Original Articles : Clinical significance of occult hepatitis B virus infection in chronic hepatitis C patients

( Jae Young Jang ),( Soung Won Jeong ),( Sung Ran Cheon1 ),( Sae Hwan Lee1 ),( Sang Gyune Kim ),( Young Koog Cheon ),( Young Seok Kim1 ),( Young Deok Cho1 ),( Hong Soo Kim ),( So Young Jin ),( Yun Soo 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3

Background/Aims: We investigated the frequency of occult hepatitis B virus (HBV) infection in anti-hepatitis C virus (HCV)-positive individuals and the effects of occult HBV infection on the severity of liver disease. Methods: Seventy-one hepatitis B virus surface-antigen (HBsAg)-negative patients were divided according to their HBV serological status into groups A (anti-HBc positive, anti-HBs negative; n=18), B (anti-HBc positive, anti-HBs positive; n=34), and C (anti-HBc negative, anti-HBs positive/negative; n=19), and by anti-HCV positivity (anti-HCV positive; n=32 vs. anti-HCV negative; n=39). Liver biopsy samples were taken, and HBV DNA was quantified by real-time PCR. Results: Intrahepatic HBV DNA was detected in 32.4% (23/71) of the entire cohort, and HBV DNA levels were invariably low in the different groups. Occult HBV infection was detected more frequently in the anti-HBc-positive patients. Intrahepatic HBV DNA was detected in 28.1% (9/32) of the anti-HCV-positive and 35.9% (14/39) of the anti-HCV-negative subjects. The HCV genotype did not affect the detection rate of intrahepatic HBV DNA. In anti-HCV-positive cases, occult HBV infection did not affect liver disease severity. Conclusions: Low levels of intrahepatic HBV DNA were detected frequently in both HBsAg-negative and anti-HCV-positive cases. However, the frequency of occult HBV infection was not affected by the presence of hepatitis C, and occult HBV infection did not have a significant effect on the disease severity of hepatitis C. (Korean J Hepatol 2011;17:206-212)

Borrmann 4형으로 진단된 진행성 위암환자의 임상적 검토

천영국,김영태,홍수진,김진오,조주영,이문성,심찬섭 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Background/Aim: It is difficult to dignosis of Borrmann type 4 gastric cancer at the early stage, because of its special morphology. Most of the cases have been detected at the advanced stage with poor survival rate. We reviewed patients with advanced gastric cancer, to define clinicopathologic characteristics of Borrmann type 4 gastric cancer comparing other types of gastric cancer. Methods: 1033 patients with advanced gastric cancer were divided into two groups, consisting of 50 patients with Borrmann type 4 gastric cancer, and the remaining 983 patients with all other types of gastric cancer, which were then compared clinicopatologically. Results: The proportion of Borrmann type 4 gastric cancer to advanced gastric cancer was 4.48%(50/1,033). The patients with Borrmann type 4 gastric cancer to advanced gastric cancer was 4.48%(50/1,033). The patients with Borrmann type 4 gastric cancer were composed 20 males and 30 males and revealed the highest frequency 3rd decade (24.0%) in age (range 26-78). In giant folds group (n=27), the number of poorly differentiated cell type, lymph node metastasis, peritoneal seeding were 20 (74.1%), 17 (63,0%), 12 (44.4%). In non-giant folds group (n=23), the number of poorly differentiated type, lymph node metastasis, peritoneal seeding were 17 (73.9%), 15 (65.2%), 6 (26.1%). Rate of tumor invasion in serosa and beyound serosa was 88.9% in giant fold group, 63.0% in non-giant fold group. Surgery was performed in only 32% as a modality of treatment (vs. 82.5%). Characteristics findings of Borrmann type 4 gastric cancer in EUS showed a thickening of the third (submucosa) and fourth (muscularis propria) layers in 72% of 50 patients, and a well preserved five-layered gastric wall structure in 33 patients. Conclusions: We concluded that Borrmann type 4 gastric cancer was diagnosed more in females, as a more advanced disease, early detection was needed. And endoscopic ultrasonography is useful for diagnosis of Borrmann type 4 gastric cancer in the cases of suspicious results of gastroscopy.

