Nationwide Comparison of Surgical and Oncologic Outcomes in Endometrial Cancer Patients Undergoing Robotic, Laparoscopic, and Open Surgery: A Population-Based Cohort Study

어경진,남은지,김상운,신민경,Kim Stella J-H,김정애,김영태 대한암학회 2021 Cancer Research and Treatment Vol.53 No.2

Purpose Population-based comparisons between minimally invasive surgery (MIS) (robotic surgery [RS] and laparoscopic surgery [LS]) and open surgery (OS) for managing endometrial cancer are lacking. This study aimed to compare surgical and oncologic outcomes between endometrial cancer patients who underwent surgical staging via MIS or OS.Materials and MethodsA population-based retrospective cohort study was performed using claims data from the Korean National Health Insurance database from January 2012 to December 2016. All patients who underwent hysterectomy under diagnosis of endometrial cancer were identified. Patients were classified into RS, LS, and OS groups. Operative and oncologic outcomes were compared among the three groups after adjustments for age group, risk group (adjuvant therapy status), modified Charlson comorbidity index, income level, insurance type, and index year using propensity scores obtained via the inverse probability of treatment weighted method.ResultsAfter adjustment, 5,065 patients (RS, n=315; LS, n=3,248; OS, n=1,503) were analyzed. Patient demographics were comparable. Hospital stay, postoperative complications, and cost were more favorable in the RS and LS groups than in the OS group (all p < 0.001). Five-year overall survival was significantly longer in the RS and LS groups than in the OS group (94.8%, 91.9%, and 86.9%, respectively; p < 0.001). Moreover, the survival benefit of RS was shown in the subgroup analysis of low-risk endometrial cancer patients.ConclusionOur study provides further evidence for the RS being a safe surgical alternative to the LS and OS, especially in low-risk endometrial cancer patients, offering surgical and oncologic outcomes equivalent to other surgical approaches.

디지털시대에 나타난 패션의 표현특성에 관한 연구 : 건축의 영향을 받은 패션을 중심으로

어경진,박현신 한국패션디자인학회 2011 한국패션디자인학회지 Vol.11 No.2

본 연구는 현대의 새로운 패러다임인 디지털시대를 중심으로 동시대의 문화 · 사회적 패러다임 속에서 외형적 유사성을 보이고 있는 패션과 건축의 상호유사성을 토대로 건축적 패션을 연구하였다. 이를 위해, 디지털의 특성을 디지털시대의 문화와 디지털 예술을 바탕으로 살펴보았다. 또한 시대별 건축적 패션을 토대로 디지털시대에 나타난 건축적 패션의 출현의 근거를 제시하였고, 건축과 패션의 사례분석을 통해 표현특성을 도출하였다. 따라서 디지털시대에 나타난 패션을 물리적 · 하이 테크놀러지를 통해 움직임을 활용한 패션디자인과 발광형 · 투사형의 빛을 활용한 패션디자인, 컴퓨터와 디지털 기술을 활용한 기능성을 강조한 패션디자인으로 분류하여 분석한 결과, 이동성, 비물질, 표피성, 지능성이라는 표현특성을 도출하였다. 이러한 디지털시대에 나타난 건축적 패션은 디지털의 특성인 이동성, 변형의 용이성, 상호작용성이 다양한 표현특성에 반영되었다. 건축에서는 움직임이 도입되어 고정된 건축 사고에서 벗어난 구조의 변형으로 이동성이 강조되었고, 이는 패션에서도 적용되어 물리적 움직임과 하이 테크놀러지를 통한 패션디자인을 추구하여 이동성과 비물질, 표피성의 특성을 나타냈다. 발광형과 투사형의 건축은 패션에서도 유사하게 나타나며 비물질과 표피성을 강조하였고, 첨단 소재와 테크놀러지를 활용하여 기능성을 강조한 패션디자인은 컴퓨터와 디지털 기술을 통한 지능형 건축과 유사성을 갖고 이동성과 지능성을 추구하였다. 이와 같이, 디지털시대의 건축적 패션은 건축과 패션의 상호유사성을 통해 움직이고 있으며, 디지털 기술의 발달에 따라 새로운 표현 방법의 시도 및 확대 등으로 그 영역을 넓히고 있다.

