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총수담관 결석을 동반한 담도 회충미입증의 내시경적 치료 1예
정인식,김성훈,김재광,김승준,오기원,정일건,김창섭 대한소화기내시경학회 1993 Clinical Endoscopy Vol.13 No.3
Biliary ascariasis is a rare complication of intestinal ascaris infestation. Retrograde migration of the adult worm through the papilla of Vater causes biliary colic, and may give rise to pancreatic and biliary obstruction, choledocholithiasis, cholecystitis, cholangitis, hemobilia, and if the worm lodges in intrahepatic bile ducts, to liver absceases. In the past, treatment of biliary ascariasis has usually involved the direct removal of ascaris throagh a surgical choledochatomy and subsequent saline lavage of the common duct through an indwelling T tube. Recently, the worm in the bile duct can be seen by ERCP and it can be removed during the endoscopic procedure. A 55-year-old woman with intermittent colicky right upper quadrant abdominal pain was admitted to out hospital. Abdominai sonogram disclosed an echogenic structure within a mildly dilated common bile duct and a high ehogenic structure with acoustic shadowing in the distal common bile duct(CBD), which suggests a CBD stone. ERCP after obtaining the sonogram revealed a thick, long, linear, smooth filling defect in the CBD with a distal CBD stone. A distal CBD stone was removed by sphinctetotomy and lithotripsy, then we directly extracted ascaris with a tripod forcep without any complication.
EGFR Inhibitors Enhanced the Susceptibility to NK Cell-mediated Lysis of Lung Cancer Cells
Kim, Hyunsu,Kim, Sun-Hee,Kim, Mi-Ju,Kim, So-Jung,Park, Soo-Jung,Chung, Joo-Seop,Bae, Jae-Ho,Kang, Chi-Dug Lippincott Williams Wilkins, Inc. 2011 Journal of immunotherapy Vol.34 No.4
As quercetin, which can inhibit phosphatidylinositol 3-kinase, nuclear factor-kappa B, and protein kinase C (PKC) pathways, induced expression of natural killer group 2, member D (NKG2D) ligands on cancer cells and made the cells sensitive to NK –cell-mediated killing; inhibition of epidermal growth factor receptor (EGFR) pathway might lead to induction of NKG2D ligands. In this study, it was investigated whether EGFR inhibitors, including erlotinib or gefitinib, could regulate expression of NKG2D ligands in various lung cancer cells including A549, NCI-H23, and SW-900. The EGFR inhibitors predominantly increased transcription and surface expression of ULBP1, and subsequently increased susceptibility of the cancer cells to NK-92 cells. When the selective inhibitors of nuclear factor-kappa B, phosphatidylinositol 3-kinase, mitogen-activated protein kinases, and PKC were treated to discriminate downstream signaling of EGFR pathway, expression of ULBP1 in the cancer cells was induced by inhibition of PKC. Treatment with phorbol 12-myristate 13-acetate restored the EGFR inhibitor-induced ULBP1 transcription. Binding activity to ULBP1 promoter region of AP-2α, which suggested as suppressor of expression of ULBP1, was decreased by treatment with EGFR inhibitors, and restored by pretreatment with phorbol 12-myristate 13-acetate in A549 and SW-900. Rottlerin, a PKC&dgr; inhibitor, also decreased the binding activity of AP-2α in dose-dependent manner. This study suggests that EGFR inhibitors enhanced the susceptibility to NK cell-mediated lysis of lung cancer cells by induction of ULBP1 by inhibition of PKC pathway and therapeutic efficacy of EGFR inhibitors in lung cancer may be mediated in part by increased susceptibility to NK cell-mediated cytotoxicity.
김은주,이문수,김홍수,이문호,김선주,김재한,박상흠,정일권,정인섭 대한소화기학회 2000 대한소화기학회지 Vol.35 No.6
Afferent loop syndrome results from obstruction of the afferent limbs of a loop after gastrojejunostomy. It is an uncommon problem encountered after gastrectomy and Billroth II reconstruction. It may begin acutely within a few days after surgery, or it may manifest as a chronic syndrome months to years after surgery. Acute pancreatitis and duodenal stump perforation complicated by the chronic afferent loop obstruction after gastrectomy and Billroth II reconstruction are rarely recognized, and often occur many years after the initial operation. These serious complications have diagnostic difficulty, grave prognosis, and high mortality. We experienced two patients who had complications of afferent loop syndrome, but showed contradictory clinical progress. One patient had acute pancreatitis and another patient had duodenal stump perforation. We report these cases with a review of relevant literatures.
