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간세포암의 고주파 열치료 후 재발 양상과 이와 관련된 인자
안병훈(Byeong Hoon Ahn),최문석(Moon Seok Choi),이준행(Jun Haeng Lee),임윤정(Yun Jeong Lim),홍일철(Il Chol Hong),최원혁(Won Hyeok Choe),이준혁(Joon Hyoek Lee),고광철(Kwang Cheol Koh),백승운(Seung Woon Paik),이풍렬(Poong Lyul Rhee) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.5
Background/Aims: There were few reports about the recurrence and related factors after radiofrequency ablation (RFA) in unresectable hepatocellular carcinoma (HCC). We assessed the recurrence rate and its related factors after RFA in patients with HCC. Methods: Thirty-nine patients (32 males and 7 females) with unresectable HCC were treated with percutaneous ultrasono-guided RFA. They had solitary tumor ≤4 cm or multiple tumor (≤3 in number and ≤3 cm in diameter) without history of transarterial chemoembolization or percutaneous ethanol injection therapy within 6 months. Results: The complete necrosis rate was 91.4% with few significant complications. Local and remote recurrence of HCC were observed in 30.7% and 66% of the patients during follow-up period of median 17 months. One-year local recurrence rate was lower in tumor smaller than 2.5 cm than in tumor bigger than 2.5 cm (5.6% vs. 28.5%, p=0.01). It was also lower in single tumor than in multiple tumor (12% vs. 60%, p=0.04). One-year remote recurrence rate was lower in Child A than in Child B (43.4% vs. 66.7%, p=0.04). Conclusions: RFA results in a high rate of complete necrosis with few significant complications in unresectable HCC. The local recurrence was fewer in small, single tumor and the remote recurrence was fewer in patients with Child A. (Korean J Gastroenterol 2001;38:350-356)
췌장암에서 Inducible Nitric Oxide Synthase 의 역할
이용욱(Yong Wook Lee),이규택(Kyu Taek Lee),안병훈(Byeong Hoon Ahn),박동일(Dong Il Park),이종균(Jong Kyun Lee),백승운(Seung Woon Paik),이종철(Jong Chul Rhee),최규완(Kyoo Wan Choi),김완섭(Wan Seop Kim),김은경(Eun Kyung Kim),공구(Gu Ko 대한내과학회 2001 대한내과학회지 Vol.61 No.6
N/A Background: The finding of frequent inducible nitric oxide synthase (iNOS) expression in human cancer indicates that nitric oxide has a pathological role in tumor progression. Increased expression of iNOS in human pancreatic cancer cells was also recently reported, but the clinicopathological and biological significance of the iNOS expression remains unclear. The aim of our study was to look for possible roles and clinical significance of iNOS expression in pancreatic cancer. Methods: 72 pancreatic adenocarcinoma tissue specimens were obtained from surgical resection. We investigated the immunohistochemical expression of iNOS in respect to variable clinicopathological characteristics, proliferation activity (assayed by Ki-67 expression), apoptosis (by TUNEL stain), and microvessel density (by CD34 expression; angiogenesis). Results: Immunohistochemical positivity for iNOS in pancreatic epithelial cells was observed in 48/72 (66.7%). Apoptotic index (AI) of positive iNOS expressions were significantly higher than for negative expression (p < 0.001) and increasing intensity of COX-2 expression showed a trend with increasing AI (p<0.001). No significant association was found between iNOS expression and proliferation index or microvessel density in pancreatic cancer. The expression of iNOS protein did not correlated with age, bilirubin, CA 19-9, location, size, AJCC stage, differentiation, distant metastasis or patient survival. Conclusion: The expression of iNOS enzyme in pancreatic cancer contributes to apoptosis of tumor cells. However, we could not find any correlation between iNOS expression and cell proliferation, angiognesis or clinical characteristics. Further in vivo investigations are necessary to determine the putative role of the iNOS expression for tumor progression in human pancreatic cancer.(Korean J Med 61:597-605, 2001)
Glutaraldehyde 와 자동 세척기를 이용한 내시경 소독방법의 임상에서의 유용성
김영호,손희정,윤성원,최규완,이남용,백승운,이준행,고광철,이풍렬,이종철,송재훈,안병훈,김재준,최원혁,홍일철 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.6
Background/Aims: Safety of endoscopic procedures has been a major issue over the last 10 years. Most endoscopy units use 2% glutaraldehyde and automated endoscope reprocessors (AERs) for disinfecting gastrointestinal endoscopes. We attempted an in-use evaluation of the current reprocessing procedures. Methods: Thirty flexible endoscopes were randomly collected just after upper endoscopic examinations and were disinfected using 2% glutaraldehyde in an AER. Cultures were taken from biopsy channels (S-l), tip of the insertion tubes (S-2), umbilical cords (S-3), and angulation knobs (S-4). Results: In 63,3% (19/30) of endoscopes, there was no microbial contamination after disinfection procedures. The culture positive rates of S-l, S-2, S-3, and S-4 samples were 20,0%, 0.0%, 3.3%, and 20.0%, respectively. Microorganisms of 13 species were identified, but there was no pathogen related with reported infectious complications after endoscopic procedures. Conclusions: Current disinfection procedure using 2% glutaraldehyde and an AER appears to be very effective in decontaminating patient-used endoscopes. Low level microbial contamination of endoscopes after conventional reprocessing methods may not impose great risk on patients.
