• Journal of Periodontal and Implant Science
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• 제26권3호
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• pp.641-654
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• 1996

In infectious disease, invasion of host tissue by bacteria or their products frequently induces a wide variety of inflammatory and immunopathologic reaction. Evidence indicates that cytokines are involved in the initiation and progression of chronic inflammatory diseases, such as periodontitis. Interleukin-6, which is a multifunctional cytokine, has important roles in acute and chronic inflammation and may also be implicated in bone resorption. Periodontal diseases are characterized by chronic inflammation of the periodontium with alveolar bone resoption. A principal driving force behind this response appears to lie in the immune system's response to bacteria. Many of the cell components which have been shown to function as virulence factors in gram-negative bacteria are associated with the bacterial surface. Of these, lipopolysaccharide has been characterized as one that mediates a number of biological activities which can lead to the destruction of host tissue. Non-steroidal antiinflammatory drug is used for reduce inflammation, and most of NSAIDs inhibit prostaglandine $E_2$ production, but it is shown that $PGE_2$ production is stimulated by IL-1 in recent study. So, the influence of other cytokines except $PGE_2$ on periodontium can not be avoided. Therefore, new antiinflammatory drug is needed. Rhizoma coptidis is used in oriental medicine for anti-inflammation and antiseptics. In this present study, we examined the IL-6 release in periodontal ligament cells treated with the lipopolysaccharide, and also the effect of rhizoma coptidis on cellular activity and IL-6 production of periodontal ligament cells. To evaluate the effect of rhizoma coptidis on cellular activity, the cells were seeded at a cell density of $1{\times}10^4$ cells/well in 24-well culture plates. After one day incubation, 1-6, 10-9 and 10-12 g/ml of rhizoma coptidis and 5, $10{\mu}g/ml$ of LPS were added to the each well and incubated for 1 and 2 days, respectively. Then, MTT assay were carried out. To evaluate the effect of rhizoma coptidis on IL-6 production, the cells were seeded at a cell density of $1.5{\times}10^4$ cells/well in 24-well culture plates. After one day incubation, 10-9 g/ml of rhizoma coptidis and 5, $10{\mu}g/ml$ of LPS were added to the each well and incubated for 3, 6, 12 and 24 hours. Then, amounts of IL-6 production is measured by IL-6 ELISA kit used. The results were as follows : 1. Rhizoma coptidisrbelow to ($10^{-6}g/ml$) significantly increaed cellular activity of periodontal ligament cells than control. 2. Rhizoma coptidist ($10^{-9}g/ml$) significantly increased cellular activity of LPS($5{\mu}g/ml$)-treated periodontal ligament cells than control. 3. LPS(5 and $10{\mu}g/ml$) significantly increased IL-6 production of periodontal ligament cells than control. 4. Rhizoma coptidis($10^{-9}g/ml$) decreased IL-6 production of LPS ($5{\mu}g/ml$)-treated periodontal.ligarnent cells than LPS only tested group. These findings suggest that stimulation of the IL-6 release of periodontal ligament cells by LPS may have a role in the progression of inflammation and alveolar bone resoption in periodontal disease, and that inhibition of the IL-6 release of cells and stimulation of cellular activity by rhizoma coptidis may help the periodontal regeneration.

• 생명과학회지
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• 제25권6호
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• pp.693-702
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• 2015

신생혈관형성을 억제하는 것은 최근들어 많은 고형암의 치료에 있어서 매우 유용한 접근 방법이다. 현재까지 가장 잘 알려진 접근 방법은 신생혈관형성의 핵심인자인 혈관내피세포성장인자(VEGF)를 표적으로 하는 방법이다. 다양한 화학예방 물질들을 포함하는 많은 자연의 생산물들이나 추출물들은 그들의 항신생혈관형성 성질을 통하여 악성종양의 성장을 억제하고 있다. 황백은 항종양, 항균, 항염증 및 그외 다른 생물학적 작용을 가지고 있는, 오래전부터 널리 사용되어온 한국 전통 약재이다. 우리는 종양의 성장, 침투, 전이에 있어서 매우 중요한 과정인 신생혈관형성에 미치는 황백 온수추출물의 효과를 연구하였다. 황백 온수추출물의 항신생혈관형성 효과를 확인하기 위해서 혈관 내피세포의 성장, 이동, 침투, 관형성 그리고, 자이모그램 분석을 수행하였으며, 흰쥐 대동맥 주변 미세혈관 발아실험을 진행하였다. 그 결과, 황백 온수추출물은 혈관내피세포성장인자(VEGF)에 의해 유도되는 혈관내피세포의 성장, 이동, 침투, 관형성 그리고, 대동맥의 혈관발아를 억제하는 효과를 in vitro와 ex vivo 실험을 통해서 확인하였다. 또한, 황백 추출물은 VEGF에 의해 유도되는 기질금속단백질분해효소 (MMP)-2와 -9의 활성화를 저해하였다. 본 연구 결과들은 황백 온수추출물의 신생혈관형성 억제작용이 암과 같은 혈관신생과 관련된 질병을 치료하는데 좋은 소재가 될 수 있음을 시사한다

