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The Usefulness of B-type Natriuretic Peptide test in Critically Ill, Noncardiac Patients (심질환 병력이 없었던 중환자에서 B-type Natriuretic Peptide 검사의 유용성)

  • Kim, Kang Ho;Park, Hong-Hoon;Kim, Esther;Cheon, Seok-Cheol;Lee, Ji Hyun;Lee, Stephen YongGu;Lee, Ji-Hyun;Kim, In Jai;Cha, Dong-Hoon;Kim, Sehyun;Choi, Jeongeun;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.311-319
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    • 2003
  • Background : Previous studies have suggested that a B-type natriuretic peptide(BNP) test can provide important information on diagnosis, as well as predicting the severity and prognosis of heart failure. Myocardial dysfunction is often observed in critically ill noncardiac patients admitted to the Intensive Care Unit, and the prognosis of the myocardial dysfunction needs to be determined. This study evaluated the predictability of BNP on the prognosis of critically ill noncardiac patients. Methods : 32 ICU patients, who were hospitalized from June to October 2002 and in whom the BNP test was evaluated, were enrolled in this study. The exclusion criteria included the conditions that could increase the BNP levels irrespective of the severity, such as congestive heart failure, atrial fibrillation, ischemic heart disease, and renal insufficiencies. A triage B-Type Natriuretic Peptide test with a RIA-kit was used for the fluorescence immunoassay of BNP test. In addition, the acute physiology and the chronic health evaluation (APACHE) II score and mortality were recorded. Results : There were 16 males and 16 females enrolled in this study. The mean age was 59 years old. The mean BNP levels between the ICU patients and control were significantly different ($186.7{\pm}274.1$ pg/mL vs. $19.9{\pm}21.3$ pg/mL, p=0.033). Among the ICU patients, there were 14(44----) patients with BNP levels above 100 pg/mL. The APACHE II score was $16.5{\pm}7.6$. In addition, there were 11 mortalities reported. The correlation between the BNP and APACHE II score, between the BNP and mortality were significant (r=0.443, p=0.011 & r=0.530, p=0.002). The mean BNP levels between the dead and alive groups were significantly different ($384.1{\pm}401.7$ pg/mL vs. $83.2{\pm}55.8$ pg/mL p=0.033). However, the $PaO_2/FiO_2$ did not significantly correlate with the BNP level. Conclusion : This study evaluated the BNP level was elevated in critically ill, noncardiac patients. The BNP level could be a useful, noninvasive tool for predicting the prognosis of the critically ill, noncardiac patients.

A Study on Preparation of 3'-$[^{18}F]$Fluoro-3'-deoxythymidine and Its Biodistribution in 9L Glioma Bearing Rats (3'-$[^{18}F]$Fluoro-3'-deoxythymidine의 합성과 9L glioma 세포를 이식한 래트에서의 체내동태에 관한 연구)

  • Shim, Ah-Young;Moon, Byung-Seok;Lee, Tae-Sup;Lee, Kyo-Chul;An, Gwang-Il;Yang, Seung-Dae;Yu, Kook-Hyun;Cheon, Gi-Jeong;Choi, Chang-Woon;Lim, Sang-Moo;Chun, Kwon-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.5
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    • pp.263-270
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    • 2006
  • Purpose: Several radioisotope-labeled thymidine derivatives such as $[^{11}C]$thymidine was developed to demonstrate cell proliferation in tumor. But it is difficult to track metabolism with $[^{11}C]$thymidine due to rapid in vivo degradation and its short physical half-life. 3'-$[^{18}F]$fluoro-3'-deoxythymidine ($[^{18}F]$FLT) was reported to have the longer half life of fluorine-18 and the lack of metabolic degradation in vivo. Here, we described the synthesis of the 3'-$[^{18}F]$fluoro-3'-deoxythymidine ($[^{18}F]$FLT) and compared with $([^{18}F]FET)\;and\;([^{18}F]FDG)$ in cultured 9L cell and obtained the biodistribution and PET image in 9L tumor hearing rats. Material and Methods: For the synthesis of $[^{18}F]$FLT, 3-N-tert-butoxycarbonyl-(5'-O-(4,4'-dimet hoxytriphenylmethyl)-2'-deoxy-3'-O-(4-nitrobenzenesulfonyl)-${\beta}$-D-threopentofuranosyl)thymine was used as a FLT precursor, on which the tert-butyloxycarbonyl group was introduced to protect N3-position and nitrobenzenesulfonyl group. Radiolabeling of nosyl substitued precursor with $^{18}F$ was performed in acetonitrile at $120^{\circ}C$ and deproteced with 0.5 N HCI. The cell uptake was measured in cultured 9L glioma cell. The biodistribution was evaluated in 9L tumor bearing rats after intravenous injection at 10 min, 30 min, 60 min and 120 min and obtained PET image 60 minutes after injection. Results: The radiochemical yield was about 20-30% and radiochemical purity was more than 95% after HPLC purification. Cellular uptake of $[^{18}F]$FLT was increased as time elapsed. At 120 min post-injection, the ratios of tumor/blood, tumor/muscle and tumor/brain were $1.61{\pm}0.34,\;1.70{\pm}0.30\;and\;9.33{\pm}2.22$, respectively. The 9L tumor was well visualized at 60 min post injection in PET image. Conclusion: The uptake of $[^{18}F]$FLT in tumor was higher than in normal brain and PET image of $[^{18}F]$FLT was acceptable. These results suggest the possibility of $[^{18}F]$FLT at an imaging agent for brain tumor.

