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위암 환자의 골수에서 발견된 Cytokeratin 양성세포의 임상적 의의
신정혜,구기범,박성훈,정호영,배한익,유완식,Shin, Jung-Hye,Ku, Ki-Beom,Park, Seong-Hoon,Chung, Ho-Young,Bae, Han-Ik,Yu, Wan-Sik 대한위암학회 2006 대한위암학회지 Vol.6 No.4
목적: 암 환자의 골수에서 발견되는 cytokeratin 양성세포와 암의 재발과의 상관관계에 대해서는 알려진 바가 많지 않다. 이에 위암환자의 골수에서 발견되는 cytokeratin 양성세포가 위암 환자의 재발과 생존율을 예측할 수 있는지 알아보고자 하였다. 대상 및 방법: 1998년 6월부터 2000년 7월까지 경북대학교병원 외과에서 원발성 위암으로 수술받은 환자 419명을 대상으로 하였다. 수술 직전 장골능선에서 골수를 흡인하여 단핵구를 분리하고 항 cytokeratin 항체를 이용하여 면역세포화학적 염색을 하였다. 결과: Cytokeratin 양성세포는 219예(52.4%)에서 발견되었고, 위암의 침윤깊이(P=0.021), 병기(P=0.026)에 따라서 통계학적으로 유의한 차이가 있었으나, 암의 위치, 육안형, 림프절전이, 원격전이, 분화도에 따라서는 유의한 차이가 없었다. 골수의 cytokeratin 양성세포 유무에 따른 5년 생존율은 유의한 차이가 없었고(P=0.248), 재발여부, 재발부위도 유의한 차이가 없었다. 결론: 위암 환자의 골수에서 cytokeratin 양성세포 유무는 예후인자로 사용되기 어렵고 재발양상을 예측하기도 어렵다. Purpose: Controversy still exists over in the prognostic significance of microscopic tumor cell dissemination in patients with cancer. This study evaluated the prognostic implication of isolated tumor cells in the bone marrow of patients with gastric cancer. Materials and Methods: Four hundred nineteen (419) patients who underwent surgery for gastric cancer between June 1998 and July 2000 were enrolled in the study. Bone marrow aspirate was obtained from the iliac crest before removal of the primary tumor. Mononuclear cells were isolated and stained with AE-1/AE-3 PAN-CYTOKERATIN. Results: Cytokeratin-positive cells were found in the bone marrow of 219 patients (52.3%). The incidence varied significantly with the depth of invasion (P=0.021) and the stage (P=0.026). The five-year survival rate of patients with cytokeratin-positive cells was 74.1% and that of patients without cytokeratin-positive cells was 81.1%(P=0.2481). There were no significant differences in the recurrence rate and the site of recurrence according to whether or not cytokeratin-positive cells were present in the bone marrow. Conclusion: The presence of cytokeratin-positive cells in the bone marrow of patients with gastric cancer did not predict outcome and recurrence. Therefore, it cannot be used as a prognostic factor.
in situ 중합효소연쇄반응을 이용한 침윤성 자궁경부암 및 자궁경부상피내 종양에서의 인유두종 바이러스의 DNA 검출
박준철(Joon Cheol Park),김태상(Tae Sang Kim),김동자(Dong Ja Kim),배한익(Han Ik Bae),김정란(Jeong Ran Kim) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.10
목적 : 본 연구는 파라핀 포매된 자궁경부조직에서 HPV type 16과 18에 대한 in situ PCR 방법의 민감도 및 특이도를 조사하고자 한다. 연구방법 : 저자는 자궁경부조직의 파라핀 포매된 표본에서 이형상피증(dysplasia), 상피내암(CIS), 침윤성 편평상피세포암(squamous cell carcinoma) 각각 15예를 대상으로 면역조직화학염색법 및 in situ PCR법을 이용하여 HPV type 16과 18의 검출을 시도하였다. 면역조직화학 염색결과 HPV-16은 이형상피증에서는 20%, 상피내암에서는 40%, 침윤성 편평상피세포암에서는 46.7%에서 양성률을 보였고, HPV-18은 파라핀 조직에서는 거의 검출되지 않았다. 결과 : in situ PCR을 이용한 결과에서는 HPV-16 DNA는 이형상피증에서 13.3%, 상피내암에서 40%, 침윤성 편평상피세포암에서 60%로 검출되었고, HPV-18 DNA는 이형상피증에서 33.3%, 상피내암에서 20%, 침윤성 편평상피세포암에서 40%의 양성으로 검출되었다. HPV-16에서 두 가지 방법에 의한 결과를 종합하면, 양성률이 이형상피증에서는 33.3%, 상피내암에서는 53.3%, 침윤성 편평상피세포암에서는 73.3%였으며, 특히 침윤성 암종에서는 in situ PCR을 통한 방법이 특이도가 높았다. 