• Tuberculosis and Respiratory Diseases
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• 제62권4호
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• pp.318-322
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• 2007

최근 평균수명의 연장과 진단 및 치료 방법의 발달로 원발성 중복암의 발견율이 높아지고 있다. 폐와 간에 발생한 중복암, 특히 동시성 중복암에 대한 보고는 매우 드물다. 저자 등은 만성기침을 호소하는 73세 남자에서 폐의 편평상피세포암을 진단한 후, 복부초음파에서 간 종괴를 발견하여 폐암의 전이를 의심하였으나 FDG-PET에 간 전이가 없어서 초음파 유도로 간 생검을 시행한 결과 간세포암을 진단하여, 폐와 간의 동시성 중복암을 경험하였기에 문헌고찰과 더불어 보고한다.

• 생명과학회지
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• 제30권6호
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• pp.563-569
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• 2020

유방암의 수술적 치료에 있어서 종양성형학적 수술이란 종양학적 안정성과 성형적 만족도를 모두 충족시키는 수술을 일컫는 용어이다. 처음 시작한 서양에서는 적은 절개나 절제, 미세침습수술을 지향하기 보다 유방축소술을 기본으로 제거될 조직에 병변을 포함하도록 계획한다. 충분한 절제가 가능하기 때문에 수술 전 검사, 절제연에 대한 고민, 수술 중 병리 검사의 필요성 등도 줄면서 종양학적 안전성에도 도움이 된다고 알려져 왔다. 개개인의 체형에 대한 병변의 종양학적 안정성을 충족시키는 최소 절제 비율에 따라 전위 또는 보충으로 나뉘게 된다. 환자의 기본 체형은 인종적인 영향을 받는 유방암의 특징으로, 유럽, 미국이나 영국의 경우 평균 크기가 대개 36D(600 ㎤) 이상으로, 유방고정술이나 유방축소술이 주로 사용되고, 성형 측면의 최대 목표인 대칭을 위해서는 반대측 유방의 축소도 흔히 이루어지고 있다. 부산대학교병원 유방암 환자 671명의 평균 분포를 분석해 본 결과, 평균은 33A (75%, <35B)로, 대략 체적은 300 ㎤ (75%, <400 ㎤)라고 생각할 수 있다. 따라서 서양과는 다른 수술법이 선택될 수 밖에 없다. 수술 전 MRI를 이용한 범위의 확인을 통한 대상 선정과 함께 초음파와 피부 표식을 이용한 정확한 절제 범위의 계획도 중요하다. 병리적 판독 기준도 절제연 음성이면 종양학적 안정성에 충분하다는 것으로 관점이 바뀐 것은 보존 수술에 유리한 측면이 된다. 동결절편검사는 여전히 고급 전문 인력, 시간이 지나치게 소요되고 있어 편리하고 안전한 병변의 절제에 도움이 될 만한 새로운 방법들이 필요하여 연구되고 있다. 대표적인 최근 연구로는 무선주파수를 이용하는 margin probe, 형광 색소를 결합한 Aqueous Quantum-Dot-Molecular Probes 등을 들 수 있다. 합병증 측면에서 박리 면적이 늘어나는 종양성형학적 수술의 단점을 보강할 수 있는 최근 기술로 초음파 에너지 기구들이 유용하고, 수술 범위가 늘어남에 따라 생길 수 있는 혈종이나 장액 저류의 감소에 도움이 될 수 있다.

• 한국환경보건학회지
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• 제41권3호
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• pp.182-190
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• 2015

Objectives: To introduce a protocol of Mobi-kids study which was aimed to examine an association between radiofrequency (RF) radiation exposure by mobile phone use and brain tumor risk in children and adolescents. Methods: The Mobi-kids study was a multinational matched case control study using a standardized protocol with the number of subjects targeted about 1,000 cases and 2,000 controls aged 10 to 24. In Mobi-Kids Korea, the source population was restricted to Seoul, Incheon, and Gyeonggi-do province. Eligible cases of primary brain tumor (glioma, meningioma, and others) were diagnosed from January 2012 to June 2015. Eligible controls were appendicitis patients operated during the study period. Two controls were matched on age, gender, and study region for 1 case. Information about pattern and history of mobile phone use and other covariates were obtained by face to face interview by trained interviewer. The Mobi-kids study has been involved in Mobi-expo as a validation study about mobile phone use, XGridmaster to localize tumor in the brain for RF energy calculation, and histological review for validation of diagnosis. Results: The Mobi-kids was the first and largest study in children and adolescents to estimate risk of brain tumor in association with the RF energy absorption in the brain estimated by mobile phone use. Forty-six-cases and 54 controls were collected as of September 2014 in Korea. Conclusions: The meaningful results of the study were expected because of the largest sample size, high validity of EMF exposure assessment as well as the susceptible study populationof children and adolescents.

