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강진경 ( Jin Kyung Kang ),서정삼 ( Chung Sam Suh ),노원식 ( Won Shick Loh ),최일생 ( Il Saing Choi ),( John T. Santinga ) 대한내과학회 1969 대한내과학회지 Vol.12 No.11
A case of pituitary adenoma with giantism is presented. The early onset at the age of nine is distinctly unusual and has not been previously described in Korea. The evaluation showed a hypopituitary state to be present as indicated by the lack of puberty a
정상인 및 간경변증에 있어서의 Wedged Hepatic Venous Pressure
강진경 ( Jin Kyung Kang ),최흥재 ( Heung Jai Choi ),고운희 ( Woon Hi Koh ) 대한내과학회 1969 대한내과학회지 Vol.12 No.6
Because of the anatomic location of the portal vein, measurement of the portal vein pressure in man has been possible only at laparatomy, The catheterization of the hepatic vein in man was first described by Warren et al. in 1944, and Myer et al. reported
각종 간질환 환자에서 혈청 Type IV Collagen 측정
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),문영명(Young Myung Moon),한광협(Kwang Hyub Han),전재윤(Chae Yoon Chon),박찬일(Chan Il Park),박영년(Young Nyun Park),정진이(Jin Yi Chung) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.2
N/A Serum type IV collagen levels determined with one-step sandwich enzyme immunoassay using monoclonal antibodies were compared with histologic changes in the liver biopsy specimens from 95 patients with various liver diseases. Although serum type IV collagen levels were not significantly increased in patients with fatty liver and chronic persistent hepatitis compared to normal controls .serum type IV collagen levels were significantly increased in patients with chronic liver disease such as chronic active hepatitis or liver rirrhosis compared to normal controls and patients with fatty liver and chronic persistent hepatitis. According to the progression of liver disease, serum type IV collager levels wen significantly increased. In addition, all the 31 patients with chronic active hepatitis with early cirrhosis and liver cirrhosis showed elevated serum type IV collagen levels higher than mear plus one standard deviation level of controls. Serurn type. IV collagen levels did not correlate with serum transaminase levels in patients with chronic liver disease, A significant positive correlation was found between the serum type IV collagen level and the degree of fibrosis, piecemeal necrosis and portal and/or periportal inflamniation in patients with chronic active hepatitis. the results suggest that the serum type IV collagen levels correlate well with the degree of hepatir fibrosis. Therefore the measurement. of serum type IV collagen level is relatively simple and useful method to reflect the progress of hepatic fibrosis.
간장 ( 肝臟 ) · 담도 ( 膽道 ) 및 췌장 ( 膵臟 ) : 원발성 간외담관암의 임상적 고찰
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),최원(Won Choi),정재복(Jae Bock Chung),김원호(Won Ho Kim),김영수(Young Soo Kim),임대순(Dae Soon Yim),송시영(Si Young Song) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.4
N/A Despite significant advances in the diagnosis and treatment of various malignancies, the manangement of extrahepatic bile duct carcinoma remains most frustrating. Unfortunately complete excision of the tumor often impossible, because non-expandable anatomic structures are involved early. In an effort to identify the clinical characteristics and those factors associated with these car- cinomas which might have prognostic value, we analyzed the 216 patients with carcinoma of extrahe- patic bile ducts who were admitted to Severance Hospital, Yonsei University from January 1979 to July 1989. 1) The mean age of the patients clinical manifestations included jaundice in 198 cases (91.7%), abdominal pain in 125 cases (57.9%), hepatomegaly in 124 cases (57.4%) and weight loss in 120 cases (55.6%). The biliary stones were associated in 20.4% and the Clonorchis sinesis in 7.4%. 2) The range of total bilirubin levels on admission was 2.0 +- 9.9 mg/dl in 54 cases (25.0%), 10.0 +- 19. 9mg/dl in 78cases (36.1%) and more than 20mg/dl in 68cases (31.5%). 3) Abdominal ultrasonography, computed tomography, ERCP and PTC were performed in 178, 125, 133, 87 cases respectively, and their diagnostic accuracies were 51.1%, 66.4%, 84.2% and 93.1%, respecti vely. 4) The tumors were located in upper third in 83 cases (38.4%), middle third in 51 cases (23.6%) and lower third in 56 cases (25.9%). And the cases of diffuse type were found in 26 cases (12.0%). 