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안정식,방호윤,이종인,노우철,황대용,최동욱,백남선,문난모,최태인,Ahn Jung-Sik,Bang Ho-Yoon,Lee Jong-Inn,Noh Woo-Chul,Hwang Dae-Yong,Choi Dong-Wook,Paik Nam-Sun,Moon Nan-Mo,Choi Tae-Inn 대한위암학회 2001 대한위암학회지 Vol.1 No.3
Purpose: The prognosis for early gastric cancer (EGC) is favorable, and the 10-year disease-specific survival rate is reported to be around $90\%$. The absolute number of recurred EGC is too small to assess the risk factors, so recruitment of a large number of cases for statistical analysis is very difficult. We carried out this study to analyze the incidence and the patterns of recurrence of EGC and to identify the clinicopathological risk factors for recurrence of EGC. Materials and Methods: The authors retrospectively investigated the follow-up records of 1418 patients who underwent a curative resection for EGC from Jan. 1984 to Dec. 1999 at the Korea Cancer Center Hospital and analyzed them with special reference to cancer recurrence. Results: In this retrospective study of 1418 cases, 43 patients died of a recurrence of gastric cancer, and 105 patients died of unrelated causes. The five-year and the ten-year overall survival rates were $89.6\%$ and $81.7\%$, respectively, while the five-year and the ten-year diseasespecific survival rates were $96.5\%$ and $94.3\%$, respectively. The recurrence patterns of the 45 recurred EGC were hematogenous metastasis (19 cases), lymph node (L/N) metastasis (8 cases), locoregional recurrence (2 cases), peritoneal seeding (3 cases), and combined form (13 cases). The mean time interval to recurrence was 38.6 months, and the number of delayed recurred cases after 5 years was 10 ($22.2\%$). Of the clinicopathologic factors, depth of invasion, L/N metastasis, macroscopic type, lymphatic invasion, and vessel invasion, were significant risk factors in the univariate analysis. However, in the multivariate analysis, only L/N metastasis was an independent prognostic factor. Conclusion: Based on the results of this study, L/N metastasis is an independent prognostic factor. Thus, in patients with node-positive disease, adjuvant therapy might be considered, and long-term close follow-up might facilitate early detection and treatment of recurrent disease due to delayed recurrence.
폐경 전 호르몬 수용체 양성 유방암 환자의 난소기능 측정을 위한 방법
김현아,우주현,최향숙,이석준,최지혜,박찬섭,성민기,노우철 이화여자대학교 의과학연구소 2017 EMJ (Ewha medical journal) Vol.40 No.3
The evaluation of menopausal status is an important subject in the field of treatment of hormone receptor positive breast cancer. According to the menopausal status, endocrine therapy should be categorized by individual patient. However, the gonadal injury caused by various therapeutic drugs and its recovery would confuse the interpretation of clinical and biological markers for ovarian reserve. There are some methods to examine the functional ovarian reserve indirectly. Ultrasonography for counting follicles is a relatively reliable procedure, although it is not feasible because of time-labor consumption and high cost. Biological marker from blood samples such as serum follicle stimulating hormone (FSH), serum estradiol (E2), serum inhibin, or anti-Müllerian hormone (AMH) would be a better choice. The examination of serum FSH and E2 is already recommended as biomarkers for measuring functional ovarian reserve in many guidelines. However, there are limitation of serum FSH and E2 in patients with chemotherapy- induced amenorrhea and treated by tamoxifen. AMH is promising biomarker in the field of infertility treatment even in the patients treated by chemotherapy. It might be a possible biomarker to determine the menopausal status for decision-making whether aromatase inhibitor could be applicable or not in hormone positive breast cancer patients with chemotherapy induced amenorrhea or treated by tamoxifen.
김옥영,배재문,한호성,노우철 대한외상학회 1995 大韓外傷學會誌 Vol.8 No.2
Controversy still exist concerning the management of patients with potentially penetrating abdominal stab wound. The article reviewed our experience of selective management of 32 patients with abdominal stab wound from september 1991 to october 1995. All patients were assessed and managed on the basis of clinical grounds such as physical examination, evisceration, shock status and local wound exploration including sialogram. The results were as follows : 1) The ratio of male to female was 2.8: 1 and the age of peak incidence was third decade. 2) 19 cases(60%) of wounds were homicidal, 9 cases(28%) were suicidal, 4 cases(12%) were accidental. The most common instument used in insult was knife(25 cases, 78%). 3) The external sites of would were distributed evenly on the surface of anterior abdominal wall. 4) The organ that most commonly injured was omentum and 14 patients(44%) had injuries in 2 or more organs. 5) There was one death due to multiple organ failure. There were 4 cases of complication(2 cases of wound infection, 1 case of pneumonia, 1 case of ARDS). 6) By using clinical examination and local wound exploration as the criteria for exploration, the number of negative laparotomy was only 9% and there was no missed intra-abdominal organ injury. In conclusion, repeated meticulous clinical examination and local wound exploration seem to be reiliable in selecting patients with potentially penetrating abdominal stab wounds for exploratory laparotomy.