• 제목/요약/키워드: WHO classification 2004

검색결과 90건 처리시간 0.026초

제5판 UICC TNM림프절 분류에 따른 pT3pN1 위암 환자에서 림프절의 해부학적인 위치에 따른 2군 림프절 양성의 의의 (Prognostic Significance of Group 2 Lymph Node Metastasis in pT3pN1 Gastric Cancer Patients)

  • 김용진;김병식;최원용;육정환;오성태;박건춘
    • Journal of Gastric Cancer
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    • 제4권1호
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    • pp.32-35
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    • 2004
  • Purpose: The most important prognostic factors in gastric cancer is the depth of invasion of the primary tumor and lymph node metastasis. The nodal staging of the 5th edition of the Union Internationale Contrala Cancrums (UICC) TNM classification in 1997 was changed based on the number of metastatic lymph node. We attempted to evaluate the prognostic significance of N2 group metastasis in pT3pN1 gastric cancer patients by comparing two different nodal staging systems. Materials and Methods: A retrospective analysis was made for 352 gastric cancer patients who underwent curative resection, including D2 dissection, from 1991 to 1997 at Asan Medical Center. A clinicopathologic comparison between two groups by using a nodal staging systems was summarized into a table. Cumulative survival rates were calculated by using the Kaplan-Meier method. The difference between the two groups was evaluated by using the log rank test with SPSS 11.5 for Windows Results: There were no statistical differences in clinicopathologic factors. However, there was a significant difference in survival rate between the two groups (P=0.0009). This suggests that N2 group metastasis in pT3pN1 gastric cancer patients has a clinical significance for predicting prognosis. Conclusion: Our results suggest a possibility of prognostic significance of N2 group metastasis. Therefore, anatomical location of the lymph node should be described.

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불임여성에서 NAT2, GSTM1, CYP1A1 유전자 다형성과 자궁내막증의 상관관계에 관한 연구 (Association between Endometriosis and Polymorphisms of N-acetyl Transferase 2 (NAT2), Glutathione S-transferase M1 (GSTM1) and Cytochrome P450 (CYP) 1A1 Genes in Korean Infertile Patients)

  • 송현정;전진현;최혜원;허걸;강인수;궁미경;이형송
    • Clinical and Experimental Reproductive Medicine
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    • 제31권2호
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    • pp.141-147
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    • 2004
  • Objective: To investigate the association between endometriosis and polymorphisms of N-acetyl transferase 2 (NAT2), glutathione S-transferase M1 (GSTM1), and cytochrome P450 (CYP) 1A1 genes in Korean infertile patients. Materials and Methods: A total of 303 infertile patients who had undertaken diagnostic laparoscopy during January, 2001 through December, 2003 at Samsung Cheil Hospital enrolled in this study. The patients were grouped according to laparoscopic findings: minimal to mild endometriosis (group I: n=147), moderate to severe endometriosis (group II: n=57), normal pelvic cavity (n=99). Peripheral blood was obtained and genomic DNA was extracted. The genotypes of each genes were analyzed using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). For NAT2, RFLP was used to detect the wild type (wt) and mutant (mt) alleles, enabling classification into slow (mt/mt) or fast (wt/wt or wt/mt) acetylation genotypes. For GSTM1, PCR was used to distinguish active (+/- or +/+) from null (-/-) genotypes. For CYP1A1, MspI digestion was used to detect the wild type (A1A1), heterozygote (A1A2) or mutant (A2A2) genotypes. Result: The genotype frequencies of NAT2 slow acetylator was 12.8%, 10.9%, 12.8% in group I, group II and control, respectively. The genotype frequencies of GSTM1 null mutation was 55.3%, 41.8%, 53.2% in group I, group II and control, respectively. The genotype frequencies of CYP1A1 MspI polymorphism was 16.3%, 9.1%, 18.1% in group I, group II and control, respectively. No significant difference was observed between endometriosis and normal controls in the genotype frequencies of the NAT2, GSTM1, CYP1A1 MspI polymorphism. Conclusion: The NAT2, GSTM1, CYP1A1 gene polymorphism may not be associated with the susceptibility of endometriosis in Korean women.

