만성간질환에서 인슐린유도에 의한 저혈당과 Glucogon 의 변동

윤오주(Oh Ju Youn),강원권(Won Kwon Kang),이헌영(Heon Young Lee),김영건(Young Kun Kim),노흥규(Heung Kyu Ro),이복희(Bok Hee Lee) 대한내과학회 1988 대한내과학회지 Vol.34 No.5

N/A To characterize the glucagon response with insulin induced hypoglycemia in patients with chronic liver disease, serum glucagon and glucose levels were measured by radioimmunoassay and glucose oxidase method in 5 patients with chronic persistent hepatitis, 7 patients with chronic active hepatitis, 5 cirrhotic patients with esophageal varix and 16 normal subjects. The blood samples were taekn before and 15, 30, 60, 90, and 120 minutes after intravenous injection of 0,1 u/Kg B.W. of regular insulin after overnight fast. The result were as follows; 1) In normal control groups, the serum glucose levels at basal time (74±8.8 mg/ml) were decreased to the nadirs (34±6.3mg/ml) at 30min after insulin injection and elevated again to the levels of 75.2±9,5 mg/ml at 90min. The serum glucagon levels at basal time (93±31pg/ml) were elavated to peak levels (204±85pg/ml) at 30min after insulin injection and returned to the levels of 98±38pg/ml at 120min, 2) In the cirrhotic patients with varix, the basal serum glucose levels were 72±8.3mg/ml, not significantly different from normal control, decreased to the levels of 43±9,2mg/ml at 30min after insulin injection, significantly different values compared to normal control. And low serum glucose levels were continued as levels of 45±8.8mg/ml at 120min after insulin injection. The serum glucaon levels at basal time (409±442pg/ml, significantly different than normal control) were elevated to peak levels of 1640±1178pg/ml at 6D min after insulin injection and showed prologed high levels. 3) In patients with chronic active hepatitis, the basal serum glucose levels were 76±9.8mg/ml, not significantly diffeent from normal control, decreased to the levels of 42.6±5.1mg/ml at 30min after insulin injection. Partial recovery of hypoglycemia were observed as levels of 58±8.2 mg/ml at 90min after insulin injection. the serum glucagon levels at basal time (120±36pg/ml) were elevated to peak levels of 293±56pg/ml at 60min after insulin injection and returned to 171±66pg/ml at 120min. 4) In patients with chronic persistent hepatitis, the basal serum glucoae levels were 74±4.5mg/ml decreased, and decreases to the levels of 38±5.9 mg/ml at 30min after insulin injetion and retured to 69±11.4 mg/ ml at 90min after injection. The serum glucagon levels as basal time (104±29pg/ml) were increased to peak levels of 268±46pg/ml at 60 min, and recovered to the level of 118±22pg/ml as like as change of normal control With the above result, it is concluded the difference of recovery in insulin induced hypoglycemia between groups of chronic liver disease were related to decreased sensitivity of glycogen depleted hepatocyte to glucagon

소화기 종양환자에서 CA19-9과 TPA의 진단적 의의

윤세진,윤오주,송민호,이헌영,김삼용,이복희 大韓消化器病學會 1987 大韓消化器病學會誌 Vol.19 No.2

백혈병 및 악성임파종 환자에서 혈청 β₂-microglobulin치의 임상적 의의

김삼용,성인환,윤오주,이헌영,신영태,노흥규 大韓血液學會 1987 大韓血液學會誌 Vol.22 No.1

복부 및 골반 방선균증 1 예

박철신(Cheol Shin Park),윤오주(Oh Joo Yune),이헌영(Heon Young Lee),김영건(Young Kun Kim),노흥규(Heung Kyu Ro),이복희(Bok Hee Lee) 대한내과학회 1989 대한내과학회지 Vol.36 No.2

Actinomycosis is a chronic, progressive, Suppurative, granulomatous disease. Definite diagnosis will generally be based upon histologic identification of actinomycotic granules or culture of the Actinomyces, or both. The diagnosis of abdomino-pelvic actinomycosis is often difficult to make. Since abdominal actinomycosis is indeed an uncommonly encountered clinical entity today, many clinicians fail to consider actinomycosis as a possibility. Actinomyces is anaerobic. It is not usually isolated from routine cultures and anaerobic cultures are difficult to obtain. It may be impossible to clinically distinguish abdominal actinomycosis from other diseases because of the variable forms of presentation which may be recognized in patients, including fever, anorexia, nausea and vomiting. Especially in Korea, the clinical presentation of actinomycosis often resembles intestinal tuberculosis, which should not usually be treated surgically. We experienced a case of Abdomino-pelvic Actinomycosis in which it was difficult to make a early diagnosis.

Shock 환자에서 혈청 Myoglobin 치의 변화

노흥규,송민호,신영태,윤오주,한성필 대한내과학회 1988 대한내과학회지 Vol.35 No.1

Serum myoglobin levels were measured by radioimmunoassay in 11 healthy subjects and 15 patients with shock, of which 11 cases were hypovolemic shock and 4 cases were septic shock. The follow-up measure of serum myoglobin levels was performed in 9 patients at intervals of 8 hours. Also the serum creatinine, PaO2, blood hydragen ion concentration, blood pressure, and urine output were measured simultaneously. The results were as follows: 1) The mean value of serum myoglobin in 11 healthy subjects was 20,5±3.1ng/ml. 2) The serum myoglobin level was increased in the patient with hypovolemic shock (552.0±188.6ng/ml) compared to the control group (p$lt;0.001). In patients with septic shock, the serum myoglobin level was markedly increased (4366.7±348.0ng/ml) compared to the control group (p$lt;0.001) and patients with hypovolemic shock (p$lt;0.001). 3) The serum myoglobin level shows a decreasing tendency after hydration and was normalized 16 hours after recovery of low blood pressure and law urine output (71.3±11.9ng/ml). 4) There was a significant relationship between serum myoglobin and blood hydrogen ion concentration (r=0.5, p$lt;0.05). 5) There was a significant negative correlation between serum myoglobin and PaO2 (r=0.7, p$lt;0.01). 6) There was a significant relationship between se- rum myoglobin and serum creatinine (r=0.8, p$lt;0.001). The above results suggest that in shock patients, the rapid recovery of blood pressure and urine output by hydration is important to protect the deterioration of renal function by myoglobin molecules.

