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1.
Cancer Research and Treatment ; : 258-269, 2023.
Article in English | WPRIM | ID: wpr-966471

ABSTRACT

Purpose@#This study aimed to compare treatment outcomes and toxicity profile between imaged-guided brachytherapy (IGBT) versus conventional brachytherapy (CBT) performed by the same practitioner during the same time period. @*Materials and Methods@#Medical records of 104 eligible patients who underwent brachytherapy for locally advanced cervical cancer were retrospectively reviewed. Fifty patients (48.1%) underwent IGBT, and 54 (51.9%) patients underwent CBT. All patients underwent concurrent chemoradiation with cisplatin. High-dose-rate intracavitary brachytherapy with dose prescription of 25-30 Gy in 4-6 fractions was performed for all patients. Late lower gastrointestinal (GI) and urinary toxicities occurred more than 3 months after the end of brachytherapy were included for comparative and dosimetric analyses. @*Results@#The median follow-up period was 18.33 months (range, 3.25 to 38.43 months). There were no differences in oncologic outcomes between the two groups. The IGBT group had lower rate of actuarial grade ≥ 3 toxicity than the CBT group (2-year, 4.5% vs. 25.7%; p=0.030). Cumulative equieffective D2cc of sigmoid colon was significantly correlated with grade ≥ 2 lower GI toxicity (p=0.033), while equieffective D2cc of rectum (p=0.055) and bladder (p=0.069) showed marginal significance with corresponding grade ≥ 2 toxicities in the IGBT group. Half of grade ≥ 3 lower GI toxicities impacted GI tract above the rectum. Optimal thresholds of cumulative D2cc of sigmoid colon and rectum were 69.7 Gy and 70.8 Gy, respectively, for grade ≥ 2 lower GI toxicity. @*Conclusion@#IGBT showed superior toxicity profile to CBT. Evaluating the dose to the GI tract above rectum by IGBT might prevent some toxicities.

2.
Cancer Research and Treatment ; : 659-670, 2023.
Article in English | WPRIM | ID: wpr-976694

ABSTRACT

Purpose@#In the present study, we aimed to establish a liquid biopsy-based monitoring method using peripheral blood cell-free DNA (cfDNA) for patients with cervical cancer who underwent radical radiotherapy (RT). @*Materials and Methods@#Twenty-five patients with cervical cancer were prospectively recruited and treated with external beam RT and brachytherapy. In all patients, except one, chemotherapy was administered concurrently during RT. Whole peripheral blood samples were obtained at least twice from each patient. We performed next-generation sequencing (NGS) for the target-captured libraries (67 oncogenes and human papillomavirus [HPV] type 16/18) using 64 plasma cfDNA samples from the 25 participants. The ratio of HPV cfDNA and the variant allele frequency (VAF) in cfDNA was calculated, and their dynamic changes were monitored. The median follow-up duration was 25.4 months. @*Results@#In total, we identified 21,866 cfDNA variants. ARID1A and frameshift variants occupied the largest portion of altered genes and HIGH-grade variant types, respectively. In most cases, tumor shrinkage was followed by a decrease in the HPV ratio; however, an increase in HPV ratio indicated distant metastasis, despite the reduced tumor size. The initial HPV ratio reflecting the tumor burden was likely associated with treatment outcomes (p = 0.16). We did not determine a role for serial changes in the VAF in cfDNA. @*Conclusion@#Our findings suggest that the HPV cfDNA ratio, calculated after targeted NGS, may be valuable for monitoring and predicting treatment responses. Accordingly, further validation of these findings is warranted.

