대장암 검진-50세 이하부터 시작하는 것은 필요한 것인가?

신종범,Jongbeom Shin 대한소화기암연구학회 2023 Journal of digestive cancer reports Vol.11 No.3

Colorectal cancer is the third most common cancer worldwide. The occurrence of colon cancer can be prevented by removing precursor lesions. Several countries are making efforts to prevent the occurrence of colon cancer via screening programs. Korea is also following suite by screening individuals < 50 years of age. Currently, the incidence of colon cancer among the young is increasing globally, and Korea has a high colon cancer incidence rate among individuals in their 20s and 40s. Therefore, it may be necessary to start the screening individuals < 50 years of age to detect the cancer's manifestation early. Moreover, advanced adenomas associated with poor prognosis can be detected early, the overall screening rate can be increased, and death from colon cancer at a young age can be prevented. Although the period of colorectal cancer screening has been expanded, the overall colorectal cancer screening rate has not. Additionally, increasing the screening rate among individuals > 50 years could reduce the mortality rate at a lower cost. Although the incidence of colon cancer is increasing in younger individuals, the evidence to conclude that screening at the age of < 50 years has a meaningful impact on the incidence and survival rates of colon cancer remains insufficient. Therefore, rather than following the trend and performing screening early, an approach that actively selects cases where tests for colorectal cancer diagnosis are required is warranted.

Acute-on-chronic liver failure as a major predictive factor for mortality in patients with variceal bleeding

신종범,Jung Hwan Yu,Young-Joo Jin,Hyung Joon Yim,Young Kul Jung,Jin Mo Yang,Do Seon Song,Young Seok Kim,Sang Gyune Kim,김동준,석기태,Eileen L. Yoon,Sang Soo Lee,Chang-Wook Kim,Hee Yeon Kim,Jae Young Jang,Soung 대한간학회 2020 Clinical and Molecular Hepatology(대한간학회지) Vol.26 No.4

Background/Aims: This study examined the risk factors associated with mortality in cirrhotic patients hospitalized with variceal bleeding, and evaluated the effects of acute-on-chronic liver failure (ACLF) on the prognosis of these patients. Methods: This study was retrospectively conducted on patients registered in the Korean acute-on-chronic liver failure study cohort, and on 474 consecutive cirrhotic patients hospitalized with variceal bleeding from January 2013 to December 2013 at 21 university hospitals. ACLF was defined as described by the European Association for the Study of Liver-Chronic Liver Failure Consortium. Results: Among a total of 474 patients, 61 patients were diagnosed with ACLF. The cumulative overall survival (OS) rate was lower in the patients with ACLF than in those without (P<0.001), and patients with higher ACLF grades had a lower OS rate (P<0.001). The chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score was identified as a significant prognostic factor in patients hospitalized with variceal bleeding (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.30–1.50; P<0.001), even in ACLF patients with variceal bleeding (HR, 1.32; 95% CI, 1.19–1.46, P<0.001). Concerning the prediction of the mortality risk at 28- and 90-day using CLIF-SOFA scores, c-statistics were 0.895 (95% CI, 0.829–0.962) and 0.897 (95% CI, 0.842–0.951), respectively, and the optimal cut-off values were 6.5 and 6.5, respectively. Conclusions: In cirrhotic patients hospitalized with variceal bleeding, the prognosis was poor when accompanied by ACLF, especially depending upon CLIF-SOFA score. CLIF-SOFA model well predicted the 28-day or 90-day mortality for cirrhotic patients who experienced variceal bleeding.

신생아 경련의 진단과 치료

신종범 대한소아청소년과학회 2001 Clinical and Experimental Pediatrics (CEP) Vol.44 No.3

A Case of Endovascular Treatment of Severe Graft Limb Kinking after Endovascular Abdominal Aortic Aneurysm Repair

신종범,박미화,정상호,권성우,신성희,우성일,박상돈 대한혈관외과학회 2016 Vascular Specialist International Vol.32 No.1

Endovascular aneurysm repair (EVAR) has been recommended as an alternative to open aneurysm repair. The risk of severe perioperative complications is lower than that in open surgical repair; however, late complications are more likely. After EVAR, regular yearly surveillance by duplex ultrasonography or computed tomography is recommended. We report the case of a 67-year-old man with a severely kinked left iliac branch of the stent graft 10 years after EVAR. He had not undergone regular follow-up during the last 4 years. We realigned the endograft kink by percutaneous transluminal angioplasty.

