• Journal of Hospice and Palliative Care
• /
• 제4권1호
• /
• pp.14-25
• /
• 2001

목적 : 통증에 있어서의 성별차이에 대한 연구결과에 있어서 일치하지 않고 있다. 이에 암환자를 대상으로 성별에 따른 통증정도를 살펴보고, 통증과 우울 및 활동도의 상호작용에 있어서도 성별에 따른 차이가 있는 지를 규명하기 위함이다. 방법 : 1999년 2월부터 6월까지 서울소재 S대학교 병원 혈액종양내과에 입원 또는 외래치료중인 암환자 140명(남성 78명, 여성 62명)을 대상으로 하였으며, 통증정도는 한국판 간이 통증 평가도구(BPI-K), 우울은 한국판 Beck Depression Inventory를 이용한 설문지를 통하여 수집되었고, 기타 인구학적 및 임상학적 자료는 의무기록 열람 및 주치의의 의견을 참조하여 수집되었다. 대상자를 서술하기위해 빈도, 평균, 표준편차를 구하였으며, 집단간 비교에서 불연속척도는chi-square test를 하였고, 연속척도는 t-test를 하였으며, 변인간 상관관계는 Pearson 상관계수를 구하였다. 결과 : 1) 통증의 중증도의 경우 통증정도가 24시간 동안 가장 심했을 때 통증 평균은 남성이 5.77점, 여성이 6.45점이었다. 통증으로 인한 지장정도는 남성의 경우 기분(5.49점), 인생을 즐김(5.36점), 통상적인 일(5.00점)이 순이었으나, 여성의 경우는 통상적인 일(7.48점), 인생을 즐김(7.16점), 기분6.53점) 순이었다. 2) 통증의 중증도의 경우 24시간 동안 평균 통증정도(t=-2.130, P=.035)에서 남성과 여성간에 유의한 차이가 나타났으며, 통증으로 인한 장애정도에서는 활동(t=-2.450, P=.015), 기분(t=-2,321, P=.022), 보행 능력(t=-2.762, P=.007), 통상적인 일(t=-4.946, P=.000), 대인관계(t=-2.595, P=.010), 수면(t=-2.071, P=.040), 인생을 즐김(t=-3.198, P=.001)에서 남성과 여성간에 통계적으로 유의한 차이가 나타났다. 3) 통증과 우울과의 상관관계 분석결과, 통증의 중증도에서 남성의 경우 24시간동안 가장 심했을 때 통증정도와 우울(r=0.323, P<.05), 평균 통증정도와 우울(r=.236, P<.05) 및 조사당시 바로 지금 느끼는 통증정도와 우울(r=0.248, P<.05)이 통계적으로 유의한 정적 상관관계가 나타난 반만 여성에서는 조사당시 바로 지금 느끼는 통증정도와 우울(r=.250, P<.05)만이 유의한 정적상관관계가 나타났다. 통증으로 인한 지장정도의 경우 남성은 모든 항목과 우울간 유의한 정적상관관계가 나타난 반만 여성에서는 전 항목과 우울간에 유의한 관계가 나타나지 않았다. 통증과 활동성 정도와의 상관관계 분석결과, 통증의 중증도에서 남성의 경우 24시간동안 가장 심했을 때 통증정도와 활동성 정도(r=0.378, P<.05), 평균 통증정도와 활동성 정도가(r=.330, P<.05)가 유의한 정적상관관계가 나타난 반면, 여성에서는 활동성 정도와 통증의 중증도는 유의한 관계가 없는 것으로 나타났다. 남성은 관계를 제외한 모든 항목의 통증으로 인한 지장정도와 활동성 정도가 유의한 정적상관관계가 나타난 반만 여성에서는 보행 능력, 통상적인 일, 인생을 즐김 항목과 활동성 정도간 유의한 정적 상관관계가 있었다. 결론 : 암환자의 통증정도 및 지장정도는 여성이 남성보다 높았으며, 통증과 우울 및 활동도와의 상관관계에서 차이를 보였다. 앞으로 암성통증 관리 대책 수립시 여성과 남성의 이러한 차이를 고려하여야 한다.

