• 한국컴퓨터정보학회논문지
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• 제24권9호
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• pp.103-108
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• 2019

The purpose of this study is to identify the factors that may affect the 5-year survival of colon cancer through network model and to use it as a clinical decision supporting system for colorectal cancer patients. This study was conducted using data from 2,540 patients who underwent colorectal cancer surgery from 1996 to 2018. Eleven factors related to survival of colorectal cancer were selected by consulting medical experts and previous studies. Analysis was proceeded from the data sorted out into 1,839 patients excluding missing values and outliers. Logistic regression analysis showed that age, BMI, and heart disease were statistically significant in order to identify factors affecting 5-year survival of colorectal cancer. Additionally, a correlation analysis was carried out age, BMI, heart disease, diabetes, and other diseases were correlated with 5-year survival of colorectal cancer. Sex was related with BMI, lung disease, and liver disease. Age was associated with heart disease, heart disease, hypertension, diabetes, and other diseases, and BMI with hypertension, diabetes, and other diseases. Heart disease was associated with hypertension, diabetes, hypertension, diabetes, and other diseases. In addition, diabetes and kidney disease were associated. In the correlation analysis, the network model was constructed with the Network Correlation Coefficient less than p <0.001 as the weight. The network model showed that factors directly affecting survival were age, BMI levels, heart disease, and indirectly influencing factors were diabetes, high blood pressure, liver disease and other diseases. If the network model is used as an assistant indicator for the treatment of colorectal cancer, it could contribute to increasing the survival rate of patients.

• Childhood Kidney Diseases
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• 제23권2호
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• pp.59-66
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• 2019

Background: Primary hyperoxaluria (PH), a rare inborn error of glyoxylate meta bolism causing overproduction of oxalate, is classified into three genetic subgroups: type 1-3 (PH1-PH3) caused by AGXT, GRHPR, and HOGA1 gene mutations, respectively. We performed a retrospective case series study of Korean pediatric patients with PH. Methods: In total, 11 unrelated pediatric patients were recruited and their phenotypes and genotypes were analyzed by a retrospective review of their medical records. Results: Mutational analyses revealed biallelic AGXT mutations (PH1) in nine patients and a single heterozygous GRHPR and HOGA1 mutation in one patient each. The c.33dupC was the most common AGXT mutation with an allelic frequency of 44%. The median age of onset was 3 months (range, 2 months-3 years), and eight patients with PH1 presented with end stage renal disease (ESRD). Patients with two truncating mutations showed an earlier age of onset and more frequent retinal involvement than patients with one truncating mutation. Among eight PH1 patients presenting with ESRD, five patients were treated with intensive dialysis followed by liver transplantation (n=5) with/without subsequent kidney transplantation (n=3). Conclusion: Most patients presented with severe infantile forms of PH. Patients with two truncating mutations displayed more severe phenotypes than those of patients with one truncating mutation. Sequential liver and kidney transplantation was adopted for PH1 patients presenting with ESRD. A larger nation-wide multicenter study is needed to confirm the genotype-phenotype correlations and outcomes of organ transplantation.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.381-385
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• 2015

Background:Hepatocellular carcinoma (HCC) is the second most common malignancy in Egypt. Data mining is a method of predictive analysis which can explore tremendous volumes of information to discover hidden patterns and relationships. Our aim here was to develop a non-invasive algorithm for prediction of HCC. Such an algorithm should be economical, reliable, easy to apply and acceptable by domain experts. Methods: This cross-sectional study enrolled 315 patients with hepatitis C virus (HCV) related chronic liver disease (CLD); 135 HCC, 116 cirrhotic patients without HCC and 64 patients with chronic hepatitis C. Using data mining analysis, we constructed a decision tree learning algorithm to predict HCC. Results: The decision tree algorithm was able to predict HCC with recall (sensitivity) of 83.5% and precession (specificity) of 83.3% using only routine data. The correctly classified instances were 259 (82.2%), and the incorrectly classified instances were 56 (17.8%). Out of 29 attributes, serum alpha fetoprotein (AFP), with an optimal cutoff value of ${\geq}50.3ng/ml$ was selected as the best predictor of HCC. To a lesser extent, male sex, presence of cirrhosis, AST>64U/L, and ascites were variables associated with HCC. Conclusion: Data mining analysis allows discovery of hidden patterns and enables the development of models to predict HCC, utilizing routine data as an alternative to CT and liver biopsy. This study has highlighted a new cutoff for AFP (${\geq}50.3ng/ml$). Presence of a score of >2 risk variables (out of 5) can successfully predict HCC with a sensitivity of 96% and specificity of 82%.

