• Radiation Oncology Journal
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• 제29권3호
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• pp.191-198
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• 2011

Purpose: Although the role of squamous cell carcinoma antigen (SCC-Ag) as a predictive and prognostic factor for uterine cervical cancer has been identified in previous studies, 1) the effective patient group of screening for recurrence with SCC-Ag, 2) the relationship between SCC-Ag and recurrence site, and 3) the relationship between the change of SCC-Ag and treatment outcome or recurrence have not been described. Materials and Methods: The study included 506 patients with histologically proven uterine cervical cancer between January 1994 and December 2010. We determining the serum SCC-Ag level before treatment and after treatment, and conducted a retrospective review of the patients' records. We evaluated the sensitivity and specificity of SCC-Ag for the detection of tumor recurrence by comparing biochemical recurrence with clinical recurrence. Results: The pretreatment SCC-Ag level and the proportion of patients over 1.5 ng/mL were higher in poor prognostic patient group. In the univariate and multivariate analysis, pretreatment SCC-Ag showed a statistically significant correlation with tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology. In patients with biochemical recurrence vs. those without, 5-year DFS and OS were 27.6 vs. 92.7% (p ${\leq}$ 0.001) and 53.7 vs. 92.5% (p ${\leq}$ 0.001), respectively. Conclusion: Our study reconfirmed the known function of pretreatment SCC-Ag, but could not confirm the function of biochemical response as a predictive factor for treatment and as a prognostic factor. There was no statistically significant relationship between SCC-Ag level and recurrence site. We confirmed the role of SCC-Ag as a follow-up tool for recurrence of disease and which patient groups SCC-Ag was more useful for.

• Radiation Oncology Journal
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• 제30권4호
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• pp.218-225
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• 2012

Purpose: The relationship between treatment outcomes, alteration of the expression of biological markers, and tumor volume response during radiotherapy (RT) in patients with uterine cervical cancer was analyzed. Materials and Methods: Twenty patients with cervical squamous cell carcinoma received definitive RT with (n = 17) or without (n = 3) concurrent chemotherapy. Tumor volumes were measured by three serial magnetic resonance imaging scans at pre-, mid-, and post-RT. Two serial punch biopsies were performed at pre- and mid-RT, and immunohistochemical staining for cyclooxygenase (COX)-2 and epidermal growth factor receptor was performed. The median follow-up duration was 60 months. Results: The median tumor volume response at mid-RT (V2R) was 0.396 (range, 0.136 to 0.983). At mid-RT, an interval increase in the distribution of immunoreactivity for COX-2 was observed in 8 patients, and 6 of them showed poor mid-RT tumor volume response ($V2R{\geq}0.4$). Four (20%) patients experienced disease progression after 10 to 12 months (median, 11 months). All 4 patients had poor mid-RT tumor volume response (p = 0.0867) and 3 of them had an interval increase in COX-2 expression. Overall survival (OS) and progression-free survival (PFS) decreased in patients with $V2R{\geq}0.4$ (p = 0.0291 for both). An interval increase in COX-2 expression at mid-RT was also associated with a decreased survival (p = 0.1878 and 0.1845 for OS and PFS, respectively). Conclusion: Poor tumor volume response and an interval increase in COX-2 expression at mid-RT decreased survival outcomes in patients with uterine cervical cancer.

• Asian-Australasian Journal of Animal Sciences
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• 제31권1호
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• pp.32-39
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• 2018

