복강경 상자궁적출술 시간에 영향을 주는 임상요인 분석

이성종 ( Sung Jong Lee ),김동빈 ( Dong Bin Kim ),이상욱 ( Sang Wook Yi ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.8

목적: 본 연구의 목적은 자궁의 양성 병변으로 CISH를 시행받은 여성 환자들의 수술시간에 영향을 미치는 임상적 인자를 발견하고 CISH의 임상적 고찰을 시행하고자 한다. 방법: 2001년 1월부터 2006년 12월까지 CISH를 성공적으로 시행받은 130명을 대상으로 후향적 연구를 하였고 수술을 시행받은 환자의 나이, 수술받은 시기, 수술에 참여했던 산부인과 전문의, 출산 자녀 수, 수술력, 키, 몸무게, 과거 병력, 초음파상 진단 및 자궁횡축길이, 수술을 시행하게 된 이유와 증상 등을 비롯하여 수술시간, 입원기간, 자궁병리조직검사, 혈색소감소치 등의 수술과 관련된 인자 등을 입원 및 외래 기록을 이용하여 조사하였다. 연구에 사용된 임상 9개 항목과 수술시간과의 상관 관계를 통계학적 방법을 이용하여 조사하였다. 결과: CISH를 시행하는 주된 수술 적응증은 생리통, 생리 과다, 질출혈을 유발하는 자궁근종, 자궁샘근육증이었으며 평균 자궁횡축길이는 7.2 cm, 평균 수술시간은 135.5분, 평균 혈색소 감소는 1.2 g/dL, 평균 재원일수는 9.1일이었다. 수술시간에 가장 큰 영향력을 준 것은 자궁횡축길이였으며 수술자 숙련도 학습곡선으로 사용된 수술시기도 수술시간에 영향을 주었다. 결론: CISH 술식에서 수술 전 초음파로 측정된 자궁횡축길이는 수술시간에 가장 큰 영향을 주는 임상 인자이다. Objective: The purpose of this study was to find clinical factors affecting the operation time of the classical intrafascial supracervical hysterectomy (CISH) performed on patients with uterine disease. Methods: From January 2001 to December 2006, a total of 148 patients were reviewed and 130 patients with CISH were entered into the study. We investigated clinical factors, such as age, parity, BMI, height, weight, transverse diameter of uterus, previous operation number, operation assistant, period in sequence of operation date, pathology of uterus and operation time of surgery. The statistical assessment was used to find out the main factor determining the operation time of CISH. Results: The mean operation time of CISH was 135.5 minutes and the mean transverse diameter of uterus was 7.2 cm. The main indications for CISH were uterine myoma or adenomyosis with dysmenorrhea, menorrhagia and vaginal bleeding. The operation time of CISH was affected by the transverse diameter of uterus and period which was categorized in sequence of operation date. Conclusion: Mainly, pre-operative ultrasonographic evaluation of uterine transverse diameter could predict the operation time of CISH.

CISH is induced during DC development and regulates DC‐mediated CTL activation

Miah, Mohammad Alam,Yoon, Cheol‐,Hee,Kim, Joonoh,Jang, Jinah,Seong, Young‐,Rim,Bae, Yong‐,Soo WILEY‐VCH Verlag 2012 European journal of immunology Vol.42 No.1

<P><B>Abstract</B></P><P>The cytokine inducible SH2‐domain protein (CISH) is a well‐known STAT5 target gene, but its role in the immune system remains uncertain. In this study, we found that CISH is predominantly induced during dendritic cell (DC) development from mouse bone marrow (BM) cells and plays a crucial role in type 1 DC development and DC‐mediated CTL activation. CISH knockdown reduced the expression of MHC class I, co‐stimulatory molecules and pro‐inflammatory cytokines in BMDCs. Meanwhile, the DC yield was markedly enhanced by CISH knockdown via cell‐cycle activation and reduction of cell apoptosis. Down‐regulation of cell proliferation at the later stage of DC development was found to be associated with CISH‐mediated negative feedback regulation of STAT5 activation. In T‐cell immunity, OT‐1 T‐cell proliferation was significantly reduced by CISH knockdown in DCs, whereas OT‐2 T‐cell proliferation was not affected by CISH knockdown. CTLs generated by DC vaccination were also markedly reduced by CISH knockdown, followed by significant impairment of DC‐based tumor immunotherapy. Taken together, our data suggest that CISH expression at the later stage of DC development triggers the shutdown of DC progenitor cell proliferation and facilitates DC differentiation into a potent stimulator of CTLs.</P>

