• Radiation Oncology Journal
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• v.15 no.1
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• pp.1-10
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• 1997

Purpose : To evaluate the role of radiotherapy in the management of incompletely resected supratentorial low grade astrocytoma with the analysis of the survival, the Pattern of failure, and the prognostic variables affecting survival. Material and methods : Between January 1990 and December 1995, fifty-one patients with supratentorial low grade astrocytoma received radiotherapy after subtotal resection(16 patients) or stereotactic biopsy(35 patients) at Asan Medical Center, External radiotherapy was done by conventional fractionation with the total dose of 4820cGy to 6000cGy(median 5580cGy) and partial brain volume. The follow-up was done from 6 to 79 months(median 48 months) Result : Overall actuarial survival rate at 2 and 5 years were $83.4\%\;and\;54.8\%$, respectively. Progression free survival at 2 and 5 years were $67.4\%\;and\;48.7\%$, respectively The significant prognostic factors affecting overall survival rate were the performance status, 1 stage, histologic subtype, radiation field and radiation response. The major pattern of failure was local failure, such as Progressive disease and primary site recurrence in 23 patients $(45.1\%)$. Progression free survivors excluding 2 patients were physically and intellectually intact without major neurologic deficit. Conclusion : Although the follow-up period of this study was relatively short, overall actuarial and progression free survival rate were encouraging. Patients with good performance status, lower T stage, pilocytic subtype, patients treated with small radiation field and radiation responder showed better survival. As the local failure was the major pattern of failure, the various efforts to decrease the local failure is necessary.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.2
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• pp.247-252
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• 1998

Neuroleptic malignant syndrome(NMS) is an acute, potentially fatal, idiosyncratic reaction to neuroleptic medication. Early recognition and intensive care are crucial. An important issue is whether NMS will recur after initial recovery and subsequent use of neuroleptic medication. The authors presented with a male adolescent who had suffered a bipolar disorder manic episode and been taking clozapine after recovering from MNS. He had been admitted into a psychiatric ward once before and similarly diagnosed. On the second admission, he showed muscle rigidity, autonomic instability, mild fever, severe diaphoresis, and altered mental status on the fourth hospital day following a haloperidol injection. He was diagnosed with NMS, according to the clinical signs and laboratory data. After the use of antipsychotics was discontinued, he was moved to intensive care unit and given dantrolene. His condition began to improve about 48 hours after the onset of NMS. Due to manic behavior, he returned to the psychiatric ward. On the 21 st hospital day, clozapine was administered to counter the manic symptoms. The final dose was 350mg and showed good remission signs without further recurrence of NMS.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.126-133
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• 2005

Purpose: to know the treatment result of squamous cell carcinoma in extremity had poor prognosis with risk factor including burn scar and chronic osteomyelitis. Material and Methods: Between Octorber 1993 and September 2002, 20 patients with squamous cell carcinoma in extremity had no distant metastasis was got operation and followed over 36 months. Amputation was done when it was hard to get enough wide margin or neurovascular structure was involved instead of wide excision. Mean age of patients was 57.2 years old and male to female was 16 to 4. TMN staging and histologic grading were performed. Results: There were 6 metastasis (30%) in 20 cases for mean 48.3 months (36-84 months). 3 metastasis to local lymph node and 3 distant metastasis were happened at lung (in 3 cases) and thorasic vertebra (in 1 case). Survival was 18 cases at last look. 5-year survival rate was 50%. 3 local recurrence was developed at average 11 months (4-18 months). Complication was focal skin defect after wide excision and skin graft in 2 cases. The patients by wide excision got average 1.9 time operation and by amputation got average 1.3 time. Conclusion: Squamous cell carcinoma at extremity in Korea had high metastasis rate due to burn scar and chronic osteomyelitis, and it showed equal treatment result which treated by wide excision compared with amputation.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.1
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• pp.17-22
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• 2011

Purpose: We analyzed the oncological outcome and prognostic factor of the chondrosarcoma arising from benign bone tumor due to malignant transformation. Materials and Methods: From April 1986 to April 2009, 18 cases were considered eligible. We analyzed retrospectively the patient's characteristics and prognostic factors that affect to the local recurrence and distant metastasis. Results: As classified by primary benign bone tumor, 4 cases were solitary osteochondroma, 11 cases were multiple osteochondromatosis and 3 cases were multiple enchondromatosis. The mean follow-up period was 85 months. The 5-year disease free survival rate of 18 patients was 85.9%. Their overall MSTS score was 25.2 (84%). There were local recurrence in 3 cases and no distant metastasis. We found that tumor location and surgical margin affected to the prognosis significantly. Conclusion: In secondary chondrosarcoma patients, the prognosis was good relatively and tumor location and surgical margin are important prognosis factor.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.3
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• pp.337-344
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• 2018

