• Asian Pacific Journal of Cancer Prevention
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• 제15권9호
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• pp.3915-3920
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• 2014

Background: Hepatocellular carcinoma (HCC) is a dismal tumor with a high incidence, prevalence and poor prognosis and survival. Management of HCC necessitates multidisciplinary clinics due to the wide heterogeneity in its presentation, different therapeutic options, variable biologic behavior and background presence of chronic liver disease. We studied the different prognostic factors that affected survival of our patients to improve future HCC management and patient survival. Materials and Methods: This study is performed in a specialized multidisciplinary clinic for HCC in Kasr El Eini Hospital, Cairo University, Egypt. We retrospectively analyzed the different patient and tumor characteristics and the primary mode of management applied to our patients. Further analysis was performed using univariate and multivariate statistics. Results: During the period February 2009 till February 2013, 290 HCC patients presented to our multidisciplinary clinic. They were predominantly males and the mean age was $56.5{\pm}7.7years$. All cases developed HCC on top of cirrhosis that was mainly due to HCV (71%). Most of our patients were Child-Pugh A (50%) or B (36.9%) and commonly presented with small single lesions. Transarterial chemoembolization was the most common line of treatment used (32.4%). The overall survival was 79.9% at 6 months, 54.5% at 1 year and 22.4% at 2 years. Serum bilirubin, site of the tumor and type of treatment were the significant independent prognostic factors for survival. Conclusions: Our main prognostic variables are the bilirubin level, the bilobar hepatic affection and the application of specific treatment (either curative or palliative). Multidisciplinary clinics enhance better HCC management.

• 한국조경학회지
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• 제36권4호
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• pp.36-47
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• 2008

본 연구는 국내 현대조경을 대표하는 공원들을 대상으로 실제 이용자들이 느끼는 만족도, 선호도, 이미지 등을 분석하여 개별 공원의 기능적, 경관적인 차이점과 공통점을 실증적으로 규명하는 것을 목적으로 하였다. 공원시설 유형으로는 관리상태, 공원활동시설, 편의시설, 동선 및 밀도, 조경 및 휴게시설 등으로 구분되었다. 공원이용행태 만족도에 대해서는 대화, 휴식, 한가로움 등에 대해서는 긍정적으로 평가하였고 학습, 체험, 경험 등에 대해서는 부정적으로 평가하였으며, 공원 이용행태의 유형으로는 공원활동, 정서 및 체험, 자연활동 등으로 구분되었다. 공원의 이미지 분석 결과 조사대상 공원은 주로 안정적이고 편안하며 자연적인 느낌의 공간으로 인식하고 있는 것으로 분석되었으며, 자연/조화성 요인, 개방감 요인, 독특성 요인 등의 요인으로 요약되었다. 선호도 조사 결과 전반적으로 양호한 선호를 보이는 것으로 나타났다. 시설만족도, 이용행태, 경관이미지, 선호도 등을 기준으로 공원을 유형화한 결과 다목적공원(일산호수공원, 여의도공원, 하늘공원, 양재천, 올림픽공원), 자연적 요소를 가진 종합공원(선유도공원, 평화의 공원), 개방된 도시공간(서울광장, 청계천), 상대적 개선필요 공원(파리공원, 서울숲), 생태공원(길동자연생태공원) 등의 5개의 유형으로 구분되었으며, 각 유형별 특징에 대한 분석이 진행되었다. 본 연구결과는 수도권에 위치한 공원을 대상으로 한 계절 동안 설문조사의 결과로 일반적인 도시공원의 유형화를 위한 기초연구라고 할 수 있다. 향후 이러한 한계점을 극복하기 위한 보다 다양한 도시공원에 대한 일반적이고 폭넓은 연구가 필요하겠다.

