ORIGINAL ARTICLE J Breast Dis 2014 December; 2(2): JBD Journal of Breast Disease 유방전절제술후즉시유방재건술을시행받은유방암

Size: px
Start display at page:

Download "ORIGINAL ARTICLE J Breast Dis 2014 December; 2(2): JBD Journal of Breast Disease 유방전절제술후즉시유방재건술을시행받은유방암"

Transcription

1 ORIGINAL ARTICLE J Breast Dis 2014 December; 2(2): JBD Journal of Breast Disease 유방전절제술후즉시유방재건술을시행받은유방암환자의치료성적 남상근, 박세호, 이동원 1, 송승용 1, 박형석, 김승일, 박병우, 유대현 1 연세대학교의과대학외과학교실, 1 성형외과학교실 Clinical Outcome of Breast Reconstruction after Mastectomy for Breast Cancer Sanggeun Nam, Seho Park, Dong Won Lee 1, Seung Yong Song 1, Hyung Seok Park, Seung Il Kim, Byeong-Woo Park, Dae Hyun Lew 1 Departments of Surgery and 1 Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea Purpose: This study aimed to investigate clinical outcomes of breast cancer patients who underwent mastectomy with or without immediate breast. Methods: Of 1,847 patients undergoing total mastectomy, 371 (20.1%) underwent immediate between January 2005 and December Clinicopathological characteristics and survival were compared by performing univariate and multivariate analysis. Results: The proportion of had been gradually increasing since Reconstruction group showed younger age at diagnosis and lower cancer stages. Adjuvant chemotherapy and radiation therapy were more frequently administered in the mastectomy alone group. During a median follow-up period of 57 months, locoregional relapse-free survival (LRRFS) was similar regardless of type of surgery. However the group showed a more favorable overall survival (OS). Multivariate analysis for LRRFS revealed no statistical significance but the OS was higher in the group. In the mastectomy alone group, two-thirds died of breast cancer, while all patients in the group died of breast cancer. Stage-matched breast cancer specific survival was similar between both groups. Conclusion: breast is oncologically safe after mastectomy for breast cancer. Considering the quality of life, the patient should be preoperatively counseled by a multidisciplinary team regarding possible immediate. Key Words: Breast neoplasms, Mastectomy, Reconstructive surgical procedures, Survival 서론 유방재건술은유방암치료를위해유방절제술을받은환자에게 원래의유방형태로복원해주기위한수술이다. 우리나라여성에서 유방암발병률은점차증가하고있을뿐만아니라 [1], 한국유방암학 회의보고에의하면유방암발생연령이 30 대가 12.7%, 40 대가 37.1% 로젊은환자에서많이발생하고있다. 이와함께유방검진의증가 와진단기술의발달로유방암의조기발견이늘어나고있으며, 삶의 질향상을위하여유방절제술후동시또는지연유방재건술에대 Correspondence: Seho Park Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul , Korea Tel: , Fax: , PSH1025@yuhs.ac Received: July 18, 2014 Accepted: October 6, 2014 한수요도증가하고있다 [2]. 유방재건술은유방절제술후신체이미지손상에대한상실감을줄여주고환자의삶의질을향상시켜주는장점이있다 [3]. 유방재건술은시술시기에따라크게종양제거수술과함께동시에유방을복원하는즉시재건술과유방절제술후보조적치료를완료한후시행하는지연재건술두가지로나뉜다. 현재까지시행되고있는대표적인유방재건술의방법은크게두가지로조직확장기와보형물을이용하는것과환자자신의근육, 지방그리고피부를포함한자가조직을이용하는피판술이있다. 유방절제술후유방재건술은보편화되고있지만재건수술이가능한환자를선택하는것과재건수술시기나방법을결정하는것에대한일관된지침은미흡한상태이다. 즉시재건술에대한종양학적인안정성은여러연구들에의해밝혀지고있다 [4-8]. Knottenbelt 등 2014 Korean Breast Cancer Society. All rights reserved. eissn This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

2 유방전절제술후즉시유방재건술을시행받은유방암환자의치료성적 45 [4] 은즉시재건술후국소재발률과생존율에차이가없으며국소재발의진단을늦추지않고보조항암요법치료결과에도영향을미치지않는다고보고하였으며, Bezuhly 등 [6] 은즉시재건술후유방암특이생존율이젊은환자에있어서증가한다고보고하였다. 하지만이러한보고들에도불구하고즉시재건술에대한종양학적인안정성은근거수준이낮으며 [9,10], 국내의연구역시부족한실정이다. 이에본연구자들은국내단일기관에서유방전절제술을시행한군과유방전절제술후즉시재건술을받은군간의임상병리학적특성과치료성적을후향적으로비교하여즉시유방재건술의종양학적안정성을평가하고자하였다. 방법 2005년 1월부터 2011년 12월까지연세대학교의과대학세브란스병원에서원발성유방암으로진단받고유방전절제술을시행받은환자를대상으로후향적연구를진행하였다. 유방보존술을받은환자, 수술전항암약물치료를받은환자, 전이성유방암이나악성엽상종양등의비상피기원유방암환자그리고지연재건술을받은환자를제외한총 1,847명의환자를대상으로하였다. 본연구는세브란스병원연구심의위원회 (Institutional Review Board) 의승인하에진행하였다 ( 승인번호 : ). 세브란스병원유방암전문클리닉등록자료와환자의의무기록검토를통하여환자의나이, 종양의크기, 액와림프절전이여부, 유방암병기, 조직학적형태와등급, 호르몬수용체발현유무, 성장인자수용체유형 2 (HER2) 과발현유무, 재발이나사망자료를조사하였다. 미국임상종양학회 / 미국병리학회 (American Society Clinical Oncology/College of American Pathologists) 권고안에따라면역조직화학염색법을이용하여종양의핵내염색이 1% 이상인경우호르몬수용체양성으로정의하였다 [11]. HER2의경우면역조직화학염색에의한점수가 3+ 이거나, 2+ 인경우는형광동소교잡반응 (fluorescence in situ hybridization) 검사상유전자증폭이확인된경우를양성으로정하였다. 생존율은무국소영역재발생존율 (locoregional relapse-free survival) 과전체생존율 (overall survival) 을비교하였다. 국소영역재발은동측피부나흉벽에암이다시발생한경우또는동측액와부, 쇄골상하림프절이나내유림프절에암이재발한경우로정의하였다. 수술일로부터사망원인에상관없이사망유무가확인되거나마지막추적관찰된날까지를전체생존기간으로정의하였다. 유방전절제술을시행한군과유방전절제술후즉시유방재건술을받은군간의임상병리학적특성이나보조치료방법의비교는 교차분석을이용하였다. 유방재건술유무에따른유방암환자의 국소영역재발률과생존율의차이는 Kaplan-Meier 분석후 logrank 검정으로유의성을평가하였으며, 콕스비례위험모형 (Cox proportional hazard model) 을이용하여독립적인설명변수를알아 보았다. 통계분석은 SPSS version 20.0 (IBM Corp., Armonk, USA) 프 로그램을이용하였으며, p 값이 0.05 미만인경우통계학적으로유의 하다고판정하였다. 환자의임상병리학적특징 결과 대상환자 1,847 명의평균나이는 51.3 ± 1 세였으며, 중앙추적 관찰기간은 57 개월 ( 범위, 개월 ) 이었다. 전체환자중유방전 절제술후즉시유방재건술을시행받은환자는 371 명 (20.1%) 이었 다. 유방재건방법으로조직확장기과보형물을이용한환자는 163 명 (43.9%) 이었으며, 자신의근육, 지방그리고피부를포함한자가조 직을이용하는피판수술을받은환자는 208 명 (56.1%) 이었다. 수술 연도에따라즉시유방재건술의비율은 2009 년도부터점차증가 추세를보이고있으며, 2011 년도에는약 1/3 의환자에서동시재건 술이시행되었다 (Figure 1). 환자의나이, 종양의크기, 액와림프절상태, 암병기, 조직학적형 태와등급, 에스트로겐및프로게스테론수용체, HER2 발현상태 등은 Table 1 과같다. 유방전절제술만을시행받은환자와비교하여 즉시유방재건술을시행받은경우 40 세이하의젊은환자가약 40% 로더많았으며, 종양과액와림프절의병기가낮아약 70% 의환 자는암병기 0 1 기였다. 에스트로겐수용체발현이나 HER2 상태 Proportion (%) Year Figure 1. Proportion of immediate according to operation year.

