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간조직내 HBV precore 변이를 동반한 HbeAg 양성 만성 B 형간염 환자에서의 인터페론 치료효과
이연재(Youn Jae Lee),옥승철(Sung Cheul Ok),이상혁(Sang Hyuk Lee),설상영(Sang Young Seol),정정명(Jung Myung Chung),박영홍(Yeong Hong Park),주남영(Nam Young Joo) 대한내과학회 1998 대한내과학회지 Vol.55 No.1
N/A type, Group 2: mixed) were received 3-6 MU INF three times a week for 4-6 months, We did follow-ups for at least six months(mean : Group 1-11.3, Group 2- 13.7 months). A complete responder was defined as persis- tent(>6 months) normalization of transaminase and loss of HBeAg and/or seroconversion. Results : The HBV precore mutants were found in 15 cases(31.2%) among 48 patients: 7 cases(21.2%) in 33 HBeAg-positive patients and 8 cases(53.396) in 15 HBeAg-negative patients. The HBV precore mutants were more frequently found in HBeAg-negative patients(p= 0.043). Differences in severity of hepatic pathology were not observed in the wild-type versus mutant-type chronic hepatitis B patients(p =1.00). Initial response rate was not significantly different between two Groups(p= 0.228), but complete response rate had a lower tendency in Group 2 (p=0.073). Conclusion : There is a tendency for HBV precore mutants to be less responsive to INF therapy than wild type. Therefore the patients with chronic hepatitis B should be treated as early as possible in natural history of their liver disease before the emergence of HBV precore mutants.
제5차 대한간학회 춘계학술대회 초록집 : B형 만성 간질환에서 HBV X, core promoter, precore변이종의 임상적 의의
이연재 ( Lee Yeon Jae ),양영일 ( Yang Yeong Il ),장원희 ( Jang Won Hui ),김석주 ( Kim Seog Ju ),장윤식 ( Jang Yun Sig ),이상혁 ( Lee Sang Hyeog ),설상영 ( Seol Sang Yeong ),정정명 ( Jeong Jeong Myeong ) 대한간학회 1999 Clinical and Molecular Hepatology(대한간학회지) Vol.5 No.1(S)
항체 파지발현 기법을 이용한 HCV E1/E2 복합체에 대한 중화항체 분절의 제작
정정명 ( Jeong Jeong Myeong ),정명교 ( Jeong Myeong Gyo ),설상영 ( Seol Sang Yeong ),이상혁 ( Lee Sang Hyeog ),박은택 ( Park Eun Taeg ),지삼룡 ( Ji Sam Lyong ),박성재 ( Park Seong Jae ),백봉력 ( Baeg Bong Lyeog ),송은경 ( Song 대한소화기학회 2003 대한소화기학회 추계학술대회 Vol.2003 No.-
Hepatitis C virus (HCV)에 의한 감염은 체액성 및 광범위한 세포 매개성 면역반응을 나타내게 된다. HCV 감염과 인체 면역 반응과의 관계에 대한 보고들은 HCV 감염에 의해 유도된 항체들이 HCV 감염을 중화시킬 수 있다고 지적하고 있다. 그러나 이러한 연구결과에도 불구하고 실제로 HCV에 감염된 대부분의 사람들은 만성 감염을 나타내고 있는데, 이 문제에 대해 가장 중요한 사실은 HCV의 자연감염시 유도되는 항체들이 HCV를 완전히 제
정정명(Jung Myung Chung),정해철(Hae Chul Chng),설상영(Sang Yeong Seol),정승진(Seung Jin Jeong),최석렬(Seok Reyol Choi),최하진(Ha Chin Choe) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.1
N/A Although several classifications of esophageal varices are reported at present monent, none of them seems to be perfect in terms of clinical applicability. Some are too simple to cover the whole features of varices, or too much complicated to apply practically to clinical practices. Recent remarkable advances of endoscopy has let more precise serial observations and prognostic evaluation of varices be possible without great difficulties. Having observed 373 cases of esophageal varices from Jan. 1981 to June. 1984 at Paik Hospital, In-Je Medical College, we have tried a new classification of esophageal varices, according to not only their shape, size, numbers, colors and locations, but having particular consideration on their bleeding episodes. Endoscopic grades of esophageal varices are classified into following 4 grades, Grade I: One or two tiny tortuous, blue colored varices, less than 2 mm in diameter, being localized in lower esophagus. Grade II: Bead-like tortuosity, blue colored varices, mostly 2-4 mm in diameter being localized in lower esophagus. Grade III: Varices on the top of the varices, red colored, mostly more than 4 mm in diameter with spreading up to mid esophagus. Grade IV: Grade III varices with spreading through the entire esophagus and or down to the fundus of stomach. Bleeding tendency was most frequently observed in Grade IV varices.
