유방암수술은 환자의 생존율을 높이지만 환자의 수술부위 통증, 상지근육의 변 화나 불균형 등의 체형변화뿐 아니라 재발에 대한 두려움, 자아존중감 저하와 우 울, 불안, 분노, 스트레스 등의 심리적 증상마저 유발할 수 있다. 그래서 유방암환 자를 위한 심신중재 프로그램의 개발이 필요하다. 이 프로그램의 1~3회기에는 단 축되거나 긴장된 부위의 자각훈련과 호흡훈련으로 구성되는 경견완부위 통증유발 점 스트레칭 요가체위가 실시된다. 4~8회기에는 통증유발점의 긴장부위를 자각하 는 훈련과 체형유지를 위한 주요근육을 강화하는 요가체위가 실시된다. 유도된 심 상 프로그램의 1~3회기에는 호흡과 신체자각, 심장박동소리듣기, 빛 명상이 실시 되고, 4~7회기에는 통증부위 빛 명상이 심화되며, 마지막 8회기는 임종명상으로 마무리된다. 유방암환자의 몸통 및 상지근육의 변화와 그에 동반되는 통증을 경감 시킬 수 있는 요가와 유도된 심상법으로 구성되는 자연치유요가 심신중재 프로그 램 개발을 위한 본 논문의 사례연구는 고유수용감각 훈련과 내수용감각 훈련을 설계하는 데 유용하다. 유방암수술을 받고 이 프로그램에 참가한 환자의 목과 어깨통증은 경감되었고 근육 밸런스는 회복되었으며 수술 후 방사선치료 등을 받으 며 느낀 공포와 불안감은 감소되었고 삶의 질이 향상되었으며 죽음에 대한 인식 도 변했다.

Esophageal cancer is a representative cancer that occur physical deterioration but, physical problems after surgery were not well reported. The purpose of this study is to report on the long thoracic neuropathy after surgery, and to identify the symptoms and effects of physical therapy after esophageal cancer surgery. This is a case of a 61-year-old man who showed winging of the scapula with long thoracic nerve injury on the results of electromyography after an esophageal cancer surgery. Physical therapy programs were implemented 8 sessions during hospitalization. The quality of life, fatigue, shoulder range of motion (ROM), numeric rating scale (NRS), 6-minute walk test, and 30-second chair stand test were assessed. The quality of life, fatigue, shoulder ROM, NRS (pain), 6-minute walk test, and 30-second chair stand test were improved. However, the esophageal-specific symptom was not different after physical therapy program. As esophageal cancer suffers from physical difficulties after surgery, physical therapy programs are thought to be helpful.

