• 대한정형도수물리치료학회지
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• 제26권2호
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• pp.19-27
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• 2020

Background: The purpose of this study was to examine the effects of a multi-modal exercise program for patients with chronic low back with respect to pain intensity, trunk muscle strength and Oswestry disability index. Methods: Thirty patients with chronic low back pain were recruited and divided equally into two groups. The multi-modal training program comprised a series of exercises such as warm-up, stabilization exercises, stretching, endurance exercises, and cool down whereas the control group performed only stabilization exercises. The both group spent an equal amount of time performing 60 minutes per day, three times per week, for five weeks. Results: The experimental group demonstrated statistically significant improvements in range of motion, trunk muscle strength, the visual analogue scale, and the Oswestry Disability Index (p<.05). Intergroup comparison showed a statistically significant difference in the range of motion of the lumbar spine and the degree of disability in the experimental group. Muscle strength and pain were statistically significant in both groups. Conclusion: The multi-modal exercise program is effective for patients with chronic low back pain, as it reduces lower back pain, increases trunk muscles strength, and decrease the potential for becoming disabled.

• Journal of Chest Surgery
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• 제40권1호
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• pp.1-7
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• 2007

배경: 심장판막 및 그 주변의 큰 혈관들의 내피세포는 다른 부위와 달리 훨씬 완화된 면역 반응을 보이는 것에 착안하여, 고정액이나 면역학적 처치를 거치지 않은 이종 판막의 대동맥 판막의 임상적 유용성을 돼지-염소 간 이종 폐동맥 판막도관 이식 실험을 통해 알아보고자 하였다. 대상 및 방법: 돼지 폐동맥 판막도관은 특별한 면역학적 처치를 거치지 않은 채 준비하여 인공심폐기 가동 하에 염소의 우심실 유출로에 이식하였다. 염소들은 군당 2마리씩 배정하여 이식 후 하루, 1주, 3개월, 6개월, 12개월 동안 각각 관찰하였다. 실험동물을 희생하기 전 심초음파검사를 시행하여 판막의 움직임을 관찰하였고, 이종 장기를 적출한 후 판막도관의 조직학적 변화를 관찰하였다. 결과: 총 12마리 중 10마리에서 정해진 기간 동안 생존하였다. 이식된 폐동맥의 전벽의 동맥류가 12개월과 3개월 관찰한 각각 한 마리의 염소에서 발견되었다. 심초음파 검사에서는 다양한 정도의 폐동맥 판막 폐쇄부전의 소견을 보였으나 판막의 협착이나 혈전형성, 증식증은 관찰되지 않았다. 조직학적 관찰에서 이식 세포의 핵은 핵농축 및 핵융해를 통해 없어졌지만, 이식된 이종 판막도관의 세 구역(폐동맥, 폐동맥 판막, 누두부)은 구조가 보존되면서 점차적으로 시간에 따라 숙주 세포로 대체되었다. 결론: 면역학적 처리를 거치지 않은 이종 폐동맥 판막도관이 돼지-염소 간 이종 이식실험에서 다소의 문제점이 발견되기는 하였지만 성공적으로 숙주 세포로 대체되어 기존의 조직판막의 대안이 될 가능성을 제시하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권3호
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• pp.250-265
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• 2008

Distraction osteogenesis is a well-established clinical treatment for limb length discrepancy and skeletal deformities. Appropriate mechanical tension-stress is believed not to break the callus but rather to stimulate osteogenesis. In contrast to fracture healing, the mode of bone formation in distraction osteogenesis is primarily intramembranous ossification. Although the biomechanical, histological, and ultrastructural changes associated with distraction osteogenesis have been widely described, the basic biology of the process is still not well known. Moreover, the molecular mechanisms in distraction osteogenesis remain largely unclear. Recent studies have implicated the growth factor cascade is likely to play an important role in distraction. And current reserch suggested that mechanical tension-stress modulates cell shape and phenotype, and stimulates the expression of the mRNA for bone matrix proteins. The purpose of this study is to examine the pattern of expression of growth factors($TGF-{\beta}1$, IGF-I, bFGF) and extracellular matrix proteins(osteoclacin, osteonectin) related to osteogenesis by osteodistraction of the mandible in rabbits. 24 rabbits is used for this experiment. Experimental group are gradual distraction(0.7mm, twice/day), acute distraction(1.4mm, twice/day) and control group is only osteotomized. After 5 days latency, osteotomic site is distracted for each 7 days and 3.5 days. Consolidation period is 28 days. The animal is sacrificed at the 3th, 7th, 14th, 28th. The distracted bone is examined by immunohistochemical analysis and RT-PCR analysis. The results obtained from this study were as follow : No significant difference was found on clinical examination according to distraction rate, but gradual distraction was shown to improve regenerate bone formation on radiographic and histologic examination. Growth factors and extracelluar matrix proteins expression increased in distraction group than control group. From these results, it could be stated that graudal distraction is shown to improve and accelerate bone formation and mechanical stress like distraction has considerable effects on osteogenesis related factors. And rabbit is the most appropriate animal model for further reseach on the molecular mechanisms that mediate osteodistraction. It is believed that understanding the biomolecular mechanisms that mediate distraction osteogenesis may guide the development of targeted strategies designed to improve distraction osteogenesis and accelerate bone healing.

