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RISS 인기검색어
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- 저자 : 신연명(Yeon Myeong Shin) (검색결과 4 건)
- 무료
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백상현(Sang Hyun Baik),양송이(Song I Yang),신연명(Yeon Myeong Shin) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.1
Purpose: Recently, diagnosis of stage 1 gastric cancer has increased in number and prognosis is excellent when proper treatment is done. However, some patients have recurrence and their prognosis is poor. Thus, we investigated the risk factors of recurrence in stage 1 gastric cancer patients. Methods: From January 2004 to December 2008, a total of 1,241 number patients were operated on for stage 1 gastric cancer at the Department of General Surgery, Kosin University Gospel Hospital. We reviewed the characteristics of all patients retrospectively and compared them to recurred group (n=24) and non-recurred group (n=1,114). We analyzed the risk factors associated with recurrence. Results: Twenty-four patients with stage 1 gastric cancer were recurred after radical gastrectomy. Recurrence rate was 2.05%. The most common pattern of recurrence was hematogenous (41.7%), and lymphatic (20.8%), peritoneal seeding (16.7%), combined form (12.5%), and locoregional (8.3%). Five-year survival rate was 50.08% of recurrence group. Of clinicopathological factors, depth of invasion, lymph node metastasis, lymphatic involvement and tumor marker were statistically significant between recurred and other group. Conclusion: In this study, tumor marker, tumor depth, node status, lymphatic channel involvement were possible risk factors of recurrence for stage 1 gastric cancer. More intensive follow up and care is needed for those with such risk factors.
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윤기영(Ki Young Yoon),안수미(Su Mi Ahn),신연명(Yeon Myeong Shin),최경현(Kyung Hyun Choi),장문경(Moon Kyung Jang),공은진(Eun Jin Kong),송윤미(Yun Mi Song) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.6
Purpose: The length of a patient’s stay in a hospital is an indication of the patient’s recovery rate. The length of the hospital stay has an important economic factor for hospitals. This study was conducted to determine the relationship of the nutritional status at the time of admission to mortality and the length of the hospital stay (LOHS). Methods: The study subjects were 1,619 patients who suffered with cancer, were admitted to Kosin University Gospel Hospital during 2005 and they met the study criteria. The patients were classified to the not at risk group, the patients having one risk factor for malnutrition were the Ⅰ group, the patients having two risk factors for malnutrition were the Ⅱ group, the patients having three risk factors for malnutrition were the Ⅲ group and the patients having 4 risk factors for malnutrition were the Ⅳ group, based on the established criteria of serum albumin <3.0 g/㎗, a total lympocyte count of <1,500 cells/㎣, a cholesterol level of ≥240 ㎎/㎗ or ≤130 ㎎/㎗, weight for height ≥120% or <90% ideal body weight. Results: 24.3% of the patients were classified into the not at risk group, 37.6% were classified into the at risk group Ⅰ, 24.2% were classified into the at risk group Ⅱ, 10.3% were classified into the at risk group Ⅲ and 3.6% were classified into the at risk group Ⅳ. The at risk group (at risk Ⅲ, at risk Ⅳ) had a significantly higher prevalence of liver disease. The relationship between liver disease and low serum albumin albumin levels may have confounded the data. Although the estimated LOHS was similar in all the groups, the average length of stay was 14.4±16.38 days in the malnourished group (at risk group Ⅳ) compared to approximately 2.8 days in the not at risk group. The more nutritional risk factors the patients had, the longer was the LOHS and the mortality rates were higher. Correlation was not observed between the risk factors and the length of the hospital stay, as well as the lack of correlation with the mortality rate. Conclusion: These results suggest that a patient’s nutritional status upon admission has an effect on the length of the hospital stay for patients with carcinoma.
