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수종(數種)의 한약재(韓藥材) 전탕액(煎湯液)이 동물 간조직내 항섬유효능검색에 관한 실험적 연구
서동진,이춘우,김홍기,이기남,Seo Dong-Jin,Lee Chun-Woo,Kim Hong-Gi,Lee Ki-Nam 대한예방한의학회 2001 대한예방한의학회지 Vol.5 No.1
Antifibrotic drugs could be delayed or inhibited massive collagen deposition in liver tissue or inhibited collagen synthesis. we investigated antifibrotic effects by several herbs(Schisnadra chinensis, Ganoderma japonicum, Sedum sarmentosum, Alisma canaliculatum, Plantago asiatica) extract with observations of collagen accumulation in liver tissue and collagen synthesis in sera. Rats were used for experimental animal that were devided 3 groups(sham control, BDL/S, BDL/S-ER). Rats were operated for inducing liver fibrosis(cirrhosis) by bile duct obstruction. Several herbs were prepared by water extraction and were applicated p. o. $3ml/day$ during 4 weeks. After observation period, rats were sacrificed and liver tissue and sera were collected. In result, the mortality of rats was 35% in BDL/S group and 20% in BDL/S-ER The color of bile juice in BDL/S-ER was bright yellow and murky yellow in BDL/S group. The significantly lower weight of liver($16.21g{\pm}5.3,\;20.58{\pm}2.4$) and spleen($1.96g{\pm}0.96,\;3.93{\pm}0.21$) were shown in BDL/S-ER than that of BDL/S(p<0.05) group. The value of collagen in liver tissue(25.7%) in BDL/S-ER was observed significantly lower than that of BDL/S group (Tab. 2). AST. ALT, ALP, t-bilirubin, BUN levels were low in BDL/S-ER as compared with those of BDL/S group, but the significance was not proven. The trichrome stained liver tissue in BDL/S-ER group was observed mild bile duct proliferation and fibrosis compared with BDL/S group. In conclusion, natural products inhibited new collagen synthesis and delayed massive collagen deposition in liver tissue, so that they have noticeable antifibrotic effects in experimental liver fibrosis(cirrhosis).
윌슨씨병으로 진단된 138예-new phenotypic classification
김인숙 ( Kim In Sook ),이영상 ( Lee Yeong Sang ),장명국 ( Jang Myeong Gug ),최원범 ( Choe Won Beom ),김성훈 ( Kim Seong Hun ),임영석 ( Im Yeong Seog ),이한주 ( Lee Han Ju ),정영화 ( Jeong Yeong Hwa ),서동진 ( Seo Dong Jin ) 대한소화기학회 2003 대한소화기학회 추계학술대회 Vol.2003 No.-
<목적> 상염색체 열성으로 유전되며 1:30,000의 발병률을 가진 윌슨씨병에 대해 본원에서 진단된 환자의 구체적 임상양상을 고찰해보고, liver international (Ferenci P et al, 23, 2003)과 hepatology (Roberts EA et al, 37, 2003)에서 새로이 정립한 hepatic wilson환자에 대한 분류를 사용하여 보고자 한다. <대상 및 방법> 환자군은 본원에서 윌슨씨병으로 진단된 138예를 대상으로
진행된 간세포암에서의 간문맥 혈전증에 대한 방사선치료 효과
