1.A Case of Primary Sclerosing Cholangitis with Ulcerative Colitis.
Kyu Won CHUNG ; Hee Sik SUN ; Doo Ho PARK ; Kyu Yong CHOI ; Soo Heon PARK ; Joon Yeol HAN ; Se Hyun CHO ; Won Hee HAN ; Chang Suk KANG
Korean Journal of Gastrointestinal Endoscopy 1996;16(6):1001-1007
Sclerosing cholangitis is cholestatic disease, characterized by progressive fibrotic inflammation and obliteration af intrahepatic bile ducts and extrahepatic bile ducts and sometimes associated with ulcerative colitis. The pathogenesis of this disease is not understood well. In this disease, however, have been proposed infectious agent, endotoxin of bacteria and immunological event. In Europe and U.S.A., the incidence of sclerosing cholangitis associated with ulcerative colitis was between 2,4 and 4.0 percent. The association is strongest in patients with pancolitis, with a prevalenee of 5.5 percent, compared with patients with disease confined to the distal colon, with a prevalence of 0.5 percent. But, in Korea, it has not been reported sclerosing cholangitis associated with ulcerative colitis. A 30-year old man was diagnosed as an ulcerative colitis 9 years ago and has been followed up, intermittently. Recently, he has experienced hematochezia and dizziness. Colonoscopy showed active ulcerative colitis(pancolitis), blood chemistry elevated alkaline phosphatase and y-GTP. ERCP and liver biopsy specimen revealed sclerosing cholangitis. we concluded that this case was a sclerosing cholangitis as a complication of ulcerative colitis and the first case report of primary sclerosing cholangitis with ulcerative colitis in Korea, Hence, we reported a case of primary sclerosing cholangitis with ulcerative colitis with a review of literatures.
Adult
;
Alkaline Phosphatase
;
Bacteria
;
Bile Ducts, Extrahepatic
;
Bile Ducts, Intrahepatic
;
Biopsy
;
Chemistry
;
Cholangiopancreatography, Endoscopic Retrograde
;
Cholangitis, Sclerosing*
;
Colitis, Ulcerative*
;
Colon
;
Colonoscopy
;
Dizziness
;
Europe
;
Gastrointestinal Hemorrhage
;
Humans
;
Incidence
;
Inflammation
;
Korea
;
Liver
;
Prevalence
;
Ulcer*
2.A Case of Primary Sclerosing Cholangitis with Ulcerative Colitis.
Kyu Won CHUNG ; Hee Sik SUN ; Doo Ho PARK ; Kyu Yong CHOI ; Soo Heon PARK ; Joon Yeol HAN ; Se Hyun CHO ; Won Hee HAN ; Chang Suk KANG
Korean Journal of Gastrointestinal Endoscopy 1996;16(6):1001-1007
Sclerosing cholangitis is cholestatic disease, characterized by progressive fibrotic inflammation and obliteration af intrahepatic bile ducts and extrahepatic bile ducts and sometimes associated with ulcerative colitis. The pathogenesis of this disease is not understood well. In this disease, however, have been proposed infectious agent, endotoxin of bacteria and immunological event. In Europe and U.S.A., the incidence of sclerosing cholangitis associated with ulcerative colitis was between 2,4 and 4.0 percent. The association is strongest in patients with pancolitis, with a prevalenee of 5.5 percent, compared with patients with disease confined to the distal colon, with a prevalence of 0.5 percent. But, in Korea, it has not been reported sclerosing cholangitis associated with ulcerative colitis. A 30-year old man was diagnosed as an ulcerative colitis 9 years ago and has been followed up, intermittently. Recently, he has experienced hematochezia and dizziness. Colonoscopy showed active ulcerative colitis(pancolitis), blood chemistry elevated alkaline phosphatase and y-GTP. ERCP and liver biopsy specimen revealed sclerosing cholangitis. we concluded that this case was a sclerosing cholangitis as a complication of ulcerative colitis and the first case report of primary sclerosing cholangitis with ulcerative colitis in Korea, Hence, we reported a case of primary sclerosing cholangitis with ulcerative colitis with a review of literatures.
Adult
;
Alkaline Phosphatase
;
Bacteria
;
Bile Ducts, Extrahepatic
;
Bile Ducts, Intrahepatic
;
Biopsy
;
Chemistry
;
Cholangiopancreatography, Endoscopic Retrograde
;
Cholangitis, Sclerosing*
;
Colitis, Ulcerative*
;
Colon
;
Colonoscopy
;
Dizziness
;
Europe
;
Gastrointestinal Hemorrhage
;
Humans
;
Incidence
;
Inflammation
;
Korea
;
Liver
;
Prevalence
;
Ulcer*
3.Liver ; Comparative Study between Laparoscopic and Histologic Findings in Patients with Viral Hepatitis .
