• 제목/요약/키워드: Poor-grade

검색결과 516건 처리시간 0.026초

동종건을 이용한 단일다발 및 이중다발 전방십자인대 재건술의 비교 분석 (Comparative Analysis of Double Bundle and Single Bundle ACL Reconstruction with Tibialis Anterior Allograft)

  • 김덕원;이강;김영우;양상진;서정국;김진구
    • 대한관절경학회지
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    • 제12권3호
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    • pp.198-204
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    • 2008
  • 목적: 본 연구의 목적은 동종건을 통한 단일다발 및 이중다발 전방십자인대 재건술의 수술 결과를 관절경적, 방사선학적, 임상적으로 비교 분석하여 이중 다발 재건술의 장점과 문제점을 분석하여 향후 개선점을 도출하는데 있다. 대상 및 방법: 동종건을 이용한 전방십자인대 재건술을 시행 받은 환자들 중 최소 1년 이상의 관찰이 가능하였던 27명의 환자를 대상으로 전후방 전위 정도, Pivot shift 검사, 사두박근 및 슬괵근의 등속성 최대우력, Tegner 활동 점수, IKDC 주관적 점수, 그리고 Lysholm 슬관절 점수를 측정하였고, 술후 1년에서 2년사이에 자기공명영상 및 2차 관절경 검사를 시행하였다. 결과: Lysholm 슬관절 검사는 평균값이 단일다발에서 $87.23{\pm}11.50$, 이중다발에서 $93.36{\pm}9.92$ (p=0.033), IKDC 주관적 검사는 단일다발에서 $80.55{\pm}12.96$, 이중다발에서 $85.91{\pm}13.78$ (p=0.105), Tegner 활동 검사는 단일다발에서 $5.23{\pm}1.36$, 이중다발에서 $6.64{\pm}2.21$ (p=0.048)이었다. Pivot shift검사상 단일다발에서 Grade 0 이 10예, 1+가 1예, 2+가 2예 있었으며, 이중다발에서 Grade 0이 13예, 2+가 1예 있었다. 60도 및 180도에서의 굴곡 및 신전 결손율은 단일다발과 이중다발사이에 통계학적으로 유의한 차이가 나타나지 않았다. 2차관절경 검사 시행상 단일다발에서 우수(excellent)가 6례, 그리고 보통(fair)이 7례 있었다. 이중다발에서는 전내측 다발은 우수가 13예, 보통이 1예, 후외측 다발에서는 우수가 4예, 보통이 9예, 불량이 1예로 후외측 다발이 전내측 다발보다 손상이 많은 것으로 나타났다. 결론: 이중다발 재건술은 젊고 활동적인 환자에게서 좋은 결과를 기대할 수 있는 수술적 방법이나 후외측 다발의 손상을 줄일 수 있는 수술 및 재활 방법의 개선을 요한다.

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생태평가모형(Integrative Star-Plot Area)을 이용한 삽교천 수계 진단 (Diagnosis of Sapkyo Stream Watershed Using the Approach of Integrative Star-Plot Area)

  • 김자현;염동혁;안광국
    • 생태와환경
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    • 제43권3호
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    • pp.356-368
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    • 2010
  • 본 연구는 삽교천 수계의 삽교천, 무한천, 곡교천의 이화학적 수질, 물리적 서식지 건강성, 생물학적 건강성을 평가하였고, 이를 바탕으로 종합적인 수생태계 건강성을 평가하였다. 3가지 건강성 평가 항목은 3개 하천에서 모두 악화된 상태이거나 보통 상태를 유지하고 있는 것으로 나타났고, 곡교천에서 가장 악화되어 있는 것으로 나타났다. 또한 상류에서 하류로 갈수록 건강성이 더 악화되는 경향을 보였다. 6개 항목의 화학적 수질 중 Chl-$\alpha$를 제외한 5개 수질 항목은 하류로 갈수록 증가하는 경향을 보였고, 곡교천에서 가장 높은 값을보였다. 물리적 서식지 건강성은 Good에서 Fair 범위를 보였고, 곡교천의 서식지 건강성이 가장 낮은 것으로 나타났다. 생물학적 건강성은 이화학적 수질과 물리적 서식지 건강도를 잘 반영하였으며, 3개 하천의 생물학적 건강도는 상류지점에서 Fair 상태로 나타났고, 하류 지점에서 Poor 상태를 보였다. 이러한 생물학적 건강성에 영향을 주는 요인을 PCA를 통하여 분석한 결과 상류 지점에서는 물리적 서식지 건강성이 좀더 영향을 주는 것으로 나타났고, 하류지점에서는 화학적수질의 영향이 좀 더 큰 젓으로 판단되었다. 화학적 수질, 물리적 서식지 건강성, 생물학적 건강성 평가 항목을 바탕으로 종합적인 수생태계 건강성을 평가한 결과 무한천의 M1 지점이 통합적인 건강성이 가장 높은 것으로 나타났으며, 곡교천의 G2와 G3 지점이 가장 건강성이 악화된 것으로 나타났다. 본 연구결과는 수생태계의 건강성을 통합적으로 나타내어 취약한 부분을 쉽게 확인할 수 있는 방법으로써 향후 수생태계 복원 및 장기 모니터링에 중요한 자료로 사용될 수 있을 것으로 사료된다.

