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( Nak Won Kwak ),( Sung Jun Ko ),( Joo Hae Kim ),( Won Bae ),( Ha Youn Lee ),( Yong Suk Jo ),( Eun Young Heo ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Pulmonary hamartoma is the most common benign tumor of lung. However, the cases of pulmonary hamartoma containing mesenchymal tissue are rare. Here, we report a case of pulmonary hamartoma having the feature of angiomyolipoma. A 62-year-old woman presented with dry cough and dyspnea. Chest CT was performed and 0.5 cm sized nodule having cavity was detected. Empirical antibiotics were prescribed for 2 weeks and chest CT was reevaluated. However, the nodule remained stationary and eventually video assisted thoracoscopic biopsy was done. In pathologic specimen, well differentiated fat, muscle, and vascular tissues were observed. However, HMB-45, that is known as specific marker of angiomyolipoma, was not stained. Thus, the patient was diagnosed as pulmonary hamartoma having the feature of angiomyolipoma.
( Nak Won Kwak ),( Young Sik Park ),( Young Whan Kim ),( Sung Soo Park ),( Deog Kyeom Kim ),( Hee Soon Chung ),( Eun Young Heo ) 대한결핵 및 호흡기학회 2014 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.118 No.-
Background: Lung cancer has been known to recur frequently even after complete resection. The impact of genetic alteration on tumor recurrence, especially in early stage lung cancer, has been debated. The aim of this study is to find the effect of genetic alteration on recurrence in patients with resected stage I lung cancer. Methods: The stage I non-small cell lung cancer patients who underwent surgical resection at Seoul National University Hospital between Jan 2007 and Dec 2011 were included. The time to lung cancer recurrence from the date of surgery was evaluated and hazard ratio (HR) for lung cancer recurrence was compared according to EGFR mutation and ALK rearrangement using Cox proportional hazard model. Results: Among a total of 410 patients, 181 patients (44.1%) had EGFR mutation and 10 patients (2.4%) had ALK rearrangement. During follow-up period (median 38.1 months), lung cancers recurred in 89 patients (21.7%) and median time to recurrence was 19.1 months (range, 0.8-71.2). Among 181 patients who had EGFR mutation, lung cancers recurred in 38 patients (21.0%). Meanwhile, among 229 patients who didn’t have EGFR mutation, lung cancers recurred in 51 patients (22.3%). Of 10 patients having ALK rearrangement, 3 patients (30.0%) had lung cancer recurrence. Among 230 patients who had not rearrangement, lung cancers recurred in 50 patients (21.7%). EGFR mutation (adjusted HR 1.08, p=0.730) and ALK rearrangement (adjusted HR 1.01, p=0.995) did not affect the risk of lung cancer recurrence. However, sublobar resection, lymphovascular invasion and larger tumor size increased the risk of lung cancer recurrence irrespective of genetic alteration. Conclusions: The risk of recurrence in patients with resected early stage lung cancer was not significantly different according to genetic alterations such as EGFR mutation and ALK rearrangement.
Which Patients Are a Better Candidate of Laparoscopic Repair in Obturator Hernia Patients?
Jae Seung Kwak,이상억,Si Min Park,Seung Jae Lee,Seong Uk Kwon,In Eui Bae,Nak Song Sung,Ju Ik Moon,윤대성,In Seok Choi,Won Jun Choi 대한내시경복강경외과학회 2020 Journal of Minimally Invasive Surgery Vol.23 No.2
Purpose: Obturator hernia is a difficult disease to diagnose. If a surgical treatment is delayed in obturator hernia, a bowel resection may be required due to strangulation. The surgical treatment of this disease is to use a classical laparotomy. Recently, the laparoscopic approach has been reported and reviewed for efficiency. We checked the indicators that determine the most appropriate surgical method according to the patient's condition. Methods: In the study, a single-institution, retrospective analysis of surgical patients undergoing an obturator hernia surgery between 2003 and 2018 was performed. The patients were divided into a laparoscopic group (5 patients underwent laparoscopic repair; no intestinal resection) and an open group (13 patients who underwent open repair; 10 with and 3 without intestinal resection). The outcomes were compared between the groups. We analyzed the relevant factors that could predict the proper method of surgery. Results: A total 18 patients were included in the study. All patients were female, with body mass index (BMI) of under 21kg/m2. Of the various factors, only the WBC and CRP counts were the factors that had shown significant differences between the two groups. It is noted that patients with open surgery had a higher WBC counts (10406 versus 6520 /㎕; p=0.011) and CRP counts (7.84 vs. 0.32 mg/dl; p=0.027). Conclusion: Obturator hernia can be treated with a laparoscopic surgery.The choice of surgical treatment can be considered in advance through the review of the patient’s WBC count or CRP count.
