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건강성인군에서 Erythromycin 1회 경구투여가 담낭배출능에 미치는 영향
배영환(Young Hwan Bae),윤병철(Byung Cheol Kim),김복근(Bok Keun Kim),이병건(Byung Kun Lee),한병훈(Byung Hoon Han),안수열(Su Yul Ahn),이상욱(Sang Uk Lee),박병채(Byung Chae Park) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.1
N/A Background/Aims: The correction of gallbladder motility defect might be useful in the prevention and treatment of cbolesterol gallstones. Reciently erythromycin has been known to have motilin like effect on the motility of gastrointestinal tract and the galbladder. Therefore we examined whether and to what extent the oral administration of erythromycin combination with a test meal is able to improve gallbladder emptying in normal population by means of real time ultrasonography. Methods: Seventeen healthy volunteers(fifteen men and two women) with a mean(range) age of 28.5(26-31) years were examined by a real time ultrasonogram(Aloka Echo Camera SSD-650, 3.5-MHz transducer). Gallbladder volume was determined after 12 hours fasting, and again 30, 60, 90, 120 and 180 min after beginning the test meal that contained 700 Cal - 55% as carbohydrate, 27% as protein, and the rest as fat. One week later, gallbladder volume was rechecked with the same way as previously after administration of erythromycin at the dose of 500 mg orally 30 min before serving test meal in the same subjects. Results: Fasting gallbladder volume was 19.2 3.3 rnl. Minimal residua] volume, and minimal residual volume % were slightly lower in the procedure of test meal with erythromycin(2.1+0.7 ml, 11.2+ 4.3%) than in the procedure of test meal only(2.9 1.5 tnl, 14.9+7.7%). The time reaching at the minimal residual volume was shorter m the procedure of test meal with erythromycin(104.1 15.0 min) than in the procedure of test meal only(111.2+13.7 min), but these differences were not significant statistically. Residual volume % was lower in the procedure of test meal with erythromycin than in the procedure of test meal only at 30 min(32.9+7.0% vs 50.9+14.3%, respectively, p=0.0001), 60 rnin(18.7 5.1% vs 30.411.1%, p=0.0012), and 90 min(13.9+ 5.4% vs 19.7L-12.8%, respectively, p=0.0357) signi- ficantly, but it showed negligible difference at 120 min(12.9+6.3% v 15.7+7.6%), and no difference at 180 min(39.6+21.8% vs 39.7 14.4%) between these two procedures. Conclusions: Erythromycin showed negligible effect on lowering minimal residual volurne, minimal residual volume %, and the time reaching at the minimal residual volurne simingly, but showed strong effect on gallbladder emptying at 30 minutes, 60 minutes and 90 minutes after test meal.
만성 C 형 간염 환자에서 인터페론치료에 의한 갑상선질환의 발생
김민대(Min Dae Kim),전익수(Ik Soo jeon),강승수(Seung Su Kang),엄재섭(Jae Sup Eum),손호성(Ho Seung Son),박현용(Hyung Lyong Park),윤병철(Byung Cheol Yun),이상욱(Sang Uk Lee),한병훈(Byung Hoon Han) 대한소화기학회 2001 대한소화기학회지 Vol.37 No.6
Background/Aims: It has been suggested that hepatitis C virus is associated with the autoimmune disease and interferon also induces hepatic and non-hepatic autoimmune reaction. We conducted this study to assess the effect of interferon-alpha (INF-α) on the induction of thyroid autoantibodies and clinical thyroid disease and to know whether the thyroid autoantibodies affect the IFN-α efficacy in patients with chronic hepatitis C. Methods: Twenty-nine patients with chronic hepatitis C were enrolled. Anti-thyroglobulin antibody (ATA), anti-microsomal antibody (AMsA), thyroid stimulating hormone and free thyroxine were measured before, during, and after IFN-α therapy. Results: Two of the 29 patients (6.5%) were positive for ATA and AMsA before IFN-α therapy. Of these two patients, one patient was a woman, who showed hyperthyroidism druing IFN-α therapy. Of the 27 patients who had been negative for ATA and AMsA, one female patient became ATA positive with the development of hyperthyroidism, and 3 male patients became AMsA positive during IFN-α therapy. There was no difference in the efficacy of INF-α therapy between the thyroid autoantibody positive and negative groups. Conclusions: IFN-α therapy induced thyroid disease with high prevalence in the patients with chronic hepatis C. Thus, thyroid status should be checked even in patients without thyroid autoantibodies, especially in woman. Antithyroid autoantibodies seem unlikely to affect the efficacy of IFN-α therapy. (Korean J Gastroenterol 2001;37:436-442)
간세포암종 환자에서 간절제술 후 간부전의 예측인자로서 알부민-빌리루빈 점수의 유용성
박현준 ( Hyun Joon Park ),서광일 ( Kwang Il Seo ),김성준 ( Sung Jun Kim ),이상욱 ( Sang Uk Lee ),윤병철 ( Byung Cheol Yun ),한병훈 ( Byung Hoon Han ),신동훈 ( Dong Hoon Shin ),최영일 ( Young Il Choi ),문형환 ( Hyung Hwan Moon ) 대한소화기학회 2021 대한소화기학회지 Vol.77 No.3
