• Journal of Gastric Cancer
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• 제13권4호
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• pp.214-225
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• 2013

Purpose: Peritoneal lavage cytology is part of the routine staging workup for patients with advanced gastric cancer. However, no quality assurance study has been conducted to show variations or biases in peritoneal lavage cytology results. The aim of this study was to demonstrate a test execution variation in peritoneal lavage cytology between investigating surgeons. Materials and Methods: A prospective cohort study was designed for determination of the positive rate of peritoneal lavage cytology using a liquid-based preparation method in patients with potentially curable advanced gastric cancer (cT2~4/N0~2/M0). One hundred thirty patients were enrolled and underwent laparotomy, peritoneal lavage cytology, and standard gastrectomy, which were performed by 3 investigating surgeons. Data were analyzed using the chi-square test and a logistic regression model. Results: The overall positive peritoneal cytology rate was 10.0%. Subgroup positive rates were 5.3% in pT1 cancer, 2.0% in pT2/3 cancer, 11.1% in pT4a cancer, and 71.4% in pT4b cancer. In univariate analysis, positive peritoneal cytology showed significant correlation with pT stage, lymphatic invasion, vascular invasion, ascites, and the investigating surgeon. We found the positive rate to be 2.1% for surgeon A, 10.2% for surgeon B, and 20.6% for surgeon C (P=0.024). Multivariate analysis identified pT stage, ascites, and the investigating surgeon to be significant risk factors for positive peritoneal cytology. Conclusions: The peritoneal lavage cytology results were significantly affected by the investigating surgeon, providing strong evidence of test execution variation that could be related to poor diagnostic accuracy and stage migration in patients with advanced gastric cancer.

• Journal of Gastric Cancer
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• 제17권1호
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• pp.74-87
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• 2017

Purpose: Neoadjuvant chemotherapy has been shown to improve survival in locally advanced gastric cancer, but it is associated with significant toxicity. Sarcopenia and sarcopenic obesity have been studied in several types of cancers and have been reported to be associated with higher chemotherapy toxicity and morbi-mortality. The aim of this study was to assess the prevalence of sarcopenia/sarcopenic obesity in patients with gastric cancer, as well as its association with chemotherapy toxicity and long-term outcomes. Materials and Methods: A retrospective analysis was performed using an academic cancer center patient cohort diagnosed with locally advanced gastric cancer between January 2012 and December 2014 and treated with neoadjuvant chemotherapy. We analyzed body composition (skeletal muscle and visceral fat index) in axial computed tomography images. Results: A total of 48 patients met the inclusion criteria. The mean age was $68{\pm}10years$, and 33 patients (69%) were men. Dose-limiting toxicity was observed in 22 patients (46%), and treatment was terminated early owing to toxicity in 17 patients (35%). Median follow-up was 17 months. Sarcopenia and sarcopenic obesity were found at diagnosis in 23% and 10% of patients, respectively. We observed an association between termination of chemotherapy and both sarcopenia (P=0.069) and sarcopenic obesity (P=0.004). On multivariate analysis, the odds of treatment termination were higher in patients with sarcopenia (odds ratio=4.23; P=0.050). Patients with sarcopenic obesity showed lower overall survival (median survival of 6 months [95% confidence interval {CI}=3.9-8.5] vs. 25 months [95% CI=20.2-38.2]; log-rank test P=0.000). Conclusions: Sarcopenia and sarcopenic obesity were associated with early termination of neoadjuvant chemotherapy in patients with gastric cancer; additionally, sarcopenic obesity was associated with poor survival.

