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Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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The Effects of Massage and Static Stretching on Cervical Range of Motion in Their 20s of Normal Adult (마사지 및 정적 스트레칭이 20대 정상 성인의 경부 관절가동범위에 미치는 효과)

  • Kwon, Won-An;Kim, Dong-Dae;Lee, Jae-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.11
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    • pp.4346-4353
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    • 2010
  • The purpose of this study was to estimate the cervical range of motion and the effects of massage and static stretching in their 20s of normal adult. One hundred participants(massage=50, stretching=50) with no musculoskeletal and nervous system problems volunteered for this study. Massage and static stretching were applied to sternocleidomstoid, scalenes, trapezius, semispinalis, splenius, suboccipital, multifidi and rotatores. Both groups received intervention for 3 times in a week. The time the intervention was applied was for 10minutes. Effleurage, petrissage and stripping technique was applied to massage group and static stretching technique was applied to stretching group. The cervical range of motion (CROM) instrument was used to measure eight cervical motions (suboccipital flexion, suboccipital extension, neck flexion and extension, and left and right lateral flexion, left and right rotation). As a result of making a statistical analysis of the data, the following findings were given: First, normal cervical range of motion revealed; suboccipital flexion($2.39^{\circ}$) and extension($38.36^{\circ}$), flexion($54.11^{\circ}$) and extension($69.39^{\circ}$), lateral flexion on left($43.50^{\circ}$) and right($41.28^{\circ}$), rotation on left($66.39^{\circ}$) and right($65.94^{\circ}$) in male and suboccipital flexion($5.14^{\circ}$) and extension($36.47^{\circ}$), flexion($55.92^{\circ}$) and extension($71.22^{\circ}$), lateral flexion on left($43.34^{\circ}$) and right($41.06^{\circ}$), rotation on left($69.38^{\circ}$) and right($68.63^{\circ}$) in female. Second, women had greater range of motions than men in suboccipital flexion, left and right rotation(p<0.05). Third, it showed significantly increasing cervical range of motion in all directions within groups following treatments but not between groups(p<0.05). Our results suggest that massage and static stretching are an appropriate intervention to increase cervical range of motion by muscle relaxation and stretching and may be provided a basis for future studies investigating the cervical range of motion.

Cancer Chemopreventive Effects of Ginsenoside $Rg_3,\;Rg_5,\;Rh_2$ and BST from Enzymatically Fermented Korean Ginseng Extract

  • Yun Taik-Koo
    • Proceedings of the Ginseng society Conference
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    • 2002.10a
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    • pp.35-46
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    • 2002
  • Panax ginseng C. A. Meyer has been one of the most highly recognized medicinal herbs in the Orient. Previous experiments have demonstrated that $Rg_3,\;and\;Rg_5$ statistically significantly decreased the incidence of benzo(a)pyrene-induced mouse lung tumor, $Rh_2$ showed tendency of decrease and $Rh_1$ showed no effect. It was, therefore, concluded that $Rg_3,\;Rg_5\;and\;Rh_2$ are active cancer chemopreventive components in red ginseng and they either singularly or synergistically act in the prevention of cancer. This study was undertaken to compare the cancer chemopreventive effects of $Rg_3,\;Rg_5\;and\;Rh_2$(purity: more than $60\%$) isolated from fermented ginseng extract and BST fermented ginseng with fortified ginsenoside $Rg_3\;and\;Rh_2$. The cancer chemopreventive effects were investigated in experimental groups treated with benzo(a)pyrene(BP) with ginsenoside $Rg_3,\;Rg_5\;Rh_2\;or\;BST$ at three doses of $50^{\circ}C/ml,\;100^{\circ}C/ml\;and\;200^{\circ}C/ml$ When mice given with $50^{\circ}C/ml$ concentration of ginsenoside $Rg_3$ combined with BP for 6 weeks after BP administration, $Rg_3\;showed\;60\%$ of lung tumor incidence, where as $100^{\circ}C/ml\;and\;200^{\circ}C/ml\;of\;Rg_3$ combined with BP groups had significant decrease of incidence $(40.0\%)$ respectively, with the inhibition rate being $35.5\%.$ While the tumor incidence was not decreased in the group treated with BP and 50 of $Rg_5,$ the incidence was $34.0\%\;and\;32.0\%$ in the group treated with BP and 100 and 200 of $Rg_5$, respectively. These incidences were significantly less than the group treated with BP alone, with the inhibition rate being $45.2\%\;and\;48.4\%,$ respectively. On the other hand, in the group treated with BP and 50 of ginsenoside $Rh_2,$ the tumor incidence was not decreased. However, the incidence was $40.0\%\;and\;38.8\%$ in the experimental treated with BP and 100 and 200 of $Rh_2,$ respectively, with the inhibition rate being $45.2\%\;and\;48.4\%,$ respectively. In addition, the incidence showed the tendency to decrease in the experimental group treated with BP and 50 of BST which contained $16.2\%\;of\;Rh_2,\;15.4\%\;of\;Rg_3\;and\;2.5%\;of\;Rg_5.$ The tumor incidence was $54.0\%$ in this group. In the group treated with 100 and 200 of EST, the incidence was $34.0\%\;and\;30.0\%,$ respectively, the incidences significantly being lower than the group treated with BP alone, with the inhibiting rate being $45.2\%\;and\;51.6\%,$ respectively. The results of this study strongly suggested that ginsenoside $Rg_3,\;Rg_5\;and\;Rh_2$ are the active components of red ginseng having a cancer chemopreventive activity and $Rg_5$ is the strongest cancer chempopreventive among them. On the other hand, the results demonstrating that the incidence of lung tumor was more markedly reduced by BST fermented ginseng with fortified ginsenoside $Rh_2\;or\;Rg_3$ compared to the single component alone, suggest that the combination of these components may remarkablely improve the cancer preventive effect

