• Title/Summary/Keyword: First Responders

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Outcomes of Non-Metastatic Gestational Trophoblastic Neoplasia: Twelve Year Experience from a Northern Thailand Tertiary Care Center

  • Suprasert, Prapaporn;Manopunya, Manatsawee
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5913-5916
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    • 2015
  • Gestational trophoblastic neoplasia (GTN) is the malignant form of gestational trophoblastic disease. In non-metastatic GTN, the outcomes of treatment are impressive with methotrexate (MTX) or actinomycin D. We retrospectively reviewed the outcomes of non-metastatic GTN treated at our center from January, 1999 to December, 2013. One hundred and nine patients were recruited to the study. The median age was 33.1 years and over 90% were referral cases. Abnormal vaginal symptoms developed in 37.6% while 56.4% were asymptomatic. The most common antecedent pregnancy was a complete mole (92.7%) with the median interval time from antecedent pregnancy to GTN development being 2.0 months. The median pretreatment B-hCG was 5,624 mIu/ml. The most common first line treatment was methotrexate (MTX) and folinic acid (91.7%) followed by weekly MTX (4.6%), etoposide+ MTX+actinomycin D (EMA) (2.8%), and actinomycin D (0.9%), with the median number of cycles at 5.0. The positive response to first line chemotherapy was 73.8%. The patients were given subsequent chemotherapeutic regimens after resistance to the first line therapy and showed a final remission rate of 89.9%.The significant factor that was frequently found in patients who were non-responders to the first line treatment was a hysterectomy procedure. Two patients developed lung metastasis and brain metastasis at one and four years after the first treatment, respectively. In conclusion, the outcomes of non-metastatic GTN were excellent. However, the patients need long term follow up due to the possibility of developing multiple organ metastases.

Outcomes of Second-Line Chemotherapy for Advanced Non-Small Cell Lung Cancer in One Institution

  • Lee, Seok Jeong;Kang, Hyun Ju;Kim, Seo Woo;Ryu, Yon Ju;Lee, Jin Hwa;Kim, Yookyung;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.1
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    • pp.13-17
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    • 2014
  • Background: This study analyzed the negative prognostic factors in patients who received second-line chemotherapy for advanced inoperable non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed the records of 137 patients with inoperable stage III-IV NSCLC who received second-line chemotherapy. The effects of clinical parameters on survival were analyzed and the hazard ratios (HR) for mortality were identified by a Cox regression analysis. Results: Sex, age older than 65 years, smoking history, cell type, T-stage, best response to first-line chemotherapy and first-line chemotherapy regimen were significant negative predictors in univariate analysis. The multivariate analysis showed that patients older than 65 years (HR, 1.530; 95% confidence interval [CI], 1.020-2.297), advanced T stage (T4 vs. T1; HR, 2.273; 95% CI, 1.010-5.114) and non-responders who showed progression with first-line chemotherapy (HR, 1.530; 95% CI, 1.063-2.203) had higher HR for death. Conclusion: The age factor, T stage and responsiveness to first-line chemotherapy were important factors in predicting the outcome of patients with advanced NSCLC who received second-line chemotherapy. The results may help to predict outcomes for these patients in the future.

Risk Factors for the First-Year Relapse in Children with Nephrotic Syndrome (신증후군 환아에서 1년내 재발과 관련된 위험 요인)