결론 : 본 연구결과 자궁경부조직에서 HPV 검출을 위해서는 면역조직화학염색과 in situ PCR방법을 병행하는 것이 유용하며, 특히 침윤성 암종에서 PCR 방법이 HPV DNA의 검출에 유용하게 적용될 수 있다는 결론을 보였다. Objectives : The purpose of this study is to evaluate the detection rate of in situ polymerase chain reactions for human papillomavirus type 16 and 18 using paraffin-embedded uterine cervical tissues. Materials and methods : Immunohistochemistry and in situ PCR were carried out to detect DNAs of human papillomavirus (HPV) type 16 and type 18 in uterine cervical cancer and related diseases, including 15 cases of dysplasia, 15 cases of in situ squamous cell carcinoma (CIS) and 15 cases of invasive squamous cell carcinoma. Results : Immunohistochemically the detection rates of HPV-16 were 20% for dysplasia, 40% for CIS and 46.7% for invasive carcinoma. HPV-18 was not detected in the immunohistochemistry. With in situ PCR reaction, the detection rate of HPV-16 DNA were 13.3% for dysplasia, 40% for CIS and 60% for invasive carcinoma, respectively. And the detection rates of HPV-18 DNA were 33.3% for dysplasia, 20% for CIS and 40% for invasive carcinoma. Conclusion : In summation of both immunohistochemistry and in situ PCR, the detection rate for HPV-16 was 33.3% for dysplasia, 53.3% for CIS, and 73.3% for invasive carcinoma.
경화성 장간막염과 감별이 어려웠던 총담관암 림프절전이 1예
박호준 ( Ho Joon Park ),이반석 ( Ban Seok Lee ),서안나 ( An Na Seo ),배한익 ( Han Ik Bae ) 대한췌담도학회 2016 대한췌담도학회지 Vol.21 No.4
경화성 장간막염은 장간막에 만성 염증과 섬유화를 보이는 드문 질환으로 비교적 양호한 경과를 가지는 질환이다. 복부 컴퓨터단층촬영을 포함한 특징적 영상소견이 진단에 도움이 된다. 그러나 경화성 장간막염은 몇몇 악성 질환들과 유사한 형태를 보일 수 있으며, 이들은 치료방법 및 경과 자체가 완전히 다르기 때문에 악성 질환에 대한 적극적 배제가 중요하다. 저자들은 체중 감소 및 지속되는 설사 증상으로 내원한 75세 남성 환자가 복부 컴퓨터단층촬영상 장간막 혈관 주변 연무양 감쇄의 특징적 소견을 보여 경화성 장간막염으로 오인하였으나, 추적관찰 및 추가적으로 시행한 조직검사와 양성자방출 컴퓨터단층촬영술을 통하여 최종적으로 총담관암과 그에 동반된 림프절전이로 진단하였던 드문 증례를 경험하여 이를 보고하고자 한다. Sclerosing mesenteritis is a rare disease presenting as chronic inflammation and fibrosis of mesentery around the small and large intestine. And in most cases, it shows indolent and benign clinical course resulting in favorable prognosis. It is often diagnosed through characterized radiologic finding in abdominal examinations including computed tomography scan. However, it is important to rule out other conditions involving mesentery when diagnosing sclerosing mesenteritis. In the case of malignancy, the method of treatment and prognosis can be completely different therefore thorough examinations are essential. We herein report a 75-year-old male who suffered from frequent diarrhea and weight loss. Initially, he was diagnosed with sclerosing mesenteritis through abdominal computed tomography scan showing "misty" soft-tissue attenuation around the mesenteric vessel. However, follow up positron emission tomography scan and biopsy finding confirmed the common bile duct cancer with lymph node metastasis.
