• Tuberculosis and Respiratory Diseases
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• 제68권1호
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• pp.10-15
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• 2010

Background: Lung cancer is the most common cause of cancer mortality in Korea. The TNM stage at presentation in patients with non-small cell lung cancer (NSCLC) has the greatest impact on prognosis. Patients who undergo a complete resection for NSCLC are likely to develop recurrent and/or metastatic disease. There are several factors influencing the development of recurrence. We explored risk factors of recurrence in patients with stages I and II NSCLC, who had undergone curative resection. Methods: We reviewed patients who had complete surgical resection as definitive treatment for stage I or II. Patients followed up for more than 36 months. We evaluated several factors which might have relationship with recurrence, such as patient's demographic factors, TNM staging, pathologic finding, tumor markers and surgical technique. Results: A total of 75 patients were enrolled for analysis, of whom 58 were men and 17 were women with mean age of 61 (range, 37 to 76) years. The average size of tumors was 3.9 cm (0.7 to 10 cm). There were 64 patients with stage I NSCLC and 11 with stage II NSCLC. Among 64 patients with stage I NSCLC, 35 patients showed recurrences whereas 8 patients have recurred in stage II NSCLC. Grade of differentiation of tumor was closely related to the recurrence. Seventy-five percent of patients who had poor tumor differentiation experienced a recurrence. In contrast, 3 patients of twelve had recurrences, who revealed differentiation in their tissue (p<0.05). Conclusion: Tumor differentiation could be a predictive factor for tumor recurrence in patients who have undergone curative resection for stage I or II NSCLC.

• 전자공학회논문지
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• 제50권12호
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• pp.247-253
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• 2013

본 연구의 목적은 Direct DR(Digital Radiography), Indirect DR, I.I(Image Intensifier) DR에서 X선 광자 검출 방식에 따른 선량측정 및 획득된 영상을 정량적이고 객관적인 측정을 통해 DR System을 비교 평가 하는 것이다. Rando phantom을 사용하여 입사표면선량을 측정하였으며, 측정된 입사표면선량 값을 통해 PCXMC 프로그램을 사용하여 유효선량과 방사선 조사로 인한 위험을 평가하였다. 21cm 아크릴 phantom을 사용하여 SNR(Signal to Noise Ratio), NPS(Noise Power Spectrum), CNR(Contrast to Noise Ratio)을 측정하였으며, 측정값은 통계학적 분석기법을 사용하여 유의성을 평가하였다. 입사표면선량, 주요장기선량, 유효선량 모두 direct DR이 가장 낮게 측정되었으며, direct DR 선량을 기준으로 I.I type DR은 약 1.3배, indirect DR은 약 2.4배 높은 선량 비율로 측정되었다. 방사선량에 따른 위험도 역시 동일한 비율로 측정되었다. SNR 측정 결과 direct DR측정값을 기준으로 I.I DR은 약 7.25배, indirect DR이 약 1.48배 낮은 비율로 측정되었다. CNR 측정 결과 direct DR 측정값을 기준으로 I.I DR은 약 1.16배 높고, indirect DR이 약 0.87배 낮은 비율로 측정되었다. 따라서 a-selenium 검출소자를 사용하여 X선 광자를 검출하는 방식인 direct DR은 적은 선량으로 우수한 화질의 영상을 구현함으로써 선량에 민감한 소아나 생식선이 포함된 검사 등에 유용할 것으로 사료된다. 또한 많은 진단 정보를 위한 영상 평가가 요구되는 경우에는 indirect DR이 유용할 것으로 판단된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제13권1호
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• pp.86-91
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• 2010

후복막 낭성 림프관종은 양성종양으로 매우 드문 질환이다. 수술적 절제가 원칙이나, 경화요법을 우선적으로 고려할 수도 있다. 9세 남자가 병원 방문 4일 전부터점점 심해지는 복통을 주소로 입원하였다. 혈색소 농도가 입원 당일 12.8 g/dL에서, 입원 3병일째 10.6 g/dL로 감소한 소견이 있었다. 복부 전산화 단층촬영에서 크고 종양내부에 격막이 있는 분엽상의 후복막 낭종($10{\times}9.5{\times}5cm$) 한 개가 좌측 신장 주위 공간에서 관찰되었다. 종양 내부에는 출혈이 동반되어 있었으며, 하장간막정맥이 종양에 의해 둘러싸여져 있었다. 수술적 치료의 위험도가 매우 높을 것으로 판단되어 낭종조영술을 시행하였고, 경피적 도관 배액술과 에탄올 경화요법을 시행하였다. 추적 검사로 시행한 복부 전산화 단층촬영에서 종양의 크기가 현저히 감소된 소견을 보였다. 환자는 퇴원 후 13개월 째 현재까지 낭종의 재발없이 건강하게 지내고 있다. 결론적으로, 수술적 치료의 위험이 높은 후복막 낭성 림프관종이 있는 경우 경피적 도관 배액술과 경화요법을 우선적으로 고려해야 할 것이다.

