소간암에 대한 임상적 고찰

김동수(Dong Soo Kim),김두일(Doo Il Kim),이상혁(Sang Hyug Lee),채창식(Chang Sik Chae),서정철(Jung Chul Seo),설상영(Sang Young Soel),정정명(Jung Myung Chung) 대한내과학회 1991 대한내과학회지 Vol.41 No.2

N/A were of high, and the rest three were iso-echogenic with s hypo-echoic halo. 3) In the diagnosis of hepatocellular carcinoma, ultrasonogrpahy showed the best diagnositic accuracy, computed tomography the next best, hepatic arteriography the thid and isotope liver scan the worst. 4) Serum alpha-fetoprotein levels were less than 20 ng/ml in 7, 20-199 ng/ml in 2, 200-499 ng/ml in 1 and more than 500 ng/ml in 2 patients. 5) Hepatic resections were carried out in 9 patients, PEI (per-cutaneous ethanol injuection) in 2 patients, and no treatmnet in 1 patient due to refusal of treatment. All 12 patients were alive during the follow-up and their mean survival duration was 8.7+2.8 months. In conclusion, the life expectancy of patients with hepato-cellular carcinoma could be much improved if we made effort to detect small hepatocellular carcinoma by regular screening of high-risk patients with real-time USG and serum AFP measurement and treat them with proper measures according to their clinical status.

위 십이지장 질환들의 위액내 Bile Acid 와 Lysolecithin 농도에 관한 관찰

정정명(Jung Myung Chung),정봉균(Bong Kun Jeon),김수찬(Soo Chan Kim),주영돈(Young Don Joo),설상영(Sang Young Soel),최하진(Ha Jin Choi) 대한내과학회 1989 대한내과학회지 Vol.37 No.3

N/A A peptic ulcer is a benign ulcerative lesion in the alimentary tract developed by corrosive and digestive action of acid and pepsin in gastric juice and its cause is thought to be due to the imbalance of aggressive factors and defense mechanisms in gastric juice. But there are many controversies about the etiologic factors of peptic ulcer and further studies are needed for understanding of the pathophysiologic mechanisms. Recently it has been reported that bile and pancreatic juice could be refluxed into the upper duodenum or stomach under certain conditions, so gastric and duodenal ulcers could be induced by those digestive actions. This reflux phenomenon is supposed to be an important etiologic factor of gastric ulcer. More specifically, bile acid and lysolecithin of the refluxed duodenal contents increase back diffusion of hydrogen ions in the stomach and this back diffusion of hydrogen ions could induce acute or chronic gastritis and gastric ulcer. Moreover, it is carefully presumed that this reflux-induced acute and chronic gastritis acts as a factor of non-ulcer dyspepsia, and chronic stimulation of refluxed bile acid and lysolecithin seems likely to be an etiological factor for the development of stump cancer in gastrectomized patients. In this study, we have investigated the levels of bile acid and lysolecithin concentration in gastric juice for the evaluation of some influences of gastroduodena1 reflux on several gastroduodenal diseases. The results were as follows: 1) Bile acid concentration of gastric juice was 46.5±31.0 μmol/l in 13 normal controls, 202.2±109,2 μmol/l in 20 cases of duodenal ulcer, 329.1±101.5 μmol/1 in 28 cases of gastric ulcer 241.8±147.7 μmon/1 in 14 cases of stomach cancer and 352.1±88.7 μmol/1 in 18 cases of non-ulcer dyspepsia. 2) Lysolecithin concentration in gastric juice was 81.0±22.9 μmol/1 in 10 normal controls, 114.3±40.1 μmol/ l in 12 cases of duodenal ulcer, 170.4±43.9 μmol/1 in 10 cases of gastric ulcer, 230.3±172.0 μmol/1 in 6 cases of stomach cancer and 238.9±187.6 μmol/l in 7 cases of non-ulcer dyspepsia. 3) Average bile acid concentration in gastric juice showed a significant increase in each disease group and it was more prominent in gastric diseases including non-ulcer dyspepsia and gastric ulcer than in other groups. 4) Lysolecithin concentration in gastric juice also showed a significant increase in each disease group and it was more prominent in gastric ulcer than in duodenal ulcer. Lysolecithin concentration in the non-ulcer dyspepsia and stomach cancer groups showed a more prominent increase than the control group and duodenal ulcer group but we could not apprehend the clinical significance because the number of cases was negligible. 5) There was no specific correlation between bile acid and lysolecithin concentration of gastric juice in 20 cases of gastric and duodenal ulcers, From our findings, the constant increase of bile acid or lysolecithin concentration in gastric juice might be one of the etiologic factors in development of gastroduodenal diseases, particularly in gastric diseases. However, further study about this problem is thought to be needed.

