식도암의 생존율에 영향을 미치는 인자

정준모(Joon Mo Chung),최용환(Yong Hwan Choi),탁원영(Won Young Tak),윤영미(Young Mee Yun),이양일(Yang Il Lee),최성곤(Sung Gon Choi),권중구(Joong Gu Kwean),이창형(Chang Hyung Lee),안병철(Byeong Cheol Ahn),곽규식(Kyu Shik Kwak) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.4

N/A Esophageal carcinoma carries an extremely poor prognosis. Despite advances in medical technology, survival rates after diagnosis remain dismal. This report was attempted to analyse the survival rate and affecting factor in 76 cases of esophageal carcinoma patients. They received various modalities of treatment, and the median sruvival for each treatment group was 10.9 months in combined radiotherapy and chemotherapy (27 cases), 6 months in radiotherapy alone (10 cases), 13 months in combined therapy including surgery (20 cases), 4.5 months in chemotherapy alone (6 cases), and 5.7 months in conservative therapy (13 cases) (p< 0. 05, Peto-Wilcoxon method). The median survival by stage was 20. 7 months for stage I, 11. 2 rnonths for stage II, 6.9 months for stage III, and 5.7 months for stage lV (p<0.05, Peto-Wilcoxon method). Using survival as an outcome, a Cox-multivariate analysi was performed looking at age, location of lesion, length of lesion, TNM stage, type of treatment, hemoglobin level, albumin level, and weight loss. This analysis revealed significant predictors for increased survival, which were type of treatment and TNM stage (p<0.05). We concluded that the significant factors affecting the survival in esophageal carcinoma were treatment strategy an TNM stage.

만성 간질환 환자에 있어서 간초음파소견과 간조직검사와의 비교

권중구(Joong Gu Kwean),이창형(Chang Hyung Lee),최성곤(Sung Gon Choi),이양일(Yang Il Lee),윤영미(Young Mee Yun),안병철(Byeong Cheol Ahn),최용환(Young Hwan Choi),정준모(Joon Mo Chung),박태인(Tae In Park),서인수(In Soo Seo),김기범(Ki Bu 대한소화기학회 1995 대한소화기학회지 Vol.27 No.2

N/A Background/Aims: Real time ultrasound scanning is accepted as the state-of-the-art imaging investigation in patients suspected with liver disease. In focal lesion, numerous studies have confirmed the accuracy of ultrasound scanning in diagnosis and this is also valuable in clinical management, In diffused parenchymal liver diseases, however, the diagnostic value of scanning in diagnosis is less valuable than focal disease. The aim of this study is to examine the clinical value of routine ultrasound examination in patients with parenchymal liver disease. Methods: The results of hepatic ultrasonography and hepatic histology in 278 patients that underwent liver biopsy between January l986 and December l992 were compared with the results ot routine ultrasound examinetion. All liver hiopsies were performed within I month of the ultrasonography. Results: Ultrasound examination revealed a sensitivity and specificity of 54% and 74%, in all cases. Ultrasound examination was highly sensitive for detecting fatty liver(81%) and similar sensitivity (64%) for cirrhosis but less sensitive for detecting chronic hepatitis(45%). Strong correlation was found between the degree of fatty change in histologically and the fine echo pattern of steatosis (p<0.001). Correlations was also between thc degree of hepatic fibrosis and echogenicity(p<0.001), hut hepatic inflammation, necrosis, and cholestasis had no significant correlation with echogenicity. Conclusions: Ultra.onography can be a useful tool in non-invasive prediction of liver histology in steatosis and cirrhosis, hut it is le.s useful in gauging hepatic inflammation, necrosis, and cholestasis. (Korean J Gastroenterol 1995;27: 199 - 205)

위장관 ( 胃腸管 ) : 식도 정맥류 출혈시 내과적 치료 효과

김성록(Sung Rok Kim),곽규식(Kyu Sik Kwak),정준모(Jun Mo Chung),탁원영(Won Young Tak),윤영미(Young Mee Yun),안병철(Byung Chul An),최용환(Young Hwan Choi) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2

