• Title/Summary/Keyword: 임상 결과 예측

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Expression of EGFR in Non-small Cell Lung Cancer and its Effects on Survival (비소세포 폐암에서 EGFR의 발현률과 생존률에 미치는 영향)

  • Kim, Hak-Ryul;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1285-1295
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    • 1997
  • Background : EGFR is one of the initial step in signal transduction pathway about multistep carcinogenesis. It is homologous to oncogene erbB-2 and is the receptor for EGF and TGF alpha. EGFR has important role in the growth and differentiation of tumor cells. So, EGFR in non-small cell lung cancer was examined to search for possible evidence as clinical prognostic factor. Methods : To investigate the role of EGFR in lung cancer, the author performed immunohistochemical stain of EGFR on 57 resected primary non-small cell lung cancer specimens. And the author analyzed the correlation between EGFR expression, clinical parameters, Sand $G_1$ phase fraction and survival. Results : 1) EGFR were detected in 56% of total 57 patients (according to histologic type, squamous cancer 50%, adenocarcinoma 63%, large cell cancer 75%) (according to TNM stage, stage I 64%, stage II 38%, stage III 55%) (according to cellular differentiation, well 50%, moderately 52%, poorly 65%). All differences were insignificant 2) Using the flow cytometric analysis, mean S-phase fraction of EGFR (+) and (-) group were 22.3(${\pm}10.5$)%. 18.0(${\pm}10.9$)% (p>0.05), mean $G_1$-phase fraction of EGFR (+) and (-) group were 68.4(${\pm}11.6$)%, 71.1(${\pm}12.8$)%, (p>0.05) 3) Two-year survival rate of EGFR (+) and (-) group were 53%, 84%, median survival time of EGFR (+) and (-) group were 26, 53 months. (p<0.05, Kaplan-Meier, generalized Wilcox) Conclusion : EGFR immunostaining may be a simple and useful method for survival prediction in non-small cell lung cancer.

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A Study on Risk Assessment Method for Earthquake-Induced Landslides (지진에 의한 산사태 위험도 평가방안에 관한 연구)

  • Seo, Junpyo;Eu, Song;Lee, Kihwan;Lee, Changwoo;Woo, Choongshik
    • Journal of the Society of Disaster Information
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    • v.17 no.4
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    • pp.694-709
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    • 2021
  • Purpose: In this study, earthquake-induced landslide risk assessment was conducted to provide basic data for efficient and preemptive damage prevention by selecting the erosion control work before the earthquake and the prediction and restoration priorities of the damaged area after the earthquake. Method: The study analyzed the previous studies abroad to examine the evaluation methodology and to derive the evaluation factors, and examine the utilization of the landslide hazard map currently used in Korea. In addition, the earthquake-induced landslide hazard map was also established on a pilot basis based on the fault zone and epicenter of Pohang using seismic attenuation. Result: The earthquake-induced landslide risk assessment study showed that China ranked 44%, Italy 16%, the U.S. 15%, Japan 10%, and Taiwan 8%. As for the evaluation method, the statistical model was the most common at 59%, and the physical model was found at 23%. The factors frequently used in the statistical model were altitude, distance from the fault, gradient, slope aspect, country rock, and topographic curvature. Since Korea's landslide hazard map reflects topography, geology, and forest floor conditions, it has been shown that it is reasonable to evaluate the risk of earthquake-induced landslides using it. As a result of evaluating the risk of landslides based on the fault zone and epicenter in the Pohang area, the risk grade was changed to reflect the impact of the earthquake. Conclusion: It is effective to use the landslide hazard map to evaluate the risk of earthquake-induced landslides at the regional scale. The risk map based on the fault zone is effective when used in the selection of a target site for preventive erosion control work to prevent damage from earthquake-induced landslides. In addition, the risk map based on the epicenter can be used for efficient follow-up management in order to prioritize damage prevention measures, such as to investigate the current status of landslide damage after an earthquake, or to restore the damaged area.

