소 간세포암의 전산화단층촬영 소견 - 조영제 증강 전후 소견의 비교검토 -

김정룡(Chung Yong Kim),이효석(Hyo Suk Lee),최병인(Byung Ihn Choi),한만청(Man Chung Han),김수태(soo Tae Kim),김주완(Chu Wan Kim),김용일(Yong Il Kim),이건욱(Kuhn Uk Lee) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.3

N/A Sixty-seven lesions of small hepatocellular carcinoma in 50 patients under 5cm in diameter detected by computed tomography (CT) were reviewed to characterize the CT feature. All 50 patients were studied with a CT-9800 scanner. CT scans were obtained both before and after administration of contrast medium given by bolus injection of 120 ml of meglumine iohatlamate. CT density of the tumor was classified as hypodense, isodense, and hyperdense on the basis of the difference in density between the lesion and the surrounding liver parenchyma. Detectability of small hepatocellular carcinoma on CT scans was divided into three categioies; Good: tumor is noted, and extent of tumor is clearly defined; Fair: tumor is noted, but extent of tumor is not defined; Poor: tumor is not noted. On nonenhanced CT scans, 40 cases (60%) showed hypodense masses and 27 cases (40%) showed isodense masses whereas all cases showed hypodense masses on contrast-enhanced CT scans. On nonenhanced CT scans, 27 cases (40%) were categorized as good, 13 cases (20%) as fair, and 27 cases (40%) as poor while 65 cases (97%) were categorized as good, and 2 cases (3%) as fair on contrast-enhanced CT scans. Additional CT characteristics of small hepatocellular carcinoma were well defined margin (99%), and peripheral hyperdense rim (44%). These results suggest that contrast-enhanced CT scans are better than nonenhanced CT scans in detecting and defining the tumor, and CT might be useful for characterization of small hepatocellular carcinoma.

간세포암의 전산화 단층촬영 소견

김정룡(Chung Yong Kim),최병인(Byung Ihn Choi),한만청(Man Chung Han),김수태(soo Tae Kim),박경주(Kyung Joo Park),이병희(Byung Hee Lee) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A A retrospective review of CT finding was undertaken from 89 patients who had hepatocellular carcinoma confirmed by histopathologically or clinically. In morphologic classification, solitary type was the most frequent one (43 cases) followed by multinodular type (27) and diffuse type (19) in order of frequency. Bulging of liver contour due to tumor was seen in 45 cases (50%). Size of the tumor in solitary type (43 cases) was mostly larger than 3cm in diameter except 6 cases. 44 cases were located in the right lobe, 19 cases in the left lobe and the remainder involved both lobes. Pre-contrast CT revealed the tumors in the 57 cases (64%) out of 79 cases in which pre-contrast CT was performed, however, detection rate increased up to 98% (87 out of 89 examinations) in post-contrast CT. A majority of tumors showed low density in both pre-contrast CT (64 cases) and postcontrast CT (85 cases) and 3 tumors had calcification in the lesion. 22 cases (25%) showed portal vein invasion in CT and regional lymph node enlargement was demonstrated in 24 cases (27%). Variable cirrhotic pattern was noticed in 55 cases (62%) of hepatocellular carcinoma.

모형 담즙과 담낭 답즙에서 콜레스테롤 핵형성 촉진 인자로서의 Phospholipase C 의 역할

김정룡(Chung Yong Kim),김용태(Yong Tae Kim),윤용범(Yong Bum Yoon) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

