원발성 (原發性) 간암의 (肝癌) 간절제가능성 (肝切除可能性) 판정에 있어서 간주사 (肝走査) , 복강경검사 (腹腔鏡檢査) 및 간혈관조영술의 (肝血管造影術) 비교

김정용(Chung Yong Kim),이효석(Hyo Suk Lee),정영화(Young Hwa Chung),김수태(soo Tae Kim) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.1

N/A For the purpose of evaluating the predictive values for the resectability of primary liver cancer, the results of radionuclide liver scan, peritoneoscopy and hepatic angiography in 152 cases including 31 cases received laparotomy were reviewed and analyzed. The results were summarized as following: 1) The positive predictive value of radionuclide liver scan, peritoneoscopy and hepatic angiography was 58.9%, 77.3% and 84.2%, respectively, while the negative predictive value was 74.5% 96.9% and 96.3%, respectively. And the sensitivity of each method was 86.4%, 97.7% and 96.9% respectively, with the specificity of 39.8%, 71.3% and 81.8%, respectively. 2) Radionuclide liver scan was high in its sensitivity, but portal vein tumor emboli and metastasis to lymph nodes and adjacent organs couldnt be detected by this method, and therefore the specificity became low. Accordingly, the predictability for hepatic resection of this method was found to be poor. 3) Peritoneoscopy was more helpful than radionuclide liver scan and angiography in detecting metastasis to adjacent organs or small tumor nodules on the liver surface. However, portal vein tumor emboli and lesions located in the posterior surface of the liver couldn't be detected. 4) Hepatic angiography had difficulties in diagnosing diffuse type of metastasis to adjacent organs and lymph nodes. However, portal vein tumor emboli could be found and the accurate location and size of primary liver cancer could be evaluated, indicating that this test is a reliable and indispensible method for the evaluation of resectability. The results above showed that radionuclide liver scan, peritoneoscopy and hepatic angiography were indispensible and complementary each other in judging resectability of primary liver cancer and should be performed in that order to select candidates for laparotomy.

항결핵약제에 의한 간독성에 대한 임상적 연구

윤용범(Yong Bum Yoon),정영화(Young Hwa Chung),이영상(Yung Sang Lee) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.2

N/A On the 44 patients who was admitted and diagnosed as toxic hepatitis due to antituberculous agents, the clinical details were reviewed. The results were summerised as following: 1) Male to female ratio was 1:1, and mean age was 34.7. They took at least two or more kinds of hepatotoxic agents, so that one definite cause of hepatotoxicity conldn't be determined. 2) Typical symproms of hypersensitivity such as fever, skin rash or lymphadenopathy were found only 2 patients, and eosionophilia above 500/㎣ was demonstrated in 28.6% of the patients. 3) 18 patients, 4.9% of total, showed severe hepatotoxicity that serum bilirubin was above 2.0 mg %, and 45.5% of the patients had mild hepatotoxicity that serum transaminase levels were belew the fivefolds of the normal range. 4) Severe jaundice, acute renal fai1ure, fever and lymphadenopathy were noted in two patients and were thonght as hepatotoxicity due to intermittent use of rifampin. 5) Readministrations of isoniazid and rifampin were successful in 81.3% and 86.7% of the patients respectively, but 71.4% of retrials of pyrazinamide were failed. No clinical differences were recognized between success and failure groups, but the frequency of eosinophilia was higher in failure group. 6) No differences between icteric and anicteric groups were noted in age, sex, used drugs, past history of drug use, the response to the readministration of the dnigs and frequency of eosinophilia, but the duration of treatment in icteric group was much prolonged in comparison with anicteric group.

Ultrastructure of the Granular Glands in the Amphibian Skin

김한화,노용태,정영화,지영득,Kim, Han-Hwa,Noh, Yong-Tai,Chung, Young-Wha,Chi, Young-Duk The Korean Society for Integrative Biology 1979 동물학회지 Vol.22 No.3

