위암종에서 p53 , Rb 및 PCNA 발현의 비교연구

이숭(Soong Lee),문범(Beum Moon),최성규(Sung Kyu Choi),유종선(Chong Sun Rew),윤종만(Chong Man Yoon),박창수(Chang Soo Park) 대한내과학회 1997 대한내과학회지 Vol.52 No.6

N/A Objectives: Recently, the studies for oncogene and tumor marker have been actively performed to investigate the carcinogenesis of gastric carcinoma, but it is not clearly understood. We investigated the expression of tumor suppressor gene and proliferation activity in gastric carcinoma. Methods: Immunohistochemistry for p53 protein (wild and mutant type), retinoblastoma protein(wild type), and PCNA was performed in 131 cases of formalin fixed paraffin embedded tissue sections of gastric carcinoma. We compared that expression with tissue invasiveness, lymph node metastasis, staging and, Lauren classification, and that expression with each other. Results: 1) The positive ratio of p53 protein, Rb protein, also PCNA in gastric carcinoma was 64.9%, 98.5%, 99.2%, 2) The expression of p53 protein was related to invasiveness, lymph node metastasis, staging, and Lauren classification(p<0.05). 3) The positive reaction for Rb gene was identified in tumor cells as well as proliferating cells. 4) There was a close relationship between Rb gene expression and PCNA in gastric carcinoma (p<0.05). Colclusion: Theses results suggested that the expression of p53 gene is related to invasiveness, lymph node metastasis, staging and Lauren classification in gastric carcinoma. Expression of retinoblastoma gene is a closely related to proliferating activity.

원발성 간암에 있어서 종양표지자로서 이상 Prothrrombin ( PIVKA - 2 ) 측정의 유용성

이숭(Soong Lee),윤경환(Kyung Whan Yoon),구철(Chul Koo),최성규(Sung Kyu Choi),유종선(Jong Sun Rew),윤종만(Jong Mann Yoon) 대한내과학회 1990 대한내과학회지 Vol.39 No.1

N/A Abnormal prothrombin, known as PIVKA-II (protein induced by vitamin K absence or antagonist-II) or DCP (des-γ-carboxyprothrombin), is released from the liver into the blood of patients with vitamin K deficiency or vitamin K antagonist users (wafarin sodium), or patients with various liver diseases, especially hepatocellular carcinoma. Recently. abnormal prothrombin has been reported to be as good a marker of hepatocellular carcinoma as alpha-fetoprotein (AFP), and its production may be due to the reduction of vitamin K-dependent carboxylase activity. In order to assess the usefulness of abnormal prothrombin and the correlation between abnormal prothrombin and AFP in hepatocellular carcinoma, we measured the plasma abnormal prothrombin using enzyme immunoassay in 60 patients with liver diseases and in 15 healthy controls. The results were as follows: 1) The mean value of plasma abnormal prothrombin in the normal controls was 0,06±0.02 AU/ml. 2) The mean value of plasma abnormal prothrombin in patients with hepatocellular carcinoma was 5.82±4.78 AU/ml, and there were significant differences between hepatocellular carcinoma and liver cirrhosis, chronic hepatitis and other non-tumorous liver diseases. The positivity of abnormal prothrombin in hepatocellular carcinoma was 70.6% 3) The sensitivity and specificity of plasma abnormal prothrombin as a marker of hepatocellular carcinoma with a diagnostic cut-off value of 0.13 AU/ml were 70.6% and 90.7%, and they were 58.8%, and 97.7% with a cut-off value of 3.0 AU/ml, respectively. The sensitivity and specificity of AFP with a diagnostic cut-off value of 20 ng/ml werC 64.7% and 76.6% and they were 35.3% and 95.3% with a cut-off value of 400 ng/ml, respectively 4) 1 here was no significant correlation between the plasma abnormal prothrombin and serum AFP in patients with hepatocellular carcinoma (r=0.45 p>0. 05). 5) There was no significant correlation between the tumor size and plasma abnormal prothrombin (r=0.04, p>0.05) or the serum AFV level (r=0.01, p>0.05). These results suggest that plasma abnormal prothrombin could be employed as a useful tumor marker together with AFP in patients with hepatocellular carcinoma.