한방안이비인후피부과 외래환자의 통계적 관찰 (The stastical analysis of ophthalmology, otolaryngology, dermatology new outpatients)

  • 차재훈;김윤범;남혜정
    • 한방안이비인후피부과학회지
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    • 제20권3호
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    • pp.169-180
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    • 2007
  • Objective : This study was to explore the change of new outpatients in ophthalmology, otolaryngology, dermatology. Methods : We did stastical analysis about 4638 new outpatients who had visited the department of ophthalmology, otolaryngology, dermatology in Kyunghee oriental medicine center from January 1, 2004 to December 31, 2006 and had ophthalmologic, otologic, rhinologic, laryngologic and dermatologic diseases. Results : The results were as follows. 1. Distribution of ophthalmology, otology, rhinology, laryngology and dermatology classification in new outpatients was 44.74% in dermatology the most, 26.50% in rhinology, 14.45% in otology, 8.78% in ophthalmology, 5.54% in laryngology. In all classifications except ophthalmology, outpatients increased, but the proportion of outpatients increased the most in dermatology. 2. The proportion of the new outpatients in ophthalmology was 20.15% in 51-60 years old the most. And 36.61% in dry eye the most, next 27.03% in visual disorder, 10.07% in strabismus. The proportion of the new outpatients in ophthalmology in strabismus decreased by 43.93 percent point but in dry eye increased by 32.17 percent point. 3. The proportion of the new outpatients in otology was 24.94% in 61+ years old the most. And 64.03% in tinnitus, hearing loss the most, next 17.46% in vertigo, dizziness. By 17.36 percent point, it in tinnitus, hearing loss decreased. But in vertigo, dizziness increased by 14.91 percent point. 4. The proportion of the new outpatients in rhinology was 40.93% in 0-10 years old the most. And it increased by 20.08 percent point. 69.30% in rhinitis the most but it decreased by 17.70 percent point. But 32.59% in sinusitis, that means it increased by 14.41 percent point. 5. The proportion of the new outpatients in laryngology was 68.09% in female, 23.35% in 51-60 years old the most. And it was 29.96% in laryngopharyngitis, 19.07% in stomatitis, 14.40% in the diseases of tongue. 6. The proportion of the new outpatients in dermatology was 37.21% in 21-30 years old the most.And it was 22.93% in atopic dermatitis the most, next 14.77% in urticaria. That means it increased by 8.19 percent point. But the proportion of the new outpatients in dermatology decreaed in acne, pruritus. Conclusions : We could know that there had been many changes of new outpatients in ophthalmology, otolaryngology, dermatology

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6미터 이하 저고도 추락 환자의 안전성 여부 (Are Falls of Less Than 6 Meters Safe?)

  • 서영우;홍정석;김우연;안력;홍은석
    • Journal of Trauma and Injury
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    • 제19권1호
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    • pp.54-58
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    • 2006
  • Purpose: The committee on trauma of the american college of surgeons, in its manual resources for optimal care of the injured patients involved in falls from less than 20 feet need not be taken to trauma centers. Because triage criteria dictate less urgency for low-level falls, this classification scheme has demerits for early detection and treatment of serious problems in the emergency room. Methods: A prospective analysis was conducted of 182 patients treated for fall-related trauma from June 2003 to March 2004. Falls were classified as group A (<3 m), group B (${\geq}3m$, <6 m), and group C (${\geq}6m$). Collected data included the patient's age, gender, site and height of fall, surface fallen upon, body area of first impact, body regions of injuries, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Injury Severity Score (ISS). Results: The 182 patients were classified as group A (105) 57.7%, group B (61) 33.5%, and group C (16) 8.8%. There was a weak positive correlation between the height of fall and the patients' ISS in the three groups (p<0.001). There were significant differences in GCS (p=0.017), RTS (p=0.034), and ISS (p=0.007) between group A and B. In cases that the head was the initial impact area of the body, the GCS (p<0.001) and the RTS (p=0.002) were lower, but the ISS (p<0.001) was higher than it was for other type of injuries. Hard surfaces as an impact surface type, had an influence on the GCS (p<0.001) and the ISS (p=0.025). Conclusion: To simply categorize patients who fall over 6 meters as severely injured patients doesn't have much meaning, and though patients may have fallen less than 6 meters, they should be categorized by using the dynamics (impact surface type, initial body - impact area) of their fall.

