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Community Residents' Knowledge, Attitude, and Needs for Hospice Care (일부 지역주민들의 호스피스에 대한 인지와 태도 및 간호요구 조사)

  • Ro, You-Ja;Han, Sung-Suk;Ahn, Sung-Hee;Yong, Jin-Sun
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.23-35
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    • 1999
  • Purpose : The hospice movement began about 30 years ago in Korea. However, basic studies have seldom been conducted about the general public's knowledge concerning hospice care and their needs for it. The purpose of this study was to investigate the general public's knowledge of and attitude toward hospice, and their needs for hospice care, and to analyze the needs for hospice care in relation to their knowledge and attitude in residents from a specific community. Methods : The survey was conducted with 924 people randomly selected from a district in Seoul. The data were collected through a self-reporting questionnaire constructed by the authors. With 30 items given in the questionnaire, the level of hospice needs showed Cronbach's alpha .89 in a pilot study and .92 in this study and the items were classified into four areas by a factor analysis. The data collected were analyzed by means of t-test and ANOVA. Results : 1) The average age of the respondents was 38. The majority of the respondents were well-educated. 2) Regarding awareness of hospice care, 54%(501 people) indicated they have heard of hospice. About 74% thought that people should be able to prepare for death in advance. About 83% wanted to be informed when they have life threatening illnesses such as terminal cancer. Also, about 63% responded that patients with terminal diseases should be provided with physical, spiritual, and psychological care for minimizing pain and peaceful death. Regarding the attitude toward hospice care, 74% responded that they would use hospice care if needed. The number of the respondents who preferred home visitation by the hospice team to care for the terminally ill ranked first with 34%. Concerning needs for hospice care : 1) By needs area, physical need showed highest mean(M=4.37), followed by social need(M=3.96), emotional need(M=3.87), and the spiritual need(M=3.79). The overall need level showed the mean value of 4.00 which reflects a considerable need for hospice care. 2) By demographic characteristics, people age over 50, the married, and the unemployed indicated higher level of needs for hospice care. Women showed higher level of needs than did men, and Catholics demonstrated higher level of needs than believers of other religion(P<0.0001). 3) As for the knowledge of and attitude toward hospice rare, the level of hospice care needs was significantly higher in the following groups: those who have heard of hospice, those who are aware of death preparation, those who want information on terminal diseases, those who want to use every method to sustain life, and those who are aware of hospice needs(P<0.001). Conclusion : It is assumed that the findings of this study on the knowledge, attitude, and needs for hospice care in the public can contribute to planning a successful hospice care program. Furthermore, the findings of this study will serve as useful data for the promotion of home hospice care to improve the quality of life of community residents, and contribute to the development of hospice care as a whole.

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Relationship between Glycated Hemoglobin and Depression, Anxiety, Alexithymia, Stress Response in Diabetic Patients - A Preliminary Study - (당뇨환자에서 당화혈색소와 관련된 우울, 불안, 감정표현불능, 스트레스반응 - 예비적 연구 -)

  • Jeong, Jong-Hyun;Ko, Seung-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Sung-Pil;Ahn, Yoo-Bae;Song, Ki-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.157-164
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    • 2004
  • Objectives : This study was designed to investigate depression, anxiety, alexithymia, stress responses between well-controlled and poorly-controlled diabetic patients by glycated hemoglobin levels. Methods : The subjects were 55 diabetic patients(mean age : $49.9{\pm}9.9$, 27 men and 28 women) who were confirmed to have diabetes depending on the laboratory findings as well as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Aug. 2004. Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on glycated hemoglobin levels, the patients were divided into 10 well-controlled group(below 7%) and 45 poorly-controlled group(above 7%). We compared BDI, STAI, TAS and SRI scores between two groups by independent t-test. Results 1) Well-controlled diabetics, compared with poorly controlled group, manifested decreased illness duration($12.2{\pm}55.4$months vs. $55.4{\pm}66.6 months)(p=0.000), but other demographic data showed no difference between two groups. 2) The STAI scores of poorly-controlled group were significantly higher in both state anxiety sores $(38.7{\pm}3.8 \;vs.\;43.7{\pm}6.7)(p=0.29)$ and trait anxiety scores$(36.9{\pm}5.7\;vs.\;41.5{\pm}6.4)(p=0.43)$ than well-controlled groups. 3) No significant differences were found in the score of BDI, TAS, SRI between well and poorly-controlled diabetic groups. Conclusion : The above results suggest that poorly-controlled diabetic patients are more likely to have higher anxiety level than well-controlled diabetic patients. However, there were no differences in depression, alexithymia, stress responses between two group. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetic patients.

