• Journal of Gastric Cancer
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• 제24권2호
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• pp.199-209
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• 2024

Purpose: Long-term outcomes of patients with positive lateral margins (pLMs) after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). This study aimed to evaluate the remnant cancer and survival rates of patients with pLMs compared with those who underwent curative resection. Materials and Methods: A retrospective analysis was performed on consecutive patients with pLMs as the only non-curative factor of expanded indication who underwent ESD for EGC with a follow-up duration of 5 years or more. The rates of remnant cancer, recurrence, and survival were analyzed and compared to those of control patients who underwent curative resection by propensity score matching. Results: Among 3,515 patients treated with ESD between 2005 and 2018, 123 non-curative EGCs were retrospectively analyzed. A total of 108 patients were followed up without endoscopic or surgical resection for 8.2 years. The control group was matched in a 1:1 ratio with patients with EGC who underwent curative resection after ESD. The observation group with pLMs had a higher incidence of remnant cancer (25.9%; 28/108) compared to that in the curative resection group (0/108; P=0.000). The remaining tumors were treated with surgical or endoscopic resection, and no additional recurrences were observed. The overall survival analysis demonstrated no significant difference between the observation and curative resection groups (P=0.577). Conclusions: No difference was observed in the overall survival rate between observation and curative resection groups. Therefore, observation may be a possible option for incomplete ESD with pLMs if continuous follow-up is performed.

• 한국도로학회논문집
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• 제10권1호
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• pp.87-95
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• 2008

형상이 일정하지 않은 구조에 충돌하는 차량의 탑승자 안전을 확보하기 위해서 그 구조물의 앞에 공간이 허용하는 한도의 깊이만큼 충격을 흡수하는 재료로 만든 모듈을 쌓아두는 방법을 생각할 수 있다. 충격흡수모듈로 사용되기 위해서는 재료가 충분한 에너지 흡수능력을 가져야 하고 동시에 탑승자의 안전을 확보할 수 있어야 한다. 본 논문에서는 에너지 흡수능력과 더불어 탑승자의 안전을 보장하기 위하여 충격흡수재료가 가져야 할 조건을 설명하고 auard-Guard 시스템 모듈, 샌드백, 재활용 타이어, 지오컨테이너, 지오셀 그리고 EPS 블록에 대한 정적압축실험을 실시하여 그 결과를 분석하였다. 이로부터 $30kg/m^{3}$의 밀도를 갖는 EPS 블록이 쿠션모듈로 사용되기 적합한 재료임을 보였다. 한편 시속 35.6km/h까지의 충돌조건으로 Drop Test를 실시하여 EPS블록의 정적특성과 동적특성간 큰 차이가 없음을 보여 주었으며 쿠션모듈로서의 성질을 개선시키기 위한 방안으로 EPS 블록에 공극을 두는 방안을 제안하고 공극이 있는 EPS블록에 대하여 Drop Test를 실시하여 EPS 블록을 이용한 충격흡수시설의 설계에 필요한 재료적 특성치를 제시하였다.

• 보건교육건강증진학회지
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• 제16권2호
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• pp.19-40
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• 1999

