식도 정맥류 경화요법후 발생한 장간막 정맥 혈전증

정규원(Kyu Won Chung),정환국(Whan Kook Chung),선희식(Hee Sik Sun),정인식(In Sik Chung),안병민(Byung Min Ahn),김승남(Seung Nam Kim),이여민(Yeo Min Lee),방춘상(Choon Sang Bang),강혜정(Hye Jung Kang),최명규(Myung Kyu Choi),이용각(Yong K 대한소화기학회 1989 대한소화기학회지 Vol.21 No.3

Although there has not been a satisfactory treatment for esophageal variceal bleeding, recently clinicians take interests in endoscopic sclerotherapy. But several complications were also reported after endoscopic sclerotherapy. One of these was mesenteric venous thrombosis which developed more prevalently when the sclerotherapy used in combination of vasopressin infusion. We experienced one case of mesenteric venous thrombosis after esophageal sclerotherapy with vasopressin infusion for control of esophageal variceal bleeding.

철결핍성 빈혈에 대한 Total Dose Imferon Infusion ( Iron - Dextran Complex ) 의 치료효과

정규원 ( Kyu Won Chung ),박완양 ( Wan Yang Park ),정준호 ( Jun Ho Chung ),김동집 ( Dong Chip Kim ) 대한내과학회 1969 대한내과학회지 Vol.12 No.9

The authors conducted the clinical study on total dose imferon infusion in 22 patients of iron deficiency anemia, and on oral ferrous sulfate in 15 patients of iron deficiency anemia, who were admitted to St. Mary`s Hospital, Catholic Medical College betwe

B 형 바이러스 간염 환자의 간조직에서 Hepatitis Be Antigen 의 발현양상과 조직학적 소견의 비교

정규원(Kyu Won Chung),최창진(Chang Jin Choi),나종순(Jong Soon Na),방춘상(Choon Sang Bhang),박수현(Soo Heon Park),한준열(Jun Yeoul Han),김재광(Jae Kwang Kim),이영석(Young Suk Lee),차상복(Sang Bok Cha),선희식(Hee Sik Sun) 대한내과학회 1997 대한내과학회지 Vol.53 No.1

Background: It has been known that the sero- logic markers of infectivity and viral replication in patients with hepatitis B virus(HBV) infection are hepatitis B e antigen(HBeAg), HRV DNA and HBV DNA polymerase. Methods: In order to clarify the relationship between chronic liver diseases and HBV infection, and the mechanism of chronicity in HBV related liver diseases, the expression patterns of hepatic HBeAg by imrnunohistochemical stain and histologic activity index(HAI) were studied from 10% formalin fixed paraffin embedded tissues in 114 patients performed liver biopsy. Results: The results were as follows: 1) Incidence of serum HReAg positivity in HBsAg positive patients was 74.6% and that of hepatic HBeAg expression was 77.6% among serum HBeAg positive cases. Hepatic HBeAg expression was 72.4% in serum HBeAg negative cases. 2) In serum HBeAg positive cases, almost all infected hepatocytes exhibited cytoplasmic HBeAg expression and half of patients showed nuclear HBeAg expression, but cytoplasmic HBeAg expression was solely predominant in serum HBeAg negative cases. Hepatic HBeAg expression showed a decreasing trend from AVH and CPH, through CAH, to cirrhosis with or without HCC, which was a consistent finding with serum HBeAg in decreasing manner. Hepatic HBeAg expreassion was highly sustained in about 60-90% of cases, regardless of duration of their illnesses. 3) HAI showed slighf3y higher tendency in patients with hepatic HBeAg negative expression than in positive cases. Conclusion: The above results suggest that HBeAg may play a role as a viral target antigen for immune-mediated liver injury and may be also related to the pathogenetic mechanism of chronicity in chronic hepatitis B.

