간세포암종 진료 가이드라인

박중원 ( Joong Won Park ) 대한간암연구회 2003 대한간암학회지 Vol.3 No.-

B형 간염바이러스 표면항원과 항체가 동시에 발현된 만성 간염 환자에서 표면항원 `a` 결정기 유전자의 변이

박중원(Joong won Park),윤정환(Jung Hwan Yoon),황유진(You Jin Hwang),이효석(Hyo Suk Lee),김정룡(Chung Yong Kim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.2

N/A Background/Aims: A humoral escape mutant of hepatitis B virus(HBV) having mutations at HBsAg a' determinant has been found in patients with concurrent HBsAg and anti-HBs in sera. This study was undertaken to investigate whether such a variant was involved in Korean patients with chronic hepatitis B, Methods: We conducted an analysis of sequences of DNA encoding the HBsAg a' determinant in six chronic hepatitis B patients with concurrent HBsAg an6 anti-HBs positivity, and in three HBsAg-positive controls without anti-HBs in sera. One of the six cases 4ad received long-term hepatitis B immunoglobulin treatment after liver transplantation and five were chronic hepatitis B patients with naturally occurring concurrent HBsAg and anti-HBs. HBV DNA extracted from sera of nine patients was amplified and sequenced within the S gene encoding the a' determinant. Results: HBVs from three controls had no rnutations in the a determinant. Six patients with concurrent HBsAg and anti-HBs had point mutations in the S gene encoding the a' determinant. A liver-transplanted patient had substitutions at nucleotide 587(arginine for glycine at aa 143) and nucleotide 561(tyrosine for serine at aa 136) of the S gene. All of the five patients with naturally occurring concurrent HBsAg and anti-HBs had a substitution at nucleotide 531(serine for isoleucine at aa 126) and four of five had substitutions at nucleoti<le 546 and 552(asparagine for threonine at aa 131 and threonine for methionine at aa 133). One case had three consecutive substitutions at nucleotide 554, 555, 556(arginine for phenylalanine at aa 134). Conclusions: These results demonstrated the presence of mutations at HBsAg a detenninant in Korean chronic hepatitis B patients with concurrent HBsAg and anti-HBs. (Korean J (astroente- rol 1997;29:182 - 191)

간세포암종 개관과 현황

박중원 ( Joong Won Park ) 대한소화기학회 2005 대한소화기학회지 Vol.45 No.4

Hepatocellular carcinoma (HCC) is a highly malignant, generally fatal neoplasm arising from hepatocytes. HCC accounts for over 80% of all primary liver cancers which ranks fourth among the organ-specific causes of cancer-related deaths worldwide. HCC is p

만성 B형 간염환자에서 재조합형 알파 인터페론 저용량 단기 치료법의 효과

박중원(Joong won Park),유병철(Byung Chul Yoo),박실무(Sil Moo Park) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.1

N/A Background/Aims: We planed the study to cvaluate the effect of low dose, short term therapy of recombinant alpha-interferon(IFN) in patients with chronic hepatitis B. Methods: Seventy two patients treated with IFN and 32 controls were included in the study. All l04 patients had serum HBsAg, HBeAg and biopsy proven chronic hepatitis B. The treated group received alpha IFN 2a 300 million units daily for four weeks, total 8400 million units. Effects of therapy on aminotransferase activities and HBsAg, HBeAg, anti-Hbe status in serum was monitored. The criterion of complete response was loss of serum HBeAg and normalization of serum aspartate aminotransferase(AST)/alanin aminotransferase(ALT), that of partial response was loss of serum HBeAg or normalization of serum AST/ALT within 8 weeks after IFN trial. The mean follow-up period was 20.6 months(treated group)and 45.8 months(control). Results: The complete responders were 18 patients(25%), the partial responders 24 patients(33.3%) and the non- responders 30 patients(41.7/o). The only difference between tbe responders and the non-responders in clincal features was AST activity. Loss of serum HBeAg within 8 weeks after IFN trial occurred in 23(3l.9%) patients and 13(l8.1%) patients had anti-Hbe seroconversion within 3 months after IFN trial. Eleven patients(l5.3%) of complete responders had normal AST/ALT for mean J9.2 months. Two of Eleven percents patients had scrum anti-HBs. Within mean 20.6 month follow-up period, 34(47.2%) patients had serum anti-Hbe and l9(26.4%) patients had that for more than 12 months. Thirty four of 72(47.2%) patients receiving interferon responded by anti-Hbe seroconversion within mean 20.6 months, compared to 13 of 32(40%) controls within 45.8 months(p<0.01). Conclusions: These findings indicate that a short course(4 weeks) of low dose recombinant alpha-interferon can induce an anti-Hbe seroconversion and an improvement of serum aminotransferase activities for significant duration in approximately one-fourth or fifth of treated patients with chronic hepatitis B and that low dose, short term recombinant IFN therapy is useful and alternative method in treatment of chronic hepatitis B. (Korean J Gastroenterol 1995;27:55-63)

