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Prognostic Value of Vascular Endothelial Growth Factor (VEGF) in Resected Non-Small Cell Lung Cancer (비소세포폐암의 예후인자로서 Vascular Endothelial Growth Factor(VEGF)의 의의)

  • Ko, Hyeck-Jae;Park, Jeong-Hyun;Shim, Hyeok;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.676-685
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    • 2001
  • Background : Angiogenesis is an essential component of tumor growth and metastasis, and the vascular endothelial growth factor (VEGF) is one of the most important angiogenic factors. Several solid tumors produce substantial amounts of VEGF, which stimulates proliferation and the migration of endothelial cells, thereby inducing neovasculization by a paracrine mechanism. To evaluate the prognostic roles of angiogenesis and VEGF expression in patients with non-small cell lung cancer, the relationship between VEGF expression in tumor tissues, the clinicopathologic features and the overall survival rate were analysed. Methods : Sixty-nine resected primary non-small cell lung cancer specimens were evaluated. The paraffin-embedded tumor tissues were stained by anti-VEGF polyclonal antibodies using an immunohistochemical method to assess VEGF expression. Results : In Forty-one patients (59%), the VEGF antigen was expressed weakly in their tumor tissue, whereas in twenty-eight patients (41%) the VEGF antigen was expressed strongly. The median survival time of the weak VEGF expression group was 24 months, and that of the strong VEGF expression group was 19 months. The three year-survival rates were 35%, 33%, respectively. The survival difference between both groups was not statistically significant. Conclusion : Although results were not statistically significant, the strong expression group tended to poorer prognosis than the weak expression group.

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IGRINS Design and Performance Report

  • Park, Chan;Jaffe, Daniel T.;Yuk, In-Soo;Chun, Moo-Young;Pak, Soojong;Kim, Kang-Min;Pavel, Michael;Lee, Hanshin;Oh, Heeyoung;Jeong, Ueejeong;Sim, Chae Kyung;Lee, Hye-In;Le, Huynh Anh Nguyen;Strubhar, Joseph;Gully-Santiago, Michael;Oh, Jae Sok;Cha, Sang-Mok;Moon, Bongkon;Park, Kwijong;Brooks, Cynthia;Ko, Kyeongyeon;Han, Jeong-Yeol;Nah, Jakyuong;Hill, Peter C.;Lee, Sungho;Barnes, Stuart;Yu, Young Sam;Kaplan, Kyle;Mace, Gregory;Kim, Hwihyun;Lee, Jae-Joon;Hwang, Narae;Kang, Wonseok;Park, Byeong-Gon
    • The Bulletin of The Korean Astronomical Society
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    • v.39 no.2
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    • pp.90-90
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    • 2014
  • The Immersion Grating Infrared Spectrometer (IGRINS) is the first astronomical spectrograph that uses a silicon immersion grating as its dispersive element. IGRINS fully covers the H and K band atmospheric transmission windows in a single exposure. It is a compact high-resolution cross-dispersion spectrometer whose resolving power R is 40,000. An individual volume phase holographic grating serves as a secondary dispersing element for each of the H and K spectrograph arms. On the 2.7m Harlan J. Smith telescope at the McDonald Observatory, the slit size is $1^{{\prime}{\prime}}{\times}15^{{\prime}{\prime}}$. IGRINS has a plate scale of 0.27" pixel-1 on a $2048{\times}2048$ pixel Teledyne Scientific & Imaging HAWAII-2RG detector with a SIDECAR ASIC cryogenic controller. The instrument includes four subsystems; a calibration unit, an input relay optics module, a slit-viewing camera, and nearly identical H and K spectrograph modules. The use of a silicon immersion grating and a compact white pupil design allows the spectrograph collimated beam size to be 25mm, which permits the entire cryogenic system to be contained in a moderately sized ($0.96m{\times}0.6m{\times}0.38m$) rectangular Dewar. The fabrication and assembly of the optical and mechanical components were completed in 2013. From January to July of this year, we completed the system optical alignment and carried out commissioning observations on three runs to improve the efficiency of the instrument software and hardware. We describe the major design characteristics of the instrument including the system requirements and the technical strategy to meet them. We also present the instrumental performance test results derived from the commissioning runs at the McDonald Observatory.