In the Treatment I-131, the Significance of the Research that the Patient's Discharge Dose and Treatment Ward can Affect a Patient's Kidney Function on the Significance of Various Factors (I-131 치료시 환자의 신장기능과 다양한 요인으로 의한 퇴원선량 및 치료병실 오염도의 유의성에 관한 연구)

  • Im, Kwang Seok;Choi, Hak Gi;Lee, Gi Hyun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.62-66
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    • 2013
  • Purpose: I-131 is a radioisotope widely used for thyroid gland treatments. The physical half life is 8.01 and characterized by emitting beta and gamma rays which is used in clinical practice for the purpose of acquiring treatment and images. In order to reduce the recurrence rate after surgery in high-risk thyroid cancer patients, the remaining thyroid tissue is either removed or the I-131 is used for treatment during relapse. In cases of using a high dosage of radioactive iodine requiring hospitalization, the patient is administered dosage in the hospital isolation ward over a certain period of time preventing I-131 exposure to others. By checking the radiation amount emitted from patients before discharge, the patients are discharged after checking whether they meet the legal standards (50 uSv/h). After patients are discharged from the hospital, the contamination level is checked in many parts of the ward before the next patients are hospitalized and when necessary, decontamination operations are performed. It is expected that there is exposure to radiation when measuring the ward contamination level and dose check emitted from patients at the time of discharge whereby the radiation exposure by health workers that come from the patients in this process is the main factor. This study analyzed the correlation between discharge dose of patients and ward contamination level through a variety of factors such as renal functions, gender, age, dosage, etc.). Materials and Method: The study was conducted on 151 patients who received high-dosage radioactive iodine treatment at Soon Chun Hyang University Hospital during the period between 8/1/2011~5/31/2012 (Male: Female: 31:120, $47.5{\pm}11.9$, average dosage of $138{\pm}22.4$ mCi). As various factors expected to influence the patient discharge dose & ward contamination such as the beds, floors, bathroom floors, and washbasins, the patient renal function (GFR), age, gender, dosage, and the correlation between the expected Tg & Tg-Tb expected to reflect the remaining tissue in patients were analyzed. Results: In terms of the discharge dose and GFR, a low correlation was shown in the patient discharge dose as the GFR was higher (p < 0.0001). When comparing the group with a dosage of over 150mCi and the group with a lower dosage, the lower dosage group showed a significantly lower discharge dose ($24{\pm}10.4uSv/h$ vs $28.7{\pm}11.8uSv/h$, p<0.05). Age, gender, Tg, Tg-Tb did not show a significant relationship with discharge dose (p> 0.05). The contamination level in each spot of the treatment ward showed no significant relationship with GFR, Tg, Tg-Tb, age, gender, and dosage (p>0.05 ). Conclusion: This study says that discharge of the dose in the patient's body is low in GFR higher and Dosage 150mCi under lower. There was no case of contamination of the treatment ward, depending on the dose and renal association. This suggests that patients' lifestyles or be affected by a variety of other factors.

