• Journal of Gastric Cancer
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• 제13권4호
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• pp.247-254
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• 2013

Purpose: In Korea, the entire population must enroll in the national health insurance system, and those who are classified as having a lower socioeconomic status are supported by the medical aid system. The aim of this study was to evaluate the association of the medical insurance status of gastric cancer patients with their survival after gastrectomy. Materials and Methods: A total of 247 patients who underwent surgical treatment for gastric cancer between January 1999 and December 2010 at the Seoul Medical Center were evaluated. Based on their medical insurance status, the patients were classified into two groups: the national health insurance registered group (n=183), and the medical aid covered group (n=64). The survival rates were calculated using the Kaplan-Meier method. Results: The median postoperative duration of hospitalization was longer in the medical aid covered group and postoperative morbidity and mortality were higher in the medical aid group than in the national health insurance registered group (P<0.05). The overall 5-year survival rate was 43.9% in the medical aid covered group and 64.3% in the national health insurance registered group (P=0.001). Conclusions: The medical insurance status reflects the socioeconomic status of a patient and can influence the overall survival of gastric cancer patients. A more sophisticated analysis of the difference in the survival time between gastric cancer patients based on their socioeconomic status is necessary.

• Asian Pacific Journal of Cancer Prevention
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• 제15권10호
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• pp.4251-4254
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• 2014

Background: Treatment of anemia is an important issue in the palliative care setting. Blood transfusion is generally used for this purpose in supportive care. However the place of blood transfusion in terminally ill cancer cases is less far established. Objective: We aimed to outline the use of transfusions and to find the impact of blood transfusion on survival in patients with advanced cancer and very near to death. Design: Patients dying in 2010-2011 with advanced cancer were included in the study. We retrospectively collected the data including age, type of cancer, the duration of last hospitalisation, ECOG performance status, Hb levels, transfusion history of erythrocytes and platelets, cause and the amount of transfusion. The anaemic patients who had transfusion at admission were compared with the group who were not transfused. Survival was defined as the time between the admission of last hospitalisation period and death. Results: Three hundred and ninety eight people with solid tumours died in 2010-2011 in our clinic. Ninety percent of the patients had anemia at the time of last hospitalisation. One hundred fifty three patients had erythrocyte transfusion at admission during the last hospitalisation period (38.4%). In the anaemic population the duration of last hospitalisation was longer in patients who had erythrocyte transfusion (15 days vs 8 days, p<0.001). Conclusions: Patients who had blood transfusion at the end of life lived significantly longer than the anaemic patients who were not transfused. This study remarks that blood transfusions should not be withheld from terminal cancer patients in palliative care.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5473-5476
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• 2013

Background: In our study, the LDH, albumin, hemoglobin, neutrophile, thrombocyte, lymphocyte counts and prognostic significance of neutrophile-lymphocyte and thrombocyte-lymphocyte ratios in NSCLC derived from these counts obtained during regular examinations of patients were examined. Materials and Methods: Histopathologically diagnosed non-small-cell-lung cancer patients between 2008 and 2010 were included in the study. Before the treatment, full blood count including routine lymphocyte count, blood biochemistry examinations including liver (AST, ALT, total protein, Albumin), LDH and kidney (BUN, Cre) function tests were performed. Results: A total of 156 patients, 76 of whom (48.7%) were female and 80 of whom (51.3%) were male were included. Mean hemoglobin level was determined as 12. Overall survival was found to be significantly dependent on whether patients were anemic or not (p: 0.005). Mean LDH level was determined as 233.4. There was nosurvival difference between patients with and without high LDH (p: 0.532). In patients where NLR showed systemic inflammatory response, overall survival was 10.8 months whereas this duration was 19.6 months in patients where the systemic inflammatory response was negative (p: 0.012). In patients where TLR showed systemic inflammatory response, overall survival was 13.6 months whereas this duration was 21.9 months in patients where the systemic inflammatory response was negative (p: 0.04). Conclusions: Molecular methods have been changing rapidly in today's world and they manage the treatment besides defining the prognosis of patients. However, easily accessible and cheap laboratory parameters should be considered in the prognosis of patients besides these new methods.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6559-6564
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• 2014