간세포암과 주위 조직에서의 Transforming Growth Factor-beta 1과 그 수용체의 발현
최규완,백승운,최문석,김소정,이준혁,고광철,이풍렬,이종철,박상종,안병훈,김재준 대한소화기학회 2001 대한소화기학회지 Vol.37 No.4
Background/Aims: Transforming growth factor-beta 1 (TGF-β1) is a potent inhibitor of hepatocyte proliferation and its receptor is known to be involved in the carcinogenesis. This study was designed to compare the expression levels of the TGF-β1 and its receptor in neoplastic cells and its surrounding tissue and to assess their role in hepatic carcinogenesis. Methods: We measured the levels of TGF-β1 mRNA and TGF-β1 receptor II mRNA by semiquantitive RT-PCR for the tumor and its surrounding tissue of 30 patients with hepatocellular carcinoma (HCC). We analyzed the relationship between the expression of TGF-β1 mRNA, TGF-β1 receptor II mRNA and clinicopathological characteristics of HCC. Results: The expression of TGF-β1 mRNA showed no difference between HCC and its surrounding tissue, but the expression of TGF-β1 receptor II mRNA was lower in HCC than in its surrounding tissue (2.47±1.08 vs 3.53±1.50, p=0.00). There was no difference in the expression level of TGF-β1 mRNA and TGF-β1 receptor II mRNAo the clinicopathological characteristics of HCC. However, the ratio of TGF-β1 receptor II mRNA in HCC to that in surrounding tissue was more decreased in HCC with portal vein invasion (0.49±0.22 vs 0.77±0.21, p=0.01). Conclusions: Our data suggest that the loss of TGF-β1 receptor II may play an important role in carcinogenesis and tumor progression of HCC.
활동성 크론병에서 초기 스테로이드 치료 반응에 따른 임상적, 생화학적, 병리학적 인자들에 관한 연구
김영호,장재권,김지은,최규완,박동일,도재혁,백승운,고광철,이풍렬,이종철,현재근,안병훈,김재준,류민규 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.6
Background/Aims: The predictory factors of the response to initial steroid therapy in active Crohn's disease has been controversial in numerous literature reviews. We evaluated any predictory faetor of the response to initial steroid therapy in active Crohn`s disease patients, Methods: The medical records of 32 patients with active Crohn`s disease who clinically responded to oral steroid therapy were retrospectively reviewed. The steroid responsive group was defined as the one showing maintenance of response for more than one month from steroid withdrawal and the steroid dependent group as the one showing relapse or exacerbation during steroid tapering or within 30 days from steroid withdrawal. The clinical, biochemical, and pathologic factors were evaluated. Results: There were 22 male and 10 female patients. The mean age was 28.9 years. The number of steroid responsive and dependent group was 22 (68.8%) and 10 (31.2%), respectively. There were no significant differences between these two groups in age, sex, time to diagnosis, perianal lesion, extent of disease, extraintestinal manifestations, presence of granuloma, presenting features, hemoglobin, ESR, and CRP, except serum albumin level. Conclusions: Serum albumin level was significantly lower in steroid dependent group than steroid responsive group, reflecting severe inflammation in steroid dependent group.
식도 Rendu-Osler-Weber Disease 1예 (Esophagus, Stomach & Intestine;A Case of Rendu-Osler-Weber Disease)
이원재,박형석,이규택,김재준,백승운,이종균,이준혁,고광철,이풍렬,이종철,안병훈 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.6
Hereditary hemorrhagic telangiectasia, also knawn as Rendu-Osler-Weber disease, is a rare autosomal dominant condition characterized by telangiectases, arteriovenous fistulas, and aneurysms involving the skin and mucosa, as well as blood vessels of the lung, liver, and central nervous system. The most common clinical manifestations are epistaxis and gastrointestinal bleeding. Arteriovenous shunting leads to hepatic congestion, and con- gestive heart failure may occur. We report a casie of Rendu-Osler-Weber disease which revealed typical clinical symptoms and radiologic findings with a review of relevant literatures.