제조업 근로자의 건강행위와 직무로 인한 스트레스 자각증상의 관련성 (Effects of Health Behaviors on Perceived Physical and Psychological Job Stress Among Korean Manufacturing Workers)

  • 박경옥;김인석;오영아
    • 보건교육건강증진학회지
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    • 제21권3호
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    • pp.195-211
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    • 2004
  • Stress is a primary health promotion issue in worksite research because psychological distress is closely related not only to workers' health status but also to their job performance. This study identified the significant health behaviors affecting workers' job-related stress in Korean manufacturing industry with the national survey data conducted by the Korean Occupational Safety and Health Agency in 2003. A total of 7,818 factory workers in 1,562 manufacturing companies participated in the Korean nation-wide occupational health survey and 3,390 workers answered that they had any stressors in their workplace among the 7,818 workers finally participated in the analysis. Participants were selected by the stratified proportional sampling process by manufacturing industry classification, company size, and company locations (8 metropolitan and 8 non-metropolitan regions) in Korea. Trained interviewers visited the target companies and interviewed the factory workers randomly selected in each company. Smoking, drinking, weight control, exercise, sleeping, break time at work, and perceived fatigue were included in the health behavior construct. Stress symptoms was consisted of physical and psychological stress with 8 items. All survey responses were anonymously coded into the SPSS statistical program and testified using stepwise multiple regression analysis. Male workers were 73.5% and the 30s were 40.0% among the age groups. The married and the high school graduate were majority with 52.1% and 61.8% each. Current smokers were 44.7% and More than 50% of the participants drank alcohol sometimes. No exercise group was 59.3% and the participants who dissatisfied with their daily sleeping hours were 43.5%. In t-test and analysis of variance, the significant general characteristics associated with physical and psychological job stress were young age (p<0.001), single marital status (p<0.001), and short working period at the present company (p<0.001). The health behaviors related to physical job stress were current smoking, weight change during the past one year (p<0.001), weight control effort (p<0.001), exercise (p<0.001), daily sleeping dissatisfaction (p<0.001), break time, and perceived fatigue (p<0.001). All 10 health behavior factors were significantly associated with psychological job stress (p<0.05). Weight change, weight control effort, exercise, daily sleeping dissatisfaction, little break at work, and high perceived fatigue were significant factors affecting job stress. Daily sleeping dissatisfaction, little break at work, little exercise, weight change for the past one year and young age were selected as the significant health behavior and general factors affecting physical job stress symptoms in stepwise multiple regression analysis. The five factors explained 18.9% of the physical stress score variance. Six factors were selected as the significant health behaviors affecting psychological job stress: daily sleeping dissatisfaction, little exercise, frequent drinking alcohol, high perceived fatigue, little break at work, and little weight control effort. The six factors explained 10.6% of the psychological stress score variance.

복부 전산화단층촬영 결과 진단된 급성 외상성 골반골 골절에서 추가적인 3차원 재구성 골반 전산화단층촬영이 필요한가? (The Need for an Additional Pelvic CT in Cases of Acute Osseous Pelvic Injury that Has Already Been Diagnosed by Abdominal CT.)