N/A We studied the variances affecting the survival rate and duration of rebleedling after treatment in three medical treatment methods (conventional medical treatment, endoscopic sclerotherapy, and percutaneous transhepatic obliteration), and also their effectiveness of bleeding control in 130 eso- phageal varices bleeding cases in liver cirrhosis. Among 130 cases of esophageal varices bleeding, 60 cases are treated with esophageal varices sclerotherapy, 54 cases are by conservative management, and 16 cases are by percutaneous esophageal varices obliteration method. The results obtained are as follows; 1) The significant variances affecting the survival rate are Childs classification, number of rebleed ing and transfusion, serum ALT and protein level, and association with hepaoma or not(p<0.05). 2) The important variances which affecting the duration of rebleeding after first treatment are the esophageal variceal degree, and association with hepatoma (p < 0. 05), and also the method of sclerotherapy is more effective than others at Wilcoxon analysis, but disclosed no significant variances at Cox regression method. 3) Bleeding is the most common cause of death after variable medical treatment.

원발성 간암파열환자에서 그 생존에 영향을 미치는 인자

안병철(Byeong Cheol Ahn),이양일(Yang Il Lee),최성곤(Seng Gon Choi),권중구(Joong Gu Kwen),이창형(Chang Hyung Lee),윤영미(Young Mee Yun),탁원영(Won Young Tak),관규식(Kyu Shik Kwak),최용환(Yong Hwan Choi),정준모(Joon Mo Chung) 대한내과학회 1994 대한내과학회지 Vol.46 No.1

N/A Background: Even though the hepatoma rupture has been known to be one of the fatal complications of hepatoma, the detailed studies on it were few in Korea. Methods: In order to investigate whether the he- patoma rupture can affect the survival of hepatoma patients or not, and also which factors can influence the prognosis of patients with hepatoma rupture, we studied 67 patients with hepatoma rupture and 74 age-matched hepatoma patients without rupture. Results: 1) Incidences of cirrhosis, ascites, hepatic encephalopathy, and unfavorable grade of Child`s classification were more prevalent in rupture group than in control group. Rupture group showed lower mean values of hemoglobin, prothrombin time, total protein and albumin, and higher mean level of GOT than those of control group. 2) But, there was no significant difference in survival time between rupture group and control group. 3) In rupture group, the survival time was more prolonged in patients with more favorable grade of Child`s classification, The survival time tended to be more prolonged in patients treated with TAE method than those managed with conservative treatment, but unfortunately, the results was statistically not significant, 4) In control group, survival time was prolonged in patients with more favorable grade of Child's classification and in those treated with TAE method. Conclusion: Treatment modality and liver status are most significant prognostic factors in hepatoma rupture patients and TAE method should be considered.

만성 활동성 간염에 있어서 Ursodeoxycholic acid의 치료효과

김성록,안병철,윤영미,탁원영,곽규식,최용환,정준모 慶北大學校 醫科大學 1991 慶北醫大誌 Vol.32 No.4

The purpose of this study is to evaluate the clinical and biochemical effects of SGD-F^(R)(UDCA, Vitamin B_1, Vitamin B_2 complex) in chronic active hepatitis. Observed cases were given orally after each meal(three times a day) for 4 weeks. The results were as follows: 1. Among subjective symptoms, improvement rate showed in easy fatigability 86.7%, anorexia 68.0%, indigestion 80.0%, nausea and vomiting 72.7%, RUQ pain 83.3%. 2. Biochemical parameters such as SGOT, SGPT, showed to be improved significantly after the 4 weeks treatment.(p<0.01) 3. There was no specific side effect during the study period in all cases. In conclusion, SGD-F^(R) capsule may be safe and effective for chronic active hepatitis.

기능성 소화불량증환자에서 Winstal® 투여에 관한 임상경험

이창형,김영탁,금민수,권중구,안병철,윤영미,권영오,김성국,최용환,정준모 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.3

