• Korean Journal of Head & Neck Oncology
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• v.22 no.2
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• pp.123-129
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• 2006

Objective ： This retrospective study was designed to evaluate the anti-tumor efficacy and toxicities of the radiation therapy(RT) combined with cisplatin-based chemotherapy in locally advanced nasopharyngeal cancer(NPC). Materials and Methods ： Fifty three patients with locally advanced NPCs(AJCC stage II, III, IV) received curative RT and cisplatin-based chemotherapy. Duration of follow-up ranged from 5.5 to 201 months(median 50.8 months). Nineteen patients(35.8%) were treated with induction chemotherapy including cisplatin $100mg/m^2$ for 1 day and 5-fluorouracil $1g/m^2$ for 5 days followed by RT(Induction CTx-RT). Another 34 patients (64.2%) were treated with concurrent chemoradiation(CCRT) using cisplatin $100mg/m^2$(D1, 22, 43). Results ： Thirty-six(67.9%) and 11(20.8%) patients achieved clinical complete response and partial response, respectively. The pattern of failure was as follows：14 locoregional recurrence(26.4%) and 7 distant metastasis(13.2%). Among them, two patients(3.8%) had both locoregional and distant failure. Median overall survival(OS) and progression-free survival(PFS) were 85.5 months and 87.5 months, respectively. Five-year OS rate was 57.1%. The stage(AJCC), tumor response to chemoradiation and T stage were significant prognostic factors for OS(p=0.0113, p=0.0362 and p=0.0469). The stage(AJCC), tumor response to chemoradiation were also significant prognostic factors for PFS(p=0.0329, p=0.0424). Compared to each treatment group(Induction CTx-RT vs. CCRT), there were no significant differences in OS and PFS(p=0.7000, p=0.8261). Grade 3-4 mucositis, nausea/vomiting and hematological toxicities were noticed in 35.8%, 11.3% and 13.2%, respectively. Delayed RT over 2 weeks was inevitable in 26.5%. Seventeen patients(50%) successfully completed planned 3 courses of cisplatin in CCRT group. Conclusions ： RT combined with cisplatin-based chemotherapy in locally advanced NPC showed high response rate, good locoregional control, and survival rate. As expected, frequency of acute toxicities increased, and the patient's compliance to treatment was need to be improved. Although our data could not show additional survival benefit of CCRT compare to that of induction chemotherapy followed by RT, patients' accrual and further follow-up are required due to limitation of retrospective study.

• Journal of muscle and joint health
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• v.6 no.1
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• pp.100-135
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• 1999

Typical symptoms of rheumatic disease affect overall daily living and cause severe stress. Individuals afflicted with rheumatic disease have many illness-related stresses. Pain was the predominantly perceived stress followed by limitation in mobility, difficulties in carrying out activities of daily living. helplessness, dependency on others, threat to self-esteem, interference in social activity, interference in family relationships. difficulties performing at work, and discomfort of the treatment. Patients with chronic arthritis are subjected to long periods of continuous stress, which may require the management by the health care provider. In these cases, the purpose of the nursing is helping to promote health through supporting patient's coping. Therefore, for the nursing intervention to be effective, it is critical to build a theoretical framework that describes stress-coping for chronic arthritis. Thus, the purpose of this dissertation is to present a theoretical framework which describes the stress-coping processes and to empirically test pathos of this framework for the people with chronic arthritis. The foundation upon which this framework is built in the Erickson, Tomlin, and Swain(1983) theory of Modeling and role-Modeling. The subjects were 275 patients with rheumatoid arthritis or osteoarthritis who visited the outpatient clinic. A hypothetical model of stress-coping was tested by covariance structure analysis with PC-LISREL 8.12 program. As a result, the overall fit was good(Chi-square=94.49, P=0.00, RMR=0.067, GFI=0.95, AGFI=0.91, NNFI=0.93, NFI=0.91) for the hypothetical model. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on coping resources. However, independent variables(basic need satisfaction, internal health locus of control, illness-related experience, emotional stress and coping resource) did not have significantly influence on coping. And then, the hypothetical model was modified by considering both the theoretical implication and statistical significance of the parameter estimates. The revised model had a better fit to the data(Chi-square=83.11(P=0.00), RMR=0.061, GFI=0.96, AGFI=0.92, NNFI=0.95, NFI=0.92). Hypothesis emerged from the revised model was tested. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on illness-related experience and coping resources. Internal health locus of control, illness-related experience, emotional stress and coping resources had a significantly influence on coping. According to the results of this dissertation, basic need satisfaction and internal health locus of control play a central role in appraisal of illness-related experience and coping resources. And illness related-experience, emotional stress, and coping resources affect on coping activities. In summary, nursing interventions to enhance basic need satisfaction and internal health locus of control will decrease illness related experience and emotional stress and increase coping resources. Increased coping resources will prompt coping activities.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.28-34
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• 1999