3 46 남상근외 Table 1. Clinicopathologic characteristics and adjuvant therapies of patients undergoing mastectomy with or without immediate Characteristic Mastectomy alone (n= 1,476) No. (%) (n= 371) No. (%) p-value Age (yr)* 53.3± ± 8.1 < (11.5) 147 (39.6) < > 40 1,306 (88.5) 224 (60.4) Tumor stage Tis 230 (15.6) 102 (27.5) < T1 724 (49.1) 193 (52.0) T2 492 (33.3) 74 (19.9) T (2.0) 2 () Node stage N0 1,000 (67.8) 297 (80.1) < N1 353 (23.9) 58 (15.6) N2 78 (5.3) 12 (3.2) N3 45 (3.0) 4 (1.1) TNM Stage (15.5) 102 (27.5) < (35.1) 152 (4) (40.2) 101 (27.2) (9.1) 16 (4.3) Histologic type Ductal 1,292 (87.5) 328 (88.4) Lobular 56 (3.8) 18 (4.9) Special 128 (8.7) 25 (6.7) Histologic grade (n= 1,366) I/II 844 (74.2) 169 (73.8) 92 III 293 (25.8) 60 (26.2) ER (n= 1,825) Negative 414 (28.3) 93 (25.7) Positive 1,049 (71.7) 269 (74.3) PR (n= 1,825) Negative 546 (37.3) 113 (31.2) Positive 917 (62.7) 249 (68.8) HER2 (n= 1,824) Negative 962 (65.8) 220 (6) Equivocal 169 (11.6) 52 (14.4) Positive 332 (22.7) 89 (24.7) Radiation therapy Not done 1,253 (84.9) 339 (91.4) Done 223 (15.1) 32 (8.6) Chemotherapy Not done 631 (42.8) 198 (53.4) < Done 845 (57.2) 173 (46.6) Hormonal therapy Not done 413 (28.0) 103 (27.8) 33 Done 1,063 (72.0) 268 (72.2) Targeted therapy Not done 1,385 (93.8) 344 (92.7) Done 91 (6.2) 27 (7.3) TNM = tumor, node, metastasis; ER = estrogen receptor; PR = progesterone receptor; HER2= human epidermal growth factor receptor 2. *Mean± SD. 는두군간에차이가없었으나, 폐경후여성의빈도가높은유방전 절제술만을시행받은환자군의경우프로게스테론수용체의양성 발현빈도는즉시유방재건술을시행받은환자군보다낮았다. 수술후보조요법 (adjuvant therapy) 으로는방사선치료, 항암약물 치료, 항호르몬치료, 표적치료가시행되었으며, 진행된암병기환자 의비율이높은유방전절제술만을받은군에서방사선치료와항 암약물치료를받은환자가통계학적으로유의하게많은것으로나 타났다 (Table 1). 수술방법에따른생존율분석 추적기간동안국소영역재발은대상환자 1,847 명중 48 예 (2.6%) 에서발생하였다. 유방전절제술시행군에서 42 예 (2.8%), 즉시재건 술환자에서 6 예 (1.6%) 확인되었다. Kaplan-Meier 방법을이용한생 존율비교에서즉시유방재건술의시행여부에상관없이무국소영 역재발생존율은통계학적으로유의한차이가없었다 (Figure 2A). 유방전절제술을시행받은군의 5 년무국소영역재발생존율은 p = Mastectomoy alone p < Mastectomoy alone Figure 2. Survival of patients undergoing mastectomy with or without immediate. (A) was similar regardless of type of surgery. (B) was favorable in the group. A B

4 유방전절제술후즉시유방재건술을시행받은유방암환자의치료성적 47 Table 2. Cox proportional hazards model for survival Variable LRRFS HR 95% CI p-value HR 95% CI p-value Age ( 40 yr) Tumor stage (T2-4) Node stage (positive) < ER (negative) HER2 (positive) Surgery (immediate ) Radiation therapy (done) Chemotherapy (done) Hormonal therapy (done) < Targeted therapy (done) LRRFS = locoregional relapse-free survival; OS = overall survival; HR = hazard ratio; CI = confidence interval; ER = estrogen receptor; HER2 = human epidermal growth factor receptor 2. OS 96.7% 였으며, 즉시재건술을시행받은군의 5년무국소영역재발생존율은 98.1% 였다. 하지만전체생존율분석에서는통계적으로유의하게유방전절제술만시행받은환자군의예후가불량하였다 (Figure 2B). 유방전절제술을시행받은군의 5년전체생존율은 92.7% 였으며, 즉시재건술을시행받은군의 5년전체생존율은 98.8% 였다 (p < 0.001). 즉시유방재건술을받은환자만을대상으로보형물을이용한재건술과자가조직을이용한재건술사이의무국소영역재발생존율이나전체생존율은유방재건술의방법에따라통계적인차이는발견되지않았다. 는유방전절제술만받은군의생존이불량한경향성을보였으나통계적인유의성은없었다 (Figure 4B, C). 추적기간동안총 103명 (5.6%) 의환자가사망하였으며, 사망원인이확인되지않은 7명을제외하고, 유방재건술을받은환자중 4명이사망하였으며, 재건술에의한합병증과관련된사망은없었고모두유방암으로사망하였다. 유방전절제술만받은환자중사망원인이확인된 92명중 34명 (37.0%) 은유방암이외의원인으로사망하였으며, 58명 (63.0%) 은유방암으로사망하였다. 암병기를일치시킨후유방암특이생존율을확인하였을때, 유방재건술의유무에상관없이유방암특이생존율은통계적으로차이가없었다. 생존율의다변량분석과사망원인다른임상병리학적특성과수술후보조치료요법을보정한다변량분석에서도즉시유방재건술여부에따라무국소영역재발생존율은통계학적인유의성을보이지않았다. 종양의크기와림프절전이유무가국소영역재발과관련된독립적인예후인자였다 (Table 2). 하지만전체생존율을다변량분석한결과즉시유방재건술을시행받은경우위험비가 (95% 신뢰구간, ) 로통계적으로유의하게생존율이양호하였다 (Table 2). 종양의크기가큰경우나액와림프절전이가있는경우는불량한전체생존율을보이는예후인자였으며, 항암약물치료와항호르몬치료를시행한경우는양호한전체생존율의독립적인예후인자였다. 암병기를일치시켜무국소영역재발생존율을비교하였을때암병기 0 1기, 2기와 3기각각에서유방재건술의여부에상관없이통계적으로차이가없었다 (Figure 3). 암병기를일치시킨전체생존율분석에서는암병기 0 1기인경우즉시유방재건술을받은군이통계적으로양호한생존을보였다 (Figure 4A). 암병기 2기와 3기에서 고찰 유방암은세계전체여성암의 23% 를차지하며여성암중최다발생률을보인다. 우리나라에서는갑상선암에이어두번째로흔한암으로점차발생이증가하고있다 [1]. 유방암에대한여성들의관심과유방검진의증가에따라초기유방암으로진단되는환자들과젊은유방암환자들의발생빈도가점차증가하는추세이며, 이와더불어삶의질향상을위해유방재건술을받는경우도해마다증가하고있다 [2]. 한국유방암학회의보고에의하면 [12], 2000년보다 2011년에는유방재건수술이 7배이상증가했으며본연구에서도 2009년부터점차증가하는추세를보이고있다 (Figure 1). 유방재건술은보형물을이용한재건방법과자가조직을이용한방법으로나뉘어진다. 보형물을이용한유방재건술은수술이간단하고, 추가적인흉터가생기지않으며, 비용이저렴하고, 회복기간이빠르다는장점이있으나, 이물질에대한거부감, 감염, 피막구축등의합병증, 보형물의내구성및수명등의단점이있다 [13]. 자가조

