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결핵성 뇌막염 진단에 있어서 뇌척수액 Adenosine Deaminase 활성도에 관한 연구
배선우(Seon Woo Bae),김원천(Won Tsen Kim),전근재(Geun Jae Jeon),성낙억(Nak Uk Sung),최경규(Kyung Gui Choi),최일생(Il Saing Choi) 대한내과학회 1988 대한내과학회지 Vol.34 No.4
N/A The prognosis of tuberculous meningitis is closely linked to the stage at which treatment is started. The cerebrospinal fluid findings, however, are often ambiguous, It has been suggested by recent investigations that ADA activities in cerebrospinal fluid may help differentiate tuberculous meningitis from aseptic meningitis. In this study, cerebrospinal fluid adenosine deaminase activities were measured in 23 cases of tuberculous meningitis, 9 cases of aseptic meningitis, 9 cases of purulent meningitis, 24 cases of miscellaneous neurologic conditions and 23 cases of normal controls. The results obtained were as follows: 1) The mean ADA activity in tuberculous meningitis was 17.39±10,34 U/L, in bacterial meningitis 7.87±8.52 U/L, in aseptic meningitis 2.83±1.92U/L, in miscellaneous neurologic conditions 2.80±5.61U/L and in control 1,09±0.51U/L. 2) The ADA activitiies in tuberculous meningitis showed significantly higher values than in other groups (P<0.001), 3) Cerebrospinal fluid ADA activities differentiated tuberculous meningitis from those with aseptic meningitis being higher than 4.5U/L in all and higher than 6.5U/L in 96% case of tuberculous meningitis, but lower than 6,5U/L in aseptic meningitis and less than 3.5U/L in normal controls. 4) In tuberculous meningitis, ADA activities showed significant correlation with protein in cerebrospinal fluid (P<0.01), but in other groups, no significant correlation with available routine parameters in cerebrospinal fluid. It is suggested that measurement of ADA activity in cerebrospinal fluid is a available test which is relatively easily performed for diagnosis of tuberculous meningitis, especially differential diagnosis with aseptic meningitis.
조직학적으로 확진한 결핵성 복막염 환자의 복수 Adenosine deaminase ( ADA ) 활성도에 관한 연구
배선우(Seon Woo Bae),진춘조(Choon Jo Jin),심영학(Young Hak Shim),신계철(Kye Chul Shin),권상옥(Sang Ok Kwon),김남동(Nam Dong Kim),차신웅(Shin Woong Cha),이광훈(Kwang Hoon Lee),장우익(Woo Ick Jang) 대한내과학회 1989 대한내과학회지 Vol.36 No.1
N/A Recent investigations have suggested that the measurement of ADA activities in various body fluids is useful in the diagnosis of tuberculous effusion. In this study, ascitic fluid ADA activities were measured in 18 cases of tuberculous peritonitis, 18 cases of malignant ascites and 33 cases of liver cirrhosis with ascites. The results obtained were as fallows: 1) The mean ADA activity in tuberculous peritonitis was 184.96±27.55U/L, in malignant ascites 22.35±3.10U/L and in liver cirrhosis 7.37±0.61U/L. 2) The ADA activity in tuberculous effusion was significantly higher than in the rest of the groups(p<0.001). 3) The malignant effusion show no significant difference with transudative effusion(p>0.05). 4) As a screening test for tuberculous peritonitis, the ADA activities above 50-70U/L had a sensitivity and specificity of 100%. In conclusion, the measurement of ascitic fluid ADA activity may be a simple and reliable screening test for the diagnosis of tuberculous peritonitis.
김태승(Tai Seung Kim),권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),배선우(Seon Woo Bae),노병선(Byoung Seon Rhoe),정순희(soon Hee Jung) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
Familial Polyposis Coli is a rare inherited disease and has been considered a disease in which polyps are confined to the colon and rectum. Systemic studies have recently been conducted on the polyps of the extracolonic gastrointestinal tract in Familial Polyposis Coli, which suggest that the incidence of polyps may be higher than previously suspected. So it seems that Familial Polyposis Coli affects the whole gastrointestinal tract, not only the colon and rectum as believed earlier. In Korea, several cases of Familial Polyposis Coli have been reported, but in all of them, the polyps were confined to the colon and rectum. Here we are reporting one case of Familial Polyposis Coli of the entire gastrointestinal tract.
조직학적으로 확진된 복강내 악성병변에 대한 세침흡입 세포학적 검사의 진단적 가치
김남동(Nam Dong Kim),장우익(Woo Ik Chang),권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),배선우(Seon Woo Bae),김태승(Tae Seung Kim) 대한내과학회 1987 대한내과학회지 Vol.33 No.2
N/A An ultrasound-guided percutaneous aspiration cytology was performed with a 22 G Chiba needle in 65 patients with intraabdominal malignancy confirmed by histologic diagnosis and the results were as follows: 1) Malignancy was confirmed by an exploratory laparotomy in 22 patients and by an aspiration biopsy in 43 patients. 2) The diagnostic accuracy of fine needle aspiration cytology was demonstrated in 89.1% of the patients. 3) The aspiration biopsy was diagnostic in 2 patients, even when the aspiration cytology was non-diagnostic. 4) There were no serious complications of the fine needle aspiration. In conclusion, the fine needle aspiration cytology with ultrasound guidance is safe, simple and accurate diagnostic method in the evaluation of space-occupying intra-abdominal malignancy. Histologic examination of tissue fragment obtained from the aspirated material appear to increase the yield of malignancy on aspiration cytology.
