HBe 항원 양성 만성활동성간염에서 베타 인터페론의 효과

정규원(Kyu Won Chung),정환국(Whan Kook Chung),선희식(Hee Sik Sun),김부성(Boo Sung Kim),정인식(In Sik Chung),안병민(Byung Min Ahn),김재광(Jae Kwang Kim) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4

N/A The lack of an effective drug against chronic type B virus infection has led to trials of variety of antiviral drugs. Among these drugs interferon has shown more encouraging results. In all studies, greater HBeAg to anti-HBe seroconversion rates occurred in treated patients than in control. The reason for the use of interferon in this disease is the effectiveness as an antiviral activity. More recently its activity has heen extended as an immunomodulating drug in the immune response. The purpose of this study was to elucidate the effect of human fibroblast interferon (β-interferon) in Korean HBsAg positive chronic active hepatitis. We has conducted therapeutic trial with total l02 X1000000 IU of beta-interferon for 28 days in fifteen cases with needle aspiration biopsy proven chronic activc heaptitis. 1) Six patients (40.0%) lost HBeAg in the serum and four of these patients (26.7%) were seroconverted to anti-HBe after β-interferon therapy. And two patients expressed anti-HBe without loss of HBeAg. However, none of the patients lost HBsAg during the study peroid. 2) The serun ALT began to increased significantly (p<0.05) from the 7th day of interferon therapy and reached its maxinauin level on 10th day of therapy, and then continued to decrease to the level below the pretreatment level in 2nd week after treatment of interferon. 3) Pre-tretament ALT showed higher levels in group of changed viral rnarkers (n=6) than in unchanged (n=8), but there was no statistical significance. 4) Peripheral blood leukocytes and granulocytes showed significant reduction in number from the 3rd day of interferon treatment (p<0.05), and recovered within one week after withdrawal, 5) There was no significant changes in serum protein, bilirubin and prothrombin time. 6) All the treated patients experienced an initial flu-like illness consisting of fever, chills, malaise, myalgia, anorexia, headache and dizzeness. Tachyphylaxis developed gradually during the treatment. The above results suggest that β-interferon therapy may be effective and safe in the treatment of patients ivith tvpe B chronic activc hepatitis.

과민성 대장염환자에서 이중 맹검 투여한 Tiropramide의 치료 효과

정규원(Kyu Won Chung),선희식(Hee Sik Sun),김부성(Boo Sung Kim),정인식(In Sik Chung),최명규(Myung Gyu Choi),최규용(Gyu Yong Choi),박수헌(Soo Heon Park),장창훈(Chang Hoon Jang),한준열(Jun Yeul Han) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5

N/A A double-blind, randomized parallel group trial comparison study was performed in 63 patients with irritable bowel syndrome for evaluation of effectiveness and safety of Tiropramide. Over a treatment period of 4 weeks, Tiropramide (300 mgjday) were administered in 32 patients and placebo in 31 patients with irritable howel syndrome. The degrecs of symptom scores for abdominal pain, belching, flatulence, diarrhea, abdominal discomfortnesi, inadequate defecation, borborygmi, etc were assessed every week by interview of pat:ient.s during the treatment. At the end of the four week. treatment, 78.2% of the treatment group with Tiropramide and 40.5% of placebo group were markedly improved their symptoms. The degrees of symptom scores for abdominal pain, inconiplete evacuation, borborygmi, flatulence, abdominal distension, and intensity of nausea showed significant improvement in the treatment group compared with placebo group in each week assessrnent. One patient with Tiropramide treatment and two patients of placebo group experiencecl aggravation of symptoms during treatment but no one had adverse reaction during treatment. These results suggest that Tiropramide is effective and safe for the treatment of irriitable bowel syndrome.

