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Խ
Ƹٿ
ڿ
۸ȭ




±ױ
λ̶
TVû

갭ڷ
 
 븶 ѹα
 
 Ÿ
 
ϵ ϴ..
 
 
 ǽü, ,
 ~!! ϼ^^
갭Ǽ Ȩ 湮ֽ մϴ.
۵ ּ~



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۾      2013-01-11 10:4 (ȸ : 32768)
     


Ͽ Ͽ ɷ ̴. ӿ 帧 ū Ѵ.
ħ, ϸ ٸ 鵵 ɸ Ѵ.

Ÿ ָӴϸ Ǹ ָӴϰ ༺ Ұ ǰ ڰ ħ ȴ.
ָӴϸ ıؼ 뽺 ϸ ȣ ð װ Ѵ Ͽ ܼ ϰ ̴ ΰ

Լ ش. 迬 Լ Ǻθ Ͽ Ǿ Լ, , ո, , Ų. ĵ


迬 ϸ Ѵ. ׸Ͽ Ѻκ װ ϸ 帶 Ų.
ž
̾Ͼ ׼ȯ ָ Ѽ ̷ Ǹ κ ߶󳻾 Ѵ.ž ̾Ͼ ׼ȯ ʾƼ

Ŀ .
а ưȭ Ų.
̰ų ݽźҼ ǰѴ
ġƺ
ġƿ ո ̻





߻ϸ, ۵Ǵ й ߻ ֽϴ.
ܺο Ĺ ϴ ٰ ̶ 꼺 ȭ ڱؿ Ǿ ֱ ˾̳ ߻ϱ ϴ. ϰ ϴµ Ϲ ̶ ϸ ü 95% ̻ ϴ մϴ.
߻ϰ, Ǽ Ͽ ַ ϸ 2% մϴ. ħ ̿ Ŀ ũ ϰ մϴ.
ηκ , , , 帷,帷 ̷ ֽϴ. Ͽ հ ִ ٸ ⿡ ħϰ ˴ϴ.
ʱ⿡ Ǵ 츦 ̶ ϸ, 쿡 ȯ ĵ ϴ. ݸ Ǵ ̻ հ ħϿ ϡ̶ ϸ ̴ ġ Ŀ ɼ Ŀϴ.



ֱ 迡 ϸ ѱ ϴ 5~6 ̸, Ư ѱ̳ Ϻ 20% ̻ Դϴ. ̿ ѱ, Ϻ ƽþƿ ̳ ̶⺸, ߻ ߿ Ȱ ȯ , Ư ĻȰ ̿ ˴ϴ. ̿ ظ ִ δ ̱ ̹ΰ Ϻ̳ ̱ 2~3 ߻ ߻ ξ ̱ ֹ ߻ ̰ ִ ֽϴ.
Ȯ ʾ ߻ ̴ δ Ľ , ︮ڹ Ϸθ ֽϴ.

Ϲ ʱ⿡ 찡 κ̸, ִٰ ϴ Ͽ ణ ȭҷ̳ 󺹺ΰ Դϴ. Ա йο ŰⰡ ų ٷ 並 ϰų  κ ġ ô Ÿ ֽϴ. ̿ Ͽ, ο Ĺ Ǵµ ָ ޱ Ʒ κп Ĺ ׿ 󺹺ο ߾а ϰ, ð 䰡 Ͼ Կ 밡 찡 ϴ.




Ǹ 밳 Ը ü ϰ Ǹ, 󺹺ο ̳ , ظ , Ⱑ ǿ Ұ ˴ϴ. Ŀ  ָ ްų Ĺ ΰ ظ ȭҷ̳ Ļ ظ, Ʈ, Ŀ Ÿ ֽϴ. δ κп Ȥ ⵵ ϸ, ִ ̳ ְ, ̷ Ͽ ȸ â鼭 Ÿ ˴ϴ.





뺯 Ĺ ü ߾Ϲ ԵǾ ֽϴ. ȭǰ Ĺ ⸦ ϴ ̷ طο 鿡 ȸ ֽϴ.
Ϲ Ⱓ Ģ , п, , ɷ Ҹ ϰ ˴ϴ. ̷ ȭ Ͼ 츦 Ȥ ̶ մϴ.  κ ̶ ν ̴ ֺ ħؼ ʽϴ. ׷ Ǽ 쿡 ļӵ ֺ ħϿ ı޵Ǿ ο ⿡ Ű ֽϴ. ̸ ̶̾ մϴ.
߻ϴ (, Ⱦ, , ) , ׸ ׹ · з ִµ, 80% 忡 ߻˴ϴ. ̿ο ϼ ̳ ѵ 츦 ̶ θ ̺ ħ 츦 ༺ ̶ θϴ





ٸ ⿡ ź¼ Ȯ强 ʰ Ÿϴ. ڰ ϴ. ߻, ũ, պ Ÿ ֽϴ. Ư غ , ̸ ̸ 빰 ٸ ġ ټҰ ̸ Դϴ.



̶ ϴ Ϲ ߻ϴ 찡 90% ̻Դϴ. ѵǾ ߰ߵDZ⵵ Ǹ ݴ Ӹ ƴ϶ ļ̳ Ͽ , , ν, , , ô ¸ ̵ ֽϴ.
Ͽ ִµ, ũ Ҽ(small cell)ϰ Ҽ (non-small cell) зմϴ.
Ҽ̶ Ҽ ƴ  θ , ̷ зϴ ӵ, ġ , , ׸ ġ ٸ Դϴ. Ҽ ü 3/4, Ҽ 1/4 ϰ ֽϴ.



ȯڰ 湮 쿡 ̹ Ǿ ִ 찡 ϴ. Ϲ δ ó ʴ ħ̳ , ȣ Ÿ Ҹ(õ), , , , ̳ ֽϴ.









-Ű-
ϼü
ϼü̶ ϼü Դϴ. ϼü ũ ΰ غκ  ִ ;Ű̶ ǫ  ִµ, ϼü 츮 ȣ ϴ ߱Դϴ. ϼü δ 繰 ʿ ýŰ ϸ鼭 ¿ ȱ ֽϴ. ϼü ߿ (浿) ȱ ̴ Ű ϴ. ϼü κ ϴ , Ŀ κ , ȣ ߷μ ȣ кϰ ֽϴ. кǴ ȣ ߿ ߿ 5Դϴ.
ȣ
ҾƱ⿡ ⿡ ü մϴ.
Ѷƾ
Ŀ кŰ մϴ. ȣ ٷ кǴ ϴ ȿ ϴ.
ڱȣ
󼱿 ȣ кŰ մϴ. ʿ ȣԴϴ.
νڱȣ
νſ νȣ кŰ մϴ. ʿ ȣԴϴ.
ڱȣ
ڱȣ Ȳüڱȣ 2 ֽϴ. ȯ, Ҹ ϸ, ȣ к մϴ. ڿ ߿ ȣԴϴ.
Ŀ ȣ 2Դϴ.
̴ȣ
忡 ۿϿ Һ ̸, ʿ ȣԴϴ.
ڱüȣ
иÿ ڱ ŵϴ.
κ ϼü 缺μ ļӵ , ̿ ⿡ ϴ 年ϴ. 20-50 οԼ ߻ϸ ü 10% ϰ ֽϴ. ϼü ִ ;Ű αٿ ٸ , ΰε ϴٸ ׿ Ǵ ҾƳ ׸ Ͽ ֽʽÿ.
ϼü ȣ кϴ (ȣк ) ȣ к ʴ (ȣ к ) ֽϴ. ȣ к кϴ ȣ ⿡ پ ü ̻ ȣ к Ŀ ÷ַ Ÿ߰ߵ ֽϴ.Ÿ ϼü ߰ߵǸ ġ ִ Ȯ ϴ. Ŀų ֺ ߿ , Ű, ް Ǹ ϱⰡ , Ŀ 缱 ̳ ๰ġ 缱() ϰԵǴ 쵵 ֽϴ.  ȣк񼺼 ๰ġḦ õϱ⵵ մϴ. Ŀ ϼü 翡 йڵDZ ϸ ü ʿ ȣ ϰ Ǹ, ̷ ȣ ʿϰ ˴ϴ.

Ű汳
Ű汳(glioma)̶ ߻ϴ Ǽμ ߼ 50% ϰ ֽϴ. ϴ ¿ ( Ǽ ϸ ߼ 25% ), (߼ 2.5%), Ǽ(2.5%), ƶ (0.5%), (2.8%) з˴ϴ. Ϲ ֺ , 谡 Ȯ ʾ ϴ ƽϴ. ϱ ؼ Ŀ 缱̳ ȭп, 缱() ʿϰ ˴ϴ.(̼ ) ߻󵵴 10 10 ̸, ̳ ̱ ˴ϴ. Ű汳 50% ϴ, Դϴ. Ű汳 ߿ ε, Ǽ ũ 4ܰ ϴ. Ǽ 1ܰ Ҿ ҳ ߻ϴ , ״ ħ Ƿ ε ġ ֽϴ. 2ܰ ̻ δ ϴ 찡 , Ŀ 缱ġᳪ ׾ ȭп, 缱() ǽõ˴ϴ. Ư 4ܰ ߿ Ǽ μ ̶ Ҹ ֽϴ. μ ġϱ ȯ, δ κ ̳ ϹǷ 缱 ȭп ʼԴϴ.

