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      • 진행성 비소세포폐암의 이차항암화학요법으로서 Docetaxel 단독요법의 성적

        강현모,이정은,장필순,이연선,권선중,안진영,정성수,김주옥,김선영 충남대학교 암공동연구소 2006 암공동연구소 업적집 Vol.5 No.

        Background : The survival benefit associated with first-line chemotherapy in lung cancer has led to the need for second -line chemotherapy, for which Docetaxel (Taxotere^(?)) has proven efficacy in both settings. This study evaluated the safety and efficacy of docetaxel in patients with non-small cell lung cancer who had failed first-line platinum-based chemotherapy. Methods : Thirty one patients with non-small-cell lung cancer, who had failed first line platinum-based chemotherapy, between March 1999 and August 2003, were enrolled in this study. Patients received intravenous docetaxel, either 75 mg/㎡ or 100 mg/㎡, with routine premedication every three weeks. Results : Fourteen patients (45.2%) had a partial response. The median survival and progression- free survival times were 12.5 months (95% CI 7.3-17.6) and 3.0 months (95% CI 1.6-4.5), respectively. This study showed 2 factors gave different survival benefits; the age (< 60 years: 20.1 months vs. > 60 years: 6.6 months, p=0.0105) and the histological type (adenocarcinoma: 25.6 months vs. others: 7.9 months, p=0.0055). The predominant toxicity was neutropenia, which occurred as WHO grade 3 or 4 in 38.7 % of patients. One treatment related death was also reported. Non-hematological toxicity was minor and easily controlled. There were no significant statistical differences in the survival benefit and toxicity between the two doses. Conclusion : Docetaxel, as second-line monotherapy, was well tolerated and effective in patients with non-small-cell lung cancer who failed first line platinum -based chemotherapy. (Tuberc Respir DiS 2005: 58: 465-472) 연구배경 : 일차항암화학요법 후에 생존의 이득을 얻었음에도 불구하고 비소세포폐암 환자들의 대다수가 결국은 재발하거나 진행성 병변을 보인다. 이에 저자들은 기존의 여러 연구에서 보고 된 구제요법으로서 docetaxel의 항암효과와 비교적 적은 독성의 결과를 바탕으로,platinum을 근거로 한 항암화학요법을 시행 밖았으나 개발되거나 진행된 비소세포폐암 환자들을 대상으로 docetaxel 단독요법의 치료효과와 부작용에 대하여 알아보고자 하였다. 방법 : 조직학적으로 비소세포폐암으로 진단을 받고 platinum을 근거로 한 항암화학요법을 받았으나 재발 또는 진행성 병변을 보인 31명의 환자들을 대상으로 docetaxel 75 mg/m² 또는 100 mg/m²을 3주마다 정주하였다. 임상기록을 통한 후향적인 방법으로 분석하였다. 결과 : 1) 재발 또는 진행성 병변을 보인 31명중 남녀 비는 24:7이고 중앙연령은 60세였다. 2) 반응평가로 완전 관해는 없었고 부분관해는 14명(45.2%), 불변이 10명(32.3%), 진행이 7명(22.6%)으로 전체적인 반응율은 45.2%이었다. 3)중앙생존기간은 12.5개월(95% 신뢰구간: 7.3개월 17.6개월) 이었고, 1년 생존율은 52%였다. 무진행생존기간의 중앙값은 3.0개월(95%신뢰구간: 1.6개월 -4.5개월)이며, 반응군에서의 중앙반응지속피간은 3.7개월(95% 신뢰구간: 3.0개월 - 4.4개월)이었다. 4) 60세 미만인 경우(20.1 months vs 6.6 months. p=0,0105), 조직학적 아형이 선암일 경우(25.6 months vs 7.9 months, 0=0.0055) 통계적으로 유의한 생존기간의 증가가 있었다. 5) 부작용으로 3도 이상의 백혈구 감소증은 12명(38.7%),호중구 감소증에 동반된 발열은 6명(19.3%),감염이 동반된 호중구 감소증은 4명(12.9%)에서 발생했다. 치료와 관련되어 1명이 사망하였다. 6) Docetaxel 용량에 따른 생존기간의 차이나 독성의 차이는 없었다. 결론 : Platinum을 근거로 하는 항암화학요법으로 치료받은 후 재발 또는 진행성 병변을 보이는 비소세포폐암환자들에게 docetaxel을 투여하는 것은 비교적 안전하고 효과적인 항암치료법으로 사료된다.

