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한준열(Joon Yeol Han) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.1
Screening for detection of hepatocellular carcinoma (HCC) has been accepted for the management of patients with chronic liver disease. In order to decrease mortality, the early detection of HCC is very important. Generally, HCC smaller than 3㎝ in diameter can be cured. Ultrasonography is the most frequently used imaging test for screening of HCC. HCC smaller than 1㎝ is seldom detected with ultrasonography. Therefore, the duration of growth from 1㎝ to 3㎝ appears to be used to determine the optimal interval of screening for HCC. The mean doubling time of HCC has been reported to be between 3.5 and 7 months, its difference was variable according to patients. Therefore, six-month screening is believed to detect most of HCC smaller than 3㎝. However, shortening of the interval and/or the use of additional diagnostic methods such as abdominal CT should be considered according to clinical characteristics of patients. (Korean J Gastroenterol 2002;39:1-3)
임계순(Kae Soon Im),한준열(Joon Yeol Han),안병민(Byung Min Ahn) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.4
Percutaneous endoscopic gastrostomy is commonly used for long-term nutritional support in patients who cannot maintain adequate oral intake. Although this procedure has less morbidity and mortality than surgical gastrostomy, many complications have been reported. We describe a patient in whom the internal bumper and intraluminal end of the tub had migrated into the abdominal wall 1 month after percutaneous endoscopic gastrostomy.
만성 C형 간염에서 Fas/Fas Ligand에 의한 간세포 자멸사
장우임 ( U Im Chang ),한준열 ( Joon Yeol Han ),김진일 ( Jin Il Kim ),최종영 ( Jong Young Choi ),조세현 ( Se Hyun Jo ),한남익 ( Nam Ik Han ),윤승규 ( Seung Kew Yoon ),양진모 ( Jin Mo Yang ),안병민 ( Byung Min Ahn ),김재광 ( Jae Kwa 대한소화기학회 2003 대한소화기학회지 Vol.41 No.4
Background/Aims: In chronic hepatitis C, the Fas/Fas ligand-mediated apoptosis is involved in the hepatic injury. The soluble forms of Fas and Fas ligand have been detected in serum and shown to inhibit Fas-mediated apoptosis. In the present study, we evaluated the relationships between the serum level of soluble Fas/Fas ligand and their histological and biochemical activities to elucidate the role of Fas system in pathogenesis of chronic hepatitis C. Methods: Liver biopsy samples were graded according to the Knodell`s Histologic Activity Index and immunohistochemically stained for Fas and Fas ligand. Serum soluble Fas and Fas ligand levels of chronic hepatitis C patients were compared with those of control group. These levels were compared with histological activities, ALT levels and Fas expression grades. Results: Serum soluble Fas levels in patients with chronic hepatitis C were higher than those in the control group, although it is not statistically significant. Soluble Fas level in patients with moderate and marked intralobular inflammation were higher significantly than those in control group. There was a positive relationship between the grade of Fas expression and HAI score. Conclusions: These findings suggest the possibility that the concentration of soluble Fas is associated with severity of intralobular inflammation in patients with chronic hepatitis C. (Korean J Gastroenterol 2003;41:205-301)
과량의 구리를 지속적으로 투여한 쥐에서 시간적 변화에 따른 간 손상의 전자현미경적 소견
한남익 ( Nam Ik Han ),최상덕 ( Sang Duk Choi ),정규원 ( Kyu Won Chung ),남순우 ( Soon Woo Nam ),한준열 ( Joon Yeol Han ),최상욱 ( Sang Wook Choi ),이영석 ( Young Sok Lee ),선희식 ( Hee Sik Sun ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.5
Background/Aims: This study was designed to clarify the sequential morphologic changes of copper overloaded-rat liver. Methods: The Sprague-Dawley rats were divided into three groups according to copper and penicillamine administration: Group I. normal control injected with lipiodol; Group II, treated with copper only; Group III, treated with copper plus D-penicillamine. Liver tissues were stained with hematoxylin-eosin and rubeanic acid. In order to elucidate the ultrastructural changes of the liver, transmission electron microscopic examination was also performed. Results: Electron microscopic findings in copper-treated group were characterized by a number of copper-containing lysosomes at pericanalicular ectoplasm, normal sized and bizarre mitochondria with small vacuoles (at 2 weeks), dilated bile canaliculi with decreased microvilli (at 3 weeks), disruption of sinusoidal border (at 4 weeks), microsteatosis (at 5 weeks), a Councilman body-like inclusion in sinusoid and round hepatocytes undergone coagulation necrosis in sinusoid (at 7 weeks), increased collagen bundles in Disse space and loss of microvilli (at 12 weeks). There were increased copper containing granules in hepatocytes of copper plus D-penicillamine treated group, but normal ultrastructural findings were observed. Conclusions: These findings indicate that hepatic injury induced by copper overload is caused by deranged copper metabolism in the lysosome of the hepatocytes and administration of D-penicillamine in copper stressed rats seems to be effective for the restoration of hepatocyte function and morphologic changes. (Korean J Gastroenterol 2003;41:374-381)
박재명 ( Jae Myung Park ),최황 ( Hwang Choi ),한준열 ( Joon Yeol Han ),김보경 ( Bo Kyoung Kim ),문성배 ( Sung Bae Moon ),김병욱 ( Byung Wook Kim ),조세현 ( Se Hyun Cho ),양진모 ( Jin Mo Yang ),안병민 ( Byung Min Ahn ),한남익 ( Na 대한소화기학회 1999 대한소화기학회지 Vol.33 No.4