Random amplified polymorphic DNA 분석에 의한 Helicobacter pylori의 분자적 형별분석

이숭(Soong Lee),신명근(Myung Geun Shin) 대한내과학회 2001 대한내과학회지 Vol.60 No.2

N/A Background : Genetic diversity among Helicobacter pylori strains isolated from different patients has been debated. This study was undertaken to determine molecular types and genetic diversity among 20 isolates of H. pylori obtained from various gastroduodenal diseases, and also examined the association between molecular types of H. pylori and these diseases. Methods : Antral biopsies were taken for culture from 38 patients with chronic gastritis, gastric ulcer and duodenal ulcer at the time of endoscopy. Biopsy specimens were primarily inoculated on chocolate agar and incubated microaerophilically at 37℃ for up to 7 days. H. pylori was identified by typical Gram stain morphology and biochemical tests. Random amplified polymorphic DNA (RAPD) fingerprinting was performed by 4 primers (OPA-07, 5'-GAAACGGGTG-3'; OPA-10, 5'-GTGATCGCAG-3'; OPA-11, 5'-CAATCGCCGT-3'; OPA-12, 5'-TCGGCGATAG-3'; Operon Technologies, Atlanta, GA). We used the NTSYS-pc (numerical taxonomy system and multivariate analysis system, version 1.50, Applied Biostatistics Inc., CA, USA) program to compose the phenogram for the differentiation of H. pylori strains. Results : Twenty strains (52.6%) of H. pylori were isolated from 38 biopsy specimens. All isolates were divided into five molecular types (I-V) at similarity (S) value of 0.63; 7 strains (35%), 4 strains (20%), 4 strains (20%), 3 strains (15%) and 2 strains (10%) belonged to type II, III, IV, V and I, respectively. The distribution of genetic S value was 0.24 to 0.91 in all isolates, thus the isolates had a wide range of S values. The mean S values of all isolates, type I, II, III, IV and V were 0.69, 0.69, 0.73, 0.75 and 0.65, respectively. There was no specific correlation between molecular types and gastroduodenal diseases. Conclusion : H. pylori isolates had high level of genetic diversity. The RAPD molecular types of H. pylori were not disease-specific since the types were diverse in the isolates from various gastroduodenal diseases.(Korean J Med 60:115-122, 2001)

위의 다발성 Carcinoid 종양

이숭(Soong Lee),강헌석(Heon Seok Kang),백종철(Jong Cheir Back),김윤미(Yun Mee Kim) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.5

Gastric multiple carcinoids with bleeding is very rare disease. A 62-year-old male patient was admitted to the hospital because of hematemesis and melena. On the gastrofiberoptic examination, blood clots, multiple small round polypoid masses in fundus and large round submucosal tumor-like polypoid mass in lesser curvature side of body were noticed. The biopsy specimen of small polypoid mass in gastric fundus by polypectomy snare showed carcinoid tumor in submucosa covered by atrophic mucosa with intestinal metaplasia and positive immunohistochemical stain for chromogranin A, neuron-specific enolase, cytokeratin. So we report a case of gastric multiple carcinoids with a review of relevant literature. (Korean J GastroenteroJ 1996;2S:721 - 726)

암성 복수의 감별진단에 있어 복수내 Fibronectin , Sialic Acid , 혈청 - 복수간 알부민 농도차 측정의 임상적 의의

이숭(Soong Lee),윤경환(Kyung Whan Yoon),최성규(Sung Kyu Choi),유종선(Jong Sun Rew),윤종만(Jong Mann Yoon),김미정(Mi Jung Kim) 대한내과학회 1990 대한내과학회지 Vol.39 No.1

N/A The differential diagnosis of ascites remains a problem in clinical practice, Although ascites is most often caused by chronic liver disease, by neoplasms metastatic to the peritoneum, and by tuberculous peritonitis, a complete differentiation has not been possible using simple and reliable parameters in ascitic fluid. Cytologic examination, despite its high specificity, also has limitations in differentiating ascites because of its low sensitivity. We measured the ascitic fluid concentration of fibronectin, sialic acid and the serum-ascites albumin difference in order to assess the diagnostic significance of these parameters for defferentiating ascites of various causes in 49 patients, 33 with liver cirrhosis and 16 with peritoneal metastasis. The results were as follows: 1) The mean concentrations of ascitic fibronectin (122.50±96.09ug/ml) and sialic acid (52.00±22.23 mg/dl) in malignant ascites were significantly higher the those of the liver cirrhosis group (p<0,001). The mean serum-ascites albumin difference (1.14±0.59 g/dl) in the malignant ascites group was significantly different from that of the liver cirrhosis group (2.67±0.54 g/dl), (p<0.001). 2) The highest diagnostic accuracy in malignancy was the value of serum-ascites albumin difference (97.8%) rather than ascitic sialic acid and fibronectin (83.7%, 80.0% respectively). 3) The highest specificity in differentiating liver cirrhosis with hepatocelluar carcinoma from peritoneal metastasis was ascitic fibranectin. These results suggested that the measurement of ascitic fibronectin, sialic acid, and serum-ascites albumin difference, combined with conventional parameters such as ascitic lactic dehydrogenase and total protein, may be useful for differentiating various causes of ascites.

