The Prognostic Impact of the Number of Metastatic Lymph Nodes and a New Prognostic Scoring System for Recurrence in Early-Stage Cervical Cancer with High Risk Factors: A Multicenter Cohort Study (KROG 15-04)

권진이,엄근용,김영석,박원,전미선,이지혜,김용배,윤원섭,김진희,최진화,장세경,정배권,이석호,차지혜 대한암학회 2018 Cancer Research and Treatment Vol.50 No.3

Purpose We aimed to assess prognostic value of metastatic pelvic lymph node (mPLN) in early-stage cervical cancer treated with radical surgery followed by postoperative chemoradiotherapy. Also, we sought to define a high-risk group using prognosticators for recurrence. Materials and Methods A multicenter retrospective study was conducted using the data from 13 Korean institutions from 2000 to 2010. A total of 249 IB-IIA patients with high-risk factors were included. We evaluated distant metastasis-free survival (DMFS) and disease-free survival (DFS) in relation to clinicopathologic factors including pN stage, number of mPLN, lymph node (LN) ratio (number of positive LN/number of harvested LN), and log odds of mPLNs (log(number of positive LN+0.5/number of negative LN+0.5)). Results In univariate analysis, histology (squamous cell carcinoma [SqCC] vs. others), lymphovascular invasion (LVI), number of mPLNs ( 3 vs. > 3), LN ratio ( 17% vs. > 17%), and log odds of mPLNs ( 0.58 vs. > 0.58) were significant prognosticators for DMFS and DFS. Resection margin involvement only affected DFS. No significant survival difference was observed between pN0 patients and patients with 1-3 mPLNs. Multivariate analysis revealed that mPLN > 3, LVI, and non-SqCC were unfavorable index for both DMFS (p < 0.001, p=0.020, and p=0.031, respectively) and DFS (p < 0.001, p=0.017, and p=0.001, respectively). A scoring system using these three factors predicts risk of recurrence with relatively high concordance index (DMFS, 0.69; DFS, 0.71). Conclusion mPLN > 3 in early-stage cervical cancer affects DMFS and DFS. A scoring system using mPLNs > 3, LVI, and non-SqCC could stratify risk groups of recurrence in surgically resected early-stage cervix cancer with high-risk factors.

Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer

권진이,엄근용,김인아,김재성,김용범,노재홍,김기동 대한암학회 2016 Cancer Research and Treatment Vol.48 No.2

Purpose The purpose of this study is to compare the prognostic efficacy of the number and location of positive lymph nodes (LN), LN ratio (LNR), and log odds of positive LNs (LODDs) in highrisk cervical cancer treated with radical surgery and adjuvant treatment. Materials and Methods Fifty high-risk patients who underwent radical hysterectomy and pelvic node dissection followed by adjuvant treatment were analyzed retrospectively. The patients had International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIB. Upper LN is defined as common iliac or higher LN, and LNR is the ratio of positive LNs to harvested LNs. LODDs is log odds between positive LNs and negative LNs. Radiotherapy was delivered to the whole pelvis with median 50.4 Gy/28 Fx± to the para-aortic regions. Platinum-based chemotherapy was used in most patients (93%). The median follow-up duration was 80 months. Results The 5-year disease-free survival (DFS) rate was 76.1%, and the overall survival (OS) rate was 86.4%. Treatment failure occurred in 11 patients, and distant failure (DF) was the dominant pattern (90.9%). In univariate analysis, significantly lower DFS was observed in patients with perineural invasion, ! 2 LN metastases, LNR ! 10%, upper LN metastasis, and ! –1.05 LODDs. In multivariate analysis, ! –1.05 LODDs was the only significant factor for DFS (p=0.011). Of patients with LODDs ! –1.05, 40.9% experienced DF. LODDs was the only significant prognostic factor for OS as well (p=0.006). Conclusion LODDs ! –1.05 was the only significant prognostic factor for both DFS and OS. In patients with LODDs ! –1.05, intensified chemotherapy might be required, considering the high rate of DF.

