• Radiation Oncology Journal
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• 제19권4호
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• pp.327-334
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• 2001

목적 : 직장암에 대한 수술 단독 또는 수술후 방사선치료를 받은 환자를 대상으로 골반종양제어율과 생존율, 합병증 발생률, 예후인자 등을 후향적으로 비교 분석하여 방사선치료의 역할을 평가한다. 대상 및 방법 : 1982년 2월부터 1996년 12월까지 총 212명의 환자가 modified Astler-Coiler 병기 $B2\~C3$ 직장암으로 진단되어 근치적목적의 수술단독 또는 수술후 방사선치료를 시행하였는데, 이중 39.6 Gy 미만의 방사선치료를 받은 18명을 제외한 194명을 대상으로 하였다. 104명은 수술후 방사선치료를 받았고 90명은 수술 단독을 시행하였다. 방사선치료는 일일 조사량 $1.8\~2.0\;Gy$로 주 5회씩 전골반강에 $39.6\~55.8\;Gy$ (평균:49.9 Gy)를 조사하였고 필요시 원발 종양 절제부위에 $5.4\~10\;Gy$를 추가 조사하였다. 생존율과 골반종양제어율의 산출은 Kaplan-Meier방법으로, 이들의 통계적 유의성검증은 Log-rank test로 하였다. 다요인 분석은 Cox proportional hazards model을 이용하였다. 결과 : 전체 환자의 5년 생존율 및 무병 생존율은 각각 $53\%,\;49\%$이었다. 수술단독군과 방사선치료 추가군의 5년 생존율은 각각 $63\%$와 $45\%$로 유의한 차이를 보였다(p=0.03). 그러나 이러한 차이는 방사선치료 추가군에서 진행된 병기의 환자가 더 많이 분포함에 기인한 것으로 생각되었다(p<0.05 by $\chi^2-test$). 수술단독군과 방사선치료 추가군의 5년생존율은 병기 B2+3, C1, C2+3 군에서 각각 $68\%$ 대 $55\%$ (p=0.09), $100\%$ 대 $100\%,\;40\%$ 대 $33\%$ (p=0.71)로 두 군간의 유의한 차이는 없었다. 위의 병기별 5년 무병생존율은 각각 $65\%$ 대 $49\%$ (p=0.14), $100\%$ 대 $100\%,\;33\%$ 대 $31\%$ (p=0.46)로 역시 유의한 차이는 없었다. 전체 환자의 5년 골반종양제어율은 $72.5\%$이었다. 수술단독군과 방사선치료 추가군의 골반종양제어율은 각각 $71\%,\;74\%$이었다(p=0.41). 병기 B2+3, C1, C2+3군에서 수술달독군과 방사선치료 추가군의 골반종양제어율은 각각 $79\%$ 대 $75\%$ (p=0.88), $100\%$ 대 $100\%,\;44\%$ 대 $68\%$ (p=0.01)이었다. 전체 환자를 대상으로 다요인 분석을 시행한 결과 생존율과 무병생존율에 병기만이 유의하였고 두 치료 군에서도 역시 병기가 유의한 인자로 나타났다. 전체환자에서 골반종양제어율에 유의한 예후인자로 다요인분석을 시행한 결과 병기와 수술방법이 유의하였다. 수술단독군에서는 병기만이 유의하였고 방사선치료 추가군에서는 수술방법만이 유의하여 복부회음절제술군의 골반종양재발률이 높았다. 결론 : 본 후향적 연구에서 수술 후 보조적 방사선치료를 시행하여 수술단독군에 비해 병기 C2+3군에서 골반종양제어율이 향상되었음을 알 수 있었다. 그러나 병기 B2이상의 모든 환자에서 골반종양제어율 뿐만 아니라 생존율의 향상을 가져오기 위해서는 최근 효용성이 널리 입증된 연속주사법의 5-FU를 포함한 동시적 항함화학방사선 병용요법이 시도되어야 할 것으로 생각된다.

• Korean Journal of Acupuncture
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• 제31권2호
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• pp.56-65
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• 2014

