• Korean Journal of Radiology
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• 제24권3호
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• pp.235-246
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• 2023

Objective: It is difficult to predict the treatment response of tissue after stereotactic radiosurgery (SRS) because radiation necrosis (RN) and tumor recurrence can coexist. Our study aimed to predict tumor recurrence, including the recurrence site, after SRS of brain metastasis by performing a longitudinal tumor habitat analysis. Materials and Methods: Two consecutive multiparametric MRI examinations were performed for 83 adults (mean age, 59.0 years; range, 27-82 years; 44 male and 39 female) with 103 SRS-treated brain metastases. Tumor habitats based on contrast-enhanced T1- and T2-weighted images (structural habitats) and those based on the apparent diffusion coefficient (ADC) and cerebral blood volume (CBV) images (physiological habitats) were defined using k-means voxel-wise clustering. The reference standard was based on the pathology or Response Assessment in Neuro-Oncologycriteria for brain metastases (RANO-BM). The association between parameters of single-time or longitudinal tumor habitat and the time to recurrence and the site of recurrence were evaluated using the Cox proportional hazards regression analysis and Dice similarity coefficient, respectively. Results: The mean interval between the two MRI examinations was 99 days. The longitudinal analysis showed that an increase in the hypovascular cellular habitat (low ADC and low CBV) was associated with the risk of recurrence (hazard ratio [HR], 2.68; 95% confidence interval [CI], 1.46-4.91; P = 0.001). During the single-time analysis, a solid low-enhancing habitat (low T2 and low contrast-enhanced T1 signal) was associated with the risk of recurrence (HR, 1.54; 95% CI, 1.01-2.35; P = 0.045). A hypovascular cellular habitat was indicative of the future recurrence site (Dice similarity coefficient = 0.423). Conclusion: After SRS of brain metastases, an increased hypovascular cellular habitat observed using a longitudinal MRI analysis was associated with the risk of recurrence (i.e., treatment resistance) and was indicative of recurrence site. A tumor habitat analysis may help guide future treatments for patients with brain metastases.

• Korean Journal of Radiology
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• 제24권8호
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• pp.761-771
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• 2023

Objective: To investigate the association among the electrode placement method, electrode type, and local tumor progression (LTP) following percutaneous radiofrequency ablation (RFA) for small hepatocellular carcinomas (HCCs) and to assess the risk factors for LTP. Materials and Methods: In this retrospective study, we enrolled 211 patients, including 150 males and 61 females, who had undergone ultrasound-guided RFA for a single HCC < 3 cm. Patients were divided into four combination groups of the electrode type and placement method: 1) tumor-puncturing with an internally cooled tip (ICT), 2) tumor-puncturing with an internally cooled wet tip (ICWT), 3) no-touch with ICT, and 4) no-touch with ICWT. Univariable and multivariable Cox proportional-hazards regression analyses were performed to evaluate the risk factors for LTP. The major RFA-related complications were assessed. Results: Overall, 83, 34, 80, and 14 patients were included in the ICT, ICWT, no-touch with ICT, and no-touch with ICWT groups, respectively. The cumulative LTP rates differed significantly among the four groups. Compared to tumor puncturing with ICT, tumor puncturing with ICWT was associated with a lower LTP risk (adjusted hazard ratio [aHR] = 0.11, 95% confidence interval [CI] = 0-0.88, P = 0.034). However, the cumulative LTP rate did not differ significantly between tumor-puncturing with ICT and no-touch RFA with ICT (aHR = 0.34, 95% CI = 0.03-1.62, P = 0.188) or ICWT (aHR = 0.28, 95% CI = 0-2.28, P = 0.294). An insufficient ablative margin was a risk factor for LTP (aHR = 6.13, 95% CI = 1.41-22.49, P = 0.019). The major complication rates were 1.2%, 0%, 2.5%, and 21.4% in the ICT, ICWT, no-touch with ICT, and no-touch with ICWT groups, respectively. Conclusion: ICWT was associated with a lower LTP rate compared to ICT when performing tumor-puncturing RFA. An insufficient ablation margin was a risk factor for LTP.

