마이크로블로깅(micro-blogging) 이용동기에 관한 연구

심홍진(Hong-Jin Shim),황유선(Yoosun Hwang) 한국방송학회 2010 한국방송학보 Vol.24 No.2

Management of open abdomen

Hong Jin Shim(심홍진) 대한외과학회 2014 대한외과학회 학술대회 초록집 Vol.2014 No.11

수술전 화학방사선 요법을 시행 받은 직장암에서 혈중 암종배아항원과 조직학적 치료반응도와의 상관관계분석

심홍진 ( Hong Jin Shim ),강정현 ( Jeong Hyun Kang ),이형순 ( Hyung Soon Lee ),허혁 ( Hyuk Hur ),민병소 ( Byung Soh Min ),이강영 ( Kang Young Lee ),김남규 ( Nam Kyu Kim ),김영완 ( Young Wan Kim ) 대한임상종양학회 2010 Korean Journal of Clinical Oncology Vol.6 No.1

목적 : 본 연구는 수술 전 화학방사선요법을 시행 받고 수술을 시행한 직장암 환자에서 조직학적 반응도와 혈청 암종배아항원의 상관관계를 알아보기 위해 시행되었다. 방법 : 2005년 8월부터 2007년 12월까지 연세대학교 세브란스 병원에서 직장암으로 진단 받고 수술 전 화학방사선요법을 시행받은 후 전직장간막 절제술을 시행한 85명의 환자를 대상으로 하였다. 화학요법은 5-Fluorouracil에 기초하였고 방사선주사는 총 5,040 cGy 를 조사하였다. 암종배아항원은 화학 방사선요법전(pre-CRT)과 직후(post-CRT), 수술 후 7일째(post-TME)에 각각 측정을 하였다. 조직학적 반응도는 TNM 병기에 따라 반응군(Favorable response : pCR 과ypStage1, 28명)과 비반응군(Unfavorable response : ypStage2와 ypStage3, 57명)으로 구분하였다. 결과 : 환자의 나이, 성별, 암의 위치, 림프혈관의 침범, 신경주위침범 등에서 반응군과 비반응군의 차이는 없었다. 반응군에서 low grade 의 조직학적 분화를 보이는 비율이 높았고(92% vs.70.2%, p=0.018) 항문보존술식을 시행한 비율이 더 높았다(92.9% vs. 71.9%, p=0.026). pre-CRT CEA수치는 반응군에서 유의하게 낮았으나(p<0.001) post-CRT, post-TME CEA값은 두 군간의 차이는 없었다. 다변량 분석에서 낮은 pre-CRT CEA(<5ng/ml) 값과 항문보존술식의 시행여부가 조직학적 반응군과 관련된 독립적인 인자로 확인되었다. 결론 : 직장암 환자에서 화학방사선치료 전 CEA 수치는 수술 후 조직학적 반응정도와 상관관계를 보였으나 화학방사선치료 후나 수술 후의 CEA값은 조직학적 반응정도와 상관 관계가 없었다. 이러한 결과를 바탕으로 CEA가 조직학적 반응정도를 예측하는 인자로서의 역할을 할 수 있는지에 대한 향후 전향적인 연구가 필요하다. Purpose: This study was designed to assess whether serum CEA is associated with pathological tumor response in rectal cancer patients who underwent preoperative chemoradiation therapy (CRT) with total mesorectal excision (TME). Methods: Eighty-five patients with rectal cancer who were treated by preoperative CRT followed by TME were enrolled between August 2005 and December 2007. 5-FU based chemotherapy and 5040 cGy of radiation were delivered. Serum CEA was measured pre-CRT, post-CRT, and post-TME period. Among 85 patients, 29 patients did not have post-CRT CEA level. Pathological tumor response (ypTNM stage) was categorized into two groups as follows; favorable response group (group A: n=28, pathological complete response and ypTNM I) vs unfavorable response group (group B: n=57, ypTNM II and III). Median follow-up period was 29.2 months (range 1.1-50.2 months). Results: There were no differences between favorable and unfavorable response group with respect to age, gender, tumor location, lymphovascular invasion, and perineural invasion (Table 1). Anal sphincter preservation surgery was more commonly performed in the group A when compared with group B (26 (92.9%) vs. 41 (71.9%)) (p=0.026). Well and moderately differentiated histology were more commonly found in the group A (26(92.9%) vs. 40(70.2%) (p=0.018). Low level of pre-CRT CEA (<5ng/ml) was more commonly found in the group A (26(92.9%) vs. 30 (52.6%) (p=0.000). However, there was no difference between group A and B with regard to post-CRT CEA and post-TME CEA. Logistic regression analyses showed that pre-CRT CEA (<5ng/ml) and sphincter preservation surgery were associated with favorable pathological tumor response. Conclusions: Low level of pre-CRT CEA (<5ng/ml) is predictive of favorable pathological tumor response but serum level of post-CRT and post-TME CEA did not have significant association with tumor response. This result should be validated in larger prospective randomized study near future.

