• 정보화정책
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• 제19권4호
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• pp.63-82
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• 2012

우리나라의 정보인프라는 세계 최고 수준이다. 그러나 심각한 보안 사고의 위험 또한 동반하고 있다. 최근 일어난 주요 사고만 정리해도 유출된 개인정보는 우리나라 인터넷 사용인구의 세 배를 넘는다. 이제 개인정보 침해 등의 정보보안의 사고는 국가의 일급재난에 해당하는 정책문제가 되었다. 이 논문은 빅 데이터 시대의 정보보안을 위한 정책적 논의를 사회과학 차원에서 탐구하였다. 이를 위해 최근 사고가 급증한 개인정보침해 사례를 위험기반으로 분석하였다. 사례분석결과는 다음과 같다. 첫째, 발생가능성과 영향에 따라 정보통신기술의 위험의 상황은 '심각, 강력, 집중, 기본'으로 구분되었다. 둘째, 위험의 상황에 따라 해당집단은 '계층주의, 평등주의, 운명주의, 개인주의' 문화유형을 지니며 '회피, 전가, 완화, 수용'의 대응 정책을 적용하였다. 셋째, 위험상황에 따라 정보통신기술은 '대용량, 고성능, 다양성'의 빅 데이터의 특성을 보였다. 이 연구의 시사점은 다음과 같다. 첫째, 위험상황별 문화유형과 빅 데이터의 특성을 이해하여 포괄적인 정책을 수립하고 적용할 수 있는 정부의 전담조직이 필요하다. 둘째, 빅 데이터 시대 정보통신기술에 대한 위험관리는 '기술, 규범, 법, 시장' 측면의 균형 있는 정책의 적용이 필요하다.

• Journal of Gastric Cancer
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• 제22권4호
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• pp.348-368
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• 2022

Purpose: Chromosomal instability is a hallmark of gastric cancer (GC). It can be driven by single nucleotide variants (SNVs) in cell cycle genes. We investigated the associations between SNVs in candidate genes, PLK2, PLK3, and ATM, and GC risk and clinicopathological features. Materials and Methods: The genotyping study included 542 patients with GC and healthy controls. Generalized linear models were used for the risk and clinicopathological association analyses. Survival analysis was performed using the Kaplan-Meier method. The binding of candidate miRs was analyzed using a luciferase reporter assay. Results: The PLK2 C_rs15009-C_rs963615 haplotype was under-represented in the GC group compared to that in the control group (P_corr=0.050). Male patients with the PLK2 rs963615 CT genotype had a lower risk of GC, whereas female patients had a higher risk (P=0.023; P=0.026). The PLK2 rs963615 CT genotype was associated with the absence of vascular invasion (P=0.012). The PLK3 rs12404160 AA genotype was associated with a higher risk of GC in the male population (P=0.015). The ATM T_rs228589-A_rs189037-G_rs4585 haplotype was associated with a higher risk of GC (P<0.001). The ATM rs228589, rs189037, and rs4585 genotypes TA+AA, AG+GG, and TG+GG were associated with the absence of perineural invasion (P=0.034). In vitro analysis showed that the cancer-associated miR-23b-5p mimic specifically bound to the PLK2 rs15009 G allele (P=0.0097). Moreover, low miR-23b expression predicted longer 10-year survival (P=0.0066) in patients with GC. Conclusions: PLK2, PLK3, and ATM SNVs could potentially be helpful for the prediction of GC risk and clinicopathological features. PLK2 rs15009 affects the binding of miR-23b-5p. MiR-23b-5p expression status could serve as a prognostic marker for survival in patients with GC.

• Radiation Oncology Journal
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• 제11권2호
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• pp.337-346
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• 1993

