Biomedical subjects

Chang Duck Kim

Publications and source records attributed to Chang Duck Kim.

23 records · Page 2Linked to original sources

PubMed2003

The prognosis of liver cirrhosis in recent years in Korea.

The survival of a recent series of 823 cirrhosis patients who were followed up for a mean of 48 months was analyzed. Cirrhosis was ascribed to alcohol (26%), hepatitis virus B (58%), hepatitis virus C (11%) or both (2%), or was cryptogenic (3%). Features of decompensation were observed in 51% of the patients at entry, and newly developed in 44% of compensated patients within 5 yr. The 5-yr survival after decompensation was 25%. The leading causes of death were liver failure (53%), hepatocellular carcinoma (HCC, 23%), and variceal bleeding (10%). Early detection of HCC significantly improved the survival of cirrhosis patients. Biannual ultrasonography increased the detection rate of small HCC. Mortality of variceal hemorrhage was much lower in patients with Child-Pugh scores from 5 to 8 than in those with scores above 8 (5% vs. 52%). Endoscopic prophylaxis significantly decreased the incidence of first variceal hemorrhage, but the effect was insufficient to improve the rate of survival. Mortality of first spontaneous bacterial peritonitis was 18%. These data suggest that the mortality of major complications of liver cirrhosis has considerably decreased during the last two decades, while there was no remarkable improvement in long-term survival. More efficient management of etiologic factors would be required.

Adult↗

PubMed2003

[A case of auto-immune hepatitis associated with primary Sjogren's syndrome].

Auto-immune hepatitis is a chronic necroinflammatory liver disorder that is characterized by hypergammaglobulinemia, auto-antibodies in serum, and, on histological examination, the presence of periportal hepatitis. Although it can be associated with a number of other auto-immune diseases, Sjogren's syndrome is rarely associated with auto-immune hepatitis. We herein report an unusual case of auto-immune hepatitis associated with primary Sjogren's syndrome. A 39-year-old woman was admitted to our hospital due to jaundice. Laboratory data showed negative viral hepatitis marker, increased serum IgG level, positive anti- nuclear antibody, and an increased rheumatoid factor titer. The patient had no history of taking medications and alcohol. Based on characteristic clinical features, liver biopsy findings, positive Schirmer's test, and salivary scintigraph, she was diagnosed as having auto-immune hepatitis and Sjogren's syndrome. The patient achieved complete remission with steroid monotherapy.

Adult↗

PubMed2003

[Current status of acute pancreatitis in Korea].

The annual incidence of acute pancreatitis (AP) per 100,00 people has increased from 15.6 in 1995 to 19.4 in 2000. Gender distribution revealed male predominance in patients aged between 30 and 60. AP has diverse etiologies. Alcohol consumption and gallstones were the main contribution factors. Due to advanced diagnostic equipments and techniques, the percentage of AP owing to miscellaneous and idiopathic causes has decreased significantly. The mortality rate of AP was 3% in 1980s, 4.4% in the early 1990s, and 2.1% in the late 1990s in Korea. During the late 1990s, the mortality rate has decreased even though the percentage of severe form has increased. This may be partly due to recent advances in medical management. Currently, there is no specific treatment capable of preventing complications of AP. Therefore, it is important to identify patients with severe AP using multiple clinical criteria, CT scans, and laboratory criteria. Close surveillance is necessary for patients with severe AP in order to identify and treat potential complications such as hemorrhage, shock, multiorgan failure as well as infection. Despite our thorough work-up using advanced diagnostic techniques, about one-fifth of the patients remain "idiopathic". As our understanding of AP improves and more advanced endoscopic and imaging techniques become available, this number will continue to decline.

Acute Disease↗

PubMed2003

[An analysis of extravariceal collaterals of gastric varices using magnetic resonance angiography in portal hypertensive patients].

BACKGROUND/AIMS: This study was aimed to analyze the relationship between gastric varices and its collaterals using magnetic resonance angiography (MRA) and to assess the usefulness of MRA in studies of portosystemic circulation. METHODS: Eighty-one patients who had portal hypertension with gastric varices took MRA before the therapy for gastric varices. RESULTS: The types of collaterals observed by MRA were left gastric vein in 67 patients (83%), short gastric vein in 28 (35%), gastrorenal shunt in 25 (31%), and splenorenal shunt in 14 (17%). In most of patients with advanced gastric varices, the size of left gastric vein was larger than others. In most cases of large gastric varices, the short gastric vein ranged between 5 to 10 mm. Gastrorenal shunt was also correlated with the size of gastric varices. The types of more prominent esophageal varices showed a right type (left gastric vein predominance), but the types of more prominent gastric varices or only the gastric varices showed a left type (posterior or short gastric vein predominance) (p<0.05). CONCLUSIONS: Gadolinium enhanced 3D-MRA can contribute to the study of the hemodynamic relationships between gastric vein and the collateral circulations by presenting more clear images for patients with portal hypertension.

Adult↗

PubMed2002

Electron microscopic evaluation of adhesion of Helicobacter pylori to the gastric epithelial cells in chronic gastritis.

BACKGROUND: The adhesion of H. pylori to the gastric epithelial cells may be an essential step for the pathophysiology of various H. pylori-induced gastrointestinal diseases. The purpose of this study was to investigate the ultrastructural relation of H. pylori and gastric epithelial cells in their adhesion. METHODS: Endoscopic biopsy of gastric antrum and body was performed from 15 patients (9 men, 6 women) with chronic gastritis and H. pylori infection. The specimens were processed for electron microscopy and observed with a transmission electron microscope (Hitachi H-600). RESULTS: On the basis of morphological appearances, the adhesions of H. pylori to the gastric epithelial cells were categorized into three types; filamentous connection, adhesion pedestals and membrane fusion. Coccoid and undetermined forms adhered mainly by the filamentous connection, whereas the bacillary forms adhered primarily by the adhesion pedestals and membrane fusion. CONCLUSION: Various types of adhesion were associated with H. pylori and gastric epithelium. Further studies are needed to evaluate the influence of different types of adhesion to the pathophysiology of H. pylori.

Bacterial Adhesion↗