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Factors Affecting Physicians who will be Vaccinated Every Year after Receiving the COVID-19 Vaccine in Healthcare Workers (의료종사자의 COVID-19 예방 백신 접종받은 후 향후 매년 예방접종 의향에 미치는 요인)

  • Hyeun-Woo Choi;Sung-Hwa Park;Eun-Kyung Cho;Chang-hyun Han;Jong-Min Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.2
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    • pp.257-265
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    • 2023
  • The purpose of this study was to vaccinate every year according to the general characteristics of COVID-19, whether to vaccinate every year according to the vaccination experience, whether to vaccinate every year according to knowledge/attitude about vaccination, and negative responses to the vaccinate every year In order to understand the factors affecting the vaccination physician every year by identifying the factors of Statistical analysis is based on general characteristics, variables based on vaccination experience, and knowledge/attitudes related to vaccination. The doctor calculates the frequency and percentage, A square test (-test) was performed, and if the chi-square test was significant but the expected frequency was less than 5 for 25% or more, a ratio difference test was performed with Fisher's exact test. Through multiple logistic regression analysis using variables that were significant in simple analysis, a predictive model for future vaccination and the effect size of each independent variable were estimated. As statistical analysis software, SAS 9.4 (SAS Institute Inc., Cary, NC, USA) was used, and because the sample size was not large, the significance level was set at 10%, and when the p-value was less than 0.10, it was interpreted as statistically significant. In the simple logistic regression analysis, the reason why they answered that they would not be vaccinated every year was that they answered 'to prevent infection of family and hospital guests' rather than 'to prevent my infection' as the reason for the vaccination. It was 11.0 times higher and 3.67 times higher in the case of 'for the formation of collective immunity of the local community and the country'. The adverse reactions experienced after the 1st and 2nd vaccination were 8.42 times higher in those who did not experience pain at the injection site than those who did not, 4.00 times higher in those who experienced swelling or redness, and 5.69 times higher in those who experienced joint pain. There was a 5.57 times higher rate of absenteeism annually than those who did not. In addition, the more anxious they felt about vaccination, the more likely they were to not get the vaccine every year by 2.94 times.

Evaluation of the Neural Fiber Tractography Associated with Aging in the Normal Corpus Callosum Using the Diffusion Tensor Imaging (DTI) (확산텐서영상(Diffusion Tensor Imaging)을 이용한 정상 뇌량에서의 연령대별 신경섬유로의 변화)

