• 제목/요약/키워드: Gynecology department

검색결과 2,575건 처리시간 0.037초

Prognostic Evaluation of Tumor-Stroma Ratio in Patients with Early Stage Cervical Adenocarcinoma Treated by Surgery

  • Pongsuvareeyakul, Tip;Khunamornpong, Surapan;Settakorn, Jongkolnee;Sukpan, Kornkanok;Suprasert, Prapaporn;Intaraphet, Suthida;Siriaunkgul, Sumalee
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4363-4368
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    • 2015
  • Background: The tumor-stroma ratio (TSR) represents the percentage of neoplastic cell components compared to the combined area of neoplastic cells and the surrounding tumor-induced stroma. A low TSR (predomination of stromal component) has been demonstrated to be an independent adverse prognostic factor in cancers of several organs. In cervical carcinoma patients, TSR has been evaluated in only one previous study with different histological types. The present study aimed to assess the prognostic value of TSR in early stage cervical cancer patients with adenocarcinoma histology only. Materials and Methods: Histological slides of patients with early stage (IB-IIA) cervical adenocarcinoma who underwent surgical treatment between January 2003 and December 2011 were reviewed. Patients who had received preoperative chemotherapy were excluded. TSR was categorized as low (<50%) and high (${\geq}50%$). Correlations between TSR and clinicopathological variables were evaluated. Prognostic values of TSR and other variables were estimated using Cox's regression. Results: Of 131 patients; 38 (29.0%) had low TSR and 93 (71.0%) had high TSR. The patients with low TSR had significantly higher proportions of deep cervical stromal invasion (outer third of wall, p=0.011; residual stroma less than 3 mm, p=0.008) and parametrial involvement (p=0.026). Compared to the patients with high TSR, those with low TSR tended to have lower 5-year disease-free survival rate (83.8% versus 88.9%) and overall survival rate (85.6% versus 90.3%), although the differences were not statistically significant. Low TSR was significantly associated with decreased overall survival in univariate analysis (HR 2.7; 95% CI 1.0-7.0; p=0.041), but not in multivariate analysis. TSR was not significantly associated with decreased disease-free survival. Conclusions: Low TSR is associated with decreased overall survival in patients with early stage cervical adenocarcinoma treated by surgery. However, it was not found to be an independent prognostic predictor in this study.

Prognostic Value of Pathological Characteristics of Invasive Margins in Early-stage Squamous Cell Carcinomas of the Uterine Cervix

  • Khunamornpong, Surapan;Settakorn, Jongkolnee;Sukpan, Kornkanok;Suprasert, Prapaporn;Lekawanvijit, Suree;Siriaunkgul, Sumalee
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5165-5169
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    • 2013
  • Background: To evaluate the pathological characteristics of invasive margins in early-stage cervical squamous cell carcinomas and their association with other clinicopathological features including clinical outcomes. Materials and Methods: Patients with FIGO stage IB-IIA cervical squamous cell carcinomas who received surgical treatment and had available follow-up information were identified. Their histological slides were reviewed for prognostic variables including tumor size, grade, extent of invasion, lymphovascular invasion, involvement of vaginal margin or parametrium, and lymph node metastasis. The characteristics of invasive margins including invasive pattern (closed, finger-like, or spray-like type), degree of stromal desmoplasia, and degree of peritumoral inflammatory reaction were evaluated along the entire invasive fronts of tumours. Associations between the characteristics of invasive margins and other clinicopathological variables and disease-free survival were assessed. Results: A total of 190 patients were included in the study with a median follow-up duration of 73 months. Tumour recurrence was observed in 18 patients (9%). Spray-like invasive pattern was significantly more associated as compared with closed or finger-like invasive pattern (p=0.005), whereas the degree of stromal desmoplasia or peritumoral inflammatory reaction was not. Low degree of peritumoral inflammatory reaction appeared linked with lymph node metastasis (p=0.021). In multivariate analysis, a spray-like invasive pattern was independently associated with marked stromal desmoplasia (p=0.013), whilst marked desmoplasia was also independently associated with low inflammatory reactions (p=0.009). Furthermore, low inflammatory reactions were independently associated with positive margins (p=0.022) and lymphovascular invasion (p=0.034). The patients with spray-like invasive pattern had a significantly lower disease-free survival compared with those with closed or finger-like pattern (p=0.004). Conclusions: There is a complex interaction between cancer tissue at the invasive margin and changes in surrounding stroma. A spray-like invasive pattern has a prognostic value in patients with early-stage cervical squamous cell carcinoma.