3.
Radiation Oncology Journal ; : 242-250, 2022.
Article in English | WPRIM | ID: wpr-968572

ABSTRACT

Purpose@#The safety of online contouring and planning for adaptive radiotherapy is unknown. This study aimed to evaluate the dosimetric difference of the organ-at-risk (OAR) according to the extent of contouring in stereotactic magnetic resonance image-guided adaptive RT (SMART) for pancreatic cancer. @*Materials and Methods@#We reviewed the treatment plan data used for SMART in patients with pancreatic cancer. For the online contouring and planning, OARs within 2 cm from the planning target volume (PTV) in the craniocaudal direction were re-controlled daily at the attending physician's discretion. The entire OARs were re-contoured retrospectively for data analysis. We termed the two contouring methods the Rough OAR and the Full OAR, respectively. The proportion of dose constraint violation and other dosimetric parameters was analyzed. @*Results@#Nineteen patients with 94 fractions of SMART were included in the analysis. The dose constraint was violated in 10.6% and 43.6% of the fractions in Rough OAR and Full OAR methods, respectively (p = 0.075). Patients with a large tumor, a short distance from gross tumor volume (GTV) to OAR, and a tumor in the body or tail were associated with more occult dose constraint violations—large tumor (p = 0.027), short distance from GTV to OAR (p = 0.061), tumor in body or tail (p = 0.054). No dose constraint violation occurred outside 2 cm from the PTV. @*Conclusion@#More occult dose constraint violations can be found by the Full OAR method in patients with pancreatic cancer with some clinical factors in the online re-planning for SMART. Re-contouring all the OARs would be helpful to detect occult dose constraint violations in SMART planning. Since the dosimetric profile of SMART cannot be represented by a single fraction, patient selection for the Full OAR method should be weighted between the clinical usefulness and the time and workforce required.

4.
Korean Journal of Radiology ; : 732-2022.
Article in English | WPRIM | ID: wpr-938770

ABSTRACT

Objective@#To determine the impact of dedicated subspecialized radiologists in multidisciplinary team (MDT) discussions on the management of lower gastrointestinal (GI) tract malignancies. @*Materials and Methods@#We retrospectively analyzed the data of 244 patients (mean age ± standard deviation, 61.7 ± 11.9 years) referred to MDT discussions 249 times (i.e., 249 cases, as five patients were discussed twice for different issues) for lower GI tract malignancy including colorectal cancer, small bowel cancer, GI stromal tumor, and GI neuroendocrine tumor between April 2018 and June 2021 in a prospective database. Before the MDT discussions, dedicated GI radiologists reviewed all imaging studies again besides routine clinical reading. The referring clinician’s initial diagnosis, initial treatment plan, change in radiologic interpretation compared with the initial radiology report, and the MDT’s consensus recommendations for treatment were collected and compared. Factors associated with changes in treatment plans and the implementation of MDT decisions were analyzed. @*Results@#Of the 249 cases, radiologic interpretation was changed in 73 cases (29.3%) after a review by dedicated GI radiologists, with 78.1% (57/73) resulting in changes in the treatment plan. The treatment plan was changed in 92 cases (36.9%), and the rate of change in the treatment plan was significantly higher in cases with changes in radiologic interpretation than in those without (78.1% [57/73] vs. 19.9% [35/176], p < 0.001). Follow-up records of patients showed that 91.2% (227/249) of MDT recommendations for treatment were implemented. Multiple logistic regression analysis revealed that the nonsurgical approach (vs. surgical approach) decided through MDT discussion was a significant factor for patients being managed differently than the MDT recommendations (odds ratio, 4.48; p = 0.017). @*Conclusion@#MDT discussion involving additional review of radiology examinations by dedicated GI radiologists resulted in a change in the treatment plan in 36.9% of cases. Changes in treatment plans were significantly associated with changes in radiologic interpretation.

5.
Radiation Oncology Journal ; : 153-162, 2018.
Article in English | WPRIM | ID: wpr-741937

ABSTRACT

PURPOSE: We aimed to evaluate clinical outcomes including progression-free survival (PFS), overall survival (OS), partial response, and complete response in patients who underwent radiation therapy (RT) for mycosis fungoides (MF). Also, we sought to find prognostic factors for clinical outcomes. MATERIALS AND METHODS: Total 19 patients confirmed with MF between 1999–2015 were retrospectively reviewed. Clinical and treatment characteristics, clinical outcomes, and and toxicities were analyzed. RESULTS: Eleven patients were treated with total skin electron beam radiotherapy (TSEBT) and 8 patients with involved field radiation therapy (IFRT) with median dose of 30 Gy, respectively. The median time interval from diagnosis to RT was 2.6 months (range, 0.4 to 87.3 months). The overall response rate was 100%; 11 patients (57.9%) had a complete response and 8 patients (42.1%) a partial response. The presence of positive lymph node at the time of consultation of RT was associated with lower OS (p = 0.043). In multivariate analysis, PFS was significantly lower for patients with increased previous therapies experienced following RT (p = 0.019) and for patients showing PR during RT (p = 0.044). There were no reported grade 3 or more skin toxicities related with RT. CONCLUSION: Both IFRT and TSEBT are effective treatment for MF patients. Patients with short disease course before RT or complete response during RT are expected to have longer PFS. Positive lymph node status at the initiation of RT was associated woth poor OS, suggesting other treatment modalities such as low-dose RT for patients with low life-expectancy.


