The prognoses and postoperative outcomes of patients with both colorectal cancer and liver cirrhosis based on a nationwide cohort in Korea

Nari Shin,Eon Chul Han,Sungho Won,Seung-Bum Ryoo,Eun Kyung Choe,Byung Kwan Park,Kyu Joo Park 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.99 No.2

Purpose: The management of patients with colorectal cancer (CRC) who have liver cirrhosis (LC) requires a thorough understanding of both diseases; however, the prognoses and postoperative outcomes of such patients remain understudied. We investigated the effect of LC on surgical and oncologic outcomes in patients with CRC, and identified prognostic factors. Methods: We analyzed 453 patients with CRC and LC (CRC-LC group), 906 with CRC only (CRC group), 906 with LC only (LC group), and 1,812 healthy subjects using health insurance claim data (2008–2013). Results: The CRC-LC group had a higher frequency of intensive care unit admission than the CRC group; there were no differences between the 2 groups in terms of early and late postoperative small bowel obstruction and incisional hernia. However, the 30-day, 60-day, and 90-day mortality rates were all significantly higher in the CRC-LC group. The higher Charlson comorbidity index (hazard ratio [HR], 1.127) and the lower socioeconomic status (HR, 0.985) were significant worse predictors of 5-year survival. Patients with underlying LC had a significantly higher HR in both the advanced CRC (HR, 1.858) and nonadvanced CRC (HR, 1.799) subgroups. However, the nonadvanced CRC subgroup showed a lower HR than the LC group (HR, 0.730). Conclusion: Patients with CRC who had underlying LC had a lower survival rate than did those without LC, although the incidence rates of postoperative complications were not significantly different. The presence of LC was associated with a significantly lower survival rate regardless of CRC presence.

Unveiling lymph node metastasis in early gastric cancer.

Shin, Nari,Jeon, Tae-Yong,Kim, Gwang Ha,Park, Do Youn WJG Press 2014 WORLD JOURNAL OF GASTROENTEROLOGY Vol.20 No.18

<P>With respect to gastric cancer treatment, improvements in endoscopic techniques and novel therapeutic modalities [such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD)] have been developed. Currently, EMR/ESD procedures are widely accepted treatment modalities for early gastric cancer (EGC). These procedures are most widely accepted in Asia, including in Korea and Japan. In the present era of endoscopic resection, accurate prediction of lymph node (LN) metastasis is a critical component of selecting suitable patients for EMR/ESD. Generally, indications for EMR/ESD are based on large Japanese datasets, which indicate that there is almost no risk of LN metastasis in the subgroup of EGC cases. However, there is some controversy among investigators regarding the validity of these criteria. Further, there are currently no accurate methods to predict LN metastasis in gastric cancer (for example, radiologic methods or methods based on molecular biomarkers). We recommend the use of a 2-step method for the management of early gastric cancer using endoscopic resection. The first step is the selection of suitable patients for endoscopic resection, based on endoscopic and histopathologic findings. After endoscopic resection, additional surgical intervention could be determined on the basis of a comprehensive review of the endoscopic mucosal resection/endoscopic submucosal dissection specimen, including lymphovascular tumor emboli, tumor size, histologic type, and depth of invasion. However, evaluation of clinical application data is essential for validating this recommendation. Moreover, gastroenterologists, surgeons, and pathologists should closely collaborate and communicate during these decision-making processes.</P>

A study on dietary habits, health related lifestyle, blood cadmium and lead levels of college students

Nari Shin,Whajin Hyun,Hongmie Lee,Mansoo Ro,Kyunghee Song 대한지역사회영양학회 2012 Nutrition Research and Practice Vol.6 No.4

This study was performed in order to investigate dietary habits, health related lifestyle and blood cadmium and lead levels in female college students. 80 college students (43 males and 37 females) participated in the survey questionnaires. Body weight and height, blood pressure, and body composition were measured. The systolic blood pressure of male and female students were 128.9 ± 13.9 and 109.8 ± 12.0, respectively. The diastolic blood pressure of male and female students were 77.1 ± 10.3 and 66.0 ± 6.9, respectively, showing that male students had significantly higher blood pressure than female students (P < 0.001). The BMI of male and female students were 23.4 ± 3.3 and 20.2 ± 2.3, respectively. Most male students were in the range of being overweight. The dietary habits score of female students was significantly higher than that of male students (P < 0.01).The blood cadmium level of male and female students were 0.54 ± 0.23 and 0.52 ± 0.36, respectively. There was no significant difference between male and female students. The blood lead level of male and female students were 1.09 ± 0.49 and 0.59 ± 0.45, respectively. The blood lead level of male students was significantly higher than that of female students (P < 0.001). The blood cadmium level of smokers and nonsmokers were 0.69 ± 0.29 and 0.49 ± 0.29 respectively (P < 0.05). The blood cadmium level of smokers was significantly higher than that of nonsmokers (P < 0.05). The blood lead level of smokers and nonsmokers were 1.09 ± 0.43 and 0.80 ± 0.54, respectively. The blood lead level of smokers was significantly higher than that of nonsmokers (P < 0.05). Therefore, proper nutritional education programs are required for college students in order to improve their dietary and health related living habits.