E-girl과 E-boy 패션 이미지에 나타난 디지털 페르소나

어경진 복식문화학회 2020 服飾文化硏究 Vol.28 No.5

The aim of this study is to select MLMA and Noen Eubanks as representatives of Gen Z’s unique subculture ‘E-girl’ and ‘E-boy’ to analyze fashion images and determine their meaning through the perspective of persona. To conduct this study, a literature review and case studies were combined and fashion images of E-girl and E-boy appearing on social media were analyzed to identify the personas they expressed. A case study of MLMA and Noen Eubanks’ Instagram and TikTok account posts showed that grotesque, kitsch, and gender-related images stand out. The digital personae demonstrated by E-girl and E-boy fashion images were demonstrated to be a strange persona that reject perfect beauty and a playful persona escaping from reality and anxiety. Lastly persona of individual identity was shown to be formed. This study provides a basis for understanding and interpreting Gen Z’s culture and aesthetics that will lead to future trends. Based on this study, I hope that various studies on E-girl and E-boy apparel will be conducted, and that by understanding the importance of E-girl and E-boy culture for Gen Z (which is paying attention to fashion trends), this can be used as a marketing strategy to consider their characteristics, with data used to inform design development.

Comparative Survival Outcome of Robot-Assisted Staging Surgery Using Three Robotic Arms versus Open Surgery for Endometrial Cancer

어경진,이대우,이지현,남은지,김상운,김영태 연세대학교의과대학 2021 Yonsei medical journal Vol.62 No.1

Purpose: There is lack of data on direct comparison of survival outcomes between open surgery and robot-assisted staging surgery(RSS) using three robotic arms for endometrial cancer. The purpose of this study was to compare the overall survival (OS)and disease-free survival (DFS) between open surgery and RSS using three robotic arms for endometrial cancer. Materials and Methods: Consecutive women with endometrial cancer who underwent surgery between May 2006 and May 2018were identified. Robotic procedures were performed using the da Vinci robotic system, and the robotic approach consisted ofthree robotic arms including a camera arm. Propensity score matching, as well as univariate and multivariate Cox regression ofOS and DFS were performed according to clinicopathologic data and surgical method. Results: The study cohort included 423 unselected patients with endometrial cancer, of whom 218 underwent open surgery and205 underwent RSS using three robotic arms. Propensity score-matched cohorts of 146 women in each surgical group showed nosignificant differences in survival: 5-year OS of 91% vs. 92% and DFS of 86% vs. 89% in the open and robotic cohorts, respectively(hazard ratio, 1.02; 95% confidence interval, 0.82–1.67). In the univariate analysis with OS as the endpoint, surgical method, age,stage, type II histology, grade, and lymph node metastasis were independently associated with survival. Surgical stage, grade, andtype II histology were found to be significant independent predictors for OS in the multivariate analysis. Conclusion: RSS using three robotic arms and laparotomy for endometrial carcinoma had comparable survival outcomes.

Comparison of the Prognostic Outcome between High-Grade Ovarian Sertoli-Leydig Cell Tumors (SLCTs) and Low-Grade SLCTs

어경진,박준식,김혜민,이마리아,김영태 연세대학교의과대학 2021 Yonsei medical journal Vol.62 No.4

The purpose of the current study was to compare prognostic outcomes between patients with high-grade ovarian Sertoli-Leydigcell tumors (SLCTs) and those with other low-grade SLCTs. We retrospectively reviewed medical records for 24 patients pathologicallydiagnosed with SLCTs between 2006 to 2019 at two institutions. The patients were grouped according to pathological grade:SLCT was classified as grade 1, well differentiated; grade 2, intermediated differentiated; or grade 3, poorly differentiated (Meyer’sclassification). Statistical analysis was performed to compare survival outcomes according to pathological grade. The median patientage was 42.5 years (range 16–75). Eighteen patients (75%) were International Federation of Gynecology and Obstetrics stageI, and none were diagnosed in stage IV. Nine patients (37.5%) were grade 3, and 15 patients (63.5%) were grades 1–2. When comparingclinical baseline characteristics of the grade 1–2 group with those of the grade 3 group, only serum CA125 level at diagnosiswas significantly higher in the grade 3 group (38.34 vs. 382.29, p=0.002). Five patients experienced recurrence of grade 3 disease,while no recurrence was reported in grade 1–2 disease. Four of the five recurrent patients died. In result, grade 3 ovarian SLCTshowed significantly poorer prognosis than grade 1–2 disease (overall survival, hazard ratio=14.25, 95% confidence interval=1.881–108.0; log-rank p=0.010). Our findings were consistent with the concept that patients with stage I/grade 1–2 tumors have agood prognosis without adjuvant chemotherapy. Since grade 3 ovarian SLCT appears to be relatively more fatal than grade 1 or 2,patients with grade 3 SLCT might require more aggressive surgical intervention and post-treatment surveillance.