Subject(s)
Humans , Diagnosis , Disease-Free Survival , Lymph Nodes , Lymphoma, T-Cell, Cutaneous , Multivariate Analysis , Mycosis Fungoides , Radiotherapy , Retrospective Studies , Skin
6.
Journal of Liver Cancer ; : 64-69, 2015.
Article in Korean | WPRIM | ID: wpr-61457

ABSTRACT

Infiltrative hepatocellular carcinoma (HCC) patients have a poor prognosis because most patients present with advanced disease. Although tumor size is small, ablation therapy is difficult because it is difficult to delineate tumor boundary and tumor often combined vascular invasion. Therefore many clinicians still try locoregional therapy (LRT) such as transarterial chemoembolization (TACE), radiation therapy (RT), or combination with LRT and sorafenib in this situation. Stereotactic body radiation therapy (SBRT) is new technology providing very highly conformal ablative radiation dose and is expected to salvage modality for HCC showed incomplete response of TACE due to combined arteriovenous (AV) shunts. Based on above suggestions, we herein offer our experience of a complete remission of tumor by combination of SBRT and TACE in a patient with infiltrative HCC. Further study, maybe regarding a combination of locoregional and systemic therapy is necessary on how to manage infiltrative HCC with AV shunts.


Subject(s)
Humans , Carcinoma, Hepatocellular , Prognosis
7.
Journal of Korean Academy of Nursing ; : 97-107, 2014.
Article in Korean | WPRIM | ID: wpr-57081

ABSTRACT

PURPOSE: This study was performed to explore levels of stroke knowledge and identify subgroups with lower levels of stroke knowledge among adults in Korea. METHODS: A cross-sectional survey was used and data were collected in 2012. A national sample of 990 Koreans aged 20 to 74 years participated in this study. Knowledge of risk factors, warning signs, and first action for stroke were surveyed using face-to-face interviews. Descriptive statistics and decision tree analysis were performed using SPSS WIN 20.0 and Answer Tree 3.1. RESULTS: Mean score for stroke risk factor knowledge was 7.7 out of 10. The least recognized risk factor was diabetes and four subgroups with lower levels of knowledge were identified. Score for knowledge of stroke warning signs was 3.6 out of 6. The least recognized warning sign was sudden severe headache and six subgroups with lower levels of knowledge were identified. The first action for stroke was recognized by 65.7 percent of participants and four subgroups with lower levels of knowledge were identified. CONCLUSION: Multi-faceted education should be designed to improve stroke knowledge among Korean adults, particularly focusing on subgroups with lower levels of knowledge and less recognition of items in this study.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cross-Sectional Studies , Decision Trees , Health Knowledge, Attitudes, Practice , Interviews as Topic , Surveys and Questionnaires , Risk Factors , Stroke/pathology
8.
Radiation Oncology Journal ; : 156-162, 2014.
Article in English | WPRIM | ID: wpr-209403

ABSTRACT

PURPOSE: This study was designed to evaluate the efficacy and safety of topically applied recombinant human epidermal growth factor (rhEGF) for the prevention of radiation-induced dermatitis in cancer patients. MATERIALS AND METHODS: From December 2010 to April 2012, a total of 1,172 cancer patients who received radiotherapy (RT) of more than 50 Gy were prospectively enrolled and treated with EGF-based cream. An acute skin reaction classified according to the Radiation Therapy Oncology Group 6-point rating scale was the primary end point and we also assessed the occurrence of edema, dry skin, or pruritus. RESULTS: The percentage of radiation dermatitis with maximum grade 0 and grade 1 was 19% and 58% at the time of 50 Gy, and it became 29% and 47% after completion of planned RT. This increment was observed only in breast cancer patients (from 18%/62% to 32%/49%). Adverse events related to the EGF-based cream developed in 49 patients (4%) with mild erythema the most common. Skin toxicity grade >2 was observed in 5% of the patients. Edema, dry skin, and pruritus grade > or =3 developed in 9%, 9%, and 1% of the patients, respectively. CONCLUSION: Prophylactic use of an EGF-based cream is effective in preventing radiation dermatitis with tolerable toxicity. Further studies comparing EGF cream with other topical agents may be necessary.