• Journal of Yeungnam Medical Science
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• 제24권2호
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• pp.197-205
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• 2007

Background : The occurrence of atrial fibrillation after ablation of atrial flutter is clinically important. We investigated variables predicting this evolution in ablated patients without a previous atrial fibrillation history. Materials and Methods : Thirty-six patients (Male=28) who were diagnosed as atrial flutter without previous atrial fibrillation history were enrolled in this study. Group 1 (n=11) was defined as those who developed atrial fibrillation after atrial flutter ablation during 1 year follow-up. Group 2 (n=25) was defined as those who has not occurred atrial fibrillation during same follow-up term. Echocardiogram was performed to all patients. We measured left atrial size, left ventricle end diastolic and systolic dimension, ejection fraction and left atrial volume index before and after ablation of atrial flutter. The differences of each variables were compared and analyzed between two groups. Results : The preablation left ventricular ejection fraction (preLVEF) and postablation left ventricular ejection fraction (postLVEF) are $54{\pm}14%$, $56{\pm}13%$ in group 1 and $47{\pm}16%$, $52{\pm}13%$ in group 2. The differences between each two groups are statistically insignificant ($2.2{\pm}1.5$ in group 1 vs $5.4{\pm}9.8$ in group 2, p=0.53). The preablation left atrial size (preLA) and postablation left atrial size (postLA) are $40{\pm}4mm$, $41{\pm}4mm$ in group1 and $44{\pm}8mm$, $41{\pm}4mm$ in group 2. The atrial sizes of both groups were increased but, the differences of left atrial size between two groups before and after flutter ablation were statistically insignificant ($0.6{\pm}0.9mm$ in group 1 vs $-3.8{\pm}7.4mm$ in group 2, p=0.149). The left atrial volume index before flutter ablation was significantly reduced in group 1 than group 2 ($32{\pm}10mm^3/m^2$, $35{\pm}10mm^3/m^2$ in group 1 and $32{\pm}10mm^3/m^2$, $29{\pm}8mm^3/m^2$ in group 2, p<0.05). Conclusion : The difference between left atrial volume index before and after atrial flutter ablation is the robust predictor of occurrence of atrial fibrillation after atrial flutter ablation without previous atrial fibrillation.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.173-181
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• 2011

Purpose: Masseter muscle is an important muscle of mastication. Because it has a great influence on the shape of low facial contour, patients who have masseteric hypertrophy show square-shaped jaw appearance. As aesthetic procedures for the reduction of the masseter muscle volume, radiofrequency ablation or botulinum toxin injection is at the center of attention. Authors studied the anatomical measurement of the thickness and width of masseter muscle and the surface mapping of the maximal thickness point using computed tomography (CT) scan to identify the useful guide for the injection of botulinum toxin in masseteric hypertrophy patients. Methods: We analyzed 2 mm-thickness OMU (ostiomeatal unit) CT of 112 normal people (224 masseter muscles) taken from June 2009 to May 2010. First, we measured the thickness, width and depth of the masseter muscle from the skin surface and analysed each by side, sex and age, respectively. The distribution of the thickness of the muscle and the correlation of thickness and width of the muscle were studied also. Second, we underwent surface mapping of the maximal thickness point using CT analysis by means of checking the vertical and horizontal distance from the angle of the mandible. Results: The average thickness and width of the masseter muscle was 17.73 mm and 40.78 mm in the male patients and were 14.33 mm and 37.42 mm in the female patients. Statistically, both figures of the male patients were larger than those of the female patients. However, the depth of the muscle from the skin surface in female patients (7.37 mm) was larger than that of the male patients (6.15 mm). There were no statistical difference in side or age. The width and thickness of the masseter muscle were in the positive correlation. The location of maximal thickness point of the masseter muscle was 27.77 mm vertically and 27.68 mm horizontally in the male patients, and 25.19 mm vertically and 25.42 mm horizontally in the female patients from the angle of mandible. Conclusion: We were able to present statistical evidence of the diagnosis and treatment of the masseteric hypertrophy regarding the anatomical measurements such as the thickness and width. And the maximal thickness point of the masseter muscle may be a useful guide for the clinical procedures of botulinum toxin injection.