      • 진행성 비소세포폐암의 이차항암화학요법으로서 Docetaxel 단독요법의 성적

        강현모,이정은,장필순,이연선,권선중,안진영,정성수,김주옥,김선영 충남대학교 암연구소 2006 암연구소 업적집 Vol.5 No.-

        Background : The survival benefit associated with first-line chemotherapy in lung cancer has led to the need for second -line chemotherapy, for which Docetaxel (Taxotere^(?)) has proven efficacy in both settings. This study evaluated the safety and efficacy of docetaxel in patients with non-small cell lung cancer who had failed first-line platinum-based chemotherapy. Methods : Thirty one patients with non-small-cell lung cancer, who had failed first line platinum-based chemotherapy, between March 1999 and August 2003, were enrolled in this study. Patients received intravenous docetaxel, either 75 mg/㎡ or 100 mg/㎡, with routine premedication every three weeks. Results : Fourteen patients (45.2%) had a partial response. The median survival and progression- free survival times were 12.5 months (95% CI 7.3-17.6) and 3.0 months (95% CI 1.6-4.5), respectively. This study showed 2 factors gave different survival benefits; the age (< 60 years: 20.1 months vs. > 60 years: 6.6 months, p=0.0105) and the histological type (adenocarcinoma: 25.6 months vs. others: 7.9 months, p=0.0055). The predominant toxicity was neutropenia, which occurred as WHO grade 3 or 4 in 38.7 % of patients. One treatment related death was also reported. Non-hematological toxicity was minor and easily controlled. There were no significant statistical differences in the survival benefit and toxicity between the two doses. Conclusion : Docetaxel, as second-line monotherapy, was well tolerated and effective in patients with non-small-cell lung cancer who failed first line platinum -based chemotherapy. (Tuberc Respir DiS 2005: 58: 465-472)

      • KCI등재후보

        선박수리업무에 종사하는 군무원들의 작업환경에 대한 인식이 직업만족도에 미치는 영향

        오경재,모영하,윤한,김명선,이정미,권근상 한국산업위생학회 2003 한국산업보건학회지 Vol.13 No.1

        This study was carried out to evaluate the relations among working environments, health behaviors and satisfaction with their duty in a group of 200 ship-repair workers in the ROK navy. The results were as following; Age of workers was 40 years and over(83%) and working duration was 10 years and over (71.5%). Most of them were married and had studied beyond high school. The 69.5% of workers satisfied with their job, whereas. about 59.5% of workers had satisfaction with their working condition. There were current drinkers, 78.5%, current exercising workers, 43.5%, obese workers, 28.0%, and salted food intakers, 18.5% in the workers. The major harmful environmental factors in the ship-repair workplace are noise, vibration, dust and chemicals. Most of workers are exposed to above harmful factors and complained about exposure of noise and dust. The consumption of cigarette or alcohol in people who exposed to noise was much higher than in people who did not, but the difference was not statistically significant. Prevalence of obesity and hypertension were not significantly different between the exposure with noise and dust. Noise or dust exposure was significant relation to satisfaction with their duty and working condition. The affective factors for satisfaction with their duty were people who worked for 10 years or more(OR= 4.53), exercisers(OR=4.78) and dust(OR=3.05) in Logistic regression analysis.