Subject(s)
Humans , Breast Neoplasms , Dermatitis , Edema , Epidermal Growth Factor , Erythema , Observational Study , Prospective Studies , Pruritus , Radiodermatitis , Radiotherapy , Skin
9.
Radiation Oncology Journal ; : 111-117, 2013.
Article in English | WPRIM | ID: wpr-116468

ABSTRACT

PURPOSE: To determine whether the maximum standardized uptake value (SUV) of [18F] fluorodeoxyglucose uptake by positron emission tomography (FDG PET) ratio of lymph node to primary tumor (mSUVR) could be a prognostic factor for node positive non-small cell lung cancer (NSCLC) patients treated with definitive radiotherapy (RT). MATERIALS AND METHODS: A total of 68 NSCLC T1-4, N1-3, M0 patients underwent FDG PET before RT. Optimal cutoff values of mSUVR were chosen based on overall survival (OS). Independent prognosticators were identified by Cox regression analysis. RESULTS: The most significant cutoff value for mSUVR was 0.9 with respect to OS. Two-year OS was 17% for patients with mSUVR > 0.9 and 49% for those with mSUVR 0.9 (p = 0.05) were significant predictors of OS. Two-year OS for patients with both good performance (Eastern Cooperative Oncology Group [ECOG] 1) or mSUVR > 0.9, 23% (71% vs. 23%, p = 0.04). CONCLUSION: Our results suggested that the mSUVR was a strong prognostic factor among patients with lymph node positive NSCLC following RT. Addition of mSUVR to performance status identifies a subgroup at highest risk for death after RT.


Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Lymph Nodes , Multivariate Analysis , Positron-Emission Tomography , Prognosis
10.
Journal of Korean Academy of Nursing ; : 663-672, 2011.
Article in Korean | WPRIM | ID: wpr-116118

ABSTRACT

PURPOSE: Purpose of this study was to investigate the status of depression in academic high school students and path analysis model for exploring the mediating role of entrapment to depression in relation to academic stress and perceived social support. METHODS: Measurements were four reliable questionnaires measuring academic stress, social support, entrapment, and depression. Data were collected from students in 17 high schools in Seoul. RESULTS: Students (n=5,346) completing the questionnaires indicated depression & entrapment from academic stress. Depression was more prevalent in girls, those whose parents' household income was less than two million won, who did not live with father or mother or both due to divorce, separation, or death, and those who smoked or used alcohol. Entrapment was more prevalent in students similar to cases of depression and in seniors. According to the proposed path model, 48.6% of depression was explained by academic stress, social support, and entrapment. The indirect effect of entrapment as a mediator between academic stress and depression was verified and larger than the direct effect of academic stress on depression. CONCLUSION: Considering levels of depression and entrapment demonstrated by these students, better mental health programs with diverse strategies should be developed for their psychological well-being.


Subject(s)
Adolescent , Female , Humans , Male , Young Adult , Adaptation, Psychological , Depression , Surveys and Questionnaires , Republic of Korea , Social Support , Socioeconomic Factors , Stress, Psychological , Students/psychology
11.
Journal of Korean Academy of Psychiatric and Mental Health Nursing ; : 106-116, 2010.
Article in Korean | WPRIM | ID: wpr-132818

ABSTRACT

PURPOSE: The purpose of this study was to explore status and relationships of anger and its expression type to biopsychosocial health in Korean adolescents. METHODS: This cross-sectional study used four reliable survey questionnaires that measure anger, depression, resilience, and psychosomatic symptoms. Data were collected from 18,752 students of 36 middle schools and 23 high schools located in 23 administrative districts in Seoul, Korea. RESULTS: The Korean adolescents who completed the questionnaires indicated moderate level of trait anger. 45% of them demonstrated using one of three undesirable types of anger expression such as dysfunctional anger-in and anger-out, high level anger-in, or high level anger-out. Also, level of trait anger and types of anger expression were significantly associated with resilience, depression, and psychosomatic health status. CONCLUSION: School-based mental health education such as anger management programs for Korean adolescents might be necessary to help them develop desirable and effective coping skills and strategies.


