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급성 간부전과 용혈성 빈혈로 증상 발현을 보인 Wilson 씨병
권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),심영학(Young Hak Shim),박진현(Jin Hyun Park),장우익(Woo Ik Jang),전근제(Geun Jae Jeon),최승옥(Seoung Ok Choi) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.1
The first manifestations of Wilsons disease are usually neuropsychiatric disorders and less fre- quently, hepatic disorders (cirrhosis or chronic hepatitis) or transient hemolytic anemia. The purpose of this work is to describe a less well known mode of onset of the disease characterized by the association of intravascular hemolysis and acute liver failure. The diagnosis of Wilson's disease was based in the presence of the Kayser-Fleischer ring and decreased serum ceruloplasmin, and acute intravascular hemolysis was based in the sudden develop- ment of anemia, the high value for the reticulocyte count, the absence of demonstrable bleeding, unconjugated hyperbilirubinemia. Necropsy revealed active liver cirrhosis, micronodular type with marked cholestasis. The mechanism of this syndrome is unknown. A hypothetical explanation might result from hepatic cell necrosis due to accumulation of copper, the consequences being acute liver failure and destruction of erythrocytes by the large amounts of copper released from the necrotic hepatic cells to the plasma. In conclusion: 1) The syndrome of acute intravascular hemolysis and acute liver failure is very suggestive of Wilsons disease. 2) This association can be the first clinical manifestation of the disease. 3) The treatment is generally unsuccessful, and the outcome is usually fatal.
수술로 치유된 간성수흉증 ( Hepatic Hydrothorax )
권상옥(Sang Ok Kwon),홍인수(In Soo Hong),이동기(Dong Ki Lee),배선우(Sun Woo Bae),이성우(Sung Woo Lee),오중환(Joong Hwan Oh) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.4
Hepatic hydrothorax is defined as the presence, in approxirnately 6% of patients with cirrhosis, of a large pleu, al effusion in the absence of primary pulmonary or cardiac disease. Clinical ascites is almost always evident and the pleural effusion is usually right-sided. A 36-yr-old woman with clinical and labolatory evidence of hepatitis B surface antigen-positive liver cirrhosis was admitted hecause of respiraton distress. A moderate amount of ascites w noted on physical i xamination arid the right hydrothorax was re:ealed on the chest X-ray film. Diagnosis was confirmed by the intraperitoneal and intrapleural injction of radioisotope Tc-tin colloid that demonstratcd the one-way transdiaphragmatic flow of fluid from the peritoneal to pleural cavity. We report on a casw of refractory hepatic hydrothroax, wiiich was succesfully treated with surgical closure of diaphragmatic defect and chemical pleurodesis.
간경변증 환자의 비정형 선종성 증식성 결절 ( Atypical Adenomatous Hyperplastic nodule ) 에서 발생한 소 간세포암
권상옥(Sang Ok Kwon),노병선(Byoung Seon Rhoe),장우익(Woo Ick Jang),이동기(Dong Ki Lee),이용규(Yong Gyu Lee),한병근(Byoung Geun Han),심영학(Young Hak Sim),조미연(Mi Yeon Cho) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.4
Adenornatous hyperplasia (AH), defined as a sizable parenchymal nodules that may follow acute or chronic liver injury, has been reported as precursor lesion of hepatocellular carcinoma in the cirrhotic liver. These lesions often coexist with obvious rnalignant foci as small nodule-in-nodule. Morphologically AH can be divided into 'ordinary' and atypical (AAH)' types. The former consisted of hepatocytes similar to those of the surrounding liver. The latter type was composed of hepatocytes showing nuclear, cellular and structural atypia relative to the surrounding liver, and shoved irregular or sparse portal tracts. Cytological and structural pattens are characteristically heterogenous within a nodule. Now AAH are considered to be precancerous lesion evolving to early hepatocellular carcinoma. Authots report one case of hepatocellular carcinoma eithin an atypical adenomatous hyperplastic nodule in 55-years-old male with a review of literatures.
권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),장우익(Woo Ik Jang),조한선(Han Seon Cho),차신웅(Sin Woong Cha),민병철(Byoung Chul Min),진춘조(Choon Jo Jin) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4
Pregnancy is rarely encountered in women with cirrhosis since cirrhosis is less common in women and usually developes after the childbearing years. Additionally, cirrhosis in young women is often accompanied by severe menstrual irregularities and infertility with disturbance of estrogen metabo- lism. The managernent of the liver disease in pregnant patients is the sarne as that of normal people. Studies have shown that while pregnancy may result in a normal healthy infant, the risk of variceal hemorrhage is high, especially in the second and third trimesters. Cirrhosis seems to have an adverse effect on fetal outcome with a high incidence of stillbirths and prematurity in pregnant women. We report our experience of three episodes of pregnancy in two cases of liver cirrhosis and ascites with brief review of literatures.
