• Proceedings of the Korean Society for Bioinformatics Conference
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• 2004.11a
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• pp.29-35
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• 2004

유방암 환자의 임상정보(clinical features)와 cDNA microarray 기술을 이용하여 얻은 유전자 발현 프로파일은 유방암 예후 인자를 찾는 데에 매우 중요하다. 본 논문에서는 임상정보와 유전자 발현 정보를 접목해서 분석하는 방법으로써 주성분 분석(Principal Component Analysis)을 이용하였다. 이 방법은 다변량 자료의 차원을 줄이는 방법으로써, 대용량 실험 데이터로 인해 발생하는 문제점을 해결하기 위하여 많이 쓰이고 있다. 본 연구에서는 주성분 분석을 이용하여 먼저 한국인 유방암 환자 73명의 cDNA microarray 데이터 차원을 줄이고, 이를 통해 얻어진 주성분(Principal Components)과 임상정보 데이터와의 상관관계를 보았다. One-way ANOVA를 이용한 상관관계 분석 결과의 P-value는 permutation test를 통해 검증하였다. 동일한 방법을 estrogen receptor(ER)(+) 환자 20명과 ER(-) 환자 31명에 적용해본 결과, ER(-) 환자 중에서 재발과 관련된 유전자를 찾을 수 있었다. 주성분 분석을 molecular phenotypic profiles of clinical features에 이용한 결과 발견된 유전자는 유방암의 재발과 관련된 예후 인자로서 의미가 있다.

• Journal of Korean Neurosurgical Society
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• v.45 no.5
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• pp.289-292
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• 2009

Objective : Although there are several descriptions of this vessel, there is no detailed angiographic study of the accessory middle cerebral artery (AMCA) in Korea. We describe the angiographic characteristics of the cortical territory and origin of AMCA and discuss the clinical significance of this anomaly. Methods : We searched for patients with AMCAs from a retrospective review of 1,250 conventional cerebral angiograms. We determined the origins, diameters and cortical territories of these AMCAs. Results : Fifteen patients (15 of 1250 = 1.2%) had 16 AMCAs (one patient had bilateral AMCAs). AMCAs originated from the distal A1 in eleven cases, middle A1 in two, proximal A1 in two, and proximal A2 in one case. All AMCAs followed a course parallel to the main middle cerebral artery (MCA). All but three of these arteries were smaller than the main MCA. Thirteen of the smaller diameter AMCAs had cortical distribution to the orbito-frontal and prefrontal, and precentral areas. Three AMCAs had diameter as large as the main MCA. These three supplied the orbito-frontal, prefrontal, precentral, central and anterior-parietal arteries. Conclusion : The AMCAs originated from A1 or A2. Most had smaller diameter than the main MCA. The AMCAs coursed along the horizontal portion of the MCA, but supplied the orbital surface, the anterior frontal lobe and sometimes wider cortical territory, including the precentral, central, anterior-parietal areas.

• Journal of Korean Physical Therapy Science
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• v.5 no.3
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• pp.651-658
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• 1998

Cerebral palsy is a neurodevelopmental impairment caused by a nonprogressive defect or lesion in single or multiple locations in the immature brain. The defect or lesion can occur in utero or during or shortly after birth and produces sensory-motor impairment that are usually evident in early infancy. The causes of cerebral palsy are not completely understood, certain prenatal, perinatal, and postnatal factors have been associated with cerebral palsy. This study was analysed the clinical features of 50 children with cerebral palsy (29 males and 21 females) in National Rehabilitation Hospital from March 17 to June 27, 1998. The time of initial visit was over than 12 months in 74%, and their cheif complains were delayed developments (78%). The preterm infants were 40% and the infants with low birth weight were 36%. The maternal age at childbirth was over than 30 years old in 52%. The most common type of cerebral palsy was spastic (54%), mixed (22%), athetosis and hypotonia (10% each), ataxia (4%). The cerebral palsy with preterm infants and low birth weight were more likely to have spastic type (P=0.002, P=0.023 each). The most preterm infants were born between 30 and 35 years old of maternal age, and there were statistical significance in difference (P=0.031).

• The Korean Journal of Pain
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• v.8 no.2
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• pp.319-323
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• 1995

The implication of cervical pain associated with an elongated styloid process is credited to W.W.Eagle. Even though there were earlier reports of ossification of the stylohyoid ligament, findings in more than 200 cases in 1980s and 1940s resulted in the naming of a clinical syndrome that continues to bear his name, Eagle's syndrome. It is also sometimes called styloid process neuralgia or elongated styloid process syndrome is more common than generally recognized. The clinical symptoms range from a dull nagging pain with occasional radiation to ear, or to a foreign body sensation. Dysphagia and odynophagia may also occur. We successfully treated one case by removal of the elongated styloid process under the general anesthesia and C2 ganglion block. We then reported the clinical feature of one case of the Eagle's syndrome and further researched with the foreign literature.

