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Surgical Outcomes of Adrenocortical Carcinoma; 20 Years of Experience in a Single Institution
Min Jhi Kim,Eun Jeong Ban,Soo Jung Jung,Hai Young Son1,Cho Rok Lee,Sang-Wook Kang,Jong Ju Jeong,Kee-Hyun Nam,Woong Youn Chung,Cheong Soo Park 대한갑상선-내분비외과학회 2014 The Koreran journal of Endocrine Surgery Vol.14 No.4
Purpose: Adrenocortical carcinoma (ACC) is a rare malignant tumor. Early detection is difficult and prognosis is poor. We report on 20 years of ACC surgical experience at our institution. Methods: This study included 32 ACC patients who underwent surgical resection at the Department of Surgery of the Yonsei University Health System in South Korea between January 1990 and February 2012. We reviewed these 32 patients and retrospectively analyzed long-term clinical outcomes and prognosis after radical surgery for ACC. Results: The median age of the 32 patients at diagnosis was 42.25 years (range 3∼81 years). There were 16 (50%) female and 16 (50%) male patients. Mean tumor size was 12.36 cm (range 1.8∼20 cm). Twenty-five patients (78.12%) had nonfunctioning tumors while the other seven patients (21.87%) had functioning tumors. Seventeen patients (53.12%) were classified as stage II, two (6.25%) as stage III, and 13 (40.62%) as stage IV. Fourteen patients underwent radical surgical resection, while 14 patients received adjuvant chemotherapy, two received adjuvant radiotherapy, and two received adjuvant chemoradiation. Four patients were lost to follow-up. Among the remaining 28 patients, 15 patients survived. The 5- and 10-year overall survival was 60.6% and 37.8%, respectively (median survival=85±24.3 months). Seventeen patients (53%) experienced disease recurrence. Five- and 10-year recurrence-free survival was 41.5% and 29.7%, respectively (median survival=18±5.5 months). Conclusion: Early stage at diagnosis and surgical resection were the most important prognostic factors associated with prolonged survival. The role of additional therapy remains controversial and new agents should continually be evaluated for efficacy.
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지역사회 획득 폐렴의 원인으로서 Chlamydia pneumoniae의 중요성에 관한 연구
김의종,김성민,오명돈,김선주,최강원 대한감염학회 1995 감염 Vol.27 No.1
연구 배경 : Chlamydia pneumoniae(TWAR)는 급성 호흡기 감염증을 일으키는 병원체로, 혈청역학적 연구 결과에 의하면 세계적으로 성인의 20-50%가 C. pneumoniae 대한 IgG 항체를 가지고 있다. 우리나라의 경우, 건강한 성인의 약 50%가 항체 양성임을 고려하면 C. pneumoniae는 우리나라에서도 호흡기 감염증의 흔한 원인중 하나일 것으로 생각된다. 대상 및 방법 : 건강인 108명과 1993년 2월부터 5월 말까지 신병 훈련소에 입대한 군인 중 폐렴으로 인해 후송병원에 입원한 환자를 대상으로 하였다. C. pneumoniae에 대한 IgG 및 IgM 항체는 microimmunofluorescent 법을 이용하여 측정하였다. 항체검사에 사용한 elementary body 항원은 Washington research Foundation으로부터 분양을 받았다. 현증 감염은 항체 역가가 4배 이상 상승하거나, IgG항체 역가 ≥512, 또는 IgM항체 역가>16으로 정의하였다. 성적 : 건강인 108명 중 IgM 항체 양성자는 한 명도 없었으나, IgG >16인 사람은 67명 (62%) 이었다. 폐렴에 걸린 신병 79명의 증상은 기침, 객담이 100%, 발열 87%,수포음 78%, 흉부 X-선상 침윤이 87%였고, 증상 발현 후 입원까지의 기간은 1주일이내가 27%, 8-13일 27%, 14-20일 27%, 21일 이상 20% 였다. 이들 폐렴 환자들 중 C. pneumoniae에 대한 lgG 항체 역가가 4배 이상 상승한 환자는 11명, lgG 항체 역가 ≥512인 환자가 4명 (3명은 항체 역가가 4배 이상 상승)으로, 전체 대상환자 중 15%(12/79)가 급성 간염증의 소견을 보였다. 