      • 비소세포 폐암 환자의 이차 치료로서 Gemcitabine과 Vinorelbine 혼합 요법의 효과

        장필순,강현모,이정은,권선중,안진영,이연선,정성수,김주옥,김선영 충남대학교 암연구소 2006 암연구소 업적집 Vol.5 No.-

        Background : Both gemcitabine and vinorelbine are effective anticancer drugs with mild toxicity on non-small cell lung cancer, and monotherapy of these drugs are effective as a second-line chemotherapy. The aim of this trial was to assess the response and toxicity of a combination of gemcitabine and vinorelbine in patients of previously treated for non-small cell lung cancer. Materials and Methods : 24 patients, initial stage III A/B,IV and previously treated with platinium and taxane based regimens, were enrolled from June 2000 to March 2004. The regimens consisted of vinorelbine 25mg/㎡ followed by an infusion of gemcitabine 1000mg/㎡ on day 1 and day 8 every three weeks. This course was repeated more than twice. Results : Twenty-four patients were analyzed for the response, survival rate, and toxicities. The overall response was 17% with a complete remission rate of 4%. The median time-to progression (TTP) was 3.1 months (95%, CI l-10months), and the survival time was 8.2 months (95%, CI 1-23 months). The grade 3/4 toxicities encountered were neutropenia (12.5%), anemia (0%), thrombocytopenia (0%). Non-hematological 3/4 toxicities were not observed. Conclusion : A combination of gemcitabine and vinorelbine in patients previously treated for non-small cell lung cancer provides a relatively good response rate, and a low toxicity profile. However, further study will be needed to confirm its effectiveness. (Tuberc Respir Dis 2005; 58: 344-351)

      • 비소세포 폐암 환자의 이차 치료로서 Gemcitabine과 Vinorelbine 혼합 요법의 효과

        장필순,강현모,이정은,권선중,안진영,이연선,정성수,김주옥,김선영 충남대학교 암공동연구소 2006 암공동연구소 업적집 Vol.5 No.

        Background : Both gemcitabine and vinorelbine are effective anticancer drugs with mild toxicity on non-small cell lung cancer, and monotherapy of these drugs are effective as a second-line chemotherapy. The aim of this trial was to assess the response and toxicity of a combination of gemcitabine and vinorelbine in patients of previously treated for non-small cell lung cancer. Materials and Methods : 24 patients, initial stage III A/B,IV and previously treated with platinium and taxane based regimens, were enrolled from June 2000 to March 2004. The regimens consisted of vinorelbine 25mg/㎡ followed by an infusion of gemcitabine 1000mg/㎡ on day 1 and day 8 every three weeks. This course was repeated more than twice. Results : Twenty-four patients were analyzed for the response, survival rate, and toxicities. The overall response was 17% with a complete remission rate of 4%. The median time-to progression (TTP) was 3.1 months (95%, CI l-10months), and the survival time was 8.2 months (95%, CI 1-23 months). The grade 3/4 toxicities encountered were neutropenia (12.5%), anemia (0%), thrombocytopenia (0%). Non-hematological 3/4 toxicities were not observed. Conclusion : A combination of gemcitabine and vinorelbine in patients previously treated for non-small cell lung cancer provides a relatively good response rate, and a low toxicity profile. However, further study will be needed to confirm its effectiveness. (Tuberc Respir Dis 2005; 58: 344-351) 배경 : Gemcitabine, paditaxel, docetaxel, vinorelbine, ir-rinotecan 새로운 항종양제의 출현으로 일차 치료의효과가 증대 되고 있고 재발시에도 좋은 신체 활동도를 보이고 있어서 이차 치료의 대상군도 늘어나는 효과를 보이고 있다. 치료의 필요성은 증대 되고 있지만 현재까지 표준 치료가 확립되지 않은 상황에서 Gem-citabine과Vinorelbine모두 독성이 강하지 않아서 혼합 요법이 가능한 장점이 있고 비소세포 폐암에 대한효과도 입증이 되어있어서 본 연구는 반응이 없거나 반응을 보인후에 재발된 진행된 비소세포 폐암에 ge-mdtabine과 vinorelbine 흔합 요법을 시행하여서 치료 반응률과 생존율 그리고 부작용을 평가하였다. 대상 및 방법 :2000년 6월부터 2004년 3월까지 충남대학교병원에내원하여 진행성 비소세포 폐암 IIIA/IIIB, IV로 진단을 받고 일차 항암화학요법치료를 받은 환자중에 초기 치료에 반응이 없거나, 치료에 반응이 있었으나 병이 진행된 환자로 추적 관찰 기간이 6개월 이상인 환자를 대상으로 생존율과 반응률 그리고 독성을 분석하였다. 결과 : 총 치료 반응률은 17%. 반응 유지기간의 중앙값은 3.1개월(1-10개월)이었고 생존기간의 중앙값은 8.2개월 (1-23개월) 그리고 1년 생존율은 35%였다. 항암화학요법에 의한 독성은 3도 이상의 중성구 감소가 12%, 오심과 구토가 12.5% 였다. 결론 : 일차 치료에 반응이 없거나 재발한 비소세포 폐암환자의 이차 치료로 gemcitabine과 vinorelbine 혼합요법은 효과적이라고 생각되며 향후 3상 연구를 통한다른 약제와의 비교 연구가 필요하다고 생각된다.

