• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.623-630
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• 2020

Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.157-165
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• 2011

Objective : We have introduced a method of characterization of invading glioma cells by using molecular analysis of marginal invading tumor cells and molecular profiles of glioma tumor margin. Methods : Each of tumor core and marginal tissues was obtained in 22 glioma patients. Tumor core cells and marginal cells from each glial tumor were collected by laser capture microdissection or intraoperative microdissection under the operating microscope. Expression of MMP-2, MMP-9, CD44 and RHAMM mRNA by invading glioma cells compared with tumor core was confirmed by realtime-PCR of twenty-four glioma specimens. Clinical data also were reviewed for invasion and recurrence pattern of the gliomas radiologically and invasive rim pattern microscopically. Results : Overall results of the molecular analysis showed that relative overexpression of MMP-2, MMP-9 and RHAMM were noted at the invasive edge of human glioma specimens comparing to the tumor core but CD44 was highly expressed in the tumor core comparing to the margin. High marginal expression of MMP-2 and MMP-9 were noted in poorly ill-defined margin on the pathological finding. High marginal expression of CD44 and MMP-2 were demonstrated in the midline cross group on the radiological review, and that of RHAMM and MMP-2 were showed in the aggressive recurrence group. High expression of MMP-2 seems to be involved in the various invasion-related phenomenons. Conclusion : Up-regulation of MMP-2, MMP-9, CD44 and RHAMM was noted in invasive edge of gliomas according to the various clinical situations.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1601-1607
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• 2013

A determination of circulating tumor cell (CTC) effectiveness for prediction of progression-free survival (PFS) and overall survival (OS) was conducted as an adjunct to standard treatment of care in breast cancer management. Between November 2008 and March 2009, 22 metastatic and 12 early stage breast carcinoma patients, admitted to Ankara Oncology Training and Research Hospital, were included in this prospective trial. Patients' characteristics, treatment schedules and survival data were evaluated. CTC was detected twice by CellSearch method before and 9-12 weeks after the initiation of chemotherapy. A cut-off value equal or greater than 5 cells per 7.5 ml blood sample was considered positive. All patients were female. Median ages were 48.0 (range: 29-65) and 52.5 (range: 35-66) in early stage and metastatic subgroups, respectively. CTC was positive in 3 (13.6%) patients before chemotherapy and 6 (27.3%) patients during chemotherapy in the metastatic subgroup whereas positive in only one patient in the early stage subgroup before and during chemotherapy. The median follow-up was 22.0 (range: 21-23) and 19.0 (range: 5-23) months in the early stage and metastatic groups, respectively. In the metastatic group, both median PFS and OS were significantly shorter in any time CTC positive patients compared to CTC negative patients (PFS: 4.0 vs 14.0 months, Log-Rank p=0.013; and OS: 8.0 months vs. 20.5 months, Log-Rank p<0.001). OS was affected from multiple visceral metastatic sites (p=0.055) and higher grade (p=0.044) besides CTC positivity (log rank p<0.001). Radiological response of chemotherapy was also correlated with better survival (p<0.001). As a result, CTC positivity was confirmed as a prospective marker even in a small patient population, in this single center study. Measurement of CTC by CellSearch method in metastatic breast carcinoma cases may allow indications of early risk of relapse or death with even as few as two measurements during a chemotherapy program, but this finding should be confirmed with prospective trials in larger study populations.

• Tuberculosis and Respiratory Diseases
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• 제59권1호
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• pp.109-113
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• 2005

저자들은 중증 폐렴으로 인한 ARDS양상으로 내원한 임신 3개월의 속립성 결핵 환자를 경기관지 폐생검과 방사선 소견 및 임상양상을 종합적으로 고려하여 속립성 결핵에 의한 ARDS로 확진할 수 있었던 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제75권6호
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• pp.238-243
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• 2013

Background: The aim of our study was to evaluate the "diagnosis changed" rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: "diagnosis maintained", "diagnosis changed" (initially notified as TB, but ultimately diagnosed as non-TB), and "administrative error" (notified as TB due to administrative errors). Results: Excluding 17 patients in the "administrative error" group, the "diagnosis maintained" and "diagnosis changed" groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of "diagnosis changed" were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn's disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a "diagnosis changed" result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high "diagnosis changed" rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the "diagnosis changed" rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of "diagnosis changed" cases is desirable.

• 대한골관절종양학회지
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• 제9권2호
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• pp.162-168
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• 2003

목적: 골격을 침해하는 원발성 악성종양으로는 골육종이나 연골육종 같은 간엽성육종과 유윙육종이나 림프종 같은 소원형세포성육종으로 나눈다. 골격육종을 진단하기 위해 관상골 육종은 MR검사를 편평골 육종은 CT검사를 주로 이용한다. MR과 CT는 공히 골파괴병소와 연조직종괴를 잘 나타내지만 무기질침착은 MR에서 식별되기 어렵다. 이에 본저자들은 관상골 MR과 편평골 CT검사의 골파괴 소견으로 간엽성육종과 소원형세포성육종을 감별하고자 하였다. 대상 및 방법: 수술적 조직생검술에 의한 병리조직학적으로 진단되고 관상골 MR 또는 편평골 CT검사를 시행했던 간엽성육종 28례와 소원형세포성육종 26례를 대상으로 하였다. 관상골 MR검사 26례와 편평골CT검사 28례에서 골파괴 병소 소견을 각각 편심성과 중심성으로 나누어 비교 분석하였다. 결과: 관상골 MR검사에서 간엽성육종 16례중 12례(75.0%)가 편심성 골파괴 소견이였고 소원형세포육종 10례는 전례(100.0%)가 중심성 골파괴 소견이었다(p>.01). 편평골 CT검사에서 간엽성육종 12례중 10례(83.3%)에서 편심성 골파괴 소견이었고 소원형세포성육종 16례중 13례(81.3%)가 중심성 골파괴 소견을 보였다(p>.01). 결론: 관상골 MR검사든 편평골 CT검사든 골파괴 양상을 중심성과 편심성으로 나누는 방사선학적 소견은 간엽성육종과 소원형세포성육종을 감별 진단하는데 도움이 되는 소견이었다.

