• Journal of Gastric Cancer
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• 제17권3호
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• pp.255-266
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• 2017

Purpose: Although Roux-en-Y (R-Y) reconstruction after distal gastrectomy has several advantages, such as prevention of bile reflux into the remnant stomach, it is rarely used because of the technical difficulty. This prospective randomized clinical trial aimed to show the efficacy of a novel method of R-Y reconstruction involving the use of 2 circular staplers by comparing this novel method to Billroth-I (B-I) reconstruction. Materials and Methods: A total of 118 patients were randomly allocated into the R-Y (59 patients) and B-I reconstruction (59 patients) groups. R-Y anastomosis was performed using two circular staplers and no hand sewing. The primary end-point of this clinical trial was the reflux of bile into the remnant stomach evaluated using endoscopic and histological findings at 6 months after surgery. Results: No significant differences in clinicopathological findings were observed between the 2 groups. Although anastomosis time was significantly longer for the patients of the R-Y group (P<0.001), no difference was detected between the 2 groups in terms of the total surgery duration (P=0.112). Endoscopic findings showed a significant reduction of bile reflux in the remnant stomach in the R-Y group (P<0.001), and the histological findings showed that reflux gastritis was more significant in the B-I group than in the R-Y group (P=0.026). Conclusions: The results of this randomized controlled clinical trial showed that compared with B-I reconstruction, R-Y reconstruction using circular staplers is a safe and feasible procedure. This clinical trial study was registered at www.ClinicalTrials.gov (registration No. NCT01142271).

• 대한임상독성학회지
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• 제4권2호
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• pp.113-121
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• 2006

Purpose: Previous studies have reported that plasma cholinesterase (AchE) concentration can serve as a useful prognostic parameter in cases of acute organophosphate (OP) poisoning. However, there has been considerable disagreement regarding the degree of its prognostic value. Earlier cross-sectional and one- time point studies were plagued with methodologic flaws, making it difficult to interpret their results. The purpose of this study was to clarify the prognostic value of time-variable cholinesterase levels and their relationship with clinical outcomes in OP poisoning. Methods: We reviewed medical and intensive care records of patients with acute OP poisoning admitted to our emergency department between March 1998 and Sep 2006. We collected patient information regarding poisoning, clinical, and demographic features. Patients were assessed for clinical outcomes and AchE concentrations on days 1, 2, 3, 5, and 7 and on the final day. Results: During the study period, 58 patients were enrolled in this study. There was a statistically significant difference in the AchE differentials on 1-3 days for patients requiring mechanical ventilation and for patients with mild poisoning (p<0.05). Also, the decrease in the log AchE concentration correlated with longer durations of mechanical ventilation (r=-0.411, p=0.002). Conclusion: In severe OP poising, measurements of time-variable AchE concentrations can be helpful in the prediction of mortality, the development of intermediate syndrome, and duration of mechanical ventilation.

• Journal of Gastric Cancer
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• 제21권1호
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• pp.49-62
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• 2021

Purpose: This study aimed to investigate the prognostic value of lymph node ratio (LNR) in patients with locally advanced gastric cancer who received neoadjuvant chemotherapy. Materials and Methods: We retrospectively enrolled gastric cancer patients treated with neoadjuvant chemotherapy and curative surgery at the First Affiliated Hospital of Zhejiang University from 2004 to 2015 as the study cohort. Patients with the same inclusion criteria treated in 2016-2017 were enrolled as the validation cohort. Kaplan-Meier curves were assessed using the log-rank test to analyze the differences in overall survival (OS). Multivariate survival analysis was performed using the Cox proportional hazards model. The areas under the receiver operating characteristic curve of ypN and LNR categories for predicting the actual 3-year OS were compared. Results: A total of 265 patients were included in the proposal cohort. The median number of retrieved lymph nodes (rLNs) was 32. The number of positive lymph nodes (pLNs) increased as rLN increased (P=0.037), but the LNR remained relatively constant (P=0.462). The LNR was categorized into 4 groups according to the prognosis: ypNr0, node-negative with rLN>25; ypNr1, node-negative with rLN≤25 or 00.3. In the validation cohort of 43 enrolled patients, there was a clear distinction in OS that significantly (P<0.001) varied depending on the LNR values and LNR was the only independent prognostic factor in multivariate analysis (P<0.001). Conclusions: LNR was an independent prognostic factor for survival of patients with gastric cancer after preoperative chemotherapy and might be an alternative predictor for ypN stage.

