Comparison of controlled ovarian stimulation outcomes for fertility preservation in women with breast cancer according to KI-67, histologic grade, pathologic type, and cancer stage

( Eun Ji Oh ),( Yeon Hee Hong ),( Seul Ki Kim ),( Jung Ryeol Lee ),( Byung Chul Jee ),( Chang Suk Suh ),( Seok Hyun Kim ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

Objective: This study aims to analyze that specific prognostic factors such as Ki-67 value, histologic grade, pathology type, and cancer stage can affect controlled ovarian stimulation outcomes(COS) for fertility preservation in women with breast cancer. Methods: This retrospective cohort study included 92 patients with breast cancer aged 21-44 who underwent COS from August 2012 to April 2020, excluding patients with previous gonadotoxic therapy history. All COS cycles were conducted letrozole-combined random start GnRH antagonist protocol. COS outcomes were compared according to prognostic factors;Ki-67 (< 30% vs. ≥ 30%), histologic grade (low vs. high), and pathologic type (intraductal carcinoma(IDC) vs. triple-negative breast cancer(TNBC)), and cancer stage (early (I, II) vs. advanced (III, IV)). Multivariate analysis was also conducted to find any parameter that can impact over 10 mature oocytes acquisition. Results: Among the 92 patients, 42 were Ki-67≥30% compared to 49 of Ki-67<30%. The number of oocytes, and initial mature oocytes were comparable between Ki-67<30% and ≥30 group. The maturation rate was significantly higher in Ki-67≥30% group than Ki-67<30% group (57.4±36.8% vs. 44.8±28.3%, p=0.041). The same results were drawn when divided according to IDC or TNBC. The maturation rate was significantly higher in TNBC than the IDC group (73.0±17.6% vs. 47.0±28.1% p=0.001). However, the histologic grade or stage did not show any difference in COS outcomes between high and low grade or early and advanced stages. With multivariate analysis, age and AMH are parameters associated with the acquisition of over 10 mature oocytes (OR 0.863, 95% CI [0.755-0.987], OR 1.408, 95% CI [1.145-1.732], respectively). Conclusion: Either Ki-67 or pathologic type can be a potential reliable marker for predicting COS outcome, especially maturation rate. Further study with larger sample size with specific conditions is necessary to clarify the correlation between breast cancer prognostic factors and COS outcomes.

Biomechanical analysis of lumbar decompression surgery in relation to degenerative changes in the lumbar spine – Validated finite element analysis

Li, Quan You,Kim, Ho-Joong,Son, Juhyun,Kang, Kyoung-Tak,Chang, Bong-Soon,Lee, Choon-Ki,Seok, Hyun Sik,Yeom, Jin S. Elsevier 2017 Computers in biology and medicine Vol.89 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>There are no studies about the biomechanical analysis of lumbar decompression surgery in relation to degenerative changes of the lumbar spine. Therefore, the purpose of this study was to compare, by using finite element (FE) analysis, the biomechanical changes of the lumbar spine in terms of annulus stress and nucleus pressure after two different kinds of lumbar decompression surgery in relation to disc degenerative changes.</P> <P><B>Methods</B></P> <P>The validated intact and degenerated FE models (L2-5) were used in this study. In these two models, two different decompression surgical scenarios at L3-4, including conventional laminectomy (ConLa) and the spinous process osteotomy (SpinO), were simulated. Therefore, a total of six models were simulated. Under preloading, 7.5 Nm moments of flexion, extension, lateral bending, and torsion were imposed. In each model, the maximal von Mises stress on the annulus fibrosus and nucleus pressure at the index segment (L3-4) and adjacent segments (L2-3 and L4-5) were analyzed.</P> <P><B>Results</B></P> <P>The ConLa model and disc degeneration model demonstrated a larger annulus stress at the decompression level (L3-4) under all four moments than were seen in the SpinO model and healthy disc model, respectively. Therefore, the ConLa model with moderate disc degeneration showed the highest annulus stress at the decompression level (L3-4). However, the percent change of annulus stress at L3-4 from the intact model to the matched decompression model was less in the moderate disc degeneration model than in the healthy disc model.</P> <P><B>Conclusions</B></P> <P>Although the ConLa model with moderate disc degeneration showed the highest annulus stress, the degenerative models would be less influenced by the decompression technique.</P>

Tetrahydroisoquinoline Alkaloids가 쥐의 동맥과 뇌균등질의 α-Adrenoceptors에 미치는 영향

이현석,백선하,황수현,박인성,김은상,정진명,한종우,장기철,장기철 대한신경외과학회 1999 Journal of Korean neurosurgical society Vol.28 No.1