• Journal of Periodontal and Implant Science
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• 제47권5호
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• pp.328-338
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• 2017

Purpose: Chronic periodontitis is an inflammatory disease induced by pathogenic bacterial accumulation. A novel index, the periodontal inflamed surface area (PISA), represents the sum of the periodontal pocket depth of bleeding on probing (BOP)-positive sites. It is advantageous for data processing and analysis because it can be treated as a continuous variable to quantify periodontal inflammation. In the present study, we evaluated correlations between PISA and periodontal classifications, and examined PISA as an index integrating the discrete conventional periodontal indexes. Methods: This study was a cross-sectional subgroup analysis of data from a prospective cohort study investigating the association between chronic periodontitis and the clinical features of ankylosing spondylitis. Data from 84 patients without systemic diseases (the control group in the previous study) were analyzed in the present study. Results: PISA values were positively correlated with conventional periodontal classifications (Spearman correlation coefficient=0.52; P<0.01) and with periodontal indexes, such as BOP and the plaque index (PI) (r=0.94; P<0.01 and r=0.60; P<0.01, respectively; Pearson correlation test). Porphyromonas gingivalis expression and the presence of serum P. gingivalis antibodies were significant factors affecting PISA values in a simple linear regression analysis, together with periodontal classification, PI, bleeding index, and smoking, but not in the multivariate analysis. In the multivariate linear regression analysis, PISA values were positively correlated with the quantity of current smoking, PI, and severity of periodontal disease. Conclusions: PISA integrates multiple periodontal indexes, such as probing pocket depth, BOP, and PI into a numerical variable. PISA is advantageous for quantifying periodontal inflammation and plaque accumulation.

• Tuberculosis and Respiratory Diseases
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• 제80권1호
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• pp.27-34
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• 2017

Background: A sputum culture is the most reliable indicator of the infectiousness of pulmonary tuberculosis (PTB); however, a spontaneous sputum specimen may not be suitable. The aim of this study was to evaluate the infectious period in patients with non-drug-resistant (DR) PTB receiving adequate standard chemotherapy, using induced sputum (IS) specimens. Methods: We evaluated the duration of infectiousness of PTB using a retrospective cohort design. Results: Among the 35 patients with PTB, 22 were smear-positive. The rates of IS culture positivity from baseline to the sixth week of anti-tuberculosis medication in the smear-positive PTB group were 100%, 100%, 91%, 73%, 36%, and 18%, respectively. For smear-positive PTB cases, the median time of conversion to culture negativity was 35.0 days (range, 28.0-42.0 days). In the smear-negative PTB group (n=13), the weekly rates of positive IS culture were 100%, 77%, 39%, 8%, 0%, and 0%, respectively, and the median time to conversion to culture-negative was 21.0 days (range, 17.5-28.0 days). Conclusion: The infectiousness of PTB, under adequate therapy, may persist longer than previously reported, even in patients with non-DR PTB.

• 한국환경보건학회지
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• 제34권1호
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• pp.12-19
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• 2008

We evaluated the relationship between birth weight and mercury exposure levels in Seoul, Korea, by following a cohort of pregnant women and the outcomes of their pregnancies between 2001-2005. Eighty-five pregnant women were recruited into this study after obtaining informed consent. Samples were collected at delivery from normal pregnant women who were living in the city of Seoul, Korea. Mercury concentrations in 85 sets of maternal and cord blood samples were measured using a gold-amalgam collection method. We used multiple regression analysis to analyze the effect of mercury exposure on birth weight. The mean levels of total mercury concentrations were 5.41(ppb) in maternal blood of pregnant women and 3.58(ppb) in umbilical cord blood. The mean concentration of umbilical cord blood mercury exposures was higher than the level recommended by WHO. There was a significant correlation between maternal and cord blood mercury concentrations. Mercury concentrations of umbilical cord blood was associated with birth weight. In addition, after adjusting for potential confounding factors, we found that mercury exposure may reduce the birth weight. This study suggests that exposure to mercury concentration during pregnancy contributes to the risk of low birth weight. Therefore, prenatal and environmental education for various and possible sources of mercury exposure might be necessary for the good health of babies. The finding of this study supports the construction of national policy for environmental health management.