구안와사와 7구역진단기의 상관성 연구 - Factor AA 제2구역의 유형을 중심으로 - (A Study on the Correlation between the Bell's Palsy and the 7-Zone-diagnostic System - Evaluated by the Patterns of Zone 2 of Factor AA -)

  • 조이현;이진복;임정균;박가영;육태한;송범용
    • Journal of Acupuncture Research
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    • 제27권2호
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    • pp.1-10
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    • 2010
  • Objectives : The 7-zone-diagnostic system is a diagnostic device to predetermine bodily locations by measuring the energy of body. This study was to investigate the relation between the different patterns of Zone 2 of Factor AA in CP-6000A (VEGA, Germany), 7-zone-diagnostic system and the factors of Bell's Palsy. Methods : This study was carried out with the data from factors of Bell's Palsy(age, sex, period after onset, postauricular pain, season which the disease happen, contributing factor). We made three groups according to the different patterns of Zone 2 of Factor AA in CP-6000A. The Factor AA pattern of Group A is that the red bar graph of zone 2 were lower than the normal range. The Factor AA pattern of Group B was that the red bar graph of zone 2 was the normal range. The Factor AA pattern of Group C was that the red bar graph of zone 2 was higher than the normal range. After collecting the data about factors of Bel's Palsy to correspond with conditions of each group were selected, the data was analyzed statistically. Results : The values of number of patient and period after onset of group A was higher than group B and C. The values of ratio of postauricular pain of group B and C was higher than group A. The season of disease happened of group A is spring and winter, group B is winter and group C is summer and autumn. The contributing factor of disease happened of group A is none, and group B and C is stress and clod. Conclusions : In Bell's Palsy, it is thought that the red bar graph of zone 2 is lower, the group have lower energy(虛) and the energy has a character of cold(寒), and zone 2 is higher, the group has the higher energy(實) and the energy has a character of fire(熱).

국내 뜸 요법 임상 실태 파악을 위한 면접조사 (An in-depth interview for use of moxibustion therapy in Korea)

  • 한창현;신미숙;강경원;강병갑;박선희;최선미
    • Korean Journal of Acupuncture
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    • 제25권1호
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    • pp.85-97
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    • 2008
  • Objectives : Moxibustion therapy is one of the most popular oriental treatments in Korea. In this study, we operate the in-depth interview for use of moxibustion therapy in Korea. Methods : Survey questions were developed based on consensus of acupuncture professors. The list of the Korean medical doctors with experiences more than 10 years is provided by the Association of the Korean Oriental Medicine. The in-depth interview was conducted in 30 Korean medical doctors who answered in the previous telephone survey that they use moxibustion therapy for more than 30 % of patients everyday. Interview survey with them were conducted by the well-trained interviewers of Korea Institute of Oriental Medicine in medical researcher from 22th May to 28th June 2007. Results : Korean medical doctors prefer to use the moxibustion with moxa stick (83.9%). The most common treatment disease was musculo-skeletal disorder (28.9%), gynecology (14.1%), digestive disorder (28.6%). The most common treatment area was the abdomen (35.3%), back (22.5%), lower extremity (15.8%) and upper extremity (16.9%). Indirect moxibustion’s was as frequent as 73.5% of moxibustion method. The most common instrument for treating was mini-moxa of manufactured goods (39.3%). Most Korean medical doctors (48.8%) took up the position that bring symptom relief following good treatment area. 'High preferences of patients' (32.7%) was one of moxibustion strong points but 'Lots of smell and smoke' (54.7%)' was a weak points. The most common side effects was the 'slight burn' (34.9%), 'skin rash' (22.5%), 'skin pruritus' (23.8%) Conclusions : This survey provides unique insight into the perception of the Korea medical doctor at moxibustion therapy. Future research needs to provide more in-depth insight into doctor views of the experience.