      • Highly robust and optimized conjugation of antibodies to nanoparticles using quantitatively validated protocols

        Jeong, Sinyoung,Park, Ji Yong,Cha, Myeong Geun,Chang, Hyejin,Kim, Yong-il,Kim, Hyung-Mo,Jun, Bong-Hyun,Lee, Dong Soo,Lee, Yoon-Sik,Jeong, Jae Min,Lee, Yun-Sang,Jeong, Dae Hong Royal Society of Chemistry 2017 Nanoscale Vol.9 No.7

        <P>Antibody-conjugated nanoparticles (NPs) have attracted great attention in diagnostic and therapeutic applications due to their high sensitivity and specificity for biotargets, as well as their wide applicability. Unfortunately, these features are significantly affected by antibody conjugation methods in terms of conjugation efficiency, orientation of the target binding site in the antibody, and denaturation during chemical conjugation reactions. Furthermore, the number of conjugated antibodies on each NP and the overall targeting efficacy are critical factors for a quantitative bioassay with antibody-conjugated NPs. Herein, we report a versatile and oriented antibody conjugation method using copper-free click chemistry. Moreover, the number of conjugated antibodies and their binding capacity were quantitatively and experimentally evaluated using fluorescently-labeled antibodies and antigens. The strong binding capability of antibody-conjugated NPs prepared using the copper-free click chemistry-based conjugation strategy was 8 times superior to the binding capability seen following the use of the EDC/NHS-coupling method. Additionally, the versatility of the developed antibody conjugation method was also demonstrated by conjugation of the antibody to three kinds of silica-encapsulated NPs.</P>