Objective: To evaluate the efficacy and safety of bevacizumab in the treatment of patients with metastatic colorectal cancer (mCRC). Methods: In a single-center, observational study of 91 Chinese patients with mCRC who received bevacizumab in combination with chemotherapy was conducted. Objective response rates (ORRs), progression-free survival (PFS), overall survival (OS) and adverse events were recorded, and the relationships between various clinical factors and PFS or OS were evaluated by Cox proportional hazards models. Results: Treatment with bevacizumab and chemotherapy was effective and tolerable. Univariate analysis showed that PFS and OS were significantly associated with the Eastern Cooperative Oncology Group performance status (ECOG-PS) score, duration of bevacizumab exposure, and whether chemotherapy was continued after discontinuation of bevacizumab treatment. A multivariate analysis showed that the duration of bevacizumab exposure and whether chemotherapy was continued after discontinuation of bevacizumab were independent prognostic factors for PFS and OS. Conclusion: In Chinese mCRC population, the shorter the duration of exposure to bevacizumab and chemotherapy, the worse the prognosis is.

• 대한치과보철학회지
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• 제47권3호
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• pp.266-272
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• 2009

연구목적: 전 세계적인 고령화 추세에 따라 무치악 환자들이 증가하고 이들의 임플란트 보철 수복에 대한 수요와 관심이 증가하고 있다. 부분 무치악 또는 완전 무치악에서 임플란트를 이용한 보철 치료는 효과적이며 그 성공율 또한 높게 보고되고 있다. 하지만 임플란트 사용 범위가 다양해짐에 따라 여러 가지 실패가 보고되고 이러한 실패를 줄이기 위한 방법들이 연구, 개발되고 있다. 이에 본 연구에서는 임플란트 생존율을 조사하고, 이를 토대로 향후 임플란트의 생존율에 대해 예측하고자 한다. 연구 방법: 1998년 8월부터 2003년 8월까지, 2003년 9월부터 2007년 4월까지 두 차례로 나누어 진료기록부 조사를 통해 최근 10년 동안 단국대학교 치과병원에서 임플란트를 치료받은 환자들의 임플란트 생존율에 대해 조사하였다. 결과: 진료기록부 조사를 통해 식립된 임플란트의 수, 임플란트 위치 및 분포, 1차 수술 후부터 2차 수술까지의 기간, 생존율 등을 조사하여 다음과 같은 결과를 얻었다. 1. 1차 조사에서 612명 환자에게 1680개의 임플란트가 식립되고, 2차 조사에서는 933명 환자에게 2438개가 식립되어 총 1545명의 환자에게 4118개 임플란트가 식립되었다. 2. 총 1545명 환자의 성비는 남성이 57.2% (884명), 여성이 42.8% (661명)였고, 총 4118개 임플란트에서 상악에 1739개 (42.2%), 하악에 2379개 (57.8%)가 식립되었으며 하악 구치부에 2043개 (53.2%)가 식립되어 제일 높은 비율을 차지하였다. 3. 1차 조사에서는 총 1680개의 임플란트 중 57개가 실패하였고 2차 조사에서는 2438개의 임플란트 중 17개가 실패하여 총 4118개의 임플란트 중 74개가 실패 하여 98.2%의 생존율을 보였다. 4. 1차 수술 이후 2차 수술이 시행되기까지의 기간은 상악에서 평균 7.4개월에서 6.8개월로, 하악에서 평균 5.6개월에서 5.0개월로 2차 조사 기간에서 0.6개월 단축되었다. 결론: 이상의 결과로 볼 때 1차 조사에서보다 2차 조사시에 식립된 임플란트의 수 및 생존율이 증가하였고 1차수술 후부터 2차 수술 전까지 기간도 단축되고 있음을 알 수 있었다. 앞으로도 임플란트에 대한 관심과 수요가 계속 증가 할 것이고 그 성공율 또한 증가하리라 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5735-5739
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• 2012