ûŰ
Ű̶ Ű ѷμ Ű ִ Űʿ ߻ϴ Ű濡 ߻ϸ, · Ÿϴ. 幰 ǼŰ ֱ⵵ Ϲ 缺 μ, ִ 쿡 ġᰡ մϴ. 缼 ļӵ ̿ ϴ 幰 Ŀ Ŀ ϴ 쵵 ֽϴ. 缺 ߿ , ϼü ̾ ° , Ǽ ü 8% մϴ. Ÿ( 1.6) 30-60 ̿ ϴ.κʹ 12, ôκʹ 32 Ű ִµ, ΰ ô߰ θ ü ٴٸϴ. Ű κ ̵ Ű ,ô ͼ ο  ߻ϴµ, ʽŰ̳ ߻ϱ⵵ մϴ. Ű ߿ ûŰ(8Ű) ߻ϴ (70-80%), Ű, ȸŰ  ߻մϴ. Ű ǰ ûŰ̱ ⼭ ַ ûŰ ϵ ϰڽϴ.κ ϰ Ű ߰ߵǸ ġ Ȯ ϴ. ׷ Ŀų ֺ , Ű, ħϸ ϱⰡ պ߻ Ȯ ϴ. ֱٿ Ư 쿡 ٵ ̿ؼ ġϴ ߼Դϴ.

(Ҿ)
(Ҿ) () , ߻ ٸ , ΰ ٸϴ. κ ߻ϸ, ߻ չ ϰ ǰų(), ų (Ű渶), ϰ Ǵ () Ÿ, Ҿ ݼ ̻ ʿ ġϴ ҳ  ߻ϹǷ ô ؿ ߻ϱ ϴ. ׷ ӿ ü Ҿ ΰ ռ ֱ ΰ ũ , ܼ Ű θų ظ ̴ ̿ Ÿ ʱ⵵ մϴ. ҾƳ ҳ 缺 , 20% ϸ, δ Ǽ (13%), ļ (10%), õ ΰε̶ Ҹ 缺 (9%), Ǽ (4%) Դϴ.

()
翡 ߻ϴ ߼ ٸ ⿡ Űܿͼ ̼ ֽϴ. ߼ 翡 缺 Ǽ 2 缺 ̶, йؼ Ű ָ Ű , Ǽ ġᰡ 쵵 ϴ. ߻ α 10 10̶ մϴ. ߼ ߿ Ű汳 ߻ϴ Ű汳, ߼ 50% մϴ. Ű汳 Ű漼 Ű漼 , Ű漼 ̿ , ̳ Ҹ Ű漼 ϴ ϰ ֽϴ. Ű汳 ü Ǽ , ³ ڼϰ зǾ ֽϴ.
Ű汳 ߿ ߻󵵰 ݱ, Ҿ ҳ ַ ߻մϴ. Ҿ 缺 ġ ֽϴ. οԼ ߻ϴ 缺 Ǽ ֽϴ. ׷ 缺 ̶ ð Ǽȭϴ 찡 ֱ ʿ䰡 ֽϴ. Ű汳 ü 40% ϴµ Ű汳 ߿ Ǽ 45-65 Լ ߻ϴ ſ ġϱ Դϴ. Ű汳 ΰ ִ ߻ϴ Դϴ. ܿ ȣ ϼü ϼü, ûŰ濡 Ű ֽϴ. ߼ ΰ ҿ , ٸ ϴ ſ 年ϴ. ׷ ٸ ⿡ ϴ ߻մϴ. ̰ ̼ ̶ մϴ. Ư ϴ , , , Դϴ. ׸ ̼ ߼ ޸ ٹ߼ Ÿ 찡 ϸ, ѷΰ ִ ô ӿ ϼ ϴ ϵ ֽϴ.

-..ĵ-
εξϡ
εδ غ , ̴ (ȮϰԴ ) Ļ Ű, ΰ ϰ ֽϴ. ߻ϴ μ Ϳ ͼ ̶ Ҹ Դϴٸ ̰ ƴմϴ. Ƶ̵ ε ϴ ϴ ε, ̰͵ ƴմϴ. εξ ֺ ߻ϴ Ǽ մϴ. ε ̰ζ Ҹ, ̿ Ǵ ⱸ ֽϴ. εξϿ ƴ϶ Ϳ õ Ÿϴ.εξ 븸, ߱, ƽþ ߻ϸ 츮 󿡼 ȯԴϴ. 2.3:1 Լ 40뿡 60밡 ϴ. Ȥ 10뿡 30 ̿ ߻ϱ⵵ մϴ. δ 찡 ȭ Ǿ̰, Ǽ ϰ ֽϴ. ΰξϿ ִ ȭ Ǿ () 年ϴ.
εξ ߻ Ÿ- ̷ ̷ ϴ ƴѰ ϴ м ֽϴٸ Ȯ ˷ ʽϴ.
ĵξϡ
ĵδ 󿬰 ġϸ ڵ ڿ ϴ. ĵ 캸, ( ޷ִ Ѹ κ) ̾ ְ, ĵΰ, , , Ϻΰ , Ʒδ ̾ϴ. ¿ 󿬰 ߰ ణ Ʒ ġ ֽϴ. 밡 ִ κ ̶ Ҹµ ׺ , Ʒ Ϻζ θϴ. ĵ ʿ εζ Ҹ ̰ ĵ ̾ϴ. ĵδ ¿ κ 븦 Ű ߼ ̿ܿ, ĵ ü μ (⵵) Ȯϰ Ĺ ԵǴ ֽϴ. ĵξ Ǹ ̵ ĵ ذ ʷ˴ϴ.
ĵξ 60 ̻ ɿ ߻ ̸, ߻ α 10 3 Դϴ. 10:1μ Լ е Ư¡Դϴ. ĵξ ֿ ڴ Դϴ. ĵξϿ ɸ ȯ 90%̸̻ ݵ ĵξ ߾ ϴµ, Ư ߻ϴ ߾Ͽ ϰ ֽϴ.
() ߻ϴ 60-65% ϸ, 25-30%, ϴ 1-2% ſ ϴ. ĵ ִ Ƿ , 븸 Ų Ƿ ֽϴ. ĵξ Ǿε, 質 ڱ ־ 󵵰 ϸ, ̻ ߻ ʷѴٰ ǰ ֽϴ.ĵξϵ ٸ ϰ ߰ ſ ߿մϴ. ĵξ ü ġ 70% ΰξ ߿ ġ , ⿡ ߰ϸ Ҹ 鼭 ġ ֽϴ.

--

伱 ̶ Ҹ ִµ, δ ߾ӿ , , ʿ ִ Դϴ. 츮 ״ ͼ Դϴٸ, ¾ƿ 鿪 ϴ ߿ մϴ. ׷ Ǹ ġ ȭ˴ϴ. 伱 ȭ 伱 ߻ϴ Դϴ. 伱 ڰ鿪ȯ̶ Ҹ 鿪̻ DZ⵵ ϴµ, ǥ ٷ ϵǴ ٹԴϴ.伱 Ǹ õõ ϸ, ̰ Ͼ 쵵 年ϴ. ׷ Ǹ , , ħϰų, ̶ Ͽ 䰭 Ѹ ϴ. 幰 伱 ߿ Ǽ ִµ, ̵ 伱̶ ҷ ϰ ֽϴ. 伱 30 ̻ οԼ ߻ϸ ̴ ϴ. 伱 幮 ȯԴϴ. ҾƿԼ ߻ϴ 年ϴ. ο ؼ Ȯϰ ˷ ʽϴ. տ 鿪̻ õ ٹ, , α׷ պϱ⵵ Ѵٰ ˷ ֽϴ.


,, 丷,,ɸ ο ֽϴ. ̵ ǥ ִ ǡμ, ǿ ߻ ̶ մϴ. ߻ 丷, , ɸ ֽϴ. Ǽ Ͱ 缺 ֽϴ. Ǽ Ϳ Ҽ (  ϴ ) ̸ (а 丷̳ ڶ ) ֽϴ. 缺 ҼԴϴ. Ǽ 幮 Դϴٸ, ϴ ٰ ˷ ֽϴ. ſ 幮 μ, Ǽ丷 Ͽ 󵵰 1% Դϴ.

