The impact of pathologic differentiation (well/ poorly) and the degree of Ki-67 index in patients with metastatic WHO grade 3 GEP-NECs.

Kim, Seung Tae,Lee, Su Jin,Lee, Jeeyun,Park, Joon Oh,Park, Young Suk,Lim, Ho Yeong,Kang, Won Ki Grune & Stratton 2017 Journal of clinical oncology Vol.35 No._suppl15

<P> e15686 </P><P> Background: Herein, we investigated the impact of pathologic differentiation (well or poorly differentiated) in metastatic grade 3 GEP-NEC patients receiving etoposide and platinum-based therapy. Simultaneously, we evaluated a more exact Ki67 index cut-off point to select patients with grade 3 GEP-NEC who might benefit from etoposide plus platinum (EP)-based therapy. Methods: Among patients pathologically diagnosed with metastatic grade 3 GEP-NECs at Samsung Medical Center between June 2013 and March 2016, 31 GEP-NEC patients receiving etoposide and platinum-based therapy were included in this study. Results: Primary sites included 13 foregut-derived GEP-NECs [stomach (n = 4), duodenum (n = 4), and pancreas (n = 5)] and 2 hindgut-derived GEP-NECs of the rectum. Sixteen unclassified GEP-NECs originated from 7 gall-bladder (GB), 6 liver and 3 unknown primary sites. According to pathologic differentiation, 14 patients had well differentiated and 17 had poorly differentiated grade 3 GEP-NECs. Between well differentiated and poorly differentiated grade 3 GEP-NECs, there was a significant difference in the distribution of Ki67 index. There was no significant difference of treatment efficacy between well and poorly differentiated grade 3 GEP-NECs (RR; 35.7% vs. 41.2%, p = 0.525). Tumor response to EP occurred in 5 of 7 patients with Ki67 > 60% and 7 of 24 with Ki67≤60%, which was significantly different (RR; 71.4% vs. 29.2%, P = 0.043). There was no significant difference in PFS according to pathologic differentiation (well differentiated vs. poorly differentiated) and Ki67 index ( > 60% vs ≤60%). Conclusions: Grade 3 GEP-NECs could be morphologically classified into well and poorly differentiated NETs. Additionally, among grade 3 GEP-NECs, there was a significant difference in ranges of Ki67 index between well and poorly differentiated NECs. Higher levels ( > 60%) of Ki67 index might be a predictive marker for efficacy of EP as a standard regimen in grade 3 GEP-NECs. </P>

개에서 발생한 수컷 가성 반음양 1례

이기찬,손정민,윤기영,최호정,박성준,이영원,정성목,신상태,조종기 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2006 動物醫科學硏究誌 Vol.14 No.-

In this report, we present a case of the male pseudohermaphrodite in a beagle dog. The animal was subjected for examination due to enlargement of clitoris that was shown as reddish finger-like structure protruding from the vulva. Visual examination of the internal genitalia revealed that the animal possessed both testes and uterus. Based on the findings of physical examination and exploratory laparotomy, it was tentatively diagnosed as male pseudohermaphrodite. Internal genitalia and enlarged clitoris were removed for the prevention of pyometra and Sertoli cell tumor.

Toluene, Xylene, Trichloroethylene 투여가 흰쥐의 시상하부와 뇌하수체의 GnRH, GnRH Receptor, Pit-1 유전자 발현에 미치는 영향

기노석,이종태,강대성,김대환,이채관,이헌,전진호,김정호,이채언 大韓産業醫學會 1998 대한직업환경의학회지 Vol.10 No.2

The workplace exposure of chemicals has steadily increased, therefore the concern for subsequent effect on reproductive outcome has been an important issue in occupational medicine. In previous studies, higher rates of spontaneous abortion, reduced fertility and menstrual disorder among women, and an impairement of sperm quantity and quality among men have been associated with a wide variety of chemical agents. This study was conducted to evaluate the effects of toluene, xylene and trichloroethylene(TCE) injection on the mRNA levels of GnRH, GnRH receptor and Pit-1 genes in male rats hypothalamus and pituitary and the effects on the plasma levels of FSH, LH, prolactin and testosterone. Sprague-Dawley male rats were divided into five groups of five each according to concentration of toluene, xylene and TCE. The rats were injected subcutaneously to 0, 50, 100, 200, 400 mg/kg body weight/day of toluene, xylene and TCE, respectively for 6 days. Rat brains were excised and hypothalamus and pituitary were separated. Reverse transcription-polymerase chain reaction (RT-PCR) and RNase protection assay(RPA) were used to evaluate the GnRH, GnRH receptor and Pit-1 mRNA levels. Plasma concentrations of FSH, LH, prolactin and testosterone were assayed by radioimmunoassay(RIA). The results were as follows; 1. GnRH, GnRH receptor and Pit-1 mRNA levels in toluene and xylene injected groups, and GnRH receptor mRNA levels in TCE injected group were lowered dose-dependently. Especially, GnRH receptor and Pit-1 mRNA levels in 200mg/kg of toluene injected group, and GnRH, GnRH receptor and Pit-1 mRNA levels in 400mg/kg of toluene injected group were significantly lower than control group (p<0.05). GnRH receptor and Pit-1 mRNA levels in 400mg/kg of xylene injected group, and GnRH receptor mRNA levels in 400mg/kg of TCE injected group were significantly lower than control group(p<0.05). 2. The plasma levels of prolactin and testosterone in 400mg/kg of toluene injected group, and LH in 100, 200 and 400mg/kg of xylene injected group, and testosterone in 400 mg/kg of TCE injected group were significantly lower than control group(p<0.05). In conclusion, we speculated that toluene and xylene affected reproductive system secondarily through hypothalamus-pituitary axis, and TCE affected directly through steroidogenesis. And we recommended that further study for assessment of the reproductive toxicity of mixed organic solvent exposures should be conducted.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

