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      • KCI등재후보

        면역방사계수법을 이용한 Thyroglobulin 측정시 항 Thyroglobulin 항체의 존재가 미치는 영향

        안병철,배진호,정신영,박호용,김정국,하승우,이재태,김보완,이규보 대한내분비학회 2004 Endocrinology and metabolism Vol.19 No.1

        연구배경: 혈청 thyroglobulin (Tg)은 옥소전신스캔과 함께 분화갑상선암환자에서 갑상선암 재발에 대한 추적관찰에 매우 예민하고, 중요한 표지자로 임상에서 널리 이용된다. 그러나 많은 수의 분화갑상선암환자는 Tg 항체인 항 Tg 항체를 가지고 있고, 이는 방사면역검사법 (radioimmunoassay) 및 면역방사계수 검사법(immunoradiometric assay)으로 Tg 측정시 영향을 미칠 수 있다. 이에 연자들은 면역방사계수법으로 Tg를 측정할 경우, 항 Tg항체에 의하여 어떤 영향이 생길수 있는지를 알아보고자 하였다. 방법: 이중위치 고상법 (solid phase two-site)법을 이용하는 ELSA-hTg in vivo test (CIS international, Schering, France) 시약을 이용하여 Tg를 측정하였다. Tg과 항 Tg 항체는 검사시약에 포함된 표준용액을 사용하였으며, Tg는 두 가지 농도 (23.5 ng/mL, 62.5 ng/mL)로, 항 thyroglobulin 항체는 세 가지 농도(25U/mL, 50U/mL, 100U/mL)로 이용하였다. Tg가 높게 나타나는 환자의 혈청에 항 Tg 항체가 높게 나타나는 환자의 혈청을 혼합하여 동일한 방법으로 Tg 검사를 시행하였다. 통계학적 분석은 ANOVA와 Scheffe test 및 Quadratic regression modeling을 시행하였다. 결과: 면역방사계수법을 이용한 Tg 측정시 항 thyroglobulin 항체가 존재하는 경우 그 값이 낮게 측정되었다. Tg 농도가 23.5 ng/mL인 표준용액이 항 Tg 항체의 농도가 0, 25, 50 및 100U/mL 경우, 각각 24.5±1.1, 11.8±0.4, 7.7±0.1 및 4.5±0.4ng/mL로 측정되었으며, Tg 농도가 62.5 ng/mL인 표준용액은 각각 65.9±5.7, 36.3±2.2, 23.7±0.7, 및 14.0±1.0 ng/mL로 측정되었다(ANOVA test, p=0.000). 항 Tg 항체에 의한 Tg 측정값의 저하 정도는 항 Tg 항체의 농도에 비례하는 것으로 나타났다 (Quadratic model regression, SigT=0.000). 결론: 분화갑상선암환자에서 항 Tg 항체의 존재는 면역방사계수법을 이용한 혈청 Tg 측정으로 갑상선암 재발을 파악하는데 방해하는 인자로 작용될 수 있으며, Tg 측정시 항 Tg 항체의 측정이 꼭 필요하며, 항 Tg 항체를 가진 분화갑상선암환자에서 Tg 수치를 해석할 경우 세심한 주의가 요구된다. Background: Serum thyroglobulin (Tg) is a valuable and sensitive tool needed in the follow-up of patients with differentiated thyroid cancer (DTC), but antithyroglobulin antibody (Anti-Tg), common in patients with DTC, can interfere with the assay for Tg. In this study, we evaluated the influence of Anti-Tg on the measurement of Tg using the immunoradiometric assay (IRMA). Methods: In using ELSA-hTg in vivo test (CIS international, Schering, France), a solid phase two-site IRMA was used to measure Tg (23.5 ng/mL, 62.5 ng/mL) under the absence or presence of three concentrations of Anti-Tg (25U/mL, 50U/mL, 100U/mL). We also performed Tg measurement using patients serum that was mixed with patients serum containing high Anti-Tg. ANOVA and Scheffe tests were performed to evaluate the effect of Anti-Tg on Tg IRMA, and an inverse regression was made to calculate the level of Tg from measured Tg and used Anti-Tg levels and also to assess the degree of effect of anti-Tg on Tg IRMA. Results: In measuring Tg using the standard solution, the presence of Anti-Tg resulted in a falsely suppressed Tg value. The IRMAs for 23.5ng/mL of the standard Tg solution resulted in 24.5±1.1 ng/mL under no Anti-Tg, 11.8±0.4 ng/mL under 25U/mL of Anti-Tg, 7.7±0.1 ng/mL under 50U/mL of Anti-Tg, and 4.5±0.4 ng/mL under 100U/mL of Anti-Tg. IRMAs 62.5 ng/mL of the standard Tg solution resulted in 65.9±5.7 ng/mL under no Anti-Tg, 36.3±2.2 ng/mL under 25U/mL of Anti-Tg, 23.7±0.7 ng/mL under 50U/mL of Anti-Tg, and 14.0±1.0 ng/mL under 100U/mL of Anti-Tg. (ANOVA test, p=0.000). The degree of suppression of the measured Tg value was positively correlated with the Anti-Tg level (Quadratic model regression, Sig T=0.000). The presence of Anti-Tg also resulted in a falsely suppressed Tg value for the Tg measurement using patient's serum. 2004). Conclusion: The presence of Anti-Tg could consist of the use of Tg as a tumor, therefore Anti-Tg should be measured in all patients diagnosed with DTC. The interpretation of the Tg level must be performed with extreme caution in patients with Anti-Tg (J Kor Soc Endocrinol 19:42∼47, 2004)

