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      • 紅門部 疾患에 對한 臨床的 考察

        林石俊 최신의학사 1978 最新醫學 Vol.21 No.1

        A total of 482 patients of various anal disease, who were treated in Seoul Nursing Junior College Hospital during the past 5 years from November 1972 to October 1977, were clinically reviewed. The following results were obtained. 1. The sex distribution assumed a ratio of 2.3:1 with 334 males and 148 females and age distribution indicated a predominant incidence in second and third decade. 2. The incidence by season revealed highest in winter. 3. The incidence of disease appeared in the order of the hemorrhoid, fissure, perianal abscess and fistula. The hemorroid occupied 43.4% of all cases. 4. The lapse after onset anal disease is under a month in 32. 3%. 5. The subjective symptoms in anal disease were bleeding, pain, constipation, discharge. The bleeding and pain in hemorrhoid and anal fissure, pain in perianal abscess, discharge in anal fistula might be specific complaints. 6. The 139 cases out of 482 cases (28.8%) underwent surgery and rest of the cases were treated conservatively. 7. Postoperative complications were noted in 6.5% and were bleeding, wound infection, intractable pain, anal stricture, persitant sinus tract in anal fistula.

      • 正常 胃粘膜과 胃癌의 癌性胎兒性 抗原, 分泌成分 및 分泌型 IgA의 出現에 관한 免疫組織化學的 硏究

        林石俊,李大一,金世民 고려대학교 의과대학 1985 고려대 의대 잡지 Vol.22 No.1

        Gastric carcinomas have been divided by some experts into intestinal type and gastric infiltnative categories based on the predominant cell type in the neoplasm. It is argued that this subdivision has pathogenic and clinical significance. Intestinal type lesions are more often of the expanding type associated with chronic gastritis and the consequent intestinal metaplasia seen in chronic gastritis. In addition, pre-and postoperative measurement of carcinoembryonic antigen (CEA) in tumor cell or serum have shown prognostic value. An additional recent line of research is immunohistochemical investigation of epithelial marker antigen. These include functional characteristics of the normal epithelium, which may disappear partly or completely during malignant development. Secretory component (SC) and secretory IgA in epithelium of Lieberku¨hn crypt belong to this category. Thus, the functional role of SC as an epithelial receptor for dimeric IgA for the purpose of local immunologic defence in normal colon might be lost in carcinomatous lesion of the colon. As far as SC and IgA are concerned, biologic behavior of normal or malignant gastric epithelial cell is not understood well. Therefore, for the purpose to compare distribution of SC in normal and carcinomatous gastric lesion, each 5 cases of formalin fixed and paraffin embedded blocks of well and moderately differentiated expanding type of adenocarcinoma and infiltrative carcinomas of stomach were selected respectively and immunoperoxidase staining of Avidin-Biotin- Complex method was performed using antihuman CEA, SC, and IgA antisera and distribution of each antigen between normal and carcinomatous gastric mucosa was compared. The results obtained are as follows; 1. In normal gastric mucosae, anti SC, and anti-CEA antisera showed negative reactions and there were many plasma cells which react to anti IgA antiserum in the lamina propria. 2. On the mucosal cells of intestinal metaplasia, Anti SC-and anti IgA antisera showed positive reaction, except goblet cells. 3. Strong positive reactions with anti-SC, anti-IgA and anti-CEA antisera were noted in the cells of well differentiated adenocarcinoma. 4. Negative reaction with anti-SC, anti-IgA, and anti CEA antisera were noted in the cells of poorly differentiated infiltrative type of gastric adenocarinoma. With the above result, SC seems to be a useful indicator to confirm adenocarcinoma of, stomach arising from intestinalized epithelial cells.

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