• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.5775-5781
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• 2013

Background: The gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) is the most common type of neuroendocrine neoplasm. We summarized data in our centre to investigate the clinicopathological features, diagnostic methods, therapeutic approaches and prognosis for this neoplasm to increase knowledge of this disease in Asian populations. Method: A total of 122 patients treated at Sun Yet-san Memorial Hospital of Sun Yat-sen University between January 2000 and December 2011 were analyzed retrospectively. Results: Pancreas was the most common site of involvement (65/122, 53.3%); this disease has no special symptoms; positive rates of chromogranin A (CgA) and synaptophysin (Syn) were 81.1% and 87.7%, respectively. The positive rate of Syn had statistical difference among the three grades, but not CgA. Some 68 patients had G1 tumors, 32 G2 tumors and 22 G3 tumors, and Chi-square test showed that higher grading was correlated with worse prognosis (${\chi}^2=32.825$, P=0.0001). A total of 32 patients presented with distant metastasis, and 8 cases emerged during following up. Cox proportional hazards regression modeling showed that the tumor grade (P=0.01), lymphatic metastasis (P=0.025) and distant metastasis (P=0.031) were predictors of unfavorable prognosis. The overall 5-year survival rate was 39.6%, the 5-year survival rate of G1 was 55.7%, and the G2 and G3 were 34.2% and 0%, respectively. Conclusions: The incidence of gastroenteropancreatic neuroendocrine tumors has risen over the last 12 years. All grades of these diseases metastasize readily, and further research regarding the treatment of patients after radical surgery is needed to prolong disease-free survival.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5095-5099
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• 2013

Background: The overall incidence of breast cancer in South Asian countries, including Nepal, is low compared to Western countries. However, the incidence of breast cancer among young women is relatively high. Breast cancer in such cases is characterized by a relatively unfavorable prognosis and unusual pathological features. The aim of this study was to investigate clinico-pathological and biological characteristics in younger breast cancer patients (<40 years) and compare these with their older counterparts. Materials and Methods: Nine hundred and forty four consecutive female breast cancer patients, admitted to the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal between November 1997 and October 2012, were retrospectively analyzed. Results: Out of the 944 female breast cancer patients, 263 (27.9%) were <40 years. The mean age was $34.6{\pm}5.0$ years among younger patients compared to $54.1{\pm}9.9$ for those ${\geq}40$ years. The mean age at menarche was also significantly lower ($13.5{\pm}1.5$ vs $14.2{\pm}1.5$ years p=0.001) while the mean duration of symptoms was significantly longer (7.6 vs 6.5 months p=0.004). Family history of breast cancer was evident in 3.0% of the young women versus 0.3% in the older one. Mammography was performed less frequently in younger patients (59.7%), compared to older (74.4%), and was of diagnostic benefit in only 20% of younger patients compared to 85% of older ones. At diagnosis, the mean tumor diameter was significantly larger in young women ($5.0{\pm}2.5$ vs $4.5{\pm}2.4cm$, p=0.005). Axillary lymph nodes were positive in 73% of younger patients and 59% of older patients. In the younger group, the proportion of stage III or IV disease was higher (55.1% vs 47.1%, $p{\leq}0.05$). The proportion of breast conserving surgery was higher in young patients (25.1% vs 8.7%) and a higher proportion of younger patients receive neoadjuvant chemotherapy (9.9% vs 2.8%). The most common histological type was ductal carcinoma (93.1% vs 86%). The proportion of histological grade II or III was higher in younger patients (55.9% vs 24.5%). Similarly, in the younger group, lymphatic and vascular invasion was more common (63.2% vs 34.3% and 39.8% vs 25.4%, respectively). Patients in the younger age group exhibited lower estrogen and/or progesterone receptor positivity (34.7% vs 49.8%). Although statistically not significant, the proportion of triple negative tumors in younger age group was higher (22.4% vs 13.6%). Conclusions: Breast cancer in young Nepalese women represents over one quarter of all female breast cancers, many being diagnosed at an advanced stage. Tumors in young women exhibit more aggressive biological features. Hence, breast cancer in young women is worth special attention for earlier detection.

