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Nari Shin,Eon Chul Han,Sungho Won,Seung-Bum Ryoo,Eun Kyung Choe,Byung Kwan Park,Kyu Joo Park 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.99 No.2
Purpose: The management of patients with colorectal cancer (CRC) who have liver cirrhosis (LC) requires a thorough understanding of both diseases; however, the prognoses and postoperative outcomes of such patients remain understudied. We investigated the effect of LC on surgical and oncologic outcomes in patients with CRC, and identified prognostic factors. Methods: We analyzed 453 patients with CRC and LC (CRC-LC group), 906 with CRC only (CRC group), 906 with LC only (LC group), and 1,812 healthy subjects using health insurance claim data (2008–2013). Results: The CRC-LC group had a higher frequency of intensive care unit admission than the CRC group; there were no differences between the 2 groups in terms of early and late postoperative small bowel obstruction and incisional hernia. However, the 30-day, 60-day, and 90-day mortality rates were all significantly higher in the CRC-LC group. The higher Charlson comorbidity index (hazard ratio [HR], 1.127) and the lower socioeconomic status (HR, 0.985) were significant worse predictors of 5-year survival. Patients with underlying LC had a significantly higher HR in both the advanced CRC (HR, 1.858) and nonadvanced CRC (HR, 1.799) subgroups. However, the nonadvanced CRC subgroup showed a lower HR than the LC group (HR, 0.730). Conclusion: Patients with CRC who had underlying LC had a lower survival rate than did those without LC, although the incidence rates of postoperative complications were not significantly different. The presence of LC was associated with a significantly lower survival rate regardless of CRC presence.
Shin, Nari,Jo, Hong-Jae,Kim, Woo-Kyung,Park, Won-Young,Lee, Jeong-Hee,Shin, Dong Hun,Choi, Kyung Un,Kim, Jee-Yeon,Lee, Chang-Hun,Sol, Mee Young,Jeon, Tae Yong,Kim, Dae Whan,Huh, Gi-Young,Kim, Gwang Ha Lippincott Williams Wilkins, Inc. 2011 The American journal of surgical pathology Vol.35 No.7
Despite wide acceptance of the chronic gastritis-intestinal metaplasia-dysplasia-carcinoma sequence, especially for intestinal-type gastric adenocarcinoma, the precise nature of the subtle precursor lesions of gastric cancer remains to be delineated. For example, pit dysplasia with surface foveolar maturation is not well defined, nor is its prevalence and biological characteristics well characterized. We have evaluated the surrounding gastric mucosa of 414 gastric cancers for the presence of gastric pit dysplasia. We investigated its relationship with various clinicopathological and immunophenotypic features of gastric adenocarcinoma, as well as the severity and extent of any surrounding gastritis and intestinal metaplasia. p53 expression and Ki-67 proliferation index were also evaluated. We have found that 21.0% (n=87) of gastric cancer cases showed pit dysplasia in adjacent gastric mucosa. Gastric cancers with pit dysplasia were significantly associated with older age, male sex, body/fundic location, and intestinal histologic type (P<0.05). Interestingly, gastric mucin-containing intestinal metaplasia (incomplete intestinal metaplasia) was highly associated with adenocarcinoma with pit dysplasia (P=0.000). In addition, MUC6 expression in gastric adenocarcinoma was associated with pit dysplasia (P=0.036). p53 overexpression and increased Ki-67 proliferation index were more evident in gastric pit dysplasia compared with adjacent gastric mucosa. We suggest that gastric pit dysplasia is an important candidate precursor of gastric adenocarcinoma and may represent another morphologic step in the pathogenesis of gastric adenocarcinoma, especially of intestinal type. More detailed prospective studies are needed to determine the precise significance of these findings.
Unveiling lymph node metastasis in early gastric cancer.