• 대한한방내과학회지
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• 제27권4호
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• pp.999-1006
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• 2006

Objectives:The purpose of this study was to examine the efficacy of SosihohapYukmijihwang-tang on seven patients with biochemical abnormality of the liver. Methods: SosihohapYukmijihwang-tangwas administered to patients for over 10 days continuously. Tests of their AST, ALT, r-GTP, ALP were taken before and after taking medicine. Results: Through this method, we found a positive effect of taking this herbal medicine on biochemical abnormality of the liver. Conclusions: The results suggest that taking this herbal medicine not only reduces hepatotoxicity, but also improves liver function. We need more study about this.

• 대한유전성대사질환학회지
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• 제14권1호
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• pp.42-47
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• 2014

Gaucher disease is a multisystemic disorder arising from a deficient activity of the lysosomal enzyme glucocerebrosidase, which leads to accumulation of glycosylceraide and other glycolipids in the regiculoendothelial system. The characteristics of Gaucher disease are anemia, thrombocytopenia, hepatosplenomegaly, and skeletal disease. Enzyme replacement therapy (ERT) has been proven to prevent progressive manifestations of Gaucher disease and effective in improving anemia, thrombocytopenia, bone markers and biomarkers. However, some patient needs still remain unmet because of the inaccessibility of certain sites including brain, bone and various organs. ERT could not Improve the irreversible lesion such as liver fibrosis, hepatopulmonary syndrome, and necrosis or infarction of bone and other organs. Adult patients with Gaucher disease should be screened for longterm complication such as bone disease, pulmonary hypertension, gallstone, and cancer, especially in patients with splenectomy. Parkinsonism and polyneuropathy was also reported among patients with type 1 Gaucher disease, but ERT does not improve neurological function. We need to review the benefits and unmet needs of ERT in Gaucher disease.

• Korean Journal of Radiology
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• 제24권3호
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• pp.190-203
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• 2023

Objective: We aimed to assess and validate the radiologic and clinical factors that were associated with recurrence and survival after curative surgery for heterogeneous targetoid primary liver malignancies in patients with chronic liver disease and to develop scoring systems for risk stratification. Materials and Methods: This multicenter retrospective study included 197 consecutive patients with chronic liver disease who had a single targetoid primary liver malignancy (142 hepatocellular carcinomas, 37 cholangiocarcinomas, 17 combined hepatocellular carcinoma-cholangiocarcinomas, and one neuroendocrine carcinoma) identified on preoperative gadoxetic acid-enhanced MRI and subsequently surgically removed between 2010 and 2017. Of these, 120 patients constituted the development cohort, and 77 patients from separate institution served as an external validation cohort. Factors associated with recurrence-free survival (RFS) and overall survival (OS) were identified using a Cox proportional hazards analysis, and risk scores were developed. The discriminatory power of the risk scores in the external validation cohort was evaluated using the Harrell C-index. The Kaplan-Meier curves were used to estimate RFS and OS for the different risk-score groups. Results: In RFS model 1, which eliminated features exclusively accessible on the hepatobiliary phase (HBP), tumor size of 2-5 cm or > 5 cm, and thin-rim arterial phase hyperenhancement (APHE) were included. In RFS model 2, tumors with a size of > 5 cm, tumor in vein (TIV), and HBP hypointense nodules without APHE were included. The OS model included a tumor size of > 5 cm, thin-rim APHE, TIV, and tumor vascular involvement other than TIV. The risk scores of the models showed good discriminatory performance in the external validation set (C-index, 0.62-0.76). The scoring system categorized the patients into three risk groups: favorable, intermediate, and poor, each with a distinct survival outcome (all log-rank p < 0.05). Conclusion: Risk scores based on rim arterial enhancement pattern, tumor size, HBP findings, and radiologic vascular invasion status may help predict postoperative RFS and OS in patients with targetoid primary liver malignancies.