소화기종양환자에서 CA19 - 9 과 TPA 의 진단적 의의

이복희(Bok Hee Lee),윤세진(Sei Jin Youn),윤오주(Oh Ju Youn),송민호(Min Ho Song),이헌영(Heon Young Lee),김삼용(Samyong Kim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.2

To evaluate the diagnostic significance of serum CA 19-9 and tissue polypeptide antigen (TPA) in patients with gastrointestinal tumors, serum CA 19-9 levels were measured by radioimmunoassay with monoclonal antibody. Serum levels of CEA, TPA and AFP were measured in 10 patients each of stomach cancer, colorectal cancer, pancreatic cancer, bile duct cancer and hepatoma and in 10 normal control subjects and 10 patients with benign gastric ulcer. The results were as follows: 1) Serum CA 19-9 and TPA levels in normal controls were 16+-5.0 u/ml(M+-SD) and 96+-38 u/1 respectively. Serum CA 19-9 and TPA levels in patients with benign gasric ulcer were 11.9+-7.4 u/ml and 113+-43 u/1 respectively and there were no significant difference between them. 2) Serum CA 19-9 and TPA levels were elevated 60% (30/50) and 54% (27/50) of all gasrointestinal tumors respectively. According to tumor types, serum CA 19-9 and TPA levels were elevated 50% and 60% of stomach caner, 50% and 40% of colorectal cancer respectively. Serum CA 19-9 levels were elevated 70% of pancreatic cancer, 80% of bile duct cancer, most prominently, Serum TPA levels were elevated 70% of hepatoma, and serum AFP were elevated 60% of hepatoma (Cut-off value was 26 u/ml in CA 19-9, 172 u/l in TPA, 4.3 ng/ml in CEA, 100 ng/ml in AFP) 3) Serum CA 19-9 and TPA levels in patients with metastasis (128+-82 u/ml, 430+-326 u/1) were significantly different from that in patients without metastasis (47+-54 u/ml, 190+-470 u/1) 4) There were no correlation between CA 19-9 and CEA, between TPA and CEA as well as AFP in patients with hepatoma and other gastrointestinal disease. 5) The sensitivities of combinations of CA 19-9 and CEA, TPA and CEA were 70% and 90% respectivelty in stomach cancer, and the sensitivities of both combinations in colorectal cancer were 70% and 60% respectively. 6) The sensitivities of combinations of Ca 19-9 and CEA, TPA and CEA were 90% and 60% respectively in pancreatic cancer, In bile duct cancer, the sensitivities of CA 19-9 alone (80%) was equal to the combinations of CEA and TPA, or CA 19-9 and CEA. 7) The sensitivities of combinations of CA 19-9 and AFP, TPA and AFP were 80% and 90% respectively in hepatoma. Thus. It is concluded that CA 19-9 and TPA are useful tumor markers in above mentioned gastrointestinal tumors, especially when used in combination it will increase sensitivity. Assays of serum CA 19-9 and TPA in gastrointestinal tumors may be useful as tumor markers.

성인 급성골수성 백혈병의 DAV ( Doxorubicin Ara - C and Vp - 16 ) 복합화학요법

박철신(Cheol Shin Park),김종완(Jong Wan Kim),송민호(Min Ho Song),조덕연(Deog Yeon Jo),윤오주(Oh Joo Yune),한성필(Sung Pil Han),김삼용(Sam Yong Kim) 대한내과학회 1989 대한내과학회지 Vol.36 No.3

N/A To evaluate the therapeutic effect and usefulness of DAV combination chemotherapy, 12 patients with adult acute myelogenous leukemia were treated with a DAV (Doxorubicin 45 ㎎/㎡ 4, days 3-5, Ara-C 100 ㎎/㎡ 4, days 1-8 and VP-16 100 ㎎/㎡ 4, days 6-8) regimen for remission induction. The results were as follows: 1) The rate of complete remission was 10/13 (76.9%) including one case of re-induction chemotherapy. 2) The median remission duration and the median survival duration in-completely remitted patients were 8 months (1-16 months) and 10 months (2-25 months), respectively. 3) Two among the 9 remitted patients were relapsed (22%). 4) The 2-year survival rates of all patients, the completely remitted patients and the in-completely remitted patients were 33%, 50% and 0%, respectively. 5) The drug toxicities of grade 3 or more (grade 2 or more in anorexia, nausea and alopecia) according to ECOG (Eastern Cooperative Oncology Group) toxicity criteria were as follows: leukopenia-11/12 (92%), anorexia and nausea-8/12 (67%), alopecia-8/12 (67%), mucositis and stomatitis-7/12 (58%) and hemorrhage-5/12 (42%). Thus, we conclude that DAV combination chemotherapy is one of the useful and encouraging therapeutic regimens in remission induction of adult acute myelogenous leukemia.