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Park, Young-Wook,MIN, Byung-Il,Lee, Jin-Gew 大韓顎顔面成形再建外科學會 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.1
반안면왜소증이란 제1및 제2새궁에서 유래되는 기관에 결손이 옴으로써 초래되는 안면기형을 일컫는 것으로 선천성 악안면기형 중 순열 및 구개파열 다음으로 빈발하는 질환이다. 결손부는 하악골을 포함한 안면골의 여러 부위와 안면근 및 저작근, 뇌신경, 이개등여러 부위에 다양하게 나타나며, 그 기형의 발현 정도도 아주 다양하다. 본 교실에서는 안면비대칭과 교합부진을 주소로 내원한 20세된 남자환자에 있어서 먼저 경조직을 바로잡기 위하여 상ㆍ하악골에 대한 악교정수술과 onlay골이식을 시행한 후, 남아있는 연조직 결손부에 대하여 진피-지방이식을 시행하여 심미적으로 만족할만한 결과를 얻었기에 보고하는 바이다. Hemifacial microsomia is a term used to describe a facial anomalies caused by the defect of anatomic structures originated from the first and the second branchial arches. The defect area encompasses some facial areas including mandible, facial muscles, maticatory muscles, cranial nerves, auricles, etc, and the degree of manifestations of the anomalies is extmely diverse. A 20-year-old man complaining of facial asymmetry and malocclusion visited our hospital. An orthognathic surgery was performed for the correction of hard tissue anomalies and then autogenus dermis-fat autotransplantation was done for the improvement of remaining soft tissue defect. The result was esthetically good and the case was presented here.
Host immune response index in gastric cancer identified by comprehensive analyses of tumor immunity
Park, Charny,Cho, Junhun,Lee, Jeeyun,Kang, So Young,An, Ji Yeong,Choi, Min Gew,Lee, Jun Ho,Sohn, Tae Sung,Bae, Jae Moon,Kim, Sung,Kim, Seung Tae,Park, Se Hoon,Park, Joon Oh,Kang, Won Ki,Sohn, Insuk,Ju Informa UK (Taylor Francis) 2017 Oncoimmunology Vol.6 No.11
<P>Tumor infiltrating lymphocytes (TIL) in Epstein-Barr virus (EBV)-associated/microsatellite-unstable (MSI) gastric carcinomas (GC) constitute immune-active principal cellular components of tumor microenvironment and contribute to better prognosis. With the remarkable success of cancer immunotherapies, there is an urgent need for a comprehensive understanding of tumor-immune interactions in patients with GC in the context of host immune response. To identify GC subtype-specific immune response gene set, we tested differentially expressed genes for MSI and EBV+ GC subtypes in randomly selected test set (n = 278) in merged ACRG-SMC microarray and TCGA RNA sequencing data set. We identified Host ImmunE Response index (HIERI) consisting of 29 immune genes classifying GC patients into robust 3 groups with prognostic significance. Immune-high cluster 1 was enriched with PD-L1(High)/EBV+/MSI/TILHigh with the best clinical outcome while immune-low cluster 3 displayed worst outcome and exemplified with PD-L1(Low)/EBV-/MSS. The results were validated in the same cohort (n = 279) and independent cohort (n = 181) with RNA from formalin-fixed paraffin-embedded (FFPE) tissue. Unexpectedly, nearly half of GC in cluster 1 were EBV-/MSS and 10% of cluster 3 GC were EBV+/MSI GC patients, suggesting that in addition to EBV+/MSI GC subtypes, EBV-/MSS subtype also constitutes almost half of high immune cluster and would be a good candidate for immune checkpoint inhibitor therapy. In contrary, almost 10% of EBV+/MSI GC patients may not respond to immune checkpoint inhibitor therapy. Thus, our HIERI gene signature demonstrates the potential to subclassify tumor immunity levels, predict prognosis and help immunotherapeutic decisions.</P>
궤양성 대장염환자에서 Ileal Pouch-Anal Anastomosis 수술후 관절염과 함께 발생한 회장낭염
최태진(Tae Jin Choi),이규춘(Gew Chun Lee),윤광수(Kwang Soo Yoon),김효종(Hyo Jong Kim),동석호(Seok Ho Dong),김병호(Byoung Ho Kim),이정일(Joung Il Lee),장영운(Young Woon Chang),이기형(Kee Hyung Lee),장린(Rin Chang) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1