Association of Histopathological Markers with Clinico-Pathological Factors in Mexican Women with Breast Cancer

  • Bandala, Cindy;De la Garza-Montano, Paloma;Cortes-Algara, Alfredo;Cruz-Lopez, Jaime;Dominguez-Rubio, Rene;Gonzalez-Lopez, Nelly Judith;Cardenas-Rodriguez, Noemi;Alfaro-Rodriguez, A;Salcedo, M;Floriano-Sanchez, E;Lara-Padilla, Eleazar
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8397-8403
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    • 2016
  • Background: Breast cancer (BCa) is the most common malignancy in Mexican women. A set of histopathological markers has been established to guide BCa diagnosis, prognosis and treatment. Nevertheless, in only a few Mexican health services, such as that of the Secretariat of National Defense (SEDENA for its acronym in Spanish), are these markers commonly employed for assessing BCa. The aim of this study was to explore the association of Ki67, TP53, HER2/neu, estrogenic receptors (ERs) and progesterone receptors (PRs) with BCa risk factors. Materials and Methods: Clinical histories provided background patient information. Immunohistochemical (IHC) analysis was conducted on 48 tissue samples from women diagnosed with BCa and treated with radical mastectomy. The Chi square test or Fisher exact test together with the Pearson and Spearman correlation were applied. Results: On average, patients were $58{\pm}10.4$ years old. It was most common to find invasive ductal carcinoma (95.8%), histological grade 3 (45.8%), with a poor Nottingham Prognostic Index (NPI; 80.4%). ERs and PRs were associated with smoking and alcohol consumption, metastasis at diagnosis and Ki67 expression (p<0.05). PR+ was also related to urea and ER+ (p<0.05). Ki67 was associated with TP53 and elevated triglycerides (p<0.05), and HER2/neu with ER+, the number of pregnancies and tumor size (p<0.05). TP53 was also associated with a poor NPI (p<0.05) and CD34 with smoking (p<0.05). The triple negative status (ER-/PR-/HER2/neu-) was related to smoking, alcohol consumption, exposure to biomass, number of pregnancies, metastasis and a poor NPI (p<0.05). Moreover, the luminal B subty was associated with histological type (p=0.007), tumor size (p=0.03) and high cholesterol (p=0.02). Conclusions: Ki67, TP53, HER2/neu, ER and PR proved to be related to several clinical and pathological factors. Hence, it is crucial to determine this IHC profile in women at risk for BCa. Certain associations require further study to understand physiological/biochemical/molecular processes.

Role of Nuclear Factor-κB in female Breast Cancer: A Study in Indian Patients

  • Jana, Debarshi;Das, Soumen;Sarkar, Diptendra Kumar;Mandal, Syamsundar;Maji, Abhiram;Mukhopadhyay, Madhumita
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5511-5515
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    • 2012
  • Introduction: The nuclear factor ${\kappa}B$ (NF-${\kappa}B$) is a super family of transcription factors which plays important roles in development and progression of cancer. The present investigation concerns NF-${\kappa}B$ /p65 activity in human breast cancers with overexpression of ER, PR, HER-2/neu, as well as the significance of p65 expression with regard to menopausal status, stage, grade, tumor size, nodal status, and NPI of invasive ductal carcinomas in Eastern India. Materials and Methods: In this hospital based study 57 breast cancer patients attending a Breast Clinic of a reputed institute of Eastern India were assessed for p65 protein expression in breast tumor tissue samples by Western blotting. ER, PR and HER-2/neu expression was determined by immunohistochemistry. Results: NF-${\kappa}B$/p65 was significantly associated with advanced stage, large tumor size (${\geq}5$ cm), high grade, negative ER, negative PR, and positive HER-2/neu. High NF-${\kappa}B$/p65 expression was more frequent in patients with a high NPI ($NPI{\geq}5.4$, 84.6%) compared with low NPI (<5.4, 44.4%) and this association was statistically significant (p = 0.002). Conclusion: NF-${\kappa}B$/p65 overexpression was associated with advanced stage, large tumor size, high grade, and high NPI which are poor prognostic factors linked to enhanced aggressiveness of the disease. NF-${\kappa}B$/p65 expression implies aggressive biological behavior of breast cancer and this study validates significant association of NF-${\kappa}B$ /p65 overexpression with negative estrogen and progesterone receptor status and overexpression of HER-2/neu oncoprotein. In our good clinical practice, patients with NF-${\kappa}B$ positive tumors need to be treated aggressively.

