• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.179-183
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• 2016

Breast cancer is the most prevalent type of cancer among women around the world, and mortality is primarily caused by micro-metastatic disease. The complex mechanisms of breast cancer invasion and metastasis are intrinsically related to the malignant cell type so that early detection of micro-metastases can help prolongation of survival for patient. The aim of the present research work was evaluation of the expression status of mammoglobin protein as a candidate molecular marker in the negative sentinel lymph node (SLN). Fifty tumor specimens, and 50 normal adjacent breast tissue samples from the same patients were selected on the basis of having more than 10% tumor content for RNA extraction from SLNs. Tumor samples and normal adjacent breast tissue were archived in the form of frozen fresh tissue in liquid nitrogen. Real-time PCR was performed on a Bioner life express gradient thermal cycler system. Mammoglobin gene overexpression in breast cancer metastasis was investigated. Single marker results were mammaglobin 66.7% and CK19 50.0%, with 58.3% for the two in combination. Due to improved outcome with at least 3 genes (83.3%), it seems, triple marker evaluation will be most likely useful for detecting micro-metastases instead of studying separate genes.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.813-818
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• 2014

Aims: To describe our institutional experience with high dose rate (HDR) interstitial brachytherapy (IBT) compared with previously reported results on the low dose rate (LDR) practice for head and neck cancer. Materials and Methods: Eighty-four patients with oral cavity (n=70) or oropharyngeal cancer (n=14) were treated with 192Ir HDR-IBT. Seventy-eight patients had stage I or II tumour. The patients treated with IBT alone (n=42) received 39-42 Gy/10-14 fractions (median=40 Gy/10 fractions). With respect to the combination therapy group (n=42), prescription dose comprised of 12-18 Gy/3-6 fractions (median=15 Gy/5 fractions) for IBT and 40-50 Gy/20-25 fractions (median=50 Gy/25 fractions) for external radiotherapy. Brachytherapy was given as 2 fractions per day 6 hours apart with 4 Gy per fraction for monotherapy and 3 Gy per fraction for combination therapy. Results: Four patients were not evaluable in the analysis of outcome. The primary site relapse rates were 23.8% (10/42) and 68.4% (26/38) in patients treated with IBT alone and combination therapy, respectively (p<0.001). Salvage surgery was performed in 19 patients. The 5-year local control rate was estimated at 62% and the disease-free survival (DFS) rate at 52% for all patients. Local control with respect to T1 and T2 tumours was 84% and 42%, respectively. Conclusions: Our present series on HDR-IBT and the previous report on LDR-IBT for head and neck cancer demonstrated similar DFS rates at 5 years (52%). The rate of regional failure in node-negative patients was <20% in both of our series. HDR-IBT offers similar results to LDR-IBT for head and neck cancer.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.827-833
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• 2020

Objective : Spine surgery is associated with higher morbidity and mortality rates in elderly patients. The modified Frailty Index (mFI) is an evaluation tool to determine the frailty of an individual and how preoperative status may impact postoperative survival and outcomes. This study aimed to determine the usefulness of mFI in predicting postoperative complications in patients aged ≥75 years undergoing surgery with instrumentation. Methods : We retrospectively reviewed the perioperative course of 137 patients who underwent thoracolumbar-instrumentation spine surgery between 2011 and 2016. The preoperative risk factors were the 11 variables of the mFI, as well as body mass index (kg/㎠), preoperative hemoglobin, platelet, albumin, creatinine, anesthesia time, operation time, estimated blood loss, and transfusion amount. The 60-day occurrences of complication rates were used for outcome assessment. Results : Major complications after spinal instrumentation surgery occurred in 34 of 138 patients (24.6%). The mean mFI score was 0.18±0.12. When we divided patients into a pre-frail group (mFI, 0.09-0.18; n=94) and a frail group (mFI ≥0.27; n=44), only the rate of sepsis was statistically higher in the frail group than in the pre-frail group. There were significantly more major complications in patients with low albumin levels or in patients with infection or who had experienced trauma. The mFI was a more useful predictor of postoperative complications than the American Society of Anesthesiologists physical status score. Conclusion : The mFI can successfully predict postoperative morbidity and mortality in patients aged ≥75 years undergoing spine surgery. The mFI improves perioperative risk stratification that provides important information to assist in the preoperative counselling of patients and their families.

