에스트로겐 수용체 ${\beta}$ 발현과 유방암 재발과의 관련성

강수환,최정은,이수정,Kang, Su-Hwan,Choi, Jung-Eun,Lee, Soo-Jung 영남의대학술지편집위원회 2011 Yeungnam University Journal of Medicine Vol.28 No.2

Background: It has been reported that estrogen receptor beta ($ER{\beta}$) mRNA expression was down-regulated during carcinogenesis and was inversely related to estrogen receptor alpha ($ER{\alpha}$) expression in breast cancer. The association of $ER{\beta}$ mRNA expression to tamoxifen resistance has also been reported. In this study, the expression of $ER{\alpha}$ and $ER{\beta}$ via immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) was prompted, and an attempt was made to find out the relationship between $ER{\beta}$ expression and recurrence in the hormonal therapy group, and between $ER{\beta}$ expression and known prognostic factors. Methods: Tumor specimens were obtained at surgery from 67 female breast cancer patients during the period of September 1995 to December 2000. All the specimens were frozen in liquid nitrogen and kept at $-70^{\circ}C$ until they were used. The medical records were analyzed retrospectively. The expressions of ER were analyzed using IHC and RT-PCR methods. Results: The median follow-up was at 93.0 months (range: 14-157 months). The percentage of $ER{\alpha}+/ER{\beta}+$, $ER{\alpha}+/ER{\beta}-$, $ER{\alpha}-/ER{\beta}+$, and $ER{\alpha}-/ER{\beta}$ group were 35.9% 9.4%, 47.2%, and 7.5%, respectively, in 53 patients with hormonal therapy. $ER{\beta}$ was positive in 42 (82.3%) of 51 ER-positive patients. In the hormonal therapy group, the recurrence rates of each group was 15.8%, 0%, 40.0%, and 0%, respectively. In this group, the $ER{\beta}$ expression tended to recur, but there was no clinical significance (p=0.084). Conclusion: The $ER{\beta}$ expression may be a predictive marker of a poor response to endocrine therapy in breast cancer patients, although this needs to be confirmed in additional studies.

유방보존술에서 절제연까지의 거리가 국소재발에 미치는 영향

강수환(Su Hwan Kang),이수정(Soo Jung Lee) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.5

Purpose: The association between the margin status and the risk of a local recurrence (LR) after breast conservation therapy (BCT) is controversial. In addition, the width of the resection margin that minimizes the risk of LR is unknown. This study examined the interaction between the margin width, tumor characteristics, and adjuvant systemic therapy on the risk of LR after BCT. Methods: The records of 348 women with T1 and T2 breast cancers, who were treated with BCT between 1997 and 2004, were reviewed. Patients who underwent a re-excision with a positive margin were excluded. The margin was classified as close (≤5 ㎜ tumor-free margin) or negative (>5㎜ tumor-free margin). Various clinical and pathologic factors were analyzed as potential prognostic factors for LR in addition to the margin width. Results: The rate of LR for all patients after a mean follow-up of 37.2 months was 3.7% (13/348). The LR rates were significantly associated with young age (<40 years, P=0.009), high nuclear grade (P=0.032), large tumor size (>2 ㎝, P=0.021) and negative hormone receptor (P=0.032). A positive axillary lymph node, the presence of EIC, high histological tumor grade, high proliferative index (Ki-67), the presence of lymphovascular invasion, the over-expression of c-erbB2 and the expression of p53 was not significant. Systemic adjuvant therapy was not associated with a lower rate of LR in both groups. The final resection margins were close in 30 patients (8.6%) and negative in 318 patients (91.4%). The rates of LR by the margin width were 6.7% (2/30) for close margins and 3.5% (11/318) for negative margins. There were no significant differences in the rate of LR according to the margin width. The rate of LR in patients with a 1 ㎜ tumor-free margin width was 13.3% (2/15). Moreover, there is a tendency for an increase in the LR with a 1 ㎜ tumor-free margin than with a margin width >1 ㎜ (P=0.046). Conclusion: According to this study, if the margin is tumorfree, a close resection margin (≤5 ㎜) is not associated with an increased rate of LR in BCT. However, a high rate of LR can be expected in patients with 1 ㎜ margins.