• Tuberculosis and Respiratory Diseases
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• 제50권5호
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• pp.591-598
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• 2001

연구배경 : 기관과 폐에서 발생하는 선양 낭포성 암종은 타액선에서 발생하는 것과 조직학적으로 동일한 종양으로 기관지에서 발생하는 것은 무척 드물다. 이에 기관지에 원발성으로 발생한 선양 낭포성 암종의 임상적 특징을 조사하고자 하였다. 방 법 : 저자들이 경험한 5예와 지금까지 우리나라에서 문헌상 보고된 8예 등 총 13예를 대상으로 임상 양상, 치료, 경과 등을 조사하였다. 결 과 : 환자의 연령은 20-74세이고 남자가 9예, 여자는 4예이었다. 발현 증상은 기침, 호흡곤란, 객혈 등이었다. 굴곡성 기관지경상 대부분 표면은 부드럽고 점막이 울혈되어 있는 용종성의 종양을 나타내었고, 기도를 거의 혹은 완전히 폐쇄시키고 있었다. 골전이 1예와 경부 림프절 전이 1예 등 2예에서 원격전이가 있었고, 종격동 침범이 1예 있었다. 10예에서 수술적 절제술을 시행하여으며 이중 2예에서 수술후 방사선 치료을 하였다. 수술한 예 중 8예에서 생존기간 정중값이 21개월이었고, 13년간 재발되지 않고 생존한 경우도 1예 있었다. 결 론 : 기관지에 원발성으로 발생한 선양 낭포성 암종이 드물지만 13예를 확인하였으며, 원격전이나 종격동 침범이 적은 편이고 수술 절제가 가능하면 예후가 좋은 경향이므로 기관지 협착이나 폐쇄가 있는 환자에서 기관지경을 활용한 조기 진단과 적극적인 수술 절제 치료가 중요하다.

• Radiation Oncology Journal
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• 제34권4호
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• pp.265-272
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• 2016

Purpose: The purpose of this study is to evaluate the treatment outcomes of adjuvant radiotherapy using vaginal brachytherapy (VB) with a lower dose per fraction and/or external beam radiotherapy (EBRT) following surgery for patients with stage I endometrial carcinoma. Materials and Methods: The subjects were 43 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I endometrial cancer who underwent adjuvant radiotherapy following surgery between March 2000 and April 2014. Of these, 25 received postoperative VB alone, while 18 received postoperative EBRT to the whole pelvis; 3 of these were treated with EBRT plus VB. The median EBRT dose was 50.0 Gy (45.0-50.4 Gy) and the VB dose was 24 Gy in 6 fractions. Tumor dose was prescribed at a depth of 5 mm from the cylinder surface and delivered twice per week. Results: The median follow-up period for all patients was 57 months (range, 9 to 188 months). Five-year disease-free survival (DFS) and overall survival (OS) for all patients were 92.5% and 95.3%, respectively. Adjuvant radiotherapy was performed according to risk factors and stage IB, grade 3 and lymphovascular invasion were observed more frequently in the EBRT group. Five-year DFS for EBRT and VB alone were 88.1% and 96.0%, respectively (p = 0.42), and 5-year OS for EBRT and VB alone were 94.4% and 96%, respectively (p = 0.38). There was no locoregional recurrence in any patient. Two patients who received EBRT and 1 patient who received VB alone developed distant metastatic disease. Two patients who received EBRT had severe complications, one each of grade 3 gastrointestinal complication and pelvic bone insufficiency fracture. Conclusion: Adjuvant radiotherapy achieved high DFS and OS with acceptable toxicity in stage I endometrial cancer. VB (with a lower dose per fraction) may be a viable option for selected patients with early-stage endometrial cancer following surgery.