• 대한예방한의학회지
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• 제8권2호
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• pp.31-44
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• 2004

Bibliographic study on pediatric Chuna in the Myung Chung dynasties resulted as the following. 1. Pediatric Chuna experts in Myung dynasty utilized methods of Chuna to a great extense as means of preventing and treating various kinds of pediatric disorders. 2. Pediatric Chuna experts in Myung dynasty put emphasis on diagnosis through the doctor's inspection. 3. Pediatric Chuna experts in Myung dynasty developed and applied special acupoints for pediatric Chuna. 4. Pediatric Chuna experts in Myung dynasty put emphasis on replenishing and discharging according to hand manipulation. 5. Pediatric Chuna experts in Myung dynasty developed and applied methods of massaging with herbal medicine. 6. Pediatric Chuna experts in Myung dynasty put methods of Chuna into songs for handier use. 7. Pediatric Chuna experts in Chung dynasty corrected the errors of the predecessors and further developed the handed down advantages. 8. Pediatric Chuna experts in Chung dynasty specifically combined the theories of Chuna with characteristics of pediatric physiology. 9. Pediatric Chuna experts in Chung dynasty described treatments by symptoms systematically. 10. Pediatric Chuna experts in Chung dynasty, criticizing the trend at the time of despising pediatric Chuna, endeavored to spread pediatric Chuna. 11. Pediatric Chuna experts in Chung dynasty arranged the relationship between hand manipulation of Chuna and herbal medicine. 12. Pediatric Chuna experts in Chung dynasty arranged various kinds of methods for diagnosis, including diagnosis by palpation of the chest and the abdomen. 13. Pediatric Chuna experts in Chung dynasty combined the method of multiple hand manipulation and method of basic hand manipulation. 14. The theories of pediatric Chuna before Myung Chung dynasties only put emphasis on Ki and Blood, not combining with the basic principles of Korean medicine like Eum/Yang and Five Phases. The scholars of Myung Chung dynasties came to successfully combine the principles of Korean medicine like stability theory, Jang and Bu (internal organs) theory, and Eum-Yang theory with the theories of pediatric Chuna. This combination best characterizes the theories of pediatric Chuna in the Myung Chung dynasties.

• 한국식물병리학회지
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• 제1권3호
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• pp.199-206
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• 1985

바이로이드(viroid)는 그의 완전한 분자구조가 처음으로 밝혀진 식물병원체이며, coat-protein이 제거된 viral-RNA가 아닌 바이로이드로서의 독립적인 특성과 병원성을 가진 작은 크기의 병원체임이 밝혀짐으로써 미생물의 영역을 한 단계 넓혀서 생각하도록 하였다. 일반적으로 생각되는 미생물 즉 곰팡이, 세균, 마이코플라스마, 바이러스들이 동물과 식물 및 인체에 병원체로서 작용하는데 바이로이드는 현재까지 고등식물에서만 발견되는 병원체이다. 다라서 바이로이드가 동물 및 인체에서 아직까지 밝혀지지 않고 있는 병의 병원체일 가능성이 있으므로 이에 대한 연구가 계속되고 있다. 바이로이드는 작은 크기임에도 독자적인 자기증식을 하는 능력과 생존을 유지하는 특성이 있기 때문에 이들의 분자구조 및 생물적 특성을 연구하는데 좋은 자료가 되며, 최근에 급속한 진전을 보이고 있는 분자생물학 및 유전공학적인 방법과 기술을 이용하여 Viroid의 여러 가지 성질과 생물학적인 위치에 대한 연구가 활발히 진행되고 있다. 앞으로 연구가 계속되어 Viroid의 증식과 병원성에 대한 문제가 해결된다면, 바이로이드병의 예방이나 치료법이 확립된 것이며 또한 목적하는 유전자를 운반하는 Vector로 개발하여 생물공학 분야에 적극적으로 활용할 수 있을 것이다.

• Journal of Preventive Medicine and Public Health
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• 제35권1호
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• pp.49-56
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• 2002

Objectives : To identify the relationship between the use of medical services by workers with three types of respiratory diseases(total respiratory diseases, acute upper respiratory infections and chronic lower respiratory diseases) and exposure to hazardous agents after controlling for other factors affecting medical services use, such as characteristics of the enterprises(scale, industry type) and employee demographics (sex, age). Methods : The study population comprised 28,882 workers who had undergone general or special medical examinations at the industrial health center at least once between Jan 1995 and Dec 1997 and had possessed medical insurance during the period. We combined medical examination data with medical insurance data in order to analyze the relationship between exposure to hazardous agents and respiratory diseases, Results : Among the 28,882 study subjects, 17,454 employees(60.4%) used medical services more than once during 3-year study period, owing to more than one kind of respiratory diseases. In logistic regression analysis, sex, age and the size of the enterprises proved to be significant variables on the use of medical services for all three types of respiratory disease; The use of medical services increased with employee age. Women used more medical services than men and the employees in the large-scale enterprises used more services than employees in small-scale enterprises. However, exposure to dust or organic solvents did not affect medical service use due to total respiratory diseases or acute upper respiratory infections. Only in the case of chronic lower respiratory diseases did workers exposed to dusts(OR=1.12, 95% CI=1.01-1.24) or organic solvents(OR=1.19, 95% CI=1.05-1.35) use more medical services than those not exposed. Conclusions : Workers exposed to dusts or organic solvents are particularly apt to suffer from chronic lower respiratory diseases and use medical services more often than those not exposed. That is, chronic exposure to hazardous agents such as dusts and organic solvents is believed to be harmful and to cause respiratory symptoms and diseases.

