The impact of pathologic differentiation (well/ poorly) and the degree of Ki-67 index in patients with metastatic WHO grade 3 GEP-NECs.

Kim, Seung Tae,Lee, Su Jin,Lee, Jeeyun,Park, Joon Oh,Park, Young Suk,Lim, Ho Yeong,Kang, Won Ki Grune & Stratton 2017 Journal of clinical oncology Vol.35 No._suppl15

<P> e15686 </P><P> Background: Herein, we investigated the impact of pathologic differentiation (well or poorly differentiated) in metastatic grade 3 GEP-NEC patients receiving etoposide and platinum-based therapy. Simultaneously, we evaluated a more exact Ki67 index cut-off point to select patients with grade 3 GEP-NEC who might benefit from etoposide plus platinum (EP)-based therapy. Methods: Among patients pathologically diagnosed with metastatic grade 3 GEP-NECs at Samsung Medical Center between June 2013 and March 2016, 31 GEP-NEC patients receiving etoposide and platinum-based therapy were included in this study. Results: Primary sites included 13 foregut-derived GEP-NECs [stomach (n = 4), duodenum (n = 4), and pancreas (n = 5)] and 2 hindgut-derived GEP-NECs of the rectum. Sixteen unclassified GEP-NECs originated from 7 gall-bladder (GB), 6 liver and 3 unknown primary sites. According to pathologic differentiation, 14 patients had well differentiated and 17 had poorly differentiated grade 3 GEP-NECs. Between well differentiated and poorly differentiated grade 3 GEP-NECs, there was a significant difference in the distribution of Ki67 index. There was no significant difference of treatment efficacy between well and poorly differentiated grade 3 GEP-NECs (RR; 35.7% vs. 41.2%, p = 0.525). Tumor response to EP occurred in 5 of 7 patients with Ki67 > 60% and 7 of 24 with Ki67≤60%, which was significantly different (RR; 71.4% vs. 29.2%, P = 0.043). There was no significant difference in PFS according to pathologic differentiation (well differentiated vs. poorly differentiated) and Ki67 index ( > 60% vs ≤60%). Conclusions: Grade 3 GEP-NECs could be morphologically classified into well and poorly differentiated NETs. Additionally, among grade 3 GEP-NECs, there was a significant difference in ranges of Ki67 index between well and poorly differentiated NECs. Higher levels ( > 60%) of Ki67 index might be a predictive marker for efficacy of EP as a standard regimen in grade 3 GEP-NECs. </P>

Poster Session : PS 0831 ; Upper GI Tract : Clinical Factors to Predict Angiographically Detectable Non-Variceal Upper Gastrointestinal Bleeding in Patients Refractory to Endoscopic Treatment

( Tae Hwan Ha ),( Tae Hoon Oh ),( Sung In Yu ),( Min Kim ),( Jong Wook Kim ),( Won Ki Bae ),( Jae Hyung Kim ),( Seung Suk Baek ),( Mi Jin Ryu ),( Ye Na Choi ),( Ji Young Park ),( Eileen L Yoon ),( Tae 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Non-variceal upper GI bleeding (NVUGIB) is a common medical problem that has signifi cant association with morbidity and mortality. Angiographic detection and subsequent transarterial embolization (TAE) is a primary treatment option when medical and endoscopic treatments fail. We investigated clinical factors that could affect the success of the angiographic detection and prognosis after TAE in patients with NVUGIB refractory to endoscopic therapy. Methods: A retrospective analysis of the clinical data was done in patients with failed endoscopic treatment who underwent angiography for the treatment of acute NVUGIB between May 2002 and May 2013. Patients were divided into detection or non-detection groups according to the presence of bleeding stigmata in angiographic fi nding. Rebleeding defi ned as subsequent bleeding event within 7 days and mortality within 30days were analyzed as outcome parameters after TAE following detection in angiography. Results: A total 45 patients 37 (male, mean age, 65.9±14.9 years) were analyzed and classifi ed as a detection group (n=25, 55.5%) and non-detection group (n=20, 44.6%). Peptic ulcers were the most common cause of refractory NVUGIB. Larger transfusion amount (5.7±3.9 unit vs. 3.5±2.8 unit; P=0.03), prolonged aPTT level (34.2±17.3 sec vs. 21.8±13.8 sec; P=0.01) and short time interval between last endoscopy and angiography (17.5±25.9 hours vs. 34.3±59.5 hours; P=0.04) were found to be signifi cant factors for predicting angiographic detection. TAE was performed in all patients detected in angiography. Rebleeding (44%) was significantly associated with higher Rockall score (8.3±1.5 vs. 6.6±2.4; P=0.046) and mortality (12%) was signifi cantly associated with higher Rockall score (9.3±0.6 vs. 7.1±2.2; P=0.002) and higher level of BUN (55.3±47.4 vs. 27.6±17.4; P=0.01). Conclusions: Clinical characteristics associated with angiographic detection in patients with NVUGIB refractory to endoscopic therapy were severe bleeding, bleeding tendency and early angiographic intervention. The Rockall score is useful parameter for predicting rebleeding and mortality after TAE.