• 대한골관절종양학회지
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• 제1권2호
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• pp.205-209
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• 1995

A desmoid tumor is a locally aggressive growth of connective tissue origin which infiltrates the surrounding tissue and has a marked tendency for recurrence. And so it was also called as an aggressive fibromatosis, musculofascial fibromatosis or fibrosarcoma etc. Thirteen cases of desmoid tumor was treated since 1980, and their retrospective study was done with 79 months of follow-up after initial surgical excision. The female was involved in 12 cases(one male) with the age ranged from 7-50 years, average 28 years, and seven patients in third decade. A slowly growing mass was excised on average 4 months after first notice of the mass, but their margins are not demarcated clearly in most cases. Wide excision in 12 cases was done, but wide excision and saphenous vein graft was performed in one case because of invasion of posterior tibial artery by tumor mass. The tumor was found on extraabdominal region in 8 cases(61.5%) but 5 cases in abdominal wall(38.5%). The recurrence rate was high(6/13, 46.2%), and 11 times in 6 patients were recurred(average 1.8 times), within 27 months of initial excision. Six cases of recurrence were treated with wide excision again in 3 cases, wide excision combined with radiotherapy(4,000-6,000cGy) in 4 cases and wide excision with chemotherapy in one case. During the follow-up for average 21 months after treatment, no recurrences are found. Tumor remission periods without recurrence are average 67 months in all, and 11 years in longest case. Histologically it was very mimic with fibrosarcoma but could be differentiated with Trichrome stain, and their findings are not changed after recurrence.

• 대한두경부종양학회지
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• 제17권2호
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• pp.205-209
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• 2001

Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.

• Journal of Periodontal and Implant Science
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• 제34권1호
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• pp.71-81
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• 2004

Peri-implantitis could be the result of biomechanical and occlusal overload as well as microbiologic invasion. The dental implant may be more susceptible to dental plaque than the natural tooth, as the predictability of a stable soft tissue attachment complex has not yet been confirmed. With the development of peri-implantitis, the implant surface would be exposed to the oral environment and becomes coated with bacteria. The objective of therapy for this condition is to regain integration of the implant with bone. Since fibroblast adherence to surfaces is impeded by endotoxin, it would seem that decontamination would be desirable to obtain maximum osseointegration. The purpose of this study was to determine whether various chemotherapeutic and mechanical treatments(distilled water, air-powder abrasive, hypersaturated citric acid, tetracycline) can detoxify contaminated titanium implant surface by means of kinetic LAL test. Experimental rough surface titanium disks were fabricated. All of them were divided into two groups(A.a group and P.g group) and each contaminated by A. actinomycetemcomitans and P. gingivalis suspension. Contaminated disks were treated with distilled water, air-powder abrasive, citric acid and tetracycline, and then all disks were placed into LPS-free water for elution. The results were as follows : 1. In A.a group, LPS elute level of all test groups were significantly lower than control group(p<0.05). 2. In A.a group, LPS elute level of test 2, test 3 and test4 groups were significantly lower than that of control group(p<0.05). But, among the test 2, test 3, test4 groups, the significant differences were not detected. 3. In P.g group, LPS elute level of test 2, test 3 and test 4 groups were lower than that of control group(p<0.05). But, among the test groups, the significant differences were not detected. From the result of this study, it would be concluded that air-powder abrasive, hypersaturated citric acid and tetracycline treatments may be effective at reducing endotoxin level on rough titanium implant surfaces, and can be clinically used. But the treatments in peri-implantitis differentially impact osseointegration making one method clinically superior. To gain this knowledges, further molecular biologic and histopathologic studies should be developed.

• 대한골관절종양학회지
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• 제19권1호
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• pp.14-19
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• 2013