미숙아의 장관영양

신종범 대한신생아학회 2009 Neonatal medicine Vol.16 No.2

Over the past 20 years, neonatal mortality rates for preterm infants, particularly those born extremely preterm and with a very low birth weight, have decreased steadily. As more very immature preterm infants survive, provision of enteral feeding has become a major focus of concern. According to many experts on neonatal nutrition, the goal for the nutrition of preterm infants should be to achieve a postnatal growth rate approximating that of a normal fetus of the same gestational age. Total parenteral nutrition for maintaining nutritional integrity is mandatory before successful transition to enteral feeding. Early initiation of trophic enteral feeding is vital for postnatal adaptation. Recently published randomized controlled trials provide no evidence to support the practice of postponing enteral feeding to reduce the incidence of necrotizing enterocolitis. Early trophic feeding yields demonstrable benefits and there is currently no evidence of any adverse effects following early feeding. Preterm milk from the infant's own mother is the milk of choice, which can always be supplemented with a human milk fortifier. Here we review over 50 randomized controlled trials and over seven systematic reviews published on neonatal parenteral and enteral feeding of preterm infants. Neonatologists must make use of the evidence from these studies as a reference for feeding protocols for preterm infants in their NICUs are to be based.

워드네트워크 분석을 활용한 컨테이너부두 ESG 변수 선정

신종범,김경태,김현덕 한국항만경제학회 2023 韓國港灣經濟學會誌 Vol.39 No.2

In a situation where the necessity and importance of ESG management is increasing recently, itis judged that selecting important ESG-related variables for container terminals, which are the basesof export and import logistics, among various variables of ESG evaluation agencies will help to establishESG management strategies for container terminals which led us to proceed with this study. The results of word network analysis are summarized as follows. The weighed degree, that is,the AWD of Environmental management(E) variables, is obtained in the order of EnvironmentalProtection Investment(54), Environmental Awareness Education(45), Work Team Structure(31),Environmental certification(32). Page Ranks, the order of centrality and connectivity index isEnvironmental Awareness Education(0.0765), Employee Engagement(0.0765), EnvironmentalProtection Investment(0.0761), Work Team Composition(0.0761), and Environmental certification(0.0761). The AWD(Average Weighed Degree) of the Social Responsibility Management(S) variables,followed by Protecting workers’ human rights and contributing to local communities(68),Safety Education(63), Safety certification(59), and Responding to infectious diseases(40). Orders byPage Ranks, centrality and connectivity Index, are Protecting workers’ human rights and contributingto local communities(0.165), Safety Education(0.153), Safety Certification(0.144) and Responding toinfectious diseases(0.102). The AWD of Governance and Ethical management(G) variables, followedby Anti-corruption(27), Transparent management(24), Mutual cooperation between stakeholders(19),and Sustainability reporting(9). Page Ranks, the order of centrality and connectivity index is theAnti Corruption(0.241), Transparent management(0.216), Mutual cooperation between stakeholders(0.174), Directors' roles and responsibilities(0.105), Shareholder protection(0.097) andSustainability Report(0.096). 최근 ESG 경영의 필요성, 중요성이 증대되는 상황에서 수출입 물류의 거점인 컨테이너터미널에 대한ESG관련 중요 변수를 ESG 평가기관의 다양한 변수 중에서 선정하는 것은 컨테이너터미널의 ESG 경영전략을 수립하는데 도움이 될 것이라고 판단되어 이번 연구를 진행하게 되었다. 본 연구의 목적을 효과적으로 달성하기 위하여 문헌연구, 인터뷰를 바탕으로 KCGS ESG 모범규준에서 ESG관련 항목을 31개를 추출하고 변수의 축소 및 그룹핑을 위하여 빈도수 분석을 실시하고 Gephi0.9 프로그램을 활용한 워드네트워크분석을 통해 변수의 연결도와 중심성을 분석하여 변수를 선정하였다. 본 연구의 실증분석의 결과를 요약하면 다음과 같다. 첫째, KCGS ESG 변수의 31개 항목의 빈도수 분석의 결과 친환경경영(E) 요소는 친환경 시설설비투자(22), 환경인식교육(13), 실무조직구성(7), 환경인증(6)의 순으로 빈도수가 높았다. 사회적책임경영(S)요소는 근로자인권보호 및 지역사회 기여(21), 안전교육(20), 안전인증획득(17), 감염병 대응(10)의 순으로 빈도수가 높았다. 지배구조 및 윤리경영(Governance) 요소는 부정부패 척결(17), 투명경영(14), 이해관계자 상호협조(11), 지속가능경영보고서(4) 순으로 빈도수가 높았다. 둘째, 워드네트워크분석결과 친환경경영(E) 요소의 평균가중차수인 Weighted Degree는 친환경 시설설비투자(54), 환경인식교육(45), 실무조직구성(31), 환경인증(32)의 순서로 나왔다. 중심성, 연결성 지수인 Page Ranks 순서는 환경인식교육(0.0765), 임직원 참여유도(0.0765), 친환경 시설 설비 투자(0.0761),실무조직구성(0.0761), 환경인증(0.0761)로 나왔다. 사회적 책임 경영(S) 요소의 평균가중차수인Weighted Degree는 근로자 인권보호 및 지역사회기여(68), 안전교육(63), 안전인증획득(59), 감염병대응(40)의 순서로 나왔다. 중심성, 연결성 지수인 Page Ranks 순서는 근로자 인권보호 및 지역사회 기여(0.165), 안전교육(0.153), 안전인증획득(0.144), 감염병 대응(0.102)로 나왔다. 지배구조 및 윤리경영(G)요소의 평균가중차수인 Weighted Degree는 부정부패척결(27), 투명경영(24), 이해관계자 상호협조(19),지속가능경영보고서(9)의 순서로 나왔다. 중심성, 연결성 지수인 Page Ranks 순서는 부정부패척결(0.241), 투명경영(0.216), 이해관계자 상호협조(0.174), 이사의 역할과 책임(0.105), 주주권보호(0.097),지속가능경영보고서(0.096)로 나왔다.