ϡ
3° Դϴ. ų 2 Ͽ ɸϴ. Ͽ ɸ ų ݾ ð ʾ 翡 츮󿡼 ̶ ǰ ֽϴ. θ ߽ 15-20 Ǿ ֽϴ. ҿ ҿ ̶ Ҹ Ǿ ֽϴ. 90% ߻ Դϴ. ҿ ߻ϴ 5-10% ̸ ҿ̶ Ҹϴ. , ҿ ̰ ˻ϸ ˴ϴ. ܿ ϡ̶ Ҹ Ư ֽϴٸ, ״ ʽϴ. Ͽ ɸ ߻ 100 1̸ 50-60 ãƺ ֽϴ.ģ̳ ڸ ߿ Ͽ ɸ ִ 쿡 Ͽ ɸ 輺 ణ ϴ. Įθ Ļ, Ļ縦 ϴ ̳ ʰ , 濬 , ڳ ų , 꿬 輺 ٰ մϴ.ϵ ٸ ϰ ⿡ ߰ϸ ̳ 缱ġḦ ġ ֽϴ. ñ⿡ ߰ߵ 쿡 Ŀ ȣ̳ ȭп ݳ⿡ 5 ǽմϴ. ó ġḦ ̶ θϴ. 濡 ״ ġصΰ Ǹ Ŀ, ܵ ؼ װ ǰų, ۿ Ǻγ ˴ϴ. ׸ ϼ װ 帧 Ÿ , , , ָ ִ ϰ Ǿ ϴ. ̰ ̶ ϸ ̿ ¸ ༺ϡ̶ θϴ. 쿡 ̶ θ, ϡ ٸϴ. Ŀ ̰ Ͼų κп ϴ 쵵 ֽϴ. ̿ ¸ ϡ̶ θϴ. ̶ ؼ ݵ ߴ ̳ ݴ 濡 ͸ ǹϴ ƴϸ 󿡼 ϴ¡쵵 ֽϴ. ϰ 10 Ѿµ ϴ 쵵 ֽϴ. ༺ , ϼ ɼ ٰ ֽϴ. ߿ 100 2-3 ݴ 濡 Ƿ, Ư ģ̳ ڸŰ Ͽ ɸ ǰ ʿմϴ.
ϡ
(1)
ȣ ߿ μ , , ĵ, ̷ ݵ̶ κ ̿ ΰ ¿쿡 ϳ ִµ, , Ҹϴ. ̶ Ҹ κ ̷ (, ߿, Ͽ) 󺸴 ణ ۰ 󿱰 Ͽ ϴ. Ҹ ϰ ̻ȭźҸ ϴ մϴ. ԰ ڸ ͼ εΡĵθ , Ҹ ¿ ¿ ϴ. ӿ Ҹ ٶ ó µ, ҿ ̻ȭźҸ ȯϴ () Ǿ ֽϴ.
(2) ߻
, , Ұ ϰ ϴ ߻մϴ. ֱٿ ߻ ̻ 迡 ̾߱Ⱑ ϴٸ, ȭ (ϰ ϴ Ǽ ϴ )ϴ ؼ Ȯ 𸣰 ִ Դϴ. ̳ ıϰ ϸ鼭 ٸ մϴ. ٸ ̶ θϴ.
(3)
Ͽ ɸ ϰ ִ ߼Դϴ.
츮󿡼 ߻ ڿ 3, ڿ 5 ϰ , 3μ ü 19.4%, 11.8% Ÿ ֽϴ. 5(ġᰳ κ 5Ⱓ ϴ ȯ ) 25-30% մϴ.

-ȭ-

ĵϡ
츮󿡼 ϻ 7 ϴ μ 10 3Դϴ. 50 ĺ ö󰥼 ް ϸ, 60뿡 ˴ϴ. ó ڿԼ 6:1 Լ Ÿϴ. ĵ ߻()μ ȯڰ ߿ϸ, , , ſ ϴ ߻ ִٰ ˷ ֽϴ. Ư θ ô пԼ Ÿϴ.ĵ ۿδ ַ Կ Ĺ Ͽ Ĺ ϴ ϴ ۿ 2 ֽϴ. ̵ ĵ ϴ Ű ڽ ν ϵ Ǿ ֽϴ.ĵ, εηκ й̶ Ҹ Ա ϴ, 30-40cm, 2-3cm, β 4mm μ, Ĺ մϴ. ĵ ĵ ִ ߻ϸ, ߻ϴ  ̳ Ʒ 3 1Դϴ. ĵ , 뵿, ߿ ֱ , Ǿ ĵ հ Ǹ ̵ ϴ. ĵ dzϹǷ, ¿ ϼ ̳ 帧 Ÿ ̳ , , , ˴ϴ.()

ϡ
ȭ, ǰ Ĺ ӹ ̸, ̰ Ͽ 뺯 ϴ. ִ ̱⵵ մϴ. ̴ 2m̰, , ׹ ̷ϴ. ִ ̸ 𼭳 , Դϴ.츮󿡼 ߻ ſ ϰ ϰ ֽϴ. Ͽ , , , Ͽ ̾ ׹° ϰ , 쵵 մϴ. Ͽ ɸ 󵵴 ϴ. 50밡 , 60밡 ڸ հ ֽϴ. ̳ ̱ , ߻ 10  ֽϴ. 5%-10% 󵵷 30 Լ ߻ϸ, ó Ÿ ̿ ߻ϴ ֱ⵵ մϴ. ߻ ġ δ ںٵ ȯ ũٰ ǰ ֽϴ. ĻȰ ް ȭ, Ư ̳ ܹ ټ밡 ̶ մϴ. ׷ 5% ο ߻Ѵٰ ˷ ֽϴ. Ͽ ɸ ڷμ 1) ɸ ִ , 2) ߿ Ͽ ɸ ִ , 3) Ⱓ ˾缺忰 ô޸ ִ , 4) ġ ġ翡 ɸ ǰ ֽϴ. ð е ˻翡 󵵷 ߰ߵ˴ϴ. Ǵ Ϻ ̸ κ ϱ ʽϴ. ߰ߵ 쿡, Ǹ ãư ũ , ˻ϰ, ð óġ ޾ƾ մϴ. ̸ ñ⿡ ߰ߵǸ ð ܰ ġ ֽϴ. ణ Ǿ ̳ (̰ ̶ θϴ.)ߴٰ ϴ ñ ܰ ġ ֽϴ. ٽ ܰ ȿԴϴ. ׷ ߰ ʾ , , ̳ ϱ ̰ Ͼϴ. ̷ ñ⿡ Բ 缱̳ ȭп ǽõ˴ϴ. Ŀ ϴ 쵵 ֽϴ. Ŀ (3-4 ) ϱ ˻縦 ޾ƾ մϴ. , , ϱ ̸, ϱ⵵ մϴ. ٸ ϰ ޸ ñ⿡ ߰ߵǸ, ٽ Ҹ Ͽ ġ ֽϴ. 80%̻ 3 ̳ ߰ߵ˴ϴ. 5 ̳ ʴ ġ ˴ϴ.


-..-
ϡ
800-1,200g ü ִ ̸ ̰ ༺ ߻ϴµ, ϰ 95% մϴ. 5% Ҿ (), ο ,ȥվ, ̺ȭ, , īó̵ 幮 ͵ ֽϴ. κ(90%) Դϴ. 츮 Ͽ ڼ 1 , 2 , 3 ̸, ߻ 1/4Դϴ. 뷫 55Դϴ. κ 40-60 ̿ ȯ ɸ ˴ϴ. Ȱ ϴ, 麸 ϴ ȯμ ȸ, ε ǰ ֽϴ. ̰ 츮󿡼 κ ϴ Ͽ ؼ ϵ ϰڽϴ.
2. ϰ ̷
Ը ֽϴٸ, 츮 ϸ κ ̷ ̶ Ǿϴ. ̷ A, B, C, D, E, F , ֱٿ G ߰ߵǾϴ. 󳪶󿡼 ǰִ A, B, C ε ϰ Ǵ B, C Դϴ. B, C̷ ˻簡 ϰ 1990 迡 ϸ, е 85% B Ǵ C ̷ Ǿ ־ϴ.̵ B, C̷ 󰣼 ۿϿ ̸ ȭŲٰ ǰ ֽϴ. 츮 쿡 ̷ Ͽ ɸ 豺 ޵˴ϴ.̷ Ǹ κ ̶ ɸ ˴ϴ. 󿡴 ű°, Ŀ, Һ (Һ ȫó £ ), ư Ȳ ֽϴ. ׷ ڰδ ƹ ̻ ¡ ڿ ġDZ⵵ մϴ. ̷ ü ħ (̰ Ǿ١ մϴ.)ϴ ͸ ݵ ɸ ƴմϴ. ̷ ǰ ü ϸ鼭 ƹ ü ظ , ̷ 쫒ܳ ä ü ӹ¡Ȳ ֱ⵵ մϴ. ó ü ̷ ϰ 鼭 ǰ ǰ ڡ մϴ.
̷ ο ֽϴ.

ϡ
忡 ߻ ̶ մϴ. ڿ ִ 20cm μ, 忡 ѷ ο ϰ ֽϴ. ҷ ϰ ִ Ӹκ̶ ϰ ð κ κ̶ մϴ. Ӹκа κ ̿ ִ 31 Ǵ ũ κ κ̶ θϴ. ֵ ȭ (ܺк) ϴ ν ȣ (к)Դϴ. ȭ ̶ Ҹ ӿ ׹ó ϴ ̶ ϴ ٶ к˴ϴ. ٶ ӿ ̶ ϳ ̸, 忡 Ӹκ Ѵ շ , ζ ֽϴ. ׷ 忡 忡 Բ 귯 ˴ϴ. 忡 ȣ ߴ ν̳ ̴ ۷ī μ, ̵ к˴ϴ. 忡 ߻ϴ 90%̻ ܺк , Ư ϴ ߻ϴµ ̰ ̶ մϴ. ̶ ϸ ϴ Դϴ. к ߻ϴ 鳻к翡 ؼ ׸ ֽʽÿ.Ե ܰ ġ ƽϴ.  , , , , , 㳶,  ѷο ֱ ߻ص ߰ϱⰡ ſ ƽϴ.  Ͽ ɸ ؼ ˷ ϴ. ̸ ܰ迡 Ư¡ Ÿ ʽϴ. ̿ ̳ ó ߰ߵǴ ϴ. ̶ ˾ ̹ ʾ 찡 ϴ.  ġẸٵ ġ ϴ ̱߰  ϸ ߰ ִ ǿ ǰ ֽϴ.
鳻к
ȭ кϴ ܺкɰ ȣ ϴ к ũ ֽϴ. ܺк ϴ ü 95% ϸ, к ϴ ϴ Ըѽμ ü 5% մϴ. Ըѽ ߻ϴ Ըѽ, Ǵ Ըѽ̶ Ҹϴ. ׷ ֱٿ Ըѽ ϴ к ԸѽӸ ƴ϶ ܺкɰ ǿ 漼 ̿ Ѵٴ ˷ , ǹ̿ 鳻к̶ Ҹ Ǿϴ. ̵ Ϲ ϴ ܺк ϴ ߻ϴ ϰ ˴ϴ.鳻к ӿ ȣ ϰ кϴ ɼ ȣ ʴ ɼ ϴ. ȣ ϰ кϴ 쿡 ȣ ü Ÿ ļ̶ θ, Ÿ ʴ ɼ翡 ؼ ļ̶ θϴ.̿ õ 幮 μ ٹ߼к̶ ֽϴ. ̰ Ǵ к ߻ϴ ȯμ, ٸ к (ϼü, ΰ ) Բ 忡 պDZ⵵ մϴ.

