한국인 산모와 신생아에서 NANB 간염과 B 형 간염에 관한 연구

최관수(Gwan Su Choi),김지운(Ji Woon Kim),장영호(Yung Ho Chang),오은아(Eun A O),양인애(In Ae Yang),유영근(Young Geun Ryoo),이봉섭(Bong Seob Lee),정남기(Nam Ki Jong),오영종(Young Zong Oh),남명숙(Myoung Soog Nam),임순선(Soon Seon Lim),김 대한소화기학회 1988 대한소화기학회지 Vol.20 No.2

N/A To assess the frequency of hepatitis in pregnant women, we examined the findings of the physical examination, medical history, liver function tests and viral markers in 7,580 pregnant women who delivered at St. Columbans Hospital in Mokpo City from April 1st, 1985 to June 30th, 1988. We compared the characteristics of hepatitis B in 28 mothers and 17 newborn infants, and of non-A, non-B hepatitis in 17 mothers and 61 newborn infants, The results were as follows; 1) Among 7,580 pregnant women, there were 629 cases (8.30%) of HBV carriers. Abnormal elevation of transaminase at delivery was noted in cases of hepatitis A (2, 0.03%), hepatitis B (25, 0. 33%), NANB hepatitis (57, 0.75%) toxemia (9, 0.12%) and drug induced hepatitis (1, 0,01%). 2) The earliest elevation of transaminase was noted at 3 months in 9 hepatitis B infants (6, 66.7%) and 61 NANB hepatitis infants (57, 93.4%). The highest elevation of transaminase was noted at 3 months in 61 NANB hepatitis infants (41, 67. 2%) and seemed to be delayed in 9 hepatitis B infants due to the effect of vaccine. 3) Abnormal transaminase was normal within 6 months in 17 cases (60.7%) of 28 mothers with hepatitis B, and 14 cases (82.4%) of 17 mothers with NANB hepatitis. If we test and observe for )onger time the cases of chronic hepatitis with intermittent elevation of transaminase may increase more. Twenty-seven of 28 hepatitis B mothers were positive for HBsAg for more than 1 year. Duration of abnormal transaminase in hepatitis B infants was much different by the vaccination, but total number of cases was very small. Among 61 NANB hepatitis infants, continuous elevation of transaminase was noted in 5(62.5%) of 8 infants who had no imrnunoprophylaxis, 19(55.9%) of 34 infants who received HBIG & Hepavax, 5(26.3%) of 19 infants who received gamma-globulin. There was slight but not significant inhibition of persistence of abnormal transaminase in group of gamma-globulin injection (0.05<p<0.1). The mean level of maximal ALT was higher in hepatitis B (148.32+162.47 IU) than in NANB hepatitis mothers (76.53<53.14 IU). It was similar in infants of both hepatitis B & NANB, and lower in infants who received Hepavax, gamma-globulin but it was not statistically significant. 4) Among the factors which may influence the elevation of ALT in hepatitis infants the level of ALT in hepatitis mothers had no influence. The immunoprophylaxis with HBIG & hepavax for hepatitis B infants, gamma-globulin for NANB hepatitis seemed to inhibit the elevation of ALT in infants, but not signficantly. ALT was normal in 5 infants (23.8%) of 21 HBeAg positive hepatitis B mothers and in 6 infants (85.7%) of 7 HBeAg negative hepatitis B mothers. There was significant elevation of ALT in infants of HBeAg positive hepatitis B mothers (p<0.0001). The results suggest that the prevalence of NANB hepatitis was higher than hepatitis B in Korean pregnant women at the time of delivery. Duration of abnormal transaminase was similar in mothers with hepatitis B and NANB. The time of the earliest and highest elevation of ALT, the mean level of maximal elevation of ALT were similar in infants with hepatitis B and NANB. Duration of abnormal transaminase and maximal elevation of ALT seemed to be decreased by the immunoprophylaxis with HBIG and Hepavax for hepatitis B infants, gamma-globulin for NANB hepatitis infants, but there was a significant difference in hepatitis B infants whose mothers had HBeAg positivity.

