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간장 ( 肝腸 ) 및 담도 ( 膽道 ) : B형 활동성 간염 환자에서 단기 Prednisolone과 ARA - AMP 겸용 치료의 경과에 따른 면역 지표의 변화에 관한 연구
민영일(Young Il Min),장린(Rin Chang),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Joung Il Lee),황이숙(Yi Sook Hwang),김정원(Jeong Won Kim),김효종(Hyo Jong Kim) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.3
N/A Withdrawal of corticosteroids in patients with chronic type B hepatitis is frequently associated with enhanced cellular immune response to hepatitis B virus. This immunolgic rebound generally results in a transient reduction in levels of HBV-DNA and DNA polymerase, and seldom results in clearance of HBeAg. There was a pilot study that the combination of a short course of prednisone followed by ARA-AMP was potentially synergistic. The object of this study was to determine the effect of short term prednisolone followed by ARA-AMP on the immune system in patients with chronic active ltepatitis-B. Patients were started 40 mg of prednisolone daily for 4 weeks. After prednisolone therapy was discontinued, patients received no medication for 2 weeks. ARA-AMP was then given for 4 weeks at a dose of 500 mg daily. Immune parameters such as T cell subsets, IL, production, NK cell activeity, and LAK cell activity were tested before and during treatement period. The resullts were as follows. 1) Basal IL2 production in CAH-B (71.3 unit/ml) was lower than that of normal control (p<0.025). Basal NK activity, T4/T8 ratio and LAK activity of CAH-B were similar to those of normal control. 2) After prednisolone treatment, IL2 production, NK cell activity and LAK cell activity were significantly lower than those of basal value. 3) After induction of immune rebound, IL, production increased to 84.8 unit/ml (basal 71.3 unit/ml,
궤양성 대장염 수술 방법으로써 회장낭-항문문합술과 영구회장조성술 후 경과와 삶의 질에 대한 비교
정용희 ( Yong Hee Joung ),김효종 ( Hyo Jong Kim ),이길연 ( Kil Yeon Lee ),이병욱 ( Byoung Wook Lee ),한요셉 ( Yo Seb Han ),동석호 ( Seok Ho Dong ),김병호 ( Byung Ho Kim ),장영운 ( Young Woon Chang ),이정일 ( Joung Il Lee ),장린 ( 대한장연구학회 2003 Intestinal Research Vol.1 No.1
Background/Aims: Ileostomy (IL) and ileal-pouch anal anastomosis (IPAA) are treatment of choice in ulcerative colitis. We investigate the complications and quality of life after operation according to the operative methods. Methods: We analyzed patients experienced total proctocolectomy. We divided them in two groups according to the operation methods. We analyzed the characteristics and outcomes after IL or IPAA group for evaluation quality of life and evaluated the characteristics of patients preoperative and postoperative state retrospectively. Results: Fourteen patients were enrolled this study. IPAA was done at eight of them and IL was done at the six of them. There were no difference in sex, age, frequency of use of immunosuppressive agent, duration of medication of steroid and duration of ulcerative colitis according to the operation methods. Most common indication of operation was medical intractability. Similar incidence of postoperative complication in both operation methods. According to the questionnares for evaluating of quality of life, we compared both operation method. There was no difference. But in IPAA, antidiarrheal medication was more needed. Conclusions: In IL and IPAA, quality of life was improved. There was no difference in quality of life in IL and IPAA. (Intestinal Research 2003;1:39-44)
