비소세포 폐암의 근치적 절제술 후 예후 인자 분석 및 IIIa 병기에서의 보조 요법의 효과에 대한 연구

조세행,정경영,김주항,김병수,장준,김성규,이원영,Cho, Se Haeng,Chung, Kyung Young,Kim, Joo Hang,Kim, Byung Soo,Chang, Joon,Kim, Sung Kyu,Lee, Won Young 대한결핵및호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.5

Background: Surgical resection is the only way to cure non-small cell lung cancer(NSCLC) and the prognosis of NSCLC in patients who undergo a complete resection is largely influenced by the pathologic stage. After surgical resection, recurrences in distant sites is more common than local recurrences. An effective postoperative adjuvant therapy which can prevent recurrences is necessary to improve long tenn survival Although chemotherapy and radiotherapy are still the mainstay in adjuvant therapy, the benefits of such therapies are still controversial. We initiated this retrospective study to evaluate the effects of adjuvant therapies and analyze the prognostic factors for survival after curative resection. Method: From 1990 to 1995, curative resection was perfomled in 282 NSCLC patients with stage I, II, IIIa, Survival analysis of 282 patients was perfonned by Kaplan-Meier method. The prognostic factors, affecting survival of patients were analyzed by Cox regression model. Results: Squamous cell carcinoma was present in 166 patients(59%) ; adenocarcinoma in 86 pmients(30%) ; adenosquamous carcinoma in II parients(3.9%); and large cell undifferentiated carcinoma in 19 patients(7.1%). By TNM staging system, 93 patients were in stage I; 58 patients in stage II ; and 131 patients in stage rna. There were 139 postoperative recurrences which include 28 local and 111 distant failures(20.1% vs 79.9%). The five year survival rate was 50.1% in stage I ; 31.3% in stage II ; and 24.1% in stage IIIa(p <0.0001). The median survival duration was 55 months in stage I ; 27 months in stage II ; and 16 months in stage rna. Among 131 patients with stage rna, the median survival duration was 19 months for 81 patients who received postoperative adjuvant chemotherapy only or cherne-radiotherapy and 14 months for the other 50 patients who received surgery only or surgery with adjuvant radiotherapy(p=0.2982). Among 131 patients with stage IIIa, the median disease free survival duration was 16 months for 21 patients who received postop. adjuvant chemotherapy only and 4 months for 11 patients who received surgery only(p=0.0494). In 131 patients with stage IIIa, 92 cases were in N2 stage. The five year survival rate of the 92 patients with N2 was 25% and their median survival duration was 15 months. The median survival duration in patients with N2 stage was 18 months for those 62 patients who