Hepatocellular carcinoma (HCC), a major type of hepatoma, is associated with high recurrence and mortality because of its uncontrolled metastatic feature. Silymarin is a polyphenolic flavonoid from Silybum marianun (milk thistle) and exhibits anti-carcinogenic activity through modulation of the epithelial-mesenchymal transition (EMT) in several cancer cells. In this study, the inhibitory mechanism of silymarin against migration and invasion was investigated in the Huh7 HCC cell line. Wound healing and in vitro invasion assays were conducted to examine the effects of silymarin on migration and invasion. Western blot analysis was also applied to evaluate the inhibitory effects of silymarin on the EMT-related genes and their upstream signaling molecules. Silymarin inhibited the migratory and invasive activities of Huh7 cells. In addition, silymarin attenuated the protein expression levels of vimentin and matrix metalloproteinase (MMP)-9 as well as their transcription factors, Snail, and nuclear factor $(NF)-{\kappa}B$, while the expression of E-cadherin was increased by the silymarin treatment. Among the upstream signaling molecules, the phosphorylation of Akt was inhibited by the silymarin treatment, which was confirmed by the selective inhibitor, LY294002. Consequently, silymarin inhibited the invasive and migratory activities in Huh7 cells through the modulation of EMT-related gene expression by the PI3K/Akt signaling pathway, which may have potential as a chemopreventive agent against HCC metastasis.

• Journal of agricultural medicine and community health
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• v.40 no.1
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• pp.9-20
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• 2015

Objectives: This study aimed to explore the persistence and adherence to secondary preventive medication of stroke patients after discharge and to assess the reasons for persistence and nonadherence. Methods: Four hundred twenty-nine patients with stroke were surveyed to determine their behaviors from discharge. Reasons for stopping medications were ascertained. Persistence was defined as continuation of all secondary preventive medications prescribed at hospital discharge, and adherence as continuation of prescribed medications according to health care provider instructions. Results: Of the 429 patients, 86.5% were treatment persistent and 41.2%(non-intentional nonadherence=39.4%, intentional nonadherence=19.4%) were adherent. Independent predictors of persistence included having experience about health education. Independent predictors of non-intentional nonadherence were modified Rankin Scale(mRS) (Exp(B)=2.858, p=0.001) and health education experience (Exp(B)=0.472, p=0.032), and independent predictors of intentional nonadherence were mRS (Exp(B)=2.533, p=0.006), depressive symptoms (Exp(B)=1.113, p=0.016), beliefs about medications questionnaire(necessity, Exp(B)=0.879, p=0.011, concern, Exp(B)=1.098, p=0.019). Conclusions: Although up to one-ninth of stroke patients continued secondary prevention medications, nonadherence is common. Several potentially modifiable patient, provider, and system-level factors associated with persistence and adherence may be targets for future interventions. Specially, interventions to improve adherence should target patients' beliefs about their medication.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1992.05a
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• pp.47-47
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• 1992