SV40 T 항원의 온도조건부 변이형 유전자가 포함된 Amphotropic Retrovirus 에 의한 사람 태아 간세포의 불멸화
이정일(Joung Il Lee),동석호(Seok Ho Dong),김효종(Hyo Jong Kim),김병호(Byung Ho Kim),장영운(Young Woon Chang),장린(Rin Chang),성세라(Se Ra Seong),박재경(Jae Kyung Park),김승보(Seung Bo Kim),이상목(Sang Mok Lee) 대한내과학회 1999 대한내과학회지 Vol.57 No.1
N/A Human cells are almost never spontaneously immortalized in vitro. We tried to immortalize human fetal hepatocytes (h-FH) and evaluate the differentiational status and its change. Methods : Hepatocytes were isolated from a liver fragment of 20 week old fetus and infected with amphotropic recombinant retrovirus containing a temperature- sensitive mutant of SV40 large T antigen and neomycin phosphotransferase gene. G418 resistant colonies were cloned and expanded. The cells which were able to divide more than 30 times were used to analyze various functions. Results : The immortalization rate was 3.3 x 10-8 and two cell lines (C11, D21) were established. C11-60, C11-80, D21-30 and D21-60 (suffix number means the cell division counts) were evaluated. D21-30 was thougt to be imcompletely immortalized because a considerable portion of cells died during culture. The morphology was similar to that of epithelial cells except for D21-30 which looked like fibroblast. The cells grew rapidly at 33oC but stopped growing at 39oC. T antigen and p53 was expressed at 33oC but disappeared at 39oC, which suggest that T antigen binds to p53. Chromosomal changes were so marked that it was impossible to discriminate exact number. Albumin was secreted as about 1/10 as that of h-FH, but alpha-fetoprotein secretion stopped after immortalization. Telomerase was activated in both cell lines except for the incompletely immortalized cells D21-30. Telomere was elongated in competely immortalized cell lines, but it was rather shortened in D21-30 compared to that of h-FH. Macroscopic colonies did not develop in soft agar assay. Conclusions : We successfully immortalized human fetal hepatocytes. Although the cells are not likely to have oncogenicity, the functions are not so good, possibly due to marked chromosomal changes which are thought to occur before telomerase is activated during immortalization step.
김병호(Byung Ho Kim),이정일(Joung Il Lee),장영운(Young Woon Chang),장린(Rin Chang),민영일(Young Il Min) 대한내과학회 1987 대한내과학회지 Vol.32 No.6
N/A We performed clinical study about patients with chronic hepatic disease who had small hepatic nodule less than 3 cm in diameter in real time ultrasonography. 18 cases, that is 9 cases of liver cirrhosis, 5 cases of chronic hepatitis and 3 patients with had a history of type B viral hepatitis were included in this study. Sono-guided aspiration cytology and serum a-FP measurement in all subjects, celiac angiography in 6 cases and abdominal CT scan in 2 cases was performed. In 4 patients with compatible findings of HCC (hepatocellular carcinoma) in celiac angiography, 3 gave positive result in aspiration cytology but 1 gave negative result. In 2 patients with compatible findings of hemangioma in celiac angiography, all showed dysplastic hepatocytes in aspiration cytology and echogenic nodule in ultrasonography. In 3 patients with small HCC confirmed by surgery, abdominal CT scan couldn't discover the mass and in a patients with hemangioma confirmed by surgery, abdominal CT scan could discover the mass, but the nature of the mass couldn't be well defined. Among 4 cases of cytologically confirmed hepatoma, only 2 cases had significantly elevated α-FP level.
