• Title/Summary/Keyword: prospective

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The Prognostic Factors Affecting Survival in Muscle Invasive Bladder Cancer Treated with Radiotherapy (방사선치료를 받은 근 침윤성 방광암의 예후 인자)

  • Chung Woong-Ki;Oh Bong-Ryoul;Ahn Sung Ja;Nah Byung Sik;Kwon Dong-Deuk;Park Kwangsung;Ryu Soo-Bang;Park Yang-IL
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.130-138
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    • 2002
  • Purpose : This study analyzed the prognostic factors affecting the survival rate and evaluated the role of radiation therapy in muscle-invading bladder cancer. Materials and Methods : Twenty eight patients with bladder cancer who completed planned definitive radiotherapy in the Departments of Therapeutic Radiology and Urology, Chonnam National University Hospital between Jan. 1986 to Dec. 1998 were retrospectively analyzed. The reviews were peformed based on the patients' medical records. There were 21 males and 7 females in this study. The median of age was 72 years old ranging from 49 to 84 years. All patients were confirmed as having transitional cell carcinoma with histological grade 1 in one patient, grade 2 in 15, grade 3 in 9, and uninformed in 3. Radiation therapy was peformed using a linear accelerator with 6 or 10 MV X-rays. Radiation was delivered daily with a 1.8 or 2.0 Gy fraction size by 4 ports (anterior-posterior, both lateral, alternatively) or 3 ports (Anterior and both lateral). The median radiation dose delivered to the isocenter of the target volume was 61.24 Gy ranging from 59 to 66.6 Gy. The survival rate was calculated by the Kaplan-Meier method. Multivariate analysis was peformed on the prognostic factors affecting the survival rate. Results : The survival rate was $76\%,\;46\%,\;33\%,\;33\%$ at 1, 2, 3, 5 years, respectively, with 19 months of median survival. The potential factors of age (less than 70 years vs above 70), sex, diabetes mellitus, hypertension, hydronephrosis, 1-stage (T3a vs T3b), TUR, chemotherapy, total duration of radiotherapy, radiation dose (less than 60 Gy vs above 60 Gy), and the treatment response were investigated with uniand multivariate analysis. Un univariate analysis, the T-stage (p=0.078) and radiation dose (p=0.051) were marginally significant, and the treatment response (p=0.011) was a statistically significant factor on the survival rate. Multivariate analysis showed there were no significant prognostic factors affecting the survival rate. Conclusion : The treatment response and radiation dose are suggested as th은 statistically significant factors affecting the survival rate of muscle invasive bladder cancer. A Further prospective randomized study is needed to confirm these prognostic factors.

The Preventive Measures On Terrorism Against Overseas Korean Businessmen(A view of recent ethnic minority separation movement) (해외근무(海外覲務) 기업체(企業體)에 대(對)한 테러 방지책(防止策) - 최근(最近) 소수민족분리주의운동지역(小數民族分離主義運動地域)을 중심(中心)으로 -)

