• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.1-13
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• 2005

Purpose: The purpose of this study is to present extended indications for the use of arterialized venous flaps in reconstructing soft tissue, tendon, nerve, blood vessel, and composite tissue defects of the hand of various sizes based on researches and clinical experiences of the authors. Moreover, procedures to achieve complete flap survival and postoperative results are presented. Materials & methods: This study is based on 154 cases of arterialized venous flaps performed to reconstruct the hand during the past 11 years. The most common cause of injury was industrial accidents with 125 cases. One hundred thirty patients or 84% of the cases had emergency operation within 2 weeks of the injury. The flaps were categorized depending on the size of the flap. Flaps smaller than $10\;cm^2$ were classified as small (n=48), those larger than $25\;cm^2$ classified large (n=42) and those in between medium (n=64). Classified according to composition, there were 88 cases (57.1 %) of venous skin flaps, 28 cases of innervated venous flaps, 15 cases of tendocutaneous venous flaps, which incorporated the palmaris longus tendon, for repair of extensor tendons of the fingers, and 17 cases of conduit venous flaps to repair arterial defect. There were 37 cases where multiple injuries to multiple digits were reconstructed. Moreover, there were 6 cases of composite tissue effects that involved soft tissue, blood vessels and tendons. The donor sites were ipsilateral forearm, wrist and thenar area, foot dorsum, and medial calf. The recipient sites were single digit, multiple digits, first web space, dorsum and palm of hand, and wrist. Results: There were seven cases (4.5%) of emergent re-exploration due to vascular crisis, and 3 cases of flap failure characterized by more than 50% necrosis of the flap. The survival rate was 98.1 % (151/154). In small flaps, an average of 1.01 afferent arteries and 1.05 efferent veins were microanastomosed, and in large flaps, an average of 1.88 afferent arteries and 2.19 efferent veins were anastomosed. In 8 cases where innervated flaps were used for reconstructing the palm of the hand, the average static two-point discrimination was $10\;(8{\sim}15)\;mm$. In 12 cases where tenocutaneous flaps were used, active range of motion at the proximal interphalangeal joint was 60 degrees, 20 degrees at the distal interphalangeal joint, and 75 degrees at the metacarpophalangeal joint. Conclusion: We conclude that the arterialized venous flap is a valuable and effective tool in the reconstruction of hand injuries, and could have a more comprehensive set of indications.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3645-3651
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• 2015

Background: Previous studies evaluating the association between the xeroderma pigmentosum group G (XPG) Asp1104His polymorphism and head and neck cancer susceptibility have proven controversial. This meta-analysis of the literature was performed to obtain a more precise estimation of the relationship. Materials and Methods: We systematically searched PubMed, Embase and Web of Science with a time limit of Dec 18, 2014. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of any association. Results: We performed a meta-analysis of eight published case-control studies, including 3,621 cases and 5,475 controls. Overall, no significant association was found between the XPG Asp1104His polymorphism and head and neck cancer susceptibility under all genetic models. In the subgroup analysis by ethnicity, the XPG Asp1104His polymorphism had statistically significant association with elevated head and neck cancer risk under CC vs GG (OR=1.24, 95% CI=1.00~1.54) and the recessive model (OR=1.22, 95%CI=1.01~1.46) in Asian populations. A similar result was found under CC vs GG (OR =1.22, 95%CI=1.01~1.47) in the population based subgroup by source of control. When performed by tumor site, the XPG Asp1104His polymorphism had statistically significant association with elevated laryngeal cancer under all genetic models (CC vs GG: OR=1.59, 95% CI=1.16~2.19; GC vs GG: OR=1.38, 95%CI=1.10~1.72; dominant model: OR=1.42, 95% CI=1.15~1.74; recessive model: OR=1.36, 95% CI=1.02~1.81). Conclusions: This meta-analysis suggested that the XPG Asp1104His polymorphism is a risk factor for head and neck cancer susceptibility, especially for laryngeal cancer and in Asian populations.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7639-7644
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• 2014

