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만성 위염에서 Helicobacter Pylori 에 대한 간편 검사법들의 진단을 비교
손지원(Ji Won Son),한상영(Sang Young Han),최석렬(Seok Reyol Choi),신우원(Woo Won Shin),홍숙희(Sook Hee Hong),한진영(Jin Yeong Han) 대한내과학회 1994 대한내과학회지 Vol.46 No.1
N/A Background: Helicobacter pylori has been implicated in the pathogenesis of chronic active gastritis, peptic ulcer disease, gastric cancer. The rapid identification of this organism may depend upon histologic diagnosis, because culture methods are complex and require a minimum of seven days in to identifying a negative specimen. The purpose of this study was to determine which simple test u to identify this organism was the most cost-effective and easiest to perform and interpret on a routine basis. Methods: The authors evaluated the use of rapid urease test (CLO test(R)), Bio-Rad G.A.P. IgG and 1gM test to detect Helicobacter pylori in 80 patients with chronic gastritis, Results: Sixty patients (75%) had H.pylori identifiable in Giemsa stains, Also, sixty patients (75%) had positive rapid urease tests, sixty eight patients (85%) had positive serum IgG tests, and fifty two patients had positive serum IgM tests. The sensitivities of the methods were as follows: 93% for the rapid urease test, 90g for the serum IgG test, and 63% for the serum IgM test. The specificities of the methods were as follows: 80% for the rapid urease test, 35% for the serum IgG test, and 15% for the serum IgM test. The accuracies of the methods were as follows: 90% for the rapid urease test, 76% for the serum IgG test, and 50% for the serum IgM test, Conclusion: The rapid urease test used in this study is a useful, highly specific screening test; That the serum IgG test has limited specificity.
라미부딘 장기투여 중 발생한 B 형 간염 바이러스 YMDD 영역의 유전자변이
이종훈(Jong Hun Lee),신우원(Woo Won Shin),안현숙(Hyun Sook Ahn),성명식(Myung Sik Seong),조정환(Jeong Hwan Cho),정동엽(Dong Yup Jung),강기태(Ki Tae Kang),김병희(Byung Hee Kim),노명환(Myung Hwan Roh),한상영(Sang Young Han),최석렬(Seok 대한내과학회 2001 대한내과학회지 Vol.61 No.4
N/A Background: The emergence of YIDD or YVDD mutant hepatitis B virus (HBV), with point mutation in the YMDD motif of DNA polymerase gene, has been reported in patient s with lamivudine treatment group. The aims of this study was to investigate the emergence of mutant HBV during long-term lamivudine therapy using nested polymerase chain reaction (PCR) method and direct DNA sequencing. Methods: Twenty-one chronic hepatitis B patients with HBeAg and HBV DNA positive were evaluated. During lamivudine therapy, there were reported breakthroughs of HBV DNA (over 50pg/mL) when investigated the emergence of YMDD mutants by nested PCR method using restriction fragment length polymorphism (RFLP) in all patients. Direct DNA sequencing of HBV DNA polymerase gene including YMDD motif was also performed. Results: There were 13 patients (61.9%) with YIDD mutant and 8 patients (38.1%) with YVDD mutant. The result s of direct DNA sequencing were consistent with those of nested PCR data based on RFLP. The breakthrough was occurred at 15 to 106 weeks (57.9±23.6). At the point of breakthrough, the level of ALT was 74.8±117.7 (14-546) IU/L, and it was lower than the level of ALT before the therapy. Conclusion: In the long-term therapy of lamivudine, the emergence of YMDD motif mutant HBV was related to the breakthrough of HBV DNA and YIDD mutant was frequent. The nested PCR method using RFLP may be simple and sensitive to detect the YMDD motif mutant HBV. (Korean J Med 61:374-383, 2001)
홍기봉 ( Ki Bong Hong ),신우원 ( Woo Won Shin ),한상영 ( Sang Young Han ),최석렬 ( Seok Ryeol Choi ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<서론> 간내 담관 낭선종 혹은 낭선암(intrahepatic biliary cystadenoma or cystadenocarcinoma)은 담관에 생기는 낭성 종양으로 간내 낭성 질환의 약 5%를 차지하며, 1892년 첫 보고가 있은 후 전 세계적으로 약 100례 정도의 보고가 있는 드문 질환으로 30-50대의 백인 여성에서 잘 생기며, 대부분 무증상이거나 증상이 현저하지 않아 우연히 발견되는 경우가 많다. 낭선암은 주로 간의 우엽에 발생하며 특히 우
포스터 발표 : 간 ; 만성 B형 간염환자에서의 라미부딘 단독치료의 효과
김광진 ( Kwang Jin Kim ),신우원 ( Woo Won Shin ),정동엽 ( Dong Yup Jung ),조정환 ( Jung Hwan Jo ),이종훈 ( Jong Hun Lee ),한상영 ( Sang Young Han ),최석렬 ( Seok Ryeol Choi ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