  • Choi, Yoon-Soo
    • Korean Security Journal
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    • no.1
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    • pp.351-370
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    • 1997
  • This study concerns possible measures to prevent separatists' terrorist acts against overseas Korean businessmen. Of late, many Korean enterprises are helping a number of foreign countries develop their economy, by building factories and manning regional offices in those countries. But recent development of terrorism especially against Korean businessmen is alarming. This report discusses the need for Korean enterprises heading overseas to prepare themselves with awareness of terrorism and possible protective measures against it, besides their routine pursuance of profits; and for the government and prospective enterprises to refrain from investing in those countries having active separatist movements. If an investment has become inevitable, a careful survey of the region in conflict should be conducted and self-protective measures should be put in place through security information exchange, emergency coordination and training of personnel, etc. This study will first review the past terrorist incidents involving employees of overseas Korean enterprises, and then will focuss on seeking effective measures on the basis of the reported incidents. In carrying out the study, related literature from both home and abroad have been used along with the preliminary materials reported and known on the Internet from recent incidents. 1. The separatist movements of minority groups Lately, minority separatist groups are increasingly resorting to terrorism to draw international attention with the political aim of gaining extended self rule or independence. 2. The state of terrorism against overseas Korean enterprises and Koreans Korean enterprises are now operating businesses, and having their own personnel stationed, in 85 countries including those in South East Asia and Middle East regions. In Sri Lanka, where a Korean enterprise recently became a target of terrorist bombing, there are 75 business firms from Korea and some 700 Korean employees are stationed as of August 1996. A total of 19 different terrorist incidents have taken place against Koreans abroad since 1990. 3. Terrorism preventive measures Terrorism preventive measures are discussed in two ways: measures by the government and by the enterprises. ${\blacktriangleleft}$ Measures by the government - Possible measures at governmental level can include collection and dissemination of terrorist activity information. Emphasis should be given to the information on North Korean activities in particular. ${\blacktriangleleft}$ Measures by individual enterprises - Organizational security plan must be established by individual enterprises and there should also be an increase of security budget. A reason for reluctant effort toward positive security plan is the perception that the security budget is not immediately linked to an increment of profit gain. Ensuring safety for overseas personnel is a fundamental obligation of an enterprise. Consultation and information exchange on security plan, and an emergency support system at a threat to security must be sought after and implemented. 4. Conclusion Today's terrorism varies widely depending on reasons and causes, and its means has become increasingly informationalized and scientific as well while its method is becoming more clandestine and violent. Terrorist organizations are increasingly aiming at enterprises for acquisition of budgets needed for their activities. Korean enterprises have extended their business realm to foreign countries since 1970, exposing themselves to terrorism. Enterprises and their employees, therefore, should establish their own security measures on the one hand while the government must provide general measures, on the other, for the protection of the life and property of Korean residents abroad from terrorist attacks. In this regard, set-up of a counter terrorist organization that coordinates the efforts of government authorities in various levels in planning and executing counter terrorist measures is desired. Since 1965, when the hostile North Korea began to step up its terrorist activities against South Koreans, there have been 7 different occasions of assassination attempt on South Korean presidents and some 500 cases of various kidnappings and attempted kidnappings. North Korea, nervous over the continued economic growth and social stabilization of South Korea, is now concentrating its efforts in the destruction and deterioration of the national power of South Korea for its earlier realization of reunification by force. The possibility of North Korean terrorism can be divided into external terrorist acts and internal terrorist acts depending on the nationality of the terrorists it uses. The external terrorist acts include those committed directly by North Korean agents in South Korea and abroad and those committed by dissident Koreans, hired Korean residents, or international professionals or independent international terrorists bought or instigated by North Korea. To protect the life and property of Korean enterprises and their employees abroad from the threat of terrorism, the government's administrative support and the organizational efforts of enterprises should necessarily be directed toward the planning of proper security measures and training of employees. Also, proper actions should be taken against possible terrorist acts toward Korean business employees abroad as long as there are ongoing hostilities from minority groups against their governments.

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A Study on Improvement of the investigation procedure for the National Security Violators - Focused on the Rights to Counsel - (안보사범에 대한 수사절차 개선방안 검토 - 피의자 신문시 변호인 참여권 문제를 중심으로 -)

