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Cytochrome P-4501A1 ( CYP1A1 ) 의 유전적다형성이 췌장암 발생에 미치는 영향
이한주(Han Chu Lee),윤용범(Young Bum Yoon),김정룡(Chung Yong Kim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.4
N/A Rackground/Aims: Cigarette smoking is the best-established risk factor for pancreatic cancer. Metabolic activation is a prerequisite for the carcinogenic effect of many carcinogens, and the CYP1A1 activates polycyclic aromatic hydrocarbons in smoke. Genetic polymorphisms of the CYP1AI have been shown to be related to inter-individual variation in metabolic activation of carcinogens and to increased susceptibilitv to lung cancer. The aim of this study was to clarify the association between genetic polymorphisms of the CYP1Al and tbe susceptibility to pancreatic cancer, another smoking-related cancer. Methods: We analyzed 45 samples from patients with pancreatic cancer (28 males, 17 females) and 53 samples from controls. DNA was isolated from blood samples and the CYP1A1 gene was amplified by PCR. Analyzing the genotypes of the CYP1A1 by allele-specific PCR or RFLP analysis, we assessed the mutant allele frequencies of the CYP1Al among cases and controls. Results: (1) The allele frequencies for mutation in the 3-flanking region of the CYP1A1 (ml) among cases and controls were 0.31 and 0.36, respectively. (2) The allele frequencies for exon 7 mutation of the CYP1A1 (m2) were 0.16 and 0,235, respectively, with no statistical significance. (3) There was no difference iin the mutant allele frequencies of the CYP1A1 among smokers and non-smokers in patients with pancreatic cancer. Conclusions: No association was found between genetic polytnorphisms of the CYP1A1 and the susceptibility to pancreatic cancer. (Korean J Gastroenterol 1997; 29:522-529)
라미부딘 내성 만성 B형 간염 환자에서 라미부딘과 아데포비어 병합요법
이한주 ( Han Chu Lee ) 대한내과학회 2009 대한내과학회지 Vol.77 No.6
The introduction of lamivudine (LAM) has opened a new era for the treatment of chronic hepatitis B (CHB). However, the major drawback of LAM, which currently limits its use as first-line therapy, is the high rate of occurrence of drug resistance. In patients with LAM-resistant CHB, recent long-term findings have indicated that adding adefovir (ADV) to ongoing LAM therapy was more beneficial than switching to ADV alone, because the former showed a diminished rate of resistance to ADV with a well-tolerated safety profile. Above all, the most important strategy for CHB treatment must be to use a potent first-line antiviral with high genetic barriers to resistance in order to prevent the development of multidrug resistance. (Korean J Med 77:713-715, 2009)
괴상형 간세포암(Massive Hepatocellular Carcinoma)을 치료할 것인가? Cons
이한주 ( Han Chu Lee ) 대한간암학회 2009 대한간암학회지 Vol.9 No.-
Massive hepatocellular carcinoma (HCC) is defined as a tumor(s) involving 1 segment or more, with indistinct boundary in ≥50% of margins. There have been only few studies regarding the treatment response in patients with massive HCC. Therefore, in this review, the author focused on the treatment response in HCC of ≥10 cm in size. Reported survival rates after surgical resection are 61~66% at 1 year, 38~44% at 3 years, and 28~31% at 5 years. However, surgical resection is usually performed in patients with solitary tumor and good hepatic reserve function, and without gross vascular invasion. In addition, it was reported that surgical complication rate or mortality increases in tumors of ≥10 cm. Therefore, these data do not represent the outcome after surgical resection in patients with massive HCC. Transarterial chemoembolization (TACE) can induce objective response in about 65% of patients with HCC(s) of ≥10 cm according to modified EASL criteria. However, frequent intra- and extra-hepatic metastases are unavoidable and the survival rate was 43% at 1 year and 20% at 2 years. Of note, 11% of cases suffered from serious adverse effects such as renal impairment, sepsis and/or hepatic failure after TACE. Recently, sorafenib has been shown to increase patient`s survival, but the survival benefit is not still satisfactory. Other systemic chemotherapies using various combinations of cytotoxic agents usually show 10-20% of objective response, but there has been no evidence that it can prolong overall patient`s survival. There also has been no evidence that intra-arterial chemotherapy with or without implantable drug delivery system is superior to conventional chemotherapy or can prolong patient`s survival. In summary, treatment response in large HCC(s) is not still satisfactory and treatment-related adverse effects are considerable. Therefore, treatment should be performed in well-selected patients.