The Effects of Urokinase Instillation Therapy via Percutaneous Transthoracic Catheter Drainage in Loculated Tuberculous Pleural Effusion: A Randomized Prospective Study (소방이 형성된 결핵성 흉막염 환자에서 경피적 도관을 이용한 유로카나제 치료의 효과 ; 전향적 무작위연구)

  • Lee, Yong-Whan;Kwak, Seung-Min;Kwon, Mee-Young;Bae, In-Young;Park, Chan-Sup;Moon, Tae-Hun;Cho, Jae-Hwa;Ryu, Jeong-Seon;Lee, Hyong-Lyeol;Roh, Hyung-Keun;Cho, Chul-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.601-608
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    • 1999
  • Background: Tuberculous pleural effusion responds well to the anti-tuberculosis agents in general, so no further aggressive therapeutic managements to drain the tuberculous effusion is necessary except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who later decortication need due to dyspnea caused by pleural thickening despite the completion of anti-tuberculosis therapy in the patients with tuberculous effusion. Especially, the patients with loculated tuberculous effusion might have increased chance of pleural thickening after treatment. The purpose of this study was that intrapleural urokinase instillation could reduce the pleural thickening in the treatment of loculated tuberculous pleural effusion. Methods: Thirty-seven patients initially diagnosed as having loculated tuberculous pleural effusion were randomly assigned to receive either the combined treatment of urokinase instillation and anti-tuberculosis agents(UK group) and anti-tuberculosis agents(Non-UK group) alone. The 16 patients in UK group received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. 100,000 units of urokinase was dissolved in 150 ml of normal saline and instilled into the pleural cavity via pig-tail catheter every day, also this group was treated with anti-tuberculosis agents. While the 21 patients in Non-UK group were treated with anti-tuberculosis agents only except diagnostic thoracentesis. Then we evaluated the residual pleural thickening after treatment for their loculated tuberculous pleural effusion between the two groups. Also the duration of symptoms and the pleural fluid biochemistry like WBC counts, pH, lactic dehydrogenase(LDH), glucose, proteins, and adenosine deaminase(ADA) were compared. Results: 1) The residual pleural thickening(RPT)($5.08{\pm}6.77$ mm) of UK group was significantly lower than that($20.3222{\pm}26.37$ mm) of Non-UK group(P<0.05). 2) The duration of symptoms before anti-tuberculosis drug therapy of patients with RPT$\geq$10 mm($5.23{\pm}3.89$ wks) was significantly longer than the patients with RPT<10 mm($2.63{\pm}1.99$ wks)(P<0.05). 3) There were no significant differences in the pleural fluid findings like WBC count, glucose, LDH, proteins, pH, ADA between the patients with RPT$\geq$10 mm and the patients with RPT<10 mm. Conclusion : The treatment of loculated tuberculous pleural effusion with the urokinase instillation via percutaneous transthoraic catheter was effective to reduce the pleural thickening.

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The Expression of Vascular Endothelial Growth Factor (VEGF) is a Highly Significant Prognostic Factor in Stage IB Carcinoma of the Cervix (병기 IB 자궁경부암에서 혈관내피세포성장인자(VEGF)의 발현이 예후에 미치는 영향)