Clinicopathological and Prognostic Characteristics of Triple-Negative Breast Cancer (TNBC) in Chinese Patients: A Retrospective Study

  • Li, Chun-Yan;Zhang, Sheng;Zhang, Xiao-Bei;Wang, Pei;Hou, Guo-Fang;Zhang, Jin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3779-3784
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    • 2013
  • Aims: To determine the clinical, pathological and prognostic features associated with triple-negative breast cancer (TNBC). Methods: Clinical and histologic data of 21,749 breast cancer patients who were treated at Tianjin Medical University Cancer Institute and Hospital between July 2002 and December 2011 were collected. Patients were divided into two groups: those with TNBC and those with other types of breast cancer. Patients and tumor characteristics were compared between the two groups using the Chi-square test. The prognostic results of 9,823 patients in the study population were also analyzed to determine long-term survival rates in the two groups of breast cancer patients. Results: Among the breast cancer patients treated in our hospital between 2003 and 2011, 10.4%-13.5% of them had triple-negative breast cancers. Data analyses revealed significant differences in disease onset age, family history of breast cancer, tumor size, tumor histologic grade, lymph note positivity and metastatic status between TNBC and non-TNBC patients. There were also significant differences in 5-year, 7-year and 9-year disease-free and 7-year and 9-year overall survival probability between the groups. Conclusions:TNBC are associated with younger disease onset age, larger tumor size, higher rate of axillary lymph node positivity, and higher tumor histologic grade. TNBC is also related to family history of breast cancer, increased metastatic risk and poor prognosis.

조리전공 남자대학생의 아침식사 빈도에 따른 식생활과 외식형태 (Dietary Life and Eating-Out Style Related to Breakfast Frequency of Male-Students in Culinary College)

  • 김숙희;정경희;채병숙
    • 대한지역사회영양학회지
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    • 제12권1호
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    • pp.13-24
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    • 2007
  • This study was to investigate dietary life and eating-out style related to breakfast frequency of male students in culinary college. This survey was conducted using questionnaires for 110 male students at college in Hongseung. Mean height and body weight of those we investigated was 174 cm and 70.5 kg. The one to two times per week breakfast eating group was 34.55%, which is exceedingly numerous; none per week breakfast eating group was 30%; three to tow times per week breakfast eating group was 15.45%; everyday breakfast eating group was only 9.09%. The breakfast frequency was very low, and the not-eating breakfast problem is serious to think of in male college students. Mean weight, body fat and body mass index(BMI) of the everyday breakfast eating group was lower than the other group even it was not significant. The self-boarding house or dormitory living condition group was not eating breakfast was significant. So a correct dietary lift and eating habit should be taught further for male college students. The smoking group was a significant low frequency of breakfast eating, as well as the lower frequency of breakfast, or worse recognition of self health condition. Higher frequency of breakfast showed more contentment of self body weight. Cooked rice was significantly the most preferable for breakfast. The lower breakfast frequency tended to eat breads or cereals. The lower frequency of breakfast, self recognition of eating rate as speedier was significant, and tended to have a higher frequency of eating-out because of being annoyed by cooking. The lower breakfast frequency ate out more. Twenty five percent of the everyday breakfast eating group ate out because of a special day, and thirty five percent of the not eating breakfast group did so because of being annoyed by cooking. Their mean dietary evaluation grade was under the normal grade, which means that culinary college male students' dietary lives were poor. The lower frequency of breakfast and lower grade of food life evaluation, indicates the importance of nutritional breakfasts education should be improved for male culinary college students also.

