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폐결핵에서 객담 결핵균 중합효소 연쇄반응 검사의 누적 양성율
경태영(Tae Young Kyong),이준호(Jun Ho Lee),채경수(Gyeong Soo Chae),김동규(Dong Kyu Kim),모은경(Eun Kyung Mo),박명재(Myung Jae Park),이명구(Myung Goo Lee),현인규(In Gyu Hyun),남기형(Ki Hyung Nam),이경화(Kyung Wha Lee),정기석(Ki Suck J 대한내과학회 1998 대한내과학회지 Vol.55 No.6
N/A Objectives: The conventional methods such as smear or culture of Mycobacteria have been proved either low sensitivity and specificity or time-consuming. Polymerase chain reaction(PCR) is a rapid and sensitive alternative method to diagnose mycobacterial infection. We investigated the positive rate of sputum PCR for Mycobacterium tuberculosis by consecutive tests for its application in clinical practice. Methods: Sputum AFB smear, culture and serial AFR PCR test were performed in all patients who were suspected of pulmonary tuberculosis, Among them, 128 patients with positive sputum PCR test were enrolled from January 1996 through March 1997. The diagnostic criteria of pulmonary tuberculosis were sputum AFB smear positive, culture positive or pathologically proven granuloma. TB-CR TM kit (Bioneer, seoul, Korea), which amplifies insertion sequence(IS6110) of Mycobacterium tuberculosis complex, was used for sputum AFB PCR. Results: Of 128 patients, active pulmonary tuberculosis were 107 (male:74, female:33, mean age:48.9 year). Cumulative positive rate of sputum AFR PCR test was 89% at 1st test, 95% at 2nd test, 98% at 3rd test and 100% at 4th test. The sensitivity of sputum PCR, smear and culture was 98.0%(105/107), 85.0%(91/107) and 82.8%(77/107), respectively. The positive predictive value of sputum PCR was 83.6%(107/128). There were 21 patients who showed positive PCR test did not meet the diagnostic criteria of active tuberculosis. They had old tuberculosis with destroyed lung, history of anti-tuberculous medication(9/21), extrapulmonary tuberculosis (6/21) and other diseases(6/21). Conclusion: Sputum PCR test is a sensitive diagnostic tool in early diagnosis of pulmonary tuberculosis when it has been performed serially, we recommend at least 2 consecutive PCR test to achieve the sensitivity of 95%.
위암 및 Helicobacter pylori 감염의 위험인자로서 염분 섭취의 역할
경태영(Tae Young Kyong),김학양(Hak Yang Kim),채경수(Gyeoung Soo Chae),유희승(Hee Seung Yoo),박수종(Soo Jong Park),김종혁(Jong Hyeok Kim),장웅기(Woong Ki Chang),김용범(Yong Bum Kim),박충기(Choong Kee Park),남은숙(Eun Sook Nam),유재영( 대한내과학회 1998 대한내과학회지 Vol.55 No.2
N/A Objectives: Gastric cancer is one of the most important malignancy of the gastrointestinal tract. High salt intake has been suggested as a risk factor of gastric cancer and promoting Helicobocter pylori infection. Few studies have been addressed about the relation between excessive salt intake and gastric cancer. This study was performed to investigate the relation of high salt intake to H. pylori infection and gastric cancer. Methods . Between May 1996 and July 19%, hospitalized patiaits with epigastric pain or dyspepsia were prospectively recruited. Patients with underlying diseases which could reduce kidney function were excluded. Salt consumption was estimated by the urine sodium to creatinine ratio(U-Na/Cr) on fresh single urine sample. Gastric cancer was diagnosed by endoscopic biopsies. H. pylori infection was evaluated by CLOtest. Gastric cancer was classified histologically by Lauren classification. Results: Ninety seven patients, 52patients with gastric cancer and 45patients with chronic gastritis were enrolled. There was no statistically significant difference in the sodium to creatinine ratio between gastric cancer group(173.60±123, range; 21-665.2) and chronic gastritis group(164.02±138, range; 20.4-482.7)(p=0.361). In gastric cancer, the sodium to creatinine ratio was not different between CLOtest positive and negative group(p=0.201), and among intestinal, diffuse and mixed type(p=0.419), either. Conclusion: This study does not support the causal relation of high salt diet on gastric carcinogenesis. There is no significant difference in H, pylori infection rate between CLOtest positive group and negative group.
조병동(Byung Dong Cho),오흥국(Heung Kuk Oh),장명국(Myoung Kuk Jang),경태영(Tae Young Kyong),이종민(Jong Min Lee),김용범(Yong Bum Kim),김학양(Hak Yang Kim),박충기(Choong Kee Park),유재영(Jae Young Yoo) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.2
N/A Background/Aims: Extrahepatic bile duct(EHBD) carcinoma is a rare tumor among the population of the world and accounts for less than 2% of cancers found at autopsy and about 10% of all biliary duct cancer. To identify the clinical characteristics associated with prognosis and the survival rate by treatment modalities, we reviewed 120 patients with extrahepatic bile duct carcinoma who were diagnosed at the Kangdong Sacred Heart Hospital of Hallym University from June 1987 to October l994. Methods: According to treatment modalities, these patients were divided into 50 cases of the operation group, 47 cases of the non-operative treatrnent group and 23 cases of the no treatment group. The survival rate of these three groups was analyzed according to Cutler-Ederer methods. Results: The most common symptom and sign were jaundice(85.8%) and hepatomegaly (57.5%). The most common site of tumor was the common hile duct(63.3%), followed by the hepatic duct bifurcation(25.8%), the common hepatic duct(9.2%), the cystic duct(0.8%) and tbe diffuse type(0.8%). The median survival was l0.7 months. The survival rate was 76.7% in 3 months, 68.4% in 6 months, 4l.6% in l year, 14.1% in 2 years, and 3.4% in 5 years. According to the treatment modalities, the median survival was l6.3 months in the operation group, 6.3 months in the non-operative treatment group, and 3.5 rnonths in no treatment group. Conclusions: The operation group had a better survival rate than the other group. We conclude that operation offers the best prognosis. The result of this study suggests that early diagnosis and operation prolong survival in these patients. Further studies of adjuvant chernotberapy and radiotapy wi]l be necessary to improve patients survival. (Korean J Gastroenterol 1996; 28:25] 259)