  • Lee Ik Jae;Park Kyung Ran;Lee Jong Young;Lee Kang Kyoo;Song Ji Sun;Lee Kwang Gil;Cha Dong Soo;Choi Hyun Il
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.335-344
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    • 2001
  • Purpose : The aim of this study was to clarify the role of VEGF expression as an independent prognostic factor and to identify the patients at high risk for poor prognosis in stage IB cervical cancer. Materials and methods : A total of 118 patients with stage IB cervical cancer who had radical hysterectomy and pelvic lymph node dissection were included in the study. All known high risk factors of the patients were pathologically confirmed from the surgical specimen. Of the 118 patients, n patients were treated with postoperative radiotherapy and/or chemotherapy. VEGF expression was examined using immunohistochemistry in formalin-fixed, paraffin-embedded specimens of post-hysterectomy surgical materials. A semiquantitative analysis was made using a scoring system of 0, +, ++, and +++ for increasing intensity of stain. We classified the patients with scores from 0 to ++ as low VEGF expression and the patients with a score of +++ as high VEGF expression. Results : Of the 118 patients, 35 patients $(29.7\%)$ showed high VEGF expression. Strong correlations were found between the high VEGF expression and both deep stromal invasion (p=0.01) and the positive pelvic node (p=0.03). The 5-year overall and disease-free survival rates for all 118 patients were $95.5\%\;and\;93.8\%$. The 5-year overall (p=0.03) and disease-free survival (p<0.001) rates were $98.5\%\;and\;100%$ for low VEGF expression (0, +, and ++) and $85.5\%\;and\;79.7\%$ for high VEGF expression, respectively. Pelvic and distant failures for low versus high VEGF expression were $1.2\%$ versus $17.1\%$, (p=0.001) and $0\%$ versus $14.3\%$ (p<0.001), respectively. In a Cox multivariate analysis of survival, the high VEGF expression (p=0.02) and the bulky mass (p=0.02) were significant prognostic factors for overall survival. The high VEGF expression (p=0.002), and bulky mass (p=0.01) demonstrated as significant prognostic indicators for disease free survival. Conclusion : These results showed that VEGF expression was a highly significant predictor for pelvic and distant failure and the most significant prognostic factor of overall and disease free survival for the patients with stage IB cervix cancer treated with radical surgery. We strongly suggest that the immune-histochemistry for VEGF expression be performed in a routine clinical setting in order to identify the patients at high risk for poor prognosis in early stage cervical cancer. Furthermore, postoperative and/or chemotherapy did not reduce the pelvic failure and distant metastasis. To improve the cure rate for the patients with high VEGF expression in stage IB cervical cancer, antiangiogenic therapy including anti-VEGF Ab may be new treatment option.

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The Value of Interleukin-12 as an Activity Marker of Pulmonary Sarcoidosis (폐유육종증의 활동성 지표로서 IL-12의 효용성에 관한 연구)

  • Kim, Tae-Hyung;Jeon, Yong-Gam;Shim, Tae-Sun;Lim, Chae-Man;Koh, Yun-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.215-228
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    • 1999
  • Background: Sarcoidosis is a chronic granulomatous inflammatory disease of unknown etiology often involving the lungs and intrathoracic lymph nodes. The natural course of sarcoidosis is variable from spontaneous remission to significant morbidity or death. But, the mechanisms causing the variable clinical outcomes or any single parameter to predict the prognosis was not known. In sarcoidosis, the number and the activity of CD4 + lymphocytes are significantly increased at the loci of disease and their oligoclonality suggests that the CD4 + lymphocytes hyperreactivity may be caused by persistent antigenic stimulus. Recently, it has been known that CD4+ lymphocytes can be subdivided into 2 distinct population(Th1 and Th2) defined by the spectrum of cytokines produced by these cells. Th1 cells promote cellular immunity associated with delayed type hypersensitivity reactions by generating IL-2 and IFN-$\gamma$. Th2 cells playa role in allergic responses and immediate hypersensitivity reactions by secreting IL-4, IL-5, and IL-10. CD4+ lymphocytes in pulmonary sarcoidosis were reported to be mainly Th1 cells. IL-12 has been known to play an important role in differentiation of undifferentiated naive T cells to Th1 cells. And, Moller et al. observed increased IL-12 in bronchoalveolar lavage fluid(BALF) in patients with sarcoidosis. So it is possible that the elevated level of IL-12 is necessary for the continuous progression of the disease in active sarcoidosis. This study was performed to test the assumption that IL-12 can be a marker of active pulmonary sarcoidosis. Methods: We measured the concentration of IL-12 in BALF and in conditioned medium of alveolar macrophage(AM) using ELISA(enzyme-linked immunosorbent assay) method in 26 patients with pulmonary sarcoidosis(10 males, 16 females, mean age: $39.8{\pm}2.1$ years) and 11 normal control. Clinically, 14 patients had active sarcoidosis and 12 patients had inactive. Results: Total cells counts, percentage and number of lymhocytes, number of AM and CD4/CD8 lymphocyte ratio in BALF were significantly higher in patients with sarcoidosis than in control group. But none of these parameters could differentiate active sarcoidosis from inactive disease. The concentration of IL-12 in BALF was significantly increased in sarcoidosis patients ($49.3{\pm}9.2$ pg/ml) than in normal control ($2.5{\pm}0.4$ pg/ml) (p<0.001). Moreover it was significantly higher in patients with active sarcoidosis ($70.3{\pm}14.8$ pg/ml) than in inactive disease ($24.8{\pm}3.l$ pg/ml) (p=0.001). Also, the concentration of IL-12 in BALF showed significant correlation with the percentage of AM(p<0.001), percentage(p<0.001) and number of lymphocyte(p<0.001) in BALF, suggesting the close relationship between the level of IL-12 in BALF and the inflammatory cell infiltration in the lungs. Furthermore, we found a significant correlation between the level of IL-12 and the concentration of soluble ICAM-1 : in serum(p<0.001) and BALF (p=0.001), and also between IL-12 level and ICAM-1 expression of AM(p<0.001). The AM from patients with pulmonary sarcoidosis secreted significantly larger amount of IL-12 ($206.2{\pm}61.9$ pg/ml) than those of control ($68.3{\pm}43.7$ pg/ml) (p<0.008), but, there was no difference between inactive and active disease group. Conclusion : Our data suggest that the BALF IL-12 level can be used as a marker of the activity of pulmonary sarcoidosis.

