• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.249-258
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• 2022

The specific muscular structure of the tongue greatly affects margin shrinkage and tumor invasion, making the optimal surgical margin controversial. This study investigated surgical margin correlated prognosis of TSCC (tongue squamous cell carcinoma) according to margin location and its value, and the histopathologic factors which are suggestive of tumor invasion. And we would like to propose defining of the surgical margin for TSCC via prognosis according to location and margin values. We reviewed 45 patients diagnosed with TSCC who visited Seoul National University Dental Hospital (SNUDH) (Seoul, Republic of Korea) from 2010 to 2019, who were managed by a single surgical team. Patient clinical and pathological data of patients were retrospectively reviewed, and in 36 out of 45 patients, the pathologic parameters including the worst pattern of invasion (WPOI) and tumor budding were investigated via diagnostic histopathology slide reading. When standardized with as 0.25 cm anterior margins, as 0.35 cm deep margin, there was no significant difference in disease specific survival (DSS) or loco-regional recurrence-free survival (LRFS). Additionally, there was a non-significant difference in DSS and LRFS at the nearest margin of 0.35 cm (P_DSS=0.276, P_LRFS=0.162). Aggressive WPOI and high tumor budding showed lower survival and recurrence-free survival, and there were significant differences in close margin and involved margin frequencies. In TSCC, the value and location of the surgical margin did not have a significant relationship with prognosis, but WPOI and tumor budding suggesting the pattern of muscle invasion affected survival and recurrence-free survival. WPOI and tumor budding should be considered when setting an optimal surgical margin.

• Radiation Oncology Journal
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• 제21권3호
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• pp.199-206
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• 2003

목적: 자궁경부암에서 수술 후 위험인자가 있는 환자에 방사선치료 후 생존율, 국소 제어율과 예후인자를 후향적으로 분석하여 수술 후 방사선치료의 효과를 알고자 한다. 대상 및 방법: 1986년 3월부터 1998년 12월까지 자궁경부암 FIGO 병기 IB-IIB로 자궁적출술 후 방사선치료를 받은 58명을 대상으로 국소 제어율, 5년 무병생존율과 생존율에 미치는 예후인자를 후향적으로 분석하였다. 수술 후 방사선치료의 적응증은 병리학적으로 림프절에 전이된 경우, 암이 수술절제연이나, 자궁주위조직 혹은 자궁체부에 침범하였거나, 림프혈관강에 침범된 경우, 자궁기질의 1/2 이상 깊이 침윤된 경우와 단순 자궁적출술 후 암으로 진단받은 환자로 하였다. 수술 후 방사선치료는 모든 환자에서 골반강에 외부조사를 시행하였으며 5명은 외부조사와 강내조사를 병용하였다. 외부조사는 6 MV x-선을 이용하여 매일 180 cGy를 4문으로 조사하였으며 총 방사선량은 $4400\~5040$ cGy (중앙값: 5040 cGy)이었다. 강내조사는 외부조사 후 2주에 Cs-137를 이용하여 저선량률로 질 표면에서 5 mm 깊이에 $4488\~4932$ cGy (중앙값: 4500 cGy)를 시행하였다. 추적기간은 15개월에서 108개월로 중앙값은 44개월 이었다. 결과: 전체환자의 5년 무병생존율은 $94\%$, 국소 제어율은 $98\%$,이었으며 원격 전이율은 $5\%$이었다. 병기에 따른 5년 무병생존율은 $IB\;97.1\%,\;IIA\;100\%,\;IIB\;68.9\%$(p=0.0145)이었다. 질 절제연에 암의 침범이 없는 경우 5년 무병생존율이 $97.8\%$, 있는 경우 $60\%$, (P=0.0002)이었으며, 자궁주위조직에 암이 침범이 없는 경우의 5년 무병 생존율은 $97.8\%$이었고, 있는 경우는 $33.3\%$이었다(p=0.0001). 다변량 분석에 의하면 자궁주위조직의 침범만이 통계학적으로 의의있는 예후인자이었다. 치료 후 만성합병증은 3명($5\%$,)에서 RTOG grade 2의 방광염, 1명에서 grade 2의 직장염과 1명에서 하지에 림프부종이 나타났다. 결론: 조기 자궁경부암 환자에 단순 자궁적출술을 시행하였거나, 근치적 자궁적출술 후 병리학적으로 재발 위험 인자가 있는 환자에 수술 후 방사선치료를 시행하여 심각한 부작용 없이 비교적 높은 국소 제어율과 생존율을 얻을 수 있었다. 생존율에 영향을 미치는 예후인자는 병리학적으로 암이 자궁주위조직에 침범된 것으로 예후가 불량하였다. 수술 후 방사선치료의 실패원인과 예후인자를 분석한 본 후향적 연구결과를 토대로 앞으로 방사선치료와 항암화학요법을 병용하여 보다 적극적이고 전향적인 연구를 시도하는데 이정표로 이용할 수 있다고 생각한다.

