출혈을 동반한 만성 췌장염 4예

김세종(Sei Jong Kim),윤종만(Chong Mann Yoon),유종선(Jong Sun Rew),최성규(Sung Kyu Choi),김현종(Hyun Jong Kim),김영진(Young Jin Kim),김현수(Hyun Soo Kim),백강우(Kang Woo Paik),구철(Cheol Koo),박창환(Chang Hwan Park) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.2

Hemorrhage is an uncommon but serious cornplicaticm of pancreatic pseudocysts. When gastrointestinal bleeding or intra-abdominal hemorrhage is associated with a pancreatic pseudocyst and the usual sources of bleeding are not detected by endoscopy, the rupture of a pseudoaneurysm inside the pseudocyst should be suspeeted. We report four cases presenting with major bleeding. Bleeding was massive in two patients and intermittent in two. It resulted from erosion of the gastroduodenal artery in two patients, bleeding into the pancreatic duct in one patient, erosion of the duodenum by a bleeding pseudocyst in one and involvement of the spleen by a bleeding pseudocyst in one. Of the four patients with bleeding pseudocysts, two underwent primary pancreatic reseetion and the other two underwent transcatheter embolization with embolus coiL Bleeding was successfully controlled by the transcatheter arterial embolization in one out of the two patient and pancreatic resection was performed in the rest of three patients. (Korean J Gastroenterol 1997; 29:266-273)

Percutaneous Balloon Membranotomy로 성공적으로 치료된 하대정맥 (下大靜脈) 막성폐쇄 (膜性閉鎖)

김세종(Sei Jong Kim),윤종만(Chong Mann Yoon),최성규(Sung Kyu Choi),김석빈(Suk Bin Kim),양건호(Kun Ho Yang),박일종(Il Chong Park),박해옥(Hae Ok Park),남광우(Kwang Woo Nam),김재규(Jae Kyn Kim),나병식(Byung Sik Ra) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

Idiopathic membranous obstruction of the inferior vena cava (MOVC) is the most common cause of hepatic outflow obstruction world-wide, especially among Orientals, and this lesion at its hepatic portion might be one of the common cause of portal hypertension in Korea, though having not been reported till now. Most of the symptoms and signs of the MOVC are those referable to portal hypertension, collateral circulation being the most prominent feature. Distribution and direction of collaterals of MOVC are, however, different from those observed in other causes of portal hypertension in that the collateral veins channels carry blood up-words to reach the superior vena caval system. So, large truncal collateral vessels, particulary on the back, strongly suggest MOVC. Final cliagnosis of MOVC comes from inferior vena caval catheterization and angiography using two catheters simultaneously inserted through the basilic and femoral vein by demonstrating web-like membranous structure in the IVC. The classical therapeutic approach has been transcardiac membranotomy by means of finger fracture technique, but percutaneous translumina1 angioplasty using balloon catheter has recently been recommended before proceeding to operative treatment because of its simplicity and safety. We have recently been confronted by one case of idiopathic membranous obstruction of the inferior vena cava (MOVC) that was successfully managed by percutaneous balloon membranotomy, which has prompted this report with a review of this relatively rare condition.

소화성궤양환자에서 (消化性潰瘍患者) Madecassol ( Centella asiatica ) 의 사용경험

김세종 ( Sei Jong Kim ),이태희 ( Tae Hee Lee ),윤종만 ( Chong Mann Yoon ),조국현 ( Kook Hyun Cho ),정태중 ( Tae Jong Chung ) 대한소화기학회 1981 대한소화기학회지 Vol.13 No.1

