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      • 대장암 환자에서 Survivin mRNA의 발현과 간 전이와의 연관성

        최종순,장희경 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.1

        연구배경 및 목적 Survivin은 새로이 고사(아포프토시스)-억제 유전자군에 추가된 유전자이다. Survivin 발현이 대장암에서 보고는 되고 있으나, 상이한 결과들로 논란이 많으며, 임상적 의의에 대해서도 불명확하다. 더욱이 이 유전자는 암 치료나 예방적 항암치료의 표적으로의 가능성이 제기되고 있다. 대장암 survivin 유전자의 발현을 조사하고 임상 및 예후 인자들과의 관련성을 분석하여 대장암의 발생과 임상 측면에서이들 유전자의 역할을 이해하고 예방과 치료에 이용할 수 있는 지를 조사하고자 하였다. 대상 및 방법 다양한 병기의 37예의 신선한 대장암 수술 조직을 대상으로 하였다. 암 조직과 주위 비종양성 조직에서 전체 mRNA를 분리하여 역전사-연쇄중합효소반응으로 survivin mRNA를 검출하였다. PCR 산물을 확인하기 위하여 아클로닝후에 DNA 염기 분석을 시행하였다. 결 과 대장에서 Survivin의 발현율은 대장암 조직에서는 94.6%였고, 비종양성 조직에서는 51.4%으로, 대장암 조직에서 survivin의 발현이 높았으나, 비종양성 조직에서의 경계성 영역의 유의한 차이가 인정되었다(0.05<p=0.065< 0.1). 연령, 성별, 침윤 깊이, 림프절 전이, 혈관과 신경 침범, 간으로의 전이 등의 임상 및 병리학적 인자들과 관련성은 없었다. 결 론 survivin은 대장암에서 암특이적으로 발현되지 않았다 (0.05<p=0.065< 0.1). 대장암의 치료나 chemoprevention에서 SSX(synovial sarcoma on X chromosome gene)와 survivin의 이용은 가능하나 제한적일 것으로 생각된다. SSX와 survivin 발현의 상관성이 인정되지 않으므로, 대장암에서 SSX은 survivin-관련 항아포토시스 경로와는 무관할 것으로 생각된다. Background : Survivin is a novel member of the inhibitors of apoptosis proteins (IAP) gene family. Although survivin expression has been reported in colon cancer, the results are still controversial and its clinical significanceincluding chemoprevention remains unclear. Some reports described thegene as a potential target in anticancer or chemopreventive therapy. To facilitate understanding of survivin in the colon cancer, the clinicopathological significance was investigated with the expression of survivin. Methods : Surgical specimen were obtained from a total 37 cases of consecutive patients with various stages of colorectal carcinoma who had undergone a resection. To determine survivin mRNA in colorectal carcinomas and adjacent normal colorectal tissue samples, total RNA was isolated from each of the samples after lysis in quanidinium isothiocyanate and phenol extraction and reverse-transcription polymerase chain reaction was done. The PCR products were confirmed by DNA sequencing after subcloning. Results : The positive rate of survivin in cancer tissue was 94.6%(35/37) and that of non-neoplastic colorectal tissue was 51.4%(19/37). S urvivin expression t ended to i ncrease in c ancer tissue, but h as s tatistically m arginal significance(0.05<p=0.065< 0.1). The correlation of survivin expressions to age, gender, invasion depth, lymph node metastasis, vessel and perineural invasions, and liver metastasis was not found. Conclusions : The expression of survivin appears not to be eligible to differentiate malignant from benign lesions in colon, even though it has marginal significance(0.05<p=0.065< 0.1). The role of survivin-associated apoptosis may be unnoticeable, in the light of insignificant correlation of gene expression to the other prognostic factors in colon cancer.

      • KCI등재후보

        Prevention of Osteoporosis in Women

        최종순,김흥열 대한폐경학회 2011 대한폐경학회지 Vol.17 No.1

        Osteoporosis, the most common bone disease, is a silent condition resulting in increased fracture risk. The disorder is characterized by compromised bone strength and increased susceptibility to fractures that have important health and socioeconomic consequences. The prevention of osteoporosis should begin early and continue throughout life with measures that maintain or improve bone health. These measures include regular physical activity and a balanced diet, including adequate intake of calcium and other minerals, proteins, and foods rich in antioxidants. In older persons at increased risk of fragility fractures, the prevention of falls and the maintenance of adequate vitamin D status are essential. Assessment of fracture risk, followed by proven effective non-pharmacologic and pharmacologic management remains low, even in patients who have sustained a fragility fracture. Non-pharmacologic intervention should always be implemented, but many patients also need pharmacologic intervention to achieve adequate fracture protection. While low bone mineral density (BMD) is a factor in bone fragility, low BMD is not the only factor. Drugs for osteoporosis should not only promote changes in BMD, but should be proven to reduce the incidence of fractures. This article reviews advances in strategies to prevent osteoporosis.

