http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
김민균(Min Kyoon Kim),한원식(Wonshik Han) 대한종양외과학회 2013 Korean Journal of Clinical Oncology Vol.9 No.1
Cancer therapy is moving definitely towards personalized therapy that maximize the benefits for the right selected patients with cost savings. The paradigm of personalized therapy in breast cancer is applying specific drugs to the specific molecular targets by better understanding of molecular biology of breast cancer that has been switched from previous giving the same treatment to presumed homogeneous patients based on histology. In the last several years, many next generation sequencing (NGS)-based studies have been carried out to provide a comprehensive molecular characterization of cancers, to identify novel genetic alterations contributing to oncogenesis, cancer progression and metastasis. These efforts have yielded significant achievements for breast cancers also. In this paper, we review the recent advances in NGS-based cancer genomic research as well as current challenges for its clinical application, and discuss the future directions in the research for the advanced achievement and cooperative works.
한상아(Sang Ah Han),김새리(Sairhee Kim),강은영(Eunyoung Kang),김정현(Jeong-Hyun Kim),하태현(Tae-Hyeon Ha),양은주(Eun Joo Yang),임재영(Jae-Young Lim),한원식(Wonshik Han),노동영(Dong-Young Noh),김성원(Sung-Won Kim) 대한의학유전학회 2010 대한의학유전학회지 Vol.7 No.1
목적 : 본 연구는 한국인 BRCA 유전자 돌연변이 가계구성원들을 대상으로 암진단 및 돌연변이 보유 여부가 심리 상태와 삶의 질에 미치는 영향을 알아보기 위해 시행되었다. 대상 및 방법 : BRCA 유전자 돌연변이를 가진 13가계에서 암에 이환된 보인자 17명, 이환되지 않은 보인자 16명, 건강한 비보인자 13명이 본 연구의 분석에 포함되었다. 이 세 군을 대상으로 우울, 불안, 낙관, 유전성 유방암관련 지식수준과 삶의 질을 설문을 통하여 평가하였다. 결과 : 설문시기는 유전자 검사 후 평균 21개월(6-35)로 세 군 간의 차이는 없었다(P=0.254). 세 군 간의 우울, 낙관, 육체적 삶의 질은 유사했다. 불안은 세 군 모두에서 일반인보다 상승되어 있었다. 이환된 보인자의 정신적 삶의 질은 암에 이환된 보인자가 다른 두 군에 비해 유의하게 낮았다(P=0.009, P=0.017). 다변량 분석 결과 정신적 삶의 질에 영향을 미친 인자는 암이환여부(P=0.043)와 직업유무(P=0.008) 였다. 결론 : 같은 돌연변이 가계 내에서 돌연변이 유무는 우울, 불안, 낙관에서 심리적반작용을 일으키지 않았으나, 돌연변이 가계 구성원의 불안 수준은 돌연변이 유무에 관계 없이 높았다. 본 연구는 소규모 표본을 대상으로 한 단면적 연구이나, BRCA 유전자 검사에 수반될 수 있는 심리적 스트레스 및 그에 대한 대처법을 수립하는 데 기초연구로 의의를 가진다. Purpose: The aims of this study are to evaluate psychological impact and quality of life according to the cancer diagnosis and mutation status in Korean families with BRCA mutations. Materials and Methods: Seventeen affected carriers (AC), 16 unaffected carriers (UC) and 13 healthy non carriers (NC) from 13 BRCA mutation families were included in the study. Outcomes were compared with regard to depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory, STAI), optimism (Reevaluation of the Life Orientation test, LOT-R), knowledge of hereditary ovarian cancer, and quality of life (QoL) (SF-36v2 Health Survey, physical component score [PCS], mental component score [MCS]) among three groups. Result: Level of depression, optimism, and PCS were similar in AC, UC, and NC. Anxiety score was elevated in all three groups. MCS was significantly low in AC than in UC and NC (P =0.009, P =0.017). Knowledge of hereditary breast and ovarian cancer was high in AC than NC (P =0.001). MCS was significantly related to whether patient was affected by cancer (P =0.043) and has occupation (P =0.008) or not in multivariable analysis. Conclusion: From this cross sectional study, psychological adverse effect was not related to the carrier status of BRCA mutation. Elevated anxiety in BRCA family members was observed but, independent to affection and the type of genetic mutation. AC showed low mental QoL. Further effort to understand psychological impact and QoL of genetic testing in BRCA family members is required for follow-up in clinical aspects.