췌장암의 가장 효과적인 치료는 수술적 절제이나 10-20% 에서만 가능하다. 그 이유는 췌장은 복막 후강에 위치하고 있어 암이 발생하더라도 초기에 특이적인 증상이 없고, 암 조직이 빠르게 성장하여 진단 당시 이미 진행된 경우가 많 기 때문이다. 절제 후에도 재발이 흔하여 근치적 절제수술 후에도 5년 생존율이 20% 이하이다. 절제 이외의 치료 방법 은 효과가 적어 전체 췌장선암종 환자의 5년 생존율은 5% 이하로 매우 예후가 나쁜 종양이다. 정확하고 엄격한 수술 전 병기 판정과 절제가능성 평가에 따른 병기별 치료는 필수적이다. 절제가 불가능하나 원격전 이가 없는 국소진행성 췌장암은 30-40%에서 관찰되며 중앙 생존기간은 치료를 안 한 경우 6-8개월, 치료한 경우 10-12 개월 정도이다. 이들 국소진행성 췌장암은 생존율 향상의 여지가 많아서, 보다 나은 치료 효과를 얻기 위해 가장 적극 적이고 집중적인 관심이 필요한 상태의 췌장암이라 할 수 있다. 췌장암의 절제술에 있어서 경계성 절제가능성 췌장암 의 개념의 등장의 배경은 낮은 R0 절제율과 힘든 절제 후의 나쁜 예후에 있다. 최근 다중검출 CT의 발전으로 새로이 분류된 경계성 절제가능성 췌장암군은 절제연 양성의 위험성 이 높아 다학적 치료법의 좋은 적용군이라 할 수 있다. 최근 R1이나 R2 절제의 가능성이 높은 경우 무리한 수술보다는 수술 전 항암요법과 방사선요법 후 영상학적으로 진행하지 않거나 개선되어 혈관침습이 국소적인 경우 혈관 절제나 재 건을 포함한 근치적 수술을 시도하여 비교적 좋은 결과들이 보고되고 있다. 수술 전 화학요법 또는 화학방사선치료는 수술 후 치료에 비해 미세원격전이가 있어 나중에 진행하여 명백한 원격전 이가 보이는 환자들에게는 불필요한 절제수술을 막을 수 있다. 또한 수술 후 보조요법을 못하는 환자가 1/3에 달하는 상황에서 전신상태가 비교적 좋을 때 여러 다양한 치료를 시도할 수 있다. 최근 췌장암에 효과적인 몇몇 약제들이 소 개되면서 이들 약제의 방사선치료와의 병합치료에 대한 기대 역시 증가하고 있다. 하지만 아직 그 정의에서 각 병원마다 차이가 많고 치료 및 효과의 판정에서도 확립되지 않은 부분이 많아 잘 짜여진 기준을 가진 전향적 무작위 대조 연 구가 필요하다. 또한 수술 전 항암 또는 방사선치료 효과를 정확히 평가 할 수 있는 영상 검사나 병리학적 기준이 필요하며 향후 개 개인에 맞는 맞춤형 치료의 개발 및 효과를 볼 수 있는 환자 군을 선택하는 것이 필요하겠다.

Prognosis of pancreatic ductal adenocarcinoma is exceptionally poor because timely diagnosis in resectable stages is rare and there is no curative treatment for unresectable cases. Numerous researches to overcome these obstacles resulted in statistically significant but small progress. Recently two randomized controlled trial reported combination chemotherapy with 5-FU, irinotecan, leucovorin and oxaliplatin or Nab-paclitaxel plus gemcitabine was better survival than gemcitabine monotherapy. Many novel biological agents targeting the pancreatic cancer itself and surrounding micro-environment has been reported to be promising in preclinical investigations and phase 1/2 clinical studies. However, only erlotinib – a small molecular inhibitor of the epidermal growth factor receptor pathway – was approved for the targeted therapy for metastatic pancreatic cancer. In this review, we discuss briefly about recent advances in the combination chemotherapy and the targeted therapy including several complications related with these drugs.

According to statistics of the Ministry of Health and Welfare at 2010, patient of breast cancer has been increasing constantly. Radiation therapy is method of treatment for breast cancer. Generally, radiation therapy technique of breast cancer is opposing 2 port. And It is using real wedge, dynamic wedge, FiF(Field in Field) technique, ISC(Irregular Surface Compensating) technique for uniformity dose in breast tissue. But each patient applied different method of surgery. In this study, It is to evaluation the usefulness of radiation therapy technique at each surgery technique. Subjects are tissue loss after breast conserving surgery, non tissue loss after breast conserving surgery, and mastectomy. Each subject applied 4 techniques of radiation therapy. Measurement tool used CI(Conformity Index), HI(Homogeneity Index), and QOC(Quality of Coverage) at suggest RTOG(The Radiation Therapy Oncology Group). Case of tissue loss is useful dynamic wedge technique. Case of non tissue loss is useful FiF technique. Case of mastectomy is useful ISC technique. In the future, this study would use to selection standard of radiation therapy for breast cancer surgery. And selection standard would require additional analyzes of normal organ.