조유경 ( Jo Yu Gyeong ),최명규 ( Choe Myeong Gyu ),김세희 ( Kim Se Hui ),이인석 ( I In Seog ),김상우 ( Gim Sang U ),정인식 ( Jeong In Sig ),이상열 ( I Sang Yeol ),최석채 ( Choe Seog Chae ),설상영 ( Seol Sang Yeong ) 대한소화기학회 2004 대한소화기학회지 Vol.43 No.3
Background/Aims: It is unknown whether the prokinetics improve the quality of life in patients with functional dyspepsia. Thus, we evaluate the effect of the mosapride, selective 5-HT4 agonist, on the symptom and life quality of patients with functional dyspepsia using the Nepean dyspepsia index-Korean version (NDI-K), a reliable and validated disease-specific quality of life questionnaire. Methods: A single, open trial was performed in 129 patients with functional dyspepsia. Patients were received mosapride 5 mg t.i.d before each meal for 4 weeks. The symptoms and quality of life were measured with the NDI-K at baseline and 4 weeks. The responsiveness of the NDI-K was evaluated by correlation with symptom scores. Results: All the 15 symptom scores and the dyspepsia score decreased after treatment (p<0.05). The total symptom score decreased from 60.9±25.8 to 24.7±20.4 (p=0.001). Correlations were observed between the total symptom score and the NDI-K score (r=0.47, p=0.001), and between the total symptom score and each score in 5 subscales (r=0.25-0.44, p=0.001). The NDI-K score was significantly increased in the effective group whose dyspepsia score decreased more than 50% of the score at baseline, compared with that of ineffective group. Any significant adverse effect and prolongation of QT interval were not occurred in all patients. Conclusions: A prokinetic drug, mosapride improves the symptoms and the quality of life in patients with functional dyspepsia. (Korean J Gastroenterol 2004;43:160-167)
간문부 담관암(Klatskin Tumor)으로 오인된 원발 담관 림프종
강현구 ( Hyoun Gu Kang ),최정식 ( Jung Sik Choi ),서정아 ( Jeong Ah Seo ),문성수 ( Sung Soo Moon ),김지현 ( Ji Hyun Kim ),지삼룡 ( Sam Ryong Jee ),이연재 ( Youn Jae Lee ),설상영 ( Sang Yeong Seol ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.3
Primary non-Hodgkin`s lymphoma of the extrahepatic bile duct presenting as obstructive jaundice is extremely rare. A 60-year-old man was admitted due to suddenly developed jaundice. Computerized tomography and endoscopic retrograde cholangiopancreatography showed a tumor at the proximal common hepatic duct. These clinical and radiologic findings resembled those of Klatskin tumor. The resection of the common hepatic duct tumor, lymph node dissection, and Roux-en-Y hepaticojejunostomy were carried out. There was no regional lymph node metastasis and no residual tumor at the resection margins. Histology and immunohistochemistry of the resected specimen confirmed a diffuse large B-cell malignant lymphoma involving the common hepatic duct. The patient is scheduled to receive adjuvant chemotherapy. In summary, primary non-Hodgkin`s lymphoma of the extrahepatic bile duct, despite its rarity, should be considered in the differential diagnosis of causes for obstructive jaundice. An accurate histopathologic diagnosis and surgical resection combined with chemotherapy may be the approach to offer a chance for cure. (Korean J Gastroenterol 2009;54:191-195)
A Case of Strangulated Intussusception due to Small Intestinal Lipoma in Adult
