산발성 대장암에서 MSI와 다른 예후인자와의 상관관계

이시내 이화여자대학교 의과대학 2004 EMJ (Ewha medical journal) Vol.27 No.2

목적 : 산발성 대장암에서 microsatellite instability의 빈도를 조사하고 대장암의 여러 다른 예후 인자와의 연관성을 알아보고자 하였다. 방법 : 절제된 대장 및 직장 조직 총 45예를 대상으로 MSI분석을 시행하여 임상, 병리조직학적 소견과 비교하였다. 결과 : Microsatellite instability는 전체 45예 중 5예(11.1%)에서 관찰되었다. MSI인 5예 중 4예(40%)가 우측 대장에서 발생하였고 고등도(0%)나 증등도(5.3%)의 분화를 보이는 암종보다 저등도의 분화를 보이는 암종(100%)과 점액성 암종(33.3%)에서 더 높은 빈도를 보였다. 이들의 P값은 0.05 이하로 통계적 유의성을 보였다. 종양의 크기는 Microsatellite instability인 경우 5.50±1.86cm, Microsatellite instability경우 4.35±1.79cm로 수치적으로 차이가 있었으나 통계적 의의는 없었다. 그 외 환자의 나이, 성별, 육안소견, 림프절 전이 및 개수, 맥관 침윤, 병기 등은 microsatellite instability와 의미 있는 연관성이 없었다. 결론 : MSI+ 산발성 대장암은 우측 대장에 호발하고 저등도의 분화도를 보이거나 점액성 암종에서 더 높은 빈도를 나타내었다. 그 외 대장암 예후에 중요한 림프절 전이와 병기등과의 연관성을 보이지 않았으나 추후의 더 많은 중례에서 연구를 해야 할 것으로 생각되었다. Objectives : The purpose of this study was to evaluate MSI status in sporadic colorectal cancer and to correlate it with clinicopathologic variables. Methods: Total 45 cases of surgically resected colorectal cancers retrospectively were reviewed about clinicopathologic findings and analyzed for micro satellite instability. Results : The microsatellite instability (MSI) was found in 5 of 45 cases (11.1%) . A significant association was found between MSI+ tumors and location in the right colon (40%), and high histological grade (100.0%), and mucinous phenotype (33.3%). There was no significant difference for age, sex, growth pattern, lymph node metastases, vessel invasion, or Duke's stage. Conclusion : These data indicate that MSI frequently occur in colorectal cancers of the right side and in tumors with poorly differentiated or mucinous histology.

일부 흡연 대학생의 지각된 스트레스와 흡연실태에 대한 상관관계 연구

강초록,권시내,권혜림,박수경,송인혜,오해인,이미지,한승아,황선아,김수지 이화여자대학교 간호과학대학 2003 이화간호학회지 Vol.- No.37

In spite of the seriousness of smoking harm has been developed these days. the increase of national smoking rate and that the people in the twenties are especially leading the rise of national smoking rate is an important issue of national health. Smoking of the university students can occur health problem and cause loss of manpower and expenses in their social activity period. So then the actual state for prevention of smoking and development of a program to prohibit smoking has to be seized urgently and starting with the study of the realities of university students, the effort to find a related fluent of smoking has to be studied. Related to this, the purpose of this study is to seize the general characteristics of smoking university students and to find out the relationship between perceived stress and smoking status among smoking university students. In addition, by collating the relationship between perceived stress and smoking status among smoking university students we have the purpose to furnish the basal data of stress care, the best way to cope with stress through group training and the plan for nursing implementation to decrease the smoking rate. For this study, a survey was conducted for 204 smoking university students of 13 universities in Seoul from 9th of May to 16th of May, 2003. The collected data was analyzed by t-test, Pearson Correlation and ANOVA in the statistical packages SPSS/PC. Major findings of this study are as follows; 1. Of the 204 respondents 85.4% of them were male and 14.6% of them were female. The average age of the sample was 23.19 years old and 41.8% of them were in senior, 21.4% in junior, 16.9% in sophomore, 19.9% in freshman grade. The major motivation to start smoking was 'because of curiosity'(33.8%) and the first smoking experience was at 'senior high school' (41.9%) and at 'college' (41.9%). 2 The highest scored stress factor of smoking university students were stresses about school work. 3. 72.7% had experience to quit smoking at least one or more times. Most of the reason to keep on smoking was 'short will to quit'(51.0%) and the smoking place was usually at 'school' (41.4%). Most respondents for the number ofsmoking friends were '5 people and above' (73.2%). 4. There was a negative relationship between the general characteristics and the entire perceived stress, however, there was a positive relationship between the general characteristics and the perceived stress in 4 categories which is 'sex distinction', 'major of study', 'residence form' and' inmate'. 5. There was a negative relationship between the general characteristics and the entire smoking status, however, there was a positive relationship between the general characteristics and the smoking status in 2 categories which is 'presence of hobby' and 'number of smoking friends'. 6. There was a negative relationship between the perceived stress and the smoking status. Through this study we have seized the relationship between the general characteristics, perceived stress and the smoking status of smoking university students. There was a positive relationship between some of the general characteristics with the perceived stress and the smoking status of smoking university students. Also there was a negative relationship between the perceived stress and the smoking status.