PD는 무엇으로 사는가?

심홍진(Hong-Jin Shim),김세은(Sae-Eun Kim) 한국방송학회 2009 한국방송학보 Vol.23 No.6

외상 환자 관리에서 Critical Pathway의 적용

심홍진 ( Hong Jin Shim ),장지영 ( Ji Yong Jang ),이재길 ( Jae Gil Lee ),김승환 ( Seong Hwan Kim ),김민정 ( Min Joung Kim ),박유석 ( You Seok Park ),박인철 ( In Chel Park ),김승호 ( Seung Ho Kim ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4

Purpose: For trauma patients, an early-transport and an organized process which are not delayed in hospital stage are necessary. Our hospital developed a procedure, the trauma Critical Pathway (CP), through which a traumatic patient has the priority over other patients, which makes the diagnostic and the therapeutic processes faster than they are for other patients. Methods: The records of patients to whom Trauma CP were applied from January 1, 2011 through April 15. 2012. were reviewed. We checked several time intervals from ER visiting to decision of admission-department, to performing first CT, to applying angio-embolization, to starting emergency operation and to discharging from ER. In addition, outcomes such as duration of ICU stay, hospital stay and mortality were checked and analyzed. Results: The trauma CP was applied to a total of 143 patients, of whom, 48 patients were excluded due to pre-hospital death, ER death, transferring to other hospital and not severe injury. Thus 95 patients(male 64, 67.3%) were enrolled in this study. Fifty-nine patients(62.1%) were injured by the traffic accident. The mortality rate was 10.5% and the mean Revised Trauma Score (RTS) of the patients was 6.4±2.0. After visiting ER, decision making for admission was completed, on average, in 3 hours 10 seconds. The mean time intervals for the first CT, angio-embolization, surgery and discharge were 1 hour 20 minutes, 5 hours 16 minutes, 7 hours 26 minutes and 6 hours 13 minutes, respectively. Conclusion: The trauma CP did not show the improvement of time interval outcome, as well as mortality rate. However, this test did show that the trauma CP might be able to reduce delays in procedures for managing trauma patients at the university-based hospitals. To find out the benefit of CP protocol, a large scaled data is required. (J Trauma Inj 2012;25:159-165)

지역민의 사회자본 형성 요인에 관한 연구

심홍진(Hong-Jin Shim),이연경(Yeon-Kyung Lee),김지현(Jee-Hyun Kim),김용찬(Yong-Chan Kim) 한국언론학회 2014 한국언론학보 Vol.58 No.4

마이크로블로깅 서비스(microblogging service)와 사회자본(social capital)

심홍진(Hong Jin Shim),황유선(Yoo sun Hwang) 한국언론학회 2010 한국언론학보 Vol.54 No.5

외상성 복부 장기 손상 및 골반 손상에 의한 혈복강으로 동맥 색전술을 시행 받은 환자에서 예후 인자

이진호 ( Jin Ho Lee ),장지영 ( Ji Young Jang ),심홍진 ( Hong Jin Shim ),이재길 ( Jae Gil Lee ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4

