• Title/Summary/Keyword: 예후판정

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Study on DNA Content and Ki-67 Antibody Expression by Means of Image Analyzer for the Benign and Malignant Lesions of the Larynx (후두 편평상피의 전암성 및 악성병변에서 화상분석기를 이용한 DNA 배수성검사와 Ki-67 항체 양성세포의 분석에 관한 연구)

  • 주형로;이선희;최종욱;김인선
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.89-89
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    • 1993
  • The laryngeal epithelial cell kinetics of 26 laryngeal lesions(invasive squamous cell carcinoma 14, epithelial hyperplasia 5, laryngeal nodule 7) were studied by immunehistochemical analysis with the monoclonal antibody Ki-67, which reacts with nuclear antigen in proliferating cells using paraffin embedded tissue. For DNA analysis, touch implint with fresh biopsy specimens were stained with feulgen and analyzed by image analyzer in 22 cases. 1) The proportion of Ki-67-positive cells were 32.65$\pm$ 11.59% in invasive squamous cell ca, 20.14$\pm$3.38% in epithelial hyperplasia lesion and 11.66$\pm$3.02% in laryngeal nodule. 2) DNA aneuploidy was found in 7 cases of 10(70%) invasive squamous cell carcinomas, 2 cases of 5(40%) epithelial hyperplasia lesions and all cases of laryngeal 3) Proliferation index(S phase+G2/M phase) show 23.42$\pm$11.33% in squamous cell carcinoma, 13.09$\pm$ 10.90% in epithelial hyperplasia lesion and 4.50$\pm$1.19% in laryngeal nodule. As the results, measuring the DNA content from touch imprint method together positivity of Ki-67 antibody from the microtissue during the laryngeal microscopic surgery, cell kinetics can be assessed as an effort of deciding the prognosis and provide a key to the management of precancerous lesions.

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Positron Emission Tomography with $^{18}F-FDG$ Fluorodeoxyglucose for Primary Lymphoma of Bone (뼈에 발생한 악성 림프종 환자의 치료 효과 판정에서 $^{18}F-FDG$ Positron Emission Tomography의 유용성)

  • Kim, Nam-Don;Park, Yeon-Hee;Ki, Seung-Seog;Park, Yong-Jin;Kim, Heoyng-Joon;Ryoo, Baek-Yeol;Kim, Heung-Tae;Kim, Sung-Eun;Cheon, Gi-Jeong;Choi, Chang-Woon;Lim, Sang-Moo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.5
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    • pp.331-335
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    • 2003
  • Purpose: Accurate assessment of the lesion after treatment of patients with bone lymphoma is difficult. In this patient who demonstrated complete remission after chemotherapy, the regions of fluorine-18 fluorodeoxyglucose $(^{18}FFDG)PET$ uptake diminished more rapidly fellowing therapy, indicating a complete response at much earlier stage than did Magnetic Resonance Imaging (MRI) or CT based findings. With the conventional methods, such as MRI and CT, It was difficult to assess whether the residual tumor tissue was viable or not. Decision to complete response is very important in patients with lymphoma to plan the further treatment. We experienced a patient with primary lymphoma of bone who revealed complete response to chemotherapy on $^{18}FFDGPET$ while CT showed persistent destructive bone lesion. Thus, $^{18}FFDGPET$ study after therapy may be superior to CT in the evaluation of response to treatment in primary lymphoma of bone.

Detection of Lymphomatous Marrow Infiltration using F-18 FDG PET at Initial Staging and after chemotherapy

  • Yun, Mi-Jin;Kim, Young-Jin;Moon, Jin-Wook;Park, Sang-Joon;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.3
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    • pp.171-177
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    • 2003
  • PURPOSE: To asess the ability of FDG PET for the detection of bone marrow infiltration compared to iliac crest biopsy in patients with lymphoma. MATERIALS AND METHODS: Seventy-three patients (30 females and 43 males, mean age of 47 years old) with malignant lymphoma (4 Hodgkin's disease, HD and 69 Non-Hodgkin's lymphoma, NHL) were included. FDG PET was performed for staging in 53 patients and to assess treatment response after the completion of chemotherapy in 20 patients. Final conclusions were based on biopsy, other imaging studies, or clinical follow-up. RESULTS: There were 54 (74%) of the 73 patients in whom FDG PET and iliac crest biopsy were concordant. Forty-seven of the 54 patients showed concordant negative results while the remaining 7 patients had concordant positive results. Of 19 patients with discordant results, FDG PET accurately detected bone marrow infiltration in 6 patients with negative iliac crest biopsy. On the contrary, iliac crest biopsy identified bone marrow infiltration in 12 or the 19 patients. In remaining one of the 19 patients with discordant results, iliac crest biopsy was true negative but FDG PET was falsely positive. CONCLUSION: FDG PET seems to be an adjunct in detecting marrow infiltration that may not be revealed by iliac crest biopsy at staging. For the assessment of treatment roponse, it may be less helpful than biopsy in detecting microscopic residual disease in the bone marrow.