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Studies on Degradation of Nucleic acid and Related Compounds by Microbial Enzymes (미생물 효소에 의한 핵산 및 그의 관련물질의 분해에 관한 연구)

  • Kim, Sang-Soon
    • Applied Biological Chemistry
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    • v.13 no.2
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    • pp.111-129
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    • 1970
  • As a series of studies on the nucleic acids and their related substances 210 samples were collected from 76 places such as farm soil, compost of heap, nuruk and meju to obtain microbial strains which produce 5'-phosphodiesterase. From these samples total of 758 strains were isolated by the use of dilution pour plate method. For all isolated strains primary screening of the productivity of RNA depolymerase was performed and useful strains with regard to 5'-phosphodiesterase productivities were identified. For these useful strains optimum condition, the effect of various compounds on the activity of 5'-phosphodiesterase, and the optimum condition for enzyme reaction were discussed. The quantitative of 5'-mononucleotides produced by the action of 5'-phosphodiesterase was performed using anion-exchange column chromatography and their identified was done by paper chromatography, thinlayer chromatography, ultra violet spectrophotometry, and characteristic color reaction using carbazole and schiff's reagent. (1) Penicillium citreo-viride PO 2-11 and Streptomyces aureus SOA 4-21 from soil were identified as a potent 5'-phosphodiesterase producing strains. (2) Optimum culture conditions for Penicillium citreo-viride PO 2-11 strain isolated were found to be pH 5.0 and $30^{\circ}C$, and the optimum conditions for enzyme action of 5'-phosphodiesterase were pH 4.2 and $60^{\circ}C$. Best carbon source for the production of 5'-phosphodiesterase was found to be sucrose and ammonium nitrate for nitrogen source. Addition of 0.01% corn steep liquor or yeast extract exhibited 20% increase in the amount of 5'-phosphodiesterase production compared to the control. 5'-phosphodiesterase produced by this strain was activated by $Mg^{++},\;Ca^{++},\;Zn^{++},\;Mn^{++}$ and was inhibited by EDTA, citrate, $Cu^{++},\;CO^{++}$. 5'-phosphodiesterase produced 5'-mononucleotide from RNA at a rate of 65.81%, and among the 5'-mononucleotides accumulated 5'-GMP only was found to have flavorous and the strain was also found lack of 5'-AMP deaminase. Productivity of flavorous 5'-GMP was found to be 186.7mg per gram of RNA. (3) Optimum culture canditions for the isolated Streptomyces aureus SOA 4-21 strain were pH 7.0 and $28^{\circ}C$, and the optimum conditions for the action of 5'-phosphodiesterase were pH 7.3 and $50^{\circ}C$. The best carbon source for 5'-phosphodiesterase production was found to be glucose and that of nitrogen was asparagine. Addition of 0.01% yeast extract exhibited increased productivity of 5'-phosphodiesterase by 40% compared to the non-added control. 5'-phosphodiesterase produced by this strain was activated by $Ca^{++},\;Zn^{++},\;Mn^{++}$ and was inhibited by citrate, EDTA, $Cu^{++}$. It was also found that the strain produce 5'-AMP deaminase in addition to 5'-phosphodiesterase. For this reason although decomposition rate was 63.58% the accumulation of 5'-AMP, 5'-CMP, 5'-GMP and 5'-UMP occurred by the breakdown of RNA. In the course of these reaction 5'-AMP deaminase converted 60% of 5'-AMP thus produced into 5'-IMP and flavorous 5'-mono nucleotide production was significantly increased by this strain over the above mentioned one. Production rates were found to be 171.8mg per grain of RNA for 5'-IMP and 148.2mg per gram of RNA for 5'-GMP, respectively.