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The Effect of Spiritual Well-being on the Mental Health of the Cho-Sun Tribal Women Residing in P.R. of China (중국거주 조선족 여성의 영적 안녕정도가 정신건강에 미치는 영향)

  • Cheung, Seung-Deuk;Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Bai, Dai-Seg;Park, Soon-Jae;Joo, Yeol;Youm, Hyoung-Uk;Jin, Cheung-Yuan;Jin, Jiu-Miao;Ahn, Yeung-Log;Huang, Da-Hong;Biao, Mei-Zi;Zheng, Tai-Ji;Zhao, Chang-Lie
    • Journal of Yeungnam Medical Science
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    • v.21 no.2
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    • pp.151-166
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    • 2004
  • Background: Spirituality has been an important part of Transpersonal Psychology and is believed to have a large effect on the mental health because it has been systematized. The aim of this study was to determine the level of spiritual disposition on human beings along with its effects on one's mental health. Materials and Methods: The study targeted 400 women residing in Youn-Gil city of JiLin Prov., which is a district of the Cho-Sun tribe in China. Their spiritual well-being was studied using the Spiritual Well-being Scale-Korean Version. The spiritual well-being scale consists of 2 sub-scales of religious well-being and existential well-being. The study was evaluated using a lie scale, psychotic trend, and a combined anxiety-depression scale. The results were considered to be factors of one's mental health. The correlation between the spiritual well-being and each tendency was analyzed by regression analysis. Results: The total score of the Cho-Sun tribal women according to the spiritual well-being scale was 68.29 which was much less than the 100.65 of Korean Christian women. There was no significant correlation between the spiritual well-being and the Lie trend. However, it was found that 86%(344) of Cho-Sun tribal women scored above 70 in the Lie trend with a mean score of 74.57 which is higher than normal populations. Regarding the correlation between the spiritual well-being and psychotic trend, the psychotic trend became significantly higher when the religious well-being was at a high level. On the other hand, the psychotic trend became significantly lower when the existential well-being was at a high level. Regarding the correlation between the spiritual well-being and anxiety, the anxiety was significantly higher when the religious well-being was at a high level. However, the anxiety level was significantly low when the existential well-being was at a high level. Regarding the correlation between the spiritual well-being and depression, the depression level was somewhat significantly high when the religious well-being was at a high level. However, the depression level was significantly low when the existential well-being was at a high level. Conclusion: This study evaluated the effects of spiritual well-being on a person's mental health among Cho-Sun tribal women in Youn-Gil city of JiLIn Prov., P.R. of China. The results found that the religious well-being, which is a sub-scale of spiritual well-being, had negative effects while the existential well-being had positive effects on the mental health. These results proved that a person's religious disposition had negative effects on their mental health in a communitarian society.

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The Influence Evaluation of $^{201}Tl$ Myocardial Perfusion SPECT Image According to the Elapsed Time Difference after the Whole Body Bone Scan (전신 뼈 스캔 후 경과 시간 차이에 따른 $^{201}Tl$ 심근관류 SPECT 영상의 영향 평가)

