The impact of pathologic differentiation (well/ poorly) and the degree of Ki-67 index in patients with metastatic WHO grade 3 GEP-NECs.

Kim, Seung Tae,Lee, Su Jin,Lee, Jeeyun,Park, Joon Oh,Park, Young Suk,Lim, Ho Yeong,Kang, Won Ki Grune & Stratton 2017 Journal of clinical oncology Vol.35 No._suppl15

<P> e15686 </P><P> Background: Herein, we investigated the impact of pathologic differentiation (well or poorly differentiated) in metastatic grade 3 GEP-NEC patients receiving etoposide and platinum-based therapy. Simultaneously, we evaluated a more exact Ki67 index cut-off point to select patients with grade 3 GEP-NEC who might benefit from etoposide plus platinum (EP)-based therapy. Methods: Among patients pathologically diagnosed with metastatic grade 3 GEP-NECs at Samsung Medical Center between June 2013 and March 2016, 31 GEP-NEC patients receiving etoposide and platinum-based therapy were included in this study. Results: Primary sites included 13 foregut-derived GEP-NECs [stomach (n = 4), duodenum (n = 4), and pancreas (n = 5)] and 2 hindgut-derived GEP-NECs of the rectum. Sixteen unclassified GEP-NECs originated from 7 gall-bladder (GB), 6 liver and 3 unknown primary sites. According to pathologic differentiation, 14 patients had well differentiated and 17 had poorly differentiated grade 3 GEP-NECs. Between well differentiated and poorly differentiated grade 3 GEP-NECs, there was a significant difference in the distribution of Ki67 index. There was no significant difference of treatment efficacy between well and poorly differentiated grade 3 GEP-NECs (RR; 35.7% vs. 41.2%, p = 0.525). Tumor response to EP occurred in 5 of 7 patients with Ki67 > 60% and 7 of 24 with Ki67≤60%, which was significantly different (RR; 71.4% vs. 29.2%, P = 0.043). There was no significant difference in PFS according to pathologic differentiation (well differentiated vs. poorly differentiated) and Ki67 index ( > 60% vs ≤60%). Conclusions: Grade 3 GEP-NECs could be morphologically classified into well and poorly differentiated NETs. Additionally, among grade 3 GEP-NECs, there was a significant difference in ranges of Ki67 index between well and poorly differentiated NECs. Higher levels ( > 60%) of Ki67 index might be a predictive marker for efficacy of EP as a standard regimen in grade 3 GEP-NECs. </P>

Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

포괄수가지불제도 적용에 따른 산부인과 진료수입의 변화

황태연,유병철,정귀언,정수진,김성준,배기택,손혜숙,이종태,전진호,엄상화 인제대학교 2001 仁濟醫學 Vol.22 No.1

Objectives: Under the fee-for-service system, Korean hospitals have been suffering from the worsening profitability caused by law medical care fees. To overcome the difficulties, they have maximized the quantity of medical services and made relatively large investment in developing new medical services using high-priced medical equipment, medicines and medical supplies which were not covered by medical insurance system rather than reduced running costs. Materials and Methods: This study was made to analyze and forecast the revenue change of the department of Obstetrics and gynecology of an university hospital in Seoul, expecting the implementation of DRG system in 2000. Results: The results were as follows : 1.During the first two days of hospitalization. 41% of total medical service fee was occurred, which was thought that most of the check-ups and operations were made during this period. After two days of hospitalization, the new occurrence of medical service fee tended to reduce. 2.Out of total medical service fee, 67% of admission fee was occurred after 5 days of hospitalization. This was because medical service fees in obstetrics and gynecology department occurred during the first 5 days of hospitalization. 3.Out of fees for operation, treatment, medical supplies and blood transfusion. 71% was occurred during the first two days. 4. In case of fees for examination, 50% was occurred during the first two days. 5.A total of 53% of fees for medication and injection was occurred during the first 5 days. Conclusions: By the implementation of the DRG system, the income is forecast to increase by 800 won to 310,000 won by the disease group of obstetrics and gynecology department. To increase hospital income with the implementation of DRG system, the results of this study suggest that examinations should be done at out-patient departments before the hospitalization of patient, the discharge of patient should be noticed in advance to reduce the period of hospitalization, and admission appointment system should be implemented for the immediate operation and delivery.

