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조병동(Byung Dong Cho),오흥국(Heung Kuk Oh),장명국(Myoung Kuk Jang),경태영(Tae Young Kyong),이종민(Jong Min Lee),김용범(Yong Bum Kim),김학양(Hak Yang Kim),박충기(Choong Kee Park),유재영(Jae Young Yoo) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.2
N/A Background/Aims: Extrahepatic bile duct(EHBD) carcinoma is a rare tumor among the population of the world and accounts for less than 2% of cancers found at autopsy and about 10% of all biliary duct cancer. To identify the clinical characteristics associated with prognosis and the survival rate by treatment modalities, we reviewed 120 patients with extrahepatic bile duct carcinoma who were diagnosed at the Kangdong Sacred Heart Hospital of Hallym University from June 1987 to October l994. Methods: According to treatment modalities, these patients were divided into 50 cases of the operation group, 47 cases of the non-operative treatrnent group and 23 cases of the no treatment group. The survival rate of these three groups was analyzed according to Cutler-Ederer methods. Results: The most common symptom and sign were jaundice(85.8%) and hepatomegaly (57.5%). The most common site of tumor was the common hile duct(63.3%), followed by the hepatic duct bifurcation(25.8%), the common hepatic duct(9.2%), the cystic duct(0.8%) and tbe diffuse type(0.8%). The median survival was l0.7 months. The survival rate was 76.7% in 3 months, 68.4% in 6 months, 4l.6% in l year, 14.1% in 2 years, and 3.4% in 5 years. According to the treatment modalities, the median survival was l6.3 months in the operation group, 6.3 months in the non-operative treatment group, and 3.5 rnonths in no treatment group. Conclusions: The operation group had a better survival rate than the other group. We conclude that operation offers the best prognosis. The result of this study suggests that early diagnosis and operation prolong survival in these patients. Further studies of adjuvant chernotberapy and radiotapy wi]l be necessary to improve patients survival. (Korean J Gastroenterol 1996; 28:25] 259)
저비중 지단백 콜레스테를 농도의 측정에 있어서 Friedwald 공식과 면역분리법을 이용한 직접측정의 비교
김규원 ( Gyu Won Kim ),조병동 ( Byung Dong Cho ),이형석 ( Hyung Seok Lee ),정승현 ( Seung Hyun Jung ),오길찬 ( Kil Chan Oh ),윤장욱 ( Jang Uk Yoon ),백승훈 ( Seung Hun Baek ),유규형 ( Kyu Hyung Ryu ),임종윤 ( Chong Yun Rhim ),조 대한내과학회 2003 대한내과학회지 Vol.64 No.1
배경 : 심혈관계 질환의 위험인자로 알려진 고지혈증에서 저비중 지단백 콜레스테롤을 측정할 때 중성지방치가 400mg/dL 이상인 사람에서는 저비중 지단백 콜레스테롤의 측정에 Friedwald의 공식을 적용할 수 없으므로 면역분리법으로 직접 측정한 저비중 지단백 콜레스테롤과 Friedwald의 공식에 의해 구한 저비중 지단백 콜레스테롤치와 비교하여 직, 간접측정방법간의 차이를 확인하여, 향후 고지혈증 치료시 저비중 지단백 콜레스테롤의 수치를 더욱 정확하고 Background : In 2001, the third report the National Cholesterol Education Program (NCEP) has concluded that LDL cholesterol levels should be a major goal for preventing coronary artery disease and atherosclerotic events. Those in the higher risk groups sh
한국인의 위궤양 및 십이지장궤양 환자에서 Helicobacter pylori 감염 빈도
장명국(Myoung Kuk Jang),김학양(Hak Yang Kim),조병동(Byung Dong Cho),장웅기(Woong Ki Jang),김동준(Dong Jun Kim),김용범(Yong Bum Kim),박충기(Choong Kee Park),신형식(Hyung Sik Shin),유재영(Jae Young You) 대한내과학회 1997 대한내과학회지 Vol.52 No.4