Subject(s)
Adolescent , Humans , Adaptation, Psychological , Anger , Cross-Sectional Studies , Depression , Education , Korea , Mental Health , Psychophysiologic Disorders , Surveys and Questionnaires , Seoul
12.
Journal of Korean Academy of Psychiatric and Mental Health Nursing ; : 106-116, 2010.
Article in Korean | WPRIM | ID: wpr-132815

ABSTRACT

PURPOSE: The purpose of this study was to explore status and relationships of anger and its expression type to biopsychosocial health in Korean adolescents. METHODS: This cross-sectional study used four reliable survey questionnaires that measure anger, depression, resilience, and psychosomatic symptoms. Data were collected from 18,752 students of 36 middle schools and 23 high schools located in 23 administrative districts in Seoul, Korea. RESULTS: The Korean adolescents who completed the questionnaires indicated moderate level of trait anger. 45% of them demonstrated using one of three undesirable types of anger expression such as dysfunctional anger-in and anger-out, high level anger-in, or high level anger-out. Also, level of trait anger and types of anger expression were significantly associated with resilience, depression, and psychosomatic health status. CONCLUSION: School-based mental health education such as anger management programs for Korean adolescents might be necessary to help them develop desirable and effective coping skills and strategies.


Subject(s)
Adolescent , Humans , Adaptation, Psychological , Anger , Cross-Sectional Studies , Depression , Education , Korea , Mental Health , Psychophysiologic Disorders , Surveys and Questionnaires , Seoul
13.
The Journal of the Korean Society for Therapeutic Radiology and Oncology ; : 78-83, 2009.
Article in Korean | WPRIM | ID: wpr-188526

ABSTRACT

PURPOSE: To examine the effect of suboptimal chemotherapy in patients undergoing preoperative chemoradiotherapy for the treatment of rectal cancer. MATERIALS AND METHODS: The medical records of 43 patients who received preoperative concurrent chemoradiotherapy, followed by radical surgery for the treatment of pathologically proven adenocarcinoma of the rectum from April 2003 to April 2006 were retrospectively reviewed. The delivered radiation dose ranged from 41.4 to 50.4 Gy. The standard group consisted of patients receiving two cycles of a 5-FU bolus injection for three days on the first and fifth week of radiotherapy or twice daily with capecitabine. The standard group included six patients for each regimen. The non-standard group consisted of patients receiving one cycle of 5-FU bolus injection for three days on the first week of radiotherapy. The non-standard group included 31 patients. Radical surgery was performed at a median of 58 days after the end of radiotherapy. A low anterior resection was performed in 36 patients, whereas an abdominoperineal resection was performed in 7 patients. RESULTS: No significant difference was observed between the groups with respect to pathologic responses ranging from grades 3 to 5 (83.3% vs. 67.7%, p=0.456), downstaging (75.0% vs. 67.7%, p=0.727), and a radial resection margin greater than 2 mm (66.7% vs. 83.9%, p=0.237). The sphincter-saving surgery rate in low-lying rectal cancers was lower in the non-standard group (100% vs. 75%, p=0.068). There was no grade 3 or higher toxicity observed in all patients. CONCLUSION: Considering that the sphincter-saving surgery rate in low-lying rectal cancer was marginally lower for patients treated with non-standard, suboptimal chemotherapy, and that toxicity higher than grade 2 was not observed in the both groups, suboptimal chemotherapy should be avoided in this setting.


Subject(s)
Humans , Adenocarcinoma , Chemoradiotherapy , Deoxycytidine , Fluorouracil , Medical Records , Rectal Neoplasms , Rectum , Retrospective Studies , Capecitabine
14.
Cancer Research and Treatment ; : 132-137, 2009.
Article in English | WPRIM | ID: wpr-68322

