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各種 刊疾患患者에 있어서의 HBs-Ag, Anti-HBs 및 AFP의 檢出率에 關한 檢討
李相彩,鄭克守 慶北大學校 醫科大學 1981 慶北醫大誌 Vol.22 No.1
우리나라에서 비교적 흔히 관찰되는 급만성 간염 간경변증, 간암 및 기타의 간질환에서 HBV와의 관련성을 조사하는 한 방편으로서 각종 간질환 357례를 대상으로 하여 이들의 혈청 HBs-Ag, Anti HBs 및 AFP을 그 예민도에 있어서 RIA와 대등하다고 알려진 RPHA방법으로서 검사하여 다음과 같은 성적을 얻었다. 1. HBs-Ag의 출현율은 평균 45.1% 였으며, 만성 간염에서 61.4%로 가장 높은 검출율을 보였고, 급성 바이러스성 간염(55.3%), 간암(48.1%), 간경변증(41.2%)의 순서를 나타냈으며, HBV와 무관하다고 생각되는 기타의 간질환의 경우는 5.0%의 성적을 보였다. 또한 생검으로 확진된 예와 임상적으로 진단된 예는 서로 유의한 차이는 없었으나, 생검예에서는 만성 활동성 간질환이 만성 비활동성 간질환에 비하여 고율로 나타났다. 2. AFP의 출현율은 평균 11.5%였으며, 이들중 간암이 대부분으로 42.0%의 출현율을 보였으나 만성 간염(4.5%), 간경변증(2.4%), 급성 바이러스성 간염(2.1%)의 순서로 나타났다. 3. Anti-HBs 검출율은 평균 62.0%였으며 비활동형 간경변증에서 87.5%로 가장 높은 검출율을 보였으며, 급성 바이러스성 간염, 만성 간염, 간암 및 활동형 간경변증의 순서로 나타났으나 HBV의 감염과 특별한 관련성이 없다고 생각되는 기타의 간질환군에서 57.9%의 성적을 보여서 이는 우리나라가 B형 간염이 많이 관찰되는 지역이라는 근거를 제시하고 있다. 4. 간암환자에서 HBs-Ag 양성과 AFP의 양성사이에는 상당한 관계가 있음을 보여 주었다. 5. 이상의 성적으로서 우리나라에서 유행하는 각종 간질환은 HBV와 밀접한 관련성이 있는 질환의 일종으로 생각된다. A study was done in order to evaluate the etiologic correlation between hepatitis B virus and various diseases of the liver, prevalent in Korea, sera from 357 patients with liver diseases were examined for HBs-Ag and AFP by reverse passive hemagglutination assay (RPHA) technique. Among 357 cases, 170 cases were proved by percutaneous needle biopsy or aspiration cytology and 187 cases were diagnosed clinically. Distributions by disease entity showed liver cirrhosis 46.2% (165 cases), hepatocelluar carcinoma 22.7% (81 cases), acute viral hepatitis 13.2% (47 cases), chronic hepatitis 12.3% (44 cases) and miscellaneous liver diseases 5.6% (10 cases) unrelated to hepatitis B virus infection. The results were summarized as followings: 1. The average incidence of HBs-Ag in patients with various diseases of the liver was 45.9%, but the peak incidence of HBs-Ag ranked as 61.4% in chronic hepatitis and the incidence of HBs-Ag in acute viral hepatitis was 55.3%, hepatocellular carcioma 48.1%, liver cirrhosis 41.2% and the miscellaneous diseases of the liver 5.0%. 2. The incidence of AFP in patients with hepatocellular carcinoma was 42.0%, chronic hepatitis 4.5% (2 of 44), liver cirrhosis 2.4% (4 of 165) and acute viral hepatitis 2.1% (1 of 47). 3. The incidence of Anti-HBs in patients with inactive liver cirrhosis was 87.5% and the next ranking showed as acute viral heptitis, chronic hepatitis, hepatocellular carcinoma and active livercirrhosis. But the incidence of Anti-HBs in patients with miscellaneous diseases of the liver that might be thought to be unrelated to hepatitis B virus infection was exceptionally high as 57.9%. This result suggested indirect evidence of the fact that Korea was one of the nations for prevalent hepatitis B virus infection. The average incidence of HBs-Ag in patients with various diseases of the liver was 62.0%. 4. The correlation between of HBs-Ag in positivity and the detectability of AFP in case with hepatocellular carcinoma was closely related significantly. 5. In conclusion, we condsidered the various diseases of the liver which were prevalent in Korea to be closely related to a spectrum of hepatitis B virus.
정극수,정동현,배정동,허성욱,김학현,안기성,이창우,서승욱 대한소화기내시경학회 1983 Clinical Endoscopy Vol.3 No.1
A clinical analysis was carried out on 306 pts c Gastric ulcer who have visited the Depart on Internal lTedicine. Daegue Catholic Hospital during the period from August 1980 to June 1982. The result were as follows: of the total 306 cases, 249(81) cases were male and 57(19io) cases were female, Male to female ratio was 4.3 1. Thirsty two percent of the cases blonged to the 6 th decade, 24. 5 to 5 th and 19 to 7 th decade. Clinically, 206(67.3%) cases were diagnosed as benign ulcer. while 100(22.7) cases as malignancy. UGI series were done in 272 cases of total 806 eases and 159 casea(58.4%) had the impression of benign ulcer. while 98 cases(36%) showed the impression of malignant ulcer. EndoscopicaIly 162 cases(52.9%) were diagnosed as benign ulcer. while 144 cases(47.1) as malignant ulcer. Concerning the size of the ulcer. Relatively small ulcer which diameter is lem or less was prevalent (129 cases (42.2%)). Among these 129 cases 85 cases(65.9%) were benign and 44 .casea(34.1 0) were malignant. Endoscopic biopsy was done in 240 cases of tot.1 306 cases and 157 cases(65.4) showed the ids of benign nature wtfile 83 caaea(84.6%) p'oved to be malignant. The moat frequent site of ulcer by its size could be summarized as below. 1.0 or less in diameter: antrum (45 of total 129 cases) 1.12.0cm: body(47 of total I08 cases) 2.1 3. 0 cm : body (59 of total 4I cases) 3.1--4. 0 cm: body(70% of total 41 cases) 4.15. 0 cm: cardia 1 case antrurn 1 case 5.10cm: body 1 case(5.6cm) When the ulcer size was greater than 3. 0 cm in diameter chance of malignancy increased remarkably, (80% or more was malignant).