간장 및 담도 : 산모와 신생아에서 B 형 간염표식자에 (肝炎標識子) 관한 연구

박광숙(Kwang Sook Park),최관수(Gwan Su Choi),정원재(Won Jae Jeong),김지운(Ji Woon Kim),정남기(nam Ki Joung),장영호(Yung Ho Chang) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1

N/A To analyze frequency and severity of liver disease in 3rd trimester and full term Korean pregnant women, to observe the prevalence of HBV markers in pregnant women and newborn infants at delivery and to evaluate the effect of HBV on fetus, newborn infants and pregnant women. We received the findings of the physical examination and history taking, and did SGPT and HBV markers with EIA method at intervals in 2,873 pregnant women who delivered at St. Columbans Hospital in Mokpo City from April 1st, 1985 to March 31st, 1986. The following results were obtained: 1) The overall HBsAg positivity in all 2,873 pregnant women was 8.3% 2) Among 2,873 pregnant women, 5 cases in 3rd trimester and 6 cases in full-term pregnant women showed typical acute viral hepatitis B and most of them were normal in their follow-up tests. 32 cases who shoWed mild elevation of SGPT were normal in their follow-up tests. But it was difficult to differentiate between a course of acute or chronic hepatitis and mild liver dysfunctions during pregnancy. 3) Among 195 HBsAg positive pregnant women, 76 cases(39.0%) were HBeAg positive, 65 cases(33.3%) were HBeAg negative and 54 cases(27.7%) were Anti-HBe positive. 4) Mother to infant transmission of HBV markers at delivery was as follows: Positive rate of HBsAg was 10.0% or 14 infants in 140 pregnant women. Positive rate of HBeAg was 17.8% or 8 infants in 45 cases. Positive rate of anti-HBs was 88.9% or 16 infants in 18 cases. Positive rate of anti-HBc was 96.2% or 125 infants in 135 cases. Positive rate of anti-HBe was 100% or 35 infants in 35 cases. 5)We evaluated the HBV markers in newborn infants 3 groups according to the maternal HBeAg/Anti-HBe status at delivery in 107 HBsAg positive pregnant women. Out of 38 HBeAg positive women, 6 infants(15.8%) were positive for HBsAg and HBeAg, 31 infants (81.6%) were negative for HBsAg, HBeAg and anti-HBe. Out of 39 HBeAg reative women, 2 infants(5.1%) were positive for HBsAg and negative for HBeAg, 31 infants(79.5%) were negative for HBsAg, HBeAg and anti-HBe. Out of 30 anti-HBe positive women, 3 infants (10.0%) were positive for HBsAg and anti-HBe, negative for HBeAg, 22 infants(73.3%) were negative for HBsAg and HBeAg, positive for anti-HBe. HBV markers in newborn infants corresponded to their mothers degree of infection. 6) Among 2,873 pregnant women, vve found 135 cases of prematurity, 6 cases of still birth cases of intrauterine death, 56 cases of congenital anomaly and 122 cases of severe physiologic jaundice. We also found in the past history 75 cases of prematurity, 18 cases of stillbirth, 36 cases of intrauterine death, 14 cases of congenital anoma!y, 34 cases of infantile death and 444 cases of spontaneous abortion. There was no significant incrcase in frequency of adverse effects of HBV according to the mothers HBsAg positivity status. 7) Positive rate of HBsAg was 16.4% in 61 cases who showed toxemia of pregnancy. Positive rate of HBsAg was 8.1%. In 2, 812 cases who showed no toxemia of pregnancy. There was significant increase of toxemia of pregnancy in HBsAg carrier(0.01<P<0.025). Positive rate of HBsAg was 14.7% in 109 cases who bled more than 500 cc postpartum hemorrhage. Positive rate of HBsAg was 8.1% in 2812 cases who bled less than 500cc postpartum hemorrhage. There was significant increase of postpartum hemorrhage in HBsAg carrier(0.01<p<0.005). Severity of hyperemesis was unrelated to HBsAg positivity. 8) We observed the course and severity of hepatitis during pregnancy. Among 5 cases in 3rd trimester and 6 cases in full term pregnant women, only one case showed elevation of SGPT for more than 6 months. Among 19 non-pregnant women, one case in 15 patients of acute viral hepatitis and 3 cases in 4 patients of chronic viral hepatitis showed elevation of SGPT for more than 6 months. There was no significant difference in couse, severity and prevalence of HBV markers between pregnant and non-pregnant women.