Clonidine의 굴근반사(屈筋反射) 억제작용(抑制作用)
권상옥(Kwon, Sang-Ok),고상돈(Koh, Sang-Don),신홍기(Shin, Hong-Kee),김기순(Kim, Kee-Soon) 대한생리학회 1987 대한생리학회지 Vol.21 No.1
Effect of intravenously injected clonidine on the flexion reflex was studied in 15 decerebrated and spinalized cats. The flexion reflex was elicited by electrical stimulation of the tibial nerve or the common peroneal nerve and it was recorded as single unit activity from filaments of the L6 or L7 ventral roots. In order to obtain the late flexion reflex discharges, Aδ and C afferent fibers were stimulated with single or train electrical pulses respectively. The flexion reflex, especially the late component, was markedly inhibited after intravenous administration of clonidine. The clonidine-induced inhibition of the flexion reflex was compared before and after treatment of the animals respectively with yohimbine and naloxone. The inhibitory effect on the flexion reflex of clonidine was not altered by naloxone, a μ-opioid receptor blocker, whereas it was completely blocked by yohimbine, an α<sub>2</sub>-adrenergic antagonist. These results indicate that clonidine inhibits the flexion reflex through excitation of α<sub>2</sub>-adrenoceptors even at the spinal cord level.
비장에 이식된 간세포의 조직학적 특성과 알부민 유전자의 발현
권상옥(Sang Ok Kwon),이동기(Dong Ki Lee),김준명(Jun Myeong Kim),박의련(Eui Ryun Park),심광용(Kwang Yong Shim),정필호(Phil Ho Jung),조미연(Mee Yon Cho),허만욱(Mann Uk Hur) 대한내과학회 1997 대한내과학회지 Vol.53 No.4
N/A Background: The morphological characteristics of hepatocytes transplanted into the spleen have been studied. However few attempts has been made to determine the expression of genes in intrasplenically transplanted hepatocytes. The aim of this study was to explore whether the pattern of expression of albumin gene in intrasplenically transplanted hepatocytes is similar to that in adult liver, resulting in the long-term expression of this hepatocyte-specific gene. Methods: Hepatocytes isolated from liver of syngeneic Fischer 344 rats and transplanted into the spleen of rats from the same strain survived for 12 months in the absence of immunosuppressive drugs. Microscopic examination of intrasplenic hepatocytes and Northern blotting for albumin gene expression of RNA extracted from liver and spleen was performed. Results: Microscopy demonstrated that hepatocytes attached themselves only in the red pulp of the spleen and isolated hepatocytes preserved the fine structures characteristic of normal hepatic parenchymal cells. Throughout the 12 months period, intrasplenically transplanted hepatocytes expressed albumin mRNA. Conclusions: Intrasplenically transplanted hepatocytes represent a unique in vivo system of extrahepatic maintenance of hepatocytes. This novel transplantation system could be used to investigate hepatocyte engraft, proliferation and gene expression.
권상옥(Sang Ok Kwon),이동기(Dong Ki Lee),배선우(Sun Woo Bae),이성우(Sung Woo Lee),여경구(Kyong Gu Yoh),백순구(Soon Gu Baek) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6
Emphysematous gastritis is an inflammatory process of the stomach caused by a gas-forming organism. It may therefore be classified as a form of Phlegmonous gastritis which represents a suppurative cellulitis of the stomach. A case of Emphysematous gastritis subsequent or accidental ingestion of Acetic acid is reported. It showed curvilinear extra-luminal gas shadow along the lesser curvature of gastric fundus and upper body on plain abdomina] X-ray. UGI study and abdominal C-T scan showed gas m the wall of stomach. The patient was rapidly deteriorated with downhill course and expired on 4th hospital day.
간장 ( 肝臟 ) 및 담도 ( 膽道 ) : 알콜성 간질환에 있어서 혈청 Procollagen Type III Peptide 및 Laminin의 측정
권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),장우익(Woo Ik Jang),이동기(Dong Ki Lee),김호근(Ho Guen Kim),김현수(Hyun Soo Kim),윤갑준(Kap Jun Yoon) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.1
N/A To evaluate if serum procollagen type III peptide (P-III-P) and laminin levels reflect the extent of liver fibrosis or inflammation, we have studied 67 patients with histologically proven alcoholic liver disease and 12 non-alcoholic control with normal liver function test. The result showed that P-III-P values were significantly elevated in the patients with alcoholic hepatitis (1.87 +- 2.01 U/ml), alcoholic chronic active hepatitis (1.16 +- 1.20) and alcoholic liver cirrhosis (1.26 +- 1.50) compared to fatty liver (90.76 +- 0.49), alcoholic hepatic fibrosis (0.68 +- 0.60) and healthy controls (0.67+- 0.34 U/ml) (p<0.05). When the cut-off value for P-III-P is set at 1.25 U/ml (mean of the fatty liver+2 SD), nearly all (94.1%) of the case with elevated values above the cut-off were alcoholic hepatitis, alcoholic chronic active hepatitis and liver cirrhosis. Furthermore, a close correlation (r= 0.60) was found between the serum P-III-P and laminin (p<0.001). Although P-III-P and laminin did not appear to be particularly useful for differentiating various types of alcoholic liver disease, their concentrations seemed to be related to a degree of hepatic inflammation. And it is evident from our finding that an unexpected increase in serum P-III-P and laminin values could indicate the presence of alcoholic hepatitis, alcoholic chronic active hepatitis and alcoholic liver cirrhosis.