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수입식품 부적합정보 및 글로벌식품 위해정보를 활용한 우리나라 수입식품 안전관리 방안
백서준 ( Seo Jun Baek ),정인권 ( In Kwon Jung ),이병곤 ( Byoung Gon Lee ),김정민 ( Jung Min Kim ),안창준 ( Chang Jun Ahn ),정희석 ( Hee Seok Jung ),최준호 ( Joon Ho Choi ) 한국산업식품공학회 2023 산업 식품공학 Vol.27 No.2
This study investigated the hazard factors based on imported food non-compliance and global food hazard information for the last 4 years to suggest imported food safety management. Food safety management on utensils or packaging containers is appropriately managed for the compounds derived from them. Food safety management on health-functional foods, processed foods, and agricultural products is concentrated on ingredient contents, food additives, and pesticide residuals. Additional hazards are illegal compounds, mycotoxins & pesticide residuals, hygiene-indicator microorganisms and food-borne pathogens in health-functional foods, processed foods, and agricultural products, respectively. The continuous increase in hazards related to safety and hygiene in global food hazard information needs additional attention. To reduce the hazard factors, this study proposes that imported food be limited to products certified by HACCP or an equivalent food safety management system because registering foreign food facilities for processed and health-functional foods is mandatory. Additionally, the customs clearance inspections should focus on the hazard factors derived from the global food hazard information system. This study suggests a global food hazard information system that could derive frequently issued hazard factors at a given period and newly issued hazard factors in aspects, such as food items, subcategories, and exporting countries.
유두상 갑상선암에서 양측성과 다른 임상병리학적 인자들과의 연관성에 대한 분석
신일용,이관주,김형래,김세준,김정구,이동호,안창준,이상철,Il Yong Shin,Kwan Ju Lee,Hyung Rae Kim,Se Jun Kim,Jeong Goo Kim,Dong Ho Lee,Chang Joon Ahn and Sang Chul Lee 대한갑상선-내분비외과학회 2008 The Koreran journal of Endocrine Surgery Vol.8 No.2
<B>Purpose:</B> The extent of the initial surgical treatment for patients with papillary thyroid carcinoma (PTC) is contro</B>versial. Many surgeons think thattotal thyroidectomy is the most optimal treatment for PTC because of its potential bilaterality. Therefore, bilaterality is an important factor for determining the extent of surgical resection. The aim of this retrospective study is to analyze the relationship between tumor bilaterality and the other clinicopathological factors. <B>Methods: </B>We conducted a retrospective analysis of 140 patients with PTC and who underwent total thyroidectomy with central lymph node dissection from January to December 2007 at our institution. <B>Results: </B>Among 140 patients, 50 patients (35.7%) had PTC in the bilateral lobes. Of these 50 patients, only 17 patients (34.0%) were operated on under the preoperative diagnosis of bilateral PTC. Two factors, 1) presence of the capsular invasion (P=0.007) and 2) an increase of the tumor size (P=0.023), were statistically correlated with bilaterality. There were no significant associations between bilaterality and the other clinicopathological factors,including age, extrathyroidal invasion and lymph node metastasis. <B>Conclusion:</B> For the surgical care of PTC, bilaterality must always be considered even though the tumor is diagnosed preoperatively as unilateral PTC. Furthermore, thorough preoperative evaluation is mandatory if unilateral lobectomy is regarded as a therapeutic option for PTC patients.<B> (Ko</B><B>rean J Endocrine Surg 2008;8:123-127)</B>