N/A Objectives: Peptic ulcer is the major condition that affect numerous individuals every year. In 1983, Warren and Marshall presented the evidence that H. pylori was associated with gastritis and peptic ulcer. Thereafter, K. pylori infection is thought to be a important factor in the pathogenesis of gastric and duodenal ulcer. In western studies, about 58% to 100% of patients with peptic ulcer disease were infected with H. pylori. But in Korea, there is no study about the prevalence of H. pylori infection in peptic ulcer disease despite of its high prevalence and importance. The aim of this study was to investigate the prevalence of H. pylori infection in case of gastric and duodenal ulcer disease in Korea. Methods - We surveyed the prevalence of H. pylori infection of 1031 patients, who were diagnosed as gastric or duodenal ulcer by gastrofiberoscopy. H. pylori infection was evaluated with Rapid Urease Test(CLO test) and/or histology by Wright-Giemsa staining. Results: 1) Peptic ulcer was more frequently developed in males than females, as the frequency of peptic ulcer was 77% in males, and 23% in females. But in view of the prevalence of H. pylori infection, there was no significant difference between males and females, 73% in males and 71% in females. 2) Gastric ulcer was most common in sixth decade(29.8%), but the prevalence of H. pylori infection was peak in fourth(76%), and fifth decade (73%). 3) Duodenal ulcer was most common in fourth decade(26.3%), but the prevalence of H. pylori infection was peak in teenagers(93%) and third decade(87%). 4) The patients who had both gastric ulcer and duodenal ulcer concurrently were most common in sixth decade(27.9%), but the prevalence of H, pylori infection was peak in third decade(100%). Conclusion: We concluded that the majority of peptic ulcer patients in Korea had H. pylori infection. Particularly, young aged patients had higher H. pylori infection rate than old aged.
안정형 및 불안정형 협심증 환자에서 관동맥 조영술상 병변형태와 관동맥내 혈전에 대한 비교
이록윤(Rok Yun Lee),한윤창(Yun Chang Han),지재환(Jae Hwan Jee),조병동(Byung Dong Cho),채경수(Gyeoung Soo Chae),장명국(Myoung Kuk Jang),서유미(Yu Mi Seo),김재삼(Jai Sam Kim),경태영(Tae Young Kyong),임종윤(Chong Yun Rim),고영박(Young B 대한내과학회 1996 대한내과학회지 Vol.51 No.6
N/A Objectives: Unlike stable angina, unstable angina is a common syndrome associated with significant morbidity and frequent progression to acute myocardial infarction. Several investigators have suggested that corronary artery thrombus formation, most likely secondary to plaque rupture in complex morphology of stenotic coronary artery, may preci- pitate unstable angina. But the frequency of coronary artery thrombus by coronary angiography is diverse. Methods: In 108 patients with either stable(27 patients) or unstable angina(81 patients), the morphology of coronary artery lesions was qualitatively assessed by angiography. Each obstruction reducing the luminal diameter of the vessel by 50% or greater was categorized into one of Ambrose morphologic classification. Results: Type II eccentric lesion was more frequent in patients with unstable angina pectoris (38.9%) than in patients with stable angina pectoris (6.1%) (p<0.01). Frequency of intraluminal ulcer was 31.9% in unstable angina, and 8.6% in stable angina(p<0.05). Intraluminal thrombus was observed more frequently in unstable angina pectoris(18.6%) than in stable angina pectoris(6.1%)(p<0,05). Conclusions: The high prevalence of type II eccentric lesion morphology, ulcer, and intraluminal thrombus observed in patients with unstable angina emphasizes the important role of intimal disruption and of subsequent thrombogenesis in the pathogenesis of myocardial ischemic in those unstable syndromes of ischemic heart disease.