〈목적〉 라미부딘은 뉴클레오사이드 유도체로서 B형 간염바이러스의 증식을 억제하여 간기능과 조직학적 소견의 혼전을 일으키는 것으로 알려져 있다. 투약의 간편성과 부작용이 별로 없다는 장점이 있으나, 일부에서 약제 내성이 유발된다는 단점이 있다. 본 연구는 만성B형 간염환자들에서 라미부딘 단독투여로 치료효과와 내성 발생을 및 각각의 예측인자에 대해서 알아보기로 하였다. 〈대상과 방법〉 동아의대 동아대학교병원에 내원하여 만성 B형 간염을 진단받은 환자들 중
간세포암의 직경과 위치에 따른 고주파 열치료의 치료효과 및 합병증에 관한 연구
유정남 ( Jung Nam Yoo ),신우원 ( Woo Won Shin ),강기태 ( Ki Tae Kang ),조정환 ( Jung Hwan Cho ),문성훈 ( Sung Hun Moon ),윤욱돈 ( Uk Don Yun ),장채령 ( Chae Ryeong Jang ),이태영 ( Tae Yeong Lee ),안원석 ( Won Suk An ),이종훈 ( Jon 대한내과학회 2002 대한내과학회지 Vol.63 No.5
N/A Background : Induction of coagulation necrosis by using thermal energy sources such as radio-frequency (RF), microwaves and lasers has recently been as a new, minimally invasive technique for percutaneous tumor ablation. RF ablation is considerd effective and safe for the local control of small HCCs. The aim of this study is to evaluate the therapeutic efficacy and complications according to the diameter and location of the HCC. Methods : Between May 1999 and December 2000, one hundred fifty patients underwent RF thermal ablation in Dong-A university hospital. Among them, forty nine patients were enrolled in this study who have no history of prior other treatment including hepatic resection, TAE, PEI, and chemotherapy, also who have follow-up CT performed at least six months after ablation. The patients devided into two groups, who have small HCC (.3 cm in diameter) and the others. Recurrence rate was also evaluated with spiral CT performd at least six months after treatment. Results : In large HCC group (>3 cm in diameter), the mean follow-up duration was 10.8 months and local recurrence rate was 51.0%?12.4. In small HCC group (.3 cm in diameter), the mean follow-up duration was 12.7 months. Local recurrence rate was 16.2%?8.6 in patients with small HCC. Among one hundred fifty patients underwent radio-frequency thermal ablation, 5 cases of intraperitoneal bleeding, 5 cases of pleural effusion and 3 cases of pneumothorax were observed. In most of cases, the necrotic area of HCC reached to the capsule of liver or located in hepatic dome. Conclusion : Radio-frequency ablation appears to be more effective and safe for the treatment of small HCC than that of large HCC and more attetion must be given to the RF ablation if the tumor is larger than 3cm or located close to the capsule of liver or in hepatic dome. (Korean J Med 63:507-512, 2002) Key Words : Radio - frequency Ablation, Carcinoma, Hepatocellular
Helicobacter pylori 감염이 동반된 만성위염의 위액 암모니아에 대한 연구
한상영(Sang Young Han),손지원(Ji Won Son),정원태(Won Tae Chung),최석렬(Seok Reyol Choi),신우원(Woo Won Shin) 대한내과학회 1994 대한내과학회지 Vol.47 No.4
N/A Objectives: Helicobacter pylori is reportedly related to gastroduodenal damage. But, the mechanism for H. pylori induced gastric mucosal injury remains obscure. H. pylori has high urease activity to produce ammonia from urea in stomach. Methods: In this sudy, we evaluated the cut-off value of gastric ammonia in basis of Giemsa stain and relationships of ammonia and urea nitorgen between in gastric juice and in serum. We also evaluated usefulness of diagnostic method of gastric ammonia test according to cut-off value in basis of Giemsa stain on chronic gastritis (n=50). And we compared gastric ammonia test with rapid urease test (CLO test). Results: 1) Thirty-one patients (62%) had H. pylori identifiable in Giemsa stain. 2) The ammonia concentration of gastric juice was significantly higher in H. pylori-infected gastritis than in H. pylori-negative gastritis (61.76±43.0 vs 20.96±17.77 mmol/dl, p<0.001). 3) There were no statistical differences between ammonia and urea nitrogen in gastric juice and in serum. 4) Cut-off value of gastric ammonia concentration according to Giemsa stain was 7.78 mmol/dl (εp sign test). 5) When we compared gastric ammonia test with rapid urease test (CLO test), the sensitivity of the methods were 100% vs 97%, and the specificity were 57% VS 95%, and probability were 79% vs 97% Conclusion: The ammonia concentration of gastric juice is significantly higher in H. pylori-infected gastritis than H. pylori-negative gastritis and the gastric ammonia test in this study i.i useful in diagnosis of H. pylori infected gastritis.
