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HBsAg 음성인 알코올성 간염, 간경변 및 간세포암 환자에서 중합효소연쇄반응을 이용한 혈청 내 Hepatitis B Virus DNA의 검출
송일한,노임환,최정,양미라 대한소화기학회 1999 대한소화기학회지 Vol.34 No.2
Background/Aims: Risk factors for the development of alcoholic liver disease (ALD) are the duration and magnitude of alcohol ingestion, gender, hepatitis B or C viral (HBV or HCV) infection, nutritional status, and genetic factors. The aim of the present study was to evaluate the role of HBV infection in the development of HBsAg-negative ALD in Korea. Methods: Fifty eight controls and one hundred thirty ALD patients were included in this study. The ALD patients consumed alcohol more than 80 g daily for at least 5 years and were negative for HBsAg and anti-HCV. In addition, they had no other factors for developing liver disease and showed positive biochemical parameters for ALD. The detection of serum HBV-DNA was performed by polymerase chain reaction. Results: The overall detection rate (16.9%) of HBV-DNA in ALD patients was higher than that (6.9%) in normal controls, but the difference was not statistically significant. Detection rate of HBV-DNA was 9.8%. in patients with alcoholic hepatitis, 19.8% in the patients with cirrhosis and 25% in the patients with hepatocellular carcinoma. The rate of cirrhotic patients was significantly higher than that of normal controls (p=0.033). The HBV-DNA detection rate (25%) in ALD patients positive for anti-HBc was significantly higher than that (6.9%) in ALD patients negative for anti-HBc (p=0.006). Conclusions: HBV infection may be involved in the development of ALD of patients who were HBsAg- negative chronic alcoholics in Korea.
송일한,김정택 단국대학교 2000 論文集 Vol.35 No.-
Hepatobiliary cystadenoma is a rate but distinct neoplasm with malignant potential, similar to that occuring in the pancreas or ovary. The differential diagnosis of hepatobiliary cystadenoma includes other cystic neoplasms, primary and metastatic, and nonneoplastic cysts including infective conditions. A preoperative distinction from hydatid disease, difficult on radiologic grounds alone, is particulary important. We report a 38-year-old woman admitted because of intermittent epigastric pain. Abdominal ultrasonography, CT and MRI revealed about 15×10㎝ sized multiloculated cystic lesion in medial segment of left lobe of the liver. Hydatid serologic analysis was normal. But serum level of CA 19-9 was raised above 2400U/mL. Under ultrasonographic guidence, we performed aspiration of the cystic fluid. In the examination of cystic fluid, malignant cell was abscent and cystic fluid level of CA 19-9 was also rasied above 2400U/mL. Under the impression of hepatobiliary cystadenoma, laparotomy was performed. A 15×10㎝ sized cystic mass was noted in the medial segment of left lobe of the liver, and then left lobectomy was done. On cut section, 1800mL of serous fluid was obtained from the multiloculated cystic mass. Microscopic findings revealed a cystadenoma lined by a single layer of columnar epithelium containing some intracellular mucin pools and hemorrhagic infact without evidence of cellular atypism or mitosis.
송일한,이무용,박석건,신정우,기명주 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.2
Background/Aims: Hypoxemia is often associated with liver cirrhosis without cardiopulmonary diseases. Pulmonary vascular impairments including intrapulmonary shunt have been considered as a major mechanism of hypoxemia. The aim of this study was to determine the incidence and pathophysiologic basis of hypoxemia in cirrhotic patients without respiratory symptoms. Methods: In fourty three cirrhotic patients without heart and lung diseases, we performed the arterial blood gas analysis and calculated alveolar arterial oxygen gradient (A-aO2). According to the A-aO2, the patients were divided into hypoxemic and normoxemic groups. In each group, a Tc-99m-macroaggregated albumin (Tc-99m-MAA) scan, a contrast-enhanced echocardiography and a pulmonary function test were performed. Results: Twenty-eight of 43 patients (65%) showed hypoxemia. Hypoxemic patients showed significantly more increased shunt fraction of 3.1±1.4% than normoxemic one of 2.1±1.1% in the Tc-99m-MAA scan (p$lt;0.05). However, only two of hypoxemic patients had shunt fraction above physiologic shunt range. By contrast-enhanced echocardiography, an intrapulmonary shunt was confirmed in one patient. There was no significant correlation between the shunt fraction and the hepatic reserve based on the Child-Pugh classification in hypoxemic patients. In the results of pulmonary function test, only DLco decreased more significantly in hypoxemic group than in normoxemic group (58.4 ± 14.2 % vs 75.3 16.5% of predicted, p$lt;0.05). Conclusions: Hypoxemia is not infrequently observed in cirrhosis, but incidence of significant intrapulmonary shunt is low. Therefore, other mechanism such as diffusion defect may be suggested to play a role in the development of hypoxemia in cirrhotic patients without respiratory symptoms. (Korean J Hepatol 2000;6:197-204)
특집 - 당뇨병환자가 소홀히하기 쉬운 간 - 당뇨병환자의 지방간 -
송일한,Song, Il-Han 사단법인 한국당뇨협회 2008 당뇨 Vol.220 No.-
이번 특집에서는 최근에 관심이 높아지면서 그 발병률이 증가하고 있는 비알코올성 지방간 질환의 발병 원인과 기전을 알아보고, 당뇨병환자에서의 지방간질환의 임상증상, 진단 등에 대해 살펴보고, 현재 응용되고 있는 치료방향에 대해서 알아보고자 한다.