• Radiation Oncology Journal
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• v.26 no.1
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• pp.1-9
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• 2008

Purpose: To evaluate the impact of postoperative radiotherapy on loco-regional failure in patients with vulvar carcinoma and to determine the treatment strategy for inguinal lymph nodes. Materials and Methods: Sixty-six patients who received treatment for primary vulvar carcinoma at Seoul National University Hospital, from October 1979 through June 2004, were retrospectively analyzed. Sixteen patients were excluded from the analysis due to the following reasons: distant metastases in two patients; palliative intent for six patients; previous radiotherapy given to the pelvis in three patients; follow-up loss after surgery for four patient; insufficient medical records for one patient. Of 50 eligible patients, 35 were treated with surgery alone(S), ten were treated with surgery followed by radiotherapy(S+RT), and five were treated with radiotherapy alone. Results: The 5-year overall survival(OS) and disease-free survival(DFS) rates of all patients were 91% and 78%, respectively. Twelve patients(26%) experienced treatment failures and the sites of initial failure were as follows: a primary site in eight patients; regional lymph nodes in three patients; the lung in one patient. Although risk factors for failure were more common in the S+RT group than the S group of patients(p<0.05), the DFS rates were similar for the two groups(5-year DFS rates, 78% vs. 83%, p=0.66). The incidences of occult lymph node metastases was 10%. Ten of 31 patients with clinically negative lymph nodes did not received inguinal lymph node dissection, but no patient experienced regional failure. Conclusion: Postoperative radiotherapy may have a potential benefit for patients with risk factors for failure. The omission of inguinal dissection or elective radiotherapy to the inguinal lymph nodes may be considered in low-risk patients with clinically negative lymph nodes.

• Journal of Preventive Medicine and Public Health
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• v.26 no.3 s.43
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• pp.359-370
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• 1993

To identify the smoking status and its related factors in middle and high school boys in Kwanju a study was performed from 15th to loth of June 1992. Population were selected by two-stage stratified random sampling method and total 3,959 students replied to the self-administered questionnaire survey (1,574 in middle school, 1,664 in academic high school, 712 in business high school). The results were as follows ; 1. The proportion of current smokers was 1.5% in middle schools and 20.1% in high schools. And the smoking rates increased with school grade years (p<0.01). 2. For the motivation of smoking, curiosity was the most frequent factor and the next was temptation by friends. 3. The most common situation on the first experience of smoking was that middle school boys smoked a cigarette which was found in a house, through curiosity, with friends, at home. High school boys smoked a cigarette taken from friends, through curiosity, with friend, on the road or at home. 4. The proportion of smokers who smoke a cigarette regularly was 34.8% among smokers in middle school and 70.2% among smokers in high school. The most proportion of duration of smoking was less than 1 month among middle school boys (20.8%) and more than 2 years among high school boys (43.9%). The first smoking experience was in elementary school among middle school boys and the third grade of middle school in high school students. Most current smokers (73.9% in middle school boys, 65.3% in high school boys) wanted to quit smoking. 5. Smokers had significant association with intimate friend's smoking, mother's and brother's smoking, inharmonious friendships, dissatisfied with home and school life, lower school grades, generous attitude to other smokers, lack of knowledge to passive smoking and no contact to mass media (TV) (p<0.01).

• Radiation Oncology Journal
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• v.11 no.2
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• pp.267-275
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• 1993

Eighty five patients of oral cavity cancer, treated with radiation at the Department of Therapeutic Radiology, Korea Cancer Center Hospital, during the period from March 1985 to September 1990 were analyzed retrospectively. Among 85 patients, 37 patients were treated with radiation only and 48 patients were treated with radiation following surgery. And 70 patients received external irradiation only by $^{60}Co$ with or without electron, the others were 7 patients for external irradiation plus interstitial implantation and 8 patients for external irradiation plus oral cone electron therapy. Primary sites were mobile tongue for 40 patients, mouth floor for 17 patients, palate for 12 patients, gingiva including retromolar trigone for 10 patients, buccal mucosa for 5 patients, and lip for 1 patient. According to pathologic classification, squamous cell carcinoma was the most common (77 patients). According to AJC TNM stage, stage I + II were 28 patients and stage III+IV were 57 patients. Acturial overall survival rate at 3 years was $43.9\%,$ 3 year survival rates were $60.9\%$ for stage I + II, and $23.1\%$ for stage III+IV, respectively. As a prognostic factor, primary T stage was a significant factor (p<0.01). The others, age, location, lymph node metastasis, surgery, radiation dose, and cell differentiation were not statistically significant. Among those factors, radiation plus surgery was more effective than radiation only in T3+T4 or in any N stage although it was not statistically sufficient (p<0.1). From those results, it was conclusive that definitive radiotherapy was more effective than surgery especially In the view of pertainig of anatomical integrity and function in early stage, and radiation plus surgery was considered to be better therapeutic tool in advanced stage.

