• 대한영상의학회지
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• 제83권2호
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• pp.317-330
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• 2022

목적 본 연구는 신장종양 환자에서 시행한 고주파절제술 이후 신장 기능에 영향을 미치는 다양한 요소들에 대한 평가를 통해서 이들의 상관관계와 임상적 가치를 평가하기 위한 것이다. 대상과 방법 2010년 1월부터 2018년 12월까지 본원에서 ultrasonography, CT 유도하에 고주파절제술을 시행 받은 91명을 대상으로 선정하였다. 신기능을 평가하는 방법으로 시술 직전과 시술 이후 혈청 크레아티닌, 사구체 여과율을 측정하였다. 시술 전과 비교하여 혈청 크레아티닌 수치가 0.3 mg/dL 이상 증가하는 것을 유의미한 것으로 정하고, 이에 근거하여 두 그룹으로 분류하였다. 신장 기능 손상에 영향을 미치는 요소를 평가하기 위해서 다변수 로지스틱 회귀분석을 이용해서 그룹 간에 비교를 시행하였다. 결과 단일 신장, 3단계 이상의 만성 콩팥병, 요관 손상은 신장 기능 손상에서 통계적으로 유의한 의미가 있었다. 성별, 연령, 다른 암, 종양 크기, 위치, 성장 형태, 집합계와의 근접성 등은 통계적으로 유의하지 않았다. 신장 기능 수치의 시간에 따른 변화는 단일 신장, 3단계 이상의 만성 콩팥병, 요관 손상 유무에 따라서 통계적으로 유의하게 달랐다. 결론 고주파절제술 시행 전의 의학적 상태 중 단일 신장, 3단계 이상의 만성 콩팥병, 시술 이후 발생한 합병증 중 요관 손상은 시술 이후 발생하는 신장 기능 손상의 위험요소로 생각할 수 있다.

• 대한영상의학회지
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• 제82권5호
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• pp.1186-1195
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• 2021

목적 대학병원 성인응급실에서 영상의학과 전공의 가판독과 전문의 최종 판독 간에 불일치가 발생한 빈도를 조사하고, 이 발생률에 영향을 미칠 수 있는 요인을 살펴보았다. 대상과 방법 2016년 12월부터 2019년 11월까지 성인응급실에서 촬영된 전산화단층촬영과 자기공명영상 검사 중, 전공의 가판독과 전문의 최종 판독 간에 불일치로 인해 환자의 진단이나 치료 계획이 변경될 수 있는 경우를 중대한 불일치로 정의하고, 이를 유형별로 분류하였다. 이후 전공의 근무 시간대, 응급실 근무 경력, 세부 분야별로 중대한 불일치 발생률의 분포를 살펴보았다. 결과 총 72137건의 가판독 중 중대한 불일치를 보인 검사는 총 1348건(1.9%) 이었다. 중대한 불일치의 유형으로는 위음성(72.0%)이 가장 많았고, 오판(26.3%), 위양성(1.7%) 순이었다. 또한 급성 소견의 중대한 불일치(87.2%)가 비급성 소견의 중대한 불일치(12.8%)보다 많았다. 중대한 불일치 발생률은 24시간 교대 근무 후반부로 갈수록 증가하였으며, 새벽 2시부터 4시 사이가 2.9%로 가장 높았다. 전공의의 응급실 근무 경력에 따른 발생률 차이는 없었고, 세부 분야별 발생률은 0.6%-4.5%로 다양했다. 결론 가판독과 최종 판독 간에 중대한 불일치 발생률은 2% 미만이었고, 24시간 교대 근무 후반으로 갈수록 증가하였다.