추골동맥 및 분지부 동맥류의 치료결과 (Management Outcomes of Aneurysms of Vertebral Artery and its Branches)

  • 안재성;김준수;김정훈;권양;권병덕
    • Journal of Korean Neurosurgical Society
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    • 제30권1호
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    • pp.33-40
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    • 2001
  • Objective : Aneurysms of vertebral artery and its branches make up approximately 3% of all intracranial aneurysms. As the aneurysm have an intimate relationship with lower cranial nerves and medulla, surgical management of the aneurysms are one of the challenging neurosurgical problems. The authors analyzed the management outcomes for aneurysms arising from vertebral artery and its branches. Methods : At the authors' institution between May 1989 and Jan. 2000, 42 patients were treated with transcranial and endovascular surgery for aneurysms of vertebral artery and its branches. The medical records and neuroimaging studies of the patients were reviewed retrospectively. Results : Forty two patients were comprised of 28 female and 14 male patients aged from 26-80 year old(mean : 51.8). Of the 42 patients, 37 patients(88%) had subarachnoid hemorrhage. Of the 37 patients with subarachnoid hemorrahge, 35 patients(95%) were in good neurological status(Hunt Hess grade I-III), 2 patients(5%) in poor grade(H-H grade IV-V) before operation. Location of the aneurysm were 16 in vertebral artery, 12 in vertebro-PICA junction, and 14 in the peripheral PICA. Twenty nine patients were treated with transcranial surgery and 13 patients with endovascular surgery. The management outcome of the transcranial surgery was : Glasgow outcome scale(GOS) I and II ; 24, GOS III ; 2, GOS IV ; 1 and GOS V(death) ; 2. The causes of mortality related to transcranial surgery were rebleeding after failure in clipping in one and suspected brainstem infarct in one. Morbidity was attributed to vasospasm(3), lower CN palsy(7, including temporary dysfunction) and pseudomeningocele(1). The management outcome of the endovascular surgery was : Glasgow outcome scale(GOS) I-II ; 9, GOS III ; 1, GOS IV ; 1, and GOS V(death) ; 2. The causes of mortality related to endovascular surgery were sepsis from pneumonia(1) and vasospasm(1). There were one cerebellar infarct and one lateral medullary syndrome. Conclusion : Excellent and good surgical results can be expected in 80% of the patients with aneurysms of vertebral arery and its branches. The outcomes of endovascular surgery in treating vertebral artery aneurysm were satisfactory and endovascular surgery may offer a therapeutic alternative especially in vertebral dissecting aneurysm.

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The Outcomes of Concomitant Chemoradiotherapy Followed by Adjuvant Chemotherapy with Temozolomide for Newly Diagnosed High Grade Gliomas : The Preliminary Results of Single Center Prospective Study

  • Choi, Jung-Won;Lee, Min-Mi;Kim, In-Ah;Kim, Jee-Hyun;Choe, Ghee-Young;Kim, Chae-Yong
    • Journal of Korean Neurosurgical Society
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    • 제44권4호
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    • pp.222-227
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    • 2008
  • Objective : Malignant gliomas are the most common primary cerebral neoplasms in adults. Despite multimodality treatments, the prognosis for patients with malignant glioma remains poor. However, recently, the effectiveness of concomitant chemoradiotherapy (CCRT) with temozolomide (TMZ) has been reported. We report for the first time preliminary results of the treatment with CCRT of newly diagnosed malignant gliomas in Korean people. Methods : Thirty-two patients over the age of 17 years with newly diagnosed and histologically confirmed high-grade gliomas (HGG), from June 2004 to August 2007 were the subjects of this study. There were 17 men and 15 women, with a median age of 53.5 years (range, 17-74). Pathologically, glioblastoma, anaplastic astrocytoma, anaplastic oligodendroglioma, and gliomatosis cerebri had been diagnosed in eighteen, eight, four, and two patients, respectively. These 32 patients were treated with CCRT with TMZ. Results : The median follow-up period was 12.5 months (range 3-48). At the time of this analysis, 13 patients died and three patients had been lost to follow-up. There was no mortality caused by drug toxicity. The median progression-free survival (PFS) of these patients was 9.0 months, and the six-month PFS rate was 72.4%. The median overall survival (OS) was 26 months, and the one-year OS rate was 83.6%. The 18 patients with glioblastoma were analyzed separately from the other patients with HGG, and the median OS was 18 months, and the one-year OS rates were 81.8%. The median PFS was seven months, and the six-month PFS rate was 75.0%. Conclusion : Our results are consistent with many other reports, confirming that CCRT with TMZ achieves good clinical outcomes in the treatment of HGG. Therefore, we suggest that CCRT with TMZ as adjuvant chemotherapy be considered as a standard therapy for patients with HGG.