  • 김병권;신동혁;한상국;최필조;이영한;박하영;배수호;송형곤
    • Journal of Trauma and Injury
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    • 제22권2호
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    • pp.206-211
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    • 2009
  • Purpose: Abdominal CT (computed tomography) is a principal diagnostic imaging modality for torso trauma at the Emergency Department (ED). When acute osseous pelvic injuries are detected by abdominal CT, additional three-dimensional (3D) reconstruction pelvic CT is often performed. We compared abdominal CT with pelvic CT to provide information about acute osseous pelvic injuries. Methods: A retrospective investigation of patients'electronic medical records during the five year period between January 1, 2004 and December 31, 2008 among Korean soldiers who underwent pelvic CT after abdominal CT at the ED was conducted. Axial images of abdominal CT were compared with axial images and 3D reconstruction images of pelvic CT. Results: Sixteen patients underwent subsequent pelvic CT after abdominal CT. Axial images of abdominal CT showed the same results in terms of fracture detection and classification when compared to axial images and 3D reconstruction images of pelvic CT. Pelvic CT (including 3D reconstruction images) followed by abdominal CT neither detected additional fracture nor changed the fracture type. Conclusion: This study has failed to show any superiority of pelvic CT (including 3D reconstruction images) over abdominal CT in detecting acute osseous pelvic injury. When 3D information is deemed be mandatory, 3D reconstructions of abdominal CT can be requested rather than obtaining an additional pelvic CT for 3D reconstruction.

유치의 이중치와 계승영구치의 발육에 관한 연구 (EFFECT OF PRIMARY DOUBLE TEETH ON THE DEVELOPMENT OF PERMANENT SUCCESSORS)

  • 라지영;김대업;이광희
    • 대한소아치과학회지
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    • 제31권2호
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    • pp.136-143
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    • 2004
  • 이중치는 유치열에서 흔히 나타나는 발육 이상으로 후속 영구치의 결손, 융합, 형태 이상 등을 일으킬 수 있다. 본 연구에서는 2003년 1월부터 9월까지 원광대학교 치과병원 소아치과에 내원한 유치열기 및 혼합치열기 어린이 1,803명을 대상으로 유치열에서 나타나는 다양한 유형의 이중치를 악궁에서의 위치에 따라 분류하고 그에 따른 영구치의 발육 이상을 평가하였으며 동시에 이중치의 치관 및 치근의 형태 및 융합 정도에 따라 이중치를 네 가지 유형으로 분류한 Tannenbaum과 Ailing의 기준에 따라 이중치를 분류하고 그에 따른 영향도 평가하여 다음과 같은 결과를 얻었다. 1. 이중치는 49명(2.7%)이었고, 이중 5명의 어린이에서 양측성 이중치를 보이고 있었으며, 세 개의 치관 및 치근을 보이는 삼중치를 갖는 경우도 1명에서 나타났다. 2. 이중치는 하악 치열에서 현저히 높은 빈도로 나타났으며, 하악 유중절치와 유측절치가 융합된 경우 및 하악 유측절치와 유견치가 융합된 경우에서 유사하게 높게 나타났다. 하지만 후속 영구치가 결손되는 빈도는 유중절치와 유측절치가 융합된 경우(23.8%)보다 유측절치와 유견치가 융합된 경우(73.9%)에서 훨씬 높게 나타났다. 3. 상악의 경우는 오직 유중절치와 유측절치 부위에서만 이중치가 발견되었는데, 이중 유중 절치와 유측절치가 융합된 경우(75%) 특히 후속 영구치의 결손 빈도가 높았다. 4 이중치의 유형별로는 융합된 두개의 치관 및 치근을 갖는Type IV의 발생율이 가장 높았고(51.9%) 이에 따라 후속 영구치도 높은 빈도로 결손되었다(60.7%). 하지만 영구치 결손 빈도만으로는 큰 치관과 큰 치근을 갖는 Type II에서 가장 높았다(75%).

