• Molecules and Cells
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• 제41권6호
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• pp.515-522
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• 2018

Patients with head and neck cancer are treated with therapeutic irradiation, which can result in irreversible salivary gland dysfunction. Because there is no complete cure for such patients, stem cell therapy is an emerging alternative for functional restoration of salivary glands. In this study, we investigated in vitro characteristics of primarily isolated epithelial cells from human salivary gland (Epi-SGs) and in vivo formation of acini-like structures by Epi-SGs. Primarily isolated Epi-SGs showed typical epithelial cell-like morphology and expressed E-cadherin but not N-cadherin. Epi-SGs expressed epithelial stem cell (EpiSC) and embryonic stem cell (ESC) markers. During long-term culture, the expression of EpiSC and ESC markers was highly detected and maintained within the core population with small size and low cytoplasmic complexity. The core population expressed cytokeratin 7 and cytokeratin 14, known as duct markers indicating that Epi-SGs might be originated from the duct. When Epi-SGs were transplanted in vivo with Matrigel, acini-like structures were readily formed at 4 days after transplantation and they were maintained at 7 days after transplantation. Taken together, our data suggested that Epi-SGs might contain stem cells which were positive for EpiSC and ESC markers, and Epi-SGs might contribute to the regeneration of acini-like structures in vivo. We expect that Epi-SGs will be useful source for the functional restoration of damaged salivary gland.

• Radiation Oncology Journal
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• 제9권2호
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• pp.221-225
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• 1991

25예의 절제 불가능한 비소세포폐암 환자를 다불할조사 방사선 치료 및 추가 조사 기술로 치료하였다. 전에 수술이나 항암제 치료를 받았거나 늑막삼출 및 심 한 체중 감소(체중의 $10\%$이상)가 있는 환자는 이 연구에서 제외했다. 처음 3주에 걸쳐 27Gy를 15번에 나누어 large field에 조사하였다. 그 후에 large field에 1.8Gy를 준 후 cone down boost field에 1.4Gy를 하루에 두번 주어 총 49.4 Gy를 주었다. 49.4 Gy를 준 후 추가조사 영 역에 하루에 두번 1.8 Gy와 1.4 Gy를 주었다. 총 조사량은 12명의 환자에서는 62.2Gy, 13명의 환자에서는 65.4Gy였다. 추적관찰 기간은 6개월에서 24개월 사이였다. 실질적인 생존율은 6, 12, 18개월에 각각 $88\%,\;62\%,\;38\%$였다. 무병 생존율은 $88\%,\;41\%,\;21\%$였다. 집합적 국소 재발율은 9, 12, 15개월에 각각 $36\%,\;43\%,\;59\%$이었다. 24개월간 추적관찰한 결과 급성 합병증이나 후기 합병증의 증가는 없었다. 더 긴 기간의 추적관찰이 필요하지만, 절제 불가능한 비소세포 폐암의 다분할조사 방사선 치료 및 추가 조사기술의 효과를 판정하는데는 무작위 추출법을 사용하여 prospective 연구를 시행함이 필요하리라 생각된다.

• 생명과학회지
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• 제26권2호
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• pp.212-219
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• 2016

다형성 신경교모세포종은 사람의 원발성 뇌종양 중 가장 흔하면서 악성이 높은 종양의 하나로 수술과 방사선치료, 화학치료 등 집중적 치료에도 불구하고 사망률이 높은 종양이다. 레스베라트롤은 다양한 자연산 물질에 포함되어 있는 폴리페놀의 일종으로 여러 종류의 암세포들에서 항암 작용이 있음이 보고되어 있으나 그 기전은 명확하게 밝혀져 있지 않다. 본 연구에서는 사람의 신경교모세포종 기원 세포인 A172 세포에서 레스베라트롤에 의한 세포 사멸 효과와 그 기전을 확인하고자 하였다. 레스베라트롤은 A172세포에서 활성산소종의 생성을 촉진하였으며 N-acetylcystein 혹은 catalase 등의 항산화제들을 전처치시 레스베라트롤의 세포 사멸 효과가 차단되었다. 레스베라트롤은 ERK와 p38 kinase, JNK 등의 인산화를 촉진하였으며 이들 인산화 효소의 억제제들을 전처치하면 레스베라트롤의 세포 사멸 효과가 차단되었다. Caspase 억제제를 전처치시 레스베라트롤에 의한 caspase-3의 활성화와 세포 사멸이 차단되었으며, N-acetylcystein을 전처치시 레스베라트롤에 의한 ERK의 활성화와 caspase-3의 활성화가 차단되었다. 이들 결과를 종합하면 레스베라트롤은 A172 세포에서 활성산소종의 생성을 촉진하며 이는 ERK와, p38 kinase, JNK 등의 활성화를 통해 caspase-의존성 기전으로 세포사멸을 유도하는 것으로 사료된다.

