• Korean Journal of Radiology
• /
• 제25권7호
• /
• pp.644-655
• /
• 2024

Objective: To develop and validate a preoperative risk score incorporating carbohydrate antigen (CA) 19-9, CT, and fluorine18-fluorodeoxyglucose (¹⁸F-FDG) PET/CT variables to predict recurrence-free survival (RFS) after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Materials and Methods: Patients with resectable PDAC who underwent upfront surgery between 2014 and 2017 (development set) or between 2018 and 2019 (test set) were retrospectively evaluated. In the development set, a risk-scoring system was developed using the multivariable Cox proportional hazards model, including variables associated with RFS. In the test set, the performance of the risk score was evaluated using the Harrell C-index and compared with that of the postoperative pathological tumor stage. Results: A total of 529 patients, including 335 (198 male; mean age ± standard deviation, 64 ± 9 years) and 194 (103 male; mean age, 66 ± 9 years) patients in the development and test sets, respectively, were evaluated. The risk score included five variables predicting RFS: tumor size (hazard ratio [HR], 1.29 per 1 cm increment; P < 0.001), maximal standardized uptake values of tumor ≥ 5.2 (HR, 1.29; P = 0.06), suspicious regional lymph nodes (HR, 1.43; P = 0.02), possible distant metastasis on ¹⁸F-FDG PET/CT (HR, 2.32; P = 0.03), and CA 19-9 (HR, 1.02 per 100 U/mL increment; P = 0.002). In the test set, the risk score showed good performance in predicting RFS (C-index, 0.61), similar to that of the pathologic tumor stage (C-index, 0.64; P = 0.17). Conclusion: The proposed risk score based on preoperative CA 19-9, CT, and ¹⁸F-FDG PET/CT variables may have clinical utility in selecting high-risk patients with resectable PDAC.

• Journal of Gastric Cancer
• /
• 제4권3호
• /
• pp.180-185
• /
• 2004

Recently, we experienced two advanced gastric cancer (AGC) patients younger than 17 years of age. The first case was a 15-year, 2-month-old male who had suffered from epigastric soreness for 5 weeks. His grandfather died of gastric cancer at 39 years of age. Under the diagnosis of AGC, he underwent a total gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 4.5$\times$4 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 42 regional lymph nodes (T2bN2M0). The second case was a 17-year, 11-month-old male who had suffered from epigastric pain for 2 years without familial clustering. Under the diagnosis of AGC, he underwent a distal subtotal gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 3$\times$2 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 45 regional lymph nodes (T2bN2M0). The two patients have been alive without recurrence for 27 months and 4 months, respectively. Even among teenagers, patients with abdominal complaints should be subjected to a thorough examination of the gastrointestinal tract.

• 한국수자원학회논문집
• /
• 제30권1호
• /
• pp.55-62
• /
• 1997

전국적인 가뭄특성을 조사하고 '94-'95 가뭄의 심도를 기왕의 주요 가뭄과 비교평가하기 위하여 전국의 47개 소유역으로 분할한 후 강우량계열로부터 작성된 가뭄우량계열의 지역빈도분석을 실시하였다. L-모멘트법을 사용하여 적정확률분포의 매개 변수를 결정하였으며, 강우지속기간별, 재현기간별 가뭄우량을 산정하여 지속기간별 확률가뭄우량도를 작성하였다. 강우지속기간-재현기간-가뭄우량 관계를 고려하여 '94-'95 가뭄의 심도와 지역적 범위를 기왕의 주요가뭄과 비교평가하였다. 본 연구결과를 고려하여 현행 이수안전도를 평가하고 안전도 기준의 상향조정을 제안하였다.