• Parasites, Hosts and Diseases
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• 제52권5호
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• pp.551-555
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• 2014

Trichomonas vaginalis, a causative agent of trichomoniasis, may trigger symptomatic or asymptomatic non-gonococcal urethritis and chronic prostatitis in men. Despite the availability of highly sensitive diagnostic tests, such as nucleic acid amplification tests, including PCR, few prospective studies present data on male T. vaginalis infection in South Korea. In the present study, the prevalence of T. vaginalis and associated clinical conditions were evaluated in 201 male patients from a primary care urology clinic in South Korea. The prevalence of T. vaginalis infection in our cohort was 4% (8/201) by PCR. T. vaginalis infection was common in men older than 40 years (median age, 52 years). Among the 8 Trichomonas-positive patients, 87.5% (7/8) had prostatic diseases, such as prostatitis and benign prostatic hyperplasia, and 25.0% (2/8) and 12.5% (1/8) were coinfected with Chlamydia trachomatis and Mycoplasma genitalium, respectively. Our results suggest that T. vaginalis infection is not rare in men attending primary care urology clinics in South Korea, especially in those older than 40 years, in whom it may explain the presence of prostatic disease. The possibility of T. vaginalis infection should be routinely considered in older male patients with prostatic diseases in South Korea.

• Pediatric Infection and Vaccine
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• 제19권1호
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• pp.28-36
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• 2012

목 적 : 이 연구는 경기서부지역의 감염성 설사의 원인 바이러스의 역학 및 지역적 유병율에 대한 정보 제공을 위해 실시되었다. 방 법 : 2009년 1월부터 12월까지 가톨릭대학교 부천성모병원에 급성 설사로 입원한 10세 미만 환아를 대상으로 흔한 세균성 병원체가 없는 310개의 대변 검체에서 rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, norovirus의 유무를 PCR과 RT-PCR을 이용하여 확인하였다. 결 과 : parechovirus (16%)가 가장 흔한 것으로 나타났으며, adenovirus (15%), astrovirus (14%), rotavirus (13%), enterovirus (5%)의 순으로 검출되었다. 단일 감염은 55.8%에서, 중복 감염은 3.2%에서 나타났다. 바이러스성 장염은 전체적으로 두 차례의 유행 시기를 보였으며, 84.6%는 2세 이하에서 발생하였다. 결 론 : parechovirus, adenovirus, astrovirus, enterovirus는 기존에 시행 중인 진단방법으로는 과소평가되어 있으나 소아 설사의 중요한 원인이다.

• Radiation Oncology Journal
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• 제24권2호
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• pp.88-95
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• 2006

목적: 삼차신경통 환자에서 사이버나이프 방사선수술이 효과적이며 안전한 치료방법인지 알아보고자 하였다. 대상 및 방법: 2004년 3월부터 2005년 5월까지 수술 후 실패하였거나 수술이 부적합한 삼차신경통 환자 26명을 대상으로 사이버나이프 방사선수술을 시행하여 후향적 분석을 하였다. 치료 표적은 삼차신경근 진입구역으로부터 3 mm 떨어진 지점의 삼차신경 최고 근위부를 제외한 6 mm 길이의 삼차신경 부위를 설정하고, 그 부위에 80% 등선량 곡선에 단일 조사로 총방사선량은 $60{\sim}64Gy$를 조사하였다(중앙선량: 64 Gy). 결과: 추적관찰기간은 $3{\sim}15$개월이었다(중앙추적관찰기간 : 9개월). 대상환자 26명에서 사이버나이프 방사선수술 후 24시간 이내에 50% (13/26)에서 통증 완화를 관찰하였으며. 7일 이내에 조기 통증 완화를 보였던 환자는 96.2% (25/26)이었다. 치료 실패는 7.7% (2/26)에서 나타났으며 통증 개선 실패와 통증 재발이 각각 1명에서 관찰되었다. 치료 부작용으로 안면감각 감퇴가 11.5% (3/26)에서 관찰되었다. 결론: 삼차신경통 환자를 대상으로 사이버나이프 방사선수술을 시행한 예비 결과로 비교적 안전하며, 효과적인 치료임을 확인하였다.

