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.

천식 환자와 정상인에 있어서의 Extracellular Phospholipase A_2의 활성도

서영의,김능수,이종명 慶北大學校 醫科大學 1992 慶北醫大誌 Vol.33 No.3

Extracellular PLA_2는 arachidonic acid cascade에 작용하는 효소로서 다양한 세포들에서 분비되며, 염증반응을 비롯한 여러가지 질환에 관여함이 알려져있다. 저자들은 기관지 천식과 PLA_2의 관계를 알아보기 위해 천식 환자들과 정상 대조군의혈청과 소변에서 PLA_2 활성도를 측정하고 폐기능 악화에 따른 천식정도, 혈청 IgE치 및 말초혈액 호산구 수와의 관계를 조사하였다. 정상 대조군에 비하여 천식 환자군에서 혈청 및 소변의 PLA_2 활성도가 유의하게 증가되어 있었으나(P<0.01, p<0.05) 혈청 PLA_2 활성도는 폐기능 정도와는 비례하지 않았다. 또한 혈청 PLA_2 활성도와 혈청 IgE치나 말초 혈액 호산구 수 사이에는 상관관계가 없었다. 이상의 결과로 볼 때 PLA_2는 기관지 천식의 병리 기전에 관여할 것으로 사료되나 혈청 PLA_2 활성도가 천식정도를 반영하지는 않는 것으로 보여진다. Extracellular phospholipase A_2(PLA_2) is known to be secreted by the mononucteocytes, granukxytes and chondrocytes in the joint, and it is also reported that this enzyme is increased in inflammatory conditions, such as acute pancreatitis, sepsis, ARDS and arthritis. To evaluate the changes of PLA_2 in the asthmatics the authors measured extracellular PLA_2 of asthmatics and healthy individuals in their serum and urine. In 84 normal controls, the levels of PLA_2 activity in serum and urine were 177.26±130.68 U/㎖ and 127.56±87.04 U/㎖, respectively. There was significant difference between male and female groups in serum and urine. In 51 asthmatics, the levels of PLA_2 activity in serum and urine were 739.10±454.52 U/㎖ and 292.50±154.49 U/㎖, respectively. These were significantly higher than those of healthy controls in both serum and urine. No significant correlation was found between serum PLA_2 activity and peripheral blood eosinophil count and there was no significant difference in serum PLA_2 activity between symptomatic asthmatics and asymptomatic asthmatics. However the level of serum PLA_2 activity in asymptomatic asthmatics was still higher than that of healthy controls. Receiving steroids seems to make no difference in serum PLA_2 activity in asymptomatic asthmatics.

소아 Lymphoreticular Malignancy의 말초혈액 T-임파구 아형 분포와 질병 경과에 대한 연구

서종진,정기영 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2

The authours studied on the relationship between peripheral blood T-lymphocyte subpopulations, outcome of lymphoreticular malignancies in childhood and frequency of infection in 12 patients with lyphoreticular malignancies. 1. Total numbers of lymphocyte of the patient group with poor outcome (Group 2) were decreased more than the patient group with good outcome (Group 1) significantly (p<0.005). 2. Percent OKT4+T-lymphocyte in cancer patients was significantly decreased compared to normal control subjects(p<0.05), but there was no significant difference between patient groups. 3. Total number of OKT4+T-lymphocyte in Group 2 were decreased significantly more than Group 1(p<0.005). 4. Percent OKT4+T-lymphocyte in cancer patients was increased compared to normal control(p<0.005), but there was no significant difference between patient groups. 5. Total numbers of OKT8+T-lymphocyte in Group 1 were increased significantly more than Group 2(P<0.005). 6. The ratio of OKT4_/OKT8+in cancer patients were decreased significantly (p<0.005), but there was no signifiant difference between patient groups. 7. We coould find no significant relationship between the frequency of infections and the status of T-lymphocyte subpopulations at diagnosis. Theses results suggest that the children with lymphoreticular malignancies have depressed cellular immune functions and the outcome of the disease can be significantly influenced by the status of T-lymphocyte subpopulations before treatment. Conclusively, the assessment of cellular immunity with T-lymphocyte subpopulations can give prognostic implications before treatment of lymphoreticular malignancies in childhood.

중부지역 옥수수 파종기에 따른 생육단계 및 수량성 변화

서종호, 문중경, 정건호, 서민정, 구자환, 박장환, 배환희, 신성휴, 권영업 忠北大學校 農業科學硏究所 2014 農業科學硏究 Vol.30 No.2

Maize hybrids were planted on April 1, April 25, May 20 and June 15 in 2012, 2013 at the experimental paddy and upland fields in Suwon city , respectively to know changes of growth stage and yield according to different planting time. Maize planting on April 1 was not recommended because total growing days at planting on April 1 was not different with that at planting on April 25 due to many days from planting to emergence over 20 days at planting on April 1. Total growing days were not much different among three planting time after April 25 because days from silking to maturity was lengthened though days from planting to silking was shortened at later planting time. Stalk weight was decreased as planting time was delayed, particularly at planting times after May 20 at paddy field by excess water injury during early growth stage. But, grain yield was not low as in May and June. It is needed to introduce early maturity maize variety as Yanganok at late planting for higher grain yield and enough time for soil preparation for next winter crops

