• Journal of Gastric Cancer
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• 제1권2호
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• pp.106-112
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• 2001

Purpose: Even with excellent surgical outcome, recurrence of early gastric cancer (EGC) after a curative resection is not declining because the incidence of EGC is increasing. The aim of this study was to propose an appropriate treatment strategy by assessing the risk factors for recurrence of curatively resected early gastric cancer. Materials and Methods: Of 3662 patients who had undergone gastric resections for gastric cancer from 1987 to 1996, the cases of 1050 curatively resected EGC patients were reviewed retrospectively. Among those 1050 patients, 50 patients ($4.8\%$) were diagnosed as having recurrent cancer, which was confirmed by clinico-radiological examination or re-operation. The risk factors that determined the recurrence patterns were investigated by using univariate and multivariate analyses. Results: The mean time to recurrence was 30.9 months, and hematogenous recurrence was the most frequent type ($32.0\%$). Among the 50 recurred patients, peritoneal recurrence showed the shortest mean time to recurrence ($18.5\pm17.7$months). Between the recurred and the non-recurred patients, there was no statistically significant difference with respect to age, sex, operation type, tumor size, tumor location, gross appearance, or histological differentiation. However, depth of invasion (submucosal invasion) and nodal involvement were significantly different (P<0.001) between the two groups. Using logistic regression analyses, nodal involvement was the only significant risk factor for recurrence in early gastric cancer (P<0.001). The median survival after the recurrence had been diagnosed was 4 months. Conclusion: Although the prognosis for EGC patients is excellent and recurrence of EGC after a curative resection is rare, the time to recurrence and the patterns of recurrence in EGC patients were diverse and unpredictable, and the result after recurrence is dismal. Considering the impact of lymph node metastasis on recurrence of EGC, a systematic lymphadenectomy, rather than limited surgery, should be performed if lymph node involvement is confirmed pre- or intraoperatively. Also if the postoperative pathologic findings reveal lymph node involvement, adjuvant chemotherapy is recommended.

• 디지털융복합연구
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• 제17권7호
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• pp.225-233
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• 2019

본 연구는 20-30대 미혼남녀 근로자의 결혼 필요성 인식 영향 요인으로 건강이 어떠한 영향을 미치는지 규명하고자 한다. 본 연구는 2016년 청년사회 경제실태조사의 원시자료를 이용하였다. 2,534명의 대상자 중 현재 근로자이며, 20-30대 미혼 남녀 904명이 분석에 포함되었다. 종속변수는 결혼 필요성 인식여부이고, 독립변수는 인구사회학적 특성인 나이, 성별, 키, 몸무게, 학력, 본인의 월 평균 소득, 부모님의 경제적 수준이었고, 건강관련 변수로는 주관적 건강, 일상생활 스트레스, 규칙적인 운동 여부 및 삶 만족도가 포함되었다. 통계분석은 로지스틱 회귀분석을 통해 수행하였다. 연구 결과, 20대 남성의 결혼 필요성 인식 영향 요인 변수는 발견되지 않았던 반면 20대 여성에서는 학력으로 나타났다. 30대 남성에서 규칙적인 운동을 할수록, 월 소득이 적을수록 결혼 필요성 인식에 긍정적이었다. 30대 여성에서 주관적 건강이 좋을수록 결혼 필요성 인식에 긍정적이었다. 본 연구의 결과는 30대 미혼남녀 근로자의 결혼인식에 건강이 영향을 줄 수 있음을 시사한다.

• Journal of Korean Neurosurgical Society
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• 제62권4호
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• pp.442-449
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• 2019

Objective : Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT. Methods : We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation. Results : The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900). Conclusion : This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.

• 대한두경부종양학회지
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• 제27권2호
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• pp.198-203
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• 2011

Background and Objectives : Distinguishing benign from malignant lesion in thyroid noddex is important but clinically difficult. FNAB is the first investigation of choice. However, cytologic results are often indeterminable. In those cases, additional molecular biologic tests are helpful. If serologic tests are available to predict malignancy, it can be useful to fortify accurate diagnosis. We analyzed whether TSH or FreeT4 level could be used as a predictor of malignancy. Materials and Methods : From January 2008 to March 2009, 540 patients received one of thyroidectomy in a single center. We only included 167 patients from 18 to 65 years old without cardiopulmonary or renal disorders. All the patients were in euthyroid state and took no medications, which affect the thyroid function. We reviewed charts retrospectively to find out differences in TSH level and FreeT4 level between the benign and malignant groups. Results : In this study, all the patients with malignancy had the papillary cancer. In benign group, average TSH level came out to be 1.48mU/L, whereas the average TSH level of malignant group was 1.98 mU/L. Moreover, the higher the cancer stage was, the higher the TSH level was. Although we have adjusted factors that can affect TSH level(age, sex, race, goiter type), we still received the same result. The risk of malignant cancer increased in proportion with TSH level within the normal range. In free T4 level, there was no difference between benign and malignant group. Conclusion : We propose that TSH level can play a role as one of the predictors for thyroid cancer. However, there is limitation because all the patients with malignancy in this study have papillary cancer. Thus, we can apply this result only in papillary cancer, and we need more study for other types of thyroid cancer.

