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내시경적 점막절제술을 이용한 위의 전암병변 및 조기위암의 치료
정필호(Phil Ho Jung),이동기(Dong Ki Lee),이상철(Sang Cheol Lee),김준명(Jun Myeong Kim),백순구(Soon Koo Baik),김일희(Il Hoi Kim),최윤종(Yeun Jong Choi),조도연(Do Yeun Cho),이종인(Chong In Lee),권상옥(Sang Ok Kwon) 대한내과학회 1998 대한내과학회지 Vol.54 No.4
N/A Objectives: Gastrectomy with lymph node dissection is the stare4rd treatment for early gastric cancer(EGC). However, patients who have high risks demand modifications in surgical treatment for EGC. Recently, endoscopic mucosal resection(EMR) has become accepted in many institutions as a treatment for cancerous mucosal lesions of the stomach. Thus we investigated the efficacy and safety of EMR prospectively in the patients with EGC who have high risks in surgery and those with premalignant lesions. Method: Twenty-five patients were treated with EMR, thirteen were EGC and twelve were premalignant lesions such as tubular adenoma, severe dysplasia. We used standard snare method and endoscopic mucosal resection using a band ligation kits(EMRI.), Resuts : The complete resection rate at the first step of EMR was 100%(13/12) in premalignant lesions, 76.9%(10/13) in EGC. Of three EGC resected incompletely at the first step, one patient was treated by surgery and two patients underwent the third step of EMR. The final complete resection rate was 92%(23/25) and it was 100%(12/12) in the premalignant lesions, 84.6%(11/13) in RX. We final complete resection rate in according to the methods was 100%(5/5) by standard snare method, 75%(6/8) by EMHL, As pathologic results, all cases of F were limited to the mucosa. No serious complications such as perforation, major bleeding were encountered. Conclusion: We consider that EMR is effective and safe in treatment of the patients with EGC who have high risks in surgery and those with prernalignant lesions.
비장에 이식된 간세포의 조직학적 특성과 알부민 유전자의 발현
권상옥(Sang Ok Kwon),이동기(Dong Ki Lee),김준명(Jun Myeong Kim),박의련(Eui Ryun Park),심광용(Kwang Yong Shim),정필호(Phil Ho Jung),조미연(Mee Yon Cho),허만욱(Mann Uk Hur) 대한내과학회 1997 대한내과학회지 Vol.53 No.4
N/A Background: The morphological characteristics of hepatocytes transplanted into the spleen have been studied. However few attempts has been made to determine the expression of genes in intrasplenically transplanted hepatocytes. The aim of this study was to explore whether the pattern of expression of albumin gene in intrasplenically transplanted hepatocytes is similar to that in adult liver, resulting in the long-term expression of this hepatocyte-specific gene. Methods: Hepatocytes isolated from liver of syngeneic Fischer 344 rats and transplanted into the spleen of rats from the same strain survived for 12 months in the absence of immunosuppressive drugs. Microscopic examination of intrasplenic hepatocytes and Northern blotting for albumin gene expression of RNA extracted from liver and spleen was performed. Results: Microscopy demonstrated that hepatocytes attached themselves only in the red pulp of the spleen and isolated hepatocytes preserved the fine structures characteristic of normal hepatic parenchymal cells. Throughout the 12 months period, intrasplenically transplanted hepatocytes expressed albumin mRNA. Conclusions: Intrasplenically transplanted hepatocytes represent a unique in vivo system of extrahepatic maintenance of hepatocytes. This novel transplantation system could be used to investigate hepatocyte engraft, proliferation and gene expression.
