The Results of Curative Radiotherapy for Carcinoma of Uterine Cervix

Ryu, Ryeong,Chang, Gee Young,Namkong, Sung Eun,Bahk, Yong Whee,Shinn, Kyung Sub,Kim, Seung Jo,Suh, Tae Suk,Yoon, Sei Chul,Kang, Ki Mun CATHOLIC MEDICAL CENTER 1994 Bulletin of the Clinical Research Institute Vol.22 No.2

One-hundred five patients with invasive carcinoma of the uterine cervix treated with curative radiotherapy from March 1983 through October 1989 at the Department of Therapeutic Radiology, Kang-Nam St. Mary's Hospital. Among them, 78 patients received radiotherapy alone and 42 patients treated with neoadjuvant chemotherapy followed by radiotherapy and 15 patients were lost to follow up. All patients had follow up from 2 to 106 months (median; 62 months). Age of the patients ranged from 32 to 79 years at presentation (median; 59 years). The overall 5-year survival rates was 50.8%, and the 5-year survival rates by stage ⅠB, ⅡA, ⅡB, ⅢA, ⅢB, ⅣA was 47.7%, 70.2%, 64.1%, 40.0%, 23.1%, 14.3%, respectively. The 5-year survival rates was noted 51.2% of radiotherapy alone and 50.4% of neoadjuvant chemotherapy followed by radiotherapy. The overall failure rate was 18.3% (22/120) including 11.7% (14/120) locoregional failure, 5.8% (7/120) distant metastasis and 0.8% (1/120) locoregional failure with distant metastasis. Treatment failure rates by the stages were 15% (3/20) in stage ⅠB, 10.5% (2/19) in stage ⅡA, 10.2% (5/49) in stage ⅡB, 20% (1/5) for stage ⅢA, 61.5% (8/13) in stage ⅢB, and 28.6% (4/14) in stage ⅣA. The overall complication rate was 34.2% (41/120), including wet desquamation 7.5% (9/120), diarrhea 6.7% (8/120), radiation proctitis 5.8% (7/120) in decreasing order. A multivariate analysis of factors influencing the survival showed patient age (P=0.0291), FIGO stage (P=0.0001), Karnofsky performance status (P=0.0043), initial hemoglobin level (P=0.0001), and intracavitary radiation (P=0.0004), but, no significancy in histology (P=0.29) and teatment method (P=0.87).

The Results of Curative Radiotherapy for Carcinoma of Uterine cervix

강기문,유미령,장지영,서태석,윤세철,박용휘,신경섭,남궁성은,김승조,Kang Ki Mun,Ryu Mi Ryeong,Chang Gee Young,Suh Tae Suk,Yoon Sei Chul,Bahk Yong Whee,Shinn Kyung Sub,Namkoong Sung Eun,Kim Seung Jo The Korean Society for Radiation Oncology 1993 Radiation Oncology Journal Vol.11 No.1

