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.

인터넷 중독 고위험 청소년의 성별에 따른 임상적, 정신병리적 특성

이지윤(Ji Yoon Lee),권준근(Jun-Gun Kwon),이준영(Jun-Young Lee),정희연(Hee Yeon Jung),손보경(Bo Kyung Sohn),최삼욱(Sam Wook Choi),김대진(Dai Jin Kim),최정석(Jung-Seok Choi) 한국중독정신의학회 2016 중독정신의학 Vol.20 No.1

Objectives : Most previous studies of Internet addiction (IA) have been performed on males, and little is known about gen-der differences in IA. We examined gender differences in the clinical and psychopathological features related to high-risk for IA among adolescents. Methods : 714 (male : N=389 ; fe-male : N=325) have reported questionnaires as follows ; 1) clinical and psychopathological features (depression, anxiety, Attention Deficit Hyperactivity Disorder (ADHD) symptoms, Smartphone addiction, impulsivity, behavioral inhibition and approach systems, state-trait anger, aggression, beliefs about aggression, and resilience) 2) Internet and Smartphone usage patterns. In 691 who completed the Young’s Internet Addiction Test (YIAT), A total of 487 adolescents were classified into the normal Internet use group, with YIAT scores of 20-39 (male :N=232 ; female : N=255) and 204 adolescents were classified into high-risk for IA group (male : N=144 ; female : N=60). Results : Most factors described above predicted high-risk for IA in male and female adolescents. Especially, the present study found that psychological resilience had negative association with possibility of IA in female, while cognitive impulsivity and hostile aggression were associated with possibility of IA in male adolescents. Conclusion : This study found gender-re-lated features in adolescents at high-risk for IA. Thus, gender-specific strategies are needed to maximize prevention and treatment effectiveness of IA.

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.

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.

제어용 전원으로 사용 가능한 공진형 컨버터 시스템

지준근,임영하 순천향대학교 부설 산업기술연구소 2003 순천향 산업기술연구소논문집 Vol.9 No.1

In this paper new control strategy of series resonant converter system for control power supply is suggested. Frequency controlled series resonant converter system is robust to load variations because it is POSR(parallel output series resonant) type. And it provides stable output voltage by changing switching frequency to input voltage variations. Firstly, operation analysis about suggested series resonant converter system was carried. Then simulations using ACSL(Advanced Continuous Simulation Language) and experiments to actual system were carried to prove characteristics of suggested system.

연행이론의 관점에서 본 평생학습축제의 현상학

박지연,박신영,이병준 한국문화교육학회 2012 문화예술교육연구 Vol.7 No.1

현재 전국적으로 중앙정부로부터 선정된 평생학습도시들은 매년 평생학습축제를 개최하고 있다. 평생학습축제는 평생학습이라는 같은 주제로 지역별로 개최되는 평생교육 관련 기관·단체 간의 교류를 통한 평생학습문화 진흥과 평생학습사회 실현을 목적으로 하는 학습, 문화, 스포츠, 복지 등의 복합적인 종합축제이다. 지역차원에서는 평생학습축제의 기획과 준비에 비교적 많은 시간과 예산, 노력이 투입되고 있으며 평생교육실천가들의 많은 에너지가 수반됨에도 불구하고 이에 대한 성찰적 연구는 매우 적은 편이다. 본 연구는 평생학습문화의 촉진을 위한 정책적 차원에서 매년 개최되고 있는 지역 평생학습축제의 문제를 다룬다. 학습문화를 촉진하기 위한 목적으로 기획되는 축제가 교육적으로 유의미하기 위해서는 축제에 기저를 둔 연행과 의례에 기반한 새로운 경험과 학습의 이행과정을 이해해야 한다. 기존의 축제들은 정책홍보적 성격을 띄고 있어 축제 주제와 컨텐츠의 탈지역성, 운영의 행정주도성으로 인해 교육적 의미가 내포되지 못한 채 중요한 지역행사로 자리잡게 되는 상황에 이르렀다. 이러한 문제의 발단은 평생학습을 생각하며 축제를 기획하는 사람들이 축제가 가지는 연행이론적 측면에서의 교육적 유의미함을 이론적으로 파악하고 있지 못하는데서 비롯된다. 즐거움과 문화적 분위기속에서 경험과 학습이 촉진될 수 있다는 컨셉이 있다면 지역평생학습축제가 전국적으로 대동소이한 주제와 방식으로 그리고 동원된 특정 계층의 참여자를 기반하지는 않을 것이다. At present, the worldwide lifelong learning cities selected by central government hold lifelong learning festival every year. The lifelong learning festival is a general festival combined by studying, culture, sports, welfare, etc. with the purposes that promotion of lifelong learning culture and realization of lifelong learning society through the exchange among the institutions·organizations related to lifelong learning, held in each region, under the same subject, lifelong learning. At regional level, relatively lots of time, budgets and efforts are invested to planning and preparation of lifelong learning festival and lifelong learning doers put lots of energy to it. In spite of it, there is few introspective studies on it. This study treats problems of regional lifelong learning festival held every year at political level for promoting lifelong learning culture. The process of new experience and studying based on festival's performance and rite must be understood so that the festival which is planned to promote studying culture can be significant educationally. Existing festivals have political publicity characteristics, so they become important regional festivals without educational meaning because of the delocality of festival subject and contents and administrative leading of operation. The problem is caused by that people who plan the festival by considering lifelong learning don't grasp the festival has educational significance theoretically from the aspect of performance theory. If there is a concept that experiences and studying can be promoted in the atmosphere of pleasure and culture, regional lifelong learning festival will be neither progressed under similar subject and method nationally nor participated by mobilized special-class participants.

