http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
- 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
- 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
RISS 인기검색어
- 검색키워드
- 저자 : 공훈식 (검색결과 3 건)
- 무료
- 기관 내 무료
- 유료
-
융모막 융모 및 임신성 융모성 질환에서 bcl-2 단백의 발현에 관한 연구
김종혁,목정은,김용만,김영탁,남주현,나준희,허주령,연규선,공훈식 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.9
저자 등은1990년 1월부터 1996년 12월까지 울산대학교 의과대학 서울중앙병원 산부인과에서 치료받은 34예의 임신성 융모성 질환 환자 조직, 10예의 임신 조직 및 4예의 정상 자궁내막 조직을 대상으로 하여 bcl-2 단백의 면역조직학적 염색을 실시하여 그 발현을 확인한 결과, bcl-2 단백이 정상 임신 제1삼분기와 임신성 융모성 질환 모두에서 최종 분화 단계의 세포인 합포영양모세포에서 주로 발현하며, 정상 임신 조직보다 종양성(neoplastic) 태반, 즉 임신성 융모성 질환 조직에서 그 발현이 약하고 포상기태, 침윤성 기태, 융모막암 및 태반부착부 융모성 종양의 차례로 종양의 악성도가 높을수록 유의하게 낮은 발현율과 약한 발현도를 보이는 것으로 보아 종양유전자로서의 bcl-2 유전자는 임신성 융모성 질환의 발생기전에서 별다른 역할이 없고 단지 종양화의 결과에 따라 발현이 낮아진 것으로 판단되나 bcl-2 유전자가 임신성 융모성 질환에서는 종양억제 기능을 할 수 있다는 점도 완전히 배제할 수는 없기 때문에, 향후 DNA 또는 mRNA 수준에서의 계속적인 연구를 해 볼 가치가 있다고 사료된다. Bcl-2 is a proto-oncogene that inhibits apoptosis induced by hormones and cytokines and thus extends cell survival, exposing the cell to oncogenic stimuli. It is expressed in various normal tissues and neoplasia, often associated with prognostic significance. In normal placenta, only syncytiotrophoblasts have been found to express bcl-2. The role of bl-2 in gestational trophoblastic disease (GTD) is largely undetermined. In this study, the authors examined the possible role of bcl-2 in oncogenesis of GTD. Bcl-2 protein in 34 cases of GTD was examined by immunohistochemical staining on routinely processed paraffin-embedded tissues, using antihuman mouse monoclonal antibody according to standard streptavidine biotin method. Cases included 21 hydatidiform moles (H-mole), 7 invasive moles, 4 choriocarcinomas and 2 placental site trophoblastic tumors (PSTT). As controls, we included 5 first trimester pregnancy, 5 abortions and 4 normal endometrium. In normal first trimester placental tissues, distinct strong diffuse cytoplasmic staining for bcl-2 was observed only in syncytiotrophoblastic cells, but not in cytotrophoblasts or intermediate trophoblasts. The reaction was stronger than in gestational endometrial glandular cells. In H-moles, diffuse cytoplasmic staining of syncytiotrophoblasts was noted in 17 cases (81.0%). The reaction was similar to, or weaker than normal in placental tissue. In invasive moles, weak to moderate staining was noted in trophoblasts invading myometrium in 3 cases (42.9%). In choriocarcinomas, weak cytoplasmic stain was seen in syncytiotrophoblasts in 1 cases (25.0%). Two case of PSTT showed diffuse cytoplasmic staining in some syncytiotrophoblasts and intermediate trophoblasts. There is a significant inverse relationship between the expression of bcl-2 and the aggressiveness of GTD. This study shows that the exclusive localization of bcl-2 in syncytiotrophoblasts is well maintained in hydatidiform moles and invasive moles, whereas almost absent staining is seen in choriocarcinoma and PSTT. Inverse relationship between bcl-2 expression and aggressiveness of GTD suggests that other molecular events are required for tumorigenesis of GTD, by which expression of bcl-2 can be altered or bcl-2 function as a tumor suppressor gene depending on cell type.