• 재활간호학회지
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• 제5권1호
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• pp.18-26
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• 2002

The purpose of this study was to elucidate the effects of inhalation method using essential oils on the preoperative anxiety of hystrectomy patients, and to provide effective and holistic nursing care to them. The research design was a nonequivalent control group non synchronized design. The data were collected from February 1 to March 31, 2002 at D Medical Center in Busan. The subjects were forty one patients that were operated on under general anesthesia for hystrectomy. They were assigned to two groups, twenty one subjects in the experimental group and twenty subjects in the control group. The tool of the Visual Analogue Scale(VAS) was used to anxiety on all patients the day before surgery and the preoperative period. Then systolic and diastolic blood pressure, pulse rate levels were measured the day before surgery and the preoperative period. The experimental group received two treatments of inhalation method using essential oils of with lavender, ylang ylang, and bergamot oil. The data were analyzed by the $X^2$ test and the independent t-test. The results of this study were summarized as follows: 1. Hypothesis 1: It has been supported that the experimental group received inhalation method using essential oils might cause lower level of the preoperative VAS anxiety than that of the control group(t=-2.93, p=.006). 2. Hypothesis 2: It has been rejected that the experimental group received inhalation method using essential oils might cause lower level in the preoperative systolic blood pressure than the control group(t=-.120, p=.905). It has been rejected that the experimental group received inhalation method using essential oils might cause lower level in the preoperative diastolic blood pressure than the control group.(t=1.766, p=.085). 3. Hypothesis 3: It has been supported that the experimental group received inhalation method using essential oils might cause lower level in preoperative pulse rate than the control group(t=5.853, p=.000). According to these results, inhalation method using essential oils can be considered an effective nursing intervention that relieves the preoperative anxiety of hysterectomy patients and stabilizes vital sign partially.

• 기본간호학회지
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• 제5권1호
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• pp.107-124
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• 1998

Based on King's goal attainment theory, this research deals with applying nursing intervention of mutual goal settings to gastrectomy patients. It tests the effects of nursing intervention, according to the patients' health locus of control, suggested as external boundary criteria for the theory by employing a quasi-experimental design which consists of a pretest-posttest non-equivalent control and experimental groups. The subjects of this research were 62 gastrectomy patients hospitalized at Y medical center and the experimental and control groups consisted of 31 subjects. The experimental group received nursing intervention at the mutual goal setting of 5 times from the day before the surgery to the 5th day after the surgery, while the control group received only routine nursing care. Recovery indicators of both groups were measured and compared. Measurement variables included patients' characteristics, health locus of control, forced vital capacity, forced expiratory volume in one second, peak expiratory flow, bowel movement recovery, mobility recovery, level of pain, patients' stress and patients' satisfaction. Data were analyzed using SPSS statistical package and the hypotheses were tested by ANOVA and ANCOVA. Results of the analyses are summarized as follows : 1) Internal health locus of control had higher effects of the nursing intervention of mutual goal setting than external health locus of control on pulmonary ventilatory functions of forced vital capacity, forced expiratory volume in one second, and peak expiratory flow. 2) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the bowel movement recovery between the internal and external health locus of control. 3) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the mobility recovery between the internal and external health locus of control. 4) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of pain between the internal and external health locus of control. 5) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of stress between the internal and external health locus of control. 6) There was a statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of satisfaction with provision of nursing information between the internal and external health locus of control, and there was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of satisfaction with outcome of nursing between the internal and external locus of control. On the basis of the research results, the following are recommended : 1) Repeated research on responses to health locus of control is necessary. 2) Not only the effectiveness of nursing intervention in acute recovery periods, but also the long term effects are to be investigated. 3) The development of instruments is needed to accurately measure mutual goal setting regarding postoperative deep breath, coughing, early ambulation, etc. so that the relationship among the postoperative recovery indicators may be explored. 4) It is required that an instrument be developed to measure perception which facilitates goal attainment in the interactive setting between patients and nurses.

