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Primary unruptured appendiceal mucocele is a rare disease. It is very difficult to diagnose preoperatively because of the rarity of classical symptoms and low incidence. Usually it is discovered incidentally during abdominal ultrasonography(US), computed tomography(CT), or appendectomy for acute appendicitis. If untreated, one type of mucoceles may rupture producing a potentially fatal entity known as pseudomyxoma peritonei, therefore preoperative diagnosis is very important. With the advent of colonoscopy, abdominal US and CT, it has been possible to preoperatively diagnose mucocele of appendix. We experienced a case of appendiceal mucocele in a 60 year-old woman who had symptoms of lower abdominal discomfort and right lower quadrant abdominal pain, and it was diagnosed preoperatively by colonoscopy, abdominal US and CT. So we present this case with review of literature.
배경: E-cadherin은 상피세포의 세포-세포 부착에 관여하며 암세포에서 해당 유전자는 대개 돌연변이가 초래되거나 낮게 발현된다. E-cadherin의 과발현은 여러 가지 integrin family의 발현을 감소시킨다는 보고가 있지만 어떻게 E-cadherin이 integrin에 영향을 미치는지, E-cadherin이 integrin과 관련된 신호물질에 어떠한 영향을 미지는지에 관해서 확실하게 밝혀진 바가 없다. 재료 및 방법: 조선대학교 부속병원에서 1997년 부터 1999년까지 진행성 위 선암종으로 위절제술을 받은 환자를 대상으로 E-cadherin에 대한 면역조직화학적 염색을 시행하여 과발현 (정상 발현 또는 과발현)을 보이는 군과 저발현 (비발현 또는 저발현)을 보이는 군을 각각 30명씩 연속적으로 선택하였다. 이들을 대상으로 βatenin과 integrin, 그리고 cyclin D1에 대한 면역조직화학적 염색을 시행하여 비교 분석하였다. 결과: E-cadherin 과발현은 cyclin D1, integrin, 그리고 P-catenin의 발현을 유의하게 감소시키며, βatenin 발현은 integrin 발현을 유의하게 증가시켰다. 결론: E-cadherin 과발현은 βatenin을 감소시켜 integrin 신호전달체계와 cyclin D1 발현을 억제할 수 있을 것으로 판단된다. Background and Objectives: E-cadherin mediates cell-cell adhesion in epithelial cells and its gene is usually mutated or lowly expressed in carcinoma cells. It has been reported that over-expression of E-cadherin can reduce the expression of several members of integrin family, such as α2β1 and α3β1 But it was still not clear how E-cadherin influences integrin or whether E-cadherin can influence the signal molecules in downstream of integrin. Materials and Methods: The authors analyzed the patterns of integrin expression along with the interrelation between E-cadherin and, βatenin, and cyclin D1 expression in 60 cases of advanced gastric adenocarcinoma, in patients who received gastric resection from 1997 to 1999. Of them, the number of E-cadherin over-expressed (normal- or over-expressed) cases was 30, and the number of E-cadherin under-expressed (non- or under-expressed) cases was 30. Results: The authors found that over-expression of E-cadherin could reduce the expression of cyclin Dl, which is a key protein related to cell cycle, in comparison with the E-cadherin under-expressed group. In correspondingly, the stainability of, β, and α5- integrins was declined significantly in the E-cadherin over-expressed group compared with the E-cadherin under-expressed group. βatenin expression in the E-cadherin over-expressed group was also decreased significantly in comparison with the E-cadherin under-expressed group. Positive expression of integrin was increased significantly in the βatenin expressed cases compared with the βatenin non-expressed cases. Conclusion: The results suggested that over-expression of E-cadherin can suppress the integrin signaling pathway and the expression of cyclin D1 through decreasing βatenin level.
Objective: Foraminal stenosis may be caused by various spinal diseases. In some of these patients, we conducted foraminotomy in a way which would not cause spinal instability. Materials and Method: 31 patients who showed formainal stenosis on MRI underwent forminotomy between October of 2000 to August of 2001. Two types of technique were used. First method, medial sublaminar approach, in this approach we removed lower 1/3 of spinous process to the base, to expand interlaminar space, and exposed yellow ligament was removed. Through this hole, all sublaminar and foraminal part of yellow ligament was detached and removed under operating microscope. 2nd method, paraspinal approach, we removed intertransverse ligament and dilated the foramen by removal of yellow ligament composing posterior part of the foramen. Operation time was an hour in case of one level bilateral foraminal stenosis. Results: The clinical state after surgery was assessed by Prologs outcome scale. Satisfactory results were obtained in 96%. Conclusions: Although follow-up period was short(mean 18months), Laminar and facet joint damage was minimal, and as the result low back pain, and instability could be prevented with satisfactory results, but in spinal stenosis of L5-S1 level, these techniques were not appropriate.
