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한국인 만성 B형 간염 바이러스 ( HBV ) 보유자에서 HBV 유전자형 - 일차 중합 효소 반응법에 의한 온전한 B 형 간염 바이러스 증폭 및 그의 염기 서열 -
김학철(Haak Cheoul Kim),서검석(Geom Suk Seo),김용성(Youg Sung Kim),송우건(Woo Gun Song),문형배(Hyung Bae Moon),조지현(Jie Heun Cho) 대한내과학회 2001 대한내과학회지 Vol.61 No.5
N/A Background : Hepatitis B virus (HBV) is major source of chronic liver disease in Korea. However this virus might have different nucleotide sequence according to races, different region, etc. Recently the novel method that allows sensitive amplification with dramatically decreased mis-incorporation has developed. We determined to get the major form of HBV nucleotide sequence from whole sequencing data of 26 Korean HBV carriers. Methods : HBV DNA were collected from 26 Korean chronic HBV carriers. We used the novel PCR with pfu for the amplification of HBV DNA, and specific primers were made with combination sequence bases of non-HBV part and HBV parts which were located head and tail in the virion. Then whole length of HBV were directly sequenced and analysed. Result : HBV DNA was consisted of 3215 bases in 20 cases of 26 Korean chronic HBV carriers. And the remainder had smaller or larger number due to deletion, insertion or both in pre-S2 and S gene. They were 99.03% homology of their nucleotide sequence and belong to genotype C. The variability of nucleotide sequence was significantly higher in the singly coding region (SCR) than doubly coding region (DCR), and also high in pre-S1 and pre-S2 gene among the DCR. Hot-spots were more frequently found in the SCR, pre-S1 and pre-S2 gene. Conclusion : In Korean chronic HBV carriers, HBV is consisted of 3215 nucleotides, and belongs to genotype C. And it might exist one genotype with the variability in Korea.(Korean J Med 61:479-488, 2001)
만성 B형 간염 바이러스를 보유한 젊은 남자에서 간손상, 혈청 HBV-DNA 및 간세포내 HBcAg의 발현 양상과의 관련성
김태현 ( Tae Hyeon Kim ),김용성 ( Yong Sung Kim ),염주진 ( Joo Jin Yeom ),조은영 ( Eun Young Cho ),김희식 ( Hee Sik Kim ),김학철 ( Haak Cheoul Kim ),박도심 ( Do Shim Park ),조지현 ( Ji Heun Cho ),윤기중 ( Gi Jung Yoon ),문형배 ( H 대한소화기학회 2004 대한소화기학회지 Vol.44 No.2
Background/Aims: Although the viral load is correlated with HBcAg, liver injury was not correlated to viral load in HBeAg positive patient. We aimed to study the inter-relationship of clinical parameters such as the level of HBV-DNA, the level of aminotra
만성 B형 간염 바이러스 감염자에서 Enhancer 1과 Pre-X Promotor 부위의 염기 다양성
송우건 ( Woo Kern Song ),김학철 ( Haak Cheoul Kim ),박도심 ( Do Sim Park ),조지현 ( Ji Hyun Cho ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.3
Background/Aims: Hepatitis B Virus (HBV) is a compact DNA virus with four genes which are controlled by 6 promotors and two enhancers during its replication. However, HBV has variability in its nucleotide sequence and thus, it can be classified into genotypes. Recently, it is suggested that nucleotide mutations in its sequence are related to chronic liver disease (CLD). Therefore, we analyzed relationships between mutations and disease severity in its Enh 1 and X-promoter regions (1021-1373). Methods: HBV DNA of the patients with chronic hepatitis (CH, n=30), liver cirrhosis (LC, n=25), and hepatocellular carcinoma (HCC, n=17) was amplified and sequenced. Then, we constructed a phylogenetic tree (PAUP4.0) and analyzed their mutation rates and specificity among the disease groups. Results: All analyzed sequences belonged to genotype C. The divergency rate was 1.71% and there was no difference in their mutation rates, but there were some hot-spots among the disease groups. The hot-spots were at nucleotides 1317, 1229, 1126, 1134, and 1041 in decreasing order. Between the groups of LC and HCC, there were higher mutation rates at nucleotides 1126 (A→C) and 1134 (T→C) in LC, and at nucleotides 1229 (G→A) and 1317 (A→G) in HCC. The mutations at nucleotides 1126 and 1134 (p< 0.001) were accompanied. Conclusions: The genotype of HBV in Korea is type C in all cases and there might exist the associated mutations and hot-spots related to CLD severity in Enh 1 and X-promoter regions. (Korean J Gastroenterol 2003;41:211-218)
간경변증 환자에서 식도 정맥류의 내시경적 정맥류 결찰요법이 보행성 24시간 식도내 pH에 미치는 영향
김형언(Hyeong Eon Kim),유재규(Jae Kyu Ryu),김학철(Haak Cheoul Kim) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.1