갑상선 수술 시 Fibrin Tissue Glue의 사용에 대한 후향적 연구
김찬호,최준호,정유승,강경호,한원식,노동영,오승근,윤여규,Chan Ho Kim,Jun Ho Choe,Yu Seung Jung,Kyung Ho Kang,Wonshik Han,Dong- Young Noh,Seung Keun Oh,and Yeo-Kyu Youn 대한갑상선-내분비외과학회 2006 The Koreran journal of Endocrine Surgery Vol.6 No.1
Purpose: This study was designed to determine the effectiveness of fibrin tissue glue for reducing the amount of drainage and shortening the hospital stay. Methods: 255 patients who underwent thyroidectomy due to papillary thyroid carcinoma (179 cases of total thyroidectomy and 76 cases of total thyroidectomy with unilateral modified radical neck dissection) were analyzed retrospectively. The clinical factors were compared between the case group (fibrin glue) and the control group (conventional hemostasis). This comparison was separately done for the cases of total tyroidectomy alone and for the cases of total thyroidectomy with MRND. Results: There were no significant differences between the two groups for the amount of drainage and the length of the hospital stay for patients who underwent total thyroidectomy alone. On the other hand, for patients who underwent total thyroidectomy with unilateral MRND, a significant reduction of the average amount of drainage (case group: 37.52±9.41 ml, control group: 42.89±10.82 ml, P*=0.025) and a significantly shortened hospital stay (case group: 3.43±0.50 days, control group: 3.75±0.69 days, P*=0.021) were observed in the case group. Conclusion: From the results of this study, we recommend the use of fibrin glue after extensive radical neck surgery such as modified radical neck dissection. Prospective randomized studies should be carried out to confirm and expand our results. (Korean J Endocrine Surg 2006;6:22-26)
지의규(Eui Kyu Chie),김규보(Kyubo Kim),최진화(Jin-Hwa Choi),장나영(Na-Young Jang),한원식(Wonshik Han),노동영(Dong-Young Noh),임석아(Seock-Ah Im),김태유(Tae-You Kim),방영주(Yung-Jue Bang),하성환(Sung Whan Ha) 대한방사선종양학회 2008 Radiation Oncology Journal Vol.26 No.3
목 적: 조기유방암의 치료에 있어 과거에는 유방 전적출술이 주된 치료였으나 현재는 유방보존술이 표준 치료방법 으로 정립되었다. 저자들은 서울대학교병원에서 유방보존수술 및 방사선치료를 받은 환자의 임상적 특성을 조사 하고 치료결과 및 예후인자를 분석하고자 하였다. 대상 및 방법: 1992년 2월부터 2002년 1월까지 침윤성 유방암으로 유방보존수술 및 수술 후 방사선치료를 받은 424명을 대상으로 후향적으로 분석하였다. 대부분의 환자는 사분절제술 및 액와림프절 청소술을 시행 받았다(396명, 93.4%). 302명이 T1이었고 122명은 T2 병기였으며, 림프절 전이는 107명에서 확인되었다. 방사선치료는 전체 유방에 28회에 걸쳐 50.4 Gy를 조사한 후 종양이 있었던 부위에 10 Gy의 추가조사를 실시하였다. 영역림프절 조사는 57명에서 시행되었다. 항암화학요법은 231명에서 시행되었으며, 그 중 170명이 cyclophosphamide, methotrexate 및 5-fluorouracil을 투여 받았다. 중앙추적기간은 64개월이었다. 결 과: 전체 환자의 5년 국소제어율은 95.6%이었다. 추적관찰 중 15명의 환자에서 국소재발이 확인되었다. 5년 생존율은 93.1%이었고, 병기에 따른 5년 생존율은 I기 94.8%, IIA기 95.0%, IIB기 91.1%, IIIA기 75.9%, IIIC기 57.1% 이었다. 5년 무병생존율은 88.7%이었고, 병기별로는 I기 93.1%, IIA기 89.4%, IIB기 82.8%, IIIA기 62.0%, IIIC기 28.6%이었다. 예후인자 분석에서는 N 병기(p=0.0483)가 생존율에, 연령(p=0.0284)과 N 병기(p=0.0001)가 무병생존율에 각각 유의한 영향을 보였다. 결 론: 조기유방암에서 유방보존수술 및 수술 후 방사선치료는 우수한 국소제어율 및 생존율을 기대할 수 있는 치료법임을 확인할 수 있었다. Purpose: We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by postoperative radiotherapy. Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months. Results: The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival. Conclusion: This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.
갑상선 세침흡인 검체에서 Colorimetric Mutation Detection Method를 이용한 BRAF Mutation검출
정유승(Yoo Seung Chung),최준호(Jun-Ho Choe),이규언(Kyu Eun Lee),박원서(Won Seo Park),김훈엽(Hoon Yub Kim),한원식(Wonshik Han),노동영(Dong-Young Noh),오승근(Seung Keun Oh),윤여규(Yeo-Kyu Youn) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.1
Purpose: The detection of papillary thyroid carcinoma (PTC) is increasing these days; however, there is currently no satisfactory definitive preoperative diagnostic method. Fine-needle aspiration cytology (FNAC) is now the most accurate method to diagnose PTC preoperatively. It is known that the specificity of BRAF mutation is high in papillary thyroid carcinoma. Therefore, detection of BRAF mutation using a FNAC slide can be helpful to diagnose PTC preoperatively. Methods: 13 patients with benign disease, 36 patients with PTC and 23 patients with an indeterminate diagnosis as determined histologically on the FNAC slide were evaluated to detect BRAF mutation with using FNAC slides and intraoperative fresh tissue. Results: Mutation was detected using direct sequencing and the colorimetric method. The frequency of BRAF mutation was 86.3% for all the PTC cases. The concordance between the colorimetric method and direct sequencing was 57.1%. During DNA extraction from the FNAC slide, the DNA damage is so severe that direct sequencing is succeeded in only one case. Conclusion: We have to take measures to overcome and prevention DNA damage during extraction. The colorimetric method is not reliable.