  • Kim, Dong-Seok;Yoo, Hee-Jae;Ryu, Jae-Kwang;Yoo, Jae-Sook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.67-72
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    • 2010
  • Purpose: In Asan Medical Center we perform myocardial perfusion SPECT to evaluate cardiac event risk level for non-cardiac surgery patients. In case of patients with cancer, we check tumor metastasis using whole body bone scan and whole body PET scan and then perform myocardial perfusion SPECT to reduce unnecessary exam. In case of short term in patients, we perform $^{201}Tl$ myocardial perfusion SPECT after whole body bone scan a minimum 16 hours in order to reduce hospitalization period but it is still the actual condition in which the evaluation about the affect of the crosstalk contamination due to the each other dissimilar isotope administration doesn't properly realize. So in our experiments, we try to evaluate crosstalk contamination influence on $^{201}Tl$ myocardial perfusion SPECT using anthropomorphic torso phantom and patient's data. Materials and Methods: From 2009 August to September, we analyzed 87 patients with $^{201}Tl$ myocardial perfusion SPECT. According to $^{201}Tl$ myocardial perfusion SPECT yesterday whole body bone scan possibility of carrying out, a patient was classified. The image data are obtained by using the dual energy window in $^{201}Tl$ myocardial perfusion SPECT. We analyzed $^{201}Tl$ and $^{99m}Tc$ counts ratio in each patients groups obtained image data. We utilized anthropomorphic torso phantom in our experiment and administrated $^{201}Tl$ 14.8 MBq (0.4 mCi) at myocardium and $^{99m}Tc$ 44.4 MBq (1.2 mCi) at extracardiac region. We obtained image by $^{201}Tl$ myocardial perfusion SPECT without gate method application and analyzed spatial resolution using Xeleris ver 2.0551. Results: In case of $^{201}Tl$ window and the counts rate comparison result yesterday whole body bone scan of being counted in $^{99m}Tc$ window, the difference in which a rate to 24 hours exponential-functionally notes in 1:0.114 with Ventri (GE Healthcare, Wisconsin, USA), 1:0.249 after the bone tracer injection in 12 hours in 1:0.411 with 1:0.79 with Infinia (GE healthcare, Wisconsin, USA) according to a reduction a time-out was shown (Ventri p=0.001, Infinia p=0.001). Moreover, the rate of the case in which it doesn't perform the whole body bone scan showed up as the average 1:$0.067{\pm}0.6$ of Ventri, and 1:$0.063{\pm}0.7$ of Infinia. According to the phantom after experiment spatial resolution measurement result, and an addition or no and time-out of $^{99m}Tc$ administrated, it doesn't note any change of FWHM (p=0.134). Conclusion: Through the experiments using anthropomorphic torso phantom and patients data, we found that $^{201}Tl$ myocardium perfusion SPECT image later carried out after the bone tracer injection with 16 hours this confirmed that it doesn't receive notable influence in spatial resolution by $^{99m}Tc$. But this investigation is only aimed to image quality, so it needs more investigation in patient's radiation dose and exam accuracy and precision. The exact guideline presentation about the exam interval should be made of the validation test which is exact and in which it is standardized about the affect of the crosstalk contamination according to the isotope use in which it is different later on.

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The Evaluation of Predose Counts in the GFR Test Using $^{99m}Tc$-DTPA ($^{99m}Tc$-DTPA를 이용한 사구체 여과율 측정에서 주사 전선량계수치의 평가)

  • Yeon, Joon-Ho;Lee, Hyuk;Chi, Yong-Ki;Kim, Soo-Yung;Lee, Kyoo-Bok;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.94-100
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    • 2010
  • Purpose: We can evaluate function of kidney by Glomerular Filtration Rate (GFR) test using $^{99m}Tc$-DTPA which is simple. This test is influenced by several parameter such as net syringe count, kidney depth, corrected kidney count, acquisition time and characters of gamma camera. In this study, we evaluated predose count according to matrix size in the GFR test using $^{99m}Tc$-DTPA. Materials and Methods: Gamma camera of Infinia in GE was used, and LEGP collimator, three types of matrix size ($64{\times}64$, $128{\times}128$, $256{\times}256$) and 1.0 of zoom factor were applied. We increased radioactivity concentration from 222 (6), 296 (8), 370 (10), 444 (12) up to 518 MBq (14 mCi) respectively and acquired images according to matrix size at 30 cm distance from detector. Lastly, we evaluated these values and then substituted them for GFR formula. Results: In $64{\times}64$, $128{\times}128$ and $256{\times}256$ of matrix size, counts per second was 26.8, 34.5, 41.5, 49.1 and 55.3 kcps, 25.3, 33.4, 41.0, 48.4 and 54.3 kcps and 25.5, 33.7, 40.8, 48.1 and 54.7 kcps respectively. Total counts for 5 second were 134, 172, 208, 245 and 276 kcounts from $64{\times}64$, 127, 172, 205, 242, 271 kcounts from $128{\times}128$, and 137, 168, 204, 240 and 273 kcounts from $256{\times}256$, and total counts for 60 seconds were 1,503, 1,866, 2,093, 2,280, 2,321 kcounts, 1,511, 1,994, 2,453, 2,890 and 3,244 kcounts, and 1,524, 2,011, 2,439, 2,869 and 3,268 kcounts respectively. It is different from 0 to 30.02 % of percentage difference in $64{\times}64$ of matrix size. But in $128{\times}128$ and $256{\times}256$, it is showed 0.60 and 0.69 % of maximum value each. GFR of percentage difference in $64{\times}64$ represented 6.77% of 222 MBq (6 mCi), 42.89 % of 518 MBq (14 mCi) at 60 seconds respectively. However it is represented 0.60 and 0.63 % each in $128{\times}128$ and $256{\times}256$. Conclusion: There was no big difference in total counts of percentage difference and GFR values acquiring from $128{\times}128$ and $256{\times}256$ of matrix size. But in $64{\times}64$ of matrix size when the total count exceeded 1,500 kcounts, the overflow phenomenon was appeared differently according to predose radioactivity of concentration and acquisition time. Therefore, we must optimize matrix size and net syringe count considering the total count of predose to get accurate GFR results.

