Ki-67 labeling index as a prognostic marker in advanced stomach cancer

Sang Hyuk Seo,Kwang Hee Kim,Sang Hoon Oh,Yunseon Choi,Ki Jung Ahn,Ji Young Lee,Sang Min Lee,박지선,Woo Gyeong Kim 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.96 No.1

Purpose: Proliferation marker Ki-67 is widely used in cancer prognosis prediction. We tried to investigate the role of Ki-67 as a prognostic factor in stomach cancer after surgery in this study. Methods: We retrospectively evaluated 251 patients who underwent curative resection for gastric cancer from 2010 to 2015. In pathologic examination, Ki-67 labeling index was defined as the percentage of Ki-67 antigen positive cells. Prognostic significance of Ki-67 for gastric cancer was evaluated. Disease-free survival (DFS) was assessed as a primary end-point. Results: The median follow-up period was 28.0 months. Thirty-one patients (12.4%) showed Ki-67 labeling index (LI) lower than 25%. Sixty-eight patients (26.6%) showed recurrence during follow-up period. Recurrence was associated with Ki- 67 LI level (≤25%, P = 0.016), and lymph node metastasis status (P = 0.002). High Ki-67 LI level (>25%) was also related to p53 positivity (P < 0.001) and poorly cohesive type (P = 0.002). The 3-year DFS was 69.4%. Low Ki-67 LI level (≤25%) was related with low DFS (47.6% vs. 72.6%, P = 0.016). T stage (P < 0.001), N stage (P = 0.006), lymphovascular invasion (P = 0.010), and neuronal invasion (P = 0.001) also affected the DFS. In addition, T stage (P = 0.03) and Ki-67 LI (P = 0.035) were independent prognostic factors for DFS. In patients treated with adjuvant chemotherapy (n = 239, 93.4%), low Ki-67 (≤25%) was a poor prognostic factor for DFS (P = 0.013). Conclusion: Low Ki-67 LI predicts high rate of progression and low DFS of stomach cancer. Ki-67 LI can be a predictive marker in resected stomach cancer treated with surgery and adjuvant chemotherapy.

Comparison of Proliferative Activity in Each Histological Subtypes of Benign and Atypical Intracranial Meningiomas by PCNA and Ki-67 Immunolabeling

최승진,장은덕,권성오,계대곤,박춘근,이상원,강준기,Choi, Seung Jin,Chang, Eun Deok,Kwon, Seung Oh,Kye, Dae Kon,Park, Choon Keun,Lee, Sang Won,Kang, Joon Ki The Korean Neurosurgical Society 2000 Journal of Korean neurosurgical society Vol.29 No.9