진료비 상담의 효율적인 업무개선을 통한 고객만족도 향상

서지연,채은경,고영준외 39인 한국의료QA학회 2006 한국의료질향상학회지 Vol.13 No.2

문제: 최근 몇 년간, 환자 및 보호자들이 의료와 관련된 전문기관을 대상으로, 민원발생이 급, 상승되고 있음이 통계상 확인되고 있다. 목적: 최근 몇 년간, 환자 및 보호자들이 의료와 관련된 전문기관을 대상으로, 민원발생이 급, 상승되고 있음이 통계상 확인되고 있다. 의료기관: 서울에 소재한 2,200병상의 전문종합요양기관 소속 보험 심사 팀 질 향상 활동: 상담 Data base 구축을 위한 전산개발 및 핵심 문제 부분에 대한 직무프로세스 변경, 보완 및 수정 활동결과: 진료비 사례 환자 상담건수는 2003년 기준 75.4%의 증가율을 보였으며, 본원의 민원검수는 전년대비 9%의 감소효과가 확인되었다.

허혈성 심질환에서 나타나는 항산화지수, 사이토카인 및 염증지표의 변화

전상훔,안지훈,방덕원,온영근,현민수,김성구,권영주 순천향대학교 교수학습개발센터 2004 Journal of Soonchunhyang Medical Science Vol.10 No.3

Purpose : As diet habits change and the elderly popuation increases conronary artery disease(CAD) has also increased. Recent ongoing studies on varous inflammatory indexes in acute coronary syndrome(ACS) are underway. Several study results have shown that total antioxidant status(TAS) was remarkably lower in unstable angina than in chronic stable angina and levels of interleukin-(IL-6), C-reactive protein(CRP), monocyte chemoattractant protein-1(MCP-1), P-selectin were reported to be elevated in unstable angina and acute myocardial infarction(AMI). In our study, we studied and compared the level changes of cytokines and inflammatory indexes that play important roles inside the blood vessel. Methods : Study subjects were patients who were admitted and underwent coronary angiography at the cardiology department in Soonchunhyang university hospital. Subjects were divided into 4 groups, a control group, a stable angina and unstable angina group and an acute myocardial infarction group. The clinical findings, TAS, inflammatory cytokines(P-selectin, MCP-1, IL-6), anti-inflammatory cytokines(IL-10), Homocysteine and CRP levels in each group were measured and compared. Results : The total number of study participants was 86 patients, with 26 patients in the control group, 21 patients with stable angina, 15 patients with unstable angina, and 24 patients with AMI. There were significant differences in the TAS among the 4 grouops. 1.7±0.51 mmol/L, 1.6±0.60 mmol/L, 1.4±0.20 mmol/L, 1.4±0.29 mmol/L respectively. IL-6 levels also showed a significant difference between groups, averaging 0.8±2.47 pg/ml, 2.7±3.77 pg/ml, 6.8±10.63 pg/ml, 10.9±17.43 pg/ml respectively. Homocysteine levels averaged 8.0±2.47 pg/ml, 6.8±10.63 pg/ml, 10.9±17.43 pg/ml restectively. Homocysteine levels averaged 8.0±1.0 μmol/L in the control group, 14.3±5.14 μmol/L in patients with stable angina, 16.0±4.66 μmol/L in patients with unstable angina, and 17.3±10.08 μmol/L in AMI patients. Conclusion : Compared to the control group, the TAS levels were significantly lower in patients with unstable angina and AMI. there was no difference between the control group and those with stable angina. IL-6 and homocysteine levels were also higher in patients with unstable angina and AMI. Therefore we concluded that measurements of TAS, IL-6 and homocysteine are useful in measuring the inflammatory index of coronary artery diseases and may be important factors in predicting the states and prognosis of cardiovascular disorders.

