다발성 원발성 악성종양

권혁문(Hyuck Moon Kwon),정재복(Jae Bock Chung),김주항(Joo Hang Kim),전상일(Sang Il Chun),조준구(Jun Koo Cho),박용준(Yong Jun Park),고은희(Eun Hee Koh),노재경(Jae Kyung Roh),서창옥(Chang Ok Suh),김귀언(Gwi Eon Kim),노준규(J . K . Loh) 대한내과학회 1987 대한내과학회지 Vol.33 No.1

N/A There is no acceptable evidence, either in this presentation of in the literature, that the patterns of occurance of multiple primary maligant neoplasms of different organs of tissues are governed by anything more than conincidence. The freqency of occurance of specific types of second primary cancers is probably largely determined by the age of the patient at the time of diagnosis of initial cancer and the expected longevity after treatment of the initial lesion. The absolute number of reported cases of multiple primary malignant tumors has increased in recent years and the freqency of occurance of this phenomenon has increased. There is no factual basis for assuming that the existence of any one malignant neoplasm influence or that it implies any susceptibility of any other organ or organ system to future cancer. But it becomes apparent that existence of one malignant neoplasm implies increased susceptibility to the development of a second lesion but also a malignant lesion in one organ may imply increased susceptibility of another organ to malignant neoplasm, particularly another organ in the same or an associated system. This report deals with the clincal analysis of 42 cases of multiple primary malignant tumors from tumor registry of Severance hospital and yonsei cancer center during 7 years from Jan 1979 to Dec. 1985 and review of the literatures, The following results were abtained. 1) The incidence of multiple primary malignant tumor was 0.26% of tumor registry (42/25, 863) and the mean age of 26 male patients at first cancer was 58.8 years old and 54.9 years old in 16 female patients. 2) The mean time interval between first and second cancer was 34.1 months in 12 metachronous tumors. 3) In male patients, the stomach cancer was the most common first cancer followed by lung cancer. In female patients, the cancer of uterine cervix was the most common first cancer. 4) The ratio between synchronous and metachronous multiple primary was 2.5:1 (30:12).

상대정맥증후군을 동반한 Behcet 씨 증후군 1 예

조승연,방동식,민희원,전상일 대한내과학회 1986 대한내과학회지 Vol.30 No.3

In 1937 Behcet described the tripple symptom-complex of recurrent orogenital ulceration and eye inflammation. Recently it was suggested that the diagnosis of Behcet's disease can be established when repeated oral aphthous ulcers occur in combination with only two of the following additional features: genital ulceration, uveitis, synovitis, cutaneous vasculitis, and meningoence-phalitis. Vascular involvement in Behcet's disease Mischima first described in 1961, is relatively rare except some racial groups like Turkey, Greece, and Japan. In Korea there were reported 2 cases of Behcet's syndrome involving aorta, abdominal aorta, brachial artery and so on. But there was no case of Behcet's disease invo1ving superior vena cava. We report a case of superior vena cava syndorme in a patient with Behcet's disease, a previously unreported finding in Korea.

제 8 흉추의 고립성 형질구종 치험 1 예

김태형,김상철,문세광,허경억,곽철승,전상일,도일환 대한내과학회 1987 대한내과학회지 Vol.33 No.1

Solitary plasmacytoma of bone is an unusual solitary tumor of plasma cell origin. The clinical difference between tis tumor and multiple myeloma remain unclear. We experienced a case of solitary plasmacytoma of thoracic spine. So we have reported the case with the review of previous literatures.

전신성 흥반성 낭창에서의 생존율에 관한 연구

한지숙,박금수,조철호,고윤웅,윤진우,전상일 대한내과학회 1986 대한내과학회지 Vol.30 No.1

We retrospectively analyzed clinical and laboratory features of 58 patients with SLE for the survival and the factors which may have influenced the outcome from 1970 through 1983. The survival was calculated using the method of Merill and Shulman, taking the time of diagnosis and the onset of symptom as the starting point. We divided 58 patients with SLE into 2 groups, those whose survival was less than or equal to 2 years and those greater than 2 years, and compared clinical and laboratory features between them with particular emphasis on those factors which may have influenced the outcome. The results obtained as follows: 1) The estimated survival from diagnosis was 76.7% in 1 year, 62.3% in 2 years, 62.3% in 3 years, 59.6% in 4 years, 53.8% in 5 years and 50.6% in 10 years. The estimated survival from the onset of symptom was 65.5%, in 1 years, 59.54% in 2 years, 56.2% in 3 years, 52.2% in 4 years, 52.5% in 5 years, and 46.l% in 10 years. 2) There was a statisticaly significant difference in prognosis between 2 groups with regard to CNS involvement, serositis, and increased serum creatinine level(≥3.0mg/dl).

