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송서영(Seo Young Song),김원석(Won Seog Kim),이혜란(Hye Ran Lee),정현식(Hyun Sik Hyun),이남수(Nam Su Lee),오성용(Sung Yong Oh),김지향(Ji Hyang Kim),김기현(Ki Hyun Kim),남은미(Eun Mi Nam),오영륜(Young Ryun Oh),정철원(Chul Won Jung),윤성수 대한내과학회 2001 대한내과학회지 Vol.61 No.3
N/A Background : To study clinical characteristics and treatment outcomes of adenocarcinoma of unknown primary site (ACUPS). Methods : A retrospective analysis of 81 patients who were diagnosed as ACUPS, seen at Samsung Medical Center from May, 1995 to July, 1999, was performed. Results : The median age of the patients was 58 years. The common sites of metastases were the lymph node, liver, lung, bone. In 49 of 81 patients (60.5%), the dominant tumor location was below the diaphragm. The majority of patiens (76 of 81) were initially treated with systemic chemotherapy including cisplatin. Responses were evaluable in 70 of 76. Eighteen of 70 patients (25.7%) responded to chemotherapy and complete remission was observed in 6 patients. The overall median survival of 81 patients was 5.6 months. The median survival of the responding patients was 18.3 months but the median survial of the nonresponding patients was 4.6 months (p<0.01). In univariate and multivariate analysis, age, performance status and response to initial chemotherapy were significant prognostic factors for overall survial. Conclusion : Poor survival rate and treatment response were observed in ACUPS but complete response and long-term survival were observed in several patients.(Korean J Med 61:234-239, 2001)
백선(Dyctamnus dasycarpus)복용 후 발생한 간 손상 2예
이화영,김재준,백승운,이종균,이준혁,고광철,이풍렬,이종철,오영륜,지영준 대한소화기학회 1998 대한소화기학회지 Vol.31 No.2
Although drug induced liver injury caused by herbal medicine is considered to be a frequent problem in Korea, there are only a few reports concerning the hepatotoxicity of herbal medicine. We recently experienced two cases of drug induced liver injury caused by ingestion of Dyctamnus dasycarpus, and one of herbal drug used for antipyretic and analgesic purposes. The first patient, a 48 year old man, was admitted due to jaundice after ingestion of the liquor containing Dyctamnus dasycarpus and some other herbal medications for 4 months. All viral markers were negative on admission, and the elevated bilirubin and transamiase levels normalized 5 months later after cessation of all herbal medications. Ten months after the first admission, he ingested only the liquor containing Dyctamnus dasycarpus, with lesser duration and amount, and was readmitted due to general weakness and fatigue and elevated transaminase ($gt;1,000 IU/L). The elevated transaminase level nearly returned to normal after discontinuing the causative agent. The second patient, a 62 year old man, was admitted due to jaundice after ingestion of Dyctamnus dasycarpus. The elevated bilirubin and transamiase levels normalized 4 months later after cessation of the causative agent. Dyctamnus dasycarpus induced liver injury presents with prolonged course lasting more than several weeks to months. Herbal drug induced liver disease should be considered in differential diagnosis of acute liver injury of unknown cause in Korea and we are also suggesting the necessity of a systematic approach for the study of the herbal drugs.
이석호,이화영,이규택,강인구,최규완,백승운,이종균,이준혁,고광철,이종철,오영륜,현재근,이풍렬,김재준,채종일 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.2
Strongyloidiasis is a parasitic disease caused by Strongyloides stercoralis which exists in two forms : the free living and parasitic forms. It exists in warm, moist climate in areas where there is frequent fecal contamination of the soil. After cutaneous invasion by the filariform larvae, petechial hemorrage, pruritus, papular rashes, edema, and urticaria occur. Infection commonly occurs in the proximal intestine of the gastrointestinal (G-I) tract but may extend from the stomach to the anus. Once the worm is established in the small intestine, the physical findings may include epigastric tenderness to palpation. The mucosal biopsy is an inefficient way of making the diagnosis because the worm is found in the biopsy specimen in only 2% of patients. Gastric strongyloidiasis is rare. We experienced a case of gastric strongyloidiasis diagnosed by the endoscopic biopsy and serologic test for parasite specific IgG antibody by micro-ELISA.
이석호,조재원,이규택,강인구,최규완,백승운,이종균,고광철,이종철,박철근,이준혁,오영륜 대한소화기학회 1998 대한소화기학회지 Vol.32 No.1
Fibrolamellar hepatocellular carcinoma (FLHCC) is a distinct variant of ordinary hepatocellular carcinoma (HCC) and is very rare in the Orient. Contrary to ordinary HCC, the FLHCC has very good prognosis and usually occurs in adolescents and young adults without sexual preference. In addition, it is rarely associated with liver cirrhosis and hepatitis B virus. The FLHCC presents a high resectability rate. Most cases of FLHCC have been reported in the Western countries and only nine cases have been reported in the Orient. We present here a case of FLHCC observed in a 48 year old man. The patient had no subjective symptoms when the tumor was revealed by ultrasonography. The patient had many ch'arateristics of FLHCC (i.e,, no association with HBV or HCV, normal range of alphafetoprotein, no evidence of cirrhosis). However, he was older than average-aged patient with FLHCC. The tumor was removed by right antero-inferior segmententomy of the liver and diagnosed as FLHCC. To our knowledge, this report is the fast case in Korea.