갑상선 미세 유두암에서 종양 크기의 구분에 따른 임상병리학적 특징의 분석
조윤정,이동호,이상철,김세준,김정구,안창준,이관주,Yun-Jung Cho,M,D,Dong-Ho Lee,M,D,Sang-Chul Lee,M,D,Say-Jun Kim,M,D,Jung-Koo Kim,M,D,Chang-Joon Ahn,M,D,and Kwan-Ju Lee,M,D 대한갑상선-내분비외과학회 2010 The Koreran journal of Endocrine Surgery Vol.10 No.3
Purpose: Although the detected incidence of papillary thyroid microcarcinoma (PTMC) has increased with development of ultrasonography and fine-needle aspiration biopsy, the best treatment has not yet been established. Treatment decisions require information on many factors including lymph node metastasis, extrathyroidal extension, and bilaterality. With this aim, the present study analyzed clinicopathologic features of PTMC according to cut-off of tumor size. Methods: The clinicopathologic features of patients with PTMC between January 2007 and December 2009 were reviewed retrospectively from medical records. Patients were divided according to tumors lesser than or equal to cut-off (Group I) and tumors exceeding cut-off (Group II). Results: Both capsule invasion and lymphovascular invasion were significantly different at all cut-off diameters (5∼9 mm). Central node metastasis revealed a difference in all cut-off values except 8 mm. Extrathyroidal extension differed at all cut-off values except 5 mm. Bilaterality displayed a statistically significantdifference only at the 8 mm cut-off. Conclusion: A cut-off of 5 mm represents a safe value to discriminate less aggressive from aggressive treatment for PTMC. (Korean J Endocrine Surg 2010;10:152-156)
진행 위암에서의 위 전절제술에 동반된 원위부 췌-비장 절제
이성호,김욱,송교영,김진조,진형민,박조현,전해명,박승만,안창준,이준현,Lee, Sung-Ho,Kim, Wook,Song, Kyo-Young,Kim, Jin-Jo,Chin, Hyung-Min,Park, Jo-Hyun,Jeon, Hae-Myung,Park, Seung-Man,Ahn, Chang-Jun,Lee, Jun-Hyun 대한위암학회 2007 대한위암학회지 Vol.7 No.2
목적: 위암이 국소적으로 진행하여 췌장과 비장으로 직접 침윤이 발생되었을 췌-비장 절제를 시행하는 것에는 반대 의견이 없지만, 췌-비장의 보존이 가능함에도 불구하고, 비장혈관이나 비문부 림프절의 완전 절제를 위해서 췌-비장 절제가 시행되는 것은 논란의 여지가 많다 저자들은 위 중-상부의 진행암으로 위 전절제술과 함께 원위부 췌-비장 절제가 시행되었던 환자들의 수술 결과 분석을 통하여 불필요한 합병절제를 피할 수 있는 방법을 찾고자 하였다. 대상 및 방법: 1990년부터 2001년까지 가톨릭대학교 의과대학 외과학교실에서 위 전절제술과 동반되어 원위부 췌-비장 절제가 시행된 118명의 환자 중, 병리 조직학적으로 암의 췌장 침윤이 없었던 90예(I군)와 침윤이 확인된 28예(II군)의 임상병리학적 특성, 이환율과 사망률 및 생존율 등을 후향적으로 분석하였다. 결과: 전체 118예 중 췌장 침윤이 확인된 pT4는 28예(23.7%)였고, 침윤이 없었던 pT3과 pT2가 각각 65예(55.1%) 와 20예(16.9%)였으며, pT1도 5예(4.3%)였다. 병기는 28예의 pT4 중에서 림프절 전이가 있어 IV기인 경우가 25예(89.3%)였고, 림프절 전이가 없는 IIIa기는 3예(10.7%)에 불과하였다. 또한 I군은 la (pT1N0)기 4예, Ib (pT2N0)기 7예였고, II기는 pT2N1 8예, pT3N0 12예, pT1N2 1예였으며, III기는 IIIa 15예, IIIb 17예, IV기는 26예였다. 두 군의 임상병리학적 특성 중 병기, 절제연 및 근치도에서 유의한 차이를 보였고, 생존에 영향을 미치는 인자들의 단변량 분석에서는 병기, 위벽 침윤, 췌장 침윤, 림프절전이, 비장혈관과 비문부 림프절 전이, 전이 림프절 비율, 근치도, 간 및 복막 전이 등에서 유의한 차이를 보였으며, 이 중 병기와 전이 림프절 비율 및 근치도가 예후에 영향을 미치는 독립적 예후인자로 나타났다. 5년 생존율은 I군이 36.2%, II군이 13.9%였고, 술 후 합병증으로 췌장 루 6예(5.1%), 복강 내 농양 5예(4.2%), 출혈 5예(4.2%)로 수술로 인한 전체 이환율은 22.1%였으며, 사망률은 6.8% (8예)였다. 결론: 진행성 상부 위암으로 위 전 절제술을 시행할 때 원위부 췌-비장 절제는 이환율이 비교적 높은 술식이기 때문에 간이나 복막전이가 없는 상태에서 위암의 병기가 높고, 절제연이 불충분하며, 근치적 절제가 불가능하다고 판단될 때에만 선택적으로 시행되는 것이 좋다고 생각한다. Purpose: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. Results: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 0.8%. Conclusion: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.