Background/Aims: The use of diagnostic laparoscopy has declined because of the trend to prefer the less invasive radiological procedure. However, it is still useful in the evaluation and diagnosis of focal and diffuse liver diseases, primary and metastatic liver tumors, and peritoneal diseases. The aim of this study was to reevaluate the clinical role and diagnostic accuracy of laparoscopy. Methods We retrospectively reviewed the records of 2185 laparoscopies performed at St. Mary' s Hospital from 1975 to 1997. Results: The most common clinical indication for laparoscopy has been changed from the diagnosis of liver tumors to the diagnosis of chronic parenchymal liver diseases since 1990. The diagnosis was confirmed in 96% of the cases by laparoscopy. The sensitivity and specificity of laparoscopic diagnosis were 97.2% and 86.7%, respectively in chronic hepatitis, 97.6% and 85.7% in liver cirrhosis, 97.3% and 90.2% in hepatocellular carcinoma, 84.4% and 70.0% in metastatic live cancer, 96.8% and 88.9% in tuberculous peritonitis, and 92.3% and 100% in carcinoma peritonei. The complication rate of laparoscopy was 1.7%. Two patients (0.1%) died of massive bleeding from the biopsy site of hepatic tumor. Conclusions: Diagnostic laparoscopy is a safe and accurate method for evaluating the chronic liver parenchymal diseases and unexplained ascites. (Kor J Gastroentero 1999;33:527 - 533)
정대영 ( Dae Young Cheung ),김재광 ( Jae Kwang Kim ),김진일 ( Jin Il Kim ),한준열 ( Joon Yeol Han ),정규원 ( Kyo Won Chung ),선희식 ( Hee Sik Sun ) 대한소화기학회 2005 대한소화기학회지 Vol.45 No.4
Background/Aims: As a preliminary study to test the possibility of oral transmission of hepatitis C virus (HCV), many investigations in order to detect the extrahepatic localization of HCV have been performed. In this study, we examined the presence of HC
위장관 ( 胃腸管 ) : 말기 식도암의 치료로 내시경적 레이저 치료술 , 화학요법 , 경피 내시경하 위수술을 이용한 2예
김부성(Boo Sung Kim),임계순(Kae Soon Im),백남종(Nam Jong Baeg),한준열(Joon Yeol Han),안병민(Byung Min Ahn),김현응(Hyeon Eung Kim) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.4
N/A Chemotherapy and palliative treatment techniques for advanced esophageal carcinoma using endoscopic Nd-YAG laser and percutaneous endoscopic gastrostomy were performed in two patients for whom curative therapy was not possible. They were not able to eat solid food and were severely undernourished. After successful endoscopic laser therapy and balloon dilation the size of the mass decreased and endoscope passed freely. Because there were many risks and difficulties in esophageal endoprosthesis, we performed percutaneous endoscopic gastostomy. We were able to give adequate nutritional support through it. The endoscopic laser therapy and percutaneous endoscopic gastrostomy will be one of the modalities for palliative treatment of advanced esophageal carcinoma.
간장 및 담도 : 내시경적 경화요법으로 소실된 식도정맥류 47예에 대한 고찰
임계순(Kae Soon Im),백남종(Nam Jong Baeg),한준열(Joon Yeol Han) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.1
N/A One hundred seventy five patients with bleeding esophageal varices were treated with endoscopic variceal sclerotherapy from November 1986 to December 1989. Forty seven patients, whose varices were obliterated, were analysed. Forty seven patients underwent 253 sessions of endoscopic sclerotherapy. The mean number of sessions for obliteration was 5.4 (range; 2~9), and the mean volume of sclerosant used for obliteration was 103.9 (range; 36~187) ml. The mean volume of sclerosant per injection was 2.5 (range; 1~4.0) ml. The complications associated with endoscopic sclerotherapy were chest pain in 183 cases (72.8%), esophageal ulcer in 81 cases (32.0%), fever in 39 cases (15.4%), dysphagia in 19 cases (7.5%), esophageal stricture in 9 cases (3.6%) and pseudotumor of esophagus in 1 case (0. 4%). Twenty three (48.9%) of the forty seven patients had episodes of hemorrhage during the period of treatment, but in only four (8.5%) did variceal bleeding occur after the varices had been obliterated. Four patients (8.5%) died after obliteration of the varices. Causes of death were hepatic failure in three (6.4%) and advanced gastric cancer in one. None of these patients died because of variceal bleeding. This study indicates that endoscopic sclerotherapy is a safe and effective treatment for prevention of recurrent varicceal bleeding.
직장 및 결장의 융모성선종에 대한 내시경적 레이저 치료
임계순(Kae Soon Im),엄현석(Hyeon Seok Um),한준열(Joon Yeol Han),안병민(Byung Min Ahn),김부성(Boo Sung Kim) 대한내과학회 1991 대한내과학회지 Vol.41 No.1
N/A Four patients with colorectal villous adenoma considered unsuitable for surgery underwent snare cautery piecemeal resection and endoscopic Nd: YAG laser therapy for palliation of symptoms and tumor eradication. Successful treatment was documented in 2 patients over a 3-to 14-months follow-up period. Tumor recurrence was noted in 2 patients. Severe dysplasia was detected in 1 patient on biopsy specimens obtained during the follow-up period. Initial symptoms were cleared in all patients after the first laser treatment period. Treatment was well tolerated in all patients with no major complications except for transient lower abdominal discomfort, dysuria and anal pain. These results suggest that endocopic laser therapy may be the treatment of choice in patients with colorectal villous adenoma unsuitable for surgery.