가톨릭의과대학 강남성모병원 치료방사선과에서 1983년 3월부터 1989년 10월까지 79개월 동안에 자궁경부암으로 근치적 방사선치료를 받았던 135명의 환자들 중에서 추적이 가능하였던 120명의 환자들을 대상으로 치료결과및 예후에 영향을 미치는 인자에 대하여 후향적 분석을 하였다. 방사선 단독으로 치료한 환자는 78명이었고 유도 화학요법을 방사선 치료전에 시행한 환자는 42명이었다. 대상 환자들의 추적 조사기간은,2개월에서 106개월이었고 중간 추적조사 기간은 62개월이었다. 환자들의 나이는 32세부터 79세까지의 분포를 보였다(중앙값, 59세). FIGO 병기별 분류에 의하면, IB 기가 20명 ($16.7{\%}$), IIA 기가 19명 ($15.8{\%}$), IIB기가 49명 ($40.8{\%}$), IIIA 기가 5명 ($4.2{\%}$), IIIB기가 13명 ($10.8{\%}$), IVA 기가 14명 ($11.7{\%}$)이었다. 전체환자의 5년 생존율은 $50.8{\%}$였다. 병기별 5년 생존율은 IB 기가 $47.7{\%}$ IIA 기가 $70.2{\%}$, IIB 기가 $64.1{\%}$, IIIA 기가 $40.0{\%}$, IIIB 기가 $23.1{\%}$, IVA 기가 $14.3{\%}$였다. 치료방법에 따른 5년 생존율은 방사선 단독으로 치료한 환자가 $51.2{\%}$였고, 유도화학요법을 방사선 치료전에 시행한 환자는 $54.0{\%}$였다. 치료후 재발은 22명 ($18.3{\%}$,)에서 관찰되었고, 이중 14명 ($11.7{\%}$)에서 국소재발이, 7명 ($5.8{\%}$)에서 원격전이가, 1명 ($0.8{\%}$)에서 국소재발과 원격전이가 함께 발생하였다. 그리고, 치료에 의한 합병증은 41명 ($34.2{\%}$)에서 관찰되었으며 9명 ($7.5{\%}$)에서 습낙설, 8명 ($7.5{\%}$)에서 설사, 7명 ($5.8{\%}$)에서 방사선 직장염의 순으로 발생하였다. 예후와 관련된 생존율에 영향을 주었던 인자로는 나이 (p<0.0291), 병기(p<0.0001), 전신상태(p<0.0041), 초기 혈색소 수치 (p<0.0001), 강내 조사(p<0.0004)였고, 조직학적 소견(p<0.29), 유도 화학요법과의 병행치료(p<0.87)는 통계학적으로 유의하지 않았다. This is a retrospective analysis of 135 patients with invasive carcinoma of the uterine cervix treated with curative radiotherapy from March 1983 through October 1989 at the Department of Therapeutic Radiology, Kang-Nam 51. Mary's Hospital. Among them, 78 patients received radiotherapy alone and 42 patients treated with neoadjuvant chemotherapy followed by radiotherapy and 15 patients were lost to follow up. All patients had follow up from 2 to 106 months (median; 62 months). Age of the patients ranged from 32 to 79 years at presentation (median; 59 years). According to FIGO classification, there were 20 ($16.7{\%}$) in stage IB, 19 ($15.8{\%}$) in stage IIA,49 ($40.8{\%}$) in stage IIB, 5 ($4.2{\%}$) in stage IIIA, 13 ($10.8{\%}$,) in stage IIIB,14 ($11.7{\%}$) in stage IVA. The pathological classification showed 96 ($80.0{\%}$) squamous cell carcinomas, 5 ($4.2{\%}$) adenocarcinomas and 19 ($15.8{\%}$) proven by cytology. The overall 5-year survival rates was $50.8{\%}$, and the 5-year survival rates by stage IB, IIA, IIB, IIIA, IIIB, IVA was $47.7{\%},\;70.2{\%},\;64.1{\%},\;40.0{\%},\;23.1{\%},\;14.3{\%}$, respectively. The 5-year survival rates was noted $51.2{\%}$ of radiotherapy alone and $50.4{\%}$of neoadjuvant chemotherapy followed by radiotherapy. The overall failure rate was $18.3{\%}$(22/120) including $11.7{\%}$ (14/120) locoregional failure, $5.8{\%}$ (7/120) distant metastasis and $0.8{\%}$(1/120) locoregional failure with distant metastasis. Treatment failure rates by the stages were $15{\%}$ (3/20) in stage IB. $10.5{\%}$ (2/19) in stage IIA, $10.2{\%}$, (5/49) in stage IIB, $20{\%}$ (1/5) in stage IIIA, $61.5{\%}$(8/13) in stage IIB, and $28.6{\%}$ (4/14) in stage IVA. The overall complication rate was $34.2{\%}$(41/120) including wet desquamation $7.5{\%}$, (9/120), diarrhea $6.7{\%}(8/120), radiation proctitis $5.8{\%}$(7/120) in decreasing order. A multivariate analysis of factors influencing the survival showed patient age (p < 0.0291), FIGO stage (p<0.0001), Karnofsky performance status (p<0.0043), initial hemoglobin level (p<0.0001), and intracavitary radiation (p<0.0004), but, no significancy in histology (p<0.29) and treatment method (p < 0.87).

