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Prognostic Value of TNM Staging in Small Cell Lung Cancer (소세포폐암의 TNM 병기에 따른 예후)

  • Park, Jae-Yong;Kim, Kwan-Young;Chae, Sang-Cheol;Kim, Jeong-Seok;Kim, Kwon-Yeop;Park, Ki-Su;Cha, Seung-Ik;Kim, Chang-Ho;Kam, Sin;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.322-332
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    • 1998
  • Background: Accurate staging is important to determine treatment modalities and to predict prognosis for the patients with lung cancer. The simple two-stage system of the Veteran's Administration Lung Cancer study Group has been used for staging of small cell lung cancer(SCLC) because treatment usually consists of chemotherapy with or without radiotherapy. However, this system does not accurately reflect segregation of patients into homogenous prognostic groups. Therefore, a variety of new staging system have been proposed as more intensive treatments including either intensive radiotherapy or surgery enter clinical trials. We evaluate the prognostic importance of TNM staging, which has the advantage of providing a uniform detailed classification of tumor spread, in patients with SCLC. Methods: The medical records of 166 patients diagnosed with SCLC between January 1989 and December 1996 were reviewed retrospectively. The influence of TNM stage on survival was analyzed in 147 patients, among 166 patients, who had complete TNM staging data. Results: Three patients were classified in stage I / II, 15 in stage III a, 78 in stage IIIb and 48 in stage IV. Survival rate at 1 and 2 years for these patients were as follows: stage I / II, 75% and 37.5% ; stage IIIa, 46.7% and 25.0% ; stage III b, 34.3% and 11.3% ; and stage IV, 2.6% and 0%. The 2-year survival rates for 84 patients who received chemotherapy(more than 2 cycles) with or without radiotherapy were as follows: stage I / II, 37.5% ; stage rna, 31.3% ; stage IIIb 13.5% ; and stage IV 0%. Overall outcome according to TNM staging was significantly different whether or not received treatment. However, there was no significant difference between stage IIIa and stage IIIb though median survival and 2-year survival rate were higher in stage IIIa than stage IIIb. Conclusion: These results suggest that the TNM staging system may be helpful for predicting the prognosis of patients with SCLC.

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Crystal Structures of Dehydrated Partially $Sr^{2+}$-Exchanged Zeolite X, $Sr_{31}K_{30}Si_{100}A1_{92}O_{384}\;and\;Sr_{8.5}TI_{75}Si_{100}AI_{92}O_{384}$ (부분적으로 스트론튬이온으로 교환되고 탈수된, 제올라이트 X의 결정구조)

  • Kim Mi Jung;Kim Yang;Seff Karl
    • Korean Journal of Crystallography
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    • v.8 no.1
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    • pp.6-14
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    • 1997
  • The crystal structures of $Sr_{31}K_{30}-X\;(Sr_{31}K_{30}Si_{100}A1_{92}O_{384};\;a=25.169(5) {\AA}$) and $Sr_{8.5}Tl_{75}-X (Sr_{8.5}Tl_{75}Si_{100}A1_{92}O_{384};\;a=25.041(5) {\AA}$) have been determined by single-crystal X-ray diffraction techniques in the cubic space group $\=F{d3}\;at\;21(1)^{\circ}C$. Each crystal was prepared by ion exchange in a flowing stream of aqueous $Sr(ClO_4)_2\;and\;(K\;or\;T1)NO_3$ whose mole ratio was 1 : 5 for five days. Vacuum dehydration was done at $360^{\circ}C$ for 2d. Their structures were refined to the final error indices $R_1=0.072\;and\;R_w=0.057$ with 293 reflections, and $R_1= 0.058\;and\;R_w=0.044$ with 351 reflections, for which $I>2{\sigma}(I)$, respectively. In dehydrated $Sr_{31}K_{30}-X,\;all\;Sr^{2+}$ ions and $K^+$ ions are located at five different crystallographic sites. Six-teen $Sr^{2+}$ ions per unit cell are at the centers of the double six-rings (site I), filling that position. The remaining 15 $Sr^{2+}$ ions and 17 $K^+$ ions fill site II in the supercage. These $Sr^{2+}$ and $K^+$ ions are recessed ca $0.45{\AA}\;and\;1.06{\AA}$ into the supercage, respectively, from the plane of three oxygens to which each is bound. ($Sr-O=2.45(1){\AA}\;and\;K-O=2.64(1){\AA}$) Eight $K^+$ ons occupy site III'($K-O=3.09(7){\AA}\;and\;3.11(10){\AA}$) and the remaining five $K^+$ ions occupy another site III'($K-O=2.88(7){\AA}\;and\;2.76(7){\AA}$). In $Sr_{8.5}Tl_{75}-X,\;Sr^{2+}\;and\;Tl^+$ ions also occupy five different crystallographic sites. About 8.5 $Sr^{2+}$ ions are at site I. Fifteen $Tl^+$ ions are at site I' in the sodalite cavities on threefold axes opposite double six-rings: each is $1.68{\AA}$ from the plane of its three oxygens ($T1-O=2.70(2){\AA}$). Together these fill the double six-rings. Another 32 $Tl^+$ ions fill site II opposite single six-rings in the supercage, each being $1.48{\AA}$ from the plane of three oxygens ($T1-O=2.70(1){\AA}$). About 18 $Tl^+$ ions occupy site III in the supercage ($T1-O=2.86(2){\AA}$), and the remaining 10 are found at site III' in the supercage ($T1-O=2.96(4){\AA}$).

