Hepatocellular Carcinoma in the Elderly: Clinical Characteristics, Outcomes and Treatment Efficacy, Safety in Older than 75 Years

( Ji Ho Seo ),( Sunmin Kim ),( Eunae Cho ),( Chung Hwan Jun ),( Sun Young Park ),( Sung Bum Cho ),( Chang Hwan Park ),( Hyun Soo Kim ),( Sung Kyu Choi ),( Jong Sun Rew ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The number of elderly patients diagnosed with hepatocellular carcinoma (HCC) has been increasing because the increase in the longevity of the general population. But there is no proper management based on age stratification in elderly patients. We compared clinical characteristics, outcomes and treatment efficacy, safety between oldest-old (aged more than 85 years), middle-old (aged between 80 and 85 years) and young-old (aged between 75 and 80 years) patients with HCC. Methods: We conducted a retrospective cohort study, from January 2010 to December 2016, at Chonnam National University Hospital. A total of 550 elderly patients whose data included demographics, co-morbidity, etiology of liver disease, presence of cirrhosis, staging of HCC, treatment modality and treatment related adverse event were evaluated retrospectively. Also overall survival was assessed in enrolled patient. Results: Fifty one patients (oldest-old; median 87 years old), 153 patients (middle-old; median 82 years old) and 346 patients (young-old; median 77 years old) were diagnosed with HCC. Both oldest- and middle-old patients, compared to young-old patients had significantly lower rate of alcohol-related disease (13.7% vs 20.9% vs 34.1%, P = 0.001). There were no significant difference in underlying sex, body mass index, presence of co-morbidity, hepatitis C-related disease and stage of HCC. The Child-Pugh class (CPT class A 88.9% vs 84.1% vs 83.6%, CPT class B 11.1% vs 15.9% vs 15.0% and CPT class C 0.0% vs 0.0% vs 1.3%, respectively, P = 0.912) and Model for End Stage Liver Disease score (mean MELD score 7.22±3.34 vs 5.88±3.01 vs 5.77±3.14, P = 0.166) were no significant difference between the patients with active treatment. The modified UICC staging (stage I 5.6% vs 17.1% vs 18.6%, stage II 55.6% vs 46.3% vs 47.3%, Stage III 22.2% vs 24.4% vs 24.8%, Stage IV-A 11.1% vs 6.1% vs 4.9% and Stage IV-B 5.6% vs 6.1% vs 4.4%, respectively, P = 0.826) and Barcelona Clinic Liver Cancer staging (stage 0 5.6% vs 9.8% vs 9.3%, stage A 16.7% vs 17.1% vs 22.1%, stage B 27.8% vs 29.3% vs 24.8%, stage C 50.0% vs 43.9% vs 41.2% and stage D 0.0% vs 0.0% vs 2.7%, respectively, P = 0.878) were no significant difference between the patients with active treatment. Furthermore, there were no difference between the age groups in treatment modality (Surgical resection 0.0% vs 3.3% vs 5.2%, P = 0.166; Radiofrequency ablation 2.0% vs 8.5% vs 11.0%, P=0.113; Transcatheter arterial chemoembolization 21.6% vs 34.6% vs 41.6%, P=0.014; Best supportive care 62.7% vs 40.5% vs 29.2%, P < 0.001), adverse event related treatment (P = 0.731) and disease-free survival days (329 .3±309.1 days vs 271.7 ± 414.2 days vs 357.2 ± 511.6 days, P = 0.336). Multivariate analysis showed that age, performance status, CTP class, MELD score, modified UICC staging, presence of portal vein thrombosis and ruptured HCC are risk factors for mortality. Conclusions: Clinician should make an active treatment in elderly patients with HCC not a age but performance status, liver function and disease status of cancer.

무청시래기를 첨가한 추어 떡갈비의 개발 및 품질특성

유지영 ( Ji Young You ),진금용 ( Jinlong Chen ),임종준 ( Jong Jun Lim ),박지인 ( Ji In Park ),백서준 ( Seo Jun Baek ),최준호 ( Joon Ho Choi ) 한국산업식품공학회 2021 산업 식품공학 Vol.25 No.4

