• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제5권1호
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• pp.39-50
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• 2002

Hepatitis B viral infection which affect about 10% of Korean population manifests asymptomatic carrier, chronic hepatitis and liver cirrhosis and even associates with hepatocellular carcinoma. Clinical manifestations induced by hepatitis B virus vary depending on the degree of immune response by cytotoxic T cells against viral epitope-presenting liver cells. Since hepatitis B virus presents high rate of mutaton that might change the presented epitope and eventually alter immune response, viral mutations, especially in promoters and enhancers, have an important implication in hepatic inflammation and viral replication. To identify mutations related to the hepatic inflammation, we investigated sequence variations of hepatitis B viral promotor regions in the presence or absence of symptoms in hepatitis B carriers. For this, sera from persistently hepatitis B virus-infected mother-child pairs were collected. After PCR amplifiation of all hepatitis B viral promoters (C promoter, S1 promoter, S2/S promoter, X promoter) using serum DNA from each pair, viral promotors were sequenced by automatic sequencer and then sequence data were analyzed by ClustalW. In most cases, the dominant type of maternal virus was transmitted to the child. However, in some children, some new host specific viral variants could be observed in Cp, S1p and S2/Sp. The mutations in C promoter did not seem to be vertically transmitted but arose in new host independently after the wild type had been transmitted. Enhancer I containing X promoter revealed high host specific variations as has been reported before. Two S promoters, S1p and S2/Sp, have shown some point mutations in children, but no deletion mutations were detected as in chronic hepatitis patients in whom deletion mutations are frequently found. In conclusion, the children with the vertically transmitted hepatitis B virus mostly retain the dominant type virus that had been transmitted. However, host specific variants tended to accumulate over time, possibly as clinical symptoms develop.

• 대한간호
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• 제33권2호
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• pp.45-58
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• 1994

This study was conducted for the purpose of identifying the trends of nursing research and to suggest the direction of future research in the graduate levels of the study. The data was collected from 469 abstracts of master's and doctoral rapers from three graduate schools, one in Nursing, another in Education, and the other in Public Health Graduate College. The results of the study are as follows: The number of research was increased from 102 to 286 between the 1970 s and 1980's. The most frequently employed research design was descriptive studies in the master's level, but there was some balance between descriptive and experimental studies along with some qualitative approaches in the doctoral thesis. Patients were the most often studied sample group reaching 42% of the cases, though it Was noted that there was steady shift: toward the non-ratient population. With this shifting of the study sample, the places of the study also have showed some changes moving toward community. The most widely studied area was in clinical practice. Chronic illness, preventive, and health promoting areas of studies also increased in numbers. However, most of them were at the descriptive level of phenomena and only a few were concerned with cost/effective measures of nursing intervention. The number of variables studied repeatedly more than five times was 43. They were not only physical but also psychosocial aspects which imply the efforts to incorporate the whole person in nursing discipline. However, most researches with repeated studies showed little relation to previous studies, and thus little accumulation in knowledge. There was also little evidence of linkage to nursing theory in most studies of master's level. For the doctoral rapers, 17 out of 51 rapers showed specific theories related to the researches. Based on the above findings, the following suggestions were made. Various research design should be employed including case studies, historical studies, as well as qualitative approaches. There should be more effort to establish linkage between theory and research. The areas needing more attention are Korean Nursing History, Ethics in our Culture, Cost/Effective Measures of Nursing Intervention, Concept and Thory Development, and the Strategies for the Implication of the Research Results in clinical practice.

• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.141-149
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• 2022

Background: The present study evaluated the clinical implications of adjuvant chemotherapy according to the mismatch repair (MMR) status and clinicopathologic features of patients with intermediate- and high-risk stage II colon cancer (CC). Methods: This study retrospectively reviewed 5,774 patients who were diagnosed with CC and underwent curative surgical resection at Kyungpook National University Chilgok Hospital. The patients were enrolled according to the following criteria: (1) pathologically diagnosed with primary CC; (2) stage II CC classified based on the 7th edition of the American Joint Committee on Cancer staging system; (3) intermediate- and high-risk features; and (4) available test results for MMR status. A total of 286 patients met these criteria and were included in the study. Results: Among the 286 patients, 54 (18.9%) were identified as microsatellite instability-high (MSI-H) or deficient MMR (dMMR). Although all the patients identified as MSI-H/dMMR showed better survival outcomes, T4 tumors and adjuvant chemotherapy were identified as independent prognostic factors for survival. For the intermediate-risk patients identified as MSI-low (MSI-L)/microsatellite stable (MSS) or proficient MMR (pMMR), adjuvant chemotherapy exhibited a significantly better disease-free survival (DFS) but had no impact on overall survival (OS). Oxaliplatin-containing regimens showed no association with DFS or OS. Adjuvant chemotherapy was not associated with DFS in intermediate-risk patients identified as MSI-H/dMMR. Conclusion: The current study found that the use of adjuvant chemotherapy was correlated with better DFS in MSI-L/MSS or pMMR intermediate-risk stage II CC patients.