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Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center (응급의료센터 내원환자 진료시 소요시간과 관련된 요인)

  • Han, Nam Sook;Park, Jae Yong;Lee, Sam Beom;Do, Byung Soo;Kim, Seok Beom
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.138-155
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    • 2000
  • Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

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The Effect of Brand Extension of Private Label on Consumer Attitude - a focus on the moderating effect of the perceived fit difference between parent brands and an extended brand - (PL의 브랜드확장이 소비자태도에 미치는 영향에 관한 연구 : 모브랜드 적합도 인식 차이의 조절효과를 중심으로)

  • Kim, Jong-Keun;Kim, Hyang-Mi;Lee, Jong-Ho
    • Journal of Distribution Research
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    • v.16 no.4
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    • pp.1-27
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    • 2011
  • Introduction: Sales of private labels(PU have been growing m recent years. Globally, PLs have already achieved 20% share, although between 25 and 50% share in most of the European markets(AC. Nielson, 2005). These products are aimed to have comparable quality and prices as national brand(NB) products and have been continuously eroding manufacturer's national brand market share. Stores have also started introducing premium PLs that are of higher-quality and more reasonably priced compared to NBs. Worldwide, many retailers already have a multiple-tier private label architecture. Consumers as a consequence are now able to have a more diverse brand choice in store than ever before. Since premium PLs are priced higher than regular PLs and even, in some cases, above NBs, stores can expect to generate higher profits. Brand extensions and private label have been extensively studied in the marketing field. However, less attention has been paid to the private label extension. Therefore, this research focuses on private label extension using the Multi-Attribute Attitude Model(Fishbein and Ajzen, 1975). Especially there are few studies that consider the hierarchical effect of the PL's two parent brands: store brand and the original PL. We assume that the attitude toward each of the two parent brands affects the attitude towards the extended PL. The influence from each parent brand toward extended PL will vary according to the perceived fit between each parent brand and the extended PL. This research focuses on how these two parent brands act as reference points to one another in the consumers' choice consideration. Specifically we seek to understand how store image and attitude towards original PL affect consumer perceptions of extended premium PL. How consumers perceive extended premium PLs could provide strategic suggestions for retailer managers with specific suggestions on whether it is more effective: to position extended premium PL similarly or dissimilarly to original PL especially on the quality dimension and congruency with store image. There is an extensive body of research on branding and brand extensions (e.g. Aaker and Keller, 1990) and more recently on PLs(e.g. Kumar and Steenkamp, 2007). However there are no studies to date that look at the upgrading and influence of original PLs and attitude towards store on the premium PL extension. This research wishes to make a contribution to this gap using the perceived fit difference between parent brands and extended premium PL as the context. In order to meet the above objectives, we investigate which factors heighten consumers' positive attitude toward premium PL extension. Research Model and Hypotheses: When considering the attitude towards the premium PL extension, we expect four factors to have an influence: attitude towards store; attitude towards original PL; perceived congruity between the store image and the premium PL; perceived similarity between the original PL and the premium PL. We expect that all these factors have an influence on consumer attitude towards premium PL extension. Figure 1 gives the research model and hypotheses. Method: Data were collected by an intercept survey conducted on consumers at discount stores. 403 survey responses were attained (total 59.8% female, across all age ranges). Respondents were asked to respond to a series of Questions measured on 7 point likert-type scales. The survey consisted of Questions that measured: the trust towards store and the original PL; the satisfaction towards store and the original PL; the attitudes towards store, the original PL, and the extended premium PL; the perceived similarity of the original PL and the extended premium PL; the perceived congruity between the store image and the extended premium PL. Product images with specific explanations of the features of premium PL, regular PL and NB we reused as the stimuli for the Question response. We developed scales to measure the research constructs. Cronbach's alphaw as measured each construct with the reliability for all constructs exceeding the .70 standard(Nunnally, 1978). Results: To test the hypotheses, path analysis was conducted using LISREL 8.30. The path analysis for verification of the model produced satisfactory results. The validity index shows acceptable results(${\chi}^2=427.00$(P=0.00), GFI= .90, AGFI= .87, NFI= .91, RMSEA= .062, RMR= .047). With the increasing retailer use of premium PLBs, the intention of this research was to examine how consumers use original PL and store image as reference points as to the attitude towards premium PL extension. Results(see table 1 & 2) show that the attitude of each parent brand (attitudes toward store and original pL) influences the attitude towards extended PL and their perceived fit moderates these influences. Attitude toward the extended PL was influenced by the relative level of perceived fit. Discussion of results and future direction: These results suggest that the future strategy for the PL extension needs to consider that positive parent brand attitude is more strongly associated with the attitude toward PL extensions. Specifically, to improve attitude towards PL extension, building and maintaining positive attitude towards original PL is necessary. Positioning premium PL congruently to store image is also important for positive attitude. In order to improve this research, the following alternatives should also be considered. To improve the research model's predictive power, more diverse products should be included in study. Other attributes of product should also be included such as design, brand name since we only considered trust and satisfaction as factors to build consumer attitudes.