• Nuclear Medicine and Molecular Imaging
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• 제43권1호
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• pp.40-47
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• 2009

목적: 분화성 갑상선 암에서 원발 종양의 F-18 FDG 섭취 정도와 여러 병리학적, 면역조직화학적 지표들과의 연관성을 알아보고자 하였다. 대상 및 방법: 본원에 내원하여 수술 전 F-18 FDG PET/CT 스캔을 시행한 후 갑상선 전 절제술 및 림프절 제거술을 시행한 분화성 갑상선암 환자들을 대상으로 하였다. PET/CT 영상에서 원발성 종양의 SUVmax를 구한 후 SUVmax와 종양의 크기, 림프절 전이, 종양의 다발성, 갑상선 밖으로의 침습, 갑상선염 동반 여부와 같은 병리학적 인자들과 Ki-67 표지을, EGFR, COX-2, 그리고 Galectin-3 같은 면역조직화학적 지표들과 관계가 있는지를 독립표본 T 검정을 사용하여 알아보았다. 결과: 106명의 환자 중 102명은 유두상암이었고 4명은 여포상암이었다. 1 cm보다 큰 종양에서의 평균 SUVmax는 1 cm이하 종양에서의 평균 SUVmax보다 의미 있게 높았다($7.8{\pm}8.5$ vs. $3.6{\pm}3.1$, p=0.004). 그 외 림프절 전이, 종양의 다발성, 갑상선 밖으로의 침습, 갑상선염 동반 유무, Ki-67 표지율, EGFR, COX-2, Galectin-3 발현 유무에 따라 분화성 갑상선 암의 SUVmax는 통계학적으로 유의한 차이가 없었다. 결론: 분화성 갑상선 암에서 F-18 FDG의 섭취 정도는 원발성 종양의 크기와 통계적으로 유의한 연관성이 있었다. 그러나 Ki-67 표지율, EGFR, COX-2, Galectin-3 발현 유무와 F-18 FDG섭취 정도는 유의한 관련성이 없었다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권1호
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• pp.9-16
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• 2000

목 적: 위식도 역류 질환 환아에서 이중 채널 24시간 식도 pH 측정 검사의 유용성을 평가하고 식도 원위부와 근위부에서 얻은 식도 pH 검사 계측치를 비교 평가하고자 본 연구를 하였다. 대상 및 방법: 1997년 7월부터 1998년 12월까지 조선의대 병원 소아과에서 식도역류가 의심되어 내원한 환아 46명을 대상으로 18~24시간 동안 식도의 상부와 하부 두 부위에서 동시에 식도 pH를 측정하였다. 병적 역류의 기준은 95백분위수 이상의 역류지표를 병적 역류로 정의하였다. 결 과: 1) 원위부 병적 위식도역류를 보인 환자군(group I)은 24명으로 평균연령이 $36.7{\pm}12$개월이었으며, 원위부 생리적 위식도 역류를 보인 대조군(group II)은 22명으로 평균연령이 $31.4{\pm}19$개월이었다. 가장 흔한 증상은 구토와 역류였으며 재발성 흡인성폐렴, 속 쓰림, 천식 등이었다. 2) 환자군에서 근위부와 원위부의 24시간 식도 pH 검사의 성적을 비교하면 최장 역류시간을 제외하고 pH 4.0 이하인 시간의 백분율, 총 역류횟수, 5분 이상 지속된 역류횟수, score 등의 항목에서 통계학적으로 의의 있는 차이를 보였다(p<0.01). 원위부와 근위부의 pH 검사 성적을 비교해 보았을 때 최장 역류시간과 총 역류횟수에서 상관계수가 각각 0.646과 0.451로 높은 상관관계가 있었다. 3) 대조군에서 근위부와 원위부의 24시간 pH 검사결과를 비교해 보았을 때, 모든 항목에서 유의한 차이가 없었다(P>0.05). 4) 원위부 병적 위식도 역류를 보인 환자군의 50%에서는 근위부 식도에도 병적 역류가 있었다. 근위부에서 비정상 역류점수를 보인 군과 정상 역류점수를 보인 군간에 원위부에서 역류점수는 유의한 차이가 없었다(p>0.05). 결 론: 근위부 위식도 역류는 원위부 역류외에도 중력, 식도 체부의 운동능력에 영향을 받은 것으로 생각되며 위식도 역류 환아 특히 재발성 호흡기증상을 보이는 경우에는 이중채널 식도 pH 측정검사가 필요할 것으로 생각된다.