장애인복지에서 자문화기술지의 역할과 가치

강은희 ( Kang Eun-whee ) 극동대학교 사회복지연구소 2023 글로벌사회복지연구 Vol.13 No.1

자문화기술지는 연구자의 경험을 기반으로 자료를 수집·분석·해석하고, 그에 기반하여 글을 쓰는 질적연구방법이다. 본 저자는 2018년부터 2022년까지 5년 동안 자폐성장애 아동과 활동하였다. 이 경험을 바탕으로 자폐성장애인의 삶(삶의 모습)과 문화를 기술하였다. 즉 자폐성장애에 대한 자문화기술지를 수행하였다. 본 저자는 이러한 자문화기술지 연구를 통해 장애인복지 현장에서 발생하는 어려움들의 본질에 접근할 수 있었다. 또한, 자문화기술지를 통해 자폐성장애인의 행동문제를 파악함으로써 관련전문가와 장애당사자, 그리고 장애자녀를 둔 부모들에게 구체적이고 실질적인 해법을 제시할 수 있었다. 이렇게 볼 때, 자문화기술지는 장애인복지 현장의 실체를 제대로 파악케 할 수 있는 연구방법이라고 할 수 있으며, 이를 통해 실천현장의 변화를 끌어낼 수 있는 연구방법이라고 할 수 있다. Autoethnography is a qualitative research methodology that collects, analyzes, and interprets data based on the researcher’s experience, and writes based on it. The author intervened a child with Autistic Spectrum Disorder (ASD) for 5 years from 2018 to 2022 for improving his/her social functioning. Based on this experience, the author described the life style and culture of persons with ASD. That is, the author conducted autoethnography of ASD. This author could approach the nature of the difficulties in the field of the social work for persons with ASD through autoethnography study. In addition, by identifying the behavioral problems of persons with ASD through autoethnography study, it was possible to provide specific and practical solutions to ASD-related experts, persons with ASD, and parents of children with ASD. In this way, autoethnography could be a research methodology that could properly grasp the reality of the social work practice for people with disability, and it could lead to changes in the field of the social work practice.

자폐성 장애인의 사회적 기능 향상을 위한 개입과 자폐성 장애의 바른 이해 : 자문화기술지를 중심으로

강은희 ( Kang Eun-whee ) 극동대학교 사회복지연구소 2023 글로벌사회복지연구 Vol.13 No.2

This study seeks to understand the characteristics of people with ASD (Autistic Spectrum Disorder), and to restructure interventions of human services for them. Human services for people with ASD to date have focused on the environment surrounding them and the services provided to them, rather than the people with ASD themselves. This study conducted an ‘autoethnography’ on the lives and culture of people with ASD. The researcher of this study has experience working with children with ASD from 2018 to 2022, and this study is based on this. Through this, the researcher implemented an intervention to improve the social skills (e.g. adaptation to daily life and educational achievement) of children with ASD. ‘Autoethnography’, one of the qualitative research methods, was useful in understanding the reality and difficulties of people with ASD. Through the autoethnography, we will be able to present specific and practical solutions to the behavioral problems of people with ASD.