  • Shin, Hye Kyoung;Kim, Ji Hee;Yoo, Kee Hwan;Hong, Young Sook;Lee, Joo Won;Kim, Soon Kyum
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.889-892
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    • 2003
  • Purpose : This study aimed to evaluate risk factors of the first year relapse in children with nephrotic syndrome(NS) without the need for biopsy. Methods : We reviewed, retrospectively, 78 children diagnosed with steroid responsive nephrotic syndrome between July 1997 and June 2002. Median years to follow up were 4.4 years(range : 1-5 years). We divided the patients into two groups(group I : primary responders with no relapse or with only two relapses in the first year after initial response; group II : initial steroid responders with three or more relapses within the first year). We retrospectively reviewed and compared variables - sex, onset age, serum albumin, serum cholesterol, 24 hours urinary protein, creatinine clearance(Ccr), presence of hematuria and hypertension(HTN), and days from initial attack to remission. Results : Of 78 patients(male : 61(78.2%), female : 17(21.8%), age range 1.1 years to 14 years, median $5.1{\pm}3.0years$), 47(60.3%) were in group I and 31(39.7%) were in group II. There were no statistically significant differences in sex, serum albumin, serum cholesterol, 24 hours urinary protein, Ccr, presence of hematuria or HTN. The median age of onset showed no statistical difference between the two groups. However, if the patients are dividing into two groups according to the age of onset of three-years, patients theree yrs old or less fit into group II, as opposed to patients older than three yrs in age(63.2% vs. 32.2%, P<0.05). The days from initial attack to remission was longer in group II($12.9{\pm}0.5$ vs. $16.2{\pm}1.1$, P<0.05). Conclusion : We may conclude that the age of onset of three yrs old or less, and the longer time remission to initial steroid therapy, are risk factors of the first year relapse.

A Scheme of Relay Device Deployment for Rapid Formed the Ad hoc Backbone Network and Optimization of Communication Coverage in Disaster Scene (재난현장에서 신속한 애드혹 백본망 형성과 통신권역 최적화를 위한 중계장치 배치기법)

  • Lee, Soon-Hwa;Yoon, Jae-Sun;Kim, Chang-Bock;Lim, Seung-Gag
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.11 no.6
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    • pp.31-39
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    • 2011
  • For rapid formed the ad hoc wireless backbone network in disaster scene, It is necessary for real-time deployment scheme of wireless ad hoc relay devices by first responders without pre-planning. However, in order to realize this scheme, redundant deployment should be minimized, as well as optimal location of relay devices should be selected to expand communication coverage. Therefore, in this paper, we propose a new deployment scheme of relay devices to optimize communication coverage and then through simulations showed that improved performance of algorithm.

A Study on the Korean Adolescent Girls' Wearing Condition of Brassiere (한국 청소년기 여성의 브래지어 착용 실태 조사)

  • Choi, Young-Lim;Yang, Heesoon
    • Journal of the Korean Society of Clothing and Textiles
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    • v.41 no.4
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    • pp.741-751
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    • 2017
  • Adolescent girls experience significant breast growth is a significant secondary sexual characteristic development; their breasts are clearly different from adults' in volume, location and shape. This study was designed to understand brassiere wearing conditions and practices of adolescent girls aged between 15 and 18, as well as to identify problems and solutions so that it can serve as basic guidelines to develop patterns and sizes for adolescent brassieres. This researcher first studied brassiere wearing conditions and size fitness of adolescent girls. We analyzed the 439 collected responses from an online survey. The survey questionnaires encompassed brassiere wearing conditions and practices, brassiere size awareness, brassiere design preference, and brassiere purchase behavior. The survey found that 55.8% of the responders did not accurately understand their brassiere sizes, and those who understood their size showed a higher satisfaction and less discomfort than those who did not. This study found a requirement to educate adolescent girls on how to select and wear the right-sized brassieres. It is also necessary to promote different brassiere designs for adolescent girls' size and body shape.

A Study on the Effectiveness of Golden Time Targeting in the Field of Disaster Response : Focusing on Mapo Fire Fighters' Realization (재난대응 황금시간 목표제의 효과성에 관한 연구 서울특별시 마포소방서 현장대응 소방공무원의 인식을 중심으로 -)