In order to ascertain the attitudes of residents to their health and the National Health Promotion Law, surveyors interviewed 1,220 subjects, 1% of men and women in Kyungsan city, who were twenty-year-old or more. The major findings are as follows: Men and women were 48.2% and 51.8%, respectively. The recognition rate of enacting and enforcing this law is 59.2% of men and 51.3% of women. With regard to the behavioral attitude to the health in the distinction of sex and age, current smokers are 31.2% of the interviewees, 61.6% of the men and 3.3% of the women. Current drinkers are 35.1%, 59.5% of the men and 12.3% of the women, but on the other hand there is little significance in the distinction of age. The acknowledgement proportion of enacting and enforcing this law is 59.2% of male and 51.3% of female. In terms of the recognition rate of the contents according to the general characteristics of interviewees, it appears that the indication of a warning expression on a packing paper of cigarette case and a liquor bottle is 92.4% and also the designation of a smoking free area in public facilities is 94.8%. Prohibition of cigarette-sale to the teenagers who are under 19, is 96.0%. Considering these facts, the recognition rate is high. On the contrary, 48.8% is accounted for encouraging a medical check-up before marriage which is in a low position. As a result of multiple behavior as a independent educational level, marital significant variables. In case of having undergone a periodic medical examination the recognition rate was high whereas frequent exercise led to the low recognition rate. Concerning the details of the undertaking in accordance with each factor of general characteristics, the greater part of them have been appraised successfully whether it is recognized or not. On the other side, no effect got answered about the result of the undertaking subjects to general and peculiar behavior attitude towards health was in effect or not. A great majority approved of more reinforcement of legal regulation about smoking and drinking regardless of whether they perceived the details of the law of promotion of National Health Promotion Law or not. Additionally there was significant difference in reinforcing legal regulation of smoking and drinking in compliance with the attitude of the substance of this law. With regard to education, public relations and evaluation about national health through public health centers by our government, the younger and the higher in education they are, the more deficient they feel. First of all, those who were aware of the enforcement of this law as well as plenty of scarcity answered that better service of disease prevention had to be expanded than ever. In consideration of the above-stated results, the education to public health and the business of public relations should be reinforced and a practical campaign for health life should also spread out for the purpose of encouraging to practise healthy life-style.

• 한국미생물·생명공학회지
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• 제32권2호
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• pp.135-141
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• 2004

인간 과립구 성장인자(hG-CSF)는 골수에서 생산되는 단백질로 호중구의 분화 및 생성을 촉진시키는 역할을 한다. 현재 재조합 hG-CSF는 암화학요법에 의한 호중구감소증, 골수이식시 호중구 감소증, 재생불량성 빈혈에 수반되는 호중구 감소증 등으로 적응증이 확대되고 있다. 본 연구에서는 OmpA signal sequence를 삽입하여 인간 과립구 성장인자(hG-CSF)가 분비발현되도록 고안된 T7 promoter 에 의하여 발현되는 pYRCl 발현백터를 제조하였다. E. coli BL2l (pYRCl) 발현시 $37^{\circ}C$에서 배양하는 경우 많은 양의 봉입체(aggregates)를 형성한다. 이에 비하여 $10\mu$M ucose를 포함하는 변형된 MBL배지에서 10 g/$\ell$IPTG를 유도물질로 7시간동안 $25^{\circ}C$에서 배양하였을 때 전체 periplasm단백질의 15%가 soluble rhG-CSF이었다. 또한, 유가식 배양방법을 사용하여 E. coli BL2l(pYRCl)에서 soluble rhG-CSF의 생산조건을 조사하였다. 유가식 배양에서 rhG-CSF의 발현량이 비증식속도를 $0.43 h^{-1}$ 에서 0.14 $h^{-1}$ 으로, 유도 배양시간을 최적화함으로써 rhG-CSF의 발현량이 4.4mg/$\ell$에서 24mg/$\ell$ 로 증가하였다.

• 대한간호학회지
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• 제26권2호
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• pp.387-398
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• 1996