5 48 남상근외 p = p = A A p = 77 p = B B p = p = C C Figure 3. Stage-matched locoregional relapse-free survival curve. (A) Stage 0 1. (B) Stage 2. (C) Stage 3. Figure 4. Stage-matched overall survival curve. (A) Stage 0 1. (B) Stage 2. (C) Stage 3. 직을이용한재건시에는이와같은합병증은없거나드물지만, 피판의괴사, 긴수술시간및회복기간그리고공유부에생기는후유증의문제가있다 [14]. 양자간에는차이가있지만즉시유방재건술은유방절제술후신체의손상에대한두려움과정신적인고통을 피할수있으며유방절제술과유방재건술을동시에실시함으로써수술의횟수도줄일수있는장점이있다. 유방암절제술후유방재건술이점차보편화되고있지만재건수술이가능한환자를선택하는것과재건수술시기나방법을결

6 유방전절제술후즉시유방재건술을시행받은유방암환자의치료성적 49 정하는것에대한일관된지침은미흡한상태이다. 유방재건술후국소영역재발의발견과치료에방해를받지않을까하는염려, 국소영역재발의증가, 수술후보조치료계획에영향을주지않을까하는걱정, 그리고이에따르는생존율에미치는영향을고려해야한다는의견들도있다 [9,10,15]. 또한 Isern 등 [16] 은지연재건술을받은환자들에서국소영역재발률이 2.08배높다고보고하기도하였다. 이와는달리 Knottenbelt 등 [4] 은즉시재건술후 5년무병생존율 (disease-free survival) 93% 로생존율에차이가없으며국소재발의진단을늦추지않고보조항암요법치료결과에도영향을미치지않는다고보고하였으며, Bezuhly 등 [6] 은즉시재건술후유방암특이생존율이재건술을받지않은군에비해증가한다고보고하였으며 ( 위험비, 4; 95% 신뢰구간, 8 0), 특히 50세미만의환자에있어서증가한다고보고하였다 ( 위험비, 0.47; 95% 신뢰구간, ). 본연구에서도즉시유방재건술을받은환자에서국소영역재발률은유방절제술만을받은환자와차이가없었다. 하지만전체생존율을단변량분석하였을때즉시유방재건수술을시행받은환자군의생존율이더높았다. 이는본연구가후향적분석으로조사하였기때문에환자군의선택편향과연관된것으로사료된다. 대상환자들의임상병리학적특성을비교하였을때즉시유방재건술을받은환자에서평균진단시연령이낮고암병기가낮았다. 즉시유방재건술을받은환자중 40대이하는 39.6% 로유방절제술만을받은군의 11.5% 에비해높았으며, TNM 병기에서도암병기 0 1은즉시유방재건술을받은환자에서 68.5% 로유방전절제술만받은군의 5% 에비해높은비율을차지하고있었다. 원발종양이큰경우와액와임파선전이가있는경우국소재발이나원격전이의확률이높음은잘알려져있으며이러한차이가생존율에영향을미칠수있을것으로생각된다. 본연구의대상환자군의임상병리학적특성이달랐으므로선택편향을보정하기위하여다변량분석을시행한결과수술방법에따라무국소영역재발생존율은통계적유의성이없었다. 하지만유방절제술만시행한군의전체생존율은즉시재건술을시행한경우보다더불량하였다. 이는상대적으로고령의환자가유방절제술만시행한군에더많았으며, 사망원인조사에서유방절제술만시행한군의사망환자중 1/3은유방암이외의원인으로사망한것으로보아유방암재발이외의원인이연관된것으로생각된다. 이를확인하기위해병기를일치시킨후유방암특이생존율을분석한결과두군간에통계적유의성은확인할수없었다. 이러한결과는즉시유방재건술의종양학적안정성을보여주는결과라할수있으며이는다른연구결과와동일하다 [4-8]. 본연구의제한점은먼저중앙추적관찰기간이 57개월로생존 율을평가하기에는짧은기간이라는것이다. 추적기간중사망은 5.6% 에서만발생하였으므로생존율의해석에주의가필요하다. 향후추적관찰기간이늘어난다면결과가달라질가능성이있으므로장기간추적관찰연구가필요할것으로사료된다. 또한재건술후보조치료의지연여부와예후와의상관성에논란이있었으나본연구에서는보조치료의방법에따른시작시기, 종류나횟수등에관해분석이되지않아추가연구가필요할것으로생각된다. 본연구에서는유방암으로유방절제수술과동시에재건수술을받은환자와재건술을시행하지않은환자의임상적결과비교를통해두군간에국소재발률이나치료성적에차이가없음을확인하였다. 유방암환자의유방절제술후즉시재건술은적절한복원방법과술기의적용으로비교적안전하게시행될수있다. 유방암환자의안전한종양치료와완전한일상생활이나사회생활의복귀를위해서수술전즉시재건술에대한외과와성형외과뿐만아니라종양내과, 방사선종양학과등유방암다학제진료팀에의한상담과치료계획수립은유방암환자들의삶의질향상에기여할것으로생각된다. REFERENCES 1. Park SK, Kang D, Kim Y, Yoo KY. Epidemiologic characteristics of the breast cancer in Korea. J Korean Med Assoc 2009;52: Enewold LR, McGlynn KA, Zahm SH, Poudrier J, Anderson WF, Shriver CD, et al. Breast after mastectomy among Department of Defense beneficiaries by race. Cancer 2014;120: Guyomard V, Leinster S, Wilkinson M. Systematic review of studies of patients satisfaction with breast after mastectomy. Breast 2007;16: Knottenbelt A, Spauwen PH, Wobbes T. The oncological implications of immediate breast. Eur J Surg Oncol 2004;30: Sandelin K, Wickman M, Billgren AM. Oncological outcome after immediate breast for invasive breast cancer: a longterm study. Breast 2004;13: Bezuhly M, Temple C, Sigurdson LJ, Davis RB, Flowerdew G, Cook EF Jr. postmastectomy is associated with improved breast cancer-specific survival: evidence and new challenges from the Surveillance, Epidemiology, and End Results database. Cancer 2009;115:

7 50 남상근외 7. Le GM, O Malley CD, Glaser SL, Lynch CF, Stanford JL, Keegan TH, et al. Breast implants following mastectomy in women with early-stage breast cancer: prevalence and impact on survival. Breast Cancer Res 2005;7:R Baker JL, Mailey B, Tokin CA, Blair SL, Wallace AM. Postmastectomy is associated with improved survival in patients with invasive breast cancer: a single-institution study. Am Surg 2013; 79: Alderman AK, Hawley ST, Waljee J, Mujahid M, Morrow M, Katz SJ. Understanding the impact of breast on the surgical decision-making process for breast cancer. Cancer 2008;112: Alderman AK, Hawley ST, Waljee J, Morrow M, Katz SJ. Correlates of referral practices of general surgeons to plastic surgeons for mastectomy. Cancer 2007;109: Rakha EA, Starczynski J, Lee AH, Ellis IO. The updated ASCO/ CAP guideline recommendations for HER2 testing in the management of invasive breast cancer: a critical review of their implications for routine practice. Histopathology 2014;64: Kim Z, Min SY, Yoon CS, Lee HJ, Lee JS, Youn HJ, et al. The basic facts of korean breast cancer in 2011: results of a nationwide survey and breast cancer registry database. J Breast Cancer 2014;17: Cordeiro PG, McCarthy CM. A single surgeon s 12-year experience with tissue expander/implant breast : part II. An analysis of long-term complications, aesthetic outcomes, and patient satisfaction. Plast Reconstr Surg 2006;118: Kim EK, Eom JS, Ahn SH, Son BH, Lee TJ. Evolution of the pedicled TRAM flap: a prospective study of 500 consecutive cases by a single surgeon in Asian patients. Ann Plast Surg 2009;63: Lewis RS, Kontos M. Autologous tissue immediate breast : desired but oncologically safe? Int J Clin Pract 2009;63: Isern AE, Manjer J, Malina J, Loman N, Mårtensson T, Bofin A, et al. Risk of recurrence following delayed large flap after mastectomy for breast cancer. Br J Surg 2011;98:

Jkbcs016(92-97).hwp

Jkbcs016(92-97).hwp Expression of bcl-2 and Apoptosis and Its Relationship to Clinicopathological Prognostic Factors in Breast Cancer - A Study with Long Term Follow-up correlated with the survival rate.(journal of Korean

More information

Jkbcs032.hwp

Jkbcs032.hwp Clinical Correlation of HER-2/neu Overexpression in Patients with Breast Cancer Sung Yong Kim, Tae Yoon Kim, Jae Jun Kim, Chang Ho Kim, Ok Pyung Song, Min Hyuk Lee, Eui Han Kim 1, and Moo Sik Cho Departments