김정훈(Jung Hoon Kim),최은경(Eun Kyung Choi),안승도(Seung Do Ahn),이상욱(Sang-wook Lee),신성수(Seong Soo Shin),최원식(Wonsik Cho),임영석(Young-suk Lim),김강모(Kang Mo Kim),서동진(Dong Jin Suh),정영화(Young Wha Chung),이영상(Young San 대한방사선종양학회 2007 Radiation Oncology Journal Vol.25 No.3
목 적: 치료방법이 정립되지 않은 진행된 간세포암에서의 간문맥 혈전증에 대한 방사선치료의 효과와 간독성을 측 정함으로써 향후 방사선치료의 효용성에 대하여 알아보고자 한다. 대상 및 방법: 2000년 5월부터 2005년 12월까지 서울아산병원에서 원발성 간세포암으로 진단받은 환자 중 간문맥혈전증이 동반된 70명의 환자를 대상으로 후향적 분석을 하였다. 대상 환자들의 나이는 24∼74세(중앙값 51세)였으며, 대부분이 Child-Pugh’s class A, B였고 Eastern Cooperative Oncology Group (ECOG) 2 이하였다. 방사선치료는 3차원입체조형치료를 시행하였으며, 1회 선량은 2∼4 Gy로 총방사선량은 40∼60 Gy (중앙값 48 Gy)였으며, 생물학적 유효선량(biologic effective dose)은 31.3∼78.0 Gy10 (중앙값 61.6 Gy10)였다. 결 과: 치료 반응평가는 치료 전과 치료 종료 후 최소 1개월 이상 경과 후 컴퓨터 단층촬영(CT)을 시행하여 평가하였으며, 대상 환자들의 추적관찰기간은 2∼24개월(중앙값 9개월)이었다. 방사선치료 후 완전반응인 경우가 2명(2.9%), 부분반응 31명(44.3%), 무반응 35명(50.0%), 진행병변 2명(2.9%)이었다. 1년 무진행 생존율(progression-free survival)은 60%였으며, 중앙 무진행 생존기간은 17개월이었다. 전체 환자의 중앙 생존기간(overall survival)은 11개월이었으며, 치료반응 유무에 따라 부분 반응 이상을 보인 환자군의 중앙 생존기간은 15개월, 무반 응이거나 진행병변을 보인 환자군은 8개월로 통계학적 차이를 보였다(p=0.032). 치료 중 일시적인 간기능 저하가 4명(5.7%), 방사선 간염은 1명(1.4%)에서 발생하였다. 결 론: 진행된 간세포암에서의 간문맥 혈전에 대해 방사선치료를 시행한 경우 비교적 유용하며 안전한 치료법이며,앞으로의 연구에서는 방사선치료가 생존율을 향상시킬 수 있는지 여부와 적절한 방사선량을 결정하기 위한 연구가 필요할 것으로 생각된다. Purpose: To determine the role of radiotherapy for the treatment of portal vein thrombosis (PVT) from hepatocellular carcinoma (HCC). Material and Methods: A retrospective analysis was performed on 70 patients that had been diagnosed with HCC and were treated with three-dimensional conformal radiotherapy (3D-CRT) for the PVT. The radiation dose ranged from 40 Gy to 60 Gy (median dose: 48 Gy) and the biological effective dose (BED) ranged from 31.3 Gy to 78.0 Gy10 (median dose: 61.6 Gy10). Response was determined by measuring the extent of the PVT on a CT image at 0, 1 and 3 months after completion of the radiotherapy. The median follow-up period was 9 months. Results: The response rate was 47.1% (33 patients), with two patients (2.9%) showing a complete response, 31 patients (44.3%) showing a partial response, and 35 patients (50%) showing stable disease or no response. The 1-year progression-free survival rate was 60%, and the median progression-free survival time was 17 months. The median overall survival time was 11 months, the median survival time in the responders was 15 months and in the nonresponders was 8 months (p=0.032). Four patients (5.7%) had transient liver function impairment during treatment. Radiation induced liver disease (RILD) was observed in only one patient (1.4%). Conclusion: Three-dimensional conformal radiotherapy for the treatment of PVT from advanced HCC was a relatively effective and safe method.
