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        난소의 원발성 투명세포암의 임상병리학적 특성과 생존율

        차선화,박현,성석주,김태진,임경택,정환욱,박인서,심재욱,박종택,전이경,김희숙,이기현 대한부인종양 콜포스코피학회 2003 Journal of Gynecologic Oncology Vol.14 No.2

        목적 : 난소암 환자에서 질병의 상태와 진행을 모니터하는데 있어 혈중 CA 125 측정의 유용성이 증명되었음에도 불구하고, 수술 전 CA 125 수치에 기초한 환자의 예후에 대한 정보는 거의 없다. 본 연구는 종양 병기를 중심으로 상피성 난소암의 수술 전 CA 125 혈중 수치가 정상군(35 U/ml 미만)과 비정상군(35 U/ml 이상)의 5년생존율 비교를 통해 상피성 난소암에서 수술 전 CA 125 정상군(35 U/ml 미만)의 임상적 가치를 알아보고자 시행하였다. 연구 방법 : 1985년 1월부터 1998년 1월 말까지 한양대학교병원 산부인과에 입원하여 치료받고 추적관찰이 가능하였던 수술 전 CA 125 정상치를 가진 51예의 상피성 난소암 환자를 대상으로 하였다. 총 51예의 수술 전 CA 125 정상군은 같은 기간동안 추적관찰 가능하였던 68예의 수술 전 CA 125 비정상군과 병기별 5년 생존율을 비교하였으며, 두 군의 연령, 종양의 병기(stage), 조직학적 유형, 종양의 조직학적 분화도, 복수 존재 유무 및 최대암 조직 절제 유무를 병기별로 match 하였다. 통계학적 분석은 Fisher exact chi-square (x2) test와 student T-test를 사용하였다(P<0.05). 결과 : 수술 전 CA 125 정상군의 5년 생존율은 84.3% (43/51)로, 대조군인 수술 전 CA 125 비정상군의 5년 생존율 64.7% (44/68)에 비해 유의하게 높았다(p=0.021). 조기암(병기 I-II기)인 경우 수술 전 CA 125 정상군(<35 U/ml)의 5년 생존율이 93.0% (40/43)로, 수술 전 CA 125 비정상군(≥35 U/ml)의 5년 생존율 71.2% (37/52)에 비해 유의하게 높았으나(p=0.015), 진행암(병기 III-IV기)에서는 수술 전 CA 125 정상군(<35 U/mL)과 비정상군(≥35 U/mL) 사이에 5년 생존율이 유의한 차이가 없었다. 결론 : 상피성 난소암에서 수술 전 CA 125 수치가 정상군이 비정상군에 비해 조기암(병기 I-II기)에서는 생존에 중대한 영향을 주며, 예후 판단에 도움이 될 것으로 판단된다. 진행암의 수술 전 CA 125 정상군과 비정상군 사이에는 유의한 차이는 없었으나, 더 큰 연구가 시행될 경우 진행된 상피성 난소암에서 수술 전 혈청 CA 125 정상군의 임상적 의의를 얻을 수 있을 것이다. Objective : To evaluate the clinicopathologic characteristics of primary clear cell carcinoma of the ovary. Methods : From February, 1993 to February, 2003, thirty patients with clear cell carcinoma of the ovary were identified, who were treated in the department of obstetrics and gynecology, Samsung Cheil Hospital and Women's Healthcare Center. The clinicopatholgic characteristics of the patients were retrospectively evaluated for age, chief complaint, preoperative CA-125 level, FIGO stage, maximal tumor diameter, association with endometriosis, management, and survival. Results : Clear cell ovarian carcinoma accounts for 5.2% of all cases of ovarian cancer at this center. Mean age was 44.6 years (26-62 years). Most patients presented with a large pelvic mass ranging from 7 to 30 cm in maximal diameter and seventeen (71%) of twenty-four patients had elevated serum level of preoperative CA-125. Associated pelvic endometriosis was 60% (18/30). Tumors were 73.3% (22/30) stage I, 10% (3/30) stage II, 13.3% (4/30) stage III and 3.3% (1/30) stage IV. Except for two patients who wanted to preserve fertility, all patients underwent total hysterectomy and bilateral salpingo-oophorectomy, omentectomy, peritoneal washing cytology and with or without pelvic and paraaortic lymph node dissection. All patient except one stage Ia received postoperative chemotherapy. With a median follow-up of 38.7 months (3-116 months), 96% (24/25) of stage I/II patients are alive, while 40% (2/5) of stage III/IV patients are alive. Conclusion : Clear cell carcinoma of the ovary demonstrates a characteristic clinical behavior. Several factors may be associated with the survival rate in the ovarian clear cell carcinoma that are FIGO stage, associated pelvic endometriosis, spontaneous capsular rupture and presence of ascites.