폐쇄성 식도암에서 고식적 목적의 방사선치료와 병행한 광역동 치료의 효과

천영국 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

진행성 폐쇄성 식도암에서 증상 완화를 위한 고식적 치료법으로는 인공관 삽관술, 방사선 치료, 레이저 소작술 또는 광역동 치료 등의 다양한 방법이 보고되고 있다. 이에 대해 저자는 폐쇄성 식도암 환자에서 광역동 치료를 시행하여 그 효과 및 경험을 보고하고자 한다. 2001년에서 2003년 사이에 진행성 폐쇄성 식도암으로 진단받은 20명의 환자를 대상으로 하였다. 광역동 치료 48시간 전에 Photogem (2mg/Kg body weight)을 정맥 주사한 후 광역동 치료를 하였다. 연하곤란 정도를 1단계 연하 곤란이 없는 경우에서 4단계 침조차 삼킬 수 없는 경우로 4단계로 하여 치료 전후의 연하곤란의 완화 정도 및 완화 지속기간을 측정하였다. 20명의 환자에서 총 43회의 광역동 치료를 시행하였고 10명은 광역동 치료 후 방사선 치료를 병행하였다. 광역동 치료 후 4주 뒤의 연하 곤란의 완화는 환자의 90%에서 관찰되었고 점수는 2.75 ± 0.91에서 1.05 ± 0.83으로 향상되었다. (p<0.05). 평균 연하곤란 완화 지속기간은 63.1 ± 81.4 일이었다. 광역동 치료 후 연하 곤란 정도의 향상이 없었던 환자는 6명으로서 치료 후 자가 팽창성 금속관을 삽입하였다. 시술과 관련된 합병증으로는 식도 협착증이 2예, 피부 착색증이 3예, 안면 부종이 1예, 기관식도루가 1예에서 있었다. 결론적으로 진행성 폐쇄성 식도암 환자에서 광역동 치료는 비교적 안전하고 효과적으로 완화의 정도를 향상시킬 수 있었다. 그러나 일부 중대한 합병증이 발생되어 향후 종양에 대한 선택성이 높은 광과민제을 사용한 광역동 치료의 연구가 필요하겠다.

진행성 위암과 동반된 후복막 섬유화증 7예의 임상적 고찰

장재영,천영국,최우봉,김진오,조주영,이준성,이문성,심찬섭 순천향의학연구소;Soonchunhyang Medical Research Institute 2000 Journal of Soonchunhyang Medical Science Vol.6 No.1

Background/Aims: Retroperitoneal fibrosis is a fibrosing disease process which frequently develops ureteral obstruction. Malignant retroperitoneal fibrosis has been reported that various types of cancer including cancer of the breast, stomach, prostate, lung, cervix, uteri, colon, pancreas, ovary, and even Hodgkin's disease. While the pathogenesis remains obscure, small foci of metastatic neoplasm in the retroperitoneal space can elicit a desmoplastic reaction in secondary form to malignancy. Methods: Recently we experienced 7 cases of retroperitoneal fibrosis with advanced gastric cancer. So, we report 7 cases of retroperitoneal fibrosis with clinical and radiologic characteristics. Results: The most common signs and symptoms were related irreversible renal dysfunction. The urologic finding noted medial deviation of the involved ureters and hydronephrosis Conclusions: Clinical manifestations are abdominal pain, back pain, hydronephrosis, and uremia. When sudden back pain and hydronephrosis develop in advanced malignancy, physicians should be considerd for retroperitoneal fibrosis.

38 Morris 7777 간암을 유발한 쥐모델에서 시행한 간질성 광역동치료효과

천영국 ( Young Koog Cheon ),김영석 ( Young Seok Kim ),조영덕 ( Young Deok Cho ),김연수 ( Yun Soo Kim ),진소영 ( So Young Jin ),이문성 ( Moon Sung Lee ),심찬섭 ( Chan Sup Shim ) 대한소화기학회 2002 대한소화기학회 추계학술대회 Vol.2002 No.-

Intraductal ultrasonography for biliary strictures

Young Koog Cheon 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.2

When diagnosing the nature of biliary strictures, it is sometimes difficult to perform non-invasive methods such as ultrasound, spiral computed imaging, magnetic resonance imaging, or endoscopic ultrasonography. Thus, treatment decisions are usually based on biopsy results. However, brush cytology or biopsy, which is widely used for biliary stenosis, has limitations owing to its low sensitivity and negative predictive value for malignancy. Currently, the most accurate method is bile duct tissue biopsy under direct cholangioscopy. On the other hand, intraductal ultrasonography administered under the guidance of a guidewire has the advantages of easy administration and being less invasive, allowing for adequate examination of the biliary tract and surrounding organs. This review discusses the usefulness and drawbacks of intraductal ultrasonography for biliary strictures.