측면 방사선 촬영 자세의 표준화를 위한 정상 척추의 시상면 정렬의 분석

김민석(Min-Seok Kim),정석원(Seok-Won Chung),황창주(Changju Hwang),이춘기(Choon-Ki Lee),장봉순(Bong-Soon Chang) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.7

목적: 양팔의 자세 변화에 따르는 척추의 시상면 정렬의 차이를 분석하고, 환자에게서 가장 기능적인 시상면 정렬을 재현 할 수 있는 측면 기립 방사선 촬영 자세를 제시하고자 하였다. 대상 및 방법: 정상 성인 남자 30명에 대해 제7 경추와 제1 천추의 피부 표면에 표식자를 부착시킨 후 전 척추측면 기립 방사선 촬영을 시행하였다. 팔을 내리고 서있는 자세(자세 A), 견관절을 각각 30°, 90° 굴곡한 자세(자세 B, C), 양팔을 끌어안은 자세(cross-arm position) (자세 D), 견관절을 90° 굴곡시킨 후 팔을 수평봉에 얹은 자세(자세 E)를 취하게 하여, 자세 변화에 따른 시상 수직축(sagittal vertical axis), 흉추 후만각, 요추 전만각, 천추 전경각의 차이에 대해 분석하였다. 결과: 자세 A에서 E의 평균 시상 수직축은 각각 +1.47±2.06 cm, -0.58±2.96 cm, -2.11±2.67 cm, +0.16±2.38 cm, -0.51±2.70 cm으로 일차원 분산분석(one-way ANOVA)을 시행한 결과 그룹간의 유의한 차이를 보였고(p<0.001), Duncan의 사후검증결과 자세 A와 D는 차이가 없는 것으로 판단되어 자세 D가 자세 A에 대해 가장 유사한 자세로 나타났다. 흉추 후만각, 요추 전만각, 천추 전경각은 자세간의 유의한 차이를 보이지 않았다. 결론: 양팔을 끌어안은 자세(crosss-arm position)는 평상시 서있는 자세와 가장 유사한 기능적인 시상면 정렬을 구현할 수 있는 자세로 생각된다. Purpose: To analyze the difference in sagittal balance based on different positions of both arms and to promote the proper lateral spine view which can reconstruct the most functional posture of sagittal balance. Materials and Methods: We applied X-rays to thirty healthy male adults with no spinal diseases after application of marks on the skin surface at the location of the C7 and S1 vertebrae with the following five postures, standing lateral position with both arms neutral (posture A) with both shoulders flexed thirty degrees and ninety degrees (postures B and C) with both arms crossed (posture D) with both shoulders flexed ninety degrees and with both arms on a parallel bar (posture E). We analyzed the differences of the sagittal vertical axis, thoracic kyphotic angle, lumbar lordotic angle, and sacral inclination angle after the postural changes. Results: The average sagittal vertical axis value from posture A to E was 1.47±2.06 cm, -0.58±2.96 cm, -2.11±2.67 cm, 0.16±2.38 cm, and -0.51±2.70 cm. We discovered that five postures were statistically different (one-way ANOVA, p<0.001) and that posture D was the closest to posture A (Duncan's multiple comparison test). However we did not observe any statistical differences among the thoracic kyphotic angle, the lumbar lordotic angle, and sacral inclination angle postures. Conclusion: We can reconstruct the functional sagittal alignment in the cross-arm position, which is the closest to the normal standing position.

Encephalo-duro-arterio-synangiosis(EDAS) using Occipital Artery in Children with Moyamoya Disease

Choi, In-Jae,Hong, Seok-Ho,Cho, Byung-Kyu,Wang, Kyu-Chang,Kim, Seung-Ki The Korean Neurosurgical Society 2005 Journal of Korean neurosurgical society Vol.38 No.6

Objective : Although an encephaloduroarteriosynangiosis procedure using the superficial temporal artery [STA-EDAS] is an effective indirect bypass method in children with moyamoya disease[MMD], there is still a need for an additional bypass operation that can cover the area of the posterior circulation. The goal of this study is to evaluate the efficacy of the EDAS procedure using the occipital arteries [OA-EDAS]. Methods : From August 2003 to April 2004, We performed OA-EDAS in sixteen patients with MMD who have a circulatory insufficiency in the territory of the posterior cerebral artery[PCA]. The medical records were reviewed retrospectively. The surgical outcomes, including the changes in neurological status and imaging studies, with the degree of neovascularization on the cerebral angiogram, and the hemodynamic changes on single-photon emission computed tomography[SPECT], were analyzed. Results : These 16 children consisted of 5 boys and 11 girls aged 2 to 9 years. The clinical outcome of their PCA symptoms, such as visual transient ischemic attacks[TIAs] or visual field defect, was favorable in 14 patients of 16. Nine patients of 11 who underwent follow up magnetic resonance imaging[MRI] showed favorable MRI changes. On angiogram most of the patients exhibited good or fair revascularization of the PCA territory [7 of 8]. The hemodynamic changes on SPECT in the PCA territory after surgery showed improved vascular reserve in 13 of the 16 territories. Conclusion : OA-EDAS is a safe and efficacious revascularization procedure in patients with MMD who have compromised cerebral perfusion in PCA territory, or with visual TIAs.

