간내담관암의 임상적 고찰

김규환(Gyu Hwan Kim),표지수(Ji Soo Pyo),김양욱(Yang Ook Kim),류승환(Seung Hwan Ryoo),이상혁(Sang Hyuk Lee),설상영(Sang Yong Seol),정정명(Jung Myung Chung),최하진(Ha Jin Choi) 대한내과학회 1995 대한내과학회지 Vol.48 No.6

N/A Objectives: Because it is difficult to differentiate the intrahepatic bile duct carcinoma from hepatocellular carcinoma by the general clinical features and the post-operative survival rate of intrahepatic bile duct carcinoma may he better than the one of hepatocellular carcinoma, we studied the clinical characteristics of the intrahepatic bile duct carcinoma. Methods: We studied 41 patients with intrahepatic bile duct carcinoma diagnosed by untrasonoguided liver biopsy or operation from January 1990 to December 1993 at our hospital. Results. 1) 178 patients were diagnosed as hepatocellular carcinoma with the ratio to intrahepatic bile duct carcinoma of 4.3:1 and the number of patients with extrahepatic bile duct carcinoma is 44 with the ratio to intrahepatic bile duct carcinoma of 1.1: 1 in the same duration. 2) Of the 41 cases, the peak incidence was in 6th decade and the average age was 58.8 years. The male to female ratio was 3.1: l. 3) Abdominal pain was the most common complaint on admission(75.6%). For the duration from symptom onset to admission, the most common duration was less than 1 month(48.8%) and hepatomegaly was the most common physical finding(51.2%). 4) On the laboratory findings, leukocytosis was seen in 25 cases(61.0 %). AST was elevated in 20 cases(48.8 %) and ALT was elevated in 12 cases(29.3). 5) The Clonorchiasis was the most commonly associated disease(34.1%). AFP was elevated in 12.8%, CEA and CA19-9 also were elevated in 57.1% and 78.3% respectively. 6) Abdominal ultrasonography showed hyperechogenicity in 13 cases(31.7%), isoechagenicity in 9 cases(22.0%), and hypoechogenicity in 19 cases(46.3 %). Celiac angiography showed hypervascularity in one case out of seven cases(14.3%). 7) Of the 41 cases, the mean survival was 6.3 months and the longest survival was 31 months, The mean survival of 14 casess with surgery was 9 months. Conclusion: If the curative resection of intrahepatic bile duct carcinoma is performed in more early clinical course with the above characteristics, the better prognosis would be expected.

Anisakis Type I 유충에 의한 위 아니사키스증 20예

설상영(Sang Yong Seol),옥승철(Sung Cheul Ok),표지수(Ji Soo Pyo),김인호(In Ho Kim),이상혁(Sang Hyuk Lee),정정명(Jung Myung Chung),최하진(Ha Jin Choi),정승진(Seung Jin Jeong),손운목(Woon Mok Sohn) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.1

N/A Twenty cases of the gastric anisakiasis caused by Anisakis type I larva were found by endo- scopic examination during the period from Sep., 1990 to Oct., 1993 in Pusan. The patients chiefly complained of epigastric pain, nausea and vomiting and recalled they had eaten raw flesh of marine fishes. Followings are the summarized clinical features of cases and the mor- phological characteristics of worms detected. Of 20 cases, the sex ratio of male to female was I to 1.5. In terms of age group, the highest rate of incidence was seen at 30's. A total 13 cases(65. 0%) were infected in the winter season, 5 and 2 ones were in the autumn and spring. The main source of infection might be Astroconger myriaster based on the past history of cases. The onset of symptom after eating causative fish occurred within 12 hours in 15 cases(75.0%). The epigastric pain was experienced in all cases. The most frequently detected site of worm in the stomach was the greater curvature(65.0%) of the body. The endoscopical findings of the gastric mucosa adjacent to worms were edematous, sometimes erosive and hemorrhagic. A total 18 out of 22 detected woms were the 3rd stage larvae of Anisakis type I and the others were the 4th stage ones. From the above results, it was confirmed that numerous cases com- plained the epigastric pain after eating raw fish caused by Anisakis type I larva.(Korean J Gastroenterol 1994; 26 : 1 7-24)

동시성 조기위암

김환태(Hwan Tae Kim),신형규(Hyoung Gyu Shin),표지수(Ji Soo Pyo),김규환(Gyu Hwan Kim),류승환(Seong Hwan Ryoo),이상혁(Sang Hyuk Lee),설상영(Sang Yung Seol),정정명(Jung Myung Chung),최하진(Ha Jin Choi) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.4