Recent advances of photodynamic therapy for biliary tract cancer

Young Koog Cheon 소화기인터벤션의학회 2021 International journal of gastrointestinal interven Vol.10 No.3

The prognosis of bile duct cancer (BDC) is limited due to tumor spread along the biliary tree leading to refractory obstructive cholestasis, cholangitis, and liver failure. Palliation with biliary endoprostheses yields median survival times between 4 and 6 months for advanced BDC. Photodynamic therapy (PDT) is a local photochemical tumor treatment that consists of a photosensitizing agent combined with laser irradiation of a distinct wavelength. Tumor ablation with PDT combined with biliary stenting reduces cholestasis and significantly improves the median survival time. However, the treatment is not widely available, and the photosensitizer used for PDT causes prolonged photosensitivity. Optimal control of tumor spread along the bile ducts and control of cholestasis and cholangitis will prolong survival in 33% to 66% of patients and render them suitable for other antitumor therapies.

Outcome of Photodynamic Therapy for Early Esophageal Cancer

( Young Koog Cheon ),( Wan Jung Kim ),( Joo Young Cho ),( Joon Seong Lee ),( Moon Sung Lee ),( Chan Sup Shim ) 대한소화기기능성질환·운동학회 2007 Gut and Liver Vol.1 No.2

Background/Aims: Endoscopic treatment as an alternative to surgery has become increasingly popular for improving the quality of life. Although photodynamic therapy (PDT) has been used for the endoscopic treatment of digestive cancer, its curative efficacy remains unclear. We evaluated the curative efficacy of PDT in superficial esophageal cancer in inoperable patients. Methods: Ten male patients with histologically proven early esophageal cancer (surgery was contraindicated for age > 80 years, surgery was contraindicated, Karnofsky performance status of at least 30%, or refusal of surgery) were intravenously injected with a hematoporphyrin derivative (2 mg/kg), and PDT was performed 48 h later. The response to treatment was assessed by gastroscopy with biopsies. Results: The mean follow-up period was 27.6 months (range, 9.6-58.7 months). Endoscopic ultrasonography revealed that all ten cases were at tumor stage T1. Complete remission (CR) to initial and subsequent PDT was observed in all patients. For the CR cases, the recurrence rate was 10% (1/10) and the time from initial PDT to recurrence was 9.6 months. Conclusions: For patients in whom surgery is risky or refused, PDT may represent an acceptable alternative treatment modality, especially for superficial esophageal cancer without lymph node metastasis. However, a study involving long-term follow-up in a large population is needed for confirmation. (Gut and Liver 2007;1:126-131)

Photodynamic Therapy in Patients with Advanced Hilar Cholangiocarcinomas

( Young Koog Cheon ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Recent advances of photodynamic therapy for biliary tract cancer

Young Koog Cheon 소화기인터벤션의학회 2021 Gastrointestinal Intervention Vol.10 No.3

The prognosis of bile duct cancer (BDC) is limited due to tumor spread along the biliary tree leading to refractory obstructive cholestasis, cholangitis, and liver failure. Palliation with biliary endoprostheses yields median survival times between 4 and 6 months for advanced BDC. Photodynamic therapy (PDT) is a local photochemical tumor treatment that consists of a photosensitizing agent combined with laser irradiation of a distinct wavelength. Tumor ablation with PDT combined with biliary stenting reduces cholestasis and significantly improves the median survival time. However, the treatment is not widely available, and the photosensitizer used for PDT causes prolonged photosensitivity. Optimal control of tumor spread along the bile ducts and control of cholestasis and cholangitis will prolong survival in 33% to 66% of patients and render them suitable for other antitumor therapies.