수변공간의 가치와 지속가능한 개발방향에 대한 인식

이헌영 ( Heon Yeong Lee ),조성철 ( Sung Chul Cho ),홍용석 ( Yong Suk Hong ) 한국물환경학회(구 한국수질보전학회) 2014 한국물환경학회·대한상하수도학회 공동 춘계학술발표회 Vol.2014 No.-

만성간질환 환자에서의 B-림프구 기능에 관한 연구

이명극 ( Lee Myeong Geug ),강원권 ( Kang Won Gwon ),김민범 ( Kim Min Beom ),박철신 ( Park Cheol Sin ),이헌영 ( Lee Heon Yeong ),김삼용 ( Kim Sam Yong ),이복희 ( Lee Bog Hui ) 대한내과학회 1990 대한내과학회지 Vol.38 No.6

N/A To investigate the B-cell function in patients with chronic liver diseases, a peripheral blood T-cell subset, a delayed type skin reaction, serum levels of IgG, IgA, IgM and in vitro production of IgA, IgG were studied in patients with chronic liver diseases(10 cases of chronic hepatitis, 12 cases of liver cirrhosis). The results were as follows: 1) The percentage of peripheral blood suppressor T-cell(CD8 positive) decreased in patients with chronic hepatitis(p<0.05). 2) The results of delayed type skin reaction with CMI test showed no difference between normal subjects and patients with chronic liver diseases. 3) Serum IgG, IgA and IgM levels increased in patients with chronic hepatitis and in patients with liver cirrhosis(p<0.05). Serum IgA levels in patients with liver cirrhosis showed the most prominent increase(330% of control). 4) Unstimulated in vitro IgA production from peripheral blood mononuclear cell lymphocytes was higher in patients with liver cirrhosis(p<0.05). IgA production stimulated with pokeweed mitogen was not different from that of the normal control subjects. IgG production stimulated with pokeweed mitogen was lower in patients with liver cirrhosis(n=5)(p<0.05, Wilcoxon rank sum test). The results of the present study indicate that there is no major defect in cellular immunity in patients with chronic liver diseases and that the B cells in patients with chronic liver disease are polyclonally activated in vivo. In patients with liver cirrhosis, the IgA-producing B cells seem predominently activated in comparison with the IgG-or IgM-producing B-cells.

다발성 폐전이를 동반한 재발성 간세포암종의 자발퇴행 1예

윤범용 ( Beom Yong Yoon ),이헌영 ( Heon Young Lee ),황세웅 ( Se Woong Hwang ),박세영 ( Se Young Park ),김혜진 ( Hye Jin Kim ),장혜원 ( Hye Won Jang ),이병석 ( Byung Seok Lee ) 대한간암학회 2015 대한간암학회지 Vol.15 No.1

Hepatocellular carcinoma (HCC) is the most common form of liver malignancy. Spontaneous regression of HCC is extremely rare phenomenon and mechanism of regression remains obscure. 75-year-old woman previously diagnosed with hepatitis C virus-related liver cirrhosis was found to have single mass in liver with elevation of α-fetoprotein level to 10,320 ng/mL. Transarterial chemoembolization (TACE) was performed. 27 months after TACE recurred HCC with multiple lung nodules were confirmed. The patient refused any therapeutic modality. The patient underwent follow-up without any anti-cancer treatment. 8 months after recurrence follow up computed tomography scan revealed spontaneous regression of HCC and completely disappeared lung nodules. The patient is currently doing well and without any evidence of recurrence. The causes of spontaneous regression of HCC are not well understood. Proposed mechanisms are ischemic injury, biological factors, herbal medicine, immunological variations. Further studies are necessary to improve our understanding of this rare phenomenon. (Journal of Liver Cancer 2015;15:46-51)

가토를 이용한 실험적 위궤양 출혈에 대한 Nd : YAG laser 광선응고법에 관한 연구

문동규(Dong Kyu Moon),이헌영(Heon Yong Lee),김석진(Suck Chin Kim),임덕(Duck Lim),선덕재(Duk Jae Shun),박성회(Sung Hoe Park) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.2

