• Title/Summary/Keyword: 조직병리검사

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An Analysis of Prognostic Factors in the Uterine Cervical Cancer Patients (자궁경부암 환자의 예후인자에 관한 분석)

  • Yang, Dae-Sik;Yoon, Won-Sub;Kim, Tae-Hyun;Kim, Chul-Yong;Choi, Myung-Sun
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.300-308
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    • 2000
  • Purpose :The aim of this study is to analysis of suwival and recurrence rates of the uterine cervical carcinoma patients whom received the radiation therapy respectively. The prognostic factors, such as Papanicolaou (Pap) smear, carcinoembriogenic antigen (CEA) and squamous cell carcinoma (SCC) antigen has been studied. Methods and Materials : From January 1981 to December 1998, eight-hundred twenty-seven uterine carvical cancer patients were treat with radiation therapy. All of the patients were divided into two groups : the radiation therapy only (S2l patients) group and the postoperative radiation therapy (326 patients) group. The age, treatment modality, clinical stage, histopathology, recurrence, follow-up Pap smears, CEA and SCC antigen were used as parameters for the evaluation. The prognostic factors such as survival and recurrence rates were peformed with the Kaplan-Meier method and the Cox hazard model, respectively. Median rollow-up was 38.6 months. Results :On the radiation therapy only group, 314 patients (60$\%$) achieved complete response (CR), 47 patients (9$\%$) showed local recurrence (LR), 78 patients (15$\%$) developed distant metastasis (DM). On the Postoperative radiation therapy group, showed 276 Patients (85$\%$) CR, 8 Patients (2$\%$) LR, 37 Patients (11$\%$) DM. The 5-year survival and recurrence rates was evaluated for all parameters. The statistically significant factors for the survival rate in univariate analysis were clinical stage (p=0.0001), treatment modality (p=0.0010), recurrence (p=0.0001), Pap smear (p=0.0329), CEA (p=0.0001) and SCC antigen (p=0.0001). Conclusion: This study indicated that after treatment, the follow-up studies of Pap smear, CEA and SCC antigen were significant parameter and prediction factors for the survival and recurrence of the uterine cervical carcinoma.

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Epidemic acute interstitial pneumonia in children occurred during the early 2006s (2006년 초에 유행한 소아 급성 간질성폐렴)

  • Cheon, Chong Kun;Jin, Hyun-Seung;Kang, Eun Kyeong;Kim, Hyo Bin;Kim, Byoung-Joo;Yu, Jinho;Park, Seong Jong;Hong, Soo-Jong;Park, June Dong
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.383-390
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    • 2008
  • Purpose : This study was aimed to analyze the clinical characteristics of patients with acute interstitial pneumonia who had presented similar clinical patterns from March to June, 2006 and to describe our experience of treatment and to identify risk factors associated with prognosis. Methods : The clinical characteristics, radiologic and histopathologic findings and response to steroids of 15 patients (non-survival group [n=7] and survival group [control, n=8]) with acute interstitial pneumonia were investigated through the review of medical records. Results : The mean age of the patients was 26 (range: 3-48) months. Cough, cyanosis and fever were frequent symptoms. The most frequent radiologic findings on admission were pneumomediastium and extensive ground glass opacity. Surgical lung biopsy was performed on 8/15 (53.3%) patients and diffuse alveolar damage was found. Mechanical ventilation was applied for 9/15 (60.0%) patients for 40 (range: 1-99) days. Five patients in survival group received steroid treatment and 7 patients in non-survivial group (P=0.20). One patient in survival group received steroid pulse treatment and 4 patients in non-survival group (P=0.12). Seven patients died all of respiratory failure. The survival rate was 53.4%. Conclusion : The patients with acute interstitial pneumonia which occurred on spring 2006 showed high mortality because of rapidly and extensively progressing pulmonary fibrosis and air leakage. Therefore, we should consider surgical lung biopsy and steroid application earlier. We should recognize this acute interstitial pneumonia occurring on spring in domestics and need to investigate the cause and treatment in large scale.

