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혈청 제4형 콜라겐 7S Domain 측정에 의한 만성 간염의 섬유화 정도 예측
이계희(Kye Heui Lee),박성훈(Seong Hoon Park),최신은(Shin Eun Choi),김안나(An Na Kim),김성용(sung Yong Kim),임선희(Sun Hee Lim),임용성(Yong Sung Lim),손인(In Son) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.2
N/A The degree of fibrosis is a major prognostic factor in chronic liver disease. Although liver biopsy is essential to assess the degree of fibrosis, a more simple diagnostic method would be helpful for its invasive nature. Type IV collagen is one of major constituents of basement membrane and serum collagen IV-7S level reflects the degree of fibrosis. To evaluate the usefulness of serum collagen IV-7S in assessing the state of hepatic fibrosis, we compared the level of serum collagen IV-7S in various liver diseases and normal volunteers. The normal value of the serum collagen IV-7S was 3.6+- 1.2 ng/ml. There was no statistically significant difference in serum collagen IV-7S levels among the group of acute hepatitis, fatty liver, chronic persistent hepatitis and the normal controls. And there was no significant difference between the group of chronic active hepatitis and liver cirrhosis, either. But the level of serum collagen IV-7S of the group of chronic active hepatitis and liver cirrhosis was significantly higher than that of the group of acute viral hepatitis, fatty liver and chronic persistent hepatitis. These results suggest that the measurement of serum collagen IV-7S is a valuable aid for evaluating the state of fibrrosis in chronic liver disease.
소화성 궤양 환자에서 Helicobacter pylori 의 약제 내성률과 재발현 및 재감염률을 고려한 H . pylori 박멸요법의 수립
송인성(In Sung Song),김나영(Na Young Kim),임채남(Chae Nam Lim),임선희(Sun Hee Lim),이계희(Kye Heui Lee),구명숙(Myung Sook Koo),정현채(Hyun Chae Jung),김정룡(Chung Yong Kim) 대한내과학회 1999 대한내과학회지 Vol.56 No.3
N/A Objective : This study was conducted to establish an ideal treatment regimen for H. pylori eradication in three aspects: clinical, microbiological, and reinfection. Methods : Four hundred thirty two patients with H. pylori positive peptic ulcer were randomized to receive two types of triple therapy: one includes colloidal bismuth subcitrate, metronidazole and tetracycline (BMT), and the other includes omeprazole, amoxicillin and clarithromycin (OAC). Results : More than 50% of symptom reduction within 1 week was 94.4% both in OAC and in BMT group. The percentages of side effects were 21.6% and 27.1% in OAC and BMT regimen, respectively. Good compliance with at least 85% intake was 99.0% and 95.2% in OAC and BMT regimen. The eradication rates of H. pylori were 85.9% and 89.1% in OAC and BMT regimen. Resistance rates to metronidazole and clarithromycin were 40.6% and 10.2% by E test, 74.3% and 27.0% by broth microdilution, and 45.3% and 10.9% by disk diffusion method. The eradication rates for H. pylori was 100% and 77.8% by BMT in patients with metronidazole-sensitive and -resistant strains, and 100% and 80.0% by OAC with clarithromycin- sensitive and -resistant strains, without significance by their resistances. The recrudescence rate within 1 year after eradication was 21.2% and 14.2% for OAC and BMT regimen without significant difference. The reinfection rate after 1 year was 4.0% and 5.0% for OAC and BMT regimen. Conclusion : Because the eradication rate of BMT regimen is 89.1% in spite of high metronidazole resistance rate, and there was no statistical difference in the aspects of symptom reduction, side effect, compliance, recrudescence and reinfection rate, BMT regimen is as favorable as OAC to eradicate H. pylori.
김나영,임선희,김성용,임용성,이계희,박성훈,김안나,성상현 대한소화기내시경학회 1992 Clinical Endoscopy Vol.12 No.1
We recently experienced a case of an elderly patient with mediastinal abscess, which is a rare complication of esophageal perforation, in whom dyspnea, chest pain and odynophagia were main clinical symptoms after eating cooked fish. During evaluation, upper mediastinal widening, with air-fluid level, and eaophageal perforation plugged with pus were detected by chest X-ray films and endoscopic examinatien. After draining of pus(about 300 cc) through the perforation site by careful manipulation of endoscope, inner wall of abacess cavity communicating with esophagus could be observed through esophago-mediastinal fistula. For further management, drainage procedure of mediastinal abscess, esophageal diversion and feeding gastrostomy were done.
