• Tuberculosis and Respiratory Diseases
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• 제47권5호
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• pp.660-668
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• 1999

Background: Lung cancer continues to increase and one half of all cases of lung cancer occur in patients age 65 years and older. However, it seems that lung cancer is less treatable in elderly patients because of co-morbid illness or poor tolerance of surgery and chemotherapy. The intention of this study is to seek an adequate treatment approach for lung cancer in the elderly through an understanding of its characteristics. Method: The clinical data of 207 patients who were diagnosed with histologically proven lung cancer at the department of internal medicine in Seoul Municipal Boramae Hospital between September 1994 and August 1998 were retrospectively analyzed according to their age groups; group I$\geq$65 years(n=122) and group II<65 years(n=85). Results: The peak incidence of age was 7th decade(36.2%) and male age 65 years and older were 42% of all patients. Although dyspnea was more common in group I(26%) than in group II(11%)(p=.0l), there were no significant difference in other symptoms, stage, and histologic type between two groups. Group I significantly had more patients with poor performance(ECOG 3&4) than group II(35.2% vs.12.9%, p=.000). The percentage of patients with non-small cell carcinoma received supportive care only was significantly higher in group I than in group I(74% vs. 35%, p=.000). However, survival of patients who had curative intent treatment was similar between two groups(median survival 11.3 mos vs. 23 mos, p>.05). The histologic subtype, stage and performance status were significant prognostic factors affecting survival, but age itself was not. Conclusion : Lung cancer is prevalent in the elderly and aggressive diagnosis and treatment should be considered in elderly patients with good performance status.

• Korean Journal of Head & Neck Oncology
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• 제18권1호
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• pp.36-40
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• 2002

Background and Objectives: To determine if laser endoscopic microsurgery is a reliable and appropriate approach in the treatment of laryngeal carcinomas. Materials and Methods: Retrospective study of 62 patients treated with CO2 laser from June 1988 to November 2000 at Seoul National University Hospital for laryngeal squamous cell carcinoma. All patients were treated with curative intention. Fifty three untreated patients with laryngeal carcinoma (39 glottic and 14 supraglottic carcinoma patients) had primary carbon dioxide laser microsurgery. Nine radiation failure patients were treated. Postoperative radiotheray was done for 17 patients. Neck dissection was performed simultaneously for 4 supraglottic cases with cervical nodal metastasis. Mean follow-up duration was 40 months. Results: In primary laser surgery group, distribution of tumors (American Joint Committee on Cancer, 1997) were 38 cases with Tl, 13 cases with T2, 2 cases with T3. Cure rate was 88.7%(47/53) and local control rate was 92.5%(49/53). Larynx was preserved in 94%(50/53) of patients. The overall 5-year survival rate(Kaplan-Meier) was 81.5%. In radiation failure group, 56% of patients were recurred after laser surgery. Conclusion: Laser surgery could be a better treatment modality for early laryngeal cancers and selected advanced cases. Additional radiation therapy should be considered if resection margin is not satisfactory.

• Journal of Hospice and Palliative Care
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• 제20권2호
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• pp.81-92
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• 2017

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

• Radiation Oncology Journal
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• 제12권1호
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• pp.117-121
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• 1994

In spite of remarkable improvement of surgical skills and anesthesia, local failure still occurred in 36-45$ \% $ of locally advanced colorectal cancer after curative resection with or without pre-or post-operative irradiation. Intraoperative radiation therapy(IORT) is the ideal modality which resectable lesions are removed surgically 3nd the remaining cancer nests are sterilized by irradiation during a surgical procedure. Therefore, the excellent local control without the damage of the adjacent normal tissues can be achieved. In IORT, judicious set up of the treatment cone on the treatment surface of the patient is required for accurate and homogenous dose distribution within treatment field, especially on the slopping surface of sacrum and pelvic sidewall which are the common sites of the local recurrence in rectal cancer. For this purpose, adequate co-ordination of gantry rotation and table tilting are essential. Adjusting gantry rotation is not difficult but tilting of the table is impossible inconventional treatment couch. Department of Therapeutic Radiology in Yeungnam University Medical Center developed the IORT table for colorectal cancer which is easy to set up and detach on the Linac treatment couch within 5 minutes. The range of tilting with head-up and head-down is about 30 degree which is efficient and easy-to-use, not only for IORT but also for colorectal surgery. So far, authors performed IORT with newly developed treatment table in 2 patients with rectal cancer and we found that this newly developed table could contribute in improving the dose distribution of IORT and surgical procedure for colorectal cancer.