N/A Objectives: There are a number of proteins that may influence cholesterol nucleation in bile, Recently, phospholipase C has been suggested as a nucleation-promoting factor in human gallbladder(GB) bile. However, it is not known whether there is a quantitative difference in phospholipase and normal controls, and whether suppression of phospholipase C in human GB bile might alter the nucleation time. So we tried to investigate the role of phospholipase C as a cholesteol nucleation-promoting factor in model bile and in human GB bile. Methods: To determine if phospholipase C has a capacity to promote nucleation of cholesterol in model bile, nucleation times were compared among model biles which were mixed with serially diluted phospholipase C(0, 10, 100, 1,000, 10,000, 100,000 U /L). To investigate if phospholipase C is a main promoting factor of cholesterol nucleation in human GB bile, nucleation times and phospholipase C activities in GB bile were compared among patients with cholesterol gallstones(n=12), pigment gallstones(n=12), and controls(n=7). The influence of suppression of phospholipase C by EDTA(2 mM) on the nucleation time in GB biles of patients with cholesterol gallstones was also studied. Phospholipese C activity was measured by the release of phosphoryl [H3] choline from the substrate 3H-phosphatidylcholine after delipidation by gel chromatography. Results: Phospholipase C decreased the nucleation time of model bile in a dose dependent way from more than 21 days to 5 days, but the activity in human GB bile was elevated more than that of the controls in only 17% of patients with cholesterol gallstones. Suppression of phospholipase C activity by EDTA did not prolong the nucleation time of the GB bile of the patients with cholesterol gallstones. Conclns1on: Phospholipase C has a capacity to decrease the nucleation time in model bile but it does not play a significant role in cholesterol gallstone formation in human GB bile.

절제술을 시행한 원발성 간세포암 100 예의 임상연구

김정룡(Chung Yong Kim),김수태(soo Tae Kim),안세현(Sei Hyun Ahn) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.2

N/A This paper describes a clinical analysis of 100 patients who underwent hepatic resection for primary hepatocellular carcinoma at the Department of Surgery, Seoul National University Hospital during the past 7 years, from Sep. 1978 to Aug. 1985. The results were as follows: 1) The sex ratio of male to female was 4.6: 1 with the predominancy in the 5th and 4th decades(73%). 2) The HBs-Ag positive rate was 71.4g and 98.5g of HBs-Ag or antibody positive rate. 3) It was 75.8% of aFP positive rate (above 20 ng/ml), and there was no correlation between aFP level and tumor size. 4) Massive hepatic resection was performed in 42.6% of cirrhotic patient and 65.5% non cirrhotic patient. 5) Cirrhosis was accompanied in 61% of patient, and there was no difference in the operative mortality between the cirrhotic and non cirrhotic group. 6) By Childs classification, the operative mortality and 1 yr, 3 yr survival rate was 5.1% 60% 41% in A group, 26% 48% 24% in B group, and 50% 0% 0%. In C group (p<0.05) 7) There was no relation between the survival and tumor size. 8) The overall operative mortality was 11% 9) The 1 yr, 3 yr survival was 57% 36% for all patient and 49% 32% for cirrhotic patient and 70% 44% for non cirrhotic patient (1yr; p>0.05, 3 yr;p< 0.05). 10) Curative resection was porformed in 64% of patients. It was 68.0% and 38% of 1yr, 3yr survival for patient of curative resection, and 37%, 2% for palliative resection (p< 0. 05).

증례 : 간의 간엽과오종 1 예

김정룡 ( Chung Yong Kim ),김선태 ( Sun Tae Kim ),변종훈 ( Chong Hoon Byeon ),최국진 ( Kuk Jin Choi ),김용일 ( Yong Ill Kim ) 대한내과학회 1978 대한내과학회지 Vol.21 No.4

간세포암의 자연경과와 여러 치료방법에 따른 생존률에 관한 연구 - 과거 20 년간의 경험을 토대로 -

김정룡(Chung Yong Kim),이준성(June Sung Lee),이한주(Han Chu Lee),이효석(Hyo Suk Lee),윤용범(Yong Bum Yoon),송인성(In Sung Song),박재형(Jae Hyung Park),김수태(Soo Tae Kim) 대한내과학회 1993 대한내과학회지 Vol.45 No.2