• Journal of Chest Surgery
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• 제38권10호
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• pp.705-709
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• 2005

배경: 염증성 폐질환에 의해 발생한 객혈을 폐절제술로 치료한 후 임상 결과를 분석해보고자 한다 대상 및 방법 : 1995년 1월부터 2004년 5월까지 양성 폐질환에 의해 객혈이 발생하여 폐절제술로 치료한 총 45명의 환자를 대상으로 하여 수술 후 이환율에 미치는 술 전 요소들과 수술 후 객혈의 재발 요인들을 분석하였다. 환자의 평균 나이는 47.1세였고 평균 추적기간은 $35\pm34$개월이었다. 결과: 수술 후 조기 사망은 2명$(4.4\%)$이었다. 술 후 합병증은 8명의 환자에게서 발생하였다. 술 전 또는 술 중에 수혈이 이루어진 그룹에서 수술 후 합병증 발생률이 높았다(p=0.002). 특히 파괴성 폐결핵 환자에게서 술 전 및 술 중 수혈 가능성이 높았고(p=0.001)수술 전에 의의 있게 많은 양의 객혈이 발생하였으며(p=0.002) 전폐절제술이 시행될 가능성이 많았고(p=0.039) 수술 후 합병증의 빈도가 높았다(p=0.015). 전폐절제술을 시행한 환자에서 술 후 출혈로 인해 재수술의 시행이 많았다(p=0.047). 추적 관찰 중 5명의 환자에서 객혈이 재발하여 이 중 3명의 환자는 소실되었고 2명의 환자는 간헐적인 혈액흔적 가래(blood tinged sputum) 양상이 지속되고 있다. 위 2명의 환자는 결핵의 재발로 현재 치료 중이다. 걸론 수술 후 이환율을 높이는 질환으로 파괴성 폐결핵을 들 수 있으며 염증성 폐질환으로 인한 전폐절제술은 술 후 출혈에 대한 각별한 주의를 요한다. 향후 보다 많은 증례를 통해 수술 후 객혈의 재발에 대한 심도 있는 연구가 필요할 것이다.

• 농촌의학ㆍ지역보건
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• 제35권1호
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• pp.77-88
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• 2010

이 연구는 고혈압, 당뇨병, 이상지질혈증으로 지출된 진료비 중 과체중 및 비만의 기여분을 추계하기 위한 질병비용연구로서 국민건강보험공단의 건강검진 및 건강보험급여 자료를 활용한 연구이다. 연구결과 2005년 현재 고혈압, 당뇨병, 이상지질혈증 때문에 지출된 총 진료비 중 과체중 및 비만의 기여분은 각각 4,561억원(4,328억원-4,805억원), 2,823억원(2,487억원-3,176억원), 165억원(147억원-183억원)이었고, 이를 모두 합하면 7,549억원(6,961억원-8,164억원)이었다. 이는 해당 연도의 고혈압 총 진료비의 34.6%(32.9%-36.5%), 당뇨병 총 진료비의 32.5%(28.6%-36.6%), 이상지질혈증 총 진료비의 19.4%(17.3%-21.6%)를 차지한다. 또한 이 세 가지 질병의 총 진료비를 기준으로 했을 때 과체중 및 비만이 기여한 금액은 33.3%(30.7%-36.0%)에 해당하였다. 이는 과체중과 비만을 예방한다면 고혈압, 당뇨병, 이상지질혈증으로 지출되는 총 진료비의 33.3%를 감소시킬 수 있다는 의미이며, 향후 만성질환 예방과 관련하여 과체중 및 비만의 예방관리사업이 얼마나 중요한가를 시사해 주는 것이다.