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부식제에 의한 상부 소화관 손상에 대한 내시경적 연속추적검사에 관한 고찰
박충기(Choong Kee Park),김학양(Hak Yang Kim),신호균(Ho Kyun shin),정인구(In Goo Jung),전성국(Sung Gook Jun),유재영(Jae Young Yu) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
The ingestion of caustic agents can initiate a progressive and devastating injury to the esophagus and stomach. Since the introduction of concentrated alkaline cleansers in the 1960s, the incidence of seveve injury has increased. If the patient survives the acute effects of caustic ingestion, the reparative response can result in esophageal and gastric stenosis and an increased incidence of esophageal cancer. There are little reports in the case of the strong acid was ingested, and especially no reports about the periodic gastrofiberscopic examination. We have done the periodic gastrofiberscopic examination every a week for four times to whom ingested the caustic agents. The results obtained were as follows: 1) Male to female ratio was 7:6. The mean age was 33.6 years. (range: 18 to 59) 2) Amount of acid ingested was about 30 to 100 cc. 3) The motive of ingestion was accidental in 2 patients, suicidal attempt in 11 patients, and 4 patients of whom was major depression patients. 4) Patients with ulcer had more severe and many symptoms than patients with gastritis and esophagitis. 5) Of the 13 patients, stricture developed in 5 patients, esophageal stricture in 3 patients, and gastric antral stricture in 2 patients. 6) The esophageal injury was more severe than the gastric injury, probably that is due to ingestion of highly concentrated acid. 7) In 3 patients, serial fiberoptic gastroscopy demonstrated nodular regeneration at 2 weeks after ingesting caustics, esophageal or gastric antral stricture 3 or 4 weeks later. 8) In 5 patients with stricture, 4 patients required operation. Remaining patients without stricture were treated conservatively with antacid or H2 antagonist without subsequent complication.9) None of 13 patients expired. 10) 9 patients had followed-up from 3 months to 15 months after ingestion, 8 patients of whom were free of symptoms, only 1 patient persisted anorexia and dysphagia.
유재영(Jae Young Yoo),신호균(Ho Kyun shin),고순희(Soon Hee Koh),김종혁(Jong Hyouk Kim),송숙희(Sook Hee Song),김규태(Kyu Tae Kim),김학양(Ho Kyun Shin),김진한(Jin Han Kim) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.4
Primary biliary cirrhosis is a relatively common liver disease with cholestasis in Western countries, especially in the middle aged women. The sex distributian of this disease between male to female was 1/9. 1n the Korean literatures, there were only 4 casea reported in female, not in male. We report a case of primary biliary cirrhosis with a review of literatures in a 62-year-old man whose serum bilirubin and alkaline phosphatase were persistently elevated.
만성 B 형 간염환자에서 알파 인터페론의 용량에 따른 치료 효과
최예원(Ye Weon Choi),박승욱(Seung Wook Park),김규태(Kyu Tae Kim),조호준(Ho Jun Cho),고순희(Soon Hee Ko),김동규(Dong Kyu Kim),신호균(Ho Kyun Shin),김학양(Hak Yang Kim),박충기(Choong Kee Park),임규성(Kyu Sung Lim),유재영(Jae Young Yoo) 대한내과학회 1991 대한내과학회지 Vol.41 No.1
To assess the effect of different dosages of interferon alpha-2b(Intron A), 43 patients with chronic hepatitis B were assigned randomly to 3 groups: Group A, l5 patients, received Intron A in a dose of 3 million units (MU) thrice weekly for 12 weeks (total dosage: 1.8×108); Group B, 14 patients, received in a dose of 3 MU every day for the first month and thereafter every other day for the following 4 months (total dosage: 2.7×108); Group C, 14 patients, received no specific therapy. They included 34 men and 9 women, between 17 to 53 (mean 35) years of ages, with elevated serum AST and ALT levels; 41 to 879 (mean 289), and 57 to 334 (mean 288)U/L, respectively. Needle biopsies of the liver before therapy revealed chronic active hepatitis in 35 cases and active cirrhosis in 7 cases, The average follow-up period was 12 months. The results were as follows; 1) During the therapy, serum ALT levels returned to normal in 12 (80%) of Group A and in 12 (86%) of Group B, but increased again in 8 out of 12 in Group A, and in 4 out of 12 in Group B during the follow-up period, In Group C, the ALT level returned to normal in 3 out of 15 during the same period. 2) Serum HBeAg became negative in 6 out of group A in 11 out of Group B, but became positive again in 2 out of 6 in Group A and in 3 out of 11 in Group B during the follow-up period; The sero-negative conversion rate of HBeAg at the end of this study was 27 in Group A and 57% in Group B. In Group C, the sero-conversion of HBeAg was found in 2 out of 14 (14%). A statistically significant difference was noted between Group B and Group C (p<0.05). 3) Comparison of responders and non-responders in the treated group showed no differences in age, sex, liver fuction test, and tissue pathology. 4) Although flu-like symptoms (100%), loss of hair l (10%), and leukopenia (40%) were observed in the treated group, no serious side effects necessitating discontinuation of the therapy were observed. In conclusion, this study showed that the effect of interferon on patients with chronic hepatitis B might be different depending on the dosage and duration of therapy and that with increased dosage, the response rate could to be higher. But further studies should be carried out to determine the exact duration and dosage of therapy in these patients.
만성 B형 간염 환자에서 재조합형 알파 인터페론(Intron-A)의 효과
김동환,최예원,박승욱,신호균,김학양,김진한,박충기,임규성,유재영 대한내과학회 1990 대한내과학회지 Vol.38 No.4
We evaluated the effect of recombinant alpha interferon(Intron-A, Schering) in 30 patients with chronic hepatitis B. They included 24 men and six women, ages 17 to 53 years(mean 37), with elevated serum AST and ALT; 41 to 789 U/㎗(mean 275) and 78 to 689 U/㎗(mean 280), respectively. All patients had serum hepatitis B surface antigen(HBeAg) longer than three years, and hepatitis B e antigen(HBeAg). Liver biopsies before therapy revealed chronic active heaptitis(CAH) in 80% and active cirrhosis in 20%. The patients were randomized into two groups: those who received Intron-A(16 patients) and those who had no therapy(14 patients). Intron-A was administered in doses of 3 million units(MU) every other day for four months and followed-up longer than one and half years. The ALT level returned to normal in 15 of 16(94%) treated patients during therapy, and 4/16 subsequently lost HBV-DNA and HBeAg. In 3/16(19%), serum ALT rebounded and HBeAg reappeared at the 21st week in one and the 54th week in the others. Serum HBeAg persisted in nine of 16 cases(56%), but serum ALT returned to normal level in five patients. In contrast, 3/14(21%) untreated patients showed improvement of serum ALT level at the 6th, 24th and 52nd week of follow-up, respectively, and two subsequently lost HBV -DNA and HBeAg. But nine of 14(64%) patients showed multiple episodes of serum ALT fluctuation during the follow-up period. This study shows that the alternate-day interferon alpha therapy for four months may be effective in some patients with chronic hepatitis B. But because of relatively low significant effect in the treated patients, compared with the untreated, studies with larger number of patients are ncessary to evaluate the duration and the dosage of interferon alpha.