Trends in incidence and survival of esophageal cancer in Korea: Analysis of the Korea Central Cancer Registry Database

Shin, Aesun,Won, Young‐,Joo,Jung, Hye‐,Kyung,Kong, Hyun‐,Joo,Jung, Kyu‐,Won,Oh, Chang‐,Mo,Choe, Sunho,Lee, Jihyun John Wiley and Sons Inc. 2018 Journal of gastroenterology and hepatology Vol.33 No.12

<P><B>Abstract</B></P><P><B>Background and Aim</B></P><P>The diagnostic and therapeutic modalities of esophageal cancer have recently improved in Asia, and its prognosis is expected to change. This study provides a population‐based report on the epidemiology of esophageal cancer in Korea.</P><P><B>Methods</B></P><P>Cancer incidence data from 1999 to 2013 were obtained from the Korea Central Cancer Registry, covering the entire population. Age‐standardized incidence rates and annual percent changes were calculated according to subsites and histological types. Five‐year relative survival rates were estimated for cases diagnosed between 1993 and 2013. Relative excess rates were compared between patients diagnosed from 2009 to 2013 and 2006 to 2008.</P><P><B>Results</B></P><P>The age‐standardized incidence rates decreased from 8.8 per 100 000 populations in 1999 to 5.9 in 2013 with an annual percent change of −2.6% in men and −2.2% in women. The most common histological type was squamous cell carcinoma, accounting for 90.2% of all esophageal cancers in 2013, followed by adenocarcinomas (3.1%), and their incidences decreased. The proportion of localized and regional cancer tended to increase compared with that of distant cancer. Five‐year relative survival of squamous cell carcinoma improved from 12.1% (1993–1995) to 34.6% (2009–2013). Relative excess rate was 0.72 (95% confidence interval 0.65–0.80) in localized stage and 0.88 (95% confidence interval, 0.82–0.95) in regional stage comparing patients diagnosed from 2009 to 2013 and 2006 to 2008.</P><P><B>Conclusions</B></P><P>The incidence of esophageal cancer has decreased in Korea for the past 15 years, and 5‐year survival rates have improved significantly. These increases may be attributable to more effective detection of early‐stage disease.</P>

농촌지도직공무원 지방직 전환 첫 해의 예비평가

김성수(Sung Soo Kim),최창욱(Chang Wook Choi),최영창(Young Chang Choe) 한국농촌지도학회 1997 농촌지도와 개발 Vol.4 No.2

The objectives of this study were 1) to evaluate the first year of localization of agricultural extension in Korea, 2) to present the development directions and implications of agricultural extension service in the next year of localization. The major results and implications were as follows. 1. The positive changes in localization were to establish local special projects and to work in agricultural extension without personnel changes. 2. The negative changes in localization were increase of unnecessary work load and decrease of morale because of lowered status. 3. The development directions were m cut back unnecessary work load, to rearrange an office, and to return to the national status of extension personnels.

심인성 다음다갈증 2예

양창국,최병무,한홍무,김영대,주승재 동아대학교의과대학 1992 동아의대학술지 Vol.4 No.1

혈청 Glutamic oxalacetic transaminase(SGOT) 측정 방법의 비교실험에 관하여

최인성,장문기,문영희,백승룡 대한병리학회 1975 Journal of Pathology and Translational Medicine Vol.9 No.2

