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- 저자 : 김해련(Kim, Hae-ryun) (검색결과 77 건)
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직장암 환자의 수술전 병기 판단을 위한 내시경적 초음파 단층촬영술의 유용성 평가
김해련(Hae Ryun Kim),김진천(Jin Chun Kim),이문규(Mun Gyu Lee),민영일(Young Il Kim) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.3
N/A Endoscopic transrecta) ultrasonography (EUS) is used to stage rectal cancer by assessing depth of invasion through rectal wall layers and/or involvement of lymph nodes. Preoperative ElJS and pelvis CT findings were compared with post operative pathologic findings to evaluate the effectiveness of EUS in staging rectal cancer. We performed EUS in 38 patients (male 24, female 14, mean age 53 years) with rectal cancer diagnosed with colonoscopic biopsy. The Olympus GF-UM3 and EU-M3 endoscopic ultrasound and display system (7.5/12 MHz) was used. Examination was performed with saline enema and diazepam injection. Water filled ballon and free filling of rectum with deaerated water provide good image. Postoperative find- ing showed 1 case of mucosal cancer, 3 cases of submucosal involvement, 9 cases of proper muscle invasion and 25 cases of serosa and peri-rectal fat involvement. Overall accuracy of EUS in determination of depth of invasion was 84% (32/38). And in cases of relatively early stage of rectal cancer (mucosa and submucosa involvement), the accuracy was 75% (3/4). Moreover 1 case of prostate involvement could be correctly diagnosed with EUS. With preop- erative pevis CT, it was impossible to diffrentiate layers of rectal wall. The sensitivity of peri- rectal fat invasion was 33% (8/24) and the false positivity was 15% (2/13). In conclusion, EUS appears to be promissing method for depth of invasion in pre-operative staging of rectal concer whereas CT scan is useful method for detection of distant metastasis. (Korean J Gastroenterol 1994; 26: 491 497)
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흰쥐 소장점막 유당분해효소 활성도에 대한 갑상선 호르몬의 영향
김해련 ( Kim Hae Lyeon ),김나영 ( Kim Na Yeong ),송인성 ( Song In Seong ),김정룡 ( Kim Jeong Lyong ) 대한내과학회 1992 대한내과학회지 Vol.42 No.5
연구배경 : 성장 흰쥐 소장 유당분해효소 활성도아 금식상태 및 갑상선호르몬의 유당분해효소 활성도에 대한 영향을 규명하고자 본 실험을 시행하였다. 방법 : 생후 10주되는 68마리의 흰쥐를 10개군으로 나누어 그중 5개군은 정상적으로 먹이을 주었고 나머지 5개군은 희생시키지 전 48시간 동안 물만을 먹여 금식군으로 하였다. 이 10개군을 금식군-비금식군의 5쌍의 군으로 분류하여 1쌍의 군은 대조군으로, 2쌍의 군은 thyroxin 투여군(0.2㎍/gm, 2.0㎍/gm)으로 이용하였고, 나머지 2쌍의 군은 실험 4주전에 갑상선 제거술을 시행하였다. 갑상선이 제거된 2쌍의 군중 1쌍의 군에는 실험 3일전부터 갑상선호르몬을 투여하였다. 실험동물을 희생시킨후 혈청 갑상선호르몬 농도와 소장점막효소(유당분해효소, 자당분해효소, trehalase, 알칼리성 인산분해효소 및 aminopetidase N) 측정하였다. 결과 : 1) 갑상선을 제거했던 군은 대조군에 비해 T_(3), T_(4)가 의미있게 감소하였고, L-thyroxine을 복장내 주사한 군들은 T_(3), T_(4)가 의미있게 증가하였다. 2) 갑상선 제거술을 시행했던 군의 유당분해효소 활성도는 대조군에 비해 증가를 보이다가 2㎍/gm의 L-thyroxine을 투여한 후 대조군 수준으로 감소하였고, L-thyroxine 만을 투여한 경우는 유당분해효소 활성도가 감소하는 경향을 보이나(35%) 통계학적으로 유의한 차이가 없었다. 3) 48시간 금식상태를 유지한 군은 먹이를 계속 먹인 그 대응되는 군보다 유당ㅂㄴ해효소 활성도가 증가하였고, 이때 T_(3), T_(4)는 모두 감소하였으나 통계학적인 차이는 없었다. 4) Trehalase 활성도는 L-thyroxine을 투여한 군에서 부분적으로 억제되었으나 금식, 갑상선 제거에 의해 영향받지 않았고, 자당분해효소, aminopetiadase N 및 알칼리성 인산분해효소는 금식이나 L-thyroxine 투여 및 갑상선 제거에 의해 영향을 받지 않았다. 결론 : 성장 흰쥐 소장의 유당분해효소 활성도가 갑상선 제거술을 시행한 군에서와 48시간의 금식상태애서 증가하였고, 금식상태에서는 갑상선 호르몬이 떨어져 있어으며 갑상성 호르몬을 투여하면 유당분해효소가 다시 감소했다는 이상의 결과로 미뤄볼때 성장 흰쥐 소장의 유당분해효소 활성도는 갑상선 호르몬에 의해 직접적인 영향을 받는다고 생각된다. 또 금식군은 갑상선 호르몬을 투여해도 비금식군에 비하여 유당분해효소 활성도가 계속 증가되어 있고 갑상선 제거술을 시행한 금식군은 비금식군에 비하여 효소활성도가 더 크게 증가하는 점으로 보아 갑상선 호르몬과 금식은 각각 독립적인 작용에 의해서 유당분해 효소 활성도에 영향을 미친다고 생각된다. Background: We performed this experiment to investigate the effect of thyroid hormone on the lactase activity of rat small intestine by observing the change of lactase level according to the thyroidectomy and starvation. Methods: Sixty eight, ten-week-old rats with 232 gm of average weight were divided into ten groups, of which five groups were fed normally and the other five groups were starved for 48 hours before death. After five pair groups were made, with one from normal feeding groups and one from starvation groups, each pair was classified as one pair of control groups, one pair of groups which were injrected intraperitoneally with 0.2 ㎍/gm body weight