장막 침윤이 있는 위암환자에서 수술 후 조기 복강 내 화학요법의 예후인자로서의 가치

유완식,김태봉,Yu, Wan-Sik,Kim, Tae-Bong 대한위암학회 2004 대한위암학회지 Vol.4 No.2

Purpose: There is no established treatment-related prognostic factor for gastric cancer except a curative tumor resection. This study was done to clarify the prognostic value of early postoperative intraperitoneal chemotherapy (EPIC) in patients with serosa-positive gastric cancer. Materials and Methods: We analyzed retrospectively the postoperative survival data of 209 patients with serosapositive gastric cancer treated by surgery and chemotherapy. The survival period for patients was calculated from the date of resection until cancer-related death or the last date of follow-up; Kaplan-Meier survival curves were plotted and compared by using the log-rank test. A multivariate analysis was done by using the Cox proportional hazards model. Results: Statistically significant differences in survival rates were noted based on gender, depth of invasion, lymph node metastasis, distant metastasis, stage, location of tumor, macroscopic type, extent of gastric resection, curability of surgery, and adjuvant chemotherapy. Five-year survival rates of patients who received EPIC and systemic chemotherapy were 49 per cent and 25 per cent, respectively (P=0.009). A multivariate analysis revealed that invasion of an adjacent organ, lymph node metastasis, total gastrectomy, and palliative surgery were poor independent prognostic factors. Also, EPIC had a marginal prognostic value (P=0.056). Conclusion: Perioperative intraperitoneal chemotherapy can possibly be one of the independent prognostic indicators in case of serosa-positive gastric cancer. (J Korean Gastric Cancer Assoc 2004;4:89-94)

절제 가능한 진행위암에서 수술 후 조기 복강 내 화학요법의 예후인자로서의 가치

유완식,정호영,Yu Wansik,Chung Ho Young,Sugarbaker Paul H. 대한위암학회 2001 대한위암학회지 Vol.1 No.4

Purpose: There are variants of gastric cancer assoclated with predominantly peritoneal spread of with haematogenous metastases. Perioperative intraperitoneal chemotherapy as an adjuvant to surgery is considered as a rational therapeutic modality to prevent peritoneal spread. We evaluated the influence of early postoperative intraperitoneal chemotherapy on the prognosis of resectable advanced gastric cancer. Materials and Methods: From 1990 to 1995, 246 patients with biopsy proven advanced gastric cancer were enrolled in the study. Among them 123 patients received early postoperative intraperitoneal mitomycin C and 5-fluorouracil. The survival rate was calculated using by the Kaplan-Meier method and was compared using the log-rank test according to 13 clinico-pathologic factors. Multivariate analysis was performed with the Coxproportional hazards model. Results: Gastric resection plusearly postoperative intraperitoneal chemotherapy showed an improved survival rate as compared to surgery alone ($54.1\%\;versus\;40.3\%;$ P=0.0325). Depth of tumor invasion, degree of regional lymph vode metastasis, distant metastasis, tumor size, tumor location, extent of gastric resection, and curability of surgery significantly influenced survival. When a multivariate analysis was performed, depth of tumor invasion, lymph node metastasis, early postoperative intraperitoneal chemotherapy, curability of surgery, and extent of gastric resection emerged as the statistically significant and independent prognostic factors. Conlusion: Early postoperative intraperitoneal chemotherapy is one of the independent prognostic indicators of resectable advanced gastric cancer.