N/A Background: Hepatocellular carcinoma (HCC) is the most common form of primary hepatic carcinoma and is a pressing sociomedical problem in Korea. Of the various solid cancers, HCC is perhaps the most diffcult to treat because of the frequently associated cirrhosis and advanced stage of tumor. In recent years, diagnostic procedures, surgical techniques and various therapeutic modalities other than surgery have been developed and improved. So, the prognosis of these patients may have changed from what it was in the past and it is necessary to establish the criteria for selection of therapeutic modality in indivisual patient with HCC. The purpose of this study was to elucidate the natural history of HCC and the survival rate of patients with HCC in relation to various therapeutic modalities in different stage of chronic liver disease. Method: A total of 1149 patients with HCC seen during the last 20 years were analyzed retropectively. The effects of treatment on survival were analyzed with regard to Child's grading and UICC stage of HCC. Results: In the 265 patients who received no specific treatment, the cumulative survival rates of 6 month and 1 year were 37.5%, 16.6% and the median survival time was 4 months. Survival rates of the surgically treated patients were better than that of other patients groups in comparable Child's grade and UICC stage, Especially, among patients with Child's A or B the actuarial survival rate for surgery was significantly better than that for transarterial chemoembolization. Transarterial chemoembolization gave a significantly better survival rate compared with systemic chemotherapy and no specific treatment in all child's grade and UICC stage. Systemic chemotherapy improved survival as compared with no specific treatment in Child's A or B patients and with UICC stage IV and Child's C with stage IV, patients. The major causes of death were hepatic failure and gastrointestinal bleeding irrespective of treatment modality. Conclusion: Adequate therapeutic modalities according to the severity of liver cirrhosis and tumor stage could improve the prognosis of HCC patients.

당원축적병에서 발생한 간세포암 1 예

김태헌(Tae Hun Kim),김경아(Kyung Ah Kim),임영석(young Suk Lim),강경훈(Gyeong Hoon Kang),이효석(Hyo Suk Lee),김정룡(Chung Yong Kim) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.3

Glycogen storage disease (GSD) is one of rare metabolic causes of hepatocellular carcinoma (HCC). We have experienced a case of HCC in a patient with GSD, who was treated by portosystemic shunt with subsequent symptomatic improvement. A 27-year-old man was admitted because of liver tumor on CT scan. Eighteen years ago, he had been admitted to pediatric hospital for the evaluation of short stature, hepatomegaly and frequent epistaxis, and diagnosed as GSD type 1. One year ago, development of multiple hepatic adenomas were confirmed by ultrasound and histologic evaluation. An abdominal CT scan taken before admission revealed that one of hepatic nodules showed augumented enhancing pattern. Thus, he was admitted for the evaluation of this nodule under the impression of malignant transformation. The tumor was identified as well differentiated HCC by liver biopsy. Hepatic angiography showed hypervascular mass, which was treated by transcatheter arterial chemoembolization with compact lipiodol retention. (Korean J Gastroenterol 2001;38:215-219)

위장관 ( 胃腸管 ) : 한국인에 있어서 대장용종

윤용범(Yong Bum Yoon),송인성(In Sung Song),최규완(Kyoo Wan Choi),김정룡(Chung Yong Kim),이효석(Hyo Suk Lee),윤세진(Sei Jin Youn),정현채(Hyun Chae Jung),김용태(Yong Tae Kim),김나영(Na Young Kim) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2

