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허윤(Yoon Hur),문한규(Han Kyu Moon),양웅석(Ung Suk Yang),김성은(Seong Eun Kim),백대근(Dae Geun Baek),도창호(Chang Ho Do),송근암(Guen Am Song),유방현(Band Hyun Liu) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.2
N/A Hepatocellular Carcinoma (HCC) is considered a highly malignant tumor with a poor prognosis. It is usually not resectable and there is no other effective treatment. The current study was undertaken to evaluate the survival time of patients wit.h hepatocellular carcinoma and to find clinical and biologic criteria. A total of 106 patients with HCC seen during the last 3 >ears were analyzed retrospectively for survival in relation to prognostic factors, treatment and disease stage. The results obtained were summarized as follow; 1) HCC vas found frequently in men, and male and female ratio vas 2.5:1. The average age was 55 years in both sex. 2) A prognostic study hased on 91 untreated patients was undertaken. The median survival times according to age, sex, performance status, positive serologic determination of hepatitis B, alcohol intake, alpha-fetoprotein, transaminase, BUN, creatinine values at the time of cliagnosis were statistically not significant. Whereas in all series of patients, bilirubin, tumor size, ascites, serum albumin values were statistically significant. A new staging scheme based on above factors was used. Clearly, thc prognosis depended on clisease stage. The midian survival of stage I patients who receivecl no specific treatment ivas 4.1 months and stage II patients was 1.8 M, and stage III patients svas 0.9 M (p<0.001). 3) The median survival of 91 patients who received no specific treatment was 2.1 M, however 2.3 M for the group of patients(8) placed on systemic chemotherapy, and 9.9 M of the group of patients(7) for hepatic resection. 1) The major causes of death were hepatic failure; 37%(40/106), gastrointestinal bleeding; 28 % (30/106), cachexia; 14% (14/106), respiratory failuire due to lung metastasis; 8% (8/106), intraperitoneal rupture; 3%(3/106). Unclear; 11% (11/106).
유방현(Bang Hyun Liu),문한규(Han Kyu Moon),허윤(Yoon Huh),양웅석(Ung Suk Yang),이강희(Kang Hi Lee),조중현(Joong Hyeon Cho),백대근(Dae Geun Baek),김무현(Moo Hyung Kim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
In cases of Gastointestinal Vascular Malfomnation, which involve the mucosa and submucosa of the gastrointestinal tract, Dieulafoys erosion consists of abnormally large gastric submucosal artery, and ruptures into the stomach. They cause massive or recurrent intragastric bleeding. The lesion is very small and easily overlooked even at laparotomy and can only be correctly diagnosed by endoscopy or arteriography when the patient is actively bleeding. The authers recently observed a case of Dieulafoys disease, this 41-year old man presented an episode of severe melena, but endoscopy and barium enema were all unremarkable. There was history of analgesic abuse because of spondylolisthesis of L4-5. The physical examination was unremarkable except for grossly melenic stools. The hemoglobin was 4.8g/dl. Repeated endoscopy by a more experienced endoscopist demonstrated a vascular malformation at the posterior wall of upper body of stomach with coated blood clot. An angiography including superior mesenteric artery studies, reveal vascular malformation of the left gastroepiploic artery. A total of 30 units of blood had been replaced prior to gastrectomy. Postoperatively, he had no further bleeding. Pathologic examination of the stomach showed dilated prominent blood vessels in the submucosa with focally ectatic capillaries in the lamina propria. Two weeks after operation, the hemoglobin showed 14.0g/dl, and he discharged after improvement.