Purpose: We studied magnetic resonance imaging of acromion morphology and superior displacement of the humeral head in the patients with diagnosis of rotator cuff impingement syndrome, and also documented the relationship of type Ⅲ acromion to the rotator cuff tear. Materials and Methods: We reviewed retrospectively 40 patients(40 shoulders) who had arthroscopic treatment for the diagnosis of stage II impingement or rotator cuff partial tear and did not have other risk lesions except acromion factor. The mean age was 48.7 years at operation. 21 men(2l shoulders), mean age of 26 years, were used as controls. Acromial type, tilt, and superior displacement of humeral head in sagittal plane, and acromial lateral angulation in coronal plane were measured. Four parameters of the patients were compared with those of control group. And then, the data were subdivided and analyzed with respect to acromial type and patient age in the impingement group. Student t test and multi-way ANOVA were used. Results: In impingement group, Farley's type I acromion, 33%, type Ⅱ, 38%, type Ⅲ, 27% and type Ⅳ, 2%. Superior displacement of humeral head( 4.8mm) were characteristic in the impingement group compared with the control group(1.3mm)(p<0.05). But acromial tilt and lateral angulation were not statistically different. In the analysis of the impingement group, the change of 4 parameters was not significant with respect to age(p>0.05), but lateral angulation in type I acromion(18 degree) and superior displacement of humeral head in type Ⅲ acromion(6.3mm) were significantly increased(p<0.05). All 4 parameters were not different between two subdivided types of type Ⅲ acromion. Conclusion: All types of acromian and large lateral angulatian cauld develop impingement syndrame, but acromial tilt was nat risk factar. Appearance of type Ⅲ acromian and increased superiar displacement of humeral head were characteristic findings in the impingement syndrame. Superiar displacement of humeral head as a result of degenerative change of rotatar cuff was probably primary cause far impingement. The type Ⅲ acromian might be an acquired farm, which cauld be expected to accelerate the tear of rotatar cuff as a cansequence.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.60-64
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• 2010

Purpose: Until now the general study for breast cancer patient has been mammography, breast sonography for anatomic diagnostics and $^{18}F$-FDG whole body PET for functional one. But the PEM (Positron Emission Mammography) was developed to increase sensitivity, specificity and accuracy to improve the disadvantage of each study. Therefore this present study aims to describe availability of PEM for improving diagnosis of breast cancer. Materials and Methods: During 3 months from January in 2010, PEM was performed on 100 patients who had history of breast cancer. Using Naviscan's PEM Flex Solo II scanner, PEM images of breast were acquired. And then we evaluated sensitivity, specificity and accuracy of PEM data by comparing results of PEM images with postoperative pathologic finding. Results: On the 100 patients, it could reveal 89 true positive, 9 false positive, 7 false negative and 87 true negative. Thus the results of sensitivity, specificity and accuracy for PEM was evaluated 92.7%, 90.6% and 91.7%. Conclusion: The sensitivity, specificity and accuracy have been reported 83.7%, 68.5% and 77.1% in mammography, and that was 89.1%, 79.1% and 83.4% in breast sonography. However the results of PEM were more increased than others. Therefore the results of this study will be available that PEM used diagnosis with breast cancer, used preoperative operation plan and helps to discovery of a part recurrence.