Background: Results from previous studies concerning the association of ERCC4 rs1800067 polymorphism with risk of cancer were inconsistent. To explore the exact relation with susceptibility, we conducted the present meta-analysis. Materials and Methods: Literature of electronic databases including PubMed, Web of Science, EMBASE, Wanfang and Chinese National Knowledge Infrastructure (CNKI) were systematically searched. ORs and their 95%CIs were used to assess the strength of associations between ERCC4 polymorphism and cancer risk. Results: There was no significant association between ERCC4 rs1800067 AA or AG genotypes and overall risk of cancer (AA vs. GG: OR=0.998, 95%CI=0.670-1.486, P=0.992; AG vs. GG: OR=0.970, 95%CI=0.888-1.061, P=0.508). A dominant genetic model also did not demonstrate significant association of (AA+AG) genotype carriers with altered risk of overall cancer (OR=0.985, 95%CI=0.909-1.068, P=0.719). In addition, no significant association was observed between A allele of ERCC4 rs1800067 A/G polymorphism and altered cancer risk compared with G allele (OR=0.952, 95%CI=0.851-1.063, P=0.381). Subgroup analysis suggested that AA genotype carriers were significantly associated with decreased risk of glioma compared with wild-type GG genotype individuals (OR=0.523, 95%CI=0.275-0.993, P=0.048). For subgroup of lung cancer, A allele of ERCC4 rs1800067 A/G polymorphism was significantly associated with decreased risk of lung cancer compared with G allele (OR=0.806, 95%CI=0.697-0.931, P=0.003). Conclusions: This meta-analysis indicated that ERCC4 rs1800067 A/G polymorphism might not be associated with risk of overall cancer. However, individuals with the AA genotype were associated with significantly reduced risk of glioma compared with wild-type GG genotype; The A allele was associated with significantly reduced risk of lung cancer compared with G allele. Future large-scale studies performed in multiple populations are warranted to confirm our results.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4247-4250
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• 2016

Background: Pax8 and peroxisome proliferator-activated receptor gamma 1 gene (Pax8-$PPAR{\gamma}1$) are important factors in tumors. Several studies have suggested that follicular thyroid cancer may arise from Pax8- $PPAR{\gamma}1$ rearrangement. In order to have a better understanding of the association between Pax8-$PPAR{\gamma}1$ rearrangement and follicular thyroid cancer, we conducted the presenmt meta-analysis. Materials and Methods: The information was extracted from PubMed, EMBASE and Web of Science. Statistic analysis was performed with Stata12.0 software. Odds ratios (ORs) were calculated using a fixed-effects model. We also performed heterogeneity and publication bias analyses. Results: Nine studies including 198 follicular thyroid cancer patients and 268 controls were considered eligible. The frequency of Pax8-$PPAR{\gamma}1$ rearrangement was significantly higher in the follicular thyroid cancer group than in the control group, with a pooled OR of 6.63 (95%CI=3.50-12.7). In addition, through subgroup analysis, the OR between Pax8-$PPAR{\gamma}1$ rearrangement and follicular thyroid cancer was 6.04 (95%CI = 3.18-11.5) when using benign tumor tissues as controls. The OR for the method subgroup was 9.99 (95% CI =4.86-20.5) in the RT-PCR. Conclusions: The final results demonstrated that Pax8-$PPAR{\gamma}1$ rearrangement has significant association with follicular thyroid cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4295-4300
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• 2016

Background: Recently, several studies have reported that elevated platelet counts may be associated with the poor prognosis of colorectal cancer. However, conclusions remain controversial. This meta-analysis was therefore designed to analyze and evaluate the prognostic role of preoperative or pretreatment thrombocytosis in patients with colorectal cancer. Materials and Methods: We searched PubMed, EMBASE, the Cochrane Library and Web of Science to March 29th, 2015. The citation lists of included studies were also hand-searched to identify further relevant trials. To investigate the association between thrombocytosis and prognosis of colorectal cancer, the 1-year, 3-year and 5-year survival of each studies were obtained. The odds ratio (OR) with its 95% confidence interval (CI) was used to evaluate the relation of overall survival (OS) between thrombocytosis and normal platelet counts (PLT). Likewise, disease free survival (DFS) was obtained and evaluated. The analysis was performed and assessed using Review Manager 5.2. Results: A total of 14 studies (N=5,566 participants, 11 including 4,468 for OS, 6 including 1,533 for DFS) were included in this meta-analysis, of which seven (N=3810) defined thrombocytosis as a platelet count ${\geq}400{\times}10^9/L$, and 375 (9.8%) patients exhibited pretreatment thrombocytosis. Thrombocytosis have a close relationship with the poor OS of colorectal cancer compared with normal PLT, with the pooled ORs of 1-year, 3-year and 5-year survival being 0.41 [95% CI 0.34-0.51; P<0.001], 0.28 [95% CI 0.21-0.38; P<0.001] and 0.26 [95% CI 0.20-0.34; P<0.001], respectively. For DFS, the same results were showed as the pooled ORs of 1-year, 3-year and 5-year survival respectively being 0.34 [95% CI 0.24-0.50; P<0.001], 0.31 [95% CI 0.23-0.43; P<0.001] and 0.25 [95% CI 0.18-0.34; P<0.001]. Conclusions: This meta-analysis indicated that thrombocytosis may predict poor prognosis for patients with colorectal cancer, and platelet counts may be a cost-effective and noninvasive marker.

