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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,
민영일(Young Il Min),이영상(Young Sang Lee),김해련(Hae Ryun Kim),김명환(Myung Hwan Kim),두영철(Young Cheoul Doo),김상위(Sang We Kim),정영화(Young Hwa Joung),이승규(Sung Gyu Lee),박건춘(Kun Choon Park),민병철(Pyung Chul Min),유은실(Eu 대한소화기학회 1990 대한소화기학회지 Vol.22 No.2
We experienced 2 cases of angiodysplasia in duodenal bulb and stomach. The patients had a history of repeated upper gastrointestinal bleeding, and were diagnosed as a angiodysplasia by gastroscopy and angiography. they were treated with surgery due to large lesional involement.
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.
속박 (束縛) 과 침수 (浸水) 로 유도된 흰쥐의 스트레스성 급성 (急性) 위점막병변 (胃粘膜病變) 발생에 있어서 위산분비의 (胃酸分泌) 역할
민영일(Young Il Min),박충기(Choong Kee Park),장린(Rin Chang),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Jung Il Lee),박승준(Seung Joon Park),정주호(Joo Ho chung),정지창(Jee Chang Jung) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.1
N/A The possible roles of gastric acid secretion in the pathogenesis of stress ulcers induced by restraint with water-immersion for 7 hours in pylorus-ligated rats were investigated. Control rats with pylorus-ligation only did not show any gastric mucosa} lesion, and their mean gastric acid output was 449.2 ± 36.1 umol/rat. In contrast, the stressed rats, group II, showed multiple, punctate and hemorrhagic erosions in gastric mucosa, and mean gastric acid output was decreased to the level of 253.7 ± 27.3 umol/rat. Subcutaneous administration of histamine(40 mg/kg every 2.5 h for a total three times) to stressed rats augmented the lesion with severe multiple, linear and hemorrhagic erosions and mean acid output increased significantly (328.1 ± 31.5 umol/, p<0.005) compared with group II. Pretreatment with rantidine(20 mg/kg) or prostaglandin E2 (30 ug/kg) before exposure to stress reduced gastric lesion formation slightly with no significance. In ranitidine pretreated rats, mean gastric acid output was decreased significantly (120.1 ± 15.3 umol/rat, p<0.005) compared with group II. However, in prostaglandin pretreated rats, mean gastric acid output showed no significant changes. Therefore, it is suggested that increased gastric acid secretion seems to be an aggravating or a permissive factor rather than a major factor in the pathogenesis of stress-induced gastric mucosal lesions.
간장 및 담도 : 복수의 감별진단으로서 혈청과 복수의 알부민 농도차의 진단적 가치
민영일(Young Il Min),박충기(Choong Kee Park),방익수(Ik Soo Bang),장린(Rin Chang),장영운(Young Woon Chang),김양학(Hak yang Kim),박종은(Jong Eun Park) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1
N/A Serum-ascites albumin concentration gradient, a parameter of oncotic pressure gradient reflecting presence of portal hypertension, was compared with the usual parameters of ascitic fluid analysis in the differential diagnosis of ascites. We evaluated 29 ascitic patients with liver disease and 21 patients with malignant neoplasm. 1) The group with malignant neoplasm showed higher ascitic fluid total protein level (2.72+-1.10 vs l.39+-0.87 gm/dl), ascites to serum ratio of total protein level(0.83%+-0.17%,0.23%+-0.13%), ascitic fluid LDH level(124.3+-118.2 vs 80.1+-67.OU/L), ascites to serum ratio of LDH level(0.33+-0.19vs0.26+-0.11) and lower serum-ascites albumia gradient(1.42+-0.41 vs2.56+-0.49) (p<0. 005). 2) The serumascites albumin gradient was less frequently overlapped between the two groups than the other 4 parameters. 3) The predictive value of the serum-ascites albumin gradient was significantly higher than the other parameters. we conclude that the serum-ascites albumin gradient offers the best diagnostic discrimination between ascites caused by liver disease and ascites caused by a neoplasm.