The multiple gastric cancer have several clinicopathological characteristics which differ from those of patients with solitary cancer,' in particular, elderly men had a relatively high in- cidence of multiple cancer and early cancer of the elevated, well differentiated type was most common. A careful preoperative evaluation with both radiography and endoscopy enables de- tection of about 70% of synchronous EGC, and perhaps increased awareness of this phenome- non can lead to better results. We reported on a case of synchronous EGC type I and Iia origi- nating from lower body and antrurn.(Korean J Gastroenterol 1994; 26: 737 741)

관상동맥조영술상 관상동맥 내경이 동맥경화증의 발현에 미치는 영향

표지수,최정식,이형준,김희,김선운,송진호,류종철,김두일,김동수 인제대학교 1999 仁濟醫學 Vol.20 No.2

Objectives: The effect of coronary artery diameterson theoccurrence of atherosclerosis is unknown. However, several studies have shown that the larger the vessel lumen diameter after coronary interventions, the less the probability of restenosis. We supposed that larger coronary arteries have a lower prevalence of atherosclerosis. Methods and Materials: We measured the diameters of major coronary arteries in 231 patients undertaken coronary arteriography who admitted to Paik hospital from August 1996 to May 1997. Results: The mean diameters of the left main coronary, the right coronary, the left anterior descending and the left circumflex arterieswere 4.50±0.372, 3.62±0.391. 3.55±0.404, and 3.17±0.392mm respectively. On the basis of these dimen-sion of each artery, all patients were divided into 3 groups according to the diameter: gloup A (average), group S(small), group L(large). Group A means that the diameter is within 1 SD of the mean. Group S and group L mean that the diameters are>1 SD smaller and larger, respecti-vely, than the mean. We compared the frequency of lesions ≥50% dia- meter stenosis in groups S and L for each artery. In group S versus L, respectively, the frequency of ≥50% lesion was 6.7% versus 2.6% (P = 0.40 7) in the left main artery, 60% versus 33.3%(P = 0.030) in the right coronary artery, 57.1% versus 35% (P = 0.044) in the left anterior descending artery, and 47.2% versus 23.7% (P = 0.034) in the left circu- mflex artery. For the left main artery, there was a trend toward higher frequency of lesions ≥50% stenosis in group S versus group L. For the other major vessels, the fr-equency of lesions ≥50% in the proximal or midsegment was significantly higher in gr- oup S than in group L. Conclusion: We observed that smaller coronary arteries had a higher prevalence of co- ronary disease in this study. Thus, small coronary artery dia- meter may be a risk factor for atherosclerosis.

당뇨병 환자의 Recombinant DNA Human NPH 인슐린에 대한 혈당 반응

이재윤,표지수,임대건,강창일 인제대학교 1993 仁濟醫學 Vol.14 No.4

종전에는 당뇨병 환자에게서 동물 인슐린(unpurified insulin of bovine/porcine)을 사용하여 혈당 반응을 연구하였으나, 저자들은 Recombinant DNA Human NPH 인슐린을 당뇨병 환자에게 사용하여 그 혈당 반응과 체중에 따른 변화를 관찰하였다. The blood glucose response to Recombinant DNA Human NPH Insulin in 60 diabetic patients with various body weight was studied and the results were as follows ; 1.The transient response pattern was 6 cases(10.0%), the normal response pattern was 44 cases(73.3%), and delayed response patters was 10 cases(16.7%) 2.The blood glucose response with various body weight showed the most groups that belonged to the normal response pattern but the delayed response pattern was relatively common in overweight and obesity group. In conclusion, the blood glucose response to Recombinant DNA Human NPH Insulin in diabetic patients with various body weight showed the most groups that belonged to the normal response pattern.

식도 유두종의 임상적 양상

송진호,이영민,이상혁,정정명,이연재,장윤식,주종은,설상영,표지수 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.1

In human, Human Papilloma Virus(HPV) is associated with benign squamous tumors in a variety of body sites. But the relationship between HPV infection and malignant epithelial lesions is not clear. Esophageal squamous papilloma is relatively rare tumor but it is reported with increasing frequency recently. We reviewed twenty six patients of esophageal papilloma diagnosed by endoscopic biopsy from 1990 to 1994. The results are as follows; The peak age is fifth decade, men and women ratio is 1: 1.2. Most papillomas located in distal esophagus and have no specific symptoms related to papilloma. All case are sessile form and no malignant change in follow up endoscopy.