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백서에서 간외폐쇄성 황달의 간손상 및 Ursodeoxycholic Acid의 예방 효과
최원충(Won Choong Choi),류호상(Ho Sang Ryu),현진해(Jin Hai Hyun) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.2
N/A Background/Aims: Generally many reports were known that the liver function was decreased with different forms of extrahepatic obstructive jaundice. To clarify the mechanism of these hepatic dysfunction in extrahepatic obstructive jaundice, we studied histologica] and biochemical alterations of experimental rats with obstructive jaundice induced by common bile duct(CBD) ligation at two time periocL(group I) and the limiting effects of administration of ursodeoxycholic acid(UDCA) or NSAID(lndomethacin) on the histological and biochernical alterations(group II). Methods: In control, lO rats underwent laparotomy without CBD-ligation(sham-operation). In group I, the CBD of 20 rats was ligated by laparotomy. Three(group Ia) and Four(group Ib) weeks aft=r ligation and 4 weeks after in case of control rats, the liver was isolated and microscopic examination was done. In group II, 40 rats with ligation of CBD were ramdomly assigned to receive UDCA(25 mg/kg/day) for 15 rats and NSAID(indomethacin, 4 mg/kg/day) for 15 rats and placebo for 10 rats. Results: In the study of group I, bi]e ducts proliferation was observed from portal tracts to porta] tracts and to hepatic lobules in group la, and hepatic ]obules were destroyed by severe prc>]iferation and fibrosis, and the area ratio of hepatocytes and sinusoid was decreased relatively in thie microscopic field in group lb. In the study of group II, the decreased area ratio of hepatocytes and sinusoid was limited in UDCA treoted group, but not in indomethacin group. Biochemical abnormalities(s-GPT, alkaline phosphatase, tota] bilirubin) were not limited significantly in both drug treated groups. Conclusions: Impairment of liver function of the rats with extrahepatic obstrutive jaundice may be due to relatively decreased hepatocytes and sinusoid ratio by bile duct proliferation and interstitial fibrosis and this alteration may be prevented by administration of UDCA. (Korean J Gastroenterol 1996; 28:232 240)
원혜진 ( Hye Jin Won ),한성훈 ( Seong Hoon Han ),박혜경 ( Hye Kyeong Park ),안효승 ( Hyo Seung Ahn ),임현민 ( Hyun Min Lim ),김정연 ( Jung Yeon Kim ),최원충 ( Won Choong Choi ) 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.4
Wegener`s granulomatosis is an uncommon disease that is characterized by granulomatous necrotizing vasculitis affecting small vessels. It typically targets the upper and lower respiratory tract and the kidney, but gastrointestinal involvement is rare. A 41-year-old man who has been already diagnosed with Wegener`s granulomatosis by nasal cavity biopsy was admitted with bloody diarrhea and high fever. He had discontinued taking the immunosuppressive medication. His colonoscopic finding revealed colitis and ulcer lesions which biopsies show vasculitis and ill-defined granuloma. Therefore he was treated with systemic steroid and improved dramatically.
Prostaglandin E2 가 신기능장애에 따라 고혈압에 미치는 영향
김형규(Hyoung Kyu Kim),최원충(Won Choong Choi),노정우(Jung Woo Noh) 대한내과학회 1988 대한내과학회지 Vol.34 No.4
N/A The renal prostaglandin E2 (PGE2) is primarily synthesized in renal medulla, and is entirely removed from blood on passage across the lung before it enters systemic circulation, and so is called the local hormone. The main physiologic effects of the PGE, on kidney are known as the natriuresis, water diuresis, vasodilatation and interaction with renin-angiotensin system. The authors attempted to evaluate the role of PGE2 on hypertension according to the state of impairment of renal function. The study of subjects were classified as following groups; namely Group A is a 24 normal control person without renal disease as well as impariement of renal function, Group B that of a 23 cases is essential hypertension without impairement of renal function. Group C is a 22 cases chronic renal insufficiency with hypertension of which creatinine clearance 21~59 ml/min. and Group D is a 24 cases with chronic renal failure with hypertension of which creatinine clearance is below 20 ml/min, Urine prostaglandin E2 diastolic blood pressure, twenty four hour urine Na excretion, creatinine clearance, plasma renin activity (PRA) and plasma aldosterone were investigated in all subjects and the interrelations among these parameters were analysed by multiple analysis method. Urine prostaglandin E2 was measured by radioim-munoassay with gamma counter. The NEM prostaglandin E2 I125 -radio-immunoassay kit is based on the use of an iodinated analog of prostaglandin E2 as the tracer. The results obtained are as follows: 1) Urine prostaglandin E2 (Mean±S.E): The value of group A, normal control groups is 365.1±20.65pg/ml., group B, essential hypertension; 353.9±20.71pg/ml., group C, chronic renal insufficiency; 149.1±10.70pg/ml. and group D chronic renal failure 83.3±8.30pg/ml. The value of group A is similar with group B (P>0.05), that of group C and D are significantly decreased in the comparsion with group A and B (P<0.01), while in the group C show the significantly high value in the comparsion with group D (P<0.01), group D is the lowest value among the comparison of group A, B and C (P<0.01). 2) Urine prostaglandin E2 has not significant relation to diastolic blood pressure, 24 hour urine Na excretion, creatinine clearance and plasma renin activity in all groups. 3) Urine prostaglandin E2 has significant correlation to plasma aldosterone in essential hypertension (r=0.489) (P<0,05), but has not significant relation to other groups. This findins suggest that the failure of compensatory protective role by renal FGE2 which is due to decreased PGE2 synthesis according to renal function impairment with diminished renal parenchyme may depend on the machanism of hypertension also is possible to mediate Na metabolism.