L-thyroxine (Sigma) dissolved in 0.01 M NaOH daily during the three days before death, another pair of groups which were injected with 2.0 ㎍/gm L-thyroixine. The rest two pairs of groups were thyroidectomised four weeks before death, and one pair of which were injected intraperitoneally with 0.2 ㎍/gm L-thyroxine daily during the three days before death. The serum thyroxine (T₄) and triiodothyronine (T₃) levels were assayed when each rat sacrificed by decapitation. And after the rnucosal homogenates were obtained from the isolated three segments of equal length from the Treitz ligament to the terminal ileum, specific enzyme activites (lactase, sucrase, trethalase, aminopeptidase N and alkaline phosphatase) were assayed. Results: 1) The T₃, T₄ levels decreased in the thyroidectomized groups and increased in the L-thyroixine injected groups. 2) The lactase specific activities were increased in thyroidectomized groups and when injected with 0.2 ㎍/gm L-thyroxine, these activities were decreased to the levels of control groups. But there was no siginificant change of lactase specific activities in the L-thyroxine replaced groups without thyroidectomy. 3) The lactase specific activites were generally increased in the 48 hour starved groups and T₃, T₄ levels of these starved groups tended to be decreased comparing with feeding groups. 4) The trehalase specific activities were suppressed partially in the L-thyroxine injected groups but the activities were not affected by starvation or thyroidectorny. The specific activities of sucrase, aminopeptidase N and alkaline phosphatase were not affected by starvation, L-thyroxine and thyroidectorny. Conclusion: Above results suggest that the rnucosal lactase specific activity in adult rat small intestine be controlled by thyroid hormone.
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김성배(Sung Bae Kim),김상희(Sang Hee Kim),김상위(Sang We Kim),서철원(Cheol Won Suh),이규형(Kyoo Hyung Lee),이정신(Jung Shin Lee),김해련(Hae Ryun Kim),민영일(Young Il Min),송호영(Ho Young Song),최은경(Eun Kyung Choi),이재원(Jae Won Le 대한내과학회 1995 대한내과학회지 Vol.48 No.5
N/A Objectives: Patients with esophageal cancer and a malignant tracheoesophageal fistula(TEF)have an extremely poor prognosis, with or without treatment. However, the presence of a TEF has historically been considered a relative contraindication to radiation therapy. Methods: To determine the appropriate treatmement(use of radiation therapy)for patients with esophageal cancer and malignant TEF, a review was performed of all such cases, obeserved at Asan Medical Center between 1989 and 1993. Results: 1) Six patients with malignant TEF were seen in total 130 esophageal cancer patients, so the incidence was 4.6%. 2) All of the patients were male, had squamous cell histologies. 3) Dysphagia as initial presenting symptom was a chief complaint in all six patients. 4) The number of TEF formation was one in five of six patients, two in the rest. 5) Three TEFs were developed during radiotherapy, two of them stopped radiation therapy, and one patient continued to treat with hyperfractionated radiation and cured. 6) The median survival length was 33(3-60) weeks after initial tumor diagnosis and 16(2-39) weeks after the first TEF occurred. The duration between initial tumor diagnosis and TEF formation was 17.6(0.6-22) weeks. 7) As a pllliative aim, gastrostomy was done in two patients, jejunostomy in one patient, and stent insertion in the other two patients. Associated symptoms with TEF were markedly improved after stent insertion. 8) The cause of death was sepsis as a resulf of aspiration pnenumonia and lung abscess in five of six patients, and advanced esophageal cancer with lung metastasis in the rest. Conclusion: Early detection and proper management were essential in malignant TEF and esophageal cancer. Stent insertion was good palliation. Radiation therapy might be initiated or continued in the presence of a TEF, and eventual resolution of the fistula might occur. Prospective randomized trials are necessary to define the role of radiation treatment, and further attempts to improve the malignt TEF are required.
