A Risk factor for the postoperative lymphocele after pelvic lymphadenectomy in women with cervical cancer

( Jung Hwan Ahn ),( Jiwoo Lee ),( Jiyun Hong ),( Yuyeon Jung ),( Ji Geun Yoo ),( Sang Il Kim ),( Jin Hwi Kim ),( Sung Jong Lee ),( Joo Hee Yoon ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: A lymphocele is a cystic mass that may occur in the retroperitoneum following a pelvic lymphadenectomy. Lymphoceles may be the cause of severe morbidity, or rarely mortality. This retrospective study was aimed to determine risk factor for development of lymphocele after pelvic and/or paraaortic lymphadenectomy in women with cervical cancer. Methods: This study was conducted on 547 cervical cancer patients who underwent radical hysterectomy and pelvic lymphadenectomy at Seoul St. Mary’s Hospital and St. Vincent’s Hospital from 1997 to 2010. We divided them into lymphocele induced and lymphocele free groups, respectively. 6 variables (the type of energy device, the number of lymph nodes removed, radiation therapy, operation time, drainage use, BMI) were retrospectively compared between both group. Results: Of 547 patients who underwent sole pelvic or combined pelvic and paraaortic lymphadenectomy for cervical cancer, the overall incidence of lymphoceles was 15.5% (85/547) that were detected by CT scan examination within 8 week after operation. To detect the independent risk factor for lymphocele development, we performed multivariate analysis with logistic regression for seven variables. Among these variables, we found a significant difference (p=0.029, p<0.05) for only the number of lymph nodes removed. The mean number of lymph nodes removed from the lymphocele group was 55.09 and the mean number of lymph nodes removed from the lymphocele-free group was 51.19. Among 85 lymphocele groups, more than 2 lymphocele were found in 20 patients and the total number of lymphocele was 106. Lymphoceles were predominantly located on the pelvic area. (pelvic wall 54.7%, ext. iliac 26.4%, int. iliac 12.3%, obturator 2.8%, inguinal 2.8%) In only one case, Lymphocele was located on the para-renal area. Conclusion: The number of lymph nodes removed during pelvic and/or para-aortic lymphadenectomy for cervical cancer is a risk factor for the development of lymphocele.

Clinical factors that affect diagnostic discrepancy between colposcopically directed biopsies and loop electrosurgical excision procedure conization of the uterine cervix

( Yuyeon Jung ),( Ah Ra Lee ),( Sung-jong Lee ),( Yong Seok Lee ),( Dong Choon Park ),( Eun Kyung Park ) 대한산부인과학회 2018 Obstetrics & Gynecology Science Vol.61 No.4

Objective This study aimed to determine the factors affecting pathologic discrepancy and final diagnosis between colposcopic biopsy and pathology by loop electrosurgical excision procedure (LEEP). Methods Between 2004 and 2016, 1,200 patients who underwent LEEP were enrolled for this study. 667 underwent cervical cytology, human papillomavirus (HPV) test, colposcopic biopsy, and LEEP. We analyzed patient's age, menopausal status, number of delivery, abortion times, cervical cytology, number of punch biopsies, HPV type, LEEP, and interval between colposcopic biopsy and LEEP. Results Logistic regression analysis of the final diagnosis showed that age 30-39 years and other high HPV group types were associated with cancer diagnosis, whereas atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), high-grade squamous intraepithelial lesion (HSIL), and HPV type 16 affected the diagnosis of cervical intraepithelial neoplasia (CIN) 2. The overall concordance rate of histopathology between punch biopsy and LEEP was 43.3%. The rates of detecting a more severe lesion by LEEP than those by biopsy were 23.1%. The rates of a less severe lesion detected by LEEP than those by biopsy were 33.6%. Factors related with biopsy underestimation were as follows: <1 vaginal delivery, HSIL, number of punch biopsies and HPV type. Punch biopsy number is a unique factor of biopsy overestimation. Conclusion Patients with ASC-H, HSIL, and HPV type 16 may undergo conization immediately without colposcopic biopsy. We suggest that colposcopically directed 3 to 5 punch biopsies may be used to determine the need for conization.