내시경적 역행성담도조영술의 담낭천공에 대한 진단적 가치
이진호(Jin Ho Lee),함희용(Hee Yong Hahm),전수영(Soo Young Jeon),최원충(Won Choong Choi),신원창(Won Chang Shin),정운태(Woon Tae Jeong),김관엽(Kwan Yeob Kim) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6
N/A The gallbladder perforation was found in patients of cholecystitis with alarmingly high mortality rate. These high morbidity and mortality rates were caused by the delay in diagnosis. Therefore early dianosis and early operative intervention can decrease the confirmatively by demonstration of extravasated contrast media from the lumen of the gallbladder into loculated spaces around it. The purposes of our study are to review the clinical manifestations and values of endoscopic retrograde cholangiography in diagnosis of perforation of the gallbladder.
포스터 전시 : 위장관 ; 지방종에 의한 성인의 대장 장중첩증 1예
허웅 ( Woong Huh ),신정아 ( Jung A Shin ),김성준 ( Seong Jun Kim ),신원창 ( Won Chang Shin ),이진호 ( Jin Ho Lee ),최원충 ( Won Choong Choi ),김관엽 ( Kwan Yap Kim ),김영덕 ( Young Duk Kim ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<배경> 소아에서 흔한 장중첩증은 성인에서는 전체의 5%이하로 드물며, 소아와는 다르게 90%이상에서 일차적 병소(lead point)로 인하여 발생한다. 특히 대장에서는 일차적 병소가 반수이상이 악성 종양이며 양성질환은 드물고, 지방종, 근종, 용종, 내막증식증, 과거 수술의 문합부 등이 있다. 저자들은 간헐적 복통을 주소로 내원한 대장 지방종에 의한 장중첩증 1례를 경험하여 보고하고자 한다. <증례> 환자는 64세 여자이며, 약 1 개월간의 간헐적인
서지영 ( Ji Young Seo ),오태훈 ( Tae Hoon Oh ),전태주 ( Tae Joo Jeon ),서동대 ( Dong Dae Seo ),신원창 ( Won Chang Shin ),최원충 ( Won Choong Choi ) 대한소화기학회 2012 대한소화기학회지 Vol.60 No.2
Hepatic peribiliary cysts (HPCs) are characterized by cystic dilatations of the peribiliary glands located throughout the branches of the biliary systems. Specifically, they are mainly located along the hepatic hilum and major portal tracts. The natural history and prognosis of HPCs are uncertain. In fact, almost all HPCs have been discovered incidentally during radiological examination or autopsy, and they are considered to be clinically harmless. Recently, several cases of HPCs associated with obstructive jaundice or liver failure were reported in patients with pre-existing liver disease in several studies. However, until now there have been no reports of such a case in Korea. Herein, we report a case of HPCs that show a disease course with a poor prognosis. These HPCs developed in a 47-year-old man with progressive alcoholic liver cirrhosis. (Korean J Gastroenterol 2012;60:119-122)
홍진희 ( Jin Hee Hong ),서동대 ( Dong Dae Seo ),전태주 ( Tae Joo Jeon ),오태훈 ( Tae Hoon Oh ),신원창 ( Won Chang Shin ),최원충 ( Won Choong Choi ),조현선 ( Hyun Sun Cho ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.2
Spontaneous regression of hepatocellular carcinoma (HCC) is extremely rare. We report a case of 67-year-old man having HBV-associated HCC with multiple lung metastases which regressed spontaneously. The patient had single liver mass and received surgical resection. The mass was confirmed as HCC histopathologically. Nine years after surgical resection, a 3.3 cm sized recurred HCC was detected on the resection margin in CT scan. Transarterial chemoembolization (TACE) was performed 3 times, and lung metastases developed thereafter. The patient received 2 more sessions of TACE, however, metastatic lung nodules were in progress very rapidly. We decided to stop TACE and followed the patient regularly without any anti-cancer treatment. Nine months after development of lung metastasis, the size and number of metastatic lung nodules decreased and were not detected anymore after 14 months. Serum alpha-fetoprotein levels also decreased to normal range and no viable tumor was noted in the liver. The patient is still alive 12 years after the first diagnosis of HCC and 16 months after lung metastasis developed. (Korean J Gastroenterol 2010;55:133-138)
백승석 ( Seung Suk Baek ),윤아일린 ( Eileen L. Yoon ),김현정 ( Hyun-jung Kim ),배경은 ( Kyung Eun Bae ),박경미 ( Kyeongmee Park ),최원충 ( Won-choong Choi ) 대한간암학회 2017 대한간암학회지 Vol.17 No.2
Heterogeneous features of liver cancer can mimic liver abscess. Therefore it is essential to double- check tumor markers in the diagnosis of liver abscess. Herein, we report a case of combined hepatocellular-cholangiocarcinoma (cHC) occurred in an unrecognized chronic hepatitis B patient initially misdiagnosed as liver abscess. A 49-year old male initially presented with chill, right upper quadrant pain, and a liver mass. Mass showed peripheral enhancement in arterial phase of computed tomography, which was not typical for hepatocellular carcinoma (HCC). Strikingly elevated alpha-fetoprotein and fine needle aspirated pathology revealed HCC. Despite discordant image findings he was treated with transarterial chemoembolization. He was treated with sorafenib due to metastatic retrocaval lymphadenopathy afterwards. The mass presumed to be HCC progressed with sorafenib. It was surgically resected and he was finally confirmed as cHC. Discordant tumor markers with presumptive image findings should prompt the suspicion of rare type of primary liver cancer, the cHC. (J Liver Cancer 2017;17:174-181)