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Relationship between Stress and Eating Habits of Adults in Ulsan (울산지역 성인 남녀의 스트레스와 식습관)

  • Kim, Hye-Kyung;Kim, Jin-Hee
    • Journal of Nutrition and Health
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    • v.42 no.6
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    • pp.536-546
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    • 2009
  • This study was done to investigate the effect of stress on appetite and eating habits, and other health-related behaviors. The subjects of this study consisted of 188 males and 224 females in Ulsan area. The results were as follows: When stressed, 56% (n = 231) of the subjects experienced a change in appetite and of these, 32% (n = 132) experienced an increased appetite. Stress-induced eating may be one factor contributing to the development of obesity. There was a gender-specific response to stress in which women are more likely to use food to deal with stress, whereas men are more likely to use alcohol consumption or smoking. It was found that types of stressors were individual (52.9%), social (50.7%), family relations (34.5%), work demands (34.2%) and physical environment (32.3%). Stress-induced symptoms of the subjects were anxiety (38.3%), headache (36.7%) and neck or shoulder aches (36.2%), and females experienced those symptoms more than males. Those older than 50 years had a higher eating habit score and lower stress score compared with younger subjects. There were significant differences between sex, age, occupation, family type, BMI, exercise, sleeping hours and eating habits or stress level. This study may be helpful in advancing findings in this area to better provide health professionals with appropriate counseling tools to improve the health of all individuals.

Mid-Term Results of 292 cases of Coronary Artery Bypass Grafting (관상동맥 우회술 292례의 중기 성적)

  • 김태윤;김응중;이원용;지현근;신윤철;김건일
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.643-652
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    • 2002
  • As the prevalence of coronay artery disease is increasing, the surgical treatment has been universalized and operative outcome has been improved. We analyzed the short and mid-term results of 292 CABGs performed in Kangdong Sacred Heart Hospital. Material and Method: From June 1994 to December 2001, 292 patients underwent coronary artery bypass grafting. There were 173 men and 119 women and their ages ranged from 39 to 84 years with a mean of $61.8{\pm}9.1$ years. We analyzed the preoperative risk factors, operative procedures and operative outcome. In addition, we analyzed the recurrence of symptoms, long-term mortality and complications via out-patient follow-up for discharged patients. Result: Preoperative clinical diagnoses were unstable angina in 137(46.9%), stable angina in 34(11.6%), acute myocardial infarction in 40(13.7%), non-Q myocardial infarction in 25(8.6%), postinfarction angina in 22(7.5%), cardiogenic shock in 30(10.3%) and PTCA failure in 4(1.4%) patients. Preoperative angiographic diagnoses were three-vessel disease in 157(53.8%), two-vessel disease in 35 (12.0%), one-vessel disease in 11(3.8%) and left main disease in 89(30.5%) patients. We used saphenous veins in 630, internal thoracic arteries in 257, radial arteries in 50, and right gastoepiploic arteries in 2 distal anastomoses. The mean number of distal anastomoses per patient was $3.2{\pm}1.0$ There were 18 concomitant procedures ; valve replacement in 8(2.7%), left main coronary artery angioplasty in 6(2.1%), patch closure of postinfarction ventricular septal defect(PMI-VSD) in 2(0.7%), replacement of ascending aorta in 1(0.3%) and coronary endarterectomy in 1(0.3%) patient. The mean ACC time was $96.6{\pm}35.3 $ minutes and the mean CPB time was $179.2{\pm}94.6$ minutes. Total early mortality was 8.6%, but it was 3.1% in elective operations. The most common cause of early mortality was low cardiac output syndrome in 6(2.1%) patients. The stastistically significant risk factors for early mortality were hypertension, old age($\geq$ 70 years), poor LV function(EF<40%), congestive heart failure, preoperative intraaortic balloon pump, emergency operation and chronic renal failure. The most common complication was arrhythmia in 52(17.8%) patients. The mean follow-up period was $39.0{\pm}27.0$ months. Most patients were free of symptoms during follow-up. Fourteen patients(5.8 %) had recurrent symptoms and 7 patients(2.9%) died during follow-up period. Follow-up coronary angiography was performed in 13 patients with recurrent symptoms and they were managed by surgical and medical treatment according to the coronary angiographic result. Conclusion: The operative and late results of CABG in our hospital, was acceptable. However, There should be more refinement in operative technique and postoperative management to improve the results.

