• Radiation Oncology Journal
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• v.13 no.1
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• pp.19-26
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• 1995

Purpose : Surgery is the treatment of choice for resectable non-small cell lung cancer. For patients who are medically unable to tolerate a surgical resection or who refuse surgery, radiation therapy is an acceptable alternative. A retrospective analysis of Patients with stage I non-samll cell lung cancer treated with curative radiation therapy was performed to determine the results of curative radiation therapy and patterns of failure, and to identify factors that may influence survival. Materials and Methods : From 1986 through 1993, 39 Patients with T2N0M0 non-small cell lung cancer were treated with curative radiation therapy at department of radiation oncology, Kyungpook national university hospital. All Patients were not candidates for surgical resection because of either Patient refusal (16 patients), poor pulmonary function (12 patients), old age (7 patients), Poor Performance (2 patients) or coexisting medical disease (2 patients). Median age of patients was 67 years. Histologic cell type was squamous cell carcinoma in 36, adenocarcinoma in 1, large cell carcinoma in 1 and mucoepidermoid carcinoma in 1. All patients were treated with megavoltage irradiation and radiation dose ranged from 5000cgy to 6150cGy with a median dose of 6000cGy. The median follow-up was 17 months with a range of 4 to 82 months, Survival was measured from the date therapy initiated. Results : The overall survival rate for entire Patients was $40.6\%$ at 2 years and $27.7\%$ at 3 years, with a median survival time of 21 months. The disease-free survival at 2 and 3 years was $51.7\%$ and $25.8\%$, respectively. Of evaluable 20 patients with complete response, 15 patients were considered to have failed. Of these, 13 patients showed local failure and 2 patients failed distantly. Response to treatment (p=0.0001), tumor size (p=0.0019) and age (p=0.0247) were favorably associated with overall survival. Only age was predictive for disease-free survival (p = 0.0452). Conclusion : Radiation therapy is an effective treatment for small (less than 3cm) tumors, and should be offered as an alternative to surgery in elderly or infirm patients. Since local failure is the prominent Patterns of relapse, potential methods to improve local control with radiation therapy are discussed.

• 한국HCI학회:학술대회논문집
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• 2008.02a
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• pp.823-828
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• 2008

This study set out investigate what kind of changes would be caused to the craving of alcohol dependent patients by stimuli through virtual reality in the preparation stage for drinking refusal training. With regard to stimulation, it included alcohol exposure, a positive situation, and a negative situation on the basis of drinking encouraging situations(social pressure) known as drinking stimulating situations for alcoholics. The purpose of the study is to provide fundamental materials for the development of new training programs to refuse alcohol and for the examination of the possibility of utilizing virtual reality technology as a new treatment and training tool for alcoholics. To this end, a virtual reality program was conducted involving 12 alcoholics admitted to Severance Mental Health Hospital in Gyeonggi province from December 2006 to September 2007. The data was dealt with various statistic analyses such as frequency analysis, Wilcoxon Matched-pairs Signed-Ranks Test using SPSS/WIN 11.5 The analysis results indicate that avatars encouraging drinking caused more craving than just the background, that the scenes with alcohol exposed caused more craving than the scenes with no alcohol exposed, and that there were no significant changes to craving according to a positive or negative situation. The results confirmed that training sessions using virtual reality presented a situation and environment of drinking pressure that's similar to the actual social pressure and that the virtual reality approach had enormous potential as an effective treatment tool when combined with the existing treatment techniques.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.192-201
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• 2000

The purpose of study was to investigate the oral health care status in institutions and special schools for the disabled in Korea. Nurses in 123 institutions and nurse-teachers in 102 special schools were asked to fill questionnaires regarding periodic oral examination, preventive dental programs. and dental treatment. The results of this study were as follow. 1. 56.8% of institutions implemented regular oral examinations and all of special schools did it twice a year. 2. Preventive programs for dental caries were done in 69.1% of the institutions and 86.3% of the special schools. Programs included regular toothbrushing and dental health education. 3. Dental treatment was done in 84.2% of the institutions and 39.2% of the special schools. Institutions utilized private dental clinics(60.2%), public health centers(16.8%), volunteers(15.3%), and dental hospitals. 4. 17.7% of the institutions experienced the refusal to treat the disabled by private dental clinics.