Hilar cholangiocarcinoma is a fatal malignancy leading to high mortality rate despite recent therapeutic advances, and the photodynamic therapy has been noted as an emerging palliative strategy for the hilar cholangiocarcinoma. Photodynamic therapy is the treatment selectively destructing cancer tissue through the laser beam irradiation with particular wavelengths. Photosensitizer administered before the treatment is accumulated in malignant tissue, and activated in the limits of those wavelengths. The procedure is performed under percutaneous transhepatic biliary drainage or endoscopic retrograde cholangiopancreatography, and more appropriate for the periductal infiltrating type rather than mass-forming type of cholangiocarcinoma due to the shallow penetrating depth (<4.5 mm). Recent investigations demonstrated the survival gain of 4-6 months in patients with cholangiocarcinoma when it is added to palliative biliary drainage. In addition, newly developed 3rd generation photo sensitizer has enabled longer therapeutic effect with less skin phototoxicity than before. However, there are still some limitations should be concerned, including lack of large-scaled prospective studies, shallow penetrating depth of tumoricidal effects, lack of treatment response measure, and relatively expensive cost. Addressing these matters through the larger prospective studies or technical improvement may lead new era of photodynamic therapy not only for the palliative purpose but also in the therapeutic field of cholangiocarcinoma.

This study examined the effects of a physical therapy program on quality of life (QOL), and neck and shoulder disability in head and neck cancer patients. The program included neck and shoulder range of motion (ROM) exercises, massage, progressive strengthening exercises, and stretching exercises. Sixteen patients who were assigned to an experimental group performed physical therapy for 40 minutes three times a week for eight weeks. Fifteen other patients were assigned to a control group who did not performed the physical therapy program. The European organization for research and treatment of cancer (EORTC QLQ-C30) and head and neck (EORTC QLQ-H&N) instruments, and the Neck Disability Index (NDI) were assessed before and after the rehabilitation program. The 40-minute program consisted of a 10-minute ROM exercise for the neck and shoulder, a 10-minute massage and 15-minute of progressive resistance exercises, followed by a five-minute stretching exercises. Statistically significant differences were noted for changes in global health, physical function in the EORTC QLQ-C30 and cancer related symptoms in the EORTC QLQ-H&N35 (p<.05). The NDI also showed significant differences (p<.05). Physical therapy may therefore benefit the physical aspects and QOL and improve neck and shoulder disability in patients with head and neck cancer.

목적 : 본 연구의 목적은 유방암 수술 후 어깨 관절가동범위에 제한이 있는 환자에게 작업치료의 중재를 통해 일상생활 수행 및 상지 기능, 삶의 질에 미치는 효과를 알아보기 위함이다. 연구방법 : 유방암 절제술 후 어깨 관절가동범위에 제한이 있는 73명의 환자를 대상으로 작업치료를 실시하였다. 치료는 기능적 작업치료와 일상생활 동작훈련을 주 2회 이상 시행하였고 홈프로그램을 제공하였으며 치료의 연속성과 효과를 보기 위하여 최소 8주이상 참여하도록 하였다. 치료 전후 어깨 관절가동범위의 수동 관절 범위, 상지장애정도(Disability of the Arm, Shoulder and Hand; DASH), 삶의 질(Functional Assessment of Cancer Therapy-General; FACT-G)과 피로도(Fatigue Severity Scale; FSS)에 대한 자료를 수집하여 분석하였다. 결과 : 작업치료 중재 후 어깨 관절의 굴곡, 외전, 내회전, 외회전의 관절가동범위는 모두 유의한 변화를 보였다(p<.001). 또한 상지 장애정도(DASH)도 유의하게 향상되었으며(p<.001) 삶의 질(FACT-G)은 신체적 삶의 질과 정서적 삶의 질에서 유의한 변화를 보였으나(p<.001) 사회적 삶의 질과 기능적 삶의 질은 유의한 변화를 보이지 않았다. 피로도(FFS)는 치료 후 유의하게 향상되었으며(p<.001) 치료 횟수가 증가하면 피로도가 감소하는 것으로 나타났다. 결론 : 유방암 절제술 후 관절가동범위의 제한이 있는 환자에게 작업치료를 중재하였을 때 어깨 관절가동범위를 증진시킬 뿐만 아니라 상지 장애 및 일상생활의 향상과 함께 삶의 질을 높이는 데에 효과적일 수 있는 것으로 나타났다. 따라서 이러한 내용을 고려하여 유방암 환자에게 다양한 작업치료를 임상적으로 적용할 수 있는 근거로 활용 할 수 있을 것이다.