Therapeutic effect of Madecassol(Centella Asiatica, I'ECA) was studied on 41 cases of peptic ulcer and the following results were obtained; 1) In 1Q cases of placebo group (6 cases of gastric lcer, 4 cases of duodenal ulcer), slight subjective improvement was observed only in 4 cases without healing effect of ulcer. 2) In 11 casesof TECA alone group (6 cases of gastric ulcer, 5 cases of duodenal ulcer), subjective improvement was observed in 10 cases (917o) and healing effect by endoscopic examination was observed in 7 cases (64%). 3) In 2Q cases of combination group of antacid, cimetidine and TECA (12 cases of gastric ulcer, 8 cases of duodenal ulcer), subjective improvement was observed in 19 cases (95%) and healing effect of ulcer was observed in 17 cases (81%). 4) During of after administration of TECA, specific side effects including alteration of blood picture, serum transaminase and electrolytes were not observed. Above results showed that TECA revealed good therapeutic effects on peptic ulcer, and combination therapy of TECA showed better than TECA alone therapy in the treatment of peptic ulcer.

각종 간질환 환자에 있어서 혈청 Aspirinesterase 활성에 관한 임상적 고찰

김세종 ( Sei Jong Kim ),구석원 ( Suk Won Koo ),이창수 ( Chang Soo Lee ) 대한내과학회 1978 대한내과학회지 Vol.21 No.1

각종 간질환에 (肝疾患) 있어서 r - GTP 와 SGOT , SGPT 의 활성에 관한 연구

김세종(Sei Jong Kim),유종선(Jong Sun Rew),양동희(Dong Hi Yang),장건성(Kun Sung Jang),박종춘(Jong Chun Park),이태희(Tae Hi Lee) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.1

N/A Of the many hepatic enzymes, only a few are generally used for diagnosis of liver disease. Alkaline phosphatase and aminotransferases are example of two differnet groups of enzymes providing information about pathologic conditions. Aminotransferase reflects hepatic cellular injury with sorbital dehydrogenase and 5-lactic dehydrogenase. Alkaline phosphatase refrects cholestasis and its activity can easily be corrected with that of other enzymes like leucine- aminopepeptidase and 5-nucleotidase. Enzymes indicating alterations of the liver, but not belonging to one of those groups mentioned, include gamma-glutamyl transpeptidase(r-GTP), which was introduced as a test of liver function by Polish authors to indicate chronic hepatitis. A special feature of this enzyme is its increasement with prolonged intake of some drugs or alcohol. This enzyme has been used for differentiating viral hepatitis from obstructive jaundice mainly correlating SGOT or SGPT with r-GTP. Later, r-GTP was not only recommended as an indicator of minor alterations of the liver but also it was introduced as a most sensitive test for alcoholic hepatic cellular injury. The SGOT/SGPT ratio is used as an indicator of minor viral hepatitis and alcoholic induced liver injury. It should be due to the different location in the hepatocyte of the enzyme, as SGPT is present free at cytosol, whereas SGOT is demonstrable at mitochondria and cytosol in hepatocyte. r-GTP in the liver is found in hepatocyte and small bile ductules. The enzyme can be detect by enzyme histochemical methods in hepatocyte and by cytochemical techniques bound to membranes and microsomes. So the observations of SGOT/SGPT, SGOT/r-GTP and r-GTP/SGPT in various hepatic diseases concurrently might be helpful for making the differential diagnosis of the hepatic diseases. So we have observed the ratios of the enzyme activities, SGOT/SGPT, SGOT/r-GTP and r-GTP/SGPT in 20 cases of control group and 130 cases of various hepatic diseases group (Male 107, Female 42), which is including 25 cases of acute viral hepatitis(A.V.H.: Male )9, Female 8 ), 17 cases of chronic active hepatitis(C.A.H.: Male 9, Female 8.), )14cases of chronic persistent hepatitis(C.P.H.: Male 10, Female 4), 14 cases of liver cirrhosis(Male 34, Female 6), 20 cases of primary hepatocellular carcinoma(Male 16, Female 4. ), 8 cases of liver abscess(Male 4, Female 4,) and 12 cases of gall stone(Male 5, Female,7) The results were as follows: 1) In normal control group, the SGOT/SGPT is l.76+- 0.44, SGOT/r-GTP 1.20+-0.67 and r-GTP/SGPT 1, 931+-l. 14 The activity of alkaline phosphatase is 2.6+-0.6 Bessey-Lowry unit 2) In A.V.H. group, the SGOT/SGPT is 0. 78+-0.46, SGOT/r-GTP 3. 46+-2.36 and r-GTP/ SGPT 0.47+-0.91. The ratio af the SGOT/SGPT and r-GPT/SGPT are decreased significantly than the nor mal(p(0.005, p(0.005), but the SGOT/r-GTP is increased significantly, 2.5 times than the normal(p(0.005) It were helpful for differentiating A.V.H. for the other hepatic diseases 3) In C.A.H. group, the SGOT/SGPT is 0. 7+-0.35, SGOT/r-GPT is 1. 63+-1.23 and r-GTP/ SGPT is l.76+-1.38. The each ratio of SGOT/r-GTP and SGPT/SGPT is slightly increased and decreased than the normal(p=0.10, p<0.05) The SGOT/SGPT ratio was markedly decreased. It was helpful for the differentiation of the C.A.H. from the other hepatic diseases. In cirrhosis of liver group, the SGOT/SGPT is 2.05+0.88, SGOT/r-GTP is 1.27+-1.59 and r-GTP/SGPT is 2.97+-2.48. All of the ratios were increased slightly with mild elevation of the alkaline phosphatase activity. It svas also helpful for differential diagnosis of the liver diseases. 5) In primary hepatocellular carcinoma, The SGOT/SGPT is 1.82+-0.97, SGOT/r-GTP is 0.49+-0.29 and r-GTP/SGPT is 5.02+-3.80,The alkaline phosphatase activity was elevated over 2.5 times than the normal as 7.2+-5.2 Bessey-Lowry unit. With the marked elevation of r-GTP/SGPT ratio and alkaline phosphatase activity, the markedly decreased ratio of SGOT/r-GTP were