Although the etiology of pouchitis after ileal pouch-anal anastomosis(IAPP) is as yet incomplete, an anecdotal relationship between pouchitis and extraintestinal manifestations has been previously reported. This relationship may indicate that the pathophysiologic mechanism underlying pouchitis provokes a systemic response similar to that which occurs in response to chronic ulcerative colitis. We report a patient in whom pouchitis was accompanied by arthritis which had developed for the first time during the postoperative period following IPAA. This case is consistent with the existing literature which supports the recurrence of inflammatory bowel disease as etiology of pouchitis. (Korean J Gastroenterol 1996;28: 137 - 142)
임상간호사의 뇌사자 장기기증에 대한 지식과 태도에 영향을 미치는 요인
이현아,허유진,이영규,송가람,이은지,신수진,Lee, Hyun Ah,Hur, Yujin,Lee, Young Gew,Song, Garam,Lee, Eunji,Shin, Sujin 한국중환자간호학회 2017 중환자간호학회지 Vol.10 No.3
Purpose : This study investigated factors affecting the knowledge and attitude of organ procurement from brain dead patients in nurse clinicians. Methods : A survey was conducted with 160 clinical nurses from a university hospital in Seoul. Descriptive statistics, t-tests, an ANOVA, $Scheff{\acute{e}}^{\prime}s$ test, Pearson's correlation coefficient, and a multiple regression analysis were used. Results : The mean score for knowledge of organ procurement from brain dead patients was $12.41{\pm}2.16$ (mean correct answers = 62.1). Factors influencing the knowledge of organ procurement among nurse clinicians were working department (${\beta}=.454$, p < .001), a recent family death (${\beta}=.187$, p = .014), experience recognizing potential brain dead patients (${\beta}=.182$, p = .033), and experience referring to potential brain dead patients (${\beta}=-.192$, p = .048). Conclusion : To ensure effective organ procurement from brain dead patients, it is necessary to continually educate nurse clinicians to improve their attitude and knowledge concerning organ donation.
Kim, Youjin,Kim, Kyoung-Mee,Choi, Min Gew,Lee, Jun Ho,Sohn, Tae Sung,Bae, Jae Moon,Kim, Sung,Lee, Su Jin,Kim, Seung Tae,Lee, Jeeyun,Park, Joon Oh,Park, Young Suk,Lim, Ho Yeong,Kang, Won Ki,Park, Se Ho The Korean Gastric Cancer Association 2018 Journal of gastric cancer Vol.18 No.4
Purpose: We aimed to discuss the roles of radiation and chemotherapy as adjuvant treatment in patients with staged IB GC who were enrolled in the adjuvant chemoradiotherapy in stomach tumors (ARTIST) trial. Materials and Methods: Among the 458 patients who were enrolled in the ARTIST trial, 99 had stage IB disease. The patients were randomly assigned to receive either adjuvant chemoradiotherapy with capecitabine plus cisplatin (XP, n=50) or chemoradiotherapy (XPRT, n=49). Survival analyses were performed in accordance with the AJCC 2010 staging system. Results: According to the AJCC 2010 system, stage migration from IB to II occurred in 71% of the patients; 98% of the T2 N0 cases were reclassified as T3 N0, and 42% of the T1 N1 cases were reclassified as T1 N2. When comparing survival outcomes between the XPRT and XP arms for stage IB cancer (AJCC 2002), no significant difference in 5-year disease-free survival (DFS) between the 2 arms was found. (median 5-year DFS, not reached, P=0.256). The patients classified as having stage IB cancer (AJCC 2002) and reclassified as having stage II cancer (AJCC 2010) exhibited worse prognoses than those who remained in stage IB, although the difference was not statistically significant (5-year DFS rate, 83% vs. 93%). When we compared 5-year DFS in 70 patients with stage II (AJCC 2010), the addition of radiotherapy to XP chemotherapy did not show better outcome than XP alone (P=0.137). Conclusions: The role of adjuvant chemoradiotherapy in the treatment of stage IB GC (AJCC 2002) warrants further investigation.