• Neonatal Medicine
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• v.17 no.1
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• pp.53-63
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• 2010

Purpose : Extrauterine growth restriction (EUGR) in preterm infants is a major problem in neonatal intensive care units (NICUs) and it has been related to long-term growth deficit and neurodevelopmental issues. The aim of this study was to investigate the frequency of and risk factors for EUGR. Methods : The study subjects consisted of very low birth weight (VLBW) infants with a gestational age $\leq$32 weeks that were born at the Seoul National University Children's Hospital between November 2005 and April 2009. EUGR was defined as weight for gestation, lower than the 10th percentile on discharge. Results : The frequency of EUGR was 67% (n=111/166). By multiple logistic regression, the presence of small for gestational age (SGA) was the greatest predictor of EUGR, birth weight and daily weight gain during the first 28 days were independent predictors of EUGR. Risk factors for EUGR in non-SGA infants were evaluated because 56% (64/114) of non-SGA infants developed EUGR at discharge. Daily weight gain in the first 28 days was also decreased in EUGR group and independently predicted the risk of EUGR in the non-SGA group. Conclusion : EUGR was a common problem in the NICU. SGA was the most significant predictive factor of the EUGR. Half of the non-SGA infants also developed EUGR, revealing poor weight gain in the early days was as an important predictor. These results support the importance of early nutritional intervention for weight gain which have lagged behind other modern therapeutic interventions when the infant is clinically unstable.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.214-220
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• 2004

Purpose: As for the malignant bowel obstruction of terminal cancer patient, a prognosis is relatively bad. Physicians consider palliative procedures or surgery for the quality of life, but sometimes it is hard to decide. After diagnosis of a malignant bowel obstruction in terminal cancer patients, we investigated the clinical characteristics, the prognostic factors and the survival of patients with palliative procedures or surgery. Methods: we retrospectively reviewed the medical records in 40 malignant bowel obstruction patients who had been diagnosed as terminal cancer from May in 2002 to May in 2004. Results: There were 21 males (53%) and 19 females (47%), and median age of patients was $64.1{\pm}1.58$ years. The most common cause of malignant bowel obstruction was colorectal cancer (18 patients, 45%), followed by stomach cancer (11, 28%), pancreatic cancer (4, 10%), others (7, 19%). Metastases were carcinomatosis peritonei (14 patients, 35%), liver (13, 33%). During a bowel obstruction, symptoms were vomiting (15 patients, 38%), abdominal pain (10, 25%), constipation (6, 15%), abdominal distension (5, 13%). Performance status (ECOG) was 2 score (16 patients, 40%), 3 score (20, 50%), 4 score (4, 10%). Palliative procedure group were 30 patients, the others 10. Median survival in palliative procedure group was 142 days, that of no palliation group 30. Median survival time of palliative procedure group from palliative procedures or surgery were significantly higher than that of no palliation group from diagnosis of malignant bowel obstruction. Prognostic factors of palliative procedure group were PS, site of obstruction and primary cancer. Median survival in PS 2, lower GI obstruction and colorectal cancer was higher than PS 3, upper GI obstruction and others, respectively. Conclusion: we recommend aggressively palliative procedures or surgery in malignant bowel obstruction patients diagnosed with terminal cancer if palliative procedures or surgery could be performed effectively.

• Tuberculosis and Respiratory Diseases
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• v.65 no.4
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• pp.292-300
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• 2008

Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was $60.3{\pm}15.6$ years and 34.0% were female. The initial mean APACHE III score was $72.3{\pm}25$. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score >70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure.