• 유통과학연구
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• 제13권7호
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• pp.53-61
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• 2015

Purpose - This research analyzes overseas expansion support systems for small- and medium-sized enterprises in Germany and Japan. Germany and Japan have developed overseas expansion support policies for such enterprises. The study then explores the implications for Korea and its local governments. Research design, data, and methodology - We did a comparative analysis of Japan and Germany and their support for overseas expansion of small and medium companies. Data were mainly collected from the Ministry of Economy, Trade and Industry (Japan) and the Germany Trade and Invest (Germany) agency through statistics and literature surveys, and analysis studies. Results - First, human resources cultivation and funding support policies, which both Germany and Japan use as part of small- and medium-sized enterprise policies, should be modified to Korean circumstances and to reflect its own small- and medium-sized enterprise support needs. Second, both the German policies that support overseas expansion of small- and medium-sized enterprises and those of Japan's include the philosophy and methods that put an emphasis on these enterprises, despite the fact that there are big differences in the overseas policies in these two countries. Third, German and Japanese governments are embracing the idea that small- and medium-sized enterprises are key to their national economies and implementing policies based on the ratio occupied by these enterprises in the domestic consumption or GDP. In other words, Germany and Japan consider small- and medium-sized enterprises as central to their nation's industry, and assess them as economic industry that should definitely exist for the continued survival of big businesses, and not just as merely supplemental to big business. Fourth, whereas Germany emphasizes support to product exhibition in its overseas expansion support policies, Japan is providing integrated support containing foreign direct investment to small- and medium-sized enterprises. Fifth, there are differences in the overseas expansion support in Germany and Japan in terms of their support to big business. Whereas Germany considers support to big business unnecessary, Japan is implementing active support policies to areas corresponding to big business. Korea will have to benchmark the policies of Germany and Japan, and decide whether or not to give full support to small- and medium-sized enterprises, while excluding areas supporting big business. Conclusions - Based on this analysis of German and Japanese overseas expansion support policies, we need to choose the policies that will engender a solid outcome and derive modified policies for the circumstances of Korea. Additionally, we can use the comparison of the overseas support policies of Japan and Germany to choose small- and medium-sized enterprise overseas expansion support policies for Korea. However, we cannot provide specific overseas support policies by industry. This point will be referenced as a limitation of this study. In future research, we expect that some researchers will take an empirical approach to exploring Korean overseas expansion support through collecting cases of overseas support policies and interviewing policy authorities.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.59-66
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• 2010

Purpose: In the finger, there are three major palmar arches in the arterial system. The location of this arches are constant. The middle and distal transverse arches are consistently large (almost 1 mm) and may be used for arterial vessel repairs either proximally or distally, depending on the length and direction needed. This paper describes our experiences in reconstruction and replantation of the finger using rerouting the transverse digital palmar arch. Methods: 31 patients with injuries according to our classification were treated from March of 2005 to October of 2008. In this study the authors subdivided injuries into those with amputation distal to the insertion of the flexor digitorum profundus (Class I, 31 fingers); those with amputation distal to the insertion of the flexor digitorum superficialis (Class II, 4 fingers). Replantation was performed using the artery-only technique with neither vein nor nerve repair. Because the artery has been damaged, it is still possible to make a direct suture by transposing the arterial arch in an inverted Y to I arterial configuration or converting the arch. Venous drainage was provided by an external bleeding method with partial nail excision, medical leech, and repaired margin. Results: The success rate was 87% (n=27) in class I and 75% (n=4) in class II. The authors conclude that crushing and complete avulsion injuries & amputations are salvageable, with acceptable functional results in select patients, especially those with amputation distal to the insertion of the flexor digitorum superficialis. Conclusion: We performed replantation and reconstruction with only-arterial transposing anastomosis successfully, resulting in good recovery of aesthetic and functional outcome. Three major digital palmar arches, especially distal two branches, give us additional treatment options. In the finger replantation and reconstructive techniques using rerouting healthy the transverse digital palmar arch increase the survival rate of the finger.

• 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.

• Journal of Yeungnam Medical Science
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• 제19권2호
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• pp.126-135
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• 2002

신생혈관녹내장에 대한 MMC 섬유주절제술의 효과와 그 예후에 영향을 미치는 요인에 대해 알아보고자 하였다. 신생혈관녹내장으로 진단하고 MMC 섬유주절제술을 시행한 55명, 62안을 대상으로 의무기록을 후향적으로 조사하였다. 수술 성공 여부의 기준은 술후 안압하강제 사용에 관계없이 술후 최종 안압이 21 mmHg이하이며 시력상실이 없는 경우를 성공으로 판정하였고, 술전 시력이 광각이상의 환자에서 광각이 소실된 경우와 광각무인 환자에서 안구위축이 발생한 경우 및 안압하강을 위해 추가적 녹내장수술을 시행한 경우는 수술실패로 판정하였다. 평균 $23.9{\pm}16.2$개월의 추적 관찰 후 전체 62안 중 37안(60%)이 수술성공으로 판정되었다. Kaplan-Meier 생존분석을 이용한 수술 후 6개월, 12개월, 24개월, 36개월의 누적 수술성공률은 각각 85%, 71%, 57%, 52%이었다. 당뇨망막병증이 있는 경우가 다른 원인을 가진 경우보다 수술성공률이 더 높았고(p=0.005), 범망막광응고술을 시행한 경우에서 시행하지 않은 경우보다 수술성공률이 더 높았다(p=0.015). 하지만, 범망막광응고술의 시행여부는 Cox proportional hazard regression 분석법에 의해 섬유주절제술 실패의 의미있는 위험인자로 작용하지는 않았다. 결론적으로 신생혈관녹내장은 원인질환이 당뇨망막병증의 경우 MMC를 사용한 섬유주절제술의 예후가 다른 원인질환에 의한 경우보다 양호하였으며, MMC를 이용한 섬유주절제술이 방수유출장치삽입술이나 모양체광응고술에 앞서 일차적 수술로 유용하다고 생각한다.

