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급속진행성치주염 환자로부터 배양분리한 Porphyromonas gingivalis 균주의 ribotyping
김진홍,최봉규,최성호,조규성,채중규,김종관,Kim, Jin-Hong,Choi, Bong-Kyu,Choi, Seong-Ho,Cho, Kyoo-Sung,Chai, Jung-Kiu,Kim, Chong-Kwan 대한치주과학회 1999 Journal of Periodontal & Implant Science Vol.29 No.4
This study examined ribotypes of 36 P. gingivalis strains isolated from 10 rapidly progressive periodontitis patients in Korean and revealed the presence of genetic heterogeneity among the patients. Ribotyping was performed by using a oligonucleotide probes based on 16S rRNA after whole genomic DNA had been digested with the restriction endonuclease enzyme Kpn I and Pst I. In addition, the antigenic heterogeneity of fimbrillin and protease activity was analysed to observe the virulency of P. gingivalis. The results were as follows. 1. Using KpnI, 6 ribotypes were detected, whereas 7 ribotypes were identified by using PstI. When combined two enzymes, a total of 8 ribotypes was subgrouped. 2. Ribotype I/e was the most common and detected in 4 among 10 patients. 3. The fimbrillin expressed from P. gingivalis isolates had the molecular size of 41kDa, 43kDa, 49kDa. It was observed that the size of fimbrillin with the same ribotypes could be identical. 4. All the P. gingivalis strains showed strong proteolytic activity and had the molecular size more than 120kDa. In summary, total 8 ribotypes were observed for isolates from rapidly progressive periodontitis patients. Forty percent of the patients harbored isolates exhibiting the same ribotype I/e, and it was observed that more than one ribotype can coexist in an individual patient.
상부위장관 점막하종양에 대한 내시경적 초음파단층촬영술 ( Endoscopic Ultrasonogrphy : EUS ) 의 의의
김진홍(Jin Hong Kim),조주영(Joo Young Cho),이문성(Moon Sung Lee),조성원(Sung Won Cho),심찬섭(Chan Sup Shim) 대한내과학회 1991 대한내과학회지 Vol.41 No.3
N/A As to the diagnosis of SMT of the upper digestive tract, a newly developed diagnostic modality of EUS allows us to visualize the structures underlying the gastrointestinal wall in a noninvasive manner and has a great advantage over conventional modalites such as endoscopy and x-ray examination. The clincal value of EUS in the diagnosis of SMT in the upper digestive tract was investigated in 36 cases that had been diagnosed as SMT by endoscopy. The differential diagnosis between 28 SMTs and 8 extrinsic compressed lesions was accurately accomplished by EUS. Furthermore, it was possible to detect which layer had SMT in the 5-layer structure of the digestive tract wall revealed by EUS. It is difficult to presume the histology of SMT through EUS findings, such as the size, the shape, the boundary, the margin, and the growth pattern of SMT, but the differential diagnosis of SMT in the submucosal layer was possible by analyzing the ultrasonographic pattern of the internal echo and the echo level of SMT, such as a cyst with anechoic mass or an aberrant pancreas with hypoechoic mass. The diagnosis of leiomyoma and leiomyosarcoma was determinated by detecting the origin in the proper muscle layer. Although it was difficult to make a distinction between leiomyoma and leiomyosarcoma through EUS findings, it tended to be leiomyosarcoma if the size of the tumor in the proper muscle layer was larger, the growth patfern was exoluminal, the ultrasonograpic pattern of the internal echo was C type, and the EUS echo level approximated a 4 grade. EUS is considered to be an indispensable diagnostic procedure for the diagnosis of SMT of the upper digestive tract when added to conventional modalites such as endoscopy and x-ray examination.
담관내압 검사로 진단된 Sphincter of Oddi Dysfunction
조성원(Sung Won Cho),심찬섭(Chan Sup Shim),김진홍(Jin Hong Kim),이문성(Moon Sung Lee),조영덕(Young Deok Cho) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.4
Biliary dyskinesia is a functional disorder of the biliary tract, especially spasm of the sphincter of Oddi(SO). It is sometimes impossible to differentiate patients with true biliary dyskinesia from those patients with papillary stenosis, which is a structural narrowing of part or all of the SO segment. Because of the difficutly in clearly separating these two clinical entities, this syndrome have been eailed SO dysfunetion. Classically, the patient with SO dysfunction is frequently a female between 20 and 50 years of age with a history of recurrent biliary-type pain. the discomfort is occasionally associated with nausea, vomiting, eructation and may be exacerbated by food intake. The diagnosi of SO dysfunction has been suggested by the symptom complex, exclusion of anatomic biliary tract disease, and finally by the pharmacologic provocation and relief of pain. Rer.ent developement in recording instrument such as biliary manometry allows the accurate evaluation of the motor activity of. the SO. In the treatrnent of SO dysfunction, endoscopic or surgical sphincterotomy has been used to abolish the sphincter mechanism, and pharmacologic means such as nifedipine may have a possible therapeutic rele. We report a case of biliary II type of SO dysfunction diagnonsed by biliary manornetry. The patient had sufferd from billiary-type pain for 5 years, and had normal liver function tests, delayed drainage of ERCP contrast beyond 45 minutes, and a dilated common bile duct. SO manometric pressure measurement revealed a signifieant elevation of SO basal pressure. The patient was treated by endoscopic sphinctecrotomy with a favorable manometric and symptomatic response.
