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복수에서 Carcinoembryonic Antigen ( CEA ) , Cholesterol 및 Albumin 치의 진단적 의의
허승식(Seoung Sik Heo),성자원(Ja Won Sung),김병호(Byeong Ho Kim),이기천(Ki Cheon Lee),이종선(Jong Sun Lee),안정기(Jeong Ki Ahn),정현용(Hyun Yong Jeong),이헌영(Heun Young Lee),김영건(Young Kun Kim) 대한내과학회 1992 대한내과학회지 Vol.43 No.1
N/A Background: Although ascites in most often caused by chronic liver disease or neoplasms metastatic to peritonium, a complete seperation between these two mechanisms has not been possible using simple and reliable ascitic fluid laboratory parameters. Ascitic fluid lactic acid dehydrogenase, protein, carcinoem- bryonic antigen, cholesterol, glucose concentration and PH have been investigated, but none has provided a complete distinction between malignant and benign ascites. Methods: To evaluate the diagnostic values of ascitic CEA, cholesterol and albumin to differentiate malignant from nonmalignant Ascites, the authors studies 96 patients with ascites (43 with benign ascites and 53 with clinical or pathologic malignant ascites). Results: 1) The mean values of CEA, cholesterol and albumin in benign ascites were 1.32ng/ml, 39.53 mg/dl and 0.39 gm/dl, and the upper limites of parameters in benign ascites were 3.26ng/dl, 106.79mg/dl and 1,65gm/dl. 2) The mean values of CEA, cholesterol and albumin in pathologic malignant ascites were 46. 80 ng/ml, 99. 35 mg/dl and 2,19 gm/dl, and the mean values of parameters in clinical malignant ascites were 58,49 ng/ml, 81. 37 mg/dl and 1 41 gm/dl. Ascites CEA, cholesterol and albumin levels were significantly higher in malignant ascites than benign ascites, but no significant difference between clinical and pathologic malignant ascites. 3) In diagnosis of malignant ascites, sensitivity, specificity and diagnostic efficacy of CEA, cholesterol and albumin were 60% 93% 75%, 35% 92% 69% and 56% 81% 71%. 4) The sensitivity, specificity and diagnostic efficacy of cholesterol plus albmin, cholesterol plus CEA and albumin plus CEA were 26% 96% 71%, 30% 100% 76%, 52% 100% 82%. 5) Significantly positive correlation were found be tween CEA/cholesterol, CEA/albumin. Conclusion: CEA, cholesterol and albumin, especially CEA plus albumin, were parameters valuable for differential diagnosis of ascites.
괴사후성과 비괴사후성 간경변증에서 원인별 주석교질 (^99mTc-tin colloid) 간스캔의 차이
이헌영,허승식,이강욱,정현용,김삼용,신영태,김영건,노흥규 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2
The differences of the liver scintigraphic features between postnecrotic and nonpostnecrotic liver cirrhosis were studied for 69 patients. Degrees of mottling and splenomegaly were no different between two groups but shrinked form was more frequent finding in postnecrotic type(23:10), and normal shape & enlarged left lobe with shrinked right lobe were relatively dominant in non-postnecrotic group(15:6, 10:2). Grade of extrahepatic uptake of ^99mTc-tin colloid was significantly higher in Child-Pugh B & C group than A group(p<0.05), but there was no difference between postnecrotic and non-postnecrotic groups. These will be important results on the dicision for the presence of cirrhosis according to the variable causes.
