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이오영(Oh Young Lee),한동수(Dong Soo Han),손주현(Joo Hyun Son),윤병철(Byung Chul Yoon),함준수(Joon Soo Hahm),이민호(Min Ho Lee),이동후(Dong Hoo Lee),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),정성수(Sung Soo Jung),이인홍(In Hong L 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5
N/A Benign recurrent intrahepatic cholestasis(BRIC) is a very rare cholestatic condition of unknown etiology and its main clinical feature is multiple recurrent episodes of cholestasis with no extrahepatic bile duct obstruction. Familial and nonfamilial forrns of BRIC have been described. We report a case of two sisters with benign recurrent intrahepatic cholestasis. They have experienced recurrent jaundice since childhood. Extrahepatic bile duct obstructions were excluded by ultrasonography and endoscopic retrograde cholangiopancreatography. Liver biopsy specimens showed centri]obular hepatocytic cholestasis. Lobular architectures and portal tracts were well preserved without inflammation.(Korean J Gastroenterol 1997; 29:249-253)
이동후(Dong Hoo Lee),이민호(Min Ho Lee),기춘석(Chun Suhk Kee),최호순(Ho Soon Choi),한동수(Dong Soo Han),윤병철(Byung Chul Yoon),이창범(Chang Beom Lee),이오영(Oh Young Lee),박경남(Kyoung Nam Park),손주현(Joo Hyun Sohn),함준수(Joon Soo 대한소화기학회 1997 대한소화기학회지 Vol.29 No.2
Ulcerative colitis is a chronie inflammatog disorder of unknown cause, which primarily involves the eolonic mucosa. There is increased incidence of carcinoma in patients with uicerative colitis. The major independent factor for coloreetal cancer in patients with ulcerative colitis is duration of disease, extent of involvement, and onset of age. We report two cases of colon cancer which arose in patients with a long history of ulcerative colitis, A 52-year-old house wife was admitted due to bloody diarrhea. She had a 10 years history of ulcerative colitis with pancolitis. The pathologic specimen shows multicentric cancer in rectosigrnoid region and proximal ascending colon with histologic features of mucinous adenocarcinoma. She died of cancer recurrence in the rectum 13 months later. Seeond case is a 62-year-old woman who presented with diffuse abdominal pain. She had a 6 year history of ulcerative colitis with pancolitis. Right hemicolectomy was done. Pathologic specimens showed adenocarcinoma with crypt abscesses and mild dysplasia in the adjacent cecal mucosa. After chemotherapy, she is still alive without complication. (Korean J Gastroenterol 1997; 29:259 - 266)
간문맥 혈전을 동반한 Alpha-Fetoprotein 분비 췌장 선암
이동후(Dong Hoo Lee),박경남(Kyung Nam Park),이민호(Min Ho Lee),기춘석(Chun Suhk Kee),박문향(Moon Hyang Park),한동수(Dong Soo Han),윤병철(Byung Chul Yoon),이오영(Oh Young Lee),손주현(Joo Hyun Sohn),함준수(Joon Soo Hahm),고병희(Byung H 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5
A 39-year-old male with alpha-fetoprotein (AFP) producing pancreatic adenocarcinoma is reported. Abdominal ultrasonography, computed tomography and magnetic resonance imaging showed a tumor extending from head to tail of the pancreas and portal vein thrombi. Neoplastic cells were confirmed by fine needle aspiration cytology from pancreas head mass and portal vein thrombus. Immunohistochemical stainings for a -fetoprotein and a 1-antitrypsin showed a strong reactivity in the neoplastic cells. We report this case with a review of the literature. (Korean J Gastroenterol 1997; 29: 699-705)
이규택(Kyu Taek Lee),성건형(Keon Hyung Sung),양석철(Suck Chul Yang),이오영(Oh Young Lee),이종철(Jong Chul Rhee),함준수(Joon Soo Hahm),이동후(Dong Hoo Lee),기춘석(Choon Suck Kee),박경남(Kyung Nam Park) 대한내과학회 1991 대한내과학회지 Vol.40 No.6
N/A Clinical observations made on 970 patients with lower gastrointestinal bleeding (hematochezia) admitted to Hanyang Universtiy Hospital over a period of 7 years starting from January 1983, revealed the following results. During the study period, patients with lower GI bleeding comprised 1.6% of the total numbers of patients admitted to the Depatment of Internal Medicine and General surgery, and the annual distribution of the patients remained unchanged. Casses of 970 patients with lower gastrointerstinal bleeding were hemorrhoid and anal fissure in 65.5%, malignant neoplasm in 21.1% (rectal cancer 16.9%, sigmoid cancer 3.3%, and anal cancer 0.9%), benign neoplasm in 4.0%, ulcerative colitis in 3.3%, acute infectious colitis in 1.9%, ischemic colitis in 1.7%, radiation colitis in 1.3% diverticulosis in 0.3%, and miscellaneous in 0.1%. The annual incidences of ulcerative colitis and recto-sigmoid cancer increased but that of infectious colitis decreased and others remained unchanged. There was no overall sexual difference. The peak age for hemorrhoid and anal fissure were 30's, benign neoplastic polyps and ulcerative colits were the 40's, malignant neoplasm was the 50's, and radiation and ischemic colitis were the 60's. Patients who required transfusion were 10.8%. Patients with ulcerative colitis (21.9%) and radiation colitis (23.1%) required more transfusions. Patients who improved with conservative treatment only wre 20.2%, and 79.8% required surgical intervention. In the management of benign neoplastic polyps, 51. 2% was treated with ploypectomy.