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Impact of Adjuvant Chemoradiation Therapy on the Postoperative 5-year Survival Rates for Stage-II Gastric Cancer (2기 위암환자의 수술 후 보조 항암요법 및 방사선 치료가 생존율에 미치는 영향)

  • Hong, Seong-Kweon;Choi, Min-Gew;Baik, Yong-Hae;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.281-287
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    • 2005
  • Purpose: This study was conducted to evaluate the effectiveness and the role of post-operative adjuvant chemoradiation therapy in a stage-II (UICC, 1997) primary gastric cancer. Materials and Methods: From September 1994 to December 2004, 954 stage-II gastric-cancer patients were seen, and all of them underwent a curative resection with extensive (D2) lymph-node dissection. The chemotherapy consisted of fluorouracil $(400mg/m^2)$ plus leucovorin $(20mg/m^2)$ for 5 days, followed by 4,500 cGy of radiotherapy for 5 weeks with fluorourcil and leucovorin on the first 4 days and the last 3 days of radiotherapy. Two five-day cycles of chemotherapy were given four weeks after the completion of radiotherapy. The Kaplan-Meier method was used to estimate the survival rates. To assess the importance of potential prognostic factors, we performed univariate and multivariate analyses using a log-rank test and Cox's proportional hazards regression model. A P value <0.05 was considered significant. Results: Univariate analysis revealed that age, tumor size, gross type, surgical method, and postoperative adjuvant therapy had statistical significance. Among these factors, age, surgical method, tumor size, surgical method, and postoperative adjuvant therapy were found to be independent prognostic factors by using a multivariate analysis. The postoperative adjuvant chemotherapy group and the chemoradiation therapy group had survival benefit compared to the surgery-only group. However the chemoradiation therapy group had no significant survival benefit compared to the chemotherapy group. Conclusion: The postoperative adjuvant therapy in stage-II gastric-cancer patients had significant benefit. Therefore, postoperative adjuvant chemoradiation therapy has an acceptable effect. A large-scale, randomized study is needed to evaluate the effectiveness and the role of postoperative radiation therapy.

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Which of Baby Boom Generation Can Get the Benefit of Extension of the Retirement Age Obligation? (베이비붐세대와 정년연장 혜택의 귀착)

  • Seok, Jae Eun;Yi, Gi Joo
    • Korean Journal of Social Welfare
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    • v.68 no.2
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    • pp.107-130
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    • 2016
  • This study is aimed at the exploratory research on the influence of the obligation of extension of the retirement age on the baby boom generation. The basic question of this study is about which of the baby boom generation can get how much benefit according as the extension of the retirement age becomes compulsory. The extension of the retirement age is the system that can be applied to regular full-time workers. Accordingly, this study is intending to analyze the characteristics of the workers having a high likelihood for benefits from extension of the retirement age by tracing the economic activity state and labor history of the baby boomers. For this purpose, this study looked into the change of the economic activity state by age cohort of the male baby boomers based on the data for the Korea Labor Panel's 4th(2001) & 17th(2014)year. Using Survival analysis, this study also analyzed who will continue to remain as a regular full-time wage earner. As the result of the analysis, it was found that the more the cohort ages of baby boomers increased, the smaller the probability of remaining as a regular full-time wage earner, and the group who can get benefits from extension of the retirement age was predicted to account for only 11.4% level among the baby boomers. In addition, the result showed that there was a high likelihood of getting more benefits from extension of the retirement age when the baby boomers worked for the government-invested institution, corporate bodies, and government organizations rather than working for private enterprises. Thus, it can be safely said that there might appear a generational conflict due to extension of the retirement age in that such jobs coincide with the ones favored by the rising generation.