• 대한임상독성학회지
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• 제3권2호
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• pp.93-98
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• 2005

Purpose: This study was to investigate the resuscitation outcomes and the clinical characteristics of non-traumatic drug-induced out-of-hospital cardiac arrest by analyzing data from a single institution's registry. Method: We conducted a retrospective study of 795 patients who came to the emergency department with non-traumatic drug-induced out-of-hospital cardiac arrest during the period $1991{\~}2004$. Only patients over 18 years of age were included. Clinical characteristics. variables associated with cardiac arrest, and data during resuscitation were obtained from our cardiac arrest database. Patients were divided into two groups: drug-induced cardiac arrest (drug group, n=33), and non drug-induced cardiac arrest (non-drug group, n=762). Results: Spontaneous circulation was restored in 23 ($72{\%}$) patients in the drug group and in 314 ($45{\%}$) patients in the non-drug group ($x^2=0.020$). The patients who discharged alive number were 46 ($6{\%}$) in the non-drug group and 0 ($0{\%}$) in the drug group ($x^2=0.005$). The witnessed arrest, the epinephrine doses, and total defibrillation energy were not different between two groups. Conclusion: The return of spontaneous circulation rate was higher in the drug group than the non-drug group. However the drug group was lower survival discharge rate than in the non-drug group.

• 대한치과보철학회지
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• 제49권2호
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• pp.106-113
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• 2011

연구 목적: 전통적인 초기의 접착성 고정성 보철물이 가능한 보존적이고 가역적인 치료를 추구했지만 유지력의 상실이 큰 문제가 되면서 임상적 성공률이 낮은 단점이 있었다. 이러한 한계를 극복하고자 하는 여러 연구들 중, 자연 치아의 언더컷과 구조물의 각기 다른 삽입로를 이용하여 유지력을 얻는 3-piece형태의 변형된 접착성 고정성 보철물이 제안되었다. 이 연구의 목적은 변형된 형태의 접착성 고정성 보철물을 이용하여 수복 치료를 받은 환자에 대한 후향적 연구를 통하여 임상가들의 상실치 수복을 위한 치료 계획 수립에 도움을 주고자 함이다. 연구 재료 및 방법: 한 개 혹은 그 이상의 치아가 상실되어 수복을 요하여 2007년부터 연세대학교 치과대학병원 보철과에 내원하여 자연치아의 언더컷과 구조물의 각기 다른 삽입로를 이용하는 변형된 형태의 접착성 고정성 보철물 수복 치료를 받은 23명의 환자중 주기적 검사가 가능한 21명을 대상으로, 후향적으로 임상 및 방사선 검사 결과를 평가하였다. 결과 및 결론: 자연치아의 언더컷과 구조물의 각기 다른 삽입로를 이용한 접착성 고정성 보철물을 이용한 21명증례, 71 unit의 최대 25개월 (평균 7개월)간의 후향적 연구에서 다음과 같은 결과를 얻었다. 1. 자연치아의 언더컷과 구조물의 각기 다른 삽입로를 이용한 접착성 고정성 보철물은 단기간의 follow-up 에서 보철물의 탈락, 파절등의 기계적인 실패가일어나지 않았다. 2. 보철물 주변의 치주조직은 비교적 안정되었다. 3. 방사선 사진상 유의성있는 골흡수를 보이지 않았다.

• Journal of Gastric Cancer
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• 제6권4호
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• pp.221-226
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• 2006

목적: 암 환자의 골수에서 발견되는 cytokeratin 양성세포와 암의 재발과의 상관관계에 대해서는 알려진 바가 많지 않다. 이에 위암환자의 골수에서 발견되는 cytokeratin 양성세포가 위암 환자의 재발과 생존율을 예측할 수 있는지 알아보고자 하였다. 대상 및 방법: 1998년 6월부터 2000년 7월까지 경북대학교병원 외과에서 원발성 위암으로 수술받은 환자 419명을 대상으로 하였다. 수술 직전 장골능선에서 골수를 흡인하여 단핵구를 분리하고 항 cytokeratin 항체를 이용하여 면역세포화학적 염색을 하였다. 결과: Cytokeratin 양성세포는 219예(52.4%)에서 발견되었고, 위암의 침윤깊이(P=0.021), 병기(P=0.026)에 따라서 통계학적으로 유의한 차이가 있었으나, 암의 위치, 육안형, 림프절전이, 원격전이, 분화도에 따라서는 유의한 차이가 없었다. 골수의 cytokeratin 양성세포 유무에 따른 5년 생존율은 유의한 차이가 없었고(P=0.248), 재발여부, 재발부위도 유의한 차이가 없었다. 결론: 위암 환자의 골수에서 cytokeratin 양성세포 유무는 예후인자로 사용되기 어렵고 재발양상을 예측하기도 어렵다.