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Craniopharyngioma 에 나타난 비만증과 그에 병발된 심한 지방간
정환국(Whan Kook Chung),김부성(Boo Sung Kim),유재영(Jae Young Yoo),홍관수(Kwan Su Hong),이완국(Wan Kook Lee),정진우(Jin Wu Jeong),박두호(Doo Ho Park) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.1
All year old boy with craniopharyngioma associated with hypogonadotropic hypogonadism, obesity and severe fatty metamorphosis of the lilver is described with review of literatures. The liver biopsy revaled severe fatty metamorphosis with periportal infiltration. It is highly suggested that morbid obesity, a manifestation of the craniopharyngioma, may be the etiology of the fatty metamorphosis of the liver.
선천성 간섬유화증을 동반한 Caroli ` s Disease
정환국(Whan Kook Chung),선희식(Hee Sik Sun),김부성(Boo Sung Kim),양진모(Jin Mo Yang),최명규(Myung Gyu Choi),박수헌(Soo Heon Park),김성수(Sung Soo Kim),정인식(In Sik Jung),정규원(Gyu Won Jung) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.1
Carols disease with congenital hepatic fibrosis was diagnosed in a 34-year-old woman. She com- plained of sudden hematemesis and easy fatigability. She showed a esophageal varix, hepatomegaly and splenomegaly, but showed normal liver function test. We could not find peripheral stigmata of liver disease such as palmar erythema and spider angioma. Abdominal sonogram, ERCP, abdominal CT and celiac angiogram showed multiple intrahepatic ducts dilatations, characteristics of Carolis disease. Histologic finding of liver biopsy showed fibrous tracts containing dilated bile ductules connecting adjacent portal spaces that were widened by mature fibrosis tissue and liver parenchymal cells appeared normal. We should suspect the Carolis disease with congenital hepatic fibrosis those who showed hematemesis or cholangitis with normal liver function test and no peripheral stigmata of liver disease. As Caroli's disease combined congenital hepatic fibrosis frequently. Carolis disease was preoperatively diagnosed by radiologic study such as ultrasonography, ERCP and abdominal CT but congenital hepatic fibrosis was diagnosed only by liver biopsy. We presented a Carolis disease combined with congenital hepatic fibrosis and renal tubular ectasia with literature.
간장 및 담도 : B형 만성 활동성 간염 환자에 있어서의 말초혈액 T , B 및 IgG Fc 수용체 임파구의 동태에 관한 연구
정환국(Whan Kook Chung),김부성(Boo Sung Kim) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.2
N/A Peripheral blood lymphocytes were estimated in 34 patients with chronic active hepatitis type B and in 22 normal controls, using a battery of surface markers for T cells, B cells and IgG Fc-receptor bearing cells. 1n all groups of patients of CAH with absolute numbers of active E-rosette forming cells as well as total T lymphocytes were decreased. In patients with CAH without cirrhosis, active E-rosette forming cells were increased. In patients with CAH with cirrhosis, absolute numbers of total T lymphocytes were decreased; however, no consistent changes in complement and IgG Fc-receptor bearing lymphocytes were observed. These results suggest the factors which mainly affect T lymphocytes is probably secondary to the liver damage and the importance of monitoring these lymphocyte subpopulations in patients with this disease is emphasized.