• Journal of Nutrition and Health
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• 제26권9호
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• pp.1049-1070
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• 1993

The purpose of this study is to investigate dietary factors which influence the conditions of Korean fatty liver patients. The subjects were 83 fatty liver patients living in city, ages of 10 to 60 yrs old, and they were the same patients studied 9 months ago in previous study. The patients were groupsed into 3 groups(improved, similar, worsened groups) according to the changes in disease condition. Nutrient and alcohol intakes and health status were investigated. In improved group, the patients tended to lose weight, the number of exercising patients was increased, the consumptions of calorie, carbohydrate, calcium, phosphorus were decreased. And alcohol intake was decreased markedly and serum total amino acids(AA), EAA, NEAA, BCAA and AMAA contents, EAA/NEAA and BCAA/AMAA ratios were increased. In worsened group, patients tended to gain weight, the number of exercising patients decreased, the consumptions of calorie, protein, carbohydrate, calcium, phosphorus and niacin decreased but vitamin. A intake increased. And also, in this group, alcohol intake of male patients decreased and that of female slightly increased, and serum EAA, BCAA and AMAA contents, EAA/NEAA and BCAA/AMAA ratios, and total fatty acid contents increased and total AA and NEAA contents decreased. In conclusion, it is desirable to reduced weight, stress, alcohol, salt and animal fat consumptions, and to exercise, and to take adequate amount and quality of protein to improve conditions of fatty liver patients.

• 대한간호학회지
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• 제15권1호
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• pp.30-43
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• 1985

Liver cirrhosis is the common cause of death in Korea today. But, if liver cirrhosis Patients were treated in the early stage of the disease Process, they can have a chance to carry their daily lives with prescribed medical and nursing regimens. Each patient has different health beliefs that there is a different Sick Role Behavior in the process of treatment. In order to increase and control the desired patient's Sick Role Behavior, it is important for nurses to understand the health beliefs influencing Sick Role Behavior. The purpose of this study was to determine factors influencing Sick Role Behavior and provide objective and scientific data to health education, treatment and nursing care. The subjects for this study were 80 Liver Cirrhosis patients selected from in and out patients of the medical department of four University Hospitals in Seoul, Won Joo and Mok Po city. Data was collected from Sep. 18, to Oct. 15, 1984. The measurement tool was the questionaire that developed by the investigator from the literature review based on Health Belief Model. The data Collection was done by interview. Analysis of data was done by use Mean, S.D., ANOVA, Pearson Correlation Coefficient and Stepwise Multiple Regression. The result of study were as follows: 1. The significant influencing variables on the Liver Cirrhosis Patient's Sick Role Behavior in general characteristics were Sex, Marital Status, Educational levels, Family's income and Duration after diagnosis. 2. Between the Sick Role Behavior and Health Belief Model, a) The first hypothesis that the stronger degree of Health Motivation, the higher degree of Liver Cirrhosis Patient's Sick Hole Behavior was supported (r=0.7892, p=0.0000). b) The second hypothesis that the higher degree of perceived susceptibility, the higher degree of Liver Cirrhosis Patients' Sick Role Behavior was supported (r=0.6383, p=0.0000) c) The third hypothesis that the higher degree of perceived severity, the higher degree of Liver Cirrhosis Patients' Sick Role Behavior was supported (r=0.5869, p=0.0000). d) The fourth hypothesis that the higher degree of perceived benefit, the higher degree of Liver Cirrhosis patient's Sick Role Behavior was supported (r=0.7535, p=0.0000). e) The fifth hypothesis that the lower degree of perceived barrier, the higher degree of Liver Cirrhosis Patient's Sick Role Behavior was supported(r=-9.7709, p=0.0000) f) The sixth hypothesis that the higher degree of knowledge in Disease, the higher degree of Liver Cirrhosis patients'lck Role Behavior was supported (r=0.7538, p=0.0000), g) In the correlation among variables, it was found positive correlation except that perceived barrier was negatively correlated. In the Stepwise Multiple Regression and Independent Variables, the factor“Health Motivation”could account for Sick Role Behavior in 62.28% of the Sample (F=128. 786, p<0.01). When the factor“perceived barrier”is added to this, it account for 70.38% of Sick Role Behavior (F=93.479, p <0.01) and the factor“knowledge in disease”is also included, it account for 74.78% of Sick Role Behavior (F=75.131, p <0.01). Finally, when the factor“perceived susceptibility”is included, it account for 75.03% of Sick Role Behavior (F=56.329, p <0.01).