위장관의 평활근육종에 대한 임상적 고찰

전봉균(Bong Kun Chun),김동욱(Dong Wook Kim),황문수(Moon Su Whang),이재관(Jae Koan Lee),설상영(Sang Young Soel),정정명(Jung Myung Chung),최하진(Ha Jin Choi) 대한내과학회 1991 대한내과학회지 Vol.40 No.2

N/A A clinical study was performed on 13 cases of leiomyosarcoma of the gastrointestinal system admitted to Inje Medical College, Pusan Paik Hospital, from 1981 to 1990, and the following results were obtained. 1) The locations of the leiomyosarcoma were the stomach (4 cases), the duodenum (4 cases), the jejunum (2 cases), the rectum (2 cases), and the ileum (1 case), in order of frequency. The age distribution was wide, from 12 years to 70 years, and the average age was 46 years. The ratio of male-to-female was 8:5, the male being 8 cases and the female 5 cases. 2) The most common symptom was gastrointestinal hemorrhage, 9 cases out of 13, and the duration of illness varied, from 3 days to 5 years, but was not closely related to the severity of illness. 3) The incidence of leiomyosarcoma of the gastrointestinal system compared with other malignant tumors in the same period was about 0.8%, the stomach 0.3%, the small intestine 22.6% (the duodenum 26.7%, the jejunum 22.2%, the ileum 14.3%), and the rectum 1.1%, which was consistent with other monographs. 4) All 13 cases underwent surgical intervention, and postoperative chemotherapy was done on 4 cases in which the regimen was VAC (Vincristine, Adriamycin, Cyclophosphamide). Postoperative radiotherapy was done in 1 case. In brief, leimyosarcoma of the gastrointestinal system was most frequent in the small intestine, gastrointestinal hemorrhage was the commonest clinical symptom, the duration of illness was mainly less than 1 year, all age groups were involved; and the overall incidence was less then 1% of the gastrointestinal malignancy.

위장관계통의 평활근육종에 대한 임상적 고찰

최경해,이부경,권혁,진기천,설상영,정정명 인제대학교 1988 仁濟醫學 Vol.9 No.4

저자들은 1981년 1월부터 1988년 6월까지 인제의대 부산백병원 내과에서 위장관계통의 평활근육종 10예를 경험하고 이들에 대한 상세한 임상적 관찰을 실시하여 그 결과를 보고하고자 한다. A clinical study was performed on 10 cases of leiomyosarcoma of the gastrointestinal system admitted to Inje Medical College, Pusan Paik Hospital, from 1981 to 1988, and the following results were obtained. 1) The locations of the leiomyosarcoma were the stomach(3 cases), the duodenum(3 cases) the jejunum(2 cases), the rectum(1 case) and the omentum(1 case), in order of frequency. The age distribution was wide from 12 years to 60 years, the most prevalent age group was fourth decade(4 cases) and the average age was 43 years. The ratio of male to female was 6 : 4, the male being 6 cases and the female 4 cases. 2) The most common symptom was gastrointestinal hemorrhage, 7 cases out of 10, and the duration of illness was variable, from 3 days to 5 years, but was loot closely related to the severity of illness. 3) The incidence of the leiomyosarcoma of the gastrointestinal system as compared with the other malignant tumor in the same period was about 0.9%, the stomach 0.3%, the small intestine 38.5%(the duofenurn 37.5%, the jejunum 40.0%), the rectum 0.8%, and the omentum 33.3%, which was consistent with other monographs. 4) All 10 cases underwent surgical intervention, postoperative chemotherapy was done on 3 cases in which the regimen was VAC(Vincristine, Adriamycin, Cyclophosphamide) and postoperative radiotherapy was done on 1 case. In brief, the leiomyosarcoma of the gastrointestinal system was most frequent in the small intestine, gastrointestinal hemorrhage the commonest clinical symptom, the duration of the illness was mainly less than 1 year, involved any age group and the overall incidence was less then 1% of the gastrointestinal malignancy.