간기능 이상을 동반한 혈액질환 환자에서 복강경하 간조직검사의 유용성

정규원(Kyu Won Chung),민우성(Woo Sung Min),김부성,김춘추(Chun Choo Kim),최황(Hwang Choi),김병욱(Byung Wook Kim),김보경(Bo Kyoung Kim),이창돈(Chang Don Lee),박재명(Jae Myung Park),최상욱(Sang Wook Choi),조세현(Se Hyun Cho),이영석(Young 대한내과학회 1999 대한내과학회지 Vol.56 No.4

Objective : Hepatic dysfunction frequently occurs in patients with hematologic malignancies and aplastic anemia who receive intensive chemotherapy or bone marrow transplantation (BMT). The role of laparoscopic liver biopsy in patients with hematologic disorders is very important to determine the etiological factors and to make treatment decisions. The aim of the present study was to evaluate the possible causes of liver disease in patients with abnormal liver function tests. Methods : Laparoscopy guided liver biopsy was performed in 38 subjects who were receiving intensive cytotoxic therapy with BMT or without BMT. Two to three pieces of liver tissues were obtained in each patients using Vim-Silverman needle with electrocoagulation on biopsy site. Platelet transfusions were given if platelet count was less than 50,000/mm3. 39 biopsies were obtained in 38 patients. Results : At the time of liver biopsy, platelet count was 170,000±138000/mm3 (range: 42,000 - 798,000/mm3). No procedure-related complications were observed. Biopsy findings after BMT (n=16) revealed graft versus host disease (GVHD) (n=9), drug induced hepatitis (n=6), veno-occlusive disease (n=2), viral hepatitis (n=1), and nonspecific reactive hepatitis (n=1). 3 patients of GVHD associated with other liver diseases such as drug-induced hepatitis, veno-occlusive disease and chronic active hepatitis B. The authors compared histologic diagnosis with laparoscopic findings. Laparoscopic findings of the liver surface were classified by Shimada's code number system. 5 patients who were biopsed before BMT showed cholestasis and fatty changes and it was possible to be treated with allogenic BMT. Histologic diagnosis in patients without BMT (n=18) showed viral hepatitis (n=6), drug induced hepatitis (n=5), non-specific reactive hepatitis (n=1), and others (n=6). In 12 cases (31%) laparoscopic liver biopsy led to a change in medical management. Conclusion : Laparascopic liver biopsy has been proven to be an effective means of assessing the cause of liver dysfunction in patients with hematologic disorders. The diagnosis obtained at laparoscopic liver biopsy could be changed the therapeutic plan in 12 of 39 (31%) patients.

한국에서의 B형간염 바이러스 보유율 감소

정규원(Kyu Won Chung) 대한내과학회 2000 대한내과학회지 Vol.58 No.6

N/A

증례 : 혈전성 혈소판 감소성 자반증

정규원 ( Kyu Won Chung ),이종무 ( Chong Moo Lee ),민병석 ( Byong Sok Min ),이수남 ( Soo Nam Lee ),송정섭 ( Jung Sup Song ),박성학 ( Sung Hak Park ),서정화 ( Jeong Hwa Suh ) 대한내과학회 1977 대한내과학회지 Vol.20 No.2

간장 및 담도 : 삼출성 복수증의 감별진단과 복강경 검사

정규원(Kyu Won Chung),차상복(Sang Bok Cha),선희식(Hee Sik Sun),김부성(Boo Sung Kim),정인식(In Sik Chung),안병민(Byung Min Ahn),김재광(Jae Kwang Kim),김태룡(Tae Ryong Kim),최규용(Gyu Yong Choi) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.1

N/A Exudative ascites should initiate an evaluation for peritoneal processes, most importantly infection and tumor. And the pathological diagnosis is required for a approapriate treatment in most cases. To assess the diagnostic accuracy and complication rates of diagnostic laparoscopy in patients with exudative ascites we studied in 73 patients with exudative ascites retrospectively. Thirty three patients had malgnancy related ascites, and peritoneal carcinomatosis was confirmed in thirty one patients. Twenty seven patients had tuberculous peritonitis, and thirteen patients had miscellaneous causes, among them eight patients had underlying liver cirrhosis and clinically spontaneous bacterial peritonitis were suspected in three patients in whom bacteria were cultivated in ascites. Pancreatic pseudocyst and leakage into peritoneal cavity was confirmed by endoscopic retrograde pancreatography in one case, but the remained four cases had not known the diagnosis. The most common primary cancer was gastric carcinoma which was diagnosed in fourteen patients, and then ovarian cancer in five patients, colon cancer in four patients, pancreatic cancer in three patients, mesothelioma in one patient and unknown origin in four patients. Cytology evaluation of the ascitic fluid was positive for tumor cells in 62% of patients with peritoneal carcinomatosis. Blind Cope needle biopsy yielded positive diagnosis of neoplastic or tuberculous in 65.4 per cent of rases. The major and minor complication rates of laparoscopy were 0% and 26.4%, respectively, with no fatalities. These findings compare favorably with general experience. We conclude that laparascopy is relatively safe and accurate diagnostic method of choice in exudative ascites, especially in cases when other non-invasive methods were failed.