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서울 지역 고등학생의 영양소 섭취와 체위 및 혈액성상 (A Study on Nutrient Intake, Anthropometric Data and Serum Profiles among High School Students Residing in Seoul)

  • 이현숙;김보은;조미숙;김화영
    • 대한지역사회영양학회지
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    • 제9권5호
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    • pp.589-596
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    • 2004
  • This study was performed to investigate the anthropometric data, serum profiles, and nutrient intakes of high school students who are living in Seoul. Anthropometric data showed that mean height and weight were 174.1 cm and 66.6 kg in 99 male and 161.4 cm and 54.0 kg in 116 female students. Mean BMl for male and female students were 21.9 and 22.3 kg/$m^2$, and subjects with BMI > 25 kg/$m^2$ were 14 and 7%, respectively. Total cholesterol, HDL- and LDL-cholesterol of subjects were 149.6$\pm 3.1,\; 46.4 \pm 1.3,\; 86.4 \pm 2.3$,/TEX> mg/dl for males and 169.2 $\pm 3.1,\;50.7 \pm 1.0,\; 100.9 \pm 2.7 mg/dl$ for females, respectively. Hemoglobin (Hb) and total iron binding capacity (TIBC) were 12.8 $\pm 0.1 g/dl, \;437.3 \pm 7.2\mug/dl\; in\; male\; and\; 11.9 \pm 0.1 g/dl,\; 439.4 \pm 5.7\mug/dl$ in female, respectively. Based on Hb classification, 45.6% of male and 45.0% of female students fell into anemic condition. Intakes of energy, Ca, Fe, Zn, riboflavin, and folate were below the Korean RDA. In particular Ca (male and female, respectively, 64.6 and 64.3% RDA) and Fe (male and female, respectively, 78.6 and 64.3% RDA) intakes were extremely low. Serum triglyceride was positively significantly correlated with weight (r =0.22), BMI (r =0.279), waist circumference (WC, r =0.235), triceps skin-fold thickness (TSF, r =0.197) and obesity index (OI, r =0.279). Hb concentration was positively correlated with height (r + 0.387), weight (r =0.349), BMI (r =0.191) and waistlhip ratio (WHR, r =0.380). As for the correlation between serum profiles and nutrient intakes, the Hb concentration was positively correlated with energy (r =0.163), protein (r =0.149), Na (r =0.153), vitamin A (r =0.165), thiamin (r =0.201) and niacin (r =0.192, p < 0.01). These result suggest that the prevalence of Ca and Fe deficiency of student is high and dietary guideline for prevent anemia in this age needs to contain the adequate intake of energy and its related vitamins.

채소 및 육류 섭취의 상대적인 선호도와 암 발생의 연관성: 국민건강보험공단 국민건강정보자료 활용 (Association between Relative Preference for Vegetables and Meat and Cancer Incidence in Korean Adults: A Nationwide Population-based Retrospective Cohort Study)

  • 이가은;김안나;조현정;강민지;문성지;김인아;고광필;이정은;박수경
    • 대한지역사회영양학회지
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    • 제26권3호
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    • pp.211-227
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    • 2021
  • Objectives: We aimed to examine the association between the relative preference for vegetables and meat and cancer incidence, in a population-based retrospective cohort in Korea. Methods: We included 10,148,131 participants (5,794,124 men; 4,354,007 women) who underwent national health screening between 2004 and 2005 from the National Health Information Database of the National Health Insurance Service (NHIS-NHID). Participants were asked whether they preferred consuming 1) vegetables more often, 2) both vegetables and meat or 3) meat more often. Participants were followed up to Dec. 31, 2017. All cancer and eighteen common cancer cases were identified through the code from the International Classification of Diseases, 10th revision. We estimated sex-specific relative risks and 95% confidence intervals, adjusting for age, body mass index, alcohol consumption, smoking, physical activity, and income level. Results: During an average follow-up of 12.4 years, 714,170 cancer cases were documented. In men, consuming meat more often was associated with lower risk of esophageal, liver, and stomach cancers, but higher risk of lung and kidney cancers. Consuming both vegetables and meat was associated with higher risk of prostate cancer, but with lower risk of esophageal, liver, and stomach cancers in men. In women, consuming meat more often was associated with a higher risk of colorectal cancer and breast, endometrial, and cervical cancers diagnosed before the age of 50. Consuming both vegetables and meat was associated with lower risk of liver cancer in women. Conclusions: Our study suggests a potential link between vegetable and meat intake and cancer incidence in the Korean population. Further investigation on the association between the intake of specific types of vegetables and meat and cancer risk in Korean prospective cohort studies is needed.