• The Korean Journal of Pain
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• 제4권2호
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• pp.127-132
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• 1991

Recently a non-electronic, disposable and portable infusor(Baxter infusor with patient control module, Baxter health care Co., Deerfield IL 60015 USA: BI $\bar{c}$ PCM) has been developed that will deliver both a continuous drug infusion as well as allow the patient to deliver extra doses of medication on a demand basis under predetermined limitation of analgesics. Patients may also not require as high analgesic dose rate to control pain when the acceptable and tolerable level of pain relief can be maintained by this device. From April l99l, we have used a total l93 units of BI $\bar{c}$ PCM. These units consisting of two components which one made by a balloon reservoir(capacity 65 ml, flow rate 0.5 ml/hr) to store medication and to regulate the pump power(490 torr), and another two PCMs to regulate additional analgesic administration by patients demand at intervals of 1S minutes and 60 minutes. The dose administered to the patient can be varied by changing the concentration of the infusate within the balloon reservoir. These devices were utilized for the pain control of 44 patients. These patients were divided into two groups. Twenty seven cases had cancer pain and 17 cases had non-cancer pain. The Touhy needle(No. l8 G.) tip was inserted into the epidural space and was used to guide the catheter to the spinal nerve level corresponding to the most painful area. The device was connected to the opposite site of the catheter tip and was filled with 60 ml of mixture solution such as 0.5% bupivacaine 15 ml, morphine HCl 10 mg, trazodone 10 ml, Tridol 3 ml and normal saline 31 ml were administed as the initial dose. When the initial dose was less effective, the next dose could be varied by increasing the concentration of bupivacaine, by adding more morphine (5~10 mg), and by reducing the volume of normal saline. Using these modules of drug self administration, we experienced the following: 1) Improvement of patient's self titration of analgesic requirement was provided. 2) The patients anxiety with pain recurrence resulting from delays in administering pain control medication was decreased significantly. 3) The working load accompanying with the single bolus injection as the usual method was reduced remarkably. 4) There was urinary retention in 5 cases and pruritus in 4 eases which developed as side effects but respiratory depression and vomiting was not encountered in a single case.

• Journal of Korean Neurosurgical Society
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• 제63권3호
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• pp.397-405
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• 2020

Objective : We retrospectively evaluated the efficacy of Gamma Knife radiosurgery (GKS) for recurrent nasopharyngeal carcinoma (NPC) in patients who previously underwent radiotherapy, and analyzed the treatment outcomes over 14 years. Methods : Ten patients with recurrent NPC who had previously received radiotherapy underwent stereotactic radiosurgery using a Gamma Knife^® (Elekta Inc, Atlanta, GA, USA) between 2005 and 2018. The median target volume was 8.2 ㎤ (range, 1.7-17.8), and the median radiation dose to the target was 18 Gy (range, 12-30). The median follow-up period was 18 months (range, 6-76 months). Overall and local failure-free survival rates were determined using the Kaplan-Meier method. Results : The NPCs recurred at the primary cancer site in seven patients (70%), as distant brain metastasis in two (20%), and as an extension into brain in one (10%). The recurrent tumors in seven of the 10 patients (70%) were found on the routine follow-up imaging studies. Two patients presented with headache and one with facial pain. Local failure after GKS occurred in five patients (50%) : two of whom died eight and 6 months after GKS, respectively. No adverse radiation effects were noted after GKS. The 1- and 3-year overall survival rates after GKS were 90% and 77%, respectively. The local failure-free survival rates at 6 months, 1 year, and 3 years after GKS were 80%, 48%, and 32%, respectively. The median interval from GKS to local failure was 8 months (range, 6-12). Univariate analysis revealed that using co-registration with positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) was associated with a lower local failure rate of recurrent NPC (p=0.027). Conclusion : GKS is an acceptable salvage treatment option for patients with recurrent NPC who previously received radiation therapy. PET-CT and MRI co-registration for dose planning can help achieve local control of recurrent NPC.

• 시큐리티연구
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• 제25호
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• pp.131-146
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• 2010

본 연구의 목적은 그간 사회의 요구로 인하여 발전을 거듭하고 있는 경호 경비학의 전공과목으로서 무도의 역사와 함께하는 경호무도의 학문적 체계 정립이 부족함을 인식하고 경호무도의 철학적 가치 연구를 위하여 그 한 방법으로 경호무도 구성원리 내에서 발견될 수 있는 미학적 가치를 탐색해보고자 하였다. 본 연구의 목적을 달성하기 위해 경호무도관련 학위논문 및 무도와 미학 관련 문헌을 광범위하게 조사였으며 이를 바탕으로 미학의 개념과 무도에서의 미학을 살피고 이를 토대로 경호무도 수련자의 반복 수련을 통한 기술습득과 경호원의 실제현장에서의 기술구사능력이 미학적 구성요소에 대한 체험을 가능하게 하고 심미적 감흥을 획득할 수 있음을 확인하였다. 궁극적으로 경호무도는 상대성 반복성 정신수양 신체일치성 힘의 방향 충격의 강화 및 완화 힘의 극대화 중심자세와 타격점 호흡조절 및 정신집중 등 그 구성원리를 따라 완성되어가는 기술연마 과정 속의 심미적 요소들로 인하여 미학적 가치를 구현할 수 있다고 여겨진다.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.654-660
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• 2017

