• 대한두경부종양학회지
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• 제18권1호
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• pp.36-40
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• 2002

Background and Objectives: To determine if laser endoscopic microsurgery is a reliable and appropriate approach in the treatment of laryngeal carcinomas. Materials and Methods: Retrospective study of 62 patients treated with CO2 laser from June 1988 to November 2000 at Seoul National University Hospital for laryngeal squamous cell carcinoma. All patients were treated with curative intention. Fifty three untreated patients with laryngeal carcinoma (39 glottic and 14 supraglottic carcinoma patients) had primary carbon dioxide laser microsurgery. Nine radiation failure patients were treated. Postoperative radiotheray was done for 17 patients. Neck dissection was performed simultaneously for 4 supraglottic cases with cervical nodal metastasis. Mean follow-up duration was 40 months. Results: In primary laser surgery group, distribution of tumors (American Joint Committee on Cancer, 1997) were 38 cases with Tl, 13 cases with T2, 2 cases with T3. Cure rate was 88.7%(47/53) and local control rate was 92.5%(49/53). Larynx was preserved in 94%(50/53) of patients. The overall 5-year survival rate(Kaplan-Meier) was 81.5%. In radiation failure group, 56% of patients were recurred after laser surgery. Conclusion: Laser surgery could be a better treatment modality for early laryngeal cancers and selected advanced cases. Additional radiation therapy should be considered if resection margin is not satisfactory.

• 공업화학
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• 제29권2호
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• pp.138-146
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• 2018

광역학치료는 질병을 치료함에 있어 전이가능성과 부작용이 매우 적고 국부적인 종양의 제거가 가능하다는 장점을 갖는 치료방법이다. 광역학치료에서는 빛 에너지를 흡수하여 세포 독성을 띠는 활성산소를 생성하는 감광제가 필수적이다. 하지만 일반적인 감광제는 가시광선을 광원으로 사용하므로 이에 따른 부작용 및 치료효과의 한계가 존재한다. 이러한 이유로 가시광선 대신 근적외선을 광원으로 사용할 수 있는 업컨버전 나노입자가 질병진단 및 치료 분야에서 주목을 받고 있다. 업컨버전 나노입자는 세포 독성 및 광원에 의한 부작용이 적고, 광원의 조직 내 높은 투과율 및 낮은 자가형광 등의 장점을 가지고 있다. 근적외선 업컨버전을 광역학치료에 활용하기 위해서는 근적외선을 흡수하는 업컨버전 나노입자를 활성산소를 생성시키는 감광제와 결합시켜야 한다. 나노입자에 결합된 감광제는 나노입자로부터 빛 에너지를 흡수하고 이를 주위의 산소에 전이시켜 활성산소를 생성한다. 뿐만 아니라 질병의 치료 효율은 업컨버전 나노입자의 표면을 개질하거나 항암 약물의 첨가, 또는 광열치료와의 결합을 통해 더욱 향상시킬 수 있다. 본 총설은 업컨버전 나노입자를 이용한 광역학치료와 이를 이용한 질병 치료 효과 향상에 대한 최근의 연구결과를 바탕으로 서술하였다.

• Radiation Oncology Journal
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• 제34권3호
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• pp.177-185
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• 2016

Purpose: To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients. Materials and Methods: Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months. Results: All patients received transanal excision or transanal minimally invasive surgery. Of 34 patients, 19 patients (55.9%) presented pathologic complete response (pCR). The 3-year local recurrence-free survival and disease free-survival were 100.0% and 97.1%, respectively. There was no recurrence among the patients with pCR. Except for 1 case of grade 4 enterovesical fistula, all other late complications were mild and self-limiting. Conclusion: PCRT followed by an LE might be feasible as an alternative to total mesorectal excision in good responders with clinical T2N0 distal rectal cancer.

• Journal of Chest Surgery
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• 제22권1호
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• pp.134-140
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• 1989

