E . R . C . P . 로 진단된 (診斷) 담관암의 (膽管癌) 임상적 (臨床的) 고찰

임준영(Jun Yeong Lim),김석주(Seok Ju Kim),변정섭(Jeoung Sup Byon),임중규(Jung Kyu Lim),박영(Yeong Park),박홍배(Hong Bad Park) 대한소화기학회 1983 대한소화기학회지 Vol.15 No.1

N/A In 938 patients suspected of having pancreatic or biliary tract disease, 104 patients were shown to have biliary tract cancer demonstrated by endoscopic retrograde cholangiopancreatography, at kwangju christian hospital from Sep, 1971j to Aug, 1982. Authors analyzed the biliary tract cancer and compared them with the final diagnosis, The results were as follow 1) There were 41 cases of primary CBD ca and 19 cases(46.3%) of them were located in upper portion of CBD. In CBD cancer, stenosis of CBD(58. 5%) were more common than obstructive type(41. 5%) by ERCP. Male and female ratio was 2.2: 1 and 6th decade were most common. 2) There were 5 cases of primary GB cancer. Four of them were diagnosed by ERCP and remainer were by ERCP. In all cases, liver metastasis was suspected by liver scanning. 3) There were 14 cases of primary ampulla of Vater cancer. All of them were diagnosed by ERCP except one and female(9) was more common than male(5) In 6 cases of them, liver metastasis was suspected by liver scanning and prognosis was better than other biliary tract cancer. 4) There were 22 cases of infiltrative obstructive ampullary cancer and 16 cases of them were from pancreas cancer and male(17) was more common than female(5).Nearly all of them were not indicated for surgical treatment 5) There were 22 cases of metastatic biliary due to early distant metastasis. Tract cancer and in all cases, their primary foci were pancreas and 13 cases of them were male. Most common metastatic site of biliary tract was upper portion of CBC(18) and in all cases, liver metastasis was also demonstrated by liver scanning.

췌장낭종의 (膵臟囊腫) ERCP 소견 및 임상 (臨床) 고찰

김석주 ( Seok Ju Kim ),박홍배 ( Hong Bae Park ),임중규 ( Jung Kyu Lim ),변정섭 ( Jeoung Sup Byon ),임준영 ( Jun Yeong Lim ),박영 ( Yeong Park ) 대한소화기학회 1983 대한소화기학회지 Vol.15 No.2

N/A ERCP has some advantages in the diagnosis of pancreatic cyst. One is that ERCP can find the ultrasonographically undetectable cyst which is less than 5 cm located in the left upper quadrant. Also ERCP provides the information about the ductal anatomy underlying diseases of pancreatic cyst. Authors report the clinical study S: ERCP finding of 10 cases of pancreatic cyst. The results were as follows 1) Out of 938 cases of ERCP, the pancreatic cysts were 10 cases and 1 case was mucinoous cystadenoma of pancreas and others were pseudocysts. 2) The etiologic causes of pancreatic pseudocysts were acute and chronic pancreatitis(4 cases) malignancy(2 cases) trauma(1 case) and unknown(2 cases). 3) There is no specific age-incidence and male to female ratio was 4: 1 4) The most common site of pseudocyst was tail and the mucinous cystadenoma was located in the head. 5) The most common chief complaints were upper abdominal pain & palpable abdominal mass and serum amylase was elevated in 4 cases & leukocytosis in 3 cases. 6) The diagnosis by UGI-series was pancreatic cyst(3 cases), retroperitoneal tumor(2 cases) normal(2 cases) and by G.I echo, pancreatic cyst(4 cases) retroperitoneal cystic tumor(1 case) & normal(1 case). 7) The complication after ERCP is absent except mild transient elevation of serum amylase 8) The complications of pancreatic pseudocyst were infection(2 cases) k retroperitoneal rupture(1 case) and tbe frequency rate was 33% 9) The ERCP finding was variable. In 5 cases, we have demonstrated the communication from the pancreatic duct system to the cyst with the filling of dye and they are small cysts located in the parenchyme. Other findings were the displacement & compression defect of CBD by the head cyst and the complete obstruction, stenosis and displacement of the pancreatic duct

내시경적 유두절개술 71 예

박홍배 ( Hong Bae Park ),조진행 ( Jin Han Cho ),김석주 ( Seok Ju Kim ),임준영 ( Jun Young Lim ),변정섭 ( Jeong Sup Byon ),임중규 ( Jung Kyu Lim ),박영 ( Yeong Park ),고정미 ( Jung Mi Koh ),김종수 ( Jong Soo Kim ) 대한내과학회 1984 대한내과학회지 Vol.27 No.12