ϡ
μ, ӿ ϳ ̵ շϸ鼭 , κ ¿ (¿ ) ϳ շϰ ˴ϴ.  ̾ ܴ ϴ. ߻δ ܴ ׵ ¿ 踦 Ȯϰ ϴ. ܴ ̰ 8cm ٶ μ , , ߺ, Ϻδ 4 е˴ϴ. ܴ ߰ Ǿ 鼭 Ͻ Ͽ ϴ ָӴϰ 㳶Դϴ. ̵ ܴ 㳶 Ʋ 㵵 θϴ. ߻ߴĿ ϰ ܴ µ, Ϲ ϡ̶ ϸ ܴ ߻ ŵϴ. μ () Բ ޵Ǵ ϴ. ߻ϴµ, 󿡴 ũ ħ(ȭ), , (,) ֽϴ. ħ ܴϿ ִ μ ߻ ũ ̷ ֺ ϴ.  () ϸ鼭 Ŀϴ.

㳶ϡ
к 귯 θ 㵵 ϸ, 㳶̶ ϴ ٶ Ű Ͽ Ͻ δ ָӴ κ 㳶Դϴ. 㳶 㳶 㳶̶ մϴ. 㳶 60뿡Լ , 1:2 1:3 Լ Դϴ.㳶 㼮 պϸ 󵵴 翡 60%ķ ǰ ֽϴ. ó 㳶ϰ 㼮 պ ٴ ǿ 㼮  ߾Ͽ ϴ ̶ ϴ. ׷ 㳶 ȯ 㼮 츮󿡼 30% Ұϰ, 㼮ȯڰ 㳶Ͽ ɸ Ȯ 5%̸ ʽϴ. 㼮 üٵ 㼮 ȭ 㳶 ߾Ͽ Ѵٰ ֽϴ. Ӹκп շϴµ, շ ̻ ִ 쿡 10-20% 󵵷 㳶 պѴٴ ˷ ־, շ̻ 㵵 ϴ ߾Ͽ ϳ ǰ ֽϴ.İ˻ ޿ 㳶 ߰ߵǴ ȸ ϰ Ǿϴ. 㳶 ߿ Ǽ 㳶 ̿ܿ ̳ 缺 ãƺ ֽϴ. 㳶 㳶̶ Ͻ ʿ ϴٸ, ׷ Ǹ Ȯ ޴ ߿մϴ.

-񴢱-
ϡ
̶ 濡 ߻ϴ 幮 μ, ߿ ϴ 1% ۿ ʽϴ. κ ͵ο ߻ϸ Լ ߻ϴ ֽϴ. 60-70뿡 ϴ. ֱ ʷθ̷ õȴٴ ָް ֽϴ.

ſ, ϡ
¿ 忡 Һ Ź迡 ſ, ̰ ̾ 귯 汤 ˴ϴ. 财ÿ 汤 䵵 Һ ɴϴ. ߿ ſ οζ մϴ. ſ, 汤, 䵵 Ϻδ Ƕ Ҹ Ǿ ֽϴ. ο ߻ϴ ַ Ǿ̶ Ҹ Դϴ. ſ-ϵ κ Ǿ 񴢱 ߿ 幮 ̸ ߻󵵴 α10 0.1 0.1Դϴ.

żϡ
10cm5cm3cm ũ μ Ȯ Ʒ ¿ ʿ , ɷ  մϴ. ȣ̳ ȣ ϱ⵵ մϴ. 忡 ߻ϴ 翡 οԼ ߻ϴ żϰ ҾƿԼ ߻ϴ Wilms ֽϴ. ſ 幮 δ ֽϴ. 忡 缺 ߻ϱ⵵ մϴ. 󵵰 Դϴ. 밳 ġ ξ ϴٸ 10cm ̻ Ŀ Ǹ ־ ġ ˴ϴ. ⼭ οԼ ߻ϴ żϿ 帮 ϰڽϴ.
ż ߻󵵴 α10 2.5 Դϴ. 23 1μ Լ ϴ. 񴢱 Ǽ ߿ , 汤 ϴ.ż ߻ 󵵰 ִٰ ˷ ֽϴ. ؼ Ǿ 鿡Լ Ͼ ִ ̻ мν ߺ 巡, Ͽ ɸ ְ Ǿϴ. ׷ ںм , װͰ 賻 ߻ ϰ ܰԴϴ. Ϲ ڷδ , 漷뷮 ֽϴ. ȯڿԼ ߻󵵰 ٴ ǵ ָǰ ֽϴ.

ϡ
(1)
̶ ӿ ϼ ߰ߵǴ Դϴ. Ը ִ μ Ϻθ ϴ. ̰ ġ (Ϻο , ϴ ϳ) ڿ ġϸ, 汤 Ʒ 鼭 忡 ֽϴ. 汤 䵵 ѷ ε ϰ, 㿭ſ ϰ ֽϴ.
(2)
̱̳ ϻ 20% ϴ Դϴٸ, 츮󿡼 1.2% 󵵰 ϴ. ׷ ĻȰ ȭ ȭȸ ࿡ 󵵴 ϴ ߼Դϴ. ɺ 45 幰, 50ĺ ɼ 󵵰 70뿡 100, 80̻󿡼 200 ˴ϴ. ̶ Դϴ.

汤ϡ
汤 ִ μ, 忡 Һ ſ, ݵ Ŀ Ͻ Ǵ ָӴ մϴ. Һ ׿ 汤 þ Ǹ Ǹ ǰ 财 ϴµ, Ͽ 汤 Һ մϴ. 汤 ǥ Ƕ Ҹ Ƿ ༺ پٴ Ư¡Դϴ. 汤 ǰ ȭϿ ߻ϴµ, δ Ǿ ü 90% ϰ ֽϴ. α 10 ų 6-7 汤Ͽ ɸϴ. ״ ƴ ظ ణ ϴ Դϴ. 3 մϴ. κ 40̻󿡼 ߻, ֱٿ Լ ߻󵵰 ϰ ֽϴ. ڰ 汤Ͽ ɸ Ȯ 2-3 մϴ. ȭоǰ̳ Ḧ ϴ 쵵 ߺ ٰ ˷ ֽϴ. 汤 ũ 3 ϴ. ġ ɾ߳ ó ǥ (ξ̶ մϴ), 汤 Ƣ ֽϴ. Ҵ 汤 ӹ ִ 찡 (ǥ缺), 幰 ħϰų մϴ. (ϰų ħ ʽϴ.) ʹ ޸ ǥ ε巯 (ξ), Ȥó Ұ Ϳ 汤 Ʒ Ͽ ξ ̴ ͱ پմϴ. 汤 Ͽ ħϱ Ѵٴ Ư¡ ֽϴ.
汤 ǥ鿡 Ÿ , Ǽ ϼ 汤 ϰ ִ (dz)Դϴ. ʱ ̱ ġ ä ״ θ ħ ϴ. ϵ Ư ٸ ,  翬 ġ ޶ ˴ϴ. 汤 汤 ߻ϴ ִµٰ, Һ 帧 ̳ ſ쿡 ϰ ִ 찡 Ƿ Ǹ մϴ.

-ΰ-
ξϡ
ξ ο ߻ϴ , ΰ 1~2% ϴ 幮 Դϴ. ξ κ 50̻󿡼 ߻ϴµ, 40 ɸ ϵ ֽϴ.

ڱðξϡ
ڱ ü ϰ ֽϴ. üδ ¾ư κ̰, Ʒ ̾ κ ø, Ǿ ֽϴ. κ ε, ʿ Ϻΰ Դϴ. ߾ӿ ڱ ϴ Ա Ա ڱñ մϴ. ڱþϿ, ڱðξϰ ڱüξ() ֽϴ.ڱðξ ڱñ αٿ ߻ϴ ϴ. ϻ ΰ ؼ κ ϰų ˻ؾ äϴ մϴ. ߰ ٸ Ͽ ϴ. õõ , ϼ ڱðο ߰ߵDZ ʱ⿡, ƴ ߰ߵ˴ϴ. θ ܰ ֽϴ.