      • SCISCIESCOPUS
      • SCOPUSKCI등재

        Biochemistry, Molecular Biology : Effects of Extracts from Rhus Verniciflua S. on Activity of Catalase and TPA Mediated-Apoptosis in Cultured Mouse Hepatocytes

        Kye Taek Lim,Kyung Sun Hea,Jae Han Shim 한국응용생명화학회 2002 Journal of Applied Biological Chemistry (J. Appl. Vol.45 No.4

        The ethanol extract of Rhus verniciflua S. was subsequently isolated and fractioned into two portions using H_2O and 99% ethanol as elution buffers through silica gel column chromatography. To study the antioxidative effect of Rhus verniciflua S. extracts

      • SCOPUSKCI등재

        Biochemistry, Molecular Biology : Effects of Extracts from Rhus Verniciflua S. on Activity of Catalase and TPA Mediated-Apoptosis in Cultured Mouse Hepatocytes

        ( Kye Taek Lim ),( Kyung Sun Hea ),( Jae Han Shim ) 한국응용생명화학회 2002 Journal of Applied Biological Chemistry (J. Appl. Vol.45 No.4

        The ethanol extract of Rhus verniciflua S. was subsequently isolated and fractioned into two portions using H_2O and 99% ethanol as elution buffers through silica gel column chromatography. To study the antioxidative effect of Rhus verniciflua S. extracts, cultured hepatocytes were exposed to hydroxyl radical generated by 20 mU·ml^-1 glucose oxidase for 4 h in the presence or absence of water or ethanol eluted extracts. Addition of 100㎍·ml^-1 water extract to the culture medium protected from hydroxyl radical-mediated cytotoxicity of hepatocytes almost equivalently to the control. When the hepatocytes after culture for 24 h were incubated with 100㎍·ml^-1 water or ethanol extract without glucose oxidase for 4h, activity of catalase was increased by 1.40- and 1.31-fold, compared to the control, whereas with the commercial catalase (100 units·ml^-1) was 1.64-fold. These results show that in vitro both extracts has a potential reducing cytotoxicity effect on hydroxyl radical and enhancing activities of the cellassociated catalase in cultured hepatocytes. Apoptosis induced by 12-O-tetradecanoylphorbol 13-acetate (TPA, 100 nM) in mouse hepatocytes were blocked by the addition of 100㎍·ml^-1 of water or ethanol extract. In the biological effects of two extracts, water extract was more effective than that of ethanol extract.

