• Journal of Life Science
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• v.30 no.6
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• pp.563-569
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• 2020

Oncoplastic surgery (OPS) combines oncologically safe tumor resection with aesthetically satisfying reconstruction of defects using established plastic surgery techniques. OPS is characterized by initial excision as extensive as is beneficial for oncological safety, and, once sufficient resection is complete, displacement or replacement techniques are selected based on remnant volume. The size of the lesion and the individual patient are important factors when considering the appropriate approach, and when pre-operative imaging, including MRI, is used to determine the technique, the complete removal of cancer cells by permanent pathology is essential. A frozen section is used during the operation to reduce the reoperation rate, but it is difficult to cover the entire margin surface theoretically and even harder in practice. A recent report about adequate margins has empowered OPS in its oncological safety. Considering the patients to whom each modality could be applied, basic breast volume is an important factor, and this is influenced by ethnic differences. In Europe or the US, for example, the average breast size is 36D (600 ㎤) and reduction mammoplasty is predominantly used. However, the average size of patients in our institution is 33A (300 ㎤), and so quite different approaches are selected in most cases. New techniques involving radiofrequency and fluorescence have been proposed as safe and easily accessible ways of reducing complications.

• Pediatric Infection and Vaccine
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• v.22 no.1
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• pp.29-35
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• 2015

Purpose: The purpose of this study was to investigate the clinical characteristics and outcome of febrile urinary tract infections (UTIs) caused by community-acquired extended-spectrum ${\beta}$-lactamase (CA-ESBL)-producing and -nonproducing bacteria. Methods: We analyzed febrile UTIs in children hospitalized at Gachon University Gil Medical Center from January 2011 to December 2013 through retrospective data collection from their medical records. Results: Among pathogens causing 374 episodes of UTIs, the proportion of ESBL-producing bacteria was 13.1% (49/374). The proportion of ESBL-producing Escherichia coli and Klebsiella spp. was 13.6% (48/354) and 5.0% (1/20), respectively. There was no significant difference between the CA-ESBL and CA non-ESBL groups in duration of fever ($4.2{\pm}2.7$ vs. $3.7{\pm}2.1$ days, P=0.10) and bacterial eradication rate with empirical antibiotics (100% vs. 100%). The risk of cortical defects on renal scan significantly depended on existence of vesicoureteral reflux rather than ESBL production of pathogen. Conclusions: There was no significant difference between the CA-ESBL and CA non-ESBL groups in renal cortical defects and clinical outcome. Careful choice of antibiotics is important for treatment of community-acquired UTI in children.

• Journal of Preventive Medicine and Public Health
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• v.31 no.2 s.61
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• pp.249-264
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• 1998

Reports on a potential relationship between sensory neural hearing loss(SNHL) and cardiovascular or hematologic factor show that the results are controversial. A detailed analysis of risk factors in the development of SNHL was carried out in 3,050 non-noise exposed healthy worker. The mean hearing threshold of both ears at 500, 1000, 2000, 4000, 8000Hz was measured and the effect of age, possible cardiovascular risk factor and hematologic factor (blood viscosity and hemostatic factors) on SNHL were evaluated. first, each of these were associated with loss of hearing sensitivity when univariately and multivariatively analysed. In a multiple regression model, age, sex, body mass index, WBC and total cholesterol level were independently associated with the mean of hearing sensitivity decrease at 4000 and 8000Hz. Second, study subjects were divided into two group (normal vs SNHL) and we compare the possible risk between both groups, and analysed univariate and multivariative logistic model. In a multiple logistic regression model, age, sex, body mass index, WBC and total cholesterol level, total protein, platelet were independently associated with SNHL. Our results show that we have some reliable indices of susceptibility to SNHL using cardiovascular measures or biochemical factor, but future, more extensive studies are required.

• Journal of Yeungnam Medical Science
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• v.10 no.2
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• pp.380-387
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• 1993

Local excision and axillary dissection followed by radiation therapy to the breast has been shown to achieve equivalent local control and survival as mastectomy in an prospective randomized trials. We analyzed 28 cases of early breast cancer in order to evaluate the therapeutic effects of conservative surgery and definitive radiotherapy in the management of early breast cancer as possible alternative of simple mastectomy, retrospectively. Obtained results were as follows : 1. Treatment related acute side reactions are more prominant in the case of chemoradiotherapy group than radiotherapy alone group. 2. There were no cases of primary, regional or systemic failures on the last follow up examination. 3. Cosmetic results after treatment were satisfactory in 26 cases out of 28 cases on the last follow up examination. 4. There were no demonstrable differences of tumor control and cosmetic results between the treatment groups. Although, these results suggested that definitive radiotherapy after local excision would be a possible and desirable alternative instead of total mastectomy in the management of early breast cancers, analyzed cases were too small and follow up period was too short to evaluate the therapeutic effect of primary radiotherapy after local excision, exactly.

