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Concurrent Chemoradiotherapy in Locally Advanced Esophageal Cancer (국소적으로 진행된 식도암에서 동시항암화학방사선치료의 결과)

  • Byun, Sang-Jun;Kim, Jin-Hee;Kim, Ok-Bae;Song, Hong-Suk
    • Radiation Oncology Journal
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    • v.29 no.1
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    • pp.20-27
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    • 2011
  • Purpose: This study was designed to evaluate the results of local control, survival rate, prognostic factors, and failure pattern in locally advanced esophageal cancer. Materials and Methods: We retrospectively studied 50 patients with locally advanced esophageal cancer treated with concurrent chemoradiotherapy at Keimyung University Dongsan Medical Center from June of 1999 to August of 2008. Seven patients with inappropriate data were excluded, and 43 patients were analyzed. There were 39 males and four female patients ranging in age from 43 to 78 years (median, 63 years). There were seven patients with stage IIA and 36 with stage III. Irradiation from 46 Gy to 63 Gy (median, 54 Gy) was carried out 5 days per week, 1.8 Gy once a day. There were eight patients with neo-adjuvant chemotherapy, and we mostly used 5-fluorouracil, cisplatin with 3 cycles for concurrent chemotherapy. The range of follow up periods was from 2 to 82 months (median, 15.5). Results: There were nine patients that exhibited a cornplete response, 23 that exhibited a partial response, 9 that exhibited no response, and 2 that exhibited disease progression. The median survival time was 15 months. Two-year and 5-year survival rates were 36.5% and 17.3%, respectively. Two-year and 5-year disease-free survival rates were 32.4% and 16%, respectively. Treatment failure occurred in 22 patients (51.2%). Patterns of failure were categorized as local failure in 18 patients and distant metastasis in four patients. In a univariate analysis for prognostic factors related to overall survival and disease-free survival, the hemoglobin levels during chemoradiotherapy (${\geq}$ 12 vs. <12, p=0.02(p=0.1) and the response to the treatments (CR/PR vs. NR/PD, p=0.002/p< 0.0001) were statistically significant. In a multivariate analysis, only response to the treatments was revealed to be statistically significant. There was no statistical significance associated with patient age, gender, disease stage, T-stage, smoking history, tumor location, or neo-adjuvant chemotherapy. Conclusion: Our survival rate was similar to those of other institutions. Local recurrence was the main reason for failure. It is suggested that further prospective studies should be performed to improve local control.

Comparison of the health behavior and nutrition status of young-old women according to the vitality in their quality of life: based on the 2019, 2021 Korea National Health and Nutrition Examination Survey (전기노인 여성의 삶의 질 중 기운에 따른 건강행태와 영양상태 비교: 2019년, 2021년 국민건강영양조사 자료를 이용하여)

  • Jiyoung Jeong;Yoon Jung Yang
    • Journal of Nutrition and Health
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    • v.56 no.5
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    • pp.496-509
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    • 2023
  • Purpose: This study aimed to identify the general characteristics, chronic diseases, health behavior, mental health, and nutritional status of young-old women based on their vitality. Methods: This study used data from the 2019 and 2021 Korea National Health and Nutrition Examination Survey (KNHANES). The subjects were 1,113 young-old women aged 65 to 74 years old. The health-related quality of life concept with an 8-item questionnaire was used to measure the quality of life. Subjects were categorized into 4 groups (always, often, sometimes, never) based on their vitality. General characteristics, chronic diseases, health behavior, dietary behavior, food intake, and nutrient intake were compared among the groups. Results: Age, education level, household income, employment, fruit intake, dietary supplements, abundance of food, and nutrition labeling recognition were associated with the vitality of the subjects. Young-old women with arthritis, diabetes, and osteoporosis displayed lower vitality. Moreover, subjective health status, exercise, activity restrictions, and average daily sitting hours were related to vitality, while no significant difference was found in vitality between smoking and drinking. In terms of mental health factors, higher vitality was associated with 6-8 hours of sleep, lower stress levels, and reduced depression. The high-vitality group exhibited a higher intake of potatoes, starch, mushrooms, fruits, meat, milk, animal oils, and beverages than the low-vitality group. Additionally, the group with higher levels of vitality showed a higher intake of protein, fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, n-6 fatty acids, dietary fiber, sugars, phosphorous, potassium, magnesium, iron, zinc, and riboflavin. Conclusion: This study suggests that the vitality of young-old women is related to socioeconomic factors, health behavior, mental health, and food intake. To maintain a vibrant lifestyle in elderly women, it is necessary to have social and economic stability, prevent arthritis, diabetes, and osteoporosis, exercise regularly, get sufficient sleep, maintain mental health, and have a balanced diet.