성정위술 자원자의 정신과적 면담 및 MMPI 반응분석

류설영,양창국,최병무,주영희 대한생물치료정신의학회 2002 생물치료정신의학 Vol.8 No.2

성정위술 기술의 발달과 이에 대한 수요가 증가하면서 성전환증 환자의 심리적 상태에 대한 관심이 높아져 가고 있는 시점에서, 본 연구는 부산 소재 일 대학병원 성형외과 및 정신과 외래를 방문한 성정위술 자원자를 정신과 전문의 2명의 면담한 기록지와 환자가 직접 작성한 MMPI 검사 결과를 분석하여 성전환증 환자의 특성에 대해 알아보고자 하였다. 결과, 인구학적 변인에 대한 빈도 분석에서는 성전환증 환자는 검사 당시 대도시에서 생활하고 있는 사람이 가장 많았고, 자신의 성정체성을 유지하기 용이하고 비슷한 심리적 갈등을 경험하는 사람들이 많은 유흥업소, 트랜스 바나게이 바에서 일하는 경향이 두드러졌으며, 결혼을 한 1명의 여자 환자를 제외하고 대부분 미혼이었고, 군대는 면제를 받는 경우가 가장 많았다. 아울러 부모의 생존여부 및 함께 생활한 것 등에 대한 빈도 분석 결과, 만5세 이전에 부모가 생존해 있고 함께 생활한 경우가 72.4%로 가장 많은 비율을 차지하고 있어 조실 부모 및 편부, 편모 하에서 성장 하는 것 자체가 성전환증 발생에 의미있는 변인으로 작용하는 것 같지는 않다. 그리고 형제 수는 검사 당시 나이의 평균 연령대에 비해 다소 많은 편이었고, 응답된 사람의 반수 이상이 형제 중 막내였다. 이성복장 시기는 남녀에서 뚜렷한 차이를 보였는데, 남자의 경우는 고등학교를 졸업하고 난후가 가장 많은 반면, 여성의 경우는 기억하는 한 여성의 옷을 입은 적이 없다고 한 경우가 가장 많은 비율을 차지하였다. 다른 수술과 호르몬 치료의 경우, 여성에 비해 남성이 보다 다양하고 많은 성전환 관련 다른 수술을 받았으며, 호르몬 치료 기간도 길었다. 인구학적 변인 중 마지막으로 자살 사고 및 자살 시도 경험 분석 결과, 청소년기에 자살 사고를 하거나 자살 시도를 한 경험을 한 사람이 90%을 넘고 있어, 이들은 현재 상태의 심리적 적응 정도가 어떠하든지 간에 한때 심각한 정도의 심리적 갈등을 경험하는 경우가 대부분인 것으로 생각된다. 남녀 MMPI 척도별 평균차 검증 결과, 남성과 여성의 MMPI 척도 중 Mf 척도가 가장 높이 상승되어 있고, 그 외 척도는 모두 40점에서 60점 사이로 정상 범위에 해당된다는 공통점이 있으나, 남성이 여성에 비해 심리적 불편감을 크게 느끼고 있는 것으로 나타났다. 이러한 경향은 MMPI 척도 중 70점이 넘는 척도가 10%를 넘는 경우에 대한 빈도 분석에서도 동일하게 나타나고 있는데, 남성은 D 척도 18.1%. Hy 척도 10.6%, Mf 척도 62.5%, Pt 척도 11.7%, Sc 척도 10.6%였고, 여성은 K 척도 12.5%, Mf 척도 27.5%에서 MMPI 점수가 70% 이상으로 나타나 남성이 여성에 비해 성정체성과 관련하여 심리적 불편감을 더욱 크게 느끼고 있음을 알 수 있었다. 마지막으로 군집 분석 결과, 전체 집단, 남녀 집단 각각 세 군집으로 나타났다. 전체 집단에서 보면, 세 군집 모두 반대성으로서의 성주체성을 확고하게 지니고 있다는 공통점을 보이고 있다. 하지만 각 군집별 특성은 상당히 상이하게 나타나고 있다. 하지만 각 군집별 특성은 상당히 상이하게 나타나고 있다. 제 1군집은 우울과 불안, 혼란감과 당혹감, 대인 관계예민성 등의 심리적 불편감을 크게 느끼고, 자신감이 저하된 채 다소 고립되어 지내고 있는 면이 있는 것 같다. 반면 제 2군집은 반대성으로서의 성정체성을 가장 완곡하게 드러내고 있는 집단으로, 심리적 불편감을 적절하게 방어하고 있으며, 약간의 불안감 외에 특별한 심리적 불편감을 느끼지 않고 활달하게 사회적 상황에 적응하며 지내는 특성을 나타내고 있다. 제 3군집은 두드러진 심리적 불편감이나 자신감 저하를 보이지는 않고 있으나 사회적 상황에서 다소 철수되어 소극적인 활동 양상을 보인다. 남성과 여성 집단의 제 1,2,3군집이 전체 집단의 제 1,2,3군집에 대칭되지는 않으나, 비슷한 MMPI 양상을 보이는 면이 많아 군집별로 남녀 차이를 살펴 본 결과 다음과 같다. 제 1군집의 경우, 남성과 여성 모두 가장 심한 심리적 갈등을 경험하고 있는 집단으로, 두 집단 모두 자신감 저하 및 다양한 심리적 불편감을 경험하고 있다는 공통점이 있으나 남성이 여성에 비해 더 심한 심리적 갈등을 경험하고 있는 것 같다. 제 2군집의 경우는 남성과 여성 모두 방어적인 경향이 있으나 남성의 경우, 약간의 심리적 갈등을 경험하고 있는 면이 드러나고 있으나 여성의 경우, 심리적 불편감을 강력하게 방어하면서 내면에 해결되지 못한 분노감을 지니고 있는 것 같다. 제 3군집의 경우가 가장 심리적으로 건강한 것 같은데, 남녀 모두 자신의 성주체성으로 인한 성적인 어려움, 자신감 저하, 심리적 갈등을 과도하게 방어하려는 경향이 두드러지게 드러나지는 않고 있다. 다만 남성의 경우는 주변 사람의 시선을 의식하고 이로인해 약간의 심리적 혼란을 경험하는 면이 있는 것 같으나, 여성의 경우는 반대성으로서의 성주체성을 과도하게 주장하지 않으며 전반적으로 매우 적응적으로 생활하고 있는 것 같다. 본 연구는 성전환증 환자의 인구학적 변인 관련 연구를 했고, 다양한 변인에서의 성전환증 환자의 남녀차를 비교 연구할 수 있었으며, MMPI 척도별 군집 분석을 실시하여 성전환증 환자의 특성을 파악할 수 있고, MMPI 척도별 군집 분석 결과를 토대로 성전환증 수술 자원자에 대한 정신과적 치료 접근의 기초를 제공한 점을 의의로 들 수 있겠다. 