원발담즙간경변증(해설논문(Review Article))

전재윤 ( Chae Yoon Chon ),박준용 ( Jun Yong Park ) 대한간학회 2006 Clinical and Molecular Hepatology(대한간학회지) Vol.12 No.3

대한간학회 제 8 차 춘계학술대회 초록집 : 구연 - 표면항원이 소실된 만성 B 형 간질환 환자의 간조직학적 소견

박준용,전재윤(Chae Yoon Chon),방승민,박영년,한광협(Kwang Hyub Han),장혜영,김균환,문영명(Young Myoung Moon) 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.3(S)

간세포암 환자에서 간동맥화학색전술 후 발생한 간십이지장 누공

박윤혜 ( Yoon Hea Park ),강세훈 ( Se Hun Kang ),김승업 ( Seung Up Kim ),김도영 ( Do Young Kim ),박준용 ( Jun Yong Park ),안상훈 ( Sang Hoon Ahn ),한광협 ( Kwang Hyub Han ),전재윤 ( Chae Yoon Chon ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.3

Transarterial chemoembolization (TACE) is recommended as one of the first line therapy for unresectable hepatocellular carcinoma (HCC). Rupture of HCC following TACE is a rare and potentially fatal complication. We report a case of hepaticoduodenal fistula with ruptured HCC and liver abscess complicated by TACE. A 52-year-old male was treated by TACE three times, followed by radiation therapy and systemic chemotherapy. 30 days after the last TACE, right upper quadrant pain of abdomen was developed. About 1 month later, computed tomography of abdomen showed ruptured HCC with debris containing liver abscess and hepaticoduodenal fistula. Esophagogastroduodenoscopy revealed hepaticoduodenal fistula and hepatic parenchyme covered with exudate. The patient was managed with supportive care, but the hepaticoduodenal fistula persisted. (Korean J Gastroenterol 2011;58:149-152)

만성 염증성 장질환 환자에서 항호중구 세포질 항체의 의의

문윤재(Yoon Jae Moon),배희동(Hee Dong Bae),박효진(Hyo Jin Park),김원호(Won Ho Kim),정석훈(Suk Hoon Chung),김현숙(Hyun Sook Kim),전재윤(Chae Yoon Chon),박인서(In Suh Park) 대한내과학회 1997 대한내과학회지 Vol.52 No.5

Objective: Anti-neutrophil cytoplasmic antibody (ANCA), known as a useful diagnostic marker in patients with ulcerative colitis (UC), are specific for granule proteins of granulocytes and monocytes and induce distinct fluorescence patterns. To evaluate the significance of ANCA in chronic inflammatory bowel disease (IHD), the presence of ANCA in chronic IBD was studied using indirect immunofluorescent test (IIF), Methods: Between March, 1994 and September 1995, 51 patients with chronic inflammatory bowel disease were subjected in this study. We had analysed the correlation between duration, disease activity, location by colonoscopy and radiologic examinations, steroid treatment. Results: 1) Among 34 patients with ulcerative colitis (UC), ANCA was demonstrated in 23 patients (67.6%). Among 19 patients with other chronic IBD (4 Crohn's disease, 6 Behcet's colitis, 7 intestinal tuberculosis and 2 radiation colitis) 2 patients (10.5%) had ANCA. The positivity of ANCA in patients with UC was significantly higher than in patients with other chronic IBD. 2) In patients with UC, c-ANCA was positive in 2 (5.9%) patients and p-ANCA was positive in 21 (61.8%) patients. In patients with other chronic IBD, ANCA was positive in one patient with Behcet's colitis or one patient with intestinal tuberculosis but negative in all patients with Crohn's disease or radiation colitis. 3) The mean duration of disease in ANCA positive patients was 42.4±39.4 months and the mean duration of disease in ANCA negative patients was 44.9±36.8 months, but there was no significant difference. 4) The number of patients in clinically mild, moderate and severe group were 23 (37.6%), 6 (83.2%) and 5 (14.7%) respectively. Among these groups the number of ANCA positive patients were 15 (65.2%), 5 (83.2%) and 3 (60%) respectively, but there was no significant difference. 5) The number of patients with proctitis, left side colitis and pancolitis were 9 (26.5%), 14 (41.2%) and 11 (32.4%) respectively, Among these groups the number of ANCA positive patients were 4 (44.4%), 10 (71.4%) and 9 (81.8%) respectively, but there was no significant difference. 6) Among 13 patients with steroid treatment 9 patients (69.2%) were ANCA positive. Among 21 patients without steroid treatment 16 patients (76.2%) were ANCA positive, but there was no significant difference. Conclusion: Although there was no correlation between ANCA and duration, disease activity, location or steroid treatment in UC patients, ANCA could be a diagnostic marker of UC in chronic IBD patients.

