우측 쇄골하동맥의 기시이상으로 인한 연하곤란증

문한규(Han Kyu Moon),허윤(Yoon Huh),양웅석(Ung Suk Yang),김치호(Chio Ho Kim),최장락(Jang Rack Choi),강필중(Pill Joong Kang),유방현(Bang Byun Liu),박희욱(Hee Ug Park) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.3

The presence of aberrant right subclavian artery which causes dysphagia in adults is rare. However its recognition as a possible cause of dysphagia is important because of its benign prognosis. This type of dysphagia must be considered in the differential diagnosis of difficulty in swallowing in the elderly as well as in children and young adults. We report a case of an aberrant right subclavian artery (Dysphagia Lusoria), 53-year-old woman who presented dysphagia. This case was confirmed and treated by surgical operation.

소화기 양성질환 및 악성종양에 있어서 CA 19 - 9 , CEA , CA125 및 AFP 에 관한 연구

문한규(Han Kyu Moon),허윤(Yoon Huh),차광수(Kwang Soo Cha),양웅석(Ung Suk Yang),최장락(Jang Rack Choi),강필중(Pill Joong Kang),이광욱(Kwang Uk Lee) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2

Serum concentrations of CA19-9, CEA, and CA125 in 147 patients with gastrointestinal and hepatobiliary diseases, 68 malignant and 79 nonmalignant, were investigated to analyze the clinical significance of these tumor markers, and furthermore, these tumor markers were compared with AFP in the patients with hepatic diseases, both benign and malignant. The results were summarized as following: 1) The serum concentrations of CA19-9, CEA, and CA125 were much higher in the malignant diseases than those of benign diseases, and also significantly higher sensitivities were observed in CA19-9 and CA125 in the malignant diseases. But the sensitivities of CEA inthe malignant and benign diseases were not showed statistical difference (28% vs 15%). 2) The serum concentrations of AFP in patients with hepatoma were significantly higher than those of liver cirrhosis or other benign liver diseases, and also significantly higher sensitivity of AFP was observed in the patients with hepatoma than the others. 3) Between the each disease and each tumor marker, there were no significant correlations. 4) According to the presence of metastasis or not, no significant diffetence in the mean values of the tumor markers was observed. But in the patients with hepatoma, much higher value of AFP was obtained in the patients with metastasis (107.7 +- 148.9 ng/ml vs 281.8 +- 108.1 ng/ml, p<0.05). 5) ln the patients with cancer of biliary tract, pancreas and colorectal region, there noted high serum levels and sensitivities of CA19-9, and highest sensitivity of CA19-9 in the patients with benign biliary tract disease, mainly composed of acute cholangitis. But the statistical significance was not defined in these small number of groups. 6) In the patients with the malignant diseases, the sensitivity of CA125 was 46%, and with color- ectal, pancreatic, and stomach cancer, the sensitivities of CA125 were 60%, 56%, and 53% in order. 7) Single CEA test is not sufficient for the screening of gastrointestinal malignancy. Combined tumor marker tests among CEA, CA19-9 and CA125 were more accurate than single test.

복수에서의 Carcinoembryonic Antigen 과 Alpha - Fetoprotein 에 관한 연구

유석동(Seuck Dong Yoo),강영진(Young Jin Kang),홍택종(Taek Jong Hong),박희욱(Hee Ug Park),김성은(Seong Eun Kim),최장락(Jang Rack Choi),조군제(Goon Jae Cho),양웅석(Ung Suk Yang),허윤(Yoon Huh) 대한내과학회 1988 대한내과학회지 Vol.35 No.2