흰쥐에서 총담관 폐쇄후의 간내담도에 대한 투과 전자 현미경적 관찰

정규원(Kyu Won Chung),김우중(Woo Joong Kim),이명석(Myung Seok Lee) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5

N/A Alteration of bile canalicular structure are known to occur in both intra-and extrahepatic cholestasis that develop in men as well as experimental animals. In order to evaluate the biochemical and ultrastructural characteristics of cholestasis in the liver of the rats, the authors conducted liver function test and examined the fine structural changes of intrahepatic biliary tract both in norrnal state and after 4 different time periods of comrnon bile ducts ligation with the transmission electron microscope. The serum SGPT began to rise irnmediately after the cornrnon bile duct ligation, showing highest value in the 24 hours group and the value decreased thereafter. The total bilirubin, total cholesterol, , r-GTP and alkaline phosphatase began to rise rapidly after the common bile duct ligation, showing highest values in the 1 week experimental group and the values decreased thereafter. After the common bile duct ligation, changes of the liver were most prominent in the bile canaliculi which showed typical structural alterations. There was the progressive dilatation of bile canaliculi with the loss of microvilli sometimes forming sacculation and diverticulation. Prominent ultrastructural changes of bile ductules after bile duct ligation were persistent bleb formations arid decreased number of rnicrovilli of luminal surface of ductular epithelial cells. The ductular epithelium showed atrophic changes and wideninp of intercellular space with abnormal microvilli was also observed.

부교감신경차단제가 실험위궤양 억제에 미치는 영향

정규원 ( Kyu Won Chung ),이규면 ( Kyu Myon Lee ),황성주 ( Sung Choo Hwang ) 대한내과학회 1969 대한내과학회지 Vol.12 No.7

Many authors were reported that anticholinergic drugs reduced gastric secretion and hence inhibited gastric ulceration clinically end experimentally, since Harry Shay introduced uniform ulceration in the pylorus-ligated rat (Shay rat 1945). In this study

간침생검후 발생된 혈종에 대한 초음파 진단

정규원(Kyu Won Chung),선희식(Hee Sik Sun),김부성(Boo Sung Kim),정인식(In Sik Chung),이영석(Young Suk Lee),안병민(Byung Min Ahn),오수혁(Soo Hyuk Oh),유진홍(Jin Hong You),정한국(Han Kook Chung) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.1

N/A Percutaneous liver biopsies were performed in 146 patients with acute and chronic liver diseases, including neoplastic diseases. Among 146 patients, 28 patients had undergone liver biopsy under laparoscopic examination and 118 patients by blind intercostal biopsies. Ultrasonographic examination was performed before biopsy and 24 hours after biopsy. Blood pressure and pulse rate were also examined in all 146 hospitalized patients. The following results were obtained. 1) Development of intrahepatic hematoma was found by ultrasound in one case (0.6%) which the biopsy had been done under laparoscopic examination, however there were no significnt hemodynamic changes in blood pressure, hemoglobin level and pulse rate. 2) No significant hemodynamic changes noted between the prebiopsy and six hours after biopsy. 3) No other serious complications encountered in all 146 cases of liver biopsy. It is concluded that routine post-biopsy ultrasonographic examination may be unnecessary in patients undergone percutaneous liver needle biopsy if a skillful personnel and good indications were applied.

위궤양에 대한 Misoprostol ( Cytotec ) 과 Cimetidine 의 효과

정규원(Kyu Won Chung),선희식(Hee Sik Sun),정인식(In Sik Chung),한석원(Suk Won Han),이영석(Young Suk Lee) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A This double blind study was undertaken to evaluate the efficacy of misoprostol and cimetidine for the healing of peptic ulcer. Twenty nine patients with gastric ulcer were randomized to receive misoprostol 50mcg or 200mg, or cimetidine 300mg gid for eight weeks. Endoscopic, clinical and laboratory assessment were made before treatment and after four weeks and eight weeks of treatment. Mean ulcer sizes were decreased significantly in all treat.ment group after four and eight weeks of treatment (p<0.05). After 4 weeks of treatment, healing rates of gastric ulcer in the misoprostol .50mcg, 200mcg and cimetidine 300mg groups were 20%, 33% and 40%, respectively. After 8 weeks of treatment, healing rates of gastric ulcer in the misoprostol 50mcg, 200mcg and cimetidine 300mg groups were 60%, 78% and 70%, respectively. There was no statistically significant difference in the healing rates between misoprostol and cimetidine at four weeks and eight weeks of treatment. Only one patients treated with misoprostol 200mcg suffered from severe diarrhea and withdrew the drug. These results indicate that misoprostol 50mcg and 200mcg, and cimetidine 300mg four times daily are effective and safe for the treatment of peptic ulcer disease.