• Journal of Applied Biological Chemistry
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• 제66권
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• pp.213-220
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• 2023

본 연구는 비자나무(Torreya nucifera (L.) Siebold & Zucc, TN)와 생물전환 된 비자나무 추출물(TNB)의 항염증 효과를 평가하기 위해 수행되었으며 이를 위해 C. acnes에 의해 유도된 RAW264.7 염증 모델에서 염증인자의 발현을 조사하였다. 실험 결과, TNB는 50, 100, 200 ㎍/mL 농도에서 TN의 높은 세포독성을 개선하였으며 nitric oxide (NO)와 NO 합성 효소인 inducible NO synthase (iNOS) 및 prostaglandin의 합성 효소인 cyclooxygenase-2 (COX-2)의 발현을 유의하게 억제하였다. 또한 TNB는 염증성 사이토카인인 tumor necrosis factor-α (TNF-α) 및 interleukin (IL)-1β, IL-6, IL-8의 발현을 유의하게 억제하였으며 특히 IL-6, IL-8의 경우 가장 고 농도인 200 ㎍/mL에서 정상세포 수준으로 감소하였다. 이후 진행된 western blot에서 인산화 된 IκB-α 및 NF-κB의 발현이 농도의존적으로 억제됨을 확인하였으며 인산화가 억제되면서 degradation이 감소하여 TNB처리 농도가 높아짐에 따라 IκB-α의 농도가 증가하는 경향을 보였다. 결론적으로, TNB는 NF-κB신호 전달 경로를 차단함으로써 다양한 염증 매개 인자의 발현을 효과적으로 하향 조절할 수 있으며 이를 통해 항 염증 활성을 유도하는 것으로 확인된다. 이러한 결과를 근거로 TNB가 C. acnes에 의해 유발된 염증성질환의 치료에 효과적인 천연물 소재로 적용될 수 있음을 제안한다.

• Korean Journal of Radiology
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• 제22권8호
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• pp.1253-1265
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• 2021

Objective: To investigate the prognostic value of preoperative cardiac magnetic resonance imaging (MRI) for long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients undergoing tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR). Materials and Methods: The preoperative cardiac MR images, New York Heart Association functional class, comorbidities, and clinical events of 78 patients (median [interquartile range], 59 [51-66.3] years, 28.2% male) who underwent TV surgery for functional TR were comprehensively reviewed. Cox proportional hazards analyses were performed to assess the associations of clinical and imaging parameters with MACCEs and all-cause mortality. Results: For the median follow-up duration of 5.4 years (interquartile range, 1.2-6.6), MACCEs and all-cause mortality were 51.3% and 23.1%, respectively. The right ventricular (RV) end-systolic volume index (ESVI) and the systolic RV mass index (RVMI) were higher in patients with MACCEs than those without them (77 vs. 68 mL/m², p = 0.048; 23.5 vs. 18.0%, p = 0.011, respectively). A high RV ESVI was associated with all-cause mortality (hazard ratio [HR] per value of 10 higher ESVI = 1.10, p = 0.03). A high RVMI was also associated with all-cause mortality (HR per increase of 5 mL/m² RVMI = 1.75, p < 0.001). After adjusting for age and sex, only RVMI remained a significant predictor of MACCEs and all-cause mortality (p < 0.05 for both). After adjusting for multiple clinical variables, RVMI remained significantly associated with all-cause mortality (p = 0.005). Conclusion: RVMI measured on preoperative cardiac MRI was an independent predictor of long-term outcomes in patients who underwent TV surgery for functional TR.

• 한국사회복지학
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• 제68권2호
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• pp.107-130
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• 2016

2013년 정년연장이 법제화되어, 베이비붐 세대가 노령기로 진입하는 2016-17년에 단계적으로 적용될 전망이다. 이 연구는 정년연장 법제화로 베이비붐세대 중 얼마나 혜택을 받으며, 실제로 누가(어떤 특성의 집단) 혜택을 누리게 될 것인가에 대한 실증적 분석을 제공하고자 하였다. 이와 같이 정년연장 혜택의 귀착 규모 및 특성을 분석함으로써, 이 연구는 정년연장 정책의 파급효과와 영향을 파악하는 데 목적이 있다. 정년연장은 상근 정규직근로자에게 적용될 수 있는 제도이다. 따라서 베이비붐 세대의 경제활동상태와 노동이력을 추적하여, 정년연장 혜택을 받을 가능성이 높은 상근 정규직근로자로 생존하게 되는 집단의 규모와 특성을 분석해 보고자 하였다. 이를 위해 한국노동패널조사 4차(2001)부터 17차(2014)까지 패널자료를 활용하여, 생존분석을 통해 베이비붐세대 중 상근 정규직근로자 생존확률을 분석하였다. 생명표 분석결과, 베이비붐세대 중에서 정년연장 혜택을 받을 수 있는 비율은 11.4%에 불과했고, 75.3만명 규모로 추정되었다. Kaplan-Meier 생존분석과 Cox 비례위험 회귀분석(Cox proportional hazards regression model) 결과, 고학력일수록, 여성근로자에 비해 남성근로자의 경우 정규직 생존확률이 높았으며, 공공 및 정부기관 종사자가 민간기업 종사자에 비해 정규직 생존확률이 높았다. 100인 이상 규모의 기업에 근무하는 경우, 노동조합이 조직되어 있는 곳에 근무하는 경우 정규직 생존확률이 높았다. 이는 정년연장 혜택이 안정적 고용집단인 특정계층에게 집중되는 계층화 효과, 젠더편향 효과를 보여주는 것이다. 이는 격차확대 위험을 시사하며, 청년층이 선호하는 괜찮은 일자리에서의 일자리 경쟁과 세대갈등 가능성을 시사한다.

