• Journal of Gastric Cancer
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• 제18권2호
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• pp.109-117
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• 2018

Purpose: This study aimed to investigate the outcomes of laparoscopic gastrectomy in very elderly patients with gastric cancer, who have outlived the average lifespan of the Korean population (men: ${\geq}77years$, women: ${\geq}84years$). Materials and Methods: Between 2004 and 2015, 836 patients with gastric cancer underwent a laparoscopic gastrectomy. They were divided into the elderly group (EldG) and non-elderly group (nEldG). Propensity score matching for covariates of sex, tumor depth, node status, and extent of resection was performed. Clinicopathologic characteristics, and surgical and survival outcomes were compared between the 2 groups. Results: The EldG had a higher American Society of Anesthesiologists (ASA) score and a higher number of comorbidities. There was no significant difference in the post-operative complications, except for pulmonary complications, which were more frequent in the EldG (5/56, 8.9%) than in the nEldG (0/56, 0%). The EldG had a shorter overall survival (OS), but cancer-specific survival was similar for both groups. Among deceased patients, 2 (25%) and 8 patients (50%) died within a year of surgery in the nEldG and EldG, respectively. Univariate and multivariate risk factor analyses for OS showed that age, ASA score, tumor, node, metastasis (TNM) stage, and occurrence of complications were significantly related to deterioration in OS. Conclusions: Laparoscopic gastrectomy can be safely performed in very elderly patients with gastric cancer who have outlived the average lifespan of the Korean population. However, impact of laparoscopic gastrectomy on improving survival is not clear, and careful patient selection is recommended.

• 한국콘텐츠학회논문지
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• 제17권3호
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• pp.609-623
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• 2017

본 연구는 한국과 영국 교복 광고들 속에서 광고의 의미가 어떻게 구성되고 다양한 재현들이 무엇을 의미하는가를 고찰하고, 광고를 둘러싸고 전개된 담론들, 특히 성 담론에 주목하면서 양국의 문화적 함의의 차이를 밝히고자 하였다. 이를 위해 한국의 <스쿨룩스>와 영국의 <아메리칸 어패럴>의 교복 광고들을 분석 대상으로 선정했고 다양한 기호학적 분석 방법들을 활용했다. 기호의 2차 의미 생성 과정 분석, 즉 기표와 기의, 함축 의미와 이데올로기의 단계적 의미들을 도출하고자 하였다. 또한 비판적 담론 분석을 시도하여 광고 텍스트의 의미와 담론적 의미 및 이데올로기적 실천 의미를 파악하였다. 분석 결과, 이들 두 나라의 학생 교복 광고들에는 여성 상품화, 남녀의 권력 불균형, 아동 성애자적 접근 등의 부정적 양태와 교복의 본연의 의미와 가치가 왜곡된 경향이 드러났다. 나아가 교복 광고를 둘러싼 양국의 담론들에 대한 비판적 담론 분석을 토대로 양 국가에서 잠재되어 있는 왜곡된 성적 대상화와 상업화를 통한 비정상적인 미적 가치 변형 양상과 '롤리타 판타지'가 만연되어 있음이 나타났다. 나아가 변태적 성적 취향으로 인해 학생들에게 성적 정체성의 혼란과 가치관의 혼돈을 야기하고 있는 것을 발견하였다.

• 대한족부족관절학회지
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• 제15권2호
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• pp.86-91
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• 2011

Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7 year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient's satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we've obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We've also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient's satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.

• 대한족부족관절학회지
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• 제13권1호
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• pp.28-33
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• 2009

Purpose: This retrospective study was designed to evaluate the treatment results of chronic Achilles tendon rupture by Lindholm method. Materials and Methods: Between 2002 and 2006, we performed the reconstruction of the Achilles tendon by using of the gatrocnemius-sloeus fascia known as Lindholm method. Ten cases of ten patients were enrolled in this study (8 men and 2 women). The mean age of the patients at the time of operation was 49 years (range, 32${\sim}$66 years). The mean follow-up duration was 15.2 months (range, 12${\sim}$19 months). The retrospective review of the clinical history, physical examination, the American Orthopedic Foot and Ankle Society (AOFAS) score were conducted. Results: The mean AOFAS score before surgery was 74.10${\pm}$2.56 and that of the latest follow-up was 90.60${\pm}$5.72. The excellent results were six and good results were four patients. Eight patients were normal triceps power and the others were good. The average of heel to floor distance was 4.5 mm less in the operated legs than the contralateral ones in each patient, but there was no significant difference (p>0.05). The average of calf muscle circumference in the mid-leg was 7.5 mm less in the operated legs than the contralateral ones and there was significant difference (p<0.05). The active range of motion of the ankles, mean plantarflexion was 40 degrees and dorsiflexion was 16.8 degrees in operated side. The contralateral side was 43 degrees in plantarflexion and 19 degrees in dorsiflexion. No case showed rerupture of the reconstructed Achilles tendon. One patient had the superficial wound infection which was treated successfully by antibiotic therapy. Conclusion: It was suggested that the overall results of Lindholm method for the chronic Achilles tendon rupture indicated satisfactory outcomes.

