• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2691-2703
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• 2015

This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

• Journal of the Korean Society of Radiology
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• v.12 no.7
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• pp.895-908
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• 2018

As modern science is developed and advanced, examination and number of times using radiation are increasing daily. General diagnostic X-ray generator is installed on stationary form, But X-ray generator was developed because patient who is in the intensive care unit, operation room, emergency room can not move to general x-ray room. What we examine patient by x-ray generator is certainly necessary, So patient exposure is inevitable. but reducing radiation exposure is highly important matter about radiation technology, guardian, patient in the same hospital room, nurse etc. For this reason, rule regarding safety control of diagnostic x-ray generator revised for radiation worker, patient and protector proclaim that mobile diagnostic x-ray shield must placed in case of examine different location excluding operation room, emergency room, intensive care unit. But, radiogical technologist is having a lot of difficulties to examine with mobile x-ray generator, diagnostic x-ray shield partition, image plate and lead apron. So, when we use x-ray generator, we manufacture shield tools can be attached to the mobile x-ray generator On behalf of x-ray shield partition and conduct analysis and in comparison to part of body and distribution of dose rate and find way to reduce radiation exposure through distribution of dose rate of patient within the radiogical technologist, medical team. Mobile x-ray generator aimed at SHIMADZU inc. R-20, We manufactured equipment for shielding x-ray scattered x-ray by installing shielding wall from side to side based on support beam on the mobile x-ray generator. Shielding wall when moving can be folded and designed to expand when examine. Experiment measured five times in each by an angle for dose rate of eyes, thyroid, breast, abdomen and gonad on exposure condition of upper and lower extremity, chest, abdomen which is examined many times by mobile x-ray generator. We used dosimeter RSM-100 made by IJRAD and measured a horizontal dose rate by body part. The result of an experiment, shielding decreasing rate of the front and the rear showed 77 ~ 98.7%. Therefore using self-production shielding wall reduce scattered x-ray occurrence rate and confirm can decrease exposure dose consequently. Therefore, through this study, reduction result which is used shielding wall of self-production will be a role of shielding optimization and it could be answer about reduction of medical exposure recommended by ICRP 103.

• Journal of Korean Public Health Nursing
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• v.10 no.2
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• pp.103-118
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• 1996

It is to be growing up the interest of community health affairs through visiting nursing care. The health medical treatment of Korea has been changed largely on the period. The juvenile population has decreased. This means that is has took the population consensus of advanced national organization to be increased by the old age. The transition of disease has changed from the contagious disease importance to the chronicity disease omportance because the domestic district population has experienced the sudden urbanization circumstance district population has experienced the sudden urbanization circumstance to be growing up $70\%$ of the whole population. When the nursing service has common function to be delivering from all direction to home, this study is getting the great important phase velocity in order to manage the kernel questional adult chronicity disease of health medical institution at the present age. (1) community over system or with people particularity (2) the first of third step medical treatments. The variety of medical treatments organization has quantity of the delivery manpower and specially between consumers and rdlated person. A qualitative difference is showed at the purpose to be seizing. That research related person is use at district health center in Seoul, by foundation on nurse registration book of H collage hospital and public health registration book. According the chronicity disease. age. and sex. nature agree-able standard 54 people took the content analysis on nurse registration book of total 108 people. The results of the study were as follows: 1. General background factors are houses or kind of medical facilities and number of patients in family. The first medical treatment is more patients than third medical treatment organization. The first medical treatment of economic environment os appering to be worse. 2. The chronicity disease frequency have been different speciality according to medical treatment organization. On case of the first medical treatment. Diabetes and High Blood Pressure were good but Cerebrum Vascular Accident(CVA) showed many for bed case. In addition. the number of family is comparative large exception of CVA on according for moving condition and health more than the first medical treatment. However. family condition. whole family percentage is decreasing preferably through the potential resource is increasing by the number of and the construction of family. The ability of real resource is considered to be low. 3. The average percentage of nurse service has appered to be differed two groups by the first step medical treatment(33.72 times) and third step medical treatment(45.70 times). However, the difference (the first step medical treatment and third step medical treatment) is to be limited to issue the medicine at the service. The condition of nurse care was the indirect nursing care. Supportiong area was to be related to volunteer service and administration support. 4. The various nursing care average percentage of the chronicity disease was increased by orders of Diabetes. High Blood Pressure. and CVA in examination result and the medical treatment. The indirect nursing care was also same. At third step medical treatment, orders of chronicity disease were same. The case of other area on service conditions were increased by order of Diabetes. High Blood Pressure, and CVA. However. it is never appearing the difference at bottleneck affairs nursing care. 5. When the visiting nursing care demand particularly. the average percentage of nursing care from the first step medical treatment that the time under a person is many more than the time over two people. However, there was no difference in statistic. Third step medical treatment is $49.81\%$ at the time under a person. The average nursing care service is appeared by more many when the visiting nursing care demand is a few by 12.83 at the time over two people. 6. By visiting nursing care percentage to be frequency that nursing care averaghe percentage and inter-relation are large. The related factor of the first medical treatment is 0.96. However, the related factor of third medical treatment has shown the decreased 0.49 for the condition of relation more than that. Therefore. the nursing care average percentage is related to the visiting times of a nurse. This result is be showing the obvious fact that the first step medical treatment is few more than third step medical treatment.