Clinical Characteristics and Antimicrobial Susceptibility of Elderly Women with Acute Pyelonephritis

Ji Kang Yun,김웅빈,이상욱,Kwang Woo Lee,Jun Mo Kim,Young Ho Kim 대한요로생식기감염학회 2020 Urogenital Tract Infection Vol.15 No.3

Purpose: Acute pyelonephritis in older patients can lead to a poorer treatment response and prognosis. The objective of this study was to classify older female patients with acute pyelonephritis according to age and compare their clinical characteristics and antibiotic susceptibility. Materials and Methods: In this retrospective study, 360 patients aged 65 years or older and hospitalized for acute pyelonephritis in a single tertiary medical facility from 2012 to 2016 were selected as research subjects. The patients were divided into three groups according to their age. Their clinical symptoms, blood tests and urinalysis, underlying diseases, causative organisms for urinary tract infections (UTIs), and antibiotic susceptibility were compared. Results: One hundred and seventy-six patients aged 69.9±2.7 years, 142 patients aged 79.4±3.1 years, and 42 patients aged 87.3±3.1 years were assigned into the young-old, old-old, and oldest-old groups, respectively. The duration of hospitalization and fever due to acute pyelonephritis increased with age. On the other hand, the maximum body temperature was similar among the three groups. In blood tests, erythrocyte sedimentation rate and C-reactive protein increased with age. Among the underlying diseases, the incidence of diabetes and chronic renal disease was similar among the three groups, while cerebrovascular diseases, heart failure, and urinary stones were associated with aging. Older patients were more likely to have UTIs over the past year. Older groups showed a more significant decrease in sensitivity to carbapenems, amikacin, and ciprofloxacin. Conclusions: Choosing appropriate antibiotics, considering the patientʼs age, is important when treating acute pyelonephritis.

Ciprofloxacin의 돼지 호흡기 감염증 및 설사증에 대한 치료효과

전무형,김지영,채미경,서상희,김명철,박창식,김태용,윤효인 충남대학교 형질전환복제돼지연구센터 2004 논문집 Vol. No.8

To evaluate the clinical efficacy of ciprofloxacin (CFX) on treatment of the pigs with respiratory diseases or diarrhea. CFX at various dosages were administered intramuscularly to the diseased pigs selected from the pig farms located in Chungnam province. One hundreds and fourteen heads of pigs with respiratory diseases were divided into five groups and CFX at 0.25, 0.5, 1.0 (= 2.5mg CFX/Kg B.W.) and 2.0 doses were administered i.m. for 5 days. The recovery rates were found 31.8%, 73.9%, 91.3% and 92.0%, respectively, being higher than that of the untreated control group (19.0%). The mortality of the treated groups were 0%, that is lower than that of the control (9.5%). Seven kinds of bacteria were isolated from the respiratory organs of 86 pigs, and 34 (39.5%) of 86 pigs showed the complicated infection. In analyzing by the pigs infected with a single pathogen as P. multocida; A. pleuropneumonia. Staphyloccus spp. or Mymplasma spp., the recovery rates were 0∼66.6% at 0.25 dose, 66.6∼100% at 0.5 dose and 100% in all of 4 pathogens at 1.0 to 2.0 doses. At 0.25 dosage the pigs infected with A. pleuropneumonia showed the lowest recovery rate. One hundreds and twenty two heads of pigs with diarrhea were divided into five groups and CFX at 0.25, 0.5, 1.0 (= 2.5mg CFX/Kg B.W.) and 2.0 doses were administered i.m. for 5 days. The recovery rates were 29.1 %, 40.0%, 80.0% and 88.0%, respectively. The mortality of the treated groups were 0∼8.3%, being much lower than that of the control. Four kinds of bacteria were isolated from the fecal specimens of 94 pigs, and 84 (89.0%) of 94 pigs showed the complicated infection.