두경부 골수외 형질세포종의 임상적 고찰

심광용,안중배,노재경,서창옥,김귀언,정현철,김주항,김병수 대한두경부종양학회 1998 대한두경부종양학회 학술대회 논문집 Vol.1998 No.2

위암종과 Epstein-Barr 바이러스와의 연관성에 대한 연구

심광용,김호영,김효열,백순구,권상옥,조미연,이창훈,이종인 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-

Objectives: Epstein-Barr virus (EBV) has been known to be linked to a spectrum of neoplastic conditions, including nasopharyngeal carcinoma, Burkitt's lymphoma, peripheral T-cell lymphoma and Hodgkin's disease. This study aims to investigate the association of EBV with gastric carcinoma in Korea. Methods: Fifty-three cases of gastric adenocarcinoma were studied for evidence of EBV infection by EBV-encoded small RNA (EBER) in situ hybridization (ISH) on the paraffin sections and amplifying the EBV genome encoding envelop glycoprotein (gp220) with polymerase chain reaction (PCR) in fresh gastric cancer specimens. Results: EBER was detected in 7 (13.2%) of 53 gastric carcinomas and all cases were male. In 6 (85.7%) of 7 EBER-positive cases, the tumors were located in the upper and middle part of the stomach. EBER ISH study showed strong positivity in all the tumor cells, but negativity in surrouning lymphocytes, stromal cells and normal gastric mucosa. DNA PCR was positive in 23 (43.4%) of 53 gastric carcinomas, including all of 7 EBER-positive cases. Conclusion: We could observe some association of EBV with gastric carcinoma, and our findings about the charateristics of EBV-positive gastric cancers involving sex, site and histological type are similar to those in Japan. However, EBV-positive rate of gastric cancer is higher than in Japan and lower than in Western countries. Further studies to elucidate oncogenic mechanism of EBV in gastric cancer should be performed.

Hepatoprotection of different water extracts from Acer tegmentosum M. on CCl4-induced acute hepatotoxicity in mice: comparative efficacies between the extracts of boughs, twigs, and leaves

심광용,김동희,Soon-Bong Song,Xu-Feng Qi,Yang-Suk Yoon,김현수,이종인,Hwa-Eun Oh,Soo-Ki Kim,이규재 대한독성 유전단백체 학회 2011 Molecular & cellular toxicology Vol.7 No.4

While Acer tegmentosum M. (AT) has been widely used as a popular folk remedy to prevent or treat liver diseases in Korea, the scientific evidences for the usage of AT against liver disease are poorly documented. To address this issue, we compared hepatoprotection of hot water extract (WEAT) from three parts of AT, boughs (E1), twigs (E2), and leaves (E3),on CCl₄-induced acute hepatic injury in mice by way of morphometric and biochemical examination: liver function test, antioxidant enzymes activity of liver,histopathological and ultrastructural examination of liver, and antioxidant capacity (DPPH assay) of WEAT. We found that only oral intake group of WEAT-boughs showed significant differences in aspartate transaminase (AST), alanine transaminase (ALT) levels and glutathione peroxidase (GPx) activities as compared to CCl4 control group, whereas the glutathione levels were significantly low in all WEAT-pretreated groups. Consistently, histopathological and ultrastructural findings displayed hepatoprotection in the order of WEATboughs¤WEAT-twigs¤WEAT-leaves. Collectively,these results indicate that of three WEAT, WEATbough extract has the highest hepatoprotection against CCl₄-induced acute hepatic injury in mice via the possible regulation of antioxidant enzyme activities in liver.

두경부 골수외 형질세포종의 임상적 고찰

심광용(Kwang Yong Shim),안중배(Joong Bae Ahn),김귀언(Gwi Eon Kim),정현철(Hyun Cheol Chung),김주항(Joo Hang Kim),김병수(Byung Soo Kim),노재경(Jae Kyung Roh) 대한두경부종양학회 1999 대한두경부 종양학회지 Vol.15 No.1

Objectives: This study was carried out to analyze the clinical profile and the results of treatment of a series of patients with extramedullary plasmacytoma(EMP) of the head and neck. Materials and Methods: The clinical features, treatment and survival of 14 patients with EMP seen at Yonsei Medical Center between 1970 and 1998 were carefully reviewed. Results: The median age was 48 years(range 15-75) and there was a male predominance(M:F 1.8:1). Nasal cavities and paranasal sinuses account for 50% of the primary sites and the most common symptom was airway obstruction(50%). Five patients(36%) showed evidence of adjacent bone destruction, one patient had lymph node involvement and one patient had an IgG monoclonal gammopathy at the time of diagnosis. All 5 patients treated with radiotherapy alone achieved local control. Of 5 patients treated with surgery alone, 2 patients(40%) had local failure. Of 3 patient treated with a combination of surgery and radiotherapy, one patient had local recurrence. A total of7 patients(54%) had local, distant or nodal relapses after primary treatment. Six of them received salvage treatment. With salvage treatment of surgery and/or radiotherapy, local control was achieved in 4 of 6 patients. Conversion to multiple myeloma was seen in one patient. Conclusion: Radiotherapy should be recommanded as treatment of choice for EMP of the head and neck. Surgery should be reserved for radioresistant or recurrent tumors, but tumors that are localized and can be removed relatively easily with little morbidity may be treated by primary surgery.

S-586 : 혈청음성 류마티스 관절염과 B형 간염이 동반된 환자에서 발생한 특발성 후복막 섬유화증 1예

이향선,심광용,강태영,최준정 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1

서론: 후복막 섬유화증(Retroperitoneal fibrosis)은 후복막강 내의 만성적 염증과 섬유화를 특징으로 하는 원인이 명확하지 않은 드문 질환이다.저자들은 혈청음성 류마티스 관절염 및 B형 간염을 진단받고 치료 중인 환자에서 후복막 섬유화증을 진단한 드문 경험하였기에 국내에서 처음으로 보고하는 바이다. 증례: 39세 남자가 건강검진으로 시행한 복부 초음파에서 우연히 발견된 좌측 수신증을 주소로 내원했다. 과거력상 중학교 때 B형 간염을 진단받았고, 2년 전 혈청 음성 류마티스 관절염을 진단받고 약물치료 중이었다. 내원 시 활력징후는 안정적이었고, 신체검사에서도 특이 소견은 관찰되지 않았다. 혈액 검사 및 생화학 검사에서 모두 정상 소견을 보였다. 복부 전산화 단층촬영에서 5.0×2.5×10.3 cm 크기의 경계가 명확한 균질성 덩어리가 하부 복부대동맥에서부터 양측 장골가지 분지부위까지 관찰되었다. 덩어리 내부의 대동맥은 전체 폐쇄 소견을 보이고 있었고, 양측 장골동맥의 중간에서 원위부위는 곁가지에 의해서 혈류가 공급되고 있었다. 좌측 요관이 덩어리와 맞닿아 있었고, 좌측 신장의 위축성 변화가 관찰되었다. 또 간경화 소견 및 비장비대가 관찰되었다. 좌측 요관협착에 대해 요관관을 삽입했으며, 악성종양 가능성을 배제하고 확진을 위해 개복 생검을 시행하였다. 개복 소견에서 딱딱한 덩어리가 복부 대동맥 주변을 둘러싸고 있는 양상으로 대동맥과 덩어리는 박리가 잘되지 않았고, 1×0.5 cm 크기의 조직 생검을 시행했다. 조직 검사에서 다른 이차적인 원인이 없는 특발성 후복막 섬유화증을 진단했다. 원발성 후복막 섬유화증에 대해 부신 피질 호르몬 치료 예정으로, 현재 B형 간염 바이러스의 활성화를 막기위해 예방적 항바이러스제를 사용 중이며, 2주 간 항바이러스제 유지 후 부신 피질 호르몬 치료 예정이다.

비노출형 유두부암

백순구,심광용,김준명,박의련,권상옥,이동기,정필호,조도연 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3

Background: Ampullary cancer is a malignant lesion in the pancreatobiliary system with a relatively good prognosis because of its slow growth, early appearance of symptoms and high resectability. Hndoscopic retrograde cholangiopancreaticography(ERCP) is an important and useful method in the diagnosis of ampullary cancer because it identifies the location of lesions endoseopically and by opacification of the bilio-pancreatic ducts and allows confirmation by biopsy, But the diagnostic accuracy of endoscopic forcep biopsy was variable according to the macroscopic appearance of ampullary cancer. In unexposed type ampullary cancer, biopsy after endoscopic sphincterotomy or intraluminal cannulatian biopsy has been recommended because the cancer tissue was either not visible at all or barely visible from the lumen of the duodenum. The purpose of this study was to evaluate the contribution of endoscopic sphincterotomy to the diagnosis of ampullary cancer and to compare the clinical eharasteristics of unexposed type ampullary cancer with those of exposed type ampullary cancer. Method: Thirty-one cases of the ampullary cancers over the past 5 years were reviewed. Macroscopically, thirty one ampullary cancers were classified into two types. The unexposed type ampullary cancer was defined normal ampullary mucosa with or without protruding. The exposed type ampullary cancer was defined abnormal ampullary mucosa including nodular, ulcerative, nodulo-ulcerative and polypoid appearance. Ampullary cancers were diagnosed preoperatively by forcep biopsy, biopsy after endoscopic sphincterotomy, or brushing cytology. Result: The proportion of unexposed type in ampullary cancer was 29%(9 cases). There were no differences of age, sex, diagnostic clue, distal common bile duct(CBD) shape and CBD dilatation by ERCP between unexposed and exposed type ampullary cancers. The serum bilirubin, alkaline phosphotase and GGT were lower in unexposed type comparing with exposed type. The unexposed ampullary cancers could be diagnosed with biopsy after endoscopic sphincterotomy except one case. Biopsy samples were successfully obtained immediately after spltincterotomy in 3 patients and a few days(3day later-lmonth later) after sphincterotorny in 5 patients. Conclusion: We consider the possibility of unexposed amullary cancer in cases of jaundice or duct dilatation with normal ampulla mucosa and should perform biopsy after endoscopic sphincterotomy.

Mesenchymal stem cell therapy for liver fibrosis

엄영우,심광용,백순구 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.5

Currently, the most effective treatment for end-stage liver fibrosis is liver transplantation; however, transplantation is limited by a shortage of donor organs, surgical complications, immunological rejection, and high medical costs. Recently, mesenchymal stem cell (MSC) therapy has been suggested as an effective alternate approach for the treatment of hepatic diseases. MSCs have the potential to differentiate into hepatocytes, and therapeutic value exists in their immune-modulatory properties and secretion of trophic factors, such as growth factors and cytokines. In addition, MSCs can suppress inflammatory responses, reduce hepatocyte apoptosis, increase hepatocyte regeneration, regress liver fibrosis and enhance liver functionality. Despite these advantages, issues remain; MSCs also have fibrogenic potential and the capacity to promote tumor cell growth and oncogenicity. This paper summarizes the properties of MSCs for regenerative medicine and their therapeutic mechanisms and clinical application in the treatment of liver fibrosis. We also present several outstanding risks, including their fibrogenic potential and their capacity to promote pre-existing tumor cell growth and oncogenicity.

상안와열 증후군을 동반한 안와로 전이된 원발성 간세포암 1예

김유미,심광용,노재경,박정엽,유내춘 대한내과학회 2001 대한내과학회지 Vol.60 No.2

The superior orbital fissure syndrome is a rare condition characterized by opthalmoplegia, ptosis, and proptosis of the eye, fixation and dilation of the pupil, and anesthesia of the upper eyelid and forehead. Tumor metastasis to the orbit is uncommon and there were only 11 histologically proven cases of metastatic hepatocellular carcinoma to the orbit. There was only one case of metastatic hepatocellular carcinoma to the orbit with superior orbital fissure syndrome. The prognosis were poor for all reported cases, but palliative radiotherapy could be some help. We report a rare case of metastatic hepatocellular carcinoma to the orbit with superior orbital fissure syndrome.(Korean J Med 60:179-182, 2001)

Relationship between Tetrahydrobiopterin and Portal Hypertension in Patients with Chronic Liver Disease

홍원기,심광용,백순구,김문영,조미연,장윤옥,박영식,한진,김가은,조윤주,황혜원,이진형,채명훈,권상옥 대한의학회 2014 Journal of Korean medical science Vol.29 No.3

Tetrahydrobiopterin (BH4) is an essential cofactor in NO synthesis by endothelial nitricoxide synthase (eNOS) enzymes. It has been previously suggested that reduced intrahepaticBH4 results in a decrease in intrahepatic NO and contributes to increased hepatic vascularresistance and portal pressure in animal models of cirrhosis. The main aim of the presentstudy was to evaluate the relationship between BH4 and portal hypertension (PHT). Onehundred ninety-three consecutive patients with chronic liver disease were included in thestudy. Liver biopsy, measurement of BH4 and hepatic venous pressure gradient (HVPG)were performed. Hepatic fibrosis was classified using the Laennec fibrosis scoring system. BH4 levels were determined in homogenized liver tissues of patients using a highperformance liquid chromatography (HPLC) system. Statistical analysis was performed toevaluate the relationship between BH4 and HVPG, grade of hepatic fibrosis, clinical stageof cirrhosis, Child-Pugh class. A positive relationship between HVPG and hepatic fibrosisgrade, clinical stage of cirrhosis and Child-Pugh class was observed. However, the BH4level showed no significant correlation with HVPG or clinical features of cirrhosis. BH4concentration in liver tissue has little relation to the severity of portal hypertension inpatients with chronic liver disease.

위암 및 간암환자의 치료에 있어 양.한방 협진의 효과에 관한 임상시험

이종인,심광용,김호영,최서영,방대건,조경숙,Lee, Chong-In,Shim, Kwang-Yong,Kim, Ho-Young,Choi, Seo-Young,Bang, Dae-Geon,Cho, Kyung-Sook 대한암한의학회 2001 大韓癌韓醫學會誌 Vol.7 No.1

Objectives: We compared the therapeutic response, the treatment-related toxicity, and the improvement of subjective symptoms between the chemotherapy alone group and the western-oriental combined treatment group and evaluated the role of oriental medicine for the improvement of chemotherapy-related toxicity in the advanced gastric cancer and hepatocellular carcinoma. Methods: We evaluated 36 gastric cancer or hepatocellular carcinoma patients(chemotherapy alone group 25 patients, combined treatment group 11 patients) who had been treated in Wonju Christian Hospital and Hana Hospital of Oriental Medicine between June 1999 and October 2000. Enrolled patients' general medical records, results of laboratory and imaging studies, treatment-related toxicities, and subjective symptoms were recorded regularly according to the planned protocol. Therapeutic responses were estimated according to the WHO response criteria and the changes of tumor marker value such as CEA, CA 72-4 and AFP. Results: 1. There was no significant difference of therapeutic response by the WHO response criteria between the two groups(p=.459). 2. There was a significant decrease of tumor marker value in the combined treatment group compared to the chemotherapy alone group(p=.023). 3. There was less comprehensive treatment-related toxicity in the combined treatment group compared to the chemotherapy alone group(p=.037), but there was not a significant difference of comprehensive improvement of subjective symptoms between the two groups(p=.091). Conclusions: Based on the above results, we could expect the possibility of improvements in therapeutic response and treatment-related toxicity with the western-oriental combined anticancer treatment.