• 대한간호학회지
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• 제11권1호
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• pp.45-63
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• 1981

This study was done to determine the relationship between the anxiety levels of hospitalized psychiatric patients and various influencing variables. The purpose of this study was to determine factors that may help hospitalized psychiatric patients to experience lower levels of anxiety in relation to changing situations and provide the basic data for a dynamic approach which is important in the field of modern psychiatric nursing that understands and analyses the meaning of patients behavior. The anxiety may produce stress, which is a common experience among all human beings. Patients may merely feel uncomfortable in the state of mild anxiety, however, the severe state could be an obstacle to treatment and recovery from disease. The anxiety of the psychiatric patient is a factor which greatly influencing the patient's behavior, so his disorderd behavior is an expression of defence or pathologically fixed behavior. According the psychiatric patient's anxiety at the time of admission is the concern of the health team. The nurse's special concern has to do with understanding and supporting the patient and meeting his individual needs by frequent close contact during the entire hospitalization period, compared to other teamembers the nurse's responsibility in this regard is greated. So this study emphasizes the necessity of creating conditions these, but above all the psychiatric nurse should create a therapeutic environment by not only regarding the patient's behavior or symptoms but understanding the meaning of them. The subjects of this study were 57 psychiatric patients selected from the K neuropsychiatric hospital located in Kunsan city. Data were collected twice from the same patients within a 24 hour period after admission and 10 days after admission. (September 18th to November 8th, 1980). The data collected method was through direct interview, and the interview time was 20 minutes for each patient. Data analysis included Item Analysis & Internal Consistency Reliability Tests, Percentages, t-test, analysis of variance and stepwise multiple regression analysis. The findings of this study were as follows. A. Test of Hypothesis a. Hypothesis 1 :“The anxiety level of psychiatric patients within 24 hours after admission will be higher than those of the same patients 10 days after admission,”was accepted. (t = 3. 15 ; p < 0.005) b. Hypothesi 2:“The more the number of admissions the higher the level of anxiety related to two categories”, was accepted. (affective anxiety: F = 5.50, p < 0.005, Somatic anxiety: F = 9.12, p <.

• 한국방사선학회논문지
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• 제10권3호
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• pp.171-180
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• 2016

본 연구는 고 에너지 방사선 조사에 기인된 방사선치료실 내 오존 농도의 변화를 비교 분석하고자 하였다. 이를 위하여 치료실 주변 대기 중 오존 농도와 치료실 내 배경 오존 농도를 분석하여 고 에너지 방사선 조사에 기인된 치료실 내 평균 오존 농도를 비교하였다. 치료실 내 배경 오존 농도는 평균 $17.4{\pm}7.9ppb$로 방사선치료실 주변의 대기 중 오존 농도(평균 $36.8{\pm}22.3ppb$)보다 약 50% 정도 통계적으로 유의하게 낮게 나타났다(p<0.05). 고 에너지 방사선 조사에 기인된 치료실 내 오존 농도는 방사선이 조사됨과 동시에 배경 오존 농도의 약 2배 수준으로 급격하게 증가되었으며 조사시간이 증가함에 따라 기울기가 일정한 증가 추이를 보이다가 약 130초에서 180초 부근에서 최대 오존 농도를 이루고 점차 포화되는 경향을 보였으며 배경 오존 농도로 감소하는데 소요되는 시간은 약 10분 이상이었다. 본 연구 결과를 토대로 고 에너지 방사선 조사에 기인된 방사선치료실 내 오존 농도는 후각을 자극하는 오존의 특이한 냄새를 맡거나 순간적인 호흡 곤란과 마른기침으로 가슴 통증 등의 신체적 증상이 나타날 수 있는 수준으로 밀폐된 방사선치료실에서 고농도 오존에 장시간 노출될 경우 폐 질환을 악화시킬 수 있기 때문에 각별한 주의가 요구된다.