Objective: In this study, we investigated the adverse effects of dietary zearalenone (ZEA) (0.5 to 1.5 mg/kg diet) on the localization and expression of the growth hormone receptor (GHR) in the uteri of post-weaning gilts and explored alternative mechanism of the reproductive toxicity of ZEA on piglets. Methods: A total of forty healthy piglets (Duroc${\times}$Landrace${\times}$Large White) aged 28 d were selected for study. Piglets were transferred to single cages after 10 days' adaptation on an obstetric table. The animals were allocated to one of four treatments: a normal basal diet supplemented with 0 (Control), 0.5 (ZEA0.5), 1.0 (ZEA1.0), or 1.5 (ZEA1.5) mg/kg purified ZEA, and fed for 35 d after the 10-d adaptation. Analyzed ZEA concentrations in the diets were 0, $0.52{\pm}0.07$, $1.04{\pm}0.03$, and $1.51{\pm}0.13mg/kg$, respectively. At the end of the feeding trial, piglets were euthanized after being fasted for 12 h. Two samples of uterine tissue from each pig were rapidly collected, one of which was stored at $-80^{\circ}C$ for analysis of the relative mRNA and protein expression of GHR, and the second was promptly fixed in Bouin's solution for immunohistochemical analysis. Results: The relative weight of the uteri and thickness of the myometrium and endometrium increased linearly (p<0.001) and quadratically (p<0.001) with an increasing level of ZEA. The results of immunohistochemical analysis indicated that GHR immunoreactive substance was mainly localizated in the cytoplasm of uterine smooth muscle, glandular epithelial, luminal epithelial, stromal, and vascular endothelial cells. In contrast, nuclear staining was rarely observed. The immunoreactive integrated optic density of GHR in the myometrium, luminal epithelium, glandular epithelium, and whole uteri of weaning gilts increased linearly (p<0.001) and quadratically (p<0.05) with an increasing level of ZEA. The mRNA and protein expression of GHR in the uteri of weaning gilts increased linearly (p<0.001) and quadratically (p<0.05) with an increasing level of ZEA. Conclusion: In conclusion, ZEA at a concentration of 0.5 mg/kg was sufficient to significantly thicken the myometrium and endometrium, and at a concentration of 1.0 mg/kg induced a high level of GHR expression to promote growth and development of the uteri. This revealed an alternative molecular mechanism whereby ZEA induces growth and development of the uteri and provides a theoretical basis for the revision of Chinese feed hygiene standards.

• Radiation Oncology Journal
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• 제14권3호
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• pp.201-209
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• 1996

목적 : FIGO 병기 Ib 자궁경부편평상피암 환자에서 고선량율 강내치료를 이용한 방사선치료후 환해율, 5년 국소제어을, 5년 생존율 및 예후인자, 방사선 합병증을 분석하여 고선량율 강내치료의 효용성을 평가하고자 하였다. 그리고 심각한 후기 합병증 없이 만족스런 국소 제어율을 얻기 위한 외부방사선선량과 강내치료선량의 최적 선량배합을 알아보고자 하였다. 대상 및 방법 : 1979. 5 - 1990. 12월 까지 연세암센타 치료방사선과에서 자궁경부 편평상피암 FlGO 병기 Ib로 진단된후 근치적 목적하에 외부 및 강내치료를 받은 162명의 환자들을 대상으로 치료 결과를 후향적 분석하였다. 외부 방사선 치료는 LINAC 10MV X-ray를 이용해 180-200cGy/fr씩 4000-4600cGy14.5-5주를 전골반 부위에 시행하였근데, 일부환자에서 2000-4000 cGy에서 중앙차폐(midline block)를 시행하였다. 코발트 선원을 이용한 원격 조정 아프터 로딩 고선량율 강내치료를 A점에 1회당 300cGy씩 주 3회, 총 10-13회 (3000-3900 cGy)실시하여 A 점에 들어간 총방사선 조사량은 6420 - 9500cGy 으로 평균 8394 cGy 였다. 결과 : 방사선 치료후 완전 관해율은 $99.4\%$ 였다. 5년 전체생존율은 $91.1\%$이고, 5년 무병생존율은 $90.9\%$였다. 추적 관찰 기간동안 치료 실패 양상을 관찰해 보면 국소 실패만 보인 경우는 7명이었고 원격전이만 보인경우가 6명이었으며, 국소 및 원격전이가 모두 발생한 경우가 1예 있어서 국소제어 실괘율은 $4.9\%$(8/163), 원격전이율은 $4.3\%$(7/164)였다. 후기 합병증은 38명 ($23.5\%$)에서 발생하였초, 그 중 30병 직장 합병증으로 $18.5\%$ 후기 합병증 발생율을 보였고, 방광 합병증은 8명에서 발생하여 $4.9\%$ 후기 합병증 발생율을 보였다. 직장 합병증이 생긴 환자관에서 직장에 소사된 방사선량은 평균 7887 cGy 이었고, 합병증이 발생하지 않은 환자군의 평균조사량은 7488 cGy이었다. 결론 : 근치적 목적으로 외부 방사선 치료 및 고선량률 강내 치료는 FIGO병기 Ib 자궁경 부편평상피암을 치료하는데 매우 효과석이라 생각하였고, 외부방사선치료중 중앙차폐를 시행하여 A점 선량이 75Gy를 넘지 않게 방사선치료 설계를 하면 심각 합병증없이 좋은 치료성적을 얻을 수 있겠다.

• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.801-813
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• 1998

우리 나라의 주요사망원인에 해당하는 암질환을 대상으로 YLD를 측정하여 주요암질환간 질병부담의 우선 순위 측정하고 이의 활용범위를 알아보고자 수행한 본 연구에서 다음과 같은 결과를 얻었다. 우리 나라 남성의 암으로 인한 질병부담의 우선 순위 위암(4081.4년), 간암(3104.2년), 대장 및 직장암(3086.2년), 식도암(1511.9년), 폐암(1166.7년), 췌장암(1093.8년), 방광암(665.6년), 전립선암(421.7년), 백혈병(397.2년), 임파선암(259.7년)으로 계산되었다. 여성의 경우 암으로 인한 질병부담의 우선 순위 위암(2707.1년), 식도암(1536.7년), 간암(1468.5년), 자궁암(1311.8년), 난소암(974.3년), 췌장암(763.5년), 유방암(724.5년), 폐암(689.9년), 백혈병(351.3년), 임파선암(241.1년)로 계산되었다. 이러한 결과는 본 연구에 사용한 연구재료 및 연구 방법의 불완전성에도 불구하고 향후 보건의료정책의 우선순위결정, 즉 한정된 자원을 보다 더 효율적으로 활용하는데 보다 구체적인 정보를 계량적으로 제공해 줄 수 있다는 점에서 중요한 의의를 갖는다고 하겠다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6749-6754
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• 2014

Background: There are limited data in the literature related to concomitant genital or extra-genital organ pathologies in patients with borderline ovarian tumors (BOTs). The aim of this study was to evaluate our experience with 183 patients to draw attention to the accompanying organ pathologies with BOTs. Materials and Methods: One hundred eighty-three patients with BOTs, diagnosed and/or treated in our center between January of 2000 and March of 2013 were evaluated retrospectively. Data related to age, tumor histology, lesion side, disease stage, accompanying incidental ipsilateral and/or contralateral ovarian pathologies, treatment approaches, and follow-up periods were investigated. Incidental gynecologic and non-gynecologic concomitant organ pathologies were also recorded. Results: The mean age at diagnosis was 40.6 years (range: 17-78). Ninety-five patients (51%) were ${\leq}40$ years. A hundred and forty-seven patients (80%) were at stage IA of the disease. The most common type of BOT was serous in histology. Non-invasive tumor implants were diagnosed in 4% and uterine involvement was found 2% among patients who underwent hysterectomies. There were 12 patients with positive peritoneal washings. Only 17 and 84 patients respectively had concomitant ipsilateral and concomitant contralateral incidental ovarian pathologies. The most common type of uterine, appendicular and omental pathologies were chronic cervicitis, lymphoid hyperplasia and chronic inflammatory reaction. Conclusions: According to our findings most of accompanying pathologies for BOT are benign in nature. Nevertheless, there were additional malignant diseases necessitating further therapy. We emphasize the importance of the evaluation of all abdominal organs during surgery.

• 대한한의학원전학회지
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• 제26권4호
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• pp.267-280
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• 2013

Objective : One of the unique syndromes in Asian traditional medicine named 'heat entering the blood chamber(熱入血室, HEBC)' first appeared in Shanghanlun(傷寒論) and Jinguiyaolue(金匱要略) written by Zhangzhongjing(張仲景) who is the most famous doctor in ancient China. Method : Through comparison between Huangdineijing(黃帝內經), Shanghanlun(傷寒論), Jinguiyaolue(金匱要略) and other medical texts, the correct meaning, causes and mechanisms of HEBC can be analysed and organized to suggest new view of HEBC in modern society. Result : This syndrome is usually occurred in women during catching cold and menstruation, accompanying alternation of chillness and fever, pseudo-malaria, delirium, raveled chest(結胸), uterine hemorrhage, etc. The main sign of this syndrome, delirium belongs to the category of liver disease and fever in Huangdineijing(黃帝內經) which is a document more early published than Shanghanlun. Although there are still many other comprehensions about what blood chamber is, it could be the same as uterus according to Huangdineijing, it is relevant to the control of menstruation and emotions, and the function of liver and thoroughfare vessel(衝脈). Conclusion : HEBC is a syndrome exclusive to women, caused by their unique physical and psychological characteristics. It's beginning can be found in Huangdineijing, and by Shanghanlun and Jinguiyaolue, its concept as a single disease pattern becomes established. In other words, HEBC is a complex disease related to menstruation and its related hormonal dysfunctions, closely related to PMS, menopausal syndrome of today. Physical symptoms accompanied by psychological anxiety and fear is characteristic of this condition. Therefore gynecological approaches as well as socio-cultural issues related to women in modern society must be adopted when dealing with HEBC.