Clinical Features and Management of Multidrug-Resistant Tuberculosis (다제 내성 폐결핵 환자의 임상상 및 치료에 대한 고찰)

  • Lee, Jae-Cheol;Lee, Seung-Jun;Kim, Gye-Soo;Yoo, Chul-Gyu;Cheong, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.14-21
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    • 1996
  • Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

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Combined Small Cell Carcinoma Associated with Microinvasive Squamous Cell Carcinoma of Bronchial Surface Epithelium - A case report - (기관지표면상피의 미세침윤성 편평세포암과 동반된 혼합성 소세포암종 -1례 보고-)

  • 김윤정;심정원
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.1031-1035
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    • 1996
  • International Ass ciation for the Study of Lung Cancer(IASLC) recommended the following classification of small cell lung carcinoma(SCLC) : (1) Small cell carcinoma (2) Mixed small cell/large cell carcinoma (3) Combined small cell carcinoma. Combined small cell carcinomas contain a squamous cell carcinoma or adenocarcinoma component. The prognostic significance of these elements is not known, but since the frequency and extent of non-small cell elements are considerably greater in posttherapy and autopsy tissues, it is possible that the non-SCLC elements are more resistant to therapy than the SCLC cells. Metaplasia & dysplasia of the bronchial surface epithelium are frequently observed in the bronchial biopsy specimens that contain small cell carcinoma of the lung. We report a case of combined small cell carcinoma with squamous element associated with microinvasive squamous cell carcinoma of the bronchial surface epithelium in 68 year old male patient, stage was IIIa. The two lesion are not connected n serial sections.

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Quantitative Method of Rapid Immunochromatographic Assay Kit for HBsAg-screening using Computer Image Analysis (컴퓨터 상 분석을 이용한 HBsAg-screening용 Rapid Immunochromatographic Assay Kit의 정량적 측정법)

  • 신형순;허태련
    • KSBB Journal
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    • v.15 no.3
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    • pp.243-246
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    • 2000
  • One of recent topics in the case of hepatits B virus(HVB) is the value of hepatitis B surface antigen(HBsAg) concentration as a prognostic maker. We developed uantitative method of rapid immunochromatographic assay(ICA) kit for HBsAg using computer image analysis (CIA) for the purpose of home diagnosis. uantitative ICA using CIA demonstrated integrated optical density(IOD) values proportional to log of reference HBsAg concentrations in the range of 2-200 ng/mL and enzyme-linked immunosorbent assay(ELISA) demonstrated the same in the range of 0.1-100 ng/mL however the test results with sample sear showed the same concentration on both kits. Furthermore repeated tests with the same samples revealed that this quantitative ICA using CIA would be reproducible and coefficient of variation(CV) of the results was 1.38~6.30%.

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The Concept and Clinical Application for the Measurement of Heart Rate Variability (심박동수 변이(Heart Rate Variability) 측정법의 개념과 임상적 활용)

  • Woo, Jong-Min
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.3-14
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    • 2004
  • In this article, the effects of stress on central nerve system and heart function and the concept of heart rate variability were reviewed. HRV(Heart Rate Variability), the periodical change of the heart rate, is indicated larger in the healthier because they respond flexibly to various sorts of facts influencing on HR. HRV analysis is largely composed of the time domain analysis and the frequency analysis. In the former the flexibility of heart function is analysed, while in the latter autonomic nerve function is examined, which is the degree of sympathetic and parasympathetic nerve activity and the state of balance. Furthermore, existence or nonexistence of disease and/or level of stress can be estimated by measuring the variability and normality of heart rate, and balance of autonomic nerve system, and through HRV biofeedback the symptoms of anxiety disorder or asthma can be reduced.