• 정신신체의학
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• 제23권2호
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• pp.79-85
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• 2015

연구목적 본 연구에서는 섬망의 운동성 아형 간의 증상과 임상적 특징의 차이를 알아보고자 한다. 방 법 일 대학병원에 입원하여 정신건강의학과에 협진의뢰된 환자 중 일반신체질환에 의한 섬망으로 진단된 256명을 대상으로 후향적으로 의무기록을 검토하였다. 운동성 아형은 Lipowski의 분류 체계에 따라 과활동형, 저활동형 및 혼재형으로 분류하였으며, 섬망평가척도를 이용하여 증상을 평가하였다. 결 과 과활동형이 130명(50.8%), 혼재형은 118명(46.1%), 저활동형은 118명(3.1%)이었다. 과활동형은 평균연령이 혼재형 환자보다 적었으며(p=0.022), 섬망을 치료하기 위해 항정신병 약물을 더 자주 사용하였다(p<0.001). 과활동형은 인지적 및 비인지적 증상 점수가 타 아형에 비해 높았다(각각 p=0.002, p<0.001). 결 론 섬망의 운동성 아형에 따라 증상 및 임상적 특징에서 차이가 있었다. 운동성 아형에 따라 진단 및 치료적 접근 방법을 달리하여, 특정 아형의 섬망 진단이 간과되거나 치료가 지연되지 않도록 관심을 가질 필요가 있다.

• 한국과학교육학회지
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• 제41권4호
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• pp.283-295
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• 2021

본 연구는 Giorgi 의 현상학적 연구 방법을 바탕으로 중학교 과학영재학생들이 겪는 과학불안의 경험을 탐색하고자 하였다. 연구참여자는 대학교 과학영재교육원에 선발된 중학교 1학년 학생 중 과학특성불안 및 과학상태불안 수준이 높고 과학불안 경험이 있는 과학영재학생 6명으로 선별하였다. 연구참여자들을 대상으로 과학불안 경험과 관련된 두 차례의 면담을 실시하였다. 분석결과, 과학영재학생들이 경험하는 과학불안은 이상적 자아 설정, 자신감 부족, 과거의 경험, 내용의 어려움, 가치있는 일에 기인하고 있었다. 학생들은 과학불안을 느낄 때 신체적·생리적, 인지적, 정서적·심리적으로 불편함을 호소하였으며, 과학불안을 성장의 기회로 인식하기도 하였다. 또한 과학영재학생들은 과학불안이 유발될 때 나타나는 여러 불편한 증상들을 극복하기 위해 불안한 상황에 직접 맞서거나 자신의 마음을 가다듬는 등 다양한 방법으로 대처하는 모습을 보였다. 일부 학생들은 시간이 지나면 불안감이 해소되기 때문에 불안 수준을 낮추기 위한 특별한 노력이 필요하지 않다고 생각하고 있었다. 학생들은 과학불안에 대하여 부정적인 의미와 긍정적인 의미를 동시에 지니고 있었다. 본 연구의 결과는 과학불안을 경험하는 중학교 과학영재학생들에 대한 교사의 심층적인 이해를 돕고, 과학불안과 관련하여 어떠한 교육환경을 조성하고 교육프로그램을 제공해야 하는지에 대한 이론적 토대 마련에 기여할 것이다.

• 한국컴퓨터정보학회논문지
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• 제27권12호
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• pp.29-40
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• 2022

본 논문에서는 딥러닝 기법의 하나인 Mask R-CNN과 랜덤포레스트 분류기를 이용해 당뇨병성 망막병증의 병리학적인 특징을 검출하고 분석하여 자동 진단하는 시스템을 연구하였다. 당뇨병성 망막병증은 특수장비로 촬영한 안저영상을 통해 진단할 수 있는데 밝기, 색조 및 명암은 장치에 따라 다를 수 있으며 안과 전문의의 의료적 판단을 도울 인공지능을 이용한 자동진단 시스템 연구와 개발이 가능하다. 이 시스템은 미세혈관류와 망막출혈을 Mask R-CNN 기법으로 검출하고, 후처리 과정을 거쳐 랜덤포레스트 분류기를 이용하여 안구의 정상과 비정상 상태를 진단한다. Mask R-CNN 알고리즘의 검출 성능 향상을 위해 이미지 증강 작업을 실시하여 학습을 진행하였으며 검출 정확도 측정을 위한 평가지표로는 다이스 유사계수와 Mean Accuracy를 사용하였다. 비교군으로는 Faster R-CNN 기법을 사용하였고 본 연구를 통한 검출 성능은 평균 90%의 다이스 계수를 통한 정확도를 나타내었으며 Mean Accuracy의 경우 91% 정확도의 검출 성능을 보였다. 검출된 병리증상을 토대로 랜덤포레스트 분류기를 학습하여 당뇨병성 망막 병증을 진단한 경우 99%의 정확도를 보였다.