A Prognostic Model for Patients with Triple-Negative Breast Cancer: Importance of the Modified Nottingham Prognostic Index and Age

권진이,엄근용,구태률,김병혁,강은영,김성원,김유정,박소연,김인아 한국유방암학회 2017 Journal of breast cancer Vol.20 No.1

Purpose: Considering the distinctive biology of triple-negative breast cancer (TNBC), this study aimed to identify TNBC-specific prognostic factors and determine the prognostic value of the Nottingham Prognostic Index (NPI) and its variant indices. Methods: A total of 233 patients with newly diagnosed stage I to III TNBC from 2003 to 2012 were reviewed. We retrospectively analyzed the patients’ demographics, clinicopathologic parameters, treatment, and survival outcomes. The NPI was calculated as follows: tumor size (cm)×0.2+node status+Scarff-Bloom- Richardson (SBR) grade. The modified NPI (MNPI) was obtained by adding the modified SBR grade rather than the SBR grade. Results: The median follow-up was 67.8 months. Five-year diseasefree survival (DFS) and overall survival (OS) were 81.4% and 89.9%, respectively. Multivariate analyses showed that the MNPI was the most significant and common prognostic factor of DFS (p=0.001) and OS (p=0.019). Young age (≤35 years) was also correlated with poor DFS (p=0.006). A recursive partitioning for establishing the prognostic model for DFS was performed based on the results of multivariate analysis. Patients with a low MNPI (≤6.5) were stratified into the low-risk group (p<0.001), and patients with a high MNPI (>6.5) were subdivided into the intermediate (>35 years) and high-risk (≤35 years) groups. Age was not a prognostic factor in patients with a low MNPI, whereas in patients with a high MNPI, it was the second key factor in subdividing patients according to prognosis (p=0.023). Conclusion: The MNPI could be used to stratify patients with stage I to III TNBC according to prognosis. It was the most important prognosticator for both DFS and OS. The prognostic significance of young age for DFS differed by MNPI.

MRI 아티팩트의 제거에 관한 연구

권진이,김응규 한밭대학교 정보통신전문대학원 2003 정보통신전문대학원 논문집 Vol.1 No.1

In this study, we present, an algorithm for canceling MRI artifacts due to some translational motion in patient’s head part. Assuming that the head part moves up and down due to patient's breathing which often makes problems during MRI imaging, rigid translational motions are treated here. Unlike the conventional iterative phase retrieval algorithm in which there is no guarantee for the convergence, this method is based on the MRI imaging process and the analysis of image property. A new constraint condition with which the image component and the motion component in the MRI signal can be separated by a simple algebraic operation is extracted After the x(read out) directional Fourier transformation of MRI signal is taken the y(phase encoding) directional spectrum phasing value is just an algebraic sum of the image component and the motion component. Meanwhile, at it is known that the density of subcutaneous fat area is almost uniform in the head tomographs, the density distribution along an y directional line on this fat area is regarded as symmetric shape. If the density function is symmetric, the phase of spectrum changes linearly with the position. Hence, the departure component methods, the motions in the x direction and the y direction are treated simultaneously. However, the x and the y directional motion is canceled by each different algorithm in two steps because the features of x and y directional motions are different from each other in this method. The x directional motion is estimated by detecting the edge boundary between the non-zero area and the zero area of the spectrum and is canceled by shifting the spectrum in inverse direction. The y directional motion is canceled by using the constraint condition which separates the true image component and the motion component. Finally, the effectiveness of this algorithm is shown by using a phantom image with simulated motion.

Role of adjuvant postoperative external beam radiotherapy for well differentiated thyroid cancer

권진이,우홍균,윤여규,이규언,김광현,박두준 대한방사선종양학회 2013 Radiation Oncology Journal Vol.31 No.3

Purpose: To analyze the outcome of adjuvant postoperative external beam radiotherapy (EBRT) in well-differentiated thyroid cancer (WDTC). Materials and Methods: We identified 84 patients treated with EBRT for WDTC from February 1981 to December 2010. Among them, we analyzed 39 patients who received EBRT after initial radical surgery. Twenty-four females and 15 males were included. The median age was 49 years (range, 16 to 72 years). There were 34 papillary thyroid carcinomas and 5 follicular thyroid carcinomas. Most patients showed pathologic T3/T4 stage (54%/26%). Ten patients (25.6%) had gross residual tumors. Five patients (12.8%) had tumor cells at the margin. The median EBRT dose and fraction size were 62.6 Gy and 1.8 to 2.0 Gy, respectively. Results: The median follow-up was 73 months (range, 21 to 372 months). The five-year overall survival (OS) and locoregional recurrence free survival (LRFS) were 97.4% and 86.9%, respectively. Locoregional failures occurred in 5 and all failure sites were the neck node area. In univariate analysis, OS was significantly influenced by invasion of the trachea (p = 0.016) or esophagus (p = 0.006). LRFS was significantly decreased by male (p = 0.020), gross residuum after resection (p = 0.002), close or positive tumor at surgical margin involvement (p = 0.044), and tracheal invasion (p = 0.040). No significant prognostic factor was identified in the multivariate analysis. No patient experienced the Radiation Therapy Oncology Group grade 3 or more toxicity. Conclusion: Our locoregional control rate of 87.2% is comparable to historical controls with surgery alone, even though our study had a large proportion of advanced stage. Adjuvant EBRT may an effective and safe treatment option in patients with WDTC.