  • Lee, Eun Wa;Yoon, Myong O;Park, Chan Seok
    • Journal of the Korea Safety Management & Science
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    • v.19 no.4
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    • pp.1-9
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    • 2017
  • In recent years after the Sewol Sank, the surroundings of Fire have rapidly changed and citizens need for Fire have been demanding very high. Under these situations, in order for satisfaction to all these demands, Seoul Metropolitan Fire & Disaster Headquarters(SMFDH) have made improvements of Golden Time in the field of disaster as the leader of Fire Department in Korea. SMFDH has been practicing many kinds of plans, or projects to achieve Gold Time of 55 types of disaster. However, There have been questioning about all these projects if they are working for the achievement. The purpose of this study is to scrutinize current projects for Golden Time Targeting focused on Mapo fire fighters as first responders and to cope with how to make them better for Seoul Citizens' safety by using SPSS(Statistical Package for the Social Science) Statistics 24. The result of this study presents that how we can find to be all the project for Golden Time Targeting running well. And This study will be positively applied to Seoul fire policies or helped for setting them up better.

Clinical Features and Long-Term outcomes of Patients with Late Steroid Resistant/Sensitive Nephrotic Syndrome: A Single Center Study

  • Yeh, Hye Ryun;Lee, JooHoon;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.19 no.2
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    • pp.98-104
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    • 2015
  • Objective: To find out clinical features and long-term outcomes of idiopathic childhood nephrotic syndrome(NS) patients with late steroid resistance(LSR)/late steroid sensitiveness(LSS). Patients and Methods: A retrospective chart review was performed on 480 patients diagnosed with idiopathic childhood NS at Asan Medical Center Children's Hospital from 1990 to 2013. Twenty-four patients whose responsiveness to steroids changed over a minimum 2 year follow-up period (2-17.5 years) were investigated. All patients had undergone a renal biopsy. Results: Among 480 nephrotic children, 428 (89%) were sensitive to the first steroid course. Of those who initially responded, 11 (2.5%) developed resistance to steroid therapy after relapses. LSR mostly developed between 1 month and 1 year after the initial episode. Six patients showed a minimal change and five showed focal segmental glomerulosclerosis (FSGS). Nine (82%) responded to cyclosporine or methylprednisolone pulse therapy. Of these, two had no further relapse, whereas the other seven experienced several relapses that ranged in length from 1.1 to 13.9 years. Three of the nine who initially responded to immunosuppression went on to experience several changes in steroid responsiveness. Two (18%) with resistance to immunosuppressants, including steroids, eventually progressed to end stage renal disease. Among the 52 patients (11%) who were initially steroid resistant, 13 (23%) were converted to steroid sensitive at relapses. Among these, 9 showed minimal change and 4 showed FSGS. Two had no further relapse and the other 11 responded to steroids on subsequent relapses ranging in length from 1.3 to 9.4 years. All these patients have had no further changes in steroid responsiveness with normal renal function. Conclusions: In this study, 2.5% of initial steroid responders and 25% of initial steroid non-responders changed their responsiveness to steroids at subsequent relapses. Eighteen percent of LSR patients developed end stage renal disease. All of the LSS patients showed preserved normal renal function. Responsiveness to immunosuppressants seemed to be the most important factor determining longterm outcomes in LSR/LSS patients.

Association Study between Treatment Response of Amisulpride and Dopamine D3 Receptor Gene Polymorphisms (조현병 환자에서 아미설프라이드의 치료반응과 도파민 D3 수용체 유전자다형성의 연관성)

  • Kang, Seung-Gul;Lee, Heon-Jeong;Lee, Seung Jae;Choi, Tae Young;Woo, Jungmin;Kim, Jihyun;Jung, Sung-Won;Koo, Bon Hoon;Lee, Kwanghun;Kim, Jeong-Lan;Chee, Ik-Seung;Lee, Jonghun
    • Korean Journal of Biological Psychiatry
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    • v.20 no.3
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    • pp.91-96
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    • 2013
  • Objectives The aim of this study is to evaluate the association between rs6280 and rs905568 genetic polymorphism of DRD3 gene and the treatment response of amisulpride. Methods After six weeks treatment of amisulpride, 125 schizophrenia patients were interviewed based on the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression-Severity (CGI-S). The genotyping for rs6280 and rs905568 was performed using TaqMan single nucleotide polymorphism (SNP) genotyping assay. Results There was no significant difference in the frequency of genotype and allele of rs6280 between the responders and non-responders based on the total, positive, and general score of PANSS and CGI-S score. However, there was a significant association between this SNP and treatment response in the negative score of PANSS (${\chi}^2=5.23$, p = 0.022). There was no significant association between rs905568 and the response in positive, negative, general, and total PANSS score and CGI-S score. Conclusions This is the first positive association study between DRD3 gene and the treatment response of negative symptoms to amisulpride in Korean schizophrenia patients. A larger scale research on more SNP of the DRD3 gene will make a progress in the study of pharmacogenetics on the treatment response of the amisulpride.