• Journal of Gastric Cancer
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• 제7권3호
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• pp.167-173
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• 2007

목적: 미슬토 추출물은 서양에서 오래전부터 사용되어진 면역치료 물질로 위암에 대해서는 연구가 부족한 실정이다. 본 연구에서 수술 받은 위암환자를 대상으로 항암제와 미슬토 추출물의 병합투여가 면역기능에 미치는 효과를 파악하기 위해 시행되었다. 대상 및 방법: 원발성 위암으로 진단받고 근치적 수술을 받은 10명의 환자를 선정하여 항암화학요법과 병행하여 수술 후 7일째부터 미슬토 추출물(ABNOVA viscum-Q)을 주 3회, 총 16주간 피하주사 하였다. 면역기능에 미치는 효과는 환자의 말초혈액에서 백혈구수와 그 분획, 백혈구에 대한 총림프구의 분율 그리고 시토카인들(Interleukin-$1{\beta}$, Interleukin-2, Interleukin-6, Interferon-$\gamma$, Tumor necrosis factor-$\alpha$)의 변화를 분석하였다. 상기 항목들은 수술 전과 수술 후 8주, 16주 총 3회 측정되었다. 결과: 남녀비는 9 : 1이며, 평균연령은 55.9세(range $33{\sim}74$세)였다. 병기는 stage Ib가 4명, II가 6명이었다. 백혈구수와 총호중구수는 기저치에 비해 치료 후 8주와 16주에 유의한 감소를 보였다. 총호산구수는 기저치에 비해 8주와 16주에 증가하는 경향을 보였지만 통계적 유의성은 없었다(P=0.15). 총림프구의 수치는 치료 전후 유의한 감소를 보이지만 백혈구 수에 대한 총 림프구의 분율은 유의하지는 않지만(P=0.91) 오히려 증가하고 있다. 각각의 시토카인들은 치료전후 큰 변화를 보이지 않았다. 결론: 치료 전후 의미있는 면역반응의 증가는 관찰하기 어려웠다. 이것은 미슬토 추출물과 항암제의 병용투여에 의한 면역활성과 억제의 상쇄반응으로 생각된다. 총호산구수가 증가하였고, 백혈구에 대한 림프구의 분율이 감소하지 않고 증가하는 양상을 보인 것은 미슬토 추출물에 의해 유발된 면역반응으로 생각된다.

• 대한영상의학회지
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• 제81권4호
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• pp.990-995
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• 2020

만성 육아종성 질환은 유전성 면역결핍질환으로 포식세포가 정상기능을 하지 못함으로써 만성적이고 반복적인 감염이 생긴다. 염증성 육아종의 형성은 다양한 장기에서 관찰되며 폐를 침범할 경우 영상학적 특징으로는 대부분 다발성 결절 또는 경결로 나타난다. 저자들은 신생아에서 종양으로 오인되는 폐 육아종의 비전형적인 소견을 보인 만성 육아종성 질환을 경험하였기에 이를 보고하고자 한다. 본 증례는 발열을 주소로 내원한 생후 24일된 남아로 전산화단층촬영 영상에서 우하폐에 위치한 비균질 조영 증강되는 종괴가 있었다. 종괴 내부 조영 증강되지 않는 부분은 자기공명영상의 확산강조영상에서 고신호 강도를 보였다. 환자는 수술적 절제를 시행하였고 X-염색체 연관 gp91^phox 유전자 돌연변이의 만성 육아종성 질환으로 확인되었다. 이에 우리는 본 증례 발표를 통해 이러한 비전형적인 만성 육아종성 질환의 임상적, 영상학적인 특징에 대해 서술하고자 한다.