ڱüξϡ
ڱþ ΰ ߿ ̸ ڱðξϰ ڱüξ ϴ. ڱó̶ Ҹ ڱüξ ¾Ƹ ڶ ϴ ڱ ָӴ ʿ ִ ڱó ϼ ȯԴϴ. 츮󿡼 ڱüξ ߻ ̾µ, ֱٿ ϴ ߼ ̰ ֽϴ. ڱó ȣϴ ߻Ѵٰ ˷ ִµ, ֽ ϴ ĻȰ ٲ ֱ ϴ ƴұ ϰ ǰ ֽϴ. ڱ Ǹ ǫ Ǵµ, ڱüξ ڱ ߻ϴ ȯ ڱ ٸ Դϴ. ȯ ؼ ڱ׸ ֽʽÿ.
(ڱó)
ڱ
ڱ ڱðο ʿ ִ ڱüη ϴ. ׸ ڱüο Ǽ翡 ̿ܿ ̶ ֽϴ. ڱüο 缺翡 ڱñ ֽϴ. ڱñ 缺̶ Ϳ ֵ ʽϴ. ׷ ڱ ϱⰡ , ڱñ̶ ϰ ־µ ˰ ڱ̾ٴ 찡 ֽϴ. ׷ ڱñ ϰ ٷ մϴ.ڱ ΰ ߿ 幮 ȯ, ڱüξ 2-5% մϴ. ڱ ڱðκ üο ߻ϸ κ ϴ. Ͽ ɸ Ȯ 豺̶ մϴ. ڱó ȣ , , , 索 豺, ڱ ̵ ȣ , ȯ , 豺 Ȯϰ ľ ϰ ֽϴ. ſ 缱 ִ Լ ߻Ѵٴ ˷ ֽϴ.

ȯ
ӽ ϸ ڱÿ ¹ ϴ. ¹ ʿ 밡 ־ ¾ƿ Ǿ ֽϴ. ¹ Ҹ ٶ Ǿ ִµ, ̰ ڱ Ǿ ֽϴ. ¾ƴ ó ϸ, ̰ Ӵ κ ҿ ޽ϴ. ¾ư ƿ ڶ ʰų װ Ǹ ¹ Ǿ ϰų ϴ ε, ڱ ȯ , ȯ̶ θϴ.

ϡ
߿ ſ 幮 ȯμ 󵵴 ⿡ ߻ϴ 1% ϴµ ʽϴ. ڱðο θ ϴ Դϴ. ǥ ִµ ߻Ͽ ϰ Ǹ, ǥ ų Ʒ Ǹ, ư α ⵵ (ħ) մϴ. Ͽ Ǿϰ ̶ ֽϴ. κ(80-90%) Ǿ̸ Ϲ 50 60 Լ ߻մϴ. ٸ ϰ ϵ ߰߰ ġᰡ ߿մϴ. ڰ ִ 쿡 ٷ ǻ ޾ƺ ϴ.
Ҿϡ
Ҵ հ ũ Ÿ μ ڱ ʿ ϳ ֽϴ. ̰ ļ ڰ ǰ ˴ϴ. ҿ ֱ ȣ кմϴ.ҿ 85% 缺Դϴ. ߻ϴ ũ е˴ϴ. ǥ ִ Ǽ, ̿ 缺 Ǽ(), 缺 Ǽ ߰ (輺) ֽϴ. Ǽ ٽ 5 µ ٸ Ư ϰ ֽϴ. Ǽ Ҿ 90% ϰ ֽϴ.Ҿ ߿ ٿ Ǵ 輼 ߻ϴ Դϴ. ̿ ؼ 輼 ׸񿡼 մϴ.
ѱ ȯ Ȯϰ ľǵ , ҾϿ ɸ 1⿡ 1,300 ̶ ǰ ֽϴ.
Ͽ ɸ Ȯ '豺'̶ մϴ. ѱ ҾϿ ɸ Ȯ ҾϿ ɸ Ȯ , ̴ پ ֽϴ. ģ̳ ڸŰ ҾϿ ɸ 찡 ׷ 쿡 ҾϿ ɸ Ȯ 3 ٰ ˷ ֽϴ.Ҵ ӿ ־ ܵ ʱ⿡ ƹ ڰ , ȯ 2/3̻ ̰ Ͼ ¿ ó 湮ϰ ˴ϴ. ҾϿ Ͼ ̴ Դϴ. ϼ ǥ鿡 ġ Ѹ Ƿ ''̶ Ҹ ֽϴ. ַ Ͼµ, ҿ ָ Ⱦݸ̶ Ÿϴ. Ǹ ̰ ˴ϴ. Ⱦݸ ٽ 䰭 Ǹ Դϴ.
̵ Ͼϴ. 켱 ĺ̶ ϴ δ뵿 װ, ο ε ˴ϴ. ̰ Ͼ Ҿ ġ , ¿ ġḦ ϴ 쿡 δ ˴ϴ. 翡 ؼ Ŀ ׾ ̿ ġḦ ǽմϴ.

ҹ輼
ҹ輼 幮 ȯε, 缺 Ǽ, ߰ ġϴ Ǽ ϴ. Ư¡ Լ ߻Ѵٴ , ҿ ؼ ߻ϴ ٴ , Ǽ ֱٿ ߵ ȭп ȿ ִٴ Դϴ.
Ǽҹ輼翡 ؼ ϰڽϴ. Ҵ ̸ ʿ , ڱ ¿쿡 ϳ ֽϴ. ڸ Ǽμ, ǥ() Ҿϰ ٸϴ.('Ҿ' ׸ ֽʽÿ.)
׸ 뷫 45 濡 ߻ϴ dz ϰ 10, 20뿡Լ 幮 Դϴ.

-.-
ȣŲ ()
Ǽ ȭ Ǽμ װų ˴ϴ. ߿ ̶ ϴ ȭ Ǽ , Ǽ ϴ Ұ ַ װ ( ӿ ִ ) Ǽ ٸϴ. Ǽ ȣŲ ȣŲ ֽϴ. Ϻ Ǽ 10% ̸ κ ȣŲԴϴ.
ȣŲ ()
ϰ ִ ȭ(Ǽȭ)Ǿ Ǽ Ǽ̶ θϴ. Ǽ ȣŲ ȣŲ ũ µ, 缼 迭 Ұ߿ Ͽ зǾ ֽϴ.
ı
, ϴ , ̴ , ߰ ϴ ׼ Ǿ ֽϴ. ̳ ٿ Ǵ ( ) ϴ. ¿ ߿ , , Ǿ ɰ ϰ ˴ϴ.Ϲ ̶, а ٿ Ǵ  ʷǾ, Ϻ ϰų ٸ ϰ Ǵ ¸ մϴ. ߻ ī Ȯ Ȯε ʰ ֽϴ. øǾ Ͼ ̶ ǰ ֽϴ.ı̶ ӿ ִ ڿ ڰ ִ ü ̻󿡼 ʷȴٴ ˷ ֽϴ. ü Ǵ ణ ̻ Ŵ ſ õõ ü ׼ ü ̻ Ǵ ¶ ǰ ֽϴ.  ϰ ǰ ü ׼ DZ ü̻ ʷ˴ϴ.ı '' Ҹų ġ ٸ ȿ ϴ κҸ ޵Ǿ Խϴ. ϸ ܰ谡 ־ Ƶ ֽϴ. 50̻ ڿԼ ߻ϸ, Ϻ α ȭ ϴ ̶ ǰ ֽϴ. ׷ %̱ ̿Լ ߻մϴ. ׾ ๰ġᳪ 缱ġḦ 쿡 2 ı ߻ ֽϴ. ı ٷ ޼ ȯǾ⵵ մϴ.
ٹ߼.
ȭ, Դϴ. ü ħ ̷ ̹ ϴ ۿ ܹ(ü) մϴ. ()ȭϴ ȯ ̶ մϴ. ɸ ȭ ϼ ü(Mܹ) ٷ Ǿ ߿ ˴ϴ. Ϻδ Һ ⵵ մϴ.翡 ִµ ˷ ִ ٹ߼Դϴ. ٹ߼ Ǵ Mܹ G, A, M, D, - з˴ϴ. ߽ɿ ִ (, , ) ȭ () ıϸ鼭 ϱ ų ϴ. ٹ߼ Լ Լ Դϴ. ɺ 󵵸 ϸ 70뿡 , 40 Ͽ ſ 2%Ͽ ʽϴ. ٹ߼ ߻󵵴 α 10 3-4 µ, ȭȸ Բ ѷ ֽϴ. ֱٿ ֹΰ̳ ǰ ȭ ˻ġ ̻ ߰ߵǾ а˻縦 ٹ߼ ˰ Ǵ ð ֽϴ.ȭ ̶ Ҹ, ̿ ϴ. Ⱓ ̵ Ϻδ ٹ߼ Ѵٴ ˷ ֽϴ. ۿ ũα۷κ̶ ֽϴ. ̰ IgM Mܹ ϴ Ư¡ ϸ ٹ߼ ڿԼ ߻ϰ 40 Ͽ 幰 Ÿϴ.

޼ ()
Ǵ ӿ 缼() ϴ Դϴ. ߽ɺο ִ Դϴ. Ϲ ӻ Ǵ ˻Ұ߿ ޼ з˴ϴ. ޼ ٽ ޼(޼) ޼ ũ ϴ. ޼ ҾƿԼ ߻մϴ.(ڼ 'ҾƱ޼) ׸ ֽʽÿ.) Ʊ ϴ, ߿ ׼(, , ) ȭ(̼ ϴ )Ǵ ϴ. ޼ ȭϴ Ʊ ȭ(ȭ) Դϴ. ޼ , Ư Ҹ ȭǾ Ʊ ȭϿ մϴ. ׼ Ǹ, ȭ Ʊ() ˴ϴ. ȭ Ʊ ȭ մϴ. () ׿ , پ, մϴ. Ϲ ׿ ȭ ϱ ĺ˴ϴ. װ˻翡 ̰ų ϴ ϵ ֽϴٸ, ̷ 쿡 ݵ ȮεǸ ִ 찡 Դϴ.

