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A Case of Human Fascioliasis in Korea
Kim, Byong-Ro,Im, Kyung-lI INSTITUTE OF TROPICAL MEDICINE YONSEI UNIVERSITY 1988 YONSEI REPORTS ON TROPICAL MEDICINE Vol.19 No.1
복통과 식욕부진을 주소로 입원한 56세 여자 환자에서 담낭내 담석증으로 진단되어 담석제거 수술하던 중 총수담관에서 흡충 1마리를 얻을 수 있었다. 충체는 제거되었을 때 움직임을 관찰할 수 있었으나 곧 죽었다. 체장은 34.9㎜, 체폭은 12.0㎜였고, 장관은 수지상으로 분지가 심하였고, 구홉반은 복홉반에 비해 약간 작았으며, 체 전단부는 원추돌기 모양을 하였다. 따라서 이 흡충은 Fasciola sp.임을 알 수 있었고 체장과 체폭의 비 2.91:1, 구흡반과 복흡반의 직경의 비 1:1.28, 난소의 분지수 20, 고환의 분표, 충란의 크기 124.6㎛ x 82.6㎛ 등 형태학적으로 보아 Fasciola hepatica나 Fasciola gigantica가 아닌 그 중간종 Fasciola indica(?)로 동정되었다. 이 환지에서 이 흡충의 감염경로는 알 수 없었다. 이 인체 fascioliasis 예는 한국에서 7번째 감염예이다. A case of surgical removal of adult Fasciola sp., presumally F.indica, from the common bile-duct of a woman suffering from anorexia and abdominal pain is presented in this report. A dilated gall blader with 8 black pigmented calculi was found during operations. A liver fluke was impacted in the portion of Ampulla of Vater, and common bile-duct was dilated with one pigmented stone. The clinical manifestation and the operative appearances are discussed.
고식적 위절제술을 받은 진행성 위암환자에서의 5-Fluorouracil, Adriamycin 및 Mitomycin(FAM) 3 제병용 화학용법의 효과
고은희,김주항,박인서,문영명,김병로,김병수,최홍재,민진석 대한내과학회 1986 대한내과학회지 Vol.30 No.3
This study compared the survival of 41 patients who were treated with palliative resection followed by combination chemotherapy with 5-fluorouracil, adriamycin and mitomycin(FAM) to 31 patients treated only by palliative resection for advanced gastric carcinoma. The patients were serially collected from March 1982 to December 1984. The survival rate at 1 year was significantly higher in FAM treated group (FAM treated group, 63.6%, control group, 37,5%; p$lt;0. 05), thereafter, patients treated with FAM, have shown continued tumor progression and death, and there was no significant survival difference at 2 nd year. Two year survival rate of 38 patients with stage IV treated with FAN was 31.4go, on the contrary, in control group, none of 25 patients survived at 2 year after resection(p$lt;0.05). The median survival of FAM treated group was 12.3 months, and 10. 3 months in control group. The survival duration of stage IV, in FAM treated group(median, 13 months) was significantly longer than control group(median, 8.5 months). Acturial two year survival rate of the patients with microscopic residual disease, showed no significant difference between two treatment groups, However, at 2 years after resection, the patients with gross residual tumor, 32.0% in FAM treated group and none of control group survived(p$lt;0. 05) The median survival period of the patients with microscopic residual tumor was 16 months in control group, of whom three of 12 patients were alive and 11 months in FAM treated group. But, in the patients with gross residual tumor, increased survival duration was observed in FAM treated group (median, 14. 1 months) than in control group(median, 7.3 months). In conclusion, FAM treatment significantly increased the survival period in patients with gross residual tumor and in stage g gastric cancer. But, some other forms of combined modality in addition with FAM would be needed for the further improvement in survival after palliative resection for advanced gestric carcinoma.