• Clinics in Shoulder and Elbow
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• v.15 no.1
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• pp.37-42
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• 2012

Purpose: To consider the proper management of proximal humerus fracture on gunshot wounds. Materials and Methods: A 28-year-old male patient, who sustained a gunshot injury on the left arm 5 days ago, was admitted through the emergency department. Although he underwent an emergency surgery (bullet fragment removal and debridement), there remained bullet fragments around the proximal humerus fracture site. The wound seemed to be infected and a partial dehiscence occurred. No neurologic deficit was noted. Immediate exploration and debridement were performed, and an external fixator was applied to restore the anatomical alignment and manage the wounds. Intravenous antibiotics were administered. On the 9th postoperative day, wound debridement was done again, and cement beads mixed with antibiotics were inserted. After two weeks, the external fixator was removed, and the pin sites were closed after debridement. One week later, the open reduction and internal fixation with locking compression plate and screws were done. Result: At 3 months after the internal fixation, the bone union was obtained with satisfactory alignment of the humerus. Conclusion: The severity of the soft tissue injury influences the fracture management plan. Further, the risk on lead toxicity should be considered.

• The Journal of Korean Society of Virology
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• v.26 no.1
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• pp.23-30
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• 1996

대략 36,000 base pairs (bp)의 두 가닥짜리 DNA를 지놈으로 가진 사람 아데노바이러스 (Ad)는 DNA 상동성(相同性) 및 생물학적/생화학적 성격이 특이한 49개의 혈청형이 알려져 있는데, 이들 대부분의 Ad가 영유아군 및 면역능이 저하된 성인에서 치사적 결과를 초래할 수 있다. Ad의 세포향성(向性)(tropism)은 매우 다양하여 종류에 따라 상기도 감염, 각결막염, 영유아 장염등을 유발하는데 최근 Ad의 다양한 병원성에 대한 원인을 분자생물학적 수준에서 규명하려는 노력의 일환으로 지역에 따라 주되게 출현하는 Ad형 규명이 활발히 이루어지고 있다. Ad 동정/확인은 표면을 이루고 있는 group 공통항원인 hexon 단백질을 탐지하는 효소면역 측정법 (EIA)에 의하며, Ad형별은 Ad fiber의 세포독성 중화시험에의 한다. 그러나, 세포독성 중화시험이 엄청난 노동력 및 시간을 요구하면서도 민감도/특이도가 만족스럽지 못하여 이를 개선하기 위하여 검체 또는 세포배양에서 Ad DNA를 추출하여 제한효소 절단형태를 비교하는 방법이 개발되었는데 이는 세포배양에 잘 자라지 않는 바이러스주의 형별뿐만 아니라 지역 분리주들의 지놈 변형주를 관찰하는 분자생물학적/분자역학적 연구에도 도움이 되고 있다. 국내에는 Ad와 관련된 소아장염의 빈도가 rotavirus에 의한 것 다음으로 빈번한데도 Ad40/41외에 주되게 출현하는 장내 Ad형들이 전혀 규명된 바 없고, 한국형 Ad들의 지놈형태가 전혀 보고된 바가 없다. 또한 세계적으로 Ad형별 조사지역이 늘어감에 따라 유아장염과 연관된 Ad 역시 Ad40, 41이 외의 형들이 Ad40, 41을 능가하는 것으로 보고되고 있는 지역도 있으나 국내에서는 Ad40, 41이외의 형들은 그 역학적 중요도가 전혀 알려져 있지 않다. 이로서 본 연구의 목적은 Ad주들에 특이 중화항체를 이용한 세포독성 중화시험과 Ad DNA 절단법을 적용하여 한국형 장내 Ad주들의 형별을 처음으로 시도함과 동시에 1989-1991사이 출현한 Ad들의 유전적 변형을 관찰하려는 것이었다. 두 방법 모두 사용하였을 때 주되게 출현하는 장내 Ad형들은 Ad4l, Ad2, Ad7, Ad5, 및 Ad40이었다. Ad40/41-양성 검체를 제외한 Ad hexon-EIA양성들의 77.5%를 형별 할 수 있었던 Ad DNA의 제한효소 절단방법은 형들간의 교차중화로 특이성이 낮았던 중화방법 (47.5%)보다 매우 효율적이어서 두 가지 방법을 함께 적응하였을 때는 40주중의 81.5%인 35주를 형별 할 수 있었다. 또한Ad DNA 제한 효소 절단방법은 Ad7 변이주 (Ad7b)도 탐지 할 수 있었다.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.139-145
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• 2004

This study describes our surgical results of transventricular complete repair of tetralogy of Fallot in infants. Material and Method: Eight hundred and forty children underwent complete repair of TOF between January 1990 and April 2002 in our institute. One hundred sixty infants of them were included to this survey. Mean age at repair was 8.1$\pm$2.6 months (3∼12). Correction was accomplished through a short right ventriculotomy less than 30% of ventricular height in all patients. A transannular patch was necessary in 78 patients (49%). Result: There were four early deaths. There were no late deaths. Follow-up with mean duration of 66 months was completed in all survivors, All patients are currently in New York Heart Association functional class I or II. Twenty patients required late reoperations. Actuarial freedom from reoperation at 1 and 10 years were 94% and 87% respectively. Two-dimensional and Doppler echocardiographic follow-up studies showed good right ventricular function in all patients except three. Conclusion: Our results suggested that early complete repair of TOF yield the acceptable results with low mortality and morbidity. Transventricular repair of intracardiac pathology can be safely applied to these patient population, yielding good postoperative right ventricular function.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.680-685
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• 2001