Epizootiology of Perkinsus sp. Found in the Manila Clam, Ruditapes philippinarum in Komsoe Bay, Korea (곰소만에 있어 바지락포자충, Perkinsus sp.의 출현에 관하여)

  • PARK Kyung-Il;CHOI Kwang-Sik;CHOI Jin-Woo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.32 no.3
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    • pp.303-309
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    • 1999
  • Mass mortality of the Manila clam, Ruditapes philippinarum has been reported all along the west and south coast of Korea for the past several years. As a pathogenic agent, Perkinsus sp., an endoparasitic protozoan has been identified in this study and believed to be responsible for the mass mortalities. Prevalence and infection intensity of Perkinsus sp. was investigated from a Manila clam population inhabiting at Komsoe Bay in the west coast where mass mortality of the clam has been reported. A total of 142 Manila clam, 50 oyster, Crassostrea gigas, 10 ark shell, Scapharca broughtonii, and 5 predatory gastropada, Rapana venosa were examined for the presence and the quantity of Perkinsus sp. Ray's fluid thioglycollate medium method (FTM method) with modified Mackin's infection intensity scale and Choi's quantitative method were used in detecting and quantifying the parasite. All individuals of R. philippinarum examined in this study were infected with Perkinsus sp., indicating $100\%$ prevalence while none of the oysters and the gastropods exhibited the parasite. Six to ten individual hypnospores of Perkinsus sp. were counted from the ark shells. The number of hypnospores in the clam tissues varied from 16,667 to 4,091,667, with a mean number of 1,077,628. Average infection intensity according to Mackin's was 2.87, indicating a moderate infection. A negative correlation was observed between the number of Perkinsus sp. in the tissue and the condition index, a ratio tissue wet weight to shell cavity volume. The clam size and the infection intensity in terms of total number of parasites were positively correlated; the bigger clam, the heavier infection. Such high number of Perkinsus sp. counted in the clams could be enough to cause physiological disturbance of clams, such as retarded growth and reproduction. It is also believed that such a high infection leads mortality of the clam via continuous draining of the energy by metabolic activities and reproduction of the parasites. Correlation between the condition index and the infection intensity observed in this study supports this hypothesis.

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The Outcome of Glioblastoma Patients Treated with Surgery and Radiation Therapy (두개 내 다형성아교모세포종 환자의 방사선치료 결과)

  • Nam Hee Rim;Lim Do Hoon;Ahn Yong Chan;Lee Jung I1;Nam Do-Hyun;Kim Jong Hyun;Hong Seung-Chyul;Lee Jeong Eun;Kang Min Kyu;Park Young Je;Kim Kyung Ju;Park Won;Huh Seung Jae
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.91-97
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    • 2004
  • Propose: To Analyze the survival outcomes and prognostic factors In glioblastoma patients treated with surgery and radiation therapy. Materials and Methods : One hundred twenty glloblastoma patients treated with postoperative radiation therapy from 1994 to 2003 at Samsung Medical Center were retrospectively reviewed. Surgical extents were gross total resection in 22 patients (18$\%$), subtotal resection in 69 (58$\%$), and biopsy only in 29 (24$\%$). The median radiation dose was 50 Gy, ranging from 45 Gy to 72 Gy The median follow-up period was 12 months ranging from 2 to 52 months. Results The overall 1- and 2-year survival rates were 52$\%$ and 14$\%$, respectively, and the median survival duration was 13 months. Favorable prognostic factors by Uunivarlate analyses of prognostic factors on 1-year survival rate were revealed that age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.03), single lesion (p=0.02), and gross total resection (p=0.04), were the favorable prognostic (actors. and by Mmultlvarlate analyses were revealed that female (p<0.01), age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.05) and gross total resection (p=0.05) were the favorable prognostic factors. Conclusions : The results of our study were comparable with those previously reported. To Improve treatment outcome, various modifications, Including radiation dose escalation through newer radiation therapy techniques and use of effective chemotherapy regimen, should be further Investigated. Investigated. Also Furthermore, the application of Individualized treatment strategy based on 4he patient's prognostic factors might be needed.

