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초음파 유도하 생검 후 진단한 비장 림프관종 : 1예 보고
기승석,정숙향,윤창진,이혜승,장세중,최준혁,하지수,김순재 대한초음파의학회 2007 ULTRASONOGRAPHY Vol.26 No.2
Lymphangioma of the spleen is an extremely rare disease in adults, and performing splenectomy has been considered necessary for its diagnosis and treatment, but the diagnosis of an isolated splenic mass lesion without performing splenectomy is a challenging problem. Herein, we report on a case of multiple splenic lymphangiomas that were found incidentally in a 56-year-old female; these lesions were diagnosed by percutaneous splenic biopsy without splenectomy. We suggest that this approach is a reasonable option for benign looking-appearing splenic tumors because splenectomy and its postsplenectomy complications can be avoided. 성인에서 비장에 생긴 일차 림프관종은 매우 드문 양성 종양이며, 대부분 무증상으로 우연하게 발견된다. 진단 및 다른 질환과 감별을 위해 여러 영상의학적 검사 방법들이 이용되고 있으나 조직학적 정보 없는 영상학 적 진단은 한계가 있는 게 현실이다. 지금까지 국내에서 보고된 비장에 발생한 일차 림프관종은 비장절제술을 통해 보고되었다. 그러나 최근 비장절제술 후 간문맥혈전증, 수술 중 과도한 출혈 및 심각한 패혈증 등을 유발 할 수 있다는 점과 비장의 생리적, 면역학적 중요성에 대해 관심이 커지면서 비장을 보존하는 치료 방법들이 등장하고 있다. 그리하여 저자들은 안전하게 널리 이용하는 복강 내 장기에 대한 초음파 유도하 경피적 흡인술 및 생검술을 비장 종괴의 경우 다소 제한적이지만 시행 후 수술을 시행하지 않고 임상적 관찰한 56세 여자환 자 증례를 보고하게 되었다.
Diethylnitrosamine으로 유발된 흰쥐 간암 발생 및 진행 과정에서 VEGF와 Factor Ⅷ R-Ag의 발현
김형준,기승석,박용진,김남돈,견종만,박언섭 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.2-3
It is widely believed that chemical carcinogenesis is a multistage process, so-called initiation, promotion and propagation. Diethylnitrosamine (DEN) has been proved to have carcinogenic potential either at initiation or at promotion stage, resulting hepatocellular carcinomas in rat liver. In addition, neoplastic and metastatic propagation of transformed cells exclusively need a plenty of vascular supply for their metabolic requirement. To elucidate the tumor angiogenesis during the chemically induced carcinogenesis in rat liver, analysis of histopathology and the expression of vascular endothelial growth factor (VEGF) and Factor VⅢ related antigen were examined by immunohistochemical study using avidine-biotin complex. The hyperplastic nodules appeared at 3 weeks, the hepatocellular carcinomas were 15 weeks, and the pulmonary metastatic foci were developed at 18 weeks after oral administration of 120 ppm DEN to the rat. The VEGF expression appeared at 3 weeks and continuously increased with weeks. The staining of Factor VⅢ R-Ag was negative in any sinusoids in normal control livers, focal or scattered expressed in hyperplastic nodules, and diffusely expressed in hepatocellular carcinomas. As above results, it could be suggested that VEGF expression plays an important role from early period of DEN-induced hepatocarcinogenesis. Also, the expression of VEGF is likely to be associated with phenotypic changes of the sinusoidal endothelium presenting Factor VⅢ expression. However, there was no correlation between the expression pattern of VEGF and the state of metastasis.
N-butyl-N(4-hydroxybutyl) Nitrosamine에 의한 흰쥐방광암 발생과정에서 E-cadherin과 Catenin의 발현
박용진,기승석,김남돈,김성곤,박언섭 중앙대학교 의과대학 의과학연구소 2003 中央醫大誌 Vol.28 No.2-3
Although urothelial cell carcinoma is the most common primary tumor of the urinary bladder, the mechanisms that regulate its development and progression remain unclear. β-catenin plays a fundamental role in the regulation of E-cadherin-catenin cell adhesion complex. Mutations in either β-catenin or E-cadherin gene result in up or down-regulation of protein expression. This study was conducted to evaluate the expression changes of β-catenin and E-cadherin protein during 0.05% BBN-induced rat bladder carcinogenesis. Spray-Dawley Rats were given 0.05% N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN) by drinking water, and sacrificed at 5, 10, 20, and 30 weeks following treatment. For sequential changes and the expression of E-cadherin and β-catenin during rat bladder tumorigenesis, morphologic assesment and immunohistochemical staining were done. During the carcinogenesis, sequential histological changes from hyperplasia to papilloma, and ultimately overt carcinomas were noted. On histopathological findings, urothelial cell hyperplasias was appeared at 5 weeks, followed by urothelial papillomas at 10 weeks, and superficial urothelial carcinomas was found at 20 weeks after BBN administration. After 30 weeks of BBN administration, invasive carcinomas were developed. The immunohistochemical stains for E-cadherin and β-catenin displayed reduced expression in papilloma and carcinomas. Abnormal cytoplasmic expression of E-cadherin and β-catenin were observed in papillomas and carcinoms, especially in invasive carcinomas. In summary, the loss or reduced expression of E-cadherin and β-catenin are closely related with tumor propagation. Abnormal cytoplasmic expression of E-cadherin and β-catenin are late events favoring tumor progression in superficial type to invasive form in rat BBN-induced bladder cancer. The present study demonstrates that E-cadherin and β-catenin may play an important role in bladder carcinogenesis.
Polyethylene glycol 용액(Colyte^(R))을 복용한 후 발생한 Boerhaave 증후군 1예
이관행,기승석,김인숙,김민정,박인호,장세중,하지수,김응수 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3
Spontaneous esophageal rupture (Boerhaave's syndrome) is a rare case that require early diagnosis and treatment because of its high mortality. The oral administration of osmotically balanced polyethylene-glycol-based electrolyte preparation is a commonly prescribed preparation for cleansing in patients undergoing colonoscopy. Nausea, vomiting and abdominal pain are frequently seen, but serious adverse reactions are rare. Esophageal rupture secondary to severe vomiting, which occurred during colonoscopy preparation using polyethylene gIycoI(PEG) electrolyte solution is extremely rare and only few cases have been published in the literature. We report a case of spontaneous esophageal rupture after routine administration of the PEG before colonoscopy. 대장 정결을목적으로 PEG 사용 후 아주 드물게 발생하는 Boerhaave 증후군 1예를 경험하였기에 보고하는 바이다.