김태희 ( Kim Tae Hui ),양성연 ( Yang Seong Yeon ),박정하 ( Park Jeong Ha ),지삼룡 ( Ji Sam Lyong ),박은택 ( Park Eun Taeg ),이상혁 ( Lee Sang Hyeog ),설상영 ( Seol Sang Yeong ),정정명 ( Jeong Jeong Myeong ),김운원 ( Kim Un Won 대한소화기학회 2003 대한소화기학회 추계학술대회 Vol.2003 No.-
성인 장중첩증은 소아에 비해 드물게 발생하며 전체 장중첩증의 5%를 차지한다. 성인에서는 증상과 징후가 매우 다양하여 복통을 주소로 내원한 환자에서 복부초음파나 복부전산화단층촬영으로 주로 진단되며 보고자에 따라 차이가 있으나 30~35%에서는 수술시야에서 진단된다. 성인 장중첩증의 원인으로는 소장의 평활근종, 지방종, 혈관종 등 양성종양이 보고되고 있으며 대장에서는 선암, 임파선암 등 악성종양이 관찰된다. 소장의 양성종양 중 3번째의 빈도로 발생하는 지
소화성 궤양 환자의 헬리코박터 파이로리 제균치료에서 Rabeprazole 삼제요법의 전향적 연구
최봉기 ( Choe Bong Gi ),양성연 ( Yang Seong Yeon ),박은택 ( Park Eun Taeg ),장윤식 ( Jang Yun Sig ),이연재 ( Lee Yeon Jae ),이상혁 ( Lee Sang Hyeog ),설상영 ( Seol Sang Yeong ),정정명 ( Jeong Jeong Myeong ) 대한소화기학회 2003 대한소화기학회지 Vol.42 No.2
Background/Aims: Rabeprazole sodium is a potent proton pump inhibitor. We assessed the efficacy, safety and compliance of one-week triple therapy including rabeprazole with amoxicillin and clarithromycin for eradication of Helicobacter pylori (H. pylori). Methods: Eighty-eight H. pylori-positive patients with peptic ulcer disease were received rabeprazole 10 mg bid, amoxicillin 1,000 mg bid and clarithromycin 500 mg bid for a week. Endoscopic examination with five biopsies (two specimens from the antrum, two from the gastric body, and one from the gastric angle) was performed. The status of H. pylori infection was assessed by histology (immunohistochemistry) of the biopsy specimens, 13C urea breath test, and CLO test at the beginning and 13C urea breath test 4 weeks after the completion of treatment. Results: H. pylori eradication rates were 74.71% by intention-to-treat analysis and 87.84% by per-protocol analysis. The percentage of side effects was 12.5% and these side effects were not serious. Conclusions: One-week rabeprzole based triple therapy is an effective and safe regimen for H. pylori eradication in patients with peptic ulcer. (Korean J Gastroenterol 2003;42:102-107)
복강경하 위 설상절제술(胃 楔狀切除術) 3례 보고 : A Report of 3 Cases
오상훈,최영길,김상효,백낙환,설상영 인제대학교 1995 仁濟醫學 Vol.16 No.2
복강경 수술은 외과의의 기술과 경험이 축적되고 수술 기구의 발달로 인해 점차 그 수술의 영역이 확대 되고 있다. 저자들은 위내시경으로 유문부의 IIc형 조기위암과 점막하 종양 및 관상선종으로 진단된 3례에서 복강경하 위 설상절제술을 시행하여 좋은 결과를 얻었기에 보고하는 바이다. Laparoscopic surgery has been currently popularized with benefit of simple, minimally invasive technique with prompt recovery and short hospital stay. Its application is expanding rapidly with accumulation of new techniques and improvement of equipments over last several years. Laparoscopic wedge resection of the stomach was carried out with gastroscopic assistance as a new surgical procedure for the resection of early gastric cancer and benign gastric tumor. Under the general anesthesia with the patient supine, a laparoscope was inserted through a 10-mm supraumbilcal cannula. Under direct vision, a 18-mm port was made on the mid-clavicular line in the left hypogastrium for introduction of a 60-mm Endo-GIA(Auto Suture), and a 10-mm cannula was placed in the epigastrium to the right of the falciform ligament for instrument access. An internist put a gastroscope into the stomach to raise up the lesion with light illumination. The raised area was grasped with a laparo-Babcock's forceps. A cuff of stomach was excised out by Endo-GIA cutting. Laparoscopic gastric resection would allow excision of small gastric tumors with assessment of the regional lymph nodes and the liver, without the risk of open surgery.