만성 C 형 간염의 조직학적 특징 : 만성 B 형 및 혼합 B , C 형 간염과의 비교 분석
김지훈(Ji Hoon Kim),이오영(Oh Young Lee),주상언(Sang Aun Joo),최호순(Ho Soon Choi),함준수(Joon Soo Hahm),박경남(Kyung Nam Park),기춘석(Choon Suhk Kee),이중달(Jung Dal Lee) 대한내과학회 1994 대한내과학회지 Vol.47 No.4
N/A Objectives: The aims of this study are to compare the differences in histologic findings between chronic hepatitis C (CH-C), mixed chronic hepatitis B and C (CH-B&C) and chronic hepatitis B (CH-B) and to evaluate histopathologic features characteristic of CH-C for diagnostic significance. Methods: Twelve liver needle biopsy specimens from 12 patients with hepatitis C were selected for histologic evaluation. Four specimens of the 12 were not inadequate, and 8 cases were selected for the study. All 8 patients were negative for HBsAg, HRsAb and HBcAb. The specimens were histologically classified as CPH in 5 cases and CAH in 3 cases. Control groups were divided into two. One was CH-B consisted of 20 patients who had negative tests for anti-HCV and positive tests for HBsAg, The 20 CH-B were classified as CAH in 11 cases (CAH-B), and CPH in 9 cases (CPH-B). The other group (CH-B&C) consisted of 14 patients who had positive tests for both anti-HCV and anti-HBs or anti-HBc. Results: 1) Portal inflammation was more frequent in the CH-C group than in the CH-B group (7/8 vs 1/20). However, the difference in portal inflammatory reaction between CH-C and CH-B8rC was not different significantly (7/8 vs 12/14). 2) Piecemeal necrosis was more prominent in the CAH-B group than in the CH-C group (11/11 vs 4/8). 3) Lymphocyte aggregates in the potal tracts were more frequent in the CH-C and CH-B&C (6/8 vs 13/14) than in the CAH-B group (4/11). However, two cases of CH-C and one case of CH-B&C group did not show lymphocyte aggregates in the portal tracts. 4) Bile duct damage and loss of bile duct in the portal tracts were more prominent in the CH-C than in the CH-B (6/8 vs 2/20). However, the difference between CH-C group and CH-B&C was not noted significantly. (6/8 vs 12/14). 5) There was no significant difference in lobular changes such as ballooning degeneration of hepatocytes, focal hepatic necrosis and steatosis between the CH-C and the control (CH-B and CH-B&C group). Conclusion: Portal inflammation with aggregates lymphocytes was more prominent and frequent in the CH-C than in the control (CH-B and CH-B&C). Bile duct damage and/or bile duct loss in portal tracts due to lymphocytes infiltrate were histologic findings chracterisic of CH-C, although not specific for the diagnosis. No significant differences in histologic features of liver needle biopsy specimens between the CH-C and CH-B&C were noted.
문윤수 ( Yun Su Mun ),권오상 ( Oh Sang Kwon ),이장영 ( Jang Young Lee ),박경남 ( Gyeong Nam Park ),한현영 ( Hyun Young Han ),이민구 ( Min Koo Lee ) 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.1
Severe blunt abdominal trauma frequently involves the liver. The development of nonsurgical treatment of liver trauma has led to more frequent appearance of unusual complications. A hepatic arterioportal fistula (APF) is a rare complication of liver trauma. We present a case of traumatic APF in a patient with liver trauma. A 31- year-old male visited our emergency department with pain in the right upper abdomen following a traffic accident. Initial physical exam and abdominal computed tomography (CT) revealed liver laceration with hemoperitoneum. An abdominal CT obtained on day 11 revealed early opacification of the right portal vein on the arterial phase. After we had come to suspect an APF of the liver, its presence was confirmed on angiography. It was subsequently managed by using transcatheter coil embolization. In patients with portal hypertension and no evidence or history of cirrhosis, one should consider an APF as a potential etiology if history of liver biopsy or penetrating trauma exists. In a patient with liver trauma, serial abdominal CT is important for early detection and treatment of an APF.