• International Journal of Stem Cells
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• 제16권2호
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• pp.215-233
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• 2023

Background and Objectives: MYC, also known as an oncogenic reprogramming factor, is a multifunctional transcription factor that maintains induced pluripotent stem cells (iPSCs). Although MYC is frequently upregulated in various cancers and is correlated with a poor prognosis, MYC is downregulated and correlated with a good prognosis in lung adenocarcinoma. MYC and two other MYC family genes, MYCN and MYCL, have similar structures and could contribute to tumorigenic conversion both in vitro and in vivo. Methods and Results: We systematically investigated whether MYC family genes act as prognostic factors in various human cancers. We first evaluated alterations in the expression of MYC family genes in various cancers using the Oncomine and The Cancer Genome Atlas (TCGA) database and their mutation and copy number alterations using the TCGA database with cBioPortal. Then, we investigated the association between the expression of MYC family genes and the prognosis of cancer patients using various prognosis databases. Multivariate analysis also confirmed that co-expression of MYC/MYCL/MYCN was significantly associated with the prognosis of lung, gastric, liver, and breast cancers. Conclusions: Taken together, our results demonstrate that the MYC family can function not only as an oncogene but also as a tumor suppressor gene in various cancers, which could be used to develop a novel approach to cancer treatment.

• Biomolecules & Therapeutics
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• 제32권1호
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• pp.123-135
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• 2024

Although gemcitabine-based regimens are widely used as an effective treatment for pancreatic cancer, acquired resistance to gemcitabine has become an increasingly common problem. Therefore, a novel therapeutic strategy to treat gemcitabine-resistant pancreatic cancer is urgently required. Piceamycin has been reported to exhibit antiproliferative activity against various cancer cells; however, its underlying molecular mechanism for anticancer activity in pancreatic cancer cells remains unexplored. Therefore, the present study evaluated the antiproliferation activity of piceamycin in a gemcitabine-resistant pancreatic cancer cell line and patient-derived pancreatic cancer organoids. Piceamycin effectively inhibited the proliferation and suppressed the expression of alpha-actinin-4, a gene that plays a pivotal role in tumorigenesis and metastasis of various cancers, in gemcitabine-resistant cells. Long-term exposure to piceamycin induced cell cycle arrest at the G₀/G₁ phase and caused apoptosis. Piceamycin also inhibited the invasion and migration of gemcitabine-resistant cells by modulating focal adhesion and epithelial-mesenchymal transition biomarkers. Moreover, the combination of piceamycin and gemcitabine exhibited a synergistic antiproliferative activity in gemcitabine-resistant cells. Piceamycin also effectively inhibited patient-derived pancreatic cancer organoid growth and induced apoptosis in the organoids. Taken together, these findings demonstrate that piceamycin may be an effective agent for overcoming gemcitabine resistance in pancreatic cancer.

• 대한영상의학회지
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• 제84권5호
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• pp.1009-1016
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• 2023

고주파 절제술(radiofrequency ablation)은 미세 침습 치료술의 한 방법으로 양성 갑상선 결절과 갑상선 재발암 환자에서 수술적 치료를 대신하여 이용되고 있다. 국내에서는 2002년 세계 최초로 갑상선 결절에 대한 고주파 절제술을 시작하여, 2008년에는 대규모 연구 결과를 발표하였다. 2009년 대한갑상선영상의학회(Korean Society of Thyroid Radiology)는 고주파 절제술에 대한 첫 권고안을 만들었으며, 2012년과 2018년에 이를 개정하였다. 대한갑상선영상의학회의 지침서는 갑상선 결절의 고주파 절제술에 대한 세계 최초의 지침서로 국내 및 국외에서 갑상선 고주파 절제술을 시행하는 시술자들을 위한 지침이 되었다. 이 지침서들은 한국 및 전 세계 여러 나라에서 고주파 절제술의 확립 및 확산에 크게 기여하였다. 또한 대한 갑상선영상의학회는 2015년부터 참가자 수준에 맞춘 고주파 절제술의 심화 실습 과정을 진행하고 있다. 본 종설에서는 대한갑상선영상의학회에서 실시한 고주파 절제술 교육의 역사를 소개하고, 고주파 절제술의 학습 곡선 및 현재 한국에서의 교육 프로그램을 기술한 후 앞으로 나아갈 방향을 제시해보고자 한다.