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the role of immediate postoperative radiotherapy (RT) in adult patients with a low-grade oligodendroglioma (LODG). MATERIALS AND METHODS: A total of 74 patients, older than 15 years, were treated in our institution between April 1990 and March 2006 for newly diagnosed LODGs. After surgery, 43 patients were treated with immediate RT with a total dose of 54~55.8 Gy with 1.8 Gy fractions (RT group) and 31 patients were followed with no adjuvant RT (OP group). All patients were closely observed until tumor progression or death with frequent work-ups including neurological examinations and MRI. Primary endpoints were overall survival and progression-free survival. The median follow-up duration of survivors was 6.2 years in the RT group and 5.8 years in the OP group. RESULTS: Median progression-free survival was 13.2 years in the RT group and 4.6 years in the OP group; multivariate analysis confirmed improved outcome with the use of immediate RT (hazard ratio, 0.22; 95% confidence interval-CI, 0.09~0.55; p<0.001). Median overall survival was 14.9 years in the RT group and 9.8 years in the OP group; the use of adjuvant RT was also associated with a trend toward better overall survival after immediate RT based on multivariate analysis (hazard ratio, 0.3; 95% CI, 0.08~1.17; p=0.082). No severe RT related complications were observed. CONCLUSION: Immediate RT following surgery appears to be an effective treatment modality for supratentorial LODGs. However, the potential benefit of adjuvant RT for overall survival needs to be tested prospectively in the future.


Subject(s)
Adult , Humans , Brain Neoplasms , Disease-Free Survival , Follow-Up Studies , Multivariate Analysis , Neurologic Examination , Oligodendroglioma , Survivors
15.
Journal of Korean Academy of Nursing ; : 145-156, 2009.
Article in Korean | WPRIM | ID: wpr-88649

ABSTRACT

PURPOSE: This study was done to develop a school-based anger management program (SAMP) of 4 sessions and examine its effects on the anger, anger expression, psychosomatic responses, psychosocial responses, and immunologic responses in adolescents. METHODS: A quasi-experimental study using a nonequivalent control group, pre-post design with repeated measures was used. Chi-square test, t-test, paired t-test, and Fisher's exact test were used to analyze the data. RESULTS: There were no differences between the experimental and control groups in outcome variables except for lymphocytes. However, following additional analyses, statistically significant differences by time point were observed for pain sensitivity, T cell, Helper T (Th) cell, Suppressor (Ts) cell and Natural Killer (NK) cell post-treatment, entrapment and psychosomatic symptoms at the 4-week follow-up, and resilience at the 10-week follow-up for the experimental group. CONCLUSION: Although some modifications in contents and administration will be required to increase the effectiveness of the program for anger management, SAMP can be used to promote anger management ability in adolescents.


Subject(s)
Adolescent , Female , Humans , Male , Adaptation, Psychological , Psychology, Adolescent , Anger , B-Lymphocytes/immunology , Depression , Expressed Emotion , Killer Cells, Natural/immunology , Program Development , Program Evaluation , Psychometrics , Surveys and Questionnaires , T-Lymphocytes/immunology
16.
The Journal of the Korean Society for Therapeutic Radiology and Oncology ; : 173-180, 2009.
Article in English | WPRIM | ID: wpr-21057

ABSTRACT

PURPOSE: To investigate the role of radiotherapy for squamous cell carcinomas of the external auditory canal and middle ear. MATERIALS AND METHODS: A series of 35 patients who were treated at a single institution from 1981 through 2007 were retrospectively analyzed. Thirteen patients were treated by radiotherapy alone; four by surgery only and 18 by a combination of surgery and radiotherapy. The total radiation dose ranged from 39~70 Gy (median, 66 Gy) in 13~35 fractions for radiotherapy alone and 44~70 Gy (median, 61.2 Gy) in 22~37 fractions for the combined therapy. Clinical end-points were the cause of specific survival (CSS) and local relapse-free survival (LRFS). The median follow-up time was 2.8 years (range, 0.2~14.6 years). RESULTS: The 3-year CSS and LRFS rate was 80% and 63%, respectively. Based on a univariate analysis, performance status and residual disease after treatment had a significant impact on CSS; performance status and histologic grade for LRFS. Patients treated by radiotherapy alone had more residual disease following the course of treatment compared to patients treated with the combined therapy; 69% vs. 28%, respectively. CONCLUSION: Our results suggest that radiation alone was not an inferior treatment modality for CSS compared to the combined therapy for squamous cell carcinoma of the external auditory canal and middle ear. However, local failure after radiotherapy is the main issue that will require further improvement to gain optimal local control.


