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담낭신티그라피에 의한 담낭담석증 및 간흡충증 환자의 담낭운동성 분석
정판준(Pan Jun Chung),심대석(Dae Seok Shim),강재황(Jae Hwang Kang),류경렬(Gyeong Yeul Reu),원용환(Yong Hwan Won),박영호(Yung Ho Park),손미정(Mi Jung Son),정순일(Soon Il Chung),이옥재(Ok Jae Lee),김영채(Young Chai Kim) 대한내과학회 1995 대한내과학회지 Vol.48 No.1
N/A Objectives: Abnormal gallbladder motility and bile stasis have been implicated in the pathogenesis of gallstone and bacterial infection, but the cause-and-effect relationship is not established. Among the various methods used to measure the gallbladder motility, cholescintigraphy using 99 mTc-labelled iminoacetic acid is nowadays used widely, which is noninvasive, convenient, and is capable of quantitative analysis of gallbladder motility. To evaluate the gallbladder motility in patients with gallstones and clonorchiasis, the authors analyzed the gallbladder filling and emptying using computer-assisted cholescintigraphy. Methods: The study group comprised 30 patients who were admitted to GNUH, from 1992, October to 1993, August, 20 patients of them had asymptomatic gallbladder stones or clonorchiasis, 10 patients were controls. All patients were studied with abdominal ultrasonography and DISIDA cholescintigraphy. We measured maximum gallbladder filling time, half time of emptying and ejection fraction after ingestion of fatty meal. Results: 1) There was no significant difference in maximum gallbladder filling time between control (52.3±9.3 min) and patients with gallbladder stones (51.5±15.8 min) and patients with clonorchiasis (56.9±10.5 min). 2) Gallbladder emptying time (T1/2) were significantly delayed in patients with gallbladder stones (48.4±16.3 min) and clonorchiasis (40.8±12.9 min), as compared with control (23.0±7.5 min). Conclusion: The gallbladder emptying time using computer-assisted cholescintigraphy in patients with gallbladder stones and with clonorchiasis were significantly delayed, as compared with control.
위 질환에서의 혈장, 위액 및 소변내 Vitamin C 농도
이삼철 ( Lee Sam Cheol ),정판준 ( Jeong Pan Jun ),이옥재 ( Lee Og Jae ),김영채 ( Kim Yeong Chae ),최진학 ( Choe Jin Hag ),하우송 ( Ha U Song ) 대한내과학회 1993 대한내과학회지 Vol.44 No.1
저자는 1991년 4월부터 1991년 8월까지 경상대학교병원을 내원한 위 질환자 87명과 위장관 증상을 호소하지 않은 만성 표재성 위염 환자 20명을 대상으로 혈장과 위액 그리고 소변에서 vitamin C 농도를 측정하여 다음과 같은 결론을 얻었다. 1) 위액의 vitamin C 농도는 급성 위염군(1.29±1.86mg/dl)과, 증상이 있는 만성 표재성 위염군 (1.34±0.96mg/dl), 만성 위축성 위염 및 화생성 위염군(1.21±1.07mg/dl), 위궤양군(1.41±1.12mg/dl), 위암군(0.62±0.51mg/dl)에서 무증상인 만성 표재성 위염군(2.54±1.86mg/dl)에 비해 통계적으로 유의하게(p<0.05) 감소되어 있었다. 특히 위암 환자군에서 가장 낮게 측정되었다. 2) 혈장에서의 vitamin C 농도는 질환군간에 유의한 차이를 보이지 않았다. 3) 위액의 산도가 4.0이상인 저산증 환자군 (0.96±0.79mg/dl)에서 위액의 vitamin C 농도는 산도가 4.0이하인 군(1.97±1.49mg/dl)에 비해 통계적으로 유의하게(p<0.05)감소되어 있었다. 4) 위액의 산도가 4.0 이상인 저산증 환자군과 4.0 이하인 군에서 혈장(1.09±0.47 vs 1.23±0.51mg/dl)과 소변(3.46±3.24 vs 3.74±2.92mg/dl)에서의 vitamin C 농도는 유의한 차이를 보이지 않았다. 5) 혈장에 대한 위액의 vitamin C 농도비는 무증상인 만성 표재성 위염군에 비해 증상이 있는 만성 표재성 위염군, 만성 위축성 위염 및 화생성 위염군 그리고 위암군에서 통계적으로 유의하게(p<0.05)감소되어 있었으나 급성 위염군과 위궤양군에서는 유의한 차이를 보이지 않았다. 6) 혈장에 대한 소변의 vitamin C 농도비는 질환군간에서 통계적으로 유의한 차이를 보이지 않았다. The level of vitamin C was measured from the specimens of plasma, gastric juice, and urine of the symptom-free subjects of chronic superficial gastritis and other gastric diseases by 2.4-dinitropheny-lhydrazine method. The object of this study is to know the relationship between vitamin C concentration of tissue fluids and gastric diseases. Follwing results have been obtained : 1) The levels of vitamin C in the gastric juice of the patients of symptomatic chronic superficial gastritis, chronic atrophic gastritis and metaplastic gastritis, gastric ulcer, and gastric cancer were lower than those of the symptom-free subjects of chronic superficial gastritis and in the case of the patients with gastric cancer, the level was the lowest. 