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위상피이형성과 위암종에서 탄수화물항원의 면역조직화학적 발현
김종성,정진숙,한상영,최석렬,감동호 대한소화기학회 2000 대한소화기학회지 Vol.35 No.6
Background/Aims: The transition from intestinal metaplasia to adenocarcinoma is characterized by further qualitative and quantitative alterations of mucin-related carbohydrate antigens. The aims of this study were to examine expression patterns of mucin-related carbohydrate antigens, to investigate the relationship between the expression patterns and prognostic factors, and to evaluate the usefulness of the expression patterns in assessing the progression of gastric carcinoma. Methods: Immunohistochemical studies of 3 carbohydrate antigens (Tn, sTn, sLex) were performed for 63 gastric carcinoma tissues (EGC:23 cases, AGC:40 cases) and 54 gastric epithelial dysplasia tissues obtained from January 1997 to December 1997. Results: The carbohydrate antigens were significantly expressed in advanced gastric cancer. By the results of immunohistochemistry for Tn and sTn antigens, distribution and intensity of staining were also significantly increased in progression to advanced gastric cancer. Especially, dysplastic lesions had the tendency to show supranuclear Golgi staining pattern, and carcinomas showed diffuse cytoplasmic pattern or luminal border pattern of neoplastic glands. The expression of Tn antigen was significantly increased in carcinomas with deep invasion. The expressions of Tn and sLex antigens were significantly increased in advanced gastric cancer with lymph node metastasis. Conclusions: These results suggest that the expression patterns of the mucin-related carbohydrate antigens may be correlated with prognostic factors and predict the progression from gastric epithelial dysplasia to advanced gastric cancer.
한상영,신우원,김두형,노명환,감동호,최석렬 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.3
Endoscopic variceal ligation(EVL) is newly developed method to manage esophageal variceal bleeding. This study asse initial control rate of active variceal bleeding, incidence of rebleeding and complications in EVL. From June in l992 to December in 1994, this study was performed on 70 patients who had visited to our medical center for melena or hematemesis by acute esophageal variceal bleeding. In all of 70 cases, eradication of esophageal varix was performed and variceal bleeding was controlled well. And first session was performed successfully with EVL. But rebleeding was occured in 12 cases(11 cases caused by esoyhageal varix and 1 case caused by esophageal ulcer) during follow-up period, so EVL therapy was performed repeatedly and 8 cases were eradicated and 4 cases were uncontrolled and died, and then 94% hemostatic effect was achieved during follow-up period. Complications of EVL therapy were mild(substernal discomfort in 12 cases, substernal pain in 4 cases, fever in 3 cases, mild dysphagia in 2 cases) and well controlled. Superficial esaphageal ulcer was shown in 18 cases by follow-up endoscopy after 1 week. These results show that EVL is a good therapeutic method to control active variceal bleeding and eradication of varix with repeat treatment. In conclusion, EVL is an effective and safe method of treatment and prevention for esophageal variceal bleeding.
김기현(Ki Hyun Kim),권혁찬(Hyuk Chan Kwon),김문범(Moon Beom Kim),안원석(Won Suk An),감동호(Dong Ho Gam),김상곤(Sang Gon Kim),김성은(Seong Eun Kim),김종성(Jong Seong Kim) 대한내과학회 1995 대한내과학회지 Vol.49 No.5
N/A Objectives: We intended to evaluate the incidence and clinical characteristics of various glomerular diseases (GD) in adults including the patients with asymptomatic urinary abnormalities. Methods: We conducted retrospective study with review of histologic findings and clinical records of the 4% cases diagnosed as GD during 9years since 1985. The diagnoses of all cases were confirmed by renal biopsies. The laboratory studies to differentiate secondary diseases were also performed. Results: 1) There were 382 (78.6%) cases of primary GD and 104 (21.4%) of secondary GD. Among primary GD, IgA nephropathy (IgAN) was the most common as 151 (39.5%) cases followed by 123(32.2%) of minimal change nephrotic syndrome (MCNS), 34 (8.9%) of membrananous glomerulonephritis (MGN), 23 (6.0%) of membranoproliferative GN type I (MPGNI), and 21 of focal glomerulo- sclerosis (FGS) in the order of frequency. 2) In the secondary GD group, HBsAg positive cases were 49 (47.1%), and the rest was 35 (33.7%) of lupus nephritis (LN), 7(6,7%) of diabetic nephropathy, and 3 (2.9%) of HenochShoenlein purpura. 3) Out of 162 IgAN, 151(93.2%) cases were idiopathic- focal GN in 70(48.6%), diffuse mesangial proliferative (DMsPGN) in 40(27.8%), minor glomerular abnormality in 29(20.1%), and sclerosing GN in 5 (3.5%) cases. In 11cases of systemic disease-associated IgAN, there were 7 HBV surface antigenemia, 2liver cirrhosis, 1alcoholic liver disease, 1thin glomerular basement membrane disease. The frequent events causing medical attention in patients with IgAN were gross hematuria (36.6%), urinary abnormality on routine check (26.7%), and edema (21.4%), but only 11% of patients had true edema and hypoalbuminemia. 4) In idiopathic nephrotic syndrome group (INS, total 230cases), the prevalence of each disease and the incidence of clinically overt NS on admission were 60.6%, 16.7%, 11.3%, and 10.3% and 94%, 71%, 65%, and 81% in MCNS, MGN, MPGNI, and FGS, respectively. 5) Serum HBsAg was positive in 40% of MPGNI, 27.3% of MGN, and 5.7% of IgAN. 6) According to WHO classification, the histologic findings of LN (35 of 106cases, 33.0%) were type IV 48.6%, V in 28.6%, and each of II and III in Conclusion. 1) IgAK was the most common primary GD. Thus, gross hematuria or abnormal urine findings on routine examination should be considered as highly suggestive of IgAN. 2) MCNS was the most common cause of INS in this study. 3) HRV infection seems to have a significant role in the pathogenesis of MPGNI and MGN, but not in IgAN. 4) In secondary GD, SLE is an important systemic disease requiring renal biopsy.