Subject(s)
Humans , Carcinoma, Squamous Cell , Ear Canal , Ear, Middle , Follow-Up Studies , Retrospective Studies
17.
Journal of Korean Academy of Nursing ; : 239-251, 2005.
Article in Korean | WPRIM | ID: wpr-196758

ABSTRACT

PURPOSE: This study was designed to construct a structural model for explaining mental health status in middle - aged women. METHODS: The data was collected by self - reported questionnaires from 206 middle - aged women in Seoul. Data analysis was done with the SAS pc program for descriptive statistics and a PC - LISREL Program for finding the best fit model which assumes causal relationships among variables. RESULTS: The overall fit of the hypothetical model to the data was good, but paths and variables of the model were modified by considering theoretical implications and statistical significances of parameter estimates. Thus it was modified by excluding 3 paths. The modified model showed was good fit to the data(chi-square=177.55, p=.00), GFI=0.908, AGFI=0.860, RMR=0.013, NFI=0.972, NNFI=0.982). Perceived stress, anger expression method, and self -esteem were found to have direct effects on mental health status in middle - aged women. These predictive variables of mental health status explained 66.6% of the model. CONCLUSION: Programs to enhance mental health status in middle - aged women should include stress management skill, anger expression skill, and self -esteem enhancement skills to be effective.


Subject(s)
Middle Aged , Humans , Female , Adult , Urban Population , Stress, Psychological/epidemiology , Self Concept , Mental Health , Korea , Anger
18.
Journal of Korean Academy of Nursing ; : 921-931, 2001.
Article in Korean | WPRIM | ID: wpr-82723

ABSTRACT

PURPOSE: The purpose of this study was to investigate the rate of pregnancy, abortion, delivery and contraceptive use and the relationship between the related factors and the early coitus among Korean teenagers. METHOD: The subjects of this study were 12,733 teenagers age 13-19 years in 7 major cities and 9 provinces in Korea. Data was collected from 2 Oct., to 28 Oct., 2000 and analyzed by using SPSS 10.0 Program. RESULTS: The results showed pregnancy rate 4.5%, delivery rate 0.5%, abortion rate 0.4%. Adolescent girls who experienced coitus relatively went to vocational school, coeduaction school, night school in the general characteristics (p=0.000). Adolescent girls who experienced coitus tend to go to video room (18.5%), go the singing room (60.7%), the bar (54.8%), petting with the partner during the dates. There were overlapping juvenile delinquencies such as drinking (89.2%), pornography (65.3%), bond inhalation (2.7%), leaving homes (43.7%), smoking (14.5%), cyber sex (70.8%), phone sex (12.9%). Adolescent girls who experienced coitus were more suffering from Wangtta (26.1%) than who had not. They showed significant positive attitudes toward coitus; such as feeling of excitement (6.6%), nature (37.9%), beauty (8.7%). On the other hand, they had more guilty (2.8%) than the inexperienced (p=0.000). The main factors relating to early coitus were 'to confirm love' (46.9%), 'afraid of rejection' (32.2%). They think the benefits of coitus were 'more intimacy with boyfriends' (20.6%), 'satisfaction of curiosity' (16.8%). The losses on coitus were 'worry about pregnancy' (73.7%) and 'unability to refuse sexual contacts' (28.7%) CONCLUSION: It could be concluded that it is necessary to plan different sex education programs according to general characteristics and delinquency behaviors of teenage girls in Korea.


Subject(s)
Adolescent , Female , Humans , Pregnancy , Abortion, Induced , Beauty , Coitus , Drinking , Erotica , Hand , Inhalation , Korea , Pregnancy Rate , Sex Education , Sexual Behavior , Singing , Smoke , Smoking
19.
Journal of Korean Academy of Nursing ; : 1174-1180, 2001.
Article in English | WPRIM | ID: wpr-42712

ABSTRACT

This cross-sectional survey was carried out to assess the decisional balance of Korean women toward mammography screening. A sample of 1, 903 naturally postmenopausal women was selected from the community-based social groups in town or city hall auxiliaries in seven metropolitan areas and six provinces in Korea. The classification of women according to the stage of adoption of mammography was 54.9% in pre-contemplation, 31.9% in contemplation, 7.8% in action, and 5.5% in maintenance. The mean differences of pros, cons, and the decisional balance by the stage of mammography adoption were statistically significant. There were significant mean differences between the stages of adoption according to a woman's experience with and intention for mammography and the pros score, the cons score, and the decisional balance score. Results provide the empirical evidence for the Transtheoretical model. An association between stages of mammography adoption and decisional balance exists.


Subject(s)
Female , Humans , Classification , Cross-Sectional Studies , Intention , Korea , Mammography , Mass Screening
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