received adjuvant chemotherapy and 14 months for the other 30 patients who did not(p=0.3988). The median survival duration was 16 months for those 66 patients who received irradiation and 14 months for the other 26 patients who did not(p=0.6588). We performed multivariate analysis to identify the factors affecting prognosis after complete surgical resection, using the Cox multiple regression model. Only age(p=0.0093) and the pathologic stage(p<0.0001) were significam prognostic indicators. Conclusion: The age and pathologic stage of the NSCLC parients are the significant prognostic factors in our study. Disease free survival duration was prolonged with statistical significance in patients who received postoperative adjuvant chemotherapy but overall survival duration was not affected according to adjuvant therapy after surgical resection. 연구 배경: 비소세포 폐암의 근치적 치료는 수술적 절제에 주로 의존하고 있고 근치적 수술을 받은 환자의 예후는 수술당시의 병기가 중요하며 진행된 병기의 환자일수록 총 생존기간 및 무병생존기간이 현저하게 단축됨이 많은 연구자에 의해 보고되었다. 또한 근치적 수술 후의 재발은 수술부위보다는 원격 전이에 의한 재발이 많으므로 수술 후의 생존율을 향상시키기 위해서는 원격전이에 의한 재발을 억제할 수 있는 효과적인 수술 후 보조요법이 필요하다. 수술 후의 보조요법은 방사선 치료 및 항암제 투여가 있으나 각각의 치료 방법에 따른 생존율의 보고는 연구자에 따라 상이 한 결과를 보이고 있으며 국내 연구보고는 거의 없는 실정이다. 이에 연구자등은 1990년 1월부터 1995년 12월까지 연세대학교 의과대학 부속 세브란스 병원 흉부외과에서 근치적 절제술을 시행받은 282 명의 비소세포 폐암 환자를 대상으로 수술 후 보조요법의 효과 및 예후인자에 대한 분석을 시행하였다. 방법: 후향적 연구였으며 환자의 생존율은 Kaplan-Meier방법으로 분석하였다. 환자생존에 영향을 미치는 예후인자에 대한 분석은 Cox regression model에 의한 단일 및 다중 변수분석에 준하였다. 결과: 대상 환자의 조직학적 유형으로는 편평상피암이 166예(59%), 선암이 86예(30%), 편평상피선암이 11예(3.9%), 미분화 거대세포암이 19예(7.1%)이었다. 병기는 TNM분류에 따라 l기 93명, II기 58명, IIIa기 131명이었다. 수술 후 재발한 환자는 139명이었고 국소 재발이 28예(20.1%), 원격전이가 111예(79.9)이었다. 병기에 따른 5년 생존율은 I기 50.1%, II기 3 1.3%, IIIa기 24.1%였고(p<0.0001) 병기에 따른 중앙 생존 기간은 I기 55개월, II기 27개월, IIIa기 16개월로 나타났다(p<0.0001). IIIa병기의 환자중 수술 후 항암제만을 투여받거나 항암제와 방사선치료를 받은 환자는 81명이었고 이들의 중앙 생존 기간은 19개월이었으며 수술만을 받거나 수술후 방사선 치료만을 받은 환자는 50명이었는데 이들의 중앙 생존 기간은 14개월로서 양군간에 통계적으로 유의한 차이는 없었다(p=0.2982) 또한 IIIa 병기의 환자중 수술만을 받은 환자는 11명이었고 이들의 중앙무병 생존기간은 4개월이었으며 수술후 항암제 투여만을 받은 환자는 21명이었고 이들의 중앙무병 생존기간은 16개월로 양군간에 통계적으로 의미있는 생존기간의 차이를 보였다(P=0.0494) IIIa 병기중 N2기의 환자는 92명으로 5년 생존율은 25%, 중앙 생존 기간은 15개월이었다. 이들 중 수술 후 항암제 투여군은 62명으로 중앙 생존 기간은 18개월이었고 비투여군은 30명으로 이들의 중앙 생존기간은 14개월이었으며 양군간에 통계적으로 유의한 차이는 없었다(p=0.3988). N2기 환자중 수술후 방사선 치료를 받은 환자는 66명으로 이들의 중앙 생존 기간은 16개월이었고 방사선 치료를 받지 않은 환자는 26명으로 이들의 중앙 생존 기간은 14개월이었다. 양군간에 통계적으로 유의한 생존 기간의 차이는 없었다(p=0.6588). Cox Multiple Regression Model을 이용하여 수술 후 환자의 생존율에 영향을 미치는 예후 인자에 대하여 분석한 결과 환자의 연령(p=0.0093)과 병기(p<0.0001)만이 통계적으로 유의하였다. 결론: 비소세포 폐암 환자의 연령과 병기가 유의한 예후 인자이었으며, 보조 요법에 따른 생존율에 유의한 차이는 없었다. 따라서 수술 후 환자의 생존율을 향상시키기 위해서는 더욱 효과적인 보조요법의 개발이 필요할 것으로 생각된다.