A New Self-management Scale with a Hierarchical Structure for Patients with Type 2 Diabetes

Eun-Hyun Lee,Young Whee Lee,Duckhee Chae,Kwan-WooLee,Jin Ook Chung,Seongbin Hong,김소헌,Eun Hee Kang 한국간호과학회 2020 Asian Nursing Research Vol.14 No.4

Purpose: The aims of this study were to develop a new instrument for measuring self-management witha hierarchical structure [the Diabetes Self-Management Scale (DSMS)] in patients with type 2 diabetes,and evaluate its psychometric properties. Method: The DSMS instrument was developed in three phases: (1) conceptualization and item generation;(2) content validity and pilot testing; and (3) field testing of its psychometric properties. A conveniencesample of 473 participants was recruited in three university hospitals and one regional healthcenter, South Korea. Results: Exploratory and confirmatory factor analyses yielded two second-order component modelsexplaining the common variance among six first-order factors. Principal axis factoring with a varimaxrotation accounted for 60.88% of the variance. Confirmatory factor analysis of the hierarchical structurerevealed the following fit indices: c2/df ¼ 1.373, standardized root-mean-square residual ¼ .050,goodness-of-fit index ¼ .935, incremental fit index ¼ .975, comparative fit index ¼ .974, and root-meansquareerror of approximation ¼ .039. All Cronbach' a values for internal consistency exceeded the criterionof .70. All of the intraclass correlation coefficients for testeretest reliability exceeded .70 exceptthat for the taking-medication subscale. The components of the DSMS were moderately correlated withthe comparator measures of self-efficacy and health literacy administered for convergent validity. Conclusion: The DSMS is a new instrument for measuring the complex nature of self-management inpatients with type 2 diabetes, comprising 17 items scored on a five-point Likert scale. The DSMS exhibitssatisfactory psychometric properties for five reliability and validity metrics, and so is a suitable instrumentto apply in both research and clinical practices.

Severe but reversible acute kidney injury resulting from Amanita punctata poisoning

( Eun Jung Kang ),( Ka Young Cheong ),( Min Jeong Lee ),( Seirhan Kim ),( Gyu Tae Shin ),( Heung Soo Kim ),( In Whee Park ) 대한신장학회 2015 Kidney Research and Clinical Practice Vol.34 No.4

Mushroom-related poisoning can cause acute kidney injury. Here we report a case of acute kidney injury after ingestion of Amanita punctata, which is considered an edible mushroom. Gastrointestinal symptoms occurred within 24 hours from the mushroom intake and were followed by an asymptomatic period, acute kidney injury, and elevation of liver and pancreatic enzymes. Kidney function recovered with supportive care. Nephrotoxic mushroom poisoning should be considered as a cause of acute kidney injury.

심부전을 주소로 진단된 삼방심 1예

박은경,김석호,강흥선,조정휘,김권삼,김명식,송정상,배종화 대한내과학회 1993 대한내과학회지 Vol.44 No.1

저자들은 분만후 울혈성 심부전으로 인한 심한 호흡곤란을 주소로 내원했던 환자에서 경흉부 심초음파도, 경식도 심초음파도 그리고 심도자술 및 심장조영술로 삼방심을 진단하여 치료하였던 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Cor triatriatum is well konwn rare cardiac malformation consisting of accessory chamber that lie within the left atrium and receives the pulmonary vein. Recently, we have experienced one case of isolated cor triatriatum presenting as congestive heart failure. A 24 years old women was admitted to the hospital because of severe dyspnea. We diagnosed isolated cor triatriatum by the transthoracic and transesophageal echocardiography and cardiac catheterization.

The Introduction of Long-term Care Insurance (LTCI) in China and Lessons from the Policy in South Korea: Focusing on the LTCI Pilot Programs of Shandong Province in China

Keun-hong Kim,Xiangqi Meng,Eun-whee Kang,Koung-won Seo,Song-hee Lee,Soon-deok Lee 한국사회적질학회 2021 사회적질연구 Vol.5 No.3