이번 연구는 남원식 추어탕의 주재료인 추어와 무청시래기에 대한 인식개선과 이를 이용하여 젊은 연령층의 기호도에 적합한 분쇄육 제품을 개발하고자 추진되었다. 떡갈비 주원료인 돈육과 우지의 15%를 추어 페이스트로 대체한 추어 떡갈비를 대조구로 사용하였으며, 대파의 일정비율(25%, 50%, 75%, 100%)을 무청시래기로 대체하여 추어와 무청시래기가 첨가된 떡갈비 시료를 제조하였다. 무청시래기를 첨가한 떡갈비는 가열·조리 후 pH와 당도는 각각 6.07-6.28과 9.94-10.9로 시중에서 유통되는 떡갈비의 개별 특성에 적합하였다. 가열·조리에 따른 가열감량은 대파를 사용한 대조구에 비하여 대파를 무청시래기로 대체한 떡갈비 시료에서 유의적으로 낮았지만 무청시래기의 첨가량에 따른 유의적인 차이는 없었다. 가열 전과 가열·조리 후 무청시래기를 첨가한 떡갈비의 수분함량은 모두 대조구 보다 높았으며 이는 무청시래기의 식이섬유가 육가공품의 보수성을 높여 가열감량을 감소시킨 것으로 판단되었다. 대파를 무청시래기로 대체한 떡갈비 시료의 명도(44.5-47.8)는 시료 간의 유의적인 차이를 보이지 않은 반면 적색도(0.77-4.97)와 황색도(6.92-12.8)는 무청시래기의 첨가량에 따라 유의적으로 감소하였다. 떡갈비 시료에 대한 TPA 결과, 부착성은 대파를 무청시래기로 대체한 떡갈비 시료에서 대조구보다 유의적으로 낮아졌으나 경도, 응집성, 검성, 씹힘성에서는 대조구와 무청시래기를 첨가한 시료 간에 유의적인 차이를 확인할 수 없었다. 무청시래기가 첨가된 떡갈비 시료에 대한 관능적인 평가에서 색, 연도, 다즙성에서 대조구보다 낮은 점수를 받았다. 전반적인 기호도 역시 무청시래기가 첨가되지 않은 대조구에서 가장 높은 점수를 받았으나 무청시래기를 첨가한 시료에서는 대파의 50%를 대체한 시료에서 높은 점수를 받았다. 무청시래기 자체가 지닌 특유의 향미는 관능적인 평가에서 확인되지 않았으며 전자코를 이용한 향기패턴 분석에서도 낮은 분별지수(-90)로 시료 간의 향기패턴 차이를 확인하기 어려운 수준이었다. 이번 연구를 통해 떡갈비의 제조에서 대파를 대체하는 무청시래기의 함량은 25-50%가 적절하였으며 무청시래기와 추어가 지닌 특유의 맛과 냄새로 인한 영향을 받지 않는 떡갈비를 개발함으로써 향후 남원지역의 향토음식과 연계되는 새로운 메뉴개발이 가능하게 되었다. This study was performed to develop tteokgalbi suitable for young-aged individuals by using mudfish and radish greens, major ingredients of Chueo-tang. Mudfish-tteokgalbi (control), in which 15% of the meat and tallow was replaced with mudfish paste, was used while substituting 25 to 100% of the green onions with radish greens. The pHs and sugar contents of the tteokgalbi developed in this study were 6.07-6.28 and 9.94-10.9, respectively, and it was suitable for tteokgalbi sold in the market. Replacing green onions with radish greens while manufacturing tteokgalbi significantly reduced the color (a and b values) and weight loss during cooking compared to the control. Replacing green onions with increasing quantities of radish greens also significantly reduced the adhesiveness of the samples in the texture profile analysis. Although the overall acceptability of the control was the best, the ideal quantity of radish greens as a substitution for green onions appears to be 25-50%. The unique flavor of the supplemented radish greens was indistinguishable in the sensory evaluation and the principal component analysis with an electronic nose. Finally, radish greens were confirmed as a good ingredient for manufacturing tteokgalbi together with mudfish paste.

