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만성 C 형 간질환에서 혈청 히아루론산 및 PIIINP 농도와 간조직 소견의 비교
이준성 ( Jun Sung Lee ),김태헌 ( Tae Hun Kim ),임영석 ( Young Suk Lim ),이효석 ( Hyo Suk Lee ),김정룡 ( Chung Yong Kim ),윤정환 ( Jung Hwan Yoon ),우광훈 ( Gwang Hoon Woo ),김경아 ( Kyung Ah Kim ),장자준 ( Ja Jun Jang ) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.4
Background/Aims: In chronic liver disease type C, there have been no clinically useful serum markers to reflect histological findings such as hepatic necroinflammation and fibrosis except for an invasive liver biopsy. In an attempt to find out serum markers predicting these histological degree of progression in patients with chronic liver disease type C, we compared the histological findings with the levels of serum hyaluronate and N-terminal peptide of procollagen III (PIIINP) which are produced during the metabolism of extracellular matrices. Methods: Thirty-seven patients with antibody to HCV were enrolled in this study. Histological findings were scored for degree of piecemeal necrosis, lobular inflammation and fibrosis according to Ludwig's score. Then, serum concentrations of hyaluronate and PIIINP were measured by enzyme immunoassay and radioimmunoassay, respectively. Results: Hyaluronate at the concentration of 100 ng/mL had a positive predictive value of 80% and a negative predictive value of 100% for diagnosis of stage 3, 4 fibrosis. The positive and negative predictive values of PIIINP at the level above 1.5 U/mL were 100% and 89.3% for the diagnosis of grade 3, 4 piecemeal necrosis, and 100%, 85.7% for the diagnosis of grade 3, 4 lobular inflammation, respectively. Conclusions: Serum hyaluronate may be a useful serum marker of liver fibrosis compared with PIIINP. However, PIIINP may be a useful marker for detecting grade 3, 4 necroinflammation in patients with chronic liver disease type C. (Korean J Gastroenterol 2001;38:254-261)
수술 가능한(UICC T병기 1, 2 및 3), Child A인 간세포암 환자의 초기 치료로서 수술적 절제술과 경동맥 항암색전술의 생존율 비교
김태헌,이태림,이효석,김정룡,윤정환,우광훈,김강모 대한소화기학회 2000 대한소화기학회지 Vol.35 No.5
Background/Aims : This study was designed to compare the survival rates of patients with hepatocellular carcinoma (HCC) who were treated either with surgical resection (SR) or transarterial chemoembolization (TACE). Methods : From 1993 through 1994, 183 patients with HCC in UICC T1-3N0M0 and liver function of Child-Pugh class A were enrolled. The patients were divided into two groups (SR group and TACE group) according to the treatment modality. Stratification was performed according to the tumor stage (UICC or CLIP) and the degree of lipiodol retention. Survival rates of SR group and TACE group were compared. Results : When the both groups were stratified with UICC T stage, median survival of SR group and TACE group was 54 and 31 months, respectively, in UICC T1 HCC (p=0.0998), 65 and 37 months in T2 (p=0.0154), and 14 and 27 months in T3 (p=0.5432). In the stratification with CLIP stage, median survival of SR group was significantly longer in CLIP 0 or 1 HCC patients than that of TACE group. In the patients showing compact lipiodol uptake, median survival of SR group and TACE group in UICC T1 and T2 was 65 and 50 months (p=0.1529), and 65 and 48 months in CLIP 0 (p=0.1012), respectively. Conclusions : When compact lipiodol uptake is observed, repeated TACE may be as effective as surgery in patients with HCC of UICC T1, 2 or CLIP 0, as well as the patients with more advanced HCC.
소간세포암의 분화도와 혈관분포 양상에 따른 종괴 및 비종괴 부위에서 Insulin-like Growth Factor-II 발현 차
김태헌,송인성,정현채,이효석,김정룡,윤정환,이준성,우광훈,윤용범,장자준 대한소화기학회 2000 대한소화기학회지 Vol.36 No.1
Background/Aims : The precise mechanisms of insulin-like growth factor-II (IGF-II) in hepatocarcinogenesis have not been clarified yet. Recently, it was suggested that IGF-II might be closely related to angiogenesis. This study was designed to verify mechanisms of IGF-II in hepatocarcinogenesis and its relation to angiogenesis. Methods : For seventeen patients with small hepatocellular carcinoma (HCC) (≤3 cm in diameter), tissues were obtained from both tumorous and nontumorous area. We analyzed the degree of histological differentiation by Edmonson and Steiner's criteria and vascularity shown on spiral computed tomography (CT). The level of IGF-II expression was analyzed by immunohistochemical staining. Results : The histological differentiation of HCCs in the 17 patients were observed as follows : grade I in 3, grade II in 7, grade III in 7. Eleven patients showed hypervascular tumors on spiral CT. There was a significant correlation between the relative expression patterns of IGF-II and the degree of histlogical differentiation of HCCs. That is, in case of the more differentiated HCCs, IGF-II was more expressed in in tumorous tissues than in nontumorous tissues (r=0.609, p=0.010). Conclusions : These results suggest that IGF-II might play a role in an early stage of hepatocarcinogenesis.