Objectives : The purpose of this study is to compare the effects of laser acupuncture to the 830 nm on the five transport points with the spleen meridian for treatment to intestinal disease in rat with dextran sulfate sodium(DSS)-induced colitis. Methods : Colitis was induced by DSS for 20 days. The laser therapy on the five transport points of spleen meridian (Laser Well Point-SP1(L-WE), Laser Brook Point-SP2(L-BR), Laser Stream Point-SP3(L-ST), Laser River Point-SP5(L-RI) and Laser Sea Point-SP9(L-SE) was practiced twice a week for 5 times. Colon length was measured using a measuring point. Histological evaluation of colitis was conducted by hematoxylin and eosin(H&E) staining. Reverse transcription polymerase chain reaction(RT-PCR) was determined using western blotting and quantitative reverse-transcriptase polymerase chain reaction, respectively. Results: Colon length increased significantly L-BR and L-ST points after 5 times of therapy. Damage to the colonic mucosa is an integral feature of the DSS model, so control colonic mucosa tissue was damaged in the areas of ulceration resulting in complete epithelial loss. However histological damage decreased on the epithelial lining at all points. Cyclooxygenase(COX)-2 concentrations decreased in all points groups and Interferon(IFN)-${\gamma}$ increased in L-WE, L-BR, L-RI and L-SE points but L-ST was decreased when compared with control. White blood cell(WBC) and neutrophils(NE) decreased after the fifth acupuncture on the all points. But hemoglobin(HGB) increased after the fifth acupuncture on the L-WE, L-BR, L-ST and L-RI points. Also Mean corpuscular hemoglobin(MCH) and Mean corpuscular hemoglobin concentration(MCHC) decreased after the fifth acupuncture on the all points. Conclusions: The present study indicated that five transport points of the spleen meridian can prevent the development of DSS-induced colitis in rat. Thereby suggesting that should be available for decreasing DSS-induced inflammation in a colonic mucosa of tissue.

• 한국자기학회지
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• 제9권4호
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• pp.190-195
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• 1999

최대 출력 3.5kW인 고주파에 의한 알곤 플라즈마 분위기에서 제작한 Fe1-xCox(x=0.2와 0.4)계와 25$\mu\textrm{m}$의 철 박막의 자기적인 성질을 상온에서의 X선 회절과 진동시료자력계를 이용한 자기이력곡선 측정 방법을 사용하여 연구하였다. arc로에서 제작된 시룐느 삼단계 처리 가공하였다. 첫째는 수압기로 9,000N/$\textrm{cm}^2$의 압력을 가하여 알약 형태로 만들었다. 이 단계는 압연기로 눌러 얇은 sheet로 만들었다. 삼단계는 시료는 질소 가스 분위기에서 90$0^{\circ}C$로 열처리하였다. 일단계 시료의 X선 회절결과는 시료가 균질이며 각 시료는 철과 동일한 bcc 결정구조를 갖는 단일결저상(single crystal phase)임을 보였다. 철 박막은 43 Oe의 항자력과 인가자기장에 대한 자화, 즉 초기 기울기는 0.328 emu/gOe를 나타냈다. 이단계 시료에서는 Co량이 증가함에 따라 항자력과 포화자화값은 증가하였다. 반면 초기 기울기는 감소하였다. 이는 항자력의 증가로 인해서 계면이동이 억제되었음을 의미한다. 삼단계 시료에서 두 시료 모두 포화자화값은 증가하였다. 반면 이들 시료의 항자력은 감소하였다. 3단계 시료의 포화자화의 열처리로 인한 시료의 X선 회절강도 변화와 연관이 있어 보인다. 또한 몇 개의 자기 매개변수를 단순모형을 써서 계산하여 다른값과 비교하였다.

• Tuberculosis and Respiratory Diseases
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• 제73권4호
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• pp.224-230
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• 2012

Background: We evaluated the clinical outcomes and prognostic factors of patients requiring prolonged mechanical ventilation (PMV), defined as ventilator care for ${\geq}21$ days, who were admitted to the medical intensive care unit (ICU) of a university hospital in Korea. Methods: During the study period, a total of 2,644 patients were admitted to the medical ICU, and 136 patients (5.1%) were enrolled between 2005 and 2010. Results: The mean age of the patients was $61.3{\pm}14.5$ years, and 94 (69.1%) were male. The ICU and six-month cumulative mortality rates were 45.6 and 58.8%, respectively. There were 96 patients with tracheostomy placement after admission and their mean period from admission to the day of tracheostomy was $21.3{\pm}8.4$ days. Sixty-three patients (46.3%) were successfully weaned from ventilator care. Of the ICU survivors (n=74), 34 patients (45.9%) were transferred to other hospitals (not university hospitals). Two variables (thrombocytopenia [hazard ratio (HR), 1.964; 95% confidence interval (CI), 1.225~3.148; p=0.005] and the requirement for vasopressors [HR, 1.822; 95% CI, 1.111~2.986; p=0.017] on day 21) were found to be independent factors of survival on based on the Cox proportional hazard model. Conclusion: We found that patients requiring PMV had high six-month cumulative mortality rates, and that two clinical variables (measured on day 21), thrombocytopenia and requirement for vasopressors, may be associated with prognostic indicators.