5) The direct invasion of surrounding structures were found in 84.9% of patients, the regional lymph node metastasis in 43.9% and the distant metastasis in 12.% 6) Among 129 cases histologically confirmed the diagnosis, the tumor was well differentiated in 28 cases (21.7%), moderately differentiated in 34 cases (26.4%), poorly differentiated in 36 cases (27.9%), undetermined differentiation in 36 cases (27.9%), and epidermoid carcinoma in 1case (0.8%) and pleomorphic giant cell carcinoma in 1 case (0.8%). 7) The conservative treatment was performed in 52 cases (24.1%), non-operative biliary drainage in 41cases (18.9%). Among 119 (55.1%) cases who underwent operation, 67cases (31.1%) had t-tube choledochostomy, 29 cases (13.4%) biliary-enteric bypass and 23 cases (10.6%) radical resection. 8) The cumulative postoperative median survival from the date of definitive diagnosis was 5.8 months and its mean survival was 9.5 months. a) When analyzed survival rate according to the location of the lesion, the survival data were: upper third lesions, 12.8%, 3.7% and 3.7% at 1 year, 3year and 5year, respectively; middle third lesion, 33.7%, 7.9% and 3.9%, respectively; the lower third lesions 40.0%, 16.8% and 8.4%, respectively. And the 1 year and 2 year survival rate were 31.0% and 12.0% respectively in the patients with diffuse lesions. The survival in patients with carcinoma of lower third bile duct lesions were significantly higher than in upper third lesions and diffue leseions (p<0.05), and there was no statistical significance between in lower third and middle third lesions. b) Survival rates according to the histologic differentiation were; well differentiated lesions, 58.1%, 29.5% and 14.8% at lyear, 3year and 5year, respectively; moderate differentiated lesions, 38.6%, 18.0% and 18.0%, respectively; poorly differentiated lesions, 12.5%, 6.3% and 0.0% respectively. The survival in well differentiated lesions were significantly higher than in poorly differentiated lesions (p<0,05). c) Survival rates according to the stage were: stage II, 83.3%, 37.0% and 27.8% at lyear, 3year and 5year, respectively; stage III, 39.2%, 8.7% and 8.7%, respectively; stage IV, 17.7%, 4.7% and 2.4%., respectively. The survival rate in stage II lesions were significantly higher than stage III (p < 0. 01) and stage IV (p<0.001). d) Survival rate according to the modalities of treatment were: conservative treatment group, 6.2% at 6 month without any surviver longer than lyear; non-operative biliary drainage group
위장관 ( 胃腸管 ) : 위암 환자에 있어서 말초혈액 단핵구 및 국소 림프절 단핵구의 NK 및 LAK 활성도에 관한 연구
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),김원호(Won Ho Kim),노성훈(Sung Hoon Noh),함기백(Ki Baik Hahm),김태수(Tae Soo Kim),안신기(Shin Ki Ahn),윤정구(Jung Koo Youn) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2
N/A Several lymphocytic subpopulations, such as natural killer (NK) cells and lymphokine-activated killer (LAK) cells, are involved in immunosurveillance against tumors. Whereas the biological significance of the regional lymph node as a tumoral barrier remains unclear, the clinical prognostic relevance of the neoplastic infiltration of these nodes is accepted. Although there is general agreement that the NK and LAK activities of peripheral blood mononuclear cells (PBMC) decreases in patients with various solid and leukemic tumors, this decrease remains unclear with regard to the NK and LAK activities of their regional lymph node mononuclear cells (LNMC). We measured NK and LAK activities of PBMC and LNMC in 10 patients with resectable gastric cancer by 4 hour Cr-release assay using K562, Raji cell and allogenous gastric cancer cell as a target cell. The results obtained are as follows: l) Recombinant interleukin-2 induced strong cytotoxic activities against various target cells in PBMC and LNMC. 2) In patients with gastric cancer, NK and LAK activities of LNMC against K56Z and Raji cell were lower than those of PBMC. 3) However, NK ad LAK activities against the allogenous gastric cancer cell did not differ between LNMC and PBMC. 4) NK and LAK activities of PBMC and LNMC against K562 and Raji cell were not different betveen in patient with early gastric cancer and in patients with advanced gastric cancer. 5) However, NK and LAK activities of PBMC ad LNMC against the allogenous gastric cancer cell were lower in patients with advanced gastric cancer than in patients with early gastric cancer.
