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포스터 전시 : 담도,췌장 ; 폐쇄성 황달을 일으킨 췌 내분비종양
허우영 ( Woo Young Heo ),동석호 ( Seok Ho Dong ),한요셉 ( Yo Sep Han ),장린 ( Rin Chang ),이동근 ( Dong Keun Lee ),김효종 ( Hyo Jong Kim ),김병호 ( Byung Ho Kim ),장영운 ( Young Woon Chang ),이정일 ( Joung Il Lee ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<서론> 췌장의 내분비 종양은 드문 질환이지만 높은 치료율을 갖는데, 기능적 종양과 비기능성 종양으로 구분된다. 기능적 종양은 증상의 발현이 늦어 90% 이상이 악성의 경과를 갖는다. 기능성 종양은 분비하는 물질에 따라 임상적인 증상이 나타나지만 비기능성 종양은 종양 자체의 크기에 따라 또는 전이에 의한 증상이 나타나게 된다. 췌장암에 의한 폐쇄성 황달은 임상에서 흔히 접하지만 내분비 종양에 의한 폐쇄성 황달은 극히 드물게 발생하기 때문에, 본 저자들은
B 형 간염바이러스 감염후 나타나는 여러 임상양상과 조직적합항원의 연관성
김현우(Hyun Woo Kim),김효종(Hyo Jong Kim),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Joung Il Lee),장린(Rin Chang) 대한내과학회 1991 대한내과학회지 Vol.40 No.2
N/A The course of disease after hepatitis B virus (HBV) infection is extremely divergent, varying from recovery to the development of chronic hepatitis, liver cirrhosis and death. The course of the disease dose not appears to be related to a variation in virulence of the HBV itself. However, there are many reasons to assume the course of the decease after HBV infection is determined by the hosts immune response, which in turn may be regulated by the major histocompatibility complex. In order to find the possible relationship between the course of the disease and HLA antigens, we studied the phenotype frequencies of HLA antigens of class 1 and class 2 loci in groups of subjects with well defined courses of HBV infection. The results obtained were as follows: 1) No significant difference in frequencies of HLA-A, B, C, DR and DQ between patients with chronic persistent hepatitis and controls were found. 2) No significant difference in frequencies of HLA A, B, C, DR and DQ between patients with chronic persistent hepatitis and controls were found. 3) The frequencies of DRw12 and DQw4 significantly increased in patients with chronic active hepatitis (corrected P<0.05). These data suggested that the elimination of HBV and the chronicity of HBV infection were not related to the HLA phenotype, but such interpretation might be dangerous because vertical transmission seemed to play the major role in the chronicity of HBV infection in Korea. However the frequencies of DRw12 and DRw4 increased so much in patients with chronic active hepatitis that those might be related to the determination of pathology in chronic hepatitis B.
장린(Rin Chang),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Jung Il Lee),김효종(Hyo Jong Kim),동석호(Seok Ho Dong),박현주(Hyun Ju Park),김경진(Kyeong Jin Kim),정일우(Il Woo Jung) 대한소화기학회 1997 대한소화기학회지 Vol.30 No.5
Subcostosternal diaphragmatic hernia of Morgagni is the least common type of congenital diaphragmatic hernia. It is usually seen at two stages in life-infancy and adulthood. In adulthood, the majority of cases are asymptomatic or produce minimal symptoms. A 73-year-old women who had a 2 1/2-year history of right upper quadrant(RUQ) abdominal pain was admitted to our hospital. She was diagnosed as acute cholecystitis due to RUQ abdominal pain, and then underwent a cholecystectomy at a provincial general hospital 1 1/2 year ago. Although her symptom slightly improved for a while after the operation, she began feeling the RUQ abdominal pain again. Examination by chest X-ray, barium enema, and chest CT, it was revealed as Morgagnis hernia contained within the omentum and transverse colon. With a transthoracic approach we could reduce the hernia and repair the diaphragmatic defect. (Korean J Gastroenterol 1997; 30:684-688)
장린(Rin Chang),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Joung Il Lee),김현우(Hyun Woo Kim) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
Crohn's disease is a subacute or chronic inflammatory disorder, characterized by granulomatous necrosis and cicatrical inflammation, occurring in various portion of the oro-gastrointestinal tract. The etiology is not clearly defined. The disease is a heterogenous and dubious entity with multiple systemic manifestations. As diagnostic clues, clinical symptoms such as diarrhea, abdominal pain, fever and weight loss are very important. But it is not easy to suspect Crohns disease without such symptoms. We had experienced a 35 year-old man with right lower quadrant abdominal mass alone. After operation, it was diagnosed as Crohns disease. We report this case.