      • KCI등재

        노년기 치매와 우울증의 유병률 및 위험인자

        서국희,김장규,연병길,박수경,유근영,양병국,김용식,조맹제 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.5

        경기도 연천군에 거주하는 만 65세이상 노인 1,037명을 대상으로 1996년 12월부터 1997년 8월까지 9개월간에 걸쳐 치매와 노년기 우울장애의 유병률과 위험인자에 관한 이 단계 역학조사(일차선별검사후 이차 진단적 면접)를 수행하였다. 다단계 층화집락표본추출에 의한 확률표본법으로 대상자 선정을 하였고, 반응률은 85.2%이 었다. 일차선별검사에는 노인정신장애 평가척도 한국어판(K-PAS)을 사용하였고, 일상생활 능력척도(ADL) 및 수단적 일상생활 능력척도(IADL)를 사용하여 기능을 평가했고, 지지도 척도(APGAR)를 사용하여 사회적 지지정도를 평가하였다. 이차 진단적 면접에서는 진 신장애의 진단 및 통계편람 제3판 개정판(DSM-III-R)의 진단기준을 따라 임상 진단을 확정하였다. 감별진단 및 장애 정도의 평가를 위하여 보조적인 진단도구들을 사용하였다. 1) 연령 보정된 치매의 유병률(%)[95% 신뢰구간]은 6.83[6.12∼7.54](남자 6.34[5.29∼7.40], 여자7.09[6.14∼8.04]이었다. 이중 알쯔하이머형 치매의 유병률(%)[95% 신뢰구간]은 4.17[3.61∼4.74] (남자 2.42[1.76∼3.08], 여자 5.31[4.48∼6.14]이었고, 혈관성치매의 유별률(%)[95% 신뢰구간]은2.38[1.95∼2.81](남자 3.46[2.67∼4.25], 여자 1.63[1.16∼2.10])이었다. 2) 연령 보정된 우울장애의 유병률(%)[95% 신뢰구간]은 10.99[10.11∼11.87](남자 7.59[6.44∼8.73], 여자 13.46[12.20∼14.73])이었다. 진단별로는 주요 우울장애의 유병률(%)[95% 신뢰구간] 이 7.50[6.76∼8.26](남자 4.42[3.54∼5.31], 여자 9.78[8.68∼10.88]), 기분부전장애의 유병률(%)[95% 신뢰구간]이 2.02[1.62∼2.42](남자 1.37[0.86∼1.87], 여자 2.46[1.88∼3.03], 달리 특정되지 않은 우울장애 유병률 (%)[95% 신뢰구간]이 1.49[1.15∼1.83](남자 1.85[1.47∼2.23], 여자 1.28[0.96∼1.60])이었다. 3) 알쯔하이머형 치매의 통계적으로 유의한 5가지 위험인자는 85셍상의 고령(O.R.= 10.27), 무학(O.R.= 4.01), 흡연[흡연년수 0.1∼30년(O.R.= 3.11), 흡연년수 30년 이상 (O.R.= 4.60)], 알코올남용(O.R.= 2.98)과 치매의 가족력 (O.R.= 4.85)이었다. 4) 혈관성 치매의 통계적으로 유의한 3가지 위험인자는 '무학' (O.R.= 3.78), 흡연[40년 이상 흡연년수 (O.R.= 11.15)]과 '뇌졸중의 과거력 (O.R.= 26.76)'이었다. 5) 우울장애의 통계적으로 유의한 3가지 위험인자는 '75∼79세 연령군' (O.R.= 2.87), '뇌졸중의 과거력' (O.R.= 3.33)과 '우울장애의 가족력' (O.R.= 7.16)이었다. 중심단어:알쯔하이머형 치매·혈관성 치매·우울장애·유병률·위험인자·흡연. An epidemiological survey was conducted to estimate the prevalence of and identify the risk factors of dementia and depression in the elderly between December 1997 and August 1998 in Yonchon County, Korea. A total of 1,037 elderly aged 65 years and over underwent a two phase diagnocstc procedure. Multiple stage, random cluster sampling method was used to select the subjects. Response rate was 85.4%. For the