More information

( )Jkstro011.hwp

( )Jkstro011.hwp 비인강암의방사선치료결과및생존율에관한예후인자분석 2005 2 1 2005 3 28. :, Tel: 053)250-7665, Fax: 053)250-7984 E-mail: jhkim@dsmc.or.kr 정영연외 2 인 : 비인강암의예후인자분석 정영연외 2 인 : 비인강암의예후인자분석 Carcinoma of the nasopharynx treated by radiotherapy

More information

김범수

김범수 Analysis of Outcomes after Resection of Sarcomatous Hepatocellular Carcinoma Purpose: Sarcomatous hepatocellular carcinoma (HCC) is rare. Therefore, the clinicopathologic characteristics and prognosis

More information

암센터뉴스레터1

암센터뉴스레터1 CANCER HOSPITAL News News Letter For Yonsei University Gangnam Severance Hospital http://gs.iseverance.com 2012.06.21 2012.08.16 2012.09.19 2012.10.04 2012.10.25 CONTENTS 2012.07.27 2012.10.06 2012.11.06

More information

012임수진

012임수진 Received : 2012. 11. 27 Reviewed : 2012. 12. 10 Accepted : 2012. 12. 12 A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar

More information

황지웅

황지웅 Comparison of Laparoscopy and Exploration in the Distal Pancreatectomy BACKGROUND: To determine the benefits of laparoscopic surgery compared with exploration, the clinical outcomes of open and laparoscopic

More information

Lumbar spine

Lumbar spine Lumbar spine CT 32 111 DOI : 10.3831/KPI.2010.13.2.111 Lumbar Spine CT 32 Received : 10. 05. 23 Revised : 10. 06. 04 Accepted : 10. 06. 11 Key Words: Disc herniation, CT scan, Clinical analysis The Clinical

More information

노영남

노영남 Purpose: Delayed massive hemorrhages from pseudoaneurysm rupture of the peripancreatic large arteries, after pancreaticoduodenectomy, are fatal. We reviewed the clinical course and outcome of bleeding

More information

기관고유연구사업결과보고

기관고유연구사업결과보고 기관고유연구사업결과보고 작성요령 2001 ~ 2004 2005 ~ 2007 2008 ~ 2010 2001 ~ 2004 2005 ~ 2007 2008 ~ 2010 1 2/3 2 1 0 2 3 52 0 31 83 12 6 3 21 593 404 304 1,301 4 3 1 8 159 191 116 466 6 11 (`1: (1: 16 33 44 106

More information

- iii - - i - - ii - - iii - 국문요약 종합병원남자간호사가지각하는조직공정성 사회정체성과 조직시민행동과의관계 - iv - - v - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 - - 9 - - 10 - - 11 - - 12 - - 13 - - 14 - α α α α - 15 - α α α α α α

More information

Kbcs002.hwp

Kbcs002.hwp Does Real-time Compound Imaging Improve Evaluation of reast Cancer Compared to Conventional Sonography? o Kyoung Seo, M.D., Yu Whan Oh, M.D., Kyu Ran Cho, M.D., Young Hen Lee, M.D., Hyung Joon Noh, M.D.,

More information

Table 1. Distribution by site and stage of laryngeal cancer Supraglottic Glottic Transglottic Total Stage Total 20

Table 1. Distribution by site and stage of laryngeal cancer Supraglottic Glottic Transglottic Total Stage Total 20 KISEP Head and Neck Korean J Otolaryngol 1999;42:1284-9 후두암수술환자에대한치료성적 송달원 김희준 정현수 김영한 안재현 이복수 박선호 Treatment Result in Laryngeal Cancer Patients Submitted to Surgical Treatment Dal Won Song, MD, Hee Jun

More information

Kaes025.hwp

Kaes025.hwp 고위험군유두상갑상선암환자에대한방사성옥소최대허용선량측정법및치료법의검증 Verification of Measurement Methods and Therapeutic Efficacy of Maximum Permissible Dose of I-131 in High Risk Patients with Differentiated Papillary Thyroid Cancer

More information

- i - - ii - - iii - - iv - - v - - vi - - 1 - - 2 - - 3 - 1) 통계청고시제 2010-150 호 (2010.7.6 개정, 2011.1.1 시행 ) - 4 - 요양급여의적용기준및방법에관한세부사항에따른골밀도검사기준 (2007 년 11 월 1 일시행 ) - 5 - - 6 - - 7 - - 8 - - 9 - - 10 -

More information

Jkbcs042.hwp

Jkbcs042.hwp Invasive Ductal Carcinoma Arising from Axillary Accessory Breast Tae Wan Kim, Sang Wook Kang, Ji Young Park 2, Seung Sang Ko 1, Min Hee Hur 1, Hae Kyung Lee 1, Sung Soo Kang 1, and Jee Hyun Lee 1 Department

More information

연하곤란

연하곤란 2015.03.04 부울경소화기내시경지회 Intramucosal gastric cancer: The rate of lymph node metastasis in signet ring cell carcinoma was as low as that in welldifferentiated adenocarcinoma 인제대부산백병원 소화기내과 지삼룡 Signet ring

More information

Kaes017.hwp

Kaes017.hwp 갑상선의 Poorly Differentiated (Insular) Carcinoma Insular Carcinoma: An Aggressive Subtype of Differentiated Thyroid Neoplasms Seok-Jin Nam, M.D., Sang-Dal Lee, M.D., Hal-lin Park, M.D., Young-Ryun Oh, M.D.

More information

한국성인에서초기황반변성질환과 연관된위험요인연구

한국성인에서초기황반변성질환과 연관된위험요인연구 한국성인에서초기황반변성질환과 연관된위험요인연구 한국성인에서초기황반변성질환과 연관된위험요인연구 - - i - - i - - ii - - iii - - iv - χ - v - - vi - - 1 - - 2 - - 3 - - 4 - 그림 1. 연구대상자선정도표 - 5 - - 6 - - 7 - - 8 - 그림 2. 연구의틀 χ - 9 - - 10 - - 11 -

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 4, August, 30, 2016:319~332 Received: 2016/07/28, Accepted: 2016/08/28 Revised: 2016/08/27, Published: 2016/08/30 [ABSTRACT] This paper examined what determina

More information

전립선암발생률추정과관련요인분석 : The Korean Cancer Prevention Study-II (KCPS-II)

전립선암발생률추정과관련요인분석 : The Korean Cancer Prevention Study-II (KCPS-II) 전립선암발생률추정과관련요인분석 : The Korean Cancer Prevention Study-II (KCPS-II) 전립선암발생률추정과관련요인분석 : The Korean Cancer Prevention Study-II (KCPS-II) - i - - ii - - iii - - iv - - v - - vi - - vii - - viii - - ix - -

More information

1..

1.. Volume 12, Number 1, 6~16, Factors influencing consultation time and waiting time of ambulatory patients in a tertiary teaching hospital Jee-In Hwang College of Nursing Science, Kyung Hee University :

More information

<283732372D3733312920B4D9C3CAC1A120BCD2C7C1C6AEC4DCC5C3C6AEB7BBC1EEC0C720B3EBBEC8C0C720BDC3B7C2BAB8C1A4BFA120B4EBC7D120C0AFBFEBBCBA20C6F2B0A1283035292E687770>

<283732372D3733312920B4D9C3CAC1A120BCD2C7C1C6AEC4DCC5C3C6AEB7BBC1EEC0C720B3EBBEC8C0C720BDC3B7C2BAB8C1A4BFA120B4EBC7D120C0AFBFEBBCBA20C6F2B0A1283035292E687770> 대한안과학회지 제 49 권 제 5 호 2008 J Korean Ophthalmol Soc 49(5):727-731, 2008 DOI : 10.3341/jkos.2008.49.5.727 다초점 소프트콘택트렌즈의 노안의 시력보정에 대한 유용성 평가 김현경 1 김효명 2 정성근 1 가톨릭대학교 의과대학 성모병원 안과학교실 1, 고려대학교 의과대학 안암병원 안과학교실

