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- 저자 : 홍은경(Eun Kyun (검색결과 2 건)
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만성 간 질환에서 Thallium-201 간 스캔의 단락지수(Shunt Index)와 간 조직 검사 소견에 대한 연구
유영조(Young Jo Yoo),정진웅(Jin Woong Jung),최춘식(Choon Sik Choi),전대원(Dae Won Jeon),이오영(Oh Young Lee),최호순(Ho Soon Choi),윤병철(Byung Chul Yoon),함준수(Joon Soo Hahm),이민호(Min Ho Lee),최윤영(Yun Young Choi),홍은경(Eun Kyun 대한내과학회 2000 대한내과학회지 Vol.58 No.2
N/A Background : The disturbances of portal circulation in chronic liver disease may cause hepatic failure, hepatic encephalopathy and variceal bleeding. The measure of porto-systemic shunt plays a significant role in the management and prognosis of the patients. So we have evaluated the relationship between the shunt index of thallium-201 liver scan and the histological grade and stage of chronic liver disease. Methods : The thallium-201 scintigraphy per rectum was evaluated in 159 patients with chronic liver disease, which were proven with percutaneous liver biopsy. We used the heart to liver activity ratio at 20 minute as shunt index, representing portal-systemic shunt. The two pathologists scored independently hepatitis activity (lobular and porto-periportal activity) and stage (fibrosis). Results : A significant difference was noted between the shunt index and the scores of fibrosis (p<0.001) although this correlation was statistically weak (r=0.26, p=0.008). In cumulative logistic regression test, the shunt index had a effect on the fibrosis (p<0.001) but not on the lobular and porto-periportal activity. Fibrosis was predicted as less than 2 if shunt index was less than 0.24, 3 if more than 0.24 but less than 0.46, 4 if more than 0.46. Conclusion : The shunt index of thallium-201 liver scintigraphy correlated only with fibrosis not with lobular and porto-periportal activity. As the fibrosis progresses in chronic liver disease, portal hypertension becomes more severe and the shunt index increases. Thallium-201 liver scan may be useful for evaluation of hepatic fibrosis instead of invasive liver biopsy in predicting the histological stage (fibrosis) of advanced chronic liver disease.(Korean J Med 58:152-160, 2000)
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Kappa-light Chain 다발성 골수종에 동반된 유전분증 및 제한성 심근증 1 예
김경수,김정호,김인순,김정현,임헌길,이정균,이방헌,홍은경,윤영무,채현기 대한내과학회 1994 대한내과학회지 Vol.47 No.3
Amyloid diseases constitute a group of conditions of diverse causes characterized by the accumulation of ultrastructually fibrillar material in various tissues in quantities sufficient to compromise vital organ function. The symptoms of the amyloidoses depend upon the amount and localization of the deposits. Myocardial involvement with amyloid is a common cause of secondary restrictive cardiomyopathies caused by a variety of conditions (amyloid, sarcoid, Gaucher disease, Hurler disease). Of the three major functional categories of the cardiomyopathies (dilated, hypertropic and restrictive), the restrictive are the least common in Western countries. The hallmark of the restrictive cardiomyopathies is abnormal diastolic function with excessively rigid ventricular walls. We had experienced one case of amyloidosis, especially involving heart who was admitted to Hangyang University Hospital due to dyspnea on exertion, abdominal distension and edema on both lower extremites. Echocardiogram showed markedly thickened septum and ventricular wall, as well as mitral valve thickening, and left atrial enlargement. Doppler echocardiogram showed markedly increased E wave, and in pulmonary venous flow by tranesophageal echocardiogram, D wave was prominent. In tissue sections of endocardium and rectum, with conventional staining technique, amyloid appears homogenous and eosinophilic. Amyloid showed apple-green birefrigence withCongo-red stain and under polarized light. On electron microscopy of endocardial biopsy, typical rigid, nonbranching fibrils (amyloid fibrils) are arranged randomly and are noted in the interstitium and around blood vessels, surrounding cardiac myocytes and capillaries. Kappa light chain multiple myeloma was diagnosed by bone marrow aspiration, biopsy and immunoelectrophoresis of serum and urine. He was treated with mephalan, prednisolone and diuretics.
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