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기저세포암에서 Syndecan-1과 Beta-catenin 발현에 관한 면역조직화학적 연구
김해련 ( Hae Ryun Kim ),김민성 ( Min Sung Kim ),나찬호 ( Chan Ho Na ),신봉석 ( Bong Seok Shin ) 대한피부과학회 2012 大韓皮膚科學會誌 Vol.50 No.8
Background: Syndecan-1 and B-catenin are cell adhesion molecules, which are expressed primarily on the surface of adult epithelial cells. The expressions of them have been appeared to be inversely correlated with tumor aggressiveness and invasiveness. Objective: The purpose of this study was to investigate the expression of syndecan-1 and B-catenin in tissue sections of the nodular and high-risk (micronodular and infiltrative type) basal cell carcinomas. Methods: Ten cases of nodular basal cell carcinoma and 10 cases of high-risk basal cell carcinoma (each 5 cases of micronodular and infiltrative type) were investigated. Specimens were assessed for syndecan-1 and B-catenin expression, using a semi-quantitative method in which the intensity of membranous staining was evaluated. Results: In a nodular basal cell carcinoma, syndecan-1 and B-catenin were expressed as similar intensity to normal epidermis. In high-risk basal cell carcinoma, syndecan-1 always showed decreased staining intensity relative to that showed in the normal skin. But, B-catenin showed similar to normal epidermis in the 5 cases, and decreased intensity relative to that of the normal epidermis in the rest. Conclusion: Our results suggest that the decreased expression of syndecan-1 and B-catenin in basal cell carcinoma is associated with the tumor aggressiveness. Especially, of the two adhesion molecules, syndecan-1 is more associated with the high-risk basal cell carcinoma.
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김해련 ( Hae Ryun Kim ),나찬호 ( Chan Ho Na ),신봉석 ( Bong Seok Shin ),최규철 ( Kyu Chul Choi ),김민성 ( Min Sung Kim ) 대한피부과학회 2012 대한피부과학회지 Vol.50 No.1
Eccrine poroma is a benign tumor, which is thought to originate from the epidermal eccrine sweat duct unit. It occurs primarily on the hairless acral surface. However, there have been some cases occurring in atypical area like scalp and face. In general, eccrine poroma lacks melanin pigment clinically and melanocytes on microscopic examination. However, in either black or yellow skin, melanin granules and melanocytes can occasionally be found dispersed within the tumor. We report a case of pigmented eccrine poroma occurring on the scalp. The lesion was located on an unusual occurring site as well as contained melanocyte and melanin. (Korean J Dermatol 2012;50(1): 79∼81)
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김해련(Hae Ryun Kim),김상윤(Sang Youn Kim),민영일(Young Il Min) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.4
N/A Lump sensation in throat is common symptom in middle aged woman and in that case, true dysphagia is usually absent. Globus hystericus is generally assumed to be of psychic origin but its pathophysiology is still remained unknown. We performed this study to evaluate esophageal functional abnormality in patients with globus hystericus by esophageal manometry. An or- ganic cause for their symptorns were ruled out by physical examination of laryngopharynx and esophagoscopy. Patients with posterior nasal drip were ex luded. Thirty six patients(mean age 45 years, 28 63) and control group of 23(mean age 49 years, 35 67) were examined with water perfused 6 lumen catheter and low compliance system. The data was analyzd with soft- ware of Synetic2'Low esophageal sphincter(LES) pressure of control group was 18.2k5.3mmHg (station pull through;SPT, mean+S.D.), 25.7+6.5mmHg(rapid pull throught, RPT) and % relaxation was 94.3+ 5.9%. Five(14% ) of patient group showed abnormally high or low LES pressure and the other 2 patients showed incomplete relaxation. Upper esophageal sphincter (UES) pressure of control group was 82.1k29.1mmHg(SPT, meankS.D.), 91.5+30.3rnmHg (RPT) and % relaxation was 88.8+5.5%. Three(8%) of patient group showed abnormally high UES pressure and the other 3 patients showed incomplete relaxation. Basal pressure of upper esophageal body(7.5mmHg) was significantly higher than that of control group (4.3mmHg, p<0.01, t t,est). In t,he body of esophagus, various kinds of abnormal finding with wet swallow were noted; nutcracker esophagus in 3 patients(8%), high amplitude of upper esophagus in 3 patients(8% ), and non-specific esophageal motility disorder in 7 patients. Twen- ty three out of 36 patients(64%) with globus hystericus showed at least one abnormal esopha geal motility findings. It could be concluded that dysmotility of esophageai body as well as UES may be pathophysiology of globus hystericus.(Korean J Gastroenterol 1994; 26: 625 630)
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