Comparison of CT Volumetry and RECIST to Predict the Treatment Response and Overall Survival in Gastric Cancer Liver Metastases (위암 간전이 환자의 반응평가와 생존율 예측을 위한 종양 부피 측정과 RECIST 기준의 비교 연구)

  • Sung Hyun Yu;Seung Joon Choi;HeeYeon Noh;In seon Lee;So Hyun Park; Se Jong Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.876-888
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    • 2021
  • Purpose The aim of this study was to compare the diameter and volume of liver metastases on CT images in relation to overall survival and tumor response in patients with gastric cancer liver metastases (GCLM) treated with chemotherapy. Materials and Methods We recruited 43 patients with GCLM who underwent chemotherapy as a first-line treatment. We performed a three-dimensional quantification of the metastases for each patient. An independent survival analysis using the Response Evaluation Criteria in Solid Tumors (RECIST) was performed and compared to volumetric measurements. Overall survival was evaluated using Kaplan-Meier analysis and compared using Cox proportional hazard ratios following univariate analyses. Results When patients were classified as responders or non-responders based on volumetric criteria, the median overall survival was 23.6 months [95% confidence interval (CI), 8.63-38.57] and 7.6 months (95% CI, 3.78-11.42), respectively (p = 0.039). The volumetric analysis and RECIST of the non-progressing and progressing groups showed similar results based on the Kaplan-Meier method (p = 0.006) and the Cox proportional hazard model (p = 0.008). Conclusion Volumetric assessment of liver metastases could be an alternative predictor of overall survival for patients with GCLM treated with chemotherapy.

Nurses' Cardiopulmonary Resuscitation Performance during the First 5 minutes in In-Situ Simulated Cardiac Arrest (심정지 초기 5분간 일반간호사의 심폐소생술 수행 분석: 현장 시뮬레이션을 이용하여)

  • Kim, Eun-Jung;Lee, Kyeong-Ryong;Lee, Myung-Hyun;Kim, Ji-Young
    • Journal of Korean Academy of Nursing
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    • v.42 no.3
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    • pp.361-368
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    • 2012
  • Purpose: The purpose of this study was to analyze the cardiopulmonary resuscitation skills and teamwork of nurses in simulated cardiac arrests in the hospital. Methods: A descriptive study was conducted with 35 teams of 3 to 4 registered nurses each in a university hospital located in Seoul. A mannequin simulator was used to enact simulated cardiac arrest. Assessment included critical actions, time elapsed to initiation of critical actions, quality of cardiac compression, and teamwork which comprised leadership behavior and communication among team members. Results: Among the 35 teams, 54% recognized apnea, 43% determined pulselessness. Eighty percent of the teams compressed at an average elapsed time of $108{\pm}75$ seconds with 35%, 36%, and 67% mean rates of correct compression depth, rate, and placement, respectively. Thirty-seven percent of the teams defibrillated at $224{\pm}67$ seconds. Leadership behavior and communication among team members were absent in 63% and 69% of the teams, respectively. Conclusion: The skills of the nurses in this study cannot be considered adequate in terms of appropriate and timely actions required for resuscitation. Future resuscitation education should focus on improving the quality of cardiopulmonary resuscitation including team performance targeting the first responders of cardiac arrest.