More information

Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp DOI: : Researc

Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp DOI:   : Researc Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp.251-273 DOI: http://dx.doi.org/10.21024/pnuedi.27.2.201706.251 : 1997 2005 Research Trend Analysis on the Korean Alternative Education

More information

Abstract Musculoskeletal Symptoms and Related Factors for Nurses and Radiological Technologists Wearing a Lead Apron for Radiation Pro t e c t i o n Jung-Im Yoo, Jung-Wan Koo 1 ) Angio Unit, Team of Radiology,

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 6, December, 30, 2016:237~251 Received: 2016/11/20, Accepted: 2016/12/24 Revised: 2016/12/21, Published: 2016/12/30 [ABSTRACT] Recently, there is an increasing

More information

386-390.hwp

386-390.hwp 386 HANYANG MEDICAL REVIEWS Vol. 29 No. 4, 2009 우리나라 미숙아의 통계와 의료비용 Statistics and Medical Cost of Preterm in Korea 윤혜선 을지대학교 노원을지병원 소아청소년과학교실 Hye Sun Yoon, M.D., Ph.D., Department of Pediatrics, Nowon

More information

이상협, 김현열 liver and lung metastasis of breast-acc on positron emission tomography (PET) scans. Breast-ACC is needed a tailored treatment Key words: bre

이상협, 김현열 liver and lung metastasis of breast-acc on positron emission tomography (PET) scans. Breast-ACC is needed a tailored treatment Key words: bre 부산대병원학술지통권제 33 호, 2013 액와림프절전이를동반한선양낭성유방암 양산부산대학교병원외과 이상협, 김현열 Primary adenoid cystic carcinoma of the breast with axillary node metastasis Sang Hyup Lee, Hyun Yul Kim Departments of Surgery Pusan National

More information

590호(01-11)

590호(01-11) T H E K O R E A N D O C T O R S W E E K L Y www.docdocdoc.co.kr I N S I D E 38 3 5 6 7 10 13 28 29 30 31 38 41 42 2 Advertisement Government & Medicine 3 Government & Medicine 4 Government & Medicine Government

More information

서론 34 2

서론 34 2 34 2 Journal of the Korean Society of Health Information and Health Statistics Volume 34, Number 2, 2009, pp. 165 176 165 진은희 A Study on Health related Action Rates of Dietary Guidelines and Pattern of

More information

03-서연옥.hwp

03-서연옥.hwp 농업생명과학연구 49(4) pp.31-37 Journal of Agriculture & Life Science 49(4) pp.31-37 Print ISSN 1598-5504 Online ISSN 2383-8272 http://dx.doi.org/10.14397/jals.2015.49.4.31 국가산림자원조사 자료를 적용한 충남지역 사유림경영율 추정 서연옥

More information

120304강신용

120304강신용 Clinical Features and Prognostic Factors Influencing Long-term Survival in pt2 Gallbladder Carcinoma Patients Purpose: The prognosis of gallbladder carcinoma is unfavorable, and the depth of invasion,

More information

( )Jksc057.hwp

( )Jksc057.hwp 직장암환자의전직장간막절제술의 예측인자분석 : 불완전절제와절제시간에영향을미치는인자에관한연구 Analysis of Factors Affecting the Degree of Difficulty in Total Mesorectal Excision for Rectal Cancer: Investigation of the Factors Affecting Incomplete

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 4, pp DOI: * A Research Trend

Journal of Educational Innovation Research 2018, Vol. 28, No. 4, pp DOI:   * A Research Trend Journal of Educational Innovation Research 2018, Vol. 28, No. 4, pp.295-318 DOI: http://dx.doi.org/10.21024/pnuedi.28.4.201812.295 * A Research Trend on the Studies related to Parents of Adults with Disabilities

More information

지원연구분야 ( 코드 ) LC0202 과제번호 창의과제프로그램공개가능여부과제성격 ( 기초, 응용, 개발 ) 응용실용화대상여부실용화공개 ( 공개, 비공개 ) ( 국문 ) 연구과제명 과제책임자 세부과제 ( 영문 ) 구분 소속위암연구과직위책임연구원

지원연구분야 ( 코드 ) LC0202 과제번호 창의과제프로그램공개가능여부과제성격 ( 기초, 응용, 개발 ) 응용실용화대상여부실용화공개 ( 공개, 비공개 ) ( 국문 ) 연구과제명 과제책임자 세부과제 ( 영문 ) 구분 소속위암연구과직위책임연구원 지원연구분야 ( 코드 ) LC0202 과제번호 1110550 창의과제프로그램공개가능여부과제성격 ( 기초, 응용, 개발 ) 응용실용화대상여부실용화공개 ( 공개, 비공개 ) ( 국문 ) 연구과제명 과제책임자 세부과제 ( 영문 ) 구분 1 2 3 소속위암연구과직위책임연구원 성명류근원전공외과 세부과제명 세부과제책임자 성명 소속 ( 직위 ) 전공 총연구기간 2011

More information

44-3대지.08류주현c

44-3대지.08류주현c A Comparative Study on the Commuting Regional Type According to the Features of Foreigner Commuting Ju-Hyun Ryu* Abstract The purposes of this study are to identify many implications of commuting regional

More information

레이아웃 1

레이아웃 1 대한위장관기질종양연구회 01 GIST 06 02 11 03 Imatinib 14 04 05 06 07 Sunitinib 32 40 44 48 GIST 6 01 7 GIST Guide book GIST 8 01 9 GIST Guide book GIST (CT) MRI FDG-PET 10 02 11 GIST Guide book 12 02 (Imatinib)

More information

ECG & EP CASES Young-Keun On, MD, PhD Division of Cardiology, Department of Medicine Cardiac & Vascular Center, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea A case of

More information

A Study on Married Female Immigrants Life Style and Marriage Satisfaction in Terms of Preparing Their Old Age in Chungcheongnam-do Department of Gerontology, Hoseo University Doctoral Student : Hi Ran

More information

IL-1β, IL-1RN, IL-8, MUC, NAT, GST 등 ) IL-1β, IL-1RN, IL-8, MUC, NAT, GST 등 ) IL-1β, IL-1RN, IL-8, MUC, NAT, GST 등 ) l l l α β α β β α β β α β 목적 (Background/Aims): 위암의가족력과 Helicobacter pylori 감염은각각위암발생의위험인자로알려져있으나,

More information

Journal of Educational Innovation Research 2019, Vol. 29, No. 2, pp DOI: 3 * Effects of 9th

Journal of Educational Innovation Research 2019, Vol. 29, No. 2, pp DOI:   3 * Effects of 9th Journal of Educational Innovation Research 2019, Vol. 29, No. 2, pp.357-378 DOI: http://dx.doi.org/10.21024/pnuedi.29.2.201906.357 3 * Effects of 9th Grade Students Participation in Career Curriculum Cluster

More information

44-4대지.07이영희532~

44-4대지.07이영희532~ A Spatial Location Analysis of the First Shops of Foodservice Franchise in Seoul Metropolitan City Younghee Lee* 1 1 (R) 0 16 1 15 64 1 Abstract The foodservice franchise is preferred by the founders who

More information

untitled

untitled 대한마취과학회지 2008; 55: 190~6 Korean J Anesthesiol Vol. 55, No. 2, August, 2008 임상연구 대한민국의 마취통증의학 임상실습 현황 연세대학교 의과대학 마취통증의학교실 및 마취통증의학연구소 장동진ㆍ안소운ㆍ안지원ㆍ김종훈 The current status of anesthesiology clerkship in Korea

More information

Jkbcs012( ).hwp

Jkbcs012( ).hwp Complications and Reasons for Dissatisfaction in Augmentation Mammoplasty - Analysis of 42 Cases of Re-operation - Sangdal Lee M.D. Clinic Purpose: Breast augmentation has recently become a common plastic

More information

Analysis of objective and error source of ski technical championship Jin Su Seok 1, Seoung ki Kang 1 *, Jae Hyung Lee 1, & Won Il Son 2 1 yong in Univ

Analysis of objective and error source of ski technical championship Jin Su Seok 1, Seoung ki Kang 1 *, Jae Hyung Lee 1, & Won Il Son 2 1 yong in Univ Analysis of objective and error source of ski technical championship Jin Su Seok 1, Seoung ki Kang 1 *, Jae Hyung Lee 1, & Won Il Son 2 1 yong in University & 2 Kang Won University [Purpose] [Methods]