김도하(Do Ha Kim),김홍자(Hong Ja Kim),박능화(Neung Hwa Park),이근찬(Geun Chan Lee),정영화(Young Wha Chung),이영상(Young Sang Lee),구동억(Dong Erk Goo),윤현기(Hyeon Ki Yoon),성규보(Kyu Bo Sung),유은실(Eun Sil Yu),서동진(Dong Jin Suh) 대한내과학회 1998 대한내과학회지 Vol.54 No.2
N/A Objectives : Liver biopsy is an essential tool to confirm suspected diagnosis and to guide specific therapy in patients with liver disease. But, the standard percutaneous needle biopsy is contraindicated in patients with coagulopathy and large amount of ascites. The transjugular approach has been developed for these problem cases, but its efficacy and safety has not been adequately tested in Korea. Methods : We retrospectively analysed 21 transjugular liver biopsy cases, and the success rate of procedure, the adequacy of obtained specimen for diagnosis and procedure related complications were reviewed. Results : The major reasons for trasjugular liver biopsy were coagulopathy(71%) and massive ascites(19%). Liver tissue was obtained successfully in 20 of 21 cases. The mean number of specimens was 3.4±1.1 per case and the mean size of specimen was 1.8±0.7mm Pathologists reviewed and judged as adequate for diagnosis in 13 cases(65%), helpful in 6 cases(30%), and inadequate in 1 case. Minor complications such as neck pain, hematoma at puncture site, or transient fever occurred in 5 cases (23.8%) but there was no major complication or procedure-related mortality. Conclusion: Transjugular liver biopsy is a safe and valuable technique that provides adequate diagnostic informations in about two thirds of patients for whom conventional percutaneous biopsy is contraindicated.
방사선 투과성 담낭결석에 대한 경구 담즙산 제제 ( ursodeoxycholic acid ) 의 용해 효과
김명환(Myung Hwan Kim),유병무(Byeong Moo Yoo),박선미(Seon Mee Park),김석균(Suk Gyun Kim),송일한(Il Han Song),최호순(Ho Soon Choi),이성구(Sung Goo Lee),서동진(Dong Jin Suh),민영일(Young Il Min) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.4
N/A Background/Aims: The gallstone composition among Asians is known to be different from that of Caucasians. Thus, we tested the hypothesis that the dissolution rate of radiolucent gallbladder stones by oral bile acid may be different between Koreans and Caucasians. Methods: Sixty patients with radiolucent gallbladder stones were treated with ursodeoxycholic acid(10mg/kg) for 6 months. Abdominal ultrasonogram was measured monthly for evaluation of complete dissolution. Results: Complete dissolution of gallstones occurred in 7 patients(l2%), especially in the patients with gallstone diameter5mm. However, symptoms of biliary colic and dyspepsia were relieved during ursodeoxycholic acid treatment in 30(75%) out of 40 patients, without relationship to complete dissolution. Conclusion: The complete dissolution rate of radiolucent gallbladder stones by ursodeoxycholic acid is lower than that of Caucasians. This may be related to the mixing of' calcium bilirubinate and cholesterol stones in the radiolucent stones. Calcium bilirubinate stones of the gallbladder origin are not rare in Koreans and such stones commonly show radiolucency by simple abdominal x-ray film. (Korean J Gastroenterol 1995;27:457-462)
한국인 간세포암 환자에서 HBsAg 및 anti - HCV 의 발현상
김주현(Ju Hyun Kim),김연수(Yeun Soo Kim),서동진(Dong Jin Suh) 대한내과학회 1994 대한내과학회지 Vol.46 No.2
N/A Obifectives: Hepatocellular carcinoma (HCC) is one of the most common malignant neoplasms. Epidemiologic surveys have established that hepatitis B virus (HCV) is a major etiologic factor. It has 1ong been suspected that non-A, non-B (NANB) hepatitis infection may occasionally lead to HCC, and the development of an assay for antibodies against hepatitis C virus (anti-HCV) has confirmed that HCV is frequently involved in chronic liver disease and HCC. In western countries and Japan, the prevalence of anti-HCV in patients with HCC was higher than that of HBsAg, which suggested that HCV infection plays a more important etiologic role in the development of HCC. But in South Africa and Taiwan where the prevslence of HBsAg is