[Discussion] A Reconsideration of Childrearing Policies in Korea

Nary Shin 가정과삶의질학회 2011 한국가정관리학회 학술발표대회 자료집 Vol.2011 No.5

Gastric Pit Dysplasia in Adjacent Gastric Mucosa in 414 Gastric Cancers: Prevalence and Characteristics

Shin, Nari,Jo, Hong-Jae,Kim, Woo-Kyung,Park, Won-Young,Lee, Jeong-Hee,Shin, Dong Hun,Choi, Kyung Un,Kim, Jee-Yeon,Lee, Chang-Hun,Sol, Mee Young,Jeon, Tae Yong,Kim, Dae Whan,Huh, Gi-Young,Kim, Gwang Ha Lippincott Williams Wilkins, Inc. 2011 The American journal of surgical pathology Vol.35 No.7

Despite wide acceptance of the chronic gastritis-intestinal metaplasia-dysplasia-carcinoma sequence, especially for intestinal-type gastric adenocarcinoma, the precise nature of the subtle precursor lesions of gastric cancer remains to be delineated. For example, pit dysplasia with surface foveolar maturation is not well defined, nor is its prevalence and biological characteristics well characterized. We have evaluated the surrounding gastric mucosa of 414 gastric cancers for the presence of gastric pit dysplasia. We investigated its relationship with various clinicopathological and immunophenotypic features of gastric adenocarcinoma, as well as the severity and extent of any surrounding gastritis and intestinal metaplasia. p53 expression and Ki-67 proliferation index were also evaluated. We have found that 21.0% (n=87) of gastric cancer cases showed pit dysplasia in adjacent gastric mucosa. Gastric cancers with pit dysplasia were significantly associated with older age, male sex, body/fundic location, and intestinal histologic type (P<0.05). Interestingly, gastric mucin-containing intestinal metaplasia (incomplete intestinal metaplasia) was highly associated with adenocarcinoma with pit dysplasia (P=0.000). In addition, MUC6 expression in gastric adenocarcinoma was associated with pit dysplasia (P=0.036). p53 overexpression and increased Ki-67 proliferation index were more evident in gastric pit dysplasia compared with adjacent gastric mucosa. We suggest that gastric pit dysplasia is an important candidate precursor of gastric adenocarcinoma and may represent another morphologic step in the pathogenesis of gastric adenocarcinoma, especially of intestinal type. More detailed prospective studies are needed to determine the precise significance of these findings.

영아의 어린이집 적응 추이의 유형 및 예측 요인에 대한 단기종단연구: 성장혼합모형과 잠재계층분석을 활용하여

신나리(Nary Shin),조우리(Woori Jo) 한국보육지원학회 2020 한국보육지원학회지 Vol.16 No.1

Objective: The purpose of this study was to examine underlying types of developmental trajectories of adaptation to child care among infants and toddlers. This study also aimed to identify latent classes in their child care adaptation types in order to find predictors that account for individual differences. Methods: Participants were 420 mothers of infants and toddlers and 123 teachers. The levels of child care adaptation of participating infants and toddlers were rated monthly from early April to June, 2019. The collected data were analyzed using growth mixture modeling, latent class analysis and multinominal logistic analysis. Results: The results of growth trajectories of child care adaptation showed there were two to four latent groups by dimension of child care adaptation. Also, the groups of individual dimensions of child care adaptation were classified into three latent classes, which were ‘complying and positive group , ‘negative group , and ‘individualized group. Multinominal logistic analysis revealed that children s age, gender, and temperament differentiated the three latent classes of adaptation to child care. Conclusion/Implications: The results show individual characteristics that infants and toddlers possess should be prudently considered in order for successful adaptation to child care.

