위암종에서 vascular endothelial growth factor 발현 및 혈관 형성능에 대한 면역조직화학적 연구

김상현(Sang Hyun Kim),김태오(Tae Oh Kim),김양정(Yang Jung Kim),이창훈(Chang Hoon Lee),류수형(Soo Hyung Ryu),이성훈(Seong Hwun Lee),이준홍(Jun Hong Lee),강대환(Dae Hwan Kang),송근암(Geun Am Song),조몽(Mong Cho),양웅석(Ung Suk Yang) 대한내과학회 2000 대한내과학회지 Vol.58 No.6

N/A Background : Many studies have shown that angiogenesis plays an important role in the growth and progression of solid tumors, including gastric carcinoma. Vascular endothelial growth factor(VEGF) is the most potent known inducer of microvascular hyperpermeability; in addition, it is a selective mitogen for endothelial cells. In this study, we studied that the relationship between angiogenesis and the expression of VEGF in gastric carcinoma. Methods : 23 early gastric carcinomas and 28 advanced gastric carcinomas obtained by surgical resection were studied. Expression of the VEGF was semiquantitatively analyzed in paraffin sections by immunohistochemical method. Histologic sections immunostained for CD31 antigen were evaluated for microvessel density. Results : The VEGF was mainly localized to the cytoplasm of carcinoma cells. Expression of the VEGF was significantly higher in advanced gastric carcinoma than in early gastric carcinoma (p<0.05). Expression of the VEGF was correlated with the tumor depth and the stage(p<0.05). The VEGF positivity was significantly higher in moderately and poorly differentiated gastric carcinoma than in well differentiated gastric carcinoma(p<0.05). But the expression of the VEGF by Lauren,s classification was not significant between intestinal type and diffuse type(p>0.05). The expression of CD31 was higher in advanced gastric carcinoma than in early gastric carcinoma. In gastric carcinoma, a correlation was observed between CD31 expression and the stage of the disease, the degree of histological differentiation. Also VEGF and CD 31 expression was observed significant correlation. Conclusion : VEGF is an important angiogenic factor associated with progression of the gastric carcinoma. Neovascularization assessment by CD 31 immunostaining was another efficient method for defining groups of tumors with aggressive clinical course.(Korean J Med 58:657-665, 2000)

간세포암과 간경변증의 감별 진단에 있어서 Lens culinaris agglutinin-A 에 반응하는 AFP 분획 측정의 임상적 의의

송근암(Geum A m Song),김태오(Tae Oh Kim),송철수(Chul Soo Song),조몽(Mong Cho),양웅석(Ung Suk Yang),류수형(Soo Hyung Ryu),이성훈(Seong Hwun Lee),조병만(Byung Mann Cho) 대한내과학회 1999 대한내과학회지 Vol.57 No.5

N/A AFP has been the most useful tumor marker of hepatocellular carcinoma (HCC) because AFP is tumor specific and organ specific. However it can be elevated in liver cirrhosis (LC) and chronic hepatitis as well. AFP in hepatocellular carcinoma has been known to be highly reactive Lens Culinaris Agglutinin-A (LCA-A). The aim of our study is to find whether LCA-A reactive AFP (AFP-L3) is useful in differentiation of HCC and LC with high serum AFP level (>20 ng/ml). Methods : The material consists of sera from 18 patients with HCC and 16 patients with LC whose serum AFP concentration was above 20 ng/ml. Sera were tested for AFP-L3 by lectin-affinity electrophoresis, coupled with antibody affinity blotting with alpha-fetoprotein differentiation kit L (Wako Pure Chemical Industries, Osaka, Japan). AFP-L3 fraction percentage was checked by densitometry (580nm, Cliniscan II, Helena). Results : AFP-L3 detection rate in membrane was 61.1% in HCC and 37.5% in LC. When cut-off value level is 15%, the positive rate was 61.1% in HCC and 31.2% in LC, and sensitivity and specificity of AFP-L3 fraction in HCC was 61.1% and 68.8% respectively. In according to these results, AFP-L3 was a useful marker in differentiation HCC and LC with high serum AFP level. There was no significant relation in AFP-L3 fraction and tumor size, but there was significant relation between AFP-L3 fraction and total AFP serum level(P=0.049). Conclusion : These results lead us to conclude that the level of AFP-L3 is a useful marker in differentiation of HCC and LC with high serum AFP level. (Korean. J. Med 57:875-880, 1999)