  • Yoon, Hae-Sung;Joo, Seong-Bhin
    • Korean Security Journal
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    • no.46
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    • pp.113-140
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    • 2016
  • Right to counsel means a defendant has a right to have the assistance of counsel (i.e., lawyers), and if the defendant cannot afford a lawyer, requires that the government appoint one or pay the defendant's legal expenses. The right to counsel is generally regarded as a constituent of the right to a fair trial. Historically, however, not all countries have always recognized the right to counsel. The right is often included in criminal law and constitutional law etc. First, any person who is arrested or detained shall have the right to prompt assistance of counsel. When a criminal defendant is unable to secure counsel by his own efforts, the State shall assign counsel for the defendant as prescribed by act in article 12(4) of the constitutional law. Second, the defense counsel or a person who desires to be a defense counsel may have an interview with the defendant or the suspect who is placed under physical restraint, deliver or receive any documents or things and have any doctor examine and treat the defendant or the suspect in article 34 of the criminal law. Nonetheless, problems about guarantee of the rights to counsel to the national security violators like spy terrorist and etc will be important for Koreans to consider. That is because national security violators's cases are qualitatively different from general criminal offense's cases and historically, lawyer obstruct a investigation in the process of examination of a suspect for national security violators. Therefore, this study suggest a way that a restriction the rights to counsel with an attorney in cases of the national security violators. To this end, in this paper, I touch on restriction of right to counsel during interrogation in the England and Germany etc in comparison to that of Korea and review Korea's Supreme Court decision and Constitution Court decision to understand the prospective and trends for Korean investigation procedure improvement.

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A Study of Sex-related Problems of Old Women in Kyeonggi Province, Korea (경기도 여성노인의 성의식에 관한 조사연구)

  • Park, Young-Soo;Choi, In-Sook
    • The Journal of Korean Society for School & Community Health Education
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    • v.5
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    • pp.71-84
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    • 2004
  • The sexual discourse has been frequent, but the subjects of it have been limited to the young, and the sex of women and that of the old people, until now, have been overlooked. According to the data in 2,000 of the Korea Statistic Service, the older-than-sixty-five-year people consist of 37.4% men and 62.6% women. Of them, the older-than-seventy-year people consist of 33.8% men and 55.2% women. The data show the fact that as the age of the old people is higher, the number of old women is enlarging. Paying attention to the above-mentioned tendency, this study conducted a survey about the aspects of the sexual consciousness of old women. The purpose of study was focused, through the survey, on discovering the ways of old women's recognization about their sexual desire, and on presenting basic data to developing the programs which could solve the problems derived from the discovery. That is to say, the purpose of it was to prevent the sexual desire's distortion and suppression of old women, if they had any, and to present basic data to developing the programs which could convert their recognization of sex. The objects of the survey were the sample group of 301 people inhabiting in Hwaseong City, Seongnam City, Yongin City, and Suwon City, chosen out of 375,298 old women of 614,316 older-than-sixty-five-year people in Kyeonggi Province (Kyeonggi Province homepage, 2002). The data were collected by the questionnairers' interviews in the fields of old men's resting house, churches, temples, old men's niversities and so like, from September 19th to September 31th in 2003. The questionnairers as volunteers were taught the prior education, being prepared for the survey about old women's sexual consciousness. The contents of education were composed of the understanding of old women, the ways of questionnairing, and the items of questionnaire. The outcomes of the survey are following; First, concerning general items, the old women of the sample group answered that they felt greatly the difficulties of health(36.5%), economy(12.0%), and loneliness(11.3%) in turn. The 48.2% of them answered that they were healthy, but the 62.3% answered that they were suffering various illnesses. The 24.4% answered they were economically rich, and the 23.9% answered they were working. The 53.5% were living alone due to divorce or death. The 71.1% had been living for more than ten years. The 83.1% believed in their own religion. Second, the 43.8% of the sample group admitted the necessity of a heterosexual friend and sexuality The 39.0% felt sexual desire, and the 33.9% were experiencing sexuality. As the obstructing factors in performing sexuality, the objects of sample group pointed out shamefulness or morality(28.7%), anxiety that such deeds might afflict their health or the problem of health itself(20.2%), weakening of sexual potency(16.9%). This outcome shows that they have ambiguous notions about their sexual alienation and manner. Third, the 33.7% of the sample group admitted sexual education and sexual counsel, and of those that admitted them, the 85.2% said that they would take part in sexual education if it were held. It shows that the demand of sexual education and sexual counsel need be fulfilled. Therefore, through this study, the following two important suggestions can be drawn: First, systematic sexual education programs should be developed, considering old people's developing steps containing their rights of health and sex. Also those should be educated through kindergartens, primary, middle and higher education institutions. Second, sexual education and sexual counsel on prospective old people and present old people should be performed.