• Annals of Clinical Neurophysiology
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• v.9 no.2
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• pp.63-68
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• 2007

The EEG plays an important diagnostic role in epilepsy and provides supporting evidence of a seizure disorder as well as assisting with classification of seizures and epilepsy syndromes. There are a variety of electroclinical syndromes that are really defined by the EEG such as Lennox-Gastaut syndrome, benign rolandic epilepsy, childhood absence epilepsy, juvenile myoclonic epilepsy and also for localization purposes, it is vitally important especially for temporal lobe epilepsy. The sensitivity of first routine EEG in diagnosis of epilepsy has been known about 20-50%, but this proportion rises to 80-90% if sleep EEG and repetitive recording should be added. Convincing evidences suggest that the EEG may also provide useful prognostic information regarding seizure recurrence after a single unprovoked attack and following antiepileptic drug (AED) withdrawal. Moreover, patterns in the EEG make it possible to disclose an ictal feature of nonconvulsive status epilepticus, separate epileptic from other non-epileptic episodes and clarify the clues predictive of the cause of the encephalopathy (i.e., triphasic waves in metabolic encephalopathy). Therefore, regardless of its low sensitivity and other pitfalls, EEG should be considered not only in the situation of new onset episode such as a newly developed, unprovoked seizure or a condition manifesting decreased mentality from obscure origin, but also as a barometer of the long-term outcome following AED withdrawal.

• Journal of Korean Critical Care Nursing
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• v.12 no.2
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• pp.50-60
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• 2019

Purpose : The purpose of this study was to identify the attributes, antecedents, and consequences of the transition of simulation-based learning (SBL) in nursing schools. Methods : The study was conducted in accordance with Walker and Avant's conceptual analysis process. We searched MEDLINE, CINAHL, EMBASE, Google Scholar, and RISS (Korean Education and Research Information Service) databases, resulting in nine studies for an in-depth review. Results : The attributes of transition of SBL include (1) preparing for a professional role, (2) practicing in a real clinical setting, and (3) progressing toward expected competency. Antecedents of the concept include novice status, changing roles, clinical experience in controlled settings, and expected competency in the clinical setting. Conclusion : The transition of SBL includes the important feature of progression toward expected competency. Further research is needed to identify graduate nurses' experiences during this transition to establish a strategy for improving it and developing a measurement tool that reflects attributes of the concept.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.147-158
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• 1996

Background : Endobronchial tuberculosis(ET) is known to affect frequently young female and serious complication like bronchial stenosis would occur if early diagnosis and treatment for ET is not performed immediately. But ET shows normal chest roentgenogram in about 10% of patients, and is often confused with bronchial asthma because ET presents clinical features like cough, dyspnea, wheezing in history and physical examination. The pulmonary function test(PFT) feature of ET is not well known, but when we consider the fact that ET is pathophysiologically different from bronchial asthma, if there is any feature of PFT in ET, and we know it, PFT will be very helpful for diagnosis and follow up of ET. Methods : We performed both PFT and bronchoscopy in 68 ET patients who visited Boramae hospital, and were confirmed as ET by bronchoscopic biopsy and were followed prospectively from November 1991 to March 1995. After history taking and physical examination, we performed chest roentgenogram, complete blood count, sputum AFB stain and culture, and also performed PFT before anti-tuberculosis chemotherapy. PFT was classified as restrictive, if only PVC was reduced below 80%, and obstructive, if only FEV1 was reduced below 75%. In the case of both FVC and FEV1 were reduced, PFT was classified as restrictive if FEY1/FVC was greater than 75%, and mixed if FEV1/FVC was reduced below 75%. We repeated the PFT and bronchoscopy for 68 ET patients who were proven by biopsy in the first month and sixth month after starting anti-tuberculosis chemotherapy, and studied the feature and change of PFT of the ET and the relation between PFT and the bronchoscopic finding, and obtained following results. Results: 1) Number of male patients was 12, and that of female patient was 56, and mean age was $35.4{\pm}17yr$.(17-74yr). Clinical symptom was in the order of cough(86.8%), dyspnea(63.2%), fever(17.6%) and hemoptysis (10.3%), and the wheezing and stridor were audible among the 40 patients(58.4%) in the physical examination. 2) Hemoglobin level was below 12g/dl among 25 patients (36.8%), and WBC level was above $10,000/mm^3$ among 9 patients(13.2%) and ESR was above 20 among 46 patients (67.6%) and AFB stain and culture were positive among 50 patients(73.5%). 3) The dominant roentgenographic finding of ET was fibronodular feature in 35 patients(51.5%), pneumonic feature in 14 patients (20.6%), collapse in 11 patients(16.2%), mass-like lesion in 3 patients(4.4%), cavitary lesion in 2 patients(2.9%), and normal in 3 patients(4.4%). 4) PFT feature at the time of diagnosis of ET was normal in 16 patients(23.5%), restrictive pattern in 32 patients (47%), obstructive in 4 patients(5.8%), and mixed in 14 patients(23.5%). So restrictive pattern was the dominate feature of ET. 5) The PFT feature was little correlated with the gross finding of bronchoscopy, but the change of PFT during treatment of ET showed relatively good correlation with the change of bronchoscopic finding. 6) FVC(2.30L vs. 2.61L) and FEV1(1.74L vs. 2.06L) increased significantly (p < 0.01), but FEV1/FVC(82% vs. 83%) and PEF(3.45L/sec vs. 3.95L/sec) did not change significantly after 1 month of treatment (p > 0.01), and there was no significant change among all parameters during first and sixth month of treatment(p > 0.01). Conclusion : PFT may be useful in the diagnosis and treatment follow up of ET but further study would be needed to confirm it.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.47-53
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• 2001