Shin, Nari,Jeon, Tae-Yong,Kim, Gwang Ha,Park, Do Youn WJG Press 2014 WORLD JOURNAL OF GASTROENTEROLOGY Vol.20 No.18
<P>With respect to gastric cancer treatment, improvements in endoscopic techniques and novel therapeutic modalities [such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD)] have been developed. Currently, EMR/ESD procedures are widely accepted treatment modalities for early gastric cancer (EGC). These procedures are most widely accepted in Asia, including in Korea and Japan. In the present era of endoscopic resection, accurate prediction of lymph node (LN) metastasis is a critical component of selecting suitable patients for EMR/ESD. Generally, indications for EMR/ESD are based on large Japanese datasets, which indicate that there is almost no risk of LN metastasis in the subgroup of EGC cases. However, there is some controversy among investigators regarding the validity of these criteria. Further, there are currently no accurate methods to predict LN metastasis in gastric cancer (for example, radiologic methods or methods based on molecular biomarkers). We recommend the use of a 2-step method for the management of early gastric cancer using endoscopic resection. The first step is the selection of suitable patients for endoscopic resection, based on endoscopic and histopathologic findings. After endoscopic resection, additional surgical intervention could be determined on the basis of a comprehensive review of the endoscopic mucosal resection/endoscopic submucosal dissection specimen, including lymphovascular tumor emboli, tumor size, histologic type, and depth of invasion. However, evaluation of clinical application data is essential for validating this recommendation. Moreover, gastroenterologists, surgeons, and pathologists should closely collaborate and communicate during these decision-making processes.</P>
Nari Shin,Whajin Hyun,Hongmie Lee,Mansoo Ro,Kyunghee Song 대한지역사회영양학회 2012 Nutrition Research and Practice Vol.6 No.4
This study was performed in order to investigate dietary habits, health related lifestyle and blood cadmium and lead levels in female college students. 80 college students (43 males and 37 females) participated in the survey questionnaires. Body weight and height, blood pressure, and body composition were measured. The systolic blood pressure of male and female students were 128.9 ± 13.9 and 109.8 ± 12.0, respectively. The diastolic blood pressure of male and female students were 77.1 ± 10.3 and 66.0 ± 6.9, respectively, showing that male students had significantly higher blood pressure than female students (P < 0.001). The BMI of male and female students were 23.4 ± 3.3 and 20.2 ± 2.3, respectively. Most male students were in the range of being overweight. The dietary habits score of female students was significantly higher than that of male students (P < 0.01).The blood cadmium level of male and female students were 0.54 ± 0.23 and 0.52 ± 0.36, respectively. There was no significant difference between male and female students. The blood lead level of male and female students were 1.09 ± 0.49 and 0.59 ± 0.45, respectively. The blood lead level of male students was significantly higher than that of female students (P < 0.001). The blood cadmium level of smokers and nonsmokers were 0.69 ± 0.29 and 0.49 ± 0.29 respectively (P < 0.05). The blood cadmium level of smokers was significantly higher than that of nonsmokers (P < 0.05). The blood lead level of smokers and nonsmokers were 1.09 ± 0.43 and 0.80 ± 0.54, respectively. The blood lead level of smokers was significantly higher than that of nonsmokers (P < 0.05). Therefore, proper nutritional education programs are required for college students in order to improve their dietary and health related living habits.
신나리(Nary Shin) 충북대학교 생활과학연구소 2010 생활과학연구논총 Vol.14 No.1
Demands for child care in Korea has been strong due to the predominant social phenomena such as growing female workforce, more intensified female education, and the low birth rates. Accordingly, supports for child care services at societal level have been emphasized. Among various elements of society, employers and local community were focused as sources to support public child care. As for the role of employers, employer-supported child care programs has been developed as a unique type of child care services. On the other hand, the role of communities was mainly regarded as providing an adequate level of supports for child care programs such as field visits, guest speakers, etc. In particular, local community networks have been emphasized as an effective way to support child care programs in systemic ways. The author criticizes the roles that employers and local community networks play still insufficient.
신나리(Nary Shin),최은영(Eun Young Choi),우송희(Song Hee Woo) 충북대학교 생활과학연구소 2012 생활과학연구논총 Vol.16 No.1
In-service education programs are crucial in order to improve and maintain professionalism of directors and teachers at child care centers. This study focused on satisfaction of professionals working with children with in-service education programs. 324 directors and 372 child care teachers responded to a questionnaire asking for their satisfaction with various components of in-serve education programs. Chi-square tests were used to identify differences in the type and location of child care centers that the participants were employed. The main findings showed that professionals working with children at child care centers were mostly satisfied with in-service education programs at moderate levels. Significant differences by types of child care centers and by regions were hardly found.