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김하경,박원,김영석,김연주 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.3
Objectives: There is no consensus on whether giving adjuvant concurrent chemoradiotherapy (CCRT) is more effective than adjuvant radiotherapy (RT) alone in patients with early stage cervical cancer and intermediate-risk factor(s). The purpose of this study was to evaluate survival difference according to adjuvant treatment in the intermediate-risk group. Methods: From 2000 to 2014, the medical records of patients with stage IB–IIA cervical cancer and a history of radical hysterectomy with pelvic lymph node dissection, followed by pelvic RT at a dose ≥40 Gy were retrospectively reviewed. Among these, 316 patients with one or more intermediate-risk factor(s) and no high-risk factors were included. The criteria defined the intermediate-risk group as those patients with any of the following intermediate-risk factors: lymphovascular space involvement, over one-half stromal invasion, or tumor size ≥4 cm. Results: The median follow-up duration was 70 months (range: 3–203 months). According to adjuvant treatment (adjuvant RT alone vs. adjuvant CCRT), the 5-year recurrence-free survival rates (90.8% vs. 88.9%, p=0.631) and 5-year overall survival rates (95.9% vs. 91.0%, p=0.287) did not show a significant difference in patients with any of the intermediate-risk factors. In multivariate analysis, a distinct survival difference according to adjuvant treatment was not found regardless of the number of risk factors. Conclusion: The present study showed that giving RT together with chemotherapy is not more effective than RT alone for stage IB–IIA cervical cancer patients with intermediate-risk factor(s). Trial Registration: ClinicalTrials.gov Identifier: NCT01101451
김하경 서울대학교 라틴아메리카연구소 2012 이베로아메리카硏究 Vol.23 No.3
At the turn of the nineteenth century, Mexico experienced a series of historic events: the Caste War, the rise of the henequen industry, and the Porfirian project of modernization. These events, combined with the immigration policies at the time, begot an increase of East Asian immigration, which complicated the race-class dynamics especially in the state of Yucatán. Despite the arrival of East Asian immigrants initially as laborers, the changes in their class identity in the process of permanent settlement resulted in the creation of new social categories and the difficulty in positioning them in the existent social dynamics. Amid such difficulty was the contradiction in the Mexican reception of foreign immigrants. Even though Mexico welcomed East Asians in the first place, they were later excluded from the discourse of mestizaje. The account of the first wave of Korean immigration to Mexico is most notable as a case that demonstrates the contradictory attitudes and the complexity of the race-class dynamics in Mexico at the time. Forgotten by Korea due to a political turmoil in East Asia and disregarded by Mexico due to their diminishing economic value and small size, the Korean immigrants were indeed without a place in terms of national and cultural identity in the host country. That is, while Koreans as physical individuals inevitably mixed into Mexican society both biologically and culturally, Korean as an ethnicity was unable to become a part of what constituted Mexicanidad. By looking into the (lack of) Mexican references to Korean immigrants in official government correspondences and Yucatecan print media from 1904 to 1909, this thesis reinterprets the significance of Korean immigration from a Mexican perspective. Unlike most analyses that tend to read Korean immigration only as an extension of Korean history, it contextualizes the event within Mexican history. It also identifies the economic and political interests of the Mexican government and Yucatecan plantation owners in relation to its Korean population.
김하경,한영진,고기영,정민재,최경학,조용필,권태원 대한혈관외과학회 2018 Vascular Specialist International Vol.34 No.4
Purpose: Surgery is the most common risk factor for pulmonary embolism (PE) in patients with a recent venous thromboembolism (VTE). This study reviewed clinical outcomes of preoperative inferior vena cava filter (IVCF) use in patients with acute VTE during abdominal-pelvic cancer or lower extremity orthopedic surgeries. Materials and Methods: We retrospectively analyzed 122 patients with a recent VTE who underwent IVCF replacement prior to abdominal-pelvic cancer or lower extremity orthopedic surgery conducted between January 2010 and December 2016. Demographics, clinical characteristics, postoperative IVCF status, risk factors for a captured thrombus, and clinical outcomes were collected for these subjects. Results: Among the 122 study patients who were diagnosed with acute VTE in the prior 3 months and underwent preoperative IVCF replacement, 70 patients (57.4%) received abdominal-pelvic cancer surgery and 52 (42.6%) underwent lower extremity orthopedic surgery. There were no perioperative complications associated with IVCF in the study population and no cases of symptomatic PE postoperatively. A captured thrombus in the filter was identified postoperatively in 16 patients (13.1%). Logistic regression analysis indicated that postoperative anticoagulation within 48 hours significantly reduced the risk of a captured thrombus (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.08-0.94; P=0.032). Conclusion: A captured thrombus in preoperative IVCF was identified postoperatively in 16 patients (13.1%). Postoperative anticoagulation within 48 hours reduces the risk of captured thrombus in these cases.
김하경,유홍석,표홍렬,노재명,주상규,이우진,박병석,김진만,강노을,신선혜,박혜윤 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.-
Background: IBM Watson for Oncology (WFO) is a cognitive computing system which helps physicians quickly identify key information in a patient’s medical record, surface relevant evidence and explore treatment options. We evaluated the level of agreement between WFO and multidisciplinary tumor board (MDT) for lung cancer. Methods: From January to April 2018, newly diagnosed lung cancer cases in Chonnam National University Hwasun Hospital were retrospectively examined using WFO version 18.4 according to four treatment categories [surgery, radiotherapy, concurrent chemoradiotherapy (CCRT), and palliative setting]. Concordance between MDT and WFO was analyzed by Cohen's kappa value. Results: Total 132 cases were enrolled in this study. The concordance rate occurred in 92.4% (k=0.881, p<0.001) for the all cases. The strength of agreement was very good in stage 1 (92.4%, k=0.855), stage 4 NSCLC (100%, k=1.000) and extensive disease SCLC (100%, k=1.000). In stage 3 NSCLC, the strength of agreement was good (80.8%, k=0.622). And the concordance was moderate in stage 2 NSCLC (83.3%, k=0.556) and limited disease SCLC (84.6%, k=0.435). There were discordant cases in surgery (4/29, 13.8%) and CCRT (5/33, 15.2%), but discordance was not occurred in radiotherapy and palliative care. Conclusion: Treatment recommendations made by WFO and MDT were highly concordant for lung cancer cases especially in stage 1 NSCLC and metastatic stage. However, WFO was just an assisting tool in stage 2-3 NSCLC and limited disease SCLC, so shared decision making may be more important in this stage.