양서류 피부과립선의 미세구조를 관찰하기 위하여 무미양서류인 무당개구리(Bombina orientalis), 두꺼비 (Bufo bufo gargarizans), 개구리 (Rana nigromaculata) 및 옴개구리 (Rana rugosa)의 피부조직은 2.5% glutaraldehyde-paraformaldehyde (pH 7.2)와 1%osmium tetroxide에 전후 고정한 후 ethanol과 acetone으로 탈수, Epon 812 mixture에 포매하여 LKB ultramicrotome으로 초박절표본을 만들어 uranyl acetate와 lead citrate으로 염색하여 JEOL-100B형 전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 1. 양서류 피부과립선은 선상피세포와 근상피세포로 이루어졌다. 2. 양서류 피부과립선의 선상피세포는 암세포들로 구성되었으나 무당개구리에서는 명세포도 관찰되었다. 3. 양서류 피부과립선은 전분지를 하였다. 4. 양서류 피부과립선 상피세포의 핵은 원형 내지 타원형으로 크고 작은 핵경함요를 보였고, heterochromatin은 주로 핵경 인접부에 많았다. 세포질에는 mitochondria가 핵주변부에 비교적 많이 산재하였고, rough-surfaced endoplasmic reticulum은 핵 주변부에 발달하였지만 smooth-surfaced endoplasmic reticulum은 미약하였다. 5. 분비과립들은 구형 또는 난형으로 높은 전자밀도를 보였으며 다소 약한 전자밀도를 보이는 과립도 관찰되었다. 6. 양서류 과립선내 분비과립들이 같은 세포내에서 다소 전자밀도의 차이를 보이는 것은 분비과립의 형성단계에 따른 농도 차이에 기인하며 그 화학적 조성은 유사하다고 생각된다. The authors observed the ultrastructure of the granular glands in the amphibian skin with an electron microscope. The specimens from the experimental animals (Bombina orientalis, Bufo bufo gargarizans, Rana nigromaculata and Rana rugosa) were fixed in 2.5% glutaraldehyde-paraformaldehyde fixative in phosphate buffer at pH 7.2 prior to fixation in 1% osmium tetroxide, dehydrated in graded ethanol and acetone, embedded in Epon 812 mixture, and sectioned with a LKB-ultramicrotome. the ultrathin sections were contrasted with uranyl acetate and lead citrate and observed with a JEOL-100B electron microscope. The results were as follws: 1. The granular gland in the amphibian skin consisted of the glandular epithelial and the myoepithelial cells. 2. The epithelial cells of the granular gland in the amphibian skin consisted of the dark cells but the light cells were also observed in that of Bombina orientalis. 3. The granular glands of the amphibian skin were in holocrine fashion. 4. The nuclei of the epithelial cells of the amphibian cutaneous granular glands were round or oval and showed small and large inforldings of nuclear envelope. Heterochromatins were mainly distributed near the nuclear envelope. Mitochondria were mainly distributed in the perinuclear portion and rough-surfaced endoplasmic reticulums were developed in the cytoplasm but smooth-surfaced endoplasmic reticulums were not well developed. 5. Secretory granules were round or oval and electron-dense and less electron-dense granules were observed. 6. The authors infer that the differences in electron density of the secretory granules in the granular glands of the amphibian skin are due to difference in the concentrations of secretory substances as related to the processes of its formation, and that those chemical components are identical.

Histological and Histochemical Studies on the Cutaneous Mucous Glands According to the Development of Frog, Rana nigromaculata

김한화,노용태,정영화,Kim, Han-Hwa,Noh, Yong-Tai,Chung, Young-Wha The Korean Society for Integrative Biology 1975 동물학회지 Vol.18 No.2