성인 식도이물의 내시경적 치료

장민희,이숭,Jang Min Hee,Lee Soong 대한기관식도과학회 2004 大韓氣管食道科學會誌 Vol.10 No.1

The majority of esophageal Foreign body ingestions occur in the pediatric population. In adults, true foreign object ingestion occurs more commonly among those with psychiatric disorders, mental impairment. The management of esophageal foreign bodies is influenced by the age, clinical condition of ingested material, anatomic location and technical abilities of the endoscopist. Recently the therapeutic endoscopy is becoming wider and more rational in application. We evaluated the role of endoscopy for removal of esophageal foreign bodies during the period of 4 years from January 2000 to December 2003 at the Department of Otolaryngology and Gastroenterology, Seonam University Hospital. The results were as follow, 1) The age ranged from 21 to 74 years old (mean 50.5), most frequent age group was between 61-70 years old and male to female ratio was 1:1.4. 2) Fish bone was the most frequent foreign body in the esophagus ($47.1\%$), food material ($23.5\%$) and meats ($17.6\%$) were next frequent foreign bodies. The most frequent site of lodgement was the first ($78.4\%$), second ($17.6\%$) and third narrowing ($3.9\%$) in order. 3) The most common symptom was foreign body sensation (28.6%). the next common symptoms were chest discomfort($23.8\%$) and dysphagia($19\%$). 4) In duration of lodgement, 49cases ($96.1\%$) were lodged for less than one day. 5) The foreign bodies of esophagus were removed successfully by flexible endoscope with basket, snare, forceps, overtube and endoscopic variceal ligation cap. There were only 3 cases of minimal complications, esophageal mucosal tearing. In conclusion, endoscopic esophageal foreign body removal is useful and safe with minimal or no complications.

위점막에서 조직화학적 및 면역조직화학적 염색을 이용한 Helocibaxter pylori 의 검출

백종철(Jong Cheul Baek),강헌석(Heon Seok Kang),이숭(Soong Lee),명재일(Jae Il Myung),김완(Wan Kim),박창수(Chang Soo Park) 대한내과학회 1997 대한내과학회지 Vol.53 No.5

N/A logic test (ELISA, BIO-RAD GAP method), histochemical stain (Warthin-Starry silver stain), immunohistochemical stain (Avidin biotin conjugate method, ABC method) were performed to identify the presence of H. pylori infection. H. pylori infection was defined that 2 of 3 studies were positive. Results: Positive result to H. pylori infection by serologic test, Warthin-Starry silver stain and immunohistochemical stain were 82% (28/34 cases), 65% (22/34 cases), 68% (23/34 cases). Sensitivity and specificity were 68%, 20% in serologic test, 95%, 83% in Warthin-Starry silver stain, 100%, 100% in immunohistochemical stain. Correlation among these tests was best between Warthin-Starry silver stain and immunohistochemical stain. Conclusion: By the above results, we can conclude that histochemical stain and immunohistochemical stain are the most accurate diagnostic method to identify the infectivity of R. pylori.

원발성 담관암 49예에 대한 임상적 고찰

윤종만(Chong Mann Yoon),유종선(Jong Sun Rew),최성규(Sung Kyu Choi),양대현(Dae Hyun Yang),이숭(Soong Lee),구철(Chull Koo) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4

N/A Bile duct carcinoma is relatively rare malignancy with an extremely grave prognosis. The case records of 49 patients with primary carcinoma of the bile ducts seen at the Chonnam University Hospital from 1981 to 1988 were reviewed and analyzed. The results were as fo]lows 1) The peak age distribution was in seventh decade and the average age being 61.4 years. The sex ratio of male to female was 1.9:l. 2) In 43 of the 49 patients, anatomic location was extrahepatic bile duct. The most frequently involved site among the extrahepatic bile ducts was common bile duct (38.8%). 3) The most common symptom and sign were RUQ abdominal pain (75.5%), jaundice (89.7%), respectively. 4) Serum alkaline phosphatase and r-GTP were more increased in extrahepatic bile duct carcinoma than intrahepatic bile duct carcinoma. 5) Associated disease were clonorchiasis (12.2%), choledocholithiasis (10.2%), and gall stone (4.0%). 6) The most useful diagnostic modality was percutaneous transhepatic cholangiography and focal stenotic lesions (66.6%) were rnost common. 7) Operability and resectability were 26.5%, 16.3%, respectively. 8) Tubular adenocarcinoma was the most frequent histo]ogic type.