상부요로폐색환자에서 신주사상 분리신기능과 크리아티닌청소치 비율의 비교

정헌영,서기석,김종성 大韓泌尿器科學會 1998 Korean Journal of Urology Vol.39 No.2

Helicobacter pylori 양성인 소화성 궤양 및 위염 환자에서 Helicobacter pylori 제균에 대한 판토프라졸 포함 삼제 요법의 임상효과 및 내약성에 대한 연구

서영호,이완식,주영은,김현수,최성규,유종선,김행재,서순팔,김세종 최신의학사 2000 最新醫學 Vol.43 No.11-12

공간전압벡터 PWM 방식을 이용한 유도전동기의 속도제어

서영수,하종욱 명지대학교 대학원 1997 대학원논문집 Vol.1 No.-

In this paper, the speed control system of Induction motor was proposed using vector control algorithm and space voltage vector PWM method to improve the dynamic performance of induction motor. The control system is composed of the PI controller for speed control and the current controller using space voltage vector PWM technique. The high-speed calculation and processing for vector control is carried out by TMS320C31 digital signal processor and IGBT module. The proposed scheme is verified through digital simulations and experiments for 3.7[kw] induction motor and shows good dynamic performance.

실기종목에 따른 중학교 체육수업의 실제 학습시간 비교

서봉한,황영성,이종현,오영도,이중숙 釜山大學校 附設 體育科學硏究所 1998 體育科學硏究所 論文集 Vol.14 No.-

The purpose of this study is to investigate the academic learning time of basketball, valleyball, vault horse, and balance beam teaching in physical education of junior high school. The subjects were 16 junior high school students living in U city, and their classes were recorded on video tape. The analatic methods were 5 seconds observation with BESTPED system, monitor stop and recording survey of Academic Learning Time-Physical Education. To analyze the academic learning time, independent varieables was set to practical carriculum(basketball, valleyball, vault horse, and balance beam) and dependent varieables were set to the academic learning time. To testify the relation between the independent varieables and the dependent varieables, dependent t-test was accomplished ar α=.05 level. The results were as follows; 1. In the comparison of ball game with gymnastics, position movement(p=.0004), practice(p=.0023), implement preparation(p=.0001), exercise(p=.000) and deviation(p=.000) brought out the differences. Also, waiting(p=.0001), watching(p=.0037) and information transmission(p=.0157) brought out the differences too, but information reception and interaction didn't. 2. In the comparison of basketball, position movement(p=.0438), practice(p=.0012), exercise(p=.0012) brought out the defferences but implement preparation didn't. Also, information reception(p=.0001), interaction(p=.0049), information transmission(p=.0000) and waiting(p=.0377) brought out the differences too, but watching didn't. 3. In the comparison of vault horse with a balance beam, practice(p=.0230) and exercise(p=.0003) brought out the differences but position movement, implement preparation, and deviation didn't. Also, information reception(p=.0013) and waiting(p=.0013) brought out the differences too, but interaction, information and watching didn't.

병원간호직 근무자의 근속성향 결정요인

서영준,고종욱 한국병원경영학회 1997 병원경영학회지 Vol.2 No.1

This study purports to investigate the determinants of propensity to stay among nursing staff working at Korean hospitals. The independent variables contains three groups of determinants : environmental variables(job opportunity, spouse support, and parent support), psychological variables(met expectations, work involvement, positive affectivity, and negative affectivity), and structural variables(job autonomy, work unit control, routinization, supervisor support, coworker support, role ambiguity, role conflict, workload, resource inadequacy, distributive justice, promotional chances, job security, job hazards, and pay). The sample used in this study consisted of 329 nurses and 175 nurse aides from two university hospitals in Seoul and its surburbs. Data were collected with self-administered questionnaires and analyzed using path analysis. The results of this study indicate that : (1) the following variables, listed in order of size, have significant positive effects on propensity to stay among hospital nursing staff : job satisfaction, met expectations, supervisor support, job security, and positive affectivity, (2) the following variables, listed in order of size, have significant negative total effects on propensity to stay among hospital nursing staff : job opportunity, negative affectivity, and rutinization, (3) the model explains 44.2 percent of the variance in propensity to stay among nursing staff working at two university hospitals, and (4) managerial support for improving the job autonomy, distributive justice, and promotional opportunity for nurse aides are needed.

EXTENDED KALMAN FILTER를 이용한 유도전동기 벡터 제어

서영수,허종명 명지대학교 산업기술연구소 2001 産業技術硏究所論文集 Vol.20 No.-

This paper presents a detailed study of the extended Kalman filter(EKF) for estimating the rotor speed of an induction motor drive. The general structure of the Kalman filter is reviewed and the various system vectors and matrices are defined. By including the rotor speed as a state variable, the EKF equations are established from a discrete two axis model of the three-phase induction motor. using the software MATLAB/Simulink, simulation of the EKF speed estimation algorithm is carried out for an induction motor drive with direct self control. The investigations show that the EKF is capable of tracking the actual rotor speed provided that the elements of the covariance matrices are properly selected. Moreover, the performance of the EKF is satisfactory even in the presence of noise or when there are variations in the indution machine parameters.