Bone Marrow T Cells are Superior to Splenic T Cells to Induce Chimeric Conversion After Non-Myeloablative Bone Marrow Transplantation

( Hyun Sil Park ),( Seok Goo Cho ),( Min Jung Park ),( So Youn Min ),( Hong Seok Chang ),( Hee Je Kim ),( Seok Lee ),( Chang Ki Min ),( Jong Wook Lee ),( Woo Sung Min ),( Chun Choo Kim ),( Ho Youn Kim 대한내과학회 2009 The Korean Journal of Internal Medicine Vol.24 No.3

Background/Aims: The bone marrow functions not only as the primary B-lymphocyte-producing organ but also as a secondary lymphoid organ for CD4 and CD8 cell responses and a site of preferential homing and persistence for memory T cells. Bone marrow T (BM-T) cells are distinguished from peripheral blood T cells by surface phenotype, cytokine secretion profile, and immune functions. In this study, we evaluated the alloreactive potential of donor lymphocyte infusion (DLI) using BM-T cells in mixed chimerism compared to that using spleen T (SP-T) cells. Methods: Cells were prepared using established procedures. BM-T cells were obtained as a by-product of T-cell depletion in BM grafting and then cryopreserved for subsequent DLI. We performed DLI using BM-T cells in allogeneic mixed chimera mice on post-BMT day 21. Results: When the same dose of T cells, 5-10×105 (Thy1.2+), fractionated from BM and spleen were administered into mixed chimeras, the BM-T group showed complete chimeric conversion, with self-limited graftversus-host disease (GVHD) and no pathological changes. However, the SP-T group showed persistent mixed chimerism, with pathological signs of GVHD in the liver and intestine. Conclusions: Our results suggest that DLI using BM-T cells, even in small numbers, is more potent at inducing chimeric conversion in mixed chimerism than DLI using SP-T cells. Further study is needed to determine whether cryopreserved BM-T cells are an effective cell source for DLI to consolidate donor-dominant chimerism in clinical practice without concerns about GVHD. (Korean J Intern Med 2009;24:252-262)

편평한 암석절리면의 속도 의존적 전단거동 특성

박병기,이창수,전석원,Park, Byung-Ki,Lee, Chang-Soo,Jeon, Seok-Won 한국터널지하공간학회 2007 한국터널지하공간학회논문집 Vol.9 No.2

최근 암반구조물의 규모가 점차 대형.대단면화됨에 따라 암반 절리면이 자유면에 노출되는 경우가 빈번하게 발생할 수 있으며 지진, 발파와 같은 외부 동적 하중의 영향을 받을 가능성이 커지고 있으므로 다양한 동적 하중조건 하에서 암반 불연속면의 거동 특성 파악을 위한 연구의 필요성이 증대되고 있다. 본 연구에서는 전단속도의 변화에 따른 편평한 화강암 전단면의 마찰특성 변화를 알아보고자 다양한 조건하에서 직접전단시험을 수행하였다. 수행한 직접전단시험은 크게 두 가지로 나눌 수 있는데 첫 번째 시험에서는 시험이 수행되는 동안 각각 7가지의 일정한 전단속도로 전단변위가 발생되도록 하여 전단속도에 따른 마찰계수의 변화를 살펴보았으며, 두 번째 시험에서는 전단변위가 발생되는 중간에3가지 형태의 순간적인 전단속도 변화가 마찰특성에 미치는 영향을 살펴보았다. 수직응력과 전단속도의 변화에 따른 편평한 화강암의 마찰계수 변화는 가해진 수직응력 수준에 영향을 받는 것으로 나타났으며, 전단속도의 변화가 마찰거동에 영향을 미치기 시작하는 전이속도는 수직응력이 증가함에 따라 낮아지는 것으로 나타났다. 또한 전단속도가 느릴수록 stick-slip 거동에서의 응력 저하 폭이 커지는 경향을 보였다. 순간적인 전단속도 변화에 따른 정상 상태에서의 마찰계수 변화를 살펴본 결과 순간적인 속도의 증가에 따라 마찰계수가 감소하는 속도 연화 현상이 나타났으며, 느린 전단속도에서 전단속도의 변화에 따른 마찰계수의 감소폭이 빠른 전단속도에서의 변화에 따른 감소폭보다 더 큰 경향을 보였다. Recently, the probability of rock joints being exposed to free faces is getting higher for the scale of rock mass structures gets larger. Also, the frequency of occurring dynamic events such as earthquakes and blasting has been increasing. Thus, the shear behavior of rock joints under different conditions needs to be investigated. In this study, a series of direct shear tests were carried out under various conditions to examine the velocity-dependent shear behavior of saw-cut rock joints. Two types of direct shear test were carried out. The first was to examine the velocity-dependent shear behavior of saw-cut rock joints at seven different shear velocities, each with three different normal stresses. The second was to examine the shear behavior of saw-cut rock joints when three different instantaneous shear velocities changed. As a result, the coefficient of friction was affected by normal stress. The breakpoint velocity, the point when the change of shear velocity starts to affect the frictional behavior, became lower as normal stress increased. Also, as the shear velocity became lower, the degree of stress-drop on stick-slip behavior became larger. As a result of examining the changes of friction coefficient, velocity weakening (decrease of friction coefficient) was observed. The decrement of friction coefficient due to the changes of shear velocity under slow shear velocity was larger than that under fast shear velocity.

