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패쇄성 황달을 동반한 간흡충 감염증에 있어서 내시경적 유두절개술의 의의
윤형신(Hyeong Shin Yoon),김연종(Yeon Jong Kim),김호동(Hou Dong Kim),장진형(JIn Hyeong Jang),임연근(Yeun Keun Lim),여향순(Hyang Soon Yeo),박홍배(Hong Bae Park) 대한내과학회 1992 대한내과학회지 Vol.43 No.6
N/A Background: Clonorchiasis is very common in the Far East, especially southern China, Taiwan, Hong Kong, Japan, and Korea, where raw or undercooked fish has long been considered a delicacy. In Korea, people who live in the vicinity of the major four rivers are most frequently infected. 3ome percentage of infected individuals will develop the symptoms of chronic clonorchiasis, which include inflammation, infection, stones, obstruction, and neoplastic changes in the biliary tree. Methods: To evaluate the effects of EST in clonorchiasis patients with obstructive jaundice, 73 patients underwent EST as a method of biliary drainage after praziquantel therapy between August 1989 and July 1991. All of the patients were diagnosed as having clonorchiasis by the stool examination and ERCP and as having obstructive jaundice according to their blood chemistry findings. Results: (pt.; patient) 1) 73 patients, 54 male (74%) and 19 female (26%), underwent EST 1.14 times in average (from 1 to 3 times). 2) The associated diseases of the patients at presentation were biliary stones (22 pt., 30%), pancreatitis (16 pt., 22%), biliary tumors (8 pt., 11%) and liver cirrhosis (5 pt., 7%). 3) AST, ALT, alkaline phosphatase and direct and total serum bilirubin were significantly improved in 32 patients (44%) within 1 week after EST and 63 patients (86%) within 4 weeks after EST (p<.0.01). 4) 10 patients (14%) with biliary tumors (5 pt., 7%), liver cirrhosis (4 pt., 5%) and CBD stone (1 pt., 1%) were not improved in their blood chemistry. 5) Complications (9 pt., 12%) were acute pancreatitis (6 pt., 8%), major bleeding (2 pt., 3%) and acute cholangitis (1 pt., 1%). Conclusion: EST is the very effective, convenient, safe and non-surgical method of biliary drainage in clonorchiasis patients with obstructive jaundice. But it is of little value in most of the patients with biliary tumors and liver cirrhosis.
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박홍배(Hong Bae Park),임연근(Yeun Keun Lim),여향순(Hyang Soon Yeo),장진형(Jin Hyeong jang),김연종(Yeon Jong Kim),김호동(Hou Dong Kim),윤형신(Heyong Shin Yoon),이윤호(Youn Ho Lee),손장신(Jang Shin Sohn) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6
A 56-year-old man was admitted to our hospital because of jaundice. His chest radiography revealed a mass lesion in the left upper lung. Bonchoscopic lung biopsy was performed and the pathological diagnosis was small cell carcinoma of the lung. In his clinical course, obstructive jaundice developed during combination chemotherapy. The findings of abdominal ultrasonography, duodenoscopy with biopsy and percutaneous transhepatic cholangiography suggested that jaundice was developed by extrahepatic biliary obstruction with ampulla of vater metastasis. We experienced one case of obstructive jaundice by ampullary metastasis of small cell carcinoma of the lung cancer in 56-year-old man.
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김호동,김연종,임중규,허진득,윤형신,장진형,김훤,손장신 대한내분비학회 1992 Endocrinology and metabolism Vol.7 No.2
Adrenal cortical carcinoma is a rare tumor that affects all ages and sexes and has a dismal prognosis. Half are functioning and half are not. Functioning neoplasma of the adrenal cortex are clinically manifested by virilization, Cushing's syndrome, feminization, or hyperaldosteronism. A 22-year-old female was admitted to our hospital in April 1990, because of amenorrhea for 6 months, hirsuitism, acne and palpable mass in left upper abdomen for 3 months. Routine laboratory examination including blood chemistry gave no abnormalities. Abdoiminal CT scan demonstrated a large mass with central necrosis and calcification, about 10×15 cm size in left upper abdomen. Endocrine tests revealed; serum testosterone 7.5ng/dl, DHEA-sulfate above 1,000ng/dl, 24-hour urine free cortisol 152 ng/day, 17-KS 50.8 ng/day, 17-OHCS 9.9mg/day. Plasma aldosterone and plasma renin activity were elevated. We report a case of adrenocortical carcinoma with hypersecretion of glucocorticoid and androgen.She also had a secondary aldosteronsm and lung metastasis. She underwent surgical resection of the tumor and treated with mitotan (O.P'-DDD) postoperatively (J Kor Soc Endocrinol 7:160~164, 1992).
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