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난소의 경계성 종양 및 침윤성 암종에서 p53 , Rb 유전자 발현과 Apoptosis 에 관한 연구
강기주,윤만수,설미영,하명완,고형권 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.3
목적 : 난소의 악성 종양의 발생에서 종양억제 유전자인 p53과 Rb 단백의 발현과 apoptosis의 역할을 규명하고 이들 인자들이 경계성 종양의 악성화에 미치는 영향을 규명하고자 연구를 시행하였다. 연구 방법 : 30예의 양성, 경계성 및 악성 난소 종양에서 면역 조직화학적 염색을 이용하여 p53 및 Rb 단백의 발현을 조사하고 TUNNEL method를 이용하여 대상 조직에서의 apoptosis 형태를 관찰하였다. 결과 : 양성, 경계성 및 악성 난소 종양에서 p53의 발현은 각각 0, 28 및 94 %로 악성 종양에서 발현율이 높았으며, 항암제에 내성을 보였던 경우 (2/3)와 술 후 잔존 종양이 있었던 경우 (4/5) 및 재발의 경우 (2/2)에서도 고도의 발현을 보였다. Rb 단백은 양성 종양에서부터 소실을 보였으며, 경계성 종양과 악성 종양에서 Rb 단백의 소실은 차이를 보이지 않았다. Apoptosis는 양성 종양에 비하여 악성 종양에서 더욱 활발하게 일어남을 보였으며 p53에 의한 apoptosis의 유도 효과를 간접적으로 확인할 수 있었으나 Rb 단백과 apoptosis 사이의 연관성은 찾을 수 없었다. 결론 : p53 및 apoptosis는 난소의 악성 종양과 양성 종양을 구별하는 인자로 이용될 수 있으며, 또한 종양의 재발 등의 예후와 밀접한 관련이 있는 것으로 나타나 난소의 악성 종양의 진행 및 재발 등의 예후를 추측할 수 있는 인자로 유용하게 이용될 수 있을 것으로 생각된다. Objective: The aim of this study is to evaluate the role of tumor suppressor genes, p53 and Rb gene, as well as apoptosis in the carcinogenesis of ovarian epithelial tumors. And the value of these factors as prognostic markers to tell the transformation of borderline tumors to overt carcinomas is also studied. Method: Thirty cases of ovarian epithelial benign and borderline tumors and invasive carcinoma were used and the expression of the p53 protein and Rb gene protein were evaluated by immunohistochemical method. The apoptosis was evaluated by TUNNEL method. Results: Positive rate of p53 expression in benign, borderline and invasive tumors were 0, 28, and 94 %, respectively. And also, p53 was highly expressed in chemoresistant cases (2/3), in residual tumor (4/5) and in recurred cancer (2/2). Rb protein was partly lost in the borderline tumors, but the rate of Rb protein loss in both borderline tumors and invasive carcinomas were similar. Apoptosis were more active in overt carcinomas than in borderline and benign tumors. In borderline tumors, p53 protein was expressed as 28.6% positivity, and apoptosis was expressed as 28.6% negativity, which showed indirectly that there was apoptosis induction effect of p53. In ten cases of invasive carcinomas showing highly expressed p53, apoptosis revealed all positive reaction except 2 cases, and Rb protein revealed variously. This result supported the apoptosis imduction effect of p53, but it was difficult to find the association of expression degree between the two tumor supressor genes Conclusion: In conclusion, the values of p53 is a discriminating factor of malignancy from benign and the expression of p53 is related with clinical aggressivity such as recurrence and residual cancers. Apoptosis are more active in overt carcinoma than in benign & borderline tumor, and in borderline tumor the expression of p53 is related to apoptosis induction which results to carcinomatous change.
거대 복수와 혈청 CA 125 상승을 동반한 난소의 양성 Steroid Cell Tumor 1예
강기주,채호진,양승홍,안영도,김기형 대한부인종양 콜포스코피학회 1999 Journal of Gynecologic Oncology Vol.10 No.3
Steroid cell tumor of ovary, first described as lipid cell tumor, is rare lesions composed entirely of cells resembling typical steroid hormone - secreting cells, that is lutein cells, Leydig cells, and adrenal cortical cells. Steroid cell tumors often secret androgen and manifest themselves with symptoms of virilization. Other presentations include abdominal swelling or pain, menstrual dysfunction, postmenopausal bleeding, or rarely ascites. We experienced a case of right ovarian steroid cell tumor, not otherwise specified(NOS), manifested hirsuitism and amenorrhea in 49-year-old patient. The tumor was about 5 cm in size, and associated with huge ascites (l3,000 ml), both pleural effusion, and elevated serum CA 125. We present a case of Meig's syndrome associated with benign ovarian steroid cell tumor with a brief review of the literature.
Establishment of a Daily E-mail Learning Program Using Intranet and It’s Initial Evaluation
강기주,이준행,민병훈,김은란,이풍렬,김재준 대한상부위장관ㆍ헬리코박터학회 2015 Korean Journal of Helicobacter Upper Gastrointesti Vol.15 No.3
Background/Aims: We started a daily web-based E-mail learning program about gastrointestinal (GI) endoscopy. We surveyed the opinion of the E-mail recipients about the usefulness of the daily E-mail learning program. Materials and Methods: Using the intranet system, PDF-file based education materials about interesting endoscopic cases were sent to 144 members of Samsung Medical Center every day. It included every resident of the Department of Medicine, and every fellow of the Division of Gastroenterology. They were invited to answer the questionnaires using E-mail. Results: A total of 92 subjects replied the questionnaire (response rate: 64%). About half of the members (47%) answered that they read the education material in the morning. They answered that they read about more than 75% of the material (48%). It took less than 5 minutes to read a daily material (87%). However, only 13 percent answered that they have sent questions to the editor of the program via E-mail. The members wanted more information about GI pharmacologic treatment (54%). Also, they wanted more cases of benign and malignant upper GI diseases (54%). Conclusions: In our endoscopy unit, we have successfully established a daily E-mail learning program. It seems to be very useful for teaching and learning interesting cases during busy working hours.