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Lymph node micrometastasis in stage I and II rectal cancer
Hye-Yoon Choi(최혜윤),Kil Yeon Lee(이길연),Su Youn Lee(이수연),Youn Wha Kim(김윤화) 대한종양외과학회 2016 Korean Journal of Clinical Oncology Vol.12 No.2
Purpose: The aim of this study was to determine the rate of lymph node (LN) micrometastasis in patients with stage I and II rectal cancer. Methods: One hundred eighty patients with either stage I or II rectal carcinoma who underwent curative resection between 1995 and 2010 were included. Forty-eight patients received neoadjuvant chemoradiotherapy. Two sections from each LN were stained with hematoxylin and eosin (H&E) and with CK20 by immunohistochemistry (IHC), respectively. Results: A total of 2,257 LNs with a median of 12.5 LNs per patient were examined. For IHC staining, CK20-positive neoplastic cells were found in 4 of the 2,257 LNs (0.2%) from 3 of the 180 patients (1.7%), and all corresponding H&E re-stained sections confirmed that these neoplastic cells were present. Three of four neoplastic cells were micrometastasis, and one was macrometastasis. All occult neoplastic cells were found in 3 of the 85 patients (3.5%) with stage II disease. Conclusion: We observed a 3.5% rate of occult neoplastic cells in stage II rectal cancer. Interestingly, the results of IHC staining corresponded with those of H&E re-stained sections, suggesting that the examination of H&E stained section by a competent pathologist may replace IHC staining.
전이성 대장암 환자에서 동시성 및 이시성 간전이 종양의 Cyclooxygenase (COX)-1과 Cyclooxygenase (COX)-2 및 E-cadherin 발현의 의의
주선형(Sun Hyung Joo),김범수(Bum Soo Kim),최성일(Sung Il Choi),송정윤(Jeong Yoon Song),이길연(Kil Yeon Lee),김윤화(Yun Wha Kim),김교영(Gyo Young Kim),이석환(Suk Hwan Lee),이상목(Sang Mok Lee),홍성화(Sung Wha Hong) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.3
Purpose: Recent studies have shown that cyclooxygenase (COX)-2 may be involved in colorectal carcinogenesis. In this study, we evaluate the differences of COX-2 expression in patients with synchronous and metachronous hepatic metastasis of colorectal cancer. In addition, the expression of COX-1 and E-cadherin were also evaluated. Methods: Paraffin embedded blocks were obtained from 41 patients who underwent surgery for colorectal cancer with hepatic metastasis. Samples from primary colorectal cancer, synchronous and metachronous hepatic lesions were stained by immunohistochemistry for monoclonal antibody against COX-1, COX-2, and E-cadherin. Results: In colonic COX-1 expression, there was no significant difference in the degree of COX-1 expression between primary colorectal cancer with synchronous hepatic metastasis and that of metachronous hepatic metastasis (P=0.507). In colonic COX-2 and E-cadherin expression, the degree of COX-2 expression was not different between the two groups. But, the patient survival rate in the positive group of COX-1 and COX-2 expression was lower than in the negative group, respectively (P=0.023, P=0.006). Conclusion: The degree of colonic COX-1 and COX-2 expression has an impact on prognosis in synchronous and metachronous hepatic metastasis. Further large-scale study is necessary to determine the meaning of COX-2 expression in colorectal cancer.
가토 간내 선택적 담관결찰후 간부피의 변화에 대한 실험적 연구
이혜원,윤엽,고영태,최우석,임주원,오주형,임형택,김윤화,이석환,Lee, Hye Won,Yoon, Yup,Ko, Young Tae,Choi, Woo Suk,Lim, Joo Won,Oh, Joo Hyeong,Rim, Heyong Teck,Kim, Youn Wha,Lee, Seok Hwan 대한영상의학회 1998 대한영상의학회지 Vol.39 No.6
Purpose : To evaluate the role of bile duct obstuction in the development of atrophy of the liver, using ananimal model. Materials and Methods : Seven rabbits were divided into two groups : group 1(n=5), in which therewas selective bile duct ligation, and group 2(n=2), which underwent a sham operation. Each group was evaluatedusing CT for changes in hepatic volume after selective bile duct ligation or a sham operation. In group I, thediameter of dilated bile duct was measured 2, 4, 8, 12 and 16 weeks after bile duct ligation, while gross andhistologic change were evaluated in all cases. Results : In group 1, bile duct dilatation was seen on CT two weeksafter selective bile duct ligation, and did not change significantly during follow-up. In four of five cases, CTrevealed no evidence of significant atrophy of the involved segment. Pathologic specimens, however, revealeddilatation of the bile duct, periductal fibrosis, infiltration of chronic inflammatory cells, and periportalfibrosis. One of five cases showed segmental liver atrophy after selective bile duct ligation. In addion to theabove pathologic findings, there was obstruction of the portal vein by foreign body reaction. In group 2, noevidence of dilated bile duct or liver atrophy was revealed by CT or pathologic specimen after a sham operation.Conclusion : During long-term follow-up of 16 weeks, obstruction of the bile duct did not play a major role in thedevelopment of lobar atrophy in the rabbit.
증례 : 소화기 ; 가족성 위-식도 미만성 평활근종증을 보인 2대의 Alport 증후군
문송미 ( Song Mi Moon ),장영운 ( Young Woon Chang ),장재영 ( Jae Young Jang ),김윤화 ( Yoon Wha Kim ),김효종 ( Hyo Jong Kim ),김병호 ( Byung Ho Kim ),장린 ( Rin Chang ) 대한내과학회 2010 대한내과학회지 Vol.79 No.2
위-식도 미만성 평활근종증은 평활근세포의 비정상적 증식에 의해 위-식도벽이 매우 두꺼워지는 드문 양성의 질환으로, 산발성 혹은 상염색체, 성염색체 유전으로 발생한다. 특히 세대에 걸쳐 평활근종증이 나타나는 경우 Alport 증후군과 밀접한 유전적 연관성을 갖고 있음이 1983년 보고되었고, 이후 이에 대한 몇몇 증례들이 발표되었다. 저자들은 신기능 저하, 난청 및 선천성 백내장으로 Alport 증후군을 진단받고, 동반된 위-식도 미만성 평활근종증에 대한 수술적 절제를 시행 받은 남아의 어머니에게서 다른 증상의 동반없이 위-식도 및 성기의 미만성 평활근종증을 확인하고 수술적 치료를 시행한 증례를 경험하였다. 이는 Alport 증후군 보유자로 의심되는 여자가 자신의 남아에게 심각한 Alport 증후군을 유전시키고, 이와 함께 2대에 걸쳐 위-식도 미만성 평활근종증이 유전된 예로 아직까지 국내에 보고된 바 없기에 이를 보고하는 바이다. Diffuse gastroesophageal leiomyomatosis is a rare, benign neoplastic condition characterized by thickening of the esophageal wall as a result ofaberrant smooth muscle proliferation. Gastroesophageal leiomyomatosis may occur in isolation or as a familial disorder and has been associated with other conditions, such as Alport syndrome. Alport syndrome is a hereditary disorder of basement membrane type IV collagen, characterized by progressive nephritis, sensorineural deafness and ocular abnormalities. In this article, we present an interesting case of gastroesophageal leiomyomatosis occurring in a single family in whichthe mother and her son had Alport syndrome. This case is the first report in Korea that gastroesophageal leiomyomatosis is associated with two generations of Alport syndrome. (Korean J Med 79:171-176, 2010)