• 대한족부족관절학회지
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• 제19권1호
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• pp.11-17
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• 2015

Purpose: To report the radiographic and clinical results of 6.5 mm cancellous full threaded buttress screw or Steinmann pin fixation to maintain a reduction of calcaneal posterior facet depression fracture. Materials and Methods: From June 2009 to June 2012, 50 consecutive cases with calcaneal joint depression fracture that underwent open reduction and screw or pin fixation were enrolled in this study. A 6.5 mm cancellous full threaded screw was inserted from the posteroinferior aspect of the calcaneal tuberosity to the posterior facet (group A) or Steinman pin was inserted from the posterosuperior aspect of the calcaneal tuberosity to the calcaneocuboidal joint (group B). Both preoperative and postoperative Bohler and Gissane angles were measured radiographically, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale on the final follow-up were assessed. Results: The mean age of patients was 44.1 years, and the mean follow-up period was 27.2 months. According to the Sanders classification, 28 cases were type II and 22 cases were type III. In Sanders type II, Bohler and Gissane angles improved significantly from $10.1^{\circ}$ and $126.2^{\circ}$ preoperatively to $27.2^{\circ}$ and $117.1^{\circ}$, respectively, in the immediate postoperative radiograph, and at the final follow-up, $26.6^{\circ}$ and $118.6^{\circ}$, respectively. In Sanders type III, Bohler and Gissane angles improved significantly from $5.0^{\circ}$ and $129.8^{\circ}$ to $29.9^{\circ}$ and $119.3^{\circ}$, respectively, in the immediate postoperative radiograph, and $26.9^{\circ}$ and $120.2^{\circ}$ at the final follow-up. All cases achieved bony union, and the average period until complete union was 13.3 weeks. AOFAS ankle-hindfoot scale was 82.6 in Sanders type II and 77.3 in Sanders type III at the final follow-up. Conclusion: A 6.5 mm cancellous full threaded buttress screw or Steinman pin fixation is a noninvasive treatment method with a merit of being able to maintain the bearing capacity of the posterior facet comparable to plate fixation.

• Journal of Acupuncture Research
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• 제25권3호
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• pp.127-138
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• 2008

Objectives : This study was designed to evaluate the general distribution and the efficacy of oriental medical treatment for Lumbar Disc Herniation. Subjects and Methods : The 137 patients who had a diagnosis of HIVD by Lumbar-CT of Lumbar-MRI and admitted to Dunsan oriental medical hospital in Daejon university from January 2005 to December 2007 were observed. They were analyzed according to the distribution of sex, age, the period of disease, causing factor, The patient-condition on admission, the symptom on admission, Admission day, Herniation type of the disc and the treatment efficacy was evaluated respectively. Results : 1. Male was more than female in the ratio of 1 : 1.174, and forties 28% the most, the acutest phase 48% the most, reason unknown 30% the most, Grade III 42% the most, Back and Leg radiate pain 65% the most, the day of 6-10 29% the most, protruded disc type 48% the most. 2. In the total treatment result, the good was 48%, the excellent 28%, the fair 15%, the poor 9% in order. 3. the "effective rate"(the percentage of positive effective treatment case) of each distribution, the thirties and fifties 100% the most, subacute phase 100% the most, exercise, traffic accident 100% the most respectively, Grade III 93% the most, only low back pain 97% the most, the day of 16-20 100% the most, Extruded disc 100% the most. Conclusions : Total effective rate was 91%. We have Known the efficacy of oriental medical treatment for HIVD, was good and early treatment was better than late treatment.