흰쥐의 알콜성 위점막 손상에 있어서 혈관 투과성의 변화 및 형태학적 변화
민영일(Young Il Min),장영운(Young Woon Chang) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.2
N/A The purpose of this study was to examine whether increased vascular permeability contributes to the development of gastric mucosal lesions after intragastric administration of ethanol, and to know whether the cytoprotective effect of misoprostol, a kind of prostaglandin E, series, is mediated through the inhibition of changes of the vascular permeability. The degree of extravasation of intravenously injected Evans blue into the rat gastric contents and glandular stomach mucosa was used as an indicator of vascular permeability. Although minimal changes occurred in gross, light and electronic microscopic findings, the degree of extravasation of Evans blue 1 min after 75% ethanol exposure was significantly increased (18.4+3.3 mcg/ml of gastric contents, 24.1+5.6 mcg/100mg of tissue) than control (4.7+2.7 mcg/ml, 5.2+3.5 mcg/100 mg). However, pretreatment with misoprostol did not induce any significant vascular permeability (21. 3+7.0 mcg/ml, 14.6+3.3 mcg/100 mg). Therefore, it is suggested that increased vascular permeability is an early pathogenetic factor in ethanol induced gastric mucosal lesion. The mechanism of cytoprotective effect of misoprostol remains to be further elucidated.
민영일(Young Il Min),장린(Rin Chang),김병호(Byung Ho Kim),장영운(Young Woon Chang),이정일(Jung Il Lee) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.1
N/A Since september, 1987 we have experienced about 995 patients in upper gastrointestinal tract examination with the videoendoscope, which has no fiberoptic bundle for imaging, but carries on its tip a light-sensitive CCD chip as a TV camera. We report our experience about the manipulation of videoendoscope, monitor image and image recording of this system. The results were summarized as follows; 1) The manipulation of the videoendoscope was convenient, because it was not necessay to use camera in the recording or image and assistant could see the image simultaneously, when performed endoscopic biopsy, removal of foreign body and percutaneous endoscopic gastrostomy and so forth. 2) The videoendoscope might be useful for the education and gave an objectivity in the diagnosis of certain lesion, because many individuals could observe simultaneously the same image. 3) The videoendoscope offered high quality image enough to observe the pattern of area gastrica or gastric pits. 4) Unsharp masking method could provide high resolution images by the enhancement of the outline of the lesion. 5) In the recording of the image, good still image could be taken and motion image also could be recorded on the videotape. Therefore videoendoscope system was though to be convenient for the manipulation, offered high quality image and it was possible to record the motion image. So this system was useful for the education and gave an objectivity in the endoscopic diagnosis.
민영일(Young Il Min),장린(Rin Chang),장영운(Young Woon Chang),김병호(Byeong Ho Kim),이정일(Joung Il Lee) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.2
N/A A clinical study about II cases of spontaneous rupture of hepatoma who were operated at Kyung Hee University Hospital between January 1980 and December 1985 was done. The results of the clinical review were as follows; 1) Of 496 cases of hepatoma diagnosed during 6 years (from January, 1980 to December, 1985), 11 cases had spontaneous rupture (2.2%). Male to female ratio was 7:4. 2) 5 cases had single mass in left lobe of the liver, 3 in right lobe including 1 case who had multiple masses in right lobe. 2 cases had multiple masses in both lobe. 3) In most instances, the presenting symptom was abdominal pain and the diagnosis was very difficult without history of chronic liver disease. 4) 10 cases had rupture of tumor mass itself, and one case had rupture of normal liver tissue overlying tumor mass. 5) The association with liver cirrhosis was 73%. All cases of spontaneous rupture of hepatoma were accompanied by verying degree of hemoperitoneum. 6) Left lateral segmentectomy was performed in 4 cases, wedge resection in 2 cases, right lobectomy in 1 case and primary suture in 2 cases. Hepatic artery ligation was employed in 2 cases who had multiple masses or severe bleeding. 7) The postoperative follow-up period ranged from 17 days to 27 months and 2 cases died during hospital admission after surgery. The cause of death in these patients were intraperitoneal bleeding and hepatic failure.