알코올에 의한 간손상시 적혈구막 지질 과산화현상의 역할

함기백,김원호,전재윤,문영명,강진경,박인서,최홍재,장학철,김한수,백승운,신용운 ( Ki Baik Hahm,Won Ho Kim,Chae Yoon Chon,Young Myung Moon,Jin Kyung Kang,In Suh Park,Heung Jai Choi,Hak Chul Jang,Han Soo Kim,Seung Woon Paik,Yong Woon Shin 대한소화기학회 1992 대한소화기학회지 Vol.24 No.2

The question of whether or not ethanol-induced liver injury is related to or accompanied by lipid peroxidation has been a subject of controversy. Short-term ethanol administration was shown by some to produce hepatic lipid peroxidation in rats, but very large doses of ethaol had to be used. Furthermore, some investigators failed to confirm these effects of ethanol. Fewer studies have explored the relationship between alcohol consumption and lipid peroxidation. In order to study this question and clarify the role of oxygen derived free radicals and lipid peroxidation of the RBC in inducing the alcoholic liver diseases, we measured the thiobarbituric acid reactivities in normal controls and patients with alcoholic liver disease. The subjects were divided into three groups according to the liver function tests and the amounts of alcohol drinking: group I-normal controls, group II-cases showing normal liver function test in spite of frequent alcohol drinking over 3 days per week and 45 g alcohol per one time, group III-patients with alcoholic liver disaesae, drinking alcohol over 4 times per week. The thiobarbituric acid reactive substances were measured as a marker of lipid peroxidation by the method of Uchiyama and Mihara. The colorimetric method was used by a measurment of malonyldialdehyde [MDA, nmole/ml (packed cells)] concentration. The results were as follows; (continue...)

만성 간질환 환자에 대한 고덱스 캅셀의 유효성.안정성에 관한 다기관, 무작위할당, 이중맹검 3상 비교임상시험

박문승,강주섭,전재윤,백승운,임규성,곽민정,전용철,이민호,Park, Moon-Seung,Kang, Ju-Seop,Chon, Chae-Yoon,Paik, Seung-Woon,Rim, Kyu-Sung,Kwak, Min-Jung,Jeon, Yong-Cheol,Lee, Min-Ho 대한임상약리학회 2001 臨床藥理學會誌 Vol.9 No.2

Background/Aims : Godex is a mixture of PMC(diphenyl-dimethyl-dicarboxylate) and Hepadif, each of which has been used for managing chronic liver disease in Korea and other countries. The purpose of this study was to evaluate the efficacy and safety of Godex in Korean patients with chronic liver disease. Methods : In this study, 154 patients with chronic hepatitis, who showed increased level of serum alanine aminotransferase(ALT), were randomly allocated into three groups. Fifty-two patients were administered 100mg/day of PMC, 48 patients were administered low dose of Godex(PMC 100mg+hepadif 600mg/day) and 53 patients were administered high dose of Godex(PMC 150mg+hepadif 900mg/day) orally for 8 weeks. To evaluate the efficacy and safety of Godex capsule, we considered primary variable as the proportion of patients who showed normal ALT blood level after treatment for 8 weeks and second variable as a proportion of patient who showed normal ALT at 4 weeks, the degree of difference of serum ALT level between 0 and 8 weeks, and incidence of adverse events during treatment period. Results : The percentage of subjects whose serum ALT levels decreased below upper normal level in control, low-dose and high-dose group were 64.54%, 67.35%, 81.13% after 8 weeks-treatment(p=0.0407) and 59.62%, 63.27%, 81.13% after 4 weeks-treatment of Godex(p=0.0790) using ITT analysis. There were no significant difference in incidence of adverse events among three groups. Conclusions : Response rate of high-dose group was significantly higher than those of low-dose group and control group. It is suggested that Godex 6 capsules per day(PMC 150mg+hepadif 900mg/day) is optimal dose for Korean patients with chronic liver disease who show elevated serum alanine aminotransferase(ALT) level.