• Journal of Chest Surgery
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• v.37 no.4
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• pp.356-363
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• 2004

Esophageal cancer is an aggressive disease with a poor prognosis. Recently, every effort has been made to improve the long term survival, but the general prognosis for patients with this disease remains poor. In this study, we reviewed 8 years of experiences with esophageal cancer patients managed in our department at Dong-A University Hospital and evaluated the effectiveness of cervical lymph node dissection performed selectively. Material and Method: From January 1995 to August 2003, 70 patients underwent esophagectomy for esophageal cancer in our department. Among them, 51 patients who underwent curative resection, had no double primary tumors and no neoadjuvant therapy were analyzed retrospectively. In most patients, intrathoracic esophagectomy and cervical esophago-gastrostomy was performed. Since 1997, 3-field lymph node dissection was performed selectively. Result: There were 46 men and 15 women. The median age was 60 years. The tumor was located in the upper third part in 10 patients (19%), middle third in 21 (41%), and lower third in 20 (40%). Majority of the patients (90%) had squamous cell carcinoma. Cervical anastomosis was made in 41 patients, and intrathoracic anastomosis in 10. 2-field lymph node dissection was done in 40 patients, and 3-field lymph node dissection in 11. The pathologic staging were as follows: stage I in 9 patients (17.6%), IIA in 20 (39.2%), IIIB in 7 (13.7%), III in 11 (21.6%), IVA in 2 (3.9%), and IVB in 2 (3.9%). The in-hospital mortality was 3.9% (2 patients) and complications occurred in 24 patients (47%). Overall actuarial 1, 3, and 5-year survival rates were 74.4%, 48.4%, and 48.4% including operative mortality. The 4-year survival rate did not differ significantly between 3-field lymph node dissection group (50.5%) and 2-field lymph node dissection group (48.9%). In 3-field lymph node dissection group, the respiratory complications were more frequent and operative time was significantly longer. Conclusion: We think that curative resection for esophageal cancer can be performed with acceptable mortality, and aggressive surgical approach may improve the long term survival. even for advanced stages. Effectiveness of 3-field lymph node dissection needs further investigations.