• Journal of Community Nutrition
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• 제5권1호
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• pp.29-36
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• 2003

This study investigated the correlation of the physical measurements and the basic physical fitness of 158 female students in the city of Seoul. The average age of the subjects was 22.0 ${\pm}$ 0.13 years old, the average height was 160.9 ${\pm}$ 0.7cm and the average weight was 53.4 ${\pm}$ 0.6kg. The mean BMI (Body Mass Index) was 20.7 ${\pm}$ 0.2kg/㎡. The average muscle mass was 36.5 ${\pm}$ 0.3 and the average body fat percentage was 28.0 ${\pm}$ 0.4%. The basic fitness levels of the subjects were measured based on the evaluation chart of the Korea Health and Science Research Institution (1994). The subjects were divided into 3 groups based on BMI(Group I : BMI < 20, Group II : 20 $\leq$ BMI < 25, Group III BMI $\geq$ 25) and the correlation between BMI and physical fitness was assessed. 1) The muscle strength of the subjects was measured by their grip strength, among other tests. Groups 1 and 2 were evaluated as “su” (level 1) and group 3 was “woo” (level 2). 2) Endurance 1 was tested by push-ups, and while groups 1 and 2 were evaluated as “su” (level 1), group 3 was “ga” (level 5). This result did not suggest any significant relevance among the subjects. 3) Endurance 2 was tested by sit-ups : groups 1 and 2 were evaluated as “mi” (level 3) and group 3 as “yang” (level 4). Group 2 and group 3 showed a significant difference. 4) Instant power was tested by standing high jumps, and although there was a significant difference between group 1 and group 3, all of the subjects were evaluated as “ga” (level 5). 5) Flexibility was measured by how far the subjects could bend forward. There was no significant relevance between the groups and they were all respectively evaluated as “woo” (level 2). 6) Agility was tested with side-steps and all the subjects showed poor agility as “yang” (level 4). 7) Heart and lung endurance was tested by the step test, calculating the maximum oxygen intake with the Physical Energy Index (PEI) and using the numbers according to the evaluation chart. Group 1 was evaluated as “mi” (level 3) and groups 2 and 3 were “woo” (level 2). From these results, we could see the group III (obese group) had a tendency of lower levels in all the variables related to body fitness They showed significantly lower endurance assessed with time for sit-ups and instant power by the standing high jumps. (J Community Nutrition 5(1) : 29∼36, 2003)

• Journal of Gastric Cancer
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• 제24권3호
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• pp.267-279
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• 2024

Purpose: The optimal treatment for gastroesophageal junction adenocarcinoma (GEJA) remains controversial. We evaluated the treatment patterns and outcomes of patients with locally advanced GEJA according to the histological type. Materials and Methods: We conducted a single-institution retrospective cohort study of patients with locally advanced GEJA who underwent curative-intent surgical resection between 2010 and 2020. Perioperative therapies as well as clinicopathologic, surgical, and survival data were collected. The results of endoscopy and histopathological examinations were assessed for Siewert and Lauren classifications. Results: Among the 58 patients included in this study, 44 (76%) were clinical stage III, and all received neoadjuvant therapy (72% chemoradiation, 41% chemotherapy, 14% both chemoradiation and chemotherapy). Tumor locations were evenly distributed by Siewert Classification (33% Siewert-I, 40% Siewert-II, and 28% Siewert-III). Esophagogastrectomy (EG) was performed for 47 (81%) patients and total gastrectomy (TG) for 11 (19%) patients. All TG patients received D2 lymphadenectomy compared to 10 (21%) EG patients. Histopathological examination showed the presence of 64% intestinal-type and 36% diffuse-type histology. The frequencies of diffuse-type histology were similar among Siewert groups (37% Siewert-I, 36% Siewert-II, and 33% Siewert-III). Regardless of Siewert type and compared to intestinal-type, diffuse histology was associated with increased intraabdominal recurrence rates (P=0.03) and decreased overall survival (hazard ratio, 2.33; P=0.02). With a median follow-up of 31.2 months, 29 (50%) patients had a recurrence, and the median overall survival was 50.5 months. Conclusions: Present in equal proportions among Siewert types of esophageal and gastric cancer, a diffuse-type histology was associated with high intraabdominal recurrence rates and poor survival. Histopathological evaluation should be considered in addition to anatomic location in the determination of multimodal GEJA treatment strategies.

• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.244-249
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• 2010

목적: 본 연구는 제 2형 SLAP 병변에서 외상의 유무에 따른 손상기전의 차이 및 임상 결과의 차이를 비교하고자 한다. 대상 및 방법: 2007년 1월부터 2009년 5월까지 제 2형 SLAP 단독 병변으로 수술을 시행한 27예를 대상으로 하였다. 제 2형 SLAP 병변의 분류는 Burkhart에 의한 분류법을 이용하여 병변이 전상방부에 위치하면 제 1형, 후상방부는 제 2형, 전후방 복합 병변은 제 3형으로 분류하였다. 치료 결과는 술 전, 술 후의 UCLA 점수와 KSS 점수를 사용하여 측정하였다. 결과: 총 27예 중 외상군은 16예, 비외상군은 11예였다. 제 2형 SLAP 병변의 형태는 외상군에서 제 1형은 12예, 제 2형은 2예 그리고 제 3형은 2예였다(p=0.013). 비외상군에서는 제 1형 2예, 제 2형 6예, 제 3형 3예였다 (p=0.026). 즉 외상군에서는 전방 병변이 더 많이 발생하였고 (p<0.05), 비외상군에서는 후방 병변이 더 많이 발생한 것으로 추정할 수 있다 (p<0.05). 외상군에서 UCLA 점수 및 KSS 점수는 술 전 평균 18점 (14~23점), 48점 (32~76점)에서 술 후 32점 (28~33), 86점 (71~92점)이었다. 비외상군에서는 UCLA 점수 및 KSS 점수는 술 전 평균 21점 (18~25점), 58점 (41~68점)에서 술 후 29점 (26~31점), 81점 (68~89점)이었다. 임상결과에 있어서 두 군 사이의 통계학적으로 유의한 차이를 보이지 않았다 (p=0.317, 0.405). 결론: 본 연구에서 제 2형 SLAP 병변의 형태가 외상 기전에 따라 차이가 있음을 관절경 소견을 통해 확인할 수 있었다. 따라서 제 2형 SLAP 병변에 대한 수술적 치료를 고려할 때 외상 유무를 파악하여야 할 것이다.

• Childhood Kidney Diseases
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• 제12권1호
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• pp.54-61
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• 2008

목적 : 요로감염 환아에서 VCUG는 VUR을 찾아내는데 필수적인 검사이다. 그러나 최근 요로감염 소아 환자에서 신장초음파와 DMSA 신스캔이 모두 정상인 경우 VCUG의 필요성에 대하여 논란이 있다. 이에 신장초음파와 DMSA 신스캔이 정상인 요로감염증 환아에서 VCUG의 필요성을 알아보고자 본 연구를 시행하였다. 방법 : 2002년 2월에서2007년 7월까지 본원에서 방광천자요(57명), 도뇨관 채뇨(58명), 채뇨백뇨(동일균주 2회 양성: 2명) 등으로 진단된 1세 미만의 요로감염 영아(117명)를 대상으로 하였다. 모든 환아들은 신장초음파, DMSA 신스캔, VCUG를 시행하였으며, 신장초음파, DMSA 신스캔의 이상 유무에 따른 VUR의 동반 여부를 비교 분석하였다. 결과 : 총 환아 중 남아가 96명(82%), 여아가 21명(18%)이었으며, VUR을 보인 환아는 28명(23.9%)이었다. 신장초음파에서 이상 소견이 있는 환아 38명(32.5%) 중 11명(11/38, 28.9%), 신장초음파가 정상인 환아 79명(67.5%) 중 17명(17/79, 21.5%)에서 VUR이 동반되었고, DMSA 신스캔 상 이상소견이 있는 환아 35명(29.9%) 중 18명(18/35, 51.4%), DMSA 신스캔이 정상인 환아 82명(70.1%) 중 10명(10/82, 12.2%)에서 VUR이 동반되었다. 신장초음파와 DMSA 신스캔 모두 정상소견을 보인 환아는 59명(50.4%)이었으며 이 중 VUR이 없는 환아는 52명(88.1%), VUR을 보인 환아는 7명(11.9%)이었다. 3명은 grade I-II, 2명은 grade III, 2명은 grade IV의 고도 역류 소견을 보였고, 그 중 1명은 양측성으로 우측은 grade IV, 좌측은 grade III의 VUR을 보였다. 결론 : 요로감염이 있는 영아에서 신장초음파와 DMSA 신스캔 소견이 정상일 경우 VUR이 동반되지 않을 경우(negative predictive value)는 88.1% 였으나, 같은 환자군에서 VUR이 동반된 경우는 11.9%이었으며 이 중 2명에서 고도 역류가 있었다. 그러므로 영아 요로감염증의 경우 신장초음파와 DMSA 신스캔이 정상 소견을 보여도 VCUG는 반드시 시행하여야 할 것으로 사료된다.