• Journal of Digital Convergence
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• v.19 no.10
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• pp.21-28
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• 2021

This study examines factors affecting correction officer's preference toward institute for forensic psychiatric. The data were collected from the correction officers who worked at the six correctional facilities in 2019. Binary logistic regression was used to find the factors on the officer's preference. The result showed that the correction officers had their own preference toward prison for forensic psychiatric, and the preference was positively related to the age of the officer, work experience at the mental health center, mentally-ill prisoner's fighting as the rule-violation in prison, refusal of medical treatment, and lack of laws and regulations for the mentally-ill prisoners. In contrast, there was a negative relationship between the officer's rank and the preference for forensic psychiatric. More work needs to be done in the future research to collect more samples and include a broader ranger of variables than now.

• The Korean Society of Law and Medicine
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• v.24 no.1
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• pp.67-98
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• 2023

In the early stages of the COVID-19 pandemic, Korea took the lead in implementing "social distancing" policies more strongly than other countries. In addition to making it mandatory to wear a mask according to the policy, all patients using medical institutions are tested for COVID-19 to prevent Healthcare-Associated Infections, and only those patients who test negative have been regulated to receive face-to-face medical treatment. In this process, situations such as the disabled, who have difficulty wearing masks, were not taken into account, and emergency patients did not receive timely treatment or surgery from medical personnel. In response, the National Human Rights Commission of Korea has decided that forcing everyone to wear a mask and restricting access to medical institutions constitutes discrimination against the disabled. Therefore, the purposes this study has that, the first is to review cases of human rights discrimination against persons with disabilities due to measures to prevent the transmission of infectious diseases that did not consider the characteristics of persons with disabilities in the COVID-19 situation and issues regarding the decisions of the National Human Rights Commission of Korea, the second is to find a reasonable plan and the need for measures to prevent refusal of treatment by medical institutions for the disabled who have difficulty wearing masks.

• Pediatric Infection and Vaccine
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• v.11 no.1
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• pp.81-89
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• 2004

Purpose : Retropharyngeal and parapharyngeal abscesses are often distinguishable from other head and neck abscesses on clinical grounds, but these infections can combine and the presentations are similar to one another. Because of the advances of antibiotic therapy, the frequency of the diseases decreased considerably, but recently the incidence of neck abscesses has increased. We sought to describe the clinical presentation of patients with deep neck abscess, and implications on management. Methods : For 10 year periods, 94 cases of charts were reviewed retrospectively, who were diagnosed as neck abscesses aged below 16 years old(between January 1993 to August 2003) in 4 hospitals. Deep neck abscesses were diagnosed by surgical pus drainage, neck CT (homogenous, hypodense area with ring enhancement) and neck sono findings. Results : The annual incidence of deep neck abscess has been increased since 2000. The median age of the patients was 4 years(range, 26 days~15 years); 63% of the patients were younger than 5 years. Abscesses in the submandibular space(34%) were most common, followed by peritonsillar space(29.7%), retropharyngeal space(11.7%), combined(10.8%), parotid space(7.4%) and parapharyngeal space(6.4%). Fever(73.4%), sore throat(37.2%), decreased oral intake(34%) and neck pain(27.7%) were the most common symptoms. In 6 children(6.4%), there was refusal to move neck, in 6(6.4%) headache, and in 4(4.3%) torticollis. Respiratory distress was observed in only 1 patient(2.1%) and stridor in 1 other(2.1%). The most common physical examinations were neck swelling/mass(67%), pharyngitis(46.8%), tonsillitis(36.2 %), and cervical lymphadenopathy(28.7%). Neck stiffness was observed in 4 patients(4.3%). Total 35 organisms were isolated in 33 patients. The most common organisms cultured by patients' blood or pus were S. aureus(34%) and S. pyogenes(28.6%). Most organisms were gram positive, and had sensitivities in vancomycin(96.4%), cefotaxime(88.9%), cephalothin (86.4%), trimethoprime-sulfamethoxazole(83.3%), and clindamycin(77.8%). 77 patients(81.9%) underwent surgery plus antibiotics; 17 patients(18.1%) were treated with antibiotics only. There is no significant differences between two groups. In duration of admission, fever after admission, and antibiotic treatment. Conclusion : The incidence of deep neck abscess has increased recently and the major symptoms have been changed. The incidence of respiratory distress or stridor is decreasing, while the incidence of abnormal head and neck symptoms and signs like headache, neck stiffness, refusal to move neck, or torticollis are increasing. Gram positive organisms are predominant, S. aureus is the most common followed by S. pyogenes. 1st generation cephalosporin has high sensitivity on gram positive organisms. Treatment with surgery plus antibiotics dose not significantly decrease total duration of antibiotic treatment or admission compared to treatment with antibiotics alone.