• Journal of the Korean Society of Radiology
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• v.9 no.4
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• pp.235-238
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• 2015

The aims of this study were to evaluate the difference of renal uptake rate in $^{99m}Tc-DMSA$ scan on pediatrics by including the bladder. Phantom and Clinical studies were performed. In the phantom study, we put $^{99m}TcO_4{^-}$ (300uCi, 11 MBq) in 3cups filled with distilled water at the rate 1:1:0, 1:1:0.5, 1:1:1, 1:1:2 and were placed Lt kidney, Rt kidney and bladder position on the table. To acquire the image, we used Symbia-E gamma camera from Siemens with preset count method(400,000 counts). In quantitative analysis, the counts of drawing ROIs on the phantom were analyzed. In clinical studies, we analyzed the 20 pediatrics who were examined by $^{99m}Tc-DMSA$ scan. At first, the images were acquired with both kidney and bladder. Secondly we acquired images after shielding the bladder. And the data were compared using a pared t-test by SPSS(ver.22.0). As a result of renal phantom's experiment, we compared with average of uptake rate(%), 1:1:0 was Lt 43.32%, Rt 45.97%, 1:1:0.5 was Lt 35.79%, Rt 36.89%, 1:1:1 was Lt 29.68%, Rt 31.45% and 1:1:2 was Lt 22.89%, Rt 24.32%. There was no correlation between the zoom and uptake rate. The results of patient were that excluded bladder was $29.83{\pm}8.81%$(Lt), $24.29{\pm}6.66%$(Rt) and included bladder was $26.65{\pm}8.03%$(Lt, $21.78{\pm}6.24%$(Rt). This is deemed statistically significant (p<0.05). Renal uptake rate was undervalued because the counts of bladder were included in the total counts.

• Journal of radiological science and technology
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• v.31 no.1
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• pp.1-10
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• 2008

Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.

• The Journal of Korean society of community based occupational therapy
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• v.2 no.1
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• pp.49-63
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• 2012

Objective : The purpose of study was to verify the clinical effect of a Korean Computer-based cognitive rehabilitation program(called CoTras) for recovering the visual perception function and ADL in stroke. Methods : A CBCRT was applied to 14 Stoke patients who rehabilitation professional medical treatment hospital. All participant were evaluated with four standardized assessment tolls(Motor-Free Visual Perception Test; MVPT, Korean version of Mini-Mental State Examination; MMSE-K, Assesment of Motor and Process Skills: AMPS) before and after the planned computer based cognitive rehabilitation sessions. Results : A significant effect was confirmed (p<.05) from the CBCRT which visual perception function. By each entry comparative result, visual memory, figure ground, visual close, spatial relation, visual discrimination, were the order of treatment. Neither was found any significant effect in improving process skills from AMPS. Conclusion : These results indicate that CoTras have effects on improving visual perception and ADL performance in stroke patients. Will be able to present with the fundamental data CoTras will be able to contribute to increase visual perception function & ADL performance to the stroke patient who has visual perception dysfunction.

• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.122-130
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• 2011

Objective: Although recombinant human erythropoietin (rhEPO) has revolutionized the treatment of anemia in chronic kidney disease (CKD) receiving hemodialysis (HD) with no need of blood transfusion, some patients have a blunted or appear to be resistant to rhEPO. There is a controversy in the causes of rhEPO resistance in maintenance HD patients with anemia. This study is to examine current anemia treatment outcomes and the factors influencing the rhEPO responsiveness in HD patient with CKD. Methods: The clinical parameters or factors relating to erythrompoietin treatment outcomes and erythropoietin responsiveness were collected from the HD patients in two large dialysis centers for three months. The collected paramenters included serum iron, total iron biding capacity (TIBC), transferrin saturation rate, ferritin, albumin, intact PTH, C-reactive protein (CRP), nPCR and medications such as an angiotensin converting enzyme inhbitor, an angiotension II receptor blocker and an HMG-CoA reductase inhibitor (HMG-CoA RI). The data were analyzed to examine the degree of acheiveing the anemia treatment goal and factors relating to ERI. Results: Among total 111 patients, 42 (42.3%) and 47 (37.8%) patients achieved the target Hct and Hb based on the Health Insurance Review and Assessment Services (HIRA) reimbursement criteria. In the higher ERI group (upper quartile), the patients had higher CRP levels (0.5 mg/dl) (p=0.0096), and lower TIBC score (<$240{\mu}g/dl$) (p=0.0027), and less patients were taking HMG-CoA RI (p=0.0019). Male patients (p=0.0204), patients with high TIBC score ($R^2$=0.084, p=0.0021) and patients taking HMG-CoA RI (p=0.0052) required to administer less dose of rhEPO meaning higher erythropoietin responsiveness. Conclusion: Less than 50% of CKD patients were achieving the goals of anemia by erythropoietin administration in large hospitals in Korea even though the goals were lower than those of NKF-K/DOQI practice guideline. The factors influencing ERI were sex, TIBC and HMG-CoA RI administration status, and neither an ACEI nor an ARB did not influence ERI.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.2
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• pp.713-720
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• 2013