PDT is an established cancer treatment modality. This can be attributed to the attractive basic concept of PDT; Combination of two therapeutic agents, a photosensitizing drug and light, which are relatively harmless by themselves but when combined, cause more or less selective tumor destruction. Hematoporphyrin-derived photosensitizers are known to be stable and highly efficient. In this study, we conducted a series of experiments to develop light-induced anticancer drugs against oral cancer cells. We tested the cytotoxicity of photodin by MTT assay and observed cell death pattern (apoptosis or necrosis) by hoechst 33342 and propidium iodide staining methods after PDT. IC50 value of photodin was 0.65 ug/ml. At higher doses of photodin ( > 7.8 ug/ml), cancer cells died exclusively from necrosis after PDT. By contrast, at IC50 value, photodin induced cancer cell to undergo apoptotic cell death. The induction begins approximately 6 hours after PDT. We investigated intracellular localization of photodin by oral cancer cell via confocal laser scanning microscopy. Oral cancer cells dual-stained with photodin and organelle-specific fluorescence probes (Mitotracker, Lysotracker, ER-Tracker) revealed that an intracellular fluorescence distribution was restricted to cytoplasmic compartments with no detectable fluorescence in the nucleus. Confocal images of cells containing photodin were overlapped with the mitochondria-specific fluorescence probe images of the same cells. These results demonstrated that photodin may play the role of a photosensitizer for oral squamous cancer cells without swelling and inflammation. Therefore, photodin-based PDT is a suitable treatment for oral cavity carcinoma patients.

Objective : Liver cancer is common cancer generating 11.3% incidence in Korea. But Oriental medical doctor (OMD) often can't measure therapy on liver cancer positively because that the prognosis on it is not good. It is impossible the results on all of diseases not only liver cancer always to have to be good. Methods : It is studied the literature referencing liver cancer, experimental articles to insist the effects of Oriental medicine planet to liver cancer and the clinical cases on liver cancer to be treated as Oriental medicine therapy to have effects. Results : it is required to find out the causes of diseases and therapy method to conquest the diseases for the medical therapy. But because the results on medical therapy are not always good, it is necessary for the doctor who want to treat the diseases like liver cancer having the prognosis to be death to protect himself, like as the legal system, a medical policy. And consequently, this protecting legal system lead the medical therapy principle or method on some special diseases to therapy completion on it. As a results of policy, medical therapy have to be developed. Recently, there have been many other development in oriental medical therapy. This development can be grouped as two type. One type is clinical part and the other is experimental research part. Specially the experimental research and clinical research on live cancer in oriental medical therapy have been developed. So the present day is the time to make medical policy on liver cancer for OMD to measure oriental medical therapy and develop oriental medical theory. Conclusions : As a above results, we propose that the name of liver cancer have to use in Korean medicine security clinical name (한방의료보험상병명) to make oriental medical policy.

We conducted a series of in vitro experiments to evaluate the anticancer effect of photodynamic therapy using hypericin and 532㎚ DPSS (diode pumped solid state laser). The cultured KB cells were treated with serial concentrations of hypericin ranging from 0.01㎍/㎖ to 5㎍/㎖ (two-fold dilution) with variable laser dosage (10J, 20J, 30J). The cell viability was evaluated by MTT assay. The type of cell death was detected by fluorescent microscope using Hoechst 33342 / PI (propidium iodide) stain methods. In this study, IC50 value with hypericin-mediated PDT with 10J DPSS laser was 35 ng/ml. The maximum cytotoxicity with Photofrin II-based PDT was observed at high drug concentrations(> 90 ng/ml) independent with laser dose. And the in vitro PDT effects depended on the laser dose and drug concentrations were displayed by the difference in the type of cell death, namely apoptosis or necrosis. According to this result, the hypericin based photodynamic therapy with DPSS laser was effective photodynamic therapy.

The Notch signaling pathway regulates cell proliferation, apoptosis and cell fate decision. Recent preclinical and clinical evidence supports a pro-oncogenic function for Notch signaling in several solid tumors including breast and prostate cancer. Consequently, there is increasing interest in targeting Notch signaling therapeutically in cancer patients. Notch inhibitors, particularly gamma-secretase inhibitors, are being investigated as candidate cancer therapeutic agents. However, rational targeting of Notch signaling in cancer will require a systematic exploration of several areas that remain incompletely understood. Therefore, a clear understanding of the Notch signaling and its cross-talk with other signaling cascade will increase our ability to design rational combination regimens for cancer therapy.