޼ ()
޼(acute lymphocytic leukemia Ǵ acute lymphoblastic leukemia : ALL)̶ Ϲ ' '̶ Ҹ ϳԴϴ. ־ ¿ ޼ ϴ. ϴ. ޼ Ǽȭ ̼ ϴ Ŀ Դϴ.׼ , ֽϴ. ¿ ɿ ٽ , ȣ߱, ȣ걸, ȣⱸ, ܱ ϴ. ׼ ϴ. ӿ ִ μ Դϴ. ׼ ӿ ɴϴ. ٸ մϴ. տ ̷ ο, ü մϴ. ŵϴ. ٶ , ̿ ִ Ǿ ֽϴ. 帣 ֽϴ. μ ſ Ǿ , Ư ܵ , , , , ݺο ֽϴ. ( 󺹺ο ִ ) 伱( ̸鿡 ִ ), ( ӿ ִ ) ϺԴϴ. װ ӿ ߰ߵ˴ϴ. ü Ҹ  հ ̷κ ݴϴ. ó , , ſ Ǿ 鼭 οϴ. Ǽȭǰ ӿ Ͽ ޼ ϴ ޼Դϴ. ޼ Ҿƺ α ɿ Ͼ, ַ ҾƿԼ ߻ϴ Դϴ. 10 Ѹ ߻մϴ. ̰ ̿ܿ Ǽ ֽϴٸ, ¿ ġ Ƽ ٸ ȯ̶ ˴ϴ.( Ǽ ؼ ׸ ֽʽÿ.) ޼ ΰ Ҿ ġ ٸϴ.(ҾƱ޼ ؼ ׸ ֽʽÿ.)޼ Ȯ ʽϴ. ڿ и ʽϴ.

T
T(adult T-cell leukemia-lymphoma : ATL) Ǽ ȣŲ Ư Դϴ.
()游(chronic lymphocytic leukemia : CLL) Ϲ '׾' Ҹ Դϴ. ִµ, ϴ. ̼ ϴ ϴ ޼ ϴ. ̵ ӿ ߻մϴ.(׼ , ؼ '', '޼' ׸ ֽʽÿ.) ӿ ϰ ° Դϴ. B T ϴ. , ,  ſ õõ Ͽ ˴ϴ.

-Ǻ-
Ǽ
(1) Ǽ ߻
Ǻο ߻ϴ Ǻξ(ǺξǼ) ִµ, Ǽ ϳμ Ǽ Դϴ. Ǻλ ѻҸ  Ǻμ Ʈ(melanocyte) ϴµ, Ǽ Ʈ Ǵ ݼ( ) Ǽȭ ̶ Ǿ , ܼ Ǵ 븶 Ҹ⵵ մϴ.
(2) Ǽ
ѱ ߻ Ȯ ǰ 500 Ǹ, 츮 ϴٰ Ǵ Ϻ ߻ 1000-1500 (α 10 1-1.5)̸ ظ ϴ ̰ ֽϴ. 48.7% ϴµ 51.3%, Լ ణ ϴ. ó ɿ 캸 0-9 0.3%, 10-19 1%, 20밡 3.1%, 30밡 8.7%, 40밡 16.1%, 50밡 17.3%, 60밡 23.1%, 70 ̻ 30.5%Դϴ. 19 Ͽ 20뿡 ݾ 40 ̻ Ǹ ްϰ þ ֽϴ. ֱٿ 70 ̻ ֽϴ.
߻ ߹ٴ 28.4% , ̾ ȸ 10.0%, Ƹ 8.7%, չ 7.1%, ü 6.6%, չٴ 6.3%, 6.0% Դϴ. Ǽ Ǻ 𿡼 ߻, ҿ Ű澲 ʴ ߹ٴڿ ߻Ѵٴ Ϳ ϼž մϴ.
̹ۿ Ǽ 幰 Ǻ ƴ϶ ߻մϴ. Ǽ Ⱥ, , ׹, , ĵ,  ߻մϴ.

ٻ
Ǻο ߻ϸ ַ Ǻη ħϴ ǺξǼ ǥ ȯԴϴ. T Ҹ ǼȭǾ Ǻο ϰ ˴ϴ. ߻ и ߻ 󵵵 ص ϴ. Ϲ 20 ߰ α⿡ ߺմϴ.

Ǻξϡ
(1) Ǻ ߻
Ǻδ ǥ鿡 ǥ, , ɺ ̶ κ ũ ֽϴ. ǥǴ µ, ̰ ǥ鿡 , , , ̶ Ҹϴ. ǥ ǿ ϰ ֽϴ. ǿ , Ű, (̶ մϴ.), , Ѽ, Ը ֽϴ. ̵ ϴ Ǽȭ Īؼ Ǻξϡ̶ θϴ.
߻󵵰 ͱ ϸ Ǻξ ſ پϱ , ⼭ 󵵰 ǥ Ǻξϰ, ؾ ϴ Ǻξ ǥdzϡ 帮ڽϴ. ǥ Ǻξ ϳμ Ǽ Ǽ ؼ õ ׸ Ͽ ֽʽÿ.
(2)ؾ ϴ
Ǻ ̻ ʹ ޸ Ƿ, Ǻξ ⿡ ߰ ɼ ٰ ֽϴ. ¾籤 (ڿܼ) ʹ ̴ ̳ 缱 뷮 Ǻ Ǻξ Ųٴ ˷ ֽϴ. ʳ ȭ ͳ ܻ , Ⱓ ɸ ݺ ( ҿ ݺ ν ٰ Ҵٰ ϴ ) Ǻξ ߻ϱ⵵ ϸ, ̳ ̶ ϰ ִ 쵵 ֽϴ. Ǻο ΰ ų ݱ ִ ڱ ޶ ϸ, ٴ÷ ų  ؼ ڱ ְų ڱ ġϷ , ⿡ Ǻΰǻ ޵ ϴ ߿մϴ.
2. Ǿ
Ǿ ǥ ߰ ϴ ϴ ߻ϴ μ, 츮󿡼 Ǻξ ϳԴϴ. Ȯ ߻󵵴 Ȯ ʽϴ

--
(Ҿ)
(Ǵ Ǽ)̶ ü ߻ Ǽ մϴ. Ȥ δ , Ǻθ , (), , , , , Ű ϰ ֽϴ. , ü, ĺ, ΰ ߻մϴ. 󵵴 幰 30 ̻ ֽϴ. Ҿ ߿ ȾԴϴ. ׹ۿ , Ű漶(ǼŰ), Ȱ, Ȱ, , Ǽ, һ󿬺, Ǽ ֽϴ. Ⱦ ؼ ׸ ֽʽÿ. ⼭ Ⱦ Ҿ ϵ ϰڽϴ. ߻ 翡 ټ ̰ ֽϴ. Ǽ ƿ ߻ϴ , ٸ ̰ ҾƿԼ ߻ϴ 찡 ϴ. ߻ ַ ߻ϴ ϵ ϰڽϴ.
(1) ( ߻) : Ȱ ٸ ߻ϸ ü ߻ϴ 쵵 ֽϴ.
(2) Ű漶(Ű濡 ߻) : , ٸ, ĺ, ü ַ ߻մϴ.
(3) Ȱ : ó ߻ϴµ и ʽϴ. ٸ ַ ߻ϸ ̾ , ü ߻մϴ.
(4) Ȱ ( ߻) : ĺ ü ߻մϴ.
(5) (濡 ߻) : ٸ , ĺ ߻մϴ.
(6) Ǽ( ߻) : , ٸ, ü, ΰο ߻մϴ.
(7) һ󿬺 : ߻ϴµ Ȯ ʽϴ. ٸ ַ ߻ϸ ̾ , ΰ ߻մϴ.
(8) Ǽ( ߻) : ٸ, ȿ ߻մϴ.
ġ ϳμ ó ġ Ŀ Ŀٶ ̰ ϴ. ġῡ ־ ⿡ ߰ϴ Ͱ ÿ ݵ ִ ġḦ ޴ ſ ߿մϴ. Ȯϰ ϱ ؼ Ϻθ ä() ˻ؾ մϴ. ġῡ ־ ſ ߿ ˻μ ݵ ʿ մϴ. Ǽ ġ ƴ϶ ȭп 缱, ¿ ġḦ Ͽ ǽմϴ(ġ). о (Ҿǻ ܿ ܰ, ܰ, 缱, Ȱ ) ؼ ġḦ ϰ ˴ϴ.

()
(Ǵ Ǽ) ߻ ǼԴϴ. Ȥ δ , ϴ Ǻθ , (), , , , , Ű ϰ ֽϴ. ȴٸ, ü, ĺ, ΰ ߻մϴ. 30 ̻ ִµ, 󵵰 ϸ Ǽ, , Ⱦ, Ȱ, Ȱ, , ǼŰ, Դϴ. Ǽ Ȱ ڿԼ, ü ߳⿡Լ, Ȱ ǼŰ ַ ߻մϴ. Ⱦ Ҿ κ ϰ ֽϴ. δ డ ų ڿԼ ణ Ȱ, Ȱ Լ ߻Ѵٰ մϴ. ߻ ޶µ Ư Ǽ 𿡼, Ȱ ū ó ߻մϴ. Ȱ ĺ 尣 ߻ϴ е Ⱦ ΰο ߻մϴ. ߻ϸ ü ߻մϴ.