수치예보자료를 이용한 강우 및 홍수 예측 적용성 평가

유완식,윤성심,황의호,채효석,정관수,Yu, Wan-Sik,Yun, Seong-Sim,Hwang, Ui-Ho,Chae, Hyo-Seok,Jeong, Gwan-Su 한국수자원학회 2019 물과 미래(한국수자원학회지) Vol.52 No.2

위암 환자에 있어서 위의 절제범위에 따른 수술 후 삶의 질 비교

유완식,이창환,정호영,-Yu, Wansikik,Lee, Chang-Hwan,Chung, Ho-Young 대한위암학회 2001 대한위암학회지 Vol.1 No.1

Purpose: Quality of life (QOL) assessment should be applied in surgical settings to compare treatment options. We compared QOL after a subtotal versus a total gastrectomy for gastric cancer to identify which resection would produce a better QOL for the patient. Patients and Methods: We studied 362 patients with no evidence of recurrent disease after curative surgery for gastric cancer. The QOL was measured by assessing patient health perceptions according to the Spitzer index and Troidl score and by treatment-specific symptoms according to Korenaga and others with some modifications. High scores reflect a better QOL. Results: The mean score of the Spitzer index was $8.87\pm1.36$ after a subtotal gastrectomy and $8.80\pm1.23$ after a total gastrectomy. More than $80\%$ of the patients in both groups maintained good quality of life when measured by the Spitzer index. The mean Troidl score was $10.41\pm2.12$ after a subtotal gastrectomy and $9.79\pm2.16$ after a total gastrectomy (p=0.033). Swallowing difficulty was more frequent after a total gastrectomy (p=0.002). There was a statistically significant difference in the meal size (p=0.044). Other variables of the Troidl score revealed no statistically significant differences. Dizziness was significantly more frequent after a total gastrectomy than after a subtotal gastrec tomy (p=0.009). Conclusion: We conclude that in terms of postoperative quality of life, a subtotal gastrectomy has advantages over a total gastrectomy. In those cases where an adequate proximal safety margin can be achieved by a subtotal gastrectomy, that procedure is preferable to a total gastrectomy.

위 아전절제술 후 소화관 재건 방법에 따른 영양상태와 삶의 질의 비교

유완식,정호영,Yu, Wan-Sik,Chung, Ho-Young 대한위암학회 2002 대한위암학회지 Vol.2 No.2

Purpose: We compared the quality of life (QOL) and nutritional outcomes following both Billroth I (BI) and Billroth II (BII) reconstructions after a subtotal gastrectomy in order to identify which reconstruction would produce a better QOL and nutritional outcomes and to provide better follow-up management. Materials and Methods: We studied 273 patients without evidence of recurrent disease following a curative distal subtotal gastrectomy for gastric cancer. Among them, 135 underwent a BI reconstruction and 138 a BII reconstruction. The nutritional status was assessed by using levels of hemoglobin, serum albumin, iron, and vitamin B12 and by calculating the relative body weight, the body mass index, and the percentage of body fat. The QOL was measured by using the Troidl score and by treatment-specific symptoms based on the criteria, somewhat modified by the authors, of Korenaga and others. Results: There was no significant difference in QOL between the BI and the BII groups. More than half of the patients revealed anemia, regardless of the type of reconstruction. The serum vitamin $B_{12}$ level of the BII group was lower than that of the BI group. The BII group showed a tendency toward lower hemoglobin levels and serum iron concentrations than the BI group did. Conclusions: The quality of life was not impaired in most patients after either a BI or a BII reconstruction. However, both resulted in iron deficiency anemia, although the incidence was higher after a BII reconstruction. The patient's serum iron and vitamin B12 should be measured periodically and these must be administered if the measurements reveal a below normal range.