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The Utility of $^{18}F$-FDG PET/CT for Following Up Head and Neck Cancer (두경부암 환자의 추적관찰에서 $^{18}F$-FDG PET/CT의 유용성)

  • Chung, Eun-Jae;Baek, Seung-Kuk;Woo, Jeong-Soo;Kwon, Soon-Young;Jung, Kwang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.2
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    • pp.178-182
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    • 2010
  • 서 론 : 두경부암의 예후에 가장 중요한 인자는 진단시 병기와 치료 후 재발의 유무이다. 따라서, 재발 병변을 조기에 발견하는 것이 매우 중요하다. 본 연구에서는 두경부암 환자의 추적 관찰에서 $^{18}F$-FDG PET/CT의 유용성에 대해 알아보고자 하였다. 대상 및 방법 : 2004년 4월부터 2008년 8월까지 고려대 안암병원에서 두경부암으로 치료를 완료한 후 추적관찰이 가능하였던 88 예의 환자를 대상으로 하였다. 환자는 본원의 두경부암 추적관찰 양식에 따라 술 후 6, 12개월째 $^{18}F$-FDG PET/CT를 시행하였으며, 원발부위 및 경부 재발, 원격전이와 중복암의 진단에 있어 $^{18}F$-FDG PET/CT의 민감도, 특이도, 양성예측율, 음성예측율을 평가하였고, 기존의 추적관찰 방법과 이를 비교하였다. 결 과 : 원발부위 재발의 진단에 있어 민감도, 특이도, 양성예측율, 음성예측율은 각각 95%, 97%, 90%, 98% 였다. 경부전이 재발의 진단에 있어서는 각각 94%, 98%, 83%, 99%였으며, 원격전이 및 이차암 진단에 있어서는 94%, 100%, 100%, 99%였다. 원발부위 재발은 고식적인 진단 방법, 원격전이와 이차암은 $^{18}F$-FDG PET/CT가 진단에 의미있게 유리하였다. 결 론 : $^{18}F$-FDG PET/CT는 두경부암의 추적관찰 과정에서 재발 여부를 판정하는데 있어 매우 유용하며, 특히 원격전이 및 이차암의 발견에 있어 유용하다. 그러나, 위양성 및 위음성의 가능성으로 고식적인 진단 방법과 병행해야 진단의 효과를 높힐 것으로 생각된다.

Evaluation of the Prognosis in Esophageal Atresia (선천성 식도 폐쇄증의 예후 판정)

  • Kim, Hyun-Hahk;Jeong, Hyeon-A;Kim, Kyung-Hun;Kim, Jung-Han;Lee, Suk-Koo
    • Advances in pediatric surgery
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    • v.7 no.1
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    • pp.1-6
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    • 2001
  • The aims of this study were to evaluate the prognostic predictabilities of the risk classifications (Waterston, Montreal, and Spitz), preoperative treatment of pneumonia and the length of esophageal gap in esophageal atresia. Twenty-five cases of esophageal atresia were reviewed retrospectively. The data was analyzed with Likelihood ratio test for trend and Fisher's exact test. Survival rates were 100.0 % in group A and B, and 60.0 % in group C according to Waters ton classification (p=0.027). By Montreal classification, 95.7 % in group I and 50.0 % in group II (p=0.086). By Spitz classification, 95.5 % in group I and 66.7% in group II (p=0.159). The survival rate was 85.7 % in the patients with pneumonia preoperatively treated and 94.4% in the patients without pneumonia. The difference was not significant (p=0.490). Survival rate in the patients with long gap (${\geq}$3cm) was 50.0 % and 100.0 % in patients with short gap (<3cm) with significant difference (p=0.020). The Waterston classification could be modified into two groups because the prognosis of both group A and B were the same. Preoperative pneumonia does not seem to be a risk factor. The length of the esophageal gap showed prognostic value.

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Bursoscopic Finding in Primary Adhesive Capsulitis of the Shoulder (견관절 일차성 유착성 관절낭염 환자의 견봉하 관절경 소견)

  • Nam, Ki-Young;Moon, Young-Lae;Kim, Dong-Hui
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.19-23
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    • 2008
  • Purpose: To evaluate the bursoscopic findings of refractory primary adhesive capsulitis of the shoulder and to determine the clinical correlation. Materials and Methods: Arthroscopic capsular release was performed in 21 refractory adhesive capsulitis patients who had not responded to conservative treatment. The VAS for pain, range of motion, UCLA score was checked before and after surgery, and at the last follow up. Results: Bursitis, mild friction and impingement on coracoacromial ligament, as well as adhesion were observed. The function and pain improved earlier than after simple acromiohumeral joint capsular release. Conclusion: Subacromial bursoscopy helps rule out a hidden secondary frozen shoulder or secondary changes with primary adhesion. In addition, it has the advantage of being both a treatment and procedure for making a prognosis.