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The Association of Neonatal Hyperbilirubinemia with UGT1A1 and CYP1A2 Gene Polymorphism in Korean Neonates (한국인의 신생아 황달과 UGT1A1 및 CYP1A2 유전자 다형성과의 연관성)

  • Kang, Hoon;Lim, Jun Ho;Kim, Ji Sook;Kim, Eun Ryoung;Kim, Sung Do;Lee, Hee Jae;Chung, Joo Ho
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.380-386
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    • 2005
  • Purpose : The incidence of nonphysiologic neonatal hyperbilirubinemia is twice as high in East Asians as in whites. Recently, UGT1A1 mutation was found to be a risk factor for neonatal hyperbilirubinemia. In congenitally-jaundiced Gunn rats, which lack expression of UDP-glucuronosyltransferase, alternative pathways can be stimulated by inducers of CYP1A1 and CYP1A2 enzymes. CYP1A2 plays a major role in bilirubin degradation of the alternate pathway. We studied the relationship between UGT1A1 and CYP1A2 gene polymorphism of neonatal hyperbilirubinemia in Koreans. Methods : Seventy-nine Korean full term neonates who had hyperbilirubinemia(serum bilirubin >12 mg/dL) without obvious causes of jaundice, were analyzed for UGT1A1 and CYP1A2 gene polymorphism; the control group was sixty-eight. We detected the polymorphism of Gly71Arg of UGT1A1 gene by direct sequencing and T2698G of CYP1A2 by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) using MboII and direct sequencing. Results : Allele frequency of Gly71Arg mutation in the hyperbilirubinemia group was 32 percent, which was significantly higher than 11 percent in the control group(P<0.0001). Mutant gene frequency of T2698G was 41.8 percent in patients and 32.3 percent in the control group(P=0.015), but allele frequency was 21 percent in patients and 19 percent in the control group, which was not significantly higher(P=0.706). There was no relationship between mutations of two genes(P=0.635). Conclusion : The polymorphism of UGT1A1 gene(Gly71Arg) and CYP1A2 gene(T2698G) was detected in Korean neonatal hyperbilirubinemia. Only polymorphisms of Gly71Arg in UGT1A1 were significantly higher than control group.

Clinical significance of loss of p16 protein by immunohistochemical staining in acute lymphoblastic leukemia (급성림프구성백혈병에서 면역조직화학염색에 의한 p16 단백질 소실의 의의)

