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이유복(Y B Lee),김춘규(C K Kim),허경발(K B Hur),송영식(Y S Song),김익수(I S Kim),(Roberta G Rice) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.1
A 46 year old man was admitted on Nov. 16th 1962 with a complaint of mass in right upper quadrant of abaomen, and this became painful with cough and deep breathing. Clinical examinations and laboratory findings did not help to make any specific diagnosis and an exploratory laparotomy was done on Nov 23rd 1962. The mass which located in the medial segment of left lobe appearad to be an atypical abscess and this was drained and biopsy was done. A few days later, the biopsied tissue showed primary hepatocellular carcinoma. Since the tumor was relatively well localized in the medial segment of left lobe and the liver appeared to be not cirrhotic, it was decided to resect the tumor. On Nov. 29th 1962, the left total lobectomy was done and size of mass was 18. 5 x 10 x 16. 5 cm. And weighted 550 gm. Postoperative recovery was uneventfull and he was discharged at P.O.D. #30.On Mar. 2nd 1964, recurrency was noted and 5-FU 750mg was given for first 4 days and 500 mg. every other day 2 doses and patient was discharged home in critical conditions. Contary to the worsening of chest P-A X-ray findings (Fig. 3 and 4), however, the patient had been doing well, and from August of 1964, his chest P-AX-ray findings started to be improving(Fig. 5) and there after he bacame well and is living for 19 years. After this case experience, we have indicated 5-FU to several mere patients but similar results or effects coul not be reproduced. We are not cetain about what mechanisms had acted on this patient to have him live long but it may be an interesting case to record.
許景渤,金益洙,兪熙,閔珖植 順天鄕病院 1977 順天鄕醫報 Vol.2 No.1
Carcinoma is one of the most frequently observed malignant tumor in Korean patients. Result of surgery, for instance, in early stomach carcinomais encouraging and it is reported to be about 45% of five year survival rate but cases are few and rare. The majority of cases are that of either unresectable or metastatic regional lymphnode involvement of carcinoma. Their prognosis is poor. In those who had regional lymph node metastasis two year and three year survival rates are reported tobe each 37.1% and 17.9% respectively. Development of tumor immunology of the malignant disease made us greatly interested on the immunotheraly on the post resection stomach carcinoma. Studies on immunological competency by way of D.N.C.B. skin test started from 1971 and few cases those who may understand the new development of additional immuno therapy were selecter for B.C.G. innoculation after the subtotal gastrectomy. Recently monitering of peripheral thymus depentent lymphocytes (T-cell) count were undertaken to correlate the clinical course of the patients with the immunotherapy. In order to evaluate the immunological competency of healthy and all kind of malignant deseases of different stages, study with D.N.C.B. sensitization was undertaken in 264 cases. In healthy men of 53, only one man showed anergy, this anergic man is still healthy after three year observation. Table 1 further demonstrate the incedence of D.N.C.B. anergy in each group of patients, it notes that the unresectable malignant patients showed anergy 77 out of 105 cases(73.3%). From the D.N.C.B. sensirtization studies it may be clear to state that patient's immunological competency inthe malignant disease is severly deteriorated in the advanced tumo patients. The peripheral T-cell count also showed that the advanced malignant patients had lower T-cell count and it is progressively decreasing at the terminal stage(Table 2). In few cases who has B.C.G. after the subtotal gastrectomy the T-cell count are increasing after the treatment(Table 4). In 1971 five partients received B.C.G. therapy after the subtotal gastrectomy and three patients are sill living well. These 5 had all regional lymph node metastasis. The usual three year survival ratein similar patients is about 17 to 20%. Number of B.C.G. cases are not sufficient to a statistical significance but it may suggest a good deal of implication. Chance of two year survival after the B.C.G. therapy may be also far better than non-B.C.G.group(Table 5). The immunotherapy on malignant patients may be controversial, and yet we understand that the malignant tumor patients had impared immunity or immnological ability and that B.C.G. or immunotherapy may be effective on microscopic malignant lesion. In a selected case an immunotherapy after subtotal gastrectomy for gastric carcinoma may offer a beneficial effects on clinical course of the disease.
直腹筋에 發生한 Granular Cell Myoblastoma 1例
許景渤,兪熙,曹湘昊,尹用燮,李有福 최신의학사 1969 最新醫學 Vol.12 No.10
Because of relative infrequency of its incidence and controversy on its histogenesis, a case of granular cell myoblastoma developed in a rectus abdominus muscle is reported with a brief review of the literature. This 40 year old male complained of a small palpable mass in right upper quadrant of the abdomen for one month. About one month prior to admission, he noticed a small finger tip-sized mass in the right .upper abdomen which grew up progressively to thumb size. It was neither painful nor tender. At 'operation a small mass was found to be located inside of rectus abdominus muscle.''The specimen consisted of an elastic nodule with a whitish grey appearance and hard consistency on section. It measured 2.5X 1 X1cm. The histologic appearance of the tumor are compatible with a diagnosis of granular cell myoblastoma.