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Epidemiological Study of Kawasaki Disease in Kyung Nam Area (경남 지역 가와사끼병의 역학적 조사)

  • Yang, Jeong Soo;Cho, Eun Young;Jung, Hae Sung;Hwang, Ji Young;Lee, Dong-Jin;No, Eun Suk;Choi, Myoung-Bum;Park, Chan-Hoo;Youn, Hee-Shang;Woo, Hyang-Ok
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.896-901
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    • 2002
  • Purpose : The aim of this study was to determine the epidemiology of Kawasaki disease in the Kyung Nam area and to evaluate whether the results of this epidemiological study could support infectious etiology. Methods : We sent a questionnaire to three training hospitals in the Kyung Nam area and retrospectively reviewed their medical records of Kawasaki disease from Jun. 1995 to Dec. 1999. Results : The total number of patients was 717 cases, with little differences of annual prevalence during the five years. In all cases, the monthly prevalence of Kawasaki disease was high in Apr. and Jul. At the eastern of Kyung Nam, the monthly prevalence was high in Apr. and Jul. in 1995 and 1996, Jul. in 1997, Apr. in 1998 and Apr. and Jul. in 1999. In the central area of Kyung Nam, the monthly prevalence was high in Apr. in 1995 and 1996, Apr. and Jul. in 1997 and Jul. in 1998 and 1999. In the western Kyung Nam, the monthly prevalence was high in Nov. in 1995, Aug. in 1996, Oct. in 1997, Dec. in 1998 and Nov. in 1999. Conclusion : In the eastern and central areas of Kyung Nam, the monthly prevalence of Kawasaki disease was similarly high in Apr. and Jul. However, in the western district, the prevalence was high in late fall and winter. We could not prove the hypothesis that Kawasaki disease occurred with the spread of single infectious agent, but the a nnually similar prevalence in eastern and central Kyung Nam supported the infection theory for the etiology of the disease.