소화성궤양 호나자에서 H. pylori 박멸을 위한 삼제병합요법
김나영,고영희,임선희,고재중,이계희,오주현,이창균 대한소화기학회 1998 대한소화기학회지 Vol.31 No.5
Background/Aims: This study was performed to find an ideal treatment regimen in the aspects of eradication of H. pylori, symptom reduction and side effects. Methods: Three hundred thirty four patients with peptic ulcer were randomized to receive two types of triple therapy: one includes colloidal bismuth subcitrate, metronidazole and tetracycline (BMT regimen), and the other includes omeprazole, amoxicillin and clarithromycin (OAC regimen). The BMT regimen was categorized into two types aceording to intake duration: 14 day (BMT 14) and 7 day (BMT 7) treatments, and the OAC regimen is categorized into three types: 14 day (OAC 14), 10 day (OAC 10) and 7 day (OAC 7) treatments. The degree of symptom reduction and frequency of the side effects were evaluated. Eradication rate was determined at least 4 weeks after the triple therapy. Results: The H. pylori eradication rate was 92.3% in BMT 14 group, 88.0% in BMT 7, 88.6% in OAC 14, 89.2% in OAC 10 and 85.2% in OAC 7. There was no significant difference in eradication rate among these five regimens. More than 50% of symptom reduction within 1 week was observed 95.9% in OAC regimen, and it was significantly higher than that of BMT regimen (84.4%, p$lt;0.05). Two types of side effects were found (major and minor side effects). The major side effects implied the cases where the symptom was too serious for the treatment to continue. The percentages of all side effects in each group were as follows; 27.3% in BMT 14 (major 9.1%); 21.2% in BMT 7 (major 4.5%); 26.0% in OAC 14 (rnajor 1.9%); 13.0% in OAC 10 (no major); 20.3% in OAC 7 (no major). Conclusions: The 7 day treatment regimen for both of the triple therapy was favorable, because the eradicatian rate almost remained as the same. The OAC 7 regimen, which is more expensive than BMT 7, gives the faster symptom reduction and the lower rate of the major side effect.
전정부와 체부에서의 H. pylori 진단율과 장상피화생
김나영,고영희,임선희,고재중,이계희,오주현,이창균,최신은 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.1
Aims: In this paper we have investigated the detection rate of each H. pylori test in the antrum and in the body for patients with nonulcer dyspepsia (NUD), duodenal ulcer (DU), benign gastric ulcer (BGU), and stomach cancer. In addition, we examined whether or not there is any relationship between the decrease of H. pylori detection rate and intestinal metaplasia in the antrum. Methods: Three different test methods for identifying H. pylori infection-CLOtest, Gram stain, H&E stain-were taken in the antrum and in the body. Results: 1) The detection rates of CLOtest, Gram stain, and H&E stain for NUD group were 88%, 75%, and 64% (mean: 76%) in the antrum, and 89%, 78%, and 67% (mean: 78%) in the body, respectively, and those of DU group were 95%, 95% and 81% (mean: 90%) in the antrum, and 97%, 87% and 64% (mean: 83%) in the body, respectively. Those of BGU group were 86%, 74%, 53% (mean: 71%) and 98%, 82%, 58% (mean: 79%), respectively, and those of stomach cancer group were 80%, 88%, 58% (mean: 75%) in the antrum, and 100%, 96%, 83% (mean: 93%) in the body, respectively. The B/A detection ratio which means the ratio of mean H. pylori detection rate of body to that of antrum was 1.03 in NUD, 0.93 in DU, 1.11 in BGU, and 1.24 in stomach cancer group. 2) The rate of intestinal metaplasia in the antrum was 12% for NUD, and 15% for DU group. Those of BGU and stomach cancer group were 47% and 72%, respectively. 3) The correlation etween B/A detection ratio and intestinal metaplasia in the antrum was good (correlation coefficient(r)=0.93). Conclusions: The result that body is more adequate for H. pylori detection in BGU and stomach cancer patients rather than antrum can be explained by the high rate of intestinal metaplasia in the antrum which is hostile surrounding for H. pylori.
김나영,고영희,임선희,고재중,이계희,오주현,이창균 대한소화기학회 1998 대한소화기학회지 Vol.32 No.3
Background/Aims: Muscle cramp is a common clinical symptom in chronic liver disease. To determine the prevalence of musele cramps in patients with chronic liver disease in and to identify factors associated with their development, we conducted this study. Methods: We performed a cross-sectiona1 survey for 83 patients (three groups; 40 patients with liver cirrhosis, 23 patients with chronic hepatitis, 20 patients with congestive heart failure). Results: The prevalence of muscle cramps in cirrhotic patients was similar to the prevalence observed in the patients with chronic hepatitis [15/40 (37,5%) vs 7/23 (30.4%), p$gt;0.05]. On the other hand, the prevalence observed in the patients with congestive heart failure [1/20 (5%), p$lt;0,05] was much lower. Higher bilirubin level and female predominance were noted in cirrhotic patients with cramps. However, there was no significant difference in Child's class. The differences caused by age, gender, electrolytes, diuretics use and etiologies of chronic liver disease were not observed among chronic liver-disease patients with or without cramps. Most of muscle cramps (18/22; 82%) were relieved by conservative treatment. Conclusions: Musele cramps in patients with chronic liver diseases were independent of etiologies of chronic liver diseases, diuretics use, serum electrolytes levels, differences in Child's class. Further research is needed to elucidate the mechanism of muscle cramp in chronic liver diseases.