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간장 및 담도 : 간농양 치유 후 추적 영상진단상 이상 소견을 나타내는 간농양의 조직병리학적소견
이동기(D . K . Lee),김원호(W . H . Kim),한광협(K . H . Han),최흥재(H . J . Choi),박찬일(C .I . Park) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.1
N/A Medical therapy is standard for intrahepatic abscess and generally effective, but frequently radiologically abnormal lesion persist for long time followed by ultrasonography(US) or abnormal C-T, even after successful medical treatment including aspiration and complete clinical recovery. To access the histologic features of medically healed abscess but not disappeared completely in follow-up US or ahdominal C-T we performed liver biopsies in 5 cases of healed liver abscesses. The biopsy specimens were obtained at the margin of the lesions by cutting needle with ultrasono- graphic guiding. The biopsies were performed one time in one patient at variable period after treatment, 4 weeks in 2 cases, 6, 12 weeks & 17 months in each one case. The lobular architecture of the liver was relatively well preserved except the 2 specimens obtained at 4 weeks after treatment. And the specimens within 2 months showed hemorrhagic features rather than inflammatory, such as central hemorrhagic necrosis with extravasation of RBC. The sinusaidal system was dilated slightly. Some fibrosis involving portal tract and parenchyme of the liver was noted in the specimen of 6 weeks and 12 weeks. The specimen obtained at 17 months after treatment showed nearly normal liver architecture except minimal infiltration of lymphocyte in portal tract and parenchyme. Therefore, we concluded that in completely healed liver abscess, enen if abnormal reaiologic lesion persist for long time, the histologic feature of the lesion showed some hemorrhagic necrosis and infiltration of chronic inflammatory cells.
B 형 바이러스성 만성 활동성 간염 환자에서 스테로이드 이탈요법 및 알파 인터페론 투여에 의한 면역상태의 변화
이관식(Kwan Sik Lee),한광협(Kwang Hyub Han),정준표(Jun Pyo Chung),전재윤(Chae Yoon Chon),이상인(Sang In Lee),문영명(Young Myung Moon),강진경(Jin Kyung Kang),박인서(In Suh Park),최흥재(Heung Jai Choi),신전수(Jeon Soo Shin),최인홍(In H 대한내과학회 1995 대한내과학회지 Vol.49 No.1
N/A Objectives: It has been suggested that cellular immune responses to the hepatitis B virus are of importance in the production of liver cell damage in chronic active hepatitis type B. Short-term corticosteroid withdrawal in patients with chronic active hepatitis type B is frequently associated with enhanced cellular immune responses to hepatitis B virus. Several clinical studies had suggested that short-term corticosteroid withdrawal followed by interferon treatment might enhance its antiviral efficacy. The present study was designed to investigate the change of immune parameters in patients with chronic active heptitis type B treatment with short-term corticosteroid withdrawal followed by interferon alpha(IFN-a). Methods: The subjects were 11 patients with chronic active hepatitis type B who were given prednisolone in decreasing daily doses of 60mg, 40mg and 20mg, each for 2 weeks, followed by a 4-week rest and l6 weeks of recombinant alpha 2a interferon (INF-α) was administered intramuscularly. Serum ALT level, serum HBV DNA level and serum sIL-2R level were assayed and CD4+ T cell/ CD8+T cell ratio, IL-2R+T cell/Total T cell(%), TLiSAI+T cell/Total T cell(%) and suppressor T cell activity were measured. Results: 1) The serum ALT level was increased significantly at 2 weeks after the end of prednisolone administration(p<0.005) and decreased significantly after the start of INF-α administration(p<0.005). 2) The serum HBV DNA level was increased significantly during the prednisolone administration(p<0.01) and decreased siginificantly after the end of prednisolone administration and resting period(p<0.05). 3) The serum sIL-2R level was increased significantly at 2 weeks after the end of prednisalone administration(p<0.05). After the end of prednisolone administration and the start of INF-α administration, the serum sIL-2R level was decreased significantly( p<0.05). 4) The increase of serum ALT level after the increase of IL-2R+T cell(%) and TLiSA1+ T cell/ Total T cell(%) after the increase of TLiSA1+T cell/ Total T cell(%) was significant. 5) The maximum increase of serum ALT level and the maximum decrease of suppressor T cell activity were observed in 4 of 5 patients(80.0%) at 2 weeks after the end of prednisolone administration. Conclusion: The serum HBV DNA level was decreased significantly by the immune rebound after the end of steroid administration. Probably increase of IL-2R+T cell/Total T cell(%) and TliSAl+T cell/ Total T cell(%) and decrease of suppresor T cell activity were related to the immune rebound.