Reoperative Thyroid Surgery

강수환(Su Hwan Kang) 대한갑상선-내분비외과학회 2015 대한갑상선-내분비외과학회 학술대회 논문집 Vol.- No.-

초기유방암에서 피하유방 전절제술과 즉시유방재건술

강수환(Su Hwan Kang),이수정(Soo Jung Lee),우상현(Sang Hyun Woo),정재호(Jae Ho Jeong),설정현(Jung Hyun Seul) 대한외과학회 1999 Annals of Surgical Treatment and Research(ASRT) Vol.57 No.4

진성 비장 낭종 3예

허영수,강수환,윤성수,Huh, Young-Soo,Kang, Su-Hwan,Yun, Sung-Su 대한소아외과학회 1999 소아외과 Vol.5 No.2

Splenic cysts are uncommon and classified as either primary(true) or secondary(pseudo-) depending on the presence or absence of a true epithelial lining. True cysts (epidermoid cyst) of the spleen are very rare. Three cases of splenic cysts in childhood were treated at the Yeungnam University Hospital in the last eleven years(1989-1999). Two of patients were girls. The ages at diagnosis were 7, 12 and 15 years. Abdominal ultrasonography and computerized tomography were utilized for the diagnosis. Radionuclide scanning was performed in one patient. Surgical resection(one partial splenectomy and two total splenectomies) was performed. The sizes of cysts were 4, 6.5 and gem in maximum demension.

소아 장중첩증의 병리적 유발병변

장선모,강수환,이정훈,허영수,Jang, Seon-Mo,Kang, Su-Hwan,Lee, Jung-Hoon,Huh, Young-Soo 대한소아외과학회 2000 소아외과 Vol.6 No.1

Pathologic lead points are found in a few intussusception patients. To evaluate the pathologic lead points in childhood intussusception, a retrospective review of 227 operated cases of intussusception treated at the Yeungnam University Hospital from January 1986 to April 1999. The patients were divided into 2 groups; idiopathic group 209 cases, (92.1 % and lead points group 18 cases, 7.9 %). Intussusception developed between age two months and six months in both groups. Enteroenteric type of intussusception was relatively more frequent in the lead point group than in idiopathic group. The lead points were veil (10 cases, 52.6 %), Meckel's diverticulum(3 cases, 15.8 %), lymphoma(3 cases, 15.8 %), ectopic pancreas(2 cases, 10.5 %), Henoch-Sch$\ddot{o}$nlein purpura(1 cases, 5.3 %). The bowel resection rate was 44.4 % in the lead point group and 8.6% in idiopathic group. The recurrence rate was 5.56 % in lead points group and 1.44 % in idiopathic group.

발전 플랜트의 엑서지 해석으로부터 발전량 및 발전효율 최적화

김덕진,이재병,강수환,Kim, Deok-Jin,Lee, Jae-Byoung,Kang, Su-Hwan 한국플랜트학회 2013 플랜트 저널 Vol.9 No.3

발전 플랜트의 발전량 최적화 및 발전효율 최적화는 에너지공학을 전공한 전문가일지라도 이해하기 힘든 개념이다. 본 연구에서는 엑서지 및 엑서지율이라는 열역학적 상태값을 적용하여 에너지 공학을 전공하지 않은 일반인일지라도 발전량 및 발전효율 최적화 개념을 쉽게 이해할 수 있는 차트가 개발되었다. 발전소의 성능을 파악할 수 있는 대표적인 물성치는 주증기의 온도 및 압력이다. 개발된 차트에서는 주증기의 온도 및 압력에 따른 최대 발전량 곡선과 최대 효율 곡선이 도시되어 있으므로, 해석하고자 하는 발전소의 온도 및 압력을 차트에 적용하여 그 발전소가 얼마만큼 최대 발전량과 최대 효율에 접근해 있는지를 쉽게 파악할 수 있다. Even if an expert who has majored energy engineering, it is a difficult concept to understand power output optimization and power efficiency optimization. In this study a diagram applying thermodynamic state value as specific exergy and exergy ratio was developed. Although general peoples who did not major energy engineering can be easily understand the concept of power output optimization and power efficiency through the developed diagram. A represented property that can identify the performance of power plant is the main steam temperature and pressure. At the developed diagram the maximum power output line and maximum power efficiency line are shown according to the temperature and pressure of main steam. Therefore we can identify how much a power plant approach to maximum power output and maximum power efficiency.