  • Jin, Hye Young;Kang, Kyoung In;Kim, Sun Young;Youn, You Sook;Kang, Joon Won;Jo, Deog Yeon;Kwon, Kye Chul;Park, Kyung Duk
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.73-77
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    • 2008
  • Purpose : p16 gene, mapped to the 9p21 chromosomal region, has emerged as a candidate tumor suppressor gene in human neoplasm. It is an inhibitor of cyclin-dependent kinase and inhibits Rb phosphorylation. In a variety of tumors including childhood acute lymphoblastic leukemia (ALL), deletion and/or mutation of the p16 gene has been found. Despite their high frequency, the prognostic importance of p16 alterations is still controversial in ALL and has been reported to be either unfavorable or similar to that of other patients. We studied the correlation between loss of p16 protein confirmed by immunohistochemical staining and clinical outcomes of patients diagnosed as ALL. Methods : We performed an immunohistochemical staining for p16 protein in 74 cases of bone marrow biopsy slide initially diagnosed as ALL between January 1998 and December 2006. We reviewed the clinical manifestations, laboratory findings, treatment outcomes retrospectively. Results : Of 74 slides, 12 were negative for p16 protein. Seven were males and 5 were females with a median age at diagnosis was 5.8 (1.3-18.8) years. Initial WBC were 17,225 $(500-403,300)/{\mu}L$. By immunologic surface marker analysis, 7 patients were early pre-B CALLA (+) and 5 patients were T-cell ALL. Two patients of intermediate risk group had relapsed and died. Three patients had family history of breast cancer. Four patients died and overall survival rates were $53.5{\pm}18.7%$. Conclusion : Loss of p16 protein is supposed to be an independent risk factor of childhood ALL associated with poor outcomes. In clinical setting, the clinician must take into account p16 status, not only at the genomic but also at the protein level. Further clinical experience on thoroughly investigated cases will help a better understanding between p16 status and clinical outcomes.

The effect of restricted fluid intakes in the first week of life on the risk of bronchopulmonary dysplasia and patent ductus arteriosus in very low birth weight infants (극소저출생체중아에서 생후 첫 주의 제한적 수액투여가 기관지폐이형성증과 동맥관개존증 발생에 미치는 영향)

  • Koo, Hoe Kyoung;Choi, Eun Na;Namgung, Ran;Park, Min Soo;Park, Kook In;Lee, Chul
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.536-542
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    • 2007
  • Purpose : We investigated the effects of restricted fluid in the first 7 days of life on the risk of bronchopulmonary dysplasia (BPD) or patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants. Methods : Eighty three VLBW infants who lived more than 28 days were selected. The amount of daily maintenance fluid was determined by calculation of insensible water loss (IWL) and urine output (UO). Seventy to 80 percent of calculated amount was given to the ventilated infants. Subjects were grouped into low (<25th%), moderate (25-75th%), and high (>75th%) fluid groups for the first 24 hours, 3 days and 7 days. Chi square tests analyzed proportions of subjects with or without morbidities across fluid groups. Multivariate logistic regression was used to analyze the effect of fluid intake on BPD or PDA, controlling for factors that are significantly associated with BPD or PDA by univariate analysis. Results : Rates of BPD and PDA were not significantly associated with fluid groups on each time period. The result was the same after controlling for factors that are significantly associated with BPD or PDA by univariate analysis. For the first 3 and 7 days, fluid intakes were positively related with maximal weight loss, urine output and mechanical ventilation duration. Conclusion : In VLBW infants, when given based on needs reflected from IWL and UO versus intake, relatively low fluid intakes in the first week of life do not decrease the risk of BPD or PDA, and vice versa. We suggest that calculation of daily fluid based on IWL and UO is appropriate for VLBW infants.

Development of Computer Program for the Arrangement of the Forest-road Network to Maximize the Investment Effect on the Forest-road Construction (임도개설(林道開設)에 있어서 투자효과(投資效果)를 최대(最大)로 하는 임도배치(林道配置)프로그램 개발(開發))

  • Park, Sang-Jun;Son, Doo-Sik
    • Journal of Korean Society of Forest Science
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    • v.90 no.4
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    • pp.420-430
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    • 2001
  • The object of this study is to develop a computer program for the arrangement of the forest-road network maximizing the investment effect in forest-road construction with factors such as terrains, forest physiognomy, management plan, logging system, cost of forest-road construction, capacity of inputted labour, capacity of timber production and so on. The operating system developed by this study is Korean Windows 95/98 and Microsoft Visual Basic ver. 5.0. User interface was designed as systematic structure, it is presented as a kind of GUI(graphic user interface). The developed program has result of the most suitable forest-road arrangement, has suitable forest-road density calculated with cost of logging, cost of forest-road construction, diversion ratio of forest-road, cost of walking in forest. And the most suitable forest-road arrangement was designed for forest-road arrangement network which maximized investment effect through minimizing the sum of cost of logging and cost of forest-road construction. Input data were divided into map data and control data. Digital terrain model, division of forest-road layout plan, division of forest function and the existing road network are obtained from map data. on the other hand, cost of logging related terrain division, diversion ratio of forest-road and working road, cost of forest-road construction, cost of walking, cost of labor, walking speed, capacity of inputted labor, capacity of timber production and total distance of forest-road are inputted from control data. And map data was designed to be inputted by mesh method for common matrix. This program can be used to construct a new forest-road or vice forest-road which compensate already existing forest-road for the functional forestry.