• 대한미생물학회지
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• 제12권1호
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• pp.11-18
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• 1977

항균제(抗菌劑)로 치료(治療)한 환자(患者)와 항균제(抗菌劑)를 투여(投與)받지 않은 의사(醫師) 및 학생군(學生群)으로부터 총(總) 665주(株)의 E. coli를 분리(分離)하여 약제내성(藥劑耐性) 및 R Plasmid의 분포(分布)를 조사(調査)했다. 분리주(分離株)의 약(約) 25-41%가 chloramphenicol, tetracycline, streptomycin sulfisomidine 및 ampicillin(AP)에 내성(耐性)이었고 9.5%가 kanamycin에 내성(耐性)이었으며 nalidixic acid에 내성(耐性)인 균주(菌株)는 극히 드물었다. 내성주(耐性株)는 의사(醫師) 및 학생군(學生群)에서보다 환자군(患者群)에서 월등(越等)히 높았다. 4 또는 그 이상(以上)의 약제(藥劑)에 내성(耐性)인 다제내성주(多劑耐性株)는 의사(醫師) 및 학생군(學生群)보다 환자군(患者群) 분리주(分離株)에서 월등(越等)히 많은 반면 3제(劑) 또는 그 이상(以上)의 약제(藥劑)에 내성(耐性)인 균주(菌株)의 빈도(頻度)는 3군(群) 분리주(分離株) 사이에 큰 차이(差異)가 없었다. 4제(劑) 또는 그 이상(以上)의 약제(藥劑)에 내성(耐性)인 균주(菌株)를 보유(保有)하고 있는 사람은 의사(醫師) 및 학생군(學生群)보다 환자군(患者群)에서 그 빈도(頻度)가 높았다. 거의 대부분(大部分)의 약제(藥劑) 내성주(耐性株)는 모든 내성(耐性) 특히 AP 내성(耐性)을 접합(接合)에 의하여 약제감수성(藥劑感受性)인 E. coli에 전달(傳達)했다. 다제내성(多劑耐性)을 가지는 균주(菌株)는 그 근원(根源)에 관계(關係)없이 더 높은 빈도(頻度)로 약제내성(藥劑耐性)을 전달(傳達)하는 경향(傾向)이 있었다.

• 대한핵의학회지
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• 제10권1호
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• pp.1-14
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• 1976

The etiologic role of renin-angiotensin system and sodium-volume status in the pathophysiology of various forms of hypertension was investigated. Plasma renin activity (PRA) was measured by radioimmunoassay, while sodium-volume status was evaluated by the determination of total exchangeable sodium(NaE) using isotope dilution method. The subjects consisted of 25 controls, 24 patients with essential hypertension, with chronic renal failure (13 with hypertension, 9 without hypertension) and with malignant hypertension. The results were as follows: 1. An inverse correlation between NaE and PRA was noted in control subjects (r=-0.598, p<0.001) and normal renin essential hypertension(r=-0.551, p<0.05) and the chronic renal failure with hypertension. (r=-0.790, p<0.001) 2. NaE increased markedly the in chronic renal failure with hypertension ($66.9{\pm}8.69mEq/kg$ of LBM, p<0.001) and the chronic renal failure without hypertension ($54.9{\pm}9.28mEq/kg$ of LBM, p<0.05), while mild increase was noted in malignant hypertension ($51.7{\pm}6.24mEq/kg$ of LBM, 0.05$50.1{\pm}7.24mEq$) as well as in its renin subgroups.(p>0.1) 3. Absolute value of PRA was not deviated significantly from control group ($2.53{\pm}1.416ng/ml/hr$) except in malignant hypertension ($6.09{\pm}2.042$, p<0.001). But PRA was inappropriately high in relation to prevailing NaE in the chronic renal failure with hypertension (eleven of thirteen patients) and malignant hypertension (ten of fourteen patients), while PRA variatiation was within physiologic range in the chronic renal failure without hypertension. 4. The NaE-PRA product was markedly increased in the chronic renal failure with hypertension ($514.4{\pm}42.10$, p<0.001) and in malignant hypertension ($442.7{\pm}55.03$, p<0.001), while moderately increased NaE-PRA product was noted in the chronic renal failure without hypertension ($402.6{\pm}59.67$, p<0.001). No significant difference in NaE-PRA product was noted in essential hypertension ($354.4{\pm}62.38$, p>0.1). It is suggested that renin-angiotensin system plays a predominant role in the pathogenesis of malignant hypertension and in hypertension of chronic renal failure, though sodium retention is also contributing factor. PRA variation in essential hypertension does not appear to be associated with any consistent change in Na-volume status, suggesting the existence of another mechanism in the genesis of hypertension and PRA variation.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5449-5454
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• 2013

Background: A large variety of familiar and non-familiar lung carcinomas (LC) are caused by long term exposure to chemical carcinogens that are present in tobacco smoke. We aimed to investigate the prevalence of 5 thrombophilic germ-line mutations in patients with lung carcinomas. Materials and Methods:A total of 52 LC patients and 212 healthy controls from same population were analyzed for FV Leiden, factor V H1299R (R2), PAI-1, MTHFR C677T, MTHFR A1298C, ACE I/D, and Apo E genes and compared. Results: Overall, heterozygous and/or homozygous point mutations in FV Leiden Apo E2, PAI-1 and MTHFR C677T genes were associated with LC in the current cohort. There was no meaningful association between LC and ACE I/D gene markers. Conclusions: The current results showed that LC is related to combined thrombophilic gene mutations and individuals with homozygosity of 4G in PAI-1 and MTHFR C677T genes and heterozygosity of FV Leiden, Apo E4 genes have a germ-line risk for LC tumorigenesis.