김태승,이경미,이찬희,김영수,김동익,허갑범,이현철,이은직,김경래,조재식,이규창,정상섭,윤도흠 대한내분비학회 1993 Endocrinology and metabolism Vol.8 No.3
Cushing's syndrome caused by ACTH secreting pituitary adenoma or by corticotroph hyperplasia in referred to Cushing's disease. Since the original description of Cushing's disease by Harvey Cushing in 1932, lthere has been marked progression in the etiology, diagnosis and treatment of this disorder. Despite the progression, the diverse clinical, endocrinological and pathological features of Cushing's disease remin incompetely understood and there also remain many problems to be resolved about the diagnosis, treatment, and prognosis of Cushing's disease. Sixteen cases with Cushing's disease were evaluated in this study. The follwing results were obtained. 1) The patients consist of 12 females and 4 males and the age was ranged from 18 to 47 years. 2) Among 16 patients, 14 patients showed central obesity and buffalo hunp, 13 moon face. Among 12 female patients, 10 patients showed abnormalities of menstration. 3) Elevated levels and loss of diurnal variation of the serum cortisol were observed in all patients, and increased 24hr urine free cortisol in 11 out of 12 patients tested. Urinary cortisol excretion was not suppressed by low dose dexamethasone suppression test but suppressed by high dose dexamethasone test. 4) Computed tomogram and MRI revealed that 15 casese were micreadenoma and 1 was macroadenoma. 5) The modalties of treatment were TSA (11 cases), TSA with Radiotherapy (2 cases), and r-knife radiosurgery (3 cases). 6) During the follow up periods(2~31 months), 2 cases were recurred. In conclusion, 15 cases of 16 Cushing's disease were microadenoma. The standard dexamethasone suppression test was useful in the biochemical diagnosis, and inferior petrous venous sampling was also needed to clarify the localization of tumor which was not detected by MRI or CT scan.( J Kor Soc Endocrinol 8: 273~280, 1993).
Predictive Mortality Index for Community-Dwelling Elderly Koreans
Kim, Nan H.,Cho, Hyun J.,Kim, Soriul,Seo, Ji H.,Lee, Hyun J.,Yu, Ji H.,Chung, Hye S.,Yoo, Hye J.,Seo, Ji A.,Kim, Sin Gon,Baik, Sei Hyun,Choi, Dong Seop,Shin, Chol,Choi, Kyung Mook Williams & Wilkins Co 2016 Medicine Vol.95 No.5
<▼1><P>Supplemental Digital Content is available in the text</P></▼1><▼2><P><B>Abstract</B></P><P>There are very few predictive indexes for long-term mortality among community-dwelling elderly Asian individuals, despite its importance, given the rapid and continuous increase in this population. We aimed to develop 10-year predictive mortality indexes for community-dwelling elderly Korean men and women based on routinely collected clinical data.</P><P>We used data from 2244 elderly individuals (older than 60 years of age) from the southwest Seoul Study, a prospective cohort study, for the development of a prognostic index. An independent longitudinal cohort of 679 elderly participants was selected from the Korean Genome Epidemiology Study in Ansan City for validation.</P><P>During a 10-year follow-up, 393 participants (17.5%) from the development cohort died. Nine risk factors were identified and weighed in the Cox proportional regression model to create a point scoring system: age, male sex, smoking, diabetes, systolic blood pressure, triglyceride, total cholesterol, white blood cell count, and hemoglobin. In the development cohort, the 10-year mortality risk was 6.6%, 14.8%, 18.2%, and 38.4% among subjects with 1 to 4, 5 to 7, 8 to 9, and ≥10 points, respectively. In the validation cohort, the 10-year mortality risk was 5.2%, 12.0%, 16.0%, and 16.0% according to these categories. The C-statistic for the point system was 0.73 and 0.67 in the development and validation cohorts, respectively.</P><P>The present study provides valuable information for prognosis among elderly Koreans and may guide individualized approaches for appropriate care in a rapidly aging society.</P></▼2>