결장암에서 5-Fluorouracil-based 보조항암화학요법의 치료반응 예측인자로써 점액성 선암의 의의

강정현,민병소,박윤아,김남규,손승국,조장환,이강영 대한대장항문학회 2009 Annals of Coloproctolgy Vol.25 No.4

Purpose: The aim of this study was to evaluate the value of mucinous histology as a predictive marker of 5-Fluorouracil (FU)- based adjuvant chemotherapy in stage II, III colon cancer. Methods: Between January 1995 and December 2004, 987 patients who underwent curative resections for stage II, III sporadic colon cancer were classified into two groups, a mucinous carcinoma (MC) group and a non-mucinous carcinoma (NMC) group, based on the histology of the primary tumor. The differences in their clinicopathological characteristics and the prognostic impact of 5-FU-based adjuvant chemotherapy for various tumor histologies were analyzed. Results: Of the 987 patients, MCs accounted for 6.8% (68 patients). MCs were more frequently located in the Rt. Colon (P< 0.001) and were more frequently seen in young patients (less than 40 yr old) (P=0.028). The 5-yr survival rates between MC and NMC did not show any statistically significant difference. Patients, including both MC and NMC patients, who received 5-FU-based chemotherapy, revealed a better overall survival rate than patients with no adjuvant chemotherapy. In the multivariate analysis for the prognosis in NMC patients, 5-FU-based adjuvant chemotherapy, initial negative nodal status, and preoperative CEA <5 ng/mL were statistically significant prognostic factors (P values: <0.001, <0.001, and <0.001, respectively). In contrast, there was no statistically independent significance of 5-FU-based adjuvant chemotherapy in MC patients. Conclusion: In stage II and stage III sporadic colon cancer patients, response to 5-FU-based adjuvant chemotherapy in MC patients might be poor than it is in NMC patients. Purpose: The aim of this study was to evaluate the value of mucinous histology as a predictive marker of 5-Fluorouracil (FU)- based adjuvant chemotherapy in stage II, III colon cancer. Methods: Between January 1995 and December 2004, 987 patients who underwent curative resections for stage II, III sporadic colon cancer were classified into two groups, a mucinous carcinoma (MC) group and a non-mucinous carcinoma (NMC) group, based on the histology of the primary tumor. The differences in their clinicopathological characteristics and the prognostic impact of 5-FU-based adjuvant chemotherapy for various tumor histologies were analyzed. Results: Of the 987 patients, MCs accounted for 6.8% (68 patients). MCs were more frequently located in the Rt. Colon (P< 0.001) and were more frequently seen in young patients (less than 40 yr old) (P=0.028). The 5-yr survival rates between MC and NMC did not show any statistically significant difference. Patients, including both MC and NMC patients, who received 5-FU-based chemotherapy, revealed a better overall survival rate than patients with no adjuvant chemotherapy. In the multivariate analysis for the prognosis in NMC patients, 5-FU-based adjuvant chemotherapy, initial negative nodal status, and preoperative CEA <5 ng/mL were statistically significant prognostic factors (P values: <0.001, <0.001, and <0.001, respectively). In contrast, there was no statistically independent significance of 5-FU-based adjuvant chemotherapy in MC patients. Conclusion: In stage II and stage III sporadic colon cancer patients, response to 5-FU-based adjuvant chemotherapy in MC patients might be poor than it is in NMC patients.