• Journal of Korean Neurosurgical Society
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• 제30권11호
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• pp.1263-1270
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• 2001

Objective : To analyze the radiosurgical results of intracranial meningiomas after Gamma Knife radiosurgery (GKS) and to assess the possible factors related to the outcome and complications in treating meningiomas. Patients and Methods : We retrospectively reviewed the clinical and radiological data in 179 patients(194 lesions) treated with GKS for intracranial meningiomas between May 1992 and October 2000. Radiosurgical responses were categorized as shrinkage, stasis and enlargement, and we defined the shrunken and static group as a radio-logical control. A Cox proportional hazards model was used to evaluate the correlation between the radiosurgical outcomes and various factors such as location and size of tumor, age and gender of patients, relation to venous sinus, pre-GKS degree of edema, treatment modality, radiosurgical parameters, and pathologic findings. Results : Patients were grouped into skull base meningiomas(57.7%), non-skull base tumor including convexity, parasagittal, and falx meningiomas(37.1%), and others(5.2%) according to the location of tumors. The mean maximum dose and the margin dose of tumor was 30.0Gy(19-45Gy) and 15.1Gy(9.5-24.5Gy), respectively. The mean volume of the tumors was 9.4cc(0.003-45.0cc). The radiologic control rate was 97.1%. The radiation induced imaging change with or without neurologic deficit was the most common complication(23.6%). There were seen mostly in convexity, parasagittal, and falx meningiomas which were deeply embedded in cortex. Conclusion : GKS for intracranial meningioma seems to be safe and effective treatments. However, GKS should be considered very cautiously in non-skull base tumor such as convexity, parasagittal, or falx meningiomas with regards to patient's age and general condition, size and location of tumor, pattern of embedding into cortex, presenting symptoms and patient's preference.

• Journal of Preventive Medicine and Public Health
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• 제45권5호
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• pp.301-308
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• 2012

Objectives: To examine the association between alcohol consumption habit, types of beverages, alcohol consumption quantity, and overall and cancer-specific mortality among Korean adults. Methods: The alcohol consumption information of a total of 16 320 participants who were 20 years or older from the Korean Multicenter Cancer Cohort were analyzed to examine the association between alcohol consumption habit and mortality (median follow-up of 9.3 years). The Cox proportional hazard model was used to estimate the hazard ratio (HR) of alcohol consumption to mortality adjusting for age, sex, geographic areas, education, smoking status, and body mass index. Results: Alcohol drinkers showed an increased risk for total mortality compared with never drinkers (HR, 1.72; 95% confidence interval [CI], 1.38 to 2.14 for past drinkers; HR, 1.21; 95% CI, 1.06 to 1.39 for current drinkers), while past drinkers only were associated with higher risk for cancer deaths (HR, 1.84; 95% CI, 1.34 to 2.53). The quantity of alcohol consumed per week showed a J-shaped association with risk of mortality. Relative to light drinkers (0.01 to 90 g/wk), never drinkers and heavy drinkers (>504 g/wk) had an increased risk for all-cause and cancer deaths: (HR, 1.18; 95% CI, 0.96 to 1.45) and (HR, 1.39; 95% CI, 1.05 to 1.83) for all-cause mortality; and (HR, 1.55; 95% CI, 1.15 to 2.11) and (HR, 2.07; 95% CI, 1.39 to 3.09) for all cancer mortality, respectively. Heavy drinkers (>504 g/wk) showed an elevated risk for death from stomach and liver cancers. Conclusions: The present study supports the existence of a J-shaped association between alcohol consumption quantity and the risk of all-cause and cancer deaths. Heavy drinkers had an increased risk of death from cancer overall and liver and stomach cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.559-562
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• 2012

Serum alpha-fetoprotein (AFP) is a significant marker for clinical diagnosis and prognosis evaluation in hepatocellular carcinoma (HCC) patients. However, some proportion of liver cancer patients are AFP-negative (AFP ${\leq}$20ng/ml). In order to study the differences between clinicopathological factors and prognosis of alpha-fetoprotein negative and positive patients, a total of 114 cases (41 AFP-negative and 73 AFP-positive) were selected for our research. By systematically statistical analysis, the results demonstrated that compared with AFP-negative patients, AFP-positive examples were more likely to feature cirrhosis nodules, non-complete neoplasm capsules, and a poor Edmondson-steiner grade. Furthermore, AFP-negative patients demonstrated a favorable long-term prognosis. By univariate analysis and multivariate analysis with Cox's proportional hazards model, multiple tumors were found to be independent risk factors for worse survival of AFP negative patients; however, less tumor-free margins, multiple tumors and Edmondson-steiner grades III/IV, proved to be independent risk factors leading to a poor prognosis of AFP positive cases. Finally, we can infer that high levels of AFP signify a highly malignant tumor and unfavorable prognosis.