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Changes in Anthocyanin Content of Aronia (Aronia melancocarpa) by Processing Conditions (물리적 처리조건 변화에 따른 아로니아(Aronia melancocarpa) 유래 안토시아닌 함량변화 특성)

  • Kim, Bo Mi;Lee, Kyung Min;Jung, In Chan
    • Korean Journal of Plant Resources
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    • v.30 no.2
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    • pp.152-159
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    • 2017
  • The purpose of this study was to obtain basic data for using Aronia as a functional food material. The composition of anthocyanin was characterized and quantitated by LC-MS/MS, HPLC, and UV-VIS spectrophotometer techniques, respectively. The anthocyanin content was analyzed by temperature, time, pH, and the addition of citric acid. The UV-VIS spectrophotometer used for analysis of anthocyanin is less accurate than the LC-MS/MS method used in recent years. In the past, cyanidin-3-Glucoside was reported to be a major anthocyanin that contains Aronia. However, LC-MS/MS analysis in this study confirmed cyanidin-3-galactoside to be the major compound. The anthocyanin content of the Aronia powder began to decrease sharply at a temperature of $65^{\circ}C$ or higher when heated for 24 hours. In an aqueous solution of Aronia, the anthocyanin content was reduced by 50% at $65^{\circ}C$ for 10 hours and decreased by 85% at $85^{\circ}C$ within 10 hours. Above pH 8, the anthocyanin content was reduced by more than 50%. The results of this study will provide useful information to maintain anthocyanin content in the manufacturing process of Aronia. It could also be used to ensure the stability of anthocyanins in similar species of berries.

Expression of Nesfatin-1/NUCB2 and Its Binding Site in Mouse Ovary (생쥐 난소 내 Nesfatin-1/NUCB2 발현과 결합 부위 확인)

  • Kim, Jin-Hee;Youn, Mi-Ra;Bang, So-Young;Sim, Ji-Yeon;Kang, Hee-Rae;Yang, Hyun-Won
    • Development and Reproduction
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    • v.14 no.4
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    • pp.287-295
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    • 2010
  • It was recently reported that nesfatin-1/NUCB2, which is secreted from the brain, controls appetite and energy metabolism. The purpose of this research was to confirm whether or not the protein and its binding site should have been expressed in the mouse reproductive organs and to know the possible effects of nesfatin-1 on the reproductive function. Using the ICR female mouse ovary and uterus, the expression of NUCB2 mRNA was confirmed with the conventional PCR and the relative amount of NUCB2 mRNA in the tissues was analyzed with real-time PCR. Immunohistochemical staining was performed using the nesfatin-1 antibody to investigate the nesfatin-1 protein expression and the biotin conjugated nesfatin-1 to confirm the binding site for nesfatin-1 in the ovary. Furthermore, in order to examine if the expression of NUCB2 mRNA in the ovary and uterus is affected by gonadotropin, its mRNA expression was analyzed after PMSG administration into mice. As a result, the expression level of NUCB2 mRNA in the ovary and the uterus was as much as the expression level in hypothalamus. As a result of the immunohistochemical staining, nesfatin-1 proteins were localized at the theca cells, the interstitial cells, and some of the luteal cells. However, the granulosa cells in the follicles did not stain. Interestingly, the oocytes in the some follicles were stained with nesfatin-1. On the other hand, nesfatin-1 protein binding sites were displayed at the theca cells and the interstitial cells near the tunica albuginea. After PMSG administration the expression level of NUCB2 mRNA was increased in the ovary and the uterus. These results demonstrate that for the first time the nesfatin-1 and its binding site were expressed in the ovary and NUCB2 mRNA expression was controlled by gonadotropin, suggesting an important role in the reproductive organs as a local regulator. Therefore, further study is needed to elucidate the functions of nesfatin-1 on the reproductive organs.