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Neuroprotective Effects of Methanol Extract of Sophorae Subprostratae Radix on Glutamate Excitotoxicity in PC12 Cells and Organotypic Hippocampal Slice Cultures

  • Kim, Soo-Man;Shim, Eun-Sheb;Kim, Bum-Hoi;Sohn, Young-Joo;Kim, Sung-Hoon;Jung, Hyuk-Sang;Sohn, Nak-Won
    • 대한한의학회지
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    • 제29권5호
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    • pp.29-40
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    • 2008
  • Objectives : It has been reported that Sophorae Subprostratae Radix (SSR) has a neuroprotective effect on cerebral ischemia in animals. In the present study, the authors investigated the neuroprotective effect of SSR on glutamate excitotoxicity. Glutamate excitotoxicity was induced by using NMDA, AMPA, and KA in PC12 cells and in organotypic hippocampal slice cultures. Methods :Methanolic extract of SSR was added at 0.5, 5, and 50 ${\mu}$g/ml to culture media for 24 hours. The effects of SSR were evaluated by measuring of cell viability, PI-stained neuronal cell death, TUNEL-positive cells, and MAP-2 immunoreactivity. Results : SSR increased PC12 cell viabilities significantly against AMPA-induced excitotoxicity, but not against NMDA-induced or KA-induced excitotoxicity. In organotypic hippocampal slice cultures damaged by NMDA-induced excitotoxicity, SSR attenuated neuronal cell death significantly in the CA1, CA3, and DG hippocampal regions and reduced TUNEL-positive cells significantly in CA1 and DG regions. In organotypic hippocampal slice cultures damaged by AMPA-induced excitotoxicity, SSR attenuated neuronal cell death and reduced TUNEL-positive cell numbers significantly in the CA1 and DG regions. In organotypic hippocampal slice cultures damaged by KA-induced excitotoxicity, SSR attenuated neuronal cell death significantly in CA3, but did not reduce TUNEL-positive cell numbers in CA1, CA3 or DG. In organotypic hippocampal slice cultures damaged by NMDA-induced excitotoxicity, SSR attenuated pyramidal neuron neurite retraction and degeneration in CA1. Conclusions : These results suggest that the neuroprotective effects of SSR are related to antagonistic effects on the NMDA and AMPA receptors of neuronal cells damaged by excitotoxicity and ischemia.

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급성 술후 통증 조절을 위한 경막외차단 2,381예의 임상적 평가 (A Clinical Assessment of Epidural Block for Acute Postoperative Pain Control in 2,381 Cases)

  • 장문석;채병국;이혜원;임혜자;장성호
    • The Korean Journal of Pain
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    • 제8권2호
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    • pp.235-243
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    • 1995
  • A retrospective study was performed to evaluate the effects, and side effects, of epidural analgesia for postoperative pain relief of 2,381 surgical patients who received general-epidural, or epidural anesthesia only. Anesthesia records, patients charts, and pain control records were reviewed and classified according to: age, sex, body weight, department, operation site, epidural puncture site, degree of pain relief by injection mode & epidural injectate, and side effects(including nausea, vomiting, pruritus, urinary retention and respiratory depression). The results were as follows: 1) From the total of 2,381 patients, there were 1,563(66%) female patients; 1.032(43%) patients were from Obstetrics and Gynecology. 2) Lower abdomen, thorax, lower extremity and upper abdomen in the operation site; and lumbar, upper, lower thoracic in puncture site were order of decreasing frequency. Length of epidural injection for pain relief averaged $1.72{\pm}1.02$ days. 3) Ninety three percent of the patients experienced mild or no pain in the postoperative course. Analgesic quality was not affected by the kind of epidural injectate. 4) Nausea occurred in 3.2% of all patients, vomiting in 1.1%, pruritus 0.9%, urinary retention 0.6%, respiratory depression 0.08%. 5) Frequency of nausea was higher with female patients compared to male patients(p<0.05). 6) Pruritus frequency was higher with male patients than female patients(p<0.05); and more frequent with patients who received epidural injection with morphine than patients who received epidural injection without morphine(p<0.01). 7) Urinary retention was higher in female patients, and more frequent with patients who had received epidural injection with morphine than epidural injection without morphine(p<0.05). 8) There were two cases of respiratory depression. The course of treatment consisted of: cessation of epidural infusion, then administration of oxygen and intravenous naloxone. We conclude that postoperative epidural analgesia with a combination of local anesthetics and opiate is and effective method for postoperative pain relief with low incidence of side effects. However, patients should be carefully evaluated as rare but severe complications of respiratory depression may ensue.