N/A Endoscopic variceat ligation(EVL), a recently developed method for controlling active variceal bleeding and eradicating esophageal varices with similar efficacy to endoscopic injec- tion sclerotherapy(EIS), has a minimal risk of complications that may damage to the esopha- gus. EIS is known to decrease the lower esophageal sphincter tone and induce gastroesophageal reflux. The effects of EVL on the esophageal motor function have recently been described compared to those of EIS, but yet there are no reports to be found describing the effects on the intraesophageal pH in the individual patient. We performed EVL in 20 patients who had recently bled from esophageal varices and had a past history of esophageal variceal bleeding. To investigate the effect of EVL on intraesophageal pH, ambulatory 24-hour esophageal pH monitorings were performed both be- fore and after EVL, and analysis of pH tracing was done. The incidence of gastroesophageal reflux disease was noted to be 4D% in patients with cirrhosis of liver(in 8 patients out of 20). After performing I to 3 EVL treatment sessions(mean 1.8) with a 7-day interval in between each session and using 3 to 21 ligations(mean 8.7), the effect of EVL showed a reduction in size of the esophageal varices in all cases. All of the results of pH monitoring studies showed that there were no significant differences in all pH parameters between those before and after EVL. In conclusion, no significant EVL-related gastroesophageal refluxes were observed when a relatively small number of legations were performed. Our study supports several recent stud- ies describing that fibrosis due to EVI- is limited to the mucosa or submucosa of the esopha- gus.(Korean J Gastroeriterol 1994; 26 : 9-16)
김의중 ( Eui Joong Kim ),주민수 ( Min Su Chu ),손기창 ( Ki Chang Sohn ),조동호 ( Dong Ho Cho ),나가혜 ( Ga Hye Na ),김학철 ( Haak Cheoul Kim ),조은영 ( Eun Young Cho ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.1
Pancreatic panniculitis is a rare complication characterized by subcutaneous fat necrosis associated with pancreatic disease. It has been postulated that pancreatic panniculitis is caused by the systemic activity of pancreatic enzymes that lead to microcirculatory disturbances. We report a 41-year-old heavy alcoholic woman with pancreatic panniculitis that coexisted with acute and chronic pancreatitis. She was diagnosed with chronic pancreatitis and alcoholic liver cirrhosis 5 years ago. She presented with multiple, tender, erythematous, subcutaneous nodules with heat sensation on both lower legs. Laboratory evaluation revealed an increase in the serum blood amylase and lipase. Histopathologic findings showed fat necrosis with inflammation around the necrotic subcutaneous fat tissue. The lesions subsided gradually with an improvement of acute pancreatitis. (Korean J Gastroenterol 2017;69:83-86)
각종 간질환에 (肝疾患) 있어서 SGOT / SGPT 비와 γ - GTP / SGPT 비의 진단적 (診斷的) 의의에 대하여
김세종(Sei Jong Kim),박세원(Sei Won Park),김상대(Sang Dae Kim),김학철(Haak Cheoul Kim) 대한소화기학회 1981 대한소화기학회지 Vol.13 No.2
N/A The SGOT/SGPT ratios and r-GTP/SGPT ratios were observed in 20 cases of normal subjects as control group and 105 cases of various hepatic disease groups including 20 cases of acute viral hepatitis(A.V H ), 12 cases of chronic hepatitis(C.H.), 8 cases of chronic active hepatitis(C.A.H.), 37 cases of liver cirrhosis(L.C.), 12 cases of primary hepatoma(H.T.), 8 cases of liver abscess(L.A.) and 8 cases of gall stone. Comparison of the SGOT/SGPT and the r-GTP/SGPT between control group and various hepatic disease groups were also observed. The results were as follows; The SGOT/SGPT and the r-GTP/SGPT were l.46+-0. 32 and l.69+-0.63 in normal control group, 0.77+-0.52 and 0.50+-1.01 in A.V.H. group, 1.22+-0.63 and 2.21+-2.19 in C.H. group, 0.84+-0.38 and l.01+-1.39 in C.A.H. group, 2.05+-0.93 and 3.08+-2.56 in L,C. group, l.91+-0.98 and 4.39+-2.23 in primary H.T. group, l.20+-0.27 and 3.75+-3.38 in L.A. group and 1.25+-0.57 and 6.16+-5.38 in gall stone group. 2. The SGOT/SGPT and the r-GTP/SGPT were decreased significantly in A,V.H. and C.A.H. group and elevated significantly in L. C. and primary H.T. group, which were significance of in differentiation from other hepatic diseases groups. There were no significance in differentiation with the ratios between A.V.H. and C.A.H. group, and between primary H.T. and L.C. group. 3 Marked elevation of the r-GTP/SGPT with the elevation of the SGOT/SGPT and the alkaline phosphatase strongly suggest the progression to the cirrhosis of the liver and primary hepatoma in the clinical evolution of chronic hepatitis.