Objective : This study was undertaken to evaluate operative results and prognosis according to preoperative clinical status and histopathological finding of spinal cord tumor. Methods : We analyzed of clinical feature, tumor location, histopathologic finding, operative results and prognosis in 55 patients with spinal cord tumor during last 10 years. Results : 1) The incidence of spinal cord tumors varies with the age of affected patients who are 2 to 75 years of age. Peak incidences were in the 5th & 7th decade of life, and the ratio of male to female was 1.2:1. 2) The most common histopathologic type was neurinoma(41.9%). 3) The tumors were located most frequently in the thoracic area(22 cases, 40.0%) and in the intradural extramedullary space(30 cases, 54.5%). 4) The most common initial clinical feature was pain in 20 cases(36.4%). For neurologic status on admission, 30 cases(54.5%) showed motor disturbance. 5) In radiologic studies, there were abnormal finding in 21 cases from plain X-rays among 37 cases. The entire 20 cases in when myelography was done showed subarachnoid blockade, either complete or incomplete. The magnetic resonance imaging, regard as the most accurate diagnostic method, revealed the exact location of the tumor and the relationship of the tumor with the adjacent anatomical structure. 6) The total removal was possible in 36 cases(65.5%), subtotal removal in 17 cases(30.9%) and biopsy in 2 cases (3.6%). Nineteen cases(90.5%) among 21 cases with preoperative radiculopathy group showed recovery or improvement, where as only 11 cases(36.7%) among 30 cases with preoperative motor weakness group showed recovery or improvement, with statistically significant difference(p<0.01). Pathologically, 26 cases(83.9%) among 31 cases of neurinoma and meningioma showed postoperative recovery or improved, but only 1 case(6.3%) among 16 cases of metastatic tumor, astrocytoma and ependymoma recovered. Postoperative complication noted in 5 cases(9.1%), and were noted postoperative hematoma, pneumonia, pulmonary edema and spinal cord infarction. Conclusion : Preoperative neurologic status and histopathologic finding are considered important factors of Postoperative outcome in patients with spinal cord tumor.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.205-209
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• 2001

Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.141-152
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• 1996

Oral Lichen Planus(OLP) is a idiopathic chronic inflammatory disease with more difficult to clear and higher recurrent rate than cutaneous lesions. But, there has been no estabilished theories about the proper treatment for OLP. The purpose of this study is to examine the clinical feature, relationship with systemic disease and dental treatment of OLP patients of Korea and to gain helpful information about clinical characteristics and treatment of OLP. The subjects chosen for the study were 54 patients who had visited Department of Oral Diagnosis & Oral Medicine at Yonsei University Dental Hospital Dental Hospital and diagnosed as OLP. Previous clinical records has been reviewed and questionnaires, oral examination, laboratory examination were done and recorded. The following results were obtained : 1. Of the 54 patients, 21 were men and 33 were women with an average age of 47.8 years. 2. The most common intraoral site was bilateral buccal mucosa, followed by unilateral buccal mucosa, gingiva, vesibule, lip mucosa, glossal mucosa, palatal mucosa and mouth floor. 3. The mixed, erosive and reticular form of OLP was most frequent(83.3%) clinical form. 4. OLP patients with liver disease were 5, and drug medication patients were 7. But, we could not find its evidence of association with OLP. 5. Associated events on onset of symptom were stress, denture wearing, dental treatemtn, and common cold. 6. Associated symptoms were dry mouth, tingling, sore throat, and altered taste perception. 30.8% of patients had no specific associated symptoms. 7. Aggravating factors of symptom were peppery food, hot food, fatigue, toothpaste, salty food, sour food, tension, and conversation. Reducing factors were cold food, sleeping. 69.2% of patients had no specific reducing factors. 8. There were no significant differences between normal papulation and OLP patients in CBC, SGOT< SGPT, Serum iron, Total iron binding capacity. 66.7% of subjects were positive response to fungus study for Candida Albicans. The incidence of stress and dental treatment on onset of symptom appeared high in OLP patients. Especially, high incidence of positive response to fungus study for Candida albicans, prescription of anti-fungal agents and dental treatment considerations may be helpful to treatment of OLP.