Objective : Mechanical thrombectomy is increasingly being used for the treatment of acute ischemic stroke. The population over 80 years of age is growing, and many of these patients have acute infarction; however, these patients are often excluded from clinical trials, so the aim of this study was to compare the functional outcomes and complication rates in very elderly patients (age ${\geq}80$ years) and aged patients (60-79 years) treated with mechanical thrombectomy. Methods : Between January 2010 and June 2015, we retrospectively reviewed 113 senior patients (over 60 years old) treated at our institution for acute ischemic stroke with mechanical thrombectomy. They were divided into a very elderly (${\geq}80$ years) and aged (60-79 years) group, with comparisons in recanalization rates, complications, death and disability on discharge be reported. Results : The mean age was 70.3 years in the aged group and 83.4 years in the very elderly group. Elderly patients had higher rates of mechanical thrombectomy failure than the younger group (40% vs. 14%; odds ratio [OR] 4.1; 95% confidence interval [CI] 1.4-11.9; p=0.012). Results from thrombolysis in cerebral ischemia and modified Rankin scale at discharge were worse in the older group (p=0.005 and 0.023 respectively). There were no differences in mortality rate or other complications, but infarction progression rates were significantly higher in the very elderly group. (15% vs. 2.2%; OR 8.0; 95% CI 1.2-51.7; p=0.038). The majority (92.3%) of the patients who failed in aged group were not successful after several trials. However, in half (4 of 8) of the very elderly group, the occlusion site could not be accessed. Conclusion : Patients older than 80 years of age undergoing mechanical thrombectomy for acute infarction were more difficult to recanalize due to inaccessible occlusion sites and had a higher rate of infarction progression, However, mortality and other complications were similar to those in younger patients.

• Journal of Korean Neurosurgical Society
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• 제50권4호
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• pp.299-303
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• 2011

Objective : Brainstem metastases are rarely operable and generally unresponsive to conventional radiation therapy or chemotherapy. Recently, Gamma Knife Radiosurgery (GKRS) was used as feasible treatment option for brainstem metastasis. The present study evaluated our experience of brainstem metastasis which was treated with GKRS. Methods : Between November 1992 and June 2010, 32 patients (23 men and 9 women, mean age 56.1 years, range 39-73) were treated with GKRS for brainstem metastases. There were metastatic lesions in pons in 23, the midbrain in 6, and the medulla oblongata in 3 patients, respectively. The primary tumor site was lung in 21, breast in 3, kidney in 2 and other locations in 6 patients. The mean tumor volume was $1,517mm^3$ (range, 9-6,000), and the mean marginal dose was 15.9 Gy (range, 6-23). Magnetic Resonance Imaging (MRI) was obtained every 2-3 months following GKRS. Follow-up MRI was possible in 24 patients at a mean follow-up duration of 12.0 months (range, 1-45). Kaplan-Meier survival analysis was used to evaluate the prognostic factors. Results : Follow-up MRI showed tumor disappearance in 6, tumor shrinkage in 14, no change in tumor size in 1, and tumor growth in 3 patients, which translated into a local tumor control rate of 87.5% (21 of 24 tumors). The mean progression free survival was 12.2 months (range, 2-45) after GKRS. Nine patients were alive at the completion of the study, and the overall mean survival time after GKRS was 7.7 months (range, 1-22). One patient with metastatic melanoma experienced intratumoral hemorrhage during the follow-up period. Survival was found to be associated with score of more than 70 on Karnofsky performance status and low recursive partitioning analysis class (class 1 or 2), in terms of favorable prognostic factors. Conclusion : GKRS was found to be safe and effective for management of brainstem metastasis. The integral clinical status of patient seems to be important in determining the overall survival time.