위장관 ( 胃腸管 ) : 위암환자에서 내시경적 초음파단층법 ( EUS ) 에 의한 TNM분류의 평가
조성원(Sung Won Cho),심찬섭(Chan Sup Shim),김진홍(Jin Hong Kim),이문성(Moon Sung Lee),조영덕(Young Deok Cho),손진휘(Jin Hwe Son),김홍수(Hong Su Kim) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3
N/A EUS-a combination of endoscopy and ultrasonography was developed to improve the diagnostic accuracy of ultrasound by direct image of the target lesion via the gastrointestinal lumen. This new technique will prove to be accurate in the staging of gastric malignant tumors because of the clear visualization of the tumor infiltration and of involvement of adjacent lymph nodes. EUS was performed preoperatively for assessing the clinical TNM classification in 54 patients with a gastric carcinoma confirmed by endoscopic biopsy. The results were correlated with those obtained with the histology of resected specimens according to the pathological TNM classification. 1) In 54 patients with a gastric carcinoma, the mean age of the patients was 55.9 years with a male to female ratio of 1.84 : l 2) Early gastric cancer was diagnosed with the histology of resected specimens in 7 patients, and advanced gastric cancer in 47 patients. In 4 cases of advanced gastric cancer, only exploratory laparotomy was performed, so that the extent of tumor infiltration could not be assessed histologically. 3) In assessing the depth of tumor invasion, the stage accuracy rate of EUS was 85.6%. for T1 tumors, 83.3% for T2 tumors, 76.5% for T3 tumors, and 85.7% for T4 tumors. The overall accuracy rate was 82.0% (41/50). 4) In staging lymph nodes, the accuracy rate of EUS was 57.9% for NO, 75.0%. for Nl, and 54.5% for N2. The overall accuracy rate was 64.8% (35/54). A rate of false-positive diagnosis was 42.1% and a rate of false-negative diagnosis was 14.3%. 5) In assessing distant metastases, the accuracy rate of EUS was 100% for MO, 57.1% for Ml. In 2 patients with metastases in the right lobe of the liver and 1 patient with metastasis in the ovary, metastases were not visualized with EUS due to its limited depth of the penetration of ultrasound. 6) In stage grouping of stomach cancer, the overall accuracy rate of EUS was 57.4% (31/54). In conclusion, EUS will become an important diagnostic procedure for clinical TNM classification with the combined use of transcutaneous abdominal ultrasonography or abdomimal computed tomo-graphy.
간장 ( 肝臟 ) · 담도 ( 膽道 ) 및 췌장 ( 膵臟 ) : 만성 췌장염에서의 췌관확장술
조성원(Sung Won Cho),심찬섭(Chan Sup Shim),김진홍(Jin Hong Kim),이문성(Moon Sung Lee),김홍수(Hong Su Kim),조영덕(Young Duk Cho) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.4
N/A We report a case of chronic recurrent pancreatitis accompanied by multiple stenosis of the main pancreatic duct which successfully treated by endoscopic dilatation of pancreatic duct. Chronic pancreatitis with stenosis of pancreatic duct was diagnosed clinically and by endoscopic retrograde cholangiopancreatography. In order to relieve recurrent abdominal pain, we performed endoscopic pancreatic bougination with Soehenda biliary uilatation catheters and balloon dilatation with Rigiflex biliary balloon catheters. No significant complications occurred following pancreatic duct dilatation except mild pancreatitis associated with pancreatic manipulation. We conclude that endoscopic pancreatic duct dilatation as a method to treat chronic pancreatitis is encouraging, but large series and longer term follow-up are necessary before its efficacy can be determined.
