• Radiation Oncology Journal
• /
• v.36 no.4
• /
• pp.285-294
• /
• 2018

Purpose: To determine the necessity of postmastectomy radiotherapy (PMRT) and which regions would be at risk for recurrence, we evaluated local and regional recurrence in breast cancer patients with 1-3 positive nodes and a tumor size of <5 cm. Materials and Methods: We retrospectively analyzed data of 133 female breast cancer patients with 1-3 positive nodes, and a tumor size of <5 cm who were treated with mastectomy followed by adjuvant systemic therapy between 2007 and 2016. The median follow-up period was 57 months (range, 12 to 115 months). Most patients (82.7%) were treated with axillary lymph node dissection. Adjuvant chemotherapy, endocrine therapy, and trastuzumab therapy were administered to 124 patients (93.2%), 112 (84.2%), and 33 (24.8%), respectively. The most common chemotherapy regimen was anthracycline and cyclophosphamide followed by taxane (71.4%). Results: Three patients (2.3%), 8 (6.0%), and 12 (9.0%) experienced local, regional, and distant failures, respectively. The 5-year cumulative risk of local recurrence, regional recurrence, distant metastasis, and disease-free survival was 3.1%, 8.0%, 11.7%, and 83.4%, respectively. There were no statistically significant clinicopathologic factors associated with local recurrence. Lymphovascular invasion (univariate p = 0.015 and multivariate p = 0.054) was associated with an increased risk of regional recurrence. Conclusion: Our study showed a very low local recurrence in patients with 1-3 positive nodes and tumor size of <5 cm who were treated with mastectomy and modern adjuvant systemic treatment. The PMRT volume need to be tailored for each patient's given risk for local and regional recurrence, and possible radiation-related toxicities.

• Journal of Microbiology and Biotechnology
• /
• v.27 no.4
• /
• pp.747-758
• /
• 2017

Chronic wounds, pressure sores, lesions, and infections of microbial origin in bedridden, paralyzed, or malnutrition patients remain the object of study of many researchers. A variety of factors behind the development of these disorders are related to the patient's immune system, making it unable to respond effectively to the treatment of the wound. These factors can be properly controlled, giving particular importance to the ethiology and stage of the wound, as well as the time periods corresponding to the replacement of the dressings. The present research reports a novel foam/soft material, ${{\small}L}$-Cys-g-PCL, with an application for decubitus/pressure ulcers, especially for wounds with a difficult healing process due to infections and constant oxidation of the soft tissues. During this work, the interactions between S. aureus and ${{\small}L}$-Cys-g-PCL foam were studied under conditions that simulate decubitus ulcers; namely, pH and exudate. The effects of duration of grafting (1 or 8 h) and pH (7.0 and 8.9) on wettability, surface energy, swelling, and porosity were also evaluated. Results showed an effective microbicidal activity exhibiting an inhibition ratio of 99.73% against S. aureus. This new ${{\small}L}$-Cys-g-PCL soft material showed saftey to contact skin, ability to be shaped to fill in sunken holes (craters) - pressure ulcers stage III - and to act as a smart material responsive to pH, which can be tailored to develop better swelling properties at alkaline pH where exudates are normally higher, so as to address exudate self-cleaning and prevention of desiccation.

• 한국노년학
• /
• v.31 no.1
• /
• pp.129-141
• /
• 2011

This study aims to find out effects of a tailored occupational activity program(TOAP) on the activities of daily living(ADL), cognitive function, depressive mood, and caregiver burden, who live in the community. Method : From October 2009 to May 2010, the TOAP was applied to 15 dementia patients and 15 of their caregivers, who was visitors of the Y-city Center for Managing Dementia in Gyunggi-do. The TOAP was designed for habituating patients and caregivers to the techniques acquired through goal activities and task and making it capable of being routinized regularly. The TOAP was applied to dementia patients and their cvaregivers twice a week for 7 weeks(one-time home visit, one-time phone inspection), a total of 14 times. Results: Significant differences among pre-test and post-test were found in the AMPS motor skills(1.10±1.14 and 1.34±1.2 respectively) scores, AMPS process skills(0.32±0.55 and 0.77±0.66 respectively) scores, ACL(3.86±0.65 and 4.17±0.64 respectively) scores, MMSE-KC(17.33±4.6 and 19.33±4.97 respectively) scores, GDS(11.73±6.87 and 8.53±7.09 respectively) scores, and caregiver burden(31.80±20.06 and 26.13±18.07 respectively) scores(p<0.05). A significant effect was confirmed from the TOAP which ADL, cognitive function, reduced patient's depression and caregiver burden(p<0.05). Conclusion: From the above results that a TOAP has an effect on the improvement of the ability to ADL, cognitive function and reduced depression and caregiver burden of dementia patients living in community. The present author hopes that, in the future, more diverse community based on tailored occupational activity programs will be developed to improve the functions of dementia patients living in community.

• Archives of Craniofacial Surgery
• /
• v.11 no.1
• /
• pp.53-57
• /
• 2010

Purpose: The radial forearm fasciocutaneous free flap is currently considered as the ideal free flap for reconstruction of mucosal and soft tissue defects of the palate. But the availability of stably attached oral and nasal mucosal lining is needed. In addition to this, for better operation field, operating convenience and esthetics, we planned a prelaminated radial forearm free flap. Methods: A 64-year-old male patient was admitted due to a $4{\times}4.5cm$ full through defect in the middle of the hard palate caused by peripheral T cell lymphoma with actinomycosis. In the first stage, the radial forearm flap was elevated, tailored to fit the hard palate defect, and then it positioned up-side down with split thickness skin graft. Two weeks later, the prelaminated radial forearm free flap was re-elevated and transferred to the palatal defect. One side covered with grafted skin was used to line the nasal cavity, and the other side (the cutaneous portion of the radial forearm flap) was used to line the oral cavity. Results: The prelamination procedure was relatively easy and useful. The skin graft was well taken to the flap. After 2nd stage operation, the flap survived uneventfully. There was no prolapse of the inset flap into the oral cavity and the cutaneous portion of the flap was mucosalized. The procedure was very successful and the patient can enjoy normal rigid diet and speech. Conclusion: The use of prelaminated radial forearm free flap for hard palate reconstruction is an excellent method to restore oral function. Based upon the result of this case, microvascular free flap transfer with prelaminated procedure is a valid alternative to the prosthetic obturator for palatal defect that provides an improved quality of life. It should be considered as an integral component of head and neck cancer therapy and rehabilitation.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.1
• /
• pp.584-592
• /
• 2020

The purpose of this study is to explore the relationship between warfarin-related knowledge, self-efficacy, and medication adherence among patients who underwent heart valve replacement surgery. The patients who underwent heart valve surgery and warfarin therapy were included in this study. The data was collected by administering questionnaires, and the data was then analyzed using the SPSS WIN 22.0 program. There was a positive relationship between warfarin-related knowledge and the adherence to medication (r=.285, p=004). Medication adherence was also positively correlated with warfarin-related knowledge (r=.250, p=.046) and self-efficacy (r=.292, p=.019) for elderly patients under 70 years of age. Further, medication adherence of elderly patients over 70 years of age was correlated with only warfarin-related knowledge (r=.358, p=.032). The results of this study show that in order to improve medication adherence, elderly people should be provided with warfarin-related knowledge through individually tailored education and nursing interventions that strengthen self-efficacy, as well as the knowledge that is needed in the elderly group under 70 years old.