• Childhood Kidney Diseases
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• 제11권2호
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• pp.299-305
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• 2007

HWW(Herlyn-Werner-Wunderlich) 증후군은 중복자궁, 일측성 폐쇄질 및 동측 신장 무형성을 보이는 비뇨생식기계의 선천성 기형으로 매우 드문 질환 중 하나이다. 대부분 초경 이후 발생하는 월경통이나 복강내 종물등으로 발견되지만, 본 증례는 소아에서 반복되는 요로 감염과 현미경적 혈뇨로 인해 진단된 경우이다. 복부 초음파 검사에서 일측 신무형성이나 중복 자궁의 소경이 보일 때는 이러한 뮬러관 기형의 가능성을 염두에 두어야 보다 빠른 진단이 가능하고, 환자의 고통 또한 중여줄 수 있을 것이다. 특히 반복되는 요로 감염시에도 단순한 감염 치료보다 정밀검사를 항상 염두에 두어야 할 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3281-3285
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• 2012

Objectives: To evaluate the clinicopathologic correlation and prognostic value of HPV18 DNA viral load in patients with early-stage cervical neuroendocrine carcinoma (NECA). Methods: Formalin-fixed, paraffin-embedded tissue of cervical NECA patients with known HPV18 infection and clinicopathologic data including follow-up results were collected. The HPV18 DNA load was assessed with quantitative PCR targeting the HPV18 E6E7 region. Results: Twenty-one patients with early-stage (IB-IIA) cervical NECA were identified. HPV18 DNA viral load ranged from 0.83 to 55,174 copies/cell (median 5.90). Disease progression, observed in 10 cases (48%), was not significantly associated with any clinicopathologic variables. However, the group of patients with progressive disease tended to have a higher rate of pelvic lymph node metastasis (50% versus 9%, p=0.063) and a lower median value of HPV18 DNA viral load (4.37 versus 8.17 copies/cell, p=0.198) compared to the non-recurrent group. When stratified by a cut-off viral load value of 5.00 copies/cell, the group of patients with viral load ${\leq}5.00$ copies/cell had a significantly shorter disease-free survival than the group with viral load >5.00 copies/cell (p=0.028). The group with a lower viral load also tended to have a higher rate of disease progression (75% versus 31%, p=0.080). No significant difference in the other clinicopathologic variables between the lower and higher viral load groups was identified. Conclusion: HPV18 DNA viral load may have a prognostic value in patients with early-stage NECA of the cervix. A low viral load may be predictive of shortened disease-free survival in these patients.

• 대한한의학방제학회지
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• 제19권2호
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• pp.161-178
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• 2011

동의보감(東醫寶鑑) 중(中) 향부자(香附子)가 주약(主藥)으로 배오(配伍)된 85개 처방(處方)에 대하여 자료조사(資料調査)를 한 바 다음과 같이 요약(要約)할 수 있었다. 1. 향부자(香附子)가 주약(主藥)으로 구성(構成)된 방제(方劑)의 치료영역(治療領域)에 따른 처방빈도는 부인문(婦人門)이 16.4%, 포문(胞門)이 15.2%, 기문(氣門)이 10.5%, 적취문(積聚門)이 8.1% 순으로 많은 빈도수를 차지하였으며, 그 밖에도 20개 치료영역(治療領域)에 사용되었음을 알 수 있었다. 2. 향부자(香附子)는 구사(求嗣), 월경부조(月經不調), 기울(氣鬱), 기통(氣痛), 적취(積聚)등의 병증(病症)에 가장 많이 활용되고 있었으며, 그밖에도 55개 병증에 사용하였다. 3. 향부자(香附子)가 주약(主藥)으로 사용된 처방(處方)의 병인병리(病因病理)는 제기울체(諸氣鬱滯), 칠정(七情), 담음(痰飮), 식상(食傷), 풍한(風寒)등의 병리(病理)가 많았다. 4. 향부자(香附子)가 주약(主藥)으로 사용된 처방(處方)의 1회 향부자(香附子) 사용량은 6리(厘)~6전(錢)까지 이며, 1전(錢)을 가장 많이 사용하였다. 5. 향부자(香附子)는 배오(配伍)되는 약물(藥物)과 처방에 따라 이기해울(理氣解鬱), 소간이기(疎肝理氣), 조경지통(調經止痛)등의 다양한 작용을 하는 것을 알 수 있으며, 향부자(香附子)가 주약(主藥)으로 사용된 처방(處方)의 기본방(基本方)으로는 교감단(交感丹), 이진탕(二陳湯), 육미삼릉환(六味三稜丸)을 가장 많이 사용하였음을 알 수 있다.