A clinical evaluation was made on total 207 cases of corrosive esophageal stricture after ingestion of various corrosive substances and 173 cases of neoplasms in the esophagus and the cardia. The various complications associated with esophageal corrosion were observed on 28 cases [13.5%] in a total of 207 cases. Pathoanatomic findings of complication may be classified to the five category as follow; [1] stenosis in the pharynx due to adhesion of the epiglottis, [2] esophagobronchial fistula, [3] esophageal perforation with bougienation, [4] necrotic rupture of the esophagus and the stomach, and [5] so-called chronic corrosive gastritis. The comparative studies were done on a total of 165 cases of the various procedures of esophagoplasty to the reconstruction of the esophagus, which consists of antethoracal esophagoplasty with jejunum, retrosternal esophagoplasty with jejunum, retrosternal esophagoplasty with right colon, and retrosternal esophagoplasty with left colon. There is no hard and fast rule in selection of jejunum, right colon or left colon as the transplanting bowel and an operative method either antethoracal or retrosternal approach. When there was no possibility of the complication and no any defect of the anatomical states, one stage retrosternal esophagoplasty using right colon was better in various points of view. The 173 patients of the neoplasm of the esophagus consist of 28 cases of benign tumors and 145 cases of malignant tumors in the esophagus and cardia. 28 cases of benign tumors in the esophagus received the surgical treatment and they obtained with excellent results postoperatively. Of the 145 patients of esophageal carcinoma who received surgical managements, 101 cases [69.6%] were found to be operable and 44 cases [30.3%] were inoperable. Due to the various level of carcinoma in the esophagus, the following different surgical procedure was properly used case by case to get the best results in each case. Esophageal carcinoma in the upper and middle third segment received the total esophagectomy and the reconstruction of the esophagus using right colon by substernal procedure. Esophageal carcinoma in the lower third segment received an esophagojejunostomy in the mediastinum after the resection of lower third segment of the esophagus. Carcinoma in the esophago cardia and the stomach received also an esophagojejunostomy after the resection of the lower third segment of the esophagus and subtotal gastrectomy. For the 44 patients with inoperable carcinoma, the several palliative surgical managements such as gastrostomy or jejunostomy for feeding and esophagojejunostomy for bypass of the lower esophagus and the stomach were properly performed case by case for their maximum improvement.

• Tuberculosis and Respiratory Diseases
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• 제61권2호
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• pp.137-142
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• 2006

연구배경: 8주 이상 지속되는 만성 기침의 원인 중 하나인 위식도역류질환는 환자의 약 75%가 증상이 없으며, 진단을 위한 24시간 식도 pH감시가 침습적이고 검사가 어려워 진단 및 치료에 어려움이 있다. 따라서 만성 기침환자 중 후비루증후군 및 기관지 천식이 아닌 환자를 대상으로 양자펌프억제제를 투여하고 치료효과를 관찰하였다. 방법 및 대상: 기침증상이 8주 이상인 만성기침 환자 중 X-ray 소견상 이상이 없고 메타콜린 기관지유발시험상 음성이며, 후비루증후군 치료에 반응이 없었던 40명을 대상으로 하였다. 8주 이상 양자펌프억제제를 투여하였으며 50%이상 기침이 감소한 경우를 부분 반응군, 기침이 거의 소실된 경우를 완전 반응군으로 분류하였다. 결 과: 대상자 40명중 29명만이 4주 이상 추적되었으며 이중 26명만이 8주까지 추적 관찰되었다. 29명중 남자가 9명, 여자가 20명이었으며 평균나이는 51세였다. 대상자들에서 기침 이외의 증상은 객담이 12%, 콧물이나 비폐색 등의 코 증상이 있는 환자는 10%, 속쓰림, 소화불량 등의 소화기 증상을 호소하는 환자는 13.4%였다. 29명중 4주간 투여 후 증상의 호전이 없는 환자가 3명(10.3%), 50% 이상의 증상호전을 보이는 환자가 22명(75.9%), 그리고 증상이 거의 소실된 환자가 4명(13.8%)로 약 90%정도의 환자가 기침의 증상호전이 있었다. 8주 투여 후 호전이 없는 환자가 2명(7.4%), 50% 이상 증상호전이 있는 환자가 8명(29.6%), 증상이 거의 소실된 환자가 16명(63.0%)이었다. 결 론: 8주이상의 만성기침 환자에서 8주 이상 양자펌프억제제 투여 후 92.6%환자가 증상호전이 있었으며 이중 63%는 거의 소실되었다. 하지만 본 연구는 위약을 통한 대조군이 없는 관계로 그 결과의 해석에 어려움이 있다. 앞으로 좀더 많은 환자를 대상으로 하는 이중맹검시험이 필요할 것으로 생각된다.

• 한국세라믹학회지
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• 제50권3호
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• pp.231-237
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• 2013