This is a retrospective cohort analysis of 58 patients who treated with postoperative radiation therapy following radical hysterectomy and bilateral pelvic adenectomy for early stage carcinoma of uterine cervix between January 1988 and December 1990 at department of radiation oncology, Keimyoung University Hospital. Sixteen percent of patients (9/58) had chemotherapy. Most patients were FIGO I b (47 patients), and FIGO I a and II a were one and ten patients, respectively. The median follow-up periods were 48.5 months. The indications for radiation therapy included pelvic lymph node metastasis, large tumor size, deep stromal invasion, lymphovascular invasion, positive surgical margin, endometrial invasion and parametrial invasion. Eighty five percent of the patients had more than one risk factor. The actuarial overall five year survival rate (5 YSR) and five year disease free survival rate (5 YDFSR) were $89.5\%,\;and\;87.8\%,$ respectively. Their overall recurrence rate was $12.1\%,$(758). Distant metastasis was the most common cause of treatment failure $(71.4\%:5/7).$ The univariate analysis of prognostic factors affecting to five year survival rate disclosed pelvic lymph node status (negative: $95.5\%,\;positive:69.2\%,$ p=0.006) and hemoglobin level $(\le11 :75\%,>11g/dl:93.3\%,p=0.05)$ as significant factor. The age status was marginally significant $(\le40:96.0\%,\;>\;40:84.3\%p=0.15).$ Multivariate analysis clarified three independent prognostic factors: pelvic lymph node metastasis (p=p.006), hemoglobin level (p=0.015) and age (p=0.035). Multivariate analysis of prognostic factor affecting to five year disease free survival rate disclosed pelvic lymph node status (p=0.0078) and status of surgical margin (p=0.008). Complications relating to radiotherapy were $10.3\%,(6/58).$ There were no severe major complication requiring surgical intervention or a long hospital stay. It is our opinion that the benefit of postoperative pelvic radiotherapy may be gained in such a high risk patient population with acceptible morbidity.

• Journal of Gastric Cancer
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• 제18권4호
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• pp.339-347
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• 2018

Purpose: To evaluate the status of number 3b lymph node (LN) station in patients with adenocarcinoma of the esophagogastric junction (AEG) and to investigate the optimal indications for radical proximal gastrectomy (PG) for AEG. Materials and Methods: Data of 51 patients with clinically advanced Siewert types II and III AEG who underwent total gastrectomy (TG) between April 2010 and July 2017 were reviewed. The proportion of metastatic LNs at each LN station was examined. Number 3 LN station was separately classified into number 3a and number 3b. The risk factors for number 3b LN metastasis and the clinicopathological features of number 3b-positive AEG patients were investigated. Results: The incidences of LN metastasis were the highest in number 1 (47.1%), followed by number 2 (23.5%), number 3a (39.2%), and number 7 (23.5%) LN stations. LN metastasis in number 3b LN station was detected in 4 patients (7.8%). A gastric invasion length of more than 40 mm was a significant risk factor for number 3b LN metastasis. All 4 patients with number 3b-positive AEG had advanced cancer with a gastric invasion length of more than 40 mm. The 5-year survival rate of patients with a gastric invasion length of more than 40 mm was 50.0%. Conclusions: Radical PG may be indicated for patients with AEG with gastric invasion length of less than 40 mm.

• Asian Pacific Journal of Cancer Prevention
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• 제16권11호
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• pp.4503-4508
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• 2015

Background: The aims of this study were compare the serum visfatin and resistin levels between endometrial cancer (EC) patients and controls and evaluate their power to predict prognosis. Materials and Methods: This prospective study was conducted between March 2013 to June 2014 on the Gynecologic Oncology Department of the University of Selcuk, Konya, Turkey. A total of 42 EC patients and 42 controls were included and assessed for differences in serum visfatin and resistin levels, along with prognostic factors. Results: Endometrial cancer patients had significantly higher visfatin levels than control s (p: 0.011), associated with deep myometrial invasion (p: 0.019). In contrast the serum level of resistin did not significantly differ between EC patients and controls (p: 0.362). However, high resistin level in EC patients was associated with increase lymph node metastasis (p: 0.009). On logistic regression analysis, we found that serum visfatin elevation was associated with risk of myometrial invasion (OR: 1,091; 95%CI: 1.021-1.166; p: 0.010) and serum resistin with risk of lymph node metastasis (OR: 1.018; 95%CI: 1.000-1.035; p: 0.046). For myometrial invasion prediction, a serum visfatin level greater than 26.8 ng/mL demonstrated a sensitivity and specificity of 66.6 % and 96.4%, respectively. For lymph node metastasis prediction, the best cut-off for serum resistin level was 599ng/mL. A serum resistin level greater than this demonstrated a sensitivity and specificity of 87.5% and 77.1%, respectively. Conclusions: Our data suggest that serum visfatin is elevated in patients with EC and serum visfatin and resistin levels could be used to predict the risk of advance stage lesions.