Serum Adiponectin Levels and Insulin Resistance in Obese Children (비만 소아의 혈중 아디포넥틴과 인슐린저항성에 관한 연구)

  • Lee, Hee-Sun;Lee, Jin;Kang, Min-Joo;Choi, Byung-Min;Lee, Kee-Hyoung
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.481-487
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    • 2005
  • Purpose : Adiponectin, adipose tissue-specific protein, has anti-inflammatory and anti-atherogenic properties. It has been found to have a negative correlation with obesity and to play a role in modulating glucose tolerance and insulin sensitivity. Serum adiponectin concentrations are decreased in adults with obesity and type 2 diabetes. We investigated the difference in adiponectin levels between obese and non-obese children, and evaluated the relationship of serum adiponectin with body mass index(BMI), serum fasting insulin, lipid profiles and homeostasis model assessment(HOMA) in children. Methods : We measured serum adiponectin levels by radioimmunoassay in 113 children(82 obese children and 31 non-obese controls) from 8 to 15 years of age, and also checked BMI, fasting serum glucose, insulin and lipid profiles. Fasting and postprandial serum adiponectin concentrations were compared by oral glucose tolerance tests in 27 obese children. The correlations of adiponectin with BMI, insulin, low density lipoprotein(LDL)-cholesterol and HOMA were analyzed by Pearson's correlation. Results : The serum adiponectin levels were significantly lower in the obese group(19.7 mg/mL) than in the non-obese group(27.5 mg/mL)(P<0.01). Serum adiponectin concentrations were negatively correlated with BMI(r=-0.39, P<0.01), serum insulin(r=-0.28, P<0.01), LDL-C(r=-0.20, P<0.01) and HOMA(r=-0.22, P<0.01). At oral glucose tolerance tests in obese children, postprandial 2 hours adiponectin level(19.8 mg/mL) was decreased compared to fasting level(25.8 mg/mL)(P<0.01). Conclusion : Serum adiponectin concentrations were inversely related to adiposity and insulin resistance in children. We suggest the serum adiponectin level could be used as an early marker of insulin resistance in obese children.

Effects of Growth Hormone Therapy in Children with Idiopathic Short Stature (특발성 저신장증 소아에서 성장호르몬의 치료효과)

  • Lee, Kyong A;Han, Heon Seok
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.865-870
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    • 2005
  • Purpose : The use of growth hormone(GH) to promote growth in normal short children without classical GH deficiency is controversial. Numerous foreign studies have shown the effects of GH therapy in children with idiopathic short stature(ISS) whereas few has been interested in Korea. Therefore, this study is designed to investigate the effects of GH therapy on ISS by observing correlations and changes among various growth parameters such as, insulin-like growth factor-I(IGF-I) and insulin-like growth factor binding protein-3(IGFBP-3). Methods : This study was conducted retrospectively with 15 children with ISS in Chungbuk National University Hospital in Korea. Mean age was $11.44{\pm}2.81$ and the children were treated with 0.66 IU/kg/wk dosage of GH for 1 or 2 years. Also, the growth parameters before and after the GH therapy were observed. Results : Height standard deviation score(HT-SDS) was increased from $-1.85{\pm}0.70$ to $-1.58{\pm}0.56$ at 1 year and to $-1.21{\pm}0.37$ at 2 years after GH therapy. Predicted adult height standard deviation score(PAH-SDS) was also increased from $-2.10{\pm}0.52$ to $-1.67{\pm}0.59$ at 1 year, and to $-0.96{\pm}0.60$ at 2 years. Serum IGF-I and IGFBP-3 levels were significantly increased after 1 year and marginally increased after 2 years of GH therapy. Conclusion : It is concluded that GH therapy has growth promoting effect. The significant increase in IGF-I and IGFBP-3 levels during the GH therapy suggests that IGF-I and IGFBP-3 are useful predictors of response to the use of GH therapy. It is expected that larger patient samples would provide more reliable information about the effect of GH therapy.