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박병채(Byung Chae Park),한병훈(Byung Hoon Han),이상욱(Sang Uk Lee),박능화(Neung Hwa Park),김병립(Byung Rib Kim) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.2
Hepatocellular carcinoma (HCC) is the most common cause of death in the Korean male. The most cases with hepatocellular carcinoma (HCC), at the time of the diagnosis, are beyond the stage of resectability due to wide distribution of tumor in the liver as well as to extrahepatic metastasis. The usual sites of extrahepatic metstasis are lung, lymph node, a.drenal gland and bone, but meatastasis to orbit is very rare. We report a case of HCC, in whom multiple intrahepatic masses accompanied with left orbital prntruding mass and visual distrubance. On resection of orbital tumor, mass was confirmed as a metastatic, mixed trabecular and acinar type hepatocellular carcinoma. 3 months after diagnosis, the patient wa., expired due to hepatic failure.
박병채(Byung Chae Park),이재준(Jae Joon Lee),구자경(Ja Young Koo) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.2
N/A Clinical observation were done on 97 cases of pancreatic cancer confirmed by surgery. The results was summerized as follows. 1) Male to female ratio was 1.7:1 and 70% of all cases were over fifty years of age, While in female cancer incidence was higher over sixty years of than in male. 2) Viewed from stage grouping. Stage III & IV group ocupied 74% of all cases and the location of cancers in stage I & II group were head inall except one. 3)The most common histologic type was adenocarcinoma(84%), and among associated diseases diabetes mellitus, gallstone or history of cholecystectomy. Clonorchiasis were more prevalent than in gengeral population. 4)The common clinical features were abdominal pain(74%), jaundice(54~63%),hepatomegraly (37%), and in head group jaundice(77~92%)was charateristic in contrast to body and /or total group in which abdominal pain (92%), weight loss(53%), and abdominal mass(80%) were more common. 5)Duration of symptoms is within three months in 74% of all cases, and there was no constant relationship between duration of symptoms and degree of progression. 6) Liver(60%) was the most common site of distant metastasses, and peritoneal metastasis is some what more frequent from cancers of body and/or tail than that of head.
진행성 간세포암에 대한 Epirubicin , Cisplatin 및 5 - FU 병용 화학요법의 치료효과
박병채 ( Byung Chae Park ),한병훈 ( Byung Hoon Han ),이상욱 ( Sang Wook Lee ),구자영 ( Ja Young Koo ),서승연 ( Sung Yeon Suh ),이성계 ( Sung Kae Lee ) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.3
N/A Forty-eight patients with unresectable primary hepatocellular carcinoma (PHC), not complicated with ascites (Group IIA) and 39 patients with ascites (Group IIB) were treated with a combination of Epirubicin (60 mg/m, IV, Day 1, q 3 weeks), cisplatin (60 mg/m, IV, Day 2, q 3 weeks) and 5 -fluorouracil (1000 mg, IV, Day 3, q 3 weeks). Partial response (PR: tumor had diminished at least 50 % from its original size) and survival rate of the treated patients were closely matched and compared with those of the untreated control patients (118 cases) who had similar tumor burden, performance status, and the presence or absence of ascites. This regimen was, in most cases, safe with moderate toxicity: nausea, vomiting, temporary ascites formation, and hair loss. PR in Group IIA was observed in 9 cases, always within the third dose with a 18.7% response rate. No complete response was observed in this group of patients. In Group IIB patients, however, PR was observed in only one case. Thirty-two (77%) of 42 symptomatic Group IIA and 13 (36%) of 36 symptomatic Group IIB patients achieved pain reduction. Survival rate of Group IIA patients (46% at 24 weeks and 20% at 48 weeks) was significantly (p<0.05) higher than those of the untreated control patients (Group IA: 20% at 24 weeks and 0% at 48 weeks). Though survival rate of Group IIB patients (9% at 16 weeks and 4% at 16 weeks) was somewhat better than contrcl patients (Group IB: 4% at 16 weeks and 0% 24 weeks), this figure was not significant statistically. In conclusion, this therapy has given more anticancer effect to the patients with advanced PHC, not complicated with ascites, than the other systemic chemotherapy. And therefore, it can be expected to be useful as a first-choice for PHC patients without ascites, prior to, or unsuitable for, chemoembolization and/or radioembolization therapy.
