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조기 간세포암종에서 간동맥 색전술과 경피적 고주파열 병합치료
임준욱 ( Jun Uk Lim ),신현필 ( Hyun Phil Shin ),이정일 ( Joung Il Lee ),박재준 ( Jae Jun Park ),전정원 ( Jung Won Jeon ),임규성 ( Kyu Seong Lim ) 대한간암학회 2012 대한간암학회지 Vol.12 No.1
In most early hepatocellular carcinoma (HCC), surgical resection or liver transplantation is the first choice of treatment. However, surgery is often impossible because of patient`s physical condition such as advanced liver cirrhosis, other comorbidities, and radiofrequency ablation (RFA) can be used as substitute treatment. Recently, it has been reported that clinical outcomes of transarterial chemoembolization (TACE) combined with RFA were similar to that of surgical resection. This report describes a 49-year-old male with 1.5 cm sized HCC. Because the patient could not undergo surgical resection and the tumor was not localized on ultrasonography (US), TACE was performed instead. But the residual tumor was still detected on follow-up contrast enhanced US, we performed additional RFA. After combined treatment with TACE and RFA, viable portion of the tumor was not detected on one month follow-up CT and MRI image. The patient remains well without recurrence, 12 months after combined treatment. It is suggested that TACE combined with RFA can be an alternative choice of early small HCC treatment.
국가 암검진 사업의 대장암 선별검사로 시행한 면역화학 분변잠혈검사의 의의
임준욱 ( Jun Uk Lim ),배나영 ( Na Young Bae ),송원경 ( Won Koung Song ),차재명 ( Jae Myung Cha ),이정일 ( Joung Il Lee ) 대한장연구학회 2010 Intestinal Research Vol.8 No.2
Background/Aims: Colorectal cancer (CRC) is one of the major causes of death and poses a major public health concern. The National CRC Screening Programme (NCSP) provides annual CRC screening using a fecal occult blood test for individuals >50 years of age since 2004. The purpose of the current study was to determine the outcomes and efficacy of a fecal immunochemical test (FIT) based on the NCSP in a quality-controlled university hospital setting. Methods: We retrospectively reviewed the medical records and a standardized questionnaire from the NCSP of 3,852 individuals who underwent a FIT between March and December 2009. All of the subjects submitted a stool specimen for a FIT, while a double-contrast barium enema or colonoscopy was performed as a confirmatory examination for FIT-positive individuals. The CRC screening rate and rate of detection colorectal adenomas, advanced adenomas, and colorectal cancers by FIT were evaluated. Results: The CRC screening rate with FIT was very high (72.3%), but the positive rate of detection by FIT was only 1.3%. The rate of detection for colorectal cancers, adenomas, and advanced adenomas by FIT was 0.08%, 0.39%, and 0.13%, respectively. The quantitative values of FIT in individuals with colorectal adenomas and cancers were significantly higher than other colorectal diseases. Men (P=0.001) and elderly individuals (P=0.039) were significantly more common in the FIT-positive group than the FIT-negative group. Approximately 28% of the subjects with FIT-positive tests did not receive a confirmatory examination. Conclusions: Although the FIT had a low rate of detection, the FIT was a useful screening tool for detection of CRC in the NCSP. It will be important to increase CRC screening rates and confirmatory examination rates. (Intest Res 2010;8:126-134)
Clinical Characteristics and Outcomes of Diverticulitis by Physician`s Specialty
( Seung Jung Jun ),( Jae Myung Cha ),( Joung Il Lee ),( Kwang Ro Joo ),( Hyun Phil Shin ),( Jae Jun Park ),( Jung Won Jeon ),( Jun Uk Lim ),( Yoon Jong Seo ),( Soo Young Moon ),( Chi Hoon Lee ) 대한장연구학회 2013 Intestinal Research Vol.11 No.2
Background/Aims: Several factors affecting the severity and outcomes of diverticulitis have been reported, but there is little research on physician specialty related with this disease. Therefore, we evaluated the clinical characteristics and outcomes of diverticulitis depending on physician`s specialty. Methods: Medical records of 239 patients, who had been hospitalized with first-diagnosed acute colonic diverticulitis at Kyung Hee University Hospital in Gang Dong (Seoul, Korea) from June 2006 to December 2012, were retrospectively analyzed. The patients were classified according to whether they had been managed by gastroenterologists or not. Clinical characteristics and treatment outcomes were compared between two groups. Results: Of these 239 patients, 38 (15.9%) patients were treated by a gastroenterologist and 201 (84.1%) patients by a non-gastroenterologist. Clinical characteristics such as age, gender, body mass index, comorbidity, medication, laboratory results, recurrence and complication were not significantly different between two groups. However, right-sided diverticulitis predominated in the nongastroenterologist group (79% vs . 91%, P =0.028). From the sub-group analysis of uncomplicated diverticulitis, intravenous antibiotics was used for a shorter period of time by gastroenterologists than non-gastroenterologists (3.3±1.9 days vs . 4.4±2.8 days, P =0.032). Multivariate logistic regression analysis showed that the 3 day administration of intravenous antibiotics significantly depended on the physician`s specialty (odds ratio 7.984, 95% confidence interval 1.990-32.043, P =0.003). Conclusions: The results suggest that the duration of intravenous antibiotics for treating uncomplicated colonic diverticulitis was shortened by gastroenterology specialists without increasing operation or recurrence. (Intest Res 2013;11:92-99)
Substantive-Rational Budget Theory:Focused Study on Irene Rubin
Lim, Hyun-Jun,JaeGal, Uk 순천향대학교 사회과학연구소 2000 순천향 사회과학연구 Vol.6 No.1
Irene Rubin은 실증적 · 과학적 개념을 도입하여 공공조직에서의 예산부분에 기여했으며, 과학적인 형상분석과 실증적인 사례연구, 분석을 통한 이론적 모델을 구축하였다. 본 논문은 주어진 환경을 고려하여 의사 집행자들의 변화들을 살펴보고, 다양한 변수들과 사례분석을 통한 합리적인 예산 모델을 제시하고자 한다. 결론적으로 Irene Rubin의 학문적 연구를 기초로 하여 공공 예산 제도의 발전방향을 모색하고자 한다.