여러 질환에서의 Antinuclear Antibody(ANA) Test 에 관한 연구

조준구,김현숙,홍천수,조철호,권오현,김현만,이수곤,허갑범,전상일 대한내과학회 1987 대한내과학회지 Vol.32 No.2

Antinuclear antibodies are autoantibodies that are usually detected by indirect immunofluorescence and are directed against components of human and other mammalian cell nuclei. Between January 1982 and December 1984, we retrospectively reviewed the records of 238 patients with a positive ANA test. The following results were obtained from this review. 1) Among 238 ANA positive specimens, 98 (41.2%) were connective tissue disorders, 43 (18.0%) immune disorders and 97 (40.8%) other disorders. 2) Among 238 ANA positive specimens, 135 (57%) were low, 26 (11%) intermediate and 77 (32%) high titers. Sixty three of 98 (64.2%) sera from patients with connective tissue disorders and 44 of 53 (83%) sera from patients with SLE had ANA titers of 1:80 or more. Thirty two of 42 (74.4%) sera from patients with immune disorders and 68 of 97 (70.1%) sera from patients with other disorders had ANA titers of 1: 20. 3) Among 238 ANA positive specimens, immunofluorescent patterns showed that 105 (44%) were homogeneous, 102 (43%) speckled, 13 (5.5%) mixed, 12 (5%) peripheral and 6(2.5%) nucleolar pattern. 4) In 53 SLE patients, 41 (77%) were high titers in ANA test and homogeneous and speckled patterns were 26 (55.5%) and 20 (37.7%) respectively. Thirty of 37 (81%) SLE patients had positive anti-DNA test and 16cases (43%) were high titers. 5) Nineteen patients (13.6%) of 140 nonrheumatic disorders showed high ANA titers. Among nine patients with idipathic thrombocytopenic purpura, three patients showed high ANA titers (1:160 1). In conclusion ANA test was useful to diagnose various rheumatic disease. Some nonrheumatic patients also revealed positive ANA test. ANA titers were high in rheumatic disorders, but some non-rheumatic patients with high ANA titers should be followed to look for evolving rheumatic disorders.

악성 임파종에서 혈청 β2-microglobulin 에 관한 연구

고은희,김현숙,한지숙,김주항,이삼열,김병수,고윤웅,윤진우,전상일 대한내과학회 1986 대한내과학회지 Vol.30 No.4

Rata 2 microglobulin, a low molecular weight polypeptide, exists in the plasma membrane of all nucleated cells and its normal serum concentration, in free form, is in the range of 1, 500 to 2,000 μg/L, Serum β2-microglobulin is increased in malignant tumors especially in B-cell lymphopro-liferative disorders, and thus the serum concentration is of help for the diagnosis, therapeutic response and prognosis of these disorders. The author attempted to correlate the serum β2-microglobulin levels and the clinical courses of malignant Iymphomas, in 35 patients with malignant lymphoma showing normal BUN and serum creatinine levels. These patients were collected from the in-patients of Severance Hospital, Yonsei Medical Center during September 1984 to July 1985. As a control group, the serum β2-microglobulin levels of 38 healthy subjects were also measured. The following results were obtained: 1) The serum β2-microglobulin in 38 healthy subjects was 1,827±546 μg/L. The serum β2-mic-roglobulin of 35 patients with malignant lymphoma revealed 2.298±1.117μg/L. The serum p, microgiobulin in 35 patients with malignant lymphoma was higher than that of control group significantly(p$lt;0.05). 2) The serum β2-microglobulin level according to clinical stage showed increasing tendency with higher with higher stages. Fourteen patients of stage I or II showed the mean serum β2-microglobulin level of 1,660±688 μg/L and 19 patients of stage g or p showed 2,754±1,196 μg/L. The statistical difference he tween those 2 groups was significant(p$lt;0.005), The serum β2-microglobulin was increased($gt;2,000ug/L) in 35.7% of stage I and g, and 77.8% of stage g and IV untreated active malignant lymphoma. Among the non-Hod-gkin's lymphoma group(n=29), serum β2-microg-lobulin was increased in 35.7% of patients of stage I and in 78.5% of those of stage III and IV. The same increased level was observed in 75.0Fo of Hodgkin's disease(n=4) of stage III and IV. 3) The serum β2-microglobulin level of 16 patients with the systemic symptoms(B symptom) was 2,870±1,203ug/L and 17 patients without B symptom was 1,744±765ug/L(pg0,005). 4) In 13 Patients. serum β2-microglobulin levels were monitored prior to and after the treatment. Six of these patients were responsive to the treatment and their serum β2-microglobulin levels prior to treatment were rather lower than normal. Serum β2-microglobulin level decreased as their clinical courses improves. On the other hand, the other 7 patients who had considerably high serum β2-microglobulin levels showed the increasing tendency of its levels inspite of the treatment. Based on these studies, it can be suggested that the serum β2-microglobulin determination is a valuable laboratory study in following up malignant lymphoma.