당(唐) 태종대(太宗代) 반위(反胃) 치료법의 개발과 백제(百濟) 의자왕(義慈王)의 질병

박준형 ( Park Jun-hyoung ),서영교 ( Seo Young-kyo ) 대구사학회 2021 대구사학 Vol.142 No.-

唐은 기본적으로 隋의 의료체계를 수용하면서도 醫術世家의 秘傳에 의해 분산ㆍ난립된 醫術의 독점을 국가의 의료체계라는 公的 영역으로 흡수하고자 하였다. 나아가 당은 그 의술을 민간에 유포함으로써 점차 의술세가의 독점적 입지를 좁혀 나갔다. 공익을 위한 의술 공개는 당 왕조의 존재 이유를 백성들에게 가장 효율적으로 각인시키는 방법의 하나였고, 이는 초기 왕조의 안정화에 기여하였다. 당 태종대 당나귀오줌을 이용한 반위 치료법 개발은 이러한 의료정책의 결실이었다. 蔣ㆍ許ㆍ巢氏 醫官들의 연구를 통해 이루어낸 새로운 치료 법은 즉위 초반부터 숙환이 있던 의자왕에게도 주목받았다. 644년 초 의자왕은 당에 파견된 사신을 통해 의사를 알아보았고, 그해 말 입당한 태자 夫餘康信이 당 태종에게 蔣元昌의 왕진을 요청했다. 당시 장원창은 益州道로 파견나가 있었기 때문에 당 태종은 그를 백제에 보낼 수 없었다. 결과적으로 태자를 보내 백제의 신라공격에 대한 입장을 해명하고 신라를 침공하지 않겠다고 약속했던 의자왕이 645년에 신라를 공격했다. 그해 고구려와 전쟁을 시작한 당 태종은 신라를 이용하여 고구려의 병력을 남쪽으로 분산시키고자 했던 의도가 무산되었다. 현재 학계에서는 백제의 신라 공격 이유를 명확하게 설명하지 못하고 있다. 645년 백제의 신라 공격으로 백제와 당의 관계가 악화되었다. 이는 신라가 대당외교에서 성공할 수 있는 여건을 만들어 주었다. 이런 점에서 645년 백제의 신라 공격은 의자왕의 질병과 의사 장원창의 왕진 요청 거부가 중요하게 작용했던 결과라고 할 수 있다. Tang China(618-907), which inherited the medical system of the preceding Sui China(589-618), attempted to reorganize it by absorbing various medical traditions which were then monopolized by hereditary medical families. The hereditary remedies and knowledge of medical specialists who were employed as government physicians were integrated into the state medical system, and the newly developed remedies were open to public. The development of Banwi (反胃, gastric disorder) remedy using donkey urine was one of the cases demonstrating the success of the early Tang medical system. The remedy, developed through a joint research by the physicians from three prestigious medical families in early Tang, was soon to be known to Baekje. King Uija (r. 641-660) of Bakje, who had been suffered from Banwi, dispatched envoys to Tang to ask to send Jiang Yuan-chang to Baekje in 644. The Baekje court seems to have regarded Jiang, a physician who participated in the development of new Banwi remedy, as the most qualified person to cure King Uija. Tang government, however, could not dispatch Jiang to Baekje as he was then working near Sichuan province, hundreds miles from Chang'an, the capital of Tang. As a result, King Uija missed a chance of being treated with the new remedy. Then Baekje, which had once promised not to attack Shilla by sending a prince to Tang, resumed invasion of Shilla in 645, spoiling Emperor Taizong's (r. 626-649) plan to mobilize Baekje's army in his campaign against Goguryeo. As the aftermath of this incident, the relation between Baekje and Tang was irreversibly deteriorated, while Shilla succeeded to consolidate the Shilla-Tang alliance which led to the fall of Baekje in 660. From the perspective of medical diplomacy between Baekje and Tang during the mid 7th centuries, Tang’s failure to meet Baekje’s request for the medical support might have had a grave effect on the Baekje’s decision to move against the Tang’s interests. Park, Jun-hyoung (Naval Academy / shimani5075@hanmail.net) Seo, Young-kyo (Jungwon University / syk367@naver.com)

고령자 급성 췌장염의 임상적 고찰

백용한,서정훈,송건훈,이진헌,송시영,정재복,강진경,박인서,이수진 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.3

Biomass 유래 퓨란계 단량체를 이용한 폴리에스터의 중합 및 특성 연구

정용석(Yong Seong Chung),이영철(Young Chul Lee),서강진(Kang Jin Seo),김명준(Myeong Jun Kim),정지혜(Ji Hea Jeong),노시태(Si Tae Noh) 한국고분자학회 2011 폴리머 Vol.35 No.6

바이오매스에서 유래된 2,5-dihydroxymethylfuran(DHMF)을 KMnO4 산화반응으로 furan-2,5- dicarboxylic acid(FDCA)를 합성하였다. 합성한 FDCA와 다이올류를 에스테르화 반응과 축중합 반응을 진행시 켜 폴리에스터를 중합하였다. 폴리에스터는 NMR을 통해 조성을 분석하였고 DSC와 TGA를 통해 열적특성을 분 석하였다. 합성된 폴리에스터의 고유점도는 0.78∼1.2 dL/g으로 상용화된 poly(ethylene terephthalate)(PET) 와 비슷하였다. 다이올의 길이가 증가할수록 Young`s modulus와 strength는 낮아지고 elongation-to-break는 높아지는 경향을 확인하였다. 합성한 poly(ethylene furandicarboxylate)(PEF)의 Young`s modulus는 3551 MPa, strength는 103 MPa로 상용화된 PET와 비슷하였다. Furan-2,5-dicarboxylic acid (FDCA) was synthesized by KMnO4 oxidation of 2,5-dihydroxymethylfuran( DHMF) derived from biomass. Polyesters were synthesized by esterification and polycondensation of FDCA with various diols(ethane-1,2-diol, propane-1,3-diol, butane-1,4-diol, hexane- 1,6-diol, decane-1,10-diol). The composition of polyesters was characterized by using 1H NMR. Thermal properties of the polyesters were characterized by DSC and TGA. Intrinsic viscosities(IV) of the polyesters were measured to be 0.78∼1.2 dL/g comparable with IV of commercial poly(ethylene terephthalate)(PET). As the chain lengths of diols increased, Young`s modulus and strength decreased and elongation-to-break generally increased. Young`s modulus and strength of the polyesters were measured to be 3551 MPa and 103 MPa, respectively, comparable with commercial PET.

