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유방현(Bang Hyun Liu),문한규(Han Kyu Moon),허윤(Yoon Huh),양웅석(Ung Suk Yang),이강희(Kang Hi Lee),조중현(Joong Hyeon Cho),백대근(Dae Geun Baek),김무현(Moo Hyung Kim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
In cases of Gastointestinal Vascular Malfomnation, which involve the mucosa and submucosa of the gastrointestinal tract, Dieulafoys erosion consists of abnormally large gastric submucosal artery, and ruptures into the stomach. They cause massive or recurrent intragastric bleeding. The lesion is very small and easily overlooked even at laparotomy and can only be correctly diagnosed by endoscopy or arteriography when the patient is actively bleeding. The authers recently observed a case of Dieulafoys disease, this 41-year old man presented an episode of severe melena, but endoscopy and barium enema were all unremarkable. There was history of analgesic abuse because of spondylolisthesis of L4-5. The physical examination was unremarkable except for grossly melenic stools. The hemoglobin was 4.8g/dl. Repeated endoscopy by a more experienced endoscopist demonstrated a vascular malformation at the posterior wall of upper body of stomach with coated blood clot. An angiography including superior mesenteric artery studies, reveal vascular malformation of the left gastroepiploic artery. A total of 30 units of blood had been replaced prior to gastrectomy. Postoperatively, he had no further bleeding. Pathologic examination of the stomach showed dilated prominent blood vessels in the submucosa with focally ectatic capillaries in the lamina propria. Two weeks after operation, the hemoglobin showed 14.0g/dl, and he discharged after improvement.
유방현(Bang Hyun Liu),양웅석(Ung Suk Yang),이강희(Kang Hi Lee),조중현(Joong Hyeon Cho),백대근(Dae Kun Baik),김성은(Seong Eun Kim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
N/A A clinical study on 71 cases of chronic hepatitis, proven by liver biopsy, and its contrasting feature according to HBsAg positivity was performed at Pusan National University Hospial from Mar. 1983 to Dec. 1986. The results were as follows; 1) Of the total 71 cases, involving 45 cases of chronic active hepatitis and 26 cases of chronic persistent hepatitis, male to female ratio was 5.5:1. The mean age of chronic active hepatitis with HBsAg was significantly lower than that of chronic acive hepatitis without HBsAg (p<0.001). 2) The incidence of HBsAg was 80.0% in chronic active hepatitis and 65.4% in chronic persistent hepatitis. 3) On admission, the chief complaints were fatigue, indigestion, epigastric and RUQ discomfortness, hepatomegaly, jaundice, and splenomegaly in order of frequency respectively. 4) On chemical liver function studies, chronic active hepatitis with HBsAg showed more increased value of serum AST, ALT than that of chronic hepatitis without HBsAg (p<0.05). 5) On radioisotope liver scan, hypertrophic pattern of liver and mild spleen visualization was the most common findings. 6) Liver biopsy findings showed the increased incidence of piecemeal necrosis and concomitant fibrosis in chronic active hepatitis than chronic persistent hepatitis, but no significant difference was found between HBsAg positive and negative chronic hepatitis.
공간점유간병소 및 췌병소에 대한 초음파 유도하 세침흡입 세포진에 관한 연구
양웅석(Ung Suk Yang),조중현(Joong Hyeon Cho),김영훈(Young Hoon Kim),강영진(Young Jin Kang),이강희(kang Hee Lee),허윤(Yun Huh),문한규(Han Kiu Moon),유방현(Bang Hyeon Liu) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
N/A Liver biopsy by Menghini technique has a relatively low sensitivity and high risk in diagnosing space occupying lesions of the liver. Moreover, any biopsy method except exploratory laparotomy has not been useful in pancreatic lesions. Recently ultrasonically guided percutaneous fine needle aspiration cytodiagnosis is widely used in evaluating space occupying lesions of the liver and deep-seated organ, such as pancrea, because of its high sensitivity, safety and simplicity. Ultrasonically guided percutaneous fine needle aspiration cytodiagnosis was carried out to evaluating its diagnostic performance in 20 patients with space occupying lesions of the liver and in 3 patients with pancreatic lesions who were admitted to the Pusan National University Hospital from Oct. 1985 to Jan. 1986. The results were as follows: 1) Clinically diagnosis before ultrasonically guided percutaneous fine needle aspiration cytodiagnosis were primary hepatoma in 16 patients, liver abscess in 2 patients, hepatic cyst in 2 pateints, pancreatic cancer in 2 patients. 2) The cytodiagnosis in space occupying lesions of liver were as follows: The 14 patients of the 16 patients with clinically primary hepatoma were positive. All of the 2 patients with suspected liver abscess were confirmed. And all of the 2 patients with suspected heaptic cyst were same as clinical diagnosis. 3) The cytodiagnosis of the pancreatic lesions were as follows: Of the two patients with suspected pancreatic cancer one was positive and the negative patient were confirmed pancreatic cancer by the exploratory laparotomy. One patient with clinically pancreatic cyst was revealed as pancreatic cyst by the cytodiagnosis. 4) There was no complication in performing ultrasonically guided percutaneous fine needle aspiration cytodiagnosis.