      • SCOPUSKCI등재

        제왕절개술후 자가통증조절시 기초주입유무에 따른 진통제 소모량의 비교

        김우선,심요택,최현규 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.3

        Bakground : Patient-Controlled Analgesia(PCA) has become popularized for postoperative pain control. Theoretically, addition of a basal infusion would ameliorate the pain control as related to less need for additional demands. Regardless of theoretical background, usefulness of a basal infusion in PCA is controversial. Therefore, in this study we compared the analgesic consumption between PCA only and PCA plus basal infusion and assessed if the use of a basal infusion improves the analgesic efficacy in intravenous PCA. Methods : 40 patients undergoing caesarian section, were assigned randomly to PCA only group(group 1) and PCA plus basal infusion group(group 2). Group 1 was programmed to deliver 1.5 ml of bolus infusion with 10 minutes of lockout interval and four times per hour of the maximum usage of patient control module. In group 2, 0.5 ml of basal infusion was added to the same PCA. The analgesic solution contained 60 mg of morphine, 180 mg of ketorolac and 5 mg of droperidol in total volume of 60 ml. PCA was started at the time of the peritoneal closure with 2 ml of loading dose in all patients. Postoperative assessments were pain score, sedation score, side effect, total analgesic consumption and the degree of patients, satisfaction. Results : Total analgesic consumption was significantly greater in group 2 than in group 1. Pain score, sedation score, complication and the degree of the satisfaction were almost the same at all time interval in each group. Conclusion : We concluded that there was no significant benefit of basal infusion in intravenous PCA after caesarean section. (Korean J Anesthesiol 1997; 33: 517∼522)

      • Efficacy and safety of fixed-dose combination therapy with olmesartan medoxomil and rosuvastatin in Korean patients with mild to moderate hypertension and dyslipidemia: an 8-week, multicenter, randomized, double-blind, factorial-design study (OLSTA-D RCT

        Park, Jin-Sun,Shin, Joon-Han,Hong, Taek-Jong,Seo, Hong-Seog,Shim, Wan-Joo,Baek, Sang-Hong,Jeong, Jin-Ok,Ahn, Youngkeun,Kang, Woong-Chol,Kim, Young-Hak,Kim, Sang-Hyun,Hyon, Min-Su,Choi, Dong-Hoon,Nam, Dove Medical Press 2016 Drug design, development and therapy Vol.10 No.-

        <P>The pill burden of patients with hypertension and dyslipidemia can result in poor medication compliance. This study aimed to evaluate the efficacy and safety of fixed-dose combination (FDC) therapy with olmesartan medoxomil (40 mg) and rosuvastatin (20 mg) in Korean patients with mild to moderate hypertension and dyslipidemia. This multicenter, randomized, double-blind, factorial-design study included patients aged ≥20 years with mild to moderate essential hypertension and dyslipidemia. Patients were randomly assigned to receive FDC therapy (40 mg olmesartan medoxomil, 20 mg rosuvastatin), 40 mg olmesartan medoxomil, 20 mg rosuvastatin, or a placebo. The percentage change from baseline in low-density lipoprotein cholesterol levels was compared between FDC therapy and olmesartan medoxomil, and the change from baseline in diastolic blood pressure was compared between FDC therapy and rosuvastatin 8 weeks after treatment. A total of 162 patients were included. The least square mean percentage change (standard error) from baseline in low-density lipoprotein cholesterol levels 8 weeks after treatment was significantly greater in the FDC than in the olmesartan medoxomil group (−52.3% [2.8%] vs −0.6% [3.5%], <I>P</I><0.0001), and the difference was −51.7% (4.1%) (95% confidence interval: −59.8% to −43.6%). The least square mean change (standard error) from baseline in diastolic blood pressure 8 weeks after treatment was significantly greater in the FDC group than in the rosuvastatin group (−10.4 [1.2] mmHg vs 0.1 [1.6] mmHg, <I>P</I><0.0001), and the difference was −10.5 (1.8) mmHg (95% confidence interval: −14.1 to −6.9 mmHg). There were 50 adverse events in 41 patients (22.7%) and eight adverse drug reactions in five patients (2.8%). The study found that FDC therapy with olmesartan medoxomil and rosuvastatin is an effective, safe treatment for patients with hypertension and dyslipidemia. This combination may improve medication compliance in patients with a large pill burden.</P>

      • KCI등재

        Comparison of the effectiveness of extensor muscle strengthening exercise by itself, exercise with polydeoxyribonucleotide injection, and exercise with extracorporeal shockwave therapy in lateral epicondylitis: a randomized controlled trial