다공질 실리콘 카바이드의 제작 및 광발광 성질

이기환,오제직,최석남,박병빈,이태호,김영유 공주대학교 사범대학 과학교육연구소 1998 과학교육연구 Vol.29 No.1

p-type α-SiC(4H, 6H, 15R polytype)를 사용하여 다공질 실리콘(porous silicon; PS)의 제작방법과 유사하게 HF/H₂O/C₂H??OH 용액에서 전기화학적으로 에칭을 하여 광발광 특성을 가지는 다공질 실리콘 카바이드(porous silicon carbide; PSC)를 제작하였다. PSC의 다공질의 분포는 전류밀도가 증가할수록 증가하고 다공질의 크기는 감소하였으며 광발광(photoluminescence; PL) 스펙트럼의 분석을 통해 전극 표면에서의 산화반응은 공급되는 전자의 양과 전류밀도에 의존하며 전류밀도가 증가할수록 전극의 산화반응은 억제된다는 결과를 얻었다. Porous silicon carbide(PSC) having photoluminescence(PL) can be prepared by a technique very similar to that used in porous silicon preparation, by electrochemical etching of crystalline p-type α-SiC(4H, 6H, 15R polytype) in ?? solution. The results show that porous distribution increase with increasing of the current densities while pore size decrease with that. Through the PL spectra analysis anodic oxidation of electrode surface was dependent on the amount of provided electrons and the current densities and inhibited with increasing of the current densities.

水質汚染에 의한 貝類中 重金屬汚染에 관한 國際的 硏究

김형석,김덕만,이기태,Chiba Momoko,Teramoto Keiko 한국환경독성학회 1994 환경독성보건학회지 Vol.9 No.2

The accumulation of heavy metals including Cd, Cu, Mn, Zn and Pb in various organs of shellfish which is the reasonable bio-indicator for hazardous substance contamination on lotic habitats with relatively limited mobility through waterbody was studied. Meretrix petechialis, Scapharca broughtonii, and Scapharca subcerenate from West Coast of Korea and Osaka Bay of Japan were selected to compare heavy metal contamination in adduct muscle, foot muscle, gill, mantle, and visceral organ of marine shellfish. Semisulcospira spp. from various area include West Coast of Korea and Han river were analyzed to compare heavy metal concentration in whole tissues between marine water and fresh water. A regional differences among Hong-chun, Kang-chon, Keum-nahm, Kah-pyung, Seo-rak, and Pal-dang of heavy metal concentration in Semisulcospira gottche was compared. There are significantly differences in mean concentration of Cd, Cu, Mn, Zn, and Pb among organs and species of M. petechialis, S. broughtonii, and S. subcerenate (ANOVA -F=60.31, p<0.001; F=36.88, p<0.001; F=27.78, p<0.001; F=9.39, p<0.001; F=2.91, p<0.001, respectively). The highest mean concentration of Cd with 0.680ppm was observed in gill and the lowest mean concentration of Cd with 0.082ppm was observed in foot muscle. The mean concentration of Cd with 0.349ppm in S. broughtonii was significantly different from other two species with 0.255 and 0.175ppm. Both Cu and Mn were highly accumulated in gill and mantle compare to other organs. Both gill and mantle had significantly different mean Cu concentration with 4.937 and 4.950ppm, respectively compare to both adduct muscle and foot muscle with 2.129 and 2.029ppm, respectively after Duncan's Multiple Range Test. The mean concentration of Cu with 1.900ppm in S. broughtonii was significantly lower then those of other two species. Both Zn and Pb were highly accumulated in gill compare to other organs. The mean concentration of all tested heavy metals except Cu in S. broughtonii were significantly higher than those of other species. There are significantly differences in mean concentration of all tested heavy metal except Cd between whole tissue of marine Semisulcospira spp. and fresh water Semisulcospira spp. Fresh water Semisulcospira spp. had high mean concentrations of Mn, Zn, and Pb while marine Semisulcospira spp. had higher mean concentrations of Cu. The mean concentrations of all tested heavy metals except Pb in Semisulcospira gottche from various area in Han River was significantly different among sites. The mean concentration of Cd in S. gottcheu from Hong-ehun, Cu in S. gottcheu from Kang-chon and Kah -pyung, Mn in S. gottcheu from Kah-pyung and Paldang, and Zn in S. gottcheu from Pal -dang was higher than those of other sites.

