• 대한두경부종양학회지
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• 제23권1호
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• pp.26-31
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• 2007

Background and Objectives：Microvascular free flap reconstruction has been revolutionized in last two decades, and became a standard option in the reconstruction of head and neck defects. We intended to review our experiences of 51 microvascular free flap for head and neck defects during 5-year period and to analyze the types of flaps according to primary sites, success and complication rates. Subjects and Methods：From Oct. 2001 through Dec. 2005, fifty one free flap reconstructions were performed in forty nine patients at ENT department of Soonchunhyang university bucheon hospital. Primary sites, pathology, T-stage, operative time, time interval of oral feeding, and various reconstructive factors such as recipient and donor vessels, free flap related complications, failure rates and salvage rates were retrospectively analyzed. The relation between complication rates and preoperative risk factors were statistically analyzed. Results：Methods of reconstruction were radial forearm free flap(RFFF)(n=28, 54.9%), anterolateral thigh free flaps(n=9, ALTFF)(17.6%), rectus abdominis free flap(n=7, RAFF)(13.7%), jejunal free flap(n=5, JFF)(9.8%), and miscellanous(n=2, 4.0%) in order. In free flap related complications, failure of free flap occurred in seven cases(13.7%) and pharyngocutaneous fistula occurred in five cases(9.8%) among fifty one free flaps. The overall success rate of free flaps was 86.3%. Salvage of free flaps was possible only one among eight cases(12.5%). In positive preoperative risk factor groups, failure of free flap was higher than in negative risk factor group. However, it was not statistically significant. Conclusion：We confirmed that free flap reconstructions are highly versatile and reliable options for use in the reconstruction of various soft tissue defects of the head and neck. Free flaps have gained great popularity given its versatility, ability for a two-team approach, and minimal donor site morbidity. However, complications related to microvascular surgery may be overcome by increased surgical experience and by intensive flap monitoring in early postoperative period.

• 한국산학기술학회논문지
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• 제10권5호
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• pp.1043-1051
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• 2009

본 연구는 극적인 타결을 이루어낸 한 미 FTA의 효력 발생이 이후 두 국가간 통화로 이루어지는 원/달러 환율의 행태에는 어떠한 영향을 줄 것인가에 대한 시사점을 얻기 위해 대미 FTA 국가들을 대상으로 FTA 체결 전 후의 환율행태가 어떻게 달라졌는지를 살펴보고 공통점 및 차이점을 발견하여 향후 원/달러환율의 행태를 전망하고자 하는 데에 목적을 두고 있다. 실증분석의 결과, 칠레를 제외하는 변동성 환위험프리미엄이 모두 효력 발생이후 다소 줄어든 반면, 칠레는 변동성과 환위험프리미엄 모두 다소 증가한 것으로 나타나 해당환율의 변동성 및 환위험프리미엄의 변화는 같은 방향으로 이루어지나 대상국가에 따라 차이가 있음을 보여주고 있다. 이러한 연구결과는 환율변화의 불확실성에 대비해야 하는 IT무역업체들에게 한 미 FTA 효력 발생 이후 원/달러환율의 변동성과 위험프리미엄 행태에 어떠한 변화가 예측되는지에 대한 정보를 제공해 줄 것으로 기대된다.

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.20-25
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• 2001