림프종으로 오인된 조기 신경 매독 1예

강정현,김도연,박성연 대한내과학회 2011 대한내과학회 추계학술발표논문집 Vol.2011 No.1

매독은 Treponema pallidum에 의한 만성 전신성 감염질환으로 대부분 성접촉에 의해 감염된다. 임상양상은 다양하여 다른 질환으로 인되는 경우가 많고, 드물게 림프종과 유사하게 발현되기도 한다. 본 증례에서는 야간발열과 발한, 체중감소 및 다발성 림프절 종대로 현된매독 증례를 보고하고자 한다. 40세 남자가 내원 3개월 전 시작된 열감과 야간발한 및 10kg의 체중감소를 주소로 내원하였다. 일반액검사상 백혈구 8,120/mm3, 혈색소 15.7 g/dL, 혈소판 112,000/mm3였고, 흉부 및 복부전산화단층촬영상 왼쇄골상, 간문, 위간, 대동정맥, 비장문, 창자간막 및 양쪽 서혜부의 림프절 종대 소견을 보였다. 서혜부 림프절 조직검사상 반응성 림프구 증식소견으로, 림프종 감별 위해 행한양전자방출단층촬영상 목에서 골반까지 다발성 고대사성 림프절 증대소견이 나타났다. 재조직 검사 위해 입원하였고, 당시 몸통에 반적인 미만성의 반구진 피부병변이 동반되었으며, 수술전 혈청학적 검사상 Rapid plasma reagin titier (RPR) 1:32 및Treponemapallidumlatex agglutination 양성이었다. 병력청취를 재시행한 결과 6개월 전 부적절한 성관계가 있었고, 3개월 전에는 성기부위 궤양이 있었다는것을 확인하였다. RPR titer 1:32로 증가해 있어, 뇌척수액 검사를 시행하였고 백혈구 80/mm3 (림프구 lymphocytes 93%) 단백질 40.0 mg/dL, 당56mg/dL, 뇌척수액 VDRL 양성이었다. 경부 림프절 조직 슬라이드에 Warthin-Starry stain시 equivocal 소견보여, T. pallidum에 대해 행한 PCR 상 양성으로 2기 매독에 동반된 조기 신경매독으로 진단하였다. 2주간 potassium penicillin G 400만 단위를 4시간마다 정주하였고, 개월 후혈청 RPR 및 6개월 후 뇌척수액 검사하기로 하고 퇴원하였다. 2기 매독은 다양한 임상 양상으로 나타날 수 있고, 림프종 양상으로 현될수 있어 피부 병변과 병력 청취로 잘 감별해야 할 것이다.

Identification of Preoperative Magnetic Resonance Imaging Features Associated with Positive Resection Margins in Breast Cancer: A Retrospective Study

강정현,육지현,김정아,권혜미,은나래,고경희,손은주 대한영상의학회 2018 Korean Journal of Radiology Vol.19 No.5

Objective: To determine which preoperative breast magnetic resonance imaging (MRI) findings and clinicopathologic features are associated with positive resection margins at the time of breast-conserving surgery (BCS) in patients with breast cancer. Materials and Methods: We reviewed preoperative breast MRI and clinicopathologic features of 120 patients (mean age, 53.3 years; age range, 27−79 years) with breast cancer who had undergone BCS in 2015. Tumor size on MRI, multifocality, patterns of enhancing lesions (mass without non-mass enhancement [NME] vs. NME with or without mass), mass characteristics (shape, margin, internal enhancement characteristics), NME (distribution, internal enhancement patterns), and breast parenchymal enhancement (BPE; weak, strong) were analyzed. We also evaluated age, tumor size, histology, lymphovascular invasion, T stage, N stage, and hormonal receptors. Univariate and multivariate logistic regression analyses were used to determine the correlation between clinicopathological features, MRI findings, and positive resection margins. Results: In univariate analysis, tumor size on MRI, multifocality, NME with or without mass, and segmental distribution of NME were correlated with positive resection margins. Among the clinicopathological factors, tumor size of the invasive breast cancer and in situ components were significantly correlated with a positive resection margin. Multivariate analysis revealed that NME with or without mass was an independent predictor of positive resection margins (odds ratio [OR] = 7.00; p < 0.001). Strong BPE was a weak predictor of positive resection margins (OR = 2.59; p = 0.076). Conclusion: Non-mass enhancement with or without mass is significantly associated with a positive resection margin in patients with breast cancer. In patients with NME, segmental distribution was significantly correlated with positive resection margins.

중독한 추체로 증상을 보인 cyclosporine에 의한 뇌증 1예

강정현,곽승근,신현영,김성은,이정호,이정찬,곽상혁,윤환중,조덕연,김삼용,김제,송창준 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

The use of cyclosporine(CsA), a potent immunosuppressive agent, is associated with numerous side effects. Neurotoxicity was earlier less well known, but with growing experience central nervous system side effects are now reported up to 40% of patients. Among various CsA-induced neurotoxicities, tremor is most common and posterior leukoencephalopathy is well characterized. An encephalopathy presenting with pyramidal weakness, however, seems to be rare and poorly documented. We report here a case of encephalopathy presenting with multiple generalized seizures followed by fluctuating quadriparesis developed a few days after starting CsA and resolved spontaneously after withdrawal of the drug . A 48-year-old woman with aplastic anemia was placed upon immmunosuppressive treatment consisting of antithymocyte globulin(ATG), CsA, and methylprednisolone. Two days after starting the therapy, she developed a generalized seizure. The next day she developed 2 more episodes of seizure and the therapy was stopped. Computed tomogram of the brain was normal. Six days after starting therapy, she developed mild motor weakness and paresthesia of both lower extremities, which progressed to a definite quariparesis confining her to a bed in 3 days. Magnetic resonance imaging(MRI) of the brain revealed asymmetric, bilateral high-signal abnormalites in the subcortical white matter of fronto-temporal areas. After reaching to a maximum with some fluactuation(14 days after starting the therapy) the motor weakness started to be resolved. She was discharged with a almost complete resolution of the weakness 45 days after starting the therapy. Five months later she did well and brain MRI was negative.