• Journal of Yeungnam Medical Science
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• 제16권2호
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• pp.296-301
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• 1999

자궁의 MMMT와 자궁내막암을 감별진단할 수 있는 자기공명영상 소견을 알아보기 위하여 자궁적출술에 의해 병리적으로 확인된 5례의 MMMT와 14례의 자궁내막암을 대상으로 종괴의 크기, 자궁근층 및 자궁경부의 침범 유무, 종괴의 성장 양상, 신호강도와 조영증강의 정도 및 양상을 후향적으로 분석하였다. 종괴의 장경은 MMMT가 1.5-9cm(평균, 5.7cm)이었고, 자궁내막암은 0.5-6.0cm(평균, 2.5cm)이었다. MMMT 5례 중 3례에서 자궁경부의 침범이 확인되었는데, 이들은 자궁강과 자궁경부의 내강을 확장시키면서 외자궁구로 성장하는 양상을 보였으며, 자궁내막암은 14례 중 1례에서만 자궁경부 침범이 확인되었다. 자궁근층 침범의 유무, T1- 및 T2-강조영상에서의 신호강도와 균일성, 조영증강의 정도와 양상은 별다른 차이가 없었다. 이상의 결과에서, MMMT와 자궁내막암을 감별할 수 있는 특이한 소견은 확인할 수 없었으나, 종괴가 5cm 이상으로 크고, 자궁경부 내강을 확장시키면서, 자궁경부를 침범하는 경우에는 MMMT의 가능성을 고려해야 할 것으로 생각한다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7689-7694
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• 2015

Background: Bone tumors are neoplasias with a high overall mortality; one of the main factors that reduce survival is their high capacity to develop metastases. It has been reported that finding lung metastases at diagnosis of osteosarcoma (OS), chondrosarcoma (CS) and giant cell tumor of bone (GCTb) is quite common. In this study, we inquire the relationship of metastases caused by these tumors with different clinical and pathological aspects, in order to guide medical personnel in the diagnosis and opportune treatment of metastases or micro metastases. Materials and Methods: We collected data of 384 patients with clinical, radiological and histopathological diagnosis of OS, GCTb and CS that attended the National Rehabilitation Institute (INR) during 2006 to 2014. Chi-square and Fisher's exact tests were performed for data analysis. Results: In the three tumor types, the presence of metastases at diagnosis was variable (p=0.0001). Frequency of metastases was 36.7%, 31.7% and 13.2% for OS, CS and GCTb respectively. The average age had no significant difference (p>0.05) in relation to metastases, even so, patients with OS and GCTb and metastases, were older while patients with CS and metastases were younger, in comparison to patients without metastases. Males had a higher frequency of metastases (68.2%, p = 0.09) in contrast to CS and GCTb, in which the metastases was more frequent in women with 51.9% (p = 0.44) and 57.9% (p = 0.56) respectively. Broadly, metastasis was associated with primary tumors located in the femur (44.4%), followed by the tibia (15.6%); metastases was more frequent when primary tumor of GCTb and OS were in the same bones, but were located in the hip (26.3%) for CS. Conclusions: The frequency of metastases in OS, GCTb and CS is high in our population and is determined by different clinicopathological variables related to the kind of tumor. Further studies are needed in order to evaluate metastases subsequent to diagnosis and associations with survival and clinicopathological factors, as well as to determine the sensitivity and specificity of current methods of detection.

• Journal of Radiation Protection and Research
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• 제29권4호
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• pp.243-249
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• 2004

본 연구는 소핵분석과 염색체 1번 및 4번의 DNA probe를 이용한 FISH 기법을 병행하여 방사선에 의한 소핵과 이수성에 관여하는 각 염색체의 감수성을 평가하고자 하였다. 방사선 선량에 따라 소핵의 빈도는 증가하였으며 염색체 1번과 4번의 이수성도 대조군, 1 Gy 및 2 Gy 에서 각각 2000개의 BN세포 당 9개, 47개 및 71개로 유의하게 증가하였다. 염색체 1번의 이수성 빈도는 4번에 비해 높게 관찰되었다. 염색체 1번 및 4번을 포함하는 소핵도 방사선의 선량에 따라 증가하였으며, 소핵내 염색체 1번의 포함빈도가 4번보다 높게 관찰되었다. 또한 방사선에 의한 소핵 중 낮은 빈도의 염색체 signal를 포함하는 소핵이 관찰됨으로써 방사선에 의한 소핵은 대부분 절단에 의한 것임을 확인할 수 있었다. 따라서 본 연구 결과 방사선은 이수성을 유도하며 이에 염색체가 다르게 관여할 수 있음을 보여준다.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.463-468
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• 2015

Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.