한편 본 연구의 제한점은 사전에 계획되어 실시되지않았고, 병력 기록지를 통한 조사 연구였으므로 정보를 제대로 알 수 없는 경우가 있었던 점, 실제로 수술 후 적응 상태에 어느 정도인지 알 수 없었던 점 등이다. Objectives : Recently, the skills of sex reassignment surgery have been developed. The number of transsexuals seeking sex reassignment surgery is growing. The purpose of this study is to know the psychological traits of patients(transsexuals seeking sex reassignment surgery)by analysing psychiatric interviews and MMPI responses. Method : Only 134 of 161 sex reassignment surgery volunteers were analysed. Male was 94 and female ws 40. Patients completed MMPI 383 or MMPI 566 and were interviewed by two psychiatrists. Results : 1) The results of frequency analysis of demographic data areas follows ; The total patients' mean age was 28.9±6.3 years old(range : 17-48). Male's mean age was 28.2 5.94 years old and female's mean age age was 30.5 6.92 years old. In the case of educatio, quitting or graduating high school(50.0%) was the most. As to occupation, 48.9% of patients worked at merrymaking place, trans bar or gay bar, 72.4% of patients were applicable to the case that parents were alive and have lived with patient at least until patient got 5 years old. About sibling order, 50.4% of patients were last child. In the case of cross-dressing, 33.9% of male patients started cross-dressing after graduating high school and 39.1% of female have had cross-dressing since childhood. The mean period of hormonal therapy was 5.8 years and 26.1 years of male patients and 66.7% of female had no experience of hormonal therapy. 62.9% of the popular had once suicidal idea and 33.9% of patients made a suicidal attempt. 2) MMPI scores of male and female were within normal range and Mf scale of both group were the highest. The result of t-test of MMPI scores according to biological sex was statistically significant and male patients showed higher scores in L, F, Hs, D, Hy, Mf, Pt, Sc scales than female. In D, Hy, Mf, Pt, Sc scales, more than 10% of male patients showed over 70 score and female patients were as well in K, Mf, scales. 3) Total group, male group and female group all divided into three clusters by cluster analysis. Cluster 1 showed prominently psychological distress including depression, anxiety, interpersonal sensitivity and male's distress seemed more severe than female. Cluster 2 was more defensive than other clusters. They seemed to experience a little psychological conflicts and female patients seemed to have unresolved anger. Cluster 3 looked like to have more acceptable attitude to their psychological gender than other clusters, however regarding in detail, male care about other's valuation. Conclusion : This stydy provides demographic data of transsexuals seeking sex reassignment surgery and shows that male transsexuals have more distress than female transsexuals because of their psychological gender. Just a part of transsexuals have abnormal personality or pathology needed to be treated psychotherapy.