Special Issue of Professor Kiehwa Lee`s Retirement: Geophysical Environments of the Korean Peninsula : Articles ; Geoelectrical Structure of the Kyongsang Basin from Magnetotelluric Sounding

( Choon Ki Lee ),( Heui Soon Lee ),( Byung Doo Kwon ),( In Ky Cho ),( Seok Hoon Oh ),( Yoon Ho Song ),( Tae Jong Lee ) 대한지구물리학회 2006 지구물리 Vol.9 No.3

한국인 관상동맥의 변화양상에 대한 형태학적 연구

권태정,이상용,이한영,고영창,권기석,조재홍,김태공,김유훈,조갑래,서중석,이원태 內務部 國立科學搜査硏究所 2001 國立 科學 搜査 硏究所 年報 Vol.33 No.-

동창의 임상 및 병리조직학적 소견과 Ki-67 발현 양상

서기석(Ki Seuk Suh),김상태(Sang Tae Kim),이기욱(Ki Wook Lee) 대한피부과학회 1999 대한피부과학회지 Vol.37 No.9

N/A Background : Pernio or chilblain is an abnormal reaction to damp cold air, resulting in pruritic erythematous swellings on acral skin. The histologic features are subepidermal edema, diffuse fluffy edema of endothelial cell, and superficial or superficial and deep perivascular lymphocytic infiltrates. Many studies with a large sample size have been conducted in western countries, but there were no collective studies of pernio that have been reported in Korea. Objective : The purpose of this study was to clarify the clinical and histopathologic features of pernio in Korea. Methods : We reviewed the clinical and histopathologic findings in ten patients with pernio who visited the Department of Dermatology, Kosin Medical College Gaspel Hospital during the 10 year period from 1988 to 1997. Results : The results were as follows. 1. The age distribution was in the range of 6∼50 year old. The prevalance was heighest in the third and fourth decade. Sex ratio was 1 : 4 (2 males : 8 females). The duration of symptoms ranged from 4 days to 30 years. All patients developed skin lesions on the acral area. Two male patients developed skin lesions on the hand associated with cold exposure and outdoor works. All patient had itching and burning papules and/or plaques, and one had a painful hard nodule. Laboratory studies were all negative and within normal ranges. 2. Histopathologic features revealed subepidermal edema, diffuse fluffy edema of endothelial cell, and superficial or superficial and deep perivascular lymphocytic infiltrates in all specimens. 3. Treatment includes prophylatic measures against cold and nifedipine(calcium channel inhibiting drug). In more severe cases, pentoxifylline might be helpful. Conclusion : Our study suggests that pernio commonly occurs in twenty to forty year old females during fall and winter. Upon exposure to cold temperatures, the acral skin develops pruritic erythematous papules and plaques. If these lesions persisit for a long time or recur, they may progress to vesicle and ulceration and possibly develop vasculitis which does not respond to therapy well. Thus, a thorough understanding of clinical and histopathologic features of pernio is vital in making a diagnosis, a treatment plan and determining the prognosis. (Korean J Dermatol 1999;37(9) : 1254∼1260)

In Vivo ^31P NMR Spectroscopy를 이용하여 젖산 운동시간과 유산소 운동시간에 따른 골격근 섬유의 고 에너지 인(P) 대사 변화

성기홍,임태환,이대근,문치웅,이정희,김상태,신명진,이덕분 대한스포츠의학회 1994 대한스포츠의학회지 Vol.12 No.1

Intracellular high energy phosphorus metabolism can be assessed noninvasively and dynamically by in vivo ^31P NMRS of skeletal muscle have shown various applications of this technique in evaluating the pathophysiology of diseased or normal muscles. High energy phosphate metavolsim in the human skeletal muscle was studies in the work. ^31P nuclear magnetic resonance spectroscopy allowed the evaluate of the lactic acid and aerobic energy system in the intracellular skeletal muscle by energy concentration of ^31P nuclear magnetic resonance spectroscopy allowed the evaluate of the lactic acid and aerobic energy system in the intracellular skeletal muscle by energy concentration of ^31P metabolite, (Pi), (PCr), (ATP). The ratio of Pi/PCr the spectra measured from normal volanteers and elite athleties indicated a signetifcant difference between the two group for each exercise protocal. It was generally ovserved that the all out time of normal volunteers in shorter that that of elite athletes, and the ration of Pi/PCr is samller for elite athlets than for normal volunteers.