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재조합 HCCS-1 아데노바이러스를 이용한 구강암 세포주의 세포사멸 유발 (INDUCTION OF APOPTOSIS IN ORAL CANCER CELL LINE THROUGH AN RECOMBINANT HCCS-1 ADENOVIRUS)

  • 김창현;이동주;이일규;김명진;김진우;표성운
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제31권4호
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    • pp.306-311
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    • 2005
  • Despite advances in surgery, radiotherapy, and chemotherapy, the survival of patients with oral squamous cell carcinoma has not significantly improved over the past several decades. Gene therapy is currently under investigation and shows us new possibility of cancer curing method. This experiment was undergone to find out the cell growth inhibition effect and evidence of apoptosis by HCCS-1(human cervical cancer suppressor-1), one of the candidates of tumor suppressor gene, transducted to human oral cancer cell line. To determine the efficiency of the adenovirus as a gene delivery vector cell line was transducted with LacZ gene and analysed with X-gal staining. Northern blot was performed to confirm the transfection with HSCC-1 gene and cell viability was assessed by cell cytotoxicity assay using cell count kit(CCK). To show the evidence of apoptosis, DNA fragmentation assay and flow cytometry(FACS) were performed. We had successfully construct the recombinant HSCC-1 adenovirus(Ad5CMV-HCCS-1), and importation efficiency was 20% at 2 MOI(multiplicity of infection), 80% at 20 MOI. Northern blot analysis showed that a single 0.6kb mRNA transcript was expressed in Ad5CMV-HCCS-1 transducted cell lines. As a result of CCK, when comparing to control subjects, transducted group showed 50% growth inhibition. In DNA fragmentation assay, according to increasing of MOI, DNA volume was diminished. In FACS analysis, DNA distribution showed fragmentation. This results imply that HCCS-1gene has growth inhibition effect in human oral cancer cell lines through apoptosis induction.

군용 항공기 이륙소음이 청력, 혈압, 스트레스 및 주관적 인지도에 미치는 영향 (The effects of aircraft noise on the hearing loss, blood pressure and response to psychological stress)

  • 한상환;조수헌;고경심;권호장;하미나;주영수;신명희
    • Journal of Preventive Medicine and Public Health
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    • 제30권2호
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    • pp.356-368
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    • 1997
  • In effort to determine whether aircraft noise can have health effects such as hearing loss, hypertension and psychological stress, a total of 111 male professors and administrative officers working a college near a military airport in Korea(exposed group) and a total of 168 males and 112 females matched by age groups(control groups) were analyzed. Personal noise exposure and indoor and outdoor sound level of jet aircraft noise were measured at the exposed are3. And pure tone, air conduction test and measurement of blood pressure were given to the exposed(males) and matched control groups (males and females). BEPSI(Brief Encounter Psychological Instrument) and psychological response to aircraft noise were examined for the exposed group. The noise dosimetry results revealed time-weighted averages(TWAs) that ranged from 61 to 68 dBA. However the levels encountered during taking off jet airplanes reached 126 dBA for two half minutes time period. Th, audiometric, test showed that mean values of HTL(hearing threshold level) in exposed group at every frequency(500, 1,000, 2,000, 4,000, and 8,000 Hz were much lower than them of male and female control groups. And in old age groups, interaction of age and noise was observed at 8,000 Hz in both ears(p<0.05). Conclusively, aircraft noise does not appear to induce hearing loss directly in high frequency, but may decreased hearing threshold level by interaction of aging process and noise exposure. However, difference of mean values of exposed and control groups on blood pressure was not significantly. In psychological test, annoyance was the most severe psychological response to noise in exposed group, but mean value of BEPSI was not correlated with job duration in exposed group.