간경변 환자에서 발생한 마크로아밀라아제혈증과 마크로리파아제혈증 1예
임평숙 ( Pyoung Suk Lim ),김소영 ( So Young Kim ),염동한 ( Dong Han Yeom ),조은영 ( Eun Young Jo ),최창수 ( Chang Soo Choi ),김학철 ( Haak Cheoul Kim ),조지현 ( Ji Hyun Cho ) 대한내과학회 2008 대한내과학회지 Vol.75 No.4
저자들은 알코올성 간경변 환자에서 지속적인 마크로아밀라아제혈증과 마크로리파아제혈증으로 ACR 및 PEG test 등 간단한 선별 검사 방법으로 진단된 1예를 경험하여 문헌고찰과 함께 보고하는 바이다. Macroenzymes are high molecular weight complexes formed in the serum by self-polymerization or by association with other proteins. Macroenzymes are filtered with difficulty by normal renal glomeruli. Clinically, it is important to detect macroenzymes, because they frequently interfere with the interpretation of serum enzyme results, and as a result they can cause diagnostic and therapeutic errors. Macroamylasemia and macrolipasemia have been found to occur in apparently healthy humans, as well as in a variety of disease states, including liver disease, diabetes, cancer, malabsorption, and autoimmune disorders. We report a patient with alcoholic liver cirrhosis and macroamylasemia and macrolipasemia, the latter two of which were discovered using a screening test. (Korean J Med 75:459-462, 2008)
식도정맥류의 내시경적 결찰술 전후의 하부 식도 내압 검사의 변화
유재규(Jae Kyu Ryu),김형언(Hyeong Eon Kim),류준형(June Hyung Lyou),최석채(Suck Chei Choi),김학철(Haak Cheoul Kim) 대한내과학회 1995 대한내과학회지 Vol.48 No.6
N/A Objectives: Endoscopic injection sclerotherapy is one of the effective therapeutic modalities for treating acutely bleeding esophageal varices. However, there are a number of complications and one of them is the changes in lower esophageal motility. A recently developed method that uses small rubber bands for treating bleeding varices, endoscopic variceal ligation (EVL), may change the lower esophageal motility. This study was designed for investigating the effects on lower esophageal motility in paients with esophageal varices before and after EUL. Methods: We prospectively performed lower esophageal manometry(using 8 lumen ESMR catheter, Arndorf, Medical Specialities Inc. in 20 patients with esophageal varices to investigate the length, pressure, relaxation percent, relaxation duration of lower esophageal sphincter(LES) and the speed of peristaltic wave, contraction amplitude, contraction duration in the lower esophagus before and after EVL therapy. EVL was performed with a Pentax EG2900 fiberoptic endoscope and Stiegmann-Goffligator kit. Results: There were noted mild epigastric discomfort, nausea, chest discomfort and sinus bradycardia during and after EVL that were improved spontaneously. The EVL caused considerable diminution in the size of esophageal varix by mean 8.7(range 3-21) ligations in mean 1.8(range 1-3) sessions. LES length after EVL was 3.7±0.8cm vs 3.7±0.7cm before treatment. LES pressure after EVL was 13.1±3.9mmHg vs 12.7±6.9mmHg before treatment. LES relaxation percent after EUL was 90.5±9.6 % vs 87.8±8.1% before treatment. LES relaxation duration after EVL was 9.1±1.8sec vs 9.5±2.1 before treatment. In the lower esophagus 3cm above LES, the speed of peristaltic waves after EVL was 3.46±0.8lcm/sec us 3.1±0.8cm/sec before treatment, contraction amplitude after EVL was 87.9±44.2 vs 73.0±39.8mmHg before treatment and contraction duration after EVL was 3.3±0.5 sec vs 2.7±0.5 sec before treatment. There were no significant changes in the length, pressure, relaxation percent and duration of the lower esophageal sphincter(LES) and in the speed of peristaltic wave in the lower esophagus after EVL. There were significant differences in the contraction amplitude and duration in the lower esophagus after EVL. Conclusion: Variceal ligation therapy may improve esophageal peristalsis due to increase in the contraction amplitude and duration in the lower esophagus and cause lesser motility dysfunction in the lower esophagus. In conclusion, EVL is a safe, easy and effective therapeutic modality in patients with esophageal varices.