• Radiation Oncology Journal
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• 제13권2호
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• pp.173-180
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• 1995

Purpose: Unresectable rectal cancer has a grave prognosis. regardless of the therapy used and median survival is less than 1 rear. Also, it is reported by many authors that $50-80\%$ of unresectable lesions were rendered resectable by radiation therapy and the median survival time for the completely resected patients were better than that of the unresected patients. So we analyzed retrospectively our data for the better treatment outcome in these patients. Materials and MEthods:From 1980 to 1992, 45 patients with initially unresectable tumors in the rectum were treated with radiation therapy with/without surgery in Department of Radiation Oncology, Yonsei Cancer Center 10 MV radiation and multiple field technique (box or AP/PA) were used. The total dose was 28-70 Gy and median dose was 48 Gy. We evaluated the lesion status at 45-50 Gy for operability. If the lesions appeared to be resectable, the Patients were operated on 4-6 weeks after radiation therapy. But if the lesions were still fixed, the radiation dose was increased to 60-65 Gy. Results: For all patients, the 2-year actuarial survival was $13.3\%$ and median survival was 9.5 months. Of 6 patients who had received less than 45 Gy, only $17\%$ of patients responded, but in the patients who had received more than 45 Gy, $60\%$ of response rate was achieved Six of the 24 patients$(25\%)$ underwent surgical resections following RT. For patients undergoing curative resection. the two-rear survival was $50\%,$ but that of the patients without resection was $9.5\%$ (p<0.01). Survival of patients with complete response following RT was $50\%$ at 2 years. Survival of patients with partial response, stable disease and progressive disease after RT was $13.4\%,\;15.4\%,\;0\%$ respectively (P<0.05). Conclision: Our data suffests that the efforts which can increase the response rate and aggressive surgical approach are needed to achieve the better local control and survival in unresectable rectal cancers.

• Journal of Chest Surgery
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• 제40권4호
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• pp.288-291
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• 2007

Background: Myxoma makes up close to 50% of adult primary cardiac tumors, and this mainly occurs in the left atrium, and rarely in the right atrium or ventricle. The patients clinically present with symptoms of hemodynamic obstruction, embolization or constitutional changes. Diagnosis is currently established most appropriately with 2-D echocardiography. Surgical resection of myxoma is a safe and effective treatment, Material and Method: We reviewed our clinical experience in the diagnosis and management of 57 cases of cardiac myxoma that were seen over a 20-year period from July 1984 to July 2004. Result: The mean age of the patients was $53.5{\pm}14.0$ years (range: 12 to 76 years). There were 38 (67%) females and 19 (33%) males. The preoperative symptoms included dyspnea on exertion in 27 patients, palpitation in 4, chest pain in 9 and syncopal episode in 4. The diagnosis was made by echocardiography alone in 51, and by combination of echocardiography, CT and angiography in 6. The tumor attachment sites were the interatrial septum in 50, the mital valve annulus in 3 and the left atrial wall in cases, The tumor was excised successfully via biatriotomy in 33 (58%), left atriotomy in 15 (26%), the septal approach via right atriotomy in 3, Inverted T incision in 3 and the extended septal approach in 3. The follow-up time ranged from 1 to 229 months (mean follow-up: $84.0{\pm}71.3$ months). There were no early and late deaths and no recurrence during the follow-up period except for follow-up loss in 5 patients. Conclusion: It's concluded that excision of cardiac myxoma is curative and the long-term survival is excellent. Immediate surgical treatment was indicated because of the high risk of embolization or of sudden cardiac death. Radical tumor excision may prevent recurrences.

• Journal of Home Health Care Nursing
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• 제10권1호
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• pp.58-72
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• 2003

The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

• Journal of Gastric Cancer
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• 제10권1호
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• pp.5-12
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• 2010

Purpose: The aim of this study was to evaluate the preoperative and postoperative nutritional statuses of patients with gastric cancer and to investigate the nutritional factors that are correlated with perioperative complications. Materials and Methods: From January 2008 to Jun 2008, 669 patients who underwent curative gastrectomy were enrolled in a retrospective study. To evaluate the changes of their nutritional status preoperatively and postoperatively, we measured the total lymphocyte count, the serum albumin, the body weight change and the BMI. The nutritional factors correlated with short-term postoperative complications were analyzed. Results: The total lymphocyte count and serum albumin decreased from the first preoperative day to the $5^{th}$ day after operation, but they tended to increase and approach the normal range 6 months after operation. The only factor correlated with the short-term postoperative complications (defined as the ones that occurred for 30 days) was the serum albumin checked on the $5^{th}$ day after operation. Conclusion: Low serum albumin on the $5^{th}$ day after operation was correlated with postoperative short-term complications. Serum albumin can be the preoperative statistical parameter that can predict the occurrence of postoperative complications.

