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최흥재(Heung Jai Choi),문영명(Young Myoung Moon),정재복(Jae Bock Chung),이상인(Sang In Lee),한광협(Kwang Hyub Han),전재윤(Chae Yoon Chon),김상애(Sang Ae Kim),조준구(Jun Koo Cho) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.2
N/A We assessed predicting factors of fafality in 42 patients with fulminant hepatitis such as age, sex, etiology, serurn levels of albumin, total bilirubin, SGOT, SGPT and alpha-fetoprotein, SGOT/SGPT ratio, plasma level of ammonia, prothrombin time, degree of encephalopathy and complication. Singificant differences were observed between the survivors (14 patients) and the non-survivors (28 patient.) by plasma level of ammonia and serum level of alpha-fetoprotein. Mortality tended to be increased by decreasing serum level of albumin and alpha-fetoprotein, prolonging prothrombin time, increasing plasma level of ammonia, a SGOT/SGPT ratio above than 1.0, deepening of encephalopathy and developing complication such as respiratory failure, cardiac dysfunction, cerebral edema or renal dysfunction. In patients with fulminant hepatitis B, the absence of HBsAg in serum had favorable prognostic value. In conclusion, the serum level of alpha-fetoprotein, plasma level of ammonia, prothrombin time, SGOT/SGPT ratio, degree of encephalopathy, and complication such as respiratorv failure, cardiac dysfunction. Cerebral edema and renal dysfunction may be used as predicting factors of fatality in fulminant hepatitis.
각종 간질환 환자에서 섬유소용해 활성도 ( Fibrinolytic Activity ) 에 관한 연구
최흥재(Heung Jai Choi),문영명(Young Myoung Moon),정재복(Jae Bock Chung),한광협(Kwang Hyub Han),전재윤(Chae Yoon Chon),박준용(Joon Yong Park),윤홍섭(Hong Sup Yoon) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
N/A To assess the fibrinolytic activity and coagulation defects in various liver diseases, antithrombin III, fibrin degradation products and prothrombin time were measured in the plasma of 49 patients with various liver diseases including liver cirrhosis, hepatoma, acute viral hepatitis and obstructive jaundice. Also antithrombin III was measured in the plasma of 29 normal controls. The results were as follows: 1) The antithrombin III level was significantly lower in liver cirrhosis and hepatoma than in controls. 2) The fibrinogen was significantly higher in obstructive jaundice than in the others. 3) Small amounts of FDP were found in some patients with liver cirrhosis and hepatoma. 4) In the cirrhotic patients, a significant difference in antithrombin III level was found between patients with FDP (+) and those with FDP (-). 5) The prothrombin time was significnatly more prologned in liver cirrhosis than in the others. 6) A significant correlation was found between antithrombin III and prothrombin time (r=0.48). 7) Comparing cirrhotic patients classified as Child A, B and C, the antithrombin III level was lower in Child C and the prothrombin time was more prolonged than in Child A and B. FDP was found in all but one of the patients classified as Child C.
이돈행(Don Haeng Lee),송시영(Si Young Song),전재윤(Chae Yoon Chon),한광협(Kwang Hyub Han),정재복(Jae Bock Chung),문영명(Young Myoung Moon),강진경(Jin Kyung Kang),박인서(In Suh Park) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.6
N/A Background/Aims: Intrahepatic cholangiocellular carcinoma is devided into the peripheral and hilar type according to the location. The clinical features of hilar type is similar to that of extrahe- patic bile duct cancer and the peripheral type similar to the hepatocellular carcinoma. We conducted this study to identify the differences of clinical characteristics and survival rates between the hilar and peripheral type. Methods: We analyzed 42 cases with intrahepatic cholangiocellular carcinoma who were histologically confirmed from January 1981 to December 1990 at Severance Hospital, Yonsei University. Results: The mean age was 57.2 years, the male to female ratio 2.2 to 1. The most common symptom was abdominal pain(83.3%), jaundice was more frequently encountered in hilar type(33.3%) than peripheral type(6.7%) and abdominal mass more common in peripheral type(48.4%) than hilar type(11.1%). Associated diseases were infestation of Clonorchis sinensis(19.0%), liver cirrhosis(19.0%) and intrahepatic bile duct stones(7.1%). The elevation of serum CEA(more than 5 ng/ml) was noted in 52.0%. On abdominal ultrasonography, the hypere- choic pattern in hilar type and the hypoechoic pattern in peripheral type were commonly noted. The hepatic arterial angiography showed mostly hypovascular pattem(72.7%). Local invasion was more frequent in hilar type than peripheral type, however distant metastasis was more common in peripheral type. The overall median survival of 36 cases was 5.5 months, and hilar type 5.3 months and peripheral type 5.9 months. According to the treatment modalities, the survival rates in cases underwent curative resection(median survival; 12.5 months) and in cases with combination of chemotherapy, radiotherapy and hyperthermia(median survival; 9.6 months) were significantly higher than that of no treatment group(median survival; 2.0 months)(pC0.05). Conclusions: To improve the survival in cases with intrahepatic cholangiocellular carcinoma, the efforts to diagnose in early stage should be recommanded, especially in the high risk group such as the patients with Clonorchiasis and intrahepatic bile duct stones. Additionally we should remind the differences including the pattern of metastasis between hilar and peripheral types in the management of these patients. (Korean J Gastroenterol 1995;27: 679 - 689)
위장관 ( 胃腸管 ) : 십이장궤양에 있어서 Niperotidine의 치료 효과
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),정재복(Jae Bock Chung),이상인(Sang In Lee),전재윤(Chae Yoon Chon),김원호(Won Ho Kim),함기백(Ki Baik Hahm) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3
N/A For the evaluation of clinical efficacy of niperotidine, a new potent histamine H, receptor anta-gonist, it was orally administered 460 mg once daily at bedtime for 4 weeks in 30 patients with active duodenal ulcer endoscopically diagnosed and then followed up by endoscopy. The observed results were as follows; 1) Clinical symptoms disappeared in 70.0%, 83.3%, and 96.7% of patients with duodenal ulcer at 1, 2, 4 weeks respectively. 2) The complete healing rates of duodenal ulcer by endoscopy at 4 and 8 weeks were 80.0% and 100.0% respectively. 3) Mild adverse reaction was observed in 5 patients including one cae of mild r-GