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위암의 침윤과 전이에 관여하는 단백분해 효소 ( uPA , PAI - 1 및 Type 4 Collagenase ) 에 관한 연구
조재용(J . Y . Cho),정현철(H . C . Chung),노성훈(S . H . Noh),김호근(H . K . Kim),박준오(J . O . Park),이종인(J . I . Lee),유내춘(N . C . Yoo),김주항(J . H . Kim),노재경(J . K . Roh),김병수(B . S . Kim),강진경(J . K . Kang),민진식(J . S 대한내과학회 1997 대한내과학회지 Vol.52 No.1
N/A Objectives : Prognosis of gastric cancer is related to invasion and metastasis. Evidence has accumulated that invasion and metastasis in solid tumors require the action of tumor associated proteases, which promote the dissolution of the surrounding tumor matrix and the basement membrane. The serine protease [(urokinase-type plasminogen activator and plasminogen activator inhibitor-1 (PAI-1)] and type IV collagenase(MMP-9 and MMP- 2) appear to play a key role in these processes. Recent reports have demonstrated that expression of these proteolytic enzymes are elevated in breast and colon cancer and that it can be associated with invasiveness and poor prognosis. We therefore evaluated whether the expression and activation of uPA, PAI-1 and type IV collagenase might be of clinical value in gastric cancer as a tumor/biologically defined risk factor. Methods: In a consecutive series of 160 gastric cancer patients who were enrolled in the Yonsei Cancer Center Study Group, the expression of uPA, PAI-1 and type IV collagenase was determined by ELISA, zymography and mmunohistochemical method. The results were as follows. Results: 1) Both uPA and PAI-1 levels were significantly higher in cancer tissues than no rmal (uPA; 9.4±8.7vs 5.3±3.1 ng/mg protein cytosol, PAI-1;10.9±9.1vs 5.8± 2.9 ng/mg protein cytosol), (p<0.001 respectively). Both high uPA and PAI-1 levels were associated with differentiation of the tumor(p=0.04, p=0.004), and a high PAI-1 level was associated with lymph nodes metastasis at an advanced stage (p=0.003, p=0.04). There was a correlation between the levels of uPA and PAI-1 expression in cancer tissues(r=0.57). 2) The activation ratio of MMP-9 and MMP-2 in cancer tissues 0.32±0.25, 0.27±0.34 were significantly higher than in normal tissue 0.19±0,27, 0.06± 0.16(p<0.001). The MMP-9 activation was associated with lymphnode metastasis and the MMP-2 activation was associated with distant metastasis(p=0.011, p=0.041). 3) In univariate analysis all of the proteolytic enzymes were associated with short relapse free survival, but in multivariate analysis only the high uPA expression was an independent prognostic parameter for short relapse free survival of the gastric cancer patients. Conclusion: These data indicate that uPA, PAI-1 and type IV collagenase were involved in the progression of gastric cancer at different points of time by different mechanisms. The combined expression and activation of these proteolytic enzymes were poor prognostic factors in gastric cancer patients, so new therapy based on these biologic behavior of the tumor in the same stage are clinically applicable. In particular, uPA is a new independent variable for the identification of patients at high risk, therefore therapy targetting uPA can be applied as a new treatment modality for gastric cancer.
비소세포폐암에서 p53유전자의 구조적 이상 및 단백질 발현이 예후에 미치는 영향
이이형 ( Y. H. Lee ),신동환 ( D. H. Shin ),김주항 ( J. H. Kim ),임호영 ( H. Y. Lim ),정경영 ( K. Y. Chung ),양우익 ( W. I. Yang ),김세규 ( S. K. Kim ),장준 ( J. Chang ),노재경 ( J. K. Roh ),김성규 ( S. K. Kim ),이원영 ( W. Y. Lee ) 대한결핵 및 호흡기학회 1994 Tuberculosis and Respiratory Diseases Vol.41 No.4
권혁문(Hyuck Moon Kwon),정재복(Jae Bock Chung),김주항(Joo Hang Kim),전상일(Sang Il Chun),조준구(Jun Koo Cho),박용준(Yong Jun Park),고은희(Eun Hee Koh),노재경(Jae Kyung Roh),서창옥(Chang Ok Suh),김귀언(Gwi Eon Kim),노준규(J . K . Loh) 대한내과학회 1987 대한내과학회지 Vol.33 No.1
N/A There is no acceptable evidence, either in this presentation of in the literature, that the patterns of occurance of multiple primary maligant neoplasms of different organs of tissues are governed by anything more than conincidence. The freqency of occurance of specific types of second primary cancers is probably largely determined by the age of the patient at the time of diagnosis of initial cancer and the expected longevity after treatment of the initial lesion. The absolute number of reported cases of multiple primary malignant tumors has increased in recent years and the freqency of occurance of this phenomenon has increased. There is no factual basis for assuming that the existence of any one malignant neoplasm influence or that it implies any susceptibility of any other organ or organ system to future cancer. But it becomes apparent that existence of one malignant neoplasm implies increased susceptibility to the development of a second lesion but also a malignant lesion in one organ may imply increased susceptibility of another organ to malignant neoplasm, particularly another organ in the same or an associated system. This report deals with the clincal analysis of 42 cases of multiple primary malignant tumors from tumor registry of Severance hospital and yonsei cancer center during 7 years from Jan 1979 to Dec. 1985 and review of the literatures, The following results were abtained. 1) The incidence of multiple primary malignant tumor was 0.26% of tumor registry (42/25, 863) and the mean age of 26 male patients at first cancer was 58.8 years old and 54.9 years old in 16 female patients. 2) The mean time interval between first and second cancer was 34.1 months in 12 metachronous tumors. 3) In male patients, the stomach cancer was the most common first cancer followed by lung cancer. In female patients, the cancer of uterine cervix was the most common first cancer. 4) The ratio between synchronous and metachronous multiple primary was 2.5:1 (30:12).
기관지천식 환자에 있어서 ACTH Stimulation Test 前後의 부신피질 홀몬 뇨배설에 관한 연구
盧在京,李愚馨,趙勝衍,李相龍 中央醫學社 1975 中央醫學 Vol.29 No.6
In 16 adult asthmatic patients, who were admitted to the Severance Hospital, the adrenal function was studied by means of 24 hour urinary excretion of 17-ketosteroids and 17-hydroxycorticoids before and after ACTH stimulation test. The basal elimination of 17-ketosteroids and 17-hydroxycorticoids were maintained within normal limits, and after the ACTH stimulation test, the urinary excretion of 17-ketosteroids and 17-hydroxycorticoids were increased within normal limits. The urinary excretion of 17-ketosteroids and 17-hydroxycorticoids were within normal limits in the allergic skin test positive patients and in the asthmatics with eosinophilia.
다발성 원격전이와 SIADH를 동반한 원발성 충수돌기 악성유암종 (Carcinoid Tumor) 1예
안광진,정현철,노재경,박중원,이화영,서창옥,노준규,이종태,최수임,김병수 대한내과학회 1990 대한내과학회지 Vol.38 No.1
Carcinoid tumors are the most trequently occurring neoplasms of the appendix and small bowel. Most carcinoid tumors of the appendix are incidentally discovered during other surgical procedures. Its natural course is usually benign and the size of the tumor is closely related with the liability of regional or distant metastasis, so this affects the mode of therapy. Lesions less than 2㎝ in greatest dimension are never shown to have metastatic lesions and those larger than 2㎝ are likely to metastasize to regional lymph nodes and occasionally to distant organs such as liver, lung and bones. We experienced a malignant carcinoid tumor of the appendix with metastasis to regional lymph nodes, lung, ribs and thoracic vertebrae, cervical lymphnodes, and the right adrenal gland without liver metastasis. The patient had no signs of carcinoid syndrome but showed hyponatremia which was corrected by fluid restriction, suggesting SIADH. The patient was treated with a combination regimen of 5-fluorouracil and doxorubicin after surgical removal of the appendiceal mass, and a palliative radiotherapy for the osteolytic lesion of the right 12th rib. A review of our experience suggests a more extensive program in disseminated malignant carcinoid tumors is required.