• Korean Journal of Heritage :History & Science
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• v.45 no.3
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• pp.60-79
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• 2012

Environment of ancient Chinese Buddhist temple can be classified to three types such as regional society(鄕村), famous mountain(名山), and urban areas(都市). This made differences in environment where a temple existed and in turn, affected development of Buddhism. And this made another type in relationship between Buddhist temple and a society. This study explains influences which regional society gave on not only Buddhist temple and a monk but also existence and development of Buddhism. When temples are placed in different environmental position, that is, urban areas and regional society, among a social structure, they eventually should adapt to a different society externally and internally. As told in above, ancient Chinese Buddhist temple was located in regional society, famous mountain, and urban areas. Since Eastern Jin and Sixteen Kingdoms, as number of temple much increased, and temples and monks were concentrated on famous mountain, temples in famous mountains and urban areas had developed showing similar aspects each other. But because temples in regional society were influenced a little differently, this study focused on the point. There are four kinds of influences between temples and monks in regional areas. Monks in regional areas had a comparatively close relationship with a society because they came from same area or surrounding areas. Therefore,powers of regional areas restrict influences made by monk group in temple. Second, temples in regional areas shared their joys and sorrows depending on regional economy. Temples in regional areas became a public place for the society and often a market place. In fact, construction and existence of a temple originally became a driving force in regional economy. This is because construction of temple needs artisans and materials and some temples had visitors and included market economy like consumption of incense and candles, though the economic size was large or small. And when regional areas experienced natural disaster or man-made disaster or had poor harvest or economy was in depression, monks left temples and then, temples themselves could not exist. Third, the relationship between temples in regional areas and Buddhists was distinguished from the temples in urban areas and famous mountains. This is because temples in China were places where monks practiced and at the same time, places where general Buddhists worshipped. So there were always a number of Buddhists around the temples. Forth, Buddhism in resional areas was connected to regional Folk beliefs. As a result, Buddhism was spread across the nation, worship with local color often was changed to Buddhist belief or was tinged with Buddhism. While temples in regional areas maintained a close relationship with regional society.they were influenced by the region or gave influences. As a representative example, temples in regional areas showed model behaviors instead of roles of facilities related to various cultures with comparatively advanced level - for example, school, hospital etc. The temples highly affected funerary rites in regional areas. Chinese tombs were mainlymade in regional areas. After death,people living in urban areas were buried in hometown or at least, they were buried in suburbs not urban areas. Temples in regional areas generally participated in funerary rites. Above shows that though most of famous Buddhist temples were located in urban areas not in famous mountains,majority of temples were located in vast regional areas. Through mutual interaction between temples and regional society, the temples in the regional areas were related to Chinese people of over 90% and regional areas became the most important foundation for Buddhism in China. Mutual influences between temples in regional areas and the general public in regions were omnidirectional and spreaded to every aspects of social life in small or large degree. Thus Tombs in temple were widely spreaded across regional areas over time and space. This is enough to explain a close relationship between Buddhist temples and rural society in ancient China.

• The Korean Nurse
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• v.28 no.3
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• pp.52-67
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• 1989