• Journal of Korean Medical Ki-Gong Academy
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• 제1권1호
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• pp.13-59
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• 1996

Dep. of Classics &Medical History, College of Oriental Medicint, Kyung Hee University Today, many people are more interested Today, many people are more interested in preventing the disease than curing it. Chi-Kung(氣功) is the way of Life-Cultivation(養生法) peculiar to the orient, it is reported in china that Chi-Kung has an excellent curative value not only in curing the disease but also in preventing it. But the full-scale study of Chi-Kung is not be made up to now in Korea, so I studied the developmental history of chinese Chi-Kung through the oriental medical books. From this study, I reached the following conclusions; 1. Chi-Kung is naturally derived from the self-preservation instinct to adapt oneself to circumstances of the nature, but in the investigation from the documentational records, it is originated in the treatment method of the Sam-Huang-O-Jae(三皇五帝) period to cure the abnormal circulation of the vital force and blood caused by damp(濕). 2. As the principle and the method of the Life-Cultivation of the Chun-Chu-Jeon-Kook(春秋戰國) period were recorded in Huang-Jae-Nai-Gyung(黃帝內經) detailly and the remedy examples by ancient Chi-Kung such as Tao-Yin(導引), Haeng-Chi(行氣) were presented, we considered that theoretical basis of the development of Life-cultivation and Chi-Kung study was furnished in that period. 3. A famous doctor, Hwa-Ta(華引) lived in Han dynasty, researched the theory and practice of Tao-Yin transmitted from the former generations, as that result, he formed a kind of medical, gymnastics what is called O-Keum-Hi(五禽?). It is considered that 'O-Keum-Hi' is a Tao-Yin method developed more practically and systemetically than the Tao-Yin appeared in the 'Jang-Ja'(莊子) or 'Hoy-Nam-Ja'(淮南子). 4. In Wui-Jin-Nambook-Jo(魏曺南北朝) periods, the contents of Chi-Kung were more abundant under the influence of Buddhism(佛敎) and Taoism(道敎). Galhong(葛洪), the author of 'Po-Bak-Ja'(抱朴子) arranged the ancient Chi-Kung method systematically first of all, Tao-Goeng-Gyung, the author of 'Yang-Seong-Yeun-Myung-Rok'(養性延命錄) recorded the 'Yook-Ja-Geul'(六字訣) first time. 5. There is a new development of Chi-Kung therapy in Soo-Tang-Odae(隋唐五代) periods, especially So-Won-Bang(巢元方), the author of 'Jey-Bang-Won-Hwu-Ron' collected almost all of the Chi-Kung method, for curing the disease formed before Soo(隋) period. From that fact, we supposed that Chi-Kung was utilized more widely in curing the disease. 6. 'So-Ju-Cheon-Hwa-Hu-Peob'(小周天火候法) was adopted as the best orthodox approach under the influence of Nae-Tan-Taoist(道敎內丹學波) in Song-Keum-Won(宋金元) periods, especially in the song dynasty, 'Pal-Dan-Geum'(八段錦) was appearde and assignment of six-Chi(六氣) for bowel and viscera in the 'Yook-Ja-Geul'(六字訣) was decided firmly, that is to say Lung-Si(肺-?), Heart-Kha(心-呵), Spleen-Hoa(脾-呼), liver-Hoe(肝-噓), Kidney-chui(賢-吹), Three-Burner-shi(三焦-?). 7. In Myung-Cheong(明淸) periods, The general practitioner applied the principle of 'Byun-Jeng-Ron-Chi(辨證論治) to the Chi-Kung field, and after Myung dynasty the style of doing 'Yook-Ja-Gyel'(六字訣) was developed to the moving style. 8. Today, in china, the study on the Chi-Kyung is being progressed constantly under the positive assistance of government, Chi-Kung-Hak(氣功學) has taking its place as a branch of study step by step. It is considered that the establishment of Chi-Kung-Hak Classroom(氣功學敎室) and Medical Chi-Kung Center(氣功療法室) for special and systematic research are needed, at the same time the settlement of institutional system for training the Chi-Kung technician(氣功師) is also needed.