Purpose: In patients with traumatic hemoperitoneum or pelvic bone fracture who underwent angiography and embolization, we want to find the prognostic factors related with mortality. Methods: Patients(333 patients) who visited our hospital with traumatic injury from March 2008 to April 2012 were included in this study. Only 37 patients with traumatic hemoperitoneum or pelvic bone fracture underwent angiography and embolization. A retrospective review was conducted, and Glasgow coma scale (GCS), Revised trauma score (RTS), Injury severity score (ISS), initial laboratory finding and time interval, the amount of transfusion from the arrival at the ER to the start of embolization, and the vital signs before and after procedure were checked. Stastical analysis was conducted using the Chi square and Mann-Whitney U test. Results: In univariate analysis, the amount of transfusion, the base deficit before procedure, the systolic blood pressure before and after the procedure, the GCS, the RTS and the ISS were significantly associated with prognosis. In the multivariate analysis, the ISS and the base deficit had significant association with prognosis. Of the 37 patients who underwent angiography and embolization, 31 patients needed not additional procedure (Group A) while the other 6 patients needed an additional procedure (Group B). After procedure, a statistically significant higher blood pressure was observed in Group A than in Group B. As to the difference in blood pressure before and after the procedure, a statistically significant decrease in systolic blood pressure was observed in Group B, but an increase was observed in Group A. Conclusion: In traumatic hemoperitoneum or pelvic bone fracture patients who underwent angiography and embolization, GCS, ISS, RTS, transfusion amount before the procedure, initial base deficit and systolic blood pressure were factors related to mortality. When patients who underwent angiography and embolization only were compared with patients who underwent re-embolization or additional procedure after the first embolization, an increase in systolic blood pressure after embolization was a prognostic factor for successful control of bleeding. (J Trauma Inj 2012;25:166-171)

트위터에서의 의견 지도력과 트위터 이용패턴

황유선(Yoosun Hwang),심홍진(Hong-Jin Shim) 한국방송학회 2010 한국방송학보 Vol.24 No.6

위장관 ; 응급 위장관 수술 후 조기 경장 섭취의 안전성

이형순 ( Hyung Soon Lee ),심홍진 ( Hong Jin Shim ),이호선 ( Ho Sun Lee ),이재길 ( Jae Gil Lee ),김경식 ( Kyung Sik Kim ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.6

Background/Aims: Postoperative early feeding has many advantages, and current guidelines recommend the early diet or enteral feeding after gastrointestinal surgery. However, there are controversies in emergency situation. The aim of this study was to assess the safety of early enteral feeding in patients underwent emergency gastrointestinal (GI) surgery. Methods: We reviewed the patients underwent emergency GI surgery by single surgeon from March 2008 to December 2010, retrospectively. The early feeding was defined when feeding was started within 72 hours after operation. Results: Fifty-three patients were enrolled. Men were 31, with mean 60.6 (±18.5) years old age. Thirty-three patients were treated in the intensive-care unit after operation. The most common cause of operation was bowel perforation, and followed by intestinal obstruction. Segmental resection with primary anastomosis of small bowel is the most common operation. Thirty-two of them started the diet within 48 hours postoperatively. Twenty-nine patients had post-operative complications. Wound complications were the most common, and followed by the abdominal pain, and ileus. Wound complications were developed in 18 patients, and the post-feeding abdominal pain was in 7 patients. Anastomotic leakage and intraabdominal abscess were developed in 2 patients, and 1 patient required reoperation to treat the anastomotic disruption. One patient developed pneumonia and sepsis, and resolved under conservative treatment. There was no mortality in these patients. Conclusions: Early enteral feeding may be safe in cases of emergency GI surgery. However, it may require further studies to confirm the safety and feasibility of the early feeding in emergency situations. (Korean J Gastroenterol 2011;58:318-322)