만성간질환에서의 혈청 procollagen 1/3 propeptides 농도비 측정의 의의

유용걸(Yong Keol Yoo),이숭환(Soong Hwan Lee),김병훈(Byoung Hun Kim),조영중(Young Jung Cho),백인규(In Kyu Paik),유병무(Byeong Moo Yoo),이오영(Oh Young Lee),한동수(Dong Soo Han),손주현(Joo Hyun Sohn),최호순(Ho Soon Choi),이동후(Dong Ho 대한소화기학회 1996 대한소화기학회지 Vol.28 No.6

N/A Background/Aims: Most of Ihe chronic liver diseases of variable etiologies are accompanied by a pathobiochemical reaction So-called fibrosis. Liver fibrosis was recently recognized as all the complexity of dynamic changes of the hepatic extracellular matrix(ECM). And ECM consists of four major components: collagen, glycoprotein such as fibronectin and laminin, proteoglycan, and elastin. Among these, collagen I and III are the representatives of disproportion of synthesis and degradation in conjunction with fibrogenesis. To elucidate the clinical significance of procollagen propeptide I(PICP) and III(PIIINP) measurements among the sera out of patients with chronic liver diseases, radioimmunoassay 4vas employed in this investigation. Methods: Sera tested were obtained from pathologically-proven 54 patients; 4 cases of fatty liver, 11 cases of chronic persistent hepatitis, 13 cases df chronic active hepatitis, 15 cases of liver cirrhosis and 11 cases of hepatocellular carcinoma. All:the patients except 4 cases of fatty liver were shown positivity of HBsAg. PICP and PIIINP radioimmunoassay kits(Farmos Diagnostica, Oulunsalo, Finland)were purchased for this study. ResOlts: PICP concentration (mean+standard error) was highest in liver cirrhosis (280.06>39,83 pg/L). PICP in liver cirrhosis was significantly elevated in cornparison to that (109.30+14.58) in fatty:liver(p=0.045), that (122.22>10.26) in chronic persistent hepatitis (p=0.003), and that (158.59>21.58) in chronic active hepatitis(p=0.016), PICP in hepatocellular carcinoma was decreased to 1'94.05+ 29.89. Similarly, PIIINP concentration revealed highest level in liver cirrhosis(17.29+3.58 pg/L). This value was significantly higher than that of chronic persistent hepatitis(5.12+0.59)(p=0.008). Contrarily to these results, concentration ratio of PICP/PIIINP was high in fatty liver (29.27>6.29) and chronic persistent hepatitis (25.04+2.00), These value were statistically higher than that of chronic active hepatitis (17.632.67) (p=0.043). PICP/PIIINP ratio in liver cirrhosis (21.58+3.29) showed no statistical difference. Conclusions: On the basis of these data, it is suggested that the elevation of PICP and PIIINP in the sera of the patients with chronic liver diseases means emerging the liver cirrhosis. And the ratio of these markers can be helpful in differential diagnosis of chronic liver diseases. (Korean J Gastroenterol 1996; 28:815-823)

폐 호산구성 유아종 2예

최완영 ( Wan Young Choi ),유용걸 ( Yong Keol Yoo ),박동일 ( Dong Il Park ),신동호 ( Dong Ho Shin ),박성수 ( Sung Soo Park ),이정희 ( Jung Hee Lee ),전석철 ( Seok Chul Jeon ),정원상 ( Won Sang Chung ),박찬필 ( Chan Pil Park ),박문 대한결핵 및 호흡기학회 1992 Tuberculosis and Respiratory Diseases Vol.39 No.2

한국인 담석중의 특성 및 변화에 대한 임상적 고찰

함준수(Joon Soo Hahm),이옥찬(Ock Chan Lee),박경근(Kyung Geun Park),유용걸(Yong Keol Yoo),손주현(Joo Hyun Sohn),한동수(Dong Soo Han),윤병철(Byul Chul Yun),이민호(Min Ho Lee),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park) 대한내과학회 1994 대한내과학회지 Vol.47 No.4

N/A Objectives: The incidence of gallstone disease seems to be increasing and the composition of stone has been changed in Korea. Therefore, a collective review of 4, 491 gallstone patients during the last twenty years from january 1973 to December 1992 were carried out at Hanyang university hospital, Seoul, Korea. Methods: The total prevalence of localization, physicochemical characteristics, blood type, associated diseases, and the composition of stones were evaluated retrospectively. The statistical analysis was evaluated by Student`s t-test. Results: 1) The prevalence among total hospitalized patient was 1.1% and showed increasing tendency annually. 2) The prevalence increased with age, reaching peak in 50 and the male/female ratio was 1:1.13 3) The prominent clinical manifestations included biliary pain (50.64%), fatty food intolerance (17.14%), jaundice (14.69%), and vomiting (11.73%). 4) The associated diseases were diabetes mellitus (29%), hypertension, chronic liver disease, pancreatitis, and Clonorchiasis. 5) The pigment stones were more prevalent than cholesterol stones (2.5:1), However, cholesterol stones seemed to be increasing gradually. Conclusion: These results indicate that most gallstones are pigment stones in Korea. However, the incidence of cholesterol stone seems to be increasing, and the overall incidence of gallstone disease is throught to be increasing annually.