Background: Malignant mesothelioma (MM) is an insidious tumor with poor prognosis, arising from mesothelial surfaces such as pleura, peritoneum and pericardium. We here aimed to evaluate the demographic, clinical, and radiological features of patients with MM followed in our center as well as their survival. Methods: The study included 228 patients (131 male, 97 female) who were followed up in our institution between 1993 and 2010 with the diagnosis of MM. Results: The mean age was 59.1 years in men and 58.7 years in women and the sex ratio was 1.4:1 in favor of males. Environmental asbestos exposure was present in 86% of the patients for a mean duration of $40{\pm}20$ years (range: 3-70). Pleural effusion and thoracic/abdominal pain were the most common presenting signs and symptoms (70.2% and 57.8%, respectively). One hundred-thirteen (66%) patients were treated with platinum-based combination chemotherapy (PBCT) plus supportive care (SC) and 67 (34%) patients received SC alone. The median follow-up time was 10.0 months. The median overall survival was significantly improved with PBCT plus SC compared to SC alone (11.4 vs. 5.1 months; p=0.005). The 6, 12, 18, and 24-month survival rates were significantly improved with PBCT plus SC compared to SC alone (72%, 43%, 19%, and 2% vs. 49%, 31%, 11%, and 1%). Conclusion: The survival of patients with MM improved in patients treated with PBCT. The survival advantage continued 12- and 24-month after the initial time of combination chemotherapy.

• Radiation Oncology Journal
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• 제35권1호
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• pp.48-54
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• 2017

Purpose: This study aimed to assess the effects of body mass index (BMI) on survival in cervical cancer patients who had undergone surgery and radiotherapy (RT). Materials and Methods: We retrospectively reviewed the medical records of 70 cervical cancer patients who underwent surgery and RT from 2007 to 2012. Among them, 40 patients (57.1%) had pelvic lymph node metastases at the time of diagnosis. Sixty-seven patients (95.7%) had received chemotherapy. All patients had undergone surgery and postoperative RT. Median BMI of patients was $22.8kg/m^2$ (range, 17.7 to $35.9kg/m^2$). Results: The median duration of follow-up was 52.3 months (range, 16 to 107 months). Twenty-four patients (34.3%) showed recurrence. Local failure, regional lymph nodal failure, and distant failure occurred in 4 (5.7%), 6 (8.6%), and 17 (24.3%) patients, respectively. The 5-year actuarial pelvic control rate was 83.4%. The 5-year cancer-specific survival (CSS) and disease-free survival (DFS) rates were 85.1% and 65.0%, respectively. The presence of pelvic lymph node metastases (n = 30) and being overweight or obese (n = 34, $BMI{\geq}23kg/m^2$) were poor prognostic factors for CSS (p = 0.003 and p = 0.045, respectively). Of these, pelvic lymph node metastasis was an independent prognostic factor (p = 0.030) for CSS. Conclusion: Overweight or obese cervical cancer patients showed poorer survival outcomes than normal weight or underweight patients. Weight control seems to be important in cervical cancer patients to improve clinical outcomes.

• 지역연구
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• 제37권4호
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• pp.3-19
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• 2021

최근 높아진 개·폐점률로 인해 자영업자들의 생존율은 낮아지고 조기폐업은 증가하고 있으며, 이는 개인의 부채 증가, 고용불안정과 같은 사회적 문제뿐만 아니라 도시공간 공동화라는 도시문제까지 야기하고 있다. 이와 관련해, 상업공간 내 사업체의 변화양상과 높은 창·폐업률에 미치는 영향요인을 밝히는 연구가 진행되고 있으나 연구의 범위가 한정적이어서 서울시 전체지역 내 사업체의 변화에 대한 객관적인 진단이 부족한 상태이다. 이에 본 연구는 서울시 내 주요상권을 대상으로 폐업 및 생존한 사업체의 영업기간 변화를 활용해 각 상권의 특성을 논의한다. 분석 결과, 서울시의 상업공간 변화특성은 크게 두 가지로 구분할 수 있었다. 도심상권(중구 및 종로구)과 영등포 상권은 사업체들이 안정적으로 영업하는 양상을 보이며, 국지적으로 활발한 사업체 변화를 보였다. 또한, 강남상권과 마포상권은 전체적으로 생존한 사업체들과 폐업한 사업체들 모두 짧은 영업기간을 보였다. 이런 상권별 변화특성의 차이는 영업체의 생존과 폐업활동이 상업공간의 장소적 특성과 밀접하게 연관되어 있음을 의미하며, 공간별 사업체 변화에 따른 적절한 해결책 제시가 필요함을 시사한다.