• 생명과학회지
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• 제26권9호
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• pp.1088-1096
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• 2016

중등도 온열요법이 종양세포에 대한 세포독성, 종양혈관에 미치는 영향 및 면역학적 영향 등 다양한 항종양 활성을 가지고 있음에도 불구하고, 중등도 온열요법은 그 자체만으로는 항암효과가 뚜렷하지 않아, 방사선치료나 항암제 치료와 병용하여 암치료에 사용되고 있으면서, 심각한 부작용이 없이 어느 정도의 긍정적인 효과를 보이고 있다. 모든 연구에서 긍정적인 결과를 보이지 못한 것은 열충격 반응 그 자체가 온열요법의 항암효과를 방해하기 때문이다. 그러므로 온열요법의 효과를 증가시키기 위해서는 온열요법의 항암효과에 대한 부정적인 영향을 제거해야 한다. 암세포뿐만 아니라 혈관, 면역 세포 및 결체조직 등을 포함하고 있는 종양조직의 열 스트레스에 대한 반응은 매우 복잡하지만, 임상적으로 사용되고 있는 약물 중 열 스트레스 반응을 조절할 수 있는 약물들이 암환자의 온열요법 치료 효과를 개선시킬 수 있는 지에 대한 연구가 필요하다. 이 종설에서는 현재 임상에서 사용하고 있는 온열요법 장치로서 최신의 기술이며, 중등도 온도가 정상 조직에 대한 부작용 없이 기존 치료법의 효과를 증가시킬 수 있기 때문에, 비침습적 체외용 고주파 중등도 온열요법을 중심으로 다룬다.

• Journal of the Korean Wood Science and Technology
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• 제37권3호
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• pp.192-199
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• 2009

본 연구에서는 수용재적 약 $3m^3$ 크기의 압체고주파진공건조시스템을 이용하여 Azobe (Lophira alata)와 국산 소나무(Pinus densiflora) 제재목을 건조하면서 건조시스템의 성능을 평가하였다. 압체고주파진공건조기의 진공도는 80~105 mbar를 유지시켰고, 건조 중 재온은 건조초기 $40^{\circ}C$에서 시작하여 건조말기 $60^{\circ}C$까지 상승시켰다. 全건조기간에 걸쳐 기전전극판측의 재온은 제어온도보다 항상 높게 유지되는 반면, 접지전극판측의 재온은 항상 낮게 유지되었다. 건조시간이 경과함에 따라 접지전극판측의 재온은 제어온도보다 더욱 낮고 기전전극판측의 재온은 제어온도보다 더욱 높게 나타났다. Azobe의 경우 입력포트측의 평균최종함수율보다 입력포트반대측의 평균최종함수율이 모든 잔적층에서 미미하게 높게 나타났으며, 잔적층의 수직방향으로의 최종함수율은 기전전극판측에서 접지전극판측을 향할수록 높게 나타났다. 기전전극판과 인접한 잔적층의 경우 재목당 평균할렬의 발생길이가 매우 경미하였으나, 접지전극판측을 향할수록 증가하는 경향을 보였다. 또한 투입된 에너지의 효율면에 있어 선진국의 상용설비와 유사한 수준을 보여 주는 것으로 평가되었다.

• 대한치과보철학회지
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• 제39권1호
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• pp.84-95
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• 2001

Titanium is widely used in dentistry for its low density, high strength, fatigue resistance, corrosion resistance, and biocompatibility. But it has a tendency of surface damage under circumstance of friction and impact for its low hardness of the surface. Coating is one of methods fir increasing surface hardness. Its effect is to improve surface physical characteristics without change of titanium. Diamond-like carbon and titanium nitride are known for its high hardness of the surface. So that this study was aimed at the wear test and the cytotoxicity test of the commercially pure titanium and Ti-6Al-4V alloy which were deposited by diamond-like carbon film or titanium nitride film to acertain improvement of the surface hardness and the biocompatibility. A disk (25mm diameter, 2mm thickness) was made of commercially pure titanium and Ti-6Al-4V alloy and these substrates were deposited by diamond-like carbon film or titanium nitride film. Diamond-like carbon film was deposited by the method of radiofrequency plasma assisted chemical vapor deposition and titanium nitride film was deposited by the method of reactive arc ion plating. Then these substrates were tested about wear characteristics by the pin-on-disk type wear tester in which ruby ball was used as a wear causer under the load of 32N, The fracture cycles were measured by rotating the substrates until their films were fractured. The wear volume was measured after 150 cycles and 3,000 cycles using surface profiler. The cytotoxicity test was peformed by the method of the MTT assay. The results were as follows : 1. In the results of the wear volume test, commercially pure titanium and titanium alloy which were coated by diamond-like carbon film or titanium nitride aim had higher resistance against wear than the substrates which were not coated by any films (P<0.05). 2. In the results of the fracture cycle test and the wear volume test, diamond-like carbon film had higher resistance against wear than titanium nitride film (P<0.05). 3. In both coatings of diamond-like carbon aim and titanium nitride film, Ti-6Al-4V alloy had higher resistance against wear than commercially pure titanium (P<0.05) 4. In the results of the cytotoxicity test, diamond-like carbon film and titanium nitride film had little cytotoxicity as like commercially pure titanium or Ti-6Al-4V alloy (P>0.05).