삼중성 동시성 원발성 대장암

정규원(Kyu Won Chung),선희식(Hee Sik Sun),정인식(In Sik Chung),양진모(Jin Mo Yang),심상인(Sang In Shim),최명규(Myung Gyu Choi),한현복(Hyun Bok Han),정홍량(Hong Ryang Jeong),이재학(Jae Hak Lee),강창석(Chang Suck Kang) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.3

Recent advent of non-surgical treatment for gallstones desires accurate in vivo analysis of chemical composition to select optimal candidate. As preliminary work, we undertook in vitro CT examimation of the surgically removed 53 gallstones and compared CT pattern with chemical compsotion. Those results were correlated with in vitro lithotripsy of the gallstones. The CT appearances were classified as follows: Laminated (43%), dense (32%), rimmed (11%), isodense (8%) and faint (6%). Dense pattern contains high calcium content. As CT density increased, calcium content increased, but cholesterol content decreased proportionslly. The number of shock waves to breakdown the gallstone ]ess than 2 mm in size, has increased as stone volume and cholesterol content increases but did not have any correlation with calcium content level. As a result, the CT exmination is very sensitive to detect small amount of calcium content in gallstones and CT pattern and density of the gallstones are well correlated with chemical compsotion and therefore in vivo CT exmination for ESWL candidate is desirable.

B 형 만성 활동성 간염에 대한 천연형 Interferon alpha 의 안정성 및 효과

정규원(Kyu Won Chung),선희식(Hee Sik Sun),김부성(Boo Sung Kim),박두호(Doo Ho Park),이창돈(Chang Don Lee),최상욱(Sang wook Choi),한남익(Nam Ik Han),정진우(Jin Wu Jeung) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.2

N/A To evaluate the efficacy and safety of natural interferon alpha (Green Cross Co.) in ten patients with chronic active hepatitis (CAH) type B, a course of 12 weeks natural IFN-alpha was given three times weekly by subuctaneous injection at a dose of 3 million unit (MU) In ten patients with HBeAg positive CAH type B, DNA polymerase and aminotransferase activities were assessed and compared before, during and after natural IFN-alpha administration. We followed up at least for 12 to 24 months. The peripheral blood white cell (WBC), granulocyte and platelet count were also checked before and after therapy. The results were as follows: 1) During administration of natural interferon alpha, DNA polymerase activities were declined significantly within first week and sustained and negative conversion in 70% (7/10). After administration of interferon, DNA polymerase activities were rebounded and negative in only 30% (3/10) at 6 months therapy. 2) Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were decreased significantly from 6 and 12 weeks after therapy, respectively (p<0.05) though transient increament of just after therapy. 3) During follow up period, loss of HBe Ag was found in 5 cases (50%). Of these, seroconversion (Anti-Hbe) of HBe Ag was found in 3 cases (30%). In 2 out of these 3 cases, loss of anti-Hbe and reappearance of HBe Ag in 1case, and sustained increament of serum alanine aminotransferase (ALT) were observed in 1 case, which were revealed progressive liver changes despite loss of Hbe Ag and seroconversion (Anti-HBe) during follow up period. HBe Ag reappeared in 2 cases, which were not seroconversion (Anti-HBe). Namely, loss of HBe Ag and seroconversion (Anti-HBe) and normal serum transaminase were observed in 1 case (10%). 4) There was no significant clinical, hematological, biochemical changes after natural interferon alpha therapy. We concluded that subcutaneous injection of 3 MU natural interferon alpha was safe and effective in decreament of DNA polymerase and transaminase level transiently in patients with CAH type B. But long term therapy more than 3 months will be necessary for the eradication of Hbe antigenemia and clinical improvement for a long time, and repeated biopsy for the exact assessment of results.