이동기,백순구,심광용,김준명,박성진,박의련,권상옥,정필호 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.6
Background/Aims: Periampuilary diverticulum has been known to be associated with various bilio-pancreatic diseases such as choledocholithiasis and disturbs performing selective cannuiation of ERCP and EST. This present study aims to investigate anatomical morphology of periampullary diverticulum and to determine whether periampullary diverticulurn influences difficulty and complication performing of ERCP and to analyse the relationship between periampullary diverticulum and choledocholithiasis. Methods: We reviewed records of chart and diverticular pictures in 1389 cases of underwent ERCP and evaluated the incidence, size, direction, location of periampullary diverticulum and its influence against performing of ERCP and investigated its relationship with bilio-pancreatic diseases such as choledocholithiasis. Results: The incidence of periampullary diuerticulum was 19.4% and showed 18.5 in male, 20.6% in female. There was a trend towards a higher rate with increasing age. In a aspect of morphology, 95.9% of diverticula were presented as single and almost directed on the upper portion of ampulla and located adJacent to ampulla. In the presence of periampullary diverticulum, the incidence of choledocholithiasis was 30.3% higher than 13.1 % without periampullary diverticulum and showed a statistically significant difference in incidence between patients with and without periampullary diverticulum. The rate of selective cannulation failure performing of FRCP was 9.3% with periampuilary diverticulum and 9.7% without periampullary diverticulum and showed no statistical difference between the two groups. In the patients with EST, rate of complication such as bleeding was with 5.9% with periampullary diverticulum and 12.7% without periampullary diverticulum and no statistical difference between the two groins was found. Conclusion: These results indicate that pariampullary divertieulum vas often found during ERCP and its incidence was nearly close to the other fareign reports. Periampullary diverticulum was correlated with chollocholithasis and didn't influence the techniques in perfarmitng of ERCP and EST.
폐경후 여성에서 에스트로겐 치료에 대한 혈중 지질의 반응과 에스트로겐 수용체 다형성과의 관계
황정규,한인권,장학철,임창훈,정호연,한기옥,윤현구,박재은,박소라,정필호 대한내분비학회 1999 Endocrinology and metabolism Vol.14 No.3
Backgound: Several biologically plausible mechanisms have been proposed for estrogen-mediated caridoprotection, including estrogen-assocaited changes in lipid metabolism and endothelial function of vessel walls. These effects are thought to be mediated via estrogen receptor (ER). Relationships between ER polymorphisms and serum lipid levels were not investigated enoughly. Methods: Three restriction fragment length polymorphisms (RFLPs) at the ER gene locus, represented as B-variant, PvuII and XbaI, and their relationship to serum lipid levels were examined in 318 postmenopausal women. Their mean age was 54.5±6.5 years (mean+SD). An association between ER genotypes and changes in lipid levels after 1 year of estrogen replacement therapy was also investigated in follow-up 251 women. Results: The B-variant was not found in Korean women. The distribution of the PvuII and XbaI polymorphisms was as follows: PP 109 (34%), Pp 166 (52%), pp 43 (14%), and XX 204 (64%), Xx 95 (30%), xx 19 (6%). Significant relationshipwas found between genotypes and changes in serum total cholesterol levels after lyr estrogen replacement therapy. There was no significant relationship between ER genotypes and changes in HDL cholesterol, LDL cholesterol and triglyceride levels after estrogen therapy. Conclusion: These data indicate that these polymorphisms are possible predictor on lipid response to estrogen replacement therapy (J Kor Soc Endocrinol 14:553-561, 1999).
G 단백질 변이를 동반한 McCune - Albright 증후군 1 예
민헌기,윤현구,한인권,장학철,임창훈,박찬문,한기옥,강영순,문인걸,홍성란,정필호,황정규,김윤이,황지주,정호연 대한내분비학회 1999 Endocrinology and metabolism Vol.14 No.4
McCune-Albright syndrome (MAS) is a sporadic disease classically including polyostotic fibrous dysplasia, cafe -au-lait spots, sexual precocity, and other hyperfunctional endocrinopathies. Recent investigations suggest an etiological role for activating embryonic somatic missense mutations in the gene for the a subunit of Gs (Gsa), the G protein that stimulates adenylyl cyclase. DNA from bone, ovary, and blood was analyzed by using polymerase chain reaction and sequenced. A embryological somatic mutation of Gsa gene encoding substitution of a Cys for Arg at amino acid 201 from cells of dysplastic bone and ovary was observed, and the distribution of mutant gene reveals mosaic pattern. We report a case of McCune-Albright syndrome with an activating mutation at codon 201 of Gsa subunit on ovary and bone tissue that was experienced recently(J Kor Soc Endocrinol 14:779-785, 1999).