The effect of angiotensin system inhibitors (angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) on cancer recurrence and survival: a meta-analysis

Song, Taejong,Choi, Chel Hun,Kim, Mi Kyoung,Kim, Mi-La,Yun, Bo Seong,Seong, Seok Ju Lippincott Williams & Wilkins 2017 EUROPEAN JOURNAL OF CANCER PREVENTION Vol.26 No.1

To assess the current evidence on the potential benefit of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on cancer recurrence and survival, we comprehensively searched PubMed, Embase, and the Cochrane Library from their inception to April 2013. Two authors screened out duplicates and independently reviewed the eligibility of each study. We included comparative studies comparing the use and nonuse of ACEIs or ARBs in cancer patients. Primary outcomes were disease-free survival (DFS) and overall survival. We included 11 studies with 4964 participants in the final analysis. The meta-analysis showed that the use of ACEIs or ARBs resulted in a significant improvement in DFS [hazard ratio (HR) 0.60; 95% confidence interval (CI) 0.41–0.87; P=0.007)] and overall survival (HR 0.75; 95% CI 0.57–0.99; P=0.04). Even when cancer stage was classified into low (I/II) or high (III/IV), DFS improvement was applied to both low stage (HR 0.56; 95% CI 0.32–0.96; P=0.04) and high stage (HR 0.59; 95% CI 0.37–0.94; P=0.03). Analysis according to cancer type showed benefits in urinary tract cancer (HR 0.22), colorectal cancer (HR 0.22), pancreatic cancer (HR 0.58), and prostate cancer (HR 0.14), but not in breast cancer and hepatocellular cancer. This meta-analysis provides evidence that the use of ACEIs or ARBs in cancer patients can lead to a 40 and 25% reduction in the risk of cancer recurrence and mortality.

Prognostic Factors in Women With Synchronous Endometrial and Ovarian Cancers

Song, Taejong,Seong, Seok Ju,Bae, Duk-Soo,Kim, Jong-Hyeok,Suh, Dong Hoon,Lee, Keun-Ho,Park, Sang-Yoon,Lee, Taek Sang BMJ 2014 International journal of gynecological cancer Vol.24 No.3

<B>Objective</B><P>The purpose of this study was to determine the prognostic factors in women with synchronous endometrial and ovarian cancers.</P><B>Methods</B><P>Medical records of 3240 patients with endometrial cancer who had undergone primary surgery were collected from 7 institutions and were retrospectively reviewed. The progression-free survival (PFS) and overall survival (OS) curves and rates were calculated using the Kaplan-Meier method. Multivariate analysis to determine independent prognostic factors was performed using the Cox regression model.</P><B>Results</B><P>The incidence of synchronous endometrial/ovarian cancer was 3.8% (123/3240 women). During the median follow-up period of 66 months, 33.3% and 26.1% of women developed recurrences and reported cancer-related deaths. The 5-year PFS and 5-year OS for all 123 women were 66.9% and 80.0%, respectively. In multivariate analysis, pretreatment CA-125 and tumor stage of the ovary showed prognostic significance about PFS (<I>P</I> = 0.043 and <I>P</I> = 0.027) and OS (<I>P</I> = 0.047 and <I>P</I> = 0.031), respectively.</P><B>Conclusions</B><P>Pretreatment CA-125 and tumor stage of the ovary were independent prognostic factors for recurrence and survival.</P>

Expression of 67-kDa Laminin receptor was associated with tumor progression and poor prognosis in epithelial ovarian cancer

( Taejong Song ),( Jin Sun Park ),( Hyo Jeong Kang ),( Ha Jeong Kim ),( Yoo Young Lee ),( Chel Hun Choi ),( Tae Joong Kim ),( Jeong Won Lee ),( Duk Soo Bae ),( Byoung Gie Kim ) 대한산부인과학회 2011 대한산부인과학회 학술대회 Vol.97 No.-

