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유창훈,강성욱,하호수,권영대 한국병원경영학회 2019 병원경영학회지 Vol.24 No.1
Purpose: As an interest in the elderly medical expenses increases, elderly people are increasingly purchasing indemnity private health insurance. Authors tried to investigate factors of having the indemnity private health insurance among the elderly people aged 65-75 years. Methods: We conducted panel logit regression analysis on 2,465 subjects as of 2016 using Korean Health Panel from 2010 to 2016. The dependent variable was whether to enroll in the indemnity private health insurance. The explanatory variables included socio-demographic characteristics, economic factors, health status, and health behaviors. Findings: As a result of the analysis of factors of purchasing indemnity private health insurances, it was analyzed that people with larger family, educated, pensioner, high household income or no disability were more likely to have indemnity private health insurance. Practical Implications: Considering the results of this study, the factor of purchasing indemnity private health insurance among elderly people were more likely to be their economic than demographic characteristics such as sex, age, and marital status. Policy makers should make efforts to reduce the burden on the elderly medical expense and to improve equity of medical use through institutional improvement such as raising age limit and lowering premium of indemnity private health insurance and expansion of public health insurance.
유창훈,오충렬,김승태,배우균,최혜진,오도연,이명아,류백렬 대한암학회 2021 Cancer Research and Treatment Vol.53 No.2
Neuroendocrine tumors (NETs) are a group of malignancies arising from neuroendocrine cells and frequently originate in the gastrointestinal tract and pancreas. Although curative resection is the main treatment for localized disease, systemic therapy is needed for relapsed or metastatic/unresectable gastroenteropancreatic NETs (GEP-NETs). Although there are several NET treatment guidelines from various countries, the geographical discrepancies between patient clinical characteristics, the regulatory approval status for therapeutic agents, and medical practices necessitate specific guidelines for Korean patients. We here provide a consensus review of the diagnosis, staging and systemic treatment of Korean GEP-NET patients. Systemic therapy options and the current Korean expert consensus on these treatments, including somatostatin analogs, targeted therapies such as everolimus and sunitinib, peptide receptor radionuclide treatments, and cytotoxic chemotherapies are addressed.
혈역학적 삼첨판 협착증을 동반한 간세포 암종의 심장내 전이와 동시에 발생한 간폐증후군 1예
유창훈,김수홍,김경찬,김재균,김일수,강욱 대한노인병학회 2008 Annals of geriatric medicine and research Vol.12 No.4
Intracardiac m etastasis of hepatocellular carcinom a w ith functional tricuspid valve stenosis is not com m on. Furtherm ore, hepatopulm onary syndrom e associated w ith hepatocellular carcinom a is rarely encountered. W e present a case of intracardiac m etastasis of hepatocellular carcinom a presenting w ith functional tricuspid valve stenosis accom panied w ith hepatopulm onary syndrom e.
Serum beta-2 microglobulin in malignant lymphomas: an old but powerful prognostic factor
유창훈,윤덕현,서철원 대한혈액학회 2014 Blood Research Vol.49 No.3
Beta-2 microglobulin is synthesized in all nucleated cells and forms the light chain subunit of the major histocompatibility complex class I antigen. Despite its potential role as a con-venient and non-invasive prognostic indicator in malignant lymphomas, the influence of serum β2 microglobulin is currently underestimated, and therapeutic decision making is rarely affected by this marker. Recent studies that included relatively large numbers of patients with specific histologic subtypes showed that serum β2 microglobulin is a po-tent prognostic marker in malignant lymphomas. In follicular lymphoma, this effort led to the incorporation of serum β2 microglobulin as an indicator in a new prognostic model. In this review, we summarize the current evidence supporting the role of serum β2 micro-globulin as a prognostic factor in patients with malignant lymphoma and discuss per-spectives for future investigations.
