췌장암에서 Cyclooxygenase - 2 발현의 역할

김은경,이용욱,이규택,최규완,박동일,백승운,이준행,이종균,고광철,이풍렬,이종철,김재준,김완선,공구 대한소화기학회 2001 대한소화기학회지 Vol.38 No.3

Background/Aims: Accumulating evidence suggests that the use of NSAID may reduce the incidence of colorectal cancer. The likely mechanisms of these effects by NSAID is cyclooxygenase-2 (COX-2)-related inhibition of tumor proliferation and induction of apoptosis. The aim of our study was to examine possible roles and clinical significance of COX-2 expression in pancreatic cancer. Methods: Seventy-two pancreatic adenocarcinoma tissue specimens were obtained from surgical resection. After the immunohistochemical staining of the specimens, we examined proliferation activity (assayed by Ki-67 expression), apoptosis (by TUNEL stain), and microvessel density (by CD34 expression). We also investigated the relationship between the immunohistochemical expression of COX-2 and various clinicopathological characteristics. Results: The COX-2 positive rate in pancreatic epithelial cells was 41.7%. Proliferation index (PI) was significant higher in COX-2 positive specimens comparing to negative specimen (p=0.015) and the increase in intensity of COX-2 expression correlated with increasing PI (p=0.036). Apoptotic index (AI) was significantly higher in positivee COX-2 expression than in negative expression (p=0.044), but there was no significant difference in AI/PI between the COX-2 positive and negative specimens (p=0.44). The expression of COX-2 protein did not correlate with microvessel density, sex, age, differentiation, tumor size, stage, metastasis or patients survival. Conclusions: The expression of COX-2 enzyme in pancreatic cancer contributes to tumor proliferation, but is not related to apoptosis, angiogenesis or clinical characteristics. Further study is needed to examine the clinical usefulness of NSAID and COX-2 selective inhibitors.

위장관 간질종양의 임상 및 병리학적 고찰

김영호,장우영,이순진,손희정,최규완,도재혁,백승운,이준행,이풍렬,이종철,박철근,임윤정,김갑철,김재준,임효근 대한소화기학회 2001 대한소화기학회지 Vol.37 No.3

Background & Aims: Gastrointestinal stromal tumor (GIST) constitutes primary nonepithelial neoplasms of the gastrointestinal tract and includes most tumors previously designated as leiomyomas/leiomyosarcomas. GIST is pathologically divided into benign, borderline and malignanct tumor. This study was carried out to delineate the clinical and pathologic features of GIST and to establish the features predicting malignancy. Methods: Clinicopathologic data of 84 patients who had GIST from 1995 to 1999 were reviewed. Results: The subjects were 42 men and 42 women, and their mean age was 59.3±13.2 years. We located fifty-two tumors in the stomach, 28 tumors in the small intestine and 4 tumors in the colorectum years. Histopathology revealed benign tumors in 23 of the 84 patients, borderline tumors in 22, malignant tumors in 39. The average size of tumors was 6.23 cm in diameter (range, 0.6-26 cm). Metastasis was noted in 15.5% of the patients at diagnosis. On endoscopy, ulceration was more common in malignancy. Endsonographic findings except size were not significant statistically. On contrast enhanced computed tomography, malignancy showed more irregular shape and variable attenuation than benign lesions, which seemed to be valuable factor. Conclusions: The variables predicting malignancy were large tumor size (≥5 cm), location of the colorectum, palpable abdominal mass, ulceration on endoscopy, and less uniformity in shape and variable attenuation on computed tomography.

