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간장및 담도 : 간경변증 및 간세포암에 있어서 Doppler 초음파검사로 측정한 복강내 동맥의 혈류속도파형에 관한 연구
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),김원호(Won Ho Kim),송시영(Si Young Song),박형석(Hyung Seok Park) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
N/A The duplex scanner combines a pulsed Doppler flowmeter with a high resolution real-time scanner, so that blood flow information can be collected from a selected position in a specific vessel, using the real-time capability of the system. Several studies on the changes of blood flow velocity waveform were reported according to the hypothesis that every artery has its own characteristic Doppler-shift signal and that this is modified by disease, either of the artery itself or of the tissue fed by the vessel. To recognize the normal value of the systolic/diastolic velocity ratio and resistance index and their changes in liver cirrhosis and hepatocellular carcinoma, we analysed the blood flow veIocity waveform of the splanchnic arteries detected by Doppler ultrasonography in 22 healthy subjects as controls, 23 patients with liver cirrhosis and 38 patients with hepatocellular carcinoma. The results obtained were as follows: 1) In controls, the S/D ratio and resistance index of the hepatic artery were 4.37 +- 1.87 and 0.74 +- 0.08, respectively; the S/D ratio and resistance index of the splenic artery were 3.45 +- 0.73 and 0.70 +- 0.06, respectiveiy; and the S/D ratio and resistance index of the superior mesenteric artery were 6.99 +- 1.42 and 0.85 +- 0.03, respectively. 2) The S/D ratios and resistance indices of the hepatic artery and splenic artery of the patients with liver cirrhosis or hepatocellular carcinoma were not different compared with those of controls. However, the S/D ratio and resistance index of the superior mesenteric artery of the patients with liver cirrhosis or hepatocellular carcinoma were significantIy smaller than those of controls. 3) In patients with hepatocellular carcinoma, the larger the tumor and the more severe the arterio-venous anstomosis, the smaller the S/D ratio and resistance index of the hepatic artery. These results suggest that every splanchnic artery has its own characteristic blood flow velocity waveform, and the peripheral resistance of the superior mesenteric artery decreases in patients with liver cirrhosis or hepatocellular carcinoma.
정상인 및 간경변증에 있어서의 Wedged Hepatic Venous Pressure
강진경 ( Jin Kyung Kang ),최흥재 ( Heung Jai Choi ),고운희 ( Woon Hi Koh ) 대한내과학회 1969 대한내과학회지 Vol.12 No.6
Because of the anatomic location of the portal vein, measurement of the portal vein pressure in man has been possible only at laparatomy, The catheterization of the hepatic vein in man was first described by Warren et al. in 1944, and Myer et al. reported
강진경(Jin Kyung Kang),최흥재(Heung Jae Choi),박인서(In Suh Park),이상인(Sang In Lee),김원호(Won Ho Kim),차동훈(dong Hun Cha) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.3
N/A Superior mesenteric artery syndrome is an unusual form of the high intestinal obstruction. The root of the small bowel mesentry at the level of the superior mesenteric artery compresses the third portion of the duodenum as it across the spine. We have reviewed 11 cases of the superior mesenteric artery syndrome and the following results were obtained. 1) The mean age of 11 patients was 27.3 year old and the ratio between female and male was 9:2. 2) The mean body weight of 11 patients was 77.3% (54 99%) of the ideal body weight. 3) The main symptoms of the superior mesenteric artery syndrome were epigastric pain (64%), vomiting (55%), nausea (55%), abdominal fullness (45%), diffuse abdominal pain (18%) and diarrhea (18%). 4) The diagnostic tools were upper G-I study (100%), abdominal ultrasonography (36%), hypotonic duodenography (27%) and abdominal aortogram combined with upper G-I study (9%). 5) The associated diseases were peptic ulcer disease (18%), achalasia (9%), nasopharyngeal cancer (9%), psychosomatic disorder (9%). 6) The treatment consisted of conservative medical management only (27%) and duodenojejunostomy (63%). In conclusion, the superior mesenteric artery syndrome is a real, although overdiagnosed, disorder. Strict adherence to clinical and radiographic features must be observed when making the diagnosis. If the patient with the superior mesenteric artery syndrome dose not respond to the conservative medical management, surgical intervention is mandatory and duodenojejunostomy probably is the procedure of choice.
Desferrioxamine이 사람 간암 세포주의 DNA 합성에 미치는 영향
강진경(Jin Kyung Kang),김원호(Won Ho Kim),송시영(Si Young Song),김도영(Doe Young Kim),문일환(Il Hwan Moon),윤견일(Kyun Il Yoon) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6
N/A Desferrioxamine (DFO), an iron chelator, has been sbown to have antiproliferative activity in a variety of malignant cells including hepatocellular carcinoma. The antiproliferative effect of DFO's known to be caused by decreased activity of ribonucleotide reductase, a key enzyme in DNA synthesis. This study was conducted to investigate the effect Of DFO on the DNA synthesis of cultured hepatoma cells. The proliferation of hepatocellular carcinoma (Hep 3B) as well as hepatoblastoma (Hep G2) cells was measured by trypan blue dye exclusion method and the DNA synthesis was measured by [3H] thymidine incorporation. The results obtained were as follows: The proliferation of hepatoma cells was slightly inhibited by 2 ug/ml and markedly inhibited by 6 ug/ml of DFO. This antiproliferative effect was not enhanced any more by higher dose of DFO. The percent viability of Hep 3B and Hep G2 cells was above 90%. after 96 hours of incubation with 60 ug/ml of DFO and that of Hep 3B and Hep G2 cells was 88.0% and 89.6% respectively after l6 hours of culture with 120 ug/ml of DFO. DNA synthesis of hepatoma ceils was decreased by DFO in a dose dependent manner up to 20 ug/ ml. The decrease of DNA synthesis was not enhanced any more by higher dose of DFO. In conclusion, the antiproliferative effect of DFO on cultured human hepatoma cell lines was caused by the inhibition of DNA synthesis rather than by direct cytocidal effect.
