족관절 골절의 임상적 고찰

정준화(Joon Wha Chung),정태영(Tae Young Chung),이영구(Young Koo Lee),권칠수(Chil Soo Kwon),서광윤(Kwang Yoon Seo) 대한정형외과학회 1978 대한정형외과학회지 Vol.13 No.3

임신과 동반된 위암의 임상적 고찰

신준한(Joon Han Shin),오제열(Je Yol Oh),박효진(Hyo Jin Park),정준표(Jun Pyo Chung),이관식(Kwan Sik Lee),이상인(Sang In Lee),박인서(In Suh Park),최흥재(Heung Jae Choi) 대한내과학회 1993 대한내과학회지 Vol.45 No.1

N/A Background: Gastric cancer associated with pregnancy is rare. Because of the similarity of symptoms between gastric cancer and preganancy, limitations in diagnostic approaches and difficulties in saving both mother and fetus, the prognosis is poor. Therefore, we analyzed the clinical features of gastric cancer associated with pregnancy, appropriated diagnostic approaches and practical guidlines for treatment. Method: We collected 23 cases of gastric cancer detected during pregnancy or within 12 months after delivery from January, 1980 to June, 1992. And age of patients, approaches of diagnosis, stage of cancer, pre- dominant histological features, results of surgical and obstetric treatment, and prognosis were analyzed according to the stage of pregnancy. Results: 1) Mean age of the patients at the time of diagnosis of the gastric cancer was 29.0±3.0 years old. Age range was 20-29 years old in 14 cases and 30-39 years in 9 cases. 2) The common presenting symptoms and signs were vomiting (52.2%), nausea (47.8%) and epigastric pain (47.8%). Mean duration from symptom onset to diagnosis was 6.5±7.8 months. 3) The percentages of patients diagnosed by endoscopic examination and barium study was 91.3% and 8.7%, respectively. In 5 cases, the distant metastases were found incidentally and then the primary focus was diagnosed by endoscopic examination or barium study. 4) Early gastric cancer was detected in 13.0% and advanced gastric cancer in 87.0%. In early gastric cancer, one case was found during pregnancy. 5) The histological features of gastric cancer were adenocardinoma in all cases and the types were poorly differentiated cell type (38.1%) and signet ring cell type (69.1%) 6) The treatment for gastric cancer was performed by surgery only in 21.7% and by combined surgery and chemotherapy in 21.7%. 7) The obstetric outcomes in patients diagnosed during pregnancy were normal spontaneous delivery in one case, preterm vaginal delivery in two cases, induced abortion in four cases and spontaneous abortion in one case. Conclusion: As the results show most of the gastric cancers associated with pregnancy was found in advanced state and their prognosis were grave. But same cases were early gastric cancers and in some cases complete resection was possible. Therefore, in order to improve the prognosis of gastric cancer associated with pregnancy, early diagnosis by endoscopy and appropriate treatment are emphasized.

췌장질환의 실험 동물모델

한기준(Ki Joon Han),정준표(Jun Pyo Chung) 대한소화기학회 2001 대한소화기학회지 Vol.37 No.3

Experimental animal models have been used to study pancreatitis for more than a century. Although they are not always closely related to the disease in humans, they have contributed greatly to our current understanding of the pathophysiology and cell biology of this disease. They have also become a standard means for testing new treatments of pancreatitis. The use of relevant animal models for the study of pancreatic cancer will help us clarify the process of pancreatic carcinogenesis and understand the effects of environmental and genetic elements on pancreatic cancer development, which will eventually contribute to prevention and treatment of this deadly disease. In this article, experimental animal models with acute and chronic pancreatitis, and pancreatic cancer are briefly reviewed considering the merits and demerits in use of experimental animal models. (Korean J Gastroenterol 2001;37:145-159)

급성 췌장염의 진단에 있어서 Urinary Trypsinogen-2 Dipstick 검사의 유용성

황성준 ( Seoung Joon Hwang ),정준표 ( Jun Pyo Chung ),김영균 ( Young Gyun Kim ),송대훈 ( Dae Hoon Song ),이재성 ( Jae Sung Lee ),백승석 ( Seung Seok Baek ),김도연 ( Do Yun Kim ),이덕용 ( Dok Yong Lee ),정연수 ( Yon Soo Jeong ) 대한소화기학회 2004 대한소화기학회지 Vol.43 No.6