Kyu Won CHUNG ; Hee Sik SUN ; Boo Sung KIM ; Young Gil LEE ; Soo Heon PARK ; Joon Yeol HAN ; Se Hyun CHO ; Choon Sang BHANG
Korean Journal of Gastrointestinal Endoscopy 1997;17(2):143-150
BACKGROUND/AIMS: The authors compared laparoscopic changes of the diseased liver surface according to Shimadas classification with laparoscopic needle biopsy in order to clarify whether the two diagnostic criteria have consistency or discrepancy in each other. By serologicai tests the patients with chronic hepatitis B were 179 cases, chronic hepatitis C 22 cases and NBNC hepatitis 54 cases. Histologically the patients with non-specific reactive hepatitis were 35 cases, chronic lobular hepatitis 20 cases, chronic persistent hepatitis 18 cases, chronic active hepatitis 8~5 cases, subacute hepatic necrosis 32 cases, circumscribed hepatic necrosis 9 cases and liver cirrhosis 56 cases. METHODS: We performed laparoscopy on 255 patients with chronic hepatitis and laparoscopic guided liver needle biopsy was done in all cases. RESULTS: 1) Age incidence of chronic viral hepatitis was peak in chronic hepatitis C, and then that in chronic hepatitis B and NBNC heatitis in decreasing order. 2) Code numbers of liver surfaces were mainly numbers between 200 and 300 in chronic hepatitis B and NBNC hepatitis, but those of chronic hepatitis C were numbers between 300 and 400 which meant advanced patterns. 3) Comparing macroscopic fmdings of liver surfaces with histologic diagnosis by guided liver biopsy, the consistency of two criteria was 83.9% in all cases and the discrepancy was 16.1%. 4) Among the cases with diagnostic discrepancy, the patients showing macroscopically chronic hepatitis but histologically liver cirrhosis were predominant in chronic hepatitis B under the age of 40. In contrast to this, the cases showing surface changes of liver cirrhosis but histologically chronic hepatitis was mainly in chronic hepatitis C over the age of 40. CONCLUSIONS: The above results suggest that laparoscopy and guided liver biopsy may be very useful diagnostic tools to determine correct diagnosis, adequate treatment and prognosis.
Biopsy
;
Biopsy, Needle
;
Classification
;
Diagnosis
;
Hepatitis B, Chronic
;
Hepatitis C, Chronic
;
Hepatitis*
;
Hepatitis, Chronic
;
Humans
;
Incidence
;
Laparoscopy
;
Liver Cirrhosis
;
Liver*
;
Necrosis
;
Prognosis
4.Primary Malignant Lymphoma of the Small Intestine Causing Adult Intussusception as an Initial Symptom.
Kyu Won CHUNG ; Hee Sik SUN ; Soo Heon PARK ; Myung Gyu CHOI ; Joon Yeol HAN ; Ki Dong YOO ; Hyun JUNG ; Hyo Young RHIM ; Se Hyun CHO
Korean Journal of Gastrointestinal Endoscopy 1994;14(1):100-104
While intussusception can occur at any age, the disease is most often seen in children and no etiologic factor can be seen in most cases of childhood intussusception. In contrast, the adult intussusception is rare and usually has an identifiable causes such as benign tumor, malignant tumor, sarcoma, Meckel's diverticulum and congenital anomaly. Especially, adult intussusception due to primary malignant lymphoma of small intestine is rare clinical condition. Here, we describe the case of a 49-year-old male patient with ileo-ileo-colic intussusception due to primary malignant lymphoma of the small intestine. The clinical, radiographic and pathologic findings are described with brief review of the literature.
Adult*
;
Child
;
Humans
;
Intestine, Small*
;
Intussusception*
;
Lymphoma*
;
Male
;
Meckel Diverticulum
;
Middle Aged
;
Sarcoma
5.Comparison of Techniques for Laparoscopic Radical Nephrectomy in a Single Center: Transperitoneal vs. Retroperitoneal vs. Hand-Assisted.