Background and Objectives : p53 is a tumor suppressor gene. Loss of function of the p53 tumor suppressor gene implicated in a wide variety of human tumors. Many mechanisms are involved in p53 dysfunction. One of the mechanisms is binding of oncogenic virus such as human papillomavirus (HPV). HPV infection are strongly linked to the development of cervical neoplasia including cervical intraepithelial neoplasia (CIN) of uterine cervix The purpose of this study is to investigate the relationship between aberrant p53 expression and presence of HPV DNA in CIN of the uterine cervix. Materials and Methods : In the present study, the author analyzed 35 cases of paraffin-embedded CIN, including 10 cases of grade 1, 10 cases of grade Ⅱ, and 15 cases of grade Ⅲ CIN by the immunohistochemistry and in situ hybridization. Results : Overall positive rate of HPV DNA type 16 and type 18 was 74.3% (26 cases) and 65,7% (23 cases), respectively. Nuclear accumulation of p53 was found in 22 cases (62.9%) of all CIN. In negative cases of HPV DNA type 16, the p53 was positive in 18 cases and negative in 8 cases. In positive cases of HPV DNA type 18, the p53 was positive in 16 cases and negative in 7 cases. In negative cases of HPV DNA type 16, the pS5 was positive in 6 cases and negative in 6cases. Conclusion : This results suggest that HPV infection may contribute to the DNA damage associated with the accumulation of aberrant p53 protein, and then closely relate to the progression of cervical neoplasms. But, alteration of p53 Protein levels and presence of HPY DNA was not an exclusive markers of cervical tumorigenesis.
Bilateral renal agenesis is an uniformly lethal malformation occurring in 1-2/10000 birth. This condition is associated with severe oligo-hydroamnios, intrauterine growth retardation, pulmonary hypoplasia and extrarenal anomalies. We experience a case of bilateral renal agenesis associated with agenesis of both ureters and bladder, and single umbilical artery. But the infant had normal pulmonary development. Specific IgM for herpes virus in maternal serum was detected.
Small bowel cancer represents 1 to 2 percent of all gastrointestinal malignancies. By far, most small bowel epithelial tumors are metastatic. We report an unusual case of primary squamous cell carcinoma of jejunum. The patient was a 69-year-old man who suffered from whole abdominal pain and transferred to our hospital for operation. There was a perforation at the jejunum which was 100cm apart from the ileocecal valve. There was a 5×4m sized ulceroinfiltrative tumor with a perforation. Histologically, it was revealed that the tumor had nests of keratinizing squamous cell carcinoma involving mainly the submucosa and the muscular layer. The overlying mucosa was eroded. The patient had no underlying duplication or inflammatory disorder. A colon study, gastrofibroscopy, computed tomogram of the chest and abdomen, and laryngoscopic exam were performed and revealed no evidence of malignancy. Also there was no evidence of metastatic lesions anywhere.
Eosinophilic gastroenteritis is an uncommon disease characterized by peripheral eosinophilia, eosinophilic infiltration of various areas of the gastrointestinal tract with gastrointestinal symptoms such as abdominal pain, vomiting, diarrhea and rarely ascites. This disorder was pathologically classified into three major types: predominant mucosal, predominant muscle layer and predominant subserosal. Although its etiology and pathogenesis was not yet definitely established, its treatment was steroid administration and the overall prognosis was favorable. We report a case of eosinophilic gastroenteritis with features of the predominant subserosal type, presented as an ascites and ileus.
Neurilemmoma is a relatively rare benign tumor which may be derived from nerve sheath of the peripheral and cranial nerve, and characterized by solitary occurrence, with sharp demarcation and encapsulation. In spite of their rarity, a high proportion of these growth are situated about the head and neck. About 30% of the disease is found in the head and neck region and the most common single site of origin is known to be the acoustic nerve. Thus, described that case involving the upper cervical spine is rare. We recently had the opportunity to care for a man with a cervical spinal neurilemmoma including affected nerve root at C3 level. When the tumor is derived from a root which is assumed to be important for extremity functions, it is still controversial whether that nerve root should be totally resected. A review of the current literature and intraoperative management will be presented to further define these concepts.
Cystine calculi is the consequence of cystinuria, an autosomal recessive defect of the transepithelial of cystine and dibasic acids in the kidney and intestine. The hardness and frequent reccurrence of cystine stones present a special challenge to the urologist. we report a case of 15-year-old man who had a cystine calculi, which was successfully treated with percutaneous lithotripsy (PCNL), extracorporeal shock wave lithotripsy (ESWL) &edical therapy include high fluid intake, alkalinization and chelating agent.
An ectopic ureter has been defined as a ureter that inserts at or distal to the bladder neck. The majority of ectopic ureter cases are associated with ureteral duplication and, therefore, single ectopic ureter is reported to be rare. The diagnosis of a single ectopic ureter may be difficult because the kidney usually is dysplastic. We report on 2 male patients with single ectopic ureters who had ipsilateral dysplastic kidney.