폐쇄성 황달증에 (黃疸症) 대한 ERCP 의 진단적 의의

김영환(Young Whan Kim),박홍배(Hong Bae Park),정윤구(Yoon Koo Jeong),임연근(Yoen Kun Lim),김석주(Suk Ju Kim),임중규(Jun Kyu Lim),김정길(Jung Gil Kim) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.2

N/A ERCP is an important new diagnostic method of biliary and pancreatic disease which has been made possible by the development of fiberoptic duodenoscopy. Authors analyzed 212 cases of obstructive jaundice out of total 646 cases of ERCP performed at the Kwangju Christian Hospital between August 1976 and July 1981, and compared them with the final diagnosis. The results were as follows: 1) Out of 212 cases, successful visualization of the duct was achieved in 189 cases (89%), 2) The ratio of male to female was about 2: 1. Most of them were in the 4th to 6th decade. 3) Out of 50 cases of CBD stone, 49 cases were diagnosed by ERCP and operation was done in 46 cases. 4) Out of 54 cases of pancreatic cancer, 32 cases were diagnosed by ERCP, But most of them were not candidate for surgical resection due to early distant metastasis. 5) Out of 32 cases of CBD cancer, 31 cases were diagnosed by ERCP alone. Also they met astasized early to liver. 6) 35 cases of hepatitis were proved to be nonobstructive cholestatic type by ERCP and biopsy. All of them were cured by medical treatment alone. 7) Out of 15 cases of ampullary cancer, 9 cases were confirmed by ERCP with endoscopic biopsy. 8) Complications of ERCP were extremely rare. Transient abdominal distention, abdominal discomfort and elevated serum amylase were noted, but were not clinically significant.

Albumin Enriched Peritoneal Dialysis 를 시행한 급성 황산동 중독 1 예

박홍배,임중규,이상운 대한내과학회 1987 대한내과학회지 Vol.33 No.6

A twent-three-year old male was admitted because of jaundice and hematuria. Two days before entry, he ingested copper sulfate (about 30 gm} for suicidal purpose. The third admission dacy, sudden decreased urine output was developed and mental deterioration was followed inspite of using chelating agents (D-Penicillamine 500mg, q 6 hours). So, peritoneal dialysis with added albumin (20% albumin + Inperinol, 10 times) was performed. The amounts of copper removed by peritoneal dialysis with albumin was significantly greater than that removed by dialysis without albumin (36 ug/dl: 2.1 ug/dl). Daily urine output, renal function test and other laboratory findings were improved after dialysis. The patient discharged on 13th admission day without any complications. Chelating agents form a copper complex, which is readily excrete in the urine, but the renal failure precludes the effectiveness of these drugs. So we conclude that albumin enriched peritoneal dialysis is effective method for management of the renal failure in acute copper poisoning.

갑상선 결절에서 T1-201 주사의 진단적 의의

김순호,임중규,정경헌,김기현,박철성,문정식,이재학,허진득,조형석,손장신 대한내분비학회 1996 Endocrinology and metabolism Vol.11 No.2

To investigate diagnostic value of Thallium 201(T1-201) thymid scan in differentiating malignant nodule from benign, 135 patients with thyroid nodule were evaluated with Tl-201 thyroid scan, fine needle aspiration(FNA), clinical characteristics and laboratory data. Each had histological diagnosis after thyroidectomy. Tl-201 scan had a sensitivity of 67.3% and a specificity of 66.3% and FNA had sermitivity of 46.9% and specificity of 100% in predicting malignancy. As the size of thyroid nodule and age of patient incteases, diagnostic value of 11-201 thyroid scan was improved. In the thyroid nodules larger then 3cm, sensitivity, specificity and negative predictive value were 100%, 70% and 100%, reqectively. By cornbining Tl-201 throid scan and FNA, sensitivity had 91.8%. From the data we conclude that Tl-201 thyroid scan is valuable with adjuvant diagnostic method in differentiating malignant fmm benign thyroid nodule and treatment planning(J Kor Soc Endocrinol 11:175~181, 1996).

