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이택상 대한의사협회 2023 대한의사협회지 Vol.66 No.6
Background: Ovarian cancer is a highly lethal gynecological cancer globally. The standard treatment for this disease is cytoreductive surgery followed by platinum-based chemotherapy. However, most patients develop platinum resistance after multiple relapses and have an inadequate response to second-line chemotherapy. Additionally, molecular heterogeneity poses a challenge to effective treatment. Current Concepts: Advancements in understanding the molecular mechanisms of cancer progression provide insight into novel targeted therapies, which have emerged as groundbreaking and promising cancer treatment strategies. Poly(ADP-ribose) polymerase inhibitors and anti-vascular endothelial growth factor monoclonal antibodies are currently the two approved and most effective targeted drugs for ovarian cancer. Discussion and Conclusion: This review article discusses related clinical trials assessing the efficacy and safety of promising targets in ovarian cancer as well as challenges associated with targeted therapy, including drug resistance, heterogeneity, and toxicity. Additionally, possible solutions to optimize treatment effects are proposed. Targeting these molecular abnormalities will bring us closer to the goal of personalized therapy and improve the prognosis for patients with ovarian cancer.
Necessity of Radical Hysterectomy for Endometrial Cancer Patients with Cervical Invasion
이택상,김재원,김대연,김영태,이기헌,김병기,D. Scott McMeekin 대한의학회 2010 Journal of Korean medical science Vol.25 No.4
To determine whether radical hysterectomy is necessary in the treatment of endometrial cancer patients with cervical involvement, we reviewed the medical records of women who underwent primary surgical treatment for endometrial carcinoma and selected patients with pathologically proven cervical invasion. Among 133 patients,62 patients underwent extrafascial hysterectomy (EH) and 71 radical or modified radical hysterectomy (RH). The decision regarding EH or RH was made at the discretion of the attending surgeon. The sensitivity of pre-operative magnetic resonance imaging for cervical invasion was 44.7% (38/85). In RH patients, 10/71 (14.1%) patients had frankly histologic parametrial involvement (PMI). All were stage III or over. Eight of 10 patients had pelvic/paraaortic node metastasis and two showed extrauterine spread. In 74 patients with stage II cancer, RH was performed in 41 and PMI was not seen. Sixty-six (89.2%) patients had adjuvant radiation therapy and there were 3 patients who had developed recurrent disease in the RH group and none in the EH group (Mean follow-up: 51 months). Although these findings cannot conclusively refute or support the necessity of radical hysterectomy in patients with cervical extension, it is noteworthy that the risk of PMI seems to be minimal in patients with a tumor confined to the uterus without evidence of extrauterine spread.
이택상,함성길,박종호,이성노 忠南大學校 産業技術硏究所 2002 산업기술연구논문집 Vol.17 No.2
The supersonic impinging jets are observed when exhaust gases from missiles or V/STOL aircrafts impinge on the ground, flame defector, ship deck, etc. The flow shows different patterns according to the nozzle geometry, nozzle-to-cone distance. This paper describes experimental works on the phenomena when underxpanded jets impinge on the cone-type deflector. The variety of flow parameter involving underexpansion ratio, nozzle to wedge apex spacing are considered.
Small punch test and simulation of HR3C steel
이택상,이후민,강석준,Fahim Ahmed Ibupoto,이정민,이종훈,김범준,최재붕,배시연,김문기 대한기계학회 2018 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.32 No.7
As the traditional uniaxial test requires substantial amount of cost and material usage for specimen, it is hardly applied to the direct diagnosis of structural integrity of in-service facilities. Small punch (SP) test has been, alternatively, introduced to procure material properties because SP test just needs a slice of material (10 ´ 10 ´ 0.5 mm) which can be easily obtained from real components without loss of integrity. In this study, for HR3C steel, SP tests were carried out and its three-dimensional finite element (FE) model was also developed to cross-validate the test results. Scanning electron microscope images for SP specimens were taken and compared with crack propagation simulation results generated by the extended finite element method. Furthermore, the minimum thickness change of specimen during the test was measured by several interruption tests. Configuration of SP test specimen was intensively observed with respect to punch displacement by both experiment and FE analysis, respectively.
이택상,성석주,송은섭,김재훈,김종혁,박노현,이기헌,이낙우,유희석,김재원,김성훈 대한부인종양학회 2009 Journal of Gynecologic Oncology Vol.20 No.2
Objective: This study was undertaken to document current practice patterns for the surgical treatment of endometrial cancer in Korea. Methods: Questionnaires were distributed to 131 Korean gynecologic oncologists, all members of the Korean Gynecologic Oncology Group. Questions addressed extent of hysterectomy procedure, pelvic (PEN) or paraaortic (PAN) lymph node dissection, ovarian preservation, and omentectomy. Results: Completed questionnaires were returned by 64.1% (84/131) of the oncologists at 50 institutes. Extrafascial hysterectomy (EH) was used by 32% of respondents and modified radical hysterectomy (MRH) or radical hysterectomy (RH) by 17%. Hysterectomy procedures were selectively employed based on tumor-related factors by 51% of the respondents. Laparoscopic hysterectomy was routinely utilized by 49% and was more commonly used by younger surgeons with 10 years of experience or less. PEN dissection was routinely utilized by 67% and was used selectively based on tumor-related factors by 33%. PAN dissection/biopsy was used either routinely (43%) or selectively based on tumor-related factors (43%). PAN dissection/biopsy had never been employed by 12% of the respondents. Sixty-nine percent of respondents stated that grossly normal looking ovaries can be preserved during surgery in young aged patients with early stage disease, and 29% stated that bilateral oophorectomy should be performed irrespective of age or stage. Omentectomy was routinely performed by 11% of respondents, and was selectively performed when extrauterine spread was present by 41%. Conclusion: Surgical procedures for the treatment of endometrial cancer are still not standardized among Korean gynecologic surgeons. Clinical trials to determine the benefits of the different surgical procedures should be developed. Objective: This study was undertaken to document current practice patterns for the surgical treatment of endometrial cancer in Korea. Methods: Questionnaires were distributed to 131 Korean gynecologic oncologists, all members of the Korean Gynecologic Oncology Group. Questions addressed extent of hysterectomy procedure, pelvic (PEN) or paraaortic (PAN) lymph node dissection, ovarian preservation, and omentectomy. Results: Completed questionnaires were returned by 64.1% (84/131) of the oncologists at 50 institutes. Extrafascial hysterectomy (EH) was used by 32% of respondents and modified radical hysterectomy (MRH) or radical hysterectomy (RH) by 17%. Hysterectomy procedures were selectively employed based on tumor-related factors by 51% of the respondents. Laparoscopic hysterectomy was routinely utilized by 49% and was more commonly used by younger surgeons with 10 years of experience or less. PEN dissection was routinely utilized by 67% and was used selectively based on tumor-related factors by 33%. PAN dissection/biopsy was used either routinely (43%) or selectively based on tumor-related factors (43%). PAN dissection/biopsy had never been employed by 12% of the respondents. Sixty-nine percent of respondents stated that grossly normal looking ovaries can be preserved during surgery in young aged patients with early stage disease, and 29% stated that bilateral oophorectomy should be performed irrespective of age or stage. Omentectomy was routinely performed by 11% of respondents, and was selectively performed when extrauterine spread was present by 41%. Conclusion: Surgical procedures for the treatment of endometrial cancer are still not standardized among Korean gynecologic surgeons. Clinical trials to determine the benefits of the different surgical procedures should be developed.