• Tuberculosis and Respiratory Diseases
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• v.57 no.6
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• pp.557-566
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• 2004

Background : To find out effectiveness of multimodality treatments based on induction chemotherapy(CTx) in patients with clinical stage IIIA NSCLC Methods : From 1997 to 2002, 74 patients with clinical stage IIIA NSCLC underwent induction CTx at the hospital of Chungnam National University. Induction CTx included above two cycles of cisplatin-based regimens(ectoposide, gemcitabine, vinorelbine, or taxol) followed by tumor evaluation. In 30 complete resection group, additional 4500-5000cGy radiotherapy(RTx) was delivered in 15 patients with pathologic nodal metastasis. 29 out of 44 patients who were unresectable disease, refusal of operation, and incomplete resection were followed by 60-70Gy RTx in local treatment. Additional 1-3 cycle CTx were done in case of induction CTx responders in both local treatment groups. Results : Induction CTx response rate were 44.6%(complete remission 1.4% & partial response 43.2%) and there was no difference of response rate by regimens(p=0.506). After induction chemotherapy, only 33 out of resectable 55 ones(including initial resectable 37 patients) were performed by surgical treatment because of 13 refusal of surgery by themselves and 9 poor predicted reserve lung function. There were 30(40.5%) patients with complete resection, 2(2.6%) persons with incomplete resection, and 1(1.3%) person with open & closure. Response rate in 27 ones with chest RTx out of non-operation group was 4.8% CR and 11.9% PR. In complete resection group, relapse free interval was 13.6 months and 2 year recur rate was 52%. In non-complete resection(incomplete resection or non-operation) group, disease progression free interval was 11.2 months and 2 year disease progression rate was 66.7%. Median survival time of induction CTx 74 patients with IIIA NSCLC was 25.1months. When compared complete resection group with non-complete resection group, the median survival time was 31.7 and 23.4months(p=0.024) and the 2-year overall survival rate was 80% and 41%. In the complete resection group, adjuvant postoperative RTx subgroup significantly improved the 2-year local control rate(0% vs. 40%, p= 0.007) but did not significantly improve overall survival(32.2months vs. 34.9months, p=0.48). Conculusion : Induction CTx is a possible method in the multimodality treatments, especially followed by complete resection, but overall survival by any local treatment(surgical resection or RTx) was low. Additional studies should be needed to analysis data for appropriate patient selection, new chemotherapy regimens and the time when should RTx be initiated.

• Korean Journal of Social Welfare
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• v.65 no.4
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• pp.61-88
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• 2013

