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Malignant tumors of the salivary glands are variable in their histologic pictures, and their histochemical changes in membrane carbohydrate composition have not been fully understood. The author selected formalin fixed, paraffin embedded normal tissue and malignant tumors of salivary gland, and performed immunohistochemical study on the selected tissue materials by avidin biotin peroxidase complex method using lectins such as Concanavalin A (Con A), Soybean agglutinin (SBA), Wheat germ agglutinin (WGA), Dolichos biflorus agglutinin (DBA), Ulex europaeus agglutinin I (UEA I), Peanut agglutinin (PNA), Ricinus communis agglutinin I (RCA I), and Pinellia ternata agglutinin (PTA). The results are summarized as follows: 1. Lectins showing different reaction pattern between normal and malignant tumor cells of the salivary glands were DBA, UEA-1, SBA and PNA. 2. DBA and SBA showed positive reaction with normal duct epithelium, but they did'nt react with malignant turner cells. 3. UEA-1 revealed positive reaction with normal duct epithelium and cancer cells of the mucopeidermoid carcinoma. But it did'nt react with adenoid cystic carcinoma cell and acinic cell carcinoma cell. 4. PNA showed positive reaction with mucoepidermoid carcinoma cell and negative reaction with nor-mal duct epithelium, adenoid cystic carcinoma and acinic cell carcinoma cell. Above findings suggest loss of N-acetyl-galactosaminyl moiety in malignant tumors of salivary gland, loss of L-fucosyl in adeniod cystic cacinoma and acinic cell carcinoma, which are present on normal duct epithelium, and appearance ofβ-D-galactosyl moiety in mucoepidermoid carcinoma which is absent on normal duct epithelium.
The authors reviewed the histopathologic and clinical features of 32 primary prostatic carcinomas seen at Korea University Hospital from 1982 to 1987, and made an attempt to categorize these cases by modified Gleason grading system. Immunohistochemical study for prostate specific antigen (PSA) and prostate specific acid phosphatase(PSAP)by avidin biotin complex method was performed to evaluate the diagnostic usefulness in surgical pathology. The results were as follows. 1. Patient's age at initial diagnosis ranged from 56 to 84 years with a mean of 69. 2. Histologically there were 29 cases of conventional adenocarcinoma, 2 cases of mucinus carcinoma and 1 case of endometrioid carcinoma. By modified Gleason grading system, 6 cases were in below grade 4, 14 cases were in grade 5 to 7, and 12 cases were graded above 8. 3. Immunohistochemically prostatic carcinoma was positive for PSA and PSAP in 30 cases (93.7%), respectively. PSA was diffusely positive in 22 and focally in 8. PSAP was focally positive in 6 and diffusely positive in 24. Four cases in which one of antigens was negative belonged to grade 5 to 10.
Although it is known that hypothyroidism can cause cardiac dysfunction, it is very hard to find a case report on sudden death due to hypothyroidism. There are only two reported cases on mediline; one is about a 15-year-old girl who died suddenly of Hashimoto's thyroiditis and the other is about a 31-year-old man who also died suddenly of hypothyroidism associated with chronic lymphocytic thyroiditis. Recently we found a young woman who unexpectedly died while she was sleeping. She was diagnosed as hypothyroidism when she went to hospital about a month before she died. At autopsy there were roughly four abnormal findings; Hashimoto's thyroiditis, mild chronic active hepatitis, diverticulosis and accessory spleen. Trace of chlorpheniramine was detected in gastric remains and blood alcohol level was 0.37 percent. To our knowledge, this is the first case reporting sudden and unexpected natural death associated with hypothyroidism in Korea.
Cryptococcosis is a systemic fungal infection by Crytococcus neoformans. This mycosis most commonly involves central nervous system, but bone involvement may occur as many as 5-10% of the patients. We experienced a case of bone cryptococcosis in a patient with SLE. The patient was a 28-year old woman, who diagnosed as SLE 3 years ago. She had been treated with immune suppressants such as steroid and cyclophosphamide. She noticed painful erythematous swelling on her left forearm and skin of left breast. X-ray findings showed sclerotic changes on her posterior aspect of left proximal ulnar. Pathologic and microbiologic examination revealed characteristic findings compatible with bone cryptococcosis. The patient was treated with bone curettage and systemic amphotericin B. The clincal symptoms and bone lesion were improved significantly without sequellae.