모체태아의학 : 자간전증과 저출생 체중아 발생을 예측할 수 있는 표지자로서 임신 1/3 분기의 산모 혈청 내 PIGF와 PAPP-A의 유용성에 대한 전향적 연구

어경진,허진영,한상원,김의혁 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

목적: 자간 전증의 발생은 자궁 태반의 발생 과정에서 영양막 세포의 나선 동맥의 부적절한 침투로 인해 발생된다고 알려져 있다. 이때 Placental growth factor (PlGF)와 pregnancy associated placental protein A (PAPP-A)는 태반의 발달과 성장에 관련이 있고 자간 전증 시 감소가 된다. 본 연구에서는 임신 일삼분기에 PlGF와 PAPP-A를 측정하여 잘 알려진 자간 전증의 위험 인자들과 상관 관계를 알아 보고자 한다. 방법: 국민건강보험 공단 일산 병원에서 산전 관리를 받는 재태연령 11+0 - 13+6 사이에 총 124명의 산모에게서 머리엉덩길이 측정 시 PlGF와PAPP-A를 측정하였다. 모든 값은 해당 주수의 multiples of the median(MoM) 값으로 표현되었다. 결과: PlGF/PAPP-A의 MoM의 평균 값은 초산모와 경산모에서 각각 0.99/1.40 vs. 1.03/1.16, 정상 나이 산모와 고령산모에서 1.03/1.46 vs.0.96/1.05, 정상 체중 산모와 과 체중 산모에서 1.03/1.32 vs. 0.92/1.30 로 자간 전증의 위험 인자를 포함한 경우 더 낮은 값을 보였다. 분만한 49명의 산모를 분석해 보면 자간 전증의 산모의 PlGF/PAPP-A의 값은 정상 혈압 산모보다 낮았다 (0.92 ± 0.28 vs. 0.85 ± 0.12, p=0.8, 1.19 ± 0.73 vs. 0.60± 0.28, p=0.2 ). 저출생 체중아의 경우에도 정상 체중아인 경우 보다 통계학적으로 의미있게 낮았다(0.89 ± 0.28 vs. 0.85 ± 0.33, p=0.7, 1.23 ± 0.75 vs. 0.73 ± 0.19, p=0.02 ). 결론: 임신 초반기의 산모에서의 PlGF와 PAPP-A의 측정은 임신성 고혈압의 예측 및 저출생 체중아의 예측에 도움이 될 수 있다.

패션 아이콘 Billie Eilish를 통해 본 Gen Z의 특성

어경진 한국복식학회 2022 服飾 Vol.72 No.1

This study provides a basis for interpreting the aesthetic and attitudes of fashion icon Billy Eilish, there by understanding the characteristics of Gen Z. The characteristics of Gen Z as modeled by Billy Eilish are as follows: First, the ‘undefined ID’ characteristic doesn't define oneself as a stereotype. Billie Eilis prefers oversized fashion style that doesn't reveal either side's sexual code, and is creating physical discourses such as ‘gender fluid’ and ‘body positivity’. Second, ‘expression of identity’ is one of individuality. Gen Z has a strong desire to reveal its own personality. Likewise, Billie Eilish pursues bootleg or luxury brand fashion that boldly reveals a logo, symbolizing to differentiate itself from others. Third, ‘ethical & environmental consistent’ is explained as social activism, in which Gen Z considers its own beliefs and pursues improvement in society. Billie Eilish shows direct participation while aiming to improve society. Fourth, Gen Z, who has grown up in a digital environment, is used to conveying emotions through visual contents. Billie Eilish expresses her neon color fashion style and herself as a character in animation, breaking down the boundaries between reality and digital space. This study helps brand marketing strategies and contributes to follow-up studies in that Gen Z's fashion icons were presented from various perspectives.