SV 40 Large T 유전자를 이용해 불멸화시킨 사람 태아 간세포주의 확립

박중원(Joong Won Park),이주영(Joo Young Lee),이효석(Hyo Suk Lee),박주배(Joo Bae Park),김정룡(Chung Yong Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.4

N/A Background: Hepatocyte culture represents a cell model for analyzing the mechanism involved in car- cinogenesis of carcinogens, a tool for measuring hepatotoxicity of drugs and a simple model for studying hepatitis virus life cycle. However, problems raised by both the short-term survival and the poor functional stability of hepatocytes in culture hindered scientist in using of this in vitro system. Thus we planed to obtain the immortalized and differentiated human hepatocyte cell line by modifying the genome by transfecting the cells with viral specific DNA, always available in studying the liver disease. Method: After primary culture of hepatocytes obtained by therapeutic abortion at 18 weeks of gestation, SV40 large T gene was transfected into the cells by using Polybren-DMSO method, And then transfected hepatocytes were selected in G418 containing medium. Selected, transformed hepatocytes were subcultured in 10% fetal bovine serum containg F-12 medium. Morphological characteristics of subcultured cells was followed by phase-contrast microscope and electoron microscope. The immunocytochemisty using anti-human albumin and anti-human alpha fetoprotein and the immunofluorescence using snti-SV40 T antigen were performed for proving the differentiation of sub-cultured hepatocytes. Results: Electron microscope revealed subcultured cell to be epithelial cell. After more than 20 passages over a period of 7 months, the cells retained an epitheloid morphology. All the SV40 transformed hepatocyte cell lines were 100% positive for T antigen. Significant anti-alpha fetoprotein staining and week anti-albumin staining were observed in cytoplasm around nucleus and so we confirmed the synthesis of liver specific protein of transformed hepatocytes, Conclusion: Human fetal immortalized hepatocytes cell line secreting the liver specific proteins was established.

진행성 간세포암종 및 전이된 간세포암종의 내과적 치료

박중원 ( Joong Won Park ),김학균 ( Hark Kyun Kim ) 대한간암학회 2002 대한간암학회지 Vol.2 No.-

간세포암종의 표적치료제

박중원 ( Joong Won Park ) 대한간암학회 2008 대한간암학회지 Vol.8 No.-

간암 진료가이드라인의 현재와 전망

김보현,박중원,Bo Hyun Kim,Joong-Won Park 대한소화기암연구학회 2016 Journal of digestive cancer reports Vol.4 No.1

Hepatocellular carcinoma (HCC) is rather unique. Most of HCC patients have underlying chronic liver diseases with or without cirrhosis and the prognosis of HCC depends on the liver function, as well as the tumor extent. Non-invasive diagnosis of HCC can be made with certain risk factors and specific imaging findings (e.g. hypervascularity). Patients with HCC can receive surgical resection, radiotherapy, and systemic chemotherapy as other solid malignancies. HCC has more treatment options such as liver transplantation, transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). A variety of practice guidelines for HCC has been published by many academic societies. Different healthcare systems and availability of resources also affect the practice guidelines; therefore, practice guidelines have similarities and dissimilarities. Herein, we review the current status of practice guidelines for HCC and future perspectives for the improvement of guidelines are also discussed.

성인에서 발생한 우유 알레르기

이용원 ( Yong Won Lee ),이재현 ( Jae Hyun Lee ),이중민 ( Joong Min Lee ),김병창 ( Byung Chang Kim ),김지현 ( Jie Hyun Kim ),김혜진 ( Hye Jin Kim ),최수영 ( Soo Young Choi ),박중원 ( Jung Won Park ),홍천수 ( Chein Soo Hong ) 대한천식알레르기학회 2004 천식 및 알레르기 Vol.24 No.3

소침습적 관상동맥우회술

나찬영,이영탁,박중원,정도현,정일상,정윤섭,김욱성,방정현,이섭,정철현,김웅한,박영관,김종환,홍승록,한재진,이건,Na, Chan-Young,Lee, Young-Tak,Park. Joong-Won,Chung, Do-Hyun,Jung, Ill-Sang,Jung, Yoon-Seup,Kim, Ok-Sung,Bang, Jung-Hyun,Lee, Sub,Chung, C 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery (J Chest Surg) Vol.31 No.2