십이지장의 원발성 악성임파종

정규원(Kyu Won Chung),선희식(Hee Sik Sun),최규용(Kyu Yong Choi),이일중(Ill Jung Lee),한명철(Myung Cheol Han),신상현(Sang Hyun Shin),최상욱(Sang wook Choi),차상복(In Sik Chung),정인식(Sang Bog Cha) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

We reported a case of 35-year old man who was diagnosed primary malignant lymphoma in duodenum confirmed by post-operation pathologic diagnosis. He complained of general weakness and epigastric pain. The endoscopy revealed marked duodenitis with necrosis and bleeding of the bulb and the 2nd portion of duodenum. The result of endoscopic biopsy was chronic inflammation with some atypism. The massive upper GI bleeding was developed and Whipples operation was done. The pathologic examination of specimens showed diffuse, well differentiated, lymphocytic malignant lymphoma.

간기능 이상을 동반한 혈액질환 환자에서 복강경하 간조직검사의 유용성

정규원(Kyu Won Chung),민우성(Woo Sung Min),김부성,김춘추(Chun Choo Kim),최황(Hwang Choi),김병욱(Byung Wook Kim),김보경(Bo Kyoung Kim),이창돈(Chang Don Lee),박재명(Jae Myung Park),최상욱(Sang Wook Choi),조세현(Se Hyun Cho),이영석(Young 대한내과학회 1999 대한내과학회지 Vol.56 No.4

N/A Objective : Hepatic dysfunction frequently occurs in patients with hematologic malignancies and aplastic anemia who receive intensive chemotherapy or bone marrow transplantation (BMT). The role of laparoscopic liver biopsy in patients with hematologic disorders is very important to determine the etiological factors and to make treatment decisions. The aim of the present study was to evaluate the possible causes of liver disease in patients with abnormal liver function tests. Methods : Laparoscopy guided liver biopsy was performed in 38 subjects who were receiving intensive cytotoxic therapy with BMT or without BMT. Two to three pieces of liver tissues were obtained in each patients using Vim-Silverman needle with electrocoagulation on biopsy site. Platelet transfusions were given if platelet count was less than 50,000/mm3. 39 biopsies were obtained in 38 patients. Results : At the time of liver biopsy, platelet count was 170,000±138000/mm3 (range: 42,000 - 798,000/mm3). No procedure-related complications were observed. Biopsy findings after BMT (n=16) revealed graft versus host disease (GVHD) (n=9), drug induced hepatitis (n=6), veno-occlusive disease (n=2), viral hepatitis (n=1), and nonspecific reactive hepatitis (n=1). 3 patients of GVHD associated with other liver diseases such as drug-induced hepatitis, veno-occlusive disease and chronic active hepatitis B. The authors compared histologic diagnosis with laparoscopic findings. Laparoscopic findings of the liver surface were classified by Shimada's code number system. 5 patients who were biopsed before BMT showed cholestasis and fatty changes and it was possible to be treated with allogenic BMT. Histologic diagnosis in patients without BMT (n=18) showed viral hepatitis (n=6), drug induced hepatitis (n=5), non-specific reactive hepatitis (n=1), and others (n=6). In 12 cases (31%) laparoscopic liver biopsy led to a change in medical management. Conclusion : Laparascopic liver biopsy has been proven to be an effective means of assessing the cause of liver dysfunction in patients with hematologic disorders. The diagnosis obtained at laparoscopic liver biopsy could be changed the therapeutic plan in 12 of 39 (31%) patients.