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위암 , 대장암 및 유방암에서 표피성장인자수용체의 발현과 악성종양 진행과의 관계 - 수정 보완한Alkaline Phosphatase 면역조직화학법으로 -
김재광(Jae Kwang Kim),신완식(Wan Shik Shin),안병민(Byung Min Ahn),선희식(Hee Sik Sun),김응국(Eung Kuk Kim),강진한(Jin Han Kang),유진영(Jin Young You) 대한내과학회 1996 대한내과학회지 Vol.51 No.5
N/A 57.8% (26/45) of breast cancer tissues, in 20.0% (2/10) of benign tumor tissues, and in 10.0% (1/10) of noncancerous breast tissues (Chi-square test, p<0.05). And it was detected in 16.7% (2/12) of metastatic lymph nodes. 3) The positivity of EGFR of stomach cancers was gradually increased from 25.0% of stage 1, 45.8% of stage 2, 61.8% of stage 3 to 77.8% of stage 4 (Bartholomew test, p<0.01). Moreover the positivity was gradually increased according to tumor invasion and lymph node metastasis (relationship of expression of EGFR with histological type, distant metastasis, localization of cancer. The positivity of EGFR of human colon cancers was also gradually increased from 12.5% of stage A, 22.2% of stage B1, 16.7% of stage B2, 42.8% of stage C1 to 76.9% of stage C2 (Bartholomew test, p<0.05). And the positivity of EGFR was related to their depth of invasion of cancer cells (Chi-square test, p<0.05). There was no relation between the positivity of EGFR and the size, site of cancer. The EGFR was expressed only in well differentiated cancers (47.6%, 10/21) and moderately differentiated (34.8%, 8/23) cancers, while not expressed in poorly differentiated (0.0%, 0/5) colon cancers (Bartholomew test, p<0.05). The positivity of EGFR of breast cancers was also related to clinical stage; positivity of stage 1 was 60.0%, stage 2 was 62.1%, and stage 3 was 45.5%, respectively (Chi-square test, p<0.05). The positivity of EGFR was related to breast tumor size; positivity of tumor size<2㎝ was 60.0%, tumor size 2-5㎝ was 61.3%, tumor size>5㎝ was 44.4%, respectively (Chi -square test, p<0.05). 4) There was no correlation of the staining percentage of EGFR with clinical stage, tumor invasion, lymph node metastasis, and distant metastasis of stomach cancers. The staining intensity was in inverse proportion to clinical stage and lymph node metastasis (measure of association, gamma, p<0.005, p<0.005, respectively), while no correlation was observed with distant metastasis. The staining intensity of EGFR was gradually increased according to clinical stages of colon cancers (measure of association, gamma, p<0.05). It was increased in stage 1 and 2 than stage 3 of breast cancers (measure of association, gamma, p<0.05). 5) The patients with EGFR-positive adenocarcinoma had much worse prognosis than those with EGFR-negative adenocarcinoma (log-rank test, p<0.0005). The mean survival duration of the patients with EGFR-positive was shorter than those with EGFR-negative (32 months vs. 48 months, median survival). The expression of EGFR had an inverse relation between both estrogen and progesterone receptor expressions (Chi-square test, p<0.05). Conclusion: These results suggested that this improved immunohistochemical technique offers a rapid, economic, reliable and sensitive method for detection of EGFR. In stomach cancer, the expression of EGFR may act on the tumor invasiveness and lymph node metastasis to some degree, but not on distant metastasis. In colon cancer, the more the clinical stage progress, the more it may act on tumor invasiveness and metastasis. In breast cancer, it may play an important role in early stage than late. Namely, the expression of EGFR may act on different stage of each cancer and may serve as a useful prognostic marker of malignancy in patients with stomach, colon, and breast cancer in Korea.
흉복부대동맥류 : 수술적 치험, 4예 Surgically treated, 4 cases
김승남,김동구,이용각,고용복,김응국,유승진 대한혈관외과학회 1988 Vascular Specialist International Vol.4 No.1
Thoracoabdominal or suprarenal aortic aneurysms are considered very rare and dangerous disease but the patents could be treated best by surgery as like the other forms of aneurysmal diseases. Because of the tedious and difficult exposure, the need to minimize the visceral ischemic time and obligatory expeditious surgical technique for reconstruction and possible lethal or irreversible complications, majority of patients have been treated only at a very limited vascular surgery centers in the United States, and no report could be obtained in Korea. In the past 3 years, the authors have experienced 4 cases of various types of thoracoabdominal aneurysm those were treated by surgery, successfully. The etiologies were arteriosclerosis in all 4 cases, and major visceral artery involvement were found in 2 cases, the diagnosis was made by ultrasound, CT scan, aortogram and confirmed by the latter 2 methods. Each aneurysms were exposed by thoracoabdominal incision, replaced with Dacron prosthesis by graft inclusion technique and direct major visceral artery reattachment introduced by Crawford et al. Aortic cross clamping time were less than 90 minutes in all patients, and no case developed paraplegia. Except the mild and temporary impaired renal function postoperatively, all patients recovered uneventfully and are enjoying normal life during follow-up period ranged from one to 3 years.