B 형 간염 백신의 효과 - 산모의 HBeAg 양성 유무에 따라 -

김세종(Sei Jong Kim),윤종만(Chong Mann Yoon),최관수(Gwan Su Choi),김지운(Ji Woon Kim),정남기(nam Ki Joung),장영호(Yung Ho Chang),오은아(Eun A O),양인애(In Ae Yang),유영근(Young Geun Ryoo),이봉섭(Bong Seob Lee) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.1

N/A The preventive efficacy for HBV infection and chronic HBV carrier rate by active and passive immunoprophylaxis was observed in 49 newborn infants whose mothers were healthy HBV carriers with normal ALT activity at delivery. All infants were divided into 3 groups; Group A received HBIG at birth and HB Vaccine (Hepavax- B) at month 0, 1 and 6. Group B received first or second vaccine only. Group C received no vaccine. ALT activity, HBsAg and anti-HBs were tested every 3 months for 18 rnonths after delivery, and the results were analyzed in 3 groups according to the mothers HBeAg positivity. 1) The anti-HBs response was57.1% (16/28) in Group A and 76.9% (10/13) in the control group whose mothers vere normal. The anti-HBs response was 64.3% (9.14) and 57.1% (8/14) according to the mothers HBeAg positivity and negativity. The anti-HBs response was 56.3% (9/16) in male and 66.7% (8/12) in female infants. The anti-HBs response svas higher in female infants and infants a hose mothers were normal or HBeAg positive carriers. 2) Chronic HBV carrier rate in infants of HBeAg positive mothers was 14.3% (2/l4) in Ciroup A, 72.7% (8/11 ) in Group 8, 100% (6/6) in Group c and was statistically significant (p=0.037) (c=0.816). There was no significant difference hetween group A, B, and C in infants of HBeAg negative mothers. 3) The positive rate of HBsAg showed significant difference between Groups A and B, A and C, A and (B+C), (A+B) and C in all 3 monthly follow-up tests in infants of HBeAg positive mothers. But there was no significant difference between (groups A, B, and C in infants of HBeAg negative mothers. The results suggest that the anti-HBs response was lower in infants of HBsAg carrier mothers. The preventive efficacy of vaccine for HBV infection and chronic HBV carrier rate was excellent in infants of HBeAg positive mothers but not significant in infants of HBeAg negative mothers by the active and passive immunoprophylaxis.