• Journal of Chest Surgery
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• 제25권3호
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• pp.296-306
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• 1992

A 6 year experience with the bileaflet St. Jude Medical valve is reported. Between Feb. 1986 and Dec. 1992, 68 patients received 87 such valves[36 mitral, 13 aortic, and 19 double mitral-aortic valve replacements]. The results are summarized as follows 1. There were 35 male and 33 female patients ranging in age from 17 to 55 years the mean age of 35.3 $\pm$ 9.7 years. 2. The mean aortic clamp time[ACT] of the MVR, AVR and DVR groups were 91.5$\pm$16.4, 117.2$\pm$28.7 and 165.5$\pm$24.1 minutes. The mean total bypass time [TBT] of the MVR, AVR and DVR groups were 112.8$\pm$19.5, 134.7$\pm$31.4 and 192.2$\pm$28.5 minutes. 3. Eighty seven valves were used [55 mitral site, 32 aortic site]. 31mm[20], 33mm[15], 29mm[15], 27mm[2], 25mm[2] and 35mm[1] were used in mitral site and 23mm[13], 21mm[8], 19mm[7] and 25mm[4] were used in the aortic site. In the DVR, there were valve combinations such as 4 cases of M[29mm]-A[19mm], 4 of M[31mm]-A[23mm], 3 of M[33mm]-A[23mm] and others. 4. Preoperative NYHA functional classes were II [3 cases], III [46 cases], IV[19 cases] and improved to I [52 cases] and Il [13 cases] postoperatively. 5 Early postoperative complications were occurred in 15 cases[2Z.l%] and there were LOS in 5 cases[7.4%], arrythmia [3 cases], wound infection [2 cases], hepatitis [2 cases], sudden cardiac arrest [2 cases] and postoperative bleeding [1 case]. The early hospital death was occurred in 3 cases[4.4%] with LOS [1 case] and sudden cardiac arrest [2 cases]. 6. Mean follow-up time of survival cases[65 cases] was 31.3$\pm$21.9 months and the total follow-up time was 169.8 patient-years. Late postoperative complications were occurred in 4 cases[2 thromboembolism, 1 paravalvular leak, 1 thromboembolism br paravalvular leak, 1 valve endocarditis] with the occurrence rate as 2.35% per patient-years. Reoperation was performed in 2 cases [1 paravalvular leak, 1 left atrial thrombus] and there was one [1.5%] late valve related death. Therefore the 6 year complication free rate was 90.6% and 6 year actuarial survival rate was 98.3$\pm$1.7%. On the basis of this experience and the results, SJMvalve appears to be one of the best performing mechanical prosthesis currently available, in terms of both hemodynamics and lower complications with warfarin antioagulation.

• 대한소아치과학회지
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• 제36권4호
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• pp.550-555
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• 2009

과거에 비해 소아 및 청소년기에 교정치료를 시작하는 경우가 증가하고 있으며 따라서 소아치과에서 교정치료가 차지하는 비율 역시 증가하는 추세이다. 이러한 변화에 맞추어 소아치과에 내원하는 교정환자의 분포 양상을 파악하기 위하여 본 연구를 시행하였다. 2006년 1월부터 2008년 12월까지 서울대학교 치과병원 소아치과를 내원한 환자 중 교정 진단 받은 792명을 대상으로 조사를 진행하였으며 다음과 같은 결과를 얻었다. 1. 교정 진단을 받은 환자의 연령 분포는 8세가 22%로 가장 많았고 7세(19%), 9세(16%) 순서로 나타났다. 2. 골격 분포는 골격성 1급 부정교합이 52%로 가장 많았고 3급(29%), 2급(19%)순서로 나타났으며 연령이 낮은 경우 3급 부정교합 환자의 비율이 높은 경향을 보였다. 3. 총 792명의 환자 중 28%인 218명에서 전치부 반대교합을 보였으며 연령이 낮은 경우 그 비율이 높은 경향을 보였다.