• The Korean Journal of Mycology
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• v.39 no.3
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• pp.164-170
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• 2011

Amanita hemibapha is a kind of mycorrhizal mushroom which has a relation with host plants and environmental factors. For the purpose of studying the relationship between environmental factors and mushrooms, in this study we conducted to investigate the soil physicochemical properties, the distribution of plants and the diversity of mushrooms in Gwangyang, Chungdo and Daegu. Soil texture in habitate of Amanita hemibapha was Sandy Loam and Sandy Clay Loam which contains a high rate of sand. Soil pH was approximately 5.0 in all study sites. Total nitrogen contents, C/N ratio and available phosphate($P_2O_5$) were the highest at the Chungdo. However, Gwangyang and Chungdo represent similar Cation Exchange Capacity(C.E.C) and Daegu has much less than other areas. Exchangeable cations, $Ca^{2+}$ content was higher at Gwangyang and Chungdo than Daegu and $Na^+$ content was the highest at Chungdo among three sites. Daegu has much $Mg^{2+}$ contents followed by Chungdo and Gwangyang. Interestingly, $K^+$ content listed in reverse order of $Mg^{2+}$ at Gwangyang, Chungdo and Daegu. The main woody plants in study sites are confirmed as Carpinus laxiflora, Quercus mongolica, Q. serrata and Pinus densiflora. Quercus species are found as a common species in three study sites. Lastly, 8 family and 12 species of mushrooms are emerged in Gwangyang, also 8 family and 12 species and 5 family and 10 species are found in Chungdo and Daegu, respectively. Amanita pantherina, Boletus edulis, Tylopilus felleus and Marasmius maximus, which found in study sites, are also kind of mycorrhizal mushroom same as A. hemibaph. By using correspondence analysis, Q. mongolica, Q. serrata, Q. variabilis and C. laxiflora are expected to as a host plant of A. hemibapha.

• Journal of Korean Public Health Nursing
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• v.13 no.1
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• pp.97-113
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• 1999