• Asian Pacific Journal of Cancer Prevention
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• 제15권11호
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• pp.4637-4642
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• 2014

Background: Hypoxia-inducible factor $1{\alpha}$ (HIF-$1{\alpha}$) plays an important role in regulating cell survival and angiogenesis, which are critical for tumor growth and metastasis. Genetic variations of HIF1A have been shown to influence the susceptibility to many kinds of human tumors. Increased expression of HIF-$1{\alpha}$ has also been demonstrated to be involved in tumor progression. However, the prognostic value of single nucleotide polymorphisms (SNPs) inthe HIF1A gene remains to be determined in most cancer types, including colorectal cancer (CRC). In this study, we sought to investigate the predictive role of HIF1A SNPs in prognosis of CRC patients and efficacy of chemotherapy. Materials and Methods: We genotyped two functional SNPs in HIF1A gene using the Sequenom iPLEX genotyping system and then assessed their associations with clinicopathological parameters and clinical outcomes of 697 CRC patients receiving radical surgery using Cox logistic regression model and Kaplan Meier curves. Results: Generally, no significant association was found between these 2 SNPs and clinical outcomes of CRC. In stratified analysis of subgroup without adjuvant chemotherapy, patients carrying CT/TT genotypes of rs2057482 exhibited a borderline significant association with better overall survival when compared with those carrying CC genotype [Hazard ratio (HR), 0.47; 95% confidence interval (95% CI): 0.29-0.76; P < 0.01]. Moreover, significant protective effects on CRC outcomes conferred by adjuvant chemotherapy were exclusively observed in patients carrying CC genotype of rs2057482 and in those carrying AC/CC genotype of rs2301113. Conclusions: Genetic variations in HIF1A gene may modulate the efficacy of adjuvant chemotherapy after surgery in CRC patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.305-311
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• 2017

Objectives: TNM staging, especially for lymph node metastasis, is the scoring system most widely used among prognostic factors for cancer survival. Several biomarkers have been studied as serologic markers, but their specificity is low and clinical applications are difficult. This study aimed to establish a scoring system for patients with oral squamous cell carcinoma (OSCC) using platelet (PLT) and mean platelet volume (MPV) levels measured postoperatively and to evaluate their significance as prognostic factors. Materials and Methods: We studied 40 patients admitted to the Department of Oral and Maxillofacial Surgery of Dankook University Hospital who were diagnosed with primary OSCC histopathologically between May 2006 and May 2012. Clinical pathological information obtained from the medical records of each patient included age, sex, height, weight, tumor location, degree of differentiation, tumor diameter, lymph node metastasis, TNM stage, and other test values including white blood cell, MPV, PLT, C-reactive protein (CRP), and albumin obtained through a test conducted within 7 days before surgery. Count of platelet (COP)-MPV Score: Patients with both PLT and MPV values below the cut-off values were defined as score 0 (group A). Patients with at least one of the two higher than the cut-off value were defined as score 1 (group B). Results: Univariate analyses showed N-metastasis, COP-MPV (A vs B), PLT, platelet-lymphocyte ratio, and CRP were statistically significant prognostic factors. A multivariate Cox proportional hazards model showed N-metastasis (hazard ratio [HR] 6.227, P=0.016) and COP-MPV (A vs B) (HR 18.992, P=0.013) were independent prognostic factors with a significant effect on survival. Conclusion: COP-MPV score is a simple and cost-effective test method and is considered a more effective prognostic factor than other considered factors in predicting the prognosis of OSCC patients.

• 한국해안·해양공학회논문집
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• 제29권6호
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• pp.363-368
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• 2017

지진해일은 그 파랑이 연안 도시로 범람하여 육상 구조물에 피해를 주게 된다. 육상 구조물에 미치는 파압 및 파력에 대한 연구는 육상 구조물의 안정성 설계의 중요한 요인 중 하나이다. 본 연구에서는 단순화한 박스구조물에 미치는 지진 해일의 수평 파력 및 파압에 대한 2차원 단면 수리모형실험을 수행하였다. 시간에 따른 수평 파압의 수직 분포와 파력을 파압계와 파력계를 사용하여 계측하여 상호 비교하였다. 또한, 쇄파의 형태도 다양하게 고려하여 계측하였다. 쇄파된 파랑이 입사하는 경우 구조물에 미치는 수평 파력이 최대가 되는 순간에는 수평 파압이 수직적으로 균일하였고, 그 외의 경우에는 육상 저면에 가까울수록 수평 파압이 커지는 분포를 보였다. 최대 수평 파력을 다양한 입사파랑 조건에 대한 함수로 표현하기 위해 쇄파상사계수를 사용하여 수평 파력과의 관계식을 산출하였다. 그 결과 무차원화한 수평 파력은 쇄파상사계수가 증가함에 따라 지수적으로 감소하는 경향을 있음을 보였다.