• Journal of Gastric Cancer
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• 제22권1호
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• pp.24-34
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• 2022

Purpose: Total gastrectomy (TG) with lymph node (LN) dissection is recommended for early gastric cancer (EGC) but is not indicated for endoscopic resection (ER). We aimed to identify patients who could avoid TG by establishing a scoring system for predicting lymph node metastasis (LNM) in proximal EGCs. Materials and Methods: Between January 2003 and December 2017, a total of 1,025 proximal EGC patients who underwent TG with LN dissection were enrolled. Patients who met the absolute ER criteria based on pathological examination were excluded. The pathological risk factors for LNM were determined using univariate and multivariate logistic regression analyses. A scoring system for predicting LNM was developed and applied to the validation group. Results: Of the 1,025 cases, 100 (9.8%) showed positive LNM. Multivariate analysis confirmed the following independent risk factors for LNM: tumor size >2 cm, submucosal invasion, lymphovascular invasion (LVI), and perineural invasion (PNI). A scoring system was created using the four aforementioned variables, and the areas under the receiver operating characteristic curves in both the training (0.85) and validation (0.84) groups indicated excellent discrimination. The probability of LNM in mucosal cancers without LVI or PNI, regardless of size, was <2.9%. Conclusions: Our scoring system involving four variables can predict the probability of LNM in proximal EGC and might be helpful in determining additional treatment plans after ER, functioning as a good indicator of the adequacy of treatments other than TG in high surgical risk patients.

• 간호행정학회지
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• 제15권1호
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• pp.81-90
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• 2009

Purpose: The purpose of this study was to identify nurses' perceptions on the older adult's dignity, and identify the risk factors that threaten older adult dignity and nurses' experiences of ethically difficult care in nursing homes. Method: Qualitative content analysis was done using an analysis scheme developed by the investigators. The data were collected from 51 nurses in 10 different nursing homes, who have agreed this study. Using a self-completion questionnaire was developed by the authors. The questionnaire which consisted of 3 items about dignity definitions, risk factors, and experiences on ethical dilemma. Results: The scheme consisted of 14 categories and 33 subcategories of the 261 significant statements. The categories of the dignity perception analyzed were respect, social right and equality. The categories of risk factors analyzed were loss of control, abuse, physical restraint, invasion of privacy, decision limitation and staff qualification. The categories of dignity experiences were abuse, physical restraint, invasion of privacy, staff qualification and decision limitation. Conclusions: This study may suggests interpretation for compromised older adult's dignity and provides data to use in the development of the useful guidelines and educational programs for the nurses in nursing homes.

• Journal of Gastric Cancer
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• 제4권2호
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• pp.109-120
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• 2004

Purpose: Individual gastric cancers demonstrate complicated genetic alterations. The PCR-based analysis of polymorphic microsatellite sequences on cancer-related chromosomes has been used to detect chromosomal loss and microsatellite instability. For the purpose of preoperative usage, we analyzed the correspondance rate of the microsatellite genotype between endoscopic biopsy and surgical specimens. Materials and Methods: Seventy-three pairs of biopsy and surgical specimens were examined for loss of heterozygosity and microsatellite instability by using 40 microsatellite markers on eight chromosomes. Microsatellite alterations in tumor DNAs were classified into a high-risk group (baselinelevel loss of heterozygosity: 1 chromosomal loss in diffuse type and high-level loss of heterozygosity: 4 or more chromosomal losses) and a low-risk group (microsatellite instability and low-level loss of heterozygosity: 2 or 3 chromosomal losses in diffuse type or $1\∼3$ chromosomal losses in intestinal type) based on the extent of chromosomal loss and microsatellite instability. Results: The chromosomal losses of the biopsy and the surgical specimens were found to be different in 21 of the 73 cases, 19 cases of which were categorized into a genotype group of similar extent. In 100 surgical specimens, the high-risk genotype group showed a high incidence of nodal involvement (19 of 23 cases: $\leq$5 cm; 23 of 24 cases: >5 cm) irrespective of tumor size while the incidence of nodal involvement for the low-risk genotype group depended on tumor size (5 of 26 cases: $\leq$5 cm; 18 of 27 cases: >5 cm). Extraserosal invasion was more frequent in large-sized tumor in both the high-risk genotype group ($\leq$5 cm: 12 of 23 cases; >5 cm: 23 of 24 cases) and the low-risk genotype group ($\leq$5 cm: 7 of 26 cases; >5 cm: 16 of 27 cases). The preoperative prediction of tumor invasion and nodal involvement based on tumor size and genotype corresponded closely to the pathologic tumor stage (ROC area >0.7). Conclusion: An endoscopic biopsy specimen of gastric cancer can be used to make a preoperative genetic diagnosis that accurately reflect the genotype of the corresponding surgical specimen.