Ist stage screening survey, the Korean Psych-ogeriatric Assessment Scale was used as a primary screening tool, which had already been standardized in Korea, and functioning and social support were assessed by ADL, IADL and APGAR. At the 2nd stage, diagnoses were confirmed according to the DSM-Ⅲ-R. And several other scales were used as supporting information for differential diagnoses and for evaluating severity. 1) Age-sex adjusted prevalence(%)[95% C.I] of dementia was 6.83[6.12-7.54](male 6.34 [5.29-7.40], female 7.09[6.14-8.04]). Prevalence of the dementia of the Alzheimer's type was 4.17[3.61-4.74](male 2.42[1.76-3.08], female 5.31[4.48-6.14]) and that of the va-scular dementia was 2.38[1.95-2.81](male 3.46[2.67-4.25],female 1.63[1.16-2.10]). 2) Age-sex adjusted prevalence(%)[95% C.I.] of depressive disorder was 10.99[10.11-11.87](male 7.59[6.44-8.73], female 1346[12.20-14.73]. Among depressive disorders, prev-alence(%)[95% C.I.] of major depressive disorder was 7.50[6.76-8.26](male 4.42[3.54-5.31], female 9.78[8.68-10.88]), that of dysthymic disorder was 2.02[1.62-2.42](male 1.37[0.86-1.87], female 2.46[1.88-3.03]) and that of depressive disorder NOS was 1.49[1.15-1.83](male 1.85[1.47-2.23], female 1.28[0.96-1.60]). 3) Five statistically significant risk factors of the dementia of the Alzheimer's type were identified : age over 85(O.R. = 10.27), illiteracy (O.R. = 4.01), alcohol abuse (O.R. = 2.98), smoking [0 < pack year ≤30(O.R. = 3.11), pack year>30(O.R. = 4.60)] and family history of dementia (O.R. = 4.85). 4) Three statistically significant risk factors of the vascular dementia were identified : illiteracy (O.R. = 3.78), history of CVA(O.R. = 26.76) and smoking over 40 pack year(O.R. = 11.15). 5) Three statistically significant risk factors of the depressive disorder were identifed : age between 75 and 79(O.R. = 2.87), past history of CVA(O.R. = 3.33) and family history of depressive disorder(O.R. = 7.16). KEY WORDS:Dementia of the Alzheimer's Type·Vascular dementia·Depressive disorder·Prevalence·Risk factor·Smoking.