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Prognostic Factors for Survival in Patients with Stage IV non-small Cell Lung Cancer (제 IV병기 비소세포폐암의 예후인자)

  • Kim, Myung-Hoon;Park, Hee-Sun;Kang, Hyun-Mo;Jang, Pil-Soon;Lee, Yun-Sun;An, Jin-Yong;Kwon, Sun-Jung;Jung, Sung-Soo;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.379-388
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    • 2002
  • Background : Although patients with stage IV non-small cell lung cancer are known to have a poor prognosis, the prognostic factors for survival have not been well evaluated. Such factors may be different from those for overall survival. This study was performed to analyze the prognostic factors for survuval and the variation of survival according to metastatic organ, in patients with stage IV non-small cell lung cancer. Materials and Methods : From January 1997 to December 2000, 151 patients with confirmed stage IV non-small cell lung cancer were enrolled into this study retrospectively. The clinical and laboratory data were analyzed using univareate Kaplan-Meied and Multivariate Cox regression models. Results : On univariate analysis, age, performance status, serum albumin level, weight loss, forced expiratory volume in one second (FEV1), systemic chemotherapy, the number of metastatic organs and serum lactate dehydrogenase (LDH) level were significant factors (p<0.05). In multivariate analysis, important factors for survival were ECOG performance (relative risk of death [RR]: 2.709), systemic chemotherapy (RR: 1.944), serum LDH level (RR: 1.819) and FEV1 (RR: 1.774) (p<0.05), Metastasis to the brain and liver was also a significant factor on univariate analysis). The presence of single lung metastasis was associated with better survival than that of other metastatic organs (p=0.000). Conclusion : We confirmed that performance status and systemic chemotherapy were independent prognostic factors, as has been recognized. The survival of stage IV non-small cell lung cancer patients was different according to the metastatic organs. Among the metastatic sites, only patients with metastasis to the lung showed bettrer survival than that of other sites, while metastasis of the brain or liver was associated with worse survival than that of other sites.

The Role of Radiotherapy in Treatment of Hepatocellular Carcinoma (간세포암에서 방사선 치료의 역할)

  • Eun, Jong Ryul;Choi, Kyo Won;Lee, Heon Ju;Kim, Mung Se
    • Journal of Yeungnam Medical Science
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    • v.17 no.2
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    • pp.137-145
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    • 2000
  • Background: Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and Methods: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. Results: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. Conclusions: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.

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A Clinical Analysis on the Restoration of Sinus Rhythm Following Mitral Valve Surgery (승모판 수술 후 동율동 회복에 관한 임상분석)

  • 백완기;심상석;김현태;조상록;진성훈
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.347-352
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    • 1999
  • Background: The atrial fibrillation in patients with mitral valvular heart disease is frequently converted to sinus rhythm after the mitral valve surgery. This sinus restoration implies an important meaning in that it not only helps postoperative convalescence in patients with unstable hemodynamics but also reduces the rate of postoperative thromboembolism. Material and Method: We retrospectively analyzed 184 patients who received mitral valve surgery from June 1986 to December 1996 to investigate the trend of rhythm change following mitral valve surgery and thus to clarify the predisposing factors of postoperative sinus rhythm conversion and its maintenance. Result: The sinus rhythm was restored after the operation in 54 out of 139 patients with atrial fibrillation preoperatively(38.8%). However, the atrial fibrillation recurred in 41 patients at the time of discharge showing a recurrence rate of 75.9 percent. The mean duration of sinus rhythm in patients with eventual atrial fibrillation recurrence was 8.2${\pm}$5.9 days. Only 15 patients were in sinus rhythm at the time of late follow-up with the mean follow-up period of 84.4${\pm}$34.7 months. While the age, duration of symptoms, duration of atrial fibrillation, left atral size, and pulmonary artery pressure were thought to be the predisposing factors for sinus conversion after the operation, only the duration of atrial fibrillation and ejection fraction were considered risk factors for the recurrence of the atrial fibrillation following sinus conversion. Conclusion: This study suggests that the early operation is mandatory for the satisfactory result regarding postoperative rhythm. Moreover, additional operative measure in adjunct to the intervention of mitral valve should be considered for the maintenance of restored sinus rhythm as reflected by high postoperative recurrence rate of atrial fibrillation.