목적: 사지에 발생한 염증성 근섬유모세포성 종양의 특성과 치료 결과에 대하여 알아보고자 하였다. 대상 및 방법: 본 연구는 1999년부터 2012년까지 본원 정형외과에서 치료받은 연부조직 종양 환자 중에서 사지에 발생한 염증성 근섬유모세포성 종양으로 병리학적으로 확진된 5명의 환자를 대상으로 하였다. 결과: 남자가 1예, 여자가 4예였으며, 평균 연령은 44세(37-55세)이고, 평균 추시 기간은 34.6개월(8-87개월)이었다. 5명의 환자 모두에서 외과적 절제술을 시행하였으며 이 중 1명의 환자에서만 광범위 절제연을 얻었고, 3명에서는 변연부 절제연을, 다른 1명에서는 병소내 절제연을 얻었다. 광범위 절제연을 얻지 못한 4명의 환자 모두에서 술 후 평균 10.3개월(8-19개월)에 재발이 발생하였으며, 재발한 4명의 환자 중 2명에서 섬유육종으로의 악성 변화가 관찰되었다. 악성 변화를 보인 2명의 환자 중 1명은 폐, 간 및 림프절로의 다발성 원격 전이가 발생하여 추시관찰 37개월에 사망하였다. 5예의 병변 중 3예에서 종양의 경계가 사지의 주요 동맥에 인접한 소견이 관찰되었으며 1예에서는 종양이 좌골 신경을 침범한 소견이 관찰되었다. 결론: 사지에 발생한 염증성 근섬유모세포성 종양은 주요 신경혈관계와 인접하여 발생하는 경향을 나타내었다. 이 종양은 재발을 잘하며 악성 변화의 가능성이 있으므로 광범위 절제술이 적절한 수술적 치료법이 될 것으로 생각된다.

• 대한두경부종양학회지
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• 제13권2호
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• pp.187-199
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• 1997

Thyroid carcinoma ranks low in incidence and as a cause of death when compared to carcinomas arising in the other site. With adequate surgical treatment, the prognosis of operable thyroid carcinoma is good. However, the extent of surgical resection in treatment of thyroid cancer remains still controversy. The aim of this study was to assess the results of thyroid cancer patients treated surgically and to analyze the prognostic factors affecting survival and to improve the survival rate. We retrospectively analyzed the outcome of a total of 278 thyroid cancer patients treated surgically at Inje University Paik Hospital from 1980 to 1995 and followed for 1 to 16 years. There were man in 47 and woman in 231 patients with age range of 14 to 79 years(mean 42 years). Histopathologic findings were papillary carcinoma in 233, follicular carcinoma in 33, mixed carcinoma in 7, medullary carcinoma in 2, and undifferentiated carcinoma in 3 patients, respectively. Operative procedures were unilateral lobectomy in 111, subtotal thyroidectomy in 100, and total thyroidectomy in 67 patients. Central node dissection was performed in 92, modified neck disseciton in 62, radical neck dissection in 28, and no node dissection in 96 patients. Thyroid hormone was administered for the period of 3 to 5 years to suppress endogenous TSH production. Overall 5-year survival rate according to Kaplan-Meier method was 91.1%. Independently, significant factors affecting the prognosis were age at diagnosis, tumor size, pathologic type, tumor stage, lymph node metastasis, angioinvasion, extrathyroidal extension, and 'risk' group category. but, the prognosis were not influenced by sex and capsular invasion. Patients at low risk or with small size carcinomas had long survival over 5 years with only lobectomy. Lymph node dissection was carried out with a limited type in no jugular metastasis, radical neck dissection was performed only therapeutically in proved jugular node metastasis. Fifteen patients were dead of tumor recurrence after surviving for three months to two and half years, and the cause of death was local recurrence in nine, bone metastasis in four and lung metastasis in two patients. In conclusion, more extensive surgery including total thyroidecotmy and systematic compartment-oriented dissection of the lymph node metastases in patient at high-risk group will results in better survival and lower recurrence rate.

• 대한골관절종양학회지
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• 제13권2호
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• pp.195-200
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• 2007

역분화성 방골성 골육종은 골육종의 드문 변이로서, 국소 재발 및 원격 전이와 관련하여 불량한 예후와 연관된 것으로 알려져 있다. 그러므로 종양의 역분화성을 진단하는 것은 치료 방침을 결정하는데 있어서 매우 중요하다고 할 수 있다. 29세 여자 환자로 2년 전부터 발생한 좌측 대퇴 근위부의 종창 및 불편감으로 내원하여 시행한 검사상 방골성 골육종으로 진단되어, 종괴 절제 및 재건술 시행하였다. 환자 병력상 수술 2주 전부터 대퇴부 통증이 심해졌고, 종괴 크기의 증가가 있었으며, 이에 수술직전 시행한 자기공명영상(MRI) 상 종괴의 크기 증가 및 인접 근육으로의 침범 소견 관찰되었고, 술 후 시행한 절제 표본의 조직검사 상 미분화성 방골성 골육종으로 진단되어 결국 환자는 수술적인 절제 후 불량한 병의 경과로 사망하게 되었다. 술전 조직 검사상 방골성 골육종으로 진단된 경우라도 급격한 통증의 증가나 종괴 크기의 증가 등의 임상양상의 변화가 있을 때는 종양의 역분화 가능성을 고려해야 한다.