        Bum Jin Shim,Eun-Min Seo,Jung-Taek Hwang,Do-Young Kim,Jae-Shin Yang,Su-Jung Seo,Myung Sun Hong 대한견주관절의학회 2021 대한견주관절의학회지 Vol.24 No.4

        Background: Extensor muscle strengthening exercises with counterforce braces (EX) is a conventional conservative treatment for lateral epicondylitis (LE) of the elbow. In addition, polydeoxyribonucleotide (PDRN) or extracorporeal shockwave therapy (ESWT) has been recently used for LE. Methods: Sixty-three patients with chronic LE participated in this study and randomly allocated in three groups (G1: EX, G2: EX+PDRN injection, and G3: EX+ESWT). All of the three groups were taught to perform EX at the first out-patient department (OPD) visit. Group 2 was injected with 3 mL PDRN (5.625 mg/3 mL), while group 3 received ESWT at the first OPD visit. Visual analog scale pain score, Mayo elbow performance score (MEPS), and ultrasonographic examination were checked before, 6 weeks, and 12 weeks after the treatments. Results: Overall functional scores and ultrasonographic findings in all three groups improved after treatment. The mean MEPS in group 2 improved more than groups 1 and 3 at 6 weeks (G1, 56.9>62.4; G2, 54.3>65.0; G3, 55.7>62.6), and more than group 1 at 12 weeks (G1, 56.9>67.9; G2, 54.3>73.6). The mean common extensor tendon depth (CETD) on ultrasonography in group 2 increased more than groups 1 and 3 at 6 and 12 weeks (6 weeks: G1, 0.385>0.386; G2, 0.332>0.392; G3, 0.334>0.357; 12 weeks: G1, 0.385>0.409; G2, 0.332>0.438; G3, 0.334>0.405 [cm]). Conclusions: PDRN injections combined with EX exhibited a greater improvement in mean MEPS and mean CETD compared to EX only or EX combined with ESWT for LE within the 12 weeks follow-up.

      • ROS1 gene rearrangement and copy number gain in non-small cell lung cancer.

        Jin, Yan,Sun, Ping-Li,Kim, Hyojin,Park, Eunhyang,Shim, Hyo Sup,Jheon, Sanghoon,Kim, Kwhanmien,Lee, Choon-Taek,Chung, Jin-Haeng Springer International 2015 Virchows Archiv Vol.466 No.1

        <P>ROS1 has attracted much attention as a possible oncogenic driver and ROS1-rearranged tumors show sensitivity to most ALK inhibitors. We aimed to clarify the prevalence of ROS1 gene rearrangement and investigate the clinical implications of ROS1 gene copy number gain (CNG) in non-small cell lung cancer (NSCLC) patients. We carried out fluorescent in situ hybridization with ROS1 and centromere enumeration 6 probes and immunohistochemistry for ROS1 protein expression. ROS1 rearrangement was detected in 3 of 375 samples (0.8 %); all of whom were female, never-smokers, and harbored an adenocarcinoma component. ROS1 gene CNG was found in 18 cases (4.8 %). ROS1 gene CNG was significantly associated with shorter disease-free survival (DFS, 12 vs. 58 months; p = 0.003) and shorter overall survival (OS, 40 vs. 67 months; p <0.001) than the group without CNG. Multivariate analysis confirmed that ROS1 gene CNG was significantly associated with poorer DFS (hazard ratio [HR]=2.16, 95 % confidence interval [CI] = 1.22-3.81, p = 0.008), and OS ([HR] = 2.53, 95 % [CI] = 1.31-4.89, p = 0.006). ROS1 protein overexpression was observed in 5.0 % (18 out of 357), of which 2 cases harbored ROS1 gene rearrangement. There was no statistically significant correlation between ROS1 gene CNG and protein overexpression. This study demonstrated ROS1 gene rearrangement was detected in 0.8 % of surgically resected NSCLC; and ROS1 gene CNG is an independent poor prognostic factor. This survival analyses may contribute to future studies on the utility of ROS1-targeted therapy for patients.</P>

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