• Tuberculosis and Respiratory Diseases
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• 제66권4호
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• pp.280-287
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• 2009

연구배경: 표피성장인자수용체(epidermal growth factor receptor, EGFR) 티로신 활성효소 억제제(tyrosine kinase inhibitor, TKI)는 진행성 비소세포폐암의 새로운 치료제이다. 몇몇 연구 결과 gefitinib와 erlotinib에 대한 반응률과 반응 예측인자에 차이가 있을 가능성을 제시하였다. 저자들은 한국인 진행성 비소세포폐암에서 gefitinib와 erlotinib의 효과 및 독성을 비교하고 각 약제에 대해 서로 다른 반응 예측인자가 있는지 평가하였다. 방 법: 2003년 7월부터 2009년 2월까지 이화여자대학 교부속병원에서 진행성 비소세포폐암으로 gefitinib 또는 erlotinib로 치료 받은 환자들의 임상정보를 수집하였다. 중앙 생존기간은 Kaplan-Meier법으로 계산하였다. 결 과: 대상 환자는 총 86명이었다(gefitinib군 52명 대 erlotinib군 34명). 나이의 중앙값은 64세였고 53명(62%)이 남자였다. 86명 중 83명에서 반응평가가 가능했으며, 83명 중 35명이 반응을 보였고 12명이 안정성 질환이었으며 36명이 진행성 질환으로, 치료 반응률이 42%였고 질병 조절률이 57%였다. 중앙 추적관찰기간 502일 동안, 진행까지의 중앙기간은 129일이었으며 중앙 생존기간은 259일이었다. 치료 반응률(gefitinib 44% 대 erlotinib 39%, p=0.678), 중앙 생존기간(gefitinib 301일 대 erlotinib 202일, p=0.151) 및 병의 진행까지 기간의 중앙값(gefitinib 136일 대 erlotinib 92일, p=0.672)은 두 군 사이에 차이가 없었다. 두 약제는 비슷한 독성을 보였다. Cox 회귀모형을 이용한 다변수분석에서 선암이 생존과 관련된 독립적인 예후인자였다(상대위험도: 0.487, 95% 신뢰구간: 0.292~0.811, p=0.006). 아집단 분석 결과 두 약제에 대한 서로 다른 반응 예측인자는 없었다. 결 론: Gefitinib와 erlotinib 사이에 반응률, 생존기간, 진행까지의 기간 및 독성에 차이는 없었다. 각 약제에 대한 특이적인 반응 예측인자도 없었다.

• Journal of Chest Surgery
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• 제55권2호
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• pp.126-142
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• 2022

Background: Thymic epithelial tumors (TETs) are rare, and information regarding their surgical outcomes and prognostic factors has rapidly changed in the past few decades. We analyzed surgical treatment practices for TETs and outcomes in terms of overall survival (OS) and freedom from recurrence (FFR) during a 13-year period in Korea. Methods: In total, 1,298 patients with surgically resected TETs between 2000 and 2013 were enrolled retrospectively. OS and FFR were calculated using the Kaplan-Meier method and evaluated with the log-rank test. Prognostic factors for OS and FFR were analyzed with multivariable Cox regression. Results: A total of 1,098 patients were diagnosed with thymoma, and 200 patients were diagnosed with thymic carcinoma. Over the study period, the total number of patients with surgically treated TETs and the proportion of patients who underwent minimally invasive thymic surgery (MITS) increased annually. The 5-year and 10-year survival rates of surgically treated TETs were 91.0% and 82.1%, respectively. The 5-year and 10-year recurrence rates were 86.3% and 80.0%, respectively. The outcomes of surgically treated TETs improved over time. Multivariable Cox hazards analysis for OS, age, tumor size, and Masaoka-Koga stage were independent predictors of prognosis. The World Health Organization classification and tumor-node-metastasis (TNM) staging were also related to the prognosis of TETs. Conclusion: Surgical treatment of TETs achieved a good prognosis with a recent increase in MITS. The M-K stage was the most important prognostic factor for OS and FFR. The new TNM stage could also be an effective predictor of the outcomes of TETs.