Objectives : A substantial number of craniopharyngiomas recur despite gross total excision. The purpose of our study was to investigate pattern of recurrence and to verify prognostic factors for recurrence after gross total excision of craniopharyngiomas in children. Methods : A series of 36 patients with craniopharyngiomas were reviewed. All patients had undergone gross total excision and none of them received radiotherapy after initial surgery. Fifteen were girls and twenty-one were boys, with a mean age of 7.3 years(range, one to 15 years). The mean follow-up period was 52 months(range, one to 149 months). Recurrence was noted in 14 patients within 83 months(mean 31.4 months). Results : The overall three-year recurrence free survival rate was 65%, and the five-year recurrence-free survival rate was 55%. Regular neuroimaging follow-up at six to 12-month intervals detected tumor recurrence of a smaller size before symptoms developed(p<0.05). At the first surgical procedure, the optic nerve/chiasm(n=23) was the most common adhesion site. The most frequent sites of recurrence were the optic nerve/chiasm(n=6) and the pitiutary fossa(n=6). Tumor location was the single significant clinical predictor of recurrence. The five-year recurrence-free survival rate was 39% for those who had an intrasellar tumor component and 81% for those who did not (p<0.05). Conclusion : Craniopharyngiomas with intrasellar components should be followed cautiously and regular followup of patients should be emphasized, even when the tumors are totally resected.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1127-1130
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• 2013

Background: The standard national protocol for treatment of acute lymphoblastic leukemia (ALL) in children was implemented in 2006. A systematic evaluation of the treatment outcome is needed. This study examined the relapse-free survival among childhood ALL cases treated with this protocol and related factors. Materials and Methods: A descriptive study was conducted in children aged between 0-15 years, newly diagnosed with ALL between March 2006 and March 2011 at Srinagarind Hospital, Department of Pediatrics, Faculty of Medicine, Khon Kaen University. The patients were treated on the basis of stratified risk as per the Thai national protocol. Data were compiled from the hospital records. The Kaplan-Meier method was used to describe relapse-free survival and the Cox proportional hazard model to investigate the associated factors. Results: Of the 103 children recruited, 86 (83.5%) achieved complete remission. The total follow-up time was 3132.5 person-months. Eighteen (20.9%) relapsed. The incidence density was 0.6 per 100 person-months (95%CI: 0.4, 0.9). The respective relapse-free rates at 1, 3 and 5 years were 93.0% (95%CI: 85.1, 96.8), 84.5% (95%CI: 74.0, 90.9) and 64.1% (95%CI: 45.6, 77.8). A factor associated with the relapse-free rate was age under 1 year (HR=6.0; 95%CI: 1.1, 33.8). Conclusions: The rate of being relapse-free in ALL children treated under the Thai national protocol at Srinagarind Hospital was better than with former protocols; however, it is still not as good as in developed countries. Further review of the treatment approach of ALL is needed.

• Radiation Oncology Journal
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• 제11권2호
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• pp.337-346
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• 1993

This is a retrospective cohort analysis of 58 patients who treated with postoperative radiation therapy following radical hysterectomy and bilateral pelvic adenectomy for early stage carcinoma of uterine cervix between January 1988 and December 1990 at department of radiation oncology, Keimyoung University Hospital. Sixteen percent of patients (9/58) had chemotherapy. Most patients were FIGO I b (47 patients), and FIGO I a and II a were one and ten patients, respectively. The median follow-up periods were 48.5 months. The indications for radiation therapy included pelvic lymph node metastasis, large tumor size, deep stromal invasion, lymphovascular invasion, positive surgical margin, endometrial invasion and parametrial invasion. Eighty five percent of the patients had more than one risk factor. The actuarial overall five year survival rate (5 YSR) and five year disease free survival rate (5 YDFSR) were $89.5\%,\;and\;87.8\%,$ respectively. Their overall recurrence rate was $12.1\%,$(758). Distant metastasis was the most common cause of treatment failure $(71.4\%:5/7).$ The univariate analysis of prognostic factors affecting to five year survival rate disclosed pelvic lymph node status (negative: $95.5\%,\;positive:69.2\%,$ p=0.006) and hemoglobin level $(\le11 :75\%,>11g/dl:93.3\%,p=0.05)$ as significant factor. The age status was marginally significant $(\le40:96.0\%,\;>\;40:84.3\%p=0.15).$ Multivariate analysis clarified three independent prognostic factors: pelvic lymph node metastasis (p=p.006), hemoglobin level (p=0.015) and age (p=0.035). Multivariate analysis of prognostic factor affecting to five year disease free survival rate disclosed pelvic lymph node status (p=0.0078) and status of surgical margin (p=0.008). Complications relating to radiotherapy were $10.3\%,(6/58).$ There were no severe major complication requiring surgical intervention or a long hospital stay. It is our opinion that the benefit of postoperative pelvic radiotherapy may be gained in such a high risk patient population with acceptible morbidity.

