2005

Visual media are taken the highest position in modem society, Modern poems also have been changed into visual poems, This aspect is the result of considering only individual talents ignoring traditions. Now, new Sigo should be concentrated on the mythological and historical voice from true nature and the body of human being, That is. ut should be converted into an ecological world view resolutely and restored a form of expression granted specific characteristics of our language. Advantages the computer media have brought. that is. equality freedom. human rights. harmony. pro-environmental value. can be maximized by positively accepting an ecological world view of Sijo which had included daily lives and spirits of the nation. Moreover. these all changes of new Sijo have to be established and recreated in the traditional expressions of Sijo. Aesthetic value of Sijo should be found in the expression forms such as phonetic harmony, rules of versification, rhythm, and etc. Then, we can overcome modern society's pathological phenomena such as severance, separation, dissolution, estrangement, psychiatric syndrome and etc. which visual media superiority brought. At the same time. it will cure ills of modern poems, Sijo and writing epochally and can establish true happiness and development.

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.183-189
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• 2005

Purpose: Despite the advance of medical science, the number of cancer patient have increased and the mortality rate is also on the rise. Therefore, a perfect cure for cancer is crucial, but the value and meaning of the remaining life for the patient are also becoming more and more important. The principal aim of this study is to examine the differences in the quality of life, physical and psychosocial symptoms according to the performance status of terminal cancer patients. Methods: We evaluated the performance status, demographical data, blood analysis and quality of life of cancer patients who visited the Department of family Medicine at Myoung-ji Hospital in Korea between September 1, 2003 and August 31, 2005. Their performance status (ECOG) was divided into two groups ($ECOG\;0{\sim}1/ECOG\;2{\sim}4$) and analyzed by ANOVA to see if there was a difference in their blood analysis and quality of life. A P value of less than 0.05 was considered to be significant. Results: A total of 104 patients were evaluated, among which 71 patients (23 male and 48 female) scored $0{\sim}1$, and 33 patients (8 males and 25 females) scored $2{\sim}4$ in the ECOG. The blood analysis showed that patients whose performance status was $2{\sim}4$ had lower levels of lymphocytes, hemoglobin, protein, albumin and sodium. The evaluation on their quality of life showed that the overall health status of patients with $2{\sim}3$ functional ability were poor (P=0.02). Also, from a functional perspective, these patients had poor physical (P=0.05) and role (P=0.01) scores, and in terms of symptoms, they showed a significant loss of appetite. Conclusion: If a patient's performance status was poor, levels related to certain nutritions were also found to fall in blood tests, thereby leading to an overall weakened state of health. However, there was no difference in symptoms except for a loss of appetite. In conclusion, it is most important to increase the appetite in patients with poor performance status.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.5
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• pp.1157-1176
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• 2003

The following conclusions are induced from a study on the acupuncture therapy depending on hyungsang of the persons. The study is made on the basis of 'Internal classic (內經)& and &Clinical Lectures by Dr. Jeesan&. The acupuncture originated from the treatment of spasm with numbness in the southern area. The acupuncture is basically a remedy for the exterior disease of meridian but also it can be a cure for the interior disease of Jang and obstinate disease with accurate method. Three mechanisms of acupuncture are described in 'Internal classic'. The first is to make meridian circulate smoothly. The second is to regulate Ki and Hyul. The third is to regulate points through which the meridian-Ki goes in and out smoothly or adversely. There are two ways of acupuncture in 'Internal classic'. One is based on pulse and symptom and the other on the Hyungsang. The former is more generally used therapy, to which depletion method, Asi point method(阿是穴 療法), Inyoung-kigu pulse comparison method (人迎氣口脈法) and method depending on jang-bu disease belong. Acupuncture is done on Su points(輸穴) and back-su point(背兪穴) in case of jang-disease. In case of bu-disease, the treatment is done on Hap points(合穴) and Mo-points(募穴). The latter includes two methods; one according to invariable Hyungsang. And the other to variable Hyungsang. The method of acupuncture according to invariable Hyungsang usually selects Won-points(原穴). Different Hyungsang requires different method of acupuncture; In case of Dam type, the acupuncture is mainly practiced on four-Kwan points with reinforcing and reducing methods achieved by the direction of the needle tip pointing to. In case of Bangkwang type, the acupuncture is usually done on Jungwan(中脘) and Poongyung(豊隆) with reinforcing and reducing methods by means of respiration. In case of female, more effective are the acupoints on the right and lateral parts of the body selected on the basis of five su-points of the twelve meridians matching the heavenly stems and earthly branches. In case of male, more effective are the acupoints on the left, front and rear parts of the eight extra meridians. In case of acupuncture to the person with Hyungsang of five jang and six bu, each person's intrinsic Hyung, color, pulse, must be observed. Because symptoms of jang-bu disease also must be checked up. Acupuncture is done on the Won-points of the meridians related to the jang and bu where the disease starts. The disease of five jang is so obstinate that it requires both of medication and acupuncture for a long time. In case of acupuncture to the person with Hyungsang of animal types, diagnosis is made on the basis of shape, temper, function and color. And the treatment is given on the Won-points of corresponding exterior and interior meridians. For the fish type, the acupuncture is done on the kidney meridian of foot-soyin and the urinary bladder of foot-taiyang. For the bird type, on the heart meridian of hand-soyin, the pericardium meridian of hand-gualyin, and the small intestine meridian of hand-taiyang For the deer type, on the liver meridian of foot-gualyin and the gallbladder meridian of foot-soyang. For the turtle type, on the lung meridian of hand-taiyin and the large intestine meridian of hand-yangmyung.

