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위암종과 Epstein-Barr 바이러스와의 연관성에 대한 연구
심광용,김호영,김효열,백순구,권상옥,조미연,이창훈,이종인 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-
Objectives: Epstein-Barr virus (EBV) has been known to be linked to a spectrum of neoplastic conditions, including nasopharyngeal carcinoma, Burkitt's lymphoma, peripheral T-cell lymphoma and Hodgkin's disease. This study aims to investigate the association of EBV with gastric carcinoma in Korea. Methods: Fifty-three cases of gastric adenocarcinoma were studied for evidence of EBV infection by EBV-encoded small RNA (EBER) in situ hybridization (ISH) on the paraffin sections and amplifying the EBV genome encoding envelop glycoprotein (gp220) with polymerase chain reaction (PCR) in fresh gastric cancer specimens. Results: EBER was detected in 7 (13.2%) of 53 gastric carcinomas and all cases were male. In 6 (85.7%) of 7 EBER-positive cases, the tumors were located in the upper and middle part of the stomach. EBER ISH study showed strong positivity in all the tumor cells, but negativity in surrouning lymphocytes, stromal cells and normal gastric mucosa. DNA PCR was positive in 23 (43.4%) of 53 gastric carcinomas, including all of 7 EBER-positive cases. Conclusion: We could observe some association of EBV with gastric carcinoma, and our findings about the charateristics of EBV-positive gastric cancers involving sex, site and histological type are similar to those in Japan. However, EBV-positive rate of gastric cancer is higher than in Japan and lower than in Western countries. Further studies to elucidate oncogenic mechanism of EBV in gastric cancer should be performed.
Relationship of Hemodynamic Indices and Prognosis in Patients with Liver Cirrhosis
( Soon Koo Baik ),( Myeong Gwan Jee ),( Phil Ho Jeong ),( Jae Woo Kim ),( Sang Won Ji ),( Hyun Soo Kim ),( Dong Ki Lee ),( Sang Ok Kwon ),( Young Ju Kim ),( Joong Wha Park ),( Sei Jin Chang ) 대한내과학회 2004 The Korean Journal of Internal Medicine Vol.19 No.3
간외담도 결석의 내시경적 치료 성적과 이에 영향을 미치는 요인
백순구(Soon Koo Baik),김준명(Jun Myeong Kim),김광현(Kwang Hyun Kim),정연수(Yon Soo Jeong),이동기(Dong Ki Lee),권상옥(Sang Ok Kwon) 대한내과학회 1998 대한내과학회지 Vol.54 No.4
N/A Objectives : Developments in endoscopic technique and equipments have improved duct clearance rate in patients with extrahepatic bile duct(EHBD) stone. In this study, we reviewed our experience in extracting EHBD stones with standard and more advanced technique and equipments such as mechanical lithotripsy and extracorporeal shock wave lithotripsy. Aims of this study were to determine the overall success rate of endoscopic extracting for EHRD stone, to identify risk factors for failed duct clearance at initial and final therapeutic ERCP. Methods : We retrospectively reviewed 214 consecutive patients who underwent Endoscopic Retrograde Cholangiopancreatography(ERCP) for EHBD stone over 45 months period. Factors evaluated for failed duct clearance included stone size, stone number, stone shape, concomitant stone of gallbladder and intrahepatic duct, presence of distal bile duct stricture, periampullary diverticula(PAD), Billroth-II gastrojejunostomy, and sepsis at admission. Results: The overall success rate of endoscopic treatment for EHBD stone was 93.5% (200/214). The causes of failed duct clearance were failed endoscopic sphincterotomy in 5/214 (2.3%), technical failure of extracting stone in 5/214(2.3%), and aggravation of acute cholecystitis between therapeutic endoscopic sessions in 4/214(1.9%), Risk factors for failed duct clearance with endoscopic extraction of EHBD stone were size and shape of the stone, concomitant stone of gallbladder and intrahepatic duct, and stricture of distal common bile duct. The duct clearance rate with initial therapeutic ERCP was 56.5%(121/200). Risk factors for failed duct clearance with initial therapeutic ERCP were size, shape and number of stone, and sepsis at admission. The complications of endoscopic treatment for EHBD stone were major bleeding in 5/200 (2.5%), pancreatitis in 18/200 (9.0%), but there was no perforation. Conclusion: Eventhough risk for failure of endoscopic treatment for EHBD stone were giant or piston shaped stone, concomitant stone of gallbladder and intrahepatic duct, and stricture of distal common bile duct, we conclude that endoscopic treatment for EHBD stone is safe and effective treatment modality, and choice of treatment.
간경변증에 동반된 특발성 세균성 복막염의 재발빈도 및 예견인자
백순구(Soon Koo Baik),권상옥(Sang Ok Kwon),박의련(Eui Ryun Park),김준명(Jun Myeong Kim),이용규(Yong Gyu Lee),최윤종(Yeun Jong Choi),김일희(Il Hoi Kim),이동기(Dong Ki Lee) 대한내과학회 1998 대한내과학회지 Vol.54 No.6
N/A Objectives: Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication of cirrhosis. In the most recently published studies, the prevalence of SBP among hospitalized cirrhotics with ascites has been estimated to be around 10-15%, the mortality rate related to this complication being more than 50%. SBP is thought to appear as a consequence of the impaired defensive mechanisms against infection present in cirrhotic patients, such as depressed reticuloendothelial system phagocytic activity, impaired leukocyte function, reduced serum compliment levels, and low antibacterial activity of ascitic fluid. It has proposed that ascitic fluid opsonin capacity is directly correlated to ascitic protein concentration and that this explains an observed predisposition to infection in patients with low ascitic fluid protein concentration. This present study aims to investigate the frequency of the recurrence of SBP in u large series of cirrhotic patient who recovered from the first episode of SBP and to identify any possible predictors of recurrent SBP. Method: We reviewed records of chart in 312 consecutive cirrhotics with ascites patients treated in our hospital between January, 1988 and August, 1995. Results: The incidence of SRP was 21.8% (68 cases) and showed 80.9% in male, 19.1% in female. Seven- teen (25%) of the 68 patients included in the study after the resolution of their first episode of SBP developed one or more episodes of SBP during follow-up. SBP recurred once in 16 of these patients, twice in 1 patients. The cumulative probability of SBP recurrence was 47.1% at 6 months, 64.7% at 12 months, and 82% at 18 months of follow-up. This study reveals that neither ascitic fluid total protein nor the severity of liver disease(Child's class) predicts the occurence of recurrant SBP. Conclusion: We conclude that the occurrence of recurrent SBP is unrelated to the type of liver disease, and severity of liver disease did not predict the presence of recurrent SBP. Also, ascitic fluid total protein ≤1.0 g/dl, prothrombin time 45% may not be a sensitive predictor of recurrent SBP.