Preserved Efficacy of Oral Metronidazole for Severe Clostridium difficile Infection

Shi Nae Yu,Eun Jung Lee 순천향대학교 순천향의학연구소 2018 Journal of Soonchunhyang Medical Science Vol.24 No.1

Objective: Although clinical practice guidelines recommend oral vancomycin for hospitalized patients with severe Clostridium difficile infection (CDI), oral metronidazole is still the preferred regimen due to its tolerability and low cost. In this study, we aimed to compare the clinical efficacy based on clinical cure, recurrence, and 30-day mortality of oral metronidazole and oral vancomycin in treating severe CDI. Methods: The medical records of patients with the diagnosis of severe CDI in a tertiary hospital in South Korea, between June, 2006 and December, 2013, were analyzed. Results: A total of 162 severe CDI patients were enrolled for this study: 139 received oral metronidazole and 23 received oral vancomycin. The rate of clinical cure was not significantly different between treatments (79.86% for oral metronidazole and 82.61% for oral vancomycin, P>0.99). The rate of recurrence was comparable (20.77% vs. 18.18% for metronidazole and vancomycin, respectively; P>0.99), as was the rate of 30-day mortality (9.35% vs. 4.35%, P=0.69). Risk factors for treatment failure were histamine-2 antagonist treatment (odds ratio [OR], 4.34; 95% confidence interval [CI], 1.64–11.51; P=0.0032) and fever (OR, 2.43; 95% CI, 1.0–5.8; P=0.049). Conclusion: The clinical efficacy of oral metronidazole for severe CDI was no difference from oral vancomycin, in a real world setting. Oral metronidazole can be a reasonable option for treating severe CDI.

Otolaryngologic skill-focused resident training

Shi-Nae Park 대한외과학회 2016 대한외과학회 학술대회 초록집 Vol.2016 No.11

Purification, crystallization and X-ray crystallographic analysis of nicotinamidase Pnc1 from Kluyveromyces lactis

Shi Nae Kim,장정호 한국구조생물학회 2019 Biodesign Vol.7 No.1

Pnc1 converts nicotinamide to nicotinic acid to generate NAD+ through the Preiss-Handler pathway that is one of theNAD+-salvage pathway. By reducing levels of nicotinamide, an inhibitor of the NAD+-dependent histone deacetylase Sir2,yeast Pnc1 contributes gene silencing. In this study, to understand the structural features and molecular mechanismof nicotinamidase Pnc1, we overexpressed, purified, and crystallized the N-terminally His6-tagged Pnc1 protein fromKluyveromyces lactis and obtained X-ray diffraction data at a resolution of 2.2 Å. The crystals of the K. lactis Pnc1 (KlPnc1)belonged to space group P212121 with unit cell parameters a=38.5, b=77.3, c=83.3, and α=β=γ= 90º. There is one moleculein the asymmetric unit.

지역사회 범위에 대한 주관적 인식과 가족친화성 평가: 서울시 거주 미취학자녀 부모를 대상으로

노신애 ( Shi Nae Noh ),진미정 ( Mee Jung Chin ) 한국가족관계학회 2013 한국가족관계학회지 Vol.18 No.3

This study aimed to examine (1) what residents perceived as a community boundary and (2) what association were found between the perception on community boundary and family-friendliness of the community. Data were drawn from a sample of 318 married men and 310 married women who had children under the school age. Descriptive analyses, multinomial logit analysis, and one-way ANOVA were used for analysis. The findings showed that there was a variation in the perception of community boundary: 15.29% of the respondents selected an apartment complex, 30.25% Dong, 41.40% Gu, and 13.06% other categories as a community boundary. Women perceived community boundary in larger scope than men did. Those who lived in multiple houses perceived community boundary in smaller scope than apartment residents. Those who selected Gu as a community boundary had higher scores on the awareness of community service infrastructure than those who selected other community boundaries. Those who selected apartment complex as a community had higher scores both on social capital and family-friendliness of community.