  • Im, In-Chul;Goo, Eun-Hoe;Lee, Jae-Seung
    • Journal of the Korean Society of Radiology
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    • v.5 no.4
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    • pp.189-194
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    • 2011
  • This study used magnetic resonance diffusion tensor imaging (DTI) to quantitatively analyze the neural fiber tractography according to the age of normal corpus callosum and to evaluate of usefulness. The research was intended for the applicants of 60 persons that was in a good state of health with not brain or other disease. The test parameters were TR: 6650 ms, TE: 66 ms, FA: $90^{\circ}$, NEX: 2, thickness: 2 mm, no gap, FOV: 220 mm, b-value: $800s/mm^2$, sense factor: 2, acquisition matrix size: $2{\times}2{\times}2mm^3$, and the test time was 3 minutes 46 seconds. The evaluation method was constructed the color-cored FA map include to the skull vertex from the skull base in scan range. We set up the five ROI of corpus callosum of genu, anterior-mid body, posterior-mid body, isthmus, and splenium, tracking, respectively, and to quantitatively measured the length of neural fiber. As a result, the length of neural fiber, for the corpus callosum of genu was 20's: $61.8{\pm}6.8$, 30's: $63.9{\pm}3.8$, 40's: $65.5{\pm}6.4$, 50's: $57.8{\pm}6.0$, 60's: $58.9{\pm}4.5$, more than 70's: $54.1{\pm}8.1mm$, for the anterior-mid body was 20's: $54.8{\pm}8.8$, 30's: $58.5{\pm}7.9$, 40's: $54.8{\pm}7.8$, 50's: $56.1{\pm}10.2$, 60's: $48.5{\pm}6.2$, more than 70's: $48.6{\pm}8.3mm$, for the posterior-mid body was 20's: $72.7{\pm}9.1$, 30's: $61.6{\pm}9.1$, 40's: $60.9{\pm}10.5$, 50's: $61.4{\pm}11.7$, 60's: $54.9{\pm}10.0$, more than 70's: $53.1{\pm}10.5mm$, for the isthmus was 20's: $71.5{\pm}17.4$, 30's: $74.1{\pm}14.9$, 40's: $73.6{\pm}14.2$, 50's: $66.3{\pm}12.9$, 60's: $56.5{\pm}11.2$, more than 70's: $56.8{\pm}11.3mm$, and for the splenium was 20's: $82.6{\pm}6.8$, 30's: $86.9{\pm}6.4$, 40's: $83.1{\pm}7.1$, 50's: $81.5{\pm}7.4$, 60's: $78.6{\pm}6.0$, more than 70's: $80.55{\pm}8.6mm$. The length of neural fiber for normal corpus callosum were statistically significant in the genu(P=0.001), posterior-mid body(P=0.009), and istumus(P=0.012) of corpus callosum. In order of age, the length of neural fiber increased from 30s to 40s, as one grows older tended to decrease. For this reason, the nerve cells of brain could be confirmed through the neural fiber tractography to progress actively in middle age.

Weight loss effects of Bariatric Surgery after nutrition education in extremely obese patients (고도비만환자에서 베리아트릭 수술 (Bariatric Surgery) 후 영양교육이 체중감량에 미치는 효과)

  • Jeong, Eun-Ha;Lee, Hong-Chan;Yim, Jung-Eun
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.30-45
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    • 2015
  • Purpose: This study was planned to determine the characteristics of extremely obese patients during Bariatric surgery and to evaluate how the difference in the number of postsurgical personal nutritional educations they received affected the weight loss. Methods: This is a retrospective study on the basis of the medical records of extremely obese patients for 15 months after receiving gastric banding. A total of 60 people were selected as the study subjects and they were divided into the Less Educated Group and the More Educated Group according to the average number of personal nutritional educations they received. We investigated both groups to determine the general characteristic, health related lifestyle habits, obesity related complications and symptoms in possession, and eating habits before their surgery, the body composition measurement result, obesity determination indices at 1, 3, 6, 9, 12, and 15 months before and after their surgery, and the biochemical parameters at 6 months before and after their surgery. Results: Body fat and weight showed rapid reduction until 6 months after the surgery, but thereafter reduced slowly depending on the result of body composition measurement. Regarding body fat and weight, the More Educated Group, who received nutrition education more often, showed significantly lower levels than the Less Educated Group at 15 months after surgery. Regarding BMI and degree of obesity, the More Educated Group showed significantly lower levels than the Less Educated Group at 15 months after surgery. Here, we were assured that BMI is reversely proportional to the number of personal nutritional educations at 15 months, which is more outstanding after surgery than before surgery. Conclusion: Long-term nutritional education is a key factor for the extremely obese patient in maintaining the effects of Bariatric surgery on weight and body fat reduction onwards. In the next stage, considering the characteristics of the study subjects, adoption of individual nutrition education is recommended for postsurgical prospective arbitration of obesity in order to monitor blood pressure, obesity related complications, symptoms in possession, and how eating habits and health related life habits change, and to judge the actual effect of the nutritional education method at the same time.