간장 ( 肝腸 ) 및 담도 ( 膽道 ) : I - 131 - Lipiodol의 간동맥주입과 간동맥 색전술에 의한 원발성 간암 치료 효과
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),이상인(Sang In Lee),한광협(Kwang Hyub Han),전재윤(Chae Yoon Chon),이종태(Jong Tae lee),유형식(Hyung Sik Yoo),한승희(Seung Hee Han),노재경(Jae Kyung Roh) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.3
N/A Lipiodol (iodized oil) is known to be selectively retained for an extended duration in hepatocellular carcinoma (HCC), so a number of therapeutic trials using Lipiodol in patients with HCC have been performed. Hepatic arterial infusion of radiolabelled iodized oil (I-131-Lipiodol) has potential as a radiotherapeutic agent in patiens with HCC. This study was undertaken to assess the therapeutic efficacy of hepatic arterial infusion of I-131-Lipiodol alone or I-131-Lipiodol combined with transcath- eter arterial embolization (TAE) in comparison with conventional TAE in patients with HCC. From March 1985 to December 1988, 136 patients with HCC were given eithep an hepatic arterial infusion of I-131-Lipiodol alone (Group 1, n=83), TAE with Ivalon or GelfoaO (Group 2, n=23) or infusion of I-131-Lipiodol combined with TAE (Group 3, n=30). There was no significant difference in sex, age, tumor size and type, biochemical tests, and Child classification among the 3 groups. We analyzed the response rate and survival rate according to the therapeutic modality and tumor size. 1) The response rates were 32.5, 43.5, and 73.3% in groups 1,2, and 3 respectively and the response rate in group 3 was significantly higher than group 1 (p<0.05). (response was defined as a decrease more than 2.5% in tumor size 3 months after treatment). 2) There was no significant difference in response rate among the 3 groups in tumors smaller than 5 cm, but the response rate of group 3 (71.4%) was significantly higher than group 1 (27.9%) in tumors larger than 5 cm (p<0.05). 3) The survival rate among tumors smaller than 5 cm was significantly highter than among tumors larger than 5 cm (p<0.05).
간 , 담도 및 췌장 : 정상인 및 간경변증에 있어서 Doppler 복부 초음파검사에 의한 문맥계의 혈역학적 연구
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),문영명(Young Myoung Moon),김원호(Won Ho Kim),정재복(Jae Bok Chung),한광협(Kwang Heup Han) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.2
N/A Portal systemic bleod flow can be measured quantitatively by the recently developed pulsed Doppler flowmetry system that consist of a mechanical sector scanner and a pulsed Doppler flowmeter. Since both modes are displayed in real time, Doppler signals can be retrieved at will from any depth. The blood flow velocity determined by the Doppler spectrogram and the vascular cross-sectional area measured from the B-mode tomographic image enables the quantitiative calculation of the blood flow volume. To evaluate the changes of portal hemodynamics in liver cirrhosis, we observed the cross-sectional area, blood flow velocity and blood flow volume of portal vein, splenic vein and superior mesenteric vein in 22 healthy adults as control and 21 patients with liver cirrhosis by the pulsed Doppler flowmetry system. The results obtained are as follows: 1) The cross-sectional area of the portal vein was significantly enlarged in patients with liver cirrhosis (1.19+-0.32 cm) cornpared with controls (0.81+-0.16 cm'), and the blood flow velocity was significantly reduced in patients with liver cirrhosis (11.46+-2.08 cm/sec) compared with controls (16.47+-3.82 cm/sec). But the blood folw volume of the portal vein was not significantly different in patients with liver cirrhosis (817.4+-265.2 ml/min) from controls (790.2+-207.2 ml/min) 2). The cross-sectional area of the splenic vein was significantly enlarged in patients with liver cirrhosis (0.54+-0.30 cm2) compared with controls (0.35+-0.12 cm), and the blood flow velocity was significantly reduced in patjents with liver cirrhosis (13.81+-5.13 cm/sec) compared with controls (22.15+-10.83 cm,'sec). But the blood flov; volume of the splenic vein was not significantly different in patients with liver cirrhosis (423.5+-220.2 ml/min) from controls (389.0+-90.4 ml-min). 3) The cross-sectional area of the superior mesenteric vein was significantly enlarged in patients with liver cirrhosis (0.59+-0.18 cm) compared with controls (0.37+-0.12 cm), and the blood flow velocity was significantly reduced in patients with liver cirrhosis (13.30+-4.98 cm/sec) compared with controls (20.21+-5.65 cm/sec). But the blood flow volume of the superior meseteric vein was not significantly different in patients with liver cirrhosis (436.4+-115.1 ml/min) frorn controls (393.3+-107. 0 ml/min). 4) In patients with liver cirrhosis, there was no significant hemodynamic change according to the presence or absence of ascites and the degree of esophageal varices. But the cross-sectional area and the blood flow volume of the splenic vein was significantly larger in patients with severe splenomegaly than in patients with mild splenomegaly. These results suggest that the pulsed Doppler flowmetry system is simple, non-invasive and particularly useful method in studying the changes of portal hemodynamics.