만삭 전 임신부에서 분만유도 성공에 대한 임상,초음파 예측지표에 관한 연구

김시내 ( Shi Nae Kim ),박교훈 ( Kyo Hoon Park ),홍준석 ( Joon Seok Hong ),정희정 ( Hee Jung Jung ),강웅선 ( Woong Sun Kang ),신동명 ( Dong Myung Shin ),이정연 ( Jeong Yeun Lee ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.11

목적: 만삭 전 임신부에서 분만유도 시 유도성공을 예측할 수 있는 임상적 지표와 초음파 지표를 확인하고자 한다. 연구 방법: 단태임신으로 만삭 전 (임신 37주 미만)에 분만유도를 위해 입원한 임신부 103명을 대상으로 전향적 연구를 시행하였다. 경질초음파를 사용하여 자궁경부 길이를 측정하고 내진을 통해 Bishop점수를 측정하였다. 또한 분만유도 시 임신 주수, 출산력, 나이, 체질량지수를 측정하였다. 결과: 45명 (44%)에서 성공적인 분만유도가 이루어졌다. 다변량 논리회귀분석에서 출산력, 체질량지수, 분만유도 시 임신주수는 분만유도 성공을 예측하는 데 유의한 독립변수임을 나타내었다. 그러나 분만유도 시 임신주수는 통계적인 유의성에는 이르지 못하였다 (P=0.056). 임신부의 나이와 자궁경부 길이, Bishop점수는 분만유도 성공을 예측하는 데 유의한 관련성을 나타내지 않았다. 결론: 만삭 전 임신부의 분만유도에서 출산력, 체질량지수와 분만유도 시 임신주수는 분만유도의 성공여부를 예측하는 독립적 인자이다. 그러나 자궁경부 길이와 Bishop점수는 성공 예측에 있어 유용하지는 않은 것으로 나타났다. Objective: To identify the clinical and sonographic parameters which predict the likelihood of successful labor induction in preterm women. Methods: This prospective observational study enrolled 103 consecutive preterm women (<37 weeks gestation) with singleton gestations scheduled for induction of labor. Transvaginal ultrasound for measurement of the cervical length was performed and the Bishop score was determined by digital examination. The parameters studied were gestational age at induction, parity, maternal age, Bishop score, sonographic cervical length, and current body mass index (BMI). Univariate and multivariate statistical methods were used for data analysis. Results: Successful induction of labor occurred in 45 (44%) of women. Multiple logistic regression analysis identified parity, maternal BMI, and gestational age at induction as the independent predictors of successful labor induction in preterm women, although gestational age did not reach statistical significance (P=0.056). However, maternal age, sonographic cervical length, and Bishop score did not provide independent contribution to success of induction. Conclusion: In preterm women undergoing induction of labor parity, maternal BMI, and gestational age at induction were independent parameters in predicting successful induction of labor. However, sonographic cervical length and Bishop score had poor predictive values for success of labor induction.

혈액종양 ; 미만성 거대 B세포 림프종 환자 치료 후 절대림프구수 감소율의 예후적 가치

김시내 ( Shi Nae Kim ),채의수 ( Yee Soo Chae ),김종광 ( Jong Gwang Kim ),문준호 ( Joon Ho Moon ),이수정 ( Soo Jung Lee ),김윤정 ( Yun Jeong Kim ),이유진 ( Yoo Jin Lee ),손상균 ( Sang Kyun Sohn ) 대한내과학회 2009 대한내과학회지 Vol.76 No.1