• 수면정신생리
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• 제25권1호
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• pp.9-14
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• 2018

연구목적 : 만성불면증은 흔하고 가장 환자들을 괴롭히는 수면장애들 중 하나이다. 본 예비연구는 불면장애 환자들과 수면을 잘 취하는 건강인 간에 공간인지기능을 비교하기 위해 수행되었다. 연구대상 및 방법 : DSM-5상 불면장애의 진단기준을 만족하는 22명의 만성 불면장애 환자와 27명의 수면을 잘 취하는 정상대조군이 연구에 참여하였다. 전산화신경인지기능검사인 Cambridge Neuropsychological Test Automated Battery (CANTAB)를 시행하여 불면장애 환자와 정상대조군 간에 공간인지기능(spatial planning function)을 비교하였다. 결 과 : CANTAB 결과 상 Stockings of Cambridge test에서 더 저조한 problems solved in minimum moves 결과를 보였다(t = -2.499, p = 0.017) 이 항목은 나이, 성별, beck depression index 비수면점수를 통제한 ANCOVA 분석에서도 유의한 결과를 보였다(F = 5.631, p = 0.017)의 유의한 차이가 관찰되었다. 결 론 : 본 연구의 결과는 불면장애 환자들의 저조한 공간계획기능을 시사한다.

• Journal of Acupuncture Research
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• 제19권6호
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• pp.35-48
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• 2002

Objective : The study was performed to evaluate the effect of treatment for thoracolumbar compression fracture by using Bee Venom Acupuncture that is well known for anti-inflammatory and analgesic effect. Methods : We investigated 39 cases of patient with thoracolumbar compression fracture. The patients with thoracolumbar compression fracture were treated at the department of acupuncture & moxibustion of Kyung-Won University Oriental Hospital from 1st January 2001 to 30th August 2002. We selected for two groups. One group was treated by Bee Venom Acupuncture therapy(Bee Venom Acupuncture Group : BAG), the other group was treated by Filiform Acupuncture therapy(None Bee Venom Acupuncture Group : NBAG). Results : 1. The distribution showed female predominance in sex and 70's predominance in age. The largest group was "accidental fall" and the next was "lifting heavy objects" in causes, and within 2 weeks in the duration of disease 2. In the duration of admission, the largest group was within 4 weeks. In regard to level of injury, T12 was found to be most predominant, followed in turn by L1, L2, L5. In regard to grade of clinical symptoms, Grade III was most predominant, followed by Grade II, Grade IV. 3. In the results of treatment, 87.5% were above "Good" in BAG and 47.8% in NBAG. 4. In the result of treatment due to the grade of clinical symptoms, BAG was more excellent than NBAG on the whols grade. 5. In the result of treatment due to duration of admission, the duration of admission was not in proportion to the results of treatment. 6. In the change of lumber flexion, the improvement above $80^{\circ}$ was 50% in BAG and 21.7% in NBAG 7. In the stability of treatment, the BAG and NBAG did't show any detrimental change in GOT, GPT, r-GTP, BUN, creatinine. Conclusions : In the treatment of thoracolumbar compression fracture, the Bee Venom Acupuncture can be regarded as more effective treatment than Filiform Acupuncture in the clinical practice. This is expected to be available for clinical use.

• Journal of Acupuncture Research
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• 제24권1호
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• pp.1-12
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• 2007

Objectives : Functional dyspepsia is a prevalent disease. It impedes subjective quality of life. The purpose of this research is to examine the effect of acupuncture treatment for functional dyspepsia. Methods : In this randomized, single blind, placebo-controlled study, we compared active acupuncture with sham acupuncture for the treatment of functional dyspepsia. Volunteers who satisfied the requirements were enrolled in study. Severity of dyspepsia was measured by Nepean Dyspepsia Index(NDI) and Functional Dyspepsia Quality fo Life(FD-QOL) before and after treatments. Results : 68 subjects finished study. There were not difference between two groups on age, sex, weight, height, severity of dyspepsia, subtype, Byeonjeung, surmise of treatment. After treatment total key symptoms score, improve rate of key symptoms were decreased than before treatment in active acupuncture group, but there were no statistical significance compared with sham acupuncture group. After treatment "pressure in upper abdomen" and " cramps in upper abdomen" were more decreased in active acupuncture group compared with sham acupuncture group(p=0.001, p=0.014). After treatment total symptom score and QOL of NDI were decreased than before treatment in active acupuncture group, but there were no statistical significance compared with sham acupuncture group. After treatment eating status of FD-QOL in active acupuncture group was significantly increased than sham acupuncture group(p=0.008). After treatment liveliness status of FD-QOL and total score of FDQOL in active acupuncture group was increased than sham acupuncture group though statistically insignificant(p=0.095, p=0.077). Conclusion : Acupuncture treatment is effective to improve the symptoms and quality of life in patients with functional dyspepsia.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1545-1551
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• 2015