교사용 영아 어린이집 적응 척도 개발

신나리(Nary Shin),윤현정(Hyun Jeong Yun) 한국아동학회 2016 아동학회지 Vol.37 No.6

Objective: This study aimed to develop and validate the Childcare Adaptation Scale for Infants and Toddlers (CASIT), which is rated by teachers of Korean children. Methods: The participants consisted of 326 childcare teachers working with infants (ages 0–2 years). Content validity, discriminant validity, convergent validity, concurrent validity, internal consistency, inter-rater reliability, and item discrimination were examined using PASW 18.0 and AMOS 19.0. Results: The results of an exploratory factor analysis identified the 29-item scale and six dimensions of the scale, including group life adaptation, negative behaviors, positive affect, regular routines, activity/interest, and peer interaction. Convergent validity was examined via confirmatory factor analysis, average variation extracted (AVE), and construct reliability, and acceptable evidences of convergent validity was established. The scales were shown to be highly consistent internally and among raters. Also, the mean between the upper group and lower group of each item regarding item discrimination showed a significant difference. Conclusion: It was concluded that the CASIT, which is a quick and convenient tool for teachers to use, is a valid and reliable instrument.

코로나19 시대의 보육: 어린이집의 운영 실태와 과제

신나리(Nary Shin),김상림(Sanglim Kim),이주연(Joo-Yeon Lee),송승민(Seung-Min Song),백선정(Sunjung Baek) 한국보육지원학회 2021 한국보육지원학회지 Vol.17 No.2

Objective: Covid-19 is changing many aspects of child care programs. The objective of this study was to explore how the pandemic and mitigation efforts affected the experiences and practices at child care centers in the summer of 2020. Methods: Focus group interviews and mobile surveys were conducted with principals and teachers of child care centers in August and September 2020. Descriptive statistics including frequency distributions, means and standard deviations and mean differences were used to analyze the survey data with SPSS 22.0. Results: It was found that each sector of child care settings experienced different difficulties and had various needs. Young children s lack of energy, child care teachers workload and stress, and principles’ efforts to interrupt transmission of the infectious disease based on insufficient government guideline and supports were revealed as the main experiences. Conclusion/Implications: The Covid-19 pandemic has had a tandem of influences on daily life at child care centers. As policy makers consider additional guidelines or supports measures to prevent the infection and spread of Covid-19 at child care centers, long-term as well as short-term plans at various levels should be considered to meet the unique needs of child care programs.

감사인 명성과 감사자원 투입수준이 상장이후 공모주 수익률에 미치는 영향

신나리 ( Nari Shin ),이영한 ( Young-han Lee ) 한국회계학회 2018 회계학연구 Vol.43 No.5

본 연구에서는 외부감사의 품질과 재무정보의 신뢰도의 연관성을 감사인의 명성과 감사보수 및 감사시간 투입이 신규상장법인의 상장직후 주식수익률에 미치는 영향을 통해 분석한다. 이를 통하여 정보비대칭 상황에서 회계정보에 대한 투입관점의 감사품질이 기업가치 평가과정에 어떠한 영향을 주는지 관찰할 수 있기 때문이다. 본 연구에서는 정보비대칭상황에서 대형회계법인이 감사하거나 감사시간과 감사보수가 많이 투입된 재무정보를 공시한 상장예정법인의 경우 중소형회계법인이 감사하거나 감사시간과 감사보수가 더 낮은 상장예정법인에 비해 공모가가 더 높게 형성되어 상장직후 주식수익률이 더 낮을 것으로 예상하였다. 그리고 2014년부터 외감법에 의해 공시되는 비상장기업의 감사시간과 상장후 사업보고서를 통해 공시되는 감사보수 자료를 통해 이를 실증 분석하였다. 분석결과 투입기준 감사품질의 측정치를 나타내는 비정상감사보수와 비정상감사시간은 상장직후 주식수익률과 음의 관련성을 보여서 투입측면의 감사품질이 공모주의 상대적 저평가현상을 완화시키는 것으로 나타났다. 반면 공모가격 산정시 활용되는 가장 최근의 재무제표를 감사한 회계법인이 대형회계법인인지의 여부는 상장직후 주식수익률에 유의미한 영향이 없었다. 본 연구의 분석결과는 감사보수와 감사시간이라는 투입기준의 감사품질 측정변수가 재무정보의 신뢰도를 제고하고 있으며 공모주 가치평가 과정에서 공모주가에 반영되고 있음을 나타내어, 기업가치평가 과정에서의 기업에 대한 사전적 불확실성 정도를 완화시킨다는 실증적 증거라는 측면에서 의미가 있다. This study analyzes the value of external audit that improves the reliability of financial information by examining the relationship between auditor's size, abnormal audit fees, and abnormal audit hours and the underpricing of initial public offerings(IPO). The IPO underpricing is a generally observed phenomenon, in which the offer price is lower than its market value, generating an abnormal return on the first day of the IPO, and it has been reported in the extensive literature. We expect that high-quality audit increases the reliability of financial information that has been provided to the underwriter, thereby, reduces the extent to which they discount the offer price. To confirm our expectation, we hand-collect audit hour data from audit report that has been mandatorily disclosed from FY2014 and use it as a proxy for audit quality as well as audit fees and Big N membership. The results show that when the auditor who audited the financial statements before the IPO was one of the big4, and when considerable audit fees and audit hour were invested, the degree to which the offer price is under-priced reclines, supporting our hypothesis on positive association between audit quality and reliability of the financial statements. However, there is no significant difference in stock returns when the auditor is one of the big 4. Our research provides the empirical evidence that the input-based audit quality measure―audit fees and audit hour― increases the reliability of financial information and alleviates the degree of ex-ante uncertainty about the company.