• Korean Journal of Acupuncture
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• 제31권2호
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• pp.56-65
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• 2014

Objectives : The purpose of this study is to compare the effects of laser acupuncture to the 830 nm on the five transport points with the spleen meridian for treatment to intestinal disease in rat with dextran sulfate sodium(DSS)-induced colitis. Methods : Colitis was induced by DSS for 20 days. The laser therapy on the five transport points of spleen meridian (Laser Well Point-SP1(L-WE), Laser Brook Point-SP2(L-BR), Laser Stream Point-SP3(L-ST), Laser River Point-SP5(L-RI) and Laser Sea Point-SP9(L-SE) was practiced twice a week for 5 times. Colon length was measured using a measuring point. Histological evaluation of colitis was conducted by hematoxylin and eosin(H&E) staining. Reverse transcription polymerase chain reaction(RT-PCR) was determined using western blotting and quantitative reverse-transcriptase polymerase chain reaction, respectively. Results: Colon length increased significantly L-BR and L-ST points after 5 times of therapy. Damage to the colonic mucosa is an integral feature of the DSS model, so control colonic mucosa tissue was damaged in the areas of ulceration resulting in complete epithelial loss. However histological damage decreased on the epithelial lining at all points. Cyclooxygenase(COX)-2 concentrations decreased in all points groups and Interferon(IFN)-${\gamma}$ increased in L-WE, L-BR, L-RI and L-SE points but L-ST was decreased when compared with control. White blood cell(WBC) and neutrophils(NE) decreased after the fifth acupuncture on the all points. But hemoglobin(HGB) increased after the fifth acupuncture on the L-WE, L-BR, L-ST and L-RI points. Also Mean corpuscular hemoglobin(MCH) and Mean corpuscular hemoglobin concentration(MCHC) decreased after the fifth acupuncture on the all points. Conclusions: The present study indicated that five transport points of the spleen meridian can prevent the development of DSS-induced colitis in rat. Thereby suggesting that should be available for decreasing DSS-induced inflammation in a colonic mucosa of tissue.

• Biomolecules & Therapeutics
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• 제23권1호
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• pp.45-52
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• 2015

To explore the anti-allergic and anti-inflammatory effects of extracts of Petasites genus, we studied the effects of s-petasin, a major sesquiterpene from Petasites formosanus (a butterbur species) on asthma and peritonitis models. In an ovalbumin-induced mouse asthma model, s-petasin significantly inhibited the accumulations of eosinophils, macrophages, and lymphocytes in bronchoalveolar fluids. S-petasin inhibited the antigen-induced degranulation of ${\beta}$-hexosamidase but did not inhibit intracellular $Ca^{2+}$ increase in RBL-2H3 mast cells. S-petasin inhibited the LPS induction of iNOS at the RNA and protein levels in mouse peritoneal macrophages. Furthermore, s-petasin inhibited the production of NO (the product of iNOS) in a concentration-dependent manner in the macrophages. Furthermore, in an LPS-induced mouse model of peritonitis, s-petasin significantly inhibited the accumulation of polymorpho nuclear and mononuclear leukocytes in peritoneal cavity. This study shows that s-petasin in Petasites genus has therapeutic effects on allergic and inflammatory diseases, such as, asthma and peritonitis through degranulation inhibition in mast cells, suppression of iNOS induction and production of NO in macrophages, and suppression of inflammatory cell accumulation.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4769-4774
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• 2016

Objective: To analyze the survival of elderly patients with breast cancer according to the type of treatment used. Methods: A cohort study of women aged 80 or over with breast cancer registered with the Brazilian National Cancer Institute (Instituto Nacional do $C{\hat{a}}ncer$ - INCA) between 2008 and 2009 was conducted. Prognosis was analyzed according to the cancer treatment performed: surgery, radiotherapy, or hormone therapy. Analysis of the overall 5-year survival rate was performed using the Kaplan - Meier method, and comparisons of curves were undertaken using the log-rank test. For multiple regression analysis, Cox regression was used, adjusting for age and clinical stage, considering values of p < 0.05 as significant. Data were all analyzed using the statistical package SPSS version 20. Results: 70 women with a mean age of $84.0{\pm}3.7years$ at diagnosis participated in the study. The median follow-up time was 37.1 months (range 0.5-75.5), and 31 deaths (44.3%) occurred during this time. The median survival time was 51.2 months (95% CI, 44.9-57.4), higher in those who underwent surgery (p = 0.012) and those who had hormone therapy (p=0.001). Treatment with surgery reduced the risk of death by 61.7% (HR 0.3; 95% CI, 0.1-0.6; p = 0.001) when adjusted for clinical stage and age at diagnosis. However, there was no significant benefit from radiotherapy (HR 1.2; 95% CI, 0.5-2.5; p = 0.694). Conclusion: Treatment with surgery and hormone therapy increased the survival of our Brazilian patients with breast cancer aged 80 or over.