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이주홍,김진도,김용은,정광진,서경덕,임권조,구대영 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.2
Anomalous pancreaticobiliary ductal union (APBDU) is an uncommon anomaly, defined as the junction between the common bile duct and the pancreatic duct outside the duodenal wall and beyond the influence of the sphincter of Oddi. This anomaly, which has been recognized frequently since the introduction of ERCP, is believed to be associated with biliary tract lesions such as congenital biliary dilatation, biliary tract carcinoma, and pancreatic lesions such as pancreatitis new paragraph. A 28-year-old male was admitted due to sudden abdominal pain and vomiting. An ERCP revealed a peculiar type of APBDU; the duct of Wirsung and CBD fused and formed a long common channel before entering the major papilla, and the duct of Santorini connected to the duct of Wirsung is patent. So, when contrast dye was inserted into the minor papilla, both the CBD and the duct of Wirsung were made visible. This case of the peculiar type of APBDU which showed characteristic ERCP findings are herein reported.
김용진,이주홍,박용기,김진도,송근암,서경덕,임권조,구대영,이경윤,신용훈,감복규 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.3
Gastritis Cystica Profunda is a rare condition showing multiple small cysts in the mucosa and submucosa of the stomach. These lesions have been found not only at the site of a gastroenterostomy but also in tbe stomchs of patients without any previous surgery. Recently, We witnessed a 56-year old e wale gastritis cystica profunda who had not undergone previous gastric surgery. The UGI and EGD revealed a 3.0 * 4.5 cm sized submucosal mass on the posterior wall of the antrum, and endoscopic ultrasonography(EUS) discovered a thickening of the third layer in which well-defined, round and nearly anechoic areas with posterior enhancement were gathered. They were thought to be cystic lesions. We report a case of gastritis cystica profunda without having had any previous surgery, the diagnosis was made based on findings from the EUS and histologic findings through surgery.
이재승,강대환,문지현,송근암,조몽,양응석,주형준,서경덕,김정렬 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.2
Background and Aims - Zinc is an essential, mostly intracellular, trace element which participates in many oxidative or deoxidative reactions and in a protective action on liver cell activity. Plasma zinc levels are known to decrease in patients with liver disease including chronic viral hepatitis. The aim of this study was to reveal whether hepatic zinc concentrations have a correlation with grades of necroinflammation or stages of fibrosis in the patients with chronic viral hepatitis. Methods - This study consisted of 50 subjects (43 chronic hepatitis B, 4 chronic hapatitis C, and 3 cirrhosis). Each specimen of liver tissue was classified with the grade of lobular inflammation, portal/periportal inflammation, and stage of fibrosis according to Scheuer`s method. Hepatic zinc concentration was determined by ICP-Atomic Emission Spectrometry. Results: The mean hepatic zinc concentration in the 50 chronic viral hepatitis patients was 233.66㎍/g dry weight of liver tissue. The hepatic zinc levels were significanty correlated with the grades of portal/periportal inflammation (rs=-0.385, p=0.006), and grades of lobular inflammation(rs=-0.342, p=0.015). The stages of fibrosis were also negatively related (rs=-0.423, p=0.002). The zinc concentrations differed significantly among grades of lobular inflammation (p=0.013) and among stages of fibrosis (p=0.044). Conclusions- Hepatic zinc concentrations showed negative correlation with grades of portal/periportal inflammation, lobular inflammation, and stage of fibrosis in the patients of chronic viral hepatitis. These results suggest that decreased hepatic zinc concentration might be associated with severe hepatic injury and reflect decreased protective activity on liver cell injury.(Korean J Hepatol 2001;7:147-152)
자기 공명 영상으로 확인한 중추성 시야 결손을 동반한 Thrombotic thrombocytopenic purpura-Hemolytic Uremic Syndrome 1예
이주홍,박용기,김진도,김용은,이태윤,서경덕,구대영,임권조,정유성,신용훈 대한내과학회 1999 대한내과학회지 Vol.56 No.1
Thrombotic thrombocytopenic purpura (TTP) and the related hemolytic uremic syndrome (HUS) are disorders characterized by thrombocytopenia, microangiopathic hemolytic anemia, a variable degree of impairment of renal function and fluctuating neurological symptoms, which are thought to be due to platelet activation and subsequent formation of thrombi in the microcirculation. The fact that there was no clear-cut clinical and laboratory features that differentiate HUS from TTP has lead to view these two syndromes as a clinical continuum. Microvascular thrombosis is the typical lesion and closely related with endothelial injury and platelet activation. Pathologic alterations of the brain parenchyma are mainly manifested by small multiple infarcts. Numerous cases of CNS complications of these syndromes have been evaluated by using CT, but few reports have mentioned the MR findings. We experienced a case of TTP-HUS that had clinical features of cortical blindness and the brain lesion was confirmed by MRI showing cerebral infarct at the occipital area but it was reversible course. So we report this case with a brief review of literature.