갑상선결절을 가장하는 전경부 지방종 1 예

김인순,김호중,안유헌,이동석,유용걸,김목현,정철현,이옥찬,조온구 대한내분비학회 1994 Endocrinology and metabolism Vol.9 No.1

Lipomas are among the most common of all benign neoplasma and occur more frequently over the back, between the shoulders, and on the back of the neck. They are usually subcutaneous in origin, and characteristically multilobulated masses of fatty tissue that vary from small nodules to large masses weighing several kilograms. A mass in the anterior part of the neck may be initially thought to be thyroid nodules and then other cervical masses should be considered. Ultrasonographic examination of benign lipoma demonstrates solid and echogenic mass and may differentiate nonthyroid from thyroid masses. When lipoma is clinically suspected, the use of CTs can establish the correct diagnosis without the use of thyroid hormone suppression or the need for urgent surgery. We experienced a case of anterior cervical mass in a 51-year-old male patient presenting a non-tender and soft mass rapidly growing for recent several months and moved with swollowing, and diagnosed his case as benign lipoma using ultrasonography, computed tomographic scan, and fine niddle asperation biopsy and therefore when we encounter patients with anterior neck mass, we should consider benign lipoma mimicking thyroid nodule(J Kor Soc Endocrinol 9:32-34, 1994).

아급성 갑상선염양 증후군을 갖는 갑상선유전분증

김정호,김인순,안유헌,유용걸,김목현,손정일,고영혜,윤석남 대한내과학회 1994 대한내과학회지 Vol.47 No.4

Amyloidosis is a disease of unknown cause characterized by the accumulation of an amorphous, proteinaceous material in various organs and tissue of the body. We had recently experienced a 31-year-old man presented with subacute thyroiditis like symptoms, diarrhea and proteinuria. He had tender, diffuse, firm goiter, low normal limit of thyroid function, and increased erythyrocyte sedimentation rate. On the basis of history, clinical settings, and laboratory findings, the diagnosis of subacute thyroiditis was initially made. Steroid therapy resulted in dramatic improvement of thyroid symptoms, Histological examinations of the patient's thyroid gland, colon and kidney revealed amyloid deposition. Retrospectively, we concluded that amyloid depasition in thyroid gland, colon, and kidney was secondary to ankylosing spondylitis from which he had suffered for 14 years. He has achieved clinical improvement with steroid and thyroid hormone replacement therapy and being followed-up. In conclusion, when patients with clinical features of subacute thyroiditis have an unusual course, the possibility of thyroid amyloidosis should be considered.

Diethylnitrosamine 으로 유도된 간암발생 과정에서의 γ - Glutamyl Transpeptidase 양성 병소에 대한 입체형태학적 분석 연구

김성우,김종철,김희수,김병훈,김홍주,박동일,이동후,이숭환,남승우,감창우,유용걸,양성규 대한간학회 1998 Clinical and Molecular Hepatology(대한간학회지) Vol.4 No.1

Background/Aim - Hepatocarcinogenesis of microscopically altered foci could be shown to be progressed into a trabecular pattern of hepatocellular carcinoma. And it is reported that down-regulation of TGF beta II receptor and up-regulation of TGF alpha and c-myc reveal the progression of diethylnitrosamine-induced foci into liver cell cancer. Up-regulation of TGF beta II receptor, however, causes apoptosis of foci. To determine characteristic morphology and growth kinetics of putatively precancerous y glutamyl transpeptidase (GGT) positive foci and hyperplastic nodules, a stereological quantification was attempted in the Peraino's neonatal rat model initiated by diethylnitrosamine and promoted by phenobarbital. Materials/Methods - Fifteen Sprague-Dawley rats were I.p. injected with 0.15 pmole/g of body weight of diethylnitrosamine mixed in corn oil at one day after birth. From weaning at 4 weeks of life, the rats were continuously fed 0.035% phenobarbital in drinking water and sacrified 5 rats at each time point of 8 weeks, 16 weeks, and 32 weeks. Teklad standard diet was fed after weaning. The livers obtained were fixed in freshly prepared, cold ethanol-acetic acid (99:1 vo1%). For the GGT histochemical staining, Rutenberg's method was modified, and counterstained with H & E or toluidine blue. For the stereological analysis GGT positive foci and nodules were traced in 200 consecutive tissue sections and quantified the 3 dimensional volumes by computer assisted planimetry. Either spheroidal or non-spheroidal morphology was determined by parabola 2nd degree equation ' y=ax+bx+c (sphere a=-P,). Results - Thirty nine (55.71%) out of 70 representative lesions were nonspheroidal. Especially at 8 weeks, the 28 out of 40 GGT positive foci were irregular, nonspheroidal shape. Later times, however, GGT positive foci and reprogrammed nodular lesions were become spheroidal. Lilliefors probabilities test for spheroidal frequency was statistically significant (p$lt;0.05). Conclusion ' Stereologically non-spheroidal characteristics of the early GGT positive foci limit growth kinetic estimation by 3 dimensional volume quantitation but permit in later times in spheroidal, GGT positive foci and reprogrammed nodules showing fade-out of GGT activity. In other words, GGT positive foci may be clonally selected for growing into hyperplastic nodules and hepatocellular carcinoma or regressed by apoptosis. (Korean J Hepatol 1998;8:46 - 58) hyperplastic nodules and hepatocellular carcinoma or regressed by apoptosis. (Korean J Hepatol 1998;8:46 - 58)