반복적인 하부위장관 출혈을 동반한 공장 평활근종 1 예
한상영(Sang Young Han),노명환(Myung Hwan Roh),최석렬(Seok Ryeol Choi),신우원(Woo Won Shin),강기태(Ki Tae Kang),김광진(Kwang Jin Kim),지삼룡(Sam Ryong Jee),이종훈(Jong Hun Lee) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.2
Small bowel tumors are rare, constituting 1.7-6.5% of all gastrointestinal tract neoplasms. Leiomyomas are uncommon benign tumors of smooth muscle and may occur wherever smooth muscle is present. The small bowel is the most frequent site and leiomyomas make up 20-30% of all benign small intestinal neoplasms. Bleeding is the most commom symptom and is usually recurrent. A 33-year-old man who came to emergency room complained of 3-day history of melena and hematochezia. An arteriogram revealed significant hemorrhage from jejunal branch of the superior mesenteric artery. Arterial embolization was performed, followed by laparoscopy-assisted small bowel resection after 17 days. Pathologic examinaton confirmed a diagnosis of leiomyoma. (Korean J Gastroenterol 2001;38:128-131)
위선암에서 Helicobacter pylori 독성인자와 유전자 아형의 관련성
신종민,한상영,금동주,김광진,지삼룡,홍기봉,이종훈,최석렬,신우원,Shin Jong Min,Han Sang Young,Keum Dong Joo,Kim Kwang Jin,Jee Sam Ryong,Hong Gi Bong,Lee Jong Hun,Choi Seok Ryeol,Shin Woo Won 대한위암학회 2002 대한위암학회지 Vol.2 No.1
Purpose: The H. pylori cagA gene, vacA gene and iceA gene are considered to be important virurence factors that have been implicated in the development of gastric adenocarcinoma. It was reported that the presence of IS605 elements may be responsible for rearrangements and lead to partial or total deletions of the cag pathogenicity island (PAI) and the virulence of cag PAI may be changed. However, different results regarding the association between these virulence factors and clinical disease have been reported from different geographic regions. This study evaluated the relationship between H. pylori virulence factors such as cagA, vacA, iceA, IS605 and gastric adenocarcinoma. Materials and Methods: H. pylori isolates were obtained from 54 infected patients (24 cases of gastric adenocarcinoma, 30 cases of control). H. pylori isolates were identified by PCR with ureC gene and 16S rRNA. PCR was performed to examine cagA, vacA, iceA and IS605 genotypes. Results: Significant difference was found in the negative rates of cagA between gastric adenocarcinoma group and control ($62.5\%\;vs.\;33.3\%$ P=0.033). No significant difference was found in the prevalence of iceA, vacA between gastric adenocar cinoma and control. The genotype of cagA+ vacA s1-m1 iceA1 was predominant in H. pylori isolates irrespective of the clinical outcome. IS605 in PAI was not found in gastric adenocarcinoma gruop and control. The positive rates of IS605 in genome were $33.3\%$ in gastric adenocarcinoma group and $36.7\%$ in control (P>0.05). In gastric carcinoma, the positive rate of $cagA^{+}/IS605$ was lower than in control ($12.5\%\;vs\;40.0\%$, P=0.025) and the positive rate of cagA-/IS605 was higher than in control ($54.2\%\;vs\;23.3\%$, P=0.02). Conclusion: H. pylori virulence factors had not related significantly with gastric adenocarcinoma. Further study is needed to examine the specificity of H. pylori strains.
박일(Il Park),한상영(Sang Young Han),박건욱(Gun Wook Park),노명환(Myung Hwan Rho),최석렬(Seok Reyol Choi),신우원(Woo Won Shin) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.4
Adenocarcinoma of the duodenum is rare. The autopsy incidence of duodenal adenocarcinoma is about 0.3%. The second and third portions of the duodenum are the usuaI sites of adenocarcinoma. Cancer in the duodenal bulb is exceedingly rare. Recently authors have experienced a case of duodenal adenocarcinoma on bulb with regional lypmph nodes and liver metastasis in a 59-year-old female patient with complaints of nausea, anorexia, epigastric pain, and weight loss. Endoscopic gasteroduodenoscopy revealed multiple protruded lesion on anterior aspect of duodenal bulb. Abdominal CT scan showed numerous variable sized round or conglomerated low density mass lesions with target appearance and multiple lympadeno-pathies. Endoscopic biopsy tissue from duodenal mucosa showed invasion by neoplastic glands with large, hyperchromatic nuclei and frequent mitosis. Fine needle aspiration biopsy tissue from the liver showed invasion by neoplastic cell sheets or neoplastic glands with hyperchromatic, pleomorphic nucleated cells. The tumor cells showed positive reaction to CEA but negative to AFP. So we report a case of duoderl bulb carcinra with liver nxtastasis with a brief review of literahne. (Korean J Gastroenterol 1995;27: 471-474)