The objective of this study was to clarify whether there are any differences between normal and over-weight middle-aged(40∼59yrs)women in their perceived weight, health status, health conception and health behavior choices. The sample consisted of 39 normal weight and 55 over-weight (11％ above on the Body Index Scale) women who live in Juan, Inchon. The Participants were randomly selected in each weight group considering socio-demographic factors. The findings from this study are summarized below. 1) Among the 55 overweight middle-aged women, 16 were above 20％ on the Body Index Scale and 14 were above 30％. Twenty-five(45.5％) of the overweight group and 12(30.8％) of the normal weight group had one disease, and there were 12(21.8％) in the overweight group and 8(20.5％) in the normal weight group where one of the family members had a disease, but these differences were not statistically significant. The average monthly family income for the overweight group was ￦l,880,000 compared to ￦2,140, 000 for the normal weight group, but this difference was also not significant. The age range for the whole group was between 40 and 59(mean＝46.8 for total, 48.6 for overweight and 45.7 for normal weight group). Again no significant difference found. Occupations were housemaker 53(56.4％), private business(13.8％), salarywoman(9.6％), and teacher (2.1％). Thirty housemaker(54.5％) from the overweight group and 23(59％) from the normal group did not constitute a statistically significant different. For the educational status, 34(61.8％) of the overweight women and 33(84.6％)of the normal weight group finished high school or more educational courses, but there was no significant statistical difference. Eleven(20.0％) of the overweight women and 5(12. 8％) of the normal weight group were single, but again no significant statistical difference was found. 2) A test for difference in health characteristics between two weight groups indicated that two groups do not show statistical differences in their perceived health status, health conception or health behavior choice. That is, the overweight group, also perceive their health status as good as the normal group, and regard ‘Health’ as a state that enables them to carry out social roles and functions rather than as the traditional concept of health as no disease or no symptoms. Moreover. the overweight group selected their health behaviors not for the prevention of diseases or maintenance of health but for promotion of health. To determine if no statistical difference might be related to the overweight group's failure of perceive themselves as overweight, the perceived and objective overweight status were compared by the chi-square analysis, and no difference was found（X/sup²＝49.37, df＝1, p＝.000）. However, 7(17.9％) of the normal group perceived themselves as being overweighted and 7(12.7％) of the overweight group thought they were of normal weight. Even though the overweight group employed in this study perceived themselves as being overweight, they regarded themselves as healthy as those in the normal weight group. It was shown that there was no statistical difference between two groups in health conception, and that they chose health behaviors to promote health status. 3) Perceived health conception was shown to be significantly related to health behavior choice （r＝ .28, p＝.006 for whole group : r＝.33, p＝.014 for overweight group : and r＝.12. p＝.463 for normal group） .There was an indication that the more complicated the perceived health conception was, the more the trend of health behavior choice to promote health. This was especially true for the overweight group. But, the perceived health status did not related to health behavior choice statistically（r＝.13, p＝.202）, and it was thought that reasons for selecting health behaviors were not related to their health status. That is, the overweight group perceive themselves as healthy as the normal weight group or thought that overweight itself does not incur any risk on their health. Data from two groups were combined and analyzed with multiple regression methodology, because the relationship pattern of the two groups was similar. The analysis showed that health behavior has a significant relationship with age and the perceived health conception（r/sup²＝.1517, p=.05, F＝8.133）. It means they come to health behavior along with their health conception and their age rather than their weights, perceived weight, health status or other social characteristics. This study was intended to understand how overweight middle-aged women perceive ‘weight’ and ‘health’, and how they meet their health related needs in comparison with normal weight middle-aged women. Other factors related to the health behavior in overweight middle-aged woman need to be determined through further descriptive studies outlined in the following recommendations. a) Reseach with the study area expanded. b) Reseach with grouping more detailed : much more overweight and underweight group c) Reseach on restricted relationship between overweight and age or profession. d) Reseach on what overweight middle-aged women do to reduce their weight and what factors motivate them to do it

• Journal of Chest Surgery
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• 제32권5호
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• pp.448-455
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• 1999