구연발표 : B 형 간염 백신의 효과 - 산모의 HBeAg 양성 유무에 따라 -

장영호(Yung Ho Chang),유영근(Young Geun Ryoo),최관수(Gwan Su Choi),박광숙(Kwang Sook Park),김지운(Ji Woon Kim),정남기(Nam Ki Jong) 대한소화기학회 1987 대한소화기학회 추계학술대회 Vol.1987 No.-

지상발표 : 특발성 세균성 복막염의 감별진단 지표

장영호(Yung Ho Chang),유영근(Young Geun Ryoo),최관수(Gwan Su Choi),박광숙(Kwang Sook Park),김지운(Ji Woon Kim),정남기(Nam Ki Jong) 대한소화기학회 1987 대한소화기학회 추계학술대회 Vol.1987 No.-

목포지역에서의 B 형 간염 (肝炎) 바이러스 감염요인에 (感染要因) 관한 역학적 연구

박광숙 ( Kwang Sook Park ),김지운 ( Ji Woon Kim ),최관수 ( Gwan Su Choi ),정원재 ( Won Jae Jeong ),정남기 ( nam Ki Joung ) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.2

N/A We tested 1389 pregnant women for HBsAg and 197 pregnant women for anti-HBs, anti-HBc, HBeAg and antiHBe with EIA method. 1) The occurance rate of HBsAg was 8.8Yo in a total of 1389 cases. 2) The occurance rate of HBsAg was unrelated with age, because it was the lowest in the age group of 21-30 years(7.9%) and much higher in the age group of below 20 years (16.0%) and over 30 years(15.3%). 3) The occurance rate of HBsAg was related a little with locality. It was slightly higher in cases from the city(9.3% than in cases from the village(8.5%). 4) The occurance rate of HBsAg was unrelated to educational background. 5) The occurance rate of HBsAg was increased in groups with an income of 400,000-500000 won(10.3%) and over 500,000 won(13.1%) than in groups with smaller income. 6) The effect of family history of liver disease: The occurance rates of all hepatitis B viral markers were increased in those who had a family history of liver disease, but the occurance rates of HBsAg(p<0.005%, antiHBs(p<0.005) and antiHBc(0.025<p<0.01) were increaed significantly. 7) The effect of acupuncture: The occurance rates of HBsAg and HBeAg were increased significantly in those who had a history of acupuncture(p<0.005, 0.025<p< 0.01), but te occurance rates of anti-HBs and antiHBe were decreased. 8) The occurance rate of antiHBs was increased significantly in student nurses(p. 6i) and graduate nurses(58.0%) compared to university students(27.7%)(p<0.005). The occurance rate of anti-HBc was increased but not significantly(0.05<p<0.1), but there was no Significant difference between each year by duration of exposure in hospital work. The occurance rate of HBsAg was not related in the three groups.