-
김영탁,남주현,김용만,김종혁,목정은,나준희,장영우,전대준,공훈식 대한부인종양 콜포스코피학회 1998 Journal of Gynecologic Oncology Vol.9 No.3
Uterine sarcomas are rare, characterized by rapid clinical progression and poor prognosis, and their management has been a challenge. The purpose of this study was to investigate the clinical and pathologic characteristics of patients with uterine sarcoma managed in the department of Obstetric and Gynecology, college of medicine, University of Ulsan, Asan Medical center, Seoul, Korea from June 1989 to August 1998. Data including clinical and histologic findings, treatment and outcome of nineteen patients were evaluated. The age of patients ranged 22 to 71 years (mean ±S.D.; 46.9 ±13.1) and half of patients were postmenopausal and four patients were nulliparous. Palpable pelvic mass or abnormal uterine bleeding were the most common sign or symptom. Twelve patients (63.2%) had stage Ⅰdisease and seven (36.8%) had stage Ⅲdisease. There were 13 cases (68.4%) of leiomyosarcoma, 4 cases (21.1%) of endometrial stromal sarcoma, 2 cases (10.5%) malignant mixed mullerian tumor. All except one received hysterectomy ple or radical) with or without bilateral salpingo-oophorectomy. Some received omentectomy or pelvic lymphadenectomy. Postoperative chemotherapy was administered in ten patients with regimen of VAC, VBP, VIC and etc. The mean follow-up duration was 29.3 (± 24.7) months and 5 patients died of the disease resulting 2-year survival of 68.1%. FIGO stage and mitotic count were considered to have prognostic significance, but without statistical confirmation. In conclusion, uterine sarcomas are aggressive tumors with a poor prognosis. Our data showed excellent outcome in early disease with surgery with or without adjuvant chemotherapy, whereas there was no long-term survivor in advanced disease despite postoperative chemotherapy.
-
김종혁,목정은,김용만,김영탁,남주현,강병문,박은주,나준희,공훈식 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.8
저자 등은 1996년 1월부터 1997년 12월까지 복강경하 자궁근종절제술을 시행 받은 10명의 환자를 대상으로 임상 결과를 분석하고 문헌 고찰을 하였다. 본 연구에서는 다른 복강경하 자궁근종절제술에 관한 연구에 비하여 수술시의 출혈이 많았으며, 이는 근종 주변의 자궁근에 혈관수축제를 사용하지 않은 것과 지혈에 비효율적인 단극성 전류를 주로 사용한 것에 기인한다고 분석하였다. 결론적으로 적절히 환자를 선택하고 양극성 전기 소작기를 구비한 상태에서 숙련된 복강경 시술자가 수술 원칙을 준수할 때만 효과적인 복강경하 근종절제술이 이루어 질 것으로 사료되며 수술중 및 수술후 출혈, 유착의 발생 및 향후 가임력의 향상 등에 관하여는 계속적인 연구가 요망된다고 하겠다. Traditionally, the myomectomy has been performed via laparotomy and there have been some reports that laparoscopic myomectomy has advantages of reduced intra-and postoperative morbidity, shorter hospital stay and recovery time, earlier return to normal activities, fewer postoperative adhesions and better cosmetic scars as compared with traditional abdominal myomectomy. However, the disadvantages of the laparoscopic myomectomy include increased operating time, inability to palpate the uterus during operation, and the requirement of advanced technical skills. Actually the role of laparoscopic myomectomy remains controversial until now. We experienced 33 cases of laparoscopic myomectomy from January 1996 to December 1997, but most of them were performed ancillarily during other operations for ovarian tumors, pelvic endometriosis, tubal pregnancies, etc. Among 33 patients, ten received laparoscopic myomectomy as a major procedure. We present clinical characteristics of these patients and laparoscopic procedures we performed. The average age of patients was 36.0±7.0 (mean±S.D.) years and the mean parity was 1.3 (±1.2). The myomas were subserosal type in 5 cases, intramural type in 4 cases and intraligamentary type in one. The maximal diameter of the myomas ranged from 1.5 to 7.5 cm and the mean diameter was 5.2 (±1.6) cm. Seven cases had only one myoma, but 3 cases had two or more. The operation time ranged from 65 to 200 minutes (mean: 121.5±46.4) and average hemoglobin change(preoperative- postoperative hemoglobin) was 2.5 (±1.2) g/dl. There was no intraoperative and postoperative complication except one case of trocar site hemorrhage. In conclusion, the laparoscopic procedure is effective for myomectomy, but it is essential to adhere to the basic surgical principles to optimize its safety and efficacy. However, its advantages are still needed to be established based on long term outcomes.
연관 검색어 추천
이 검색어로 많이 본 자료
활용도 높은 자료