Relationship of Amplification and Expression of the C-MYC Gene with Survival among Gastric Cancer Patients

Khaleghian, Malihea,Shakoori, Abbas,Razavi, Amirnader Emami,Azimi, Cyrus Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.16

Background: During the past decades, the incidence and mortality rate of stomach cancer has demonstrated a great decrease in the world, but it is still one of the most common and fatal cancers especially among men worldwide, including Iran. The MYC proto-oncogene, which is located at 8q24.1, regulates 15% of genes and is activated in 20% of all human tumors. MYC amplification and overexpression of its protein product has been reported in 15-30% of gastric neoplasias. The aim of this investigation was to find the relative efficacy of CISH (chromogenic in situ hybridization) or IHC (immunohistochemistry) in diagnosis and prognosis of gastric cancer, as well as the relationship of amplification and expression of C-MYC gene with patient survival. Materials and Methods: In this cross-sectional study, 102 samples of gastric cancer were collected from patients who had undergone primary surgical resection at the Cancer Institute Hospital, Tehran University of Medical Sciences, from July 2009 to March 2014. All samples were randomly selected from those who were diagnosed with gastric adenocarcinomas. CISH and IHC methods were performed on all of them. Results: Patients were classified into two groups. The first consisted of stage I and II cases, and the second of stage III and IV. Survival tests for both groups was carried out with referrnce to CISH test reults. Group II (stage III & IV) with CISH+ featured lower survival than those with CISH- (p=0.233), but group I (stage I & II) patients demonstrated no significant variation with CISH+ or CISH- (p=0.630). Kaplan-Meier for both groups was carried out with IHC test findings and showed similar results. This data revealed that both diffuse and intestinal types of gastric cancer occurred significantly more in men than women. Our data also showed that CISH+ patients (43%) were more frequent in comparison with IHC+ patients (14.7%). Conclusions: For planning treatment of gastric cancer patients, by focusing on expanding tumors, which is the greatest concern of the surgeons and patients, CISH is a better and more feasible test than IHC, in regard to sensitivity and specificity. Therefore, CISH can be used as a feasible test for tumor growth and prognosis in stage III and IV lesions. This study also indicated that C-MYC amplification in gastric cancer is correlated with survival in advanced stages.

골반경 근막하 자궁적출술의 임상적 효용성

강규현(Kue Hyun Kang),이우석(Woo Seok Lee),윤성준(Seong Jun Yoon),이상훈(Sang Hoon Lee),허민(Min Hur),배도환(Do Hwan Bae),박형무(Hyoung Moo Park),김동호(Dong Ho Kim) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.11

