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복수중에서의 혈청 및 복수내 Adenosine Deaminase 활성도 측정의 진단적 가치
박태군(Tae Koon Park),양은수(Eun Soo Yang),박태준(Tae Joon Park),이희승(Hee Seung Lee),류종철(Jong Cheol Ryu),신원창(Won Chang Shin),최원충(Won Chong Choi),이진호(Jin Ho Lee),김관엽(Kwan Yop Kim) 대한내과학회 1994 대한내과학회지 Vol.47 No.1
N/A Objectives: In this study, we would like to evaluate the diagnostic value of adenosine deaminase activity in serum and ascitic fluid from patients with ascites of various causes, including tuberculous peritonitis, liver cirrhosis with or without hepatoma, and cancer peritonitis. Methods: The ADA was assessed in serum and ascitic fluid, and simultaneous calculation of ascitic fluid/ serum ADA ratios were obtained in 89 patients with ascites due to various causes; 42 for liver cirrhosis, 18 for hepatoma, 14 for tuberculous peritonitis, 15 for malignant ascites. Results: 1) Serum ADA activity was significantly higher in patients with liver cirrhosis than those with other causes of ascites, with the level of 61.3±49.0 U/L, and the corresponding ADA levels of other diseases were 42.8±20.4 U/L in hepatoma, 46.1±21.9 U/L in tuberculous peritonitis, 24.0±19.8 U/L in malignant ascites (p<0.05). 2) Ascitic fluid ADA activity was highest in patients with tuberculous peritonitis than those with non-tuber-culous causes of ascites, with the level of 82.0±72.3 U/L, and the corresponding ADA levels of other diseases were 21.1±31.7U/L in liver cirrhosis, 8.8±7.7U/L in hepatoma, 29.0±19.7 U/L in malignant ascites (p<0.05). Ascitic fluid ADA level greater than 80 U/L had a specificity of 97%, sensitivity of 50%, and diagnostic efficiency of 76% for the diagnosis of tuberculous peritonitis. 3) The ascitic fluid/serum ADA ratios were significantly higher in patients with malignant ascites than those with other causes of ascites, with the level of 3.5±7.0, and the corresponding levels of other diseases were 0.8±1.8 in liver cirrhosis, 0.3±0.4 in hepatoma, 1.7±1.3 in tuberculous peritonitis (p<0.05). Conclusion: These results suggest that the assessment of serum and ascitic fluid ADA activity, and simultaneous calculation of ascitic fluid/serum ADA ratios would be useful in the differential diagnosis between patients with tuberculous peritnnitis and non-tuberculous causes of ascites.
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유진형,한상원,염호기,조혜제,김예희,최원충 대한내과학회 1990 대한내과학회지 Vol.39 No.1
Gardner syndrome is a rare inherited disease transmitted with an autosomal dominant trait and characterized by a triad of intestinal polyposis, soft tissue and bone tumors along with other manifestations. For a person with Gardner syndrom the risk of malignant transformation of colon polyps during an adult life is ultimately 100%, and a better understanding of this genetic disorder is essential far surgeons, gastroenterologists, cancer researchers and geneticists alike. In Korea, a few cases have been reported, but there were none which showed various manifestations, including the triad of this syndrome. We experienced a case of Gardner syndrome in a 29-year-old female who showed familar gastrointestinal polyposis associated with epidermal inclusion cyst, frontal sinus osteoma, thyroid papillary cancer, and abnormal hypertrophy of the retinal epithelium.
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