N/A The neodymium YAG laser was used to bleeding experimental house rabbit gastric ulcer in two separate studies: (1) Extensive investigation by using the l. 06 um YAG laser wave lenth, 2 mm in spot size, 30-90 watt power and 0. 5-l. 5 sec pulse duration were performed to determine opitimal YAG laser photocoagulation parameters to maximize hemostatic efficacy while minimizing associated tissue injury. 11 out of 21 combination of power, pulse duration and spot size, with coaxial CO2 were found to be useful. (2) 11 of these treatment combination were studied more detail to assess the respective effect of pulse duration and power. Four repeated study were performed for each combination. From these studies we conclude: (1) YAG laser photocoagulation effectively stopped experimental gastric ulcer bleeding when applied at laparotomy. (2) Under the upper described condition of pulse, spot size and pulse duration most useful combinations for hemostasis were following: a) In 0. 5 sec pulse duration; 60 watt and 70 watt power. B) In 1. 0 sec pulse duration; 50-90 watt power. C) In l. 5 sec pulse duration; 40-50 watt power. (3) 3 out of 44 combination were perforated (7%) (4) Mean effective joules for hemostasis were 220. (5) There were no close relation between decrease of tissue injury, joules, power and treatment time.

B 형 만성활동성간염 환자에서 Prednisolone 단기 이탈 및 Alpha Interferon 병합요법의 효과

이종선(Chong Sun Lee),김병호(Byung Ho Kim),성자원(Ja Won Sung),허승식(Sung Sik Hur),이기천(Ki Cheon Lee),정현용(Hyun Yong Jeong),이헌영(Heon Young Lee),김영건(Young Kun Kim) 대한내과학회 1993 대한내과학회지 Vol.45 No.5

N/A Background: There is no satisfactory method of treatment for chronic active hepatitis caused by hepati- tis B virus(CAH-B). Randomized controlled studies on a limited number of patients with CAH-B using alpha interferon or combination with corticosteroid showed some promise in reducing or eliminating viral replication. We evaluated thc safety and efficacy of prednisolone withdrawal followed by recombinant alphaInterferon 2b therapy. Methods: Sixteen patients (treatment group) with CAH-R were injected alpha-Interferon for 16 weeks after prednisolone tapered for 6 weeks, and compared to 12 controlled patients (control group). We measured serum aminotransferase activities, HBsAg, Anti-HBs, HBeAg, Anti-HBe and HBV-DNA before and after therapy. Results: I) Serum levels of AST and ALT were decreased significantly in treatment group (AST: 36±17, ALT: 38±14 IU/L) compared to control group (AST: 188±152, ALT: 272±155 IU/L). The responses were maintained for 1 year after therpy. 2) The negative conversion rates of HBeAg and HBV-DNA were significantely higher in treatment group (HBsAg: 50%, HBV-DNA: 87%) than control group (I4Be Ag: 0%, HBV-DNA: 14%) after treatment. But there was no significant differenee in follow up period (36 & 43%: 17 & 25%, 1yr. after). 3) Loss of HRsAg was not observed in both groups. 4) Mild tolerable side effects were observed; fever (94%), myalgia (75%), headache (19%) and hair loss (13%). 5) Leukocytopenia (19%) and thrombocytopenia (19%) were transient. Conclusions: Prednisolone withdrawal followed by recombinant alpha-Interferon 2b therapy was effective for decreasements of serum aminotransferase activities, for the loss of HBeAg and HBV-DNA, and relatively safe for patients with CAH-B. But it is necessary for study with larger number of patients, more prolonged duration of follow up and more strict control study.

소화기암에서 조직내 Carcinoembryonic Antigen 측정치와 DNA 배수성과의 관계에 대한 연구

정현용 ( Jeong Hyeon Yong ),김병호 ( Kim Byeong Ho ),성자원 ( Seong Ja Won ),허승식 ( Heo Seung Sig ),이기천 ( Lee Gi Cheon ),이헌영 ( Lee Heon Yeong ),김영건 ( Kim Yeong Geon ),노승무 ( No Seung Mu ),윤완희 ( Yun Wan Hui ),장일성 대한내과학회 1993 대한내과학회지 Vol.44 No.2

