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양재홍,최영식,박요한,김우미,김정훈,김영옥 고신대학교(의대) 고신대학교 의과대학 학술지 2009 고신대학교 의과대학 학술지 Vol.24 No.2
Background: It is estimated that papillary microcarcinoma of the thyroid (PTMC) account for up to 30% of all papillary thyroid cancers. Recently, it was reported that the cases of lateral lymph node metastasis showed significantly higher growth based on proliferating activity, apoptosis, and expression of metastatic suppressor than demonstrating no or occult metastasis. Cathepsin B has been implicated in processes important for tumor development and progression. The purpose of this study was to determine the relationship between cathepsin B expression and clinicopathologic characteristics of PTMCs. Methods: Forty six PTMC patients who underwent thyroidectomy at Kosin University, Gospel Hospital from November, 2004 to March, 2006, were included in the study. The author examined the expression of cathepsin B in these PTMCs by immunohistochemistry. Results: The expression of cathepsin B was not related with age, sex, and number of nodule, but was significantly related with size (p=0.035). According to the expression patterns of cathepsin B, lateral lymph node metastasis was higher in diffuse group than peripheral group. (p=0.001) According to the expression intensity of cathepsin B, there was no difference between intense group and weak group. Conclusion: These results suggested that the expression of cathepsin B was highly related with unfavorable prognostic markers of PTMC, such as size, and lateral lymph node metastasis. Further study is needed for clinical application of cathepsin B in the PTMCs.
증례 : Von Hippel-Lindau 유전자 배선 돌연변이와 동반된 가족성 양측성 갈색 세포종 1예
양재홍 ( Jae Hong Yang ),최영식 ( Yonung Sik Choi ),박요한 ( Yo Han Park ),오경승 ( Kyung Seung Oh ),천봉권 ( Bong Kwon Chun ),이상준 ( Sang Jun Lee ),김일진 ( Il Jin Kim ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
Von Hippel-Lindau (VHL)병은 VHL 유전자의 배선 돌연변이(germline mutation)의 결과로 발생하며, 상염색체 우성으로 유전하는 질환으로 소뇌, 척수, 뇌간 및 망막의 혈관모세포종과 신세포암, 갈색세포종 및 췌도종양 등의 여러 장기에 양성 및 악성 종양을 초래 하는 질환이다. 저자들은 양측성 갈색세포종을 가진 딸과 양측성 갈색세포종과 시력장애 및 췌장종양을 가진 환자에서 시행한 유전자 검사상 VHL exon2, codon 121에서 GAT (Asp)가 AAT (Asn)으로 배선돌연변이를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Von Hippel-Lindau (VHL) disease is an autosomal dominant inherited tumor syndrome characterized by multiple benign and malignant tumors of the central nervous system (CNS), retina, kidney, pancreas and adrenal glands. VHL disease is associated with a germline mutation of the VHL tumor suppressor gene on the short arm of chromosome 3. VHL disease has been divided in four subtypes, based on development of different tumors. VHL diseases without pheochromocytoma are classified as type 1, and those with pheochromocytoma type 2. VHL disease type 2 is divided into 2A based on the presence of renal cancer or 2B by the absence of renal cancer, and 2C has pheochromocytoma only. Recently we experienced a family with VHL type 2A and VHL type 2C who carry a novel type GAT (Asp) to AAT (Asn) missense germline mutation in codon 121 of exon 2 of VHL gene. The authors report this case with literature review. (Korean J Med 69:S873-S878, 2005)