PDT is an established cancer treatment modality, This can be attri buted to the attractive basic concept of PDT; the combination 0 1' two therapeutic agents , a photosensiti zing drug and light, which are relatively harmless by themselves but combined ultimately cause more 0 1' less selective tumor destruction, The bacteri ochlorophyll - derivatived photosensitizer s are known to be s tabl e and highly effïcient, ln thí s study, we conducted a seríes of experiments to develope the light induced anticancer drugs against oral cancer cell , We tested the cytotoxi city of the hydroxybacteriochlorine by MTT assay and observed the cell death pattern(apoptosis or necrosis) after PDT by hoechst 33342 and propidium iodide s taining methods, lC50 value of the hydroxybac teriochlorine was 3 1 ， 3 ng/ n띠， At higher doses of hydroxybacteriochlori ne () 60ng/ rnQ) , cancer cells died exclus ively by necrosis after PDT By contrast, at lC50 value, hydroxybacteri ochlorine induced cancer cell to undergo apop totic c e ll death, The induct ion begins approximately 6 hours a fter PDT, We inves tigates intrace l1 ular localization of hydroxybacte riochlorine by oral cancel‘ cell via confocal laser scanning mi croscopy, Oral cancer cells dua l-stained with hydrox ybacteriochlo1' ine and organelle-specific flu orescence probes (Mi totracker , Lysotracke1', ER- Tracker) revealed an intracellular f1 uores c ence dis tribution restricted to cyt oplasmic compartments with no det ectable fluorescence in the nucleus, Confocal im ages of cells containing hydroxybacte1'iochl orine were never overla p to mitochondria, lysosome . endoplasmic reticulum when digita lly overla pped with tqe organel1e-specific f1 uorescence p1'obe images o{' the same cells These results demons trated tha t the hydroxybacte1' iochlorine may have a fun ction as a photosensitizer and cytotoxicity hydroxy bacteriochlo1'ine for o1'al cancer cell is more sensitive than head & neck cancer cell 0 1' ce1'vical cancer cell Therefore PDT using hydroxybacte1'iochl orine is suita ble treatment for oral cavity carcinoma patients

PDT is an establi shed cancer treatment modali ty , This can be attributed to the attractive basic concept of PDT; the combina ti on 0[' two ther a peut ic agents, a photosensitizing drug and light, which are r elatively harmless by themselves but combined ultimately ca use more 0 1' less selective tumor destruction, The bacteriochlorophyll - derivatived photosensitizers are known to be s ta ble and hi ghly efficient‘ In this s tudy, we conducted a series of experiments to develope the ligh t induced anticancer drugs against oral cancer cell ‘ We tested the cytotoxicity of the hydroxybact eriochlorine by MTT a ssay and observed the cell death pattern (apoptosis or necrosis) after PDT by hoechst 33342 and propidium iodide s taining methods , IC50 value of the hydroxybacteriochlorine was 31,3ngjm.Q, At higher doses of hydroxybacteriochlorine () 60 ng/ 뼈) ， cancer cells died exc lus ively by nec rosis after PDT By contrast, at IC50 value, h ydroxybacteri ochlorine in duced ca ncel' cell to undergo a poptotic cell death The induction begins approximately 6 hours after PDT We investigates int racellu la r localizati on of hydroxybact eri ochl orine by ora l cancer cell via confocal laser scanning microscopy, Oral can cer cells dual-stained with hydroxybactel' iochlorine and organelle-specific fluoresc ence probes (Mi totracker, Lysotracker , ER- Trac ker) revealed an int l'acellula l' flu orescence distribution restrict ed to cytoplasmic compartments with no detectable fl uoresce nce in the nucleus Confocal images of cells containing hydroxybacteriochlorine were never overlap to mi tochondria, lysosome, endoplasmic l'eticulum when digitally overlapped with the organelle-specific flu orescence probe images of the same cells , These resul ts demonstrat ed that the hydroxybacteriochlorine may have a function as a photosens it izer and cytotoxicity hydroxybactel' ioc hlorine for oral ca ncer cell is more sensitive than head & neck cancer cell or cervical cance l' cell Ther efore PDT using hydroxybact eriochlorine is suitable treatment for oral cavity car cinoma patients.