중국은 1979년 이후로 한자녀정책을 주요 정책으로 추진해왔고, 이로 인해 저출산 사회로 전환되었 다. 또한 발전된 보건과 의료기술로 노인들의 수명이 급격히 늘어나면서 중국의 고령화율 역시 급증하 였다. 이렇듯 수발이 필요한 고령인구는 급증하였으나, 현재 중국에는 이들을 돌볼 돌봄인력이나 인프 라가 턱없이 부족한 상태이다. 본 연구는 이러한 노인수발 문제를 해결하기 위한 제도적 해법으로 노인 장기요양보험에 주목한다. 본 연구는 중국 노인장기요양보험제도의 도입과정과 시범사업 등을 살펴본 후, 노인장기요양보험제도 도입의 선도국가인 한국으로부터 어떤 정책교훈을 얻을 수 있는지 살펴보았 다. 본 연구는 연구를 수행함에 있어 주로 문헌연구 분석을 사용하였다. 본 연구는 두 가지 의의를 갖는다. 첫째, 중국 노인장기요양보험제도의 시범사업을 개관함으로써 그 흐름은 물론 그에 관한 기초 자료를 제공하고 있다. 둘째, 중국의 노인수발 문제를 연구함에 있어 기존 연구들에서 찾아볼 수 없는 비교사회정책학적 접근법, 특히 동아시아 사회복지에 대한 비교연구를 수행하였다. China implemented the one-child policy in 1979 and has experienced its various negative effects since then. In particular, the social phenomenon during the transition of its society to an aging one is a representative example of the negative effects. During its transition to an aging society, China has been in a situation where it has had to deal with problems related to the elderly and family support that some East Asian countries such as Japan and South Korea has also experienced. With this as background, this study tried to focus on long-term care insurance for the elderly as an institutional solution for solving various problems that arose during its transition to an aging society. Specifically, the introduction process of long-term care insurance system for the elderly in China was examined, and some implications were obtained from the policies in South Korea, which is known as an advanced country regarding this system. Through various related literature and prior research, the study summarized the background to the introduction of the long-term care insurance system for the elderly in China, the progress of the trial program of the long-term care insurance system for the elderly in China, the expansion of the trial program, and implications of the long-term care insurance system for the elderly in South Korea. The implications of this study are as follows: First, this research is significant in that it will show how the pilot operation of China's long-term care insurance system flowed along with basic related data. Second, it is meaningful as South Korea’s long-term care insurance system was explored as an institutional way to address problems related to providing support for the elderly in China.

심근경색에서 측부순환 유무에 따른 99mTc-MIBI 심근 SPECT 소견

김덕윤(Deog Yoon Kim),양형인(Hyung In Yang),강홍선(Heung Sun Kang),조정휘(Chung Whee Choue),김권삼(Kwon Sam Kim),김명식(Myung Shick Kim),송정상(Jung Sang Song),배종화(Jong Hoa Bae),김재만(Jae Man Kim),나득영(Deug Young Na),박은경(Eun 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.1

N/A The coronary collateral vessels have revealed their significance in terms of reduction of infarct size, preservation left ventricular function, and prevention of left ventricular aneurysm in patients with myocardial infarction. The purpose of this study were to evaluated the relation between collateral circulation and 99mTc-MIBI Heart SPECT in patient with acute myocardial infarction and their clinical significance. The fifty six MI patients with antegrade TIMI perfusion grade 0 and 1 were studied. The pat#ients #were classified into two groups; Group I inclueded 30 patients with grade 2, 3 Collateral flow. Group II inclueded 26 patients with grade 0, 1 Collateral flow. Collateral filling were graded from 0 to 3; 0- none, 1- Filling of side branch only, 2- Partial filling of the epicardial segment, 3- Complete filling of epicardial segment. Clinical variables, left ventricular function, 99mTc-MIBI Heart SPECT were analyzed with angiographic finding. Results were following: 1) Collateral visualization was found to be greater in patient with invoivement of right coronary artery (RCA). The callateral development site of infarct related artery was RCA 15 cases, left anterior descending artery (LAD) 10 cases, left circumflex artery (LCX) 5 cases, and the collateral circulation from LAD to RCA was 13 cases (40.6%). 2) There was a tendency to be decreased in peak CK activity with group I . 3) The presence of good collateral channels was more frequently 99mTc-MIBI reversible perfusion defect (83.4% vs 15.3%, p<0.05). 4) No differences af left ventrieular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), ejection fraction (EF) were noted between group I and group II. The presence of good collateral channels did affect the frequency of occurrence of 99mTc-MlBI reversible perfusion defect.