Clinical Experiences for Cardiac Myxomas (심장 점액종의 임상적 고찰)

  • Lee, Geun-Dong;Lee, Jae-Won;Jung, Jae-Seung;Jung, Sung-Ho;Je, Hyoung-Gon;Choo, Suk-Jung;Song, Hyun;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.703-709
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    • 2008
  • Background: Diagnosis and treatment are often successful in the setting of cardiac myxomas. However, cardiac myxomas can lead to catastrophic complications, due to intracardiac obstruction and embolism preoperatively, and can recur postoperatively. Material and Method: We retrospectively reviewed the clinical characteristics, surgical treatment, and recurrence data of 85 patients who underwent cardiac myxoma surgery at Asan Medical Center between November 1994 and June 2007. We analyzed the morphologic characteristics of 58 patients with left atrial myxomas and determined the development of functional mitral valve stenosis and systemic embolism through reviewing the results of preoperative echo-cardiograms to find potential preoperative risk factors. Result: Twenty-seven (31.8%) patients were men, and 58 (68.2%) were women. The mean patient age was $54.5{\pm}14.3$ years. Preoperative symptoms included obstructive symptoms in 41 (48.2%) patients, signs of embolism in 19 (22.4%), constitutional symptoms in 8 (9.4%), and no symptoms in 19 (20.0%). Among the 58 patients with left atrial myxomas, the mean maximal tumor diameter was $4.3{\pm}1.8$ (range $1.1{\sim}8\;cm$)cm. Twenty-six (44.8%) patients had a prolapsing type, defined as a tumor mobile enough to move down. to the mitral. annular plane during diastole, and 32 (55.2%) had villous type, defined as a tumor consisting of multiple fine villous extensions on the surface. Twelve (20.7%) patients had severe functional mitral valve stenosis, and 15 (25.9%) had systemic embolism preoperatively. The incidence of severe functional mitral valve stenosis was significantly higher in patients with the prolapsing type than in those with the non-prolapsing type (p=0.001). The mean maximal tumor diameter in patients with severe functional mitral valve stenosis was $5.1{\pm}1.0\;cm$, significantly larger than that seen in patients without severe functional mitral valve stenosis (p=0.041). The incidence of systemic embolism was significantly higher in patients with the villous type than in those with the smooth type (p=0.006). Postoperative complications were noted in 6 (7.1%) patients, and early mortality was noted in 1 (1.2%). The mean postoperative follow-up duration was $36.2{\pm}37.5$ months, with recurrence reported in 2(2.4%) patients during the follow-up period. The disease free interval were 48, 12 months, respectively. Conclusion: Surgical treatment for cardiac myxomas was performed safely, and long-term prognosis was good. In patients with left atrial myxoma, close attention should be maintained and surgery should be performed promptly in those of prolapsing type, those with large maximal diameter in order to prevent severe functional mitral valve stenosis, and those of villous type in order to prevent systemic embolism. Echocardiography should be followed serially in order to detect recurrence.

Radiation Therapy for Carcinoma of the Oropharynx (구인두암의 방사선치료)