여성 외음부에 발생한 선상 편평상피세포암종

김창옥,양기화,강석진,이안희,김병기,김선무 대한병리학회 1991 Journal of Pathology and Translational Medicine Vol.25 No.1

원발성 유방암에서 Sodium Iodide Symporter의 발현과 ^(99m)Tc-MIBI 유방스캔의 관계

석주원,김성장,곽희숙,이창훈,김인주,김용기,배영태,김동수 대한핵의학회 2002 핵의학 분자영상 Vol.36 No.6

목적: hNIS는 갑상선 조직 외에 다른 조직들에서도 발현된다고 알려져 있다. 유방암 세포는 그런 조직들 중에 하나이며, 그에 의한 유방암의 방사성옥소치료의 가능성이 제시되고 있다. 본 연구에서는 유방암 조직에서 hNIS의 발현정도를 알아보고, ^99mTc-MIBI 유방스캔과 hNIS의 발현 정도와의 관계를 조사하여 보았다. 대상 및 방법: 본 연구에서는 유방암으로 수술을 시행했던 56명의 환자를 대상으로 하였다. hNIS의 발현은 면역조직화학염색에 의해서 평가되었으며, 그 결과를 ^99mTc-MIBI 유방스캔의 판정 결과와 비교하였다. 결과: 전체 56명의 환자에서 hNIS의 발현율은 41.1%였다. 병리학적 진단에 의해 침윤성관상피암종이었던 49명에서의 발현율은 42.9%, 관상피내암종이었던 7명에서의 발현율은 28.6%였다. ^99mTc-MIBI 유방스캔에서 국소섭취 소견이 관찰되었던 41명에서의 hNIS의 발현율은 31.7%였다. 비정상적인 섭취 소견이 관찰되지 않았던 15명의 환자에서의 hNIS의 발현율이 의미있게 높게 관찰되었다(66.7%, p>0.05). 결론: 유방암 환자에서의 hNIS의 발현율은 그다지 높지 않았다. ^99mTc-MIBI 유방스캔에서 섭취증가 소견이 없을 때 hNIS의 발현율이 더 높았다. Purpose: Human Na^+/I- symporter (hNIS) is known to be expressed in many tissues other than thyroid gland. The breast cancer cells are one of them and the possibility of radioiodine therapy in treatment of the breast cancer may be suggested. We investigated the expression rate of hNIS and the relationship between the expression of hNIS and the finding of 99mTc-MIBI scintimammography in the breast cancer. Materials and Methods: Surgically proved 56 patients with breast cancer were the subjects of this study. The expression of hNIS were evaluated by immunohistochemistry and the results were compared to the findings of 99mTc-MIBI scintimammography. Results: Overall expression rate of hNIS was 41.1% in 56 patients. According to the pathologic diagnosis, it was 42.9% in 49 patients with invasive ductal carcinoma and 28.6% in the 7 patients with ductal carcinoma in situ. The expression rate of hNIS in the 41 cases with a focal increased uptake at he breast lesion on 99mTc-MIBI scintimammogram was 31.7%. That in the 15 cases without any abnormal uptake on the scan was significantly higher(66.7%, p<0.05). Conclusion: The expression rate of hNIS in the patients with breast cancer was not so high. The rate was higher in the patients with no increased uptake at the breast lesion on 99mTc-MIBI scintimammography. (Korean J Nucl Med 2002;36;325-32)

HBsAg 양성 환자의 혈청에서 branched DNA 신호 증폭 방법을 이용한 B형 간염바이러스 DNA의 정량

기창석,양윤선,김종원 대한임상병리학회 1997 대한임상병리학회지 Vol.17 No.5