Disorders of Liver : Is Endoscopic Variceal Ligation Effective For The Treatment Of Bleeding From Gastroesophageal Varices (GOV)?

( Won Hyeok Choe ),( So Young Kwon ),( Jeong Hwan Kim ),( Byung Kook Kim ),( Chi Hoon Kim ),( Chang Hong Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: The optimal management of bleeding from gastroesophageal varices (GOV) remains controversial. The aim of this study was to investigate whether endoseopic variceal ligation (EVL) is effective and safe for the management of bleeding from GOV. Methods: Forty-one cirrhotic patients receiving EVL due to a history of variceal bleeding from GOV were analyzed. In twenty-two patients of them, serial endoseopic ultrasonography (EUS) were performed. GOV were grade using the system suggested by Sarin et al: type I (GOVI) and type 2 (GOV2). Results: Twenty-eight patients were GOVI and thirteen patients were GOV2. Successful treatment for controlling acute bleeding were achieved in 26/28 (93%) in GOVI and 9/13 (85%) in GOV2. Rebleeding was 15% in GOVI, while 40% in GOV2. Multivariate Cox regression indicated that type of GOV, variceal size and residual variceal size after EVL were independent factors predictive of GOV re-bleeding. Serial EUS findings demonstrated that the size of GOVI became decreased after EVL in 10/15 (67%) patients, while GOV2 did not change. Conclusions: EVL was safe and effective for the emergency treatment of acutely variceal bleedings from GOV. For the preventing variceal rebleeding, EVL was more effective in GOVI than GOV2.

위저선 폴립의 임상 및 병리학적 분석 : 가족성 선종성 폴립증에 동반된 다발성 위저선 폴립과 산발적으로 발생된 위저선 폴립의 비교 A Clinical and Pathologic Analysis with Special Reference to Familial Adenomatous Polyposis

김나영,이동호,송인성,김용일,김우호,최규완,이국래,최기영,장미수 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.2

Background/Aims: The aims of this study are to clarify the morphology of fundic gland polyp (FGP) and to compare the features of FGP between familial adenomatous polyposis-associated group and sporadic development group. Methods: A total of 15 endo- scopic biopsy specimens of FGP from 13 patients were divided into three groups; Group A(3 cases; familial adenomatous polyposis family, multiple FGPs), Group B(3 cases; sporadic development, multiple FGPs) and Group C(7 cases; sporadic development, single FGP), and their endoseopic /microscopic features including mucin histochemistry and immunohistoc- hemistty(for PCNA) were compared. Results: FGPs were confined to the gastric body and fundus in all 3 groups, and measured 2-8 mm. Their numbers varied even in Group A and Group B, The difference was observed in their median age: 26 years in Group A and 55 years in Group B, respectively, but there were no differences in endoscopic, histologic, mucin histochemical and immunohistochemical(for PCNA) features. Micro-scopically, all FGPs were composed of fundic glands and scattered microcysts with a spectrum of disordered glandular architecture which ranged from convoluted gland to Y-shaped gland, to stellateshaped gland, and to irregular tortuous glancl with dilated lumen. Conclusions: We assume that diversity af morphologic features of FGP may develop from progression of hyperplastic/hamartomatous fundic glandular proliferation which may end up with microcyst formation as an evolutional change. Familial adenomatous polyosis-associated FGPs were not endoscopically and histologically distingishable from sporadic deveoped FGPs.

궁경1호전(宮頸1號煎)이 자궁경부암세포(子宮頸部癌細胞)(HeLa Cell)에 미치는 영향(影響)

강영금,최창민,조한백,유심근,Kang, Young-Keum,Choe, Chang-Min,Cho, Han-Back,Yoo, Sim-Keun 대한한방부인과학회 2005 大韓韓方婦人科學會誌 Vol.18 No.1