We conducted a series of in vitro experiments to evaluate the efficiency of photodynamic therapy on head and neck cancer cell using hydroxybacteriochlorine from photosynthetic bacteria. We tested the cytotoxicity of the hydroxybacteriochlorine by MTI assay and observed the cell death pattern(apoptosis or necrosis) after PDT by hoechst 33342 and propidium iodide staining methods IC50 value of the hydroxybacteriochlorine was 0.22μg/rrúi. At higher doses of hydroxybacteriochlorine () 0.6μg/rrúi) , cancer cells died exclusively by necrosis after PDT. By contrast, at IC50 value, hydroxybacteriochlorine induced cancer cell to undergo apoptotic cell death. The induction begins approximately 6 hours after PDT. We investigates intracellular localization of hydroxybacteriochlorine by head & neck cancer cell via confocal laser scanning microscopy. Head & neck cancer cells dual-stained with hydroxybacteriochlorine and a panel of organelle- specific fluorescence probes (Mitotracker, Lysotracker, ER-Tracker) revealed an intracellular fluorescence distribution restricted to cytoplasmic compartments with no detectable fluorescence in the nucleus Confocal images of cells containing hydroxybacteriochlorine were never overlap in subcellular organelle fluorescence when digitally over layed with the organelle-specific fluorescence probe images of the same cells. These results demonstrated that the hydroxybacteriochlorine may have a function as a photosensitizer.

방사선치료 기법의 발전으로 치료가 더욱 정밀해졌음에도 불구하고 치료 부위 외에도 방사선에 의해 피폭되는 것은 피할 수 없다. 이에 본 연구에서는 유방암의 방사선치료 시 치료 반대편 유방의 bolus 두께에 따른 흡수선량을 평가하고 선량 저감 효과에 대해 분석하고자 하였다. 실험 및 방법으로 Rando phantom을 대상으로 VMAT 치료방법을 이용하여 실험을 진행하였다. 치료 반대편 유방에 A, B, C, D, E의 5개 지점을 선정하여 bolus를 사용하지 않았을 때와 5, 10, 15, 20 ㎜ 의 bolus를 사용하였을 때의 선량을 유리선량계를 사용해 평가하였다. 그 결과, 치료지점과 가장 가까운 지점에서 높은 흡수선량이 측정되었으며 치료지점과 가장 먼 B 지점에서는 가장 낮게 측정되었다. 평균 흡수선량은 bolus를 사용하지 않았을 때 8.61 cGy 그리고 두께에 따라 8.10, 7.94, 8.06, 8.10 cGy로 나타났다. 연구 결과 선량 저감 효과를 확인할 수 있었으며, 본 연구를 바탕으로 적절한 bolus 두께를 설정하여 정상조직의 선량 저감화를 위해 노력해야 할 것이다.

세기변조방사선치료와 입체적세기조절회전치료 시 조사체적과 선량 퍼짐 현상을 줄이기 위한 방법으로 조사 각도를 제한하는 부분 각도에 의한 회전치료 기능을 적용하여 표적체적과 주변 정상장기의 선량에 대해 입체조형방사선치료와 비교 분석하였다. 치료계획에 따른 표적체적의 선량분포는 통계적으로 유의한 차이를 확인할 수 없었으며, 폐의 5 Gy(V5) 체적에서 입체조형방사선치료 56.53%, 세기변조방사선치료 52.03%, 입체적세기조절회전치료 47.84%를 나타내어 유의한 차이를 나타내었다(CRT-IMRT p=0.035, CRT-VMAT p<0.001, IMRT-VMAT p<0.001). 10 Gy 체적(V10)에서는 입체조형방사선치료 35.12%, 세기변조방사선치료 34.04%, 입체적세기조절회전치료 33.28%를 보여, 입체조형방사선치료와 세기변조방사선치료(p=0.018), 입체적세기 조절회전치료(p=0.035)에서 유의한 차이를 나타내었으나 20 Gy 체적(V20)에서는 유의한 선량 차이를 확인 할 수 없었다. 심장의 평균선량과 20 Gy 체적은 치료계획에 따라 유의한 차이를 확인할 수 없었으나, 30, 40 Gy 체적은 입체적세기조절회전치료에서 37.16%, 22.46%를 나타내어 입체조형방사선치료와 비교에서 유의한 차이(p=0.028)를 보였다. 이와 같이 조사체적 감소에 따른 폐의 저 선량 체적(V5, V10)의 감소를 확인할 수 있었으며, 세기변조방사선치료와 입체적세기조절회전치료 시 조사 각도를 일부 제한함으로써 표적체적의 선량분포는 동일하게 유지함과 동시에 조사체적을 줄일 수 있었다. 이로 인해 폐의 선량 퍼짐 현상의 감소로부터 폐의 독성을 낮추는데 기여할 수 있을 것으로 사료된다.