목적 : 기능성 소화불량증은 소화, 흡수등 장관의 기능적인 이상과 관련되어 있을 것으로 생각되며 복합소화효소제(Winstal®)를 투여하여 그 임상효과를 평가하고자 본 연구를 실시하였다. 대상 및 방법 : 1994년 3월 부터 6월까지 경북대학교병원 내과를 방문한 기능성 소화불량증을 호소하는 환자 20명을 대상으로 Winstal®을 1회 1정씩, 1일 3회 식후 30분내에 경구로 2주간 투여하였다. 결과 : 소화불량증의 증상은 복부불쾌감, 복부팽만감, 식욕부진 및 오심, 복부동통, 공기연하증, 고창 및 구토순이었으며, 증상의 개선은 복부불쾌감이 76.4%(13/17)로 가장 높았으며, 그 다음으로 복부팽만감 및 공기연하증이 66.5%(10/15, 6/9)이었고, 오심 61.5%(8/13), 식욕부진 53.8%(7/13), 복부동통 41.6%(5/12), 고창 37.5%(3/8)이었다. 각 환자별 종합적인 증상의 개선도는 현저한 개선이 2예(10%), 중등도 개선이 3예(15%), 약간개선이 11예(55%), 불변이 4예(20%)이었으며 종합적인 유효율은 80%(16/20)이었다. 부작용은 한 예에서도 관찰되지 않았다. 결론 : 본 제제는 기능성 소화불량증 환자의 증상개선에 추천할 만한 유효한 약제로 생각된다. Dyspepsia is a common symptom in gastroenterologic practice and trigger for numerous consultations with physician. The treatment of chronic functional dyspesia is unsatisfactory. This study was performed to evaluate the efficacy of the digestive compound (Winstal®) on 20 functional dyspepsia patients. On open trial, all patients were given 6 tablets daily for 2 weeks and we evaluated the efficacy of this preparation according to the degree of the improvement. The improvement of symptoms was 76.4%(13/17) in abdominal discomfort, 66.5%(10/15, 6/9) in abdominal distension and aerophagia, 61.5%(8/13) in nausea, 53.8%(7/13) in abdominal pain, and 37.5% (5/12) in flatulence, respectively. Overall effectiveness of subjective symptoms was 80% (16/20) and there were no untoward effects of the preparations during this study. As a result, We think that this preparation is an effective one to relieve symptoms of functional dyspepsia.

식도 소세포암과 위선암이 병발한 원발성 중복암 1예

김성국,정준모,최용환,권영오,윤영미,안병철 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.3

Double primary cancer means that more than two cancers with different origin exist independently in an individual. The diagnosis of double primary cancer was determined by following criteria. Each of the tumors must present a definite picture of malignancy, and each must be distinct, and the probability of one being a metastasis of the other must be excluded. Small cell carcinoma has a distinct biological behavior such as, early invasion and metastasis, a rapid clinical course, and significant sensitivity to chemotherapy. Small cell carcinoma in the esophagus is relatively rare, and rarer when it is combined with other malignant disease. We have experienced a case of double primary cancer, a 70-year-old man with esophageal small cell carcinoma and gastric adenocarcinoma, which were diagnosed by gastrointestinal endoscopic biopsy. A review of the Korean medical literature failed to reveal any previously described case of esophageal small cell carcinoma with gastric adenocareinoma. We report this case with review of literatures.

폐 결핵에 속발된 십이지장결핵 1예

김성국,정준모,최용환,권영오,윤영미,안병철 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.4

Intestinal tuberculosis has been known since antiquity. After about 1950's, effective antituberculous chemotherapy and an improved standard of living resulted in a steady decline in all forms of tuberculosis. However, intestinal tuberculosis has been reported with impressive frequency in developing countries including Korea. Disease affecting the duodenum is reported to be rare and isolated duodenal tuberculosis sparing the rest of the intestine is uncommon. We experienced a case of tuberculosis of duodenal bulb associated pulmonary tuberculosis. The diagnosis was made on the basis of the histological study of the endoscopic biopsy specimen. We have confirmed the healing of the duodenal lesion by the follow-up endoscopy after 9 months treatment of antituberculous medication.

위암과 직장암이 병발한 이중 원발성 암 1예

정준모,안병철,김성록,탁원영,곽규식,윤영미,최용한 대한소화기내시경학회 1990 Clinical Endoscopy Vol.11 No.1

Double primary cancer is defined as the case of primary malignant tumors, which must be arise in different sites and have a different histologic appearences. The number of reported cases of double primary malignant tumors has increased in recent and the occurrence of multiple primary cancers in the same individuals is one of the interesting subjects for investigation and research in relation to the carcinogenic mechanism and/or genetic factors. We have experienced a case with double primary malignant tumors of different site origins such as stomach adenocarcinoma and rectal adenocarcinoma, which were diagnosed by biopsies with gastro and colono fiberscopy. For its great rarity, we report this case with review of literatures.