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Early Response of Cardiopulmonary Exercise Test(CPET) in Patients with Locally Advanced Non-Small Cell Lung Cancer Treated with Radiation (방사선 치료 후 폐암환자의 운동부하 심.폐 기능의 초기변화)

  • Shin, Kyeong-Cheol;Lee, Deok-Hee;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.466-473
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    • 2000
  • Background : Patients with locally advanced non-small cell lung cancer are often treated with radiation alone or in combination with chemotherapy. Both modalities have a potentially damaging effect on pulmonary function. In order to examine changes in the cardiopulmonary exercise function of patients with locally advanced non-small cell lung cancer before and after conventional radiotherapy, we conducted a prospective study involving patients with such cancer, that had received radiation therapy. Method : Resting pulmonary function test, thoracic radiographic finding and cardiopulmonary exercise test(CPET) were assessed prior to and 4 weeks following radiation therapy in 11 male patients with locally advanced non-small cell lung cancer. Patient with endobronchial mass were excluded. Results : The forces vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$ and maximal voluntary ventilation (MVV) did not decreased between before and 4 weeks after radiation but the diffusing capacity (DLCO) had decreased by 11% 4 weeks after radiation, which was not statistically significant. No changes in maximal oxygen consumption ($VO_2$max), carbon dioxide production ($VCO_2$), exercise time and work load were attributed to radiation therapy. Follow up cardiopulmonary exercise testing revealed unchanged cardiovascular function, ventilatory function and gas exchange. No difference in cardiopulmonary exercise test performance was observed between pre- and post-radiation. Conclusion : Cardiopulmonary exercise function did not decrease within the short-term after the radiation of patients with locally advanced non-small cell lung cancer.

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Comparison of Forcep-biopsy and Cryo-biopsy by a Flexible Bronchoscopy (굴곡성 기관지경을 통한 겸자 생검술과 냉동 생검술의 비교)

  • Kim, Jae Hyun;Choi, Jung Min;Song, Sung Eun;Lee, Eun Mi;Lee, Song Ju;Oak, Chul Ho;Jang, Tae Won;Jung, Man Hong;Jang, Hee Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.2
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    • pp.110-115
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    • 2009
  • Background: A forceps-biopsy is performed to acquire tissue from patients with an endobronchial carcinoma using a flexible bronchoscope. Recently, a cryo-biopsy has also been used to acquire tissue samples. Cryo-biopsy is the diagnostic application of extreme cold for the local destruction of abnormal living tissue. This technique is safe, with no radiation danger, no risk of electrical accidents, and a little risk of bleeding. This study compared a forceps-biopsy with a cryo-biopsy using a flexible bronchoscope, and examined the chemosensitivity and level of VEGF (vascular endothelial growth factor) in the specimens obtained from the cryo-biopsy. Methods: We present a prospective study of 30 consecutive patients who underwent a forceps-biopsy between January 2007 and October 2007 with a mean age of 62.1 years and a male:female ratio of 5 : 1. A flexible bronchoscope was inserted to the area of the abnormal lesions, and a cryo-probe was then applied through the working channel of the flexible bronchoscope. A temperature of approximately -h80 was delivered to the tumor site for 8 seconds. The cryo-biopsy was performed after destroying the tumor mass. Results: The mean size of the tissue from the forceps-biopsy and cryo-biopsy were 2.0${\pm}$1.2 mm and 6.0${\pm}$3.0 mm. A chemosensitivity test was performed on 5 specimens obtained using cryo-biopsy and the level of VEGF was examined in 2 specimens obtained from a cryo-biopsy. There were no side effects in either group. Conclusion: Cryo-biopsy using a flexible bronchoscope is a safe and effective technique for acquiring tissue samples.