To investigate the actual condition of the adult-smoking in Chinan County. I used self-reporting questionnaires among 923 residents living in nine districts selected at random among the sites of eleven eup-myons from December 28. 1998 to January 6. 1999. collected data and analyized using SPSS. The smoking rate of adults in Chinan County was $36.9\%$. There was a significant difference in smoking rate according to the age. gender, education and job among general characteristics. The smoking rate in group of above 40s was about $40\%$ and that of the male took $55.5\%$ which was higher than that of female and the smoking rate of the people having high-school education was the highest$(46.2\%)$. With regard to the career. the smoking rate of the farmers ranked first$(46.1\%)$. Therefore anti-smoking business for smokers should be focused on above 40 years old, males. people having high school education and farmers. As the result of the survey of smoking habits of 340 people who smoke currently, the average smoking begining age was 21.8 and $81.5\%$ among them was between 16-25 years old. $4.4\%$ was under 15. during around the elementary school. Most motives to smoke were as followed; curiosity or taste$(33.6\%)$, relief of stress $(31.2\%)$, peer presure$(26.5\%)$ And considering the amount of the cigarette which is smoked per day, the case which is less than a pack of cigarettes was highest as $75.5\%$ and the people who smoke over one pack of cigarettes took $24.5\%$. As for the kind of tobacco which is smoked, how to smoke and the desire for the smoking, most case was toxin was moderate$(47.8\%)$ or mild$(46.9\%)$. shallowly$(49.0\%)$ or deeply$(46.3\%)$ and under stress$(33.4\%)$. after meals$(27.8\%)$, during drink$(15.7\%)$ and so on. The highest point marked among the factors of smoking motives was 'the reduce of negative emotion' $(3.27\pm1.00)$. followed by 'uncomfortable habits' $(2.87\pm1.02)$, 'addiction' $(2.84\pm1.06)$. 'habit' $(2.74\pm1.12)$. 'pleasure' $(2.70\pm1.04)$. 'stimulus' $(2.59\pm.90)$, 'sensation-exercise satisfaction' $(2.42\pm.97)$. Smokers smoke to reduce the negative emotions when angry in most common case. depressed. anxious. uncomfortable. lone. ashamed or embarrased. and intend to solve the certain problem. etc. Other motives are uncomfortable habit. addiction. habit. pleasure and the pursuit of stimulus. The level of nicotine dependence of adults m Chinan County was 10.57 which amount to 'high' wholly. As the resulf of the level of nicotine dependence score. the people who are low in the level of nicotine was $33.5\%$. the people who are high was $48.2\%$. very high was $18.4\%$. The approach for anti-smoking for smokers should be conducted differently according to the level of the nicotine. For the people who are in low level of nicotin dependence the prohibition of the smoking should be guided through the approach to foster strong will. for those who are in 'high' by acquiring proper method for the prohibition of smoking. and for those who are 'very high' the anti-smoking should be induced by providing proper program because of the possibility of the suffer from abstinence syndrome. The difference of the level of nicotine with the general characteristics of the objects had not statistically significant difference. The difference of the level of nicotine dependence accompanied by smoking habit had statistically significant difference according to the amount of smoke, the kind of tobacos. smoke inhale habit. In other words, the group of heavy smokers had higher level of the nicotine dependence than that of the light smokers relatively and the group which smoke strong taboaco has higher level of nicotine than that of which smoke mild or moderate. And the group of smokers who smoke deeply has higher level of nicotine than that who smoke shallowly or nonswallow. Aa a result of the analysis of the correlation between smoking motive factors and the level of nicotine, there was the indication that people who smoke for the decrease of the negative emotion. habit, pleasure. stimulus. sensation-exercise satisfaction had high level of the nicotine dependence. As the result of the anti-smoking will of smokers. $65.0\%$ of them had prohibition of smoking will. $29.3\%$ had no will to quit smoke. The most important reason for anti-smoking was health. $67.9\%$ had experience to try to quit smoke and the biggest reason to fail to quit smoking was the lack of the will power to keep anti-smoking. $52.8\%$ of them were advised to stop smoking from their spouses or children. only $2.8\%$ were by medical. The people who have the opinion to need anti-smoking education were $69.6\%$. Therefore when the business for the hygine of the mouth for adult is set. it should be centered on the people who have intention of prohibition of the smoking and help to quit smoking by way of other affirmative counter-program not smoking under stress.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.81-87
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• 2007

Purpose: Chondroblastoma of bone is rare with the potential for local recurrence and metastasis. A retrospective review of 30 patients with chondroblastoma of bone treated at a single institution during a 24-year period was conducted to determine the clinical outcome and relevant prognostic factors. Materials and Methods: Thirty patients with biopsy-proven chondroblastoma of bone, treated between September of 1981 and September of 2005, were retrospectively reviewed. There were 16 men and 14 women with an average follow-up period of 7.2 years (range, 1.6~21.2). The most common sites were the distal femur (n=7), proximal humerus (n=6), proximal tibia (n=6) and proximal femur (n=4). The average age of the patients was 20 years (range, 12~47) with closed physes in 20 patients(67%.) Twenty-seven patients(90%) were treated by curettage of the tumor with or without bone grafting or cementing. Three patients(10%) were treated with en bloc resection. Clinical and pathological factors reported to be associated with poor outcome were analyzed. Results: Four local recurrences(13%) developed in postoperative 4, 6, 7 and 16 months. These patients underwent further curettage (once in 2 patients and twice 2) and had no further recurrence. All patients showed no evidence of disease at the final follow-up. Local recurrence developed in the two cases which removal of the tumor was incomplete. Curettage and bone-grafting (1) and cementing (1) were performed in the two other cases with local recurrences. In contrast, no local recurrences were observed in the 3 cases treated with en-bloc resection. The status of physes or the histologic presence of aneurysmal bone cyst, the anatomic location of the tumor did not affect local recurrence. Conclusion: Adequate removal of the tumor with aggressive curettage or en bloc resection seems to be necessary to prevent local recurrence in chondroblastoma. The status of physes, the histologic presence of aneurysmal bone cyst or the anatomic location of the tumor was not related with local recurrence.