표승일 ( Seung Il Pyo ),이한주 ( Han Chu Lee ),서동대 ( Dong Dae Seo ),신정우 ( Jung Woo Shin ),류수형 ( Soo Hyung Ryu ),박영환 ( Young Hwan Park ),정영화 ( Young Hwa Chung ),이영상 ( Yung Sang Lee ),유은실 ( Eun Sil Yu ),서동진 ( 대한내과학회 2003 대한내과학회지 Vol.64 No.1
목적 : 자가 면역성 간질환에는 AIH, PBC, 중복 증후군, AIC, PSC 등이 있으며, 면역학적 기전에 의해서 발생한다고 알려졌고, 약물 치료로 호전되는 경우가 많아 임상적 중요성을 갖는다. 저자 등은 한국인에서 자가 면역성 간질환들의 임상 양상 및 치료에 대한 반응을 알아보고, 질환들 간에 임상양상, 생화학적지표, 혈청학적 지표 및 조직소견을 비교해보고자 본 연구를 시행하였다. 방법 : 1990년 1월부터 2001년 3월까지 서울아산병원에서, Background : Autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), primary biliary cirrhosis (PBC), and autoimmune cholangiopathy (AIC) are major classes of liver diseases currently considered autoimmune. We investigated the clinical, biochemi
사례보고 : 중증 간질환을 동반한 적혈구조혈성 포르피린증 환자에서의 cholestyramine 치료: 사례보고
유동준 ( Dong Jun Yoo ),이한주 ( Han Chu Lee ),유은실 ( Eunsil Yu ),진영주 ( Young Joo Jin ),심주현 ( Ju Hyun Shim ),김강모 ( Kang Mo Kim ),임영석 ( Young Suk Lim ),정영화 ( Young Hwa Chung ),이영상 ( Yung Sang Lee ),서동진 ( Dong 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.1
EPP는 ferrochelatase의 결핍이나 활성 감소로 프로토포르피린이 적혈구, 간, 혈장 등에 축적되는 유전질환이다 축적된 프로토포르피린은 EPP의 주된 임상적 특징인 광과민 증상과 간질환을 일으키게 된다. EPP로 인한 간질환에 대해 다양한 치료법이 개발되고 있으나, 효과적인 치료 방법은 아직 없다. 그 중 cholestyramine resion의 유용성에 대한 보고는 드물며, 다른 치료와 같이 대부분 사용되었다. 저자들은 cholestyramine resion의 단독치료로 성공적인 결과를 나타낸 사례를 보고하는 바이다. 향후 EPP로 인한 간질환의 증상 및 예후 개선을 위해서, 이번 사례를 포함한 더 많은 연구가 필요하다. Erythropoietic protoporphyria (EPP) is a rare disorder of heme biosynthesis caused by mutations in the gene encoding the enzyme ferrochelatase. In EPP, deficient ferrochelatase activity leads to the excessive production and biliary excretion of protoporphyrin (PP). The major clinical features of EPP are photosensitivity and hepatobiliary disease that may progress to severe liver disease, that are caused by the toxicity of PP. EPP-related liver disease has been treated medically or surgically including liver transplantation. We described a 20-year-old male with severe liver disease who was diagnosed with EPP based on clinical and laboratory findings. He was treated with cholestyramine resin. Six months after the treatment, he was doing well without any abdominal pain or photosensitivity. (Korean J Hepatol 2010;16:83-88)