절제 가능한 위암 환자에서 수술 전 혈청 알파태아단백치 측정의 의의

유완식,김태봉,Yu, Wan-Sik,Kim, Tae-Bong 대한위암학회 2003 대한위암학회지 Vol.3 No.1

Purpose: Alpha-fetoprotein (AFP) is widely accepted as a useful tumor marker for diagnosis of hepatocellular carcinomas. On rare occasions, however, an abnormal elevation of serum AFP also has been reported in an adenocarcinoma of the gastrointestinal tract. We evaluated the influence of preoperative abnormal elevation of serum AFP (AFP positivity) on the prognosis of resectable gastric cancers. Materials and Methods: 812 gastric cancer patients, who were investigated for serum AFP before their operations and who underwent gastric resections with D2 or more extended lymph node dissection, were enrolled in the study. The survival rates were calculated by using the Kaplan-Meier method and were compared by using the log-rank test. A multivariate analysis was performed using the Cox proportional hazards model. Results: Fifty patients ($6.2\%$) were AFP positive (10.1. 4322.6 ng/ml). The survival rate of the AFP positive group was significantly lower than that of the AFP negative group ( $46.6\%\;vs.\;67.0\%$; P=0.0002). The depth of tumor invasion, the degree of regional lymph node metastasis, distant metastases, the TNM stage, the gross type, differentiation, the extent of gastric resection, and the curability of the surgery also significantly influenced survival. Multivariate analysis revealed that the depth of tumor invasion, the degree of regional lymph node metastasis, the curability of the surgery, and AFP positivity were independent prognostic indicators. Conclusion: Preoperative serum AFP can be used as an independent prognostic factor of resectable gastric cancer.

성인 서혜부탈장에서 Shouldice 복원술

유완식(Wan-Sik Yu),이영하(Young-Ha Lee),황일우(Il-Woo Whang) 대한외과학회 1986 Annals of Surgical Treatment and Research Vol.30 No.5

위암환자의 위 절제범위에 따른 수술 후 영양상태의 비교

유완식(Wansik Yu),정호영(Ho Young Chung) 대한외과학회 2001 Annals of Surgical Treatment and Research Vol.60 No.3

입ㆍ출력 관계에서 언어적 퍼지모델의 추출

유완식(Wan-Sik Yu),김성락(Sung-Rak Kim),김종성(Jong-Sung Kim),변증남(Zeungnam Bien),박동조(Dong-Jo Park) 한국지능시스템학회 1992 한국지능시스템학회논문지 Vol.2 No.3

수치예보의 공간예측 불확실성을 고려한 강우 앙상블 추정 및 홍수 예측

유완식(Yu Wan sik),최미경(Choi Mi kyoung),정안철(Jeong An chul),문혜진(Moon Hye jin),정관수(Jung Kwan sue) 한국방재학회 2017 한국방재학회논문집 Vol.17 No.5

본 연구에서는 일본 기상청에서 제공하고 있는 중규모모델(MSM)의 수치예보자료를 이용하여 태풍 및 정체전선 등 3개의 강우사상에 대해 강우 및 홍수 예측 정확도를 평가하였다. 또한 수치예보자료의 공간이동을 통해 생성된 앙상블 강우분포를 이용하여 공간예측 변위를 평가하였다. 그 결과, 태풍과 같은 광역적 범위에 대한 예측에 대해서는 높은 정확도를 나타냈으나, 정체전선과 같이 국지적으로 발생하는 강우사상에 대해서는 공간예측의 오차가 많이 발생하였다. 앙상블 강우 및 홍수예측결과 전체적으로 관측값의 패턴과 유사한 예측결과를 보였으며, 과소예측되는 구간에 대해서는 앙상블 범위가 관측값을 포함하는 결과를 나타냈다. 이를 통해 수치예보의 공간이동기법을 이용한 앙상블 강우 및 홍수예측 적용 가능성을 확인할 수 있었다. This study evaluated the accuracy of rainfall and flood forecasts with three rainfall events such as typhoon and stationary front by using MSM provided by Janpan Meteorology Agency. In addition, prediction misplacement was estimated using ensemble rainfall distribution generated by spatial shift of original MSM rainfall field. As a result, the wide-area prediction such as typhoon event showed high forecast accuracy, and the local-area prediction such as stationary front event has a limitation to quantitative precipitation forecast (QPF) due to spatial prediction error. The ensemble rainfall and flood forecasts showed similar pattern to the observed value, and the forecast accuracy was improved in the under-predicted area because the ensemble range included the observed value. From these results, it could confirm the applicability of ensemble rainfall and flood forecasts by using spatial shift of numerical weather prediction.