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강순구,이중화,설종구 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1
We report a case of tuberous sclerosis accompying the typical stigmata in a 18-year-old women who had undergone right nephrectomy. 40 to 80 per cent of tuberous sclerosis patients have renal angiomyolipoma. When angiomyolipoma is associated with tuberous sclerosis, the renal tumors usually are bilateral, muliple, samll and asymptomatic. Currently, it should be possible to make the diagnosis of angiomyoliporna in most cases on the basis of the combined imaging characteristics of CT and ultrasongraphy. Lesions associated with tuberous sclerosis require surgical intervention only when they become symptomatic or enlarge silently.
방광이행상피암에서 24시간 요중 Tissue Polypeptide Antigen(TPA) 및 Carcinoembryonic Antigen(CEA)의 임상적 가치
강순구,이중화,설종구 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1
Tumor markers already play an important part in the management of the urologic neoplasm. As the number of emerging markers increases, clinical judgement may be an even more important part of the use of tumor markers. Ideally, a tumor marker should be produced reliably only by a specific malignancy, be easily and reproducibly measured, be detectable when a tumor is in its early stages and correlate with a response to therapy. Unfortunately, an ideal tumor marker has not yet been identified. Tissue polypeptide antigen(TPA) is heterogeneous in nature and SDS-polyarcrylamide gel electrophorsis resolves it into components with molecular weights raging from 45,000 to less than 20,000. Thus TPA is capable of being filtered through the kidney and excreted in the urine. The increased levels of TPA in urine and serum are probably due to a more rapid turnover and autolysis of cells and may parallel a more aggressive tumor behavior. Carcinoembryonic antigen(CEA) is a glycoprotein first found in extracts of human colonic cancer and the colon of human fetus during the first trimester of pregnancy. Initially it was considered that plasma CEA elevations were found only in case of endodermally-derived carcinomas. As bladder is, in part, endodermally-derived, this led Hall et al. to look for raised plasma and urine CEA levels in patients with urothelial carcinoma. We measured the TPA and CEA levels of 24-hours urine from 20 healthy individuals and 96 patients with definitive transitional cell carcinoma of the urinary bladder. And we evaluated the corelationships with grades, stages and recurrence of transitional cell carcinoma of the urinary bladder. The results are as follows; 1. Positive values(mean+2S.D.) of TPA and CEA levels of 24-hours urine showed significant differences between normal individuals and patients with transitional cell carcinoma of the urinary bladder(p<0.001 and p<0.05, respectively). 2. TPA and CEA levels in 24-hours urine showed significant differences between normal individuals and patients with transitional cell carcinoma of the urinary bladder(p<0.001 and p<0.05, respectively). 3. TPA levels in 24-hours urine of patients with transitional cell carclinoma of the urinary bladder showed significant difference in each grades or each stages. 4. CEA levels in 24-hours urine of patients with transitional cell carnoma of the urinary bladder did not show significant difference in each grades or each stages. 5. The recurrence rate in stage A patients whose 24-hours urine TPA level were above the positive value was 77%. The recurrence rate in stage A patients whose 24-hours urine CEA level were above the positive value was 66.7%. So, TPA level of 24-hours urine in patients with transitional cell carcinoma of the urinary bladder can be a good tumor marker and show the more close corelationships with tumor grades or stages than CEA levels of 24-hours urine in patients with transitional cell carcinoma of the urinary bladder.
강순구,유종근 대한화학요법학회 1990 대한화학요법학회지 Vol.8 No.2
All chemical antibiotics should have the excellent antibiotic activity and the least side effects. The varacillin®, the prodrug of ampicillin, was synthesized in order to increase the absorption via intestine, therefore minimize the side effects of ampicillin. We orally administrated the varacillin® for 3 to 5 days according to the severity and complexity of infection to 57 patients with the urogenital infections and evaluated the clinical response, antimicrobial susceptibility, and side effects. The results were as follows ; 1) There were E. coli, 28 cases : S. epidermidis. 4 cases : alpha-hemolytic streptococcus, 2 cases : E. aerogens, 1 case : Ent. cloacae, 1 case : K. oxytoca, 3 cases : and the excellent effect was in 23 cases of E. coli. The colony change was 1 case from E. aerogens to S. marcescens, and the new growth of Ps. aeruginosa. in 1 case. 2) The effects on Pyuria of Urogenital Infection were Eliminated : 38 cases(77.6%) Decreases : 10 cases(20.4%), Unchanged : 1 case(2.0%) 3) The clinical effect was excellent in the 53 cases(91.2%) of 57 cases. Especially, there were many cases with the satisfactory clinical effect even in the cases with poor antibacterial susceptibility. 4) In complete blood count, blood chemistry and urine analysis, there were no clinically considerable side effects, no associated change between pre- and post-administration test, and no considerable change with the dosage and duration of the drug. 5) The availability was excellent in the 51 cases(89.5%). So Varacillin® (Lenampicillin) is a very effective and safe antimicrobial agent in the treatment of the urogenital infection.