간경변증 환자에서 체내 나트륨 대사변화와 그 기전에 대한 연구
채현기(Hyun Kim Chae),윤영무(Young Moo Yun),이오영(Oh Young Lee),한동수(Dong Soo Han),손주현(Joo Hyun Sohn),김호중(Ho Joong Kim),함준수(Joon Soo Hahm),박경남(Kyung Nam Park),기춘석(Choon Suhk Kee) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.4
N/A This prospective study was performed to evaluate the concentration of the serum sodium and its pathogenesis in 16 patients of liver cirrhosis without ascites and 8 patients with ascites who were admitted to Hanyang University Hospital from November 1992 to January 1993. In order to evaluate the pathogenesis of the hyponatremia, we measured the level of serum sodium, serum albumin, serum creatinine, creatinine clearance, 24 hour urinary sodium excre- tion, plasma renin activity(PRA), aldosterone and sympathetic activity in cirrhotic patients without ascites(Group I, n=16) and with ascites(Group II, n=8). Serum Na level and ex cretion of Na in 24 hour urine were decreased significantly in patients with decompensated liver cirrhosis(liver cirrhosis with ascites)(P=0.006). And the frequency of patients with hyponatrernia was high in liver cirrhosis with ascites(Group I:13%, Group II: 50% ). The serum albumin and creatinine clearance were significantly decreased in liver cirrhosis with as- cites(P=0.000, P=0.012). The PRA and serum norepinephrine were also significantly in- creased in liver cirrhosis with ascites(P=0.000, P=0.018). During hospital 10 days, the serum sodium concentration was significantly more decreased(P = 0.04, 136 + 1.9mEq/1132+ 2.6mEq/ 1) with significant weight loss and decreased creatinine clearance in liver cirrhosis with asci- tes. The serum concentration of sodium showed positive correlation with serum albumin(R=O. 6, P=0.004) and negative correlation with PRA(R=0.7, P=0.001) in all patients with liver cirrhosis. These findings indicate that the hyponatremia in liver cirrhosis is associated with de- creased creatinine clearance and disturbance of frea water excretion due to hypoalbuminemia, decreased effective circulatory volume, increased PRA and increased sympathetic activity. (Korean J Gastroenterol 1994; 26: 662 668)
Hepatorenal Syndrome에 대한 Prostaglandin E1 유사화합물인 Misoprostol의 치료 효과
정철헌(Chul Hun Jung),김지훈(Ji Hoon Kim),이오영(Oh Young Lee),김정호(Jeong Ho Kim),김호중(Ho J oong Kim),함준수(Joon Soon Hahm),박경남(Kyung Nam Park),기춘석(Choon Suhk Kee) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.3
N/A Hepatorenal syndrome is a functional renal impairrnent occuring mainly, but not exclusive- ly, in decompensated cirrhosis. Its pronosis is very poor. We studied to evaluate the effect of misoprostol (prostaglandin E, analogue) in patients with hepatorenal syndrome. We observed the therapeutic effect of oral misoprostol(0.4mg, four times per day) for 12 days in six pa- t.ients with hepatorenal syndrome who had oliguria and renal functional deterioration despite adequate supp)ement of fluid. The mean urinary output obtained over the 4 days preceding misoprostol administration was 263, 328, 275, 232, 265 and 356 ml per 24 hours, respectively, in the six patients, despite adequate volume expansion by plasma albumin and fresh frozen plasma. Diuresis increased t,o 906, 900, 625, 1085, 1495 and 1038 ml per 24hours, respectively, on day 1 12 after onset of therapy. In addition of diuresis, serum creatinine levels were 3.5, 2.6, 2.7, 4.5, 4.2 and 3.6mg/ dl before and changed to 2.0,1.9, 2.2, 5.0, 2.1 and 2.9mg/dl during treatment. Therefore, recov- ery of renal function in five patients were evident. Spot urine sodium concentration increased from average 30mEq/L to 40mEq/L in six cases before and during the treatment of misoprostol. In the present study, the oral administration of high dose of misoprostol in patients with hepatorenal syndrome seems to produce marked diuresis with recovery of renal failure, sug gesting again the role of prostaglandin in the pathogenesis of hepatorenal syndrome. There- fore, until further improvements in the management of hepatorenal syndrome in the future, administration of synthetic prostaglandin E,(misoprostol) may constitute an acceptable thera peutic intervention.(Korean J Gastroenterol 1994; 26: 498 505)