Laparoscopic tube-preserving surgical procedures for ectopic tubal pregnancy

( Taejong Song ),( Dong Hee Lee ),( Hwa Cheung Kim ),( Seok Ju Seong ) 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.6

Objective To present our experience with laparoscopic tube-preserving surgery for ectopic tubal pregnancy and evaluate its feasibility and efficacy. Methods This was a prospective study of 57 consecutive patients with ectopic tubal pregnancies undergoing laparoscopic tube-preserving procedures including salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking. The outcome measures were treatment success rates and homolateral patency rates. Results Of the 57 surgical procedures, 55 (96.4%) were performed successfully without any additional intervention. The number of patients receiving salpingotomy, salpingostomy, segmental resection and reanastomosis, and fimbrial milking were 24 (42.1%), 25 (43.9%), 4 (7.0%), and 2 (3.5%), respectively. Two case was switched to salpingectomy because excessive bipolar coagulation was required to obtain hemostasis at the tubal bleeding bed. Over a mean β-human chorionic gonadotropin resolution time of 18.3±5.9 days, no persistent trophoblast or postoperative complications occurred. A tubal patency test using hysterosalpingography was performed in 15 cases at 3 months postoperatively. Among these, the homolateral tubal patency rate was 75% (11 of 15) and the contralateral patency rate was 80% (12 of 15). Conclusion Tube-preserving surgery is a feasible and safe treatment option for ectopic tubal pregnancy. However, considering that the optimal goal of tube-preserving surgical procedures is not the treatment success, some caution is warranted in interpreting results of this study.

The risk of cesarean section after trial of labor in low risk pregnancies according to maternal body characteristics

( Serae Kim ),( Taejong Song ),( Woo Young Kim ),( Kyo Won Lee ),( Kye Hyun Kim ),( Jee Yoon Park ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

목적: To evaluate the risk of cesarean section during spontaneous labor and success rate of vaginal delivery in term nulliparous women according to maternal height, prepregnancy body mass index (BMI) and gestational weight gain (WG). 방법: A retrospective study was conducted with 269 nulliparous women who gave birth at term gestational period in Kangbuk Samsung Hospital from March 2015 to March 2016. Pregnancies with planned cesarean section (n=28) were excluded. Various anthropometric measures and obstetric outcomes were reviewed and analyzed. 결과: Forty-two (17.4%) women underwent emergency cesarean section and among them, 19 cases (45.2%) were due to failure to progress (FTP). Maternal height was significantly shorter among women who underwent cesarean section due to FTP than those who delivered vaginally (161 cm vs. 163cm, p=0.039). However, prepregnancy BMI and WG were not associated with success rate of vaginal delivery in patients who experienced trial of labor in our data. In subgroup analysis, patients who gained weight during gestation below the recommended values from Institute of Medicine (IOM) demonstrated increased rate of vacuum assisted delivery than women who gained weight adequately (8.8% vs. 1.1%, p=0.044). Especially in women who were categorized as underweight before pregnancy according to IOM, patients with WG below recommendation showed higher rate of failure for vaginal delivery than those with adequate WG although the difference did not reach statistical significance (17.6% vs. 0%, p>0.05). 결론: Our study shows maternal height was the only important factor associated with successful vaginal delivery. Various studies from Western countries reported prepregnancy obesity or over WG were strongly associated with failure of vaginal delivery, however those factors were not significant in our study population, which was composed of Asian low risk pregnancies. Moreover, underweight BMI and WG below the recommended values seemed to be associated with higher cesarean section rate. Future research with large Asian population should be conducted further.