폐실질내의 주변형 결절로 나타난 소세포성 폐암의 CT 소견

이태희,최요원,전석철,서흥석,함창곡,박충기 한양대학교 의과대학 1998 한양의대 학술지 Vol.18 No.2

We evaluated CT findings of the small cell carninoma, which presented as a solitary pulmonary nodule at the periphery of the lung parenchyma. Of pathologically-proven 45 patients with small cell carcinoma, 10 patients was included in this study, who had a solitary, peripheral lung nodule at distal portion of the subsegmental bronchus. We retrospectively reviewed clinical data and CT findings including size, location, margin, enhancement pattern, lymph node enlargement, metastasis. Peripheral small cell carcinomas were 22.2%(10/45). All masses had well-defined margin and lobulated margin was seen in 7 patients. Mean diameter was 3.8cm (2.5-7.0cm). Enhancement pattern were homogeneous in 3 cases and inhomogeneous in seven. Calcification or air-bronchogram was not present, and focal cavitation was seen in one case. In five, only lung mass was present, and lung mass with lymph node enlargement was seen in one. distant metastasis without lymph node enlargement was noted on two patients and another two patients showed lymph node enlargement and distant metastasis. Peripheral small cell carcinoma is not rare(22.2%). Most frequent CT finding is a well-defined, lobulated mass with inhomogeneous enhancement, these findings would be helpful in differentiating small cell carcinoma from other neuroendocrine tumors when differentiataion is difficult cytologically.

방사선조사가 Streptococcus mutans에 미치는 영향

안기동,김규태,최용석,황의환 대한구강악안면방사선학회 2007 Imaging Science in Dentistry Vol.36 No.1

Purpose : To observe direct effect of irradiation on cariogenic Streptooccus mutans. Materials and Methods : S. mutans GS5 was exposed to irradiation with a single absorbed dose of 10, 20, 30, and 40 Gy. Viability and changes in antibiotic sensitivity, morphology, transcription of virulence factors, and protein profile of bacterium after irradiation were examined by pour plate, disc diffusion method, transmission electron microscopy, RT-PCR, and SDS-PAGE, respectively. Results : After irradiation with 10 and 20 Gy, viability of S. mutans was reduced. Further increase in irradiation dose, however, did not affect the viability of the remaining cells of S. mutans. Irradiated S. mutans was found to have become sensitive to antibiotics. In particular, the bacterium irradiated with 40 Gy increased its susceptibility to cefotaxime, penicillin, and tetracycline. Under the transmission electron microscope, number of morphologically abnormal cells was increased as the irradiation dose was increased. S. mutans irradiated with 10 Gy revealed a change in the cell wall and cell membrane. As irradiation dose was increased, a higher number of cells showed thickened cell wall and cell membrane and lysis, and appearance of ghost cells was noticeable. In RT-PCR, no difference was detected in expression of gtfB and spaP between cells with and without irradiation of 40 Gy. In SDS-PAGE, proteins with higher molecular masses were gradually diminished as irradiation dose was increased. Conclusion : These results suggest that irradiation affects the cell integrity of S. mutans, as observed by SDS-PAGE, and as manifested by the change in cell morphology, antibiotic sensitivity, and eventually viability of the bacterium. (Korean J Oral Maxillofac Radiol 2007; 37: 35-43)

경화된 열경화성 수지와 고분자재의 혼합성형에 관한 특성

김석호,윤한기,여홍태 東義大學校産業技術開發硏究所 1998 産業技術硏究誌 Vol.12 No.-

For the purpose of recycling the rigid thermosets, this study investigated the film of thermoplastic mixed with some weight fraction of rigid phenol in the hot compression molding at temperature of 200℃. The results abtained are as follows; the tensile stress according to the weight fraction of phenol particle is linearly proportional to the strain upto 2% of strain, the more the grain fraction of phenol is, the smaller the stress and strain is at frature, in case of the same weight fraction of phenol, the stress and strain of large grain is larger than those of small grain.