2) The plasma level of vitamin C concentration was not different among the specimens from the groups of the patients. 3) In the case of hypochlorhydria (pH>4.0), the level of vitamin C concentration in the of gastric juice was low. However the plasma and urine vitamin C concentrations were not different, compaired to that of the patients with gastric pH below 4.0. 4) The ratios of the gastric juice to plasma vitamin c concentrations was low in the groups of symptomatic chronic superficial gastritis, chronic atrophic gastritis and metaplastic gastritis, and gastric cancer, but the ratios were not low in patients of acute gastritis and gastric ulcer, compared to the symptom-free subjects of chronic superficial gastritis (p<0.05). 5) The ratios of the urine to plasma vitamin c concentrations in the groups of various gastric diseases were not different to those of the symptom-free subjects of chronic superficial gastritis.
신기능 장애를 동반한 Hereditary Coproporphyria 1예
김정렬,김호철,김성욱,황일용,심대석,함종렬,강재황,정판준,이근홍 대한신장학회 1993 Kidney Research and Clinical Practice Vol.12 No.4
We report a case of hereditary coproporphyria with renal insufficiency in a 20 years old girl who had frequent abdominal pain. The typical clinical and biochemical findings of hepatic porphyria represent the hereditary coproporphyria, most likely. Her symptoms and signs were clearly exacerbated in a relation to the menstrual cycle. During admission, serum creatinine changed up to 3 8 mg/dl. Until 35 days after discharge, she was found to have persistently elevated serum creatinine concentration. On the renal biopsy, there was chronic Tubulo-Interstitial Nephritis, which presented with focal and mild degree interstitial edema, chronic inflammatory cells infiltrtion, and vacuolization of tubular cells. Possible etiologic factors including porphyria or its precursor itself for the renal insufficiency of this patient (HCP) should be discussed.
최진학(Jin Hak Choi),김영채(Young Chai Kim),우성경(Sung Kyeong Woo),심상군(Sang Goon Shim),신원호(Won Ho Shin),심대석(Dae Suk Shim),함종렬(Jong Yeul Ham),정판준(Pan Jun Chung) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.4
Despite the ubiquitous presence of tuberculosis, gastric involvement is so rare and is usually secondary to pulmonary or intestinal tuberculosis. It requires deliberate consideration in the differential diagnosis of many gastric lesions as it may simulate nontuberculous inflammatory disease, peptic ulcer, or gastric carcinoma. Such consideration may result in a correct diagnosis and the institution of proper therapy to avoid undue surgery. A case of gastric tuberculosis which was clinically diagnosed as gastric carcinoma was presented. A chest roentgenogram showed fibrostreaky infiltration with mottled calcified lesions in both lungs suggestive of inactive phase of old pulmonary tuberculosis. The diagnosis was confirmed with histological study of endoscopic specimen. Prompt antituber-culous therapy was given with some relief of his symptoms one month later.