N/A The present report analyzed a series of 767 polyps from 15,000 cases who wore undogone colonos- copy or sigmoidoscopy at the dept, of internal medicine, Seoul National Universily Hospital from June 1976 to Dec. 1989. The results are as follows. 1) The prevalence of colorectal polyp was 5,1% (767 cases out of 15,000 cases) and increased from 1976 to 1989. 2) The most common symptom was anal bleeding (27%). 3) The 43 cases out of 203 cases (21%) revealed a positive finding in occult blood examination of stool, and 88 cases out of 158 cases (55%) turned out to have polyps in colon study. 4) The most common histologic type of polyp was adenomatous (49%) and the most common gross iype was Yamada type II (30.%). 5) Eleven cases out of 30 cases (36.9%) whose polyps were over 2 cm in diameter were villous adenoma, and 4 cases out of 11 cases (36%) had a foci of cancer. Ten cases out of 245 cases (4%) whose polyps wore under 1 cm in diameter were villous adenoma, and the foci of cancer were not seen. These figure suggest that as polyps grow, the risk of villous adenoma and cancer increase. 6) When we compared endoscopic findings with histologic types in polypectomized specimens, 9 cases (64%) out of 14 cases were diagnosed as hyperplastic polyp by only endoscopy, and 68 cases (91%) out of 75 cases were diagnosed as adenomatose polyp by only endoscopy. 7) Six cases (4.4%) out of 135 cases in tubular, four cases (16.6%) out of 24 cases in villotubular, four cases (19%) out of 21 cases in villous adenoma, were colorectal cancer with polyp remnant, respectively. The annual prevalence of colorectal polyp increased and endoscopy was superior to Barium enema in diagnosing colorectal polyps. For prevention of colorectal cancer, more effort should be done in detecting and eradicating colorectal polyps.

위장관 ( 胃腸管 ) : 식도 확장술에 합병된 식도 천공의 치료

윤용범(Yong Bum Yoon),송인성(In Sung Song),최규완(Kyoo Wan Choi),김정룡(Chung Yong Kim),정현채(Hyun Chae Jung),김용태(Yong Tae Kim),한철주(Cheol Joo Han),이준혁(Joon Hyeok Lee),김진욱(Jin Wook Kim),김태호(Tae Ho Kim),최상운(Sang Oun 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3

N/A We reviewed the total 291 procedures in 134 patients in whom esophageal dilatation or esophageal endoprosthesis insertion had been performed in Seoul National University Hospital from March 1987 to September 1990. Twelve cases(4.1%) of esophageal perforation developed. Eight cases of them were managed successfully only with medical treatment. Two cases were not followed up after self-discharge during medical treatement. One case was treated successfully with immediate surgical intervention and one case underwent delayed surgical repair two times because of the failure of initial medical treatment. There were 7 cases of esophageal perforation with pleural or peritoneal involvement. Five of them were managed successfully with medical treatment. Thus we recommended the medical management as the first choice of treatment in iatrogenic esophageal perforation even in the cases with pleural or peritoneal involvement except in some selected cases.

췌장가성낭종의 보존적치료

윤용범(Yong Bum Yoon),김정룡(Chung Yong Kim),신건성(Gun Sung Shin),김용태(Yong Tae Kim),김태현(Tae Hun Kim) 대한내과학회 1996 대한내과학회지 Vol.51 No.3

N/A Objectives: Several results of clinical studies on the etiology, clinical manifestation, diagnosis and management of pancreatic pseudocysts were reported in Korea; however they were almost all in concerned with the surgical aspect and little attention was focused on the conservative management of pancreatic pseudocysts. This study was designed to evaluate the efficacy of conservative management of pancreatic pseudocysts in Korean patients. Methods : We reviewed the medical records of 55 patients with pancreatic paseudocysts managed from 1985. 1 to 1993. 12 in Seoul National University Hospital. Results: 1) Pancreatic pseudocysts were usually associated with acute pancreatitis caused abdominal pain, and were frequently located on the head and the tail of the pancreas. 2) Sixy five percent of pancreatic pseudocysts were managed successfully with conservative treatment, and the small pseudocysts associated with pancreatitis were more prone to successful conservative treatment. 3) With respect to decreases in the size of the pseudocysts, 86% of the cases showed some size decrease within 4 weeks after treatment. Conclusion: Conservative treatment alone is effective in 65% of pancreatic pseudocysts and in Korea at least 4 weeks of conservative treatment is necessary for the management of small pseudocysts associated with pancreatitis.