True nursing care means total nursing care which includes physical, emotional and spiritual care. The modern nursing care has tendency to focus toward physical care and needs attention toward emotional and spiritual care. The total nursing care is mandatory for patients with terminal cancer and for this purpose, hospice care became emerged. Hospice case originated from the place or shelter for the travellers to Jerusalem in medieval stage. However, the meaning of modem hospice care became changed to total nursing care for dying patients. Modern hospice care has been developed in England, and spreaded to U.S.A. and Canada for the patients with terminal cancer. Nowaday, it became a part of nursing care and the concept of hospice care extended to the palliative care of the cancer patients. Recently, it was introduced to Korea and received attention as model of total nursing care. This study was attempted to assess the efficacy of hospice care. The purpose of this study was to prove a difference in terms of physical, emotional a d spiritual aspect between the group who received hospice care and who didn't receive hospice care. The subject for this study were 113 patients with advanced cancer who were hospitalized in the S different hospitals. 67 patients received hospice care in 4 different hospitals, and 46 patients didn't receive hospice care in another 4 different hospitals. The method of this study was the questionaire which was made through the descriptive study. The descriptive study was made by individual contact with 102 patients cf advanced cancer for 9 months period. The measurement tool for questionaire was made by author through the descriptive study, and included the personal religious orientation obtained from chung(originated R. Fleck) and 5 emotional stages before dying from Kubler Ross. The content ol questionaire consisted in 67 items which included 11 for general characteristics, 10 for related condition with cancer, 13 for wishes far physical therapy, 13 for emotional reactions and 20 for personal religious orientation. Data for this study was collected from Aug. 25 to Oct. 6 by author and 4 other nurse's who received education and training by author for the collection of data. The collected data were ana lysed using descriptive statistics, $X^2-test$, t-test and pearson correlation coefficient. Results of the study were as follows: "H.C Group" means the group of patient with cancer who received hospice care. "Non H.C Group" means the group of patient with cancer who did not receive hospice care. 1. There is a difference between H.C Group and Non H.C Group in term of the number of physical symptoms, subjective degree of pain sensation and pain control, subjective beliefs in physical cure, emotional reaction, help of present emotional and spiritual care from other personal, needs of emotional and spiritual care in future, selection of treatment method by patients and personal religious orientation. 2. The comparison of H.C Group and Non H.C Group 1) There is no difference in wishes for physical therapy between two groups(p=.522). Among Non H.C Group, a group, who didn't receive traditional therapy and herb medicine was higher than a group who received these in degree of belief that the traditional therapy and herb medicine can cure their disease, and this result was higher in comparison to H.C Group(p=.025, p=.050). 2) Non H.C Group was higher than H.C Group in degree of emotional reaction(p=.050). H.C Group was higher than Non H.C Group in denial and acceptant stage among 5 different emotional stages before dying described by Kubler Ross, especially among the patient who had disease more than 13 months(p=.0069, p=.0198). 3) Non H.C Group was higher than H. C Group in demanding more emotional and spiritual care to doctor, nurse, family and pastor(p=. 010). 4) Non H.C Group was higher than H.C Group in demanding more emotional and spiritual care to each individual of doctor, nurse and family (p=.0110, p=.0029, P=. 0053). 5) H.C Group was higher th2.n Non H.C Group in degree of intrinsic behavior orientation and intrinsic belief orientation of personal religious orientation(p=.034, p=.026). 6) In H.C Group and Non H.C Group, the degree of emotional demanding of christians was significantly higher than non christians to doctor, nurse, family and pastor(p=. 000, p=.035). 7) In H.C Group there were significant positive correlations as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and: the degree of intrinsic behavior orientation in personal religious orientation(r=. 5512, p=.000). (2) Between the degree of emotional demandings to doctor, nurse. family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.4795, p=.000). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic: belief orientation in personal religious orientation(r=.8986, p=.000). (4) Between the degree of extrinsic religious orientation and the degree of consensus religious orientation in personal religious orientation (r=. 2640, p=.015). In H.C. Group there were significant negative correlations as following; (1) Between the degree of intrinsic behavior orientation and extrinsic religious orientation in personal religious orientation (r=-.4218, p=.000). (2) Between the degree or intrinsic behavior orientation and consensus religious orientation in personal religious orientation(r=-. 4597, p=.000). (3) Between the degree of intrinsic belief orientations and the degree of extrinsic religious orientation in personal religious orientation(r=-.4388, p=.000). (4) Between the degree of intrinsic belief orientation and the degree of consensus religious orientation in personal religious orientation(r=-. 5424, p=.000). 8) In Non H.C Group there were significant positive correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic behavior orientation in personal religious orientation(r= .3566, p=.007). (2) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.3430, p=.010). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic belief orientation in personal religious orientation(r=.9723, p=.000). In Non H.C Group there were significant negative correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of extrinsic religious orientation in personal religious orientation(r= -.2862, p=.027). (2) Between the degree of intrinsic behavior orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5083, p=.000). (3) Between the degree of intrinsic belief orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5013, p=.000). In conclusion above datas suggest that hospice care provide effective total nursing care for the patients with terminal cancer, and hospice care is mandatory in all medical institutions.