• Radiation Oncology Journal
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• 제17권1호
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• pp.43-51
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• 1999

목적 : 연부조직종양을 제거한 직후 조직내 방사선치료용 도관을 삽입하여 근접방사선치료를 시행했던 증례들을 토대로 고선량율 조직내 방사선치료의 시술방법, 치료시기, 선량, 및 부작용 등에 대해 논의 하고자 한다. 재료 및 방법 : 1995년 5월에서 1997년 12월까지 10명의 원발성 혹은 재발성의 연부조직종양 환자가 종양의 제한적 절제술 후에 조직내 방사선치료 및 외부방사선치료를 시행받았다. 종양을 제거한 직후 도관을 종양이 있었던 자리에 1~l.5cm 간격으로 삽입하였고 종양 가까이에 신경혈관속 혹은 뼈가 있었던 경우에는 젤폼, 근육, 혹은 tissue expander로 덮어 이들 중요 구조물들과 도관이 적어도 0.5cm 간격을 유지하도록 하였다. 조직내 방사선치료는 이리디움-192가 장착된 고선량율 근접방사선치료기를 사용하여 수술 후 6일째부터 시작하였고 동위원소의 중심축으로부터 1cm 거리에 총 12~15Gy(2~2.SGy/fraction)를 일일 2회씩 3일간 시행하였다. 수술 후 한 달 이내에 외부방사선치료를 시행하였으며 총 50~55Gy를 조사하였다. 결과 : 모든 환자가 감염이나 출혈과 같은 근접방사선치료와 직접 관련된 부작용 없이 계획되어진 조직내 방사선치료를 마쳤다. 중앙 추적관찰기간 25개월째(범위 12~41개월)까지 국소재발은 관찰되지 않았고 RTOG/EORTC 등급 3 혹은 4의 만성 부작용도 없었다. 결론 : 주위정상조직에 조사되는 방사선량을 최소화하면서 수술 후 단기간 내에 시행할 수 있는 고선량율 조직내 방사선치료는 연부조직종양의 제한적 수술 후의 치료방법으로써 안전하고 손쉽게 이용할 수 있으며 또한 치료효과 및 부작용 측면에서도 우수한 치료방법이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4609-4614
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• 2016

Purpose: To evaluate the therapeutic effects of copper reduction on angiogenesis-related factors in patients with glioblastoma multiforme treated by gamma knife radiosurgery. Materials and Methods: In the present block randomized, placebo-controlled trial, fifty eligible patients with a diagnosis of glioblastoma multiforme who were candidates for gamma knife radiosurgery were randomly assigned into two groups to receive daily either 1gr penicillamine and a low copper diet or placebo for three months. The intervention started on the same day as gamma knife radiosurgery. Serum interleukin-6 (IL-6), tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$), vascular endothelial growth factor (VEGF) and copper levels were measured at baseline and after the intervention. The serum copper level was used as the final index of compliance with the diet. In order to control probable side effects of intervention, laboratory tests were conducted at the beginning, middle and end of the study. Results: The patients had a mean age and Karnofsky Performance Scale of 43.7 years and 75 respectively. Mean serum copper levels were significantly reduced in intervention group. Mean survival time was 18.5 months in intervention group vs. 14.9 in placebo group. VEGF and IL-6 levels in the intervention group were also significantly reduced compared to the placebo group and $TNF-{\alpha}$ increased less. Conclusions: It seems that reducing the level of copper in the diet and dosing with penicillamine leads to decline of angiogenesis-related factors such as VEGF, IL-6 and $TNF-{\alpha}$. Approaches targeting angiogenesis may improve survival and can be used as a future therapeutic strategy.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4447-4453
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• 2013

Purpose: To investigate the risk factors for anastomotic leakage (AL) after anterior resection for rectal cancer with a double stapling technique. Patients and Methods: Between January 2004 and December 2011, 753 consecutive patients in Jiangsu Cancer Hospital and Research Institute diagnosed with rectal cancer and undergoing anterior resection with a double stapling technique were recruited. All patients experienced a total mesorectal excision (TME) operation. Additionally, decrease of postoperative tumor supplied group of factors (TSGF), which have not been reported before, was proposed as a new indicator for AL. Univariate and multivariate analysis were performed to determine risk factors for AL. Results: AL was detected in 57 (7.6%) of 753 patients with rectal cancer. The diagnosis of anastomotic leakage was confirmed between the 6th and 12th postoperative day (POD; mean 8th POD). After univariate analysis and multivariate analysis, age (p<0.001), gender (p=0.002), level of anastomosis (p<0.001), preoperative body mass index (BMI) (p=0.001) and reduction of TSGF in 5th POD was less than 10 ${\mu}/ml$ (p<0.001) were selected as 5 independent risk factors for AL. It was also indicated that a temporary defunctioning transverse ileostomy (p=0.04) would decrease the occurrence of AL. Conclusion: AL after anterior resection for rectal carcinoma is related to elderly status, low level site of the tumor (below the peritoneal reflection), being male, preoperative BMI and the decrease of TSGF in $5^{th}$ POD is less than 10 ${\mu}/ml$. Preventive ileostomy is advisable after TME for low rectal tumors to prevent AL.