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간세포암에서 현미부수체 불안정성과 p53 유전자 이형접합 소실
김준석(Jun Seok Kim),임만섭(Man Sup Lim),김두진(Doo Jin Kim),김주섭(Joo Seop Kim),김관석(Kwan Seok Kim),김홍기(Hong Ki Kim),조성진(Seong Jin Cho),권미정(Mi Jung Kwon),남은숙(Eun Sook Nam),최경찬(Kyung Chan Choi),신형식(Hyung Sik Shin 한국간담췌외과학회 2009 한국간담췌외과학회지 Vol.13 No.3
Purpose : Hepatocellular carcinoma (HCC) shows various molecular and genetic alterations in its development and progression. Recently, microsatelite instability (MSI) and the loss of heterozygosity (LOH), have been postulated as useful prognostic factors in many malignant tumors. LOH is related to the allelic loss of various tumor suppressor genes, however, MSI has been found to be the result of a mismatched DNA pairing. Our objectives were to evaluate MSI and p53 gene LOH and to correlate this to clinicopathological factors. Methods : MSI analysis was performed by using polymerase chain reaction with 5 microsatellite markers (BAT25, BAT26, D2S123, D5S346 and D17S250 recommended in the 1998 NCI International Workshop) on 50 surgically resected tumors. p53 LOH was detected with 4 markers(D17S796, TP53, D17S5, D17S513). Results : MSI and p53 LOH were detected in 30% and 66%, respectively. 18% of HCCs exhibited MSI in 5 NCI-recommended markers and 18% of HCCs demonstrated MSI in 4 p53 markers. MSI was mostly detected in BAT25 and BAT26 markers. MSI was more frequently detected in tumor grade Ⅰ, small HCC, and non-lymphovascular group. For the most aprt, p53 LOH was detected by D17S513 marker(38.1%). p53 LOH results were correlated with higher tumor grade and invasiveness. LOH-High group showed a significant correlation with advanced HCCs and lymphovascular invasion. There was no demonstrated correlation between MSI and p53 LOH was not demonstrated. Conclusion : These results suggest that MSI may be involved to some extent in hepatocarcinogenesis and tumor invasion. Also MSI and p53 gene LOH may be a useful clinical indicator in determining the prognosis among patients with HCC.
조기 위암 환자에서 내시경적 절제술 후 고식적 수술에 영향을 주는 인자
이재석(Jae Seok Lee),임만섭(Man Sup Lim),조지웅(Ji Woong Cho) 대한종양외과학회 2013 Korean Journal of Clinical Oncology Vol.9 No.2
Purpose: The increase in the incidence of early gastric cancer (EGC) cases has led to an increase in endoscopic resections, thereby resulting in an increasing number of endoscopic resection failure cases. The purpose of this study was to identify indicators for endoscopic resection, such as depth of invasion and tumor differentiation. Methods: This study included 273 patients who underwent endoscopic resection for EGC at Hallym University Sacred Heart Hospital from January 2006 to May 2013. Of these resection cases, 41 were also surgical treatment cases. The endoscopic findings and lesion characteristics were analyzed, retrospectively using medical records. Results: The results suggested that when the location of tumor was in the middle third of the stomach (P=0.002), the patient was younger (P=0.057), there was a higher likelihood of surgical treatment after endoscopic resection. Conclusion: To determine the indicators for endoscopic resection, it is essential to consider tumor location as well as tumor size, tumor differentiation and depth of invasion, which are considered important factors. If the lesion was located in the upper and middle third of the stomach, sufficient explanation and consent was required.
캡슐내시경으로 진단된 공장의 다발성 위장관 간질종양 1예
김소연 ( So Yeon Kim ),박철희 ( Cheol Hee Park ),천승연 ( Seung Yeon Chun ),김수진 ( Su Jin Kim ),김종혁 ( Jong Hyeok Kim ),박충기 ( Choong Kee Park ),임만섭 ( Man Sup Lim ),서진원 ( Jin Won Seo ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.3
More than 90% cases of chronic gastrointestinal bleeding can be diagnosed by upper endoscopy and/or colonoscopy, and therefore, obscure gastrointestinal bleeding has been defined as bleeding of unknown origin that persists after these conventional endoscopic evaluation, Gastrointestinal stromal tumors (GISTs) are rare tumors, but the most common form of mesenchymal tumors of the gastrointestinal tract. Small bowel is the second most common primary site for GISTs, and accounts for 2-10% of chronic bleeding sites, GISTs usually present as a sporadic and solitary tumor, and a minority of the cases of multiple GISTs are discovered as forms of hereditary or idiopathic tumor syndromes, Small bowel tumor has been difficult to diagnose because of absence of accurate and proper diagnostic tools. Recently developed wireless capsule endoscopy helps in the diagnostic work-up of small bowel diseases. We report a case of multiple jejunal GISTs presenting melena in a 39-year-old male, which was diagnosed with wireless capsule endoscopy.