      • 한국어판 DIS-IV의 개발과 표준화

        서국희,손현균,최상섭,이미경,이중서,최인근,방현숙,연병길 大韓神經精神醫學會 2001 신경정신의학 Vol.40 No.5

        연구목적 : DSM-Ⅲ-R의 개정판이라기 보다는 새로운 진단 기준으로 간주될 정도였던 DSM-Ⅳ의 출현은 정신장애의 진단분류체계에 매우 큰 영향을 미쳤다. DSM-Ⅳ의 변화를 반영하여 정신과적 진단을 내릴 수 있도록 DIS-Ⅲ를 개정하여 DIS-Ⅳ가 개발되었다. 본 연구는 국내에서의 정신의학적 연구를 더욱 활성화하고 활발하게 국제 공동연구가 이루어질 수 있도록 DIS-Ⅳ 한국어판을 개발하고 이를 표준화하는 데 그 목적이 있다. 방 법 : 번역 위원회에서 번역, 역번역, 어의적 정확성 확인, 한국어 용법에 맞도록 수정한 후 예비 연구를 거쳐 한국어판 DIS-Ⅳ가 완성되었다. 의과대학생 4명에게 Washington University DIS-Ⅳ training course와 동일한 내용과 방법으로 교육을 실시하였다. 두 명의 조사요원들이 한 환자를 DIS-Ⅳ를 사용하여 동시에 검사한 후의 진단을 비교하여 검사자간 신뢰도를 측정하고, 정신과 의사가 독립적으로 DIS-Ⅳ를 사용하여 검사한 후의 진단과 비교하여 절차 타당도를 평가하였다. 조사 대상은 2000년 1월부터 8월까지 2개 대학 병원 정신과 및 국립감호정신병원에서 치료중이던 환자 124명이었다. 결 과 : 평가자간 신뢰도의 kappa값 평균은 0.74였다. 양극성 Ⅰ장애, 범불안장애, 우울장애, 강박장애, 반항장애, 동통장애, 병적 도박, 외상후 스트레스 장애, 특정공포증 및 대부분의 물질 사용 혹은 관련 장애의 kappa값이 0.7 이상이었다. 정신과 의사의 진단과 조사요원의 진단의 일치도를 비교한 절차 타당도를 살펴보면 다음과 같다. 전체적인 sensitivity는 67.6%, specificity는 98.3%, kappa 값은 0.69이었다. 물질 사용 장애 및 물질 관련 장애의 SE는 79%, SP는 98.6%, kappa 값은 0.77이었다. 이를 제외한 나머지 정신 장애의 SE는 60.5%, SP는 98%, kappa 값은 0.64이었다. 본연구의 결과는 Robins 등에 의해 최초로 보고된 DIS의 신뢰도 및 타당도와 거의 비슷한 수준이었다. 결 론: 한국어판 DIS-Ⅳ가 높은 신뢰도와 타당도를 지닌 것으로 생각된다. 이 도구를 통해 물질 사용 및 관련 장애를 타당도와 신뢰도 높게 진단할 수 있다는 점이 매우 중요하다. 향후 정신장애의 진단 능력을 향상시키고 임상연구를 활성화하고 국제적인 학술적 교류를 늘리는데 일조할 수 있을 것이다. Objective : Appearance of DSM-Ⅳ has influenced greatly on the nosological classification of mental disorder, not considered as revised one of DSM-Ⅲ-R but a new criteria. DIS-Ⅳ has been developed after revision of DIS-Ⅲ in consideration of various changes in DSM-Ⅳ. This study is to develop and validate the DIS-Ⅳ, Korean version to activate Korean psychiatric research much more and to modivate more frequent international collaborative study. Method : Translation committee produced DIS-Ⅳ, Korean version through all the procedures of translation, back-translation, confirmation of retained original meaning of the English version, adaptation to Korean linguistic usage and preliminary study. Four medical students were trained during DIS-Ⅳ training course that retained the same contents and methods as of Washington University. Inter-rater reliability was measured by comparison between two diagnoses made from two interviewer who rated one patient at the same time. Procedural validity was measured by comparison between lay-interviewer's diagnosis and psychiatrist's diagnosis which were made after independent DIS-Ⅳ using interview. Subjects were 124 patients who were being treated at two University Hospital and National Forensic Psychiatric Hospital between January, 2000 and August, 2000. Results : Average kappa value of inter-rater reliability was 0.74. Diagnoses showing over 0.7 in kappa value were bipolar I disorder, generalized anxiety disorder, depressive disorder, obsessive-compulsive disorder, oppositional defiant disorder, pain disorder, pathological gambling, post-traumatic stress disorder, specific phobia and almost all substance use disorder or substance-related disorder. Procedural validity, that compared lay-interviewer's diagnosis and psychiatrist's diagnosis, were as follows: For all diagnoses, sensitivity, specificity and kappa were 67.6%, 98.3% and 0.69. For diagnoses of substance use disorder or substance- related disorder, sensitivity, specificity and kappa were 79%, 98% and 0.77. For other diagnoses except substance use disorder or substance- related disorder, sensitivity, specificity and kappa were 60.5%, 98% and 0.64. This results are almost at the same level as that of Robins and her colleagues who tirst reported reliability and validity of DIS. Conclusion : We think that DIS-Ⅳ, Korean version has higher reliability and validity. It is very important that diagnoses of substance use disorder and substance-related disorder can be made reliably and validly by this instrument. We expect that it can help to improve diagnosability of mental disorder, activate clinical research and increase international scientific communication.