목 적 : 양성 뇌수막종에 비하여 이형성 및 악성 뇌수막종이 나쁜 임상적인 예후 및 양상을 보이는 것은 잘 알려져 있으나, 양성 뇌수막종에 있어서 각각의 병리조직학적 아형에 따른 생물학적 양상의 차이에 대해서는 잘 알려지지 않거나 일부 논란이 되고있다. 본 연구에서는 이형성 뇌수막종 및 양성 뇌수막종의 각각의 병리조직학적 아형에 따른 증식능의 차이여부를 알아보고자 PCNA와 Ki-67표지지수를 분석하였다. 방 법 : 본원에서 뇌수막종으로 수술을 시행하여 얻은, 재발을 보여 재수술을 시행한 2례를 포함하여, 파라핀에 포매시킨 27개의 조직을 대상으로 병리학적인 증식능을 분석하기 위해, PCNA에 대한 단일항체 및 MIB-1 단일항체를 이용한 면역조직화학적 염색을 시행하였다. 조직학적 분류상 meningothelial type이 8례, transitional type이 9례, fibroblastic type이 5례였으며, 이형성 수막종이 5례였다. 결 과 : PCNA표지지수의 평균값은 양성 수막종에서 meningothelial type이 $4.82{\pm}5.10%$, transitional type이 $9.01{\pm}4.25%$, fibroblastic type이 $5.66{\pm}5.32%$를 보였으나 이형성 수막종에서는 $27.62{\pm}19.67%$의 높은 지수를 나타냈고, Ki-67 표지지수의 평균값은 양성 수막종의 아형에서 각각 $0.43{\pm}0.85%$, $0.44{\pm}1.08%$, $0.24{\pm}0.18%$를 보이고, 역시 이형성 수막종에서는 $0.84{\pm}0.59%$의 높은 지수를 보였다. 즉, 양성 수막종에서 각각의 아형에 따른 PCNA 및 Ki-67 표지지수는 통계학적으로 의미있는 차이는 없었으나(p>0.05), 이형성 수막종에서는 의미있는 높은 표지지수를 보여(p<0.05) 양성 수막종에서 보다 높은 증식능을 보임을 알 수 있었다. 결 론 : PCNA 및 Ki-67 표지지수를 이용한 증식능의 비교결과, 양성 뇌수막종에서는 각각의 아형에 따른 생물학적 양상이나 예후는 차이가 없을것으로 생각되나, 이형성 수막종에서는 높은 증식능을 보여 이에 대한 예후를 예상할 수 있을것으로 생각되며, 또한 이러한 표지지수가 병리조직학적으로 양성과 이형성의 감별에 많은 도움이 될것으로 사료된다. Objective : The clinical prognosis and biological behavior of atypical and especially malignant meningiomas are well known to be worse than benign meningioma, but the degree of biological aggressiveness in each classical subtypes of benign meningioma is controversy. This study was performed to see whether there is a difference in the proliferative activity between each different histological subtypes of benign meningioma as well as atypical meningioma. Methods : Paraffin-embedded surgical specimens of 27 meningiomas, including two recurrent tumors, were studied to evaluate proliferative activity by immunohistochemical method with monoclonal antibodies to proliferating cell nuclear antigen(PCNA) and MIB-1. The specimens consisted of 8 cases of meningothelial, 9 cases of transitional, 5 cases of fibroblastic subtypes and 5 cases of atypical meningiomas. Results : Mean PCNA labeling indices of meningothelial, transitional and fibroblastic meningiomas were $4.82{\pm}5.10%$, $9.01{\pm}4.25%$ and $5.66{\pm}5.32%$, but that of atypical meningiomas was $27.62{\pm}19.67%$, noting a higher value compared to all three subtypes of benign meningiomas. Mean Ki-67 labeling indices of the above 3 subtypes were $0.43{\pm}0.85%$, $0.44{\pm}1.08%$ and $0.24{\pm}0.18%$, and that of atypical meningiomas was also revealed to be of higher value ($0.84{\pm}0.59%$). PCNA and Ki-67 labeling indices were not statistically different between histological subtypes of benign meningioma(p>0.05), but the differences of both immunolabeling between benign and atypical meningiomas were statistically significant(p<0.05). Conclusion : Immunolabeling of PCNA and Ki-67 in intracranial meningiomas reveals no prognostic difference between meningothelial, transitional and fibroblastic subtypes in classical benign meningiomas by measuring expression of PCNA and Ki-67, but it seems to be helpful in differentiating benign and atypical meningioma, later showing more proliferative activity and biological aggressiveness.

욕창 환자에서 빈혈과 혈청 단백질의 변화

오상향,남기석,이상오,박상일,최은,이양균 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Objective : To investigate the pathogenesis of anemia and serum protein alteration in patient with pressure ulcer and proper management method. Method : Eleven patients with pressure ulcer were investigated. To investigate the change of anemia and serum protein between pre- and post-treatment of pressure ulcer, we measured hemoglobin, hematocrit, serum iron, ferritin, transferrin, mean corpuscular volume(MCV), red cell count, serum albumin and globulin before and after healing of pressure ulcer. Result : There was significant increases of hemoglobin, hematocrit, red cell count, MCV, serum iron, ferrtin and transferrin after healing of pressure ulcer(p<0.05). The serum ablumin and A/G ratio were increased significantly(p<0.05). The total globulin and α1-globulin were decreased significantly(p<0.05). There was no statically significant relationship between the ulcer size and the degree of anemia and hypoalbuminemia. Conclusion : This research suggested that anemia and serum protein alteration in patient with pressure ulcer are thought result from chronic inflammatory process. So, anemia and alteration of protein does not require any treatment such as transfusion, iron and albumin supply.

간이식 환자에서 발생한 Aspergillus fumigatus에 의한 고관절염 1예

김탁,이상록,조오현,박기호,오련,이상오,김양수,우준희,김미나,최상호 대한감염학회 2008 감염과 화학요법 Vol.40 No.3

저자들은 간이식을 받은 환자에서 조직 배양 검사를 통하여 진단된 A. fumigatus에 의한 화농성 고관절염을 경험하였기에, 문헌 고찰과 함께 보고하는 바이다. Septic arthritis is an uncommon finding of invasive Aspergillosis. It can be caused by direct inoculation, Post-surgical infection, and hematogenous spread. Articular aspergillosis often involves the knee. A 49-year-o1d man who received a liver transplant in China on two months ago, due to liver cirrhosis caused by hepatitis B virus was admitted because of left side hip pain. Hip MRI showed joint effusion and bony destruction of the left hip and acetabulum. Incision and drainage was done and Aspergillus fumigatus was isolated from the resected tissue. After eight weeks of amphotericin B therapy, total hip replacement arthroplasty was done. Oral itraconazole 400mg/day was prescribed for six months after operation. The patient is now doing well without physical restriction.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

判別分析을 利用한 道路 交通騷音의 影響 分析

오석기,고상선 東亞大學校 建設技術硏究所 1997 硏究論文集 Vol.21 No.2

Noise caused by vehicles has been one of serious problem in the developed cities. Because it can bring physical and spiritual problem to passengers and pedestrians. But vehicles can't be eliminated in daily life as they are closely related to the urban activities. Therefore, this study focuses on the analyzing the effect of traffic noise on road by the using Discriminant Analysis. And the result of this study indicates that noise level should be reduced in order to be achieved more environmentally sound traffic.