N/A In order to determine whether carcinoembryonic antigen (CEA) & alpha-fetoprotein (AFP) in ascitic fluid assist in the diagnosis of malignant disease in abdominal cavity and their peritoneal metastasis, the authors studied 39 cases of malignant ascites patients (of which 19 cases were proven to be peritoneal metastasis) and 38 cases of nonmalignant ascites patients and analyzed the CEA 8z AFP levels of those cases from February, 1987 to August, 1987 in Pusan National University Hospital. The results obtained were as follows: 1) The CEA level of the malignant ascites group was significantly higher than that of the nonmaligant ascites group in ascitic fluid (p<0.005), but not significant in serum (p>0.05). 2) The AFP level of the malignant ascites group was significantly higher than that of the nonmaligant ascites group in ascitic fluid and serum (p<0.01; ascitic fluid, p<0.005; serum). 3) The CEA level of the hepatoma group was significantly lower than that of the non-hepatic malignant group in ascitic fluid and serum (p<0.005), but the AFP level of the hepatoma group was significantly higher only in ascitic fluid (p<0.005). 4) The AFP level of the hepatoma group was significantly higher than that of the liver cirrhosis group in ascitic fluid and serum (p<0.005) but the CEA level of the hepatoma group was significantly higher only in ascitic fluid (p<0.005). 5) Ascitic fluid and serum CEA levels were higher than the upper limit (4.37 ng/ml; ascitic fluid, 5.35 ng/ml; serum) in 15 of 39 of the cases in the malignant ascites group (38.5%), of which 11 eases proven to be peritoneal metastasis (8 cases of stomach Ca, 2 cases of pancreatic Ca, 1 case of colon Ca). 6) The specificity of ascitic fluid CEA for malignant diseases in the abdominal cavity was 86.8%, the positive predictability was 82.1%, the sensitivity was 59.0%, and the negative predictability was 67.3%. The specificity of serum CEA was 94.7/o, the positive predictability was 88.2%, the sensitivity was 38,5% and the negative predictability was 60.0%. 7) Ascitic fluid and serum AFP levels were higher than the upper limit (35.40 ng/ml; ascitic fluid, 43.02 ng/ ml; serum) in 14 of 39 of the cases in the of the cases in the malignant ascites group (35.9%), all of which were primary hepatoma out only 2 cases proven to be peritoneal metastasis. It was concluded that the measurement of ascitic fluid CEA & AFP levels is useful in determining the existence, peritoneal metastasis and differential diagnosis of malignant diseases in the abdominal cavity.

위암의 내시경소견과 병리조직학적 소견의 비교검토 : 내시경적 Borrmann type 을 중심으로

김경수,양웅석,문한규,허윤,최장락,송철수,박희욱 대한소화기내시경학회 1990 Clinical Endoscopy Vol.10 No.1

In order to evaluate the accuracy of endoscopic findings in the diagnosis of gastric can the endoscopic findings of gastric lesion were compared with the macroscopic and pathologic findings of excised identical lesion. 105 operated gastric cancer paitients (advanced cancer 95 cases, early cancer 10 cases) who were diagnosed endoscopically at Pusan National University Hospital from January 1983 to August 1987 were studied. The results were as follows; 1) The accuracy of endoscopic findings were 94.7% in the advanced gastric cancer, and 45.5% in the early gastric cancer. 2) The accuracy of gross findings endoscopic and pathologic in advanced gastric cancer were 50.0% in Borrmann type I, 45.0% in Borrmann type II, 73.2% in Borrmann type III, and 66.7% in Borrmann tyye IV. 3) The accuracy of the endoscopy ia morphologic classification of advanced gastric cancer according to pathologic tumor location were 60.0% in C (upper 1/3), 43.9% in M(middle 1/3),76.3% in A (lower 1/3), 55.6% in the anterior wall, 50.0% in the posterior wall, 66.7% in the greater curavature, and 67.2% in the lesser curvature. 4) The accuracy of endoacopy in morphologic classification of gastric cancer to tumor size ware 54.5% in below 2 cm, 54.5% in from 2.1 cm to 4 cm, 65.4% in from 4.1 cm to 6.0 cm, 80% in from 6.1 cm to 8 cm, 75.0% in above 8.1 cm. 5) The accuracy of endoscopy in the morphologic classification according to the pathologic tumor stage in advanced gastric cancer were 55.6% in TNM stage I, 52.0% in TNM stage II, 65.4% in TNM stage III, and 73,7% in TNM stage IV.

류마치스성 관절염과 동반된 Ochronosis(조직갈변증) 1 예

김상현,이종수,김진도,문한규,최장락,강필중,이광욱,나하연,이헌직,여동승,윤영권,황병욱,곽임수 대한내과학회 1991 대한내과학회지 Vol.41 No.1

Ochronosis, which is autosomal recessive, results from a decreased amount of the enzyme homogentisic acid oxidase, due to which tyrosine and phenylalanine cannot be broken down via the normal pathway. The clinical manifestations of ochronosis usually appear after the age of 30 as a result of the deposition of pigment in the extracellular macromolecules of the connective tissue, particular of the skin and joints. The diagnosis is made by determination of urinary homogentisic acid excretion, and the clinical and radiological findings can help to diagnose this disease. We report a case of Ochronosis with Rheumatoid arthritis presented with skin pigmentation and migrating polyarthritis in a 57-year-old female patient who was managed with an antiinflammatory agent, steroids, and symptomatic care.