-к-

νſ ߻ϴ Դϴ. ν ¿ ִ 5-10g , پ ȣ سϴ. ȣ ̴ Ƶ巹, 븣Ƶ巹 īݾƹ ϰ ǰ кǾ Ͼ ֿ Դϴ. ̶ Ī Ǿϴ. ν ̿ܿ Ű Ǿ ִ κ(뵿 汤 ) ߻ϱ⵵ մϴ.
찡 10% Ÿٰ մϴ.

ٹ߼к̶ ϴ, , ΰ, ν к ̻ ⵵ ϹǷ Ű˻簡 ʿ ֽϴ.
0.1-0.5%, Ǵ ų 1 ߻Ѵٰ ˷ ֽϴٸ, ̶ ʸ̳ ˴ϴ.
鳻к
ȭ кϴ ܺкɰ ȣ ϴ к ũ ֽϴ. ܺк ϴ ü 95% ϸ, к ϴ ϴ Ըѽμ ü 5% մϴ. Ըѽ ߻ϴ Ըѽ, Ǵ Ըѽ̶ Ҹϴ. ׷ ֱٿ Ըѽ ϴ к ԸѽӸ ƴ϶ ܺкɰ ǿ 漼 ̿ Ѵٴ ˷ , ǹ̿ 鳻к̶ Ҹ Ǿϴ. ̵ Ϲ ϴ ܺк ϴ ߻ϴ ϰ ˴ϴ.鳻к ӿ ȣ ϰ кϴ ɼ ȣ ʴ ɼ ϴ. ȣ ϰ кϴ 쿡 ȣ ü Ÿ ļ̶ θ, Ÿ ʴ ɼ翡 ؼ ļ̶ θϴ.̿ õ 幮 μ ٹ߼к̶ ֽϴ. ̰ Ǵ к ߻ϴ ȯμ, ٸ к (ϼü, ΰ ) Բ 忡 պDZ⵵ մϴ.


-Ҿƾ-
(1) ( ߻) : Ȱ ٸ ߻ϸ ü ߻ϴ 쵵 ֽϴ.
(2) Ű漶(Ű濡 ߻) : , ٸ, ĺ, ü ַ ߻մϴ.
(3) Ȱ : ó ߻ϴµ и ʽϴ. ٸ ַ ߻ϸ ̾ , ü ߻մϴ.
(4) Ȱ ( ߻) : ĺ ü ߻մϴ.
(5) (濡 ߻) : ٸ , ĺ ߻մϴ.
(6) Ǽ( ߻) : , ٸ, ü, ΰο ߻մϴ.
(7) һ󿬺 : ߻ϴµ Ȯ ʽϴ. ٸ ַ ߻ϸ ̾ , ΰ ߻մϴ.
(8) Ǽ( ߻) : ٸ, ȿ ߻մϴ.

(Ҿ)
(Ҿ) () , ߻ ٸ , ΰ ٸϴ. κ ߻ϸ, ߻ չ ϰ ǰų(), ų (Ű渶), ϰ Ǵ () Ÿ, Ҿ ݼ ̻ ʿ ġϴ ҳ  ߻ϹǷ ô ؿ ߻ϱ ϴ. ׷ ӿ ü Ҿ ΰ ռ ֱ ΰ ũ , ܼ Ű θų ظ ̴ ̿ Ÿ ʱ⵵ մϴ.
ҾƳ ҳ 缺 , 20% ϸ, δ Ǽ (13%), ļ (10%), õ ΰε̶ Ҹ 缺 (9%), Ǽ (4%) Դϴ.


ڷ б ǰ Ͽҿ ޾ҽϴ.

















纴(Kuru disease) Ǫ Ͼ 뿡 , ʽ ȯ ü Դ ɸ ˴ϴ. ̵ Դ´ٰ ˷ .
̶ '캴'( vCJD, ũƮ- )) ְ. 纴 CJD Ͽ ظ ɰ ̻  ٹ ɴϴ. κ 1 ȿ .
δ ο ΰ ֽϴ. ¿ ظ ٰ Դϴ. ߺ ʰ ֽϴ.( dz
Ը
Ī 'Ը ' Ҹ '༺ȭ'(ALS) ô Ű ı 踦 ޴ Ҿ ༺ Ű溴Դϴ.

ó , , ٸ ü Ϻ DZ ᱹ Ĺΰ ¿ ̸ ġ . ⿡ ΰȣ⿡ ϰ Ǹ 35 ̳ ȣ ϰ ˴ϴ.

׸ Ը ġ ..

1. Ÿ̷ν(hereditary tyrosinemia)
ߺ ġ ִ ȯ  Ÿ̷ν(hereditary tyrosinemia)̶ ִ. ¾ Ϸ縸 Żư ϴ 쵵 ִ. δ ȯڿ ȯ Ⱓ ų ִ ๰ ̱ ǰǾ౹(Food and Drug Administration)κ ޾Ҵٴ ҽ̴.
ݱ Ÿ̷ν ġ ִ ߴ. ϴ ߺϸ ٸ ۿ ̴. ݱ ̿ ұ ĵ ſ ߿ ǹ̸ 򰡵ȴ. ׷ ǰ ʹ α ȯڵ ִٴ ִ. ذ ȯڿ ๰ Ǵ ϱ α׷ ̱ ֱⱸ(National Organization for Rare Disorders)  ̶ Ѵ.
2 . ٳ(ҥ)
( ʿ ȯ. )
ٳ(ҥ) ״ ' () 忡 ' ̴. α 1000 1÷ ߻ϴ ϳ ϹοԴ . ̰ ũⰡ Ŀ ڵ þ ߿ ̳ ౸ Ư¡̴.
Ŀ ᱹ ߸. ̴ ,,ΰ, Ἦ ҷ´. а ź,Ʒ, Ǹ ȯ պϱ⵵ Ѵ.
ġᣦ̿
ٳ Ư ġ . ׷ ֱ Ű ڰ 16 Ȥ 14 ü ִ Ը Ȱ ̷ ־,ġ ߵ Ƿ ִ.
μ ⿡ ߰ 2 պ ϴ ּ . о Բ ź , ̳ ̽ ؾ Ѵ.
3. ܷν ı
Ǻ ε⸸ ص
-ܷν ı Ǻ ǥ ؿ ִ ̻ ȯ̴.
ȯ ɸ ȯڴ Ǻο ź ó,ƴ þ. ̻ ܼ, հ ڷ µ, ɸ Ȱó ־. Ǻΰ ؼ ,ó ʰ ´. ɸ ȯڴ ջ ÿ Ÿڻ Դ´.
ȯڿ پ ,9 зȴ. ׷ ȯ  ü ɿ ̻ 鵵 ,ƿ ɸ 𸣰 쵵 ʴٰ Ѵ.
I ־,Ǻΰ þ, Ż ô Ÿ. IIV ̿ ϳ ϴ. III ũ ־ ̴ֿ. IV Ǻ þ پϰ Ÿ, ̳ ų ӽ ڱ ĿǴ ɰ պ δ.
翡 IV ȯ ջⰣ 48̸, κ Ŀ Ÿ. VI ȱ ,ǺΡ þ, ô Ÿ. VII Ż ϰ,VIII ո̳ ̻ ó ,IX ½ɹ ½ɽ ̿ ִ Ǹ(د) ġ  ¸ Ż Ư¡̴.
Ǻο DZ ؼ (ݶ)̶ ܹ ʼ ʿѵ,ν-ܷνı ݶ  ̻ ߺϸ, ̻ ڴ 빰ȴ.
4. Ʈ ˵帮 ı(WAS)
Xü ȯ
Ʈ ˵帮 ı(WAS) ü ϴ Xü ̷ ȯ̴.
1937 Ʈ ó 54 ˵帮 ߰ ߰ߵ ̷ ƴ.
ܱ 100 12 ߻ 󵵸 ̰ , 4 ȯڸ Ȯ ȯڼ Ѵ.
ֿ ,ݺǴ ,Ǻ . ȯڵ κ ҷ ϰ ȴ.
ܱ õȺ Ҿư 񾾴 밳 Ʊ(1 ) Ǽ Ǻο̳ ,,̿,, ̰,ûҳ ̳ ϰ Ǵ ˷ ִ١ ߴ.
ġ ǰ ٺ ִ ġῡ ġ Ѵ. ̽ĸ ȯ ǰ ̴.
1997 뺴 Ҿư ó 4 ȯڿ ̽ ̷,ٸ 12 ̽ ʰ ִ
5 .ȣýƾ
Σġ
޿=ȣýƾ(Homocystinuria) ýŸġ ռȿ ġѰ ȣýƾ̶ ƹ̳ ü Ǹ鼭 ߻ϴ õ ̻ ȯ̴. 츮 صǴ ϴµ, ó ؼ ̻ȯ̴. 2030 ÷ ߻ϴ ִ.
=κ õ ̻ ȯ ɰ ָ ʷϱ⵵ ϰ, ߸⵵ Ѵ. ״ θ ġ ָ Ȱ ȴ. ȣýƾ ȯڿԼ ,, ŽŰ ü Ż,÷ ,ٽ,鳻 Ȱ Ÿ. DZ⵵ Ѵ.
= ġġ Ǿ ְ,Һ 뷮 ȣýƾ 輳Ǵ Ȯϸ ִ. ص Ư 쿡 ˻縦 , ¾ ĥ Żƿ õ ̻ ˻縦 Ѵ. ˻ ȣýƾ ܿ dz 索,д,Į佺,  ִ.
ġ=õ ̻ ȯ κ ⿡ ߰ϸ ̿,ȣ ġ Ǵ Ȱ ִ. ȣýƾ ȯڿԴ Ÿ B6 뷮 Ѵ. ġ ġġ ȭǰ Һ ӿ ȣýƾ ʰ Ǹ ̿ ʾƵ ȴ.
׷ Ÿ B6 뷮 ȿ ġѽİ Ÿ(betaine) Ѵ. ̵ ȯڸ Ư ǰȭ ִ. ϸ ϱ ؼ ܰ ġᰡ ߿ϴ(:̵ȯõ뺴 Ҿư ).
6.ô(meningomyelocele)
ô߻ 渷 õ ־ Ͽ ô߰ ִ ô߰ ְ Ǻ ݵ .
õ Ÿ. ߽Ű ô µ, ô Ű漶 ִ ô߻ 渷 ѷο ְ ô 帣 ִ ָϰ ִ. ̷ ô߻ 渷 õ ־ Ͽ ô߰ ִ ô߰ ְ, Ǻ ݵ 츦 Ѵ. » ʱ⿡ Ű Ǵ 簳 ǰų, Ű漼 ȭ̻ Ű ̻ ȯ̴.
7 . ߼ ȭ (sclerosing cholangitis)
߼ ȭ ȯ̴. ֳϸ ȯ ڿ ڵ鿡 ߻ 󵵰 ũ ̴. ׸ ȯ ߻ ҿ ɼ ִٰ Ѵ.
8. 콺 ı- ı
¾ ׼ȯ ַ ߺ
콺 ı ı ߺϱ⵵ 밳 Բ ߻ϴ Ϲ.
߻ Ȯϰ ʾ ƴ ľǵǰ ִ. ٸ ӽ Ⱓ ߿ ¹κ ¾Ʒ ׼ȯ ü ߻ϴ ϰ ̴.
콺 ı Ư Ư¡. Ư ȸŰ ǥ . ۰ ȡٸ ߴ ̷ ʰų, ִ. ȯ 15% ɹߴ޿ ְ,ýŰ ڿ ִ.
ı ų ̾ Ư¡. ʿ ִ. Ȥ ô ̳ ϱɿ ߻ϱ⵵ Ѵ. 밳 2 1÷ ߺϸ ̿ 3 ߻Ѵ.
9.
ֻ ȿ 谨
=߻ Ʋ. ա,Ӹī,ġ Ϻ ϰ ü ,ַ 󱼡,ܵ,ȡٸ, ߻Ѵ. 󱼰 Ÿ,ũ⵵ پϴ. ؿ ߻ϸ ⵵ ִ. ȡٸ ߻ϸ ܾ ܿ 塤 .
߻ Ȥ ܺο ߻ ƴ϶ ӿ ߻ 谡 ҷ 밳 ľ ִ. ӿ ij MRI ˻縦 ϸ , ũ ִ. պ DZ⵵ Ѵ. ߻ 鼭 ,. Ŀ鼭 ȣ ϱ⵵ Ѵ.
10. õ (Congenital hypothyroidism)
õ ϵǾ ִ ¸ ϸ, 1 ̳ ߰Ͽ ġ ɰ ʷϰ Ǵ ̴. ٷ ܹް, ġḦ ϰԵǸ ΰ Ȱ Ȱ ִ.
11. - ı(Peutz-Jeghers syndrome )
Լ̳ ϰ Ǵ Ÿµ, , ߿ Ÿ ֽϴ. 󿰻ü 켺 dz ׷ 쵵 ֽϴ. (polyp) ݵǴ 찡 Ƿ ˻縦 ʿ մϴ.
Ῡ Ʋ
- ı Ǻο Ұ ħǸ鼭 ͺ̴. 󿰻ü 켺 ϴ ˷ ڴ ʾҴ. θ ȯڸ ڳడ ȯ ɼ .

