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- 저자 : 이헌직(Hun Jig Lee) (검색결과 4 건)
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최성호(Seong Ho Choi),신영민(Young Min Shin),김상현(Sang Hyun Kim),박승근(Seung Keun Park),이헌직(Hun Jig Lee),강대환(Dae Han Kang),조몽(Mong Cho),양웅석(Ung Suk Yang),문한규(Han Gyu Moon) 대한내과학회 1993 대한내과학회지 Vol.45 No.1
N/A Background: AFP is known as one of the most sensitive tumor markers for hepatocellular carinoma. But in many cases of hepatocellular carcinoma, low or negative levels of AFP have been observed. And because AFP levels may be increased in cases of other liver diseases such as liver cirrhosis, its specificity and sensitivity are problems. PIVKA-II has been studied as a new tumor marker for hepatocellualr carcinoma with AFP. It is a precursor protein of prothrombin and is converted to active form of prothrombin by the action of Vitamin K dependent carboxylase in hepatocyte microsomes. As this process can be suppressed by Vitamin K deficiency or Vitamin K antogonist such as warfarin, PIVKA-II levels might be increased due to functional derangement of Vitamin K-dependent carboxylation in hepatocellular carcinoma. We measured the levels of PIVKA-II in patients with various liver diseases including hepatocellular carcinoma and evaluated the meaning of increased PIVKA-II levels. Methods: We measured the levels of PIVKA-II in the plasma of 30 patients with hepatocellular carcinoma and 41 patients with other liver diseases by EIA method using monoclonal antibody specific to PIVKA-II. AFP was checked by RIA method. Results: The levels of PIVKA-II were increased above 0.1 AU/mL in the plasma of 25 (83%) patients with hepatocellular carcinoma and 1 patient with liver cirrhosis and 1 chronic hepatitis, 1 receiving warfarin, 2 toxic hepatitis, 2 cholangiocarcinoma and 1 liver metastatis from stomach cancer. In this study, with diagnostic cut-off value of 0.1 AU/ mL, the sensitivity and specificity of PIVKA-II to detect hepatocellular carcinoma were 83.3% and 78% each. With cut-off value of 8.0 AU/ml, the sensitivity and specificity were 66.7% and 100% each. By the combination assay with the cut-off values of AFP above 100ng/mL & PIVKA-II above 0.1 AU/mL the sensitivity for hepatocellular carcinoma could be elevated to 86.7%. Conclusion: We can conclude that PIVKA-II is more sensitive and specific than AFP and is a useful tumor marker which can elevate the sensitivity and specificity to detect hepatocellular carcinoma by combination assay with AFP. And PIVKA-II can be a useful screening method to detect hepatocellular carcinoma arising from liver cirrhosis.
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이민기,신영기,박순규,허재영,도창호,조군제,임홍섭,문원국,최장락,이헌직 대한내과학회 1990 대한내과학회지 Vol.39 No.2
Tuberculous osteitis of the skull is an uncommon condition, first reported by Reid of Erlangen, who described two cases in 1842. By 1933. only 220 cases had been recorded in world literature (Strauss). It occurs in approximately 1%. of all patients with tuberculous osteitis and is diagnosed by clinical manifestation, skull roentgenogram, smear and culture of aspirated pus, and biopsy of granulation material. It responds readily to chemotherapy and the prognosis is favorable. To the best of our knowledge, the condition has not been previously reported in Korea. But recently we experienced a case of tuberculous osteitis of the skull in an 18-year-old male patient who complained of dyspnea, chest pain, multiple swelling of scalp and right eye proptosis. The patient was treated with antituberculous medication and discharged with his condition improved.
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류마치스성 관절염과 동반된 Ochronosis(조직갈변증) 1 예
김상현,이종수,김진도,문한규,최장락,강필중,이광욱,나하연,이헌직,여동승,윤영권,황병욱,곽임수 대한내과학회 1991 대한내과학회지 Vol.41 No.1
Ochronosis, which is autosomal recessive, results from a decreased amount of the enzyme homogentisic acid oxidase, due to which tyrosine and phenylalanine cannot be broken down via the normal pathway. The clinical manifestations of ochronosis usually appear after the age of 30 as a result of the deposition of pigment in the extracellular macromolecules of the connective tissue, particular of the skin and joints. The diagnosis is made by determination of urinary homogentisic acid excretion, and the clinical and radiological findings can help to diagnose this disease. We report a case of Ochronosis with Rheumatoid arthritis presented with skin pigmentation and migrating polyarthritis in a 57-year-old female patient who was managed with an antiinflammatory agent, steroids, and symptomatic care.
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