More information

A 617

A 617 Special Issue Diabetic Retinopathy Won Ki Lee, M.D. Department of Ophthalmology The Catholic University of Korea College of Medicine Kangnam St. Mary s Hospital E mail : wklee@catholic.ac.kr Abstract R

More information

Jkbcs030(10)( ).hwp

Jkbcs030(10)( ).hwp Treatment of Breast Fibroadenoma with Interstitial Laser Photocoagulation Doo Min Sohn, Hyo Won Lee, Tae Yun Kim, Dan Song, Sung Yong Kim, Chul Wan Lim and Min Hyuk Lee Department of Surgery, College of

More information

Minimally invasive parathyroidectomy

Minimally invasive parathyroidectomy 2013. 2. 2 대한간암연구학회 7차 심포지움 및 학술대회 Indication and Clinical Outcomes of Metachronous HCC Metastasectomy Shin Hwang Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan

More information

Study on the Improvement of Management System through Analysis of golf semi- market: Focus on Physical Education Facility Act Ji-Myung Jung 1, Ju-Ho Park 2 *, & Youngdae Lee 3 1 Korea Institute of Sport

More information

저작자표시 - 비영리 - 변경금지 2.0 대한민국 이용자는아래의조건을따르는경우에한하여자유롭게 이저작물을복제, 배포, 전송, 전시, 공연및방송할수있습니다. 다음과같은조건을따라야합니다 : 저작자표시. 귀하는원저작자를표시하여야합니다. 비영리. 귀하는이저작물을영리목적으로이용할

저작자표시 - 비영리 - 변경금지 2.0 대한민국 이용자는아래의조건을따르는경우에한하여자유롭게 이저작물을복제, 배포, 전송, 전시, 공연및방송할수있습니다. 다음과같은조건을따라야합니다 : 저작자표시. 귀하는원저작자를표시하여야합니다. 비영리. 귀하는이저작물을영리목적으로이용할 저작자표시 - 비영리 - 변경금지 2.0 대한민국 이용자는아래의조건을따르는경우에한하여자유롭게 이저작물을복제, 배포, 전송, 전시, 공연및방송할수있습니다. 다음과같은조건을따라야합니다 : 저작자표시. 귀하는원저작자를표시하여야합니다. 비영리. 귀하는이저작물을영리목적으로이용할수없습니다. 변경금지. 귀하는이저작물을개작, 변형또는가공할수없습니다. 귀하는, 이저작물의재이용이나배포의경우,

More information

12이문규

12이문규 Review on Conservative Treatment of Spinal Scoliosis Moon-kyu Lee, O.M.D., Gil-jae Lee, O.M.D., Yun-kyung Song, O.M.D., Hyung-ho Lim, O.M.D. Dept. of Oriental Rehabilitation Medicine College of Oriental

More information

Journal of Educational Innovation Research 2017, Vol. 27, No. 3, pp DOI: (NCS) Method of Con

Journal of Educational Innovation Research 2017, Vol. 27, No. 3, pp DOI:   (NCS) Method of Con Journal of Educational Innovation Research 2017, Vol. 27, No. 3, pp.181-212 DOI: http://dx.doi.org/10.21024/pnuedi.27.3.201709.181 (NCS) Method of Constructing and Using the Differentiated National Competency

More information

- i - - ii - - iii - - iv - - v - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 - - 9 - - 10 - - 11 - - 12 - - 13 - - 14 - - 15 - - 16 - - 17 - - 18 - - 19 - α α - 20 - α α α α α α - 21 - - 22 - - 23 -

More information

139~144 ¿À°ø¾àħ

139~144 ¿À°ø¾àħ 2 139 DOI : 10.3831/KPI.2010.13.2.139 2 Received : 10. 04. 08 Revised : 10. 04. 26 Two Case Report on Wrist Ganglion Treated with Scolopendrid Pharmacopuncture Accepted : 10. 05. 04 Key Words: Wrist Ganglion,

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 6, December, 30, 2016:275~289 Received: 2016/12/02, Accepted: 2016/12/22 Revised: 2016/12/20, Published: 2016/12/30 [ABSTRACT] SNS is used in various fields. Although

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp DOI: * A Study on the Pe

Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp DOI:   * A Study on the Pe Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp.405-425 DOI: http://dx.doi.org/10.21024/pnuedi.28.1.201803.405 * A Study on the Perceptions and Factors of Immigrant Background Youth

More information

???? 1

???? 1 The Korean Journal of Applied Statistics (2014) 27(1), 13 20 DOI: http://dx.doi.org/10.5351/kjas.2014.27.1.013 Maximum Tolerated Dose Estimation by Stopping Rule and SM3 Design in a Phase I Clinical Trial

More information

(

( 317 318 319 320 1 3 5 5 5 5 2 321 : 1.,,,,, 06 2. X-ray beam penetration (density) (contrast) 03 3. patch coating, precipitation, flaking 03 4. centering 03 5. Esophagus, cardia, fundus, body, angle, antrum,

More information

878 Yu Kim, Dongjae Kim 지막 용량수준까지도 멈춤 규칙이 만족되지 않아 시행이 종료되지 않는 경우에는 MTD의 추정이 불가 능하다는 단점이 있다. 최근 이 SM방법의 단점을 보완하기 위해 O Quigley 등 (1990)이 제안한 CRM(Continu

878 Yu Kim, Dongjae Kim 지막 용량수준까지도 멈춤 규칙이 만족되지 않아 시행이 종료되지 않는 경우에는 MTD의 추정이 불가 능하다는 단점이 있다. 최근 이 SM방법의 단점을 보완하기 위해 O Quigley 등 (1990)이 제안한 CRM(Continu 한 국 통 계 학 회 논 문 집 2012, 19권, 6호, 877 884 DOI: http://dx.doi.org/10.5351/ckss.2012.19.6.877 Maximum Tolerated Dose Estimation Applied Biased Coin Design in a Phase Ⅰ Clinical Trial Yu Kim a, Dongjae Kim

More information

Journal of Educational Innovation Research 2017, Vol. 27, No. 1, pp DOI: * The

Journal of Educational Innovation Research 2017, Vol. 27, No. 1, pp DOI:   * The Journal of Educational Innovation Research 2017, Vol. 27, No. 1, pp.243-268 DOI: http://dx.doi.org/10.21024/pnuedi.27.1.201703.243 * - 2001 2015 - The Research Trends on Peer Counseling in Elementary and

More information

001-학회지소개(영)

001-학회지소개(영) Review Article Randomization, What is the Proper Method? Jin Ho Hong, M.D., Jae Chul Yoo, M.D. Shoulder & Sports medicine, Department of Orthopedic Surgery, Samsung Medical Center Purpose: Among the numerous

More information

내시경 conference

내시경 conference 부울경소화기내시경학회 6월집담회 고신대학교복음병원소화기내과전임의서광일 F/63 CASE C.C) epigastric pain for 2 wks P. I) 2014.04.16 EGD at LMC adm via OPD for further evaluation. P. Hx) CASE HTN/DM/Hepatitis/Tbc (+/+/-/-) S. Hx) N-S ROS)

More information

Jkcs022(89-113).hwp

Jkcs022(89-113).hwp 대한배뇨장애 및 요실금 학회지 J. Korean Continence Society 2004;8:89-113 Bristol Female Lower Urinary Tract Symptom 설문지의 한국어 번역 및 번역본의 언어 타당도 Seung-June Oh*, Hyung Geun Park*, Sung Hyun Paick, Won Hee Park and Myung-Soo

More information

00약제부봄호c03逞풚

00약제부봄호c03逞풚 경희대학교 동서신의학병원 약품 정보지 2 0 0 7. S P R I N G. V O L. 0 1 신약 소개 02 Journal Review 03 Special Subject 04 복약 지도 06 의약품 안전성 정보 07 약제부 알림 07 약제부 업무 소개 08 E A S T - W E S T N E O M E D I C A L C E N T E R 본 약품

More information

Kor. J. Aesthet. Cosmetol., 및 자아존중감과 스트레스와도 밀접한 관계가 있고, 만족 정도 에 따라 전반적인 생활에도 영향을 미치므로 신체는 갈수록 개 인적, 사회적 차원에서 중요해지고 있다(안희진, 2010). 따라서 외모만족도는 개인의 신체는 타