The objectives of this study are to identify whether the small area variation also exists in the oriental medicine and, if it exists, what causes, to expand our boundary of research interests on the small area variation observed at the western medicine toward the oriental medicine as one of the fundamental research foundations and to provide any fundamental findings from this study results to the healthcare politicians to promote consumer's rational behaviors for the use of healthcare. This study analyzed the health insurance claim data (2010, 2011) which were the patients of western medicine and the outpatients of the oriental medicine with the top 10 most frequent diseases and looked into the variation of healthcare utilization among the areas after grouping resident area into an 86-area category. The study result shows that the small area variation was also observed at the part of the oriental medicine in which the characteristics of patients critically affect the healthcare expenditure per visit day rather than those of providers and the characteristics of both patients and providers equally affect the healthcare expenditure per patient. Therefore, this study suggests that government set up healthcare policies on the standardization of oriental medicine to prevent its over-utilization and unmet need, enforcing the roles of oriental medicine in the markets, enhancing the appropriate health care utilization, and expanding provision and sharing the health care information to reduce unnecessary health care utilization.

• Asian Oncology Nursing
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• v.1 no.2
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• pp.204-216
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• 2001

The purpose of this study was to test the effects of foot reflexology on pain and mood in patients who have just had a mastectomy. The research design was a nonequivalent control group, non-synchronized design. The participants for this study were 28 patients with breast cancer on first or second day after mastectomy surgery. The first 12 patients were assigned to the control group and the second 16 to the experimental group. The study was conducted from October 28, 2001 to December 22, 2001 on a surgical unit of Y Medical Center in Seoul, Korea. Pain intensity, blood pressure, pulse rate and mood were measured as dependent variables. The instrument used for pain intensity and mood was a 10 cm visual analogue scale. Cronbach alpha for this study was .70. For the experimental group pre and post tests were done immediately before and 15 minutes after completion of foot reflexology. Foot reflexology was performed once for 20 minutes. After the pretest, patients in the control group were instructed to have a quiet time for a 35 minute period and then the post-test was done. The number of participants was small so the data were analyzed by Mann-Whitney U test, and Wilcoxon signed ranks test. The results of this study are as follow : 1. In the experimental group there were significant decreases between the pre and post tests for pain intensity (z=-3.47, p<.001), diastolic blood pressure (z=-2.67, p<.01) and pulse rate (z=-3.44, p<.001) but there was no difference between the two groups on the post test. 2. The systolic blood pressure, diastolic blood pressure and pulse rate were also not significantly different between the experimental group and the control group on the post test. 3. The mood score was significantly improved after foot reflexology(z=-3.52, p=.000) and the difference between the two groups was also significant (u=49.0, p=.03). In conclusion, there was a statistically significant difference in mood between the two groups, but no difference for pain intensity, blood pressure, or pulse rate. However, there were significant differences between the pretest and post-test for pain intensity, diastolic blood pressure and pulse rate in the experimental group. On the basis of the above findings, this study suggests that foot reflexology can be an effective method of relieving pain and improving mood in clinical practice in women who have had mastectomy surgery.