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원발성폐암 환자에서 말초혈액과 국소림프절 단핵구의 NK 및 LAK 활성도에 관한 연구
이이형(Yi Hyeong Lee),김세규(Se Kyu Kim),김형일(Hyung Il Kim),정경영(Kyoung Young Chung),장준(Joon Chang),김성규(Sung Kyu Kim),이원영(Won Young Lee),한명호(Myung Ho Hahn),윤정구(Jung Ku Youn) 대한내과학회 1998 대한내과학회지 Vol.54 No.3
N/A Background: Several lymphocytic populations, such as natural killer(NK) cells and lymphokine-activated killer(LAK) cells, are involved in immunosurveillance against tumors. Whereas the biological significance of the regional lymph node as a tumor barrier remains unclear, the clinical prognostic relevance of the neoplastic infiltration of these nodes is accepted. It appears that lymph node metastasis are more frequent in lung cancer than in other cancers because of impaired defensive mechanisms in the regional lymph nodes. However little is known about the immunologic function of regional lymph node lymphocytes in patients with lung cancer. Although there is general agreement that the NK and LAK activities of peripheral blood mononuclear cells(PBMC) decreases in patients with various solid and leukemic tumors, this decrease remains unclear with regard to the NK and LAK activities of their regional lymph node mononuclear cells(LNMC). We performed this study to determine the NK and LAK activities of regional lymph node, and to compare with those of peripheral blood in patients with lung cancer. Methods: We measured the NK and LAK activities of PBMC and LNMC that were extirpated at lung cancer operations in 17 patients with lung cancer by 4 hour 51Cr-release assay using K562, Raji cell and allogenous lung cancer cell line(NCIH1092) as a target cell. BT ratio were 12.5:1, 25:1, and 50:l. Results: 1. Recombinant interleukin-2 induced strong cytotoxic activities against various target cells in PBMC and LNMC. 2. In patients with lung cancer, NK and LAK activities against K562 and allogenous lung cancer cell line(NCIH 1092) were lower than those of PBMC. 3. Against Raji cell, NK activities were not significantly different between PBMC and LNMC, but LAK activities were significantly lower than those of PRMC. 4. NK activities against K562, Raji, and NCIH1092 cell were not significantly different between in patients with early stage and advanced stage lung cancer. 5. LAK activities of PBMC and LNMC against K562, Raji, and NCIH1(62 cell were significantly lower in patients with advanced stage than those in patients with early stage lung cancer. Conclusion: NK and LAK activities of LNMC in patients with lung cancer were lower than those of PBMC, but the cytotoxicity was markedly increased after culture with rIL-2.
월경성 객혈로 발현되고, 부분폐엽절제술로 치료된 폐실질의 자궁내막증식증
이선민 ( Sun Min Lee ),정성철 ( Sung Chul Chung ),김상돈 ( Sang Don Kim ),마경애 ( Kyung Ai Ma ),김영준 ( Young Joon Kim ),송영구 ( Young Goo Song ),황성철 ( Sung Chul Hwang ),이이형 ( Yi Hyung Lee ),류한영 ( Han Young Ryu ),이철 대한결핵 및 호흡기학회 1997 Tuberculosis and Respiratory Diseases Vol.44 No.1
비소세포폐암에서 p53 종양억제 유전자와 K - ras 유전자의 돌연변이가 임상상에 미치는 영향
이홍렬(Hong Lyeol Lee),류정선(Jeong Seon Ryu),김주항(Joo Hang Kim),김성규(Sung Kyu Kim),이원영(Won Young Lee),이이형(Yi Hyung Lee) 대한내과학회 1998 대한내과학회지 Vol.55 No.5
N/A Objective: A multistep process of gene alterations is required for tumor formation, p53 gene mutation is the most frequent and K-ras gene mutation places second in the gene abnormalities of non-small cell lung cancer (NSCLC). The effect by the mutations of the p53 and ras genes on clinical manifestation is still highly controversial Little is known about the interaction between them in NSCLC. The present study was designed to investigate the effect by the mutations of the p53 tumor suppressor gene and K-ras oncogene on clinical manifestation, and the interaction between the mutations of two genes in the Korean NSCIC. Methods: Fifty-eight patients were enrolled in this study who had been diagnosed as having NSCLC from stage I to stage Ⅲ. They all had been alive for more than one month without any complication after curative resection. The paraffin-embedded lung tissues after resection were used to investigate the p53 expression by immunohistochemical staining, the mutations of the p53 and K-ras genes by polymerase chain reactionsingle strand conformation polymorphism(PCR-SSCP) and nucleotide sequencing. Results: p53 protein was overexpressed in 25.9% by immunohistochemical staining. Overexpression was significantly more frequent in epidermoid carcinoma(p=0.01634). But there was no significant difference between the overexpression group and the negative expression group according to stage and survival. By PCR-SSCP analysis, the mobility shift of the p53 gene was found in 29.1%. There was no significant difference between the groups with and without mobility shift according to cell type, stage and survival. By nucleotide sequencing, p53 gene mutation was 37.9%. The locations of mutation were dispersed among numerous