Jung Min HA ; Tae Hyo KIM ; Won Yeol CHO ; Se Il JUNG ; Gyung Tak SUNG ; Jin Han YOON
Korean Journal of Urology 2009;50(7):675-681
PURPOSE: Laparoscopic surgery has become the standard method of radical nephrectomy within the urological community. We compared the safety and efficacy of different techniques for laparoscopic radical nephrectomy (LRN) in a single medical center. MATERIALS AND METHODS: Between June 2002 and August 2007, we performed LRN for renal cell cancer in 45 cases by a transperitoneal approach (TLRN), in 21 cases by a retroperitoneal approach (RLRN), and in 32 cases by a hand-assisted approach (HLRN), and the results of each approach were compared. Surgical results such as operative time, estimated blood loss (EBL), transfusion rate, hospital stay, complications, and pathologic results were reviewed retrospectively and analyzed by one-way ANOVA. RESULTS: There were no significant differences in demographic data among the 3 groups. The pathologic reports showed clear cell type in 97 cases and chromophobe type in 1 case. For each group (TLRN vs. RLRN vs. HLRN), the mean operative time was 207.9+/-57.06 vs. 211.8+/-52.85 vs. 184.4+/-49.43 minutes, respectively (p=0.03); the EBL was 135.0+/-29.40 vs. 153.8+/-45.59 vs. 183.4+/-89.25 ml, respectively (p=0.14); time to oral intake was 2.3+/-0.79 vs. 1.2+/-0.54 vs. 2.6+/-0.84 days, respectively (p<0.01); and the hospital stay was 6.7+/-0.77 vs. 5.4+/-0.73 vs. 8.2+/-1.51 days, respectively (p<0.01). There were no severe complications. The pathologic surgical margins were all negative. CONCLUSIONS: LRN can be performed efficiently and effectively with the transperitoneal, retroperitoneal, and hand-assisted techniques. Operators may select the technique for LRN according to their own preferences. In our experience, RLRN may protect the organ from injury and promote the recovery of lifestyle because of the early recovery of bowel movement.
Carcinoma, Renal Cell
;
Laparoscopy
;
Length of Stay
;
Life Style
;
Nephrectomy
;
Operative Time
;
Retrospective Studies
6.Immunohistochemical Study of the Expression of Bone Morphogenetic Protein(BMP-7) Following Regenerative Periodontal Surgery.
Kyung Yoon HAN ; Se Yeol CHO ; Ki Jung LIM ; Heung Jung KIM ; Ju Cheol PARK ; Byung Ock KIM
The Journal of the Korean Academy of Periodontology 2000;30(1):51-63
Extracellular matrix component is degraded by enzymes of thematrix metalloproteinases(MMPs). MMPs are produced by both hemopoietic and structural cells. Increased activity of MMP-3 in periodontium is strongly associated with inflammatory periodontal disease. The purpose of the present study was to estimate the effect of BMP-7 on regeneration of periodontium. The optical density was measured by microwell plate reader at 450 nm.The difference of the optical density and the relative activity ofMMP-3 according to the concentration were statistically analyzed by one way ANOVA. The results were as follows: 1.Tetracycline-HCl showed the tendency to inhibit the activity of MMP-3 at the concentration lower than 25microgram/ml. 2.Doxycycline-HCl inhibited significantly the activity of MMP-3 at the concentration lower than 100microgram/ml. 3.Minocycline-HCl inhibited the activity of MMP-3 at the concentration in the range of 10 to 200microgram/ml. Within the limit of the present study, the above results suggested that bone morphogenetic protein-7 may play a important role in development of periodontium.
Bone Morphogenetic Protein 7
;
Extracellular Matrix
;
Matrix Metalloproteinases
;
Periodontal Diseases
;
Periodontium
;
Regeneration
7.The Treatment of Trochanteric Femoral Fracture with Using Proximal Femoral Nail Antirotation (PFNA).
Se Ang CHANG ; Young Ho CHO ; Young Soo BYUN ; Jae Hui HAN ; Jae Young PARK ; Chung Yeol LEE
Journal of the Korean Hip Society 2009;21(3):252-256
PURPOSE: This study was performed to evaluate the usefulness of proximal femoral nail antirotation (PFNA) for internal fixation of femur trochanteric fractures. MATERIALS AND METHODS: We operated on 36 femur trochanteric fracture patients with performing PFNA from September, 2006 to November, 2008 and we analyzed the operation time, the blood loss, the union time, the tip apex distance (TAD), the Cleveland index, the sliding distance of the blade and the complications. We also evaluated the clinical results according to the recovery of ambulatory function and the functional recovery score. RESULTS: The mean operation time was 54 minutes and the mean amount of blood loss amount was 119cc. Thirty two cases progressed to union within 4 months and 4 cases also progressed to union within 6 months without a further operation. The mean TAD was 16mm and the mean sliding distance was 3.8 mm. Clinically, the mean loss of ambulation ability was 1.2 grades and the Jensen functional recovery score was 1.8. There was one case of back out of the blade, but there was no skin problem. There were no significant complications. CONCLUSION: The findings from this study indicate that PFNA is a useful and reliable choice for the treatment of trochanteric fracture of the femur.