IgA 신증 환자에서 신이식 후의 임상 경과 및 예후에 관한 연구

조세행,이승우,이승근,장윤수,강신욱,최규헌,이호영,한대석,김유선,박기일 대한신장학회 1995 춘계학술대회 초록집 Vol.1995 No.-

초록입홍합추출오일복합물(관절팔팔)이 Monosodium Iodoacetate로 퇴행성관절염을 유도한 흰쥐의 연골 및 관절에 미치는 영향 효능 평가

조세행 한국식품영양과학회 2019 한국식품영양과학회지 Vol.48 No.2

This study examined the effect of green lipped mussel extract oil complex (GLMOC; green lipped mussel oil, olive oil, and D-α-tocopherol) on the joints and cartilage in an osteoarthritis-induced animal model. A total of 40 seven-week-old Sprague-Dawley rats were divided randomly into 5 groups; 1) normal, 2) control, 3) GLMOC 32.5 mg/kg, 4) GLMOC 65 mg/kg, 5) GLMOC 130 mg/kg. Osteoarthritis was induced by injection of monosodium iodoacetate (MIA) into the knee joints of the rats. The rats were sacrificed at the end of 4th week after daily administration of GLMOC and then rat tibial articular cartilage was removed. Serum NF-κB was measured by ELISA and the expression levels of type Ⅰ, Ⅱ collagen, matrix-metalloproteinase (MMP)-2, 9 mRNA were analyzed by qPCR. The morphological changes in the joint were evaluated by micro-CT and staining with H&E and Safranin-O & Fast Green. No adverse events were observed during the experiment period. GLMOC significantly inhibited serum NF-κB level in rats with MIA-induced osteoarthritis. Expression of the catabolic genes of MMP-2 and MMP-9 were lower in the cartilage of the animals fed GLMOC. A histological examination of animals showed that GLMOC administration improved the lesions significantly. Bone volume fraction (BV/TV), trabecular thickness (Tb.Th), and trabecular number (Tb.N) were increased in rats fed GLMOC compared to the control group and bone surface/bone volume (BS/BV) was decreased significantly. These results suggest that GLMOC effectively protects the joints and cartilage by suppressing inflammatory responses and cartilage destruction. 골관절염은 관절을 보호하고 있는 연골의 손상이나 퇴행성 변화로 인해 관절을 이루는 뼈와 인대 등에 손상이 생겨 염증과 통증이 발생하는 질환이다. 초록입홍합오일은 1970년대 후반부터 관절염에 효능이 있다고 알려진 원료지만 연골 건강에 어떠한 영향을 미치는지에 대한 연구는 미비한 실정이다. 본 연구는 초록입홍합오일을 포함하고 있는 관절팔팔이 퇴행성 관절염 동물 모델의 관절 및 연골에 미치는 영향과 이에 대한 작용기전을 확인하기 위해 수행되었다. 초록입홍합추출오일복합물은 LPS로 염증반응을 유도한 대식세포에서 iNOS, COX-2의 생성을 유의하게 감소시키고 IL-6, IL-1β, TNF-α 등의 염증성 사이토카인의 분비를 억제하며, NF-κB, MAPKs signaling을 조절한다고 보고되어 있다. 본 실험에서는 MIA로 골관절염을 유도한 수컷 흰쥐에서 염증을 유발하는 인자인 NF-κB의 생성을 감소시켜 염증반응을 억제하였다. 그리고 연골을 분해하는 효소인 MMP-2, MMP-9 mRNA의 발현을 억제함으로써 관절 조직의 활막 과형성, 판누스 형성 및 연골 파괴를 모두 감소시켜 연골 손상을 감소시켰다. 대퇴골 및 경골의 해면골 면적 비율, 해면골 두께 및 해면골 수는 증가시키고 뼈 부식은 감소시켰다. 결론적으로 관절팔팔의 주원료인 초록입홍합추출오일복합물은 염증반응을 감소시키고 연골 파괴가 진행되는 것을 억제함으로써 관절 및 연골을 보호하는 것으로 판단된다.

간세포암의 간동맥 화학색전술 후 발생한 급성 폐손상

조세행 ( Se Haeng Cho ),김주항 ( Joo Hang Kim ),김병수 ( Byung Soo Kim ),장준 ( Joon Jang ) 대한결핵 및 호흡기학회 1995 Tuberculosis and Respiratory Diseases Vol.42 No.5

IgA 신증 환자에서 신이식 후의 임상 경과 및 예후에 관한 연구

조세행(Se Haeng Cho),김유선(Yu Seun Kim),정현주(Hyun Joo Jeong),이승우(Seoung Woo Lee),구본권(Bon Kwon Koo),강신욱(Shin Wook Kang),최규현(Kyu Hun Choi),이호영(Ho Yung Lee),한대석(Dae Suk Han),박기일(Ki Il Park) 대한내과학회 1997 대한내과학회지 Vol.52 No.1