Role of BRCA1 methylation in ovarian cancer

( Yuyeon Jung ),( Sooyoung Hur ),( Youn Jin Choi ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

Objective: In families with multiple individuals affected by early onset disease, these percentages increase substantially. BRCA 1/2 variants explain approximately 12 % of familial ovarian cancer. In this study, we investigate predictive factor inducing cancer in BRCA1/2 (-) with family history participants. Methods: We examined BRCA1 DNA methylation through deep bisulfite sequencing of CpG islands and known promoter in peripheral blood DNA from 55 healthy control and 52 ovarian cancer patients. Results: We have shown that 32 (61.5%) of ovarian cancer patients and 22 (40%) of healthy participants harbored hypermethylated BRCA1 promoter. We observed BRCA1 hypermethylation showed BRCA1/2 (+) than BRCA1/2 (-) healthy participants and ovarian cancer patients (p < 0.001, and p < 0.001). The hypermethylation for the promoter regions of BRCA1 in BRCA1/2 (-) with family history, BRCA1/2 (+) with family history than BRCA1/2 (-) without family history in healthy participants (p = 0.022, and p < 0.001). Conclusion: Our observations suggest a broader role for BRCA1 methylation in familial risk healthy control and sporadic ovarian cancer. This methylation BRCA1 has important implications for diagnostic testing of individuals at high risk of ovarian cancer and for optimum treatment selection.

New risk factors of patients with stage IB cervical cancer on prognosis in the revised FIGO classification

( Yuyeon Jung ),( Soo Young Hur ),( Keun Ho Lee ),( Youn Jin Choi ),( Jung Hwan Ahn ),( Sung Jong Lee ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: The new FIGO classification revised mainly stage IB cervical cancer based on tumor size. In past FIGO stage, Peters and Sedlis critierae have been utilized as high and intermediate risk factor, respectively, to determine adjuvant treatment after surgery. There is a need to identify new risk factors in the revised stage. The purpose of this study is to find pathologic risk factors after surgery in patients with stage IB. Methods: To obtain pathologic data, we retrospectively analyzed patients with cervical cancer IB who underwent surgery as primary treatment at our institution from 1996 until 2006. Patients treated with radiation therapy initially were excluded in this study. The overall survival (OS) and progression free survival (PFS)s were analyzed by the Kaplan-Meier model. Cox proportional hazard regression model was used to identify risk factors affecting OS and PFS in patients with cervical cancer 1B. Results: Out of 442 patients, the number of stage IB1, IB2, and IB3 were 313, 100, and 29, respectively. PFS (p=0.003) and OS (p=0.002) of the stage IB subdivided by the tumor size decreased significantly as the stage was raised, confirming that tumor size affected the survival. The revised stage IB2 (2≤ tumor size <4 cm) and IB3 (tumor size ≥4 cm) affect OS with hazard ratio (HR) 1.9 and 3.5, respectively, compared to the stage IB1 (tumor size <2 cm). In addition, lymphovascular space invasion (LVSI) was significantly related to OS with HR 2.4. The predictive marker for adjuvant therapy such as radiation or chemotherapy was also LVSI (HR 2.570, 95% CI 1.346-4.906, p=0.04). Conclusion: The new FIGO classification showed a significant difference in PFS and OS from stages IB1 to IB3. Also, it reflects the strong impact of tumor size and LVSI on survival with regard to risk stratification in patients with stage IB.

미생물 공서배양 해조류 발효 추출물의 항치주염증효과

정유연(YuYeon Jung) 한국산업기술융합학회(구. 산업기술교육훈련학회) 2023 산업기술연구논문지 (JITR) Vol.28 No.4

항균과 항염증 특성을 지닌 다양한 천연물질들은 치주질환을 포함한 인간의 질병 예방 및 치료로 알려져 있다. 본 연구의 목적은 마우스에서 LPS로 유발된 염증을 미생물 공서배양 해조류 발효 추출물을 통해 항염증 효과를 통해치주염증을 억제하는 것을 평가하였다. 실험방법은 Laminaria japonica를 Saccharomyces cerevisiae와 Lactobacillus plantarum으로 발효시키고 그 추출물(LJFE)을 마우스에서 LPS로 유발된 치주염에 대한 억제 활성을 평가하였다. 결과적으로 염증 조절 단백질인 iNOS, COX-2 및 NF-κB DNA 결합 활성을 억제하는 작용 기전을 통해 항염증 및치주염 억제 효과를 확인하였다. 따라서, LJFE는 항염증성 사이토카인 치료제로서 상당한 잠재력을 보였다.