To address the ability of Kung-Kyung-Ilho-Jeon(KK) to induce cell death, we investigated the effect of KK on cell viability. Forty-eight hours later, loss of viability occurred following KK exposure in a dose-dependent manner. The treatment of KK, a commonly used herb formulation in Korea and China, caused a decrease in cell viability. KK also resulted in apoptotic morphology a brightly blue-fluorescent condensed nuclei by Hoechst 33258-staining, and reduction of cell volume. Our results show that KK induces caspase-3 and -9 activation in a time-dependent manner. In addtion, the translocation of cytochrome c release into cytoplasm has been observed under the presence of $5mg/m{\ell}$ KK. The subsequent loss of mitochondria membrane potential is collapsed by the addition of KK. Our immunoblotting data show that PARP, a well known caspase-3 and -6 substrate, is cleaved by KK. We show that a pro-apoptotic protein, Bax is increased in the presence of KK but that the amount of Bcl-2 is not changed. We suggest that Bax, a critical protein which can regulate channel of mitochondria to release cytochrome c, is a key protein in KK-induced apoptosis of Hela human cervical carcinoma cells

前腕部 經穴 取穴에서 骨度分寸法과 一夫法의 比較 硏究

박히준,채윤병,차웅석,박종배,이혜정,이향숙,인창식,고형균,김수영,최일환,김강식,문정배,배기태,유경환,육근영,정병주,손인철,임사비나 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2004 東西醫學硏究所 論文集 Vol.2004 No.-

Background : The cun measurement System, an essential and convenient method in locating acupoints, has been widely used in the practice of acupuncture. However, traditional cun measurement has been criticized for its lack of reliability. Objectives : The purposes of this study are to determine if one cun measured by the directional methods have a consistency with that of proportional methods and to investigate which factors are related with these differences, especially in forearm. Methods : The distance between the elbow crease and the wrist crease of forearm was compared to a reference value of one cun obtained by the directional method. In this method, one cun is one third of the distance between index finger and Small finger of a subject, measured at proximal interphalangeal joint. In addition, to investigate the factors influencing the differences between these two methods, we measured the height and body weight and calculated body mass index (BMI). Finally we analyzed the factors correlated with these lengths by linear regression test. Results : The results showed that one cun obtained by the directional methods were significantly different from one cun by the proportional methods in forearm. It was demonstrated that the length acquired with the directional method was more correlated with body weight and body mass index, while the length obtained by the proportional method was more correlated with the height.

Nucleos(t)ide Analogue Treatment for Chronic Hepatitis B Patients in Highly Replicative but Immune-tolerant or Mild Inflammatory Phase Prolongs Overall Survival

( Young Chang ),( Won Hyeok Choe ),( Dong Hyun Sinn ),( Jeong-hoon Lee ),( Joon Yeul Nam ),( Hyeki Cho ),( Young Youn Cho ),( Eun Ju Cho ),( Su Jong Yu ),( Yoon Jun Kim ),( Jung-hwan Yoon ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: The antiviral treatment for chronic hepatitis B (CHB) patients in highly replicative but low inflammatory phase (including immune tolerant phase) is still controversial. The aim of this study is to assess whether antiviral treatment can improve survival in HBeAg-positive CHB patients with high HBV DNA but normal to mildly elevated ALT level. Methods: This multi-center retrospective study included 602 patients diagnosed as HBeAg-positive CHB with HBV DNA above 20,000 IU/mL and ALT below 80 IU/L without evidence of liver cirrhosis (LC) in three large volume medical centers in Korea. The involved patients were categorized into two groups; antiviral treatment group (n=69) and control group (n=533). Primary endpoint was overall survival (OS) and secondary endpoints were development of LC and hep atocellular carcinoma (HCC). To compare the endpoints, baseline characteristics of the two groups were adjusted or balanced by Cox proportional hazards model and inverse probability weighting (IPW). Results: Baseline liver function was more favorable for the control group. In multivariate analysis, the treatment group showed significantly lower risk of developing LC (adjusted hazard ratio [aHR〕=0.326; P=0.006) and HCC (aHR=0.202; P=0.016), and consequently longer OS (aHR=0.137; P=0.052) than the control group. After balancing the baseline characteristics between the two groups by IPW, antiviral treatment significantly prolonged OS (aHR=0.067; P=0.016) (Figure 1) and the risk of LC (aHR=0.169; P<0.001) and HCC (aHR=0.101; P<0.001) in the treatment group were also reduced significantly compared to the control group. Assuming to treat the relevant patients with entecavir, the additional costs for reducing one patient of LC, HCC, and death were supposed to be approximately 10,000 USD, 25,000 USD, and 45,000 USD, respectively, in Korea. Conclusions: Antiviral therapy for CHB patients with high viral load prolongs OS and reduces the risk of LC and HCC even if ALT levels would not exceed two times of upper limit of normal.