“Freshman effect” on care for gynecologic surgery at a teaching hospital in Korea

( Haeree Yang ),( Taejong Song ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

Objective: The freshman effect, so-called July phenomenon in United States, is a perceived increase in the risk of medical errors and surgical complications that occurs in association with the time of academic year in which medical school graduates begin residencies. The purpose of this study was to evaluate the presence of the freshman effect in patients who underwent gynecologic surgery at a teaching hospital in Korea by comparing surgical outcomes, morbidity, and mortality rates between the first academic quarter and other quarters. Methods: All data were collected prospectively (ClinicalTrials.gov Identifier: NCT02405936) and the study was approved by the Institutional Review Board. Between January 2015 to March 2018, patients who underwent gynecologic surgery during the first academic quarter (March, April, or May in Korea) were retrospectively compared patients who underwent gynecologic surgery during the other academic quarters. The primary outcome measure was the incidence of operative complication. Secondary outcomes were the operative time and the operative blood loss. Results: Among 1241 patients who underwent gynecologic surgery during the study period of 39 months, 1136 patients were analyzed and divided into the first academic quarter group (n=335) and the other academic quarters (n=801). The baseline characteristics were not different between two groups. When separately analyzed each phase of operative time, the skin closure time in the first academic quarter group significantly took 13.4% longer than that in the other academic quarters group (13.5 9.9 min versus 11.9 7.0 min; P = 0.009). No significant differences were in operative blood loss and length of hospital stay. No significant difference in operative complication was found in the first and other academic quarters groups (1.5% versus 3.0%; P =0.143). Conclusion: This study does not demonstrate the presence of a freshman effect or an increase in morbidity or mortality at Korean teaching hospital providing gynecologic surgical care.

Synchronous Gynecologic Malignancy and Preliminary Results of Lynch Syndrome: A Single Institution Review

( Min Kyu Kim ),( Sang Yong Song ),( In Gu Do ),( Ha Jeong Kim ),( Taejong Song ),( Yoo Young Lee ),( Chel Hun Choi ),( Tae Joong Kim ),( Jeong Won Lee ),( Duk Soo Bae ),( Byoung Gie Kim ) 대한산부인과학회 2011 대한산부인과학회 학술대회 Vol.97 No.-

Public perception of “scarless” laparoendoscopic singlesite surgery in gynecology

( Doo Haeng Lee ),( Su Hyun Nam ),( Taejong Song ),( Woo Young Kim ),( Kyo Won Lee ),( Kye Hyun Kim ) 대한산부인과학회 2015 Obstetrics & Gynecology Science Vol.58 No.4

Objective: To investigate the public perception of laparoendoscopic single-site surgery (LESS) according to the age group. Methods: An anonymous questionnaire about the desire for cosmesis and the preference for LESS in treatment of benign gynecologic diseases was provided to healthy volunteers (n=102). The survey participants were divided into two age groups (young women ≤40 years and middle-aged women >40 years). The desire for cosmesis was assessed using a validated scale, Body Image Scale. Results: All of the participants completed the questionnaire. The Body Image Scale scores were not different between the two age groups (11.5±3.5 vs. 11.8±4.0, P=0.656). The most common fear of surgery was the risk of complications in both age groups (69% in the young age group and 65% in the middle-aged group). Unless the operative risk increased, most of the participants (61% to 67%) in both age groups preferred LESS. Their choice was influenced by reduced scarring (43% to 61%), more safety (20% to 39%), reduced postoperative pain (8% to 10%), and new technology (4% to 6%). Conclusion: Based on these results, there was no difference in the desire for cosmesis and perception of LESS according to the age. Therefore, physicians should discuss and consider LESS even in middle-aged women.