단일신을 가진 소아의 임상적 특징과 동반기형

김주휘,이세은,정윤혜,한경희,이현경,강희경,하일수,정해일,최용,Kim, Joo-Whee,Lee, Se-Eun,Jung, Yun-Hye,Han, Kyung-Hee,Lee, Hyun-Kyung,Kang, Hee-Gyung,Ha, Il-Soo,Cheong, Hae-Il,Choi, Yong 대한소아신장학회 2010 Childhood kidney diseases Vol.14 No.1

목 적 : 단일신을 가진 소아의 임상적 특징과 동반기형 및 장기적 신기능 등에 대해 알아보고자 하였다. 방 법 : 1989년 12월부터 2009년 12월까지 20년간 서울대학교 어린이병원에서 진단된 38예의 단일신 환자를 대상으로 후향적 조사를 하였으며, 단일신은 영상검사를 통해 진단된 일측성 신장 무형성으로 정의하였고, 일측성 이형성 신의 퇴행으로 발생한 단일신은 제외하였다. 결 과 : 진단 연령의 중앙값은 6.5개월(출생직후-13세)이었고, 남자가 12명(31.6%), 여자가 26명(68.4%) 이었다. 19예(50.0%)에서는 좌측 신장이 없었고 19예에서는 우측 신장이 없었다. 산전 초음파에서 진단된 경우가 14예(36.8%), 신장 혹은 요로계 질환에 대한 검사 도중 13예(34.2%), 우연히 발견된 경우가 10예(26.3%)이었다. 동반 기형으로는 방광요관 역류 11예(28.9%)를 포함한 신장기형이 17예(44.7%), 기타 비뇨생식기계의 기형이 16예(42.1%) 그리고 다 기관 증후군 혹은 염색체 이상이 9예(23.7%)에서 진단되었다. 혈청 크레아티닌의 중간값은 0.6 mg/dL이었으며 만성 신부전이 2예(5.3%)에서 확인되었다. 결 론 : 단일신은 신장의 선천성 기형 중 상대적으로 흔한 질환이며, 일반적으로 증상이 없다. 그러나 일부에서는 단일신은 다른 기관의 이상과 연관이 되어있거나 관련된 증상이 발생한다. 단일신을 가진 소아의 연관 기형의 조기 발견과 추적 관찰이 장기적인 신 손상의 위험을 감소시키기 위해 필요하다. Purpose : The clinical characteristics and associated anomalies in children with solitary kidney (SK) were analyzed retrospectively. Methods : Total 38 children diagnosed to have SK at our hospital between December 1989 and December 2009 were recruited, and the clinical records including imaging studies were retrospectively reviewed. SK was defined as unilateral renal agenesis by imaging studies only, and patients with regression of unilateral dysplastic kidney were excluded. Results : Among total 38 patients, 12 were male. The median age at the diagnosis of SK was 6.5 months (at birth-13 years). SK was detected by prenatal ultrasonography in 14 patients and during work-up for renal or urinary tract diseases in 13 (including urinary tract infection in 7). In 10 patients, SK was detected incidentally. Anomalies in the SK were noted in 17 patients including vesicoureteral reflux in 11. Other anomalies in the genitourinary tract were present in 16 patients, and multi-organ-involving syndromes or chromosomal anomalies were detected in 9. The mean duration of follow-up was 9 years (9 months-20 years). Two patients developed chronic renal failure during follow-up, and the median serum creatinine concentration of the remaining 36 at their last follow-up was 0.6 mg/dL. Conclusion : SK may be isolated and clinically asymptomatic; it is frequently accompanied by other anomalies in genitourinary tract and other organs, some of which can induce progressive renal dysfunction. Early recognition of associated anomalies with SK and regular follow-up is recommended to reduce long-term risk.