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증례 : 소화기 ; 간세포암 완치 절제 4년 후 자궁에만 국소적으로 재발한 간세포암 1예
이상진 ( Sang Jin Lee ),신정우 ( Jung Woo Shin ),박능화 ( Neung Hwa Park ),나양원 ( Yang Won Nah ),유항조 ( Hang Jo Yoo ),정융기 ( Yoong Ki Jung ),최혜정 ( Hye Jeong Choi ) 대한내과학회 2012 대한내과학회지 Vol.82 No.5
Extrahepatic metastasis of hepatocellular carcinoma (HCC) can be found in various organs, but metastasis to the female genital tract is extremely rare. A 48-year-old woman who had undergone curative left lobectomy for small HCC 4 years earlier was admitted because of sequential alpha-fetoprotein elevation. Upon abdominal MRI and hepatic angiography, no evidence of HCC recurrence was found in the remnant liver. However, a positron emission tomography CT scan showed a hypermetabolic lesion in the uterine fundus, which was revealed as metastatic HCC after total hysterectomy. This is, to our knowledge, the first documented case of metastatic uterine tumor that originated from HCC without intrahepatic recurrence. (Korean J Med 2012;82:603-608)
만성 C형 간염에서 B형 간염바이러스 잠재감염의 임상양상과 C형 간염 치료에 미치는 영향
변성수 ( Sung Soo Byun ),신정우 ( Jung Woo Shin ),고명관 ( Myung Kwan Ko ),홍정민 ( Jung Min Hong ),김경훈 ( Kyung Hoon Kim ),이무열 ( Mu Yeol Lee ),최혜정 ( Hye Jeong Choi ),정융기 ( Yoong Ki Jeong ),박보령 ( Bo Ryung Park ),박 대한내과학회 2012 대한내과학회지 Vol.83 No.6
Background/Aims: The prevalence of occult HBV infection (OBI) in patients with chronic hepatitis C (CHC) in Korea has not been reported. Additionally, it is unclear whether OBI influences treatment outcome in CHC patients. We investigated the prevalence of OBI and its impact on treatment outcome in patients with CHC. Methods: Seventy-six patients with CHC were enrolled and treated with pegylated or conventional interferon and ribavirin. Hepatitis B virus (HBV) DNA was detected by nested polymerase chain reaction. Results: Among the 68 patients who completed treatment and follow-up, HBV DNA was detected in serum from nine (13.2%) patients, liver tissue from 10 (14.7%), and serum or liver tissue from 15 (22.1%). OBI was diagnosed in nine (12.7%) control subjects. No difference in the prevalence of OBI between patients with CHC and controls was observed (13.2 vs. 12.0%; p = 0.92). No significant differences in age, sex, genotype 1 frequency, amount of hepatitis C virus RNA, anti-hepatitis B surface antigen/anti-hepatitis B core-IgG seropositivity, staging, or histology grading were observed in patients with or without HBV DNA. Sustained virological response was achieved in 73.3% of patients with OBI and 83.0% without OBI (p = 0.46). Conclusions: These results demonstrate that a significant proportion of patients with CHC have occult HBV infection and that OBI does not affect treatment outcome in patients with CHC. (Korean J Med 2012;83:731-739)