Thermodynamic modeling of the $Ni_{0.5}Zn_{0.4}Cu_{0.1}Fe_2O_4$ complex ferrite system has been adopted as a rational approach to establish routes to better synthesis conditions for pure phase $Ni_{0.5}Zn_{0.4}Cu_{0.1}Fe_2O_4$ complex ferrite. Quantitative analysis of the different reaction equilibria involved in the precipitation of $Ni_{0.5}Zn_{0.4}Cu_{0.1}Fe_2O_4$ from aqueous solutions has been used to determine the optimum synthesis conditions. The spinel ferrites, such as magnetite and substitutes for magnetite, with the general formula $MFe_2O_4$, where M= $Fe^{2+}$, $Co^{2+}$, and $Ni^{2+}$ are prepared by coprecipitation of $Fe^{3+}$ and $M^{2+}$ ions with a stoichiometry of $M^{2+}/Fe^{3+}$= 0.5. The average particle size of the as synthesized $Ni_{0.5}Zn_{0.4}Cu_{0.1}Fe_2O_4$, measured by transmission electron microscopy (TEM), is 14.2 nm, with a standard deviation of 3.5 nm the size when calculated using X-ray diffraction (XRD) is 16 nm. When $Ni_{0.5}Zn_{0.4}Cu_{0.1}Fe_2O_4$ ferrite is annealed at elevated temperature, larger grains are formed by the necking and mass transport between the $Ni_{0.5}Zn_{0.4}Cu_{0.1}Fe_2O_4$ ferrite nanoparticles. Thus, the grain sizes of the $Ni_{0.5}Zn_{0.4}Cu_{0.1}Fe_2O_4$ gradually increase as heat treatment temperature increases. Based on the results of Thermogravimetric Analysis (TGA) and Differential Scanning Calorimeter (DSC) analysis, it is found that the hydroxyl groups on the surface of the as synthesized ferrite nanoparticles finally decompose to $Ni_{0.5}Zn_{0.4}Cu_{0.1}Fe_2O_4$ crystal with heat treatment. The results of XRD and TEM confirmed the nanoscale dimensions and spinel structure of the samples.

• 한국환경보건학회지
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• 제14권2호
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• pp.73-87
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• 1988

This study was performed to investigate the effect of lactose in 4 different concentrations against the protective effect of calcium on the acute lead poisoning in rats after 4 weeks treatment. In this animal experiment, 70 albino male weanling rats (50-70g of body weight) of Sprague-Dawley strain were used. Lead was dissolved in the distilled water and intubated at the dose of 400mg lead (as acetate)/ kg of body weight/day. Calcium and lactose were administered in drinking water ad libiturn dissolved with the solution of 0.7% calcium gluconate mixed with 40, 80, 160 and 320mM lacotse respectively. The results obtained were summarized as follows: 1. The rate of body weight gain in all treated groups turned out to be lower than that in the control group during 4 weeks treatment. The slow-down of body weight gain was the most significantly observed in the group treated with lead only ( p < 0.05). 2. The relative spleen weight in lead only treated group was significantly lower than that of lead + calcium, lead + calcium + 80mM lactose treated group ( p < 0.05). 3. The value of RBC, WBC, Hb and Hct showed a decreasing tendency in the group treated with lead only ( p < 0.05), however, a significant decrease was not observed in the group treated with lead + calcium. On the other hand, the protective effect of calcium was deteriorated in the group treated with lead + calcium + lactose. 4. The activity of $\delta$-aminolevulinic acid dehydratase ($\delta$-ALAD activity) showed the same tendency as No. 2. 5. The lead concentration in the blood (PbB) showed an increasing tendency and the interrelation among the different groups was also identical with No. 2. 6. With a statistical approach, it was found out that the activity of $\delta$-ALAD and the lead concentration in the blood show a relation of inverse proportion(r=-0.7301). The diagram was interpreted with the logarithmic equation InY = 5.5357-0.0251X (X:PbB, Y:$\delta$-ALAD activity). 7. In the histopathological findings of the kidney, the protective effect of calcium was observed. However, the protective effect of calcium was restricted in the group treated with lead + calcium + lactose. As a conclusion, the intensity of the acute ingested lead poisoning was obviously reduced by calcium, however, the protective effect of calcium was deteriorated in proportion with the concentration of the lactose to be administered. On the other hand, it was also noted that the deterioration was lightly restrained in the group treated with the physiological concentration of 80mM lactose than the results shown in the groups treated with lactose of other concentrations.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.6093-6097
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• 2015

Background: HPV DNA testing has been recently introduced as an adjunct test to cytology in the follow-up of patients after treatment for cervical lesions using the loop electrosurgical excision procedure (LEEP). The aim of this study was to evaluate the role of HPV testing in the detection of persistent or recurrent disease after LEEP in patients with cervical epithelial lesions in northern Thailand. Materials and Methods: Patients who underwent LEEP as a treatment for histological low-grade (LSIL) or high-grade squamous intraepithelial lesion (HSIL) or worse at Chiang Mai University Hospital between June 2010 and May 2012 were included. Follow-ups were scheduled at 6-month intervals and continued for 2 years using co-testing (liquid-based cytology and Hybrid Capture 2 [HC2]) at 6 months and 24 months and liquid-based cytology alone at 12 and 18 months. Results: Of 98 patients included, the histological diagnoses for LEEP included LSIL in 16 patients, and HSIL or worse in 82 patients. The LEEP margin status was negative in 84 patients (85.7%). At follow-up, 10 patients (10.2%) had persistent/recurrent lesions; 4 among LSIL patients (25.0%) and 6 in the group with HSIL or worse (7.3%). Only 2 of 82 patients (2.4%) with HSIL or worse diagnoses had histological HSIL in the persistent/recurrent lesions. Using histologically confirmed LSIL as the threshold for the detection of persistent/recurrent disease, cytology had a higher sensitivity than HC2 (90.0% versus 70.0%). At the 6-month follow-up appointment, combined cytology and HC2 (co-testing) had a higher sensitivity in predicting persistent/recurrent disease (80.0%) compared with that of cytology alone (70.0%) and HC2 (50.0%). Conclusions: After LEEP with a negative surgical margin, the rate of persistent/recurrent lesions is low. The addition of HPV testing at the 6-month visit to the usual cytology schedule may be an effective approach in the follow-up after LEEP.