개에서 발생한 자궁축농증 1례

서수원,손정민,윤기영,최호정,박성준,이영원,정성목,신상태,조종기 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2006 動物醫科學硏究誌 Vol.14 No.-

A 12-year-old, female miniature pinscher dog with history of fever and vaginal discharge 3 days ago was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. A diagnosis of pyometra was made by survey of abdominal radiographs and ultrasonography. The uterus appeared as convoluted and tubular appearance filled with anechoic to hypoechoic fluid. Ovariohysterectomy was the choice of cervical patency. Medical therapy for pyometra may be appropriate in bitches that were of breeding age and that were not systemically ill. The surgery was fine. After 1 week, the dog was getting better.

1993년 신입생 실태조사 결과분석

전광희,편서영 충남대학교 1994 學生生活硏究 Vol.21 No.-

오스템퍼링 처리한 구상흑연주철의 절삭시 공구마멸에 관한 연구

전태옥,박흥식,예규현,서영백 동아대학교 공과대학부설 생산기술연구소 1996 生産技術硏究所硏究論文集 Vol.1 No.-

This study was carried out to investigate the character ot cutting tool's wear by acoustic emission(AE) in machining austempered ductile iron(ADI). The following results have been obtained. (1) Ceramic tool among tools of P20, NC123K and ceramic had the best performance in machining ADI materials. (2) As cutting speed increased, the amplitude level of AE signal increased. (3) The In-process detection of cutting tool's wear in able to by use of AE signals. (4) In initial of cutting, surface roughness was large effect to the flank wear to some range.

알루미나 연마제가 혼합된 희석된 실리카 슬러리의 CMP 특성

서용진,박창준 대불대학교 2002 論文集 Vol.8 No.1

In this paper, we have studied the CMP(chemical mechanical polishing) characteristics of diluted slurry by adding of raw alumina abrasive and annealed alumina abrasive. As a experimental results, we obtained the comparable slurry characteristics compared with original silica slurry in the view point of high removal rate and low non-uniformity. Therefore, we can reduce the cost of consumables(COC) of CMP process for ULSI applications.

Calcium Carbonate와 fibrin adhesive의 병용이 성견 2급 치근분지부 치주조직 재생에 미치는 영향

서은표,정현주,김영준 전남대학교 치과대학 2000 전남치대논문집 Vol.12 No.1

The purpose of this study was to evaluate the effect of combined use of fibrin tissue adhesive and porous resorbable calcium carbonate on the periodontal regeneration of the class Ⅱ furcation defects in dogs. Class Ⅱ furcation defect was surgically created on the second, third, and fourth premolars bilaterally in the mandibles of six mongrel dogs. The experimental sites were divided into four groups according to the treatment modalities: Control-surgical debridement only; GroupⅠ-calcium carbonate grafting; Group Ⅱ-application of fibrin adhesive only; Group Ⅲ-application of fibrin adhesive after calcium carbonate grafting. The animals were sacrificed at 2, 4, and 12 weeks after periodontal surgery and the decalcified specimens were prepared for histologic and histometric examination. The results are as follows : Clinically, there were no inflammatory response in all groups after 2, 4, and 12 weeks. In the Control group, junctional epithelium migrated apically to the reference notch. In Group Ⅰ, graft materials exfoliated from the defect throughout the experimental periods and new bone was seen in the notch area at 4 and 12 weeks' specimens. At 2 weeks, fibrin adhesive was indistinguishable in Group Ⅱ. In Group Ⅲ, the graft material was maintained in the defect throughout the experimental periods and the amount of periodontal tissue regeneration was greater than other groups. These results suggest that the use of fibrin tissue adhesive in conjunction with porous resorbable calcium carbonate would improve the stability of graft material and inhibit the epithelial downgrowth and contribute to periodontal regeneration.