      • 소아 야뇨증에 대한 임상적 고찰

        김승수,곽병곤,김영대,김우경,김영균,이종국 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

        Objectives: The aim of this study was to describe the clinical characteristics of enuretic children and to evaluate the efficacy of treatments. Methods: Our study subjects enrolled were 52 children with nocturnal enuresis, who visited outpatient clinic of pediatrics in Seoul Paik Hospital and Ilsan Paik Hospital, during the period from October 1998 to August 2004. The data of gender, age, family history, symptom, clinical type of enuresis and drug therapy were collected and analyzed retrospectively. Results: The male : female ratio was 2.25 : 1. The mean age at diagnosis was 6.8 years with an age range from 4.3 years to 12.5 years. Fourty five cases(86.5%) were diagnosed as primary enuresis and 7 cases(13.5%) were diagnosed as secondary enuresis. A family history of enuresis was noted in 5 cases(9.6%) including 4 cases with parental enuresis history. The accompanying urinary symptoms were urgency(11.5%), frequency (7.7%), and dysuria(2.0%). Conclusion: We found frequent occurrences of enuresis in boys and primary type and an occasional association with a family history of enuresis. The two main treatment modalities were behavior control with an alarm system and drug therapy with imipramine, desmopressin, or oxybutynin. We recommend continuous drug medications to control nocturnal enuresis along with encouragement.

      • 展開板에 대한 數値解析 : 1. 展開板 주위에서의 유체흐름의 패턴 1. Pattern of Fluid Flow besides Otter Board

        高冠瑞,權炳國,盧基德 國立統營水産專門大學 附設 水産科學硏究所 1990 수산과학연구소보고 Vol.2 No.-

        平板型과 彎曲型展開板 주위에서의 流體特性을 파악하기 위하여 回流水槽에서 水素氣泡法에 의한 可視化實驗을 流速 0.05 및 0.1m/sec, 迎角 0˚~45˚까지 5˚ 간격으로 流線과 타임라인에 대해서 실시하였다. 1. 彎曲型展開板에서의 流線은 영각 20˚까지는 균일한 분포를 이루다가 영각 25˚에서 後面에 인접한 流線이 翼弦長의 1/3 지점에서 剝離가 시작되며 인접한 流線은 展開板의 후면쪽으로 휘어들어가고, 그리고 영각 35˚ 이상에서는 前緣에서 부터 剝離가 시작되면 迎角이 증가할수록 剝離層이 증가하는 것으로 나타났다. 2. 平板型展開板에서는 영각 20˚부터 前緣에서 渦와 剝離가 발생되며, 剝離層은 彎曲型과 마찬가지로 영각에 비례하는 것으로 나타났다. 3. 後緣에서 발생한 渦의 크기가 前緣의 것보다 약 2~3배 큰것으로 나타났다. 4. 展開板의 後緣에서 流線은 양 展開板 모두 展開板의 방향과 같은 방향으로 흐르다가 점차 유체흐름과 같은 방향이 되는 것으로 나타났다. 5. 展開板 前後面에서의 流速差는 영각 0˚~30˚에서 점차 증가하다가 영각 35˚이상에서는 그 차가 비슷하게 나타났다. 6. 영각 20˚~30˚에서 前後面의 流速差는 彎曲型의 경우 後面의 流速이 前面보다 약 1.4~1.5배 빠르게 나타났으며, 平板型은 약 1.2배 빠르게 나타났다. The authors carried out a visiualizational model test by the hydrogen bubble method to examine the pattern of the fluid flow besides the simple camber type and plane type otter board in circulation water channel. The experimental conditions are velocity of flow 0.05 and 0.1m/sec, angle of attack 0˚∼45˚(5˚step). The results obtained are as follows: 1. In the case of the simple camber type otter board located angle of attack 25˚, vortex at the leading edge was geneated at 1/2 of chord length. 2. Size of the vortex generated in the trailing edge was about 2∼3 times larger then that of the leading edge. 3. In the case of the simple camber type otter board located angle of attack 30˚, separation of stream-line at leading edge was generated at 1/3 of chord length. 4. In the case of the plane type otter board, separation of stream-line at leading edge was generated from angle of attack 20˚. 5. Nearest stream-line in the back side of the simple camber type otter board was bent in the direction of otter board when the angle of attack was 25˚ and 30˚, and in the case of plane type otter board was expanded outside of the flow direction. 6. Area separated of the simple camber type otter board at the angle of attack 30˚ was smaller then that of plane type otter board. 7. Flow speed in the back side of the simple camber type otter board was about 1.4 times faster then that in the front side, and in the case of the plane otter board about 1.2 times faster.