      • KCI등재

        요양보호사의 직무환경에 따른 직무스트레스와 소진이 직무만족에 미치는 영향

        정윤모(Jeong, Yun-Mo),강영식(Kang, Young-Sig) 한국산학기술학회 2010 한국산학기술학회논문지 Vol.11 No.10

        본 연구는 노인장기요양기관 종사자인 요양보호사들의 직무환경과 관련된 속성 및 스트레스와 소진을 파악 하고 이들 요인이 직무만족에 어떠한 영향을 미치는지 효과를 분석하여 요양보호사의 조직업무를 향상시켜 노인의 삶의 질과 노인복지 발전에 도움이 되는데 목적을 갖고 연구하였다. 연구대상은 전북 군산시에 소재한 노인장기요양 기관(요양시설, 재가노인복지시설)에 근무하는 요양보호사 129명을 대상으로 하였다. 분석결과 요양보호사의 직무환경 의 하위요인으로 인적환경과 보상체계, 업무전문성 등이 직무소진, 직무스트레스, 직무만족에 유의적인 영향을 미치는 요인임을 실증시켜 주었다. 이는 그만큼 인적환경을 위한 업무전문성 및 능력과 혁신적 사고를 가진 업적에 비례한 보상체계가 잘 되어 있을수록 긍정적인 관계 형성과 동시 직무소진과 스트레스의 감소 및 직무만족이 향상됨을 의미 한다. 이는 최근 장기요양을 위한 노인성 환자의 급증과 장기요양기관에서의 요양보호사의 역할과 직무가 중요시되는 현실에 비추어 볼 때 전문직으로서의 다양한 복지 수혜적 봉사자로서의 요양보호사들의 직무환경 개선을 위한 직무 전문화 보장과 이들 직무능력에 따른 적절한 보상시스템의 체계화가 필요시 됨을 시사한 것으로 볼 수 있다. 따라서 직업에 대한 자긍심이 높은 전문 인력의 배출과 참여로 요양보호사의 잦은 직무소진과 스트레스를 낮출 수 있는 경 감요인을 찾아 제거함으로써 보다 많은 인력의 참여와 조직헌신을 통한 직무만족 극대화를 통해 조직몰입을 높일 수 있을 것이다. The purpose of this study is to understand attributes, stress and burnout related to job environment of healthcare facilities workers for the aged, care-givers, analyze the effect of these factors on job satisfaction, and improve their organizational task to help advance the quality of life and the healthcare facilities for the aged. A survey was made on 129 care-givers working in the healthcare facilities for the aged(care facilities, in-home facilities for the aged) located in Jeonbuk Gunsan area. This study showed that sub-factors of care-givers' job environment such as human environment, compensation system and job expertise have a significant effect on the job burnout, stress and satisfaction. This means that a well-organized compensation system, which is proportionate to the job expertise and ability for human environment, and achievement of innovative thinking, will make a positive relationship, reduce the job burnout and stress, and improve the job satisfaction at the same time. Compared to the rapid increase of old aged patients for long-term care and care-givers' real role and job in the facilities, the job specialization has to be guaranteed to improve job environment of care-givers as various beneficial workers for welfare - professional workers - and the compensation system needs to be properly systematized according to their job capacity. Consequently, the production and participation of professionals with high self-esteem may raise organizational commitment through the maximization of job satisfaction by the participation and devotion to the organization of more professionals by removing factors, which can reduce the frequent job burn-out and stress of care-givers.

      • Distinct clinical outcomes of two CIMP-positive colorectal cancer subtypes based on a revised CIMP classification system

        Bae, Jeong Mo,Kim, Jung Ho,Kwak, Yoonjin,Lee, Dae-Won,Cha, Yongjun,Wen, Xianyu,Lee, Tae Hun,Cho, Nam-Yun,Jeong, Seung-Yong,Park, Kyu Joo,Han, Sae Won,Lee, Hye Seung,Kim, Tae-You,Kang, Gyeong Hoon Nature Publishing Group 2017 The British journal of cancer Vol.116 No.8