B 형 간염 백신의 효과 - 산모의 HBeAg 양성 유무에 따라 -

김세종(Sei Jong Kim),윤종만(Chong Mann Yoon),최관수(Gwan Su Choi),김지운(Ji Woon Kim),정남기(nam Ki Joung),장영호(Yung Ho Chang),오은아(Eun A O),양인애(In Ae Yang),유영근(Young Geun Ryoo),이봉섭(Bong Seob Lee) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.1

N/A The preventive efficacy for HBV infection and chronic HBV carrier rate by active and passive immunoprophylaxis was observed in 49 newborn infants whose mothers were healthy HBV carriers with normal ALT activity at delivery. All infants were divided into 3 groups; Group A received HBIG at birth and HB Vaccine (Hepavax- B) at month 0, 1 and 6. Group B received first or second vaccine only. Group C received no vaccine. ALT activity, HBsAg and anti-HBs were tested every 3 months for 18 rnonths after delivery, and the results were analyzed in 3 groups according to the mothers HBeAg positivity. 1) The anti-HBs response was57.1% (16/28) in Group A and 76.9% (10/13) in the control group whose mothers vere normal. The anti-HBs response was 64.3% (9.14) and 57.1% (8/14) according to the mothers HBeAg positivity and negativity. The anti-HBs response was 56.3% (9/16) in male and 66.7% (8/12) in female infants. The anti-HBs response svas higher in female infants and infants a hose mothers were normal or HBeAg positive carriers. 2) Chronic HBV carrier rate in infants of HBeAg positive mothers was 14.3% (2/l4) in Ciroup A, 72.7% (8/11 ) in Group 8, 100% (6/6) in Group c and was statistically significant (p=0.037) (c=0.816). There was no significant difference hetween group A, B, and C in infants of HBeAg negative mothers. 3) The positive rate of HBsAg showed significant difference between Groups A and B, A and C, A and (B+C), (A+B) and C in all 3 monthly follow-up tests in infants of HBeAg positive mothers. But there was no significant difference between (groups A, B, and C in infants of HBeAg negative mothers. The results suggest that the anti-HBs response was lower in infants of HBsAg carrier mothers. The preventive efficacy of vaccine for HBV infection and chronic HBV carrier rate was excellent in infants of HBeAg positive mothers but not significant in infants of HBeAg negative mothers by the active and passive immunoprophylaxis.

CMV감염에 의한 Infection-Associated Hemophagocytic Syndrome 1예

최관수,정 만,류영근,김지운,강상구,천석배 대한감염학회 1993 감염 Vol.25 No.4

저자들은 임상과 혈액검사에서 CMV monoucleosis로 진단된 21세 남자환자에서 골수검사상 적혈구를 탐식하는 조직구의 증식으로 보아 CMV가 그 원인으로 추정되는 IAHS 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The 21-year-old male patient complained of high fever, chills, severe malaise, myalgia, and gingival bleeding for 10 days. The patient presented pancytopenia and hepatosplenomegaly. We examined peripheral blood smear, bone marrow aspiration and biopsy, serologic tests for antibodies on cytomegalovirus(CMV), platelet and heterophil, and upper abdominal ultrasonography. There were pancytiopenia and peripheral lymphocytosis with atypical lymphocytes in the peripheral blood smear and histocytes phagocytosing red blood cells in the bone marrow examination. The CMV-specific IgM antibody was positive. The antibodies for platelet and heterophil were absent. We diagnosed as Infection-Associated Hemophagocytic Syndrome (IAHS) due to CMV for the patient. Therefore, we report a case of IAHS associated with CMV mononucleosis with a brief review of literature.

진폐증이 동반된 공피증 1 예

박광숙,장영호,김지운,최관수,정남기,정원재 대한내과학회 1986 대한내과학회지 Vol.31 No.2

Scleroderma is a multisystem and multistage disorder charaterized proliferative vascular lesions, obliterative microvascular lesions, and residual atrophy with fibrosis of skin and internal organ, with variable duration and prognosis. A 39 year-old male patient who had coal miner's pneumoconiosis was admitted to our hospital because of numbness of fingers, digital pitting scar and difficulty of mastication for 4 years. So we report this case of scleroderma associated with pneumoconiosis after laboratory, radio- logic study and skin biopsy with review of the literatures.