• Archives of Plastic Surgery
• /
• 제47권1호
• /
• pp.70-77
• /
• 2020

Background As the demand for cosmetic surgery continues to rise, plastic surgery programs and the training core curriculum have evolved to reflect these changes. This study aims to evaluate the perceived quality of current cosmetic surgery training in terms of case exposure and educational methods. Methods A 16-question survey was sent to graduates who completed their training at a U.S. plastic surgery training program in 2017. The survey assessed graduates' exposure to cosmetic surgery, teaching modalities employed and their overall perceived competence. Case complexity was characterized by the minimum number of cases needed by the graduate to feel confident in performing the procedure. Results There was a 25% response rate. The majority of respondents were residents (83%, n=92) and the remaining were fellows (17%, n=18). Almost three quarters of respondents were satisfied with their cosmetic training. Respondents rated virtual training as the most effective learning modality and observing attendings' patients/cases as least effective. Perceived competence was more closely aligned with core curriculum status than case complexity, i.e. graduates feel more prepared for core cosmetic procedures despite being more technically difficult than non-core procedures. Conclusions Despite the variability in cosmetic exposure during training, most plastic surgery graduates are satisfied with their aesthetic training. Incorporation of teaching modalities, such as virtual training, can increase case exposure and allow trainees more autonomy. The recommended core curriculum is adequately training plastic surgery graduates for common procedures and more specialized procedures should be consigned to aesthetic fellowship training.

• 한국간담췌외과학회지
• /
• 제27권4호
• /
• pp.403-414
• /
• 2023

Backgrounds/Aims: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. Methods: Data were extracted from the Recurrence After Whipple's (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). Results: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6-21), group B (49 days, 39-64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-to-death (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p = 0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. Conclusions: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence.

• Clinical and Experimental Pediatrics
• /
• 제51권5호
• /
• pp.487-491
• /
• 2008

목 적 : 마이코플라스마 폐렴은 일부 천식의 과거력이 없는 환자에서도 천명, 호흡곤란 등의 증상을 보여 천식의 발생과 관계된다고 한다. VEGF는 천식의 만성 염증 형성에 중요한 역할을 한다. 본 연구는 마이코플라스마 폐렴에서 천명이 동반되는 환아와 천명이 없는 환아에서 혈청 VEGF의 농도가 차이가 있는지 알아보고자 하였다. 방 법 : 2006년 8월부터 2007년 2월까지 고려대학교 안암병원 소아과에 천식의 과거력이 없는 마이코플라스마 폐렴으로 입원한 환아들 중 의사의 청진상 천명음이 처음으로 확인된 환아 9명(천명군)과 천명음이 한번도 없었던 비천명군 63명을 대상으로 혈청 VEGF농도, M. pneumoniae 항체가, 혈액 호산구 염증지표 및 혈청 IgE 농도 등을 측정하였다. 결 과 : 천명군의 혈청 VEGF 농도는 $650.2{\pm}417.9pg/mL$로 비천명군($376.5{\pm}356.2pg/mL$) 보다 높게 나타났고(P=0.049), M. pneumoniae 항체가도 천명군에서 더 높았다(1:1,380 vs. 1:596, P=0.048). 혈청 총IgE 값은 천명군이 591.8 IU/mL, 비천명군이 162.2 IU/mL 이었다(P=0.032). 두 군의 말초혈액 호산구수(천명군 : $263.0/{\mu}L$ vs. 비천명군 : $166.5/{\mu}L$)와 혈청 ECP 농도(천명군 : $22.8{\mu}g/L$ vs. 비천명군 : $17.4{\mu}g/L$)는 유의한 차이가 없었다. 천명군에서 혈청 VEGF 농도는 항체가와 유의한 상관관계를 보였다(r=0.568, P=0.034). 결 론 : 천식의 과거력이 없는 아토피 소아에서 높은 VEGF 농도는 마이코플라스마 폐렴에서 천명 발생과 관계가 있는 것으로 생각할 수 있으며, 이들 환자에서 앞으로 천식 발생 유무에 대한 추적 관찰이 필요하리라 생각한다.