• 임상간호연구
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• 제25권2호
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• pp.189-197
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• 2019

Purpose: The purpose of this study was to identify the effects of symptom experience and depression on the falls efficacy of elderly patients who were undergoing chemotherapy. Methods: The questionnaires were administered to 105 elderly patients over 65 years hospitalizing for chemotherapy from October 25 to December 30, 2018. The data were analyzed by descriptive statistics, t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlations and Multiple Linear Regression, ursing an SPSS/WIN 22.0 program. Results: Falls efficacy was negatively correlated with the symptom experience (r=-.58, p<.001), and depression (r=-.57, p<.001). Symptom experience and depression were positively correlated (r=.72, p<.001). The significantly influential factors of falls efficacy were age (${\beta}=-.34$, p<.001), symptom experience (${\beta}=-.24$, p=.022), and the history of falls (${\beta}=-.15$, p=.040), explaining 57.0% of the variance in falls efficacy. Conclusion: The main findings of this study can be used as the foundation for developing programs to increase the falls efficacy of elderly patients undergoing chemotherapy.

• Hip & pelvis
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• 제30권4호
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• pp.210-218
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• 2018

Purpose: This is a report on the outcomes associated with a consecutive series of 1,000 cementless hip arthroplasties utilizing the $Bencox^{(R)}$ hip stem-the first Korean-developed hip prosthesis. Materials and Methods: A consecutive series of 1,000 hip arthroplasties using the $Bencox^{(R)}$ hip stem were analyzed, starting from its initial release (September 2006) until June 2014. Patients in this consecutive series underwent surgery for fractures (n=552), arthritis (n=155), avascular necrosis (n=209), and revisions (n=84). Of these 1,000 cases, patients with a minimum follow-up of at least 1 year (n=616) were retrospectively analyzed for radiographic and clinical outcomes (i.e., Harris hip score). The stability of the prosthesis was evaluated by examining subsidence. Results: During the follow-up period (mean follow-up period of 54.8 months), there were 2 cases requiring revision of the femoral stem-both were caused by periprosthetic fractures and neither involved stem loosening. The mean Harris hip score during follow-up was 95.5. Bone ongrowth occurred in 95% of patients; no cases of subsidence or aseptic loosening of the stem were detected, and no cases of postoperative complications such as ceramic breakage were observed. Conclusion: Clinical and radiographic evaluations of hip arthroplasty using the $Bencox^{(R)}$ hip stem revealed excellent outcomes with an average of 54.8 month follow-up in a consecutive series of 1,000 cases.

• 디지털융복합연구
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• 제15권9호
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• pp.261-271
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• 2017

본 연구는 정신질환자의 성지식, 성태도 및 성행동 정도와 차이를 파악하고 변수 간 관계를 파악하기 위해 시도되었다. 연구대상자는 J도 K시에 소재한 정신전문병원에 입원한 성인 정신질환자 222명이었다. 자료는 구조화된 설문지를 사용하여 2016년 3월 11일부터 4월 15일까지 수집되었다. 수집된 자료는 SPSS/WIN 20.0 프로그램을 이용하여 independent t-test, One-way ANOVA, $Scheff{\acute{e}}$ test, Pearson's Correlation Coefficients로 분석하였다. 연구 대상자의 성지식 평균점수는 2.60점, 성태도는 2.74점, 성행동은 0.49점이었다. 대상자의 성지식은 부모의 양육태도에 따라 유의한 차이를 보였고(${\rho}$<.01), 성행동은 진단명에 따라 유의한 차이를 나타났다(${\rho}$<.05). 성지식은 성태도(r=.75, ${\rho}$<.001) 및 성행동(r=.15, ${\rho}$<.05)과 유의한 양의 상관관계가 있었다. 성태도는 성행동 하부영역 중 적극적 성행동 간에 유의한 양의 상관관계가 있었다(r=.20, ${\rho}$<.01). 본 연구결과는 정신질환자의 성 관련 문제에 관한 정신간호중재방법의 개발에 기초자료로 활용될 수 있을 것이다.

• 한국병원경영학회지
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• 제1권1호
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• pp.1-20
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• 1996

This study is purposed to compare PR activities among the 5 large hospitals in Seoul and Kyonggido. The research methods are used in interview survey for employees and Questionnaires survey for patients or their relatives. The 427 patients or their relatives(response rate: 85.4%) were surveyed. The hospital which is below, is more active than any others in special PR activities. 1. Distribution of hospital information books: E, P, A 2. Distribution of calendar: P 3. Broadcast in hospital: E 4. Education of employees about PR : E, A 5. Education of employees about service: all hospitals are active. The PR sectors are organized under the Department of planning(S,J,E) or CEO(P,A). And the budget of PR activities is almost a similar level among all. The degree of recognition and utilization for PR activities is not different among hopitals by the sociodemographic variables of patients. And the average of correlation ratio between recognition of each hopital's PR activities and its utilization is 62.01%(range:51.29%-67.98%) average.