각종 간질환 환자에서 혈중 lipoprotein ( a ) 농도의 변화

함기백,김원호,한광협,전재윤,강진경,박인서,최홍재 ( Ki Baik Hahm,Won Ho Kim,Kwang Hyub Han,Chae Yoon Chon,Jin Kyung Kang,In Suh Park,Heung Jai Choi ) 대한소화기학회 1992 대한소화기학회지 Vol.24 No.2

Lipoprotein (a) [Lp (a)] is a LDL-like lipoprotein whose concentrations in plasma are significantly are correlated with atherosclerosis. The characteristic protein compoment of Lp (a) is apoliporotein (a) which is linked to apolipoprotein B-100 by disulfide bonds. Although Lp (a) might play an important role in the development of premature atherosclerotic vascular lesions, only scarse information about the metabolism of this lipoprotein is available. The major site of synthesis of Lp (a) appers to be the liver because it was found that a complete conversion of the Lp (a) phenotype of thc receipient to that of the donor occurs after liver transplantation and presence of apo (a) mRNA in human liver and hepatoma cell line. Until the present time, little information is available about determining the influence of liver disease on Lp (a) concentration. This study was designed to find out the changes of Lp (a) concentrations in 88 patients with various liver diseases, diagnosed histologically through the peritoneoscopic liver biopsy. The Lp (a) concentrations were checked by the method of radioimmunoassay. The mean Lp (a) concentrations of CAH with LC (6.1+4.8 mg/ml) and LC group (4.1+2,2 mg/ml) were significantly lower than those of normal control (24.4+19.1 mg/ml), CPH (25.4+18.5mg/ml), and CAH group (16.6+13.7 mg/ml). The Lp (a) concentrations were significantly correlated with serum albumin concentrations (r=0.54 p<0.05) and prothrombin time (r=0.62, p<0.01). There was a significant difference in mean Lp (a) coincentration between the cases with serum albumin above and below 3.0 g/ml in patients with liver cirrhosis. These data suggest that lipoprotein (a) may be secreted frorn the liver in accordance with the capability of liver to synthesize the protein and we find out that as the liver diseases progressed and deteriorated, the levels of Lp (a) concentrations were significantly decreased.

식도암 조직절편에서의 human papillomavirus 검출

김원호,정준표,송시영,전재윤,이상인,강진경,박인서,최흥재,김건홍,김윤수,박영년,박찬일 ( Won Ho Kim,Jun Pyo Chung,Si Young Song,Chae Yoon Chon,Sang In Lee,Jin Kyung Kang,In Suh Park,Heung Jai Choi,Kun Hong Kim,Yoon Soo Kim,Young Nyun Park 대한소화기학회 1992 대한소화기학회지 Vol.24 No.3

Since Syrjanen published his observation on histological changes identical to those of condylomatous lesions in squamous cell carcinoma of the esophagus, much evidence has been accumulated implicating the etiologic role of HPV infection in the development of this carcinoma. The aim of the present study is to clarify the relationship between HPV infection and esophageal cancer by light microscopic examination, immunohistochemistry and in situ hybridization using paraffin-embedded esophageal squamous cell cancer tissue. (continue...)