Study for Treatment Effects and Prognostic Factors of Bronchial Asthma -Follow Up Over 2 Years- (2년 이상 관찰중인 성안 기관지 천식환자의 치료 효과 및 예후인자에 관한 연구)

  • Choung, Bo-Young;Park, Jung-Won;Kim, Sung-Kyu;Hong, Chein-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.559-573
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    • 1997
  • Background : Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway responsiveness to a variety of stimuli. Method : Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of "Global initiative for asthma, Global strategy for asthma management and prevention" (NHLBI/WHO) with PFR(%) larger than 80%, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/WHO, group 5 (long term control group) : patients who were controlled for more than 2 years by step 1 or 2 treatment of NHLBI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC20 and peripheral blood eosinophil count, pulmonary function test, steroid doses and aggrevation numbers after treatment. Results : On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and initial pulmonary function was better. The long term control group required lower amounts of oral steroid. had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control Atopy, allergic skin test, sputum and blood eosinophil, total IgE, nonspecific bronchial responsiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was $20.3{\pm}9.7$ months and relapse did not occur. Conclusion : Patients who had asthma of onset age younger, shorter symptom duration, better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.

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The Comparative Study of on Pump CABG during Pulsatile $(T-PLS^{TM})$ and Nonpulsatile $(Bio-pump^{TM})$ Perfusion (관상동맥우회술 시 사용된 박동성펌프$(T-PLS^{TM})$와 비박동성펌프$(Bio-pump^{TM})$의 비교연구)

  • Park Young-Woo;Her Keun;Lim Jae-Ung;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.354-358
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    • 2006
  • Background: Pulsatile pumps for extracorporeal circulation have been known to be better for tissue perfusion than non-pulsatile pumps but be detrimental to blood corpuscles. This study is intended to examine the risks and benefits of $T-PLS^{TM}$ through the comparison of clinical effects of $T-PLS^{TM}$ (pulsatile pump) and $Bio-pump^{TM}$ (non-pulsatile pump) used for coronary bypass surgery. Material and Method: The comparison was made on 40 patients who had coronary bypass using $T-PLS^{TM}\;and\;Bio-pump^{TM}$ (20 patients for each) from April 2003 to June 2005. All of the surgeries were operated on pump beating coronary artery bypass graft using cardiopulmonary extra-corporeal circulation. Risk factors before surgery and the condition during surgery and the results were compared. Result: There was no significant difference in age, gender ratio, and risk factors before surgery such as history of diabetes, hypertension, smoking, obstructive pulmonary disease, coronary infarction, and renal failure between the two groups. Surgery duration, hours of heart-lung machine operation, used shunt and grafted coronary branch were little different between the two groups. The two groups had a similar level of systolic arterial pressure, diastolic arterial pressure and mean arterial pressure, but pulse pressure was measured higher in the group with $T-PLS^{TM}\;(46{\pm}15\;mmHg\;in\;T-PLS^{TM}\;vs\;35{\pm}13\;mmHg\;in\;Bio-pump^{TM},\;p<0.05)$. The $T-PLS^{TM}$-operated patients tended to produce more urine volume during surgery, but the difference was not statistically significant $(9.7{\pm}3.9\;cc/min\;in\;T-PLS^{TM}\;vs\;8.9{\pm}3.6\;cc/min\;in\;Bio-pump^{TM},\;p=0.20)$. There was no significant difference in mean duration of respirator usage and 24-hour blood loss after surgery between the two groups. Plasma free Hb was measured lower in the group with $T-PLS^{TM}\;(24.5{\pm}21.7\;mg/dL\;in\;T-PLS^{TM}\;versus\;46.8{\pm}23.0mg/dL\;in\;Bio-pump^{TM},\;p<0.05)$. There was no significant difference in coronary infarction, arrhythmia, renal failure and morbidity rate of cerebrovascular disease. There was a case of death after surgery (death rate of 5%) in the group tested with $T-PLS^{TM}$, but the death rate was not statistically significant. Conclusion: Coronary bypass was operated with $T-PLS^{TM}$ (Pulsatile flow pump) using a heart-lung machine. There was no unexpected event caused by mechanical error during surgery, and the clinical process of the surgery was the same as the surgery for which $Bio-pump^{TM}$ was used. In addition, $T-PLS^{TM}$ used surgery was found to be less detrimental to blood corpuscles than the pulsatile flow has been known to be. Authors of this study could confirm the safety of $T-PLS^{TM}$.