아동의 전정-고유감각 중심의 감각통합중재 효과에 대한 체계적 고찰: 국내연구를 중심으로 (A Systematic Review of Effects on Sensory Integration Intervention Based on Vestibular-Proprioceptive System for Children in Korea)

  • 박영주;공인주
    • 대한감각통합치료학회지
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    • 제13권2호
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    • pp.53-61
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    • 2015
  • 목적 : 아동을 대상으로 국내에서 실시하는 전정-고유감각 중심의 감각통합중재의 효과를 알아보기 위해 체계적 고찰을 사용하여 근거를 제시하고자 하였다. 연구방법 : 본 연구는 2015년 8~9월 동안 한국학술정보(KISS), 학술연구정보서비스(RISS), 누리미디어(DBpia)의 데이터베이스에서 '감각통합중재', '감각통합치료', '전정-고유감각'을 키워드로 검색하여 최종적으로 7개의 연구를 선정하였다. 각 연구는 근거의 질적 수준과 방법론적 질적 수준으로 분석하였고 그 결과는 연구 설계와 대상자, 중재, 결과측정, 결과에 따라 분석하였다. 결과 : 분석에 포함된 연구의 근거수준은 수준 III이 5개, 수준 IV가 1개, 그리고 수준 V가 1개이었다. Down과 Black의 기준에 따라 대상 연구의 방법론적 질을 살펴보면, '완벽'과 '우수'는 0개, '보통'은 2개, '나쁨'은 5개이었다. 발달지연을 대상으로 한 단일대상연구가 가장 많았고 결과측정은 운동영역에 대한 평가요소 빈도가 가장 높았으며 결과는 평가영역에 대한 긍정적인 향상이나 긍정적인 감소를 보였다. 결론 : 국내 전정-고유감각 중심의 감각통합중재의 특징을 제시하여 관련 분야 전문가들이 이에 대한 정보를 활용할 수 있도록 도움을 주고자 하였다. 앞으로 감각통합 중재에 대해 높은 근거 수준과 다양한 실험설계를 바탕으로 한 연구가 필요하다.

Efficacy and Tolerance of Pegaspargase-Based Chemotherapy in Patients with Nasal-Type Extranodal NK/T-Cell Lymphoma: a Pilot Study

  • Wen, Jing-Yun;Li, Mai;Li, Xing;Chen, Jie;Lin, Qu;Ma, Xiao-Kun;Dong, Min;Wei, Li;Chen, Zhan-Hong;Wu, Xiang-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권15호
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    • pp.6275-6281
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    • 2014
  • Nasal-type extranodal natural killer (NK)/T-cell lymphoma (ENKL) is a highly invasive cancer with a poor prognosis. More effective and safer treatment regimens for ENKL are needed. Pegaspargase (PEG-Asp) has a similar mechanism of action to L-asparaginase (L-Asp), but presents lower antigenicity. The aim of the present research was to evaluate the safety profile and the latent efficacy of a PEG-Asp-based treatment regimen in patients with ENKL. Data collected from 20 patients with histologically confirmed ENKL, admitted to the Third Affiliated Hospital of Sun Yat-Sen University from January 2009 to August 2013, were included in the study. All patients received $2500IU/m^2$/IM PEG-Asp on day 1 of every 21-day treatment cycle. Patients received combination chemotherapy with CHOP (n=5), EPOCH (n=7), GEMOX (n=7) or CHOP with bleomycin (n=1). After 2-5 treatment cycles (median, 4 cycles) of PEG-Asp-based chemotherapy, five patients (25%) showed a complete response (CR), and the overall response rate (ORR) was 60%. Grade 3/4 neutropenia occurred in fourteen patients (70%). Grade 3 alanine aminotransferase (ALT) elevation was observed in two. Grade 1-2 non-hematological toxicity consisted of activated partial thromboplastin time (APTT) elongation (n=9), hypofibrinogenemia (n=6), hypoproteinemia (n=17), hyperglycemia (n=3), and nausea (n=6). No allergic reactions were detected. No treatment related death was reported. Our results suggested that PEG-Asp-based chemotherapy presented an acceptable tolerance and a potential short-term outcome in patients with nasal-type ENKL.