• 대한방사선기술학회지:방사선기술과학
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• 제40권1호
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• pp.35-40
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• 2017

본 연구는 임신초기 초음파에 의해 측정된 임산부의 복부 피하지방두께(Abdominal Subcutaneous Fat Thickness; ASFT)와 임신중기 발현되는 임신성당뇨(Gestational Diabetes Mellitus; GDM)와의 연관성을 확인하고 GDM 예측을 위한 ASFT의 기준을 알아보고자 하였다. 286명의 임산부를 대상으로 임신초기 ASFT를 측정한 후 임신중기 GDM 선별검사(50 g OGTT) 140 mg/dL 이상을 고위험군으로 산정하고 산모연령, 임신 전 체질량지수, 임신 중 체중증가량과 함께 비교 분석하였다. ROC 곡선분석을 이용하여 GDM 예측을 위한 ASFT의 cut-off value를 결정하였다. 산모연령, 임신 중 체중증가량은 임신중기 GDM과 관련성이 없었으며, 임신 전 체질량지수와 임신초기 ASFT는 정상군과 GDM 고위험군에서 의미있는 차이를 보였다. GDM 예측을 위한 ASFT의 cut-off value는 2.23 cm(AUC 0.913, Sensitivity 76.19%, Specificity 93.72%)로 결정하였다. 임신초기 초음파로 측정된 ASFT는 임신중기 GDM 예측을 위한 중요한 지표로 유용하게 평가되었다. 따라서 ASFT는 GDM을 조기에 인식하는데 있어서 보조적인 진단지표로 활용할 수 있을 것으로 사료된다.

• 한국운동역학회지
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• 제33권4호
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• pp.164-174
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• 2023

Objective: The aim of this study was to quantitatively analyze the impact characteristics of the lower extremity on strike pattern during running. Method: 19 young subjects (age: 26.53 ± 5.24 yrs., height: 174.89 ± 4.75 cm, weight: 70.97 ± 5.97 kg) participated in this study. All subjects performed treadmill running with fore-foot strike (FFS), mid-foot strike (MFS), and rear-foot strike (RFS) to analyze the impact characteristics in the lower extremity. Impact variables were analyzed including vertical ground reaction force, lower extremity joint moments, impact acceleration, and impact shock. Accelerometers for measuring impact acceleration and impact shock were attached to the heel, distal tibia, proximal tibia, and 50% point of the femur. Results: The peak vertical force and loading rate in passive portion were significantly higher in MFS and FFS compared to FFS. The peak plantarflexion moment at the ankle joint was significantly higher in the FFS compared to the MFS and RFS, while the peak extension moment at the knee joint was significantly higher in the RFS compared to the MFS and FFS. The resultant impact acceleration was significantly higher in FFS and MFS than in RFS at the foot and distal tibia, and MFS was significantly higher than FFS at the proximal tibia. In impact shock, FFS and MFS were significantly higher than RFS at the foot, distal tibia, and proximal tibia. Conclusion: Running with 3 strike patterns (FFS, MFS, and RFS) show different impact characteristics which may lead to an increased risk of running-related injuries (RRI). However, through the results of this study, it is possible to understand the characteristics of impact on strike patterns, and to explore preventive measures for injuries. To reduce the incidence of RRI, it is crucial to first identify one's strike pattern and then seek appropriate alternatives (such as reducing impact force and strengthening relevant muscles) on that strike pattern.

• 한국전문물리치료학회지
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• 제11권4호
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• pp.1-6
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• 2004

The kinematics involved in different landing strategies may be related to the occurrence of trauma. Several sources suggest that the angle of knee extension on touchdown and impact with the ground determines the magnitude of the impact force and, indirectly, knee loading. This study compared the initial knee angle and maximum knee flexion angle at the instant of impact on drop-landings between healthy men and women. In this study, 60 participants (30 males, 30 females) dropped from a height of 43 cm. A digital camera and video motion analysis software were used to analyze the kinematic data. When landing, there was significant difference between the two groups ($15.67{\pm}6.05^{\circ}$ in male, $24.10{\pm}6.34^{\circ}$ in female) in the mean knee flexion angle. The range of knee flexion on landing ($44.06{\pm}10.97^{\circ}$ in male, $36.96{\pm}9.99^{\circ}$ in female) also differed significantly (p<.05). The greater knee flexion that was observed in the male subjects would be expected to decrease their risk of injury. Women land with smaller range of knee flexion than men and this might increase the likelihood of a knee injury.

