• 대한정형외과스포츠의학회:학술대회논문집
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• 2003.11a
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• pp.44-57
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• 2003

1) Choice of graft selection : depends on surgeon's philosophy & experience, tissue availability(anatomical anomalies, prior surgery or injury) & patient activity level & desiers. patients - educated as to potential advantage & disadvantages of each choice available to them. No one graft has been shown to be overwhelmingly superior to another. 2) High demand individual (cutting, pivoting, jumping sports, skiing) - BPTB graft choice Lower demand or older individuals - hamstring reconstruction Allograft : older individuals(45 years old) sign of arthritis(compelling evidence of instability) individual who do not want their own tissue Prosthetic ligaments - long term results : disappointing

• Radiation Oncology Journal
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• v.8 no.2
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• pp.183-188
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• 1990

Between January 197l and December 1987, 113 patients with nasopharyngeal cancer (NPC) were treated by radiation therapy with or without chemotherapy in the department of Radiation Oncology, Yonsei University Hospital. There were 19 patients under thirty years of age. The histology was undifferentiated carcinoma in $68\%$ of the younger patients as compared to $47\%$ of the older patients. Sex, stage, initial symptoms and treatment modalities differed little from those of older patients. In younger patients, the initial complete response rate was $79\%$ as compared to older patients with $54\%$, distant metastases were more common and the overall five year survival rate was not significantly different between the two age groups ($33.7\%$ for the young vs. $37.4\%$ for the old). The five year survival rates for stage III and IV were $60.0\%$ and $24.5\%$, respectively. Histologic subtype was not correlated with survival. The best survival was found only in patients who obtained a complete clearance of disease after radiation therapy.

• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.533-541
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• 1999

Background: Lung cancer in younger patients seems to be a more aggressive disease and their prognosis may be worse than that of older patients. Abnormal p53 expression in primary lung cancer may be an independent prognostic factor for poor prognosis. This study was conducted to determine the difference of abnormal p53 mutation in patients with primary non-small cell lung cancer (NSCLC) under 45 years of age and 55 years old or greater. Method: The present study was performed to compare the clinical and pathological features of primary NSCLC between patients younger than 45 years old and older than 55 years old and to evaluate the difference of abnormal p53 mutation between two groups. Immunohistochemical detection of abnormal p53 mutation was assessed in all primary NSCLC specimens by pathologist. Results: Positive nuclear staining of p53 mutation was found in 76.0% of younger patients and in 76.9% of older patients with variable intensity of staining. And there was no significant correlation between abnormal p53 mutation according to the disease stage or histologic subtype. Conclusion: In this investigation, these were no difference in p53 mutation between two groups.

• Tuberculosis and Respiratory Diseases
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• v.79 no.4
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• pp.274-281
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• 2016

Background: Factors associated with the prognosis of patients with small cell lung cancer (SCLC) is relatively unknown, than of those with non-small cell lung cancer. This study was undertaken to identify the prognostic factors of SCLC. Methods: The medical records of 333 patients diagnosed with SCLC at tertiary hospital from January 1, 2008, to December 31, 2012 were retrospectively reviewed. Patients were categorized by age (${\leq}65$ years vs. >65 years) and by extent of disease (limited disease [LD] vs extensive disease [ED]). Overall survival and progression free survival rates were determined. Factors associated with prognosis were calculated using Cox's proportional hazard regression model. Results: Most baseline characteristics were similar in the LD and ED groups. Eastern Cooperative Oncology Group (ECOG) performance status (PS), first chemotherapy regimen, and prophylactic cranial irradiation (PCI) differed significantly in patients with LD and ED. Mean ECOG PS was significantly lower (p<0.001), first-line chemotherapy with etoposide-cisplatin was more frequent than with etoposide-carboplatin (p<0.001), and PCI was performed more frequently (p=0.019) in LD-SCLC than in ED-SCLC. Prognosis in the LD group was better in younger (${\leq}65$ years) than in older (>65 years) patients, but prognosis in the ED group was unrelated to age. Conclusion: This study showed that overall survival (OS) was significantly improved in younger than in older patients with LD-SCLC. Univariate and multivariate analyses showed that age, PCI and the sum of cycles were significant predictors of OS in patients with LD-SCLC. However, prognosis in the ED group was unrelated to age.

• Journal of Korean Neurosurgical Society
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• v.49 no.2
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• pp.92-96
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• 2011

Objective : We retrospectively evaluated the prognostic factors that can influence long-term survival in patients who suffered acute large cerebral infarction. Methods : Between June 2003 and October 2008, a total of 178 patients were diagnosed with a large cerebral infarction, and, among them, 122 patients were alive one month after the onset of stroke. We investigated the multiple factors that might have influenced the life expectancies of these 122 patients. Results : The mean age of the patients was $70{\pm}13.4$ years and the mean survival was $41.7{\pm}2.8$ months. The mean survival of the poor functional outcome group ($mRS{\geq}4$) was $33.9{\pm}3.3$ months, whereas that of the good functional outcome group ($mRS{\leq}3$) was $58.6{\pm}2.6$ months (p value=0.000). The mean survival of the older patients (270 years) was $29.7{\pm}3.4$ months, whereas that of the younger patients (<70 years) was much better as $58.9{\pm}3.2$ months (p value=0.000). Involvement of ACA or PCA territory in MCA infarction is also a poor prognostic factor (p value=0.021). But, other factors that are also known as significant predictors of poor survival (male gender, hypertension, heart failure, atrial fibrillation, diabetes mellitus, a previous history of stroke, smoking, and dyslipidemia) did not significantly influence the mean survival time in the current study. Conclusion : Age (older versus younger than 70 years old) and functional outcome at one month could be critical prognostic factors for survival after acute large cerebral infarction. Involvement of ACA or PCA territory is also an important poor prognostic factor in patients with MCA territorial infarction.