Femoral Fractures
;
Femur
;
Humans
;
Nails
;
Skin
;
Walking
8.Radiofrequency Ablation of Hepatocellular Carcinoma (≤ 5 cm) with Saline-Perfused Electrodes: Factors Affecting Local Tumor Progression
Dong Ho KIM ; Dong Jin CHUNG ; Se Hyun CHO ; Joon-Yeol HAN
Journal of the Korean Radiological Society 2020;81(3):620-631
Purpose:
We aimed to assess local tumor progression (LTP) rate and associated prognostic factors in 92 patients who underwent radiofrequency ablation (RFA) using saline-perfused electrodes to treat hepatocellular carcinoma (HCC) (≤ 5 cm).
Materials and Methods:
Total 92 patients with 148 HCCs were treated with RFA using salineperfused electrodes, from 2009 to 2015. We retrospectively evaluated technical success, technique efficacy, and LTP rates. Potential prognostic factors for LTP were perivascular tumor, subphrenic tumor, artificial ascites, tumor size (≥ 2 cm), and previous treatment of transarterial chemoembolization. Analysis was performed by lesion, rather than by person.
Results:
During follow-up period from 1 to 97.4 months, total cumulative LTP rates were 7.9%, 11.4%, and 14.6% at 1, 3, and 5 years, respectively. These values were significantly higher in the perivascular (35.1%; p = 0.009) and subphrenic group (38.9%; p = 0.002) at 5-year. We did not observe any significant difference in LTP according to other prognostic factors (p > 0.05).
Conclusion
RFA with saline-perfused electrode is a safe and effective treatment modality for HCC (≤ 5 cm), with lower LTP rates. Nevertheless, perivascular and subphrenic HCCs demonstrated higher LTP rate than other sites. It is imperative to note that perivascular and subphrenic location of HCC are associated with a high risk of local recurrence, despite the use of salineperfused electrodes.
9.A Case of Spontaneous Regression of Advanced Gastric Cancer.
Ho Sang LEE ; Dae Young CHEUNG ; Jin Il KIM ; Se Hyun CHO ; Soo Heon PARK ; Joon Yeol HAN ; Jae Kwang KIM
Journal of Korean Medical Science 2010;25(10):1518-1521
An 84 yr-old male with a history of nausea and vomiting for 3 weeks was admitted to our hospital. Esopahgogastroduodenoscopy showed the diffuse infiltrative type of gastric cancer encircling from the cardia to the lower body. On abdominal computerized tomography, the gastric wall was diffusely thickened with overlying mucosal enhancement without lymph node involvement. Histologic examination revealed poorly differentiated adenocarcinoma. So surgical resection was planned. However, patient refused all medical care, and then he was discharged. He lived without any medical support and then he revisited our hospital and showed relieved symptoms on the follow-up exam. On esophagogastroduodenoscopy, the gastric mucosa of the body looked normal without any dysplastic change. Abdominal CT revealed a decreased thickening of the gastric wall of the body. The histology from the endoscopic forceps biopsy showed no evidence of malignancy. The patient is alive without any sign of tumor recurrence after 14 months.
Adenocarcinoma/*diagnosis/pathology
;
Aged, 80 and over
;
Diabetes Mellitus/drug therapy
;
Endoscopy, Gastrointestinal
;
Humans
;
Hypoglycemic Agents/therapeutic use
;
Male
;
Stomach Neoplasms/*diagnosis/pathology
;
Tomography, X-Ray Computed
10.A Case of Transmesocolic Hernia in Elderly Person without a History of Operation.
Hoon Suk PARK ; Jin Il KIM ; Myoung Seok KIM ; Soon Sub KIM ; Se Hyun CHO ; Soo Heon PARK ; Joon Yeol HAN ; Jae Kwang KIM
The Korean Journal of Gastroenterology 2006;48(4):286-289
Internal hernia is defined as the herniation of viscera through an anatomic or pathologic opening within the boundaries of peritoneal cavity. Transmesocolic hernia, a subtype of internal hernia, has a herniated sac through the transverse mesocolon. Transmesocolic hernia has been rarely described in the literature, and most of reported cases were associated with a history of operation or congenital anormaly. A 72-year-old female with chronic intermittent abdominal pain and bloating was admitted. Small bowel series showed multiple jejunal loops confined to the left upper quadrant of abdomen. Abdomen spiral computed tomography (CT) showed a cluster of mildly dilated small bowel loops with mesenteries on the same area. On the three-dimensional reconstruction CT scan, a herniated sac through the transverse mesocolon was identified. She was diagnosed as transmesocolic hernia by using the three-dimensional reconstruction CT and small bowel series, without surgical exploration. The symptoms were managed with conservative measures.
Colitis, Ulcerative/*drug therapy
;
Cyclosporine/*therapeutic use
;
Drug Tolerance
;
Humans
;
Hydrocortisone/administration & dosage/*therapeutic use
;
Injections, Intravenous
;
Methylprednisolone/administration & dosage/*therapeutic use