Case Report : Unusual bilateral vulvar liposarcoma
( Ju Hyun Kwak ),( Sun Mi Shin ),( Jae Won Kim ),( Nak Woo Lee ) 대한산부인과학회 2014 Obstetrics & Gynecology Science Vol.57 No.6
Liposarcoma of vulva is a rare malignant tumor. Only fifteen cases of vulvar liposarcoma have been reported in English literature. Because of extreme rarity of vulvar liposarcoma, it is initially misdiagnosed as benign tumor such as lipoma. This paper aims to present a unique case of liposarcoma of bilateral vulvae with a review of the literature of previously reported cases.
Jae Seung Kwak,Sung Gon Kim,Sang Eok Lee,Won Jun Choi,Dae Sung Yoon,In Seok Choi,Ju Ik Moon,Nak Song Sung,Seong Uk Kwon,In Eui Bae,Seung Jae Lee,Seung Jae Roh 대한외과학회 2022 Annals of Surgical Treatment and Research(ASRT) Vol.103 No.3
Purpose: This study was performed to investigate the role of the perioperative neutrophil-to-lymphocyte ratio (NLR) as an early predictor of major postoperative complications after total gastrectomy for gastric cancer. Methods: This single-center, retrospective study reviewed consecutive patients with gastric cancer who underwent total gastrectomy at a single institution from March 2009 to March 2021. The postoperative complications were graded according to the Clavien-Dindo classification. We analyzed the patient demographics and surgical outcomes according to the grade of postoperative complications in the major complications group (≥grade III) and the no major complications group (<grade III and no complication). Laboratory tests were performed preoperatively and on postoperative days (POD) 2 and 5 to determine the NLR. Results: Out of 212 patients (mean age, 64.1 years; 152 male [71.7%]), 63 (29.7%) underwent minimally invasive surgery. Twenty-five (11.8%) were in the major complications group and 187 (88.2%) were in the no major complications group. There was a significant difference in the NLR on POD 2 (16.54 . 8.83, P = 0.033) between the 2 groups. According to the receiver operating characteristic curve for the NLR on POD 2, the cutoff was calculated to be 9.6. In multivariate analysis, an NLR on POD 2 of ≥9.6 and an American Society of Anesthesiologists physical status classification of ≥III were statistically significant predictors of major postoperative complications. Conclusion: Determination of the NLR on POD 2 is a simple and useful method for the early prediction of major complications after total gastrectomy for gastric cancer.
( Choon Geun Lee ),( Sang Won Yoon ),( Jaeyoung Cho ),( Nak-won Kwak ),( Sun-mi Choi ),( Jinwoo Lee ),( Chang-Hoon Lee ),( Sang-min Lee ),( Chul-gyu Yoo ),( Sanghyun Lee ),( Bin Hwangbo ),( Young Sik 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Background Healthcare professionals need to understand the changes in medical data stored in electronic charts, and data science and artificial intelligence can help in the big data era. The aim of this study is to develop and validate the algorithm for the classification of brain metastasis in the brain MRI reports of lung cancer patients. Methods Newly registered lung cancer patients from August 2007 to March 2020 at tertiary referral hospital were enrolled and the first radiologic reports of brain MRI from each patient were collected. All reports were manually reviewed by the pulmonary specialist (no metastasis, single, and multiple metastasis). We developed two classification algorithms for the reports using natural language processing (NLP) and machine learning (ML), binary (no metastasis, metastasis) and ternary classifications (no metastasis, single, and multiple metastasis). Finally, these algorithms were externally validated against independent data from other hospital. Results The total of 8,675 patients and their reports were collected. Among them 1,724 patients (19.9%) had brain metastasis from manual review. In binary classification algorithm, the accuracy was 95.7% for the training set and 92.1% for the test set. In ternary classification algorithm, the accuracy was 92.7% for the training set and 90.4% for the test set. For the external validation, we collected 5,021 patients and their reports. Among them, 16.6% of brain metastasis was manually reviewed. When these algorithms were applied, the classification performance showed 96.8% in binary classification and 94.6% in ternary classification. Conclusions The combined NLP and ML Method using the radiologic reports shows great performance in classifying brain metastasis from lung cancer patients.