• Journal of Chest Surgery
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• 제24권5호
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• pp.445-450
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• 1991

Forty eight patients diagnosed as atrial septal defect, had been operated from April 1986 to December 1990 at the Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, were analysed retrospectively. Of the 48 patients, 12 patients, were male and 36 patients were female, Their ranged from 8 months to 51 years old, and the mean was 18.0 years old. The proceeding two symptoms were exertional dyspnea and frequent upper respiratory infection. But 10 patients [20.8%] were asymptomatic. Electrocardiographic findings were regular sinus rhythm in 100.0%, RVH in 29.2%, incomplete RBBB in 27.1%, and first degree AV block in 2.1%. Hemodynamic studies were performed in 38 of 48 patients. Significant pulmonary hypertension[over 50mmHg in systolic pulmonary arterial pressure], which is the most serious risk factor, was developed in 4 patients[8.3%]. There was statistical significance between size of defect[cm2/BSA-M2] and systolic pulmonary arterial pressure[sPAP] retrospectively[p=0.036]. We could not find the correlationship between age and Qs % size. Anatomically, secundum type constituted 97.9%, in which 43 patients were PFO type[91.6%] and 3 patients were IVC type[6.3%]. 38 of 48 ASD patients were repaired with patch closure[72.9%] and remains were repaired with direct closure[27.1%]. The operative result was excellent except two cases of transient postoperative arrhythmia. There was no operative mortality.

• Journal of Chest Surgery
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• 제20권1호
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• pp.22-29
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• 1987

From Sep. 1978 to Aug. 1986, 44 cases of Fontan operation were performed at Seoul National University Hospital. 1] The diagnoses were TA in 13 [38.6%], UVH in 21 [47.79`], DORV in 3 [6.8%], TGA in 2 [4.5%] and C-ECD with DORY in 1[2.3%]. 2] There were 20 operative deaths [44.5%]. 3] The operative risk factors were early date of operation between 1978 and 1983, young age below 3 years old, direct atriopulmonary anastomosis without roofing, and postoperative high CVP above 25cmH,O. But the relation between operative mortality and various cardiac diseases was absent. 4] survived patients were followed from 1 to 54 months except 3 patients who were lost to follow up. 16 patients were in functional class I and 1 in class II, 2 of the above 17 patients were reoperated due to residual right to left shunt. In remained 4 patients, 3 patients persisted cyanosis after operation and 1 patients died 1 month postoperatively due to pulmonary embolism. 5] As 4 result, the Fontan procedure can be done with a good result for tricuspid atresia and other complex lesions. The operative mortality can be reduced further with a correct anatomical diagnosis preoperatively, rigid operative criteria to pulmonary vascular resistance, direct atriopulmonary anastomosis with roofing, and use of `Venous Assist Device` postoperatively in low cardiac output patients.

• The Korean Journal of Pain
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• 제13권2호
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• pp.237-241
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• 2000

Vertebral compression fractures commonly afflict the elderly. Some patients suffer from severe mechanical pain in spite of treatments with strong analgesics and bracing. Vertebroplasty, which was originally used for vertebral hemangioma, is effective for patients who do not respond to these more conservative treatments. However, the procedure has some risk. Leaks of bone cement into perineural tissues can be a serious complication. In contrast to the lumbar vertebrae, the outer margin of the pedicle of the thoracic vertebrae is almost in line with the outer margin of the body. This, combined with the thinner pedicle of the thoracic vertebrae, makes proper needle placement difficult. The posterolateral approach is preferred to the transpedicular approach in order to avoid the danger of destroying the inner cortex of the pedicle. But there can be a problems with the standard posterolateral approach. The rib can be broken, the pleura can be punctured. A new and safer approach is possible. Before penetrating the bone, the needle is positioned at the upper margin of the transverse process, 5 mm away from the pedicle. To achieve this positioning, the needle must puncture the skin 1~1.5 cm laterally and 3~5 mm cranially to the target point on the bone. This approach was used for 10 patients and we achieved good results with no serious complication.

• Journal of Korean Neurosurgical Society
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• 제29권7호
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• pp.923-928
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• 2000

Objective : The reliability of transcranial doppler sonography(TCD) for predicting delayed ischemic neurologic deficit( DIND) was investigated in patients with aneurysmal subarachnoid hemorrhage(SAH). Methods : The velocity of blood flow through the middle cerebral artery was measured by TCD in 70 patients treated surgically within 72 hours due to ruptured cerebral aneurysm. A correlation between measured maximal mean blood flow velocities and clinical factors including age, hypertension, Hunt-Hess grade, Fisher grade, DIND, and outcome was made. Results : An age-dependent reduction of the measured maximal mean velocities was found(r＝-0.4043, p<0.001). Flow velocities in hypertensive patients were significantly lower than in the normotensive individuals(two-tailed T test, p<0.05). There was no significant difference between the flow velocities and evaluated other clinical factors. When the flow velocities of 14 patients who developed DIND were compared with those of patients without deficits, no significant difference was seen. A significant increase in flow velocities in the days before the onset of DIND was found only in 4 of 14 cases. High flow velocities did not necessarily mean impending neurological deficits : 6 of 70 patients tolerated flow velocities over 160cm/s. Conclusion : We suggest that TCD readings have limited utility for predicting DIND following SAH, especially in older or hypertensive patients. More direct measurements of blood flow are necessary to adequately predict which patients are at high risk of DIND.