조직학적 으로 확인된 Dieulafoy`s Vascular Malformation 2예
정진우(Jin Woo Jeong),김효종(Hyo Jong Kim),동석호(Suk Ho Dong),김병호(Byoung Ho Kim),이정일(Jung Il Lee),장영운(Young Woon Chang),장린(Rin Chang) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.3
Dieulafoys vascular malformation is an uncommonly reported cause of massive upper gastrointestinal hemorrhage. It is charact.erized by the followings .' a negative past medical his tory, independence from peptic ulcer disease, sudden onset, increasing bouts of hematemesis, subcardial location, a tiny mucosal lesion, an open submucous artery of seemingly large cali- ber, failure of conservative treatment, and high mortality. The diagnosis is usually made by gastroscopy or laparotorny. We experienced 2 cases of Dieulafoys vascular malformation of the stomach, which werv. Proved by histology.(Korean J Gastroenterol 1994; 26: 568 572)
김양수(Yang Soo Kim),김현우(Hyun Woo Kim),김병호(Byung Ho Kim),동석호(Seok Ho Dong),김효종(Hyo Jong Kim),장영운(Young Woon Chang),이정일(Joung Il Lee),장린(Rin Chang) 대한내과학회 1993 대한내과학회지 Vol.45 No.1
N/A Background: Osteopenia has long been recognized as a potential complication of chronic liver disease. Severe osteopenia, regardless of its cause, is a risk factor for the development of fracture, which may contribute to mortality in patients already debilitated by chronic liver disease, However, data an the prevalence and the severity of osteopenia in the patients with liver cirrhosis are scant in Korea. We determined the prevalence of osteopenia in cirrhotic patients and tried to elucidate the mechanism of osteopenia in cirrhotic patients. Methods: In 36 male patients with liver cirrhosis, twenty were nonalcoholics and sixteen were alcoholics. Fifteen male controls matched in age and sex were included in this study group. We determine of the prevalence of osteopenia using the dual energy absortiometry and various hormones and biochemical items relevant to bone metabolism were also measured. Results: 1) Bone density was significantly decreased in both groups of patients 'with liver cirrhosis, nonalcoholics and alcoholics, compared with normal controls (p<0.05). 2) The prevalence of osteopenia of whole body was 20Fo in non-alcoholic cirrhotics and 25% in alcoholic cirrhotics. The most frequent site of osteopenia was lumbar spine in both groups (30%, 31%). 3) The levels of ionized calcium and 1, 25-(OH)2-D3 were significantly decreased in both non-alcoholics and alcoholics compared with controls (p<0.05). Parathyroid hormone didn't show any significant difference between cirhotics and controls, but calcitonin was rather increased in cirrhotics. 4) In cirrhotic patients with osteopenia (whole body), the levels of ionized calcium, 25-OH-D3 1, 25-(OH)2-D3 were significantly decreased compared with non-osteopenic liver cirrhotics (p<0.05). 5) Regional bone density of spine, arm, and pelvis were significantly decreased in osteopenic cirrhotics compared with non-osteopenic cirrhotics. Conclusion: The prevalence of osteopenia was 10-30% in non-alcoholic cirrhotics, 19-31% in alcoholic cirrhotics depending on the site studied and the most frequent site of osteopenia was lumber spine in both groups. Decreased vitamin D and ionized calcium may be one of various pathogenic factors involving the developement of osteopenia in patients with liver cirrhosis, and especially decreased blood level of 25-OH-D3 in cirrhotics suggested that defect of 25-hydroxylation in cirrhotic liver may be partially responsible for decreased vitamin D. However, further studies need to be performed to elucidate the obvious mechanism of osteopenia according to the etiology of chirrhosis, remained liver function and the histologic form of osteopenia.