• The Korean Journal of Physiology and Pharmacology
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• 제20권5호
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• pp.507-514
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• 2016

Although 3D-complex fractionated atrial electrogram (CFAE) mapping is useful in radiofrequency catheter ablation for persistent atrial fibrillation (AF), the directions and configuration of the bipolar electrodes may affect the electrogram. This study aimed to compare the spatial reproducibility of CFAE by changing the catheter orientations and electrode distance in an in -silico left atrium (LA). We conducted this study by importing the heart CT image of a patient with AF into a 3D-homogeneous human LA model. Electrogram morphology, CFAE-cycle lengths (CLs) were compared for 16 different orientations of a virtual bipolar conventional catheter (conv-cath: size 3.5 mm, inter-electrode distance 4.75 mm). Additionally, the spatial correlations of CFAE-CLs and the percentage of consistent sites with CFAE-CL<120 ms were analyzed. The results from the conv-cath were compared with that obtained using a mini catheter (mini-cath: size 1 mm, inter-electrode distance 2.5 mm). Depending on the catheter orientation, the electrogram morphology and CFAE-CLs varied (conv-cath: $11.5{\pm}0.7%$ variation, mini-cath: $7.1{\pm}1.2%$ variation), however the mini-cath produced less variation of CFAE-CL than conv-cath (p<0.001). There were moderate spatial correlations among CFAE-CL measured at 16 orientations (conv-cath: $r=0.3055{\pm}0.2194$ vs. mini-cath: $0.6074{\pm}0.0733$, p<0.001). Additionally, the ratio of consistent CFAE sites was higher for mini catheter than conventional one ($38.3{\pm}4.6%$ vs. $22.3{\pm}1.4%$, p<0.05). Electrograms and CFAE distribution are affected by catheter orientation and electrode configuration in the in-silico LA model. However, there was moderate spatial consistency of CFAE areas, and narrowly spaced bipolar catheters were less influenced by catheter direction than conventional catheters.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2857-2860
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• 2016

Background: Chronic hepatitis B (CHB) infection is one of the important causes of hepatocellular carcinoma (HCC) in Thailand, involved in the pathogenesis and leading to a development of HCC with or without cirrhotic changes of the liver. This study was aimed to investigate the predictive factors for HCC among CHB patients in a tertiary care center in Thailand. Materials and Methods: We conducted a retrospective study of CHB patients with or without HCC during the period of January 2009 and December 2014 at Thammasat University Hospital, Pathumthani, Thailand. Data on clinical characteristics, biochemical tests and radiologic findings were collected from review of medical records. Results: A total of 266 patients were diagnosed with CHB in Thammasat university hospital during the study period. However, clinical information of only 164/266 CHB patients (98 males, 66 females with mean age of 49.4 years) could be completely retrieved in this study. The prevalence of HCC in CHB infection in this study was 38/164 (23.2%). CHB patients with HCC had a mean age older than those without HCC (59.5 vs 47 years, P-value = 0.01). Furthermore, history of upper GI bleeding, tattooing, blood transfusion, and chronic alcoholism were significantly more common in CHB patients with HCC than patients without HCC (13.2% vs 3.2% P-value 0.03, OR = 4.6, 95%CI = 1.2-18.1, 20% vs 3.9%, P-value = 0.01, OR= 6.1, 95% CI= 1.6-23.6, 20% vs 6.3%, P-value = 0.03, OR = 3.8, 95%CI =1.1-12.7, 62.2% vs 30.3%, P-value <0.0001, OR = 3.7, 95%CI= 1.7-8.1 respectively). Interestingly, more CHB patients with HCC had evidence of cirrhosis than those without HCC (78.9% vs 20.4%, P-value <0.0001, OR = 14.6, 95%CI = 5.8-36.7). In CHB patients with HCC, surgical therapy provided longer survival than radiofrequency ablation (RFA) (72 vs 46.5 months, P-value= 0.04). The mean survival time after HCC diagnosis was 17.2 months. Conclusions: HCC remains a major problem among patients with CHB infection in Thailand. Possible risk factors are male gender, history of upper GI bleeding, chronic alcoholism, tattooing, blood transfusion and evidence of cirrhosis. For early stage HCC patients, surgical treatment provided longer survival time than RFA. Most HCC patients presented with advanced disease and had a grave prognosis. Appropriate screening of CHB patients at risk for HCC might be an appropriate approach for early detection and improvement of long-term outcomes.