켱 ̹ ̳ Ÿ ˻ ã copy ƴ 帮 մϴ. մϴ
1. Ǻ (Oculocutaneous albinism; OCA)
-õ ǥ

Ұ Ǵ Ư¡̴.
ֿ Ҵ ε ü Ҹ ұ ռǴ ̴.
ȭ ռ ƹ̳ ϳ Ÿ̷νſ ۵ȴ
̰ ó dehydroxy-phenylalanine(DOPA) ȭ
DOPA quinone ȭȴ.
̵ tyrosinaseȿҿ ˸ŵǴµ,
κ OCA tyrosinaseȿ Ȱ յμ Ÿ
̷ ȯڵ DOPA DOPA quinone ռ Ѵ.
̵ ڸ ȭ Ѵ
⺻ tyrosinaseм Ÿ̷νŰ ݹ Բ ϸ ȴ
̰ Ǵµ, tyrosinaseȰ ʴ´.
Ӹ Ǻ ֿ ڿܼ ̵ ȣ ش
޺ ΰϰ
Ǻξ ų ִ ִ
̵ ڿ ׸ ޺ Ÿ ʰ ϴ ٸμ
޺ ؾ Ѵ

2. ҿ (Osteogenesis Imperfecta: OI,oi)
-󿰻ü 켺 ̴

ҿ ſ ȯ̴
ַ ݶ ̷ ܹ (matrix) ַ calcium phosphate) ⹰ ̷ ִ.
oi ڴ ȭ Ǿ ʰ Ͼ.
õ ﰢ ܰ ġᰡ ʿϰ
̴ ΰ κ ȣǾ Ѵ.
̿ иÿ Ÿ ȯ OIܿ
ٸ ϳ 󿰻ü ȯ hypophosphatasiaε,
alkaline phosphatase ȿ Ÿ.
alkaline phosphatase Į ü ̷ ϴµ
ʿϴ.
hypophosphatasia ̴ е ִµ,
־ ԰ ȴ
oi ̰ų alkaline phosphatase 󵵸 ְ,
hypophosphatasia ʴ´.
oi ̵ Ǫ̳ Ǫ ȸ ִ
̴ oi ȯ̶ Ÿ, ٴ ش.
󺸴 Ÿ ʴ´.
oi ̵ ߴ ̴.
ΰ ߴް õ(Ӹտ ִ ΰ ǻ̿ ִ μ ùؿ ȴ) ʰ .
׷ ̷ ̵ ߿ ӵǴ ̴.
ܻ Ͼ ִµ, ͸ Ͱ
ÿ Ͼ Ͽ Ͼ ִ.
̸ ȣϱ ּ Ѵ Ͽ
oi ̵鿡
̰ ʿϰ ǰ ߴ Ѵ.
oi 10,000 1 ÷ Ÿ.
ٸ
λ̿ ϴ.
󿰻ü 켺 ü ü ȴ
, ڽ 50% ȴ.

3. ڽÿ ̿(Duchenne's Muscular Dystrophy: DMD)
-Xü õ
X Ư xü󿡼 ڰ ڴ ü(hemizygous)¶ ̴. ٸ 󿰻ü ʹ ޸ ڸ 1 ִٴ ̴
x ü ڿ Ÿ, 켺ȯ ü ¿ ü ڵ鿡 ɰϰ ǥȴ.
x ƺ Ƶ鿡 ޵ ʴ´.
x ٸ ߿ Ư¡ ڿ ھ (dosage compensation) ִٴ ̴.
ΰ xü ϳ Ȱȭ Ǿ ִµ
̴ ߻ ʱ ۵ȴ ̰ ڿ ڿԼ x .
x ̿ ü ڴ Ǵ 븳ڸ ϴ ũmosaic ´.
DMD ǵǴ Ư¡ ִ.
x DZ κ ڰ ȯ̴
¾ ȵǾ Ÿ.
ȯ ̴ ȴ Ѵ.
ū ó δ.
̰ ִ ̸ Ͼ Ҷ ˼ ִ.
̷ Ͽ Ͼ ϱ μ
¯ ʰ Ŀ⸸ ؼ ߳ Ȱ ȴ
ü
κ ̵ Ĺ̳ 10 ʹݿ ü ϰ ȴ.
̵ ȯ ȭ ϸ
ᱹ Ȱ ձ ϰ ȴ.
Ŀ հ ߰ ϰ Ͼ ȴ
׷ ʴ´.
Ǿ ̿ϵ ɱ Ű ɺ ϴµ,
̴ ϰ ϴ ô ȭȴ.
ɷ ǵ ߰ߵǸ
DMD ̵ 10 Ĺ̳ 20 ʹ Ѵ.
 Ƿ ġ ȿ ϴ.
ûcreatine phosphokinase(CPK) Ǵ
ȯ ȣ ִ
CPK ݱ, , ߰ߵǴ ȿ̴.
ıǾ CPK û 귯 ȴ.
DMD ȯڵ ſ CPK ִ.
ȭ ϱ ÿ ִ.
DMD ˻ ü ˻̴.
 ̰ ϴ ̴.
ȭ 濡 Ư¡ .







Barnypok (2017-07-07 6:55:43)
LFwV0R http://www.LnAJ7K8QSpkiStk3sLL0hQP6MO2wQ8gO.com
gunoziepf (2017-07-31 11:13:58)
zXSNWo cfkmwrmgeoal, [url=http://agnwuaxehudr.com/]agnwuaxehudr[/url], [link=http://yokktxevqvzw.com/]yokktxevqvzw[/link], http://olfnkpjvemfk.com/
tnxyshlojks (2017-08-01 1:25:51)
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