$\beta$수용체에 대한 차단약으로 propranolol이 1964년에 도입된 후, 현재까지 수십여종의 $\beta$-차단약이 개발되었다. 그중 특이 $\beta$1 수용체에 대해 선택적인 억제효과를 지닌 atenolol, metoprolol, betaxolol, celiprolol 및 최근에 bisoprolol 등이 개발되어 임상적으로 부정맥, 협심증, 고혈압의 치료에 사용되고 있다. 그 작용기전으로는 심박출량의 감소, renin 유리억제, 중추억제효과 등이 제시되고 있으나, 이들의 약효검색은 주로 $\beta$1수용체가 많이 존재하는 심장에 대한 억제효과를 중심으로 실시한다. 즉, SHR 및 개를 사용한 생체실험과 심장, 심방 ($\beta$1) 및 기완지, 혈관($\beta$2)을 이용한 적출장기실험을 통하여 isoproterenol에 대한 억제효과를 용량반응 곡선으로 그리고, Van rossum 법에 의해 pA$_2$ 치를 구하여 $\beta$-차단제의 효력을 평가한다. 특히, pA$_2$ 치가 클수록 $\beta$-차단제의 효력이 큰 약물이다. 또한 수용체 결합실험으로 소의 심실 세포막을 분리하여 $^3$H-DHA 와의 결합실험을 통해 해리항수(Kd) 를 측정하고, 이어서 $^3$H-DHA의 일정농도와 함께 미지의 $\beta$-차단제를 여러 농도로 변화시켜 가하여 치환곡선을 작성한다. 여기에서 얻은 치환약의 $IC_{50}$/ 치로부터 치환약의 해리항수(Ki)를 산출한다. 이때 약물과 수용체의 친화력은 해리항수의 역수이므로 해리항수가 적을수록 $\beta$ 수용체에 대한 친화력이 큰 약물이다. 시사되었으며, 이 조직에서 또한 5-$HT_2$와 5-$HT_3$ 수용체의 존재를 확인하고 각각의 기능을 분명히 했다.가 수월하게 하였고 메모리를 동적으로 관리할 수 있게 하였다. 또한 기존의 smpl에 디버깅용 함수 및 설비(facility) 제어용 함수를 추가하여 시뮬레이션 프로그램 작성을 용이하게 하였다. 예를 들면 who_server(), who_queue(), pop_Q(), push_Q(), pop_server(), push_server(), we(), wf(), printfct() 같은 함수들이다. 또한 동시에 발생되는 사건들의 순서를 조종하기 위해, 동시에 발생할 수 있는 각각의 사건에 우선순위를 두어 이 우선 순위에 의하여 사건 리스트(event list)에서 자동적으로 사건들의 순서가 결정되도록 확장하였으며, 설비 제어방식에 있어서도 FIFO, LIFO, 우선 순위 방식등을 선택할 수 있도록 확장하였다. SIMPLE는 자료구조 및 프로그램이 공개되어 있으므로 프로그래머가 원하는 기능을 쉽게 추가할 수 있는 장점도 있다. 아울러 SMPLE에서 새로이 추가된 자료구조와 함수 및 설비제어 방식등을 활용하여 실제 중형급 시스템에 대한 시뮬레이션 구현과 시스템 분석의 예를 보인다._3$", chain segment, with the activation energy of carriers from the shallow trap with 0.4[eV], in he amorphous regions.의 증발산율은 우기의 기상자료를 이용하여 구한 결과 0.05 - 0.10 mm/hr 의 범위로서 이로 인한 강우손실량은 큰 의미가 없음을 알았다.재발이 나타난 3례의 환자를 제외한 9례 (75%)에서는 현재까지 재발소견을 보이지 않고 있다. 이러한 결과는 다른 보고자들과 유사한 결과를 보이고 있지만 아직까지 증례가 많지 않기 때문에 생존율을 얻기에는 미흡한 점이

• Journal of Chest Surgery
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• v.42 no.5
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• pp.677-683
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• 2009

May-Thurner syndrome is a deep vein thrombosis of the ilio-femoral vein due to compression of the left common iliac vein by the overlying right common iliac artery. Although, catheter directed thrombectomy (CDT) and thrombolysis with stent insertion has become the standard treatment method for acute or subacute May-Thurner syndrome, because of technical feasibility and lower recurrence rate, however, sometimes this methods make fatal complications. Furthermore, there are few reports on optimal treatment strategies for patients in a chronic state of May-Thurner syndrome. We now present two cases of chronic (> 1 month since onset of symptoms) May-Thurner syndrome treated by surgical thrombectomy and femoral arteriovenous shunt with simultaneous stent insertion after failed endovascular treatment. This technique may provide a significant benefit for patients who are not suitable for conventional endovascular treatment.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.157-169
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• 1999

Eighty-nine shoulders in eighty-eight patients with traumatic unilateral anterior shoulder instability were evaluated for Rowe and UCLA scores, recurrence, return to activity, and range of motion by an independent examiner at an average of 39 months after either arthroscopic or open Bankart repair using suture anchors. The arthroscopic technique included a minimum of 3 anchors, and a routine incorporation of capsular plication and proximal shift. Twenty­six shoulders(86.6%) out of thirty in the open Bankart repair group had excellent or good results while fifty­four(91.5%) of the fifty-nine shoulders with arthroscopic Bankart repair had excellent or good results. The arthroscopic group revealed significantly better results in the Rowe(p=.041) and UCLA scores(p=.026). Two shoulders in each group developed redislocation. There were no significant differences in the loss of external rotation and return to prior activity between the two groups(p>.05). The residual instability occurred more frequently in the group of patients with lesser anchors. Arthroscopic suture anchor capsulorraphy has results equal to or better than the open Bankart procedure.