• 한국생물공학회:학술대회논문집
• /
• 한국생물공학회 2001년도 추계학술발표대회
• /
• pp.918-922
• /
• 2001

In a previous study, we have isolated a number of lactobacilli from Korean women, and one of them (KLB46) was identified as Lactobacillus crispatus by 16S rRNA gene sequencing. For the ecological treatment of bacterial vaginosis (BV) cell suspension of L. crispatus KLB46 was instillated into BV patients. L. crispatus KLB46 was found to persist for several days in cell suspension with no nutrients. In this study, in order to assess the influence of starvation on physiological activity, we compared the viability and culturability of KLB46 following suspension in various buffer solutions. A pair of in situ fluorescent dye was used to assess viability (i.e. membrane integrity) and the culturability was examined by plate count assay. A rapid epifluorescence staining method using the LIVE/DEAD Bacterial Viability Kit $(BacLight^{TM})$ was applied to estimate both viable and total counts of bacteria in cell suspension. $BacLight^{TM}$ is composed of two nucleic acid-binding stains ($SYTO\;9^{TM}$ and propidium iodide). $SYTO\;9^{TM}$ penetrates all bacterial membranes and stains the cells green while propidium iodide only penetrates cells with damaged membranes, therefore the combination of the two stains produces red fluorescing cells. Optimal staining conditions for $BacLight^{TM}$ were found to be with 0.0835M $SYTO\;9^{TM}$ and 0.05M propidium iodide for 15 min incubation at room temperature in dark. When cells were microscopically examined during 140 hours of starvation, the culturability decreased markedly while the viability remained relatively constant, which suggests that large fraction of KLB46 cells became viable but non-culturable (VBNC) upon starvation.

• Bioinformatics and Biosystems
• /
• 제1권1호
• /
• pp.67-72
• /
• 2006

The aim of this paper is to discuss the effect of missing values in detecting differentially expressed genes in a cDNA microarray experiment in the context of a one sample problem. We conducted a cDNA micro array experiment to detect differentially expressed genes for the metastasis of colorectal cancer based on twenty patients who underwent liver resection due to liver metastasis from colorectal cancer. Total RNAs from metastatic liver tumor and adjacent normal liver tissue from a single patient were labeled with cy5 and cy3, respectively, and competitively hybridized to a cDNA microarray with 7775 human genes. We used $M=log_2(R/G)$ for the signal evaluation, where Rand G denoted the fluorescent intensities of Cy5 and Cy3 dyes, respectively. The statistical problem comprises a one sample test of testing E(M)=0 for each gene and involves multiple tests. The twenty cDNA microarray data would comprise a matrix of dimension 7775 by 20, if there were no missing values. However, missing values occur for various reasons. For each gene, the no missing proportion (NMP) was defined to be the proportion of non-missing values out of twenty. In detecting differentially expressed (DE) genes, we used the genes whose NMP is greater than or equal to 0.4 and then sequentially increased NMP by 0.1 for investigating its effect on the detection of DE genes. For each fixed NMP, we imputed the missing values with K-nearest neighbor method (K=10) and applied the nonparametric t-test of Dudoit et al. (2002), SAM by Tusher et al. (2001) and empirical Bayes procedure by $L\ddot{o}nnstedt$ and Speed (2002) to find out the effect of missing values in the final outcome. These three procedures yielded substantially agreeable result in detecting DE genes. Of these three procedures we used SAM for exploring the acceptable NMP level. The result showed that the optimum no missing proportion (NMP) found in this data set turned out to be 80%. It is more desirable to find the optimum level of NMP for each data set by applying the method described in this note, when the plot of (NMP, Number of overlapping genes) shows a turning point.

• 재활치료과학
• /
• 제3권2호
• /
• pp.83-89
• /
• 2014

목적 : 본 연구의 목적은 양쪽 눈을 반쪽씩 가린 안경착용 중재가 뇌졸중 환자의 좌측편측무시에 미치는 효과를 알아보는 것이다. 연구방법 : 연구 기간은 2014년 10월 뇌졸중 환자 1명을 대상으로 실시되었고 참가자는 자발적으로 연구에 동의하였다. 실험은 1일 1회씩 총 12회 실시하였다. A기간은 기초선 기간으로 안경을 착용하지 않고 3회의 자료를 수집하였다. B기간은 치료기간으로 안경을 세수할 때와 잠잘 때를 제외한 모든 시간 동안 착용하도록 하였다. A(withdrawal)는 안경을 제거하고 3회의 자료를 수집하였다. 모든 검사의 측정은 1일 1회씩 동일 시간과 동일 검사자에 의해서 이루어졌다. 결과 : 선나누기 검사의 오차 평균(mm) 앨버트 테스트의 오차평균은(개)는 크게 감소하지 않았다. 결론 : 이 치료가 편측무시를 감소시키는 방법이라고 할 수는 없었다. 앞으로의 연구에서는 좀더 여러 가지 편측무시 평가를 사용하여 치료의 효과를 알아보고 여러 사항을 고려한 연구가 필요하다고 생각된다.