위암 환자의 예후인자로서 림프관 정맥 및 신경 침범의 의의

김치호,장석원,강수환,김상운,송선교,Kim Chi-Ho,Jang Seok-Won,Kang Su-Hwan,Kim Sang-Woon,Song Sun-Kyo 대한위암학회 2005 대한위암학회지 Vol.5 No.2

목적: 표준화된 술식으로 위절제술을 시행한 위암 환자를 대상으로 임상병리학적 특성, 특히 암세포의 림프관, 정맥 및 신경 침범 유무가 환자의 예후에 미치는 영향을 확인 하고자 하였다. 대상 및 방법: 1995년 1월부터 1999년 12월까진 만 5년간 영남대학교 의과대학 부속병원 외과에서 위암으로 진단되어 위절제를 시행받은 1,018명의 의무기록을 토대로 후향적 연구를 시행하였다. 통계는 chi-dquare test를 이용하고 예후 인자들은 Cox proportional hazards regression model을 사용한 다변량 분석을 통해 분석하였다. 생존율은 Kaplan-Meier 방법으로 5년 생존율을 구하고 log-rank test로 검정하였다. 유의 수준은 P < 0.05를 기준으로 하였다. 통계처리는 SPSS for Windows (Version 10.0, SPSS lnc, USA) 프로그램을 이용하였다. 결과: 각 임상병리학적 특성에 대한 단변량 분석 결과, 환자의 연령, 종양의 크기 및 위치, Borrmann형, 조직 분화도, 위절제술의 범위, 암의 위벽 침윤도, 림프절 전이 정도, 병기, 원격 전이 유무, 수술의 근치도 등이 유의하였으며, 이상의 유의한 인다들을 다변량 분석한 결과 암의 위벽 침윤도, 림프절 전이, 림프관 침범, 신경 침범 및 수술의 근치도가 독립적 예후 인자로서 유의하였다. 결론: 기존의 TNM 병기 분류법이 병의 진행 상태를 객관적으로 표현할 수 있고 기본적인 예후 인자로서 역할을 하지만, 병리조직학적 검사 소견에서 림프관 및 신경 침범 유무를 확인하는 것은 위암의 예후 판정에 추가적인 정보를 제공할 수 있을 것으로 기대한다. Purpose: Some controversies exist over the prognostic values of lymphatic, venous, and neural invasion in patients with gastric cancer. This study was conducted to confirm the prognostic values of these histopathologic factors in gastric cancer patients who received a gastrectomy. Materials and Methods: Data for clinicopathologic factors and clinical outcomes were collected retrospectively from the medical records of 1,018 gastric cancer patients who received a gastrectomy at Yeungnam University Medical Center between January 1995 and December 1999. A statistical analysis was done using the SPSS program for Windows (Version 10.0, SPSS Inc., USA). The Kaplan-Meier method was used for the survival analysis. Prognostic factors were analyzed by using a multivariate analysis with Cox proportional hazard regression model. Results: Ages ranged from 21 to 79 (median age, 56). A univariate analysis revealed that age, tumor size, location, gross type, depth of invasion, extent of gastrectomy or lymph node dissection, lymph node metastasis, distant metastasis, lymphatic invasion, venous invasion, neural invasion, pathologic stage, histologic type, and curability of surgery had statistical significance. Among these factors, lymph node metastasis, curability of surgery, neural invasion, lymphatic invasion, and depth of invasion were found to be independent prognostic factors by using a multivariate analysis. Venous invasion showed no prognostic value in the multivariate analysis. Conclusion: Neural invasion and lymphatic invasion are useful parameters in determining a prognosis for gastric cancer patients.

1,275명 유방암 환자의 AJCC 병기분류법의 변화에 따른 임상양상의 비교

전영산(Young San Jeon),강수환(Su Hwan Kang),이수정(Soo Jung Lee) 대한외과학회 2004 Annals of Surgical Treatment and Research(ASRT) Vol.67 No.3

초기유방암에서 피하유방절제술 후 즉시유방재건술의 조기결과

김기석(Ki Suk Kim),강수환(Su Hwan Kang),이수정(Soo Jung Lee) 대한외과학회 2005 Annals of Surgical Treatment and Research(ASRT) Vol.68 No.4