김병호(Byung Ho Kim),정용희(Young Hee Joung),장영운(Young Woon Chang),민선기(Sun Kee Min),문주영(Ju Young Moon),한요셉(Yo Seb Han),이동근(Dong Keun Lee),동석호(Seok Ho Dong),김효종(Hyo Jong Kim),이정일(Jung Il Lee),장린(Rin Chang) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.4
Alendronate (Fosamax), an aminobisphosphonate and a selective inhibitor of osteoclast-mediated bone resorption, is used to treat postmenopausal osteoporosis and Paget's disease. In recent years, reports of severe esophageal injury in patients who took alendronate have evoked attention to the irritant effects of this drug on the mucosa of the upper gastrointestinal tract. We present a case of gastric ulcer caused by alendronate. The patient chiefly complainted of epigastric pain during 14 days. She had taken mefenamic acid for pain control for 3 years and she took once-weekly 70 mg of alendronate for 2 weeks for treatment of osteoporosis before the symptom started. Upper gastrointestinal endoscopy revealed two active gastric ulcers in the low body. The results of rapid urease test (CLO test) and modified Giemsa test for the detection of Helicobacter pylori infection were negative. After withdrawal of alendronate, the symptom resolved completely in one week. Six weeks later, follow-up endoscopy showed complete healing of the ulcer. (Korean J Gastroenterol 2001;38:284-287)
내시경적 정맥류 결찰요법의 단기 치료성적 및 안정성 - 내시경적 경화요법과의 비교 -
김병호 ( Byung Ho Kim ),김효종 ( Hyo Jong Kim ),김영관 ( Young Kwan Kim ),장린 ( Rin Chang ),이정일 ( Joung Il Lee ),동석호 ( Seok Ho Dong ),장영운 ( Young Woon Chang ) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.5
N/A Endoscopic sclerotherapy is an effective method for bleeding esophageal varices, however it is often associated with local and systemic complications which may limit its usefulness. A newly developed endoscopic treatment for bleeding esophageal varices, endoscopic variceal li- gation, which uses small rubber bands to occlude and eradicate the varices, may cause less damage to the esophagus and have no systemic complication theoretically. We compared the effectiveness and safty of the two techniques retrospectively. The patients had proved bleeding from esophageal varix and showed advanced liver cirrhosis. Nineteen patients were treated with ligation, and 20 patients with sclerotherpy. They were followed for a mean of 4 months. Acitve bleeding was controlled by ligation in 2 of 3 patients(67% ) and by sclerotherapy in 3 of 4 patients(75%). The eradication of varices was achieved by ligation in 6 of 14 patients(43 A ) and by sclerotherapy in 10 of 15 patients(67% ). But the mean number of treatments with ligation was lower than that with sclerotherapy(3.4 vs 4.2) ar J than other ligation treatment group(4-5). There was no significant difference in recurrent hernorrhage between two groups. There were one case of pleural effusion and one case of sepsis with acute renal failure in scle- rotherapy treated-patients, whereas none of these complications occurred in ligation treated patients. Two cases of treatment induced bleeding were developed in ligation group. Endoscop- ic variceal ligation has fewer local and/or systemic complications than sclerotherapy. To eradi- cate varices more completely and to achieve denudation of lower esophageal mucosa for pre- vention of recurrent hemorrhage, combination with sclerotherapy would be effective rather than ligation alone.(Korean J Gastroenterol 1994; 26: 765 770)
간경변환자의 Na 및 수분저류에 있어서 혈중 Atrial Natriuretic Polypeptide 의 병인론적 역할
김병호(Byung Ho Kim),이정일(Joung Il Lee),장영운(Young Woon Chang),장린(Rin Chang),민영일(Young Il Min) 대한내과학회 1989 대한내과학회지 Vol.36 No.6
N/A The aim of this study was to investigate the possible role of ANP in sodium and water retention in patients with liver cirrhosis. The dynamic change of plasma ANP to acute water loading (intravenous loading of 5% dextrose solution, 20 ml/kg of body weight within 20-30 minutes) in 14 stable cirrhotic patients and 6 normal controls was measured. In addition, the change of urinary excretion of sodium after water loading was also observed. 