A Study of Educational System for Medical Technologists in Korea (한국(韓國)의 의료기사(醫療技士) 교육제도(敎育制度)에 관(關)한 조사(調査) 연구(硏究))

  • Song, Jae-Kwan;Lee, Gun-Sub;Kim, Byong-Lak;Kim, Chung-Rak;Cho, Jun-Suk;Huh, Joon;Lee, Joon-Il
    • Journal of radiological science and technology
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    • v.6 no.1
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    • pp.131-181
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    • 1983
  • After the investigation on, and the analysis of, the educational system for medical technicians and the present educational situation for medical technologies in this country, the following conclusions were drawn. 1. As of March 1983 the current academic system for education in medical technologies included the regular 4-year college courses and those of the 2-year professional junior college courses. But except in the cases on clinical pathology and physical therapy, there were no college-level departments. Particularly, no educational institutions, at whatever level, had a department for working therapies. 2. The total number of credits needed for graduation from a department of medical technologies was 150 points at a regular 4-year college and 85 to 96 points at a 2-year professional college. The obligatory minimum number of credits for a student at a professional college was set at 80 points and above. 3. As for the number of the educational institutions for medical technologies in this country, there were one regular college and 14 professional colleges, a total of 15 institutions. As many as 14 colleges had departments of clinical pathology, 12 had departments of Radiotechnology, 11 had departments of physical therapy, 12 had departments of dental technology, and eight had departments of dental hygiene. 4. The total capacity of the professional colleges in admitting new enrollment each year were 1,920 for clinical pathology, 1,552 for radiology, 1,012 for physical therapy, 1,334 for dental technologies, 828 for dental hygiene, an aggregate of 6,646 for all of the professional college departments. 5. The total number of graduates from the 12 professional colleges by department during the period of 1965-83 were 7,595 for clindical pathology, 4,768 for radiology, 2,821 for physical therapy, 3,000 for dental technologies, and 1,787 for dental hygiene, totalling 19,971 for all departments in the professional colleges. 6. In the state examination for licensed medical technicians, 12,446 have passed from among the total of 26,609 participants, representing a 45% passing ratio. By departments the ratios showed 44% for clinical pathology, 39.7% for radiology, 51.2% for physical therapy, 42.5% for dental technology, 72.5% for dental hygiene and 73.1% for working therapy. 7. As for the degree of satisfaction shown by the people in this field, 52.2 percent of the teaching staffs who responed to the questionaires said they were satisfied with their present profession, while the great majority of medical technicians(66%) replied that they were indifferent to the problem. 8. The degree of satisfaction shown by the students on their enrollment in this particular academic field was generally in the framework of indifference(43.7%), but mere students(36.5%) were satisfied with their choice than those were not satisfied(14.4%) 9. As for the student's opinions on the lectures and practicing hours, a good many students replied that, among such courses as general science and humanities courses the basic medical course, the major course and practicing hours, the hours provided for the general courses(47.1%) and practicing(47.6%) were insufficient. 10. When asked about the contents of their major courses, comparatively few students (23.6%) replied that the courses were too difficult, while a convincing majority(58.5%) said they were neither difficult nor easy. As for the appropriateness of the number of the present teaching staffs, a great majority(71.0%) of the students replied that the level of the teaching personnel in each particular field was insufficient. 11. Among the students who responded to the poll, good part of them(49.5%) wanted mandatory clinical practicing hours, and the the majority of them(64.6%) held the view that the experimental and practicing facilities of their schools were insufficient. 12. On the necessity of the attached hospitals, 71.1% of the teaching staffs and 58.0% of the medical technicians had the opinion that this kind of facility was indispensable. 13. As for the qualifications for applicants to the state examination in the licensing system for medical technicians, 52.2% of the teacher's and 36% of the medical technicians replied that the present system granting the qualifications according to the apprenticeship period should be abolished. 14. On the necessity of improving the present system for education in medical technologies, an overwhelming majority(94.4% of the :caching staffs, 92.0% of the medical technicians and 91.9% of students) of these polled replied that the present system should be changed for the better. 15. On the method of changes for the present educational system, a great majority(89.4% of the teaching staffs, 80.4% of the medical technicians and 90.1% of the students) said that the system must be changed so that it fits into the reality of the present day. 16. As for the present 2-year program for the professional colleges, 61.6% of the teachers, 72.0% of the medical technicians and 38.8% of the students expressed the hope that the academic period would be extended to four regular years, hemming a full-fledged collegelevels program. 17. On the life-long eductional system for medical technicians, there was a considerable number of people who expressed the hope that an open university system(38.9% of the teaching staffs, 36.0% of the medical technicians) and a graduate school system would be set up. 18. As for the future prospects for medical technicians as professionals, the optimists ana pessimists were almost equally divided, and 41.1% of the teaching staffs 36.0% of. the technicians and 50.5% of the students expressed an intermediate position on this issue.