筋小胞體의 ATPase Kinetics에 關한 硏究

朴映淳,李承兩,朴泰水,庾基洙,李 弘,金允坤 圓光大學校 1982 論文集 Vol.16 No.2

본 연구에서는 토끼 골격근 소포체에서 분리한 근소포체의 ATPase활성에 대한 일반적 특성과 수종의 2가 양이온(??)의 영향에 관한 연구를 하였다. ATPase활성과 Ca uptake에 미치는 2가 양이온의 저해 효과와 저해기작은 Dixon plot, Lineweaver-Burk plot, Hanes-Woolf plot, Woolf-Augustinsson-Hofstee plot, Eadie-Scatchard plot, Arrhenius plot등을 이용하여 분석하였으며 그 결과는 다음과 같다. 1. 근소포체의 ATPase는 ??과 ??의 존재하에서 활성화 되어지며 ??의 농도가 4mM일 때 ??의 최적 농도는 0.1mM이었다. 2. 근소포체의 ATPase는 ??-ATPase와 (??)-ATPase로 구성되어 있고 (??) - ATPase의 활성은 ??-ATPase의 활성보다 높았다. 3. ATPase의 활성화 에너지는 약 19Kcal/mol이었다. 4. ATPase 활성에 미치는 2가 양이온은 12.5㎛과 400㎛의 범위 내에서 이온 농도가 증가됨에 따라서 활성도는 점점 감소되었다. 5. ATPase활성율 50% 저해시키는데 2가 양이온의 농도는 Ki값과 같아서 ??, ??, ?? Pd ??에 대한 각각의 농도는 10㎛, 30㎛, 130㎛ 및 350㎛이었다. 특히 ??은 저 농도에서 (12.5-100㎛)는 활성제로, 고농도에서 (200-400㎛)는 저해제로 작용하는 것 같다. 6. 2가 양이온은 ATPase의 Km에는 변화를 주지 않으나 Vmax의 저하를 일으키는 것으로 보아 비경쟁 저해제임이 판정되었다. 7. 2가 양이온은 가역적 저해제임이 판명되었다. 8. Ca 吸收能에 대한 CuCl₂의 阻害는 50~500㎛의 CuCl₂농도에서 현저히 나타났으며 이 현상은 Ca 吸收能과 ATPase 活性과 밀접한 관계를 보여주는 것이다. General properties of the ATPase and the effects of the divalent cations (??) on the total ATPase activity of the fragmented sarcoplasmic reticulum (FSR) isolated from rabbit skeletal muscle were investigated in the present resent research. The inhibitory effect of divalent cations on the FSR ATPase activity and its mechanism were analyzed by various plots such as Dixon plot, Lineweaver-Burk plot, Hanes-woolf plot, Eadie-Scatchard plot and Arrhenius plot. The results obtained were as follows: 1. The FSR ATPase is activated by ?? and ??; the optimum concentration of is 0.1 mM in the presence of 4 mM MgCl₂. 2. The FSR ATPase could be distinguished as ??-ATPase and (??)-ATPase. The activity of (??)-ATPase predomiant over that of ??-ATPase. 3. The apparent energies of activation for total ATPase was approximately 19Kcal/mole. 4. The inhibitory effects of the divalent cations on the enzyme activity increased as the concentrations of the divalent cations increased in the concentrations between 12.5 and 400㎛. 5. Concentration of 50% inhibition for each divalent cation was almost identical with the inhibition constant (ki). The Ki's were 10,30,130, and 350㎛ for ??, ??, ??, and ??, respectively. ?? seemed to be anactivator at lower concentrations and an inhibior at higher concentratios. 6. The divalent cations did not change the Km but decreased the Vmax of the FRS ATPase, suggesting that they are noncompetitive inhibitors on the FSR ATPase. 7. The divalent cations were also found to be revesible inhibitors on the FSR ATPase. 8. The inhibitory effect of CuCl₂on a uptake increased as the concentration CuCl₂increased in the range between 50㎛.

지역사회획득 폐렴의 치료지침 권고안

송재훈,정기석,강문원,김도진,배현주,서지영,심태선,안중현,안철민,우준희,이남용,이동건,이미숙,이상무,이영선,이혁민,정두련,지역사회획득 폐렴 치료지침 제정위원회 대한감염학회 2009 감염과 화학요법 Vol.41 No.3

A successful therapy of community-acquired pneumonia requires appropriate empirical antimicrobial therapy. Etiology and antimicrobial susceptibility of major pathogens of pneumonia can differ by country. Therefore, an ideal treatment guideline of community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia in immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.