• 지역사회간호학회지
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• 제7권1호
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• pp.170-177
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• 1996

신체의 활력을 측정하는 혈압은 다른 어느 측정치보다 변동이 심하고 정상적으로 변할 수 있는 생리적 현상이어서 정확하게 측정하기란 쉽지 않다. 1mmHg 차이의 혈압일지라도, 특히 큰 집단일 경우, 연구목적에서 그 결과를 크게 왜곡 시킬 수 있다. (Wright & dore, 1970). 혈압 측정에는 직접적 방법과 간접적 방법이 있다. 이 중 간접적 방법은 임상분야와 연구분야에서 실제로 넓게 사용되고 있을 분만 아니라 신체로의 직접적 침투하는 방법도 아니고 가격 또한 비싸지 않다. 그러나, 간접적 측정 방법은 혈압에 영향을 끼치는 많은 요인들인 관찰자 편견, 확장기음의 청취음 선택, 관찰자와 환자 사이의 상호관계 때문에 방법론적으로 문제제기가 되기도 한다. 이런 요인을 최소화하기 위하여 가장 타당도가 높은 측정도구의 선택이 필요하다. 도시지역의(Ease Baltimore) 고혈압을 가진 젊은 흑인 남성(연령별/성별/종속별/거주지역) 중 수축기 혈압이 140mmHg 이고 확장기 혈압이 90mmHg인 사람, 또는 확장기 혈압이 90mmHg인 사람, 또는 혈압하강제를 먹고 있는 사람 200명을 대상으로 훈련받은 community health worker(CHW)에 의해 Random-Zero Sphygmdmanometer(RZS)와 Digit Automatic Device(DAD)로 혈압을 측정하게 하였다. 이 중 36명을 무작위 추출하여 regular Mercury Sphygmdmanometer (RMS)로 혈압을 측정하게 했다. Bland 와 Altman에 의해 제기된 두측정값의 차이에 대한 scattergram(일치도 검증법)과 AAMI(Association for the Advancement of Medical Instrument) 기준, BHS 기준, Central Tendency와 숫자선호도로 검증되었다. AAMI와 BHS 기준에 의하면 확장기 혈압에서 RZS와 DAD의 일치도와 평균을 중심으로 더 넓게 퍼져있어 낮은 일치도를 보였으며 또 DAD와 RMS의 혈압치는 숫자 선호도를 볼 수 있는데 특히 RMS는 더 뚜렷하게 나타났는데 확장기 혈압의 최빈치(30.6)는 100mmHg이었다. 혈압치들이 가장 가까이 "0"점으로 치우쳐져 있었다. RZS의 Central tendency는 DAD와 RMS보다 뚜렷하였다. 결론적으로 RZS는 이 연구목적으로 가장 적절함을 보여준다.

• Clinics in Shoulder and Elbow
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• 제21권2호
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• pp.59-66
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• 2018

Background: Massive, irreparable rotator cuff tears (RCTs) are a challenging clinical problem in young patients. In recent years, arthroscopic superior capsular reconstruction (ASCR) is a popular treatment in the massive, irreparable RCTs. However, studies reporting clinical results of ASCR are rare in the literature. Methods: Between 2013 and 2015, six patients underwent ASCR. One patient treated with dermal allograft, while five patients with autogenous fascia lata graft. Demographic data, as well as preoperative and last follow-up clinical data including pain, range of motion (ROM), strength, American Shoulder and Elbow Surgeons system, the Constant system, the University of California at Los Angeles system, the Simple Shoulder Test, and the Shoulder Pain and Disability Index system were obtained. Acromiohumeral distances and Hamada classification were measured on standard anteroposterior x-ray. Results: All patients were men, and the average age was $59.5{\pm}4.18years$ (range, 53-65 years).The minimum follow-up was 18 months with a mean follow-up was $27.33{\pm}7.58months$ (range, 18-36). All patients had postoperative improvement in pain scores and functional scores. The ROM and strength did not improve after surgery. The Hamada score progressed of radiographic stage in 2 patients. In the case of dermal allograft, there was graft failure 6 weeks after ASCR. Conclusions: Our results support the ASCR as a viable treatment for surgical salvage in massive, irreparable RCTs. This treatment option may provide patients with decreased pain and increased function. And studying our case of dermal allograft failure provides opportunities to decrease graft failure in ASCR using dermal allograft.

• Clinics in Shoulder and Elbow
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• 제6권1호
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• pp.27-36
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• 2003

Antegrade interlocking intramedullary nailing (AIIN) for the humeral shaft fracture can induce shoulder pain and decrease of shoulder function postoperatively. The purpose of this study was to estimate the outcome of the shoulder functions after AIIN through the rotator interval between the subscapularis and the supraspinatus to decrease the shoulder pain. Out of consecutive 43 cases that underwent AIIN 42 had been followed for two years or more. Among them we analysized 40 cases of 39 Patients excluding two cases of Pathologic fractures. The average was 47 years. There were 17 men and 23 women. The average follow-up was 34 months. Open nailing was performed in 26 fractures and closed nailing in 14. Bone graft was done in 7 fractures with open nailing. With a single operation, all but two patients achieved osseous union. Average pain score with visual analog scale was one (range; 0∼4) postoperatively By the Neer's score 37 patients received a excellent or satisfactory results while 3 patients' unsatisfactory or failed results. By the functional score of ASES (American Shoulder and Elbow Society) 6 cases received the fair or poor results. Except three cases with persistent nerve palsy and one case of technique failure with protruded nail over humeral head, all patients could achieved satisfactory results with Neer's score and 35 cases (94%) satisfactory results with functional score of ASES. An insertion of antegrade nail to the rotator interval was recommended for better shoulder functions and less pain postoperatively.