연구배경 : 소화기암 조직에서 carcinoembryonic antigne (CEA)의 생산 정도를 측정하고, 종양세포의 생물학적인 악성도를 반영하는 것으로 알려진 DNA 배수성을 분석하여 그들 사이의 관계를 파악하고, 임상상 및 병리조직학적인 특성들과의 상호관계를 알아보자 하였다. 방법 : 절제수술이 가능했던 위암 26예와 결장직장암 14예를 대상으로 조직내의 CEa를 추출한 후 방사선면역 측정법으로 농도를 측정하고 유식세포분석기를 이용하여 DNA 함량과 세포주기분석을 시행하였다. 결과 : 1) 정상 위점막의 CEA 농도는 평균 10.2ng/gm이었고, 위암조직의 CEA치는 평균 42.1ng/gm으로 정상점막에서보다 4배이상 높았으며, 암의 병기가 높을수록 높았다. 2) 정상 대장점막의 CEA치는 평균 27.3ng/gm으로 정상 위점막보다 높았고 (p<0.05), 결장직장암 조직의 CEA 농도는 평균 164.0ng/gm으로 정상 대장점막에서 보다 6배, 위암조직보다 4배정도 높았다(p<0.05). 3) 위암 DNA배수성 유형은 56.0%가 2배성을, 44.1%가 이수성을 보였으며, 결장대장암은 25.0%에서 이수성을 보였고, 75.0%는 2배성암이었다. 소화기암에서 수술 후 병기등의 임상상과 이수성의 빈도는 통계학적으로 유의성이 없었다. 4) 위암 조직의 평균 CEA 농도는 DNA배수성 유형상 이수성인 경우가 86.4ng/gm으로서 2배성암의 14.5ng/gm보다 6배가 높았고 (p<0.05), 결장직장암에서는 이수성암이 244.8ng/gm으로 2배성암보다 (161.7ng/gm)높은 경향을 보였다(p<0.05). 결론 : 소화기암 조직에서 carcinoembryonic antigen의 생산은 DNA배수성 유형상 이수성을 보이는 DNA stemline과 밀접한 관계가 있음을 알게 되었다. 조직내 CEa 농도와 DNA배수성 유형이 예후를 판정하는데 지표로써의 가치여부는 대상환자에 대한 추적이 필요할 것으로 사료된다. Background : This study was performed to obtain additional information about intratumor heterogeneity and prognosis of gastrointestinal cancers, as defined by different DNA stemlines in relation to tumor CEA expression na clinicopathologic characteristics. Methods : In 26 patients with stomach cancer and 14 patients with colorectal cancer, carcinoembryonic antigen concentrations in tissue extracts were measured by radioimmunoassay and the DNA ploidy patterns of same specimens were determined by flow cytometry. Result : 1) Mean tissuc CEA concentrations in the normal gastric mucosa of the patients with stomach cancers was 10.2ng/gm. Tissue CEA concentrations (mean 42.1ng/gm) of stomach cancers were 4 times higher than the normal mucosa (p<0.05), significantly correlated to TNM stages. 2) Tissue CEA concentrations (mean 27.3ng/gm) in the normal colonic mucosa of the patients with colorectal cancers were higher levels than normal gastric mucosa (p<0.05). Tissue CEA concentrations (mean 164.0ng/gm) of colorectal cancers were 6 times higher than the colorectal mucosa` and 4 times higher than stomach cancer`s (p<0.05). 3) The incidence of aneuploid pattern in the stomach cancer was 44.0%, and 25.0% in the colorectal cancers. The incidence of aneuploid cancer was not significantly related to clinicopathologic findings. 4) Tissue CEA concentrations of aneuploid stomach cancers (mean 86.4ng/gm) were 6 times higher than diploid cancers (mean 14.5ng/gm) (p<0.05). Aneuploid colorectal cancers (mean 244.8ng/gm) had higher CEA levels than diploid cancers (mean 161.7ng/gm) (p<0.05). Conclusion : The production of carcinoembryonic antigen in gastrointestinal cancers was significantly correlated with aneuploid DNA stemlines. To estimate prognostic values of tissue CEA concentrations and DNA ploidity, follw up for these patients and further studies should be pursued.