간장및 담도 : HBe 항원 양성인 만성활동성간염에서 α - 및 β - Interferon ( INF ) 의 치료효과
박병채(Byung Chae Park),한병훈(Byung Hoon Han),서승연(Sung Yun Suh),최경희(Kyoung Hee Choi),하봉준(Bong Jun Ha),서보원(Bo Won Suh),김태용(Tae Yong Kim),이상욱(Sang Uk Lee) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
N/A Forty four patients with biopsy proven chronic active hepatitis B were received human a- or B-interferon (INF) and followed up for 6 to 12 months after completion of the treatment. All patients were HBeAg positive. Thirty four patients (group 1) were given a single daily intramuscular injection of a-INF at a starting dose of 1 * 10 units/day increasing to a maximum of 5 x 10 units/day for 2 weeks (induction) and 3 * 10 units/day, twice a week for 10 weeks (maintenance) thereafter. Ten patients (group 2) were treated with a daily intravenous injection of 3 * 10 units of B-INF for 28 days. Seroconversion of HBeAg and levels of serum alanine aminotransferase (ALT) in the treated patients were compared. The respective rates of seroconversion of HBeAg, evaluated at 6 months and one year after completion of therapy, were 17.6% (6/34), 35% (7/20) in group 1 and 30% (3/10), 33% (2/6) in group 2. Neither the group 1 nor the group 2, during the observation period, became negative for serum HBsAg. Normalization of serum ALT at 6 and 12 months after therapy were observed in 29%(10/34), 30% (6/ 20) in group 1 and 40% (4/10), 50% (3/6) in group 2. These findings indicate that both a- and B-INF used in the present study can induce a remission in disease in approximately one-third of patients with HBeAg positive chronic active hepatitis.
간세포암 환자에 있어서 AST / ALT 비의 진단적 의의
박병채(Byung Chae Park),안수열(Su Yul Ahn),김영곤(Young Gon Kim),조기범(Gi Beum Cho),김미선(Mi Sun Kim),고용호(Yong Ho Ko),박무인(Mu In Park),우인기(In Ki Woo) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5
N/A To assess the possibility that the measurement in peripheral venous blood of AST/ALT ratios might be helpful in detection of hepatocellular carcinoma (HCC), the AST/ALT ratios were evaluated in 282 cases of chronic active hepatitis (CAH), 59 cases of CAH with early cirrhotic change (CAH with LC), 213 cases of liver cirrhosis (LC), and 220 cases of hepatocellular carcinoma (HCC). The ratio of male to female was 72.9% to 27.1% in HBsAg seropositive groups and 68.8% to 3I.2% in HBsAg seronegative groups, respectively. The mean age was 43.7 years old in HBsAg seropositivity and 49.9 years old in HBsAg seonegativity, respectively. In HBsAg seropositive groups, the AST/ALT ratio was 0.68+-0.30 in CAH group, 0.78+-0.19 in CAH with LC, 1.68+-0 83 in LC, 2.17+- l.60 in HCC. In HBsAg seronegative groups, AST/ALT ratio was 0.71+-0.58 in CAH group. 0.82+-0.31 in CAH with LC, 1.72+-0.87 in LC, 1.95+-1.38 in HCC. AST/ALT ratio was gradually increased according to the progress of the chronic liver disease in both HBsAg seropositive groups as well as negative groups. AST/ALT ratio was significantly (p<0.005) elevated in patients with HCC, being above 2.0, as compared to other groups. AST/ALT ratio in the patients with serum AST>200 units was higher than in those with AST<200 units, and the mean AST/ALT ratio in the HCC patients with AST.> 200 units was significantly higher than in other chronic liver disease. AST/ALT ratio above 3.3, without evidence of circulatory disturbance, was almost entirely restricted to the patients with HCC. In conclusion, since elevated AST/ALT ratio reflects the progress of chronic liver disease from CAH to HCC, a gradual increase in AST/ALT ratio might be a useful marker assessing for detection of HCC.