심한 황달을 동반하며 악화되는 만성 B 형 간염환자에 대한 임상적 고찰
추원석(Won Suk Choo),이재명(Jae Myung Lee),조병동(Byung Dong Cho),이록윤(Rok Yun Lee),오흥국(Heung Kook Oh),정의훈(Eui Hun Jeong),김용범(Yong Bum Kim),김학양(Hak Yang Kim),박충기(Choong Kee Park),유재영(Jae Young Yoo) 대한내과학회 1996 대한내과학회지 Vol.51 No.1
N/A Objectives: Recurrent exacerbation of hepatitis activity is regarded as one of the most important etiological factor in the natural history of chronic hepatitis B in Korea. Among them the development of progressive jaundice seems to be the worst prognostic marker for the progression. This study is conducted to investigate the significance of progressive jaundice in patients with exacerbation of hepatitis H. Methods: We evaluated 30 patients with exacerbation of chronic hepatitis H. The patients were divided into two groups according to the development of jaundice. 15 patients with progressive jaundice were included in Group A, and the other 15 without jaundice were in Group B. Liver function test, serum HBV markers, HBV-DNA and immunoperoxidase staining for HBsAg and HBcAg were performed and followed-up up to one and half years. Results: 1) Among 30 patients, 27 were male and 3 were female and ages from 16 to 57(Mean in Group A;A3 8r Group B; 37) year.;. 2) Serum bilirubin was markedly elevated in Group A, 17.5-36.4(mean 28.0)mg/dL and serum pro- tein, albumin and cholesterol were also markedly decreased compare with those of Group B. 3) Serum HBV-DNA was detectable in all 26 HBeAg positive patients, but was undetectable in 4 HBeAg negative patients in Group A. 4) There was no difference of distribution of HBsAg and HBcAg in the liver tissures by immunoperoxidase staining. The staining pattern was also similar in 2 Groups, mostly cytoplasmic HBcAg. 5) In Group A, spontaneous bacterial peritonitis was complicated in all patients who developed ascites. Hut no ascites or bacterial peritonitis was found in Group B. 6) In Group A, 2 patients died during the hospitalization (within 4 weeks after developing jaundice), and one died during follow-up(15 month after initial exacerbation) 6 progressed to decompensated cirrhosis and the rest 6 were in stable state during follow up. In contrast, there was no death in group H and only 2 were progressed to decompensated cirrhosis. Conclusion: Patients with acute exacerbation of hepatitis developing jaundice showed more severe disease activity regardless of the etiological factor(s). It may be related to the immune status of the patients and/or some kinds of environmental factors which are not yet identified. It would also be necessary to identify the precore mutant infection to these type of patients and extensive treatment modalities should be investigated.
흡연력을 고려한 궤양성 대장염 발생과 충수 절제술 사이의 상관 관계
김승용,홍원선,남승우,민영일,정훈용,양석균,심기남,조병동,박의련 대한소화기학회 1998 대한소화기학회지 Vol.32 No.1
Backgraund/Aims: Recently, some authors have suggested that the development of ulcerative colitis (UC) has a strong negativc association with appendectomy, while others have claimed a weak association. We postulated that this discrepancy might be partly explained by the smoking status, a well-known confounding variable, because the previous studies did not consider the smoking status. This study was carried out to evaluate the relationship between appendectomy and the risk for the development of UC after control of smoking status. Methods: The 201 patients with UC and 201 controls recruited from the orthopedic-traumatology clinic were included in this study. For the selection of controls, we matched smoking status as well as age (±1 yr) and sex. For all patients and cantrols, data of previous appendectomy were collected. Results: Prior to development of UC, appendectomy had been performed in 3 out of 201 patients with UC (1.5%) and in 27 out of 201 controls (13.4%). The odds ratio for patients with UC, who had received an appendectomy was O.11 (95% CI, 0.03-0.37; p$lt;0.001). Conclusions: Even after control of the smoking factor, appendectomy is negatively associated with ulcerative colitis.