무증상 갑상선기능저하증 환자에서 Thyroxine 치료에 따른 혈청 지질 및 아포지단백의 변화

조보연,신찬수,김원배,고창순,김성연,박혜영,박건상,이홍규,박형규,김숙경 대한내분비학회 1996 Endocrinology and metabolism Vol.11 No.1

Background: Subclinical hypothyroidism(SCH) is a common biochemical abnormality which can be found in routine screening tests of thyroid function. We are increasingly faced with the question of whether its an indication for thyroxine replacement therapy. The effect of thyroxine replacement on lipid profile in SCH has aroused a great interest because of an association of overt hypothyroidism(OVH) with hyperlipidemia and increased risk of coronary artery disease. Method: We prospectively evaluated the changes in lipids and apoproteins before and after thyroxine replacement therapy in 23 patients with SCH and in 37 patients with OVH. We measured serum total cholesterol and triglyceride using autoanalyzer, high density lipoprotein(HDL) chole-sterol by dextran sulfate method, Apo A1 and Apo B by immunonephelometric assay. Results: Thyroxine replacement therapy significantly decreased total cholesterol, low density lipoprotein(LDL) cholesterol and apo B levels, but did not affect the level of triglyceride, HDL cholesterol or apo AI in patients with OVH. In SCH, thyroxine replacement therapy with the doses to normalize serum TSH concentrations also decreased significantly the level of cholesterol and LDL cholesterol albeit apo B levels did not change. Moreover, in most of patients with OVH (11 of 12) and in all of patients with SCH(5 of 5) who had had hyperchlesterolemia before treatment, thyroxine replament normalized their cholesterol and LDL cholesterol levels. Conclusion: In regard to the beneficial changes in blood lipid levels, patients with SCH should be treated, especially in cases who have other risk factors for the development of atherosclerosis. If thyroxine replacement only will reduce the incidence of coronary artery disease in SCH remains to be elucidated by long-term prospective studies(J Kor Soc Endocrinol 11:41-51, 1996).

500 g 이상의 거대자궁에 대한 단일공 복강경하 자궁절제술

이건우 ( Geon Woo Lee ),김장규 ( Jang Keu Kim ),신창수 ( Chang Su Shin ),최원규 ( Won Kyu Choi ),강병헌 ( Byung Hun Kang ),양정보 ( Jung Bo Yang ),고영복 ( Young Bok Koh ),이기환 ( Ki Hwan Lee ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.6

목적 500 g 이상의 거대자궁에 대하여 일반 복강경하 자궁절제술과 단일공 복강경하 자궁절제술에 대한 결과를 비교하고자 하였다. 연구방법 충남대학교병원에서 2010년 1월부터 2011년 7월까지 단일 집도의에 의해 시행된 수술 중 일반 복강경하 자궁절제술을 받은 32명과 단일공 복강경하 자궁절제술을 받은 27명을 인구학적 특성과 수술 결과에 대하여 후향적으로 비교 분석하였다. 결과 두 군 사이에 나이, 체질량지수, 과거 수술 병력, 수술 후 추가 통증 조절 여부, 재원일수는 통계상 유의한 차이가 없었다. 자궁무게는 단일공 복강경하 자궁절제술이 706.5 ± 363.2 g (범위, 500-2,415 g)이었으며, 일반 복강경하 자궁절제술이 634.0 ± 153.3 g (범위, 500- 1,130 g)으로 두 군 간의 유의한 차이는 없었다. 수술 시간은 81.1±18.1분과 67.2 ±16.8분으로 일반 복강경하 자궁절제술보다 단일공 복강경하 자궁절제술이 유의하게 길었다. 수술 전과 수술 후의 혈색소치와 적혈구용적률도 1.9±0.9g/dL, 2.9±4.2%와 1.0 ± 1.3g/dL, 6.2±2.9%로 유의한 차이를 보였다. 결론 일반 복강경하 자궁절제술과 비교하여 단일공 복강경하 자궁절제술이 수술 시간 및 혈색소치와 적혈구용적률 변화에 유의한 차이를 보였지만, 앞으로 수술 기술이 발전함에 따라 단일공 복강경하 자궁절제술이 일반 복강경하 자궁절제술을 대치할 수 있을 것으로 생각된다. Objective To compare the outcomes of single port access (SPA) laparoscopic hysterectomy and conventional laparoscopic hysterectomy for the large uterus of more than 500 g. Methods Twenty-seven cases of SPA laparoscopic hysterectomy and 32 cases of conventional laparoscopic hysterectomy were retrospectively analysed. The surgery had performed by single surgeon from January 2010 to July 2011 in Chungnam National University Hospital. We compared demographic characteristics and surgical outcomes. Results There were no significant difference in patients` age, body mass index, past surgical history, postoperative additional pain control and duration of hospital stay between the two groups. Uterine weight was 706.5±363.2 g (range, 500-2,415 g) for SPA laparoscopic hysterectomy and 634.0±153.3 g (range, 500-1,130 g) for conventional laparoscopic hysterectomy and signifi cantly not different between the two groups. Operation time was signifi cantly longer in SPA laparoscopic hysterectomy than conventional laparoscopic hysterectomy (81.1±18.1 minutes vs. 67.2±16.8 minutes). Postoperative change in hemoglobin and hematocrit was statistically higher in SPA laparoscopic hysterectomy than conventional laparoscopic hysterectomy (1.9±0.9g/dL, 2.9±4.2% vs. 1.0±1.3g/dL, 6.2±2.9%, respectively). Conclusion Operation time was longer and postoperative change in hemoglobin and hematocrit was signifi cantly higher in SPA laparoscopic hysterectomy than conventional laparoscopic hysterectomy. However, SPA laparoscopic hysterectomy will replace conventional laparoscopic hysterectomy in a future with improving surgical technique.