• Childhood Kidney Diseases
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• v.10 no.1
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• pp.8-17
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• 2006

Purpose : We describe the changes of rat glomerular epithelial cells when exposed to high levels of glucose and advanced glycosylation endproducts(AGE) in the in vitro diabetic condition. We expect morphological alteration of glomerular epithelial cells and permeability changes experimentally and we may correlate the results with a mechanism of proteinuria in DM. Methods : We made 0.2 M glucose-6-phsphate solution mixed with PBS(pH 7.4) containing 50 mg/mL BSA and pretense inhibitor for preparation of AGE. As control, we used BSA. We manufactured and symbolized five culture dishes as follows; B5 - normal glucose(5 mM) + BSA, B30 - high glucose(30 mM) + BSA, A5 - normal glucose(5 mM) + AGE, A30 - high glucose(30 mM) + AGE, A/B 25 - normal glucose(5 mM) + 25 mM of mannitol(osmotic control). After the incubation period of both two days and seven days, we measured the amount of heparan sulfate proteoglycan(HSPG) in each dish by ELISA and compared them with the B5 dish at 2nd and 7th incubation days. We observed the morphological changes of epithelial cells in each culture dish using scanning electron microscopy(SEM). We tried the permeability assay of glomerular epithelial cells using cellulose semi-permeable membrane measuring the amount of filtered BSA through the apical chamber for 2 hours by sandwich ELISA. Results : On the 2nd incubation day, there was no significant difference in the amount of HSPG between the 5 culture dishes. But on the 7th incubation day, the amount of HSPG increased by 10% compared with the B5 dish on the 2nd day except the A30 dish(P<0.05). Compared with the B5 dish on the 7th day the amount of HSPG in A30 and B30 dish decreased to 77.8% and 95.3% of baseline, respectively(P>0.05). In the osmotic control group (A/B 25) no significant correlation was observed. On the SEM, we could see the separated intercellular junction and fused microvilli of glomerular epithelial cells in the culture dishes where AGE was added. The permeability of BSA increased by 19% only in the A30 dish on the 7th day compared with B5 dish on the 7th day in the permeability assay(P<0.05). Conclusion: We observed not only the role of a high level of glucose and AGE in decreasing the production of HSPG of glomerular epithelial cells in vitro, but also their additive effect. However, the role of AGE is greater than that of glucose. These results seems to correlate with the defects in charge selective barrier. Morphological changes of the disruption of intercellular junction and fused microvilli of glomerular epithelial cells seem to correlate with the defects in size-selective barrier. Therefore, we can explain the increased permeability of glomerular epithelial units in the in vitro diabetic condition.

• Radiation Oncology Journal
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• v.20 no.3
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• pp.221-227
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• 2002

Purpose : To evaluate the role of postoperative chemoradiotherapy in locally advanced rectal cancer, we retrospectively analyzed the treatment results of patients treated by curative surgical resection and postoperative chemoradiotherapy. Materials and Methods : From April 1989 through December 1998, 119 patients were treated with curative surgery and postoperative chemoradiotherapy for rectal carcinoma in Gyeongsang National University Hospital. Patient age ranged from 32 to 73 years, with a median age of 56 years. Low anterior resection was peformed in 59 patients, and abdominoperineal resection in 60. Forty-three patients were AJCC stage II and 76 were stage III. Radiation was delivered with 6 MV X rays using either AP-PA two fields, AP-PA both lateral four fields, or PA both lateral three fields. Total radiation dose ranged from 40 Gy to 56 Gy. In 73 patients, bolus infusions of 5-FU $(400\;mg/m^2)$ were given during the first and fourth weeks of radiotherapy. After completion of radiotherapy, an additional four to six cycles of 5-FU were given. Oral 5-FU (Furtulone) was given for nine months in 46 patients. Results : Forty $(33.7\%)$ of the 119 patients showed treatment failure. Local failure occurred in 16 $(13.5\%)$ patients, 1 $(2.3\%)$ of 43 stage II patients and 15 $(19.7\%)$ of 76 stage III patients. Distant failure occurred in 31 $(26.1\%)$ patients, among whom 5 $(11.6\%)$ were stage II and 26 $(34.2\%)$ were stage III. Five-year actuarial survival was $56.2\%$ overall, $71.1\%$ in stage II patients and $49.1\%$ in stage III patients (p=0.0008). Five-year disease free survival was $53.3\%$ overall, $68.1\%$ in stage II and $45.8\%$ in stage III (p=0.0006). Multivariate analysis showed that T stage and N stage were significant prognostic factors for five year survival, and that T stage, N stage, and preoperative CEA value were significant prognostic factors for five year disease free survival. Bowel complication occurred in 22 patients, and was treated surgically in 15 $(12.6\%)$, and conservatively in 7 $(5.9\%)$. Conclusion : Postoperative chemoradiotherapy was confirmed to be an effective modality for local control of rectal cancer, but the distant failure rate remained high. More effective modalities should be investigated to lower the distant failure rate.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.27-34
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• 1992