This study was conducted to apply a horticultural therapy program to childhood cancer patients, to analyze their psychosocial changes and thus to examine its possibility as a way to manage the recovery of childhood cancer patients. This study was conducted on patients who were diagnosed with childhood cancer, and they were divided into the experimental group (8 patients who visited H association offices located in 3 cities and participated in the horticultural program) and the control group (5 patients who did not participate in the program). The homogeneity between the two groups before conducting the program was compared, and there was no statistically significant difference, which proved that the two groups were homogeneous. After conducting the program, the score of social immaturity, one of the sub-categories of problem behaviors, of the experimental group was statistically significantly lower than that of the control group (p=.019). Changes before and after the program within the groups were compared, and the somatization score (p=.039) of the experimental group (p=.039) after the program was 1.13, down from 2.13 before the program. The social immaturity score (p=.017) of the experimental group after the program was 1.00, down from 2.63 before the program, and the attention problem score (p=.026) of the group after the program was 1.25, down from 2.50 before the program. The total problem behavior score (p=.034) of the experimental group after the program was 9.63, down from 18.50 before the program, showing a statistically significant decrease. The cumulative subjective mood score (p=.000) of the experimental group throughout the entire sessions after the program was 7.82, up from 6.99 before the program, showing a statistically significant increase. Therefore, it can be concluded that the horticultural therapy program developed based on the ‘relaxationsocial support-cognitive behavior’ strategy was effective to reduce the negative psychosocial state of childhood cancer patients.

고용량 131I 치료는 분화갑상선암으로 인한 갑상선전절제술을 받은 환자에게 보편적으로 시행되어 왔다. 고용량 131I 치료를 하는 경우 환자로부터 일반인이 받게 되는 피폭선량을 선량한도 이내로 제한하기 위해 환자를 일정 기간 동안 격리하여야 한다. 유효반감기는 환자로부터 가족들이 얼마나 피폭되는지 계산하거 나 격리기간을 결정하는데 중요한 값이다. 이에 본 연구에서는 NM670 SPECT/CT를 이용해 고용량 131I 치 료환자의 유효붕괴상수, 유효반감기, 격리기간을 도출하였다. 본 연구를 통해 고용량 131I 치료환자의 유효반감기를 도출하였고, 체내에 잔류 방사능량이 퇴원기준인 1. 2 GBq 에 도달하는 시간을 확인하였다. 또한 치료선량별 유효반감기를 비교하였을 때 유의한 차이가 없 었으나, 격리기간은 치료선량이 커질수록 격리기간이 길어지는 것을 확인할 수 있었다. 전처치 유형별 유 효반감기를 비교하였을 때 rhTSH 환자군과 THW 환자군의 유효반감기가 유의한 차이를 보이지 않았으나, 격리기간은 rhTSH 환자군이 THW 환자군 보다 짧게 나타났다. 이는 치료선량의 차이로 인해 격리기간이 짧아진 것으로 판단된다. 따라서 현행 의료보험체계(rhTSH 사용 시 3.7 GBq 이하에서 보험적용)가 유지된다면, 전처치 유형별로 구분하여 현행 격리기간(2박 3일)보다 더 이른 시간에 환자를 퇴원시킬 수 있을 것이다.