  • Park, In-Kyu;Kim, Jae-Choel
    • Radiation Oncology Journal
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    • v.14 no.2
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    • pp.95-103
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    • 1996
  • Purpose : A retrospective analysis for patients with oropharyngeal carcinoma who were treated with radiation was performed to assess the results of treatment and patterns of failure, and to identify the factors that might influence survival. materials and methods : From March 1985 through June 1993, 53 patients with oropharyngeal carcinoma were treated with either radiation therapy alone or combination of neoadjuvant chemotherapy and radiation therapy at the Department of Radiation Oncology, Kyungpook National University Hospital. Patients' ages ranged from 31 to 73 years with a median age of 54 years. There were 47 men and 6 women, Forty-two Patients ($79.2\%$) had squamous cell carcinoma, 10 patients ($18.9\%$) had undifferentiated carcinoma and 1 patient ($19\%$) had adenoid cystic carcinoma. There were 2 patients with stage I, 12 patients with stage II, 12 Patients with stage III and 27 patients with stage IV. According to the TNM classification, patients were distributed as follows: T1 7, T2 28, T3 10, T4 7, TX 1, and N0 17, Nl 13, N2 21, N3 2. The primary tumor sites were tonsillar region in 36 patients ($67.9\%$), base of the tongue in 12 patients ($22.6\%$), and soft palate in 5 patients ($9.4\%$). Twenty-five patients were treated with radiation therapy alone and twenty-eight Patients were treated with one to three courses of chemotherapy followed by radiation therapy. Chemotherapeutic regimens used were either CF (cisplatin and 5-fluorouracil) or CVB (cisplatin, vincristine and bleomycin). Radiation therapy was delivered 180-200 cGy daily, five times a week using 6 MV X-ray with or without 8-10 MeV electron beams A tumor dose ranged from 4500 cGy to 7740 cGy with a median dose of 7100 cGy. The follow-up time ranged from 4 months to 99 months with a median of 21 months. Results : Thirty-seven patients ($69.8\%$) achieved a CR (complete response) and PR (partial response) in 16 patients ($30.2\%$) after radiation therapy. The overall survival rates were $47\%$ at 2 years and $42\%$ at 3 years, respectively. The median survival time was 23 months. Overall stage (p=0.02) and response to radiation therapy (p=0.004) were significant prognostic factors for overall survival. The 2-year disease-free survival rate was $45.5\%$. T-stage (p=0.03), N-stage (p=0.04) and overall stage (P=0.04) were significant prognostic factors for disease-free survival. Age, sex, histology, primary site of the tumor, radiation dose, combination of chemotherapy were not significantly associated with disease-free survival. Among evaluable 32 Patients with CR to radiation therapy, 12 patients were considered to have failed Among these, 8 patients failed locoregionally and 4 Patients failed distantly. Conclusion : T-stage, N-stage and overall stage were significant prognostic factors for disease-free survival in the treatment of oropharyngeal cancer Since locoregional failure was the predominant pattern of relapse, potential methods to improve locoregional control with radiation therapy should be attempted. More controlled clinical, trials should be completed before acceptance of chemotherapy as a part of treatment of oropharyngeal carcinoma.

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Analysis of Bone Mineral Density and Related Factors after Pelvic Radiotherapy in Patients with Cervical Cancer (골반부 방사선 치료를 받은 자궁경부암 환자의 골밀도 변화와 관련 인자 분석)

  • Yi, Sun-Shin;Jeung, Tae-Sig
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.15-22
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    • 2009
  • Purpose: This study was designed to evaluate the effects on bone mineral density (BMD) and related factors according to the distance from the radiation field at different sites. This study was conducted on patients with uterine cervical cancer who received pelvic radiotherapy. Materials and Methods: We selected 96 patients with cervical cancer who underwent determination of BMD from November 2002 to December 2006 after pelvic radiotherapy at Kosin University Gospel Hospital. The T-score and Z-score for the first lumbar spine (L1), fourth lumbar spine (L4) and femur neck (F) were analyzed to determine the difference in BMD among the sites by the use of ANOVA and the post-hoc test. The study subjects were evaluated for age, body weight, body mass index (BMI), post-radiotherapy follow-up duration, intracavitary radiotherapy (ICR) and hormonal replacement therapy (HRT). Association between the characteristics of the study subjects and T-score for each site was evaluated by the use of Pearson's correlation and multiple regression analysis. Results: The average T-score for all ages was -1.94 for the L1, -0.42 for the L4 and -0.53 for the F. The average Z-score for all ages was -1.11 for the L1, -0.40 for the L4 and -0.48 for the F. The T-score and Z-score for the L4 and F were significantly different from the scores for the L1 (p<0.05). There was no significant difference between the L4 and F. Results for patients younger than 60 years were the same as for all ages. Age and ICR were negatively correlated and body weight and HRT were positively correlated with the T-score for all sites (p<0.05). BMI was positively correlated with the T-score for the L4 and F (p<0.05). Based on the use of multiple regression analysis, age was negatively associated with the T-score for the L1 and F and was positively correlated for the L4 (p<0.05). Body weight was positively associated with the T-score for all sites (p<0.05). ICR was negatively associated with the T-score for the L1 (p<0.05). HRT was positively associated with the T-score for the L4 and F (p<0.05). Conclusion: The T-score and Z-score for the L4 and F were significantly higher than the scores for the L1, a finding in contrast to some previous studies on normal women. It was thought that radiation could partly influence BMD because of a higher T-score and Z-score for sites around the radiotherapy field. We suggest that a further long-term study is necessary to determine the clinical significance of these findings, which will influence the diagnosis of osteoporosis based on BMD in patients with cervical cancer who have received radiotherapy.