• Korean Journal of Radiology
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• 제21권9호
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• pp.1077-1086
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• 2020

Objective: To evaluate the effect of perfluorobutane microbubbles (Sonazoid^®, GE Healthcare) on steam popping during radiofrequency (RF) ablation for treating hepatocellular carcinoma (HCC), and to assess whether popping affects treatment outcomes. Materials and Methods: The institutional review board approved this retrospective study, which included 90 consecutive patients with single HCC, who received percutaneous RF ablation as the first-line treatment. The patients were divided into two groups, based on the presence or absence of the popping phenomenon, which was defined as an audible sound with a simultaneous sudden explosion within the ablation zone as detected via ultrasonography during the procedure. The factors contributing to the popping phenomenon were identified using multivariable logistic regression analysis. Local tumor progression (LTP) and disease-free survival (DFS) were assessed using the Kaplan-Meier method with the log-rank test for performing comparisons between the two groups. Results: The overall incidence of the popping phenomenon was 25.8% (24/93). Sonazoid^® was used in 1 patient (4.2%) in the popping group (n = 24), while it was used in 15 patients (21.7%) in the non-popping group (n = 69). Multivariable analysis revealed that the use of Sonazoid^® was the only significant factor for absence of the popping phenomenon (odds ratio = 0.10, p = 0.048). There were no significant differences in cumulative LTP and DFS between the two groups (p = 0.479 and p = 0.424, respectively). Conclusion: The use of Sonazoid^® has a suppressive effect on the popping phenomenon during RF ablation in patients with HCC. However, the presence of the popping phenomenon may not affect clinical outcomes.

• Childhood Kidney Diseases
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• 제9권2호
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• pp.183-192
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• 2005

목 적 : 소아 HSPN의 임상 경과와 이에 영향을 미치는 예후 인자를 조사하였다. 방 법 : 소아 HSPN 환자 75명(남아 44명, 여아 31명)을 대상으로 하였으며 발병연령은 $8.0{\pm}3.1$세(2.3-l5.3세)였고 추적관찰 기간은 $4.3{\pm}3.6$년(1.0-17.1년)이었다. 신생검은 24명(32$\%$)에서 시행되었다. 발병시 임상 양상과 검사 결과를 조사하였으며, 대상 환자들의 RAS 유전자의 다형성(ACE 유전자의 I/D 다형성, AGT 유전자의 M235T 다형성, AGTR 유전자의 A1166C 다형성)에 대해 검사하였다. 발병시와 마지막 추적관찰시 임상 상태는 다음과 같이 4군으로 분류하였다: A, 정상; B, 정도의 소변이상; C, 활동성 신질환(신증후군 범위의 단백뇨) 또는 고혈압 소견을 보이면서 혈청 크레아티닌 1.5 mg/dL 이하; D, 신부전. 결 과 : 발병시 환자들의 임상 상태는 26명(35$\%$)이 B, 45명(51$\%$)이 C였고 D가 3명(4$\%$)이었다. RAS 유전자 다형성의 분포는 100명의 건강한 대조군과 다르지 않았다. 마지막 추적관찰시 환자들의 임상 상태는 A가 23명(31$\%$), B가 38명(50$\%$), C가 9명(12$\%$), D가 5명(7$\%$)이었다. Multiple logistic regression 결과 발병 연령과 발병시 단백뇨의 양이 유의한 예후 인자로 확인되었다. RAS 유전자는 HSPN의 예후 인자로 통계학적 유의성이 없었다. 결 론 : 본 연구에서는 발병 연령이 높을수록, 발병시 단백뇨의 양이 많을수록 소아 HSPN의 예후가 나쁜 것으로 나타났고 RAS 유전자는 HSPN의 예후와 상관 관계가 없었다. 더 정확한 연구를 위해서는 더 많은 수의 환자를 대상으로 전향적인 연구가 필요하리라 생각한다.