Relationship between Dietary Mercury Intake and Blood Mercury Level in Korea
유창훈,김병권,김유미,이상아,김록범,서정욱,홍영섭 대한의학회 2014 Journal of Korean medical science Vol.29 No.2
This study was performed to evaluate the effect of dietary factors for mercury exposure by comparing with blood mercury concentration. Study population consisted of 1,866 adults (839 men and 1,027 women) in randomly-selected 30 districts in southeast Korea. Dietary mercury intake was calculated from food frequency questionnaire (FFQ) on seafood items and 24 hr recall record. Blood mercury concentration was measured with atomic absorption spectrometry. Mean age of the subjects was 43.5±14.6 yr. The FFQ showed that mercury-laden fish (tuna, shark) and frequently-eating fish (squid, belt fish, mackerel) were important in mercury intake from fish species. The recall record suggested that fish and shellfish was a highest group (63.1%) of mercury intake and had a wide distribution in the food groups. In comparison with the blood mercury concentration, age group, sex, household income, education, drinking status and coastal area were statistically significant (P<0.001). In multiple regression analysis, coefficient from the FFQ (β=0.003) had greater effect on the blood mercury than the recall record (β=0.002), but the effect was restricted (adjusted R2=0.234). Further studies with more precise estimation of dietary mercury intake were required to evaluate the risk for mercury exposure by foods and assure risk communication with heavily-exposed group.
유창훈,김성배,노정실,임석아,임영혁,김지현,안진희,정경해,송홍석,강석윤,박희숙,정현철 대한암학회 2016 Cancer Research and Treatment Vol.48 No.2
Purpose This study analyzed the role of plasma biomarkers for TSU-68 in a previous phase II trial comparing TSU-68 plus docetaxel and docetaxel alone in patients with metastatic breast cancer. Materials and Methods A total of 77 patients were eligible for this study (38!in the TSU-68 plus docetaxel arm and 39 in the docetaxel alone arm). Blood samples were collected prior to the start of each cycle, and vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF)- AA, -AB, -BB, fibroblast growth factor, M30, C-reactive protein (CRP), and interleukin 6 (IL-6) levels were measured using enzyme linked immunosorbent assay. The primary endpoint was progression-free survival (PFS). Results In patients with baseline PDGF-AA " median, median PFS was significantly worse in the TSU- 68 plus docetaxel group than in the docetaxel alone group (5.4 months vs. 13.7 months, p=0.049), while a trend toward a PFS benefit was observed in those with baseline PDGFAA < median (9.7 months vs. 4.0 months, p=0.18; p for interaction=0.03). In the TSU-68 plus docetaxel group, PFS showed significant association with fold changes in CRP (p=0.001), IL-6 (p < .001), PDGF-BB (p=0.02), and VEGF (p=0.047) following the first treatment cycle. Conclusion Baseline PDGF-AA levels and dynamics of VEGF, PDGF-BB, CRP, and IL-6 levels were predictive for the efficacy of TSU-68.
유창훈,김성배,안진희,김정은,정경해,공경엽,손병호,안세현,안승도,김학희,신희정,김우건 대한암학회 2015 Cancer Research and Treatment Vol.47 No.3
Purpose Given the promising activity of capecitabine and vinorelbine in metastatic breast cancer, this randomized phase II trial evaluated the efficacy and safety of this combination as neoadjuvant chemotherapy in breast cancer. Materials and Methods Patients with operable breast cancer (n=75) were randomly assigned to receive either four cycles of adriamycin 60 mg/m2 plus cyclophosphamide 600 mg/m2 every 3 weeks followed by four cycles of docetaxel 75 mg/m2 every 3 weeks (AC-D) or four cycles of capecitabine 2,000 mg/m2 (day 1-14) plus vinorelbine 25 mg/m2 (days 1 and 8) every 3 weeks followed by four cycles of docetaxel 75 mg/m2 (CV-D). The primary endpoint was pathologic complete response (pCR) in the primary breast (ypT0/is). Results Most patients (84%) had locally advanced (n=41) or inflammatory breast cancer (n=22). pCR rates in the primary breast were 15% (95% confidence interval [CI], 7% to 30%) and 11% (95% CI, 4% to 26%) in the AC-D and CV-D groups, respectively. The overall response rates and 5-year progression-free survival rates in the AC-D and CV-D groups were 62% and 64%, and 51.3% (95% CI, 34.6% to 68.0%) and 30.2% (95% CI, 13.3% to 47.1%), respectively. Although both regimens were well tolerated, CV-D showed less frequent grade 3-4 neutropenia and vomiting than AC-D, whereas manageable diarrhea and hand-foot syndrome were more common in the CV-D group. Conclusion CV-D is a feasible and active non-anthracycline–based neoadjuvant chemotherapy regimen for breast cancer.