Calcium Bioavailability and Antiosteoporotic Effects of Cheonggukjang Containing High Poly-Gamma Glutamate Contents (고함량 폴리감마글루탐산(PGA) 청국장에 대한 칼슘 생체이용률 및 골다공증에 미치는 영향)

  • Lee, Mu-Jin;Jung, Ho-Kyung;Sim, Mi-Ok;Jang, Ji-Hun;Kim, Tae-Mook;Lee, Hyun-Joo;Lee, Ki-Ho;An, Byeong-Kwan;Cho, Jung-Hee;Jang, Min-Cheol;Yong, Ju-Hyun;Kim, Jong-Choon;Cho, Hyun-Woo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.11
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    • pp.1544-1551
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    • 2016
  • Various types of fermented soybean foods are consumed in various Asian countries, including China, Indonesia, Japan, Korea, and Vietnam. Cheonggukjang is a Korean whole soybean paste fermented by Bacillus subtilis and regarded as a healthy food. The objective of this study was to investigate the Ca-bioavailability and anti-osteoporotic effects of cheonggukjang (CGJ) containing high poly-gamma glutamate (PGA) contents in an animal model. Blood samples were collected from the jugular vein at 0, 0.5, 1, 2, 3, 4, and 5 h after a single oral dose in male rats. Ca-bioavailability in CGJ containing high PGA contents was approximately 3~5 times higher than that of natural CGJ. Female rats were either sham-operated (sham; n=5) or surgically ovariectomized (OVX; five animals per group) and then administered to OVX control, raloxifene hydrochloride (RLX) 1 mg/kg/d, or CGJ containing high contents of PGA (20 and 200 mg/kg/d) for 12 weeks. Serum osteocalcin concentration was significantly lower in the CGJ 200 mg/kg/d group compared with the OVX control group. Serum progesterone concentration was significantly higher in the CGJ 200 mg/kg/d group compared with the OVX control group. Reduction grade of the trabecular bone decreased in the RLX 1 and CGJ 200 mg/kg/d group compared with that of the OVX control group. In conclusion, CGJ 200 mg/kg/d may have inhibitory effects on osteoporosis in OVX rats, and Ca-bioavailability was improved in CGJ containing high PGA contents.

Role of Postoperative Conventional Radiation Therapy in the Management of Supratentorial Malignant Glioma - with respect to survival outcome and prognostic factors - (천막상부 악성 신경교종에서 수술 후 방사선 치료의 역할 - 생존율과 예후인자 분석 -)