codons and the modes of mutation were also diverse. There was also no significant difference between the groups with and without mutation according to cell type, stage and survival. K-ras gene mutation was 24.1% and only in codon 12 by nucleotide sequencing. Although there was no significant difference between the groups with and without mutation according to cell type or stage, K-ras gene mutation carried a significantly worse prognosis in NSCLC (overall survival p=0.0391, disease-free survival p=0.0318). When the patients were divided into 4 groups according to p53 gene mutation and K-ras gene mutation. there was also no significant difference among any group according to cell type or stage. The prognosis became worse if K-ras gene mutation accompanied(overall survival p=0.0021, disease-free survival p=0.0166). Only the stage(p=0.0313) and K-ras gene mutation(p=0.0457) were significant prognostic factors by Cox regression test. An analysis in stage III showed the significantly shorter survival period in the patients with K-ras gene mutation. K-ras gene mutation, therefore, was confirmed as the independently significant prognostic factor separately from stage. Conclusion: p53 gene mutation had no clinical or prognostic significance because of scattered locations and diverse modes of mutation in contrast to K-ras gene mutation, which had a significantly negative effect on the prognosis of NSCLC. p53 and K-ras gene mutations were apparently independent genetic alterations which played different roles in the clinical manifestation and prognosis of NSCLC.
폐결절의 감별진단 : 이중시기 나선식 조영증강 CT의 유용성 Efficacy of Two-Phase Enhanced Spiral CT
박경주,강두경,황성철,이이형,서정호 아주대학교 의과학연구소 1998 아주의학 Vol.3 No.2
To evaluate the efficacy of two-phase enhanced spiral CT in differentiating between benign and malignant pulmonary nodules, 31 patients with pulmonary nodules with less than 5 cm in diameter underwent spiral CT at unenhanced, early, and late enhanced phases. Enhanced scans were carried out 30(early phase) and 70-180 sec (late phase) after intravenous injection of mixed solution of 100 mL 60% iodinated contrast media and 60 mL normal saline in a rate of 2.5 mL/sec. The pattern, measured degree of enhancement, and nodule-to-muscle enhancement ratio were compared between 17 benign (mean size: 2.8 cm, 15 tuberculomas included) and 14 malignant nodules (mean size: 3.6㎝). The degree of enhancement of nodules was higher in the late enhanced phase than in the early phase. The measured degree of enhancement was significantly greater in malignant nodules in the early (mean±SD: 13.0±10.9 HU) and late (19.0±9.7 HU) enhanced phases than in benign nodules (early: 3.4±4.2HU, late: 7.2±9.6 HU) (p<0.01 by Wilcoxon rank-sum test). Nodule-to-musde enhancement ratio was greater in malignant (2.1±1.2) than in benign nodules (0.5±0.7) in the late enhanced phase (p<0.01). The enhancing pattern of nodules was more efficiently evaluated with the late enhanced images. Most (70%) of the benign nodules showed no enhancement (23%) or thin rim enhancement in the peripheral region (47%). Malignant nodules were enhanced in homogeneous (57%), mosaic (29%), or peripheral pattern with thick enhancing rim (14%). Two-phase enhanced spiral CT is efficient in evaluation of the pattern and the degree of enhancement of pulmonary nodules and useful for noninvasive differential diagnosis.
박태병,송영구,김상돈,정성택,황성철,이이형,박경주,전희선 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1
Nocardia species are Gram positive, partially acid fast, branching actinomycetes which infreguently cause illness in man. But in an immune-supressed host, it can cause opportunistic pulmonary infection first and later dissemination. There are nine species of Nocardia. Common pathogens are N. asteroides and N. brasiliensis which account for 85∼95 % of all nocardiosis. Infections by other Nocardia species are rarely reported and N. caviae accounts for only 0.5∼3% of all nocardiosis. Here we present a case of pulmonary infection with Nocardia caviae in a patient on chronic steroid therapy. The patient was a 69-year-old male with pulmonary tuberculosis 10 years ago. He habitually had taken over-the-counter steroids due to degenerative arthritis of knees. This time, he visited the hospital with fever, cough, sputum, general weakness and dyspnea of about 20-days duration. He was Cushingoid in appearance, and chest auscultation revealed crackles on both lungs. Radiologic examination showed multiple nodular opacities on the right lung. But, non-invasive studies were inconclusive. Percutaneous needle aspiration was performed for the lung lesion and Nocardia species were found on Gram stain and modified acid fast slain. Culture and biochemical study of aspirated materials concluded that N. caviae was the causative organism. Treatment was successful with ampicillin-sulbactam and trimethoprim-sulfame-thoxazole.