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외음부 암의 방사선 치료 (Radiation Therapy in Carcinoma of the Vulva A Review of Fifteen Patients)

  • 이형식;오원용;서창옥;김귀언;박찬규
    • Radiation Oncology Journal
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    • 제3권1호
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    • pp.51-58
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    • 1985
  • 외음부에서 발생하는 악성종양은 부인과 영역의 악성종양 중에서는 드물게 발생하는 것으로 알려져 있으며 치료에 있어서도 수술 또는 방사선치료 단독의 경우보다는 수술 후 보조적으로 방사선 치료를 시행하는 것이 더 효과적이고 치료율도 높은 것으로 알려져 있다. 이에 1971년 1월부터 1985년 4월 사이에 연세대학교 의과대학 치료방사선과에서 외음부 악성 종양으로 진단되어 방사선 치료를 받았던 15예에 대하여 후향성 분석을 시행한 바 다음과 같은 결과를 얻었기에 보고하는 바이다. 1. 15예의 외음부 종양 환자 중 4예는 수술요법 시행 후 보조적요법의 방사선 치료를 받았으며, 1예는 수술전 방사선 치료를 받았고, 나머지 10예는 근치적 목적의 방사선 치료를 받았다. 2. 방사선치료만을 시행한 군과 방사선치료 및 수술요법을 병행한 군과의 국소제어율을 비교하여 본 결과, 전 15예의 국소제어율은 $53\%(8/15)$였으며, 단지 방사선 치료만을 시행한 군에서는 $40\%$(4/10), 방사선 치료 및 수술요법을 병행한 군에서는 $80\%(4/5)$의 국소제어율을 보였다. 3. 치료 실패율은(국소적 잔존+국소재발 또는 원격전이) 단지 방사선 치료만을 시행한 군에서는 $70\%(7/10)$, 수술 후 방사선 치료를 시행한 군에서는$40\%(2/5)$의 성적을 보였으며, 치료실패 호발부위는 원발병소(외음부)였다.

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컴퓨터단층 혈관조영술에서 스텐트 사이즈의 정확한 측정을 위한 상대적 측정법의 기초연구 (Fundamental Study of Relative Measurement for Accurate Measurement of Stent Size in Computed Tomography Angiography)

  • 이승영;홍주완;강수미;김수빈;전상훈;허영철
    • 한국방사선학회논문지
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    • 제13권5호
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    • pp.713-720
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    • 2019
  • 본 연구의 목적은 컴퓨터단층 혈관조영술에서 혈관 직경을 정확하게 측정할 수 있는 새로운 측정 방법인 상대적 측정법의 기초연구 자료를 제공하고자 한다. 비이온성 요오드 조영제를 자체 제작한 관류 팬텀에 일정한 속도로 흐르게 한 후 컴퓨터단층 혈관조영술 검사를 시행하였다. 원시 데이터를 얻은 후 다중평면재구성 및 최대강도투사법으로 영상을 재구성하였고 장비 사에서 제공하는 거리측정 장치를 사용하여 팬텀의 직경을 측정하였다. 측정법은 고식적 측정법과 본 연구에서 제안하는 상대적 측정법을 사용하였다. 관류팬텀의 평균 직경은 다중평면재구성기법과 최대강도투사법 모두에서 상대적 측정법이 기존 측정법 보다 실측에 더 가깝게 나타났다(34% VS 24%, p<0.05). 하지만 두 가지 측정법 모두 실측보다 여전히 확대된 결과를 나타내고 있음을 확인하였다. 따라서 상대적 측정 방법에 대한 추가 연구가 필요한 실정이며, 이에 본 연구가 기초 자료를 제공할 수 있을 것이라 사료된다.