Background/Aims: Post-hepatectomy liver failure (PHLF) is a major concern for patients with hepatocellular carcinoma (HCC) who have undergone liver resection. The albumin-bilirubin (ALBI) score is a novel model for assessing liver function. We aimed to investigate the effectiveness of the ALBI score as a predictor of PHLF in HCC patients who have undergone hepatectomy in South Korea. Methods: Between January 2014 and November 2018, HCC patients who underwent hepatectomy and indocyanine retention rate at 15 min (ICG-R15) test were enrolled in this study. Results: A total of 101 patients diagnosed with HCC underwent hepatectomy. Thirty-two patients (31.7%) experienced PHLF. The ALBI score (OR 2.83; 95% CI 1.22-6.55; p=0.015), ICG-R15 (OR 1.07; 95% CI 1.02-1.12; p=0.007) and ALBI grade (OR 2,86; 95% CI 1.08-7.58; p=0.035) were identified as independent predictors of PHLF by multivariable analysis. The area under the receiver operating characteristic curve of the ALBI score and ICG-R15 were 0.676 (95% CI 0.566-0.785) and 0.632 (95% CI 0.513-0.752), respectively. The optimal cutoff value of the ALBI score in predicting PHLF was -2.62, with a sensitivity of 75.0% and a specificity of 56.5%. Conclusions: The ALBI score is an effective predictor of PHLF in patients with HCC, and its predictive ability is comparable to that of ICG-R15. (Korean J Gastroenterol 2021;77:115-122)
증례 : 소화기 ; 자가면역성 간염과 동반된 전신성 홍반성 낭창 및 원발성 쇼그렌 증후군
이규진 ( Gyu Jin Lee ),최정민 ( Jung Min Choi ),한병훈 ( Byung Hoon Han ),이상욱 ( Sang Uk Lee ),윤병철 ( Byung Cheol Yun ),김근태 ( Geun Tae Kim ),허방 ( Bang Hur ) 대한내과학회 2011 대한내과학회지 Vol.80 No.6
저자들은 황달 및 가려움증을 호소하는 52세 여자와 60세 여자에서 각각 자가면역성 간염과 동반된 전신성 홍반성 낭창과 원발성 쇼그렌 증후군을 경험하여 문헌고찰과 함께 보고하고자 한다. Autoimmune hepatitis is a generally progressive chronic hepatitis of unknown etiology. Systemic lupus erythematosus (SLE) and Sjogren`s syndrome are chronic, multifaceted inflammatory diseases that can affect every organ system, although hepatic involvement is rare. Here, we report two rare cases: autoimmune hepatitis associated with SLE and with primary Sjogren`s syndrome. A 52-year-old woman and a 60-year-old woman were admitted our hospital with jaundice and pruritus. They had no history of viral hepatitis, alcohol consumption, or drug use. The pathological findings, clinical manifestations, and laboratory findings satisfied each of the diagnostic criteria for autoimmune hepatitis as well as for SLE and Sjogren`s syndrome in the first and second cases, respectively. These patients were treated with prednisolone, and then followed regularly. (Korean J Med 2011;80:697-702)
송인성(I S Song),최규완(K W Choi),김정룡(C Y Kim),정현채(H C Jung),윤용범(Y B Yoon),양석균(S K Yang),임용철(Y C Lim),윤병철(Byung Cheol Kim),노임환(I H Roe),유권(K Yoo) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4
N/A A total of 486 cases of upper gastrointestinal bleeding admitted to Seoul National University Hospital via emergency room from Jan. 1986 to Jun. 1988 were clinically reviewed and the following results were obtained: 1) The male to female ratio was 4.7:1 and peak incidence was in the 6th and 5th decades. The sex and age had no prognostic value. 2) The causes of bleeding were esophageal varix (35.2%), gastric ulcer (17.7%), duodenal ulcer (13.4%), stomach cancer (6.6%), gastritis (5.15), Mallory-Weiss syndrome (2.7gp), miscellaneous causes (l.0%), and unknown causes (18.3%). Variceal bleeders had the highest mortality rate. 3) There was no past history of bleeding in 61.5% overall, and it had no prognostic value. But variceal bleeders had past history of bleeding in, 50.3% and the first episode of bleeding offered higher mortality rate. 4) Three types of bleeding hefore admission were hematemesis in 27.85, melena in 25.7% and both of them in 46.5%, which had no prognostic value if variceal and nonvariceal bleeders were considered respectively. 5) Systolic blood pressure and pulse rate had some prognostic value, that is, high pulse rate on admission carried higher morthalty rate in variceal bleeders and low systolic blood pressure did in nonvariceal bleeders. 6) The three patterns of bleeding after admission were single bleeding in 63.0%, repeated bleeding in 21.0% and continuous bleeding in 16.0%. The mortality rate of repeated and continuous bleeding was higher than that of single bleeding. 7) The patients who received transfusion were 86.8% and the amount of blood transfused was more than 10 pints in 24.1%. The mortality rate increased as the amount of blood transfused increased. 8) Esophageal varix ivas the cause of the first bleeding in 76.4% of patients with chronic liver disease with esophageal varix. If the cause of the first bleeding was the esophageal varix in patients with chronic liver disease with esophageal varix, the cause of the second bleeding was also esophageal varix in 93.5%.