• 한국안전학회지
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• 제23권1호
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• pp.46-50
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• 2008

The purpose of the present study was to investigate the mariner's information characteristics in ship-ta-ship collision situation using the full mission ship-handling simulator. Risk levels of ship-to-ship collision were manipulated by whether the target ship complies with the naval regulations and by movement patterns of target ship. Dependent variables reflecting mariner's information characteristics in ship-ta-ship collision situation were measured in terms of radar detection reaction time, free recall performance of past navigation situation, and subjective ratings for the task difficulty. The results showed that, in general, the mariners appeared to be deteriorated in their radar detection reaction time and free recall performance as the risk of ship-ta-ship collision increased. Also, the mariners tended to rate required tasks more difficult in the high risk ship-ta-ship collision situation.

• 대한지역사회영양학회지
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• 제13권1호
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• pp.125-133
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• 2008

This study was carried out to compare bone density risk factors affecting women's BMD, and to examine the relationship age, lifestyle and dietary habits for bone health by physical measurement and questionnaires. The subjects of this study were 194 women living in the Seoul area. When the subjects were divided into normal and risk groups, BMD, height, weight, BMI, total body water, soft lean mass, fat free mass, protein, mineral, body-fat of normal group were much higher than those of the risk group. The breakfast eating rate of the normal group was much higher than that of the risk group, walking time was significantly longer and exercise was more (p < 0.05). The normal group had more frequent intakes of tunas, squid, radishes, the green parts of radish, cucumbers, carrots and Iucchinis, tomatoes, and grapes than the risk group (p < 0.01 or p < 0.05). In conclusion, breakfast eating, exercise, intakes of some foods such as anchovies, radishes, carrots, zucchinis and tomatoes were significantly important factor to prevent bone density risk.

• 보험의학회지
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• 제31권1호
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• pp.34-36
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• 2012

Lung cancer such as small cell lung cancer(SCLC) and non small cell lung cancer(NSCLC) have high mortality rate, so, we insurance doctors have little interest in their risk. But nowadays there's a lot of development in targeted therapy of NSCLC. Screening by CT scanning and early resection strategy also shows better prognosis. It is helpful for underwriters and insurance doctors to review the current development of targeted therapy of NSCLC and estimation of extra-risk of early lung cancer. The preferred treatment option for patients whose tumors contain EGFR-activating mutations are one of the EGFR-directed tyrosine kinase inhibitors, such as gefitinib or erlotinib. In patients with NSCLC whose tumors harboured an ALK rearrangement, there was 61% objective response rate to crizotinib in the phase 1 study. The median survival progression-free survival was 10 months. Mortality analysis of early lung cancer who were detected by CT screening, MR of 105% and EDR of 1‰ were calculated.

• 사상체질의학회지
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• 제25권2호
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• pp.81-97
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• 2013