• Journal of Yeungnam Medical Science
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• 제14권1호
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• pp.155-167
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• 1997

본 연구는, HBV의 증식 및 감염력을 파악하는데 가장 중요한 표지자로 알려진 HBV DNA를 최근 임상에서 많이 이용되고 있는 PCR법을 사용해 검출함으로써 기존의 dot blot법과 PCR법을 비교하고, 만성 간질환 환자에서 HBV의 e항원, 항체체계에 따른 HBV DNA의 검출율을 PCR법을 이용하여 알아봄으로써 HBV의 증식 및 감염력을 파악하고자 무증상 HBsAg 보유자 17명(HBeAg 양성 9명, anti-HBe 양성 8명), 만성 B형 간염 환자 91명(HBeAg 양성 50명, anti-HBe 양성 41명), 간경변증 한자 57명(HBeAg 양성 21명, anti-HBe 양성 36명), 원발성 간세포암 환자 27명(HBeAg 양성 10명, anti­HBe 양성 17명)을 대상으로 HBV DNA의 검출빈도를 조사하여 다음과 같은 결과를 얻었다. Dot blot법의 경우 HBeAg 양성인 환자군, anti-HBe 양성인 환자군에서의 HBV DNA의 검출율은 각각 58.9%, 34.3% 이었고, PCR법에 의한 검출율은 상기군에서 각각 72.2%, 53.9%였다. HBeAg 음성인군에서의 PCR법에 의한 HBV DNA 검출율은 무증상 HBsAg 보유자의 경우 25.0%, 만성 B형 간염 환자군의 경우 61.0%, 간병변증 환자군의 경우 52.8%, 원발성 간세포암 환자군의 경우 52.9%였다. 무증상 HBsAg 보유자에서 HBeAg 양성인 군과 음성인 군간의 HBV DNA 검출율은 각각 77.8%, 25.0%로 유의한 차이가 있었으나, 나머지 군에서는 HBeAg 양성인 군과 음성인 군간의 HBV DNA 검출율의 유의한 차이는 없었다. 이상의 결과로 PCR을 이용할 경우 기존의 dot blot보다 훨씬 예민하게 HBV DNA를 검출할 수 있고, HBsAg 양성인 만성 간질환 환자의 대부분에서는 HBeAg 및 anti-HBe 표식자 체계와는 무관하게 바이러스의 증식이 지속되고 있음을 알 수 있었으며, PCR법이 무증상 HBsAg 보유자의 예후를 알 수 있는 지표로서 유용성에 대한 가능성을 의미하나 확실한 의의를 알기 위하여 전향적인 연구가 필요할 것으로 사료된다.

• Korean Journal of Radiology
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• 제23권12호
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• pp.1269-1280
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• 2022

Objective: This study aimed to evaluate the usefulness of quantitative indices obtained from deep learning analysis of gadoxetic acid-enhanced hepatobiliary phase (HBP) MRI and their longitudinal changes in predicting decompensation and death in patients with advanced chronic liver disease (ACLD). Materials and Methods: We included patients who underwent baseline and 1-year follow-up MRI from a prospective cohort that underwent gadoxetic acid-enhanced MRI for hepatocellular carcinoma surveillance between November 2011 and August 2012 at a tertiary medical center. Baseline liver condition was categorized as non-ACLD, compensated ACLD, and decompensated ACLD. The liver-to-spleen signal intensity ratio (LS-SIR) and liver-to-spleen volume ratio (LS-VR) were automatically measured on the HBP images using a deep learning algorithm, and their percentage changes at the 1-year follow-up (ΔLS-SIR and ΔLS-VR) were calculated. The associations of the MRI indices with hepatic decompensation and a composite endpoint of liver-related death or transplantation were evaluated using a competing risk analysis with multivariable Fine and Gray regression models, including baseline parameters alone and both baseline and follow-up parameters. Results: Our study included 280 patients (153 male; mean age ± standard deviation, 57 ± 7.95 years) with non-ACLD, compensated ACLD, and decompensated ACLD in 32, 186, and 62 patients, respectively. Patients were followed for 11-117 months (median, 104 months). In patients with compensated ACLD, baseline LS-SIR (sub-distribution hazard ratio [sHR], 0.81; p = 0.034) and LS-VR (sHR, 0.71; p = 0.01) were independently associated with hepatic decompensation. The ΔLS-VR (sHR, 0.54; p = 0.002) was predictive of hepatic decompensation after adjusting for baseline variables. ΔLS-VR was an independent predictor of liver-related death or transplantation in patients with compensated ACLD (sHR, 0.46; p = 0.026) and decompensated ACLD (sHR, 0.61; p = 0.023). Conclusion: MRI indices automatically derived from the deep learning analysis of gadoxetic acid-enhanced HBP MRI can be used as prognostic markers in patients with ACLD.