Glutaraldehyde 와 자동 세척기를 이용한 내시경 소독방법의 임상에서의 유용성

김영호,손희정,윤성원,최규완,이남용,백승운,이준행,고광철,이풍렬,이종철,송재훈,안병훈,김재준,최원혁,홍일철 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.6

Background/Aims: Safety of endoscopic procedures has been a major issue over the last 10 years. Most endoscopy units use 2% glutaraldehyde and automated endoscope reprocessors (AERs) for disinfecting gastrointestinal endoscopes. We attempted an in-use evaluation of the current reprocessing procedures. Methods: Thirty flexible endoscopes were randomly collected just after upper endoscopic examinations and were disinfected using 2% glutaraldehyde in an AER. Cultures were taken from biopsy channels (S-l), tip of the insertion tubes (S-2), umbilical cords (S-3), and angulation knobs (S-4). Results: In 63,3% (19/30) of endoscopes, there was no microbial contamination after disinfection procedures. The culture positive rates of S-l, S-2, S-3, and S-4 samples were 20,0%, 0.0%, 3.3%, and 20.0%, respectively. Microorganisms of 13 species were identified, but there was no pathogen related with reported infectious complications after endoscopic procedures. Conclusions: Current disinfection procedure using 2% glutaraldehyde and an AER appears to be very effective in decontaminating patient-used endoscopes. Low level microbial contamination of endoscopes after conventional reprocessing methods may not impose great risk on patients.

간세포암과 주위 조직에서의 Transforming Growth Factor-beta 1과 그 수용체의 발현

최규완,백승운,최문석,김소정,이준혁,고광철,이풍렬,이종철,박상종,안병훈,김재준 대한소화기학회 2001 대한소화기학회지 Vol.37 No.4

Background/Aims: Transforming growth factor-beta 1 (TGF-β1) is a potent inhibitor of hepatocyte proliferation and its receptor is known to be involved in the carcinogenesis. This study was designed to compare the expression levels of the TGF-β1 and its receptor in neoplastic cells and its surrounding tissue and to assess their role in hepatic carcinogenesis. Methods: We measured the levels of TGF-β1 mRNA and TGF-β1 receptor II mRNA by semiquantitive RT-PCR for the tumor and its surrounding tissue of 30 patients with hepatocellular carcinoma (HCC). We analyzed the relationship between the expression of TGF-β1 mRNA, TGF-β1 receptor II mRNA and clinicopathological characteristics of HCC. Results: The expression of TGF-β1 mRNA showed no difference between HCC and its surrounding tissue, but the expression of TGF-β1 receptor II mRNA was lower in HCC than in its surrounding tissue (2.47±1.08 vs 3.53±1.50, p=0.00). There was no difference in the expression level of TGF-β1 mRNA and TGF-β1 receptor II mRNAo the clinicopathological characteristics of HCC. However, the ratio of TGF-β1 receptor II mRNA in HCC to that in surrounding tissue was more decreased in HCC with portal vein invasion (0.49±0.22 vs 0.77±0.21, p=0.01). Conclusions: Our data suggest that the loss of TGF-β1 receptor II may play an important role in carcinogenesis and tumor progression of HCC.

허혈성 대장염의 임상 양상과 예후 인자

이미숙,손희정,강태욱,최규완,박동일,백승운,이준행,고광철,이종철,임윤정,이풍렬,김갑철,김재준 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.2

Background/Aims: Colonic ischemia is recognized as the most common vascular disorder of the intestines in the elderly. The severity of the disease may vary considerably with the prevalent benign transient forms, being amenable to conservative treatments and the severe gangrenous forms, requiring surgery. Correct diagnosis is usually made after the ischemic episode is over and colonic ischemia is frequently misdiagnosed. The aim of this study is to identify the clinical patterns and prognostic factors of ischemic colitis. Methods: We found 60 patients with nonoccusive ischemia of the large intestine, We analyzed age, sex, symptoms, signs, associated disease, location, endoscopy, hematologic, histologic, radiologic finding and treatment, retrospectively. Results: The mean age was 60.2±6.3 years. The most common symtoms were abdominal pain or bloody diarrhea. The most common sign was diffuse abdominal tenderness. The most common hematologic findings were anemia and leukocytosis. Associated medical illnesses wer diabetes, rhematoid arthritis and cerebrovascular accident, et al. Both computed tomography (CT) and endoscopy were useful diagnostic tools. The most common involved site was sigmoid colon. 46 patients were treated conservatively and 14 patients were managed surgically. Conclusions: Male gender, those with rebound tenderness, severe anemia, right or total colon involvement as well as rheumatoid arthritis had a poor prognosis. Both CT and endoscopy were useful in predicting prognosis.