Background/Aims: The clinical usefulness of urinary trypsinogen-2 dipstick test is still in controversy. We evaluated the usefulness of urinary trypsinogen-2 dipstick test in patients with acute pancreatitis. Methods: Urinary trypsinogen-2 dipstick test was prospectively performed in 50 patients with acute pancreatitis, 50 patients with non-pancreatic abdominal pain, and 50 healthy controls. Results: On admission, urinary trypsinogen-2 dipstick test was positive in 36 of 50 patients with acute pancreatitis (sensitivity, 72%) and in 4 of 50 patients with non-pancreatic abdominal pain (specificity, 92%). On the other hand, it was all negative in controls. The sensitivity and specificity of serum lipase were 78% and 94%, respectively. At 24 hours after admission, the positive rate of urinary trypsinogen-2 dipstick test rose from 72% to 94% (p=0.02). The results of urinary trypsinogen-2 dipstick test was positive in 14 of 15 patients with severe pancreatitis and 22 of 35 patients with mild pancreatitis according to the criteria by Atlanta International Symposium, 1992. Conclusions: Urinary trypsinogen-2 dipstick test is comparable to serum lipase in diagnosing acute pancreatitis. Delayed measurement and severe pancreatitis are more likely to yield positive results with urinary trypsinogen-2 dipstick test. Thus, we suggest that the cut-off value of urinary trypsinogen-2 dipstick test should be lowered to increase its sensitivity. (Korean J Gastro-enterol 2004;43:364-369)

간내담석에 동반된 이소성 폐흡충증 1 예

김똘미(Dol Mi Kim),정준표(Jun Pyo Chung),박우일(Woo Il Park),박영년(Young Nyun Park),박승우(Seung Woo Park),이세준(Se Joon Lee),송시영(Si Young Song),이관식(Kwan Sik Lee),정재복(Jae Bock Chung),이상인(Sang In Lee),강진경(Jin Kyung Ka 대한소화기학회 2002 대한소화기학회지 Vol.39 No.2

Paragonimiasis is essentially a pulmonary disorder, but many organs such as the brain, muscle, mesentery, genital tract, spinal cord, spleen, and liver may be involved. Cases of hepatic paragonimiasis presented with hepatic masses have rarely been reported in Korea. We experienced a case of hepatic paragonimiasis incidentally found after a hepatic resection for treatment of localized left intrahepatic stones in an asymptomatic 51-year-old female patient. We report this interesting case of hepatic paragonimiasis accompanied with intrahepatic bile duct stones with a review of literature. (Korean J Gastroenterol 2002;39:133-136)

위하수의 임상적 의의

김은숙(Eun Sook Kim),박효진(Hyo Jin Park),염준섭(Joon Sup Yeom),권선옥(Sun Ok Kwon),정준표(Jun Pyo Chung),이관식(Kwan Sik Lee),이상인(Sang In Lee),박인서(In Suh Park) 대한내과학회 1997 대한내과학회지 Vol.52 No.4

N/A Objectives: Gastroptosis is defined as a condition in which the gastric angel is located below the interiliac line in standing position in the UGI barium study. The present study was designed to evaluate its prevalence, relation to clinical symptoms, body weight and gastric emptying time. Methods: Two hundred-twenty seven consecutive subjects undertaken a UGI barium study for general check-up. We analyzed age, sex distribution, body weight percentile according to ideal body weight, and clinical manifestations. Gastric emptying scan was performed with a semi-solid test meal (2mCi of labeled (99m)Tc-suifur colloid-scrambled egg) on 12 healthy, asymptomatic subjects and 17 patients with gastroptosis. Results: Twenty-one (9.3%) of the 227 subjects had gastroptosis. The ratio of male to female was 1 to 4.57. In age, three (16.7%) of the patients were below the age 40, 14 (8.9%) were between 40 to 49, 4 (7.8%) were above 50. According to the percentile of ideal body weight, 4 (8.6%) of the 14 subjects were under the 90 percentile, 15 (12.6%) of the 179 subjects were between 90 to 110 percentile, and 2 (0.02%) of the 94 were above 110 percentile, which significantly higher in that of under 110 percentile of ideal body weight. The symptoms, which were complained in 8 of the 21 patients, were epigastric discomfort, belching, hunger pain, constipation, and nausea. The mean gastric emptying time (T1/2) was 69.8min and 92.6min in control and gastroptosis group, respectively. T1/2 was delayed in 7 (63.6%) patients with symptomatic gastroptosis and 1 control. Conclusion: The gastroptosis was more common in female and lower body weight group and had a tendency of delay in T1/2z. We consider that gastroptosis may be one of the possible cause of non-ulcer dyspepsia in Korea.