• Journal of Gastric Cancer
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• v.16 no.4
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• pp.215-220
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• 2016

Purpose: This study aimed to evaluate the rate, patterns, and risk factors associated with tumor recurrence in patients with T1N0 gastric cancer. Materials and Methods: The medical records of 8,753 patients with pathological T1N0M0 gastric cancer who underwent gastrectomy between 1994 and 2014 at Sungkyunkwan University School of Medicine were examined. Results: Among the 8,753 patients, 95 patients (1.1%) experienced tumor recurrence; this included 31 remnant, 27 hematogenous, 9 lymph nodal, 5 peritoneal, and 23 multiple-site recurrences. When patients were divided into two groups according to the presence of tumor recurrence, the following characteristics were higher in the recurrence group than in the non-recurrence group: older age (${\geq}65years$), male gender, undifferentiated histology, submucosal invasion, and venous invasion. In multivariate analysis, older age, male gender, tumor depth (sm2 and sm3 invasion), and venous invasion were independent risk factors for tumor recurrence. The recurrence rates were 0.7% in patients with less than two risk factors, 1.7% in those with two risk factors, 3.0% in those with three risk factors, and 6.3% in those with four risk factors (P<0.001). Conclusions: Although tumor recurrence is rare in pT1N0M0 gastric cancer, some patients with certain risk factors demonstrate an increased rate of tumor recurrence. Careful follow-up is required for patients with three or four risk factors.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6339-6342
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• 2014

Background: The incidence of rectal cancer is increasing in younger age groups. Limited data is available regarding survival outcome in younger patients with conflicting results from western world. The goal of this study was to determine survival in patients with rectal cancer <30 years of age and compare it with their older counterparts in the Pakistani population. Materials and Methods: A retrospective chart review of patients operated for rectal adenocarcinoma between January 2005 and December 2010 was performed. Patients were divided into two groups, Group 1 aged ${\leq}30years$ and Group 2 aged >30years. Patient characteristics, surgical procedure, histopathological details and number of loco-regional and distant failures were compared. Expected 5 year survival was calculated using Kaplan Meier curves and significance was determined using the Log rank test. Results: There were 38 patients in group 1 and 144 in group 2. A significantly high number of younger patients presented with poorly differentiated histology (44.7% vs 9.7%) (p=0.0001) and advanced pathological stage (63.1% vs 38.1%) (p=0.04). Predicted overall 5 year survival was 38% versus 57% in groups I and II, respectively (p=0.05). Disease free survival was 37% versus 52% and was significantly different (p=0.007). Conclusions: Early onset rectal cancer is associated with poor pathological features and a worse outcome in Pakistani population.

• Healthcare Informatics Research
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• v.24 no.4
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• pp.346-358
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• 2018

Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

• Journal of Gastric Cancer
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• v.19 no.2
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• pp.202-211
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• 2019

Purpose: Poor physiological reserve for withstanding major cancer surgery in older adults is an important concern in the selection of patients for oncologic gastrectomy. The present study aimed to analyze mortality patterns among patients who underwent gastrectomy for cancer according to age groups. The primary outcomes of this study were early- and middleterm results: 30-day and 3-, 6-, 12-, and 36-month mortality rates. Materials and Methods: A retrospective review of 288 patients who underwent surgical resection for gastric cancer in two centers was carried out. Patients were stratified into four groups according to age: 29-50 years (group I, n=27), 51-65 years (group II, n=117), 66-75 years (group III, n=81), and 76-92 years (group IV, n=58). Statistical calculations focused on the differences in the survival rates between groups I and II as well as between groups II and IV. Results: The middle-aged patients (group II) had significantly better 3-year survival than either the youngest (group I) or the oldest patients (group IV). The 6-month mortality rates were 16.9% in group III and 29.3% in group IV. Two-thirds of the patients from groups III and IV who died between 2 and 6 months after surgery had an uneventful postoperative course. Conclusions: Age is an important prognostic factor of middle-term survival after gastrectomy for cancer. Geriatric assessment and better patient selection for major surgery for cancer are required to improve the outcome of gastrectomy for cancer in patients aged over 75 years.

• Korean Journal of Health Education and Promotion
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• v.19 no.2
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• pp.127-138
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• 2002

Objective: This prospective survey assessed factors associated with influenza vaccination behaviors among high-risk adults. Methods: 106 patients aged 65 or high risk for complications of influenza were interviewed to identify influencing factors to vaccination. Six potential consequences of Influenza infection and nine factors of vaccination were analysed between compliance and non-compliance groups. Results: Among the 106 patients, the vaccination rate was 62.3%. The rate of the group under the sixties was 37.0010, but the rate over the sixties was 88.5%. Factors in dependently associated with both influenza vaccination behaviors included older age, chronic disease, and especially, related to factors in older age were having positive attitudes toward immunization, perceived severity of infection and willingness to comply with the provider's recommendation. Conclusions: Emphasis on provider recommendations and the knowledge and attitudes of influenza infection and vaccination may enhance influenza vaccination rates in the organized vaccination programs.