• 대한치매학회지
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• 제21권4호
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• pp.147-161
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• 2022

Background and Purpose: Subjective cognitive decline (SCD) refers to the self-perception of cognitive decline with normal performance on objective neuropsychological tests. SCD, which is the first help-seeking stage and the last stage before the clinical disease stage, can be considered to be the most appropriate time for prevention and treatment. This study aimed to compare characteristics between the amyloid positive and amyloid negative groups of SCD patients. Methods: A cohort study to identify predictors for the clinical progression to mild cognitive impairment (MCI) or dementia from subjective cognitive decline (CoSCo) study is a multicenter, prospective observational study conducted in the Republic of Korea. In total, 120 people aged 60 years or above who presented with a complaint of persistent cognitive decline were selected, and various risk factors were measured among these participants. Continuous variables were analyzed using the Wilcoxon rank-sum test, and categorical variables were analyzed using the χ² test or Fisher's exact test. Logistic regression models were used to assess the predictors of amyloid positivity. Results: The multivariate logistic regression model indicated that amyloid positivity on PET was related to a lack of hypertension, atrophy of the left temporal lateral and entorhinal cortex, low body mass index, low waist circumference, less body and visceral fat, fast gait speed, and the presence of the apolipoprotein E ε4 allele in amnestic SCD patients. Conclusions: The CoSCo study is still in progress, and the authors aim to identify the risk factors that are related to the progression of MCI or dementia in amnestic SCD patients through a two-year follow-up longitudinal study.

• International Journal of Molecular Medicine
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• 제43권6호
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• pp.2409-2419
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• 2019

The use of finasteride for alleviating hair loss has been investigated, and it has been applied as an oral dose medication. However, due to the inconvenience of daily drug administration over long period of time, novel controllable finasteride delivery has been actively investigated. As a novel method of finasteride delivery, the development of finasteride-loaded microspheres for subcutaneous administration is becoming increasingly pharmaceutically important. Therefore, the present study aimed to use finasteride-loaded microspheres in a controlled manner in an attempt to overcome the limitations of the oral administration of finasteride and to cause fewer adverse effects. Finasteride-loaded microspheres containing poly(lactic-co-glycolic acid) and finasteride at a ratio of 4:1 were prepared, and a testosterone-induced androgenic alopecia mouse model was used. Following observation for 10 weeks, the percentage hair growth was 86.7% (total hair growth 60%, partial hair growth 26.7%) in the orally-applied finasteride-treated group as a positive control, and 93.3% (total hair growth 60%, partial hair growth 33.3%) in the finasteride-loaded microspheres-treated group. Serum dihydrotestosterone levels began to decrease at week 6 in the orally-applied finasteride- and finasteride-loaded microsphere-treated groups. In addition, the finasteride-loaded microspheres-treated group exhibited similar follicular number, follicular length, anagen/telogen ratio and hair bulb diameter values to those of the orally-applied finasteride-treated group. Furthermore, the finasteride-loaded microspheres increased the activities of phosphoinositide 3-kinase/protein kinase B and Wnt/β-catenin in relation to hair follicle cell growth signaling in mouse skin, and suppressed the apoptosis of hair follicle cells by reducing the expression of transforming growth factor-β2 and caspase-3, which are indicators of apoptosis. In conclusion, the administration of a single injection of finasteride-loaded microspheres was effective in treating testosterone-induced alopecia. Furthermore, it led to equivalent hair growth effects when compared with orally-applied finasteride, thus revealing the possibility of effective treatment via different routes of administration.

• The Korean journal of internal medicine
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• 제39권3호
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• pp.458-468
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• 2024