      • Sensitivity of AutoPap Primary Screening System with Location-Guided Screening in Uterine Cervical Cytology

        최종순,장회숙,김희숙,전이경,김혜선,박지영,박인서,홍성란,Choi, Jong-Sun,Jang, Hoi-Sook,Kim, Hy-Sook,Chun, Yi-Kyeong,Kim, Hye-Sun,Park, Ji-Young,Park, In-Sou,Hong, Sung-Ran The Korean Society for Cytopathology 2003 대한세포병리학회지 Vol.14 No.2

        Objective: The sensitivity of the AutoPap Primary Screening System with Location-Guided Screening (AutoPap LGS) for Identifying atypical cells in cervicovaginal smears was evaluated. Methods: Two hundred forty one slides with atypical cervical cytology randomly sampled were rescreened both manually and by the AutoPap LGS. The AutoPap LGS localized the atypical cells as 15 fields of view(FOVs), which were reexamined by manual review. The sensitivity was also evaluated in accordance with the cellularity of the smears. Results: The AutoPap LGS successfully processed 232 out of 241 slides. The sensitivity of the AutoPap LGS identifying the atypical cells in successfully processed slides was 97.4%(226/232). The false negative rate was 2.6%(6/232). There was no false negative case on high grade squamous intraepithelial lesion (HSIL) or squamous cell carcinoma(SCC) smears in the AutoPap LGS. The FOVs localized the diagnostic-atypical cells in 97.8%(221/226). The number of diagnostic-atypical FOVs was increased in higher-degree of atypical cytology. The AutoPap LGS localized the atypical cells in 100% of adequately cellular smears and in 92.5% even in low cellular smears. Conclusion: The AutoPap LGS showed relatively good sensitivity to detect atypical cells. It can be a valuable system to localize atypical cells, especially in HSIL or cancer slides, even in smears with low cellularity.

      • KCI등재

        Expression of vascular endothelial growth factor is a clinically useful predictor for aggressive basal cell carcinoma

        최종순,장희경,이동찬 고신대학교(의대) 고신대학교 의과대학 학술지 2018 고신대학교 의과대학 학술지 Vol.33 No.1

        Objectives: Basal cell carcinoma (BCC) tumors are locally invasive but rarely metastatic. However, aggressive metastatic variants are being increasingly reported in elderly people. Here we investigated the clinical utility of vascular endothelial growth factor (VEGF) as a predictive biomarker for aggressive BCC variants. Methods: Thirty-five pathologically confirmed cases of BCC that underwent surgical removal in the Plastic Surgery Department between January 1, 2011 and December 31, 2012 were studied. VEGF expression was analyzed in formalin-fixed paraffin-embedded tumor tissue by immunohistochemical staining. Positive staining was defined as more than 10% of the tumor cells showing immunoreactivity. The associations of VEGF expression with various clinicopathologic parameters were analyzed. Results: The face was the most prevalent site (28/35), with 15 cases from the nose, 6 cases from the eyelid, and 5 cases from the cheek. The patients were aged between 41 and 86 years, with a mean age of 69.26 ± 173.903 years. The mean BCC size was 1.34 ± 3.853 cm, with a range of 0.3 cm to 12.0 cm. The mean tumor invasion depth from the basement epidermal membrane was 0.17 ± 0.035 cm, with a range of 0.03 cm to 1.10 cm. A mean of 5.66 ± 20.938 intraoperative frozen section slides were examined. VEGF was not expressed in 14 of the 35 patients (40.0%), whereas 42.9% of the patients had low expression and 17.1% of the patients had high expression. VEGF expression was significantly associated with age ( P = 0.022), size ( P = 0.030), site ( P = 0.013), tumor invasion depth ( P = 0.019), and number of intraoperatively frozen sections ( P = 0.003). Conclusions: These results suggest that VEGF expression as assessed by immunohistochemistry can predict aggressive or poor prognosis in BCC.

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