B형 만성 간 질환이 있는 소아와 성인에서 HBV core promoter, precore/core 유전자 부위의 돌연변이에 대한 고찰
정정명,박영홍,설상영,이상혁,장윤식,이연재,채창식 인제대학교 1998 仁濟醫學 Vol.19 No.2
B형 간염은 전세계적으로 수억의 인구가 감염되었을 뿐아니라 간경변증 및 간암의 중요한 원인으로 알려져 있다. 특히 우리나라는 B형 간염바이러스에 전 인구의 약 60%가 과거 HBV에 감염되었던 소견이 있다. 또한 만성 간질환 및 간암 환자의 약 60∼70%가 HBsAg 양성으로 우리나라에서는 HBV가 간질환의 가장 중요한 원인임을 알 수 있다. 그러나 현재까지 간염의 중증도에 어떤 요인이 작용하는지 밝혀져 있지 않다. 이런 점에서 저자들은 B형 간염 바이러스의 변이종과 간질환의 관계를 조사하였다. 변이는 성인에서 많은 경향을 나타내었는데 변이가 주로 발생하는 부위는 core promoter, precore/core 영역에 공히 존재하나 변이와 질환의 중증도와의 직접적인 관계는 관찰되지 않았다. Objectives: To clarify the frequency of mutations in core promoter, precore and core region of HBV(hepatitis B virus) and their possible effects on the clinical course of HBV associated chronic liver diseases. Methods and Materials: we performed PCR (polimerase chain reaction) and direct sequencing for the sera of 48 patients who had been HBsAg positive for more than 6 months (adult 31, children 17). And in this study, adult patients were divided into 3 groups according to the histopathological severity of liver disease i.e. Group 1 as minimal change and chronic persistent hepatitis. Group 2 as chronic active and lobular hepatitis, Group 3 as liver cirrhosis and hepatocellular carcinoma, respectively. Results: 1.The number of mutations at core promoter region did not show statistically significant difference between children and adults. In comparisons among Group 1 vs Group 2 and Group 1 vs Group 3, statistically significant differences were not seen either. About 53.3% of mutations occurred at nucleotide 1753, 1762 and 1764. 2.The number of mutations at precore region which were associated with amino acid changes did not show statistically significant differences between children and adults. And 63.3% of mutations were developed at codon 28(nucleotide 1896). In comparisons among Group 1 vs. Group 2 and Group 1 vs. Group 3, there were no differences in the numbers of mutations. The mutations at this region were more prevalent in Anti-HBe positive group rather than in HBeAg positive group (p= 0.013). 3.At the core region, total number of mutations which were associated with amino acid changes were more frequent in adults than in children. At CTL epitome (codon 18∼27), there were no significant differences of mutations between adults and children, In comparisons among Group 1 vs Group 2 and Group 1 vs Group 3, statistically significant differences were not seen either. CD4 epitope showed statistically significant differences between children and adults (p=0.025), but the histopathological severity was not related with the frequency of mutations. At the B cell epitome, there were significantly different rates of mutations between children and adults(p=0.038). Group 1 and 2 did not show differences, but Group 1 and 3 showed significance. Assuming that the hot spot as mutations over 10% of total cases, 5 spots were identified in children and 11 spots were identified in adults. The area of more frequent mutations in adults were codon 13∼27, 33∼49, 59∼63, 92∼97, 113∼117, which comprise 67.5% of all mutations. Conclusion: We could not find the definite relationships between the mutation in the core promoter, precore/core gene region of HBV and the histopathological severity of HBY associated liver diseases. Further investigations are needed with larger number of patients.