폐실질내의 주변형 결절로 나타난 소세포성 폐암의 CT 소견

이태희,최요원,전석철,서흥석,함창곡,박충기 한양대학교 의과대학 1998 한양의대 학술지 Vol.18 No.2

We evaluated CT findings of the small cell carninoma, which presented as a solitary pulmonary nodule at the periphery of the lung parenchyma. Of pathologically-proven 45 patients with small cell carcinoma, 10 patients was included in this study, who had a solitary, peripheral lung nodule at distal portion of the subsegmental bronchus. We retrospectively reviewed clinical data and CT findings including size, location, margin, enhancement pattern, lymph node enlargement, metastasis. Peripheral small cell carcinomas were 22.2%(10/45). All masses had well-defined margin and lobulated margin was seen in 7 patients. Mean diameter was 3.8cm (2.5-7.0cm). Enhancement pattern were homogeneous in 3 cases and inhomogeneous in seven. Calcification or air-bronchogram was not present, and focal cavitation was seen in one case. In five, only lung mass was present, and lung mass with lymph node enlargement was seen in one. distant metastasis without lymph node enlargement was noted on two patients and another two patients showed lymph node enlargement and distant metastasis. Peripheral small cell carcinoma is not rare(22.2%). Most frequent CT finding is a well-defined, lobulated mass with inhomogeneous enhancement, these findings would be helpful in differentiating small cell carcinoma from other neuroendocrine tumors when differentiataion is difficult cytologically.

실내 기후동에서 개인형 국소냉방 장치의 기류 및 온도 분포해석

엄태인,장은숙,경남호,신기식,문승현,전영남,류창국 한밭대학교 생산기반기술연구소 2002 생산기반기술연구소 논문집 Vol.2 No.1

Numerical simulation is performed by the commercial code FLUENT for individual air condition system to calculate the velocity and temperature profiles around worker in climate room. The main calculation region is the space of ㄱ shape between wall and worker in the individual air condition system. The fresh air is emitted from 3 inlet attached on the right, left and center wall. Because the comfort of worker is closely related with the velocity and temperature of wind, these data are key role for design of the individual air condition system. This work is previous study for evaluation of thermal comfort of workers in room without much experiments according to metabolism and heat emission of human body. Numerical simulation results are as followings, 1. There is an possibility of the thermal comfort of worker is gotten worse due to the presence of dramatic change of wind velocity around worker. 2. Temperature gap exists in worker's body between top and bottom according to fresh air inlet velocity and position which is right, left and center of wall. 3. Calculation results of the skin temperature of worker are key data for evaluation of thermal comfort with experimental data in climate room. 4. Optimum condition of temperature, direction and velocity of fresh air will be obtain by numerical simulation for energy effective individual air condition system.