원위부 진행성 위암에서의 상장간막정맥(14v) 림프절 절제술의 적응증 (Indication of Dissection of the 14v Lymph Node in Advanced Distal Gastric Cancer)

  • 임정택;정오;김지훈;오성태;김병식;박건춘;육정환
    • Journal of Gastric Cancer
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    • 제6권3호
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    • pp.154-160
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    • 2006
  • 목적: 1998년도에 제정된 일본위암학회의 위암취급규약 영문판 제2판에 따르면 원위부 위암에 있어 2군에 속하는 림프절 중 14v (상장간막정맥) 림프절도 포함되어 있으나 조기 위암에서는 14v 림프절의 절제가 제외되는 등 상황과 술자에 따라 선택적으로 절제되고 있다. 저자들은 원위부 진행성 위암에 있어 14v 림프절의 전이 정도를 조사하여 14v 림프절 절제의 필요성에 대해 알아보고 이 림프절의 절제 적응증을 알아보고자 하였다. 대상 및 방법: 2004년 4월부터 2005년 8월까지 서울아산병원 외과 위암팀에서 원위부 위암으로 수술 받은 환자 중 수술장에서 육안적 소견으로 진행성 위암으로 판단된 환자를 대상으로 일본위암학회의 위암취급규약 영문판 2판에 정의된 D2 림프절 곽청술을 시행하고 림프절의 구획을 표기하였다. 각 림프절 구획의 위암 전이 여부를 확인하여 전이율을 계산하고, 6번 림프절의 양성율과 14v 림프절 양성율의 상관 관계와 14v 림프절 양성군과 음성군을 비교하여 14v 림프절 전이를 예측할 수 있는 인자가 있는지 분석하였다 후향적으로 의무기록을 검토하였고 환자의 예후에 대한 장기 추적은 하지 않았다. 결과: 전체 환자는 50명이었고 평균 연령은 56 ($30{\sim}80$)세, 남녀비는 1.63 : 1이었다. 47명(94%)에서 위원위부 절제술과 위십이지장 문합술을 시행하였고 3명(6%)에서는 위원 위부절제술과 위공장문합술을 시행하였다. D2 림프절 곽청술을 시행 후 림프절의 전이율이 가장 높았던 림프절은 3번(위소만부) 림프절과 6번(유문하림프절)이 54%)로 가장높았고 14v 림프절의 전이율은 10%로 다른 2군 림프절 중 7번 9번 림프절의 전이와 비슷하였다. 14v 림프절 양성군과 음성군을 비교하였을 때 전이된 림프절의 수와(평균 25.4개 vs 4.91개, P<0.001) 6번 림프절의 전이된 림프절 수에서(평균 6.5개 vs 1.42개, P<0.001) 차이를 보였고, 14v 양성군은 UICC 병기 3기 이상으로 음성군에 비해 진행된 위암인 경우가 많았다. 결론: 위암의 상태가 진행되어 있고 6번 림프절이 양성일수록 14v 림프절로의 전이 가능성이 높았다. 따라서 수술장 소견에서 3기 이상, 6번 림프절이 양성일 경우 14v 림프절의 절제가 필수이다. 그러나 14v 림프절 절제의 유용성에 대한 판단은 14v 림프절 절제하지 않은 군과 전향적인 연구를 시행하여 재발과 생존율 분석을 통해 이루어져야 할 것이다.

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