안정기,이기천,허승식,이종선,정현용,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.1
Nizatidine is a newly introduced potent H2-receptor antagonist of acid secretion with long duration of action. For evaluation of clinical efficancy and safety, twenty one patients with endoscopically proved thirteen gastric ulcers and eight duodenal ulcers were treated with nizatidine 300mg at bed time via per os for 6 weeks. The results were as follows 1. The rate of complete endoscopic healing of duodenal ulcer 92.3% and 87.5% after 6 weeks. The overall healing rate of peptic ulcer was achieved in 89.9% at 6 weeks. 2. Clinical symptoms disappeared in 84.6%, 92.3% and 100% of patients with duodenal ulcer and 75.0%, 87.5% and 87.5% patients with gastric ulcer at 2, 4 and 6 weeks respectively. 3. There were not developed any symptoms and signs suggesting side effect of drug. In conclusion, data from this study suggest that nizatidine 300mg p.o. at sleeping time is effective and safe in treatment of peptic ulcer disease, and is well tolerated on a short-term basis.
김영건,김병호,성자원,이기천,허승식,이종선,정현용,이헌영 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2
From January 1987 to October 1991, we performed 14,333 cases of upper gastrointestinal endoscopy and diagnosed 527 cases with U.G.I polyp. We assesed these 527 cases and obtained following results: 1) The overall incidence of U.G.I. polyps was 3.6%, and there was no sexual difference. The peak incidence was in 6th decades(32.4%). 2) The U.G.I. polyps were located chiefly at stomach(415 cases, 78.7%), among which antrum occupied antrum 43.5%, body 24.0% and funds 5.1%. And the others were esophagus(6.5%) and duodenum(12.3%). 3) The size of U.G.I. polyp was below 1cm in 72.3%, from 1cm to 1.9cm in 20.7% and above 2cm in 7.0%. According to Yamada' classification, type Ⅰ, Ⅱ, Ⅲ and Ⅳ was 31.9%, 51.3%, 13.7% and 3.0%. 4) Histological nature of U.I.G. polyp were hyperplastic polyp(85.8%), adenomatous polyps(9.3%), carcinomatous polyps(3.3%) and etc. The size of neoplastic polyp such as adenomatous polyps(mean 1.0±0.7cm) and carcinomatous polyps(niean 2.0±1.8) were larger man hyperplastic polyp(mean 0.6±0.4) (p<0.05) 5) The gastric polyps were associated with peptic ulcer(7.5%), gastric cancer(3.2%), other malignancy(3.5%), hepatobiliary disease(5.5%), post subtotal gastrectomy(5.5%). And others(75%) werenot associated with specific disease.
급성 및 만성 간질환에서 C형 간염바이러스 항체(anti-HCV)양성률
김삼용,성자원,김병호,이기천,허승식,길준영,정현용,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1992 충남의대잡지 Vol.19 No.2
The prevalence of antibody against hepatitis C virus (anti-HCV) was investigated in 331 patients with various liver diseases from April 1992 to September 1992. The presence of anti-HCV was detected by Lucky HCD EIA test in 331 cases and by (Ortho HCV Antibody ELISA test 148 patients) The results are summarized as follows: 1. Overall, antibody to HCV(anti-HCV) was positive in 37(11%) of 331 patients with various liver diseases. 2. 16(11%) of 144 patients with chronic hepatitis, 2(5%) of 37 patients with alcoholic liver disease, 17(22%) of 76 patients with liver cirrhosis and 2(5%) of 38 HBsAg carriers were positive for anti-HCV.None of 12 patients with acute hepatitis, 11 patients with drug induced hepatitis and 13 patients with hepatocellular carcinoma was anti-HCV positive. 3. HBsAg positivity in patients who had anti-HCV was 24%(9/37). 4. A positive correlation was found between Lucky HCD and Ortho HCV test. Of 128 Lucky HCD negative cases, 124 cases were negative for Ortho HCV ELISA and 4 cases were positive for Ortho HCV ELISA Of 20 Lucky HCD positive cases, 11 cases were positive for Ortho HCV ELISA and 9 cases were negative for Ortho HCV ELISA. These results suggest that hepatitis C virus has an important etiologic role in HBsAg negative chronic hepatitis and liver cirrhosis in Korea. The diagnostic value of Lucky HCD EIA test may be slightly better or equivalent to Ortho HCV ELISA test in the diagnosis of Hepatitis C virus infection.