Cis-Platinum (DDP) was utilized as a radiosensitizer in a pilot study for stage III and IV squamous cell carcinoma between 1984-1987, and DDP 20 $mg/M^2$/day was administered for 4 days at 3 week interval with concurrent radiotherapy. This study consisted of three phases: cytoreduction phase, eradicative treatment phase and adjuvant phase. Total 59 patients were subjected to evaluate a tumor response and its toxicity. During the eradicative phase,27 patients underwent surgery (group I ), 29 patients were treated with radiotherapy only (group II) and 3 patients did not complete the second phase of therapy. At the cytoreduction phase, $95\%$ response rate with complete response (CR) $47.5\%$ and partial response (PR) $47.5\%$ was observed. Complete tumor clearance (CTC) rate following 2nd phase of therapy was $84\%$ (47/56) with 26/27($96\%$) in group I achieved CTC with surgery and 21/29 ($72\%$) patients In group II achieved CTC following 2nd phase. $67\%$ of primary lesions and $70\%$ of nodal diseases in group I showed no tumor in the surgical specimen. $34\%$ of patiets who achieved CTC at 2nd phase developed recurrence and median time to recur was 8 months. Actuarial disease free survival at 4 years was $59\%$ and $51\%$(24/27) of patients who achieved CTC at 2nd phase were alive without any evidence of disease at median follow-up 31 months (range, 10-48 months). There was no significant difference in overall and disease free survival between group I and II between CR and PR group following 1st Phase. Only significant Prognostic factor in this study was the complete tumor clearance following 2nd phase theapy. In general, toxicity was not excessive. Author concludes that this study confirmed the significant radiosensitizing effect of DDP with the acceptable toxicity and warrant the prospective study to determine optimum scheduling for DDP and radiotherapy which maximizes the therapeutic gain.

• Radiation Oncology Journal
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• v.5 no.1
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• pp.31-36
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• 1987

Radiobiological and clinical evidences indicate that hyperthermia combined with ionizing radiation produces a significant improvement in therapeutic effect of cancer. In general, malignant cells are more sensitive to heat than normal cells in the heat range of $41\~45^{\circ}C$. We report the experiences obtained from 42 patients with advanced malignant neoplasms managed with 2,450MHz microwave-induced local hyperthermia and ionizing radiation at the Department of Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. A clinical analysis of 42 thermoirradiated patients showed result of 11(26\%),\;15(36\%),\;11(26\%)\;and\;5(12\%)$ patients with complete response (CR), partial response (PR), minor response (MR) and no response (NR), respectively. Histologically there were $17(40.2\%)$ squamous cell carcinomas, $12(28.6\%)$ adenocarcinomas and $6(14.3\%)$ miscellaneous cancers. Eleven patients with CR consisted of five squamous cell carcinomas, five adenocarcinomas, and one chloroma. Among 15 patients with PR were five squamous cell carcinomas, five adenocarcinomas, three unknown primary tumors, and one poorly differentiated, and miscellaneous tumor each.