스포츠 지도자의 지도유형에 따른 체벌의 유형 비교

오성기,전도선 부산 외국어 대학교 2001 外大論叢 Vol.23 No.1

This study is for knowing corporal punishment types and reasons by coaching types of sports leaders. We analyzed and compared with the style of corporal punishment by coaching types of sports leaders so that we can achieve our study aim. Study object was chosen as 289 sportsmen belonging to Middle school, High school, University & general sports team located in U city & K city. The statistics technique for this study is Multiple Regression Analysis and data were verified at significance level, a=.05. After we analyzed and compared with corporal punishment style by coaching types of sports leaders, we made a following conclusion. The coaching type to inflict much punishment on sportsmen by whipping, punishment among the types of corporal punishment is task-coaching type. The coaching type to inflict much punishment on sportsmen by mental stress and appealing to sportsmen among the types of corporal punishment is reformatory coaching type.

判別分析을 利用한 道路 交通騷音의 影響 分析

오석기,고상선 동아대학교 건설기술연구소 1998 硏究報告 Vol.22 No.1

Noise caused by vehicles has been one of serious problem in the developed cities. Because it can bring physical and spiritual problem to passengers and pedestrians. But vehicles can't be eliminated in daily life as they are closely related to the urban activities. Therefore, this study focuses on the analyzing the effect of noise on road by the using Discriminant Analysis. And the result of this study indicates that noise level should be reduced in order to be achieved more environmentally sound traffic.

상악골 전벽골 겸손에 대한 재건술에 있어서 동결건조 콜라겐 매식과 소강판고정술의 임상적 유용성

오승환,장관식,조병호,민승기,이동근,김수남 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.6

Maxilla is located in midfacial area and has intimate relationship with adjacent anatomical structure such as nasal cavity, orbit, oral cavity, and zygoma. Skeletal defects of maxillary antral wall may be developed by various postoperative causes for comminuted maxillary fractures, tumors of head and neck area or cystic lesions of maxillary sinuses. If these bony defects are left untreated state, this results in several postoperative complications such as soft tissue impingement into bony defects or dysfunction of sinus mucosa. Hence, these defects should be pertinently treated as possible. The main purpose of such surgery is to preservation of normal physiologic function of maxillary sinus. In the past, a variety of materials have been used to reconstruct defects of the maxillary antral wall. Alloplastic materials are popular today because of availability without an additional operation and their ease of use. With favorable results and review of related literatures, we report the availability of lyophilized collagen implantation and microplate fixation as the reconstructive surgical methods on the defects of maxillary anterior wall resulted from various reasons.

최근 글로벌 금융위기와우리나라 예보제도 개선 방안에 관한 연구

오승곤,이기영,김상수 梨花女子大學校 社會科學大學 社會科學硏究所 2011 사회과학연구논총 Vol.25 No.-

This study reviews the deposit insurers’ responses to cope with the recent global financial crisis and provides policy implications how to improve the financial safety net and the deposit insurance system to effectively prevent and overcome a financial systemic crisis. This study also evaluates the effectiveness of the deposit insurance system in Korea. Then, the study suggests some policy recommendations to correct those problems by establishing a kind of systemic risk regulator, improving the soundness of the mutual savings bank’s account, and introducing an efficient resolution regime. 본 연구는 글로벌 금융위기 중 위기극복을 위해 주요국 예금보험기구들이 취한 대응현황을 정리하고, 향후 위기예방과 효율적인 위기극복을 위한 금융안전망 체계와 예보제도의 개선방안에 대한 정책적 시사점을 살펴본다. 이번 위기중 세계 각국은 전액보호제도와 예금보호한도 확대 조치를 시행하여 시스템리스크의 급속한 확산에 따른 금융시스템의 붕괴 방지에 주력하였다. 특히, 미국과 영국은 예금보호한도 확대뿐만 아니라, 유동성지원 프로그램 도입, 예금보험기금체계 정비, 특별정리제도 등 선제적인 정책수단들을 도입하였다. 우리나라의 경우에도 시스템위기에 효과적으로 대응하기 위한 금융안전망 체계 미비, 저축은행계정의 누적적자, 부실정리절차 상의 비효율성과 감독실패의 문제점 등이 노정되어 있는 것으로 분석된다. 이에 본고는 첫째, 시스템위기에 대응한 금융안전망 기구 간 상설협의체 구성, 둘째, 저축은행계정 건전화를 위한 방안, 셋째, 부실의 사전예방과 기금손실의 확대를 방지하기 위한 부실정리절차 개선을 제안한다.