조세 공평성 인식과 공공서비스의 현재소비와 미래소비에 대한 납세자의 태도 분석: 통일세에 대한 선호도를 중심으로

신나리 ( Nari Shin ),이영한 ( Young-han Lee ),박기백 ( Ki-baeg Park ) 한국회계학회 2017 회계학연구 Vol.42 No.6

정부와 국민들의 사회적 교환거래에서의 조세의 역할을 분석해온 납세순응 연구들은 정부가 합리적인 조세부담 수준으로 납세자들이 더 선호하는 공공서비스를 제공한다는 확신이 높을수록 납세자들의 납세의향이 높아지며 이러한 납세의향은 공공재의 기간별 소비행태, 조세공평성에 대한 인식에 영향을 받는다는 이론을 제시하고 있다. 본 연구에서 분석대상으로 삼은 통일세는 이 세금으로 마련된 공공서비스의 기대수혜시기가 불확실한 장기이고 기대수혜자가 납세자 본인이 되지 않을 가능성이 존재하는 세금이다. 따라서 통일세의 납세의향을 복지재정지출과 같은 즉각적이고 직접적인 재정지출 선호도와 비교해볼 경우 조세와 공공서비스의 사회적 교환이 어떠한 요인에 의해 영향을 받는 것인지를 명확하게 살펴볼 수 있는 연구기회를 제공한다. 따라서 본 연구에서는 한국조세재정연구원의 제5차 재정패널 자료를 이용하여 납세자의 사적재 소비 행태가 공공재의 기간별 소비행태에도 유지되는지 확인하고, 조세의 공평성에 대한 인식을 수직적 공평성, 수평적 공평성, 교환적 공평성으로 구분하여 각 요소가 공공재의 현재소비와 미래소비에 어떤 영향을 주는지, 연령별로는 기대효용을 극대화하는 경제적 합리성에 근거한 의사결정을 하는지를 통일세 납세의향과 복지재정지출 선호도를 통해서 분석하였다. 본 연구의 분석결과에 따르면 저축성향과 통일세에 대한 선호도의 경우 예상과 달리 음의 관련성을 보여서 사적재화에 대한 소비 및 저축행태가 통일비용 지출과 같은 불확실한 공공서비스에서는 유지되지 않으며 경제적 요인외에 사회, 심리적 요인이 연구결과에 영향을 미치는 것으로 판단된다. 조세제도의 공평성에 대한 인식은 통일세의 선호도 및 납세의향에 정의 관련성을 보여서 공평성 인식이 통일세 납세순응도 제고와 관련성이 있음도 발견 하였다, 또한 고소득자, 고령층이 통일세 선호도가 높아, 경제적 동기보다 민족의식과 같은 심리적 동기가 작용하는 것을 보였으며 청년층의 경우는 통일세 담세의향이 낮은 것으로 나타났다. The unification tax is recognized by taxpayers as an ambiguous and uncertain tax that when to be exchanged as public goods, who would be the beneficiary, or why they are to be collected have not been agreed. Thus, comparing the intention to pay unification tax to the intention to pay for the fiscal expenditure which the taxpayers may receive an immediate benefit provides a research opportunity to examine what factors affect the social exchange between tax and public services. Therefore we use the National Survey of Tax and Benefit data, publicly provided by the Korea Institute of Public Finance, to identify whether taxpayer's private consumption behavior affects the consumption behavior of public goods and whether the taxpayer's perception of equity affects taxpayers' preference on current consumption and future expenditure of public goods. The results reveal that the taxpayers’ substitution behavior on private goods does not hold in their attitude toward public service. In addition, consistent with the literature, the perception of equity in the tax system is essential for overall tax compliance, and its impact is more significant on the tax consciousness when the purpose of the tax, timing of the related expenditure, and size to levy are uncertain and the beneficiary is not deterministic.