• 한국가축번식학회지
• /
• 제10권1호
• /
• pp.58-65
• /
• 1986

The results from a survery on the reproduction of a, pp.oximately 500 dairy cows raised in four different farming areas including Cheju city, Jochun, Hallim and Sung-up are summarized as follows; 1. At the occurrence of first estrus, the average age of the heifers was 15.1 months (330 Kg/B.W.), and at first conception 18.0 months (354Kg/B.W.). There was no regional differences. 2. The average interval of the estrous cycle was 20.4 days. And the repetition of esturs after unsuccessful insemination occurred on an average of 1.6 times, especially 2.0 times in the herds of the Jochun district. 3. The ages at the first calving were similar to the data recorded for the domestic mainland's herds at 27.1 months. But some regional differences were recognized within the four districts: i.e. 28.6 (Cheju city), 27.4(Jochun), 27.1(Hallim) and 25.3 months (Sung-up). There was no significant differences in sex ratio of newborns at 50.4%(♂) and 49.6%(♀). 4. The intervals of esturs recurrence and the following conception after calving were 80.0 and 95.8 days respectively. In the followsing conception intervals after cavling, 90.6-97.4 days were average for the herds of Cheju city and Jochun districts, 62.4-69.7 days for those of Hallim and Sung-up districts. 5. The average gestation period was 279.8 days, and was almost identical in the four districts. 6. The calving intervals was 377.7 days in average, and it was shorter than the data recorded for the domestic mainland's herds. Also it was reduce gradually according to the calving frequency.

• 한국항공운항학회지
• /
• 제26권4호
• /
• pp.36-42
• /
• 2018

Although continuous passenger injuries and physical damages are repeated due to the unexpected aviation turbulence encountered during operations, there is still exist the limitation for preventing recurrence of similar events because the lack of real-time information and delay in technological developments regarding various operating conditions and variable weather phenomena. The purpose of this study is to compare and analyze the meteorological data of the aviation turbulence occurred and actual flight data extracted from the Quick Access Recorder(QAR) to provide some precursors that the pilot can identify aviation turbulence early by referring thru the flight instrumentation indications. The case applied for this study was recent event, a scheduled flight from Incheon Airport, Korea to Narita Airport, Japan that suddenly encountered turbulence at an altitude of approximately 14,000 feet during approach. According to the Korea Meteorological Administration(KMA)'s Regional Data Assessment and Prediction System(RDAPS) data, it was observed that the strong amount of vorticity in the rear area of jet stream, which existed near Mount Fuji at that time. The QAR data analysis shows significant changes in the aircraft's parameters such as Pitch and Roll angle, Static Air Temperature(SAT), and wind speed and direction in tens of seconds to minutes before encounter the turbulence. If the accumulate reliability of the data in addition and verification of various parameters with continuous analysis of additional cases, it can be the precursors for the pilot's effective and pre-emptive action and conservative prevention measures against aviation turbulence to reduce subsequent passenger injuries in the aviation operations.