약년자 위암에 관한 연구 - 약년자 , 위암 , 임상상 -

박해옥(Hae Ok Park),최성규(Sung Kyu Choi),양대현(Dae Hyun Yang),조정곤(Jong Keun Cho),이숭(Soong Lee),윤경환(Kyung Hwan Yoon),유종선(Jong Sun Rew),윤종만(Chong Mann Yoon) 대한내과학회 1989 대한내과학회지 Vol.36 No.2

N/A Carcinoma of the stomach, which remains the leading cause of death, could be treated successfully with early detection and curative resection, Carcinoma of the stomach in young adults is known to be so uncommon that it is often overlooked as is the case with a benign lesion, because the subjective symptoms are vague and nonspecific. In this regard, we intended to determine the clinicopathologic characteristics of this neoplasm in young adults and to find diagnostic clues for early detection. The hospital records of 39 patients, age 35 years or younger, seen at our institution between 1976 and 1986, were reviewed. The results were as follow: 1) Of the 863 cases of gastric carcinoma encountered 39 were 35 years of age or younger an incidence of 4.2% and the male to female ratio was 1.1:1.0 2) The mean time interval between the onset of symptoms and the first visit to a physician was 7.2 months, and the cases with complications or metastases at the time of diagnosis reached 50% and 56.4%, respectively. 3) Most of the symptoms were nonspecific and epigastric pain was the major symptom (59%). 4) The majority of tumors occurred in the lesser curvature side of the gastric body (51%), and were proximal to the gastric angle (64%). 5) The macroscopic findings in the 35 cases of advanced gastric cancer were in the order of frequency of type IV (33,4%), type IIL (28.2%), type II (17.9%), and type I (10.3%). 6) Histopathologic findings revealed that 90% (35 cases) of the cases were adenocarcinoma and 77% (27 cases) showed low grade differentiation. 7) Of the 15 cases which underwent surgical therapy, a resectable operation wss done in 11 cases, including 4 cases of early gastric cancer. These results may be helpful to diagnose and treat gastric cancer in young persons. In addition, it is suggested that a more aggressive and thorough diagnostic approach should be taken in young persons, which will help detect gastric cancer in the early stages.

남원지역 고연령 인구에서 당뇨병의 유병률

김상국(Sang Guk Kim),양승원(Seung Won Yang),박상후(Sang Hoo Park),이경록(Kyung Rok Lee),박재홍(Jae Hong Park),장안수(An Soo Jang),서정평(Jeong Pyeong Seo),이숭(Soong Lee),남해성(Hae Sung Nam),손명호(Myung Ho Sun),신명근(Myung Geun S 대한내과학회 2001 대한내과학회지 Vol.60 No.6

N/A Background : Significant ethnic and geographic differences exist in the prevalence of diabetes mellitus, which has increased dramatically in South Korea. But a few population-based studies were performed in South Korea. The purpose of this study was to determine the prevalence of diabetes mellitus, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) by the World Health Organization (WHO) and the American Diabetic Association (ADA) diagnostic categories, and to investigate their associated risk factors. Methods : Between march 22, 1999 and July 14, 1999, a random sampling of 1445 residents over 40 year of age in five villages in the Namwon county of South Korea was carried out. Among these subjects, 665 (46.0%) participants completed 75 g OGTT. WHO and ADA diagnostic criteria were used for the diagnosis of diabetes mellitus, IGT and IFG. Detailed questionnaire were performed and anthropometric data were collected. Results : After age-adjustment for population projection for Korea (1999), the prevalence of diabetes and IGT were 13.7% and 13.8% with WHO criteria, while the prevalence of diabetes, IGT and IFG were 15.8%, 12.8% and 5.7% with ADA criteria. The age-adjusted prevalence of previously diagnosed diabetes was 5.8%. The level of agreement between WHO and ADA diagnostic criteria except IFG was high (κ=0.94; p<0.001). The ROC curve analysis determined FSG of 114.5 mg/dL (6.4 mmol/L) to yield optimal sensitivity and specificity corresponding to a PP2SG 200 mg/dL (11.1 mmol/L). The prevalence of diabetes and IGT with ADA diagnostic criteria rose with increasing age (p<0.05). The difference in the prevalence of diabetes, IGT and IFG by BMI was not significant. The prevalence of diabetes rose with increase in the waist-hip ratio. The prevalence of diabetes was increased in subjects with dyslipidemia (Odds ratio 2.29, 95% CI: 1.16-3.49).