N/A Objectives : Primary IgA nephropathy is the most common type of glomerulonephritis, which may progress to end stage renal failure in about 30-35% of the cases. The incidence of recurrence of IgA nephropathy in transplanted kidney is approximately 50-60% but IgA nephropathy which is recurred in graft has relatively benign clinical course so the rate of graft loss due to recurrent IgA nephropathy is about 10%. Overall graft survival rate of IgA nephropathy is higher than other glomerular disorders which cause end stage renal disease according to recent clinical studies. However accurate causative disorders of end stage renal failure had seldom been reported by pathologic examination and accurate graft survival rate and recurrence rate of original disease after renal transplantation couldn't be investigated. We performed analysis of clinical outcome and prognosis for IgA group. Methods: 1259 cases of kidney transplantation were performed in the Severance hospital between Apr 1979 and Dec.1994. We selected 178 cases of those who got renal biopsy and excluded the cases of cadaveric transplants, hepatitis B antigen carrier, diabetes mellitus and not taking cyclosporine A. 178 cases of those were divided into two groups, IgA and nonIgA group. We performed analysis of 5 year graft and patient survival rate between two groups. The IgA group was divided into two group, recurrent and not-recurrent IgA group. We also performed analysis of recurrence rate and graft survival rate between two groups. Results: 1) 62 cases(35.2M) were IgA group and 116 cases were non-IgA group. 2) Male to female ratio of IgA group was 2.9:1, whose age averaged 35 years old. 3) Among 6 cases of the IgA group, 3 cases lost their graft due to chronic rejection, 2 cases due to recurrence and 1 case due to acute rejection. 4) The 5 year graft survival rate of IgA and nonIgA group were 85%, 90% each without statistical significance(p>0.05). The 5 year patient survival rate of IgA and nonlgA group after renal allograft were 100%, 97% each without statistical significance(p>0.05). 5) 266 cases of posttransplant kidney biopsies were performed and 10 cases were diagnosed as re- current IgA nephropathy with recurrence rate of 15%. 6) Renal insufficiency was noted in 4 cases of recurrent IgA nephropathy, 2 cases of those were chronic renal failure and the other 2 cases lost their graft. The histologic findings of these cases included mesangial widening and proliferation(4 cases), glomerulosclerosis(2 cases), crescent formation(1 cases). 7) The interval between transplantation and recurrence averaged 41 months. 24hr proteinuria and serum level of creatinine at the time of diagnosis averaged 2.6g and 2.2 mg/dl each. 8) Male to female ratio, age, HLA type and degree of HLA match showed no significant difference between nonrecurrent and recurrent IgA group in graft but 5 year graft survival rate of recurrent IgA group was lower than nonrecurrent group with statistical significance(71% vs 83%, p<0.05). Conclusion: Recurrent IgA nephropathy in transplanted kidney might be one of major cause of graft loss with chronic rejection. However precise pathologic examination of before k after transplantation on larger patient population and more long term follow-up are advised.

PME88 멜론SOD의 자외선으로 인한 피부 광노화 억제 효과

조세행(Se Haeng Cho) 한국식품영양과학회 2009 한국식품영양과학회지 Vol.38 No.4

PME88 멜론(글리아딘과 결합된 식물 추출물) superoxide dismutase(SOD)의 섭취는 체내에 존재하는 superoxide dismutase, catalase 및 glutathione peroxidase를 포함한 항산화 효소의 활성 및 총량을 증가시키는 것으로 이전 연구에서 확인되었다. 본 연구에서 minimal erythema dose(MED) 값의 변화, 홍반점수의 변화, 분광비색계 측정값을 분석함으로써 자외선으로 인한 피부 광노화 억제 효과를 알아보았다. MED 값의 변화 분석에서는 PME88 멜론SOD 섭취 군에서는 시험 물질을 28일 동안 섭취한 후 MED가 유의하게 증가하였으며, 14일과 28일 사이에 그 유의성은 더욱 증가하였다. 홍반의 심한 정도(홍반점수) 분석에서 28일 동안 섭취 후 위약 군이 PME88 멜론SOD 투여군보다 1.25 MED의 자외선을 조사하였을 경우 홍반이 유의하게 나타났다. 또한 분광비색계 측정값 분석에서 0.64 MEDD14, 0.80 MEDD14, 1.0 MEDD14에서 a*변수(색변화에 가장 민감한 변수, 홍반의 색조 변화를 반영)가 위약 군에서 PME88 멜론 SOD 투여군보다 유의하게 높았다. 4주간의 시험기간 동안 대변에 대한 횟수나 성향의 이상 징후 및 거부반응은 없었다. 이상의 결과들을 종합하면 PME88 멜론SOD의 섭취는 안전하게 UV로 인한 피부의 광노화를 억제하는데 유용하다는 사실을 확인하였다. PME88 (gliadin-combined) melon superoxide dismutase (SOD) is known to promote the production of the body’s own natural antioxidants including superoxide dismutase, catalase and glutathione peroxidase. In this study, we investigated the inhibitory effects of PME88 melonSOD on the ultraviolet-induced photo-aging by the evolution of minimal erythemal dose (MED), erythema quotation and spectrocolorimetric measurements of erythema. The analysis of the evolution of the MED showed a significant increase 28 days after the daily taken of the PME88 melonSOD. The analysis of the erythema quotation showed that on D29, for the dose 1.25 MED, erythema intensity is significantly higher for placebo group than for PME88 melonSOD group. At doses 0.64 MEDD14, 0.80 MEDD14 and 1 MEDD14 the value of parameter a* (the most sensitive to the colour changes bound to the variations of blood flow. It permits to assess the evolution of erythema) is significantly higher for placebo group. No significant difference has been observed between groups (PME88 melonSOD and placebo) on the evolution of the number and consistency of feces after 4 weeks of treatment. No intolerance has been observed during the 4 weeks of treatment. These results mean that PME88 melonSOD as a dietary supplement could be useful to attenuate ultraviolet-induced skin photo-aging.