Stress analysis of Multiloop Edgewise Arch Wire with various degree of tip back bend : a study using the finite element method (Multiloop Edgewise Arch Wire의 tip back 정도에 따른 응력 분포에 관한 유한요소법적 연구)

  • Lee, Young-Il;Cha, Kyung-Suk;Ju, Jin-Won;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.127-142
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    • 2000
  • This study have been carried out to find out the mechnical effect of Multiloop Edgewise Arch Wire(MEAW) making use of the finite element method. The tip back bend of MEAW taken in this analysis is $5^{\circ},\;10{\circ}\;and\;15{\circ}$. In addition, Class II or up & down elastic is applied to find out stress distribution and their values in PDL. A adult male of normal occlusion was selected to create the models of teeth and PDL. And the model of MEAW was also created using commercial finite element code (ANSYS version 5.2). The MEAW is forcibly engaged with a class II or up & down elastic, to determine the initial stress generated in PDL. Comparing the compressive and tensile stress at each reference-planes, following results are obtained. 1. When a MEAW of $5^{\circ},\;10{\circ}\;15{\circ}$ tip back bend was engaged with Class II or up & down elastic, the distribution of compressive, tensile stress in entire PDL is similar in each case. 2. The values of compressive and tensile stress in PDL is higher in $15{\circ}$ tip back bend case than in $10{\circ}\;or\;15{\circ}$ tip back bend case. 3. In the distal PDL of 1st and 2nd molar, compressive stress appears. The compressive area is more wide and its values is higher in PDL of 2nd molar than those in 1st molar. The compressive area and its values become more wide and higher according to the increase of the tip back bend. 4. The values of compressive stress are comparatively smaIIer in PDL of molars than those in premolars. 5. Comparing class II and up & down elastic case, tensile stress values in anterior teeth PDL are smaller md their distribution is more wide in up & down elastic case than class If elastic case. On another hand, there is no difference in distribution and stress values in PDL of posterior teeth between two cases. 6. Comparing the tensile area in PDL of anterior teeth, tensile stress values are maximum in PDL of canine.

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A Study of Effect on Pulmonary Function of Pleural Effusion in Tuberculous pleurisy patients (결핵성 흉막염 환자에서 흉수가 폐기능에 미치는 영향에 대한 연구)

  • Yim, Jeong Yoon;Lee, Kee Hyun;Jung, Hye Kyung;Chang, Jung Hyun;Cheon, Seon Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.491-499
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    • 1996
  • Background : Pleural effusion is a common disease in clinical practice but its effect on pulmonary function and altered pulmonary mechanics after removal of effusion are not still largely understood. Previous studies have shown that there is little or a relatively small improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracentesis. The present study was designed to assess the effect on pulmonary function of pleural effusion and to test whether there was a significant improvement in pulmonary function and arterial oxygenation after thoracentesis and to observe long tenn effect after thoracentesis. Method : We examined flow-volume curve, body box and arterial blood gas analysis according to severity of effusion, present symptom, and symptom duration. Then, we measured changes of pulmonary function after thoracentesis and observed longterm effect after thoracentesis. Result: 1) Pleural effusion cause restrictive pulmonary insufficiency. Not only functional impairment of small airway but also large airway is provoked. 2) MMFR, FEV1, Raw, POz are earlier improved than FVC and TLC after thoracentesis and patients without complication have mild restrictive pulmonary insufficiency after longterm observation. 3) FVC, FEV1, & TLC are similarly restricted as severity of pleural effusion and po, is relatively decreased. 4) Cases with symptom duration 1 week or less and cases with dyspnea have more severe pulmonary insufficiency than others. 5) The flow volume curves show a relatively greater improvement in flow rates at large lung volumes than small airway. 6) Significant relationship is shown between first thoracentesis amount and changes of FEV1, FVC, TLC. Conclusion: Pleural effusion cause restrictive pulmonary insufficiency and not only functional impairment of small airway impairment but also large airway is provoked. Then, Pulmonary function is progressively improved after thoracentesis and remained mild restrictive pulmonary insufficiency after recovery.