당뇨병성 말초 신경병증에 대한 PGE1의 효과

김민선,조보연,이홍규,신찬수,고창순,김성연,박경수,박건상,김진성,박형규,김현규,문병술 대한당뇨병학회 1995 Diabetes and Metabolism Journal Vol.19 No.4

Surgical treatment of Lip hypertrophy secondary to port-wine stain

( Hyun Chul Shim ),( Geon Kim ),( Ji Hyun Choi ),( Ji Hye Kim ),( Bo Kyung Koh ),( Eun Jung Kim ),( Hyang Joon Park ),( Ok Ja Joh ) 대한피부과학회 2011 초록집 Vol.49 No.20

Application of tumor kinetics for evaluation of hyperprogression in immune checkpoint inhibitor treatment for non-small cell lung cancer

( Cheol-kyu Park ),( Joon-young Yoon ),( Ji-eun Kim ),( Min-seok Kim ),( Bo-geon Koh ),( Ha-young Park ),( Tae-ok Kim ),( Hong-joon Shin ),( Yong-soo Kwon ),( In-jae Oh ),( Yu-il Kim ),( Sung-chul Lim 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Background: Existing criteria for response assessment (RECIST v1.1) have limitations in differentiating categories of disease progression upon immune checkpoint inhibitor (ICI) treatment: primary resistance, pseudoprogression or hyperprogression (HPD). This study was aimed to investigate a real-world feasibility of pre- and on-treatment tumor kinetics for ICIs-specific response assessment in NSCLC. Methods: We retrospectively recruited stage III/IV NSCLC patients treated with anti-PD-1/PD-L1 monotherapy after failure of first-line platinum-doublet chemotherapy (n=91) between June 2016 and October 2018. We analyzed tumor kinetics prior and upon ICI treatment using ratio of tumor growth rate (TGR ratio, TGRR), tumor growth kinetics (TGK ratio, TGK_R) and difference in TGR (delta TGR, ΔTGR), respectively. HPD was defined as TGRR ≥2, TGK_R ≥2 and ΔTGR >50%. Results: After excluding 18 patients without CT scan after start of ICIs, 73 patients were enrolled. Overall response rate by RECIST v1.1 was 16.4% (12/73) and disease control rate was 62% (45/73). HPD patients was 12% (9/73) and 15% (11/73) when defined by TGRR and TGK_R, respectively. There was no HPD patients defined by ΔTGR. HPD patients classified by each criterion were associated with shorter median progression-free survival (PFS) according to iRECIST (TGRR ≥2, 1.6 vs 2.1 months, p<0.001; TGK_R ≥2, 1.6 vs 2.1 months, p<0.001) and median overall survival (OS) than non-HPD-PD patients (TGRR ≥2, 2.4 vs 5.2 months, p=0.002; TGK_R ≥2, 2.4 vs 5.2 months, p=0.002). There was no pseudoprogression in patients classified as HPD. Conclusion: HPD defined by pre- and on-treatment tumor kinetics was observed in 12-15% of patients with advanced NSCLC treated with second-line ICI monotherapy, and correlated with shorter PFS and OS. TGR and TGK could classify HPD patients from non-HPD PD with similar discriminability. Further studies are needed to investigate clinical and molecular determinants that distinguish HPD from non-HPD PD and pseuoprogression.

MRKH 증후군에서 골반복막피판을 이용한 복강경보조 질 성형술 6예

박상도 ( Sang Do Park ),이종선 ( Jong Seon Lee ),이건우 ( Geon Woo Lee ),이경은 ( Kyung Eun Lee ),고영복 ( Young Bok Koh ),양정보 ( Jung Bo Yang ),이기환 ( Ki Hwan Lee ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.11

Vaginal agenesis is rare gynecologic condition, and the most common etiology is Mayer-Rokitansky-Kster-Hauser (MRKH) syndrome, characterized by the absence of uterus and vagina and presence of normal ovaries and tubes. In such patients, the evaluation for associated malformations as well as careful non-surgical and surgical approach are essential. The neovaginoplasty is an important issue for these patients in regard of functional and psychological standpoint. There are many options available for creation of neovagina. We report six cases of laparoscopic assisted neovaginoplasty using pelvic peritoneal flap.