Flow Cytometric DNA Ploidy and Cell Phase Fractions in Recurrent Pituitary Adenomas : A Correlative Study of the Flow Cytometric Analysis and The Expression of Proliferating Cell Nuclear Antigen 유세포 측정법과 PCNA 발현의 관계연구
Flow cytometric analysis was applied to embedded tissue to measure the proliferative activity and the DNA ploidy of sixteen recurrent and seventeen nonrecurrent pituitary adenomas. The results were compared with data from a previous study which demonstrated that proliferationg cell nuclear antigen (PCNA) labelling index was higher in recurrent adenomas than in nonrecurrent adenomas. Flow cytometric analysis as a tool for predicting aggressive behavior has been useful in a variety of human tumors, however its prognostic value in pituitary adenoma is controversial. Therefore we decided to explore the relationship of the results of flow cytometry and proliferating cell nuclear antigen labelling indices with the prognosis of pituitary adenomas. Three out of 16 recurrent adenomas and five out of 17 nonrecurrent adenomas demonstrated a DNAaneuploid pattern. All the nonfunctional recurrent adenomas had a diploid pattern, while only 40% of the functional recurrent adenomas had a diploid pattern. The G0/Gl phase fraction was higher in the recurrent adenomas than in the non- recurrent ones. (p=0.0005) In contrast, the S phase fraction and the coefficient of variation were 1 higher in the nonrecurrent adenomas (5.9 1.0%, 7.0 0.75, respectively) than in the recurrent ones(2.5 0.6%, 4.0 0.2%, respectively) (P=0. 003 and p=0. 001, respectively). The proliferating cell nuclear antigen lavelling indices were higher in the recurrent adenomas (18.9 4.5%) than in the nonrecurrent adenomas (2.6 1.6%) (P=0.003). The S phase of flow cytometry correlated weakly with the proliferating cell nuclear antigen labelling indices when the recurrent and the nonrecurrent adenomas were considered as one group. (r=-0. 356, p=0.033) But no significant correlations were observed when the groups of recurrent (r=0.311, p=0.195) and nonrecurrent tumors (r=-0.019, P=0. 942) were compared separately. The results of flow cytometric analysis suggests that recurrent adenomas may have a higher proportion of cells in the presynthetic phase than the nonrecurrent adenomas. This study suggests that flow cytometric analysis is of limited value in predict- ing recurrence of pituitary adenomas.
악성 임파종(malignant lymphoma)중 non-Hodgkin 임파종이 중추신경계로 침범하는 빈도는 약 10% 정도로 드물게 중추신경계를 침범하는 Hodgkin 임파종에 비하여 높으나 이러한 경우 대개 종양의 파종(dissemination)이 상당히 진행하였거나 종양 발견 후기에 발생되는 것이 대부분이다. 이 중 척수경막으로의 전이로 인하여 척수 압박증세를 일으키는 경우는 0.1%에서 10.2%^(10)12)13)19)22)31)37))의 환자에서 볼 수 있으나 이러한 증세가 환자에서 초기 증상으로 나타나는 것은 매우 드물다. 뿐만 아니라 환자의 초기 증세가 척수 혹은 신경근압박증세로 나타나 수술 혹은 조직검사로 임파종이 확인되어 staging 검사를 시행하여도 다른 장기의 침범소견이 없는 국소성 혹은 원발성의 경우 더욱 드물다. 저자들은 최근 척수 경막상에 위치한 non-Hodgkin 임파종을 2례 치험하여 문헌 고찰과 함께 보고하는 바이다. 이 중 1례는 27세 남자 환자로 좌측 하지로의 방사통만을 주소로 본원에 내원하여 수술 후 조직검사 및 staging 검사 결과 원발성 척수경막상 악성 임파종(non-Hodgkin lymphoma)으로 진단된 매우 희귀한 경우였으며, 다른 1례는 40세 남자 환자로 과거력상 수년간의 요통이 있어오다가 입원 수일전부터 진행되는 하반신 부전마비 증세가 나타나 본원에 내원하여 수술 시행받은 후 조직검사 및 staging 검사 결과 상기 환자와 같은 임파종으로 진단되었으나 이 환자는 골수검사에서 임파종세포가 확인되었다. 