두류가 첨가된 글루텐-프리 쌀쿠키의 품질 특성에 가공방법이 미치는 영향

김유연(Yuyeon Kim),정두연(Duyun Jeong),정현정(Hyun-Jung Chung) 한국식품과학회 2018 한국식품과학회지 Vol.50 No.5

본 연구에서는 4가지 가공방법(침지, 삶음, 볶음, 가압볶음)에 의해 처리한 두류가루로 쿠키를 제조한 후 그들의 이화학적 특성과 텍스처 특성을 살펴보았다. 품질특성과 영양적 가치를 높이기 위하여 두류-찹쌀 혼합가루를 이용하여 글루텐-프리 쌀쿠키를 제조하였다. 가압볶음과 삶음에 의해 두류가루는 호화가 일어나 페이스팅 점도를 나타나지 않았으며 볶음처리에 의한 두류가루는 열처리에 의해 상호작용이 유도되어 호화온도가 증가하고 치반점도가 거의 나타나지 않은 특성을 보였다. 볶음처리한 두류가루로 제조된 쿠키는 대조군과 거의 유사한 색상을 나타냈으며 가압볶음이나 삶음 처리한 두류가루 보다는 높은 경도를 나타냈다. 녹두가루보다는 동부가루로 제조한 쿠키가 더 우수한 색상을 나타냈으며 경도도 더 높은 결과를 보였다. 결과적으로 본 연구에서 두류의 종류와 두류의 가공방법에 의해 글루텐-프리 쌀쿠키의 품질에 영향을 미치는 것을 확인할 수 있었다. Different processing methods, including steeping, boiling, roasting, and pressure roasting were used to deactivate anti-nutritional factors and remove off-flavor present in legumes. The physical and textural characteristic of cookie made with the treated flours were examined. The lightness of roasted cowpea flour was higher than that of the other treated legume flours, whereas that of pressure-roasted mungbean flour was the lowest. The boiled and pressure-roasted legume flours exhibited substantially lower pasting viscosity since the starches in these flours were considerably gelatinized during the heat treatment. Steeped mungbean flour had a significantly higher final viscosity than the other treated legume flours. Cookies containing mungbean flour had a higher protein content but lower lipid content than those containing cowpea flour. Cookies made with cowpea flour had a greater hardness than those made with mungbean flour. Cookies containing roasted flour had relatively better color properties than did those containing flours that were treated using other methods.

카페 주문대기열을 개선하는 QR 주문시스템 및 방법

정민(Min Jung),소동주(Dongju So),문지원(Jiwon Moon),임유연(Yuyeon Im),이상은(Sangeun Lee),김정룡(Jeong-yong Kim) 대한인간공학회 2013 대한인간공학회 학술대회논문집 Vol.2013 No.10

Hobnail-like shallow Electrosurgical Excision Prosedure(HEEP) for the treatment of HSIL: prevention of IIOC

( Jiyun Hong ),( Jiwoo Lee ),( Yuyeon Jung ),( Jung Hwan Ahn ),( Ji Geun Yoo ),( Sang Il Kim ),( Jin Hwi Kim ),( Sung Jong Lee ),( Joo Hee Yoon ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: We knew that conventional conization can make the incompetent internal os of cervix, which can induce the abortion and preterm delivery. So, we try to minimize the removed volume after conization. Methods: 34 young patients with HSIL ( final diagnosis: CIS or cervical cancer FIGO stage IA1 ) were enrolled in the Department of Obstetrics and Gynecology of St. Vincent\’s Hospital from Jan. 2014 to Aug. 2018. We treated those patients with Hobnail-like shallow Electrosurgical Excision Prosedure(HEEP) of uterine cervix for the treatment HSIL. Results: 4 women experienced 5 pregnancies. 4 of 5 pregnancies were kept more than 34 gestation weeks. Furthermore, all of 5 pregnancies gave healthy live births. Conclusion: HEEP could be considered as a treatment of choice for HSIL.