목적: 미만성 거대 B 세포 림프종에서 IPI와 절대림프구수는 예후인자로 알려져 있다. 그러나 리툭시맙을 이용한 치료에 있어 리툭시맙과 관련하여 새로운 예후인자가 필요할 것으로 생각된다. 이에 저자는 초기 병기의 미만성 거대 B 세포 림프종 환자에서 R-CHOP 요법의 생존율 관련 예후인자를 평가하였다. 방법: 2003년 8월부터 2007년 11월까지 내원한 초기병기의 미만성 거대 B 세포 림프종 환자로 계획된 R-CHOP 요법을 시행받은 마친 78명을 후향적으로 조사하였다. 생존율분석을 위해 연령, 임상수행능력, LDH, 림프절외 침범, 병기, 절대림프구수, 백혈구 감소율 및 절대림프구수 감소율에 대해 평가하였다. 결과: 초기병기의 미만성 거대 B 세포 림프종 환자 78명 중 26명(33.3%)은 병기 1기였고, 73명의 환자들은 좋은 임상수행능력을 보였으며 20명의 환자에서 LDH 증가를 보였다. IPI 분류시 저위험군은 67명(85.9%)이고, 저중등군은 8명(10.3%), 고중등군은 3명(3.8%)이었다. 전체 반응율은 100%로서 완전관해율이 94.8%였다. 생존율 분석시 전체 생존율에서는 연령이 가장 중요한 예후인자였고(p=0.006), 무진행 생존율에 있어서는 첫 R-CHOP 요법 후 절대림프구수 감소율이 유일한 예후인자였다(p=0.037). 결론: 본 연구에서 초기 병기의 미만성 거대 B 세포 림프종 환자에서 R-CHOP 요법시 나이, IPI와 함께 절대림프구수 감소율이 의미있는 예후인자임을 알 수 있었다. Background/Aims: The International Prognostic Index (IPI) and absolute lymphocyte count (ALC) are prognostic factors in diffuse large B cell lymphoma (DLBCL). Nevertheless, in the Rituximab era, a new predictive marker related to Rituximab might be needed. We evaluated prognostic factors for survival in patients with early stage DLBCL after R-CHOP (Rituximab, cyclophosphamide, adriamycin, vincristine, prednisolone) treatment. Methods: From Aug 2003 to Nov 2007, 78 patients with early stage DLBCL, who finished R-CHOP as scheduled, were reviewed retrospectively. Survival analyses were performed according to clinical parameters (age, performance status, lactate dehydrogenase (LDH), extra-nodal involvement, stage, ALC, and the rates of reduction of the white blood count (WBC) and ALC). Results: Of the 78 patients with early stage DLBCL, 26 (33.3%) were classified as stage I. Seventy-three patients (93.6%) presented with a good performance status, while LDH was elevated in 20 patients (25.6%). According to the IPI, 67 (85.9%), 8 (10.3%), and 3 (3.8%) patients were classified in the low, low-intermediate, and high-intermediate risk groups, respectively. The overall response rate was 100%, including a 94.8% complete response. Survival analysis demonstrated that the rate of reduction of ALC following the first cycle of the R-CHOP regimen was the only factor associated with time-to-progression (p=0.037), whereas age was the single most important prognostic factor for overall survival (p=0.006). Conclusions: In our study, the rate of reduction of ALC in addition to age and IPI was found to be a significant prognostic factor in patients with early stage DLBCL treated with the R-CHOP regimen. (Korean J Med 76:52-59, 2009)

Effects of complex extracts having Drynariae Rhizoma on suppression of collagenolysis and bone resorption in mouse calvarial osteoblasts