Mirizzi 증후군이 임상적 고찰

안상훈 ( Sang Hoon Ahn ),박승우 ( Seung Woo Park ),정재복 ( Jae Bock Chung ),이진헌 ( Jin Heon Lee ),이세준 ( Se Joon Lee ),정준표 ( Jun Pyo Chung ),송시영 ( Si Young Song ),강진경 ( Jin Kyung Kang ) 대한췌담도학회 1999 대한췌담도학회지 Vol.4 No.1

The Mirzzi syndrome, which occurs in 0.7~1.4% of patients undergoing cholecystectomy, is an unusual benign obstruction of common hepatic duct resulting from ex-trinsic compression by a gallstone impacted in either the neck of the gallbladder or the cystic duct. The aim of this study is to investigate the clinical features of Mirizzi syndrome. From January 1989 to April 1998, among 1,320 patients with gallstone disease, 17 patients were diagnosed as having Mirizzi syndrome at Severance Hospital. Their medical records were reviewed and their clinical, radiological, and surgical features were analysed retrospectively. The incidence of Mirizzi syndrome was 1.3% (17/1320). Included patients comprised of 12 males and 5 females, with an average age of 59.0 years (range 3~86). 2. The presenting symptoms were right upper quadrant pain 11(64.7%), followed by jaundice 9 (52.9%), indigestion 7 (41.2%), nausea 6 (35.3%), fever 2 (11.8%), and pruritus 2 (11.8%). 3. According to the Cse-ndes` classification, the cases were categorized into type I 12 cases (70.5%), type Ⅱ 1 case(5.99%), type Ⅲ 2 cases (11.8%), and type Ⅳ 2 cases(11.8%). 4. Open cholecystectomy was applied to nine patients. Three patients who were believed to be unfit for surgery because of high risk were treated by endoscopic approach. There was no procedure-related complication. The Mirizzi syndrome is an unusual complication of gallstone disease. Though accurate diagnosis and cholecystectomy is a rational option, medical treatment can be performed in selected patients who are unfit for surgery.

자기공명담관조영술에 의한 간외담관담석의 기원분석

박영수(Young Soo Park),서정훈(Jeong Hun Suh),고준상(Jun Sang Ko),정재복(Jae Bock Chung),김명진(Myung Jin Kim),박승우(Seung Woo Park),이세준(Se Joon Lee),정준표(Jun Pyo Chung),송시영(Si Young Song),강진경(Jin Kyung Kang) 대한내과학회 2002 대한내과학회지 Vol.63 No.3

목적 : 담낭담석과 간외담관담석의 자기공명영상의 특성 및 형태학적인 비교를 통하여 간외담관담석의 을 알아보고자 하였다. 대상 및 방법 : 담석증으로 내원하여 담낭담석과 간외담관담석이 있는 환자를 대상으로 자기공명담관 조영술을 촬영한 38예을 대상으로 하였다. 대상환자는 남자 22명 여자 16명으로 남녀비는 1.38:1이었으며, 연령분포는 30세에서 84세까지 였다(평균 연령 60.7세). 자기공명 담관 조영술은 3명의 연구자가 각각 따로 판독하여 합의를 보았다. 38예 모두에서 담낭담석과 간외담관담석이 각각 외형적 특징과 T2 강조 영상에서의 신호특성에 따라 분석되었다. 담석의 외형적 특징은 난형, 막대기형, 다각형, 모래형, 원형, 혼합형으로 구분 되었고, T2 강조 영상에서의 신호특성은 담석전체에 약한 영상 신호를 보이는 경우를 dark형, 그 외의 불규칙한 영상 신호를 보이는 경우를 heterogeneous형 등 두 가지로 구분하였다. 결과 : 담석의 외형적인 형태에 따른 분류에서 담낭담석 및 간외담관담석의 모양이 동일한 경우는 38예 중 23예(60.5%)였고, 특히 담낭담석 및 간외담관담석에서 모두 난형인 경우는 7예, 다각형인 경우는 10예로 두 경우에 있어는 통계적으로 의미있는 일치도를 보였다. 그리고 간외담관담석의 모양은 난형이 9예, 다각형이 15예, 원형이 6예, 모래형이 4예, 막대형이 1예, 혼합형이 3예에서 관찰되었다. T2 강조 영상에서의 신호특성에 따른 분류에서는 담낭담석과 간외담관담석의 영상신호가 일치한 경우가 38예 중 30예(78.9%)이었다. 이 중 영상 신호가 없는 dark형 24예와 heterogeneous형 6예에서 서로 일치하는 소견을 보였다. 결론 : 담낭담석과 간외담관담석의 자기공명담관 조영술 소견상 담석의 외형적 형태의 일치율이 60.5%로 담낭담석과 간외담관담석이 같이 있는 경우 간외담관담석 중 적어도 약 60%가 담낭담석에서 기인된 이차성 담석임을 추정할 수 있었다. Background : Extrahepatic bile duct stones can be classified into two types. Primary stones are formed de nevo in the bile duct, whereas secondary stones migrate from the gallbladder into the bililary tree. The differentiation between primary and secondary stones is very difficult before operation. The aim of this study is to determine the origin of extrahepatic bile duct stones by analyzing MRC features. Methods : MRC was obtained in 38 patients with stones in both the common duct and gallbladder. MRC findings were compared for gross characteristics and MR signal patterns between common duct stone and gallbladder stone pairs. The gross morphologic characteristics of gallstones on MRC were classified into oval, polygonal, round, rod, sandy and mixed shape. Gallstone patterns seen on heavily T2-weighted images were categorized into one of two patterns: dark, and mixed signal. Results : According to the morphologic characteristics on MRC images, the common duct stones were oval (n=9), polygonal (n=15), round (n=6), sandy (n=4), mixed (n=3) and rod (n=1). The visualized MR signal patterns of common duct stones on heavily T2-weighted images were dark (n=28) and heterogenous (n=10). Conclusion : On MRC, the gross morphologic characteristics and gallstone patterns of common duct stones were similar to those of their paired gallbladder stones in 60.5 to 78.9% of patients. (Korean J Med 63:267-272, 2002)

