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김희종(Hee Jong Kim),최정매(Jung Mae Choi),허원영(Won Young Huh),김한식(Han Sik Kim),김상균(Sang Kyoon Kim),조진웅(Jin Woong Cho),김민철(Min Chul Kim),김문중(Mun Joong Kim) 대한내과학회 1992 대한내과학회지 Vol.43 No.6
N/A Background: There have been many reports about the multiple primary cancers, and they have played a role to study the pathogenesis of the cancer. Methods: During 25 years from 1967 until 1991, 22946 primary cancers had registered at the Presbyterian Medical Canter, and there were 68 cases of multiple primary cancers compatible with Warren k Gates' criteria. Among them 29 cases were multiple primary cancers associated with gastric cancer. Results: The incidence of multiple primary cancers associated with gasric cancer is 0.13% in total primary cancers (0. 38% in total stomach cancers, 42,6% in total multiple primary cancers). All stomach cancers were adenocarcinomas. The other sites except for stomach are esophagus (8; all squamous cell carcinomas), liver (4; all hepatocellular carcinomas), uterine cervix (4; all squamous cell carcinomas), larynx (3; all squamous cell carcinomas) and miscellaneous (10). The ratio between synchronous and metachronous (interval more than 6 months) is 1.07:1, and the average time interval between first and second cancer in the metachronous cases is 5, 7 years. The 9 cases of 14 metachronous cases were treated with chemotherpy of radiation therapy after first surgery. Conclusion: The multiple primary cancers associated with gastric cancer may be largely caused by exposure to the same carcinogens in the contiguous aerodigestive organs and also iatrogenic causes play an important role in the pathogenesis of the multiple primary cancers.
NADH-Methemoglobin Reductace 결핍에 의한 선천성 Methemoglobin 혈중 1 예
김영재,김건영,이춘희,김문중,한기욱,장봉열,최정매,신성혜 대한내과학회 1991 대한내과학회지 Vol.40 No.4
The authaos experienced a case of hereditary methemoglobinemia due to NADH-met-Hb-reductase deficiency. The patient, a 47-year-old female, had intermittent cyanosis, general weakness, and mild dyspnea for the last 15 years. During her admission to PMC (Presbyterian Medical Center) no cardiopulmonary problems were detected, and the level of met-Hb was elevated to 50% of Hb. We analyzed the level of NADH-met-Hb-reductase of the patient and her family by Hegesh's and Scott's method. Her and her sisters NADH-met-Hb reductase level decreased to one-third of the normal (3.6+1.8 ?/g, 2SD), and two son's met-Hb level were abnormally elevated(Table 1). The patient's symptoms and cyanosis were well controlled by methylene blue. Since being discharged from PMC, she has tolerated the administration of methylene blue (P.0.) and Vitamin-C relatively well. Thus, we concluded that her dissase was a hereditary methemoglobinemia due to NADH-met-Hb-reductase deficiency, and report this case with some reviews of hereditary methemoglobinemia.