현웅조(Ung-Jo Hyun),원용재(Yong-Jae Won),정응기(Eung-Gi Jeong),안억근(Eok-Keun Ahn),이정희(Jeong-Heui Lee),정국현(Kuk-Hyun Jung),박향미(Hyang-Mi Park),전용희(Yong-Hee Jeon),곽지은(Jieun Kwak),성낙식(Nak-Sig Sung),김정천(Jeong-Cheon K 한국육종학회 2021 한국육종학회지 Vol.53 No.2
Alchanmi’, a japonica rice variety, was developed from a cross between ‘Junam’ and ‘Chilbo’ by a rice breeding team at the NationalInstitute of Crop Science and Icheon, Agricultural Technology Center in 2018. The heading date of ‘Alchanmi’ was August 10 in the middleplain area-two days later than that of ‘Hwaseong’. ‘Alchanmi’ had a culm length of 69 cm, 16 cm shorter than that of ‘Hwaseong’, and 103spikelets per panicle. The viviparous germination rate of ‘Alchanmi’ was 24.4%. It showed resistance to blast, bacterial blight (K1, K2, K3race), and stripe virus, but was susceptible to the K3a race of bacterial blight, dwarf and black streak dwarf viruses, and plant hoppers. Themilled rice of this variety exhibited a translucent and medium short grain shape. The cooked rice grains of ‘Alchanmi’ had an excellent palatabilityindex (0.7) and showed lower amylose content (18.6%) than that of ‘Hwaseong’. The grain milling characteristics of ‘Alchanmi’ were betterthan those of ‘Hwaseong’, especially the head rice milling recovery ratio and head rice ratio (96.2%). ‘Alchanmi’ showed 5.83 MT/ha of milledrice productivity at 6 sites under ordinary cultivation (Registration No. 8132).
Mortality and Causes of death of patients with asthma
( Choon-geun Lee ),( Jaeyoung Cho ),( Nak-won Kwak ),( Sun-mi Choi ),( Jinwoo Lee ),( Young-sik Park ),( Sang-min Lee ),( Chul-gyu Yoo ),( Young Hwan Kim ),( Chang-hoon Lee ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-
Background: Asthma is a disease with a prevalence of more than 300 million people worldwide, with 420,000 asthma patients deaths in 2018. Asthma patients mortality rates continue to decline in Korea, but the second-highest among OECD countries. In the past study, the study mainly defined the definition of asthma based on clinical diagnosis such as history, not the spirometry-based diagnosis. Therefore, this study was conducted to define asthma based on appropriate diagnosis criteria and to compare the cause of death and mortality of asthma patients. Methods: We reviewed retrospectively patients who underwent bronchodilator response or Provocation test from January 1, 2005 to December 31, 2017, and finally 3397 patients were analyzed. Asthma was defined as a positive bronchodilator response or a provocation test at least once in the period, and the control group was defined as having both tests result in bronchodilator response & provocation test and each negative results in bronchodilator response and provocation test In the asthma group, the first day with a positive bronchodilator response or provocation test was defined as the index date. In the control group, the latter date which the bronchodilator response negative and the provocation test were negative once was defined as the index date.Results: In total, 1292 patients with asthma and 2105 control participants were included. Twenty-nine (1.3%) asthma patients and 31 control patients died during the mean 150.84 ± 1.45 months follow-up period. There was no significant difference. (Logrank test P=0.73) Cancer was the most common cause of death for both group (20 (64.5%) vs 18 (62.1%), and pneumonia was the following cause. Conclusions: There was no statistically significant differences in the survival and mortality of the normal control group in the analysis of asthma patients based on spirometry