• Journal of Yeungnam Medical Science
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• 제24권2호
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• pp.186-196
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• 2007

1991년 2월부터 8월까지 7개월간 영남대학교 의과대학 부속병원에 근무하는 여성 471명을 대상으로 요통 발생에 대한 역학적 설문조사를 실시하고 그 자료를 분석한 결과는 다음과 같았다. 1. 배선원과 조리사 및 교환수에서 요통의 발생빈도가 타 직종에 비해 높았다. 2. 요통의 발생 빈도는 정신 신체 증상의 발현빈도에 주로 관계하였고 부분적으로는 미는 형태의 작업에 관계하였다. 3. 요통에 의한 근무의 지장정도는 드는 형태의 작업 혹은 육체적 노동량이 증가할수록 증가하였고, 정신 신체증상의 발현빈도 및 근무에 대한 불만의 정도와 관계가 있었다. 4. 사소한 요부 손상 혹은 불안정성은 주로 걷는 작업이 긴 형태 혹은 육체적 노동량이 많을수록 증가하였고, 사무적인 작업에서는 감소하였다. 또한 높은 연령과 밀접한 관계가 있었으며 부분적으로는 정신 신체증상의 발현빈도와 관계가 있었다. 이상의 설문지 조사를 통한 역학적 조사를 시행한 결과 요통의 발생 및 이로 인한 장애는 정신 신체적인 요소와 작업의 형태가 관계하여, 이의 예방 및 치료를 위해서는 작업에 대한 인간공학적인 연구 등을 통한 보다 합리적인 접근법이 요구되고 정신적인 인자에 대한 보다 다각적인 접근이 요구되었다. 또한 요부손상은 연령 등의 생리적 요소가 관계하며 이에 대한 보다 합리적인 대처가 요구 되었다.

• 대한족부족관절학회지
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• 제15권4호
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• pp.201-206
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• 2011

Purpose: Subtalar distraction arthrodesis is useful treatment option for restore hindfoot alignment. but, using structural autograft have high risk of donor site morbidity. Recently, by replacing the structural allograft has been reported satisfactory clinical results. Therefore, the authors reviewed the results of subtalar distraction arthrodesis using a structural allograft, retrospectively. Materials and Methods: From January 2008 to May 2010, 12 patients (12 feets; 9 male, 3 female) underwent subtalar distraction arthrodesis using frozen structural allograft. 9 cases were calcaneal malunion, 2 were nonunion or malunion after subtalar arthrodesis, 1 was other cause. Mean age was 38.9 (12~66) years old and follow up period was 16.5 (12~36) months. Surgical was performed with posterolateral approach and tricortical allobone block of frozen femoral neck was used. Analysis was done with retorspective manner to evaluate preoperative, postoperative, and final follow up radiologic measurement and AOFAS ankle-hindfoot scale. Results: There was statistically significant increase (p<0.05) of ankle-hindfoot scale from preoperative 27.5 points to postoperative 72.5 points, talocalcaneal height by 6.62 mm, calcaneal pitch angle by 5.73 degrees, lateral talocalcaneal angle by 6.38 degrees and significant decrease (p<0.05) of tali-1st metatarsal angle by 5.23 degrees. 11 feet (91.7%) acquired bony union and it takes average 5.1 months. Final post-operative result revealed talocalcaneal height changed by 2.57 mm, calcaneal pitch anble, lateral talocalcaneal angle, talar-1st metatarsal angle were changed by 2.63 degrees, 1.62 degrees, 1.18 degrees, respectively (p<0.05). 3 cases of partial osteonecrosis of posterior facet of calcaneus were observed in operation field, 4 cases of complication were developed (1 case of nonunion, 1 collapse of allobone graft, 1 screw loosening, 1 superficial skin necrosis). Conclusion: Subtalar distraction arthrodesis using frozen structural allobone graft is useful alternative treatment method of arthrodesis with structural autobone graft.