Purpose: Rectal cancers with high microsatellite-instable have clinical and pathological features that differentiate them from microsatellite-stable or low-frequency carcinomas, which was studied rarely in stage II rectal cancer, promoting the present investigation of the usefulness of microsatellite-instability status as a predictor of the benefit of adjuvant chemotherapy with fluorouracil in stage II rectal cancer. Patients and Methods: Data of 460 patients who underwent primary anterior resection with a double stapling technique for rectal carcinoma at a single institution from 2008 to 2012 were retrospectively collected. All patients experienced a total mesorectal excision (TME) operation. Survival analysis were analyzed using the Cox regression method. Results: Five-year rate of disease-free survival (DFS) was noted in 390 (84.8%) of 460 patients with stage II rectal cancer. Of 460 tissue specimens, 97 (21.1%) exhibited high-frequency microsatellite instability. Median age of the patients was 65 (50-71) and 185 (40.2%) were male. After univariate and multivariate analysis, microsatellite instability (p= 0.001), female sex (p<0.05) and fluorouracil-based adjuvant chemotherapy (p<0.001), the 3 factors were attributed to a favorable survival status independently. Among 201 patients who did not receive adjuvant chemotherapy, those cancers displaying high-frequency microsatellite instability had a better 5-year rate of DFS than tumors exhibiting microsatellite stability or low-frequency instability (HR, 13.61 [95% CI, 1.88 to 99.28]; p= 0.010), while in 259 patients who received adjuvant chemotherapy, there was no DFS difference between the two groups (p= 0.145). Furthermore, patients exhibiting microsatellite stability or low-frequency instability who received adjuvant chemotherapy had a better 5-year rate of DFS than patients did not (HR, 5.16 [95% CI, 2.90 to 9.18]; p<0.001), while patients exhibiting high-frequency microsatellite instability were not connected with increased DFS (p= 0.696). It was implied that female patients had better survival than male. Conclusion: Survival status after anterior resection of rectal carcinoma is related to the microsatellite instability status, adjuvant chemotherapy and gender. Fluorouracil-based adjuvant chemotherapy benefits patients of stage II rectal cancer with microsatellite-stable or low microsatellite-instable, but not those with high microsatellite-instable. Additionally, free of adjuvant chemotherapy, carcinomas with high microsatellite-instable have a better 5-year rate of DFS than those with microsatellite-stable or low microsatellite-instable, and female patients have a better survival as well.

• 한국콘텐츠학회논문지
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• 제11권8호
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• pp.198-203
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• 2011

24~69세의 일반검진대상자 106명을 대상으로 골밀도 검사시 최근 사용이 많이 증가하고 있는 QCT와 QUS에 따른 BMD의 차이를 알아본 결과 다음과 같은 결론을 얻었다. QCT와 QUS에 의한 골밀도의 측정값은 전체적으로 유의한 상관관계를 나타냈다(p>0.05). 성별에 따른 측정방법간의 차이에서 여성에서는 QUS에 의한 검사방법에서 T-score가 유의하게 낮았고(p<0.05). 나이에 따라서는 40세 이상에서는 유의한 범위(p<0.05)에서 T-score의 차이가 있었다. 키 및 몸무게에 따른 차이에서는 특징적인 차이가 없었으며, BMI값이 22.9이하 그룹에서는 QCT로 검사시 T-score가 유의하게(p<0.05) 낮게 측정되었고 나머지 그룹에서는 검사방법에 따라 영향을 미치지 않았다. 이와 같이 골밀도의 측정에 있어서는 환자의 성별, 나이, 키 및 BMI에 따라서 측정방법에 따른 차이가 있을 수 있으므로 특별한 경우에는 여러 검사방법 등을 통하여 정확한 자료를 얻을 필요가 있을 것으로 사료된다.

• Journal of Chest Surgery
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• 제31권9호
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• pp.855-860
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• 1998

배경: 판막성형술을 포함한 승모판막 수술에 있어서 충분한 승모판의 노출은 필수적이다. 최근 확장된 경중격 절개술은 수술 후 동결절동맥의 손상에 기인한 율동이상의 가능성에도 불구하고 특히 재수술이거나 좌심방 크기가 작을 때 유리한 술식으로 알려져 있다. 대상 및 방법: 저자등은 중격절개만 시행한 10례 (I 군)와 절개를 확장한 25례(II 군)를 대상으로 수술 전후의 조건 및 결과를 비교 분석하였다. 결과: 양 군의 나이, 성별, 그리고 수술 전후의 NYHA 기능적 분류, 좌심방 크기, 좌심실 기능의 변화는 차이가 없었다. II 군에서 과거 개심술을 시행 했던 환자의 재수술 빈도가 높았고 나중에 회복된 수술 후 조기 율동 이상이 3명의 환자에서 나타났으나, I군에서는 없었다. 결론: 따라서 확장된 경중격절개술은 수기상 동결절 동맥의 손상에 기인한 술 후 조기 이상 율동이 나타날 수 있으나 나중의 결과에는 차이가 없으므로 경중격절개술로 시야 확보가 불충분한 경우에 언제라도 적용할 수 있으리라 판단된다.