Background: Tricuspid valve replacement is very rarely performed procedure and its long-term result is not yet satisfactory. Moreover, it is not well known whether bioprosthesis or mechanical prosthesis is the best selection for artificial valve. We reviewed 72 cases of tricuspid valve replacements in 71 patients between January 1989 and December 1998, trying to analyze the overall results and risk factors for mortality and morbidity. Material and Method: Average age of the patients at the time of operation was 42$\pm$13 years(range 16 to 65 years) and the sex ratio of male versus female was 32/39. Primary diagnosis consisted of 50 cases of aquired valvular heart disease and 18 cases of congenital heart disease, such as Ebstein’s anomaly. 4 cases had isolated tricuspid valve regurgitation. Implanted valves were 69 mechanical prosthesis and 3 bioprosthesis. Concomitant mitral or aortic valve replacements were performed in 50 cases. One patient received concomittant pulmonary valve replacement. Result: There were 7(9.72%) operative deaths and 7(13.0%) late deaths. Actuarial survival at 10 years was 59.2$\pm$7.2%. Prosthetic tricuspid valve thrombosis occurred 11 times in 5 patients. Reoperation for prosthetic tricuspid valve failure was performed in 1 patient. In this case, examination of the explanted prostheses showed that the tricuspid stenosis was the result of valve thrombosis. Among the 47 survivors, 46 patients(98%) were in functional class I or II. Conclusion: In our ten-year experience of tricuspid valve replacement, mortality and morbidity were satisfactory. Mechanical prosthesis in tricuspid position showed comparable clinical results as bioprosthesis.

• Journal of the Korean Data and Information Science Society
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• v.25 no.2
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• pp.337-347
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• 2014

There is no known publication about assessment of quality of life (QOL) in Korean HIV patients. We aimed to assess the QOL of HIV patients. We developed Korean version of the WHOQOL-HIV BREF (short forms of WHOQOL-HIV, 31 questions with 6 domains). Survey data from 220 HIV-positive adults were obtained in 14 centers in South Korea. Male were dominant (202/220, 91.8%). Mean age was $40.6{\pm}12.1$. Mean CD4+ T-cell count was $414.9{\pm}226.6/ml$. Overall of WHOQOL-HIV BREF were $53.2{\pm}14.9$ (perfect score=100) (Cronbach's ${\alpha}$ = 0.942). It is similar score comparing to another country (Portugal: 54.75/100, measured by WHOQOL-HIV). Correlations of WHOQOL-HIV BREF score with patients' subjective QOL and with subjective satisfaction were 0.747 (p <0.01) and 0.651 (p <0.01), respectively. WHOQOL-HIV BREF have internal reliability. There is in need of monitoring for QOL of HIV patients in the clinical practice and trials. This survey tool could be used to assess the effect of intervention. Additionally, comparison across countries would be possible and promising.

• The Korean Journal of Emergency Medical Services
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• v.13 no.2
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• pp.99-108
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• 2009

Purpose : The purpose of this study is to offer basic data in arranging the improved working environment to Emergency Medical Technicians, by analyzing the influence of job satisfaction in Emergency Medical Technician within hospital upon organizational commitment. Method : This study was carried out targeting 203 Emergency Medical Technicians who are working at hospitals in B Metropolitan City, U Metropolitan City, D Metropolitan City, an d G Province. The data collection was performed from April 1, 2009 to June 10. The statistical processing was used a program of SPSS WIN 12.0 Version. The statistical significance was set to p<.05. Results : 1. In the descriptive statistics of the job satisfaction and the organizational commitment. the whole average for job satisfaction was 3.06 points. The whole average for organizational commitment was 3.05 points. 2. In the difference between job satisfaction and organizational commitment, the group for job satisfaction was indicated to be statistically significant in job-choice motive(F=2.710, p<.05) and turnover propensity(t=.662, p<.001). The group for organizational commitment was indicated to be statistically significant in working department(F=2.871, p<.05), job-choice motive(F=2.944, p<.05), turnover propensity(t=.903, p<.001), and turnover reason(F=3.415, p<.01). 3. In the correlation between job satisfaction and organizational commitment, the job satisfaction showed positive correlation(r=.736, p<.01) with organizational commitment. 4. As for the influence of job-satisfaction factor upon organizational commitment, salary(${\beta}$=.162, t=2.739, p<.01), autonomy(${\beta}$=.372, t=4.633, p<.001), working environment(${\beta}$=.139, t=1.968, p<.05), and organizational needs(${\beta}$=.172, t=2.291, p<.05) were indicated to have significant effect on organizational commitment. Conclusion : The institutional arrangement is considered to be likely to be necessarily made highly for improving social image and enhancing salary and working environment so that Emergency Medical Technician within hospital can be enhanced job satisfaction and organizational commitment.