  • Nam Taek Keun;Chung Woong Ki;Ahn Sung Ja;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.389-398
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    • 1998
  • Purpose : To evaluate the role of conventional postoperative adjuvant radiotherapy in the management of supratentorial malignant glioma and to determine favorable prognostic factors affecting survival. Materials and Methods : From Sep. 1985 to Mar. 1997, the number of eligible patients who received postoperative radiotherapy completely was 69. They ranged in age from 7 to 66 years (median, 47). Forty-two (61$\%$) patients were glioblastoma multiforme and the other 27 (39$\%$) were anaplastic astrocytoma. Twenty patients (29$\%$) had Karnofsky score equal or more than 80 preoperatively. Forty-three patients (62$\%$) had symptom duration equal or less than 3 months. Twenty-four patients (35$\%$) had gross total resection and forty patients(58$\%$) had partial resection, the remaining five patients (7$\%$) had biopsy only. Radiotherapy dose ranged from 50.4 Gy to 61.2 Gy (median, 55.8; mode, 59.4) with fraction size of 1 8 Gy-2.0 Gy for 33-83 days(median, 48) except three patients delivered 33, 36, 39 Gr, respectively with fraction size of 3.0 Gy due to poor postoperative performance status. Follow-up rate was 93$\%$ and median follow-up period was 14 months. Results : Overall survival rate at 2 and 3 years and median survival were 38$\%$, 20$\%$, and 16 months for entire patients; 67$\%$, 44$\%$, and 34 months for anaplastic astrocytoma; 18$\%$, 4$\%$, and 14 months for glioblastoma multiforme, respectively (p=0.0001). According to the extent of surgery, 3-year overall survival for gross total resection, partial resection, and biopsy only was 38$\%$, 11$\%$, and 0$\%$, respectively (p=0.02) The 3-year overall survival rates for patients age 40>, 40-59, and 60< were 52$\%$, 8$\%$, and 0$\%$, respectively (p=0.0007). For the variate of performance score 80< vs 80>, the 3-year survival rates were 53$\%$ and 9$\%$, respectively (p=0.008). On multivariate analysis including covariates of three surgical and age subgroups as above, pathology, extent of surgery and age were significant prognostic factors affecting overall survival. On another multivariate analysis with covariates of two surgical (total resection vs others) and two a9e (50> vs 50<) subgroups, then, pathology, extent of surgery and performance status were significant factors instead of age and 3-year cumulative survival rate for the five patients with these three favorable factors was 100$\%$ without serious sequela. Conclusion : We confirmed the role of postoperative conventional radiotherapy in the management of supratentorial malignant glioma by improving survival as compared with historical data of surgery only. Patients with anaplastic astrocytoma, good performance score, gross total resection and/or young age survived longest. Maximum surgical resection with acceptable preservation of neurologic function should be attempted in glioblastoma patients, especially in younger patients. But the survival of most globlastoma patients without favorable factors is still poor, so other active adjuvant treatment modalities should be tried or added rather than conventional radiation treatment alone in this subgroup.

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Short-Term Efficacy of Steroid and Immunosuppressive Drugs in Patients with Idiopathic Pulmonary Fibrosis and Pre-treatment Factors Associated with Favorable Response (특발성폐섬유화증에서 스테로이드와 면역억제제의 단기 치료효과 및 치료반응 예측인자)

  • Kang, Kyeong-Woo;Park, Sang-Joon;Koh, Young-Min;Lee, Sang-Pyo;Suh, Gee-Young;Chung, Man-Pyo;Han, Jung-Ho;Kim, Ho-Joong;Kwon, O-Jung;Lee, Kyung-Soo;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.685-696
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    • 1999
  • Background : Idiopathic pulmonary fibrosis (IPF) is a diffuse inflammatory and fibrosing process that occurs within the interstitium and alveolus of the lung with invariably poor prognosis. The major problem in management of IPF results from the variable rate of disease progression and the difficulties in predicting the response to therapy. The purpose of this retrospective study was to evaluate the short-term efficacy of steroid and immunosuppressive therapy for IPF and to identify the pre-treatment determinants of favorable response. Method : Twenty patients of IPF were included. Diagnosis of IPF was proven by thoracoscopic lung biopsy and they were presumed to have active progressive disease. The baseline evaluation in these patients included clinical history, pulmonary function test, bronchoalveolar lavage (BAL), and chest high resolution computed tomography (HRCT). Fourteen patients received oral prednisolone treatment with initial dose of 1mg/kg/day for 8 to 12 weeks and then tapering to low-dose prednisolone (0.25mg/kg/day). Six patients who previously had experienced significant side effects to steroid received 2mg/kg/day of oral cyclophosphamide with or without low-dose prednisolone. Follow-up evaluation was performed after 6 months of therapy. If patients met more than one of followings, they were considered to be responders : (1) improvement of more than one grade in dyspnea index, (2) improvement in FVC or TLC more than 10% or improvement in DLco more than 20% (3) decreased extent of disease in chest HRCT findings. Result : One patient died of extrapulmonary cause after 3 month of therapy, and another patient gave up any further medical therapy due to side effect of steroid. Eventually medical records of 18 patients were analyzed. Nine of 18 patients were classified into responders and the other nine patients into nonresponders. The histopathologic diagnosis of the responders were all nonspecific interstitial pneumonia (NSIP) and that of nonresponders were all usual interstitial pneumonia (UIP) (p<0.001). The other significant differences between the two groups were female predominance (p<0.01), smoking history (p<0.001), severe grade of dyspnea (p<0.05), lymphocytosis in BAL fluid ($23.8{\pm}16.3%$ vs $7.8{\pm}3.6%$, p<0.05), and less honeycombing in chest HRCT findings (0% vs $9.2{\pm}2.3%$, p<0.001). Conclusion : Our results suggest that patients with histopathologic diagnosis of NSIP or lymphocytosis in BAL fluid are more likely to respond to steroid or immunosuppressive therapy. Clinical results in large numbers of IPF patients will be required to identify the independent variables.