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위암환자에서 근치적 위절제술후 시행한 보조적 PMF 항암 화학요법에 대한 무작위 전향적 연구
최우식,신연명,최경현 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2
연구 목적: 위암 수술 후 보조 항암 치료의 효과에 대하여서는 아직 논란이 있다. 전향적으로 무작위표본 추출법으로근치 절제 수술한 위암 환자에서 수술 후 cisplatin, mitomycin C 그리고 5-FU(PMF)의 주사가 5년 생존율이나 무병생존율을 증가할 수 있는지를 연구하였다. 연구 방법: 1995년 5월부터 2002년 5월까지 147명의 근치 수술된 위암 환자들 중에 병기 IB, II, IIIA, IIIB 및 IV를 대상으로 하였으나 65세 미만을 대상으로 하여 무작위적으로 2군으로 나누어, 경구 5-FU제를 투여하는 군(대조군)과, PMF 항암 주사 치료군(치료군)으로 나누어 치료하였다. 경구 5-FU항암제는 수술 후 퇴원할 시기부터 투여하였다. PMF 주사치료는 수술 후 8주 이내에 시작하며 2코스 이상 완료한 사람들을 치료군에 포함하였다. 항암 주사는 다음과 같이 진행하였다; cisplatin 30mg 정맥 주사를 제 1-5일에, mitomycin C 4mg과 5-FU 250mg정맥 주사를 주 2회 4 주간 주사하였다. 이런 주사치료를 매 4주마다 시행하였다. 이 후 5년 생존율과 무병 생존율을 Kaplan-Meier 분석과 log-rank 검정으로 구하였다. 결과: 중앙 추적기간은 36개월이었다. 전체 5년 생존율은 치료군과 대조군에서 각각 68.8%와 65.2%(p=0.26), 무병 생존율은 각각 72%와 64%(p=0.24)로 치료군에서 다소 나았으나 유의성은 없었다. 치료에 동의한 환자의 수가 적어 각 병기별 생존율보다 비교적 조기인 병기 IB와 병기 II를 A군으로, 병기 IIIA을 B군, 그리고 진행된 병기인 병기 IIIB 와 병기 IV를 C군으로 나누어 생존율 비교하여 보았다. A군과 C군은 5년 생존률이나 무병생존율의 차이가 없었으나, B군에서는 5년 생존율이 치료군에서 100%, 대조군은 40.8%(P=0.0019)로 유의한 차이가 있었고, 무병 생존율도 치료군 100%, 대조군 52.94%(p=0.005)으로 의미 있게 차이가 있었다. 항암 주사치료에 의한 부작용은 심하지 않았으며, 사망자는 없었다. 결론: 위암 수술 후 PMF에 의한 항암 보조치료는 경구 5-FU에 비하여 병기 IB, II, IIIB와 IV에서는 5년 생존율이나 무병 생존율에 차이가 없었으나 병기 IIIA에서는 5년 및 무병 생존율에 의미있게 좋았다. 앞으로 C군에 대한 수술 후 보조 항암치료법의 연구가 요망된다.
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안수미,윤기영,신연명,최경현,임근승,장문경,송윤미,공은희 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2
Background : About 30% of patients in the hospital are under nourishment. A large portion of people are undernourished when they are admitted to the hospital and in the majority of these, undernutrition develops further while in hospital. Patient-Generated subjective global assessment(PG-SGA), a method of nutritional assessment based on clinical judgment, has been widely used to assess the nutritional status of adults for both clinical and research purposes. Modified PG-SGA can be used as a nutrition screening tool, and a comprehensive nutrition assessment is desirable for those who are malnourished. The purpose of this study is to develop a simple, reliable and valid nutrition screening program(NSP). Methods : We applied the nutrition screening program(NSP) to adult inpatients who are at risk of malnutrition using the Modified Patient-Generated subjective global assessment(PG-SGA) and objective assessment(electrical medical record data). Results : Therefore simple and beneficial NSP is developed for patients with severe malnutrition. Using NSP. nutritional information of the severe malnutrition patient should be shared with the physicians and they should be taken care of by clinical dietitians to improve their nutritional status. Conclusion : The Modified PG-SGA and nutrition screening tool are simple, reliable and valid nutrition screening program(NSP).
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