성인에서 반복적인 위장관출혈로 발현한 공장 거대 중복성 낭종

김영호,이경수,이상수,문원,강태욱,최규완,박동일,도재혁,백승운,이풍렬,이종철,김재준,류민규 대한내과학회 2001 대한내과학회지 Vol.61 No.3

Duplication of the alimentary tract is an unusual congenital anomaly which may occur at any level, from the oral cavity to the rectum. Jejunal duplication cyst is quite rare and most of them are presented in infancy with the symptoms of abdominal mass, obstruction, hemorrhage and perforation. But some cases has not been diagnosed till adult if duplication cyst was too small enough to cause symptoms. We report a case of a 28-year-old woman who presented with recurrent gastrointestinal hemorrhage as a result of an ulceration without ectopic mucosa in jejunal duplication cyst and was successfully treated with surgery.(Korean J Med 61:264-269, 2001)

당뇨병 유발 백서에서의 간 세포질 단백질의 산화성 손상

박형섭,장연진,이재담 대한당뇨병학회 1993 Diabetes and Metabolism Journal Vol.17 No.2

고온자전합성법에 의한 Ti/Al 복합판재의 미세조직 형성과정

박우진,안상호,정재영,김낙준,이원철 대한금속재료학회(대한금속학회) 1998 대한금속·재료학회지 Vol.36 No.10

Microstructural evolution of Ti/Al layered structures annealed at various temperature has been investigated by using optical microscopy, scanning electron microscopy, and X-ray diffractometry. Ti/Al layered sheets have been produced by dipping two Ti sheets in Al melt. The Ti/Al interfaces showed good bonding characteristics in as-dipped sheet. Microstructure of the heat-treated Ti/Al sheet varies depending on the subsequent annealing temperature. In the Ti/Al layered composite annealed at temperature below Al melting point, thin TiAl₃ layer was formed by the diffusion process at the Ti/Al interfaces. In the case of composite exposed at temperature above Al melting point, the equiaxed TiAl₃particles protruded into Al matrix from the thin TiAl₃ layer as well as the formation of thin TiAl₃ layer. TiAl₃ particles become homogeneously distributed within the Al matrix away from the Ti/Al interface with increasing annealing time. The formation of TiAl₃ phase in Ti/Al sheet annealed at temperature above Al melting point is believed to be formed by the exothermic chemical reaction.

심장 이식 후에 발생한 침윤성 폐 Aspergillosis 2 예

김희정,박성훈,홍석근,현민수,고경환,윤재형,이수금,오미혜,김명아,박국양 대한내과학회 1997 대한내과학회지 Vol.53 No.2

Case 1: A 39-year-old man underwent orthotopic heart transplantation on November 1994 for dilated cardiomyopathy. His postoperative course was unevenful and medications included daily cyclosporin A, Immuran and prednisone. On December 13.1994, he developed cough and sore throat. Chest radiographs revealed multiple patch growing lesions. Sputum fungus culture revealed Aspergillus Fumigatus. The patient was treated with daily infusion of amphotericin B. He remains well without evidence of relapse of Aspergillus, Case 2: This 39-year-old man had undergone orthotopic heart transplantation on November 16 1994 for dilated cardiomyopathy. In December 7.1994. he developed recurrent syncope. Chest radiographs revealed fungus ball like lesion on right lung field. On open lung biopsy and wedge resection of the mass was performed. Aspergillosis and CMV infection was demonstrated in the biopsy specimen. The patient was treated with conventional amphotericin B therapy for over 7weeks and Ganciclovir for over 2weeks. At the end of therapy chest X-ray showed only small residual scar in the area of previous mass.

역류성 식도염 환자에서 Helicobacter pylori 치료 1 년 후 증상과 내시경적 변화

김영호,손희정,최규완,박동일,백승운,이준행,고광철,이풍렬,이종철,임윤정,김재준 대한소화기내시경학회 2001 Clinical Endoscopy Vol.24 No.1