20대 전반 여성의 로러지수 비만도와 자기인식 비만도에 따른 인체 인지에 관한 연구

권진 한국니트디자인학회 2015 패션과 니트 Vol.13 No.3

This study were intend to provide theoretical materials about clothing trend that females in their twenties favor through analysis on how they are aware of their own body according to Rohrer's Index and self-perceived obesity. This study were deal with differences between measured values from Rohrer's Index and self-awareness level regarding obesity. Domestic and overseas information database, network screening, and published data were utilized to obtain the relevant research materials. Closed-ended questions were used for research method. Anthropometry was adopted for assessment of Rohrer's Index. Collected samples were analyzed with PASW 18.0 statistical program. The results show a great difference between real obesity and awareness level among the women in their twenties. Majority of subjects do not know their exact obesity. Most of them even consider themselves as more obese than real. Also, the weight increases as an obesity level increases when compared to height. According to body size against obesity, measured sizes become larger in weight, chest, hip, waist, bust length, and bust point width as obesity increases in relation to both Rohrer Index and self-perceived obesity, indicating that weight and girth size are more influential to self-perception than height in obesity that they feel. In difference of body perception, there appears not much different perception among standard body shape group and obese body shape group as to both Rohrer Index and self-perceived obesity. Unlike this, there appears some difference in slim body shape group's breast, abdomen, and shoulder-waist-hip line as to real obesity and perceived level. For the ideal body shape that they think of, similar level appears in such body shapes as face, silhouette, abdomen, back, hip, and shoulder-waist-hip line in Rohrer Index and self-perceived obesity. However, difference takes place in breast shape, depending on the obesity. Results indicated that there are differences in perceiving the body, implying that differentiation is necessary in developing the female clothing based on obesity, accordingly.

편평세포암종으로 오인된 협부에 발생한 간질 호산구 증다증을 동반한 외상성 궤양성 육아종:

권진일(Jin-Il Kwon),김현우(Hyun-woo Kim),남웅(Woong Nam),차인호(In-Ho Cha),김형준(Hyung Jun Kim) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.3

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is an ulcerative lesion on oral mucosa featuring as a benign mass of self-limiting growth. It can be easily misdiagnosed as squamous cell carcinoma (SCC) due to its long healing period and elevated or rolled-up margin. A 57-year old male patient who visited our department was diagnosed as SCC according to the clinical features, results of positron emission tomography (PET) and magnetic resonance imaging (MRI) of the oral lesion. However, after performing incisional biopsy, histopathologically, there were no atypical cells, but eosinophil and CD 30+ T-cells were clustered in subcutaneous and muscle tissue. It is very significant to consider this reactive lesion in the field of oral and maxillofacial surgery because of its possibility of mistaken as malignant disease. Here, we will report a couple of cases of TUGSE with references and limit of radiographic tools used for diagnosis of head and neck cancer.

실과 중심 프로젝트 학습이 초등학생의 자기 주도적 학습능력에 미치는 영향

권진,류상희 한국실과교육학회 2006 한국실과교육학회지 Vol.19 No.4

The purpose of this study was to investigate the effects of project learning based on Practical Arts on self-directed learning ability of elementary school students. The research question was that what effects does subject-integrated project learning have on self-directed learning ability of elementary school students. To conduct this purpose, 32 students of one class as an experimental group and 32 students of the same grade as a control group were selected. The subject-integrated project activities were applied to experiment group, but conventional lesson was applied to control group.The results were summarized as follows.First, students who learned by subject-integrated project teaching method showed higher self-directed learning ability than those who were educated in a traditional way. Second, students of the experimental group showed higher meta cognition, information search, and problems solving skills among sub-domains of self-directed learning ability than students of the control group. ※ 주제어(Key Words) : 실과(Practical Arts), 프로젝트 학습(project teaching method), 자기주도적 학습(self-directed learning)

발표2. : 한국 기혼남성의 성역할태도와 일-가족 갈등에 관한 연구 - 일ㆍ가족 지향성의 매개효과를 중심으로 -

권진,김진욱 한국사회보장학회 2017 한국사회보장학회 정기학술대회 Vol.2017 No.2

영남문집해제 : 야일집

권진 영남대학교 민족문화연구소 1988 민족문화연구소 자료총서 Vol.4 No.-