위암 환자에서 세포성 면역 기능에 관한 연구

이재익(Jae Ik Lee),윤일국(Ilk Kuk Yoon),이종선(Jong Sun Lee),김종완(Jong Wan Kim),장준(Joon Jang),안정기(Jeong Ki Ahn),송민호(Min Ho Song),정현용(Hyeon Young Jeong),이헌영(Heon Young Lee),김삼용(Sam Yong Kim),김영건(Young Kun Kim) 대한내과학회 1990 대한내과학회지 Vol.39 No.6

N/A We performed a variety of lymphocyte stimulation tests, delayed hypersensitivity skin tests, and enumeration of several lymphocyte subpopulations in 21 patients with gastric cancer who did not receive any form of anticancer therapy, and in 20 healthy controls. The gastric cancer patients had significantly de- creased number and total score of positive reactions in delayed hypersensitivity skin tests compared with the healthy controls. The percent of CD4 positive lymphocytes in the gastric cancer patients was significantly decreased compared to the normal control subjects, but it had no correlation with the total score of delayed cutaneous hypersensitivity reactions. The ratio of helper to suppressor cells was lower in the cancer group. The uptake of 3H-thymidine was markedly depressed in cancer patients when stimulated with various mitogens. There was little correlation between any of the stimulation tests and any of the lymphocyte subpopulation proportions to delayed hypersensitivity cutaneous reactions. Optimal proliferative response was found in lymphocytes stimulated with 10 micrograms of concanavalin-A and 10 microgram of phytohemagglutinin. Advanced stage patients had greatly depressed delayed hypersensitivity skin reactions and proliferative responses to mitogens compared with localized diseases. These results suggest that gastric cancer patients have depressed cellular immune functions, which mainly result from the decreased helper cells and defects in functional proliferative response to mitogens. Interleukin-2 and interferon-gamma restored the in vitro proliferative response of lymphocyte in patients with gastric cancer.

초치료 만성 B형간염 환자에서 엔테카비어의 장기 치료 효과 및 그 예측인자

김범희 ( Beom Hee Kim ),윤범용 ( Beom Yong Yoon ),박대화 ( Dae Wha Park ),이엄석 ( Eaum Seok Lee ),김석현 ( Seok Hyun Kim ),이병석 ( Byung Seok Lee ),이헌영 ( Heon Young Lee ) 대한내과학회 2010 대한내과학회지 Vol.85 No.2

목적: 초치료 만성 B형간염 환자들에서 엔테카비어의 치료 효과와 그 예측인자에 대해 분석하였다. 방법: 2007년 3월부터 2011년 5월까지 과거 항바이러스제 치료 경험이 없는 만성 B형간염 환자로서 엔테카비어 0.5 mg을 매일 최소 48주 이상 복용한 환자 77명을 후향적으로 조사하였다. 엔테카비어 투여 중 혈청 HBV DNA치가 116 copies/mL 이하로 감소하여 검출되지 않는 경우인 바이러스 반응과 혈청 ALT치의 정상화되는 경우인 생화학적 반응, HBeAg의 혈청 소실과 혈청전환을 각각 평가하였다. 결과: 치료 12, 24, 48, 96, 144주에 대한 누적 바이러스 반응률은 각각 59.7%, 82%, 88.3%, 89.6%, 93.1%였다; 누적 생화학적 반응률은 각각 51.9%, 74%, 84.4%, 94.8%, 98.3%였다; HBeAg의 누적 혈청 소실률은 10.5%, 18.4%, 28.9%, 36.8, 47.4%였다; 누적 HBeAg 혈청 전환율은 7.9%, 18.4%, 21.1%, 28.9%, 39.5%였다. 다변량 분석을 시행한 결과 혈청 HBV DNA 음전과 관련된 독립적 예측인자는 기저 HBeAg 음성(p = 0.006)과 치료 12주 후 바이러스 반응인 초기 바이러스 반응(p = 0.027)이었다. 또한 HBeAg 혈청 소실과 관련된 독립적 예측인자도 초기 바이러스 반응(p = 0.001)이었다. 결론: 엔테카비어는 초치료 만성 B형간염 환자에서 뛰어난 생화학적 반응과 바이러스 반응을 보였다. 초기 바이러스 반응은 혈청 HBV DNA 음전과 HBeAg 혈청 소실을 예측할 수 있는 독립적 인자로 확인되어 치료 중 초기 바이러스 반응이 엔테카비어의 장기적인 치료 반응을 예측하는 데 유용할 것으로 생각된다. Background/Aims: The aims of this study were to characterize the treatment response to entecavir and to examine factors affecting that response. Methods: A total of 77 nucleoside-na?ve patients with chronic hepatitis B who had received entecavir (0.5 mg daily) for at least 48 weeks were consecutively enrolled between March 2007 and March 2011. The rates of virological response (hepatitis B virus [HBV] DNA < 116 copies/mL), biochemical response (alanine aminotransferase ≤ upper limit of normal), hepatitis B e antigen (HBeAg) loss, and seroconversion were retrospectively analyzed. Results: The cumulative rates of virological response at 12, 24, 48, 96, and 144 weeks were 59.7%, 82%, 88.3%, 89.6%, and 93.1%, respectively; biochemical response rates were 51.9%, 74%, 84.4%, 94.8%, and 98.3%, respectively; HBeAg loss rates were 10.5%, 18.4%, 28.9%, 36.8%, and 47.4%, respectively; and HBeAg seroconversion rates were 7.9%, 18.4%, 21.1%, 28.9%, and 39.5%, respectively. In multivariate analysis, independent predictors associated with HBV DNA polymerase chain reaction (PCR) negativity were the absence of HBeAg at baseline (p = 0.006) and early virological response (HBV DNA < 2,000 copies/mL after 12 weeks of therapy; p = 0.027). In univariate analysis, early virological response was an independent factor predicting HBeAg loss (p = 0.001). Conclusions: Entecavir induced excellent biochemical and virological responses in nucleoside-na?ve patients with chronic hepatitis B. Early virological response was an independent factor predicting HBV PCR negativity and HBeAg loss, and can be used to predict long-term treatment response to entecavir. (Korean J Med 2013;85:157-166)