위장관 ( 胃腸管 ) : 당뇨병성 자율신경 장애증 환자에서 복부 초음파 촬영술을 이용한 위내용물 배출시간 ( Gastric Emptying Time ) 의 측정
조성원(Sung Won Cho),심찬섭(Chan Sup Shim),김진홍(Jin Hong Kim),이문성(Moon Sung Lee),조주영(Joo Young Cho),김대수(Dae Soo Kim) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.3
N/A To determine the validity of the ultrasonographic methods for evaluation of gastric emptying, a total of 41 subjects were examined including 20 normal subjects and 21 patients with diabetic autonomic neuropathy (DAN). Gastric emptying times of liquid meals (500ml isotonic saline contained 37MBq of DTPA marked with 99mTc) were determined in all subjects by three different methods; Method A: measuring the changes in sums of anteroposterior and laterolateral diameters with a single ultrasonographic scan performed at the epigastrium, Method B: measuring the changes in the ultrasonographic cross sectional areas at the same sections, and method C: measuring the changes in gastric isotope counts by scintigraphy. In a subgroup of 16 subjects (9 normal, 7 DAN) gastric emptying times of solid meals (717Kcal contained egg white with 37MBq of sulfur colloid marked with 99m Tc) was considered by the same three methods. The results show that 1) 50%, 80% and 95% gastric emptying of liquid and 50%, 80% emptying of solid meals obtained by Method A, B or C in DAN were significantly prolonged compaired to normal subjects (p<0.01), and 2) the values obtainhd by Method A or B do not differ from the ones obtained by Method C. These suggest that DAN had delayed gastric emptying of the liquid and solid meals, and the determination of gastric diameters or areas in a single section of stomach by ultrasonography is a valid method for evaluating gastric emptying in DAN as well as nomal subjects.
간장 ( 肝臟 ) 및 담도 ( 膽道 ) : 간세포암과 간경변증에서 C형 간염바이러스 항체의 측정
조성원(Sung Won Cho),심찬섭(Chan Sup Shim),김진홍(Jin Hong Kim),이문성(Moon Sung Lee),조주영(Joo Young Cho),황성규(Seong Gyu Hwang),이희발(Hi Bahl Lee) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2
N/A To assess the contribution of hepatitis C virus (HCV) in liver cirrhosis and hepatocellular carcinoma, antibody to HCV (anti-HCV) was studied by enzyme immunoassay in 87 patients with liver cirrhosis and 49 patients with hepatocellular carcinoma and 100 healthy controls. Anti-HCV was detected in 12.2% and 10.3%. of patients with hepatocellular carcinoma and liver cirrhosis, respectively. No significant difference in the prevalence of anti-HCV was found between these two groups. Of the 100 healthy controls, none were anti-HCV positive. HBsAg was detected in 67.3% and 55.1% of patients with hepatocellular carcinoma and liver cirrhosis, respectively, and 4% of healthy controls. Anti-HCV was detected in 1 of 33 (3%) HBsAg-positive patients with hepatocellular carcinoma and 5 of 16 (31.2%) HBsAg-negative patients with hepatocellular carcinoma. In liver cerrhosis, Anti-HCV was detected in 3 of 48 (6.2%) HBsAg-positive patients and 6 of 39 (15.3%) HBsAg-negitive patients. 38%.of patients with liver cirrhosis and 22% of patients with hepatocellular carcinoma were negative for both anti-HCV and HBsAg. In conclusion, hepatitis B virus appears to be a more important cause of hepatocellular carcinoma than HCV. But HCV may have a role in the development of hepatocellular carcinoma in some HBsAg-negative patients.
이동화(Dong Hwa Lee),조성원(Sung Won Cho),심찬섭(Chan Sup Shim),김진홍(Jin Hong Kim),이문성(Moon Sung Lee),조주영(Joo Young Cho),조영덕(Young Deok Cho) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.4
Small cell lung cancer can present with jaundice clue to diffuse hepatic metastasis without extraheypatir obstauction or a pancreatic metastasis resulting in extrahepatic biliary obstruction. But jaundice at diagnosis is usually assumed to be due to diffuse hepatic mvolvement, a commoner finding in small cell lung cancer. Small cell 1ung cancer has only rarely been reported to cause extrahepatic biliary obstruetion despite its propensity for early dissemination. As opposed to patients presenting with jaundice due to cliffuse hepatic metastasis which is associated with a poor prognosis, patients with extrahepatic biliary ibstructton have rapid resolutiori of jaundice with chemotherapy, good palliation of symptims, and a prolonged survival. We report a case of extrahepatic biliary obstruction caused by metastatic patscreatic small cell cancer presepted with jaundlice, general weaknees and epigestric pain in a 50-year-old male patient. The patiet vas treated with endsuopic retrograde hiliary drainage (ERBD) and CAV & VP-16+ Cisplatin alternative chamotherpy regimen with three weeks interval, and has shown good palliation of syrnptoms and clinical response with prolonged survival. We reconamanrl that the inital evaluation of a paatient with small cell lung cancer and jaundice include an abdominal CT scan and/or abdominal ultasonography.