결론 : C. pneumoniae 감염은 비교적 흔히 발생하며, 지역 사회 획득 폐렴의 중요한 원인 중 하나로 생각된다. Background : Chlamydia pneumoniae strain TWAR cause acute infections of the respiratory tract. Previous study showed that prevalence of TWAR antibody in adults from different areas of the world ranged from 25% to 50%. In Korea, positive rate of poly- IgG antibodies against TWAR was reported to be about 50% among healthy adults. These suggest that infections caused by TWAR may be quite prevalent in Korea. We tried to determine whether TWAR is an important pathogen of community-acquired pneumonia. Methods : We studied 108 healthy persons and 79 military recruits with pncumonia who were evacuated from the training camp to the military hospital from February to April 1993. IgG and IgM antibodies to TWAR were measured using the microimmunofluorescence method. Elementary body antigen from TWAR was provided by the Washington Research Foundation. Serologic evidence of current infection was defined as a four-fold rise in antibody titer. In addition, a titer of 16 or greater in the IgM fraction and of 512 or greater in the IgG fraction were considered presumptive evidence of current or recent infection. Results : Of the 108 healthy subjects, none had IgM TWAR antibody, while 67 (62%) had IgG antibody at a titer of 16 or greater. Of the 79 military recruits with pneumonia, cough and sputum developed in 100%, fever in 87%, and crackles in 78% Chest X-ray infiltration was noticed in 87%. Duration of symptoms before admission was less than 7days in 27%, 8-13 days in 27%, 14-20 days in 27%, 21 days or longer in 20%. Of the military recruits with pneumonia, 15% (12/79) showed evidence of acute TWAR infection: 11 showed a four-fold antibody titer rise, and 1 had IgG antibody titer greater than 512. Conclusion : These results suggest that TWAR infections are quite prevalent and TWAR may be one of the important pathogens of community-acquired pneumonia in Korea.
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주암댐 집수유역 내 하상퇴적물의 중금속 오염현황 및 거동 특성
염승준Seung-Jun Youm 1 *이평구,Pyeong-Koo Lee 1 강민주,Min-Ju Kang 1,신성천Seong-Cheon Shin 1 and 유연희Youn-Hee Yu 2 대한자원환경지질학회 2004 자원환경지질 Vol.37 No.3
전라남도 보성강에 축조된 주암댐의 집수유역 내 하상퇴적물을 대상으로 중금속의 오염현황과 거동 특성을 알아보았다. 주암댐의 집수유역에는 많은 폐금속 및 탄광이 위치하고 있어 주암댐 호저퇴적물에 잠재적인 오염원으로 작용할 수 있다. 집수유역 내 하상퇴적물의 중금속 함량(Cr, Cu, Ni, Pb, Zn)은 매우 낮기 때문에 주암댐의 호저퇴적물에 영향을 줄 것으로 판단되지 않는다. 하지만 폐금속광산지역 내 하상퇴적물의 Pb 함량은 하류로 갈수록 증가하는 경향을 보여, Pb의 오염 확산이 우려된다. 폐금속광산의 환경을 고려한 강산성 조건의 용출실험결과, 하상퇴적물의 용출비로부터 결정된 중금속의 상대적 이동도는 Pb>Zn=Cu>Ni>Cr으로서, Pb이 주암댐 호저퇴적물에 영향을 미치는 원소가 될 수 있음을 지시해준다. 한편 댐으로 유입한 퇴적물이 호저에 놓이게 되면(즉, 환원환경), Pb의 이동도가 비교적 높게 나타나 물-퇴적물 경계에서 Pb의 수중으로 재용출될 수 있다 We investigated the contamination and behavior of heavy metals in stream sediments within the watershed of Juam Reservoir. Many abandoned mines within the reservoir can act as a potential contaminant source for water quality. Heavy metal concentrations (Cr, Cu, Ni, Pb and Zn) in stream sediments from watershed are very low, indicating that content of heavy metals in the sediments probably do not affect the water quality in Juam Reservoir. However Pb concentration in the stream sediments increases downward streams, suggesting the possible diffusion of Pb contamination. According to the leaching ratio for stream sediments at a strong acidic condition in the abandoned mine areas, the relative mobility for metals decreases in the order of Pb>Zn=Cu>Ni>Cr, indicating that Pb can have a bad effect upon the water quality in Jum Reservoir. Moreover, if contaminated sediment is placed in the bottom of reservoir (i.e., reducing condition), the relative mobility of Pb is the highest, indicating that Pb in the bottom sediments can be leached to water at interface between water and sediment with changing in physicochemical conditions.
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