각종 악성 종양질환에서의 세포성 면역기능에 대한 연구 - 말초혈액 T - 임파구 아형 분포 및 지연형 과민반응에 대한 검색 -

조덕연(Deong Yeon Jo),김용한(Yong Han Kim),송재화(Jae Wha Song),노홍규(Heung Kyu Rho),이복희(Bok Hee Lee),신영태(Young Tai Shin),김삼용(Sam Yong Kim),이헌영(Heon Yung Lee),성인환(In Whan Sung) 대한내과학회 1987 대한내과학회지 Vol.33 No.3

N/A The authors studied delayed cutaneous hypersensitivity and peripheral blood T-lymphocyte subpopulations in 54 patients with malignant tumors. 1) The number and total score of positive reactions in delayed cutaneous hypersensitivity were significantly decreased in cancer patients (p<0.005, p<0.05). 2) Percent OKT4+, T-lymphocyte in cancer patients were significantly decreased compared to normal control subjects (p<0.05), and it had positive correlation with total score of delayed cutaneous hypersensitivity reactions (r=0.768). 3) Percent OKT8+, cells were not different from that of normal control subjects. 4) The ratio of OKT4+/OKT8+ in cancer patients were not different from that of normal control subjects except in patients with colorectal carcinoma and malignant lymphomas. 5) Markers of activated T-lymphocyte, OKT10+ and OKIA1 cells were increased in all the patients groups, 6) Leu7 cells, reflecting natural killer cells, were not different from normal control subjects. These results suggest that the cancer patients have depressed cellular immune functions, which mainly results from the decrease of helper T-lymphocyte number, Short of functional assays of cellular immunity, the authors concluded that the testing of delayed cutaneous hypersensitivity and enumeration of peripheral blood lymphocyte subsets, especially OKT4+ cells and activated T-cells provide useful informations on cellular immune reactivity in cancer patients. Futher studies on prognostic value of these parameters should be pursued.

1996년도 제35차 대한소화기학회 추계학술대회 / 포스터 발표 : 간 ; 대전지역에서 집단적으로 발생한 A 형 간염환자의 실태조사

신경상,김석현,이병석,서광식,김남재,이두용,박성규,최덕례,이헌영 ( Kyung Sang Shin,Seok Hyun Kim,Byung Seok Lee,Kwang Sik Seo,Nam Jae Kim,Doo Yong Lee,Seong Kyu Park,Deok Rye Choi,Heon Young Lee ) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1