한국(韓國)에 만연(蔓延)하고 있는 만성간염(慢性肝炎)의 자연병력(自然病歷)
정환국,Chung, Whan-Kook 한국생명보험의학회 1985 保險醫學會誌 Vol.2 No.1
Korea is an endemic area of chronic hepatitis in the world. Liver cirrhosis and liver cell carcinoma, presumed to be related to such chronic hepatitis, are the major causes of death in this country. The purpose of this study is disclosing the sources of chronic hepatitis in Korea establishing its histologic characteristics, disclosing the patterns of progression in chronic hepatitis, delineating its prognosis and finally speculating its etiology. The study group was composed of 183 patients with biopsy-proven acute icteric viral hepaticis, 32 patients with biopsy- proven anicteric hepatitis and 260 patients with biopsy- proven chronic hepatitis. These patients submitted to long-term follow-up by means of liver needle biopsy and/or clinicolaboratory evaluation. The period of follow-up ranged from two months to 18 years. The histological features of the initial biopsy specimens of chronic hepatitis permitted a division of the cases cases into the following five types: Type I. Persisting portal hepatitis : so called persisting hepatitis 43 Type II. Chronic inactive hepatitis with incomplete strand septal fibrosis. This type has thin fibrotic septation in addition to Type I with portal sclerosis 38 Type III. Chronic active periportal hepatitis(CAPH) : so called aggressive hepatitis, characterized by marked piecemeal necrosis. This type has been subdivided further into three groups: AB and C on the basis of histologic features. A CAPH without cirrhosis 15 B CAPH with cirrhosis 99 C CAPH with diffuse acinus type parenchymal nodules; characterized by rosette-forming micronodules 21 Type IV. Subacute hepatic necrosis; characterized by multilobular and/or bridging necrosis. 14 Type V. Persisting lobular hepatitis; characterized by spotty necrosis, which looks very similar to acute viral hepatitis. Such histologic changes should be persisted for more than six months 30 In Korea the main source of chronic hepatitis is the anicteric type. Of the chronic hepatitis observed in the hospital, Type IIIb was the most frequent in its incidence and occasionally exhibited development of hepatocellular carcinoma, but the mortality was highest in Type IIIc during the period of follow-up. Histologic characteristics of these five types suggest a spectrum of chronic hepatitis in Korea from an early and mild stage to advanced and fatal cirrhosis, which is occasionally associated with primary hepatic cell carcinoma. It seems that Type IV can be followed by flare-up of various stages of acute and chronic hepatitis with HBsAg and that many cases of liver cirrhosis prevalent in Korea occur through such an active process of Type IV. The etiology is not established, but in Korea it is mainly related to HBsAg.
자연발생 또는 백신접종후 생긴 HBsAg에 대한 항체의 지속성과 Anamnestic Response
정환국,선희식,정규원,노재철,김부성,Chung, Whan-Kook,Sun, Hee-Sik,Chung, Kyu-Won,Ro, Jae-Chul,Kim, Boo-Sung 대한예방의학회 1987 Journal of Preventive Medicine and Public Health Vol.20 No.2
For evaluating the boosting (anamnestic) effects of the most recent commercially produced plasma derived heat-inactivated hepatitis B vaccine (A. Co.), 117 adults with naturally acquired antibody to hepatitis B surface antigen (anti-HBs) were selected at random. In addition, out of case immunized at zero and 1 month, and boosted at 6 months (primary boosting) by conventional vaccine (B. Co), inactivated by pepsin digestion and formalin treatment, 11 cases who showed elevated titer after primary boosting were also submitted to the study. The results were as follows: 1) Out of the 117 subjects with naturally acquired anti-HBs, 6(5.1%) showed isolated anti-HBs and the titers were below 10 ratio units (RU). Negative seroconversion was seen in 4(3.4%) of the 117 cases at 12 months after the screening and, of these cases, 3 showed isolated anti-HBs and the titers were below 10 RU. 2) Eighty-three percent of the cases with naturally acquired isolated anti-HBs below 10 RU did not respond to a booster injection with 3 us dose of A. Co. vaccine at all, but 90% of the other subjects responded. 3) The anti-HBs titers of all the 11 cases who showed a rise of more than 10 RU (increased GMT, 28.04) at one month after primary booster injection by $20{\mu}g$ dose of B. Co. vaccine decreased at 19 months after the primary booster. And 3 subjects (27.3%) of the 11 reached negative seroconversion. All of the 11 cases, who had secondary booster injection with $3{\mu}g$ dose of A. Co. vaccine at 19 months after primary boosting, showed increased anti-HBs titer at least 20 RU or more (increased GMT, 57. 72) at one month after the boosting. According to the above results in the anti-HBs screening survey for the purpose of immunization with hepatitis B vaccine, subjects with isolated anti-HBs below 10 RU should be regarded as being in an unimmunized state. In cases who are in risk circumstances, immunized primarily with a $20{\mu}g$ dose of B. Co. vaccine, a secondary booster injection should be given within 2 years after initiation of primary immunization and a $3{\mu}g$ booster dose of A. Co. vaccine can be reliably used.