• Archives of Pharmacal Research
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• 제23권1호
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• pp.59-65
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• 2000

Cancer development and the efficiency of chemotherapy relies on the patients calcium-related pathological status such as hyper- or hypocalcemica. In the present study, we investigated the effect of extracellular cations such as calcium and magnesium on the therapeutic efficacy of antitumor drugs. The analytic parameters used were cellular drug uptake/excretion and the chemosensitivity of the human breast cancer cell lines, MCF7 and MCF7/ADR. Both calcium and magnesium ions decreased the membrane permeability of cancer cells, which was determined bycell size analysis. These divalent ions also lowered the drug uptake and the cytoplasmic levels of rhodamine 123 and adriamycin, suggesting that they might interfere with the diffusion of these drugs by modifying the physical properties of the cytoplasmic membrane. The acute cytotoxicity of adriamycin after a short period of incubation correlated with changes in its cytoplasmic level. Our results indicate that these extracellular cations might play an important role in the therapeutic activities of anticancer drugs in cancer patients. These results also provide insight a new aspect of chemotherapy, because they suggest that the therapeutic dose of anti-cancer drugs should be modified in cancer-bearing patients presenting with abnormal blood calcium levels.

• Archives of Pharmacal Research
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• 제25권6호
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• pp.984-988
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• 2002

The issue of whether or not the presence NOx (NO and oxidized metabolites) in the hepatocytes at pathological levels affects the functional activity of transport systems within the sinusoidal membrane was investigated. For this purpose, the effect of the pretreatment of isolated hepatocytes with sodium nitroprusside (SNP), a spontaneous NO donor, on the sinusoidal uptake of tributylmethylammonium (TBuMA) and triethylmethyl ammonium (TEMA), representative substrates of the organic cation transporter (OCT), and taurocholate, a representative substrate of the $Na^+$/taurocholate cotransporting polypeptide (NTCP), was measured. The uptake of TBuMA and TEMA was not affected by the pretreatment, as demonstrated by the nearly identical kinetic parameters for the uptake ($i.e., V_{max}, K_{m} and CL_{linear}$). The uptake of mannitol into hepatocytes was not affected, demonstrating that the membrane integrity remained constant, irregardless of the SNP prutreatment. On the contrary, the uptake of taurocholate was significantly inhibited by the pretreatment, resulting in a significant decrease in V_{max}$, thus providing a clear demonstration that NOx preferentially affects the function of NTCP rather than OCT on the sinusoidal membrane. A direct interaction between NOx and NTCP or a decrease in $Na^+/K^+$ ATPase activity as the result of SNP pretreatment might be responsible for this selective effect of NOx.

• Nutrition Research and Practice
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• 제5권4호
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• pp.365-369
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• 2011

This study investigated the preventive effect of Saururus chinensis Baill against renal damage induced by a high-fructose diet in rats. The rats (n = 30) were fed either a cornstarch-based (65%), high-fructose (65%), or high-fructose (64.5%) diet with 0.5% S. chinensis Baill extract for 10 weeks. Twenty-four hour urine collections were obtained and the animals were sacrificed after an overnight fast. Serum urea and creatinine and urine albumin were measured using colorimetric methods, and creatinine clearance was determined. In addition, thiobarbituric acid reactive substances (TBARS), reduced glutathione (GSH), and the activity of superoxide dismutase (SOD) in the kidney were determined. Kidney samples were also examined histologically. The fructose-fed rats showed renal dysfunction, indicated by decreased creatinine clearance, increased albumin in the urine, and increased urea and creatinine in the serum. These renal function parameters were comparable to control levels in rats that consumed S. chinensis Baill. Fructose consumption increased renal TBARS and reduced GSH and SOD activity, whereas these levels were near-normal in the rats consuming S. chinensis Baill The kidneys of fructose-fed rats showed glomerular basement membrane thickening, mesangial matrix expansion, and tubule dilation. These pathological changes were not seen in the rats that consumed S. chinensis Baill. Therefore, S. chinensis Baill effectively alleviated fructose-induced renal damage in these rats, at least partially due to antioxidant activity.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권2호
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• pp.112-117
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• 2010