• Journal of the Korean Society of Radiology
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• v.11 no.7
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• pp.597-603
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• 2017

High-dose $^{131}I$ therapy has been generally carried out to remove remaining thyroid tissue or to cure metastasize lesion of patients who received full thyroidectomy due to differentiated thyroid cancers. In case high-dose $^{131}I$ therapy is carried out for a patient, the patient should be hospitalized being isolated for a certain period in order to restrict the amount of exposure to radiation of people at large from the patient within the limit of a level of radiation. Effective half-life is an important value to calculate how family members are exposed to radiation from a patient or to decide the period of isolation of the patient from the family members. Therefore, in this study we calculated the effective decay constant, effective half-life and period of isolation of high-dose $^{131}I$ therapy patient using NM670 SPECT/CT. As a result of carrying out this study, the effective half-life of high-dose $^{131}I$ therapy patients was derived and the time to reach the discharge level of 1.2 GBq was confirmed. When they were compared with each other in each of curative doses, the effective half-life did not have significant difference, but the time when the level of radiation remaining in the interior of the body to reach the criteria of isolation and discharge showed significant difference and it could be confirmed that the higher the curative dose the longer the period of isolation becomes. When the effective half-lives in each type of preparation were compared with each other, they did not show significant difference. However, When the times to reach the level of radiation that is the criteria of isolation and discharge in each type of preparations, they showed significant difference. The cause of the shortening of the isolation period for rhTSH patients group is decided to be low curative dose. Accordingly, if the current national health insurance (the insurance is applied to using of rhTSH in 3.7 GBq or lower) is maintained, while discerning them in each of types of preparation, we would be able to discharge patients at the time earlier than the current period of isolation (2 nights and 3 days).

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.213-221
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• 2005

Purpose: Hemophagocytic syndrome (HPS) is characterized by persistent high fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, and/or hypofibrinogenemia. Hepatic manifestations including overt hepatic failure and fulminant hepatitis are common in HPS. Liver transplantation (LT) should be considered in a case of fulminant hepatitis by other than HPS, but LT is contraindicated and complete cure is possible by chemotherapy in HPS. Therefore, we conducted this study to define the characteristics of HPS presenting as severe acute hepatitis. Methods: Among the total of 23 patients diagnosed as HPS by bone marrow examination between 1994 and 2005 in Asan Medical Center, 11 cases presented as severe acute hepatitis were enrolled in this study. We analyzed the clinical features, laboratory findings and outcome retrospectively. Results: Seven (64%) of the 11 children with HPS and hepatitis were referred to pediatric gastroenterologist at first. The mean age of onset was 50 months. There was no case with family history of primary HPS. Epstein-Barr virus was positive in 4, and herpes Simplex virus was positive simultaneously in 1 case. As the presenting symptoms and signs, fever was present in 10, hepatosplenomagaly was noted in all and jaundice in 10. Anemia was observed in 10, thrombocytopenia in 10, leukopenia in 8, hypertriglyceridemia in 9, hypofibrinogenemia in 8 and hyperferritinemia in 7 cases, respectively. Nine children received chemotherapy including etopside. The overall mortality rate was 72% (8/11). Conclusion: HPS, which needs chemotherapy, should be considered as a cause of severe acute hepatitis especially when accompanied with prolonged high fever and cytopenias.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.134-141
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• 1998