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Radiation Therapy for Carcinoma of the Oropharynx (구인두암의 방사선치료)

  • Park, In-Kyu;Kim, Jae-Choel
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.95-103
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    • 1996
  • Purpose : A retrospective analysis for patients with oropharyngeal carcinoma who were treated with radiation was performed to assess the results of treatment and patterns of failure, and to identify the factors that might influence survival. materials and methods : From March 1985 through June 1993, 53 patients with oropharyngeal carcinoma were treated with either radiation therapy alone or combination of neoadjuvant chemotherapy and radiation therapy at the Department of Radiation Oncology, Kyungpook National University Hospital. Patients' ages ranged from 31 to 73 years with a median age of 54 years. There were 47 men and 6 women, Forty-two Patients ($79.2\%$) had squamous cell carcinoma, 10 patients ($18.9\%$) had undifferentiated carcinoma and 1 patient ($19\%$) had adenoid cystic carcinoma. There were 2 patients with stage I, 12 patients with stage II, 12 Patients with stage III and 27 patients with stage IV. According to the TNM classification, patients were distributed as follows: T1 7, T2 28, T3 10, T4 7, TX 1, and N0 17, Nl 13, N2 21, N3 2. The primary tumor sites were tonsillar region in 36 patients ($67.9\%$), base of the tongue in 12 patients ($22.6\%$), and soft palate in 5 patients ($9.4\%$). Twenty-five patients were treated with radiation therapy alone and twenty-eight Patients were treated with one to three courses of chemotherapy followed by radiation therapy. Chemotherapeutic regimens used were either CF (cisplatin and 5-fluorouracil) or CVB (cisplatin, vincristine and bleomycin). Radiation therapy was delivered 180-200 cGy daily, five times a week using 6 MV X-ray with or without 8-10 MeV electron beams A tumor dose ranged from 4500 cGy to 7740 cGy with a median dose of 7100 cGy. The follow-up time ranged from 4 months to 99 months with a median of 21 months. Results : Thirty-seven patients ($69.8\%$) achieved a CR (complete response) and PR (partial response) in 16 patients ($30.2\%$) after radiation therapy. The overall survival rates were $47\%$ at 2 years and $42\%$ at 3 years, respectively. The median survival time was 23 months. Overall stage (p=0.02) and response to radiation therapy (p=0.004) were significant prognostic factors for overall survival. The 2-year disease-free survival rate was $45.5\%$. T-stage (p=0.03), N-stage (p=0.04) and overall stage (P=0.04) were significant prognostic factors for disease-free survival. Age, sex, histology, primary site of the tumor, radiation dose, combination of chemotherapy were not significantly associated with disease-free survival. Among evaluable 32 Patients with CR to radiation therapy, 12 patients were considered to have failed Among these, 8 patients failed locoregionally and 4 Patients failed distantly. Conclusion : T-stage, N-stage and overall stage were significant prognostic factors for disease-free survival in the treatment of oropharyngeal cancer Since locoregional failure was the predominant pattern of relapse, potential methods to improve locoregional control with radiation therapy should be attempted. More controlled clinical, trials should be completed before acceptance of chemotherapy as a part of treatment of oropharyngeal carcinoma.