• 대한두경부종양학회지
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• 제15권2호
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• pp.149-155
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• 1999

Objectives: To study the clinical features of the primary nasal/nasopharyngeal non-Hodgkin's lymphomas and to evaluate the implication of immunophenotyping as a prognostic factor. Patients and Methods: From January 1990 to December 1997,41 patients(median age, 41 years) of primary nasal/nasopharyngeal non-Hodgkin's lymphoma were studied. The clinical records and paraffin-embedded tissue blocks were reviewed retrospectively. The histologic features, immunophenotypic findings(pan-T, pan-B, CD3, CD56) and Epstein-Barr virus in situ hybridizatios were examined. The prognostic factors for clinical outcome were evaluated in these patients. According to Ann-Arbor system, there were 30 patiets(73%) with stage IE, 4(10%) with stage IIE, 3(7%) with stage IIIE, 4(10%) with stage IVE lymphoma. Among the patients with stage IE/IIE, 4 patients received local radiation alone, 4 received chemotherapy alone, 25 received combination chemotherapy and radiotherapy and 1 refused treatment. The patients with stage IIIE/IVE were given combination chemotherapy and radiotherapy. Results: Immunophenotyping were performed in 40 patients and staining results were as follows: 3(7%) patients with B cell, 17(42%) with T cell, 18(44%) with NK/T cell(CD56 positive), and two patients with unclassifiable result. Epstein-Barr(EB) virus in situ hybridization were performed in 28 patients and 23(82%) patients had positive EBV-encoded RNAs(EBERs). 21(55%) patients achieved a complete remission. There was no difference in complete remission between radiation alone and combination therapy. With median follow-up of 30 months, 5-years disease free survival of complete responders was 60% and 5-years overall survival rate was 36%. Multivariate analysis showed that better overall survival was related with absence of B symptoms, ECOG performance${\leq}1$ and non-NK cells. Conclusion: Most of all cases were positive for EBER. Since NK/T phenotype carried the worst prognosis, analysis for CD56 expression should be done. Further prospective studies were warranted to evaluate the role of chemotherapy in stage IE/IIE.

• Nuclear Medicine and Molecular Imaging
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• 제43권4호
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• pp.317-322
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• 2009

목적: 담관암의 진단과 치료 평가를 위해서 여러 영상학적 방법이 이용되나 성장 형태를 포함한 질환의 성상이 아주 다양하고 종양과 주변 조직간의 대조도가 낮은 경우 발견이 어렵고 주로 종양 부분에 대한 국소 영상을 시행하여 질병의 전신 평가에는 충분하지 못할 수 있다. 이러한 점을 보완하기 위하여 $^{18}$F-FDG PET에 대한 연구가 이루어 지고 있는데, 본 연구에서는 담관암의 발생위치와 성장형태에 따라 $^{18}$F-FDG 섭취양상의 변화와 그에 따른 임상적 의의를 알아보고자 하였다. 대상 및 방법: 2005년 4월부터 2008년 5월까지 담관암으로 진단 받고 PET/CT를 촬영한 환자를 대상으로 하였다. 위치에 따른 담관암의 분류는 간내담관암과 간외담관암으로 나누고 간외담관암은 간문부암과 원위부 담도 암으로 나누었다. 간외담관암은 다시 그 성장형태에 따라 경화형, 결절형, 용종형으로 분류하여 PET양성인 환자들 중 SUV$_{max}$를 비교하였다. 결과: 총 82명의 담도암 환자들 중PET양성을 보인 환자는 81.7%이었다. PET 양성을 보인 간내담관암 환자는 23명으로 이들의 SUV$_{max}$는 9.4$\pm$4.1로 간외담관암보다 의미있게 높았다. 용종형의 간외담관암은 9명중 모두가 PET 양성이었고, SUV$_{max}$도 10.1$\pm$7.0으로 경화형, 결절형에 비해 높았다. 결론: 본 연구의 결과를 바탕으로$^{18}$F-FDG PET은 간외담관암보다는 간내담관암을 가진 환자의 진단에 더 유용할 것으로 보이며, 간외담관암의 진단에 있어서는 담도벽을 따라 침윤성으로 발생하는 경화형보다는 종괴를 형성하는 용종형에서 더 의미있는 검사방법이 될 수 있겠다.

• 생명과학회지
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• 제26권9호
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• pp.1056-1062
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• 2016

폐암은 전세계적으로 높은 발병율과 사망률을 보이는 암종으로 소세포암종과 비소세포암종으로 구분되어지며, 비소세포암이 75-80%를 차지하고 있다. miR-155의 유전자의 과 발현은 갑상선암, 유방암, 대장암, 자궁 경부암, 췌장선암(PDAC), 폐암 등의 고형암에서 관찰된다. 본 연구에서는 한국인 폐암 환자의 조직에서 특이적으로 발현되는 miRNA의 양상을 양성 폐질환자 와 비교 분석하고, 폐암환자의 임상병리학적 특성과의 상관성을 분석하여 miRNA가 암 진단의 생물표지자로서의 가능성을 조사하여 향후 암의 조기 진단 및 치료, 예후 연구에 기초 자료를 제공하고자 하였다. 파라핀 포매 된 비소세포폐암환자 및 양성 폐 질환자의 블록에서 total RN를의 분리하여, 정량 실시간연쇄중합반응을 통해 miR-155의 발현량을 정량 분석을 실시하였으며, miR-155의 발현과 폐암환자의 임상적 특징과의 상관관계를 분석하였다. 폐암 환자군과 양성 폐질환자의 miR-155의 △Ct 값을 분석한 결과 폐암환자군에서 유의하게 높게 발현되었다(p<0.001). 병리조직학적 분류에 따라서는 편평상피세포암종에서 선암종에 비해 높게 발현되었다. 분화도에 따라서는 저분화 암에서 고분화암에 비해 유의하게 높게 발현되었다(p=<0.001). 또한 miR-155의 과발현은 림프절 전이와도 통계적으로 유의성 나타내었다(p<0.05). 생존분석결과 miR-155의 과발현은 폐암환자의 생존률과 유의한 상관관계를 나타내었다(p<0.05). 본 연구의 결과로 miR-155의 발현은 폐암의 진행 및 전이에 중요한 역할을 할 것으로 생각되며, 폐암의 조기진단과 예후의 예측을 위하여 보다 다양한 종류의 miRNAs에 대한 연구가 이루어져야 할 것으로 판단된다.