색소 혈관 모반증 Type Ia

정준(Joon Chung),이원수(Won Soo Lee),안성구(Sung Ku Ahn) 대한피부과학회 1994 대한피부과학회지 Vol.32 No.3

Phakomatosis pigmentovascularis is characterized by the coexistence of pigmentary nevus and hemangioma. Since the term was first described by Ota et al in 1947, about 80 cases have been reported in the literature. In 1979, Hasegawa et al subclsssified the disorder into eight types : type I, nevus flammeus and nevus pigmentosus et verrucosus, type II, nevus flamme is and dermal melanocytosis, type III nevus flammeus and nev.us spilus, type IV, nevus flammeus, dermal melanocytosis and nevus spilus. Each type is subdivided into localized(a) and systemic(b) types, A 25-year-old male had brown papules on the left knee and thigh and purple patches on the left leg that had been present for approximately 7 years. He had no concon ittant systemic disease. The histopathologic findings on brown papules and purple patches are compatible with epidermal nevus and nevus flammeus respectively. We herein report a case of phakomatosis pigmentovascularis type I a. (Kor J Dermatol 1994; 32(3): 537-541)

수장 족저부에 발생한 표피낭종의 병리 및 면역조직화학적 연구

정준(Joon Chung),안성구(Sung Ku Ahn),이승헌(Seung Hun Lee),이원수(Won Soo Lee) 대한피부과학회 1994 大韓皮膚科學會誌 Vol.32 No.5

Background : Superoxide disrnutase(SOD) is an essential enzyme oi protective defense mechanism in cellular compartments against the potential cytotoxicity of superoxileinion. It seems SOD activity is increased in psoriasis because of an increase in oxygen intermediates dae to hyperoxia. However SOD activity is decreased paradoxically. Objective : In order to understand the pathophysiology of psoriasis and to elucidate the significance of SOD aetivity in keratinocyte proliferution, we measured the SOD activities in psoriatic and in normal skin. Methods : Authors assayed the level of SOD activities in 16 psoriatie and 16 normal skin specimens, which were obtained from face/neck (1and 4 speeimens), forearm(5 and 4 specimens), trunk(6 and 3 specimens), and lower extremiy(4 and 5 specimens). We also investiga.ed changes of SOD activity by age and regional differences of' SOD sctivities in the psoriatic and normarl skins. Result : First, activities of tot,al SOE Mn-SOD and Cu, Zn-SOD were L2.75+8.15, 4.28+ 3.62, 8.48+ 6.37 units/mg protein respect,ively in the psoriatic skin. Activities of toal SOD, Mn-SOD and Cu, Zn- SOD were 17.63+9.10, 3.38+ 1..85, 1.25+8.16 units/mg protein respec,ively in the normal skin. There was a significant differenc between psoriatic and normal skins in C-SOD activity(p<0.05). Second, the changes of total SOD, Mn-FOD and Cu, Zn-SOD activities showed no significant differences between the age groups. Third, in sun exposed area and unexposedire there were no significant differences between the psoriatic and normal skins in SOD activities. Elut in the normal skin, there were significant differences between sun exposed area and unexposed area in total SOD and Cu, Zn-SOD activities. Conclusion : There is a signiificant difference between psoriatic and normal skins in Cu, Zn-SOD activity. Namely, the Cu, Zn-SOD activity is significantly decreased in psoriasis. (Kor J Dermatol 1994;32(5):860-865)