Comparison of abdominal and minimally invasive radical hysterectomy in patients with early cervical cancer

( Jiwoo Lee ),( Jiyun Hong ),( Yuyeon Jung ),( Jung Hwan Ahn ),( Ji Geun Yoo ),( Sang Il Kim ),( Jin Hwi Kim ),( Sung Jong Lee ),( Joo Hee Yoon ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: Recently, results from the Laparoscopic Approach to Cervical Cancer (LACC) trial were published indicating that patients undergoing minimally invasive radical hysterectomy have a lower rate of disease-free survival and overall survival than those who undergo abdominal radical hysterectomy. This is an extremely important trial that has the potential to cause a paradigm shift in how cervical cancer is managed and therefore led us to further evaluate the data from our institution. Our objective was to compare risks of recurrence, and survival in a cohort of women undergoing abdominal radical hysterectomy (ARH) versus minimally invasive radical hysterectomy (MRH) for early stage cervical cancer at a single institution. Methods: A retrospective cohort of patients undergoing radical hysterectomy for cervical cancer from 2000 to 2017 was identified. 127 patients with pathologically confirmed 2018 FIGO stage IB1, IB2 and IB3 cervical cancer were included and were grouped by minimally invasive and abdominal radical hysterectomy. Tumor characteristics, recurrence rate, progression-free survival (PFS), and overall survival (OS) were compared between groups. Results: 127 patients were identified; 44 underwent ARH and 83 underwent MRH. Those who underwent ARH were more likely to have tumors that were ≥ 2 cm, < 4cm (29.5% vs 22.9%, p = 0.41) and ≥ 4 cm (16% vs 8.4%, p = 0.20), but there were no significant differences. There were no significant differences in recurrence rate (12% vs 2.3%, p = 0.06), progression-free survival (PFS) (p = 0.19), or overall survival (OS) (p = 0.24). Conclusion: Recurrence rate, progression-free survival, and overall survival (OS) of minimally invasive radical hysterectomy (MRH) showed noninferiority compared to abdominal radical hysterectomy (ARH).

Comparative Outcomes between abdominal and tumor-sealing Laparoscopic Radical Hysterectomy in cervical cancer : Results from a single surgeon’s experience

( Sang Il Kim ),( Ji Woo Lee ),( Yuyeon Jung ),( Jung Hwan Ahn ),( Ji Geun Yoo ),( Jin Hwi Kim ),( Sung Jong Lee ),( Dong Choon Park ),( Joo Hee Yoon ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: The objective of this study was to compare risks of recurrence, and survival in a cohort of women undergoing abdominal radical hysterectomy (ARH) versus minimally invasive radical hysterectomy (MRH) using tumor sealing method and vaginal stent for early stage cervical cancer from a single surgeon’s experience. Methods: In this single institution retrospective study, we reviewed medical records of patients who underwent radical hysterectomy for cervical cancer between Jan. 2009 and Dec. 2017. 97 patients with pathologically confirmed 2018 FIGO stage IA1 with LVSI, IA2, IB1 and IB2 cervical cancer were included and were grouped by minimally invasive and abdominal radical hysterectomy. Tumor characteristics, recurrence rate, progression-free survival (PFS), and overall survival (OS) were compared between groups. Results: 97 patients were identified; 14 underwent ARH and 83 underwent MRH. Those who underwent ARH significantly had more tumors that were ≥ 2 cm, < 4cm (71.4% vs 38.5%, p = 0.021). There were no significant differences in recurrence rate (7.1% vs 9.6%, p = 0.769), progression-free survival (PFS) (p = 0.446), or overall survival (OS) (p = 0.685). Among 97 patients, 52 patients were operated by a single surgeon. 9 underwent ARH and 43 underwent MRH. And MRH group is subdivided into tumor sealing group and non-tumor sealing group. In tumor sealing group we created a vaginal cuff and used vaginal stent. There were 1 recurrent case in ARH group (1/9 ; 11.1%) and 3 recurrent cases in MRH group (3/42 ; 7.1%). All 3 recurrent cases were included in non-tumor sealing group. Conclusion: In conclusion, recurrence rate (RR), disease free survival (PFS), and overall survival (OS) of minimally invasive radical hysterectomy (MRH) showed non-inferiority compared to abdominal radical hysterectomy (ARH). And in early stage cervical cancer, tumor sealing method by creating a vaginal cuff and using BUMI manipulator is expected to reduce recurrence after minimally invasive radical hysterectomy.