신경섬유종증 환자에서 발생된 우상면검 (右上眠瞼) 및 면와 (眠窩) 의 총상 (叢狀) 신경섬유종증
김동석(Dong Seok Kim),김상원(Sang Won Kim),배한익(Han Ik Bae) 대한피부과학회 1986 대한피부과학회지 Vol.24 No.5
We have experienced a case of plexiform neurofibrorna of the right upper eyelid and orbit in a 12-year-old girl who had typical skin features of neurofibromatosis and no family history. The non-pulsating proptosis of the right eye and diffuse thickening with hypertrophy of the upper lid, had increased insiduciusly since the birth on. Biopsy taken from eyelirl lesion showed the features of plexiform neurofibroma. Skull X-ray and brain computerized tomogram showed that the right orbit was wider, with the enlarged mass and defects in orbital roof and lesser and greater wings of the sphenoid bone. The surgical excision of the right eyelid lesion was performed.
Acquired Digital Arteriovenous Malformation 7예
정홍대 ( Hong Dae Jung ),지성근 ( Seong Geun Chi ),이석종 ( Seok Jong Lee ),김병수 ( Byung Soo Kim ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ),정호윤 ( Ho Yun Chung ),배한익 ( Han Ik Bae ) 대한피부과학회 2009 대한피부과학회지 Vol.47 No.2
Acquired digital arteriovenous malformation (ADAVM) consists of an abnormal connection between the arteriole and venule in the acral area of extremities, particularly the fingers. Clinically, the lesions appear as small, slightly-elevated, dark brown erythematous macules on the distal part of fingers. The histological specimens shows close approximation between thin-walled venule and thick-walled arteriole and possibly a direct arteriovenous shunt adjacent to each other lying in the dermis. We herein report seven stereotypical cases of ADAVM. (Korean J Dermatol 2009;47(2):203∼207)
이원채 ( Won Chae Lee ),오병민 ( Byung Min Oh ),장윤환 ( Yun Hwan Jang ),이석종 ( Seok Jong Lee ),정상립 ( Sang Lip Chung ),이수경 ( Soo Kyung Lee ),배한익 ( Han Ik Bae ) 대한피부과학회 2003 대한피부과학회지 Vol.41 No.4
Ganglioneuroma is the benign tumor exclusively composed of fully differentiated mature ganglion cell, Schwann cells and fibrous tissue. It develops most commonly in the posterior mediastinum and retroperitoneum but cutaneous involvement is exceedingly rare. Cutaneous tumor showing ganglion cells includes the following three entities: 1) primary ganglioneuroma, 2) well differentiated cutaneous metastasis from neuroblastoma, and 3) ganglioneuroma associated with von Recklinghausen`s neurofibromatosis. Among them, the third has been considered as a neurofibroma with entrapment of ganglion cell. We described 2 cases of ganglioneuroma associated with von Recklinghausen neurofibromatosis and reviewed the histopathological and immunohistochemical findings. (Korean J Dermatol 2003;41(4) : 470-473)
박경덕 ( Kyung Duck Park ),정홍대 ( Hong Dae Jung ),이석종 ( Seok Jong Lee ),김병수 ( Byung Soo Kim ),이원주 ( Weon Ju Lee ),김도원 ( Do Won Kim ),서보익 ( Bo Ik Suh ),정호윤 ( Ho Yun Chung ),배한익 ( Han Ik Bae ) 대한피부과학회 2007 대한피부과학회지 Vol.45 No.12
Cutaneous angiosarcoma is a rare, aggressive vascular malignancy with a grave prognosis. It usually arises in the scalp or face as a locally-advanced patch, plaque or tumor at presentation and most often affects males and the elderly. Histopathologically, well-differentiated angiosarcomas are composed of well- or ill-formed vascular channels, often lined by flattened atypical endothelial cells and are distinguished from benign counterparts by their so-called collagen dissection pattern and anastomosing architecture. Varied differentiation may be observed even in the same tumor. Epithelioid angiosarcoma is a rare variant of poorly-differentiated angiosarcoma. The patients were seven cases of angiosarcomas including an epithelioid variant. They were six males and one female with an age range between 65∼84 years (avg. 74 years). Lesions resembled seborrheic dermatitis, erysipelas or spreading bruise that varied from blue to red in color and from papule to mass in size. They revealed satellite lesions far from the main lesion in some cases. Skin biopsies were performed for all patients and histopathologic features were compatible with angiosarcoma and epithelioid angiosarcoma. We herein report seven angiosarcomas of diverse clinical features because their early detection and precise differential diagnosis should be mandatory for effective management. (Korean J Dermatol 2007;45(12):1284∼1290)