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Activity of Moxifloxacin Against Ofloxacin-Resistant Mycobacterium Tuberculosis: A Study of Cross-Resistance Between Ofloxacin and Moxifloxacin (Ofloxacin 내성 마이코박테리아에 대한 Moxifloxacin의 항결핵 효과: Ofloxacin과 Moxifloxacin의 교차내성 연구를 중심으로)

  • Kim, Byoung Ju;Kang, Young Soo;Park, Seung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.5
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    • pp.405-410
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    • 2004
  • Background : Moxifloxacin is an 8-methoxyquinolone compound which has been shown to have the best activity of the quinolones against M. tuberculosis but there is no literature showing the rate of cross-resistance between moxifloxacin and the other quinolones such as ofloxacin. Therefore, we tested the activity of moxifloxacin against ofloxacin resistant M. tuberculosis by a study of cross-resistance. Methods : We tested MIC's of moxifloxacin and ofloxacin by proportion method against 34 M. tuberculosis isolates showing resistance against ofloxacin at $2.5{\mu}g/m{\ell}$ concentration and 13 ofloxacin susceptible isolates from specimens submitted to clinical laboratory of National Masan Hospital from March 2003 to March 2004. Results : For ofloxacin susceptible isolates, $MIC_{50}$ and $MIC_{90}$ of ofloxacin were all $1.25{\mu}g/m{\ell}$, and $MIC_{50}$ and $MIC_{90}$ of moxifloxacin were $0.31{\mu}g/m{\ell}$ and $0.63{\mu}g/m{\ell}$ respectively. For ofloxacin resistant isolates, $MIC_{50}$ of ofloxacin was over $10{\mu}g/m{\ell}$ and $MIC_{50}$ of moxifloxacin was $5{\mu}g/m{\ell}$, $MIC_{90}$ of ofloxacin and moxifloxacin were all over $10{\mu}g/m{\ell}$. The rate of cross-resistance between the two was 67.6%(23/34) at $2.5{\mu}g/m{\ell}$ concentration. Conclusions : Moxifloxacin showed activity against 82.4%(28/34) of ofloxacin resistant M. tuberculosis at $10{\mu}g/m{\ell}$, but more studies are needed so that moxifloxacin will be used for patient with multi-drug resistant tuberculosis including oflokacin resistance.

Characterizing the Spatial Distribution of Oak Wilt Disease Using Remote Sensing Data (원격탐사자료를 이용한 참나무시들음병 피해목의 공간분포특성 분석)

  • Cha, Sungeun;Lee, Woo-Kyun;Kim, Moonil;Lee, Sle-Gee;Jo, Hyun-Woo;Choi, Won-Il
    • Journal of Korean Society of Forest Science
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    • v.106 no.3
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    • pp.310-319
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    • 2017
  • This study categorized the damaged trees by Supervised Classification using time-series-aerial photographs of Bukhan, Cheonggae and Suri mountains because oak wilt disease seemed to be concentrated in the metropolitan regions. In order to analyze the spatial characteristics of the damaged areas, the geographical characteristics such as elevation and slope were statistically analyzed to confirm their strong correlation. Based on the results from the statistical analysis of Moran's I, we have retrieved the following: (i) the value of Moran's I in Bukhan mountain is estimated to be 0.25, 0.32, and 0.24 in 2009, 2010 and 2012, respectively. (ii) the value of Moran's I in Cheonggye mountain estimated to be 0.26, 0.32 and 0.22 in 2010, 2012 and 2014, respectively and (iii) the value of Moran's I in Suri mountain estimated to be 0.42 and 0.42 in 2012 and 2014. respectively. These numbers suggest that the damaged trees are distributed in clusters. In addition, we conducted hotspot analysis to identify how the damaged tree clusters shift over time and we were able to verify that hotspots move in time series. According to our research outcome from the analysis of the entire hotspot areas (z-score>1.65), there were 80 percent probability of oak wilt disease occurring in the broadleaf or mixed-stand forests with elevation of 200~400 m and slope of 20~40 degrees. This result indicates that oak wilt disease hotspots can occur or shift into areas with the above geographical features or forest conditions. Therefore, this research outcome can be used as a basic resource when predicting the oak wilt disease spread-patterns, and it can also prevent disease and insect pest related harms to assist the policy makers to better implement the necessary solutions.