관상동맥우회술은 인공심폐기 및 심근보호의 안정성으로 인공심폐기 사용하에 시행하는 것이 보편화된 방법이다. 그러나 좌전하행지 및 우관상동맥에 병소가 위치하는 경우는 인공심폐기의 사용 없이 심장이 박동하는 상태에서 관상동맥우회술을 시행하는 방법도 일부에서는 시행되어 왔으며 최근에는 최소한의 절개하에서 관상동맥우회술을 시행하는 방법도 대두되었다. 본 병원에서는 1996년 3월부터 8월까지 시행한 35례의 관상동맥우회술중 6례에서 인공심폐기를 사용하지 않고 관상동맥우회술을 시행하였다. 환자는 남자 4례와 여자 2례였으며 나이는 55세에서 76세로 평균 64세였다. 수술전 관상동맥의 병소는 6례 모두 좌전하행지에 90%이상의 협착을 보였으며 1례는 대각지가 50%, 또 다른 1례에서는 좌주관상동맥이 50%정도의 협착을 동시에 보였다. 수술에 필요한 개흉방법은 통상적인 정중흉골절개가 1례, 부분흉골절개술을 시행한 경우가 2례, 좌측전흉부를 개흉한 경우가 3례였다. 관상동맥우회술은 5례에서 좌측내흉동맥을 좌전하행지에 문합하였으며, 1례에서는 좌측내흉동맥에 요골동맥편을 단단문합한후 좌전하행지에 문합하였다. 또한 1례는 복재정맥을 이용하여 대각지에도 동시에 우회술을 시행하였다. 수술후 기관발관시간은 4시간에서 14시간으로 평균 9시간이었다. 수술에 사용한 혈액의 양은 평균 800 ml였으며 2례에서는 전혀 혈액을 사용하지 않았다. 이들중 5례에서 수술후 추적관상동맥조영술을 술후 7일에서 10일사이에 시행하여 100%의 개통율을 보였다. 결론적으로 좌전하행지나 우관상동맥에 협착이 있는 경우나 상기병소에 경피적풍선확장술이 실패한 경우에 인공심폐기를 사용하지 않고 최소한의 개흉하에 관상동맥우회술을 시행하는 것도 하나의 방법이라 사료되며 앞으로 기술적 발전과 더불어 적응대상군이 증가할 것으로 판단된다.32, 88.67$\pm$10.22 mmHg로 감소하였고 폐동맥압의 평균은 수술전에 11.4$\pm$5.68 mmHg에서 25.94$\pm$11.53, 29.67$\pm$9.31 mmHg로 증가 하였으나 모두 통계적 의의는 없었다(p>0.05). 양측 폐이식수술에서인 폐동정맥문합부위의 파열, 협착, 뒤틀림 등의 수술수기상의 문제점을 예방하면서 우측폐를 먼저 이식하면서, 폐수술시야를 충분히 확보하고, 재관류손상을 방지하는 경우 cystic fibrosis, pulmonary hypertention, emphysema와 같은 심한 호흡부전증 환자의 치료방법으로 적합하리라 사료된다.에서 선택수술 (elective coronary artery bypass graft)에 비하여 특별한 위험 요소의 증가 관상 동맥 우회술을 적용하여 좋은 결과를 얻을 수 있었으며 이들에 대한 장기 추적이 릴요할 된다.착군에 비하여 의미있게 작았는데 이는 아마도수술 당시 협 착 부위의 완전제거가 이루어지지 않은 것이 원인이라고 사료되었다. 본 분석에서는 어린 연령(3개월 이하), 3개월이하에 시행한 쇄골하동맥편 교약성형술이 의미있는 재협착의 위험요소로 밝혀졌다. 결론 적으로 저자등은 본연구를 통하여 대동맥협부지수, 횡대동맥 지수 등이 개개 대동맥교약 환아의 해부학 적, 임상적 특징을 파악하는데 도움이 되는 도구라는 사실을 발견하였고 아울러 교약의 해부학적 특성, 동반 심기 형, 연령, 수술방법 등이 수술사망 및 재협착에 영향한다는 사실을 입증하였다.t was resulted from increase of weight of single cocoon. "Manta"2.5ppm produced 22.2kg of cocoon. It is equal Minimally invasive coronary artery bypass grafting without using cardiopulmonary bypass (CPB) is a recently accepted modality of myocardial revascularization prcedures which is particularly suitable to the patients with lesions in the left anterior descending(LAD) and the right coronary arteries. Of the consecutive 35 patients of coronary artery bypass grafting performed at Sejong General Hospital from March to August 1996, six patients underwent minimally invasive coronary artery bypass grafting without CPB. All had stenotic lesions of the LAD more than 90%. Bypass grafting of the LAD was approached through midline sternotomy in one, through ministernotomy in two, and through limited left anterior thoracotomy in three patients, respectively. The internal mammary arteries were prepared without the use of thoracoscope. The mobilized mammary arteries were connected directly to the LAD in 5 patients, and the anastomosis required interposition of a segment of the radial artery in the remaining one. The diagonal branch was revascularized with the saphenous vein graft at the same time in one patient. No blood transfusion was necessary in 2 patients, and average blood required during surgery was 800ml in 4 patients. All patients were extubated from 4 to 14 hours(mean 9 hours) after operation. Early postoperative coronary angiography in 5 patients between 7 and 10 days after surgery has proved full patency of the grafts. With these limited clinical experiences, the clinical results demonstrated that minimally invasive coronary artery bypass grafting without CPB is an useful procedure especially in patients with isolated lesion in the proximal LAD.