배경: 비디오흉강경수술은 최근 기기의 급속한 발달로 인해 많은 흉부 질환에 적용되고 있으며, 자연기흉에 대한 적절한 치료법으로 제시되고 있지만 개흉술에 비해 높은 재발율이 문제점으로 거론되고 있으며, 수술후 재발에 대한 장기 추적관찰이 미흡한 실정이다. 대상 및 방법: 고대 안암병원 흉부외과에서는 비디오흉강경이 도입된 1992년 3월부터 1997년 3월까지 288명의 자연기흉 환자에 대해서 292례의 비디오흉강경수술을 시행하였다. 수술후 추적 관찰한 결과와 재발에 관여하는 인자를 전향적으로 분석하였다. 개흉술로의 전환례 8례는 제외하였다. 결과: 남자 249명(88.9%), 여자 31명(11.1%)이었으며, 나이는 평균 28.1 12.2세(15~69세)였다. 원발성 자연기흉이 237명(83.5%), 이차성 자연기흉이 47명(16.5%)였으며 이차성 자연기흉 중에서는 결핵성이 27명(57.5%)으로 가장 많았다. 수술 적응증으로는 동측 재발성 기흉이 123명(43.9%)과 지속적 공기누출 53명(18.9%)으로 대부분을 차지하였으며, 그외 흉부촬영상 폐기포가 존재한 경우 40명(14.3%), 긴장성 기흉 30명(10.7%), 반대측 기흉 21명(7.5%), 양측성 기흉 3명(1.1%), 합병증이 동반된 경우 2명(0.7%), 그리고 환자나 보호자가 원한 경우가 8명(2.9%)이였다. 흉강경수술시 폐기포가 관찰된 경우 247례(87%)였다. 244례(85.9%)에서 폐기포절제술이 시행되었다. 평균 수술시간은 52.8 23.1분(20~165분)이었다. 술후 합병증으로 5일 이상 공기누출이 16례이었으며, 이중 4례에서 재수술이 필요하였으며 전례에서 폐기포가 다시 발견되었다(100%, 4/4). 출혈이 5례 있었으며 이중 3례에서 재수술이 필요하였다. 그외 무기폐 2례, 농흉 5례, 창상감염 1례가 병발되었으며 술후 사망례는 없었다. 평균 흉관거치기간은 5.0 4.5일(2~37일), 평균 입원일은 8.2 5.5\ulcorner(3~43일)이었다. 평균 22.3 18.4개월(1~65개월)의 추적 관찰기간 동안 12례가 누락됐으며(4.2%), 24례(8.5%,)가 재발하였다. 이중 7명의 경우 재수술이 필요하였으며 6례에서 폐기포가 재발견되었다(85.7%, 6/7). 12개의 요인(나이, 성별, 기흉의 위치, 기흉의 정도, 원인질환 유무, 수술 적응증, 폐기포의 수, 폐기포의 크기, 폐기포의 위치, 폐기포절제 유무, 흉막유착술 방법, 술후 지속성 공기누출 유무)가 재발에 관여하는 지에 대해 분석하였다. 원인질환 유무, 흉막유착술 방법과 술후 지속성 공기누출 유무가 재발에 관여하는 위험요인으로 나타났다. 이차성인 경우가 원발성인 경우보다 재발율이 높았고[17.0%(8/47) : 6.8% (16/237), p=0.038], 술후 지속적 공기누출이 있었던 경우 재발율이 높았으며[37.5%(6/16) : 6.7%(18/268), p=0.001], 기계적 흉막유착술이 흉막절제술보다 재발율이 높았다[11.4%(19/167) : 4.3%(5/117), p=0.034]. 폐기포절제술을 시행한 경우가 하지않은 경우보다 재발율이 낮았으나 통계학적 의의는 없었다[10.0%(4/40) : 8.2%(20/244), p>0.05]. 결론: 비디오흉강경술에서 재발을 낮추기 위해 수술시 폐야 전체를 관찰하여 존재하는 폐기포를 놓치지 않는 것이 중요하며, 폐기포를 확인하지 못한 경우와 이차성 자연기흉에 대해서는 흉막유착술에 더 세심한 주의가 필요하다는 것을 확인하였다. 비디오흉강경수술은 통증이 적고, 입원기간이 짧고, 사회로의 복귀가 빠르며, 고위험군에 적용할 수 있고, 무엇보다도 미용상의 이점이 크다는 면에서 자연기흉에 대해 유용한 치료방법임에는 틀림이 없으나 개흉술에 비해 재발율이 높고 비용이 비싸다는 문제가 제기되고 있는 만큼 더 세심한 주의와 장기 추적관찰이 필요하리라 사료된다.