N/A Objectives : Our purpose was to evaluate the efficacy of pelviscopic classic intrafascial supracervical hysterectomy (CISH) & compare it with total abdominal hysterectomy (TAH). Methods : We analyzed retrospectively, the clinical data of 1126 patients admitted from January 1993 to December 1998, at 11 university or general hospitals in Korea, for CISH group and 363 patients admitted from January 1993 to December 1998, at Chung-Ang university hospitals, Seoul, Korea, for TAH group. These patients were operated on with the indication of benign uterine disease without cervical malignant lesion. The patients with malignant cervical lesion were excluded in this study. Results : ① The average age of CISH group was 42.2 (range 24-63) years old and TAH group was 46 (range 31-54) years old. ② The mean operative time was 150.7±49.9 (mean±SD, range 55-395) minutes in CISH group and 133.8±35 (mean±SD, range 65-350) minutes in TAH group. The mean estimated blood loss was 206±183.6 (mean±SD, range 20-2000) ml in CISH group and 596±452.3 (mean±SD, range 100-6500) ml in TAH group. The mean hemoglobin change was 1.52±0.98 (mean±SD, range 0-7) g/dL in CISH group and 3.03±1.47 (mean±SD, range 0.2-8.4) g/dL in TAH group. The mean time in hospital was 6.3±1.43 (mean±SD, range 3-18) days in CISH group and 11.0±4.08 (mean±SD, range 7-37) days in TAH group. ③ Overall complications occured at 5.3% in CISH group and 9.1% in TAH group. ④ Pathologic findings of cervix were benign in 1121 patients (99.6%) and severe dysplasia or carcinoma in situ in 5 patients (0.4%) among CISH groups. In TAH groups, 351 patients (96.7%) had benign cervical lesion and 12 patients (3.3%) had more than moderate dysplasia or carcinoma in situ. In both groups, no invasive cervical cancer was found and the transformation zone of the cervix was included within the resection margin of the cervix in all cases. Conclusion : The pelviscopic CISH group has less operative blood loss, less postoperative hemoglobin change, shorter hospital stay and less operative complication than TAH group. Pelviscopic CISH is truly a minimally invasive and organ-preserving surgery and coring out the cervix with the calibrated uterine resection tool may prevent the development of cervical cancer. Therefore, we believe that pelviscopic CISH is preferred in cases of benign uterine diseases, because it lowers operative complications and it may have several benefits compared with total hysterectomy, especially, in women with no pathologic lesion of the cervix.

1,049명의 CISH 환자에서의 수술적 합병증

정수경 ( Soo Kyoung Jung ),허주엽 ( Chu Yeop Huh ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.3

목적: 이 연구의 목적은 CISH 수술의 합병증에 관하여 조사하는 것이다. 방법: 1997년 4월부터 2006년 8월까지 본원 산부인과에서 CISH 수술을 받은 환자의 차트를 후향적으로 조사하여 CISH 수술 시에 발생하는 합병증의 종류 및 빈도를 분석하였다. 결과: 281명 (26.79%)의 환자는 개복 수술의 기왕력이 있었다. CISH 수술의 합병증으로 가장 흔한 것은 수혈로 30명 (2.86%)이었고, 일시적인 방광 기능 장애가 19명 (1.81%), 자궁경부 절단면의 출혈이 12명 (1.14%), 복부 창상 부위의 감염 및 벌어짐이 11명 (1.05%), 장마비가 7명 (0.67%), 절개 부위 탈장이 6명 (0.57%), 자궁경부 절단면의 감염이 4명 (0.38%), 요관 손상이 2명 (0.19%), 방광 손상이 2명 (0.19%), 종아리 신경 마비, 투관침에 의한 출혈, 투관침 부위의 자궁내막증, 방광 내 이물질, 골반 내 농양이 각각 1명 (0.10%)씩으로 총 98명 (9.34%)에서 합병증이 발생하였다. 결론: CISH 수술은 요관 및 방광의 손상의 빈도가 낮으나, 자궁경부 절단면의 출혈 및 감염의 위험성이 높다. Objective: The aim of this study is to evaluate the complication rate of Cervical Intrafascial Semm Hysterectomy (CISH). Methods: 1,049 CISH were carried out from April 1997 to August 2006 at our department. Retrospective review of medical records was performed to investigate the incidence and the type of complications during CISH procedures. Results: 281 (26.79%) of the patients had a history of laparotomy. Overall 98 (9.34%) complications occurred. There were 30 (2.86%) transfusion, 19 (1.81%) transient bladder dysfunction, 12 (1.14%) cervical stump bleeding, 11 (1.05%) abdominal wound infection or disruption, 7 (0.67%) paralytic ileus, 6 (0.57%) incisional hernia, 4 (0.38%) cervical stump infection, 2 (0.19%) ureter injuries and 2 (0.19%) bladder injuries. And there were one case of transient peroneal nerve palsy, trocar site bleeding, trocar site endometriosis, foreign body in bladder and pelvic abscess. Conclusions: CISH procedure lessens the risk of ureteral and bladder injury, but this procedure increases the risk of cervical stump bleeding and infection morbidity.