Hong, Shi-Nae,Jeong, Ji-Cheon 동국대학교 한의학연구소 2000 東國韓醫學硏究所論文集 Vol.9 No.-

한방에서 ??骨시키는 효능이 있는 5가지 약물(骨??, ??生, 金毛??, 別甲, 法?古?)로 구성된 처방(CEDR로 약칭)으로 실험을 하였다. 생쥐의 calvarial osteoblast를 분리하고 배양한 후 실험을 행하였는데, 골 재흡수 인자인 PTH, 1,25(OH)₂D₃, TNF-α, IL-1에 자극받은 osteoblasts는 활동적인 gelatinase를 생산하므로서 collagen 용해를 증가시켰다. 암컷 생쥐의 long bone organ을 culture하여 골 재흡수를 자극하는 IL-1를 실험한 결과, IL-1은 골의 재흡수를 자극하였으며 동시에 존재해있을 때에는 뚜렷한 재흡수를 보였다. 더욱이, indomethacin과 dexamethasone은 IL-1의 투여량에 대한 곡선 그래프를 오른쪽으로 이동시켰다. 시험관내에서 세포 독성에 대하여 관찰하였을 때, CEDR 추출물은 1-60㎍/㎖의 농도에서 아무런 세포 독성이 나타나지 않았으며, 뿐만 아니라 생쥐의 두개골 세포에서는 120㎍/㎖ 농도에서 전혀 세포독성이 관찰되지 않았다. CEDR 추출물은 생쥐의 calvarial cells에서 PTH (5 units/㎖), IL-1 α (1 ng/㎖), TNF-α, 1,25(OH)₂D₃ (20 ng/㎖) 및 IL-1 α, IL-1 β에 유되도는 collagen 용해를 보호하는 효과가 있었다. CEDR 추출물을 1시간동안 전처리하였을 때, 그 자체로는 세포 생존에 영향이 없었으며, collagen 용해를 증가시키지도 않았으며 전처치로 collagen 용해를 유의성있게 감소시키지도 않았다. 게다가, 추출물은 IL-1 α 와 IL-1 β에 의해 유도되는 collagen 용해를 방지하는 효과가 있었다. 1시간 동안 전처리로 한 결과, collagen 용해를 유의서있게 감소시켰다. 흥미로운 것은 CEDR 추출물이 gelatinase 활성과 PTH, 1,25(OH)₂D₃, TNF-α, IL-1 β 및 IL-1 α의 재흡수 인자에 유도되어 진행되는 활성을 억제하였으며, CEDR 전처리시에는 강력한 보호 효과를 나타내었다. CEDR 추출물은 IL-1 α와 IL-1 β에 자극되는 골 재흡수를 억제하는 효과를 나타내었으며, 또한 농도를 다양하게 한 CEDR의 전처리시에는 유의성이 있었다. Indomethacin과 dexamethasone의 비 스테로이드성 항 염증 인자에 의한 IL-1에 자극받은 골 재흡수를 억제하는 정도와 현상은 CEDR 추출물을 생쥐의 두개골 배양 시스템에 적용시켜 얻은 결과와 유사하였다. 이러한 결과들로 보건데, CEDR 추출물은 임상적으로 골다공증의 치료에 매우 안정적으로 적용할 수 있음을 제시하고 있다. Anti-bone resorption properties of the Korean herbal medicine, CEDR, which is comprised 5 herbs of [Drynariae Rhizoma, Loranthi Ramus, Cibotii Rhizoma, Amydae mram, Psoraleae semen], were investigated. Mouse calvarial osteoblast cells were isolated and cultured. Mouse osteoblasts, which were stimulated by PTH, 1,25(OH)₂D₃, TNF-α and IL-1 as bone resorption agents, showed increased collagenolysis by producing the active gelatinase. IL-1 in stimulating bone resorption was examined using fetal mouse long bone organ culture. IL- 1 stimulated bone resorption and produced marked resorption when present simultaneously. The results of in vitro cytotoxicities showed that CEDR extracts have no any cytotoxicities in concentrations of 1-60 pg/ml and furthermore there is no any cytotoxicity even in concentration of 120 pg/ml on mouse calvarial bone cells. CEDR extracts had protective activity against PTH (5 units/ml), or IL-1 a (1 ng/ml) or TNF- a or 1,25(OH)zD3 (20 ng/ml), IL-1 cy and IL-1P -induced collagenolysis in the mouse calvarial cells. Pretreatment of the CEDR extracts for 1 h, which by itself had little effect on cell survival, did not enhance the collagenolysis, nor significantly reduced the collagenolysis by pretreatment. Furthermore, the medicinal extracts were shown to have the protective effects against collagenolysis induced by IL-1 cy and IL-1P. Pretreatment of the extracts for 1 h significantly reduced the collagenolysis. Interestingly, the CEDR extracts were shown to have the inhibiting effects against gelatinase enzyme and processing activity induced by the bone resorption agents of PTH, 1,25(OH)₂D₃, TNF-a, IL-1β and IL-1 a with strong protective effect in pretreatment with the extracts. CEDR extracts were shown to have the inhibiting effects against IL-1β- and IL-1P-stimulated bone resorption and the effect of the pretreatment with a various concentrations of the medicinal extracts were significant. These results indicated that the CEDR extracts are highly stable and applicable to clinical uses in osteoporosis.

요로폐쇄와 수신증을 동반한 난소의 성숙기형종에서 유래된 편평상피세포암

김시내 ( Shi Nae Kim ),이용우 ( Yong Woo Lee ),정지윤 ( Ji Yoon Jung ),문종수 ( Jong Soo Moon ),권미정 ( Mi Jung Kwon ),남은숙 ( En Suk Nam ),장봉림 ( Phong Rheem Jang ),권용일 ( Yong Il Kwon ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.1

Mature cystic teratoma of the ovary is the most commom ovarian germ cell tumor and almost benign. Malignant transformation occurs in less than 2% of benign mature teratoma. Squamous cell carcinoma derived from ectoderm is the most frequent malignancy. Prognosis of squamous cell carcinoma in ovarian mature teratoma is generally poor but there is no consensus on optimal thrapy. We report one case of squamous cell carcinoma arising from mature cystic teratoma with a brief review of the literature.