• 한국컴퓨터정보학회논문지
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• 제16권10호
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• pp.155-164
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• 2011

정보통신기술이 빠른 속도로 발전하면서 교육 분야에서의 정보기술 활용이 변화를 가져오고 있으며 또한 스마트 폰의 교육적 활용이 긍정적인 효과를 보이면서 많은 사람들로부터 관심을 모으고 있다. 이제까지 개발된 전자 교과서 및 웹 기반의 학습 콘텐츠들은 학교 교육현장에서 주교재로 활용하는 데에는 한계점을 지니고 있기에 본 연구에서는 그 한계점을 집어보고, 모바일과 QR코드 기술을 기존의 교과서에 융합시켜 새로운 서책형 전자교과서 모델을 구현하여 전문계교육의 새로운 방향을 제시하였다. 본 연구는 전문교과를 접하는 학생들에게 열린교육의 환경을 조성하고 흥미를 유발할 수 있는 새로운 교수-학습의 방법을 적용하여, 학습의 동기부여와 쉽고 재미있게 수업에 참여시키는 것을 목적으로 하였다. 물론 이러한 연구의 궁극적인 목적은 전문교과의 학습능력을 높이고 나아가서는 수업 흥미도를 향상시켜 자기주도적 학습능력을 증대하는데 있었고, 본 모델을 운영해 본 결과 서책형 전자교과서를 활용한 학습이 학업 성취도에 긍정적인 영향을 미치는 것으로 나타났다.

• 한국강구조학회 논문집
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• 제18권5호
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• pp.543-551
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• 2006

최근까지 벽식 스틸하우스에 구조재로 주로 적용되어오고 있는 박판냉간성형형강 스터드의 경우 열교현상에 의한 단열상의 문제를가지고 있기 때문에 추가적인 단열재를 사용하여야 한다. 이러한 문제를 해결하기 위한 새로운 개념의 아연도금강판(t =1.0mm-1.2mm)과 난연 강화플라스틱(GFRP) 패널 (t=4.0mm-6.0mm)로 구성된 복합스터드가 개발되었다. 복합스터드 패널을 주택 에 적용하기 위하여, 복합스터드의 구조적인 거동 및 내하력 평가를 수행하였다. 본 논문에서는 ATTM(Axial/Torsional Test machine)을 이용하여 수행된 압축력과 비틂을 동시에 받는 복합스터드의 실험적인 연구결과를 기술하였다. 압축-비틂 실험의 주요 변수는 복합스터드의 길이, 초기 압축력, 가력방법 등이며, 초기 압축력을 일정하게 유지한 상태에서 스터드 시험체가 종국적인 파괴에 이르도록 비틂 하중을 점차 증가시키는 방법으로 실험을 수행하였다. 또한 고강도 아연도금강판과 GFRP의 기계적인 특성을 고려한 비선형 유한요소해석을 수행하여 실험결과와 비교, 검증하였다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5541-5547
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• 2015

Background: The role of surgical resection for patients with single large (${\geq}5cm$) and/or multinodular (${\geq}2$) hepatocellular carcinoma (HCC) is still controversial. This systematic review was performed to evaluate the safety and efficacy of resection for patients with single large and/or multinodular HCC. Materials and Methods: Databases (the PubMed, Web of Science, Embase, and Cochrane databases) were systematically searched to identify relevant studies exploring the safety and efficacy of resection for single large and/or multinodular HCC, published between January 2000 and December 2014. Perioperative morbidity and mortality, overall survival, and disease-free survival of the resection group were calculated. In addition, these outcome variables were also calculated for the control group in the included studies. Results: One randomized controlled trial and 42 nonrandomized studies involving 9,580 patients were eligible for analysis. Eight (1,594 patients) of the 43 studies also reported the outcomes of transarterial chemoembolization (TACE). Although 51.4% of patients featured cirrhosis, 90.7% of them demonstrated Child-Pugh A liver function in the resection group. The median rates of morbidity (24.5%) and mortality (2.5%) after resection were significantly higher than that of TACE (11.0%, P<0.001; 1.9%, P<0.001). However, patients who underwent resection had significantly higher median one-, three-, and five-year overall survival (76.1%, 51.7%, and 37.4%) than those who underwent TACE (68.3%, 31.5%, and 17.5%, all P<0.001). The median 1-, 3-, and 5-year DFS rates after resection were 58.3%, 34.6%, and 24.0%, respectively. Conclusions: Although tumor recurrence after resection for patients with single large and/ or multinodular HCC continues to be a major problem, resection should be considered as a strategy to achieve long-term survival.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6171-6176
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• 2014