이차성 비기능항진증에서 부분적 비장동맥색전술의 장기 치료 효과

이중민 ( Jung Min Lee ),전재윤 ( Chae Yoon Chon ),한재용 ( Jae Yong Han ),윤기태 ( Ki Tae Yoon ),문창모 ( Chang Mo Moon ),안상훈 ( Sang Hoon Ahn ),한광협 ( Kwang Hyub Han ),이종태 ( Jong Tae Lee ),문영명 ( Young Myoung Moon ) 대한내과학회 2007 대한내과학회지 Vol.72 No.5

Background: Liver cirrhosis causes secondary hypersplenism and thrombocytopenia is clinically troublesome. Splenectomy (SPL) was thought to be the curative management for correcting thrombocytopenia. However, decompensated liver function prevents any surgical approach due to high morbidity and mortality. Hence, partial splenic embolization (PSE) has been introduced, which is a less invasive procedure. The purpose of this study was to assess the long-term therapeutic effects of PSE and to compare them with those of SPL. Methods: This study was performed retrospectively in patients who underwent PSE or SPL from Jan. 1999 to Dec. 2003. The patients either had symptoms of bleeding or they needed to correct their thrombocytopenia for further treatment of associated diseases. The therapeutic effects were evaluated, and the complications were assessed. Results: Forty and 35 patients were enrolled in the PSE and SPL groups, respectively. WBC, platelet and hemoglobin counts were all significantly increased at the 2 year follow-up in both groups. Child-Pugh score significantly decreased in the PSE group from 6.5 before treatment to 5.5 after treatment (p=0.004). Minor complications were easily controlled with supportive care, and major complications very rarely occurred in both groups. Conclusions: PSE and SPL both proved to be effective measures with few serious complications for treating pancytopenia in patients with liver cirrhosis. Considering the improved liver function (the prothrombin time) and the Child-Pugh score after PSE, it may be more reasonable to initially recommend PSE for the patients with liver cirrhosis and secondary hypersplenism. (Korean J Med 72:470-479, 2007)

복막위점액종의 임상적 고찰

정준근(Jun Keun Jung),전재윤(Chae Yoon Chon),조현근(Hyeon Geun Cho),김경철(Kyung Chul Kim),박효진(Hyo Jin Park),정준표(Jun Pyo Chung),이관식(Kwan Sik Lee),이상인(Sang In Lee),강진경(Jin Kyung Kang),박인서(In Suh Park) 대한소화기학회 1998 대한소화기학회지 Vol.30 No.3

Background/Aims: Pseudomyxoma peritonei is a rare malignancy in which the peritoneal surfaces and omentum are involved with diffuse gelatinous mucinous implants. It arises from mucinous neoplasma of the appendix and ovary, and from mucin-producing cells disseminted within the peritoneal cavity. A large scale collective review of pseudomyxnma peritonei has not been reported at present in Korea, The aims of this study were to analyze the natural history of the disease, to examine the clinical and pathologic features that might act as prognostic indicators, and to review our experience with available therapeutic modalities. Methods: Thirty-six patients(10 men, 26 women) were included. The clinical data were collected retrospectively. Information on both survival and tumor recurrence was described using the Kaplan-Meier method. Univariate assess- ments of potential risk factors with respect to both recurrence and survival were performed for categoric variables. Results: There was a preponderance of women(M:F=l:2.6), the mean patient age at presentation was 54.9 years, and the median duration of symptoms was 2 months. The most common presenting symptoms were abdominal pain(50%) and a4dominal fullness(47%). The site of tumor origin was most commonly the ovary(42%). The pathologic diagnosis was adenocarcino- mas(50%), and cystadenocarcinomas(47%). Surgery was performed in 26 patients(72%); 50% of these patients also received postoperative adjuvant chemotherapy. The median survival time was were 25.3 months for the entire group; 29.5 months for surgery 1(I,3 months for chernotherapy, and 7.5 months for na treatent group respectively. Postoperative adjuvant chernotherapy did not improve the surate. The recurrence rate of disease after curative resection was 56%. Weight loss(p=0.013) and residual tumor after surgery(p=0.026) were an adversely affecting factors on survival, Conclusions: Pseudomyxoma peritonei is a progressive and frequently relapsed mali- gnancy, but aggressive and repeated debulking surgery is recommeded. (Korean J Gastroenterol 1997; 30:323-332)