Mallory-Weiss syndrome의 내시경적 진단과 치료

송근암(Geun Am Song),김태오(Tae Oh Kim),강대환(Dae Hwan Kang),조몽(Mong Cho),양웅석(Ung Suk Yang),배상문(Sang Moon Bae),류수형(Soo Hyung Ryu),안준협(Jun hyup An),이성훈(Seong Hwun Lee) 대한내과학회 2000 대한내과학회지 Vol.58 No.5

N/A Background : Mallory-Weiss syndrome is a laceration of gastroesophageal junction due to abruptly increased intraabdominal pressure. Bleeding from Mallory-Weiss tears stops spontaneously within 2-3 days without specific therapy in 80-90% of cases, but in some cases, aggressive treatment is required due to massive bleeding. Methods: Among two hundreds and fifteen cases of upper gastrointestinal bleeding from January 1997 to January 1999, twenty three cases (10.7%) were diagnosed as Mallory-Weiss syndrome by endoscopy. We assessed the site, number, coexisting diseases, precipitating factors and bleeding lesion according to the time interval after the tears. After supportive care or specific therapy, we performed follow-up endoscopy to evaluate the healing of the lesions. Results: The mean age was 49.1 years and male:female ratio was 4.8:1. The most common precipitating factors were nausea, vomiting and alcohol drinking. In twenty cases, coexisting diseases such as gastritis and esophageal varix were detected. As for the number of tears, one tear was the most common (69.6%), while two tears were identified in five cases and three were in two cases. Thirteen cases of the Mallory-Weiss tears were located on the gastroesophageal junction, seven cases on the lower esophagus, one case on the cardia and two cases from lower esophagus to cardia. Eighteen cases were diagnosed by endoscopy within 24 hours after bleeding, of whom fourteen cases had active bleeding. Among four cases diagnosed after 24 hours, endoscopic finding revealed active bleeding in two cases and blood clots in the other two cases. We treated thirteen cases with supportive care, one case with hypertonic saline injection and nine cases who had active bleeding or deep and long tears with endoscopic band ligation. One or two weeks later, we performed follow-up endoscopy, and no bleeding was detected in all cases. Conclusion: We diagnosed twenty three cases of Mallory-Weiss syndrome by endoscopy and treated all cases with supportive care or endoscopic band ligation successfully.(Korean J Med 58:542-547, 2000)

VP-16으로 성공적으로 치료된 위 Kaposi 육종 1예

양웅석,송근암,조몽,이재승,송철수,김형욱,김영민,이수봉,김태오,이성훈 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.4

The skin is an uncommon site of distant metastasis from any internal malignancy, and the incidence of metastatic skin lesions as the first symptom of disease is only 0.8% in patients with all systemic malignancies. Furthermore, cutaneous metastasis from adenocarcinoma of the stomach has been found to be extremely rare. A 35-year-old female patient was admitted due to multiple cutaneous nodules in her chest, abdomen, and back. A gastroendoscopic examination and biopsy was made according to the results of skin pathologic findings. Stomach and skin biopsy results revealed a signet ring cell type of adenocarcinoma. A case of gastric adenocarcinoma in which metastatic skin nodules appeared as the first sign of disease, is here in reported with a review of related literature.

난소에 전이를 일으킨 위암의 임상적, 병리학적 고찰

옥창민,이성훈,김형욱,이재승,강대환,송철수,송근암,조몽,양웅석 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.6

난소에 전이를 일으킨 위암의 임상적 ,병리학적 고찰

강대환,양웅석,송근암,조몽,이재승,송철수,옥창민,이성훈,김형욱 대한소화기학회 1999 대한소화기학회지 Vol.32 No.6

Background/Aims: The gastric cancer is highly prevalent in Korea, and it is the most common primary cancer metastatic to the ovary (Krukenberg tumor). We analyzed the clinical, endoscopic, and histologic features of the gastric cancer metastatic to the ovary. Methods: We retrospectively revie wed 11 patients with gastric cancer metastatic to the ovary. They were admitted in Pusan Nationa University Hospital from 1991 to 1997. Results: The mean age of the patients was 38.2 years. The primary gastric cancer was located on the body in 5 cases, both on body and cardia in 2 cases, both on body and antrum in 2 cases, and on antrum in 2 cases. In 5 cases, the gross appearance of th gastric cancer was Borrmann type 3 and that of the remaining 6 cases was Borrmann type 4. In 7 cases, the histologic features was poorly differentiated adenocarcinoma and in 4 cases, it was signe ring cell carcinoma. According to Lauren classification, 9 cases showed diffuse type and 2 cases were intestinal type. Conclusions: The primary gastric cancer metastatic to the ovary was characterized by young age, gastric body in location, and diffuse and poorly differentiated type in histology. Thus, i is important in younger patients with gastric cancer to examine ovary as a metastatic organ.