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손병관(Byoung Kwan Sohn),함준수(Joon Soo Hahm),이항락(hang Lak Lee),이준수(Joon Soo Lee),은창수(Chang Soo Eun),박준용(Joon Yong Park),한동수(Dong Soo Han),최호순(Ho Soon Choi),안유헌(You hern Ahn) 대한소화기학회 2001 대한소화기학회지 Vol.37 No.6
Background/Aims: The aim of this study was to assess the prevalence and incidence of gallstone disease in Korean patients with liver cirrhosis in relation to age, sex, etiology and severity of cirrhosis, and obesity. Methods: A cross-sectional study was performed for 680 patients with liver cirrhosis. A longitudinal study was undertaken for 103 patients with liver cirrhosis who had neither gallstone nor biliary sludge at the beginning of the study. Gallstone development was monitored ultrasonographically every 6 month. Results: The prevalence of gallstone in the patients was 17.5% (119/680). Only the patients of Child’s class B and C were significantly related to a higher risk of gallstone (odds ratio 1.83, p=0.01 for class B vs. A; odds ratio 2.53, p=0.001 for class C vs. A). In longitudinal study, gallstones developed in 18 (17.5%) of the 103 patients with liver cirrhosis but no gallstone or biliary sludge during mean follow-up of 31 months. Only Child’s class indicated a risk of gallstone formation with statistical significance (odds ratio 5.00, p=0.017 for class C vs. A; odds ratio 3.20, p=0.052 for class B vs. A). Conclusions: There was a significant association between cirrhosis and the prevalence and incidence of gallstone. The results suggest that cirrhosis is a major risk factor for gallstone and the risk increases with the severity of cirrhosis. (Korean J Gastroenterol 2001;37:443-447)
만성 간질환에서의 ICG - Rmax 와 Thallium - 201 Test per Rectum ( Sunt Index ) 의 임상적 의의
이경상(Kyung Sang Lee),황선호(Seon Ho Hwang),함준수(Joon Soo Hahm),이종철(Jong Chul Rhee),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이민호(Min Ho Lee),정화순(Wha Soon Chung),조석신(Seok Shin Cho),이재원(Jae Won Lee) 대한내과학회 1994 대한내과학회지 Vol.46 No.1
N/A Objectives: Thallium-201 test per rectum (shunt index) and ICG-Rmax have been used for studying the portosystemic shunt and the functional reserve of liver. The clinical values of shunt index and ICG-Rmax in pateints with chronic liver disease were evaluated using the data obtained in 74patients. Methods: 0.5mCi thallium-201 was administered per rectum to 37 patients witchronic active hepatitis (CAH) and 37Patients with liver cirrhosis, and the heart to liver uptake ratio was taken at 20min. ICG-Rmax was also taken using Paumgartner`s method. We used simple linear regression and ANOVA methods for the correlation between ICG Rmax and shunt index. Results: 1) The mean shunt index was 0.251±0. 140 in CAH group and 0.565±0.351 in cirrhosis group (P<0,005). 2) The mean ICG-Rmax was 1.720±l.320 (mg/kg/ min) in CAH group and 0.867±0.625 in cirrhosis group (P<0 005). 3) There was no significant correlation between ICG- Rmax and shunt index in CAH group (P=0.358). 4) Correlation between ICG-Rmax and shunt index was significant in cirrhosis group (P=0,001; R-square= 0 321; 1/ICG-Rmax=2 64 * shunt index+0.49) Conclusions: Thallium-201 scintigraphy per rectum and ICG-Rmax may be useful in diagnosis of chronic liver diseases, especially differentiating CAH from cirrhosis. These study will help us to predict the prognosis of chronic liver diseases and give us more information for the treatment of chronic liver diseases.
호흡부전과 신경학적 이상을 동반한 Acute Intermittent Porphyria
전대원(Dae Won Jun),최춘식(Choon Shik Choi),최호순(Ho Soon Choi),전용철(Yong Chul Jung),손주현(Joo Hyun Sohn),한동수(Dong Soo Han),윤병철(Byung Chul Yoon),함준수(Joon Soo Hahm),이민호(Min Ho Lee),이동후(Dong Hoo Lee),기춘석(Choon Shu 대한소화기학회 2000 대한소화기학회지 Vol.36 No.3
The acute intermittent porphyria (AIP) is characterized biochemically by increased excretion of porphyrins and porphyrin precursors, S-aminolevulinic acid (ALA) and porphobilinogen (PBG). AIP presents with abdominal pain, mental disturbances and neurologic dysfunction. A 24-year-old woman with a medical history of AIP was admitted to our hospital because of abdominal pain and proximal muscle weakness. She was treated by carbohydrate loading with intravenous glucose. Twenty five days later, she developed tachycardia, fluctuation of blood pressure and syndrome of inappropriate secretion of antidiuretic hormore (SIADH). On 90th day, intubation was required to control her breathing. Complete flaccid paralysis developed, and the patient became comatose. The neurologic effects of acute porphyria are generally reversible, but the clinical course of severe case is complicated with respiratory failure, fluid electrolyte imbalance. AIP should be considered in differential diagnosis of patient with unexplained respiratory failure. (Kor J Gastroenterol 2000;36:413 - 418)
독성 거대결장과 단백상실성 장병증 소견을 보인 위막성 대장염
이항락 ( Hang Lak Lee ),한동수 ( Dong Soo Han ),김진배 ( Jin Bae Kim ),박준용 ( Joon Yong Park ),전용철 ( Yong Chul Jeon ),손주현 ( Joo Hyun Sohn ),최호순 ( Ho Soon Choi ),함준수 ( Joon Soo Hahm ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.5
With increasing therapeutic and prophylactic use of antibiotics, Clostridium difficile colitis or antibiotics-induced colitis has become a major clinical problem. The clinical spectrum of presentation of antibiotics-induced colitis ranges from an asymptomatic carrier state to fulminant toxic colitis or toxic megacolon. Toxic megacolon and protein losing enteropathy have rarely been reported in the course of antibiotic-induced pseudomembranous colitis. We experienced a 68-year-old patient who was referred to our hospital due to abdominal distension, edema, fever, and diarrhea two days after spine operation. We could diagnose the case as toxic megacolon and protein losing enteropathy complicated by pseudomembranous colitis. After conservative management including removal of the offending antibiotics, bowel rest, and oral metronidazole, the patient completely improved. (Korean J Gastroenterol 2003;41:410-413)