부산 및 경남지역에서의 원발성 위장관 임파종의 임상적 고찰
박병규(Byung Kyu Park),양상호(Sang Ho Yang),김인영(In Young Kim),김성식(Sung Sik Kim),구자영(Ja Young Koo),박병채(Byung Chae Park),전인선(In Sun Chun),허만하(Man Ha Huh) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1
A total of 492 patients admitted to Kosin Medical Center from 1970 to 1985 with lymphoma were reviewed for gastrointestinal involvement. Primary involvement was found in 42 cases whose incidence was 8.5%. Of all lymphoma observed during the same period. There was no particular age predominance and male to female ratio was 2:l. The commonest initial presenting symptom was abdominal pain(90.5%), abdominal mass (42.9%) and dyspepsia(33.3%) in order. The sites of involvement were the stomach in 13 cases(31.0%), the ileum in 14 cases(33.3%), the jejunum in 4 cases(9.5%), the ileocecal area in 17 cases(40.5%) and the large intestine in 12(26.2%). By the histological classification by Rappaport method in 42 cases, 38 were NHL and 4 HD Most of NHL were diffuse type in which DPDL was the commonest subtype. Retrospective staging according to Ann Arbor staging classification showed 8 to have presented as Stage II, 4 as Stage III and 10 as IV, Clinical follow-up was available in 31 cases in which 5 year survival rate of them was 83.3% in Stage I, 46.2% in Stage I and II, and no case in Stage III and IV. The results of this study would indicate that the prognostically important factor seems to be the stage of disease at the time of diagnosis, but not to be histological subtype.
간장및 담도 : 복수를 동반한 간경변증 환자에서 혈청 Albumin 및 Aldosterone치의 변화와 Atrial Natriuretic Factor의 대응에 관한 연구
구자영(Ja Young Koo),박병채(Byung Chae Park),서승연(Sung Yeon Suh),한병훈(Byung Hoon Han),이상욱(Sang Wook Lee),서보원(Bo Won Suh),최경희(Kung Hee Choi),남철우(chul Woo Nam) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
N/A In order to evaluate the role in 24hr urinary sodium retension of serum albumin, aldosterone and ANF concentration in patients with decompensated liver cirrhosis, we measured the levels of serum albumine, aldosterone, ANF and 24hr urinary sodium excretion in patients with compensated liver cirrhosis (Group I,n=15), decompensated liver cirrhosis (Group II, n=15) and normal control person (Group III, n=13). The results are as follows; 1) Albumin, aldosterone, 24hr urinary sodium output show no defference between group I & III, but albumin and 24 hr urinary sodium output was significanctly decreased (p<0.005), aldosterone was significantly increased (p<0.005) in group II. 2) ANF was 38.0 +- 17.9 fmol/ml in group I, 50.2 +- 33.9 fmol/ml in group II, 23.4 +- 20.3 fmol/ml in group III, showed significant difference between group II and III (p<0.025). 3) Albumine shows positive correlationship with 24 hr urinary sodium output (r=0.642, p<0.005), negative correlationship with ANF (r= -0.346, p<0.025) and aldosterone (r=-0.529, p<0.005). These findings indicate that decreased albumine concentration has a strong relationship with sodium retention and ascites development. ANF begins to increase to compensate the sodium retension at early liver cirrhosis, but not enough at the late stage of liver cirrhosis so brings the ascites, and aldosterone increament is only but a secondary phenomenon to ascites.