골반경을 이용한 자궁적출술의 방법에 따른 비교 분석

박평식(P . S . Park),탁병모(B . M . Tak),김경모(K . M . Kim),김성태(S . T . Kim),양거승(K . S . Yang),정호순(H . S . Chung) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

N/A Objective: Recently, pelviscopic hysterectomy is quite often tried. We mentioned here three techniques, that is, a classic intrafascial Semm hysterectomy(CISH), total pelviscopic hysterectomy(TLH), and laparoscopically assisted vaginal hysterectomy(LAVH), and compared the three techniques and the outcomes of each other through the clinical cases. Methods: We studied 138 pelviscopic hysterectomy cases, including 88 CISH, 35 TLH, and 15 LAVH cases, which were performed at Seoul Adventist Hospital from March 1994 to July l997. We compared the results each other with regard to the age, parity, operation time, blood loss, weight of uterus, past history of abdominal surgery, other additional operations, surgical indication, and, intra and post operative complications. As a statistic analysis, ANOVA and DMR were used for the study. Results: The mean operation time is affected by the surgens experiences and surgical instruments, but there was no significant difference on each operation time as following, 134.01 minutes for CISH, 129.23 minutes for TLH, and, 141.33 minutes for LAVH. The mean weight of uterus was 217.46 gm for CISH cases(the heavist among three), 188.23 gm for TLH, 190.40 gm for LAVH. The mean estimated blood loss of CISH was 178.74 cc, which was 36.67% less than that of TLH, 48.24% than that of LAVH. Especially in the cases of uterine myoma and adenomyosis, the estimated blood loss of CISH was 32.57% less than that of TLH, 50.78% than that of LAVH. As a surgical indication for all three techniques, uterine myoma was more comman indication than any other gynecological problem. The rate of intra and post operative complication of CISH was 15.9%, which was lower than 42.9% of TLH and 60.0% of LAVH, but, there was no fatal complication for all three. In the cases of CISH, complication of sexual function after operations was less compared to the other techniques, TLH and LAVH, because the pelvic floor support was maintained and less damaged, Conclusion: Among the above three pelviscopic hysterectomy techniques, CISH was least of the mean estimated blood loss and complications and the most organ protective method in the case of the benign gynecological disease.

골반경하 전자궁적출술(TLH)과 골반경하 근막하 자궁절제술(CISH) 및 복식 전자궁 적출술(TAH)의 임상적 고찰

이상걸,차선희,신명철,김종욱,김현철,선우태원,이위현,조진호,이정노 대한산부인과내시경학회 2000 대한산부인과내시경학회잡지 Vol.12 No.1

Chromogenic In Situ Hybridisation Test for Breast Cancer Patients with Equivocal IHC Results - a Study from Iran

Mehrazma, Mitra,Kalantari, Elham,Rezvani, Hamid,Bahar, Babak,Basi, Ali,Razavi, Seyed Mohsen,Rakhshani, Nasser Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.17

Background: HER2/neu overexpression on cell membranes of breast cancer cells is due to HER2/neu gene amplification and it is important to identify potential candidates for anti HER2 therapy with trastuzumab. IHC, FISH and CISH are standard FDA approved assays currently used to determine HER2 status in routine practice. The aim of this study was to determine HER2 gene amplification, using the CISH method in breast carcinoma samples which had IHC +2 reactions. Materials and Methods: This study was conducted from 2008-2010 using 334 consecutive breast carcinoma samples referred from local laboratories to Mehr Hospital. CISH assays were performed for all cases, and IHC tests were also done for determining efficacy and accuracy of local labs. HER2 status in local IHC tests was compared with central IHC and CISH results. Results: Of 334 breast cancer patients, 16 were negative for HER2 IHC (0, +1), 201 cases were equivocal (+2), and 31 positive (+3). Of 334 referral cases, 88 were CISH positive (26.3%) and 246 were CISH negative (73.7%). Of 201 IHC +2 cases, HER2 gene amplification was observed in 42 cases (kappa: 0.42). A 29.9% concordance was found between local IHC and central IHC. Sensitivity and specificity of local IHC were 90% and 53.8%, respectively. Conclusions: Low accuracy of IHC results in local labs was associated with the following factors: using former FDA-approved criteria for HER2 interpretation, utilizing non-validated kits, and lack of any quality assurance program. Therefore, following the new 2014 ASCO/CAP guideline and comprehensive quality assurance should be implemented to ensure accuracy of HER2 testing.