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Meat Quality and Nutritional Properties of Hanwoo and Imported New Zealand Beef (한우고기와 뉴질랜드산 냉장수입육의 육질 및 영양성분 비교)

  • Cho, Soo-Hyun;Kang, Geun-Ho;Seong, Pil-Nam;Park, Beom-Young;Jung, Seok-Geun;Kang, Sun-Moon;Kim, Young-Chun;Kim, Ji-Hee;Kim, Dong-Hun
    • Food Science of Animal Resources
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    • v.31 no.6
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    • pp.935-943
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    • 2011
  • This study was conducted to investigate the proximate composition, meat color, Warner-Bratzler shear force (WBS), cooking loss (CL), fatty acids composition, amino acid composition and mineral contents of Hanwoo beef (QG $1^+$, 1) and imported New Zealand black Angus beef with loin, strip loin, eye of round and chuck tender. The intramuscular fat contents were higher in the strip loin, loin and chuck tender of Hanwoo beef than New Zealand beef (p<0.05). Hanwoo QG 1 beef had higher Fe contents in the strip loin (30.52 mg/100g) and chuck tender (40.70 mg/100g) (p<0.05). Hanwoo beef had lower cooking loss and than those of New Zealand beef, whereas New Zealand beef had higher protein and amino acids contents (%) than their counterpart. There was no significant difference in the WBS between two origin samples except the chuck Hanwoo beef had significantly lower saturated fatty acids (SFA) and higher monounsaturated fatty acids contents than New Zealand beef (p<0.05). WBS values indicated that Hanwoo and New Zealand beef had similar tenderness in the loin, striploin and eye of round due to the longer aging periods of the New Zealand beef than Hanwoo beef during the distribution.

Meat Quality and Nutritional Properties of Hanwoo and Imported Australian Beef (한우고기와 호주산 냉장수입육의 육질 및 영양성분 비교)

  • Cho, Soo-Hyun;Seong, Pil-Nam;Kang, Geun-Ho;Park, Beom-Young;Jung, Seok-Geun;Kang, Sun-Moon;Kim, Young-Chun;Kim, Jong-In;Kim, Dong-Hun
    • Food Science of Animal Resources
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    • v.31 no.5
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    • pp.772-781
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    • 2011
  • This study was conducted to investigate the proximate composition, meat color, Warner-Bratzler shear force (WBS), total collagen content (%), cooking loss (CL), fatty acid composition, amino acid composition, and mineral content of loin, strip loin, top round, and chuck tender Hanwoo beef and imported Australian beef. Protein content was significantly lower for strip loin and loin of Hanwoo QG $1^+$ and 1 beef when compared to that of Australian black Angus or cross beef (p < 0.05), whereas it was not significantly different for top round and chuck tender. Intramuscular fat content was higher for QG $1^+$ Hanwoo beef strip loin (15.48%) than that in Australian cross beef (8.83%) and it was also higher in loin for QG $1^+$ (17%) and 1 (15.52%) Hanwoo beef than that in Australian Angus beef (10.59%) and cross beef (9.21%) (p < 0.05). The CIE $L^*$ value was significantly higher for Australian cross beef strip loin than that of Hanwoo beef but the CIE $a^*$ value was not significantly different between the same cuts from different origins. However, CIE $b^*$ values were significantly higher for the Australian cross beef than those for four cuts of Hanwoo beef and Australian Angus beef (p < 0.05). No significant difference in WBS of loin, top round, or chuck tender was observed among the different beef sample origins except that strip loin had significant higher WBS for Australian cross beef (3.02 kg) but lower for Australian Angus beef (2.13 kg). Australian cross beef contained significantly higher palmitic acid, stearic acid, linolenic acid, but lower palmitoleic acid, oleic acid, eicosenoic acid content in strip loin, loin, and top round than those of QG $1^+$ and 1 Hanwoo beef (p < 0.05). QG $1^+$ Hanwoo beef had significant lower saturated fatty acid and higher monounsaturated fatty acid content than those in Australian cross beef (p < 0.05). Hanwoo $1^+$ beef had more glycine in top round and chuck tender, whereas Hanwoo QG 1 beef and Australian Angus beef had higher cysteine, methione, and glycine levels in strip loin and loin and valine and leucine in top round and chuck tender than the same cuts of Hanwoo $1^+$ beef (p < 0.05). No significant differences were observed for Ca, Fe, or Zn content among the different beef samples.