• Korean Circulation Journal
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• 제53권5호
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• pp.313-327
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• 2023

Background and Objectives: Pulmonary arterial hypertension (PAH) is a rare but fatal disease. Recent advances in PAH-specific drugs have improved its outcomes, although the healthcare burden of novel therapeutics may lead to a discrepancy in outcomes between developing and developed countries. We analyzed how the epidemiology and clinical features of PAH has changed through the rapidly advancing healthcare infrastructure in South Korea. Methods: PAH was defined according to a newly devised 3-component algorithm. Using a nationwide health insurance claims database, we delineated annual trends in the prevalence, incidence, medication prescription pattern, and 5-year survival of PAH in Korea. Cumulative survival and potential predictors of mortality were also assessed among 2,151 incident PAH cases. Results: Between 2002 or 2004 and 2018, the prevalence and incidence of PAH increased 75-fold (0.4 to 29.9 per million people) and 12-fold (0.5 to 6.3 per million person-years), respectively. The proportion of patients on combination PAH-specific drug therapy has also steadily increased up to 29.0% in 2018. Among 2,151 incident PAH cases (median [interquartile range] age, 50 [37-62] years; 67.2% female), the 5-year survival rate and median survival duration were 71.8% and 13.1 years, respectively. Independent predictors of mortality were age, sex, etiology of PAH, diabetes, dyslipidemia, and chronic kidney disease. Conclusions: This nationwide study delineated that the prevalence and incidence of PAH have grown rapidly in Korea since the early 2000s. The use of combination therapy has also increased, and the 5-year survival rate of PAH in Korea was similar to those in western countries.

• Journal of Chest Surgery
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• 제48권3호
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• pp.180-186
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• 2015

Background: Extracorporeal membrane oxygenation (ECMO) has recently attracted interest as a treatment for severe acute respiratory distress syndrome (ARDS). However, the outcomes of this procedure in post-surgical settings have not yet been characterized. In this study, we evaluated the outcomes of ECMO in patients with severe postoperative ARDS. Methods: From January 2007 to December 2012, a total of 69 patients (aged $58.3{\pm}11.5$ years, 23 females) who underwent venovenous ECMO to treat severe postoperative ARDS were reviewed. Of these patients, 22 (31.9%) had undergone cardiothoracic surgery, 32 (46.4%) had undergone liver transplantation, and 15 (21.7%) had undergone other procedures. Results: Thirty-four patients (49.3%) were successfully weaned from ECMO, while the other 35 patients (50.7%) died on ECMO support. Among the 34 patients who were successfully weaned from ECMO, 21 patients (30.4%) eventually died before discharge from the hospital, resulting in 13 hospital survivors (18.8%). Multivariable analysis showed that the duration of pre-ECMO ventilation was a significant independent predictor of death (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.29 to 3.90; p=0.004), whereas the concomitant use of continuous venovenous hemodialysis (CVVHD) was associated with improved survival (OR, 0.55; 95% CI, 0.31 to 0.97; p=0.038). Conclusion: Although the overall survival rate of patients treated with ECMO for postoperative ARDS was unfavorable, ECMO offered an invaluable opportunity for survival to patients who would not have been expected to survive using conventional therapy. CVVHD may be beneficial in improving the outcomes of such patients, whereas a prolonged duration of pre-ECMO ventilator support was associated with poor survival.