단측 및 양측뇌손상에 의한 인지장애

廉泰鎬,金基錫 漢陽大學校 精神健康硏究 1988 精神健康硏究 Vol.7 No.-

수돗물중 異臭味에 關한 硏究

김형석,이기태 慶熙大學校 1995 論文集 Vol.24 No.-

The taste and odor in city tap water could be a reason of discomfort by citizen. Even though the concentration of odor substances is trace amount in drinking water, human can detect with sensory system easily. The sources of taste fund odor come from anthropogenic activity and natural origin. Industrial wastewater could contain chemicals and chlorine taste comes from disinfection process during drinking water treatment. Natural sources are the algae and Streptomyces tendae which produce geosmin and 2-methylisoborneol. The numbers of actinomycetes in river water were found to increase coincidentally at the onset of spring. When more than one hundred actinomycetes isolates from water samples were tested for their ability to produce geosmin and 2-methylisoborneol(2-MIB), the majority were able to produce one of both of these odorous compounds. Cyanobacteria also could produce geosmin or 2-methylisoborneol and produce musty-odor. Gas chromatography/mass spectrometry(GC/MS) analyses indicated that volatile fractions of earthy/musty odor compounds are geosmin and 2-MIB. In the water purifying plants algae would make earthy and musty odor. In Japan 1,750 person were complained about the tap water odor. The area of odor problem are related with eutrophication, where the total phosphorous is more than 0.02㎎/L and total nitrogen is more than 0.6㎎/L. The odor of 2-MIB is produced by Phormidium tenue, Oscillatoria tenuis, and geosmin producing algae is produced by Anabaena macrospora and Anabaena spiroides var.crassa. Those 4 algae contain not only chlorophill, but phicocyanin. The detection method of geosmin and 2-MIB is difficult when sample is analyzed directly in GC, so we need to concentrate the sample in advance. Purge and trap method is one of the effective method. Authors tried to detect the geosmin and 2-MIB in drinking water by extracting the water sample in purge and trap methods and SPME(solid phase micro extraction) method was applied to detect benzene, toluene, and xylene. There are two kinds of sources for odor substances. One is fungus, e.g., Streptomyces tendae. Penicillium expansum, Actinomycetes, which produce geosmin. The other one is blue-green algae, e.g., Phormidium tenue, Oscillatoria limnetica, which produce 2-methylisoborneol. We could detect the geosmin and 2-methylisoborneol standard solution with gas chromatograph. The volatile organic coumpounds, BTEX, were detected with SPME(solid phase micro extraction) method.

트리아민-구리(Ⅱ)-이미다졸염 착물의 촉매작용에 관한 연구

김태원,홍순영,민재기,김창석 漢陽大學校 環境科學硏究所 1992 環境科學論文集 Vol.13 No.-

Acetylsalicylic acid의 가수분해 반응에서 imidazole과 몇 가지 triamine-copper(Ⅱ)-imidazolate complex들의 촉매효과를 비교 하였다. 촉매로서는 imidazole(ImH)과 그 2- 또는 4-치환 유도체, diethylenetriamine-copper(Ⅱ)-imidazolate complex(C₂C₂CuIm)와 그 imidazole-ring 치환 유도체 및 N-(2-aminoethy1)-1, 3-propanediamine-copper(Ⅱ) imidazolate complex(C₂C₂CuIm)와 그 imidazole-ring 치환 유도체들을 택하였다. 촉매효과의 비(kcat값으로 비교)는 ImH : C₂C₂CuIm = 1.00 : 2.81 : 2.66로 나타났으며 촉매의 효과는 이들 complex의 imidazole-ring의 전자주는 치환기에 의해 증가 하였다. Catlytic effects of imidazole and several of triamine-copper(Ⅱ)-imidazolates were investigated for the hydrolysis of acetylsalicylic acid. As catalysts, imidazole(ImH) and its 2- or 4-substituted derivatives, diethylenetriamine-copper(Ⅱ)-imidazolate complex(C₂C₂CuIm) and its imidazole-ring substituted derivatives, and N-(2-aminoethyl)-1, 3-propanediamine complex(C₂C₂CuIm) and its imidazole-ring substituted derivatives were chosen. The ratio of efficiency among these catalysts was observed to bh ImH : C₂C₂CuIm : C₂C₂CuIm = 1.00 : 2.81 : 2.66, and the effect of catalytic action was enhanced by an electron-releasing substituent on imidazole-ring of the complex.

다공질 실리콘 카바이드의 제작 및 광발광 성질

이기환,오제직,최석남,박병빈,이태호,김영유 공주대학교 사범대학 과학교육연구소 1998 과학교육연구 Vol.29 No.1

p-type α-SiC(4H, 6H, 15R polytype)를 사용하여 다공질 실리콘(porous silicon; PS)의 제작방법과 유사하게 HF/H₂O/C₂H??OH 용액에서 전기화학적으로 에칭을 하여 광발광 특성을 가지는 다공질 실리콘 카바이드(porous silicon carbide; PSC)를 제작하였다. PSC의 다공질의 분포는 전류밀도가 증가할수록 증가하고 다공질의 크기는 감소하였으며 광발광(photoluminescence; PL) 스펙트럼의 분석을 통해 전극 표면에서의 산화반응은 공급되는 전자의 양과 전류밀도에 의존하며 전류밀도가 증가할수록 전극의 산화반응은 억제된다는 결과를 얻었다. Porous silicon carbide(PSC) having photoluminescence(PL) can be prepared by a technique very similar to that used in porous silicon preparation, by electrochemical etching of crystalline p-type α-SiC(4H, 6H, 15R polytype) in ?? solution. The results show that porous distribution increase with increasing of the current densities while pore size decrease with that. Through the PL spectra analysis anodic oxidation of electrode surface was dependent on the amount of provided electrons and the current densities and inhibited with increasing of the current densities.