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The National Survey of Open Lung Biopsy and Thoracoscopic Lung Biopsy in Korea (개흉 및 흉강경항폐생검의 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.5-19
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    • 1998
  • Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.

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Recurrent ossifying and cemento-ossifying fibroma of the jaws;report of 2 cases (재발된 골섬유종과 백악질골섬유종)

  • Ryu, Sun-Youl;Oh, Hee-Kyun;Kim, Geon-Jung;Yun, Young-Su;Choi, Hong-Ran
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.297-308
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    • 1989
  • These are two case reports of recurrent ossifying and cemento-ossifying fibroma in a year or 5 months following conservative treatment. Ossifying fibroma or cemento-ossifying is a relatively uncommon benign fibro-osseous tumor of the jaws, and is generally believed to originate from periodontal ligaments. In recent, it is not demanded more differentiation of ossifying, cementifying and cemento-ossifying fibroma due to the thought that these lesions represent a spectrum of the same disease process rather than separate entities. The tumor commonly presents as an asymptomatic mass lesion and is usually well-circumscribed clinically so that conservative surgical excision has been the treatment of choice, but on occasion extended surgical procedures may become necessary, especially for those tumors which demonstrate rapid expansions and are poorly encapsulated (either initially or when recurrent) and when tumor growth is progressed aggressively or recurrent. En-bloc resection of mandible with iliac bone and inferior alveolar nerve graft was performed in case 1, recurrent cemento-ossifying fibroma of 32-year old male patient, and extended surgical enucleation of mass including normal marginal bone was done in case 2, recurrent ossifying fibroma of 72-year old female patient. By follow-up check of the patients, we obtained good result without any sings of recurrence.

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A study on association of progesterone receptor gene polymorphism (PROGINS) with Endometriosis (자궁내막증과 progesterone receptor gene polymorphism (PROGINS)과의 연관성에 관한 연구)

  • Kim, Yun-Jin;Noh, Ji-Hyun;Koh, Jae-Whoan;Kim, Yong-Bong
    • Journal of Genetic Medicine
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    • v.4 no.2
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    • pp.128-132
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    • 2007
  • Purpose : Endometriosis is a steroid dependent disease with a particular genetic background but the location of possible genomic aberrations are still poorly clarified. This study was designed to investigate the associations between the polymorphism of the progesterone receptor gene (PROGINS) and endometriosis. Methods : 100 women with surgically diagnosed and histologically confirmed endometriosis were enrolled as a patient population and a total of 110 female control subjects undergoing health examination were enrolled as control population. DNA extraction and polymerase chain reaction (PCR) were used to genotype women for the presence of the PROGINS polymorphism in peripheral blood samples. The x2-test was used to compare genotype distributions between endometriosis and controls. Results : T1/T2 heterozygote was found to be one patient in each group, and the rest of the subjects were all T1/T1 homozygotes. There was no difference in the genotype distribution between the endometriosis group and the control group. Conclusion : These results suggest that the progesterone receptor gene PROGINS is not associated with the risk for endometriosis.

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