거대 해면상간혈관종 2예

김세종(Sei Jong Kim),윤종만(Chong Mann Yoon),박일종(Il Chong Park),김석빈(Suck Bin Kim),범희승(Hee Seoung Bom),김성렬(Seoung Ryul Kim),양건호(Kim Ho Yang) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1

Benign tumors of the liver are rare, and Henson and associates collected only 34 hemangiomas between 1907 and 1954 at the Mayo Clinic. Most of the cavernous hemangiomas of the liver are small in size, and produce no symptoms during life, but some can reach massive proportions and often present as abdominal masses or causes symptoms by encroachment on adjacent viscera. We have recently been confronted by two case of those large tumors, which has prompted this report with a review of this relatively rare condition. 1) A 32-year-old woman was admitted because of anorexia and indigestion associated with headache, myalgia, mild elevation of fever and weight loss of 5kg in two months. Examination of the abdomen disclosed one finger breadth palpable liver which was slightly tender. A large intrahepatic space-occupying lesion was discovered on radionuclide scan, ultrasonography and computed tomography of the abdomen. Selective hepatic angiography revealed characteristic features of puddling of contrast media along the branches of right and middle hepatic arteries throughout the arterial and venous phase of the angiograms. The resected specimen using Cavitron Ultrasonic Surgical Aspirator was proved to a giant cavernous hemangioma of the liver on microscopic exam. A 32-year-old man came to the hospital because of abdominal pain and a extremely huge mass nearly occupying the whole of his belly. The lesion was found to be a multiloculated highly echogenic mass in the left lobe of the liver on ultrasonography, and a huge hypodense, well-circumscribed homogeneous one with central low density component in the liver on computed tomography of the abdomen. Extensive pooling of contrast media was found throughout the markedly enlarged liver with persistence of tumor stain wliich was measured to be about 25cm in diameter until the late venous phase of the selective hepatic arteriograms. The tumor was considered to be an unresectable one, and we recommended radiation therapy.

HBsAg 및 antiHBs 검출에 있어서 EIA 법과 RPHA 법 및 PHA 법의 비교

김세종(Sei Jong Kim),홍경표(Kyung Pyo Hong) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A The first and second generation tests for hepatitis B surface antigen(HBsAg) and antibody(anti-HBs), gel diffusion method, counterimmunoelectrophoresis and complement fixation test etc., are considered relatively insensitive tests. It is not clear which of the more sensitive third generation tests would be most suitable for routine use even though radioimmunoassay(RIA) and enzyme immunoassay (EIA) are generally accepted as being the most sensitive methods currently available. We have studied the concurrence rates, sensitivities, specificities and predictabilities of reversed passive hemagglutination (RPHA) and passive hemagglutination (PHA) compared to EIA for evaluation their clinical availability. Study subjects consisted of 288 cases of acute and chronic liver disease in Chonnam National University Hospital. The results are as follows; 1) In 288 cases of liver diseases, the positivities of HBsAg by EIA and RPHA method were 51.0% (147 cases), 47.9% (138 cases) respectively, and the positivities of anti-HBs by EIA and PHA rnethod were 34.7% (100 cases) and 29.5% (85 case) respectively. 2) In detecting of HBsAg, concurrence rate, sensitivity, specificity and predictability of RPHA to EIA were 96.9%, 93.9%, 100% and 100% respectively. 3) In detecting of anti-HBs, concurrence rate, sensitivity, specificity and predictabiltiy of PHA to EIA were 89.2%, 77.0%, 95.9% and 90.6% respectively. In terms of sensitivity, specificity and the costs of RPHA with problems of procedures of EIA for detecting HBsAg, RPHA is more available in clinical laboratories than the EIA for mass screening test in HBsAg detection. But EIA is more available than the PHA in detecting anti-HBs as 77.0% of sensitivity and 95.9% of specificity of PHA.