• Journal of Preventive Medicine and Public Health
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• 제48권1호
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• pp.1-9
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• 2015

The purpose of the present review is to give an overview of the association between alcohol intake and the risk of developing cancer. Two large-scale expert reports; the World Cancer Research Fund (WCRF)/American Institute of Cancer Research (AICR) report from 2007, including its continuous update project, and the International Agency for Research of Cancer (IARC) monograph from 2012 have extensively reviewed this association in the last decade. We summarize and compare their findings, as well as relate these to the public health impact, with a particular focus on region-specific drinking patterns and disease tendencies. Our findings show that alcohol intake is strongly linked to the risk of developing cancers of the oral cavity, pharynx, larynx, oesophagus, colorectum (in men), and female breast. The two expert reports diverge on the evidence for an association with liver cancer and colorectal cancer in women, which the IARC grades as convincing, but the WCRF/AICR as probable. Despite these discrepancies, there does, however, not seem to be any doubt, that the Population Attributable Fraction of alcohol in relation to cancer is large. As alcohol intake varies largely worldwide, so does, however, also the Population Attributable Fractions, ranging from 10% in Europe to almost 0% in countries where alcohol use is banned. Given the World Health Organization's prediction, that alcohol intake is increasing, especially in low- and middle-income countries, and steadily high in high-income countries, the need for preventive efforts to curb the number of alcohol-related cancers seems growing, as well as the need for taking a region- and gender-specific approach in both future campaigns as well as future research. The review acknowledges the potential beneficial effects of small doses of alcohol in relation to ischaemic heart disease, but a discussion of this lies without the scope of the present study.

• 패션비즈니스
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• 제1권3호
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• pp.1-18
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• 1997

The purpose of this study is to investigate Modernism of Gabrielle Chanel in respect to her fashion business. Chanel always considered the work of a fashion designer 'a technique, a craft, a trade' and chastised couturiers who looked upon themselves as artists. She was the first to cater to the public in its broader sense and to produce standard which appealed to every taste, the first to democratize the art of dressmaking for purely economic reasons. The results were as follows; 1. Chanel personified ~his new spirit of independence and evolved a style of dress for the modern, liberated woman. 2. Chanel excelled at fabrics, their interpretation, and an ability to use them. She had taken a humble material, one that was used by men and that they had shunned, and turned it into a fashionable fabric. In the process she also accelerated the growth of the ready-to-wear industry for it was a fabric within the financial reach of the majority of woman who wanted to dress fashionably but were not well off. 3. Chanel thought black chic and would never go out of fashion. As American Vogue for 1 October 1926 prognosticated, her little black dress became a kind of uniform. 4. Chanel represented an exception among couturiers because she was flattered that her styles were so popular and widely copied. She believed that her style would be affirmed by high-street copies-after all, copying is the sincerest form of flattery. 5. Chanel changed the concept of costume jewellery. It was not an original idea of Chanel's. Whereas Poiret had pioneered the original idea of costume jewellery, it was Chanel's avant-garde way with it not to mention her usual deceptive simplicity and supreme artistry that made costume jewellery evolve a successful and lucrative part of the fashion industry.

• Physical Therapy Rehabilitation Science
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• 제3권1호
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• pp.69-75
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• 2014

Objective: We developed a Motor-Assisted Rowing Machine (MARM) for Spinal Cord Injury (SCI), by modification of the Concept II rowing machine, so that the seats could be operated automatically in a backward and forward direction by a motor. Design: Case report. Methods: Motor rowing consisted of a chair with inclination control, a motor system, control button, monitor, program, leg supporter, safety belt, and seat. The patients were 2 men rowing athletes with SCI, classified as American Spinal Injury Association class B, participated in the study. Level of thoracic injury ranged from T8 to T10. The subjects rowed at a self-selected stroke rate with 50 watts. Two different rowing methods (static rowing without movement of the seat, dynamic rowing using MARM) were assigned to each participant during 10 minutes; 34 reflective markers were attached to their full bodies. Kinematic data were collected using the Vicon motion analysis system. Based on the full body model provided as a default by the equipment. In the rowing exercise, the rowing motions were divided into Drive Phase and Recovery Phase. Results: The two rowing methods differ in handle range, seat range, handle and seat ratio, handle velocity, and seat velocity during static and dynamic rowing. The rowing exercise using a rowing machine developed MARM increased tendency to the range of motion in the dynamic method compared to the static method. Conclusions: The newly developed MARM could be a useful whole body exercise for people with SCI.