환자들은 모두 술 전에 비하여 증세가 호전되어 퇴원하였으며 현재까지 추적 조사 중이다. The spinal epidural non-Hodgkin's lymphoma, especially the primary lesion, is uncommon. Usually back pain can be the prodromal symptom a long time before the spinal compression syndrome appears, as in second patient, but unusual presentation such as sciatica alone, as in our first patient, may be the only clinical feature. Therefore, one should be borne in mind that there exist wide varity of clinical spectrums in these patients. Some of characteristics that should be drawn to diagnostic consideration for spinal epidural lymphoma are clinical presentation of spinal cord compression manifested by a prodrome of back pain followed by an acute neurological deterioration, no prior history of cancer, normal plain spine radiographs, and neuroimaging consistent with an extradural compressive lesion. Although these patients are reported to have favorable prognosis, especially in younger patients, aggressive approach is suggested in order to obtain good local response and long term survival. Further follow up is necessary in our patients to make remarks on this matter.
Background: Colorectal cancer (CRC) is one of the most common malignancies worldwide. Approximately 10%–15% of the CRC cases have defective DNA mismatch repair (MMR) genes. Although the high level of microsatellite instability status is a predictor of favorable outcome in primary CRC, little is known about its frequency and importance in secondary CRC. Immunohistochemical staining (IHC) for MMR proteins (e.g., MLH1, MSH2, MSH6, and PMS2) has emerged as a useful technique to complement polymerase chain reaction (PCR) analyses. Methods: In this study, comparison between the MMR system of primary CRCs and paired liver and lung metastatic lesions was done using IHC and the correlation with clinical outcomes was also examined. Results: Based on IHC, 7/61 primary tumors (11.4%) showed deficient MMR systems, while 13/61 secondary tumors (21.3%) showed deficiencies. In total, 44 cases showed proficient expression in both the primary and metastatic lesions. Three cases showed deficiencies in both the primary and paired metastatic lesions. In 10 cases, proficient expression was found only in the primary lesions, and not in the corresponding metastatic lesions. In four cases, proficient expression was detected in the secondary tumor, but not in the primary tumor. Conclusions: Although each IHC result and the likely defective genes were not exactly matched between the primary and the metastatic tumors, identical results for primary and metastatic lesions were obtained in 77% of the cases (47/61). These data are in agreement with the previous microsatellite detection studies that used PCR and IHC.
Background: Hepatocyte growth factor (HGF) is a potent mitogenic cytokine. C-met protein, which is known to be the HGF receptor has transmembrane tyrosine kinase activity and is encoded by the c-met oncogene. The HGF/c-met signaling pathway may play various roles in the carcinogenesis of various organs. Methods: We examined HGF and c-met mRNA expression by utilizing reverse transcription polymerase chain reaction on 40 surgically resected intracranial meningiomas (25 benign, 10 atypical, and 5 anaplastic cases). Results: An HGF overexpression was detected in 28%, 50%, and 80% of the benign, atypical and anaplastic meningiomas, respectively; a high expression of HGF or the coexpression of HGF/c-met was detected in the high grade meningiomas (the atypical and anaplastic cases, p=0.046, p=0.014). An HGF expression was statistically significant in the recurrent meningiomas (p=0.003), and HGF expression was significantly lower than c-met mRNA expression in benign meningiomas (p=0.034). Conclusions: There was no correlation between histologic subtypes and HGF/c-met expression. Determination of HGF expression can be used as a molecular predictor for recurrence of meningioimas. These results suggest that HGF and c-met expression in meningiomas may be associated with anaplastic progression.