• 대한간호학회지
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• 제25권2호
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• pp.351-361
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• 1995

The main purpose of the study is to identify critical risk factors for development of a family assessment tool to screen high risk family. This study used a conceptual framework of family diagnosis developed by Eui-sook Kim's (1993) and analyzed risk factors to identify the high risk family. As employing a explorative and methodological study design, this study has four stages. 1. In the first stage, 34 family risk factors were identified by doing intensive literature review on conceptual framework of family diagnoses. 2. In the second stage, above risk factors were tested for content validity by consultation with 29 persons in community health nursing, nursing education, family theory, and social work. 3. In the third stage, existing survey data was used for actual application of the identified risk factors. The survey data used for this purpose was previously collected for the community diagnosis in a region of Seoul. At the final stage, through the comparison between high risk and low risk families, initially identified 34 risk factors decreased to 25 risk factors. Among 34 risk factors, six factors did not agree with content of questionnaries sand two factors were not significant in differentiating the high risk family Also, two risk factors showed high correlation between themselves, so only one of those two factors was chosen. As a result, twenty-five risk factors chosen to identify the high risk family are following ; 1. A single parent family due to divorce or death of a partner, or unweded single mother 2. A family with an unrelated household members 3. A family with a working mother with a young child 4. A family with no regular income 5. A family with no rule in family or too strict rules 6. A family with little or no support from other lam-ily members 7. A family with little or no support from friends or relatives 8. A family with little or no time to share with each other 9. A family with family history of hypertension, diabetus, cancer 10. A family with a sick person 11. A family with a mentally ill person 12. A family with a disabled person 13. A family with an alcoholic person 14. A family with a excessive smoker who smokes more than 1 pack / day 15. A family with too much salt intake in their diet. 16. A family with inappropriate management skills for family health 17. A family with high utilization of drug store than hospital to solve the health problems of the family 18. A family with disharmony between husband and wife 19. A family with conflicts among the family members 20. A family with unequal division of labor among family members 21. An authoritative family structure 22. A socially isolated family 23. The location of house is not residential area 24. A family with high risk of accidents 25. The drinking water and sewage systems are not hygienic. The main implication of the results of this study is clinical use. The high risk factors can be used to identify the high risk family effectively and efficiently. The use of high risk factors woule contribute to develop a conceptual framework of family diagnosis in Korea and the list of risk factors need to be revised continuously. Further researches are needed to develop an index of weight of each risk factor and to validate the risk factors.

• 한국산학기술학회논문지
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• 제10권12호
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• pp.3931-3942
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• 2009

본 연구의 목적은 현장에서 근무하는 119 구급대원들을 대상으로 DNR(Do not resuscitate)과 관련된 이들의 윤리문제 인식 및 태도를 알아봄으로써, DNR 대상 환자 처치에 도움이 되는 객관적인 기틀을 마련하기 위해 시도된 서술적 조사연구이다. 연구대상은 전라북도 소방서에서 근무하는 구급대원 219명을 대상으로 하였다. 자료수집 기간은 2009년 5월 6일부터 6월 20일까지였으며, 자료수집 방법은 구조화된 질문지를 이용하였다. 자료 분석 방법은 SPSS 12.O program을 이용하여 빈도, 백분율, $x^2$-test, 교차분석이다. 연구 결과 대상자의 성별, 연령, 종교, 결혼상태, 임상근무경력, 현재 근무지 경력, 현재직위, 윤리 및 가치관에 관한 교육경험, DNR 교육 받은 곳, DNR 실행경험, DNR 상담요청에 따라 윤리적 태도간에 유의한 차이가 있었다. 따라서 본 연구 결과를 바탕으로 DNR에 관한 대책을 마련하기 위하여 더 많은 후속 연구가 필요하다고 사료된다.