• Proceedings of the Computational Structural Engineering Institute Conference
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• 1992.10a
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• pp.3-3
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• 1992

타이어 Curing공정은 공기압 타이어의 제조시 상당히 정교한 단계를 거쳐서 이루어지며, 이는 타이어 설계에 큰 영향을 줄 뿐만아니라, 타이어의 성능에도 관건이 있다. 본 연구에서는 유한요소법을 이용하여 타이어의 molding 공정을 분석하였다. 유한요소해석 프로그램인 MARC가 Cured 타이어 내부의 Curing Bladder 팽창과정해석에 이용되었다. 비압축성 요소로 Curing Bladder를 모형화하였으며, MARC의 접촉문제해석기법(contact option)을 이용하여 Cured 타이어 내부와 Curing Bladder 외부의 접촉부위를 Simulation하였다. 본 연구의 주요 관심내용으로서는 Curing Bladder의 형상변화에 따른 Curing Bladder의 팽창거동해석과, Cured타이어와 Curing Bladder의 접촉부위에서 얻을 수 있는 접촉압력의 비교.검토이다. 타이어 Curing시 타이어와 Bladder의 Contact과정을 해석하여, 아래와 같은 결과를 도출하였다. Bladder의 형상은 Cylinderical 형상 보다는 Toroidal 형태가 접촉압 분포의 균일성 및 크기 측면에 서 우수한 것으로 판단된다. Curing Bladder의 증심선 부위 보다 이에서 약간 떨어진 부위에서 최대 접촉압력이 발생되며, 이는 타이어 내면의 굴곡현상과 깊은 관련이 있윰 것으로 사료된다. 타이어 Bead부의 Carcass 자연평형현상이 유지된 제품을 얻기위해서는, Side-Bead구간의 접촉압력 증가가 필요하며, 이를 위하여는 Bladder 형상이 Cylinderical 보다는 Toroidal 형태가 유리하고, Bead부의 Gage Down, 전체직경의 증가 및 높이의 증가가 유리한 것으로 판단된다. 본 연구 결과를 이용하여, 타이어 Curing과정에서 발생되는 불량제품의 원인파악 및 타이어 설계자가 원하는 제품생산의 불가능한 원인을 파악하는데 도움을 줄 것이다.를 C의 structure와 pointer를 기반으로 하게끔 변경시키고 이에 따르는 제반 변경 사항을 수정 보완하여 프로그램의 분석을 용이하게 하며 기능의 변경 및 추가가 수월하게 하였고 메모리를 동적으로 관리할 수 있게 하였다. 또한 기존의 smpl에 디버깅용 함수 및 설비(facility) 제어용 함수를 추가하여 시뮬레이션 프로그램 작성을 용이하게 하였다. 예를 들면 who_server(), who_queue(), pop_Q(), push_Q(), pop_server(), push_server(), we(), wf(), printfct() 같은 함수들이다. 또한 동시에 발생되는 사건들의 순서를 조종하기 위해, 동시에 발생할 수 있는 각각의 사건에 우선순위를 두어 이 우선 순위에 의하여 사건 리스트(event list)에서 자동적으로 사건들의 순서가 결정되도록 확장하였으며, 설비 제어방식에 있어서도 FIFO, LIFO, 우선 순위 방식등을 선택할 수 있도록 확장하였다. SIMPLE는 자료구조 및 프로그램이 공개되어 있으므로 프로그래머가 원하는 기능을 쉽게 추가할 수 있는 장점도 있다. 아울러 SMPLE에서 새로이 추가된 자료구조와 함수 및 설비제어 방식등을 활용하여 실제 중형급 시스템에 대한 시뮬레이션 구현과 시스템 분석의 예를 보인다._3$", chain segment, with the activation energy of carriers from the shallow trap with 0.4[eV], in he amorphous regions.의 증발산율은 우기의 기상자료를 이용하여 구한 결과 0.05 - 0.10 mm/hr 의 범위로서 이로 인한 강우손실량은 큰 의미가 없음을 알았다.재발이 나타난 3례의 환자를 제외한 9례 (75%)에서는 현재까지 재발소견을 보이지 않고 있다. 이러한 결과는 다른 보고자들과 유사한 결과를 보이고 있지만 아직까지 증례가 많지 않기 때문에 생존율을 얻