Comparison of Clinical Outcomes of BRCA1/2 Pathologic Mutation, Variants of Unknown Significance, or Wild Type Epithelial Ovarian Cancer Patients

어경진,박형석,박지수,이승태,한정우,이정윤,김상운,김성훈,김영태,남은지 대한암학회 2017 Cancer Research and Treatment Vol.49 No.2

Purpose The purpose of this study was to investigate the clinical features of epithelial ovarian cancer (EOC) patients according to BRCA1/2 mutation status (mutation, variant of uncertain significance [VUS], or wild type). Materials and Methods We analyzed 116 patients whose BRCA1/2 genetic test results were available for mutation type and clinical features, including progression-free survival (PFS), overall survival (OS), and response rate. These characteristics were compared according to BRCA1/2 mutation status. Results Thirty-seven (37/116, 31.9%) BRCA1/2mutations were identified (BRCA1, 30; BRCA2, 7). Mutation of c.3627_3628insA (p.Leu1209_Glu1210?fs) in BRCA1 was observed in five patients (5/37, 13.5%). Twenty-five patients had BRCA1/2 VUSs (25/116, 21.6%). Personal histories of breast cancer were observed in 48.6% of patients with BRCA1/2 mutation (18/37), 16.0% of patients with BRCA1/2 VUS (4/25), and 7.4% of patients with BRCA wild type (4/54) (p < 0.001). Patients with BRCA1/2 mutation showed longer OS than those with BRCA1/2 wild type (p=0.005). No significant differences were detected in PFS, OS, or response rates between patients with BRCA1/2 VUS and BRCA1/2 mutation (p=0.772, p=0.459, and p=0.898, respectively). Conclusion Patients with BRCA1/2mutation had longer OS than those with BRCA1/2wild type. Patients with BRCA1/2 mutation and BRCA1/2 VUS displayed similar prognoses.

Long-Term Survival Analysis of Intraperitoneal versus Intravenous Chemotherapy for Primary Ovarian Cancer and Comparison between Carboplatin- and Cisplatin-based Intraperitoneal Chemotherapy

어경진,이정윤,남은지,김성훈,김영태,김상운 대한의학회 2017 Journal of Korean medical science Vol.32 No.12

In epithelial ovarian cancer (EOC), intraperitoneal (IP) administration of chemotherapy is an effective first-line treatment and may improve outcomes, compared with intravenous (IV) chemotherapy. We used Kaplan-Meier survival analysis to compare long-term survival between propensity score-matched patients with advanced EOC receiving IP (n = 34) vs. IV (n = 68) chemotherapy. Additionally, clinical features associated with carboplatin-based (n = 21) and cisplatin-based (n = 16) IP chemotherapy were analyzed and compared with those associated with IV chemotherapy. The IP and IV chemotherapy groups had a median follow-up duration of 67 (range, 3–131) and 62 (range, 0–126) months, respectively, with no significant difference in progression-free survival (PFS) (P = 0.735) and overall survival (OS) (P = 0.776). A significantly higher proportion of patients in the IV (91.2%) than in the IP (67.6%) chemotherapy group (P = 0.004) received ≥ 6 cycles. However, the frequency of toxic events (anemia, granulocytopenia, nausea/vomiting, abdominal pain, hepatotoxicity, neuromuscular effects) was significantly higher in the IP than in the IV group. Within the IP group, no significant differences were observed in PFS (P = 0.533) and OS (P = 0.210) between the cisplatin-based and carboplatin-based chemotherapy subgroups. The 10-year OS was 28.6% and 49.2% in carboplatin-based and cisplatin-based IP chemotherapy groups, respectively. Toxic events (granulocytopenia, leukopenia, nausea/vomiting, abdominal pain, hepatotoxicity, neuromuscular effects) were significantly more common in the cisplatin-based subgroup. In patients with EOC, cisplatin-based IP chemotherapy may be an acceptable alternative to IV chemotherapy regarding long-term survival, but toxicity must be addressed.

OB-14 : A Prospective Study on the maternal serum PlGF and PAPP-A identified at the first trimester as parameters of subsequently developed pre-eclampsia and SGA

어경진,김의혁 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

목적: The purpose of this study is to examine whether first-trimester maternal serum PlGF & PAPP-A levels can be used as predictive value of subsequently developed pre-eclampsia or growth complication. 방법: We designed a prospective observational study, in which the concentration of placental growth factor (PlGF) & Pregnancy Associated Plasma Protein?A (PAPP-A ) at 11+0 ? 13+6 weeks were measured in 175 cases. The relation between these measurements and maternal characteristics that are known as risk factors of pre-eclampsia, and the final presence of small for gestational age (SGA) were analyzed. 결과: Among 175 pregnant women, total of 145 women delivered. The level of PlGF & PAPP-A and development of SGA were shown to be negatively correlated with the statistical significance (p value: 0.03, 0.03 respectively). Among the known risk factors of pre-eclampsia, mutilparity, advanced maternal age, presence of GDM and smoking were more likely to be related with low level of PlGF or PAPP-A. 결론: Low level of PlGF and PAPP-A could be play a role as the predictive value of SGA and pre-eclampsia.