Public perception of risk-reducing salpingectomy for preventing ovarian cancer

( Jun Hyeok Kang ),( Se Hyun Nam ),( Taejong Song ),( Woo Young Kim ),( Kyo Won Lee ),( Kye Hyun Kim ) 대한산부인과학회 2015 Obstetrics & Gynecology Science Vol.58 No.4

Objective: The fallopian tube is considered as the site of origin of serous ovarian cancer, and risk-reducing salpingectomy (RRS) has been proposed as a new and safe strategy for preventing ovarian cancer. However, little is known about the public perception of RRS. Methods: We performed a questionnaire survey of 100 healthy female volunteers in November 2014. Questionnaire for this survey included questions on demographics, medical history, knowledge of and belief about RRS, and barrier to its application. Results: Among 100 respondents, 71% did not realize the seriousness of ovarian cancer, 79% were unaware of the fact that salpinx was the origin of ovarian cancer, and 87% stated that they had never heard of RRS as a preventive method for ovarian cancer. Also, 98% of respondents replied that they had the right to be informed about RRS and the choice given. The respondents’ fears about RRS included increased risk of surgical complications (68%), no benefit (8%), and increased surgical costs (3%). Conclusion: Most general women were unaware of RRS as a method for preventing ovarian cancer in women at average risk. Therefore, physicians should discuss RRS with patients and consider this procedure at the time of abdominal or pelvic surgery.

MW급 EGS 지열발전 상용화 기술개발사업의 추진 배경 및 계획

윤운상(Woon-Sang Yoon),송윤호(Yoonho Song),이태종(TaeJong Lee),김광염(Kwang-Yeom Kim),민기복(Ki-Bok Min),조용희(Yong-Hee Cho),전종욱(Jongug Jeon) 한국암반공학회 2011 터널과지하공간 Vol.21 No.1

지열에너지는 여러 신재생에너지원 중에서도 기저부하를 담당할 수 있는 중요한 자원으로 인식되고있다. 국내에서도 천부지열을 이용한 지열냉난방은 효율 높은 신재생에너지 활용 사업으로 그 보급이 활성화 되어 있다. 반면, 전세계적으로 지열 발전 기술이 진일보하고, 그 시장이 크게 확대되고 있는 상황에서 아직까지 국내의 심부 지열을 이용한 지열 발전 기술은 낮은 단계에 머무르고 있다. 이러한 조건에서 2010년 12월에 국내 최초의 EGS(Enhanced Geothermal System) 지열 발전 상용화 기술 개발 과제가 착수되었다. 총 5개년의 기간으로 수행되는 이 과제는 2단계로 구분되어 진행될 계획이다. 처음 2년의 1단계에서는 3 ㎞ 심도에서 최소 100°C의 지열저류층 온도를 확인하는 것을 주요 과제 내용으로 하여 지중 지열수 순환시스템의 설계가 이루어질 예정이다. 이후 3년을 통해 수행될 2단계에서는 5 km 심도의 생산정과 주입정 등 두 개의 지열발전정을 설치하고, 수리자극을 통하여 온도 180℃의 지열저류층에서 유량 40 ㎏/s 이상의 지열수를 활용하는 ㎿급 지열발전소를 건립 운영하게 된다. 이 사업을 성공적으로 추진하기 위하여 현재 지질, 수리지질, 지구물리, 암석역학, 플랜트 엔지니어링 등 다양한 분야의 산학연 연구 기관 등이 망라되어 연구진을 구성한 상태이며, 이후 관심있는 여러기관과 연구자들의 지원과 참여를 기대하고 있다. Geothermal energy is believed to be an important source among the renewable energy sources to provide the base load electricity. Although there has been a drastic increase in the use of geothermal heat pump in Korea, there is no geothermal power plant in operation in Korea. Fortunately, the first EGS (Enhanced Geothermal System) Project in Korea has started in Dec 2010. This five year project is divided into two stages; two years for exploration and drilling of 3 ㎞ depth to confirm the minimum target temperature of 100 degrees, and another three years composed drilling 5 ㎞ doublet, hydraulic stimulation of geothermal reservoir with expected temperature of 180 degrees (40 ㎏/s) and construction of ㎿ geothermal power plant in the surface. This EGS project would be a landmark effort that invited a consortium of industry, research institutes and university with expertises in the fields of geology, hydrogeology, geophysics, geomechanics and plant engineering.