        <P><B>Background:</B></P><P>Colorectal cancer (CRC) is a heterogeneous disease in terms of molecular carcinogenic pathways. Based on recent findings regarding the multiple serrated neoplasia pathway, we revised an eight-marker panel for a new CIMP classification system.</P><P><B>Methods:</B></P><P>1370 patients who received surgical resection for CRCs were classified into three CIMP subtypes (CIMP-N: 0–4 methylated markers, CIMP-P1: 5–6 methylated markers and CIMP-P2: 7–8 methylated markers). Our findings were validated in a separate set of high-risk stage II or stage III CRCs receiving adjuvant fluoropyrimidine plus oxaliplatin (<I>n</I>=950).</P><P><B>Results:</B></P><P>A total of 1287/62/21 CRCs cases were classified as CIMP-N/CIMP-P1/CIMP-P2, respectively. CIMP-N showed male predominance, distal location, lower T, N category and devoid of <I>BRAF</I> mutation, microsatellite instability (MSI) and <I>MLH1</I> methylation. CIMP-P1 showed female predominance, proximal location, advanced TNM stage, mild decrease of CK20 and CDX2 expression, mild increase of CK7 expression, <I>BRAF</I> mutation, MSI and <I>MLH1</I> methylation. CIMP-P2 showed older age, female predominance, proximal location, advanced T category, markedly reduced CK20 and CDX2 expression, rare <I>KRAS</I> mutation, high frequency of CK7 expression, <I>BRAF</I> mutation, MSI and <I>MLH1</I> methylation. CIMP-N showed better 5-year cancer-specific survival (CSS; HR=0.47; 95% CI: 0.28–0.78) in discovery set and better 5-year relapse-free survival (RFS; HR=0.50; 95% CI: 0.29–0.88) in validation set compared with CIMP-P1. CIMP-P2 showed marginally better 5-year CSS (HR=0.28, 95% CI: 0.07–1.22) in discovery set and marginally better 5-year RFS (HR=0.21, 95% CI: 0.05–0.92) in validation set compared with CIMP-P1.</P><P><B>Conclusions:</B></P><P>CIMP subtypes classified using our revised system showed different clinical outcomes, demonstrating the heterogeneity of multiple serrated precursors of CIMP-positive CRCs.</P>

      • Downregulation of acetyl-CoA synthetase 2 is a metabolic hallmark of tumor progression and aggressiveness in colorectal carcinoma

        Bae, Jeong Mo,Kim, Jung Ho,Oh, Hyeon Jeong,Park, Hye Eun,Lee, Tae Hun,Cho, Nam-Yun,Kang, Gyeong Hoon Springer Science and Business Media LLC 2017 Modern pathology Vol.30 No.2

        <P>Acetyl-CoA synthetase-2 is an emerging key enzyme for cancer metabolism, which supplies acetyl-CoA for tumor cells by capturing acetate as a carbon source under stressed conditions. However, implications of acetyl-CoA synthetase-2 in colorectal carcinoma may differ from other malignancies, because normal colonocytes use short chain fatty acids as an energy source, which are supplied by fermentation of the intestinal flora. Here we analyzed acetyl-CoA synthetase-2 mRNA expression by reverse-transcription quantitative PCR in paired normal mucosa and tumor tissues of 12 colorectal carcinomas, and subsequently evaluated acetyl-CoA synthetase-2 protein expression by immunohistochemistry in 157 premalignant colorectal lesions, including 60 conventional adenomas and 97 serrated polyps, 1,106 surgically resected primary colorectal carcinomas, and 23 metastatic colorectal carcinomas in the liver. In reverse-transcription quantitative PCR analysis, acetyl-CoA synthetase-2 mRNA expression was significantly decreased in tumor tissues compared with corresponding normal mucosa tissues. In acetyl-CoA synthetase-2 immunohistochemistry analysis, all 157 colorectal polyps showed moderate to -strong expression of acetyl-CoA synthetase-2. However, cytoplasmic acetyl-CoA synthetase-2 expression was downregulated (acetyl-CoA synthetase-2 low expression) in 771 (69.7%) of 1,106 colorectal carcinomas and 21 (91.3%) of 23 metastatic lesions. The colorectal carcinomas with acetyl-CoA synthetase-2-low expression were significantly associated with advanced TNM stage, poor differentiation, and frequent tumor budding. Regarding the molecular aspect, acetyl-CoA synthetase-2-low expression exhibited a tendency of frequent KRT7 expression and decreased KRT20 and CDX2 expression. In survival analysis, acetyl-CoA synthetase-2-low expression was an independent prognostic factor for poor 5-year progression-free survival (hazard ratio, 1.39; 95% confidence interval, 1.08-1.79; P = 0.01). In conclusion, these findings suggest that downregulation of acetyl-CoA synthetase-2 expression is a metabolic hallmark of tumor progression and aggressive behavior in colorectal carcinoma.</P>

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