Prophylactic cranial irradiation in limited small-cell lung cancer : incidence of brain metastasis and survival and clinical aspects (예방적 두강내 방사선 조사후 소세포 폐암 환자의 뇌전이 빈도와 생존율에 대한 연구)

  • Suh, Jae-Chul;Kim, Myung-Hoon;Park, Hee-Sun;Kang, Dong-Won;Lee, Kyu-Seung;Ko, Dong-Seok;Kim, Geun-Hwa;Jeong, Seong-Su;Cho, Moon-June;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.323-331
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    • 2000
  • Purpose: Brain metastases are present in approximately 10-16% of small cell lung cancer patients at diagnosis. Brain metastasis is an important clinical problem associated with increasing the survival rate, with a cumulative incidence of up to 80% in patients surviving 2 years. Prophylactic cranial irradiation(PCI) reduces the incidence of brain matastasis and may prolong survival in patients with limited small-cell lung cancer who achieved complete remission. This study was performed to analyze the incidence of brain metastasis, survival and clinical aspects after PCI in patients with limited small-cell lung cancer who achieved complete remission. Methods : Between 1989 and 1999, forty-two patients with limited small-cell lung cancer who achived achieved complete remission after therapy were enrolled into this study retrospectively. All patients received etoposide and cisplatin(VPP) alternating with cytoxan, adriamycin, and vincristine(CAV) every 3 weeks for at least 6 cycles initially. All patients received thoracic radiotherapy: concurrent(38.1%) and sequential(61.9%). All patients received late PCI. Results : Most patients(88.1%) were men, and the median age was 58 years. The median follow-up duration was 18.1 months. During the follow-up period, 57.1% of the patients developed relapse. The most frequent site of relapse was chest(35.7%), followed by brain(14.3%), liver(11.9%), adrenal gland(44%), and bone(2.2%). With the Kaplan-Meier method, the average disease-free interval was 1,090 days(median 305 days). The average time to development of brain relapse after PCI and other sites relapse(except brain) were 2,548 days and 1,395 days(median 460 days), respectively. The average overall survival was 1,233 days(median 634 days, 21.1 months), and 2-year survival rates was 41.7%. The average overall survival in the relapse group was 642 days(median 489 days) and in the no relapse group was 2,622 days(p<0.001). The average overall survival in the brain relapse group was 928 days(median 822 days) and in the no brain relapse group was 1,308 days(median 634 days)(p=0.772). In most patients(85.7%), relapse(except brain) or systemic disease was the usual cause of death. Brain matastasis was the cause of death in 14.3% of the cases. Conclusions : We may conclude that PCI reduces and delays brain metastasis in patients with limited small cell lung cancer who achieved complete remission. We found decreased survival in relapse group but, no significant survival difference was noted according to brain matastasis. And relapse(except brain) or systemic disease was the usual cause of death. In order to increase survival, new treatment strategies for control methods for relapse and systemic disease are required.

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Clinical Characteristics and Adherence of Patients Who Were Prescribed Home Oxygen Therapy Due to Chronic Respiratory Failure in One University Hospital: Survey after National Health Insurance Coverage (한 대학병원에서 조사된 재택산소요법을 받고 있는 환자의 특성과 재택산소요법 처방에 대한 순응도: 건강보험급여전환 후 조사)

  • Koo, Ho-Seok;Song, Young Jin;Lee, Seung Heon;Lee, Young Min;Kim, Hyun Gook;Park, I-Nae;Jung, Hoon;Choi, Sang Bong;Lee, Sung-Soon;Hur, Jin-Won;Lee, Hyuk Pyo;Yum, Ho-Kee;Choi, Soo Jeon;Lee, Hyun-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.192-197
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    • 2009
  • Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.