심포지움 : 20세기 간학의 발전상(임상분야)

정규원 ( Kyu Won Chung ) 대한내과학회 1999 대한내과학회 추계학술발표논문집 Vol.1999 No.2

B 형 만성 활동성 간염에 대한 천연형 Interferon alpha 의 안정성 및 효과

정규원(Kyu Won Chung),선희식(Hee Sik Sun),김부성(Boo Sung Kim),박두호(Doo Ho Park),이창돈(Chang Don Lee),최상욱(Sang wook Choi),한남익(Nam Ik Han),정진우(Jin Wu Jeung) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.2

N/A To evaluate the efficacy and safety of natural interferon alpha (Green Cross Co.) in ten patients with chronic active hepatitis (CAH) type B, a course of 12 weeks natural IFN-alpha was given three times weekly by subuctaneous injection at a dose of 3 million unit (MU) In ten patients with HBeAg positive CAH type B, DNA polymerase and aminotransferase activities were assessed and compared before, during and after natural IFN-alpha administration. We followed up at least for 12 to 24 months. The peripheral blood white cell (WBC), granulocyte and platelet count were also checked before and after therapy. The results were as follows: 1) During administration of natural interferon alpha, DNA polymerase activities were declined significantly within first week and sustained and negative conversion in 70% (7/10). After administration of interferon, DNA polymerase activities were rebounded and negative in only 30% (3/10) at 6 months therapy. 2) Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were decreased significantly from 6 and 12 weeks after therapy, respectively (p<0.05) though transient increament of just after therapy. 3) During follow up period, loss of HBe Ag was found in 5 cases (50%). Of these, seroconversion (Anti-Hbe) of HBe Ag was found in 3 cases (30%). In 2 out of these 3 cases, loss of anti-Hbe and reappearance of HBe Ag in 1case, and sustained increament of serum alanine aminotransferase (ALT) were observed in 1 case, which were revealed progressive liver changes despite loss of Hbe Ag and seroconversion (Anti-HBe) during follow up period. HBe Ag reappeared in 2 cases, which were not seroconversion (Anti-HBe). Namely, loss of HBe Ag and seroconversion (Anti-HBe) and normal serum transaminase were observed in 1 case (10%). 4) There was no significant clinical, hematological, biochemical changes after natural interferon alpha therapy. We concluded that subcutaneous injection of 3 MU natural interferon alpha was safe and effective in decreament of DNA polymerase and transaminase level transiently in patients with CAH type B. But long term therapy more than 3 months will be necessary for the eradication of Hbe antigenemia and clinical improvement for a long time, and repeated biopsy for the exact assessment of results.

간침생검후 발생된 혈종에 대한 초음파 진단

정규원(Kyu Won Chung),선희식(Hee Sik Sun),김부성(Boo Sung Kim),정인식(In Sik Chung),이영석(Young Suk Lee),안병민(Byung Min Ahn),오수혁(Soo Hyuk Oh),유진홍(Jin Hong You),정한국(Han Kook Chung) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.1

N/A Percutaneous liver biopsies were performed in 146 patients with acute and chronic liver diseases, including neoplastic diseases. Among 146 patients, 28 patients had undergone liver biopsy under laparoscopic examination and 118 patients by blind intercostal biopsies. Ultrasonographic examination was performed before biopsy and 24 hours after biopsy. Blood pressure and pulse rate were also examined in all 146 hospitalized patients. The following results were obtained. 1) Development of intrahepatic hematoma was found by ultrasound in one case (0.6%) which the biopsy had been done under laparoscopic examination, however there were no significnt hemodynamic changes in blood pressure, hemoglobin level and pulse rate. 2) No significant hemodynamic changes noted between the prebiopsy and six hours after biopsy. 3) No other serious complications encountered in all 146 cases of liver biopsy. It is concluded that routine post-biopsy ultrasonographic examination may be unnecessary in patients undergone percutaneous liver needle biopsy if a skillful personnel and good indications were applied.