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거대 간 낭종에 의한 심부정맥 혈전증을 하대정맥 필터 삽입 및 낭종 배액으로 치료한 1예
고명관 ( Myung-kwan Ko ),김태홍 ( Taehong Kim ),이원혁 ( Won Hyuk Lee ),박승하 ( Seung Ha Park ),최준혁 ( Joon Hyuk Choi ),신민우 ( Minwoo Shin ),허내윤 ( Nae-yun Heo ) 대한소화기학회 2018 대한소화기학회지 Vol.72 No.3
An 88-year-old woman complained of right quadrant abdominal pain and severe edema in both legs. She had a history of pulmonary embolism one month ago. Abdomen CT showed a huge hepatic cyst compressing the intrahepatic portion of the inferior vena cava (IVC). The venogram CT showed multifocal thrombosis in the iliocaval and both lower extremity veins. Percutaneous hepatic cyst drainage was carried out. Fluid analysis presented leukocytosis, which suggested an infected hepatic cyst. To prevent secondary pulmonary thromboembolism, an IVC filter was inserted before catheter drainage for the hepatic cyst. One week later, abdominal pain was relieved. Then, sclerotherapy for the remnant hepatic cyst was performed by ethanol. Follow-up CT showed an increased amount of thrombosis in the iliocaval and left calf vein, but the IVC filter prevented another thromboembolic event successfully. The patient started dabigatran, a new oral anticoagulant, and compression stockings were applied to both legs. After one month, no visible thrombosis in the pelvis or either extremity was detected in abdominal CT. This case suggests that a huge hepatic cyst, especially with infection, should be considered as a possible cause of deep vein thrombosis if no other risk factors for thromboembolism exist. (Korean J Gastroenterol 2018;72:146-149)
만성 C형 간염에서 B형 간염바이러스 잠재감염의 임상양상과 C형 간염 치료에 미치는 영향
변성수 ( Sung Soo Byun ),신정우 ( Jung Woo Shin ),고명관 ( Myung Kwan Ko ),홍정민 ( Jung Min Hong ),김경훈 ( Kyung Hoon Kim ),이무열 ( Mu Yeol Lee ),최혜정 ( Hye Jeong Choi ),정융기 ( Yoong Ki Jeong ),박보령 ( Bo Ryung Park ),박 대한내과학회 2012 대한내과학회지 Vol.83 No.6
Background/Aims: The prevalence of occult HBV infection (OBI) in patients with chronic hepatitis C (CHC) in Korea has not been reported. Additionally, it is unclear whether OBI influences treatment outcome in CHC patients. We investigated the prevalence of OBI and its impact on treatment outcome in patients with CHC. Methods: Seventy-six patients with CHC were enrolled and treated with pegylated or conventional interferon and ribavirin. Hepatitis B virus (HBV) DNA was detected by nested polymerase chain reaction. Results: Among the 68 patients who completed treatment and follow-up, HBV DNA was detected in serum from nine (13.2%) patients, liver tissue from 10 (14.7%), and serum or liver tissue from 15 (22.1%). OBI was diagnosed in nine (12.7%) control subjects. No difference in the prevalence of OBI between patients with CHC and controls was observed (13.2 vs. 12.0%; p = 0.92). No significant differences in age, sex, genotype 1 frequency, amount of hepatitis C virus RNA, anti-hepatitis B surface antigen/anti-hepatitis B core-IgG seropositivity, staging, or histology grading were observed in patients with or without HBV DNA. Sustained virological response was achieved in 73.3% of patients with OBI and 83.0% without OBI (p = 0.46). Conclusions: These results demonstrate that a significant proportion of patients with CHC have occult HBV infection and that OBI does not affect treatment outcome in patients with CHC. (Korean J Med 2012;83:731-739)