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Valve Replacement in Children (소아심장판막치환술)

  • 김재현;이광숙;윤경찬;유영선;박창권;최세영
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.341-346
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    • 1999
  • Background: Thirty children ranging from 3 to 15 years of age underwent cardiac valve replacement at Dongsan Medical Center from 1982 to 1997. Material and Method: There were 16 boys and 14 girls. The mean age was 12.1. The underlying pathological cause for valve replacement was congenital heart disease in 17 children and acquired heart disease in 13. The valve replaced was mitral in 15 children, aortic in 11, tricuspid in 3, and combined aortic and mitral in 1. Twenty-one mechanical and 10 tissue valves were placed: primary mechanical valve have been utilized since 1985. Eight of ten patients with tissue valves have had successful second valve replacements 4 to 11 years after the initial operation. Result: The operative mortality was 6.7%, but mortality was higher among patients less than 5 years of age and patients who had previous cardiac operations. Of the 28 operative survivors, 4 patients were lost to follow-up: the remaining patients were observed for a total of 2091 patient/months(mean 74.7 months, maximum 187 months). There was one late death from dilated cardiomyopathy after mitral valve replacement in 7 year-old patient with atrioventricular septal defect. After the operation, all patients with mechanical valves were placed on a strict anticoagulant regimen with Coumadin. The actuarial survival rate was 96% at the end of the follow-up. No instance of thromboembolism or major bleeding were observed in the survivors. Conclusion: These results indicate that valve replacement can be performed with low mortality in children, and with satisfactory long-term survival.

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Aprotinin Therapy for Cardiac Operation in Adult -Full dose regimen- (개심술에서 아프로티닌의 효과 (고용량 요법))

  • 장운하;오태윤;김미혜
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.358-363
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    • 1999
  • Background: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. Material and Method: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. Result: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186${\pm}$40cc, control group:409${\pm}$69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317${\pm}$53cc, control group: 671${\pm}$133cc, P=0.024). Conclusion: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.

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Composite Graft Aortic Root Replacement with Coronary Button Reimplantation: The Early and Mid-Term Results (Composite graft를 이용한 대동맥근부 치환술: Button 술식의 중단기 결과)

  • 나찬영;백만종;김웅한;오삼세;김수철
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.356-364
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    • 2002
  • Background: This study was undertaken to investigate the outcome of composite graft aortic root replacement using coronary button reimplantation technique for the treatment of aneurysms of the ascending aorta involving the aortic root. Material and Method: Between April 1995 and September 2001, 54 patients having aortic root replacement with a composite valve graft using direct coronary button reimplantation were reviewed retrospectively. Left ventricular dysfunction was present in 14 patients(25.9%), aortic regurgitation in 48(89%), and Marfan's syndrome in 17(31.5%). The indications for operation were annuloaortic ectasia in 29 patients(53.7%), aortic dissection in 11(20.4%), aneurysms of the ascending aorta involving aortic root in 12(22.2%), and aortitis in 2(3.7%). Six patients(11.1%) had previous cardiac or ascending aortic operations. Concomitant procedures were arch replacement in 21 patients(38.9%), coronary artery bypass graft in 7(13%), mitral valve repair or replacement in 4(7.4%), and others in 6. The mean time of circulatory arrest, total bypass, and aortic crossclamp were 18 $\pm$ 9 minutes, 177 $\pm$ 42 minutes, and 127 $\pm$ 31 minutes, respectively. Result: There was 1 early death(1.9%). Mean follow-up was 24.6$\pm$ 19.5 months. There were two late deaths(3.8%) including one death due to the traumatic cerebral hemorrhage. The Kaplan-Meier survival rate was 98.0 $\pm$ 2.0% and 93.1 $\pm$ 5.1% at 1 and 6 years, respectively. Two patients required reoperation owing to a false aneurysm at the root anastomosis site and a malfunction of prosthetic aortic valve(3.8%). Staged operation for dissection of the remaining thoracoabdominal aorta was performed in 1 patient. The freedom rate from reoperation was 97.8 $\pm$ 2.0% and 65.3 $\pm$ 26.7% at 1 and 6 years, respectively.