• 대한두경부종양학회지
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• 제19권1호
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• pp.34-40
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• 2003

Objective: To analyze the treatment-related parameters after the radiotherapy of T1N0 squamous cell carcinoma of the glottic larynx. Materials and Methods: Between October 1989 and August 2000, 54 patients with histologically proven T1N0 squamous cell carcinoma of the glottic larynx who received definitive radiation therapy in Department of Radiation Oncology, Asan Medical Center were analyzed. They were all males with age ranged from 31 to 80 years (median 61 years). 1997 AJCC stages were 31 T1a, 23 T1b. Patients were treated with 4-MV X-rays with a parallel-opposed two-field technique. Ten patients received 66.0-68.4Gy at 1.2Gy per fraction twice daily, 21 patients received 64.8-66.6Gy at 1.8Gy per fraction once daily, and 23 patients received 66.0Gy at 2.0Gy per fraction once daily. Follow-up period was 16-119 months (median 56 months). Results: 5-year overall survival and local control rates for patients with T1 lesions were 87.0% and 88.5%, respectively. 5-year local control with larynx preservation rate was 90.5%. Host and tumor-related prognostic factors including age, stage, anterior commissure involvement and tumor bulk proved not to be significant. Only shorter overall treatment time among treatment-related factors had correlation with imporved local control. Conclusion: Comparable high local control rate with organ preservation was achieved with primary radiation therapy and salvage surgery. Shortening of overall treatment time is related to improved local control rate. To determine the optimal fractionation scheme, randomized trial is mandatory.

• Experimental and Molecular Medicine
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• 제50권12호
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• pp.1.1-1.14
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• 2018

DNA methylation is a regulatory mechanism in epigenetics that is frequently altered during human carcinogenesis. To detect critical methylation events associated with gastric cancer (GC), we compared three DNA methylomes from gastric mucosa (GM), intestinal metaplasia (IM), and gastric tumor (GT) cells that were microscopically dissected from an intestinal-type early gastric cancer (EGC) using methylated DNA binding domain sequencing (MBD-seq) and reduced representation bisulfite sequencing (RRBS) analysis. In this study, we focused on differentially methylated promoters (DMPs) that could be directly associated with gene expression. We detected 2,761 and 677 DMPs between the GT and GM by MBD-seq and RRBS, respectively, and for a total of 3,035 DMPs. Then, 514 (17%) of all DMPs were detected in the IM genome, which is a precancer of GC, supporting that some DMPs might represent an early event in gastric carcinogenesis. A pathway analysis of all DMPs demonstrated that 59 G protein-coupled receptor (GPCR) genes linked to the hypermethylated DMPs were significantly enriched in a neuroactive ligand-receptor interaction pathway. Furthermore, among the 59 GPCRs, six GI hormone receptor genes (NPY1R, PPYR1, PTGDR, PTGER2, PTGER3, and SSTR2) that play an inhibitory role in the secretion of gastrin or gastric acid were selected and validated as potential biomarkers for the diagnosis or prognosis of GC patients in two cohorts. These data suggest that the loss of function of gastrointestinal (GI) hormone receptors by promoter methylation may lead to gastric carcinogenesis because gastrin and gastric acid have been known to play a role in cell differentiation and carcinogenesis in the GI tract.

• Journal of Korean Medical Science
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• 제33권43호
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• pp.277.1-277.10
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• 2018

Background: To examine survival rates and renal function after partial nephrectomy (PN) and radical nephrectomy (RN) in patients with chronic kidney disease (CKD). Methods: We studied 4,332 patients who underwent PN or RN for pathological T1a-T2N0M0 renal cell carcinoma from 1988 to 2014. Patients were divided into two subgroups of CKD stage I-II and stage III. Kidney function, and survival outcomes were compared between groups. Results: We included 1,756 patients with CKD I-II and 276 patients with CKD III in the final pair-matched analysis. Kidney function was significantly better preserved in the PN than in the RN group among all patients. However, the beneficial effect of PN on kidney function gradually disappeared over time in CKD III patients. The 5-year overall survival (OS) rates after PN and RN differed in patients with CKD I-II disease (99.4% vs. 96.5%, respectively, P = 0.015). The 5-year OS rates after surgery were not affected by mode of nephrectomy in CKD III patients (97.8% vs. 93.5%, P = 0.103). The 5-year cancer-specific survival rates did not differ between treatment groups in all CKD stage. Cox hazard analysis showed that the operative method was a significant factor for OS in CKD I-II patients (hazard ratio [HR], 0.320; confidence interval [CI], 0.122-0.840; P = 0.021). However, PN was not beneficial in terms of OS in CKD III patients (HR, 0.395; CI, 0.086-1.172; P = 0.117). Conclusion: PN is associated with a higher OS rate and better kidney function in patients with preoperative CKD stage I and II, but not in those with CKD stage III.