양서류 발생에 따른 피부점액선의 조직학적 및 조직화학적 변화를 밝히고저 개구리(Rana nigromaculata) 변태 각 단계의 유생 피부조직을 10% formalin 완충액에 고정($4^{\circ}C$), paraffin에 포매, 4$\mu$m 두께로 절편한후 periodic acid-Schiff(PAS) 및 alcian blue(AB) pH 2.5, pH 1.0에 반응시켜 다음과 같은 결과를 얻었다. 1. 피부점액선의 출현은 변태 XV에서 처음으로 표피내 세포군이 형성되면서 비롯되는데 변태 XX, XXIII 및 XXIV에서 현저한 수적 증가가 있었다. 2. 피부점액선은 두 종류로 구분되는데 A형점액선은 선체부 상피세포들이 PAS와 AB pH2.5에 강양성, 경세포는 PAS에 강양성을 보이며, B형점액선의 선체부 상피세포들은 AB pH 2.5에 강양성을 보였다. 3. A형점액선은 변태 XIX에서 처음으로 내강을 형성하며 선상피내 점액질들이 PAS 및 alcian blue에 염색성을 보였고 변태가 진행됨에 따라 PAS 및 AB pH 2.5에 염색성이 점차로 증가되었다. 4. B형점액선은 변태 XX에서 처음으로 관찰되었으며 변태가 진행함에 따라 AB pH 2.5에 강양성을 보였다. 5. A형점액선과 B형점액선의 출현비는 변태 XX, 변태 XXI과 XXII, 변태 XXIII ~ XXV에서 각각 99 : 1, 7 : 3, 5.5 : 4.5였다. 6. 이상의 사실들로 미루어 양서류가 수서에서 양서로 생활양식이 변화함에 따라 피부내 수분 및 전해질의 평형을 유지하기 위해서는 피부점액선의 현저한 발달이 요구된다구 사료된다. The present study was performed histologically and histochemically to observe the cutaneous mucous glands in the frog, Rana nigromaculata during metamorphosis. The cutaneous thssues including dermal plicae in the dorsal portions of the frog tadpoles at each metamorphosis stage were fixed in 10% buffered formalin at$4^{\circ}C$, embedded in paraffin wax, sectioned 4 $\mu$m thickness and stained with periodic acid-Schiff(PAS) and alcian blue (AB) at both pH 2.5 and pH 1.0. The results of observation were as follows: 1. The developments of cutaneous mucous glands of the frog tadpole were begun with appearance of gland cell nest in the dermis at metamorphosis XV stage and significant numerical increases could be seen at metamorphosis XX, XXIII and XXIV stages. 2. This cutaneous mucous gland of the frog tadpole could be divided into two types; A-type glands showed strong positivities to both PAS and AB at pH 2.5 in the gland body cells and to PAS in the gland neck cells, and B-type glands at AB pH 2.5 in the gland body cells. 3. In the A-type mucous glands, the reactivities of the glandular epithelial cells to both PAS and AB stain could be first seen at the metamorphosis XIX stage of frog tadpole. The reactivities of the glandular epithelial cells to both PAS and AB pH 2.5 were gradually increased according to the process of metamorphosis after XX stage of metamorphosis. 4. The B-type mucous glands were first seen at the XX stage and the reactivity of the glandular epithelial cells to AB at pH 2.5 was gradually increased according to the process of metamorphosis after XX stage. 5. The A-type and the B-type mucous glands were in the ratio of 99 : 1, 7 : 3 and 5.5 : 4.5 for each of metamorphosis XX, XXI-XXII and XXIII-XXV stages. 6. The remarkable development of the cutaneous mucous glands of the frog tadpoles might be needed to maintain water and electrolyte balances according to the change of way from aquatic life to amphibious.

도룡뇽 (Hynobius leechi) 피부선의 미세구조: I. 점액선

김한화,노용태,정영화,지영득,Kim, Han-Hwa,Noh, Yong-Tai,Chung, Young-Wha,Chi, Young-Duk The Korean Society for Integrative Biology 1980 동물학회지 Vol.23 No.2

도룡뇽 피부점액선의 미세구조를 전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 1. 피부점액선은 선체부와 분비관으로 구성되며, 선체부는 선상피세포와 근상피세포로 구성되었다. 2. 피부점액선의 선체부의 선상피세포는 명세포, 암세포, mitochondria-rich cell, endoplasmic reticulum-developed cell, secretory granule-containing cell 및 vesiculated cells들로 구성되었다. 3. 명세포, 암세포 및 mitochondria-rich cell은 미분화세포, endoplasmic reticulum-developed cell은 분비전기세포, secretory granule-containing cell은 성숙세포 그리고 vesiculated cell은 분비후기세포라고 생각된다. The ultrastructures of the mucous glands in the Asiatic land salamander (Hynobius leechi) skin were observed by means of electron microscope. The results were as follows; 1. The mucous gland of the Asiatic land salamander skin consisted of a body of gland and a duct. The body of gland consisted of the glandular epithelial and the myoepithelial cells. 2. The light, the dark, the mitochondria-rich, the endoplasmic reticulum-developed, the secretory granule-containing and the vesiculated cells were observed in the mucous glandular epithelium. 3. It is supposed that the light, the dark and the mitochondria-rich cells are undifferentiated cells, the endoplasmic reticulum-developed cell is pre-secretory cell, the secretory granule-containing cell is mature cell and the vesiculated cell is evacuated cell.