• Journal of Gastric Cancer
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• 제22권4호
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• pp.339-347
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• 2022

Purpose: Lymphovascular invasion is a criterion for non-curative resection in patients who have undergone endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). We aimed to determine the rate of extragastric metastasis (EGM) and identify the predictors of EGM in patients with negative resection margins (R0 resection) and lymphovascular invasion in post-ESD pathology. Materials and Methods: A total of 2,983 patients underwent ESD for EGC. Among them, 110 had a pathology of R0 resection and positive lymphovascular invasion. Patients underwent additional gastrectomy (n=63) or further follow-up without gastrectomy (n=47). Results: The 110 patients were assigned to one of the 3 groups according to ESD indications based on post-ESD pathology. The first group satisfied the absolute indication for ESD (n=18), the second group satisfied the expanded indications for ESD (n=34), and the last group satisfied the beyond indication (n=58). The number of occurrences of EGM in each group was 1 (5.6%), 3 (8.8%), and 3 (5.2%), respectively. The logistic regression analysis adjusted for age, sex, tumor size, and indication for ESD, showed that larger tumor size was associated with EGM (odds ratio, 1.76; 95% confidence interval, 1.00-3.10; P=0.048). In contrast, ESD indication criteria did not affect EGM (P=0.349). Conclusions: Tumor size was the only predictive indicator for EGM in patients who underwent R0 resection and lymphovascular invasion on post-ESD pathology. Even patients with pathology corresponding to the absolute indication criteria of ESD had lymphovascular invasion, which means that they require additional gastrectomy due to the risk of EGM.

• 환경생물
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• 제40권4호
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• pp.525-549
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• 2022

개체군은 진화적 단위이자 개체군 통계적 단위로서, 생물학적 침입의 과정은 개체군의 생태적, 진화적 동태에 기인한다. 개체군의 공간구조는 개체군 동태에 영향을 줄 수 있으며, 분산이 반드시 동반되는 생물학적 침입에 대한 연구에서는 공간구조를 고려할 필요가 있다. 메타개체군 이론은 공간구조를 가진 개체군에 대한 대표적인 접근으로, 주로 생태학 및 진화생물학 연구에 활용되고 있다. 메타개체군은 공간적 구조를 가진 개체군의 동의어로 여겨지기도 하지만, 용어의 모호한 사용을 피하기 위해서는 절멸 가능성이 고려되는 경우에 한해 정의되어야 한다는 비판이 있다. 침입 초기 단계의 개체군은 높은 절멸 가능성을 가지는 경우가 많으므로, 메타개체군 이론을 적용하기에 용이하다. 한편, 침입 초기 개체군의 생태적·유전적 특성은 분산의 영향을 크게 받기 때문에, 메타개체군 이론은 개체군 수준에서 침입성의 변화와 침입 가능성을 설명하는 강력한 도구가 될 수 있을 것으로 생각된다. 그러나, 한국에서 침입생물에 대한 생태학적 연구는 주로 종 수준의 분포 변화에 대해 이루어지고 있고, 메타개체군 개념을 적용한 경우가 드문 실정이다. 메타개체군 이론을 활용한다면, 국내 연구가 상대적으로 미진했던 개체군 단위의 침입 기작을 보다 상세히 규명할 수 있을 것으로 생각된다. 본 연구에서는 실제 침입생물에 미치는 메타개체군의 영향을 쉽게 파악하기 위해 침입생물 메타개체군이 자연적인 분산 거리를 넘어서 연결되는지 여부에 따라 장거리와 중거리 두 가지 규모로 나누는 체계를 활용할 것을 제안하였다. 메타개체군 개념에 입각한 침입생물 연구가 침입의 기작을 이해하고 장래의 침입 리스크를 예측·관리하는 데에 도움을 줄 것으로 기대한다.