• Genomics & Informatics
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• 제20권3호
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• pp.29.1-29.12
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• 2022

Several studies have shown associations between irinotecan toxicity and UGT1A genetic variations in colorectal and lung cancer, but only limited data are available for gastric cancer patients. We evaluated the frequencies of UGT1A polymorphisms and their relationship with clinicopathologic parameters in 382 Korean gastric cancer patients. Polymorphisms of UGT1A1*6, UGT1A1*27, UGT1A1*28, UGT1A1*60, UGT1A7*2, UGT1A7*3, and UGT1A9*22 were genotyped by direct sequencing. In 98 patients treated with irinotecan-containing regimens, toxicity and response were compared according to the genotype. The UGT1A1*6 and UGT1A9*22 genotypes showed a higher prevalence in Korean gastric cancer patients, while the prevalence of the UG1A1*28 polymorphism was lower than in normal Koreans, as has been found in other studies of Asian populations. The incidence of severe diarrhea after irinotecan-containing treatment was more common in patients with the UGT1A1*6, UGT1A7*3 and UGT1A9*22 polymorphisms than in controls. The presence of the UGT1A1*6 allele also showed a significant association with grade III-IV neutropenia. Upon haplotype and diplotype analyses, almost every patient bearing the UGT1A1*6 or UGT1A7*3 variant also had the UGT1A9*22 polymorphism, and all severe manifestations of UGT1A polymorphism-associated toxicity were related to the UGT1A9*22 polymorphism. By genotyping UGT1A9*22 polymorphisms, we could identify high-risk gastric cancer patients receiving irinotecan-containing chemotherapy, who would experience severe toxicity. When treating high-risk patients with the UGT1A9*22 polymorphism, clinicians should closely monitor them for signs of toxicity such as severe diarrhea or neutropenia.

• 환경영향평가
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• 제28권6호
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• pp.536-548
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• 2019

기타 수계 중 삽교천 유역에 새롭게 수립된 오염총량관리제도의 시행에 따른 효과를 정량화하기 위해 2015년을 기준으로 유역유출모형인 HSPF 모형을 구축한 후, 최종 목표연도인 2030년의 부하량을 입력하여 각 단위유역 말단에 설정된 목표수질 달성여부를 평가하였으며, 미시행지역인 무한천과 삽교천 유역을 포함하여 유량구간별 수질(BOD, T-P)을 예측하였다. 보정 및 검증이 완료된 모형에 2030년의 부하량을 입력하여 재구동한 후, 모의결과로부터 부하지속곡선을 작성함으로써 기준년도 부하량을 입력하여 구동한 모의 수질과 목표연도 부하량을 입력하여 모의한 예측 수질을 유량구간별로 도식화한 결과, 평수량 구간(40~60%)에서 3개의 단위유역 모두 BOD 목표수질에 근접하게 모의되었으며, 목표수질 달성율도 높게 산정되었다. T-P의 경우, 천안A 46%, 곡교A 29%, 남원A 25% 정도의 수질이 개선되는 것으로 예측되었으며, 무한천과 삽교천유역은 중권역 목표기준인 III등급 이내의 수질로 모의되었다. 총량관리 대상 단위유역은 목표수질을 달성하고, 미시행지역은 목표등급을 달성하는 수준의 수질이 삽교호 내로 유입될 것으로 예측됨으로써 총량제 시행에 따른 삽교천 유역의 수질개선효과가 긍정적일 것으로 판단된다.