Objectives The purpose of this study was to investigate the relationship between osteoporosis and cardiovascular risk factors according to Sasang constitution. Methods A total of 1773 participants, over 40 years old, were examined as part of a community-based cohort in Wonju city in Gangwon province of South Korea, from June 2006 to August 2009. We measured bone mineral density by Achilles ultrasonometer, serum levels of lipids, fasting blood sugar, insulin and other cardiovascular risk factors like blood pressure and waist circumference. Constitution was verified by a Sasang constitution specialist using the results of PSSC(Phonetic System for Sasang Constitution), facial photos and a simplified Sasang constitutional questionnaire. Results The prevalence rate was 11.2% in total participants, and 10.6% in Soyangin, 10.4% in Taeeumin and 13.9% in Soeumin. In general characteristics, educational and economic property and exercise were concerned with osteoporosis. Systolic blood pressure, pulse rate and total cholesterol were significantly high in osteoporosis group. Age and menopause were the key risk factors for osteoporosis. There was a significantly high prevalence in Soeumin for osteoporosis in men alone. Low physical activity was a major risk factor for osteoporosis. Waist circumference and hip circumference had significantly high odds ratio and weight had significantly low odds ratio. By Sasang constitution, Soyangin has the negative correlation with free fatty acid, Taeeumin has the negative correlation with waist circumference, pulse rate, systolic blood pressure, total cholesterol and low density lipoprotein and Soeumin has the positive correlation with body fat amount. Conclusions Regimens on osteoporosis should be considered according to Sasang constitution. Cardiovascular diseases should be considered according to Sasang constitution. Soeumin should be cautious of osteoporosis and gain weights and reasonable amount of fat food. Soyangin had better do exercise lower body and eat little food containing triglyceride. Taeeumin had better lose weights and eat little cholesterol food.

• Radiation Oncology Journal
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• 제26권3호
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• pp.149-159
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• 2008

목 적: 본 연구는 자궁내막암 병기 $1{\sim}2$ 환자에 수술 후 방사선치료의 결과와 예후인자를 분석하여 향후 치료원칙을 결정하는 데 도움을 얻고자 시행하였다. 대상 및 방법: 1991년 1월부터 2005년 12월까지 이화여자대학교 의과대학부속병원에서 자궁내막암으로 진단받고 수술 후 방사선치료를 받은 병기 $1{\sim}2$환자를 대상으로 후향적 분석을 하였다. 전체 환자는 35명이었으며 17명은 자궁절제술과 양측 난소제거술을 시행하였고 18명은 완전한 수술적 병기의 수술을 시행하였다. 골반강 방사선치료를 받은 환자는 17명, 질강내근접치료를 받은 환자는 12명, 골반강 방사선치료와 질강내근접치료를 받은 환자는 6명이었다. 결 과: 추적기간의 중앙값은 54개월이었다. 전체 환자의 5년 생존율은 91.4%, 무병생존율은 81.7%이었다. 저위험군, 중간위험군, 고위험군의 위험군에 따른 5년 생존율은 각각 100%, 100%, 55.6%이었으며 무병생존율은 각각 100%, 70.0%, 45.7%이었다. 국소재발된 환자는 없었으며 5명(14%)에서 원격전이가 발생하였으며 호발부위는 폐, 뼈, 간, 부신, 전복강의 순이었다. 원격전이에 대한 단변량 통계분석에 따르면 위험군, 조직학적 세포형태와 조직학적 등급이 유의성이 있었으며, 다변량 통계분석에 따르면 조직학적 세포형태로서 유두형, 장액형, 그리고 투명세포암은 자궁내막양암과 샘암편평암에 비하여 원격전이율이 높고 생존율이 낮았다. 골반강 방사선치료에 의한 후유증은 장염이 30%에서 나타났으며 다음으로 직장염이었으나 대부분 등급 $1{\sim}2$로 등급 $3{\sim}4$의 후유증은 발생하지 않았다. 결 론: 수술 후 골반강 방사선치료 혹은 질강내근접치료를 시행한 자궁내막암 병기 $1{\sim}2$환자들의 경우 저위험군과 중간위험군은 국소제어율과 생존율이 높았으나, 고위험군은 골반강 방사선치료를 시행하여 국소제어율은 높으나 원격전이율이 높고 생존율이 낮았다. 따라서 고위험군은 방사선치료와 동시에 항암화학요법이 요구된다. 중간 위험군의 더 효율적인 치료를 위하여 많은 환자를 대상으로 골반강 방사선치료와 강내근접치료를 비교하는 전향적 무작위연구가 필요하다.