Ultrastructure of the Cutaneous Gland in the Asiatic Land Salamander, Hynobius Leechi II. Granular Gland

김한화,노용태,정영화,지영득,Kim, Han-Hwa,Noh, Yong-Tai,Chung, Young-Wha,Chi, Young-Duk The Korean Society for Integrative Biology 1980 동물학회지 Vol.23 No.4

도룡뇽 (Hynobius leechi Boulenger)의 피부과립선의 미세구조를 전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 1. 도룡뇽의 피부과립선은 선체부와 분비관으로 구성되며, 선체부는 선상피세포와 근상피세포, 분비관은 각질세포들로 구성되었다. 2. 피부과립선의 선상피세포는 세포질의 전자밀도가 높은 암세포와 세포질의 전자밀도가 낮은 명세포가 관찰되었다. 3. 피부과립선의 분비과립은 구형 또는 나형이었고, 높은 전자밀도를 보이는 과립, 중등도의 전자밀도를 보이는 과립 그리고 낮은 전자밀도를 보이는 과립들로 구분할 수 있었다. 또한 낮은 전자밀도를 보이는 과립중에는 과립막 인접부에 부분적으로 높은 전자밀도를 보이는 과립들이 관찰되었다. 4. 피부과립선내 분비과립들이 같은 세포내에서 전자밀도의 차이를 보이는 것은 분비과립의 성숙단계 및 성숙된 과립의 수분흡수 정도에 따른 농도차이에 기인하며, 그 화학적 조성은 유사하다고 생각한다. The ultrastructures of the granular glands in the asiatic land salamander (Hynobius leechi) skin were observed by means of electron microsope The results were as follows; 1. The granular gland of the asiatic land salamander skin consisted of a body of gland and a duct. The body of the granular gland consisted of the glandular epithelial cells and the myoepithelial cells. The duct of the granular gland consisted of the keratinocytes. 2. The glandular epithelial cells in the asiatic land salamander skin were divided into the dark cell and the light cells in accordance with the electron density of the cytoplasm. 3. The secretory granules of the granular glands were round or oval in form and were divided into the various granules, showing the secretory granules showing weak electron density had the parts showing strong electron density near the granular membrane. 4. It is supposed that showing the different electron densities of the granules in a glandular epithelial cell is due to different mature stages and to different level of water absorption, and the chemical components of the granules showing different electron densities are identical.

양서류 피부 점액분비세포의 미세구조

김한화,노용태,정영화,지영득,Kim, Han-Hwa,Noh, Yong-Tai,Chung, Young-Wha,Chi, Young-Duk 한국통합생물학회 1978 동물학회지 Vol.21 No.1

양서류 피부 점액선의 선상피세포의 미세구조를 관찰하기 위하여 양서류 피부조직을 2.5% glutaraldehyde-paraformaldehyde(pH7.2) 1% osmium tetroxide에 전후 고정 한후 ethanol과 aceton으로 탈수, Epon 812에 포매 Sorvall MT-2B ultramicrotome으로 ultrathin section을 만들어 uranyl acetate와 lead citrate으로 염색하여 JEOL-100B형 전자현미경으로 관찰하여 다음과 같은 결과를 얻었다. 1. 양서류 피부 점액선은 선상피세포와 근상피세포로 이루어졌다. 2. 양서류 피부 점액선의 선상피세포는 미세구조적인 면에서 종에 따라 여러형의 세포들이 관찰되었다. a. 도롱뇽에서는 암세포와 명세포가 관찰되었다. b. 무당개구리에서는 mitochondria가 많은 세포와 원형의 분비과립을 갖는 세포들이 관찰되었다. c. 맹꽁이에서는 구형의 분비과립을 갖는 세포와 거품모양의 과립괴를 갖는 세포들이 관찰되었다. d. 개구리 피부 점액선은 A형과 B형점액선으로 구분되었고, A형점액선 상피에서는 mitochondria가 많은 세포와 원형의 분비과립을 갖는 세포, B형점액선 상피에서는 mitochondria가 많은 세포와 많은 분비과립을 갖는 세포 및 거의 전 세포질이 endoplasmic reticulum으로 채워진 세포들이 관찰되었다. 3. 위의 사실들로 미루어 양서류 피부점액선의 선상피는 mitochondria가 많은 미분화세포와 점액분비과립을 많이 함유한 성숙세포 및 전 세포질이 거의 rough endoplasmic reticulum으로 채워진 분비후기세포로 구성된다고 생각된다. The authors observed the ultrastructure of the mucous glandular epithelial cells in the amphibian skin by mean of electron microscope. The specimens from the experimental animals were fixed in 2.5% glutaraldehyde-oaraformaldehyde fixative in phosphate buffer at pH 7.2 prior to fixation in 1% osmium tetroxide, dehydrated in graded ethanol and acetone, embedded in Epon 812 mixture, and sectioned with Sorvall MT-2 ultramicrotome. The ultrasections were contrasted with uranyl acetate and lead citrate and observed with a JEOL-100B electron microscope. The results were as follows: 1. The cutaneous mucous glands in amphibia consisted of the glandular epithelial and the myoepithelial cells. 2. Several different cells in ultrastructure were observed in the mucous glandular epithelium of the adult amphibian skin. a. The dark and the light cells were observed in Hynobius leechi. b. The mitochondria-rich and the round secretory granule-containing cells were observed in Bombina orientalis. c. The round secretory granule-containing and the foam-like granule mass-containing cells were observed in Kaloula tornieri. d. The cutaneous mucous gland of Rana nigromaculata were divided into two types: A and B-type glands. In the A-type mucous gland, the mitochondria-rich and the round secretory granule-containing cells and in the B-type mucous gland, the mitochondria-rich, the secretory granule-containing and the ER-rich cells were observed. 3. Based upon the above findings, the authors infer that the mucous granular epithelium of the amphibian skin consists of the mitochondria-rich undifferentiated, the secetory granule-containing and mature, and the ER-rich evacuated cells.