The aim of this study was to explore the work experiences of hospital-based child protection team staffs who had intervened the child abuse cases resulting in death. In order to gather the relevant data, all 62 child protection teams registered nationwide were contacted and 5 teams which had actually experienced at least one child abuse deaths were found. The staffs (hospital social workers and doctors) who belonged to these teams were intensively interviewed, and the interviewed materials were thoroughly analyzed by qualitative research methodology. The result showed that treatment delay was the most important obstacle to prevent unnecessary deaths of the victims. Some abused victims were sent to the hospital only after their physical condition had so gravely deteriorated. In other cases, custodians' bland denial or refusal to treatment made impossible the timely intervention to save the child lives. Nevertheless, child protection team staffs' reasonable suspicion and active intervention could sometimes uncover the hidden truth that child abuse was the actual cause of death. These incidents were regarded as a team's meaningful accomplishments by team members. Meanwhile, lack of awareness and excessive burden about the role and responsibility of mandated reporter precluded medical staffs' active involvement. Also, substantiating the abuse suspicion by securing positive evidences was found to be a facilitatory factor for the rapid public intervention. On the basis of these results, several practice and policy implications were discussed to improve the early detection process, securing evidence and uncovering the actual cause of death in child abuse deaths.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.662-668
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• 2000

Background: Many recent results of clinical trials show that pre-operative concurrent chemoradiotherapy and surgical resection could increase the survival of N2 positive stage IIIA non-small cell lung cancer. This study was performed to assess the feasibility, toxicity, and affect rates of concurrent chemoradiotherapy and surgical resection in N2 positive stage IIIA non-small cell lung cancer. Material and Method: Thirty-one patients who underwent preoperative concurrent chemoradiotherapy for N2 positive stage IIIA non-small-cell lung cancer from May 1997 to April 1999 were entered into the study. Mean age was 61 yrs(43∼70 yrs), There were 24 men and 7 women. The confirmation of N2 disease were achieved through mediastinoscopic biopsy(24) and CT scans(7). Induction was achieved by two cycles of cisplatin and etoposide(EP) plus concurrent chest radiotherapy to 45 Gy. Resections were done at 3 weeks after the complection of preoperative concurrent chemoradiotherapy. Resections were performed in 23 patients, excluding 5 refusals and 3 distant metastasis. Result: All patients were compled the thoracic radiotherapy except one who had distant metastasis. Twenty three patients were completed the planned 2 cycles of EP chemotherapy, and 8 patients were received only 1 cycle for severe side effects(6), refusal(1), and distant metastasis(1). There was one postoperative mortality, and the cause of death was ARDS. Three patients who had neutropenic fever and one patient who had radiation pneumonitis were required admission and treatment. Esophagitis was the most common acute side effect, but relatively well-tolerated in most patients. The complection rate of concurrent chemoradiotherapy was 74%, resection rate was 71%, pathologic complete remission rate was 13.6%, and pathologic down-staging rate was 68%. Conclusion: Morbidity related to each treatment was acceptable and many of the patients have benefited down staging of its disease. Further prospective, preferably randomized, clinical trials of larger scale may be warranted to confirm the actual benefit of preoperative concurrent chemoradiotherapy and surgical resection in N2-positive stage IIIA non-small cell lung cancer.

• Korean Journal of Family Social Work
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• no.55
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• pp.91-128
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• 2017

The purpose of this study is to develop an effective intervention strategy for marriage migrant woman in family therapy. For this purpose, we collected counseling cases of professional counselors who successfully completed counseling and attempted the qualitative analysis of treatment intervention strategies and effects. The results of the study were obtained by dividing the meaning units in the immigrant woman's statements made during the counseling process composed of a total of 6 sessions. The counselors were analyzed to have tried the following intervention strategies. They attempted the following six strategies: Helping emotional differentiation by searching for unresolved emotional problems, dealing with undifferentiation due to family projection process and love triangle, dealing with multi-generational transfer process of the original family relationship patterns and coping mechanism, shedding lihgt on ineffectiveness of inconsistent communication due to emotional oppression applying a communication model of MRI, switching client's awareness through reorganization, suggesting a way of communication that leads to real self. Such counselors' attempts resulted in positive changes and treatment effects were found to include first, cognitive insights and motivation for change, second, improved communication skills and third, anxiety reduction and self-differentiation. Due to their husbands' refusal to participate in counseling, marriage migrant women often get involved in counseling alone, so they tend to worry that the effectiveness of family therapy may be low but it was found that the proper intervention of the counselor could improve the ability of the wife to resolve conflicts, which would be a great help in solving problems such as family violence and this study is meaningful in that it provided the appropriate therapeutic intervention strategies needed.