Comparison of the Serum Cholesterol, Insulin Resistance and Markers of Metabolic Syndrome Based on Hepatitis C Virus RNA (C형 간염 바이러스 RNA 유무에 따른 지질, 인슐린저항성 및 대사증후군 지표 수준의 차이)

  • Cho, Sung-Hwan;Kim, Yun-Jin;Lee, Sang-Yeoup;Cho, Byung-Mann;Hwang, Hye-Lim;Yi, Yu-Hyeon;Cho, Young-Hye;Tak, Young-Jin;Jeong, Dong-Wook;Lee, Seung-Hun;Lee, Jeong-Gyu
    • Journal of agricultural medicine and community health
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    • v.41 no.4
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    • pp.205-216
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    • 2016
  • Objectives: We compared the difference of lipid, insulin resistance and metabolic markers based on HCV RNA in Korean adults.Methods: This was a cross-sectional study of 222 subjects visited the health promotion center of Pusan nationaluniversity hospital from 2004 to 2007. Subjects were anti-HCV antibody positive and were performed RT-PCR for HCV RNA. The HCV RNA (+) group were 85 subjects, HCV RNA (-) control group were 115 subjects, and the HCV RNA (-) but past positive group were 22 subjects. We performed anthropometry, anti-HCV, RT-PCR, plasma concentrations of insulin, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride.Results: BMI, waist circumference, blood pressure, fasting plasma glucose, triglyceride, HDL cholesterol, insulin resistance such as HOMA-IR and QUICKI were not significantly different between HCV RNA positive and negative groups. The serum total cholesterol and LDL cholesterol level were significantly lower in the HCV RNA positive group than in the negative group ($186.24{\pm}37.63$ vs $197.22{\pm}37.23$ mg/dl, p=0.041, $111.66{\pm}34.06$ vs $121.38{\pm}35.50$ mg/dl, p=0.042). After adjusting age and sex, high total cholesterol (${\geq}200mg/dl$) (adjusted OR=0.51, 95%CI 0.28-0.94, p=0.03) and high LDL cholesterol (${\geq}130mg/dl$) (adjusted OR=0.46, 95%CI 0.24~0.87, p=0.02) were inversely associated with being HCV RNA positive (p<0.05). Conclusion: The serum total cholesterol and LDL-cholesterol level were significantly lower in HCV RNA (+) group than in HCV RNA (-) group, but not in HCV RNA (-) but past positive group. Prospective cohort studies are needed to clarify the relationship between HCV RNA and metabolic markers.

A Study of the Accidents of the Residents in a Rural Area (일개 보건진료소 사업 지역의 사고조사)

  • Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Seok-Beom;Kim, Chang-Yoon;Lee, Ok-Keum
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.174-184
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    • 1991
  • To determine the incidence rate of accidents and its associated factors, a prospective survey was carried out in a rural area of a total of 1,360 residents for 1 year from January 1 to December 31, 1988 in Shin-am Ri, Jungdong Myun, Sangju Kun, Kyungpook Province. Data for accidents were collected by the community health practitioner who is working at Primary Health Post in Shin-am Ri. A total number of accident cases was 85 among 1,360 persons during one year study period, and annual incidence rate was 62.5 per 1,000 persons. The highest incidence rate of accident was observed in the age group of 30-39 was 179.8. The incidence rate of accident in male was 86.5 which was about 2 times that in female. In male, the highest incidence rate was seen in 30-39 age group and in female, 60-69 age group. The highest incidence rate of accident was observed in spring(29.4%) and summer(29.4%), and the lowest in fall(17.7%). The highest incidence rate of accident was observed in Friday(24.5%) by day of week, and between 9 a.m. to 12 a.m. by time zone. The most frequent use of medical facilities was Primary Health Post(51.8%) and the next was clinic(38.8%). Mean duration of treatment was 9.8 days. The accident occured in the room and kitchen(23.5%), in the yard and barn(23.5%), on the road(22.4%). and in the rice field and dry field(20.0%). The causes of accident were motor vehicle accident(20.0%), piercing or cutting(20.0%), collision or fighting(12.9%), and poisoning(11.8%) in order of frequency. The most common type of injury was open wound which was 43.5%. The most common tool of accident was farm machine which was 23.5%. The most common injuried part of body was extremity(55.3%).