SEMM 식 자궁적출술에 대한 임상적 고찰

우소영(So Young woo),박영순(Young Soon Park),이상호(Sang Ho Lee),문종수(Zong Soo Moon),서수형(Soo Hyung Seo),박양서(Yang Suh Park) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.10

N/A Objectives : We performed this study to review the clinical availability of the classical intrafascial SEMM hysterectomy (CISH), and report our experience for 2 years restrospectively. Methods : From March 1999 to February 2001, 100 cases of CISH were performed at the Department of Obstetrics and Gynecology, College of Medicine, Kangdong Sacred Heart Hospital, Hallym university. We performed this procedure by 3 steps. The dissection of uterus was done by classical suture methods (including extracorporeal and intracorporeal suture techniques) to uterine isthmic portion. And then transvaginal cylindrical coring out of the cervical tissue was done using a cervix corer, the Calibrated Uterine Resection Tools (CURT) for resection of cervical tissue especially transformation zone. Finally, the dissected uterus was extracted by using a Serrated Edged Macro-Morcellator (SEMM) without colpotomy. We reviewed the patient's data retrospectively and made phone calls to each patients. Results : The indications for CISH, based on the pre-and intraoperative diagnosis, were leiomyoma, adenomyosis, endometrial hyperplasia and chronic pelvic inflammatory disease or pelvic pain, in order of frequency. The mean operative time was 126 minutes and the mean hemoglobin change was 1.27 gm/dL. The mean hospital days were 5.7 days and the mean age of the patients was 44.6 years old. There were no definite intra- and postoperative complications except for 3 cases of CO2 retentions and 2 cases of delayed bleeding on cervical stump. The mean days to first sexual contact after surgery were 34.5 days. In view of sexual feeling, 86% of the patients didn't feel any difference and only 13% felt worse than before. During postoperative follow-up, the cervical cytologic study were found no endocervical cells at all of 44 checked patients. Conclusion : The CISH procedures can be safely performed by well-trained laparoscopists, and this technique minimally alters the anatomy and integrity of the pelvic floor and vagina. Therefore the reductions of surgical morbidity, blood loss, hospitalization and postoperatve discomfort were obtained. Through the preservation of the anatomical relations of the pelvic floor and the function of female sexuality, this technique is the new proposal in gynecologic surgery.

Characterization of porcine cytokine inducible SH2-containing protein gene and its association with piglet diarrhea traits

Buyue Niu,Dongchun Guo,Zhiran Liu,Xiaofei Han,Xibiao Wang 아세아·태평양축산학회 2017 Animal Bioscience Vol.30 No.12

Objective: The cytokine inducible SH2-containing protein (CISH), which might play a role in porcine intestine immune responses, was one of the promising candidate genes for piglet anti-disease traits. An experiment was conducted to characterize the porcine CISH (pCISH) gene and to evaluate its genetic effects on pig anti-disease breeding. Methods: Both reverse transcription polymerase chain reaction (RT-PCR) and PCR were performed to obtain the sequence of pCISH gene. A pEGFP-C1-CISH vector was constructed and transfected into PK-15 cells to analysis the distribution of pCISH. The sequences of individuals were compared with each other to find the polymorphisms in pCISH gene. The association analysis was performed in Min pigs and Landrace pigs to evaluate the genetic effects on piglet diarrhea traits. Results: In the present research, the coding sequence and genomic sequence of pCISH gene was obtained. Porcine CISH was mainly localized in cytoplasm. TaqI and HaeIII PCR restriction fragment length polymorphism (RFLP) assays were established to detect single nucleotide polymorphisms (SNPs); A-1575G in promoter region and A2497C in Intron1, respectively. Association studies indicated that SNP A-1575G was significantly associated with diarrhea index of Min piglets (p<0.05) and SNP A2497C was significantly associated with the diarrhea trait of both Min pig and Landrace piglets (p<0.05). Conclusion: This study suggested that the pCISH gene might be a novel candidate gene for pig anti-disease traits, and further studies are needed to confirm the results of this preliminary research.