      • KCI등재

        Nano-crystallized glass-ceramic of BaO-TiO2-SiO2 system containing ZrO2

        Byeong-Guk Kang,SeungguKang 한양대학교 세라믹연구소 2020 Journal of Ceramic Processing Research Vol.21 No.S1

        Fresnoite (Ba2TiSi2O8) materials, which exhibit piezoelectricity, ferroelectricity, and nonlinear optical properties, can be usedas core materials for optical communication and optical information processing devices. In this study, glass-ceramics withnanometer size fresnoite crystal phase were prepared from BaO-TiO2-SiO2 (BTS) glass containing ZrO2 as a nucleating agentand their microstructure, crystallization behavior, and photoluminescence properties were analyzed. The heat treatmentprocess for glass-ceramics was designed based on data obtained by non-isothermal analysis using differential thermal analysis(DTA). The crystal morphology and microstructure of the prepared specimens were analyzed by X-ray diffraction analysis(XRD), optical microscopy (OM), and field emission scanning electron microscopy (FE-SEM), respectively. The luminescenceproperties of the specimens were analyzed by photoluminescence (PL) measurements. When the BTS glass with 15 wt% ZrO2(15Z)was heat treated at 1,015 oC, a dendritic structure by gathering very small spherical crystalline phases of 10-30 nm wasformed. In addition, when the 15Z was excited by light of 309 nm wavelength, strong light of 469 nm wavelength was emitted,and this light appeared to be blue light close to white in the Commission International de l'Eclairage (CIE) diagram.

      • KCI등재

        Retrospective study on factors affecting the prognosis in oral cancer patients who underwent surgical treatment only

        Kim, Byeong-Guk,Kim, Jun-Hwa,Kim, Myung-In,Han, Jeong Joon,Jung, Seunggon,Kook, Min-Suk,Park, Hong-Ju,Ryu, Sun-Youl,Oh, Hee-Kyun Korean Association of Maxillofacial Plastic and Re 2016 Maxillofacial Plastic Reconstructive Surgery Vol.38 No.-

        Background: This study was performed to evaluate their 5-year survival rates and identify the factors affecting the prognosis of oral cancer patients who had undergone surgical treatment only. Methods: Among 130 patients who were diagnosed with malignant tumor of oral, maxillofacial, and surgical treated in the Department of Oral and Maxillofacial Surgery at Chonnam National University Hospital within a period from January 2000 to December 2010, for 11 years, 84 patients were investigated who were followed up for more than 5 years after radical surgery; oral cancer is primary and received only surgical treatment. The survival rate according to gender, age, type and site of cancer, TNM stage, cervical lymph node metastasis and its stage, recurrence or metastasis, time of recurrence and metastasis, and differentiation were investigated and analyzed. Results: Overall, 5-year survival rate in patients who received only surgical treatment was 81.2 %, and disease-specific 5-year survival rate was 83.1 %. The disease-specific 5-year survival rate based on TNM stage, metastasis of cervical lymph node, N stage, and presence of recurrence/metastasis was a significant difference (p < 0.05). The disease-specific 5-year survival rate based on sex, age, type of tumor, primary site, and differentiation was not a significant difference (p > 0.05). Conclusions: These results suggest that good survival rate can be obtained with surgical treatment only, and stage of oral cancer, cervical lymph node metastasis and stage, recurrence or metastasis, time of recurrence, and metastasis have a significant effect on survival rate in oral cancer patients.

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