장우익 ( Jang U Ig ),안강현 ( An Gang Hyeon ),이종인 ( Lee Jong In ),김현수 ( Kim Hyeon Su ),김효열 ( Kim Hyo Yeol ),김수경 ( Kim Su Gyeong ),이동기 ( Lee Dong Gi ),배선우 ( Bae Seon U ),심영학 ( Sim Yeong Hag ),강명서 ( Kang Myeo 대한내과학회 1993 대한내과학회지 Vol.44 No.4
연구배경 : 종양표지자는 암외 진단, 임상적 병기구분 및 치료효과 판정에 유용하며, 위장관암에서 alphafetoprotein, carcinoembryonic antigen, CA 19-9, 및 CA 72-4 등이 중요한 지표로 사용되고 있으나 위암의 경우, 현재까지 만족할 만한 유용성을 가진 종양표지자는 없는 실정이다. 저자등은 위암에 대한 새로운 종양표지자로 CA 125의 역할을 규명하고자 위암을 비롯한 각종 위장관암에서 CA 125와 기존의 종양표지자와의 유용성을 검토하였다. 방법 : 대상은 위장관 악성종양 181예, 위장관 양성질환자 55예를 대상으로 하였으며 CA 72-4는 CIS ELSA CA 72-4 RIA kit, CA 19-9는 Abbott CA 19-9 RIA kit, CEA는 Abbott CEA kit, CA 125는 Centocor CA 125 RIA kit를 사용하여 측정하였으며, 각각의 정상치 한계는 4 U/ml, 37 U/ml, 5ng/ml그리고 35 U/ml로 하였다. 결과 : 1) CA 125는 양성 소화기 질환에서 93%의 높은 특이도를 보였으나 복수가 있는 간경변증의 경우 거의 전예에서 혈중 CA 125값이 증가하여 악성종양군과 감별이 어려웠다. 2) CA 125는 위암에서 민감도가 36%로 CA 72-4와 차이가 없었다. 3) CA 125는 췌담도암에 대한 민감도가 55%로 CA 19-9의 85%에 비해 낮았으며 두 종양표지자를 병합하여 사용한 경우 민감도의 증가(95%)를 볼 수 있었다. 4) 23예의 조기위암 환자에서 CA 125의 민감도는 9%로 낮았다. 5) Conventional image study 상으로 인지되지 않은 복강내 암종증 환자에 대한 CA 125의 민감도는 36%였다. 결론 : CA 125는 위암에서 기존의 종양표지자인 CA 72-4와 유용성의 차이를 보이지 않았으며 전이성 위암에서 높은 민감도를 나타내었다. 혈중 CA 125의 증가는 위장관의 악성 및 양성질환에 관계없이 복수의 유무와 밀접한 연관관계를 가지는 것으로 사료되며 통상적인 영상 진단법상으로 인지되지 않은 복강내 암종중의 예견에 있어서는 유용하지 않을 것으로 생각된다. Background: Detection of tumor markers could offer an accessible method for screening risk groups in order to achieve an early diagnosis of cansers, to contribute to and adequate staging, and to help evaluate effects of therapy. CA 125 is an antigenic determinant defined by murine monoclonal antibody OC 125, and synthesized by coelomic epithelial derivatives such as Mullerian epithelium and mesothelial tissues. CA 125 is regarded as useful tumor marker for non-musinous epithelial ovarian tumors. So we investigated whether CA 125 is reliable tumor marker for gastrointestinal malignancies and especially for detection of intraperitoneal carcinomatosis unrecognized by conventional imaging studies. And we compared CA 125 with other conventional tumor markers in the serodiagnosis of gastrointestinal malignancies. Methods: Serum CA 72-4, CA 19-9, CA 125 and CEA were determined radioimmunologically with monoclonal antibodies. A cut-off value of 4 U/ml, 37 U/ml, 35 U/ml and 5 mg/ml were used respectively. Results: The results are summarized as follows. 1) CA 125 had high specificity (93%) for benign gastrointestinal disease but was not useful to differetiate malignant ascites and benign ascites. 2) In gastric carcinoma, the sensitivity of CA 125 (36%) was not so different to that of CA 72-4(36%). 3) In pancreatobiliary carcinoma, the sensitivity of CA 125(55%) was inferior than that of CA 19-9 (85%), but combined use of these two tumor markers increases sensitivitu(95%) for the diagnosis. 4) The sensitivities of CA 125 for 23 early gastric cancer was 9%. 5) The sensitivities of CA 125 for the intraperitoneal carcinomatosis that was not recognized by conventional imaging studies was 36%. Conclustion: Our data indicates that CA 125 is not better in the serodiagnosis of gastrointestinal malignancies than other conventional tumor markers, and CA 125 has a little predictive value in the diagnosis of intraperitoneal carcinomatosis unrecognized by the conventional imaging studies. Serum CA 125 elevation in benign or malignant diseases closely correlated with the presence of ascites.
Neuroleptic Malignant Syndrome 에 동반된 급성신부전증 1 예
이광훈,최승옥,진소영,김원천,배선우,전근재 대한내과학회 1988 대한내과학회지 Vol.35 No.5
Neuroleptic malignant syndrome is characterized by muscular rigidity, hyperthermia, altered consciousness, and autonomic dysfunction, and it appears to be an idiosyncratic reaction to major tranquilizers, all of which interfere with dopamine transmission in the hypothalamus and basal ganglia of the central nervous system. Usually the syndrome develops early in the course of treatment of when the dose of the drug is increased. Acute renal failure, one of the serious complications in neuroleptic malignant syndrome, develops very rarely. Myoglobinuria, following rhabdomyolysis, is responsible for the renal impairment. We report a case of neuroleptic malignant syndrome with myoglobinemic acute renal failure after ingestion of a large amount of various antipsychotic drugs for suicide. The patient recovered after treatment by hemodialysis, administration of bromocriptine and other conservative measures.