Background: In order to design effective educational intervention for cancer survivors, it is necessary to identify most-trusted sources for health-related information and the amount of attention paid to each source. Objective: The objective of our study was to explore the sources of health information used by cancer survivors according to their access to the internet and levels of trust in and attention to those information sources. Materials and Methods: We analyzed sources of health information among cancer survivors using selected questions adapted from the 2012 Health Information National Trends Survey (HINTS). Results: Of 357 participants, 239 (67%) had internet access (online survivors) while 118 (33%) did not (offline survivors). Online survivors were younger (p<0.001), more educated (p<0.001), more non-Hispanic whites (p<0.001), had higher income (p<0.001), had more populated households (p<0.001) and better quality of life (p<0.001) compared to offline survivors. Prevalence of some disabilities was higher among offline survivors including serious difficulties with walking or climbing stairs (p<0.001), being blind or having severe visual impairment (p=0.001), problems with making decisions (p<0.001), doing errands alone (p=0.001) and dressing or bathing (p=0.001). After adjusting for socio-demographic status, cancer survivors who were non-Hispanic whites (OR= 3.49, p<0.01), younger (OR=4.10, p<0.01), more educated (OR= 2.29, p=0.02), with greater income (OR=4.43, p<0.01), and with very good to excellent quality of life (OR=2.60, p=0.01) had higher probability of having access to the internet, while those living in Midwest were less likely to have access (OR= 0.177, p<0.01). Doctors (95.5%) were the most and radio (27.8%) was the least trusted health related information source among all cancer survivors. Online survivors trusted internet much more compared to those without access (p<0.001) while offline cancer survivors trusted health-related information from religious groups and radio more than those with internet access (p<0.001 and p=0.008). Cancer survivors paid the most attention to health information on newsletters (63.8%) and internet (60.2%) and the least to radio (19.6%). More online survivors paid attention to internet than those without access (68.5% vs 39.1%, p<0.001) while more offline survivors paid attention to radio compared to those with access (26.8% vs 16.5%, p=0.03). Conclusions: Our findings emphasize the importance of improving the access and empowering the different sources of information. Considering that the internet and web technologies are continuing to develop, more attention should be paid to improve access to the internet, provide guidance and maintain the quality of accredited health information websites. Those without internet access should continue to receive health-related information via their most trusted sources.

• Journal of Yeungnam Medical Science
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• 제24권2호
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• pp.148-153
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• 2007

배경 : 의학시뮬레이션 교육방법이 새로이 도입되면서 다양한 방법이 개발되었다. 특히 컴퓨터와 인터넷을 이용한 시뮬레이션 교육이 학생들에게 사전에 임상수기 교육 및 임상경험을 가능하게 하여 많은 도움을 주고 있다. 본 연구는 $Microsim^{(R)}$ 프로그램을 이용한 학생들의 첫 경험을 보고하고 컴퓨터와 인터넷을 이용한 시뮬레이션 교육에 대하여 소개하고자 한다. 대상 및 방법 : 의학과 3학년 학생을 대상으로 임상의학입문 과정의 일환으로 $Microsim^{(R)}$ 프로그램을 이용하여 2주간의 실습후 획득한 점수를 산정하여 통과여부를 알아보고자 하였다. 모듈 1은 기도 및 호흡, 모듈 2는 심정지, 모듈 3은 심장 부정맥, 모듈 4는 흉통으로 정하였으며, 4개의 모듈에서 미리 지정된 각각의 증례하나를 선택하여 반복하여 실습하고 최종적으로 각각 통과점수가 70% 이상이 되어야 인정되도록 하였다. 결과 : 전체 75명의 학생이 참가하여 이중 56명(74.7%)이 4개의 모듈을 모두 통과하였다. 각각의 모듈의 평균 통과율은 모듈 1이 86.7%, 모듈 2가 85.3%, 모듈 3과 4가 각각 84.0%였으며, 4개 모듈의 평균점수는 88.6이었다. 결론 : 의학시뮬레이션이 비록 완전하게 통과되지는 않았지만 학생들로 하여금 실제적인 임상경험을 가능하게 하였다. 하지만 이는 아직은 기존의 교육방식의 보조적인 역할을 담당한다고 할 수 있으며 향후 좀 더 다양한 방법으로 반복된 시뮬레이션 교육과 이에 대한 평가가 필요할 것으로 사료된다. 아울러 의학시뮬레이션의 다양한 교육방법에 대하여 소개를 하고자 하였다.