Primary lung cancer has recently increased progressively in its incidence in Korea. It is clearly evident that surgical resection offers the best offortunity for cure of non-small cell carcinoma. This study was designed to analyse the clinical data of 100 primary non-small cell carcinoma patients who underwent lung resection surgery from January 1992 to July 1995 at the department of Thoracic and Cardiovascular Sugery, Kyungpook National University Hospital. There were 86 males and 14 females(6:1). In the age distribution, the peak incidence was recorded in the seventh decade(43%). The methods of tissue diagnosis were bronchoscopic biopsy in 53 patients(50.5%), percutaneous needle aspiration in 17 patients(16.2%), transbronchial lung biopsy in 11 patients(10.5%), mediastinoscopic biopsy in 2 patients (1.9%), sputum cytology in 2 patients(1.9%), and thoracotomy in 20 patients(19.0%). Fifty-five lobectomies, 22 pneumonectomies, 15 bilobectomies, 2 segmentectomies, 4 sleeve lobectomies, a sleeve pneumonectomy, and a wedge pneumonectomy were performed. Operative mortality occured in 4 cases(sepsis in 2 cases, respiratory failure in 1 case, and acute myocardiac infarction in 1 case). The histologic types of tumor were 67 squamous cell carcinomas, 26 adenocarcinomas, 6 large cell carcinomas, and an adenosquamous cell carcinoma. Eighteen patients with N2 mediastinal lymph node metastases had 8 squamous cell carcinomas(11.9%), 9 adenocarcinomas(34.6%), and a large cell carcinoma(16.7%). The primary tumors in these patients were in the right upper lobe in 4 patients, the right middle and lower lobe in 9 patients, the left upper lobe in 3 patients, and the left lower lobe in 2 patients. With regard to pathologic stages, 45 patients had stage I disease; 13 patients, stage II; 36 patients, stage IIIa; 5 patients, stage IIIb; and 1 patient, stage IV. The overall actuarial survival rate was 77.5% at 12 months, 56.1% at 24 months and 43.7% at 43 months. The actuarial survival rates at 43 months were 81.3% in Stage I, 20.8% in Stage II, 27.9% in Stage IIIa, 25.0% in Stage IIIb and 33.3% in Stage IV. These facts suggest that early detection and surgical resection are recommended for favorable postoperative survival in non-small cell lung cancer.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.150-155
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• 2010

Background: Endovenous laser treatment (EVLT) has recently been introduced as a less invasive technique for treating an incompetent small saphenous vein and many good results have been reported. The purpose of this study is to assess the efficacy and safety of EVLT combined with high ligation in patients with an incompetent small saphenous vein. Material and Method: The study included 60 patients (66 limbs) who were treated with EVLT combined with high ligation of an incompetent small saphenous vein between January 2006 and May 2009. The preoperative clinical findings, the postoperative results and the postoperative ultrasonography follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were observed in 17 patients (15 limbs, 28.3%) and postoperative paresthesia occurred in 5 limbs (7.6%), but there was no deep vein thrombosis. Ultrasonography follow up at 3 month was performed in 93.9% of the limbs (62/66). The vein occlusion rate at 1 and 3 months were found to be 91.9% (57/62) and 90.3% (56/62), respectively. Conclusion: We performed EVLT combined with high ligation and ambulatory phlebectomy in patients with an incompetent small saphenous vein, and this all revealed relatively satisfactory results with a low complication rate, but it showed a relatively low cure rate even though we also performed EVLT combined with high ligation altogether. We need to determine whether EVLT combined with a high ligation procedure will improve the venous occlusion rate. We also need to investigate how we can minimize the occurrence of nerve injury.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.5
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• pp.511-519
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• 2008

Statement of problem: An incompatibility between the initiator systems of self-curing composite resins and light-curing adhesives was supposed recently. Purpose: The purpose of the study was to evaluate the influence of activators for self/dual bonding on dentin shear bonding strengths. Material and methods: Fifty human molars were divided into 5 groups. A flat dentin surface was created for each tooth. A self-curing composite resin (Luxacore) was bonded with the following adhesives (n = 10); One-Step, Prime&Bond NT, AdheSE, Prime&Bond NT and AdheSE were also used in combination with activators. Shear bond strengths were measured after 24 hours of water storage. The specimens were loaded in shear in the Instron until failure at a 1 mm/min crosshead speed. Data were compared using one-way ANOVA and Tukey HSD test (${\alpha}$= 0.05). Results: The dentin adhesive systems in order of decreasing median bond strength were One-Step > Prime&Bond NT with activator, AdheSE with activator > Prime&Bond NT, AdheSE. Among adhesives, One-Step had the highest bond strength. Prime&Bond NT with activator had higher bond strengths than Prime&Bond NT that was used alone, and so was AdheSE. Conclusion: Shear bond strengths were increased in Prime&Bond NT and AdheSE when these were used with activators comparing used without activators. But using activators was not effective clinically comparing One-Step.