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),문영명(Yong Myung Moon),한광협(Kwang Hyub Han),전재윤(Chae Yoon Chon),김경희(Kyung Hee Kim),이관식(Kwan Sik Lee),임대순(Dae Soon Lim) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.1
N/A We studied clinical significance of 2'.5'-AS activity in PBMC in HBs Ag positive liver disease and the relation between the anti-viral effect and 2'5'-AS activity in PMBC after interferon administration in chronic active hepatitis. 2'.5'-AS activity in PBMC was determined in 51 patients with HBsAg positive liver disease (acute hepatitis; 10, chronic persistent hepatitis; 10, chronic active hepatitis; 25, liver cirrhosis; 6) and in 10 healthy adult controls. 1) 2'.5'-AS activity in PBMC was in healthy controls, 508.2 +- 123.5 fmole/lhr/lml lysate, where as in patients with acute hepatitis, it was 1250.5 +- 790.5 fmole/1hr/1ml lysate, 862.1 +- 432.0 fmole/1hr/ 1ml lysate in chronic persistent hepatitis, 862.6 +- 432.0 fmole/lhr/lhr/lml lysate in chronic active hepatitis, 699.8 +- 222.6 fmole/lhr/lml lysate in liver cirrhosis. 2) The level of 2'.5'-AS activity in PBMC during acute exacerbation of chronic active hepatitis was 1264 +- 494 fmole/lhr/lml lysate, where as in patients without acute exacerbation, it was 693 +- 398 fmole/lhr/lml lysate. 3) In 9 patients with chronic active hepatitis treated with HuIFN-B, the pretreatment 2'.5'-AS activity in PBMC who became negative for HBV DNA and HBeAg at 6 months after interferon treatment was higher than in patients who did not become negative. In conclusion, in vivo interferon system is activated during acute viral hepatitis and acute exacerbation in chronic hepatitis and that measurement of 2'.5'-AS activity could be used to evaluate in vivo state of the interferon system and to predict the result of interferon treatment.
담관내압측정검사 ( Biliary Manometry ) 로 진단된 Biliary Dyskinesia 2예
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),정재복(Jae Bock Chung),이상인(Sang In Lee),김원호(Won Ho Kim),송시영(Si Young Song) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
Biliary dyskinesia is a rare disease and is defined as a primary disorder of sphincter of Oddi (SO) tonic/phasic motor activity without evidence of a structural narrowing of part or all of the SO segment. It is suspected when a patient, usually a woman, presents with biliary-type pain in the absence of a structural cause for such pain. Some authors classified SO motor disturbances into two broad categories. papillary stenosis: defined as a structural narrowing of the SO segment, and biliary dyskinesia. But because of the difficulty in clearly separating these two clinical entities, this syndrome is sometimes referred to such as SO dysfunction. Even though various tools to diagnose biliary dyskinesia have been developed, such as simple ultrasonography and ultrasonography after a fatty meal or cholecystokin administration, cineradio-graphy, ERCP, nuclear scintigraphy and biliary manometry, ERCP and biliary manometry are still considered as the gold standards. In Western countries, the number of reports of biliary dyskinesia confirmed by manometry have tended to increase recently, but it was known to be absent up to now in Korea. We report two cases of biliary dyskinesia confirmed by manometry who had suffered from recurrent biliary colic and showing normal findings on ERCP and ultrasonography without evidence of structural lesions. On biliary manometry, the basal and peak pressures of SO phasic contractions were markedly elevated and the frequencies of the phasic wave also increased (tachyoddia). After endoscopic sphincterotomy was performed for the purpose of treatment, a remarkable decrease in basal and peak pressure of SO phasic contraction was noted and the subjective symptoms were disappeared campletely.