( Chi Min Park ),( Jeong Meen Seo ),( Min Gew Choi ),( Dae Sang Lee ),( Dong Kyung Chang ),( Kyeong Man Jeon ),( Mi Yong Rha ),( Hyun Jeong Kim ),( Seon Hye Lee ),( Un Mee Kim ),( Young Yun Cho ) 한국정맥경장영양학회 2012 한국정맥경장영양학회 학술대회집 Vol.2012 No.-
Background: Optimal delivery of enteral nutrition (EN) may improve clinical outcomes of critically ill patients and enteral feeding protocols help to improve EN practice. The purpose of this study was to evaluate the impact of implementation of enteral feeding protocol on the improvement in EN practice and on the clinical outcomes of adult critically ill patients. Methods: This was a retrospective cohort study with prospectively collected data. Multidisciplinary working group, including dietitian, nurse, and intensivist, developed the evidence-based protocol by extensive literatures and guideline review. We included the consecutive patients admitted to the medical and surgical ICU and received EN more than 24 hours. The EN practices and clinical outcomes were compared between before and after implementation of enteral feeding protocol. Results: A total of 270 patients were included in this study; 134 patients before implementation, 136 after implementation. Basic clinical characteristics were not different between two phases. Enteral feeding was initiated earlier (35.8 vs 87.1 hours, p=0.001) and more patients received EN within 24 hours (59.6% vs 41.0%, p=0.002) after implementation of protocol. Interval between starting and reaching caloric goal was not different, however more patients reached caloric goal after implementation (52.2% vs 38.3%, p=0.037). Post-implementation group used more prokinetics (53.7% vs 34.3%. p=0.001) and less parenteral nutrition. Diarrhea and gastrointestinal bleeding were significantly decreased after implementation. There was no difference in clinical outcomes including ICU death, ICU free day, and hospital day. Conclusion: The implementation of enteral feeding protocol significantly improved the practices of EN and decrease complications in critically ill patients. The clinical outcomes were not different before and after implementation.
Necessity of adjuvant concurrent chemo-radiotherapy in D2-resected LN-positive gastric cancer
Yu, Jeong Il,Lim, Do Hoon,Lee, Jeeyun,Kang, Won Ki,Park, Se Hoon,Park, Joon Oh,Park, Young Suk,Lim, Ho Yeong,Kim, Seung Tae,Lee, Su Jin,Kim, Sung,Sohn, Tae Sung,Lee, Jun Ho,An, Ji Yeong,Choi, Min Gew Elsevier 2018 Radiotherapy and oncology Vol.129 No.2
<P><B>Abstract</B></P> <P><B>Background and purpose</B></P> <P>To investigate the role of adjuvant concurrent chemo-radiotherapy (CCRT) by analyzing the outcomes of adjuvant CCRT versus chemotherapy alone (CA) in patients with D2-resected gastric cancer with lymph node (LN) metastasis.</P> <P><B>Materials and methods</B></P> <P>Patients with gastric cancer from the institutional registry who underwent curative D2 and R0 resection from December 2004 to January 2013 followed by adjuvant CCRT or CA and demonstrated pathologically confirmed LN metastasis without distant metastasis were included in the study.</P> <P><B>Results</B></P> <P>A total of 1633 patients were included (909 patients in the adjuvant CCRT group and 724 patients in the CA group), and median follow-up was 65.4 months (range, 3.9–141.7 months). There was a significant difference in age (<I>p</I> < 0.0001), Lauren’s classification (<I>p</I> = 0.02), number of LN metastases (<I>p</I> < 0.0001), and pN stage (<I>p</I> < 0.0001) between the CCRT and CA groups.</P> <P>During follow-up, recurrence was detected in 419 (25.7%) of patients overall, 236 (26.0%) in the CCRT group, and 183 (25.3%) in the CA group. Recurrence-free survival (RFS) was not significantly different between the CCRT and CA groups in univariable analysis (<I>p</I> = 0.92). After adjustment, pT/pN stage and perineural invasion showed statistical significance in multivariable Cox regression analysis; however, RFS was significantly higher in the CCRT group (<I>p</I> = 0.03, hazard ratio 0.801, 95% confidence interval 0.658–0.975).</P> <P><B>Conclusions</B></P> <P>The adjusted RFS was significantly higher in the CCRT group than the CA group in patients with D2 resected LN metastatic gastric cancer.</P>