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Analysis of Bone Mineral Density and Related Factors after Pelvic Radiotherapy in Patients with Cervical Cancer (골반부 방사선 치료를 받은 자궁경부암 환자의 골밀도 변화와 관련 인자 분석)

  • Yi, Sun-Shin;Jeung, Tae-Sig
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.15-22
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    • 2009
  • Purpose: This study was designed to evaluate the effects on bone mineral density (BMD) and related factors according to the distance from the radiation field at different sites. This study was conducted on patients with uterine cervical cancer who received pelvic radiotherapy. Materials and Methods: We selected 96 patients with cervical cancer who underwent determination of BMD from November 2002 to December 2006 after pelvic radiotherapy at Kosin University Gospel Hospital. The T-score and Z-score for the first lumbar spine (L1), fourth lumbar spine (L4) and femur neck (F) were analyzed to determine the difference in BMD among the sites by the use of ANOVA and the post-hoc test. The study subjects were evaluated for age, body weight, body mass index (BMI), post-radiotherapy follow-up duration, intracavitary radiotherapy (ICR) and hormonal replacement therapy (HRT). Association between the characteristics of the study subjects and T-score for each site was evaluated by the use of Pearson's correlation and multiple regression analysis. Results: The average T-score for all ages was -1.94 for the L1, -0.42 for the L4 and -0.53 for the F. The average Z-score for all ages was -1.11 for the L1, -0.40 for the L4 and -0.48 for the F. The T-score and Z-score for the L4 and F were significantly different from the scores for the L1 (p<0.05). There was no significant difference between the L4 and F. Results for patients younger than 60 years were the same as for all ages. Age and ICR were negatively correlated and body weight and HRT were positively correlated with the T-score for all sites (p<0.05). BMI was positively correlated with the T-score for the L4 and F (p<0.05). Based on the use of multiple regression analysis, age was negatively associated with the T-score for the L1 and F and was positively correlated for the L4 (p<0.05). Body weight was positively associated with the T-score for all sites (p<0.05). ICR was negatively associated with the T-score for the L1 (p<0.05). HRT was positively associated with the T-score for the L4 and F (p<0.05). Conclusion: The T-score and Z-score for the L4 and F were significantly higher than the scores for the L1, a finding in contrast to some previous studies on normal women. It was thought that radiation could partly influence BMD because of a higher T-score and Z-score for sites around the radiotherapy field. We suggest that a further long-term study is necessary to determine the clinical significance of these findings, which will influence the diagnosis of osteoporosis based on BMD in patients with cervical cancer who have received radiotherapy.

The Effect of Deep Breathing Methods on Pulmonary Ventilatory Function of Patients Who experiened Upper-abdominal surgery (심호흡 방법에 따른 상복부 수술환자의 폐 환기능에 미치는 효과)

  • Hwang Jin-Hee;Park Hyung-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.1 no.2
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    • pp.129-147
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    • 1994
  • The purpose of this study was to examine the effect of deep breathing exercise with Incentive Spirometer on the pulmonary ventilatory function of postoperative patients. This experiment was operated by quasi-experimental design which was compared pre-experimental measures with post-experimental ones. The subject of this study was 46 inpatients who were scheduled for elective upper abdominal surgery under the general anesthesia in P National University Hospital in Pusan and classified into the experimental group(23 patients) and control group(23 patients) by using Incentive Spirometer or unusing one. The data were collected from November, 1, 1993, to December, 31, 1993. The effects of the deep breathing exercise on the pulmonary ventilatory function were compared between experimental group who were recieved deep breathing exercise with Incentive Spirometer and control group who were recieved same method without Incentive Spirometer. The Forced Vital Capacity (FVC) and the First Second Forced Expiratory Volume ($FEV_1$) were represented as index of the pulmonary ventilatory function and those were measured by Vitalograph Compact. The collected data were analysed by SPSS/PC+ (percentage, average, standard deviation, chi-square test, t-test, and ANOVA). The results were as follow : (1) The $FVC_s$ of the experimental group were significantly increased in course of time, 24, 48, 72 hours after surgery(F=3.530, P=0.035). (2) The $FVC_s$ and $FEV_{1S}$ of the control group were significantly increased in course of time, 24, 48, 72 hours after surgery ($FVC_s$ : F=3.480, P=0.037, $FEV_{1S}$ : F=6. 153, P=0.004). (3) The FVC which was measured at 72 hours after surgery was significantly higher in the experimental group than in the control group(t=2.620, P=0.013). (4) The $FEV_{1s}$ which were measured at 24 and 72 hours after surgery were significantly higher in the experimental group than in the control group(24hr. : t=2.530, P=0.017, 72hr. : t=2.540, P=0.016). (5) Among general characteristics, sex was significant variable which influenced to effect of pulmonary ventilatory function. In conclusion, this study showed that the deep breathing exercise with Incentive Spirometer was more effective to recover the pulmonary ventilatory function after surgery than the deep breathing exercise without Incentive Spirometer.

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