• 전자공학회논문지
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• 제51권2호
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• pp.55-68
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• 2014

현대의 지하 시설물들은 보행자의 보행에 방해되지 않도록 지하에 매설 되어 있기 때문에 가시적인 확인이 어렵다. 이러한 폐색 시설물들을 다루는 건설현장에서는 시각적으로 위치를 정확히 추정하기 어렵기 때문에 작업자의 경험 또는 종이 도면 등에 의존하다 보니 침수나 붕괴의 위험에 노출되는 등 많은 문제점이 발생한다. 본 논문에서는 일반적인 건설 현장에서 폐색된 지하 시설물을 모바일을 이용한 작업자 중심의 시각화 시스템을 제안한다. 논문의 구성은 크게 3단계로 이루어 진다. 먼저, "맨홀 검출 및 특징점 추출 단계"에서는 폐색된 건축물의 기준점인 폐색되지 않는 맨홀을 검출 및 추출한다. 다음으로, "특징점 추적 단계" 에서는 이전단계에서 추출한 특징점을 추적한다. 마지막으로, "폐색 건축물 시각화 단계" 에서는 맨홀에 따라 서로 다른 지하시설물이 존재함으로 이전 단계에서 검출 및 추적된 맨홀의 위치에 모바일에 내장된 GPS 데이터를 분석하여 현장에 해당하는 폐색된 건축물인 3차원 객체를 정합 한다. 제안된 방법은 실내 환경에서 맨홀 검출과 특징점 추출 및 추적방법들의 비교 분석을 통해 최적의 방법을 적용하였으며, 실제 환경에서의 폐색된 상/하수도 배관 증강을 통해 가능성을 확인하였다. 또한, 폐색된 상하수도 등의 건축물의 증강된 3차원 결과들로부터 작업자 중심의 보다 유용한 건설 환경을 제공할 수 있다.

• Tuberculosis and Respiratory Diseases
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• 제71권4호
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• pp.266-270
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• 2011

Background: Photodynamic therapy (PDT) is effective in managing small superficial early lung cancer patients who were deemed nonsurgical candidates. However, we do not have any previous report on the usefulness of PDT in early lung cancer in South Korea. Thus we report here our experience of PDT in early lung cancer patients. Methods: 10 patients who underwent PDT for managing early lung cancer between June 2006 and July 2010 were analyzed. PDT was carried out 48 hours after photosensitizer injection. Re-bronchoscopy was carried out 48 hours after PDT in order to remove a necrotic tissue from the PDT site. For evaluation of PDT response, bronchoscopy and chest computed tomography (CT) were performed after 3 months. Results: The median age of patients was 69 (49~77) and all patients were male. The smoking history of patients was 48 (20~75) pack-year and the median follow up of patients was 25 (11~52) months. Complete remission was observed in 10 patients and the recurrence of lung cancer was observed in 3 patients. Out of 10 patients, 3 patients died (one case of lung cancer progression and two cases of pneumonia). Conclusion: The PDT is a safe and effective treatment in early lung cancer patients who are not suitable for surgical resection. The PDT in clinical practice is an attractive option in the treatment of early lung cancer.

• 대한두개안면성형외과학회지
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• 제17권3호
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• pp.135-139
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• 2016

Background: The ultimate goal of craniofacial reconstructive surgery is to achieve the most complete restoration of facial functions. A bioabsorbable fixation system which does not need secondary operation for implant removal has been developed in the last decade. The purpose of this study is to share the experience of authors and to demonstrate the efficacy of bioabsorbable mesh in a variety of craniofacial trauma operations. Methods: Between October 2008 and February 2015, bioabsorbable meshes were used to reconstruct various types of craniofacial bone fractures in 611 patients. Any displaced bone fragments were detached from the fracture site and fixed to the mesh. The resulting bone-mesh complex was designed and molded into an appropriate shape by the immersion in warm saline. The mesh was molded once again under simultaneous warm saline irrigation and suction. Results: In all patients, contour deformities were restored completely, and bone segments were fixed properly. The authors found that the bioabsorbable mesh provided rigid fixation without any evidence of integrity loss on postoperative computed tomography scans. Conclusion: Because bioabsorbable meshes are more flexible than bioabsorbable plates, they can be molded and could easily reconstruct the facial bone in three dimensions. Additionally, it is easy to attach bone fragments to the mesh. Bioabsorbable mesh and screws is effective and can be easily applied for fixation in various craniofacial trauma reconstructive scenarios.