• Journal of Korean Medical classics
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• 제4권
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• pp.19-73
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• 1990

Today, many people are more interested in preventing the disease than curing it. Chi-Kung (氣功) is the way of Life-Cultivation (養生法) peculiar to the orient, it is reported in china that Chi-Kung has an excellent curative value not only in curing the disease but also in preventing it. But the full-scale study of Chi-Kung is not be made up to now in Korea, so I studied the developmental history of chinese Chi-Kung through the oriental medical books. From this study, I reached the following conclusions ; 1. Chi-Kung is naturally derived from the self-preservation instinct to adapt oneself to circumstances of the nature, but in the investigation from the documentational records, it is originated in the treatment method of the Sam-Huang-O-Jae (三皇五帝 )period to cure the abnormal circulation of the vital force and blood caused by damp (濕). 2. As the principle and the method of the Life-Cultivation of the Chun-chu-Jeon-Kook (春秋戰國) periods were recorded in Huang-Jae-Nai-Gyung (黃帝內徑) detailly and the remedy examples by ancient Chi-Kung such as Tao-Yin (導引), Haeng-Chi (行氣) were presented, we considered that theoretical basis of the development of Life-cultivation and Chi-Kung study was furnished in that period. 3. A famous doctor, Hwa-Ta (華陀) lived in Han dynasty, researched the theory and practice of Tao-Yin transmitted from the former generations, as that result, he formed a kind of medical gymnastics what is called O-Keum-Hi (五禽戱). It is considered that 'O-Keum-Hi' is a Tao-Yin method developed more practically and systemetically than the Tao-Yin appeared in the 'Jang-Ja' (莊子) or 'Hoy-Nam-Ja' (淮南子). 4. In Wui-Jin-Nambook Jo (魏晋南北朝) periods, the contents of Chi-Kung were more abundant under the influence of Buddhism (佛敎) and Taoism (道敎). Galhong (葛洪), the author of 'Po-Bak-Ja' (抱朴子) arranged the ancient Chi-Kung method systematically first of all, Tao-Goeng-Gyung (陶宏景), the author of 'Yang-Seong-Yeun-Myung-Rok' (養性延命錄) recorded the 'Yook-Ja-Geul' (六字訣) first time. 5. There is a new development of Chi-Kung therapy in Soo-Tang-Odae (隋唐五代) pefiods, especially So-Won-Bang (巢元方), the author of 'Jey-Byung-Won-Hwu-Ron' (諸病源候論) collected aimost all of the Chi-Kung method, for curing the disease formed before soo (隋) period. From that fact, we supposed that Chi-Kung was utilized more widely in curing the disease. 6. 'So-Ju-Cheon-Hwa-Hu-Peob' (小周天火候法) was adopted as the best orthodox approach under the influence of Nae-Tan-Taoist (道敎內丹學派) in Song-Keum-Won (宋金元) periods, especially in the song dynasty, 'Pal-Dan-Geum' (八段錦) was appeared and assignment of six-Chi (六氣) for bowel and viscera in the 'Yook-Ja-Geul' (六字訣) was decided firmly, that is to say Lung-Si (肺-呬), Heart-Kha (心-呵), Spleen-Hoa (脾-呼), Liver-Hoe (肝-噓), Kidneychui (賢-吹), Three-Burner-shi (三焦-嘻). 7. In Myung-Cheong (明淸) periods, The general practitioner applied the principle of 'Byun-Jeng-Ron-Chi' (辨證論治) to the Chi-Kung field, and after Myeong dynasty the style of doing 'Yook-Ja-Gyel' (六字訣) was developed to the moving style. 8. Today, in china, the study on the Chi-Kung is being progressed constantly under the positive assistance of government, Chi-Kung-Hak (氣功學) has taking its place as a branch of study step by step. It is considered that the establishment of Chi-Kung-Hak Classroom (氣功學教室) and Medical Chi-Kung Center (氣功療法室) for special and systematic research are needed, at the same time the settlement of institutional system for training the Chi-Kung technician (氣功師) is also needed.