비소세포 폐암의 근치적 절제술 후 예후 인자 분석 및 3a 병기에서의 보조 요법의 효과에 대한 연구

조세행 ( Se Haeng Cho ),정경영 ( Kyung Young Chung ),김주항 ( Joo Hang Kim ),김병수 ( Byung Soo Kim ),장준 ( Joon Chang ),김성규 ( Sung Kyu Kim ),이원영 ( Won Young Lee ) 대한결핵 및 호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.5

담낭 결석, 담낭염, 뇌동맥류 및 신낭종을 동반한 Von Meyenburg Complex 1 예

김성남,조세행,옥찬호,허춘웅,윤일주,서형심 대한내과학회 2001 대한내과학회지 Vol.60 No.4

Von Meyenburg complexes (VMC) have many synonyms such as bile duct hamartomas and biliary hamartoma. These r are benign disorder s are considered as congenital diseases caused by malformed differentiation of duct al plate. The diagnosis of VMC by common radiologic modality such as ultrasound and computed tomography was nearly impossible until the emergence of cholangiopancreatography by magnetic resonance imaging (MRCP) and the pathologic examination was the only way to confirm the diagnosis of VMC. But MRCP is now considered as most accurate noninvasive method for diagnosis of VMC. We report a histologically pr oven case of VMC associated with calculous cholecystitis, cerebral aneurysm and renal cortical cyst. To our knowledge, no comparable case has been reported and this would be the only second reported case of VMC, which was diagnosed by MRCP.(Korean J Med 60:388- 392, 2001)

Green lipped mussel oil complex suppresses lipopolysaccharide stimulated inflammation via regulating nuclear factor-κB and mitogen activated protein kinases signaling in RAW264.7 murine macrophages

Jing Chen,Cheng Bao,조세행,이홍진 한국식품과학회 2017 Food Science and Biotechnology Vol.26 No.3

Here we investigated the effect of green lipped mussel oil complex (GLMOC) on inflammation and underlying mechanism in lipopolysaccharide stimulated RAW264.7 murine macrophage cells. GLMOC containing green lipped mussel oil (GLMO), olive oil, and vitamin E (10:20:1) can induce significant suppression of iNOS, leading to reduced nitric oxide synthesis, and cyclooxygenase- 2, leading to reduced prostaglandin E2 synthesis. In addition, it down-regulated the release of pro-inflammatory cytokines, including tumor necrosis factor-a, interleukin (IL)-6, and IL-1b. Similar to upstream signaling mediators, GLMCO inhibited the degradation of inhibitory jB, nuclear translocation of NF-jB, and phosphorylation of mitogen activated protein kinases (MAPKs) in a dose-dependent manner. Among the components of GLMOC, GLMO was responsible for anti-inflammatory efficacy. Taken together, GLMOC induces anti-inflammatory activity via regulating NF-jB and MAPK signaling in lipopolysaccharide-induced RAW264.7 cells, providing underlying mechanisms that elucidate the anti-inflammatory efficacy of GLMOC.

한국 성인 급성 골수성 백혈병에서의 염색체 분석

최성준,이규형,서을주,배창황,김정균,조세행,김태원,장대영,이제환 大韓血液學會 1998 大韓血液學會誌 Vol.33 No.2