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비구조성 해면골 이식과 무두 압박나사 고정술을 이용한 주상골 요부 불유합의 치료
이준구,홍인태,김 욱,김준현,한수홍 대한수부외과학회 2016 대한수부외과학회지 Vol.21 No.3
Purpose: The authors performed an autologous cancellous bone graft from the iliac crest and headless compression screw fixation for the treatment of Mack- Lichtman type II scaphoid waist nonunion. The purpose of this study was to determine whether this procedure was effective in achieving bony union and restoration of alignment. Methods: We retrospectively reviewed medical records and radiographs of 30 patients who underwent a cancellous bone graft and headless compression screw fixation for scaphoid waist nonunion. There 28 men and 2 women with a mean age of 32.8 year-old (range, 21–63 year-old). The mean time to surgery from initial injury was 10 months (range, 3–25 months) and the average followup duration was 37.5 months (range, 15–52 months). The authors analyzed bony union, lateral intrascaphoid angle (LISA), scapholunate angle (SLA), radiolunate angle (RLA), and scaphoid length in radiographs and evaluated the modified Mayo wrist score (MMWS) as a functional outcome. Results: Bony union was achieved in all cases. In lateral plain X-ray, preoperative anatomic alignment including LISA, SLA, RLA, and scaphoid length was recovered at immediate postoperative measurement. Those alignment restoration was likely to maintain in final follow-up in despite of statistical difference. The wrist motion and the MMWS improved significantly at the last follow-up. Conclusion: A non-structural autologous cancellous bone graft from the iliac crest and headless screw fixation provided reliable results and can be one of the effective treatment options for patients with symptomatic Mack-Lichtman type II nonunion in the middle one-third of the scaphoid. 목적: Mack-Lichtman type II의 주상골 요부 불유합의 치료로 장골능에서 채취한 자가 해면골 이식술과 무두 압박 나사 고정술을 통한 골유합 및 정렬(alignment)의 회복에 미치는 임상적인 의의를 고찰하고자 한다. 방법: 방사선 사진과 의무 기록을 통한 후향적 연구로 총 30명(남 28명, 여 2명)의 환자가 포함되었다. 평균 나이 32.8세(범위, 21-63세), 수상 후 수술 시까지 평균 10개월(범위, 3-25개월), 평균 추시 37.5개월(범위, 15-52개월)이었다. 골유합 유무, 측부 주상골 내각(lateral intrascaphoid angle), 주상월상 각(scapholunate angle), 요월상 각(radiolunate angle), 주상골 길이(scaphoid length)를 측정하였고, 기능적 척도로 modified Mayo wrist score (MMWS)를 평가하였다. 결과: 전례에서 골유합이 이루었다. 측면 방사선 사진상 통계학적 차이는 있었으나 측부 주상골 내각, 주월상 각, 요월상 각 및 주상골 길이 모두 수술 전에 비해 수술 직후 해부학적 정렬의 호전을 보였으며, 통계적 차이는 있지만 수술 직후 회복한 해부학적 정렬은 최종 추시까지 유지되는 경향을 보였다. 전반적으로 임상적 평가에서 손목 관절 운동 및MMWS도 최종 추시 시 호전된 소견을 보였다. 결론: Mack-Lichtman type II의 주상골 요부 불유합의 치료로 장능골에서 채취한 자가 해면골 이식술 및 무두 압박 나사 고정술은 골유합 및 정렬의 회복에 좋은 결과를 보였으며, 효과적인 수술 방법으로 적용할 수 있을 것으로 생각된다.
Total Diet Studies as a Tool for Ensuring Food Safety
이준구,김신희,김해정,윤해정 한국독성학회 2015 Toxicological Research Vol.31 No.3
With the diversification and internationalization of the food industry and the increased focus on health from a majority of consumers, food safety policies are being implemented based on scientific evidence. Risk analysis represents the most useful scientific approach for making food safety decisions. Total diet study (TDS) is often used as a risk assessment tool to evaluate exposure to hazardous elements. Many countries perform TDSs to screen for chemicals in foods and analyze exposure trends to hazardous elements. TDSs differ from traditional food monitoring in two major aspects: chemicals are analyzed in food in the form in which it will be consumed and it is cost-effective in analyzing composite samples after processing multiple ingredients together. In Korea, TDSs have been conducted to estimate dietary intakes of heavy metals, pesticides, mycotoxins, persistent organic pollutants, and processing contaminants. TDSs need to be carried out periodically to ensure food safety.
이준구,이대원,김지연,임유주,이은영,문형곤,김태용,한세원,오도연,이세훈,한원식,김동완,김태유,노동영,임석아 한국유방암학회 2013 Journal of breast cancer Vol.16 No.1
Purpose: Exemestane has shown good efficacy and tolerability in postmenopausal women with hormone receptor-positive metastatic breast cancer. However, clinical outcomes in Korean patients have not yet been reported. Methods: Data on 112 postmenopausal women with metastatic breast cancer were obtained retrospectively. Clinicopathological characteristics and treatment history were extracted from medical records. All patients received 25 mg exemestane daily until objective disease progression. Progression-free survival (PFS) was the primary endpoint, and secondary endpoints were overall survival (OS), objective response rate (ORR), and clinical benefit rate (CBR=complete response+partial response+stable disease for 6 months). Results: The median age of the subjects was 55 years (range, 28-76 years). Exemestane treatment resulted in a median PFS of 5.7 months (95% confidence interval [CI], 4.4-7.0 months) and median OS of 21.9 months (95% CI, 13.6-30.3 months). ORR was 6.4% and CBR was 46.4% for the 110 patients with evaluable lesions. Symptomatic visceral disease was independently associated with shorter PFS (hazard ratio, 3.611; 95% CI, 1.904-6.848; p<0.001), compared with bone-dominant disease in a multivariate analysis of PFS after adjusting for age, hormone receptor, human epidermal growth factor receptor 2, Ki-67 status, dominant metastasis site, and sensitivity to nonsteroidal aromatase inhibitor (AI) treatment. Sensitivity to previous nonsteroidal AI treatment was not associated with PFS, suggesting no cross-resistance between exemestane and nonsteroidal AIs. Conclusion: Exemestane was effective in postmenopausal Korean women with hormone receptor-positive metastatic breast cancer who failed previous nonsteroidal AI treatment.