• 대한치과교정학회지
• /
• 제48권1호
• /
• pp.23-29
• /
• 2018

Objective: In accordance with the changing demographics in the United States, orthodontists working on various ethnic populations should be more conscious when using the standardized profile analyses for the African American patient. The objective of this study was to examine whether the perception of lip protrusiveness in modern African American faces has changed. For this purpose, we investigated the most favorable African American lip profile using the opinions of 10 experienced and 10 newly trained younger orthodontists. Methods: Attractiveness was converted to a number on visualized analog scales. Comparative ranks on 16 African American profiles, with focus on lip protrusiveness and thickness, were made among the groups. Mixed-effects linear regression models were fit and group differences were estimated. Results: Younger orthodontists favored a more protrusive lip profile, and the variance in their perceptions was narrower than those of older orthodontists. Measurements related to upper lip protrusion showed the strongest correlation to attractiveness (r = -0.82). The association with attractiveness decreased linearly as the protrusiveness of the upper lip increased. Steiner's E-line was the most influential reference for determining the level of attractiveness for the older orthodontists, whereas upper lip protrusion was the most influential factor for the young orthodontists. Conclusions: An adequate level of lip protrusiveness and thickness should be essential for maintaining attractive esthetics in African American patients. Yet, a new set of standards for prominent lips in this population is necessary to reflect the current trend in the concept of a beautiful face in the modern world.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제33권6호
• /
• pp.609-616
• /
• 2007

Purpose: The aim of the present study was to evaluate the effect of Bio-Oss on bone formation in terms of healing period and type of membrane so that determine the most suitable condition for implant fixation in grafted maxilla. Material & Method: Forty-five biopsy specimens from graft site were evaluated. Sinus lift was performed in the patients with reduced alveolar bone height(less than 5mm). The specimen was taken at the time of implant fixation, which was performed at least 5 months after the sinus lift procedure. All specimens were stained with H&E and Trichrome staining and evaluated histomorphometrically. Result: The results showed that Bio-Oss particle was in direct contact with newly formed bone in all cases. In the present study, the amount of newly formed bone and the residual bone substitute material were not statistically different according to various membrane and different healing period. There was no difference between the histological feature of the specimen of 5 and 31 months. No statistical significance was detected between male and female. Conclusion: The result implies that Bio-Oss does not seem to be resorbed over time regardless of the type of the membranes. The further investigation is needed to clarify this issue with the extended period of follow-up.

• Parasites, Hosts and Diseases
• /
• 제32권4호
• /
• pp.231-242
• /
• 1994

자연 감염된 가재에서 폐흡충의 피낭유충을 분리하고 개에 경구 감염시켜 성충을 얻었다. 폐흡충 성충의 조효소를 ion-exchange chromatography, affinity chromatography와 gel filtration chromatoglaphy를 실시하여 cysteine proteinase를 순수 정제하였다. 이들 효소의 생화학적 특성과 분해능을 관찰하였으며. 효소면역전기영동이적법을 이용하여 순수 정제한 효소의 항원성을 관찰하였다. 정제된 효소는 저분자 합성기질인 CBZ-arg-arg-AFC 보다 CBZ-phe-arg-AFC에서 높은 활성을 보였으며. 이들 효소는 thiol-dependent이었다. 정제된 효소 및 조효소의 최적 pH는 5.5이었고. 최적 mole 농도는 0.1 M(0.1 M sodium citrate, pH 5.5)이었고, 이들 효소는 $4^{\circ}C$에서 48시간 동안 80%의 안정성을 보였다 정제된 효소의 native 분자량은 20.000 dalton이었고, SDS- PAGE상에 나타난 분자량은 17,500 dalton이었다 정제된 효소는 cysteine proteinase 특이 억제 인자인 E-64, lodoacetic acid, NEM에 의해 활성이 완전히 억제되었으며, serine proteinase, aspartic proteinase 및 metallo proteinase 특이 억제인자에 의해 활성이 억제되지 않았다. 정제된 효소는 collagen(Type I)과 hemoglobin을 분해하였고, 효소면역전기영동이적법으로 정제된 효소의 항원성을 확인하였다.