소화성궤양의 (消化性潰瘍) 국소요법 (局所療法)

김세종(Sei Jong Kim),윤종만(Chong Mann Yoon),조남중(Nam Joong Joh),장건성(Kun Sung Jang),강형구(Hyeong Koo Kahng) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.2

N/A The therapeutic efiect of topical therapy using gastrofiberscope was evaluated on 48 eases of gastric or duodenal ulcer. Healing agents such as allantoin and ulcerlmin were topically injected and directly coated via endoscope at tbe site of the ulcers weekly. All cases received antiulcer medical therapy concurrently. Results were as follows; 1. Total number of cases was 48; 44 gastric ulcer and 4 duodenal ulcer. 39 patients were male and 9 female. Mean age was 42.2. Duration of ulcer symptoms ranged from one month to 36 months(mean 13 months) and the initial size of ulcer was 7 to 41 mm(mean 19. 8 mm), which was chronic in most cases. 3. Topical therapy was performed in the first group, allantoin was injected topically every week(26 cases) and in the second group, ulcerlmin@ was coated directly(9 cases). In the third group, the above two methods were combined. (13 cases) Mean duration of treatment for healing was 5. 1 weeks; 5 9 weeks in the first group, 5. 7 weeks in the second group and 4. 0 weeks in the third group. 4 Forty-six cases out of 48 cases were healed completely within twelve weeks on endoscopic examination. Only one case recurred and one case showed only slight decrease in ulcer size despite of protracted topical therapy.

HBeAg 양성 만성활동성간염에 있어서 α2b - Interferon ( IFN ) 의 치료 반응에 대한 전조요인에 관한 연구 - IFN 치료 전후 검사소견을 중심으로 -

김세종(Sei Jong Kim),김형원(Hyung Won Kim),양동욱(Dong Wook Ryang) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6

N/A To have the knowledge for the factors predicting response to a2b-interferon (IFN) therapy, 3 million units of a2b-Interferon (Intron-AR: Shering Co., U.S.A.) was injected subcutaneously 3 times a week for 12 weeks in 23 patients with HBeAg postitive CAH (male: 17, female: 6). The subjects were divided into two groups according to the seroconversion of HBeAg after IFN therapy. One is responder group which HBeAg is negative consecutively more than 24 weeks, the other is nonresponder group which HBeAg is negative less than 24 weeks. The statistical analysis of the pretreatment data of two groups was made. In routine examination except platelets in peripheral blood, there were no significant changes before and after a2b-Interferon therapy. But platelets was begun to decrease significantly (p<0.05) from the 4th to the 8th week with IFN therapy and th pretreatment platelets were lowered very significantly (p<0.005) to the low normal level around 130 thousand per cubic milimeter in the responder. So subcutaneous injection of 3 million units three times a week for 12 week may be safe in HBeAg positive CAH. In liver function tests, serum AST and ALT were markedly increased in pretreatment status as 231. 7+- 134.9 I U and 403.6+- 186.7 IU respectively. But these began to decrease from the 4th week after IFN therapy. It fall down significantly from the 8th to the 116th week after the therapv (p<0.01). Serum albumn levels were within normal range before and after the therapy. But it increased more significantly (p <0.005) within normal range frorn 4th to the 64th week with the therapy in the responder. There were significant differences in pretreatment level of serum AST and albumin between two groups (p<0.05). HBeAg negativity was more than 26% from the 48th week after therapy. HBV DNA levels were 418.3+-835.3 pg/75 ul in pretreatment status. It began to decrease significantly frorn the 4th week to..... (continue..)