인천 인현동 호프집 화재 피해자 분석

최정태,안무업,안희철,최영미,정재봉,서정열,유기철,이삼우,박석현,조준휘,김성환,김아진,송근정 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4

Purpose : This study was conducted to develop field triage, transportation, distribution, and prehospital care at a fire disaster by analyzing the victims of the fore that broke out at a bar in Incheon. Method : We analyzed the cases of the victims of a fire in Incheon in Oct. 1999. We determined the primary care hospital, the arrival time, the burn size, the outcome, and the injury type from the medical records, the concerned organ records, and interviews with concerned persons. Result : The total number of victims was 137: 56 prehospital deaths, 1 hospital death, and 80 survivals. The Pearson correlation coefficient between the burn size and the severity was -0.175. There were 121(89.6%) cases of inhalation injury, 59 (43.7%) cases of flame burns, 66 (48.9%) cases of hypoxic brain damage, and 16 (11.9%) cases involving other types of injury. Conclusion : The causes of death of the fire victims were inhalation injury and hypoxic brain damage due to CO poisoning and other toxic inhalants. We propose the use of a simple triage and rapid treatment(START) system and a reassessment the delayed category in fire disasters.

산-염기 평형 장애 진단 전문가 시스템의 설계 및 구현

김기태,유석희,황수철 중앙대학교 기술과학연구소 1989 기술과학연구소 논문집 Vol.19 No.-

In this study, we designed and implemented a diagnostic system model to process the diagnosing problem of acid-base balance disorder by means of OPS5 and LISP which are a tool and a language, respectively for developing Al systems. The implemented knowledge base system consists of three kind of the knowldege : one analytic knowledge of blood test, two diagnostic knowledges obtained by etiologies and symptoms. The knowledge representation and the inference mechanism for diagnosis were implemented by OPS5, and all input / output was processed by a menu-driven method in support of the window functions of LISP.

포괄수가지불제도 적용에 따른 산부인과 진료수입의 변화

황태연,유병철,정귀언,정수진,김성준,배기택,손혜숙,이종태,전진호,엄상화 인제대학교 2001 仁濟醫學 Vol.22 No.1

Objectives: Under the fee-for-service system, Korean hospitals have been suffering from the worsening profitability caused by law medical care fees. To overcome the difficulties, they have maximized the quantity of medical services and made relatively large investment in developing new medical services using high-priced medical equipment, medicines and medical supplies which were not covered by medical insurance system rather than reduced running costs. Materials and Methods: This study was made to analyze and forecast the revenue change of the department of Obstetrics and gynecology of an university hospital in Seoul, expecting the implementation of DRG system in 2000. Results: The results were as follows : 1.During the first two days of hospitalization. 41% of total medical service fee was occurred, which was thought that most of the check-ups and operations were made during this period. After two days of hospitalization, the new occurrence of medical service fee tended to reduce. 2.Out of total medical service fee, 67% of admission fee was occurred after 5 days of hospitalization. This was because medical service fees in obstetrics and gynecology department occurred during the first 5 days of hospitalization. 3.Out of fees for operation, treatment, medical supplies and blood transfusion. 71% was occurred during the first two days. 4. In case of fees for examination, 50% was occurred during the first two days. 5.A total of 53% of fees for medication and injection was occurred during the first 5 days. Conclusions: By the implementation of the DRG system, the income is forecast to increase by 800 won to 310,000 won by the disease group of obstetrics and gynecology department. To increase hospital income with the implementation of DRG system, the results of this study suggest that examinations should be done at out-patient departments before the hospitalization of patient, the discharge of patient should be noticed in advance to reduce the period of hospitalization, and admission appointment system should be implemented for the immediate operation and delivery.

경화된 열경화성 수지와 고분자재의 혼합성형에 관한 특성

김석호,윤한기,여홍태 東義大學校産業技術開發硏究所 1998 産業技術硏究誌 Vol.12 No.-

For the purpose of recycling the rigid thermosets, this study investigated the film of thermoplastic mixed with some weight fraction of rigid phenol in the hot compression molding at temperature of 200℃. The results abtained are as follows; the tensile stress according to the weight fraction of phenol particle is linearly proportional to the strain upto 2% of strain, the more the grain fraction of phenol is, the smaller the stress and strain is at frature, in case of the same weight fraction of phenol, the stress and strain of large grain is larger than those of small grain.