Histological and Histochemical Studies on the Mucous Secreting Cells of the Gastric Mucosae according to the Development of Frog, Rana nigromaculata

김한화,노용태,정영화,Kim, Han-Hwa,Noh, Yong-Tai,Chung, Young-Wha The Korean Society for Integrative Biology 1976 동물학회지 Vol.19 No.1

양서류 발생에 따른 위점막 점액세포의 조직학적 및 조직화학적인 변화를 밝히고저 개구리(Rana nigromaculata)변태 각 단계의 위체부 조직을 10% formalin 완충액에 고정($4^{\circ}C$), paraffin에 포매, 4 $\mu$m 두께로 절편한후 periodic acid-Schiff(PAS) 및 alcian blue(AB) pH 2.5, pH 1.0에 반응시켜 다음과 같은 결과를 얻었다. 1. 위 표면점액세포내 점액질은 변태과정에 따라 특이한 변화없이 PAS에 강한 반응을 AB pH 2.5 및 pH 1.0에서는 약한 alcianophilia를 보였으며, 변태 XXIV와 XXV에서 세포내 중성 점액질의 함량이 현저히 증가하였다. 2. 위소와점액세포는 변태 XXI이후에서 볼 수 있었는데 PAS에 강한 반응을, AB pH 2.5 및 pH 1.0에서 약한 alcianophilia를 보였으나, AB pH 1.0에서는 AB pH 2.5에서 보다 강하였고, 변태 XXIV와 XXV에서 세포내 중성 점액질의 함량이 현저히 증가하였다. 3. 분비능을 보이는 점액질세포는 변태 XXIV이후인데 변태 XXIV에서는 PAS에 강양성을, AB pH 1.0에서는 약한 alcianophilia를 보였고, 변태 XXV 이후에는 PAS에 약한 반응을, AB pH 2.5에는 약하고 AB pH 1.0에는 중등도의 alcianiphilia를 보였는데 이들 점액질은 전 세포질에 비교적 고르게 분포하였다. To observe the changes of mucosubstances of the mucous secreting cells, stomach tissues in frog tadpoles at each stage of metamorphosis were fixed in 10% buffered formalin at $4^{\circ}C$, embedded in paraffin, sectioned to 4 $\mu$m thickness and stained with periodic acid-Schiff(PAS) and alcian blue (AB) of pH 2.5 and pH 1.0. The results obtained were as follows: 1. The reactivities of the surface mucous cells, which exhibited strong PAS-positivity and weak alcianophilia at both pH 2.5 and 1.0, were not changed in metamorphosis stages and the intracellular contents of neutral mucosubstances in the surface mucous cells increased significantly in XXIV and XXV stages of metamorphosis. 2. In the foveolar mucous cells, which appear after metamorphosis XXI, the staining reactivities to PAS, AB of pH 2.5 and 1.0 were the same as that of surface mucous cells during metamorphosis and the alcianophilia were stronger at pH 1.0 than at pH 2.5. 3. THe mucous neck cells, which appear after metamorphosis XXIV, exhibited a strong PAS-positive reaction and weak alcianophilia at metamorphosis XXIV but at metamorphosis XXV weak reactivity to PAS and strong alcianophilia at pH 1.0.