• Journal of Korean Medical Ki-Gong Academy
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• v.4 no.2
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• pp.153-186
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• 2000

Jigam(止感), Josik(調息), Kumchock(禁觸), from the lecture on Truth of ${\ll}Samilshingo{\gg}$(三一神誥) treat three elements of Kigong, regulation of mental activties, regulation of breathing and adjustment of posture and there are some similar mentions with the view of human body based on oriental medicine like those Samjin(三眞), Sammang(三妄), Samdo(三途) and Sippalkyoung(十八境) ect. Thus as a result of comparison and observation about the interrelationships between principle of Kigong in the lecture on Truth of ${\ll}Samilshingo{\gg}$(三一神誥) and oriental medicine. I have conclusion as follows. 1. According to the lecture on Truth, the components of human body are the one and only Samjin(三眞), Sammang(三妄) and Samdo(三途) resulted from facing Samjin(三眞) to Sammang(三妄) and Sippalkyoung(十八境). This fact presents the principle of human change. 2. the principle of Kigong mentioned in the lecture on Truth shows the original Ilshin(一神) on the basis of Samjin(三眞), Sammang(三妄), Samdo(三途) and Sippalkyoung(十八境). This makes common, unity and sound Sim(心), Ki(氣) and Shin(身), Sammang(三妄) through Jigam(止感), Josik(調息) and Kumchock(禁觸), be versed, intellected and guaranteed Sung(性), Myoung(命) and Jung(精), Samjin(三眞) and emit Kyun(見), Mun(聞), Ji(知) and haeng(行), Sadaeshingi(四大神機) and finally all these are harmonized into Duk(德), Hye(慧) and Ryuk(力), Samdae(三大) which is the entity of God. 3. Samsipyookjongmyowhasang(三十六種妙化相) is an ascetic practice done after a chulin(哲人) deduce Ji(止), Jo(調) and Kum(禁), Sambup(三法) on the basis of the lecture on Truth. So I suppose it correlates nature's six elements. Kong(空)(Chun(天)). Yol(熱)(Wha(火)). Jin(震(Jeon(電)), Seup(濕)(Shoo(水)), Han(寒)(Poong(風)) and Ko(固)(Ji(地)), human's Samjin(三眞), Sung(性), Myoung(命) and Jung(精) and Sammang(三妄), Sim(心), Ki(氣) and Shin(身) and makes clear the principle of discipline. 4. In comparison with Samjin(三眞) and Sammang(三妄) says from the lecture on Truth and the Three Essential Elements of the body construction(三寶) from oriental medicine, Samjin(三眞) and Sammang(三妄) as factors of human body in the concept of practical knowledge. That is the one and only Samjin(三眞) in terms of the Three Essential Elements of the body construction(三寶) is considered a structural principle for every single person and Sammang(三妄) is considered a functional form for each individual. And it can be Sung(性)+Sim(心)=Spirit(神), Myoung(命)+Ki(氣)=Vital Force(氣) and Jung(精)+Shin(身)=True Essence(精). 5. In comparison with Sippalkyoung(十八境) of Samdo(三途) from the lecture on Truth and three medical causes of disease, Gamdoyookkyoung(感途六境) is similar with endopathic cause caused by Naesangchiljung(內傷七情), Sikdoyukkyoung(息途六境) is similar with exopathic cause by six climatic conditions in excess as pathogenic factors(六淫) and Yoegi(?氣) and Chokdoyukkyoung(觸途六境) is similar with non-endo-exopathogenic causes by diet imbalance, fatigue, intemperance in sexual life and trauma etc. 6. In the lecture on Truth, the Chulin(哲人) who discipline Sambup(三法), Sangchul(上哲), Choongchul(中哲) and Hachul(下哲) can be compared with Kigong expert(health preserving expert) such as the Spiritual Men(眞人), the Sapients(至人), the Sages(聖人) and the Men of Exellent Virtue(寶人) in the Sang Gu Tian Zhen Lun of the Huang Ti Nei Ching Su Wen(素問 上古天眞論) and then Sangchul(上哲) is the Spiritual Men(眞人), Choongchul(中哲) is the Sapients(至人) and Hachul(下哲) is the Sages(聖人) while the men of Exellent Virtue(賢人) is inferior to Chulin(哲人) when he goes to extremes.