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Database study for clinical guidelines of children with pneumonia who visited an emergency department (응급의료센터에 내원한 소아 폐렴의 진료 지침을 위한 기초 자료 연구)

  • Hong, Dae Young;Lee, Kyung Mi;Kim, Ji Hye;Kim, Jun Sig;Han, Seung Baik;Lim, Dae-Hyun;Son, Byoung Kwan;Lee, Hun Jae;Lee, Kyung-Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.757-762
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    • 2006
  • Purpose : Pneumonia is one of the most common infections in children who visit emergency departments(ED), but standard clinical guidelines for children with pneumonia in Korea have not been studied. This study was performed to collect and evaluate a data-base of children with pneumonia for establishing clinical guidelines in ED. Methods : This study reviewed 304 children who were diagnosed and treated for pneumonia in the ED at one tertiary hospital between January 2003 and December 2003 retrospectively by reviewing the charts and analyzing the clinical characteristics, laboratory findings, and radiologic findings between an admission group and a discharge group. Results : The 2 year-5 year age group was the top of age distribution and the peak incidence of monthly distribution was December. Two hundred forty seven(81.3 percent) children were hospitalized(admission group), and the mean length of hospitalization was $7.24{\pm}3.24$ days. The most common indications of admission were fever, tachypnea and an age of less than three months. There was statistical differences in the outpatient department follow-up between the two groups(85.8 percent in admission group vs 35.1 percent in discharge group). Conclusion : More prospective studies are needed to establish clinical standard guidelines for children with pneumonia. This will be helpful in ED management and will aid the prevention of pneumonia.

Risk factors associated with complicated methicillin-resistant Staphylococcus aureus bacteremia in neonates (신생아의 MRSA 균혈증에서 합병증 발생과 연관된 위험인자)

  • Lee, Young Jin;Kim, Hyen Jin;Byun, Shin Yun;Park, Su Eun;Park, Hee Ju
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.173-177
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    • 2010
  • Purpose : Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen that causes nosocomial infection in NICU. It contributes to neonatal morbidity and mortality with variable complications. This study was conducted to identify the risk factors associated with complicated MRSA bacteremia in neonates. Methods : We reviewed the medical records of 44 neonates with positive blood culture for MRSA who were admitted to the NICU of Pusan National University Hospital from January 2002 to December 2007. We compared various factors of the complicated and uncomplicated MRSA bacteremia cases. Results : Of the 44 neonates, 31 were male and 13, female. The mean gestational age and birth weight were $33.2{\pm}4.9$ weeks and $1,859.9{\pm}962.2g$, respectively. Twenty-one of infants were treated with a mechanical ventilator during a mean of $8.8{\pm}13.8$ days. There were 13 cases of complicated and 31 cases of uncomplicated MRSA bacteremia. Between the 2 groups, we compared the following variables: gestational age, birth weight, ventilator use, umbilical catheter use and central catheter insertion, $O_2$ inhalation, first oral feeding day after birth, underlying disease, transfusion, and initial vancomycin use. The underlying disease and transfusion were the risk factors related to complicated MRSA bacteremia. Conclusion : Complicated MRSA bacteremia is related to underlying disease and transfusion. Since this was a retrospective study with a small sample size, it offered limited capacity to compare complicated and uncomplicated MRSA bacteremia. A prospective study with a larger population is needed to determine the exact characteristics of MRSA bacteremia in NICU.