high, HBsAg was detected more frequently than anti-HCV in patients with HCC. We investigated the prevalence of HBsAg and anti-HCV in 427 patients with HCC to evaluate etiologic role of HBV and HCV in HCC in Korea where HBV infection is endemic. Methods: The sera which had been collected on admission and stored at -20℃ were tested for HBsAg, HBeAg and AFP, using commercially available RIA kits (Ausria-II, Abbott-HBe and alpha-Feto RIABEAD; Abbott Lab., North Chicago, IL). Anti-HCV was detected by the 2nd generation ELA kit (United Biochemical Inc.). Results: 1) In 427 patients with HCC, 306 cases (71.7%) were positive for HBsAg. 2) Anti-HCV was positive in 20.4% (87/427) of patients with HCC. The positive rate of anti-HCV was significantly higher in HBsAg-oegative patients (42.1%) than in HBsAg-positive ones (11.8%). 3) Considering HBsAg and anti-HCV positivity together, 63.2% of patients with HCC were positive for HBsAg only, 12.0% positive for anti-HCV only and 8.4% positive for both HBsAg and anti-HCV, 16.4% of patients had neither HBsAg nor anti-HCV. 4) Male to female sex ratio of patients with HCC was 4:1 as a whole, and highest prevalence was found in the fifties. However, patients positive for anti-HCV only had relative female preponderance (M:F=2.6:1) than HBsAg-positive patients and highest prevalence was found in the sixties in them. 5) In patients positive for both HBsAg and anti-HCV, 67.6% had serum AFP level greater than 400 ng/ml, while those with neither HBsAg nor anti-HCV tended to have lower AFP and 47.1% had serum AFP level less than 100 ng/ml. Conclusion: It is suggested that HBV is the main etiologic factor of HCC in Korea. However, HCV infection is not uncommon, especially in HRsAg-negative HCC and HCV is considered another risk factor for HCC. HCC patients positive for anti-HCV only tend to be older in age and to have relative female preponderance and lower serum AFP level than HBsAg-positive patients.
간경변증 환자에서 Lupus anticoagulant 및 Anti-cardiolipin antibody의 양성율
김홍자(Hing Ja Kim),이성순(Sung Soon Lee),최승목(Sung Mok Choi),김석균(Suk Gyun Kim),정영화(Young Hwa Chung),이영상(Yung Sang Lee),서동진(Dong Jin Suh),서을주(El Ju Suh),지현숙(Hyun Sook Chi) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.5
N/A Background/Aims: Anti-phospholipid antibody syndrome(APS) is clinical syndrome of venous and arterial thrombosis, recurrent fetal losses and thrombo-cytopenia, which are associated with lupus anticoagulant(LA) and/or anti-cardiolipin antibody(aCL). There are some repors about the prevalence of LA and aCL in liver cirrhotics, but enough data are not available in Korean literature, and the menaing of positiveness of t4ese antibodies has been elusive. So, to know the prevalence and clinical meaning of these antibodies in liver cirrhotics in Korea, this study was performed. Methods: Ninety-one patients with liver cirrhosis requiring admission were randomly selected. LA was tested by combination of LA-aPTT, kaolin clotting time and platelet neutrali- zation method, and aCL by ELISA using Imu]yse ACA kit. Clinical data including etiology and severity of liver disease were analysed. Results: Positive rates of LA and aCL were ]6.5% (15/91) and 34.1%(31/91), respectively. 5 out of 91 (5.5%) patients had both anribodies. There were no corre]ations between the positivity of LA and aCL and age,sex, and etiology of liver disease, but the chance to have severe li ier disease (Child class C) was higher in LA positive patients than negative patients(10/15, 66.7% vs 23/76, 30.3%, p=0.001). 5 out of 41 (12.2%) positive cases seemed to have symptoms and signs of possible APS. 4 out of 41(9.8%) had possible primary illnesses other than liver cirrhosis. Conclusions: About one third of cirrhotics requiring admission and treatment had LA and/or aCL, but only few of positive patients were likely to be symptomatic. Severe liver disease(Child class C) could be a risk factor for LA positivity. (Korean J Gastroenterol 1996; 28:669-676)