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B형 만성활동성간염 환자에서 Prednisolone 단기 이탈 및 Alpha-Interferon 병합요법의 효과
김인환(In Hwan Kim),이일세(Il Se Lee),신현수(Hyeon Soo Shin),신영호(Young Ho Shin),김양식(Yang Sig Kim),김호규(Ho Gyu Kim),배효근(Hyo Keun Bae),김경환(Kyung Hwan Kim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.2
N/A Background/Aims: This study was conducted to investigate the effect of alpha-interferon after prednisolone withdrawa] therapy on chronic active hepatitis B with HBeAg. Methods: Twenty- three CAH patients were recruited at a general hospital in Pohang city from August 1990 to July 1991. Dose of 45mg, 30mg and 15mg of prednisolone were administered to patients for two weeks and two weeks pause, after that three million units of alpha-interferon 2b was injected once a day for the first week, and then the same dose was injected three times per week for eleven weeks. Patients were followed up for side effect and changes in serum ALT, HBsAg and HBsAb, HBeAg and HBeAb, HBV-DNA, DNA-polymerase and peripheral blood smear during and after treatment. Results: Seroconversion rate of twenty three HBeAg positives at 6 months after treatment was 61% and that of HBV-DNA positives was 48% and both seroconversions occurred in 39% of patients. The normalization rate of ALT was 61% after alpha-interferon therapy. However there were no patients who was become negative among HBsAg positives, Serum ALT decreased at four weeks after administering the alpha-interferon, and a continued decrease was obsered during therapy. However, a gradual increasing of ALT happened after finishing therapy and reached the average level of 79.6IU/L in the eighth week after theropy. The incidence of side effects after alpha-interferon therapy was not serious enough to withdraw therapy, They reported mild symptomes such as, anorexia(69.6%), myalgia(56.5%), fever(52.2%), fatigue(34.8%), arthralgia (26%), nausea(26%), mild hair loss(17.4%) and headache(13%). Conclusions: It was shown that alpha-interferon with prednisolone withdrawal therapy was effective in patients with CAH in terms of seroconversion of HBeAg and decreasing activity of HBV-DNA and normalization of ALT value.(Korean J Gastroenterol 1997; 29:199-206)
전신성 홍반성 낭창 환자에 동반된 골수 섬유화증 1 예
정재혁,김양식,서영배,이순,김호규,최성대,원영준,배효근 대한내과학회 1998 대한내과학회지 Vol.55 No.1
Myelofibrosis is characterized by excessive deposition of collagen, laminin and fibronectin within the bone marrow stroma. These change can be due to primary myeloproliferative disorders, a variety of malignant process, endocrine disturbances, or inflammatory disease. Clinical and laboratory finding are suggest in the immune process with myelofibrosis. It has been rarely reported that myelofibrosis coexisting with SLE. This is a case report of systemic lupus erythematosus coexisting with bone marrow fibrosis in a 44 years old female patient presenting with menorrhagia, syncope and palpitation. We report the case with relevant literature review. Treatment with corticosteroid in a patient with SLE and myelofibrosis remit to the clinical and hematologic abnormalities.