Aurora kinases represent a novel family of serine/threonine kinases crucial for cell cycle control. Aurora-2 kinase is mainly involved in centrosome function, mitotic entry, and spindle assembly. Aurora-2 kinase overexpression causes centrosome amplification and the formation of multipolar mitotic spindles, which leads to tumor aneuploidy and so it has been found to play an important role in tumorigenicity in many cancers such as colorectal cancer, breast cancer and cervical cancer. Hence, the goal of this study is to identify the correlation of clinicopathlogical factors and overexpression of Aurora-2 kinase in oral squamous cell carcinoma. We studied the immunohistochemical staining of Aurora-2 kinase in 20 specimens of 20 patients with oral squamous cell carcinoma and the relationships between Aurora-2 kinase over expression and each of the clinico-pathological parameters were analyzed by Pearson correlation analysis. Statistical significance was set at P < 0.05. The results were as follows. 1. In the immunohistochemical study of poorly differentiated and invasive oral squamous cell carcinoma, the high level staining of Aurora-2 kinase was observed. 2. The correlation between immunohistochemical Aurora-2 kinase expression and histopathological differentiation of specimens was significant. These findings suggest that overexpression of Aurora-2 kinase may play a important role in carcinogenesis of oral squamous cell carcinoma.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5433-5438
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• 2012

Background: Hepatocellular carcinoma (HCC) is a common and aggressive malignancy. Despite of the improvements in its treatment, HCC prognosis remains poor due to its recurrence after resection. This study provides complete genetic profile for Egyptian HCC. Genome-wide analyses were performed to identify the predictive signatures. Patients and Methods: Liver tissue was collected from 31 patients with diagnosis of HCC and gene expression levels in the tumours and their adjacent non-neoplastic tissues samples were studied by analyzing changes by microarray then correlate these with the clinico-pathological parameters. Genes were validated in an independent set by qPCR. The genomic profile was associated with genetic disorders and cancer focused on gene expression, cell cycle and cell death. Molecular profile analysis revealed cell cycle progression and arrest at G2/M, but progression to mitosis; unregulated DNA damage check-points, and apoptosis. Result: Nine hundred fifty eight transcripts out of the 25,000 studied cDNAs were differentially expressed; 503 were up-regulated and 455 were down-regulated. A total of 19 pathways were up-regulated through 27 genes and 13 pathways were down-regulated through 19 genes. Thirty-seven genes showed significant differences in their expression between HCC cases with high and low Alpha Feto Protein ($AFP{\geq}600$ IU/ml). The validation for the microarray was done by real time PCR assay in which PPP3CA, ATG-5, BACE genes showed down-regulation and ABCG2, RXRA, ELOVL2, CXR3 genes showed up-regulation. cDNA microarrays showed that among the major upregulated genes in HCC are sets. Conclusion: The identified genes could provide a panel of new diagnostic and prognostic aids for HCC.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.315-318
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• 2012

Objective: Cyclooxygenase-2 (COX-2) has been claimed to play role in carcinogenesis and be related to a bad prognosis in tumours. The aim of this study was to investigate the relationship between COX-2 expression and clinical and pathological parameters in early and advanced stage lung cancer patients. Materials and Methods: A total of 73 patients with lung cancer (27 adenocarcinomas, 33 squamous cell carcinomas, 4 large cell carcinomas and 9 small cell cancer) were analysed retrospectively. COX-2 expression was evaluated by immunohistochemistry in resection materials or lung biopsies. Tumor cells demonstrating more intense staining than smooth muscle and endothelial cells were recorded as COX-2 positive. We investigated the correlation between increased COX-2 expression and histological type of the tumor, the stage of the disease and survival. Results: COX-2 expression was observed in 55% of the adenocarcinomas, 45% of the squamous cell carcinomas and 22% of the small cell carcinomas. No correlation was apparent between COX-2 expression and disease stage, histological type and the survival. Conclusion: The results of this study do not support COX-2 expression as an independent prognostic factor in lung cancer. However, since results of the literature are different, further studies made in larger series are needed.