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당뇨병성 경화부종 - 임상 - 병리조직학적 연구 및 문헌고찰 -
황호근(Ho Geun Hwang),이승하(Seoung Ha Lee),형근영(Keun Young Hyoung),신봉주(Bong Joo Shin),김경년(Kyoung Nyeon Kim),조정구(Chung Gu Cho),김주섭(Ju Seob Kim),차승훈(Seung Hoon Cha),박석돈(Seok Don Park) 대한내과학회 1996 대한내과학회지 Vol.51 No.4
N/A Objectives: We studied clinical feature, underlying disease and histo-pathologic finding of scleredema diabeticorum that was observed as non-pitting indurated edematous skin of the nape, occiput in non-insulin dependent diabetes mellitus. Methods: We performed clinico-histopathologic study in 5 cases of scleredema diabeticorum which were diagnosed at our hospital and reviewed 6 cases in Korean literatures. Results: 1) The male to female ratio was 4:1, The overweight or obese middle-aged (mean:54.6) males were prone to develop these cutaneous changes. There was no relationship between the development of diabetic scleredema and the duration, the severity of diabetes. Hypertension and hyperlipidemia were frequent associated finding among the patients. 2) The increased level of fasting C-peptide implicated that the ability of insulin secretion was preserved. 3) Non-pitting hardening of the skin on the nape, head and surrounding parts of the body was common skin change in all patients. No evidence of systemic involvements was found. 4) Typical histopathologic findings, consisted of the thickening of dermis, the degeneration of collagen bundles in mid- to deep dermis, and the deposition of acid mucopoleysaccharides, hyaluronic acid, were noted in 4 cases of our study. 5) The therapeutic responses of cutaneous changes were generally poor. Conclusion: These results implies that scleredema diabeticorum is not a rare cutaneous manifestation among the diabetic dermadromes, and special histopathologic stainings with skin tissue sections are necessary for diagnosis. Although the exact mechanisms of this disease are not known, and no effective therapy is available, it needs to be studied exactly that the facts of hyperlipidemia, overweight, hypertension and well-preservation of fasting C-peptide observed in our cases, may be related to syndrome-X.
황호근(Ho Geun Hwang),김제형(Je Hyung Kim),양세훈(Sei Hoon Yang),안선호(Seon Ho Ahn),서검석(Geom Seog Seo),최석채(Suck Chei Choi),김학철(Haak Chul Kim),나용호(Yong Ho Nah) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5
Hepatic granuloma is an uncommon entity, occurring in various conditions; infectious disease, sarcoidosis, primary biliary cirrhosis, drug reactions, and unknown etiology. It represents the hosts immunologic response. Granulomas are most frequent near the portal tracts, are sharply defined and do not disturb the normal pattern of the liver. The histopathologic findings consist of pale-staining, epithelioid cells with surrounding lymphocytes, giant cells, and central caseation nec.rosis. Older lesions may be surrounded by a fibrous capsule, and hyaline change. We experienced hepatic granuloma of unknown etiology diagnosed by its clinical features, laboratory findings and liver biopsy and this case underwent surgical excision of the mass, subsidence of his symptoms. We report this case with review of the related literature. (Korean J Gastroenterol 1997;29:683-686)
김제형,황호근,최두환,유광현,류준형,최석채,김학철 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.1
Biloma has been defined as an extraductular collection of bile within a defined capsular space. Development of an intraabdominal bile collection usually occurs secondary to traumatic or iatrogenic injury including abdominal surgery, percutaneous catheter drainage and transhepatic cholangiogram. Spontaneous bile leakage associated with other primary causes, including sickle cell anemia, gall bladder cancer and hepatocellular carcinoma, has been reported rarely. We present a case of biloma secondary to traumatic injury with liver biopsy, who had right upper guadrant pain, jaundice and yellowish skin discoloration in a patient with cholangiocellular carcinoma. Huge biloma was confirmed by percutaneous transhepatic biliary drainage and drained with pig tail catheter successfully. A case of huge biloma secondary to liver biopsy is presented with brief review of the literatures.
김제형,황호근,김학철 圓光大學校 醫科學硏究所 1997 圓光醫科學 Vol.13 No.1-2
Background Tumors of the ampulla of Vater are usually reported in the group of periampullary tumors, as they have similar clinical symptoms and therapeutic managements due to their neighboring region. And there is no review of it as an isolated literature in Korea and only a few in the world. So we review the tumors of the ampulla of Vater Subject and Method The specimens from 20 carcinoma (surgery:18, endoscopy:2) and 3 adenoma (surgery:2, endoscopy:l) patients of the ampulla are selected from 106 cases of periampullary tumor provided by Wonkwang University Hospital during the period of 1984 to 1995. The subjects are reviewed and analysed by various factors with SPSS analytic program. Results 1) Of their distribution, it is usually distributed over the 5th decade and most frequently in the 7th decade, and their mean age is 64 year old. Sex ratio of male to female is 1.6:1. 2) Their frequency are in the order of fever & chillness, jaundice, right upper quadrant pain, weight loss and pruritus in clinical manifestations and hyperbilirubinemia. elevation of transaminase and alkaline phosphatase in laboratory examination. 3) In diagnostic procedures of ampullary tumors, the abdominal sonogram and computer tomogram have indirect abnormal findings of them with high freqency(82.6%) and the direct finding of them with moderate frequency(56.2%). But all cases have had abnormal findings on the ampullary region by duodenoscopy. 4) When they are first detected as tumors, the maximal size of benign tumor(4.66±0.47㎝) is significantly larger than malignant tumor(1.43±0.66㎝). 5) Among 20 malignancies, their staging distribution are like this: stage Ⅰ: 8(34.8%), stage Ⅱ: 3(13.0%), stage Ⅲ 9(39.1%). When resection were performed in 18 cases(stage Ⅰ: 8, Ⅱ: 3, Ⅲ: 7), their mean survival time of stage Ⅰ, Ⅱ and Ⅲ are accordingly 87, 16 and 13 months. And stage Ⅰ has significantly longer survival time than others. Conclusions As the above results, it is concluded that clinical manifestations are important at least in ampullary tumor, tumor size is larger in benign than malignant tumors when they are detected and better prognosis in early stages of malignant ampullary tumor. These finding suggest early detection of malignant ampullary tumor might be related to the relationship between the characteristics of invasiveness in malignancy and the characteristic anatomy that is narrow luminal capacity in ampulla of Vater.
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나용호,최석채,황호근,유광현 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.6
The routine of endoscopy in the evaluatien of gastrointestinal bleeding demonatratd that telangiectasia in the upper gastrointestinal tract may be responsible for the chronic recurrent bleeding. If the bleeding lesion within the reach of the endoscaiye, it is amenahle to endoscopic therapy, One of the several treatment modalities that has been employed is laser photocoagulation. We report a case of ef fective laser therapy in a 63-years old woman presented with a about 3 years history of recurrent upper gastrointestinal bleeding and persistent iron deficieney anemia in gaatic multiple telangeictasias. An upper gastrointestinal endoscopy demonstrated variable sized multiple bleeding telangectatic lesions in the entire stomach. Nd-YAG laser photocoagulation was appligd in 0.5 seconds pulse of 60-70W power(2300 joules and total 7 sessions). All legions in the stomach were treated. Local epinephrine injection prior to laser treatment was carried out in the telangiectatie lesions greater than 1 cm. Follow-up endoscopy 5 months after laser treatment demonstrated no telangiectatic lesions in the stomach and no episodes of upper gastrointestinal bleeding were noted and the other symptoms improved.