불등풀가사리 추출물이 파골세포 형성 및 난소적출 흰쥐의 골다공증에 미치는 영향

강정현,박미화,정경임,김미향 한국식품영양과학회 2024 한국식품영양과학회지 Vol.53 No.4

본 연구에서는 불등풀가사리 추출물이 파골세포 형성에 미치는 영향을 검토하고, 난소적출 흰쥐의 골다공증 동물모델을 이용하여 골 형성에 미치는 영향을 분석하였다. 우선 RANKL로 유도한 파골세포에 불등풀가사리 추출물을 10~ 100 μg/mL의 농도로 처리 후 세포 생존율을 확인한 결과, 대조군과 비교해 농도 의존적으로 유의적인 세포 성장 억제를 확인하였다. 파골세포의 분화 인자인 TRAP 활성 측정 결과, 100 μg/mL 농도의 불등풀가사리 추출물을 처리하였을 때 활성이 78%까지 감소하였다. 또한 추출물의 농도 10 μg/ mL와 100 μg/mL 처리 시 파골세포 분화인자인 NFATc1, TRAP의 단백질 발현이 감소하는 것을 확인하였다. 앞선 실험 내용을 바탕으로 난소적출로 골다공증을 유발한 흰쥐에서 불등풀가사리 추출물의 급여가 골 형성에 미치는 영향을 검토하였다. 식이효율은 난소를 절제한 OVX-CON군과 비교하여 다른 모든 군에서 감소하였으며, 자궁조직의 무게는 OVX-CON보다 다른 모든 군에서 높은 것으로 보아 불등풀가사리 추출물 투여로 인한 자궁조직 위축 감소를 확인하였다. 골 관련 혈청 parameter 분석 결과, 골 교체율이 높은 폐경기 또는 골 질환이 있을 때 값이 증가하는 ALP 및 OCN 수치는 SHAM군에 비해 OVX-CON군에서 증가하였으나, estradiol과 불등풀가사리 추출물 20, 200 mg/kg을 투여한 OVX-E2, OVX-GFE20, OVX-GFE200 군에서는 감소하는 것으로 나타났다. 또한 골 흡수 지표인 TRAP, RANKL의 수치는 OVX-CON군에서 증가하였으나, 불등풀가사리 추출물 투여군에서는 유의적으로 활성이 감소하였다. 그리고 난소적출을 통해 골 손실을 유도한 뒤, 대퇴골의 골밀도 및 조직학적 검사를 실시한 결과, SHAM군과 비교하여 OVX- CON군의 대퇴골에서 섬유 골 파괴가 증가하였으며, 불등풀가사리 추출물 투여군은 OVX-CON군과 비교해 유의적으로 골밀도 증가와 골 파괴 회복을 확인하였다. 이상과 같이 불등풀가사리 추출물은 파골세포 분화억제와 골 형성에 긍정적인 영향을 미치며, 향후 이를 활용한 식품 소재 및 기능성 식품 개발에 접목시켜 질병 예방 및 증상 완화에 있어 우수한 기능성 식품 소재로서 개발이 가능할 것으로 사료된다. Osteoporosis is an age-dependent metabolic bone disease characterized by reduced bone mass. Postmenopausal women with estrogen deficiency are at high risk of developing osteoporosis. This study examined the effects of Gloiopeltis furcata ethanol extract (GFE) on osteoclastogenesis in vitro and ovariectomy (OVX)-induced osteoporosis in vivo. GFE (10∼250 μg/mL) inhibited the receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclast proliferation and tartrate-resistant acid phosphatase (TRAP) activity. The RANKL-induced protein expression of nuclear factor of activated T cells c1 and TRAP, which are the key transcription factors for osteoclastogenesis, was also decreased by a treatment with GFE. On the other hand, female rats were assigned to five experimental groups: SHAM (sham-operated), OVX-CON (OVX), OVX-GFE20 (OVX+GFE 20 mg/kg/d), OVX-GFE200 (OVX+GFE 200 mg/kg/ d), and OVX-E2 (OVX+estradiol 10 μg/kg/d). After six weeks, an analysis of various bone-related serum parameters showed that the levels of alkaline phosphatase, osteocalcin, TRAP, and RANKL decreased after the administration of GFE. 3D micro-CT analysis showed that the low bone density that developed in the OVX-CON group was reversed in the OVX-GFE20 and OVX-GFE200 groups. H&E and Safranin-O staining revealed less bone destruction in the OVX-GFE groups than in the other groups. Therefore, GFE may serve as a novel therapeutic agent for the treatment of osteoporosis.