• 대한두경부종양학회지
• /
• 제6권2호
• /
• pp.79-84
• /
• 1990

본 논문은 구강암의 근치적 절제술후 결손부위 재건을 위한 근피부판(myocutaneous flaps)이 환자의 생존율에 미치는 의의를 알아보고자 저자들의 경험을 살펴본 것이다. 1974년부터 1988년까지, 만 15년간 98명의 환자들이 구강 및 구인두 부위에 발생한 암으로 절제술을 받았다. 이 중 14명은 하악골 절제술없이 근치적 복합적 절제술(composite resection)을 받았으며, 4명은 방사선 조사후 재발한 경우로서 경부곽청술없이 광범위 단순절제술(enbloc resection)만을 시행받았다. 이들을 제외한 근피부판을 사용또는, 사용하지 않은 COMMANDO를 시행받은 84명의 나머지 환자들을 대상으로 여러가지 술식에 따른 재발율 및 생존율을 비교 분석하여보았다. 1) 술기에 있어서 국소 또는 근피부판을 사용하지않은 표준 COMMANDO술식이 24 예, 전두피부판(forehead flap)을 사용하여 재건한 경우가 12 예, 후경부피부판(Nape flap)을 사용한 경우가 19 예, 큰피부판 또는 골근피부판(osteomyocutaneous flap)을 사용한 경우가 27 예였으며 두 종류의 피부판 복원을 시행한 경우가 2 예였다. 2) 비교정(uncorrected) 2년 무병생존율은 표준 COMMANDO가 14%, 전두피부판을 이용한 COMMANDO가 17%, 후경부피부판 사용 COMMANDO가 35% 이었으며 근피부판을 이용한 COMMANDO에서도 역시 35% 이었다. 3) 병기(stage)에 따른 2년 무병생존율은 제 1병기가 100%, 제 2병기가 45%, 제 3병기가 41% 이었으며, 제 4병기에서는 18% 이었다. 4) 근피부판을 사용한 경우와 조직학적으로 이에 상응하는 제 1대조군, 즉 표준 COMMANDO를 시행했거나 국소피부판(전두피부판 빛 후경부피부판)을 사용한 COMMANDO 경우 들과 비교하였을 때 ,2년 무병생존율은 큰 차이가 없이 대조군 양쪽 모두에서 공히 40% 이었다. 5) 근피부판을 사용한 경우를 제 2대조군, 즉 국소피부판(전두피부판 및 후경부피부판) 복원만을 시행한 경우들과 비교했을 때에도 역시 차이가 없이대조군 양쪽 모두에서 27%의 2년 무병생존율을 보였다. 6) 근피부판을 사용한 경우를 제 3대조군 즉 어떠한 종류의 피부판도 사용하지않고 단순한 표준 COMMANDO만을 시행한 경우들과 비교했을 때는 큰 차이를 보였다. 즉, 근피부판을 사용하여 복원했던 경우는 50%의 2년 무병생존율을 보인데 비해, 표준 COMMANDO만을 시행했던 경우는 25%의 생존율을 보였다. 7) 국소재발율은 표준 COMMANDO에서 25%, 후경부피부판 사용 경우에서 26%, 전두 피부판 사용경우에서 33% 이었으나 근피부판을 사용한 경우는 재발율이 가장 낮아 22% 이 었다. 이러한 결과들을 병기가 진행된 예(stage III & IV)에서 본다면, 표준 COMMANDO에서 67%가 제 3, 제 4병기이었고, 후경부피부판을 사용한 경우는 79%에서 제 3, 제 4병기이었다. 전두피부판을 사용한 예에서는 100% 모두가 제 3, 제 4병기이었고, 근피부판을 사용했던 경우는 96% 에서 제 3, 제 4병기이었던 점을 고려한다면 매우 중요한 의미가 있다고 하겠다.

• Journal of Chest Surgery
• /
• 제52권4호
• /
• pp.248-329
• /
• 2019

Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

• 대한소아치과학회지
• /
• 제44권4호
• /
• pp.469-473
• /
• 2017

말초성 거대세포 육아종은 국소적인 자극 또는 만성적인 외상에 의해 발생하는 구강 내의 반응성, 증식성 병소이다. 유사한 형태의 다른 연조직 병소와의 감별진단을 위해서는 병리조직학적 검사가 필요하다. 본 증례는 상악 중절치의 맹출 시기에, 해당 부위에 발생한 발생한 거대세포 육아종에 대해 절제생검을 시행하였고, 1년 경과 관찰 시 재발 없이 양호한 치유 결과를 나타내고 있기에 보고하는 바이다.

• 대한두경부종양학회지
• /
• 제28권2호
• /
• pp.125-128
• /
• 2012

Salivary duct carcinoma(SDC) is a highly malignant tumor of the salivary gland. The tumor is clinically characterized by a rapid onset and progression, the neoplasm is often associated with pain and facial paralysis. The nodal recurrence rate is high, and distant metastasis is common. SDC resembles high-grade breast ductal carcinoma. Curative surgical resection and postoperative radiation were the mainstay of the treatment. If facial paralysis is present, a radical parotidectomy is mandatory. Regardless of the primary location of SDC, ipsilateral functional neck dissection is indicated, because regional lymphatic spread has to be expected in the majority of patients already at time of diagnosis. If there is minor gland involvement, a bilateral neck dissection should be performed, because lymphatic drainage may occur to the contralateral side. The survival of SDC patient is poor, with most dying within three years. We experienced a unique case of SDC in parotid deep lobe. We report the clinicopathologic features of this tumor with a review of literature.

• 대한기관식도과학회지
• /
• 제2권2호
• /
• pp.274-279
• /
• 1996

저자들은 좌측 전경부 종물을 주소로 내원한 9세 여아에서 발생한 갑상선수질암종을 갑상선 전절제술 및 술후 방사성요드로 치료한 경험을 보고하는 바이다.