주문맥침범이나 원격전이가 있는 간세포암 환자에서 Cisplatin 간동맥투여 및 전신적 알파인터페론 병합요법의 효과

송일한(Il Han Song),정영화(Young Hwa Chung),고문수(Moon Soo Koh),이영상(Yung Sang Lee),이문규(Mun Gyu Lee),성규보(Kyu Bo Sung),오용호(Yong Ho Aoh),서동진(Dong Jin Suh) 대한내과학회 1996 대한내과학회지 Vol.50 No.5

N/A Objectives: Hepatocellular cearcinoma(HCC) patients presenting with vascular involvement or extrahepatic metastasis are usually contraindicated to surgery or chemoebolization, and median survival of those has been reported to be only a few weeks. Recent several studies suggested that certain chemotherapeutic agent or recombinant interferonalpha(rIFN-α) may be useful in a proportion of patients with inoperable HCC. Methods: To evaluate the effect of intraarterial cisplatin infusion and systemic rlFN-α in the treatment of HCC, 68 HCC patients with major portal vein thrombosis or distant metastasis were randomized to three groups: group A(n=19) treated with cisplatin and rIFN-α, group B(n-23) with cisplatin and group C(n=26) with supportive care only. Cisplatin of 2mg/kg body weight was infused transarterially every 8weeks and rIFN-α of 3×10(6) IU/m2 Bady Surface area was administered subcutaneously three times per week. Patients with severe hepatic decompensation(serum bilirubin>3.0 mg/dL, albumin<3.0g/L, prothrombin time<60%), hypersplenism(peripoheral WBC count <3,000/mm3, platelet count<40,000/mm3), uncontrolled ascites, active gastrointerstinal bleeding, cardiac or renal dysfunction were excluded in this study. The effects of therapy were assessed by the changes of tumor size and durations of survival. Results: The partial response rate assessed by the change of tumor size in group A was significantly higher than that in group B(33 vs 14%: p<0.05). 1 year survival rate of group A (27%) was also significantly higher than that of group B (9%) or C (0%) (p<0.05, p<0.01, respectively). Furthermore, median survival period of group A (19weeks) was significantly longer than that of group B(11weeks) or C(5weeks) (p<0.05, p<0.01, resectively). Side effects of combined therapy were flu-like symptoms, gastrointestinal upset, transient elevation of serum creatinine or ALT level, leukopenia, thrombocytopenia, and oral ulcer. However, these were transient and well tolerated by all of the patients. Conclusion. These data suggest that combined therapy of intraarterial cisplatin infusion and systemic rIFN-α administration may be useful in the treatment of HCC patients with major portal vein thrombosis or distant metastasis, in terms of tumor response or prolonging survival period.

간암의 크기와 혈청 Alpha - Fetoprotein 치 및 초음파 밀도와의 상호관계

송인성(In Sung Song),김정룡(Chung Yong Kim),이효석(Hyo Suk Lee),정영화(Young Hwa Chung),윤용범(Yong Bum Yun),정현채(Hyun Chae Jung),이진호(Jin Ho Lee),김용태(Yong Tae Kim) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.3

N/A The patients with hepatocellular carcinoma (HCC) show a wide range of serum alpha-fetoprotein (AFP). The ultrasonographic (US) echogenicity of HCC is also variable. The determinant factors of serum AFP level and US echogenicity are unclear. There are still a lot of controversies on the adequate criteria of the earlier detection of HCC. This study was designed to reevaluate the relationship between the size of 75 HCCs and serum AFP and between the size and US echogenicity, and then to propose a more adequate detecton criteria for smaller HCCs which can still be resectable. The results were as following; 1) There was no significant correlation between the diameter of HCC (in cm) and the logrithmic values of serum AFP when all the HCC (n=75) were included. However, a closer correlation between the diameter and those of serum AFP when only 37 HCCs with serum AFP higher than 100 ng/ml were selected (r=0.53, p<0.01). 2) HCCs less than 4 cm in diameter were hypoechoic on US in 61%, while those, the size of which were between 4 cm and 8 cm and larger than 8 cm were hyperechoic in 78% and 92%, respectively (p < 0.01). 3) The echogenicity of HCC was significantly correlated with serum AFP level (p<0.05), but was not related to tumor location in the liver, HBsAg positivity, associated liver cirrhosis and pathological type of HCC (p>0.05). These findings suggested that when serum AFP is above 100 ng/ml, the increment of the size can be expected by the elevation of serum AFP and that there is a pitfall in the US detection of HCC; the HCCs with the diameter of around 4 cm which can be isoechoic. Therfore, we proposed that US be used in complement with follow-up serum AFP to detect smaller HCC.