Safety and Reactogenicity of the Inactivated Poliomyelitis Vaccine (PoliorixTM) in Korea (2006-2012)

신종범,박문성,마상혁,최영륜,신손문,김원덕,Sherine Kuriyakose,Liliana Ulianov,Karin Hardt 대한소아감염학회 2013 Pediatric Infection and Vaccine Vol.20 No.3

Objective: As per the requirement of Korean Food and Drug Administration, this post-marketing surveillance was conducted in Korea to evaluate the safety and reactogenicity of PoliorixTM following its introduction in 2006. Methods: In this open, multicenter study, the vaccine was administered as per the current practice of Korean doctors and in reference to the guidebook by the Korean Pediatric Society and as indicated in the Korean label which was as follows - for primary vaccination three doses were given to infants at ages 2, 4 and 6 months whereas, for the booster dose a single dose was given to children aged 4-6 years. Safety data during this six year surveillance was collected using diary cards which were distributed to the parents to record adverse events. Results: A total of 639 subjects were enrolled into the study. Of these, 617 subjects and 22 subjects received the vaccine as a primary and booster dose, respectively. At least one unsolicited symptom was reported in 11.4% (73/639) of the subjects during the 7-day follow-up period; upper respiratory tract infection (2.5%;16/639) was the most frequently reported unsolicited symptom. One subject reported at least one unsolicited symptom (gastroenteritis) of grade 3 intensity within the 31- day post-vaccination period. Approximately 1.7% (11/639) of subjects reported 13 serious adverse events (SAEs). All SAEs were resolved by the end of the study. Conclusion: In Korea, primary and booster vaccination with PoliorixTM was well-tolerated in healthy subjects when administered according to the prescribing information as part of routine clinical practice.

Fecal microbiota transplantation is not a magical treatment, but better too early than too late

신종범 대한내과학회 2023 The Korean Journal of Internal Medicine Vol.38 No.1

대장암 검진—50세 이하부터 시작하는 것은 필요한 것인가?

신종범 대한소화기암연구학회 2023 Journal of Digestive Cancer Research Vol.11 No.3

Colorectal cancer is the third most common cancer worldwide. The occurrence of colon cancer can be prevented by removing precursor lesions. Several countries are making efforts to prevent the occurrence of colon cancer via screening programs. Korea is also following suite by screening individuals < 50 years of age. Currently, the incidence of colon cancer among the young is increasing globally, and Korea has a high colon cancer incidence rate among individuals in their20s and 40s. Therefore, it may be necessary to start the screening individuals < 50 years of age to detect the cancer’s manifestation early. Moreover, advanced adenomas associated with poor prognosis can be detected early, the overall screening rate can be increased, and death from colon cancer at a young age can be prevented. Although the period of colorectal cancer screening has been expanded, the overall colorectal cancer screening rate has not. Additionally, increasing the screening rate among individuals > 50 years could reduce the mortality rate at a lower cost. Although the incidence of colon cancer is increasing in younger individuals, the evidence to conclude that screening at the age of < 50 years has a meaningful impact on the incidence and survival rates of colon cancer remains insufficient. Therefore, rather than following the trend and performing screening early, an approach that actively selects cases where tests for colorectal cancer diagnosis are required is warranted.

신생아 관리의 지역화 및 전원시스템

신종범 대한소아청소년과학회 2007 Clinical and Experimental Pediatrics (CEP) Vol.50 No.1

In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis of functional capabilities; level I-primary or basic care, level II-secondary or specialty care, level III-tertially or subspecialty care. These facilities should be organized within a regionalized system of perinatal care. The transport system of newborn infants should be organized for referral of high risk newborn to centers with the personnel and resources needed for their degree of risk and severity of illness. In Korea, The korean society of neonatology was established and articulated in the 1994. During the past decade, the number of neonatologist has increased and neonatal intensive care units have proliferated in Korea. However, no standard definitions exist for the graded levels of complexity of care that neonatal intensive care units provide and no uniform guideline or recommendation for regionalization and referral system of high risk neonate have been established. With the rapid changing neonatal care system in Korea, the optimal neonatal care demands regionalization of care in utilization of manpower resources and in efficient use of advanced technology and facility.