Kor. J. Aesthet. Cosmetol., 및 자아존중감과 스트레스와도 밀접한 관계가 있고, 만족 정도 에 따라 전반적인 생활에도 영향을 미치므로 신체는 갈수록 개 인적, 사회적 차원에서 중요해지고 있다(안희진, 2010). 따라서 외모만족도는 개인의 신체는 타 RESEARCH ARTICLE Kor. J. Aesthet. Cosmetol., 20-40대 여성의 외모만족도가 미용관리태도에 미치는 영향 홍수남 1, 김효숙 2 * 1 건국대학교 뷰티사이언스디자인학과, 2 건국대학교 의상디자인과 Effects of Extrinsic Body Satisfaction on Beauty Management Behavior of

More information

untitled

untitled J Korean Surg Soc 29;77:43-49 DOI:.474/jkss.29.77..43 원 저 아포크린유방암의임상병리적특성 국민건강보험공단일산병원외과, 연세대학교의과대학 2 외과학교실, 3 병리학교실 허호,2 ㆍ안영재 ㆍ박세호 2 ㆍ김주희 2 ㆍ구자승 3 ㆍ박병우 2 Clinicopathologic Characteristics of Apocrine

More information

<30312DC1A4BAB8C5EBBDC5C7E0C1A4B9D7C1A4C3A52DC1A4BFB5C3B62E687770>

<30312DC1A4BAB8C5EBBDC5C7E0C1A4B9D7C1A4C3A52DC1A4BFB5C3B62E687770> Journal of the Korea Institute of Information and Communication Engineering 한국정보통신학회논문지(J. Korea Inst. Inf. Commun. Eng.) Vol. 19, No. 2 : 258~264 Feb. 2015 ID3 알고리즘 기반의 귀납적 추론을 활용한 모바일 OS의 성공과 실패에 대한

More information

433대지05박창용

433대지05박창용 Recent Changes in Summer Precipitation Characteristics over South Korea Changyong Park* JaYeon Moon** Eun-Jeong Cha*** Won-Tae Yun**** Youngeun Choi***** 1958 2007 6 9 6 9 10 10 10 10 10 Abstract This

More information

Abstract Background : Most hospitalized children will experience physical pain as well as psychological distress. Painful procedure can increase anxie

Abstract Background : Most hospitalized children will experience physical pain as well as psychological distress. Painful procedure can increase anxie Volume 12, Number 1, 92~102, An Intervention Study of Pain Reduction during IV Therapy in Hospitalized Children Myo-Jin Kim 1), Joung-Hae Bak 1), Won-Seok Seo 2) Mi-Young Kim 3), Sun-Kyoung Park 3), Jai-Soung

More information

KIM Sook Young : Lee Jungsook, a Korean Independence Activist and a Nurse during the 이며 나름 의식이 깨어있던 지식인들이라 할 수 있을 것이다. 교육을 받은 간 호부들은 환자를 돌보는 그들의 직업적 소

KIM Sook Young : Lee Jungsook, a Korean Independence Activist and a Nurse during the 이며 나름 의식이 깨어있던 지식인들이라 할 수 있을 것이다. 교육을 받은 간 호부들은 환자를 돌보는 그들의 직업적 소 1 의사학 제24권 제1호(통권 제49호) 2015년 4월 Korean J Med Hist 24 ː1-34 Apr 2015 c대한의사학회 http://dx.doi.org/10.13081/kjmh.2015.24.1 pissn 1225-505X, eissn 2093-5609 간호부 이정숙의 독립운동 김숙영* 1. 서론 2. 본론 1) 출생에서 정신여학교 수학시절까지

More information

원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현

원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 지도김석원교수 이논문을석사학위논문으로제출함

More information

Rheu-suppl hwp

Rheu-suppl hwp Objective: This paper reviews the existing Korean medical and public health, and nursing academy articles on disease-specific and domain-specific quality of life, and provides recommendations for the universally

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 6, December, 30, 2016:21~34 Received: 2016/12/04, Accepted: 2016/12/27 Revised: 2016/12/19, Published: 2016/12/30 [ABSTRACT] With the development of the Internet,

More information

,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012). (2007) 26%., (,,, 2011;, 2006;

,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012). (2007) 26%., (,,, 2011;, 2006; ,,.. 400,,,,,,.,,, -, -, -., 3.. :, Tel : 010-9540-0640, E-mail : sunney05@hanmail.net ,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012).

More information

388 The Korean Journal of Hepatology : Vol. 6. No COMMENT 1. (dysplastic nodule) (adenomatous hyperplasia, AH), (macroregenerative nodule, MR

388 The Korean Journal of Hepatology : Vol. 6. No COMMENT 1. (dysplastic nodule) (adenomatous hyperplasia, AH), (macroregenerative nodule, MR 6 3 2000 ; 387-392 (3) Dysplastic Nodule Young Nyun Park, M.D., Chanil Park, M.D. Department of Pathology, Yonsei University College of Medicine BRIEF HISTORY 56. AST/ALT 72/73 IU/L, total bilirubin 0.7

More information

Kaes010.hwp

Kaes010.hwp 갑상선자극호르몬이갑상선암세포의 VEGF, 신생혈관형성, 성장, 침윤및전이에미치는영향 Effects of TSH on the Production of VEGF, Angiogenesis, Growth, Invasion and Metastasis in Thyroid Cancer Cells Euy Young Soh, M.D., Hee Boong Park, M.D.,

More information

歯1.PDF

歯1.PDF 200176 .,.,.,. 5... 1/2. /. / 2. . 293.33 (54.32%), 65.54(12.13%), / 53.80(9.96%), 25.60(4.74%), 5.22(0.97%). / 3 S (1997)14.59% (1971) 10%, (1977).5%~11.5%, (1986)

More information

04_이근원_21~27.hwp

04_이근원_21~27.hwp 1) KIGAS Vol. 16, No. 5, pp 21~27, 2012 (Journal of the Korean Institute of Gas) http://dx.doi.org/10.7842/kigas.2012.16.5.21 실험실의 사례 분석에 관한 연구 이근원 이정석 한국산업안전보건공단 산업안전보건연구원 (2012년 9월 5일 투고, 2012년 10월 19일

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 6, December, 30, 2016:3~20 Received: 2016/12/04, Accepted: 2016/12/27 Revised: 2016/12/27, Published: 2016/12/30 [ABSTRACT] This study aims to comprehensively analyze

More information

Journal of Breast Cancer ISSN J Breast Cancer 2007; September 10 (3): ORIGINAL ARTICLE 70 세이상유방암환자의임상적특징과치료결과 이정선ㆍ홍수정ㆍ김희정ㆍ손병호ㆍ김성배 1

Journal of Breast Cancer ISSN J Breast Cancer 2007; September 10 (3): ORIGINAL ARTICLE 70 세이상유방암환자의임상적특징과치료결과 이정선ㆍ홍수정ㆍ김희정ㆍ손병호ㆍ김성배 1 Journal of Breast Cancer ISSN 1738-6756 J Breast Cancer 2007; September 10 (3): 199-205 ORIGINAL ARTICLE 70 세이상유방암환자의임상적특징과치료결과 이정선ㆍ홍수정ㆍ김희정ㆍ손병호ㆍ김성배 1 ㆍ안진희 1 ㆍ안승도 2 ㆍ안세현 울산대학교의과대학서울아산병원외과학교실, 1 종양내과교실,

More information

<30322EBABBB9AE2E687770>

<30322EBABBB9AE2E687770> Korean Journal of Obstetrics and Gynecology Vol. 48 No. 1 January 2005 동시항암화학방사선요법을시행받은자궁경부암환자에서빈혈이예후에미치는영향 연세대학교의과대학산부인과학교실 조정미 김영태 김성훈 노종환 김재훈 김재욱 Department of Obstetrics and Gynecology, Yonsei University

More information

09구자용(489~500)

09구자용(489~500) The Study on the Grid Size Regarding Spatial Interpolation for Local Climate Maps* Cha Yong Ku** Young Ho Shin*** Jae-Won Lee**** Hee-Soo Kim*****.,...,,,, Abstract : Recent global warming and abnormal