• 생명과학회지
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• 제29권5호
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• pp.530-536
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• 2019

교모세포종은 형질 전환된 신경 교세포로부터 유래한 악성 종양이다. 교모세포종의 치료는 외과적 수술을 포함한 약물 및 방사선 치료를 통해 진행된다. 그러나 이러한 치료 과정이 환자의 예후에 크게 기여하지 못하는 실정이다. 교모세포종 치료의 어려움 중 하나로 뇌종양줄기세포의 존재를 들 수 있다. 주요하게 proneural (PN) 아형과 mesenchymal (MES) 아형으로 나누어지는 뇌종양줄기세포는 교모세포종의 발달, 유지 및 항암 치료 후 재발의 원인이 되는 암세포로 이해되고 있다. 본 연구에서는 PN 아형 뇌종양줄기세포들이 특정 사이토카인에 선택적으로 MES 아형으로 전이가 될 수 있다는 것에 중점을 두고 실험을 진행하였다. PN 아형 뇌종양줄기세포 중 GSC11 세포는 $TNF-{\alpha}$ 사이토카인에 의해, 그리고 GSC23 세포는 $TGF-{\beta}1$ 사이토카인에 노출이 될 때 MES 아형 뇌종양줄기세포의 표지 인자인 CD44의 발현 증가가 관찰되었다. 또한, Ivy Glioblastoma Atlas Project (Ivy GAP) 데이터 베이스를 통해, $TNF-{\alpha}$와 $TGF-{\beta}1$은 종양미세환경을 구성하는 요소 중 각각 괴사 부위와 미세혈관 주위에서 높은 발현을 보임을 확인하였다. 따라서 본 연구 결과는 PN 아형의 뇌종양줄기세포가 특정 종양미세환경에서 조절되는 다양한 종류의 사이토카인 신호에 의해 MES 아형으로의 전이가 결정될 수 있다는 가능성을 시사한다.

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.148-158
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• 2021

Background: Radiotherapy is a common treatment option for lung or esophageal cancer, particularly when surgery is not feasible for patients with poor lung function. However, radiotherapy can affect pulmonary function and thereby induce pneumonitis or pneumonia, which can be fatal in patients with respiratory impairment. The purpose of this study is to evaluate if reductions in pulmonary function after radiotherapy can be minimized through simultaneous pulmonary rehabilitation (PR). Methods: In this matched case control study, we retrospectively analyzed patients who had undergone radiotherapy for thoracic malignant disease between January 2018 and June 2019. We analyzed results from pulmonary function tests and 6-minute walking tests (6MWT) conducted within the six months before and after radiotherapy treatment. Results: In total, results from 144 patients were analyzed, with 11 of the patients receiving PR and radiotherapy simultaneously. Of the 133 patients in the control group, 33 were matched with 11 patients in the PR group. Changes in forced expiratory volume in one second (FEV₁) and FEV₁/forced vital capacity were significantly different between the PR group and the matched control group (240 mL vs. -10 mL, p=0.017 and 5.5% vs. 1.0%, p=0.038, respectively). The median distance of 6MWT in the PR group also increased significantly, from 407.5 m to 493.0 m after radiotherapy (p=0.017). Conclusion: Simultaneous PR improved pulmonary function, particularly in measures of FEV₁, and exercise capacity for patients with lung or esophageal cancer even after radiotherapy treatment. These findings may provide an important base of knowledge for further large population studies with long-term follow-up analysis in the identification of the PR's effects during thoracic radiotherapy.

• 한국엔터테인먼트산업학회논문지
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• 제15권8호
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• pp.389-401
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• 2021

본 연구는 질병관리청이 퇴원한 환자를 대상으로 조사 보고한 퇴원손상심층조사 결과 중 충북지역에 거주하는 퇴원환자의 특성을 파악하여 충청북도 지역 주민의 건강증진계획수립을 위한 기초자료로 제시하고자 시도되었으며 2013년부터 2017년까지 100병상 이상의 병원에서 퇴원한 환자를 대상으로 인구·사회학적 특성, 의료기관이용 특성, 의료이용 특성, 질병 특성을 파악하였다. 2013년부터 2017년까지 입원 후 퇴원한 환자 중 보정 값을 적용하여 산출한 총 환자는 1,656,590명으로 추정되었으며 퇴원율(인구 10만은 21,089명이었고 2016년 전국 평균 퇴원율 13,882명보다 높았다. 이 기간 동안 퇴원율이 증가한 지역은 괴산, 영동, 보은, 옥천, 증평, 음성군으로 주로 농촌지역이었으며, 서울을 포함한 타 지역 병원에서 퇴원한 환자는 서울 지역은 감소하였으나 인천, 경기, 대전, 충남지역은 증가하였다. 충북지역 주민의 악성종양으로 인한 퇴원율은 폐암(기관, 기관지암 포함)이 가장 높았으며, 주 진단별 퇴원율은 호흡기계통 질환이 가장 많았고, 퇴원율이 증가하고 있는 감염, 순환기계통, 소화기계통, 비뇨생식계통, 근골격계통질환의 퇴원율을 낮추기 위한 노력이 필요함을 알 수 있었다.

• Korean Journal of Radiology
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• 제22권2호
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• pp.263-280
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• 2021

Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.