1) Fourteen patients with liver cirrhosis were classified in 2 groups according to the rate of urinary excretion to water load, that is, patients excreting more than 85% of the water load over the next 160 minutes were defined as excretor (group II) and patients excreting less than 85% as nonexcretor (group III). Six normal controls were defined as group I. 2) The basal level of plasma ANP was significantly higher in cirrhotic patients (group II; 21±7.5pg/ml, group III; 27.2±13.5 pg/ml) than in normal control subjects (undetectable level). The plasma ANP level was also more increased in the cirrhotics of group II and group III(130.4±25.9 pg/ml, 154.2±27 pg/ml) at 40 minutes after water loading than in normal controls (47.6±6.1 pg/ml, group II; p<0.05, group III; p<p.025). 3) At 40 minutes after water loading, urinary excretion of sodium was increased significantly in all 3 groups (p<0.005, p<0.005, p<0.025). But the level of urinary sodium excretion of group III was markedly lower than that of normal controls (p<0.005), and patients in group II excreted a similar amount of sodium to normal controls. 4) The maximal ANP level correlated with the maximal urinary sodium excretion after water loading in normal controls (r = 0.7, p < 0.1), but there was a tendancy of a reverse correlation in group II (r = -.074, p<0.05). 5) Ten cirrhotic patients with ascites had no significant correlation between 1 plasma ANP and basal plasma AVP (r = 0.13), And there was no significant correlation between basal plasma ANP and basal plasma norepinephrine in 7 cirrhotic patients with ascites (r =-0.46). In conclusion, increased ANP in cirrhatics might have occurred as a result of decreased response to ANP in the kidney, and this decreased response to ANP might cause sodium and water retention in patients with liver cirrhosis. In the future, more detailed study about the ANP receptor might be required to clarify the cause of decreased sensitivity to ANP in the kidney.
특발성 세균성 복막염 진단에 복수의 산도 및 동맥혈 - 복수산도차 측정에 관한 연구
민영일(Young Il Min),장린(Rin Chang),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Joung Il Lee),정호연(Ho Yeon Chung),이석훈(Suk Hoon Lee) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.1
N/A To evaluate the diagnostic value of ascites pH and arterial-ascites pH gradient in patients with probable spontaneous bacterial peritonitis, we analyzed ascitic fluid in 27 patients. The results were as followed. 1) Mean ascites pH in probable spontaneous bacterial peritonitis was significantly lower than that of sterile ascties(P <0.01), but individual value showed many overlap. 2) Mean arterial-ascties pH gradient in probable spontaneous bacterial peritonitis was significantly higher than that of sterile ascties(P <0.01), but individual value also showed many overlap. 3) Mean ascites polymorphonuclear leukocytes count showed significant difference between sterile ascties and pobable spontaneous bacterial peritonitis(P <0.005). 4) Mean ascites protein concentration did not show significant difference between sterile ascites and probable spontaneous peritonitis. In conclusion, ascites polymorphonuclear leukocyte count may be more significant parameter than ascites pH or arterial-ascites pH gradient in differentiating probable spontaneous bacterial peritonitis from sterile ascies.
간장및 담도 : 각종 간질환에서의 중합 알부민 결합능에 관한 연구
민영일(Young Il Min),장린(Rin Chang),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Joung Il Lee),정호연(Ho Yeon Chung),안재형(Jae Hyung Ahn) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
N/A By a solid-phase radioimmunoassay, we measured a polymerized human serum albumin binding activity (PBA) in 60 patients with various HBsAg-positive liver disease and compared with HBV- DNA measured by a spot-hybridization to evaluate the prognostic meaning of PBA; The results were as follows; 1) At clinical onset of acute hepatitis B, PBA was detected in 70% while HBV-DNA was positive in 8.3% 2) PRA positive percent was 91% in chronic persistent hepatitis, 61% in chronic active hepatitis, and 54% in liver cirrhosis, but the titer was not significant1y different. 3) In patients with HBeAg-positive ]iver disease, mean PBA titer and positive percent were significantly higher than those of HBeAg-negative patients. 4) Mean sGPT level in patients with PBA-positive acute hepatitis B was higher than that of PBA-negative acute hepatitis B. In conclusion, follow-up studies in same patients and further researches in the more samples are needed to evaluate the prognostic meaning of PBA in various liver disease groups.