More information

<30382EC0C7C7D0B0ADC1C22E687770>

<30382EC0C7C7D0B0ADC1C22E687770> 대한내과학회지: 제 76 권 제 2 호 2009 의학강좌-개원의를 위한 모범처방(Current Clinical Practice) 간기능검사의 이해와 적용 인제대학교 의과대학 일산백병원 내과학교실 김 경 아 Understanding and application of liver function tests Kyung-Ah Kim, M.D. Department of

More information

Àå¾Ö¿Í°í¿ë ³»Áö

Àå¾Ö¿Í°í¿ë ³»Áö Disability & Employment 55 Disability & Employment 56 57 Disability & Employment 58 59 Disability & Employment 60 61 Disability & Employment 62 63 Disability & Employment 64 65 Disability & Employment

More information

(49-54)Kjhps004.hwp

(49-54)Kjhps004.hwp Biliary Cystadenoma and Cystadenocarcinoma of the Liver Jae Hoon Lee, M.D., Dong Ho Choi, M.D. 1, Kyeong Geun Lee, M.D., Hwon Kyum Park M.D. and Kwang Soo Lee, M.D. Department of Surgery, College of Medicine,

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp DOI: * A Analysis of

Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp DOI: * A Analysis of Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp.99-117 DOI: http://dx.doi.org/10.21024/pnuedi.28.1.201803.99 2015 * A Analysis of the Characters and Issues about the 2015 Revised Social

More information

:,,.,. 456, 253 ( 89, 164 ), 203 ( 44, 159 ). Cronbach α= ,.,,..,,,.,. :,, ( )

:,,.,. 456, 253 ( 89, 164 ), 203 ( 44, 159 ). Cronbach α= ,.,,..,,,.,. :,, ( ) :,,.,. 456, 253 ( 89, 164 ), 203 ( 44, 159 ). Cronbach α=.83.91.,.,,..,,,.,. :,, (402-751) 253 E-mail : yspark@inha.ac.kr ..,.,.,. Bandura(1997),.,,,,., (,,, 2009), (,,,, 2014).?.,,,.. Bandura (1995) (Resiliency

More information

Treatment and Role of Hormaonal Replaement Therapy

Treatment and Role of Hormaonal Replaement Therapy Treatment and Role of Hormone Replacement Therapy Chung-Ang University Hospital Chee Jeong Kim 7.2 5.3 6.4 5.6 7.3 5.5 1 1 2 3 4 10 11 7 34 49 122 123 1.0 - - 10. 2001 1998 1998 Improvement of postmenopausal

More information

Kjhps016( ).hwp

Kjhps016( ).hwp Surgical Extent and Types in Pancreatic Cancer Song Cheol Kim, M.D. Department of Surgery, Ulsan University College of Medicine & Asan Medical Center, Seoul, Korea Pancreatic cancer continues to pose a

More information

Effects of baseball expertise and stimulus speeds on coincidence-anticipation timing accuracy of batting Jong-Hwa Lee, Seok-Jin Kim, & Seon-Jin Kim* Seoul National University [Purpose] [Methods] [Results]

More information

1. 서론 1-1 연구 배경과 목적 1-2 연구 방법과 범위 2. 클라우드 게임 서비스 2-1 클라우드 게임 서비스의 정의 2-2 클라우드 게임 서비스의 특징 2-3 클라우드 게임 서비스의 시장 현황 2-4 클라우드 게임 서비스 사례 연구 2-5 클라우드 게임 서비스에

1. 서론 1-1 연구 배경과 목적 1-2 연구 방법과 범위 2. 클라우드 게임 서비스 2-1 클라우드 게임 서비스의 정의 2-2 클라우드 게임 서비스의 특징 2-3 클라우드 게임 서비스의 시장 현황 2-4 클라우드 게임 서비스 사례 연구 2-5 클라우드 게임 서비스에 IPTV 기반의 클라우드 게임 서비스의 사용성 평가 - C-Games와 Wiz Game 비교 중심으로 - Evaluation on the Usability of IPTV-Based Cloud Game Service - Focus on the comparison between C-Games and Wiz Game - 주 저 자 : 이용우 (Lee, Yong Woo)

More information

서론

서론 - i - - ii - - iii - - iv - - v - - vi - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 - - 9 - - 10 - - 11 - - 12 - - 13 - - 14 - - 15 - - 16 - - 17 - - 18 - - 19 - - 20 - - 21 - - 22 - - 23 - - 24 - -

More information

歯kjmh2004v13n1.PDF

歯kjmh2004v13n1.PDF 13 1 ( 24 ) 2004 6 Korean J Med Hist 13 1 19 Jun 2004 ISSN 1225 505X 1) * * 1 ( ) 2) 3) 4) * 1) ( ) 3 2) 7 1 3) 2 1 13 1 ( 24 ) 2004 6 5) ( ) ( ) 2 1 ( ) 2 3 2 4) ( ) 6 7 5) - 2003 23 144-166 2 2 1) 6)

More information

<303720C7CFC1A4BCF86F6B2E687770>

<303720C7CFC1A4BCF86F6B2E687770> 1) < 論 文 > 라이프스타일 세분화를 통한 실버타운 수요자 분석 133 주택연구 제15권 4호 2007. 12/15(4) : 133~160 Housing Studies Review Vol. 15, No. 4 : 133~160 접수일 : 2007. 7. 9, 심사일 : 2007. 7. 16, 심사완료일 : 2007. 8. 29 라이프스타일 세분화를 통한 실버타운

More information

Microsoft PowerPoint - 김미영

Microsoft PowerPoint - 김미영 암세포의위험한여행 한국과학기술원 김미영 강의개요 전이란무엇인가? 전이는어떤과정을통해진행될까? 전이예측방법은어떤것들이있을까? Cancer ( 악성종양 ) US South Korea 질병사망률질병사망률 1. 심장병 26% 1. Cancer 26.7% 2. Cancer 23% 2. 뇌출혈 12.7% 3. 뇌출혈 5.6% 3. 심장병 7.9% >20,000 환자가악성종양에의해매일사망함

More information

( )Kjhps043.hwp

( )Kjhps043.hwp Difference of Fistula Maturation Degree and Physical Property by the Types of Tube Material: An Experimental Study Sang Koo Kang, M.D. 1, Hee Chul Yu, M.D. 1,4, Woo Sung Moon, M.D. 2,4, Ju Hyoung Lee,

More information

歯14.양돈규.hwp

歯14.양돈규.hwp : The Korean Journal of Counseling and Psychotherapy 2003. Vol. 15, No. 3, 615-631. 1 2 3 1,410.,, ( ),., ( 69%),.,, ( ), ( ).,,.., ( ).,. :,,. :, (390-711) 21-1, : 043-649-1362 E-mail : ydk9498@hanmail.net

More information

부산대병원학술지통권제 32 호, 2012 유방외상부혹은외중앙부에위치한유방암의부분유방절제술후상부축회전진피유선조직피판을이용한유방종양성형술 부산대학교병원외과 이석원, 배영태 Oncoplastic breast surgery for the upper quadrant breast

부산대병원학술지통권제 32 호, 2012 유방외상부혹은외중앙부에위치한유방암의부분유방절제술후상부축회전진피유선조직피판을이용한유방종양성형술 부산대학교병원외과 이석원, 배영태 Oncoplastic breast surgery for the upper quadrant breast 부산대병원학술지통권제 32 호, 2012 유방외상부혹은외중앙부에위치한유방암의부분유방절제술후상부축회전진피유선조직피판을이용한유방종양성형술 부산대학교병원외과 이석원, 배영태 Oncoplastic breast surgery for the upper quadrant breast cancers: Superior based dermoglandular rotational

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 3, pp DOI: * Strenghening the Cap

Journal of Educational Innovation Research 2018, Vol. 28, No. 3, pp DOI:   * Strenghening the Cap Journal of Educational Innovation Research 2018, Vol. 28, No. 3, pp.27-43 DOI: http://dx.doi.org/10.21024/pnuedi.28.3.201809.27 * Strenghening the Capacity of Cultural Arts Required in Special Education

More information

슬라이드 1

슬라이드 1 Proposed Korean guideline for the diagnosis of BPH Hyun Woo Kim The Catholic University of Korea BPH Guideline AHCPR guideline on BPH (1994) AUA guideline on BPH (2003) EAU guideline on BPH (2004) International

More information