Background/Aims: The SAMe-TT₂R₂ score is used for assessing anticoagulation control (AC) quality with warfarin. However, it is hard to apply SAMe-TT₂R₂ score in Asian patients with atrial fibrillation (AF), because it has not been proven in those populations. This study aimed to validate the SAMe-TT₂R₂ score in Asian patients with AF and suggest a modified SAMe-TT₂R₂ score for this population. Methods: We analyzed 710 Korean patients with AF who were using warfarin. The AC quality was assessed as the mean time in therapeutic range (TTR). Each component of SAMe-TT₂R₂ score was evaluated for the relationship with AC. Further clinical factors that predict AC were analyzed. Identified factors were re-assorted and constructed as SA₂Me-TTR scoring system. Results: Of the components of the SAMe-TT₂R₂ score, female, age, and rhythm control were associated with AC. Heart failure and renal insufficiency were newly identified factors associated with AC. The modified SA₂Me-TTR score was reconstructed with the relevant risk factors (S, female gender, 1 point; A, age < 60 yr, 2 points; Me, medical history of heart failure, 1 point; T, treatment for rhythm control, 1 point; T, history of stroke or transient ischemic attack, 1 point; R, renal insufficiency, 1 point). The modified SA₂Me-TTR score demonstrated an excellent relationship with the grading of AC. The modified SA₂Me-TTR score ≤ 1 identified patients with good AC (hazard ratio 2.46, 95% CI 1.75-3.47). Conclusions: The modified SA₂Me-TTR score was useful for guiding oral anticoagulants selection in Asian patients with AF.

• 한방안이비인후피부과학회지
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• 제37권3호
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• pp.17-28
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• 2024

Objectives : The aim of this study is to explore the potential of oriental medicine in managing rosacea through the regulation of the autonomic nervous system. Methods : We reviewed studies on the pathophysiology and medical treatment (both western and oriental medicine) of rosacea, as well as the relationship between rosacea and the autonomic nervous system, using four databases: PubMed, OASIS, RISS, and NDSL. Results : Rosacea is a chronic recurrent inflammatory disease characterized by symptoms such as facial flushing, inflammatory papules, and pustules. In Western medicine, symptomatic treatments like vasoconstrictors, doxycycline, and anti-inflammatory drugs are primarily used. According to the pathophysiological mechanisms of rosacea, the autonomic nervous system is closely related, particularly with sympathetic overactivity causing vasodilation and local inflammation in rosacea patients. Additionally, recent studies report that rosacea patients frequently exhibit neuropsychiatric symptoms such as anxiety, depression, and insomnia, which are closely linked to autonomic dysfunction and contribute to the worsening of skin symptoms. However, current studies on the use of oriental medicine for rosacea focus mainly on anti-inflammatory effects at the local level, similar to conventional treatments. Conclusions : Based on the close involvement of the autonomic nervous system in the pathophysiological mechanisms of rosacea and numerous studies showing that oriental medicine can effectively regulate autonomic function, applying such treatments to rosacea patients may improve not only skin symptoms but also the frequently associated neuropsychiatric symptoms like anxiety, depression and insomnia.

• International Journal of Stem Cells
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• 제17권3호
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• pp.319-329
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• 2024

Leucine-rich repeat kinase 2 (LRRK2), a large GTP-regulated serine/threonine kinase, is well-known for its mutations causing late-onset Parkinson's disease. However, the role of LRRK2 in glioblastoma (GBM) carcinogenesis has not yet been fully elucidated. Here, we discovered that LRRK2 was overexpressed in 40% of GBM patients, according to tissue microarray analysis, and high LRRK2 expression correlated with poor prognosis in GBM patients. LRRK2 and stemness factors were highly expressed in various patient-derived GBM stem cells, which are responsible for GBM initiation. Canonical serum-induced differentiation decreased the expression of both LRRK2 and stemness factors. Given that LRRK2 is a key regulator of glioma stem cell (GSC) stemness, we developed DNK72, a novel LRRK2 kinase inhibitor that penetrates the blood-brain barrier. DNK72 binds to the phosphorylation sites of active LRRK2 and dramatically reduced cell proliferation and stemness factors expression in in vitro studies. Orthotopic patient-derived xenograft mouse models demonstrated that LRRK2 inhibition with DNK72 effectively reduced tumor growth and increased survival time. We propose that LRRK2 plays a significant role in regulating the stemness of GSCs and that suppression of LRRK2 kinase activity leads to reduced GBM malignancy and proliferation. In the near future, targeting LRRK2 in patients with high LRRK2-expressing GBM could offer a superior therapeutic strategy and potentially replace current clinical treatment methods.