온라인 환경 하에서 e-CRM 구축을 위한 항공사 인터넷 서비스 전략 연구

강정현 한국관광진흥학회 2016 관광진흥연구 Vol.4 No.1

Influence of Difficulty Variation of the Core Stabilization Exercise on Thickness Changes of Abdominal Muscles in Healthy Subjects: A Pilot Study

강정현,서혜림,김창용,김형동,김형근 대한물리치료학회 2016 대한물리치료학회지 Vol.28 No.2

Purpose: This study examined thickness changes in abdominal muscles according to difficulty level of core stabilization exercise in healthy subjects. Methods: Thirty healthy subjects (age range: 21-30 years) volunteered under three conditions. In the first condition, the subjects performed an abdominal draw-in maneuver (ADIM). In the second condition, they performed the ADIM during quadruped exercise using a suspension device without extending their lower limbs. In the third condition, the subjects performed the ADIM during quadruped exercise using a suspension device while extending both lower limbs. The changes in thickness of transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles were measured by ultrasonography (US) imaging during the three experimental conditions, and US was used to measure the improvement ratio of muscle thickness at rest. The interventions were conducted over three trials in each condition, and measurements were performed on each subject by one examiner. Results: Our results showed a significantly greater increase in the muscle thickness of TrA and IO muscles after performance of quadruped exercise using a suspension device without knee extension (p<0.05) compared to the other conditions. The results also showed a significantly greater increase in the thickness changes of EO muscle in those who performed the ADIM during quadruped exercise using a suspension device with knee extension (p<0.05) compared with the ADIM only. Conclusion: These findings demonstrated positive evidence that a low-level core stabilization exercise could improve thickness of abdominal muscles.

복합 전처리를 통한 하수슬러지의 가용화 및 생물학적 유용성에 관한 연구

강정현,이희수,이태진 유기성자원학회 2011 유기물자원화 Vol.19 No.3

In this study, anaerobic biological decomposition were attempted after solubilization treatment of sewage sludge with the complex pre-treatment (acid/base treatment with ultrasonic radiation). Solubilization ratios were compared for ultrasonic treatment at acid or base condition. Solubilization effect of the complex pre-treatment was more effective at higher pH. Biological decomposition of complex pre-treated sludge was faster than non treated (raw) sludge, showing 10 times higher total gas production. Biological digestion of the sludge shows more biogas production. B/A ratio. which indicates hydrogen production potential, was 50% higher with complex pre-treated sludge than raw sludge but lactic acid or propionic acid were also detected during anaerobic decomposition process. 본 연구에서는 하수슬러지를 전처리 과정을 통해 가용화한 후 혐기성 생물학적 분해를 실시하였다. 산 또는 알칼리 조건과 초음파처리를 복합적으로 적용하여 전처리 후 슬러지의 가용화율을 비교하였으며 알칼리 조건에서 초음파처리를 병행하였을 때 최대 가용화율을 얻을 수 있었다. 가용화된 슬러지의 생물학적 유용성은 복합전처리를 실시한 경우 빠른 생물학적 분해와 더불어 총 가스 발생량은 10배 이상 증가하였으며 가용화된 슬러지에서 바이오가스 생산 가능성을 확인 하였다. 전처리를 실시한 슬러지를 이용하여 생물학적 분해를 실시하였을 때 약 50%정도 높은 수소생성율의 지표가 되는 B/A비를 확인할 수 있었으나 수소생성에 저해가 되는 lactic acid와 propionic acid가 검출되는 것으로 보아 후속연구가 필요할 것으로 판단되었다.

도매시장 비용구조 연구필요성과 시사점

강정현 한국식품유통학회 2022 한국식품유통학회 학술대회 Vol.- No.하계

An Extragastrointestinal Stromal Tumor in the Omentum With Peritoneal Seeding Mimicking an Appendiceal Mucinous Cancer With Carcinomatosis

강정현,전태주,윤선옥,이강영,손승국 대한대장항문학회 2014 Annals of Coloproctolgy Vol.30 No.2

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. These tumors tend to present most frequently in the stomach, followed by the small intestine. GISTs can also arise from the omentum, retroperitoneum, mesentery, or pleura and are termed extragastrointestinal stromal tumors (EGISTs) when they do so. EGISTs arising from the omentum are very rare. Due to the limited incidence of EGISTs in the omentum, the diagnostic criteria are not well established, and making a correct diagnosis may be difficult. In this report, we present a case of an EGIST of the omentum with peritoneal metastasis that was initially suspected to be an appendiceal mucinous carcinoma with carcinomatosis on positron emission tomography/computed tomography imaging.