이차성 알도스테론증을 동반한 부신피질 선암 1예

김호동,김연종,임중규,허진득,윤형신,장진형,김훤,손장신 대한내분비학회 1992 Endocrinology and metabolism Vol.7 No.2

Adrenal cortical carcinoma is a rare tumor that affects all ages and sexes and has a dismal prognosis. Half are functioning and half are not. Functioning neoplasma of the adrenal cortex are clinically manifested by virilization, Cushing's syndrome, feminization, or hyperaldosteronism. A 22-year-old female was admitted to our hospital in April 1990, because of amenorrhea for 6 months, hirsuitism, acne and palpable mass in left upper abdomen for 3 months. Routine laboratory examination including blood chemistry gave no abnormalities. Abdoiminal CT scan demonstrated a large mass with central necrosis and calcification, about 10×15 cm size in left upper abdomen. Endocrine tests revealed; serum testosterone 7.5ng/dl, DHEA-sulfate above 1,000ng/dl, 24-hour urine free cortisol 152 ng/day, 17-KS 50.8 ng/day, 17-OHCS 9.9mg/day. Plasma aldosterone and plasma renin activity were elevated. We report a case of adrenocortical carcinoma with hypersecretion of glucocorticoid and androgen.She also had a secondary aldosteronsm and lung metastasis. She underwent surgical resection of the tumor and treated with mitotan (O.P'-DDD) postoperatively (J Kor Soc Endocrinol 7:160~164, 1992).

말단거대증을 동반한 Albright 증후군 1 예

임동명,김순호,임중규,허진득,장진형,김훤,위대철,윤철승 대한내분비학회 1992 Endocrinology and metabolism Vol.7 No.4

The syndrome of polyostotic fibrous dysplasia (PFD), cutaneous pigmentation and endocrinopathy (Albright's syndrome) continuous today to remain enigmatic. Not all patient with PFD have complete syndrome. In addition to the described in Albright's original patients, other endocrinopathies have been reported, including hyperthyroidism, acromegaly, hyperparathyroidism, Cushing's syndrome, adenoma of pituitary, thyroid, parathyroid and adrenal gland, vitamine Dresistant rickets and hypothalamic hypogonadotrophic hypogonadism. A 27-year-old man was found to have polyostotic fibrous dysplasia of bone, cutaneous pigmentation and acromegaly with diabetes mellitus. He started to have pain in left hip joint and it caused an alternation on his gait in 1983. X-ray study revealed that he had fibrous dysplasia. He gradually developed clinical feature of acromegaly. Subsequent biochemical study of growth hormone and radiologic study of the sellar confirmed the diagnosis of acromegaly. Bone biopsy and microscopic examination of the pituitary tumor tissue obtained through transsphenoidal procedure were reported to be fibrous dysplasia and acidophilic adenoma, respectively. The purpose of this report is to describe a patient with incomplete Albright's syndrome with acromegaly, which is very rare and we believe this is the first case to be reported in Korean literature.(J Kor Soc Endocrinol 7:402~408, 1992)

당뇨병과 동반된 Klinefelter 증후군 1 예

이윤호,김승준,김순호,임중규,전인표,임석환,배원엽,허진득 대한내분비학회 1994 Endocrinology and metabolism Vol.9 No.1

Klinefelter syndrome is the most common form of male hypogonadism. It is characterized by small, firm testis, gynecomastia, a variable degree of eunuchoidism, azoospermia, elevated gonadotropin level. Increased frequency of diabetes mellitus, breast cancer, empysema, chronic bronchitis, varicose vein, germ cell neoplasia occurs in Klinefelter syndrome. We report a 19 year-old male patient with diabetes mellitus in association with Klinefelter syndrome, which was confirmed by chromosome analysis. The patient is being treated with insulin for diabetes mellius and with testostrone replacement for Klinefelter syndrome(J Kor Soc Endocrinol 9:46-49, 1994).

자가면역성 다선증후군 1 예

이윤호,김승준,김순호,임중규,전인표,임석환,배원엽,허진득 대한내분비학회 1995 Endocrinology and metabolism Vol.10 No.2

Polyglandular autoimmune(PGA) syndrome designates the dysfunction of endocrine and nonendocrine system involving two or more glands on the basis of autoimmunity. There are three types of PGA syndrome and their pathogenesis is still not completely understood. A 27-year-old woman developed polyglandular autoimmune syndrome manifesting insulin-dependent diabetes mellitus, myasthenia gravis and Graves' disease associated papillary thyroid carcinoma. The thyroid antimicrosomal antibody and antiacetylcholine receptor antibody were positive. Her HLA serotype was A2, A11, A62, B60, CW3, CW4, DR4, DR9. We report here a case of polyglandular autoimmune syndrome, type III manifesting insulin-dependent diabetes mellitus, myasthenia gravis and Graves' disease associated with papillary thyroid carcinoma(J Kor Soc Endocrinol 10: 142-147, 1995).