Study on the prevalence of allergic diseases based on the health behavior of multicultural families youth - The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014, Centers for Disease Control & Prevention - (다문화가정 청소년의 건강행태에 따른 알레르기질환 유병률 연구 - 질병관리본부 제10차(2014년) 청소년건강행태온라인조사 -)

  • Kim, Hyang-Sug;Jung, Lan-hee
    • Journal of Korean Home Economics Education Association
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    • v.29 no.2
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    • pp.41-52
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    • 2017
  • The purpose of this study was to identify the factors related to allergic diseases based on the health behavior of the youth in multicultural families according to the data from Tenth Korea Youth Risk Behavior Web-Based Survey 2014 (Centers for Disease Control & Prevention). The subjects from 712 multicultural adolescents were analyzed by the SPSS program. For the characteristics of health behavior of the multicultural youth, 267 students (37.5%) have experienced drinking alcohol, 164 students (23.0%) have experienced smoking, and 35 students (4.9%) have experienced taking drugs. Also, 198 students (27.8%) were depressed, 259 students (36.3%) are suffering from stress, and 286 students (40.2%) failed to fully relieve fatigue. In addition, 497 students (69.8%) consider themselves as healthy, 449 students (63.1%) consider themselves as happy, and 251 students (35.3%) consider themselves as overweight. Among the allergic disease of the multicultural youth, 46 middle school students (6.5%) and 35 high school students (4.9%) have asthma, 95 middle school students (13.3%) and 87 high school students (12.2%) have allergic rhinitis, and 67 middle school students (9.4%) and 53 high school students (7.4%) have atopic dermatitis. 47 male students (6.6%) and 34 female students (4.8%) have asthma, 81 male students (11.4%) and 101 female students (14.1%) have allergic rhinitis, and 53 male students (7.4%) and 67 female students (9.4%) have atopic dermatitis. Among the multicultural youth, 81 students (11.4%) have asthma, 182 students (25.5%) have allergic rhinitis, and 120 students (16.8%) have atopic dermatitis. For the allergic diseases from the health behavior of the multicultural youth, depression (p<0.001), alcohol experience (p<0.05), drug experience (p<0.05), health recognition (p<0.05), happiness recognition (p<0.05), and body type recognition (p<0.05) had a statistically significant relationship with asthma. Fatigue recovery recognition (p<0.001), health recognition (p<0.001) and stress recognition (p<0.05) had a statistically significant relationship with allergic rhinitis. Body type recognition (p<0.01), depression (p<0.05), fatigue recovery recognition (p<0.05), health recognition (p<0.05), and happiness recognition (p<0.05) had a statistically significant relationship with atopic dermatitis. Such results show that schools and society need to educate the multicultural youth about health, happiness, and body type recognition which are big factors of allergic diseases. Schools and society also need to be more systematic and continuous in order to help multicultural youth to be have correct recognition of depression, stress and fatigue recovery.

A study on OHIP-14 and EQ-5D of residents in some rural areas (일부 농촌지역 주민들의 OHIP-14와 EQ-5D에 관한 연구)

  • Lee, Eun-Gyeong;Park, Jeong-Hee;Park, Jeong-Ran;Park, Jae-Yong
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.2
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    • pp.197-211
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    • 2011
  • Objectives : OHIP-14 and EQ-5D were used, targeting the residents of farming communities to identify the elements that influence oral cavity's health and quality of life due to health and to identify the importance of oral cavity's health in order to increase health of adults' oral cavity and quality of life via improved health. Methods : This research was conducted from July 17th, 2010 to August 16th, 2010 targeting 600 residents in Goryeong-gun, Gyeongsangbuk-do, aging over 40. The data has been analyzed using Mann-Whitney U test, Kruskal-Wallis test and hierarchical multiple regression through SPSS Win Program 18.0 version. Results : 1. OHIP-14 and EQ-5D based on general characteristics showed lower oral health-related quality of life and health-related quality of life on the following cases: women (p=0.004, p<0.001), older (p<0.001, p<0.001), lower scholastic ability (p<0.001, p<0.001), lower average of average spending money (p<0.001, p<0.001), higher number of chronic disease (p<0.001, p<0.001), less drinking (p=0.012, p=0.008), lower perceived oral health and health status (p<0.001, p<0.001) and non smoking showed only EQ-5D (p<0.001). 2. OHIP-14 and EQ-5D based on oral health behavior showed lower oral health-related quality of life and health-related quality of life on the following cases: no periodic oral check-up (p<0.001, p<0.001), less experience of oral health education (p<0.001, p<0.001), horizontal tooth-brushing method(p<0.001, p<0.001) and lower frequency of tooth-brushing showed only OHIP-14 (p=0.042). OHIP-14 and EQ-5D based on oral health status and subjective oral symptom showed lower oral health-related quality of life and health-related quality of life on following cases: number of existing tooth less than 20 (p<0.001, p<0.001), the number of missing teeth more than 9 (p<0.001, p=0.044), DMFT (Decay, Missing, Filling Teeth) index more than 18 (p<0.001, p<0.001), wears denture (p<0.001, p<0.001), edentulous (p<0.001, p=0.002), have xerostomia (p<0.001, p<0.001) and have chewing discomfort (p<0.001, p<0.001). 3. Factors affecting OHIP-14 were gender, age, perceived oral health status, perceived health status, number of existing teeth, dental status, xerostomia and chewing discomfort, and the of reliability (how well it explains) the final model was 48.7%. EQ-5D showed relevance on gender, age, presence of chronic disease, perceived health status, xerostomia, chewing discomfort and oral health-related quality of life, and the reliability of the final model was 42.9%. Conclusions : In order to improve the quality of life of ruralists, oral health needs to be improved or remained by increasing the rate of possession of the existing teeth and preventing the loss of teeth. In order to do so, improvement of accessibility of dental clinic, change of direction from treatment-centered to prevention-centered health care system, development of oral health education program and various oral health care policies which would vitalize continuous oral health care system are considered to be necessary.

Recurrence Analysis after Video-assisted Thoracic Surgery for the Treatment of Spontaneous Pneumothorax (자연기흉의 비디오흉강경수술 후 재발에 대한 분석)

  • Kim, Sung-Wan;Kim, Duk-Sil;Lim, Chang-Young;Lee, Hyeon-Jae;Lee, Gun;Kong, Joon-Hyuk
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.710-715
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    • 2010
  • Background: Video-assisted thoracic surgery (VATS) became common in the treatment of spontaneous pneumothorax (SP). Therefor we've reviewed the recurrence rate after VATS and analysed the factors affecting recurrent pneumothorax after VATS on this study. Material and Method: This retrospective analysis was performed on 321 patients of SP who had undergone VATS from Jan. 2001 to Dec. 2008. The two groups were divided as follow: group A, non-recurrent group (298 patients: 93%); and group B, recurrent group (26 patients: 7%); the two groups were analysed retrospectively. Result: The average age of the study groups were $20.9{\pm}4.3$ years old in recurrent group vs. $25.9{\pm}11.7$ years old in non-recurrent group with statistical significance (p < 0.05). There were no statistical significance in male to female ratio, height/weight ratio, location of pneumothorax, smoking history, operative time, duration of drain, hospital stay, indication of opertion and incidence rate. Average length of duration in recurrence was 12.9 months. There was 22 (95.7%) recurrent patients after VATS within 4 year period among recurrent group. Treatment methods in 23 of recurrent patients were, 8 (VATS), 2 (Axillary thoracotomy) with 15% or more in amount of pneumothorax and 7 (7 Fr. chest tube), 6 (nasal 02) with 15% or less in amount of pneumothorax. Among 10 cases of reoperation, there were 3 cases of over looking type and 7 cases of new growing type. There was no additional recurrence after these procedures were given. Conclusion: There was higher recurrence rate in younger age after VATS thus for those under 20 yrs old, detailed and possible preoperative warning for recurrence is warranted. Most recurrence occured within 4 year period, thus for this reason, regular interval based follow up with chest x-ray study is suggested during this period.

The Diagnostic Value of Isocapnic Hyperventilation of Cold Air in Adults with Suspected Asthma (기관지 천식을 의심하는 성인환자에서 등탄산 찬공기 과호흡의 진단적 유용성)

  • Cho, Jae-Hwa;Ryu, Jeong-Seon;Lee, Ji-Young;Kwak, Seung-Min;Lee, Hong-Lyeol;Cho, Chul-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.232-239
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    • 2001
  • Background : Asthmatic patients frequently suffer cold-weather-associated respiratory symptoms. The sensitivity, specificity, accuracy and diagnostic value of isocapnic hyperventilation of cold air(IHCA) using a multistep method, was investigated in patients suspected to have asthma. Method : One hundred and 29 adult patients who had an IHCA performed between july 1999 and December 2000, had an methacholine bronchoprovocation test because of a clinical suspicion of asthma. Results : According to strict criteria, 50 were defined as asthmatics and 79 as symptomatic nonasthmatics. There were no differences in age, sex and smoking state between the asthmatic and symptomatic nonasthmatic groups. There was a significant decrease in the percentage reduction in the forced expiratory volume in 1 second($FEV_1$) after the IHCA between the asthmatics($-10.0{\pm}6.8%$) and the symptomatic nonasthmatics($-2.3{\pm}2.5%)$. The factors associated with a reactivity to IHCA were $FEV_1$/FVC, $FEF_{25-75}$%/FVC and $FEV_1$(% of predicted). The accuracy was highest using a 7% fall in $FEV_1$ ; the sensitivity was 76% and the specificity 96%. Conclusion : IHCA is a specific, although not a sensitive, test for diagnosing asthma in adult patients. Furthermore, the diagnostic cut-off value of the different methods of IHCA need to be determined.

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Resting Energy Expenditure in Patients with Lung Cancer (폐암 환자의 안정시 에너지 소비)

  • Lee, Jae-Lyun;Kim, Ki-Beom;Lee, Hak-Jun;Jung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1019-1029
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    • 1997
  • Background : Elevation of resting energy expenditure(REE) in patients with lung cancer has been described in earlier studies and may contribute to cancer cachexia, but limited information is available regarding the prevalence and determinants of the increased REE. The aim of this study was to assess the prevalence and contributing factors of a hypermetabolic state in newly detected patients with lung cancer and to assess the energy balance in order to improve our knowledge about weight loss in patients with lung cancer. Method : Thirty one consecutive, newly detected patients with lung cancer and 20 control patients with benign lung diseases were included in this study. Resting energy expenditure(REE) was measured by indirect calorimetry using ventilated hood system and predicted REE was calculated by the Harris-Benedict formular. Results : The energy balance in newly detected lung cancer patients was disturbed in a high proportion of patients, and hypermetabolic state occurred in 61% of the patients. Tumor volume, cancer type, location, stage, the presence of atelectasis or infiltration, pulmonary function, or smoking behavior were not associated with increase in REE. But patients with distant metastasis had significantly higher REE comparing with patients without metastasis. Thirty nine percents of the patients with lung cancer had substantial loss of more than 10% of their pre-illness weight. Weight losing patients with lung cancer were not accompanied by an increase in REE. Conclusion : We concluded that the REE was elevated in a higher proportion of patients with lung cancer and distant metastasis was found to be contributing factor to the elevated REE.

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Analysis of health habit and hair mineral nutrition status of media addicted adolescent (미디어중독 청소년의 스마트폰 사용의존도에 따른 건강습관 및 모발 무기질 영양상태 분석)

  • Lim, Hee-Sook;Kim, Soon-Kyung
    • Journal of Nutrition and Health
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    • v.51 no.4
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    • pp.295-306
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    • 2018
  • Purpose: Koreans' internet and smartphone usage hours are steadily increasing and the dependence of young people on smartphones is causing social problems. Therefore, this study was conducted to examine health and dietary habits, as well as hair mineral contents according to the level of dependence of smartphone use among adolescents to clarify the interrelation of smartphone dependence, lifestyle, dietary behavior, and mineral nutrition status. Methods: A total of 80 smartphone-addicted adolescents participated in this study and were divided into three groups (general, potential and danger group) according to smartphone dependence. The subjects' lifestyles and dietary behaviors were then surveyed, and hair mineral contents were analyzed. Results: Higher smartphone dependence was associated with lower average weekly sleeping time and later first smoking age. In the danger group, the rate of eating fast and the rate of snacking twice a day was also relatively high. Parents (45.0%) and mobile (30.0%) were the factors having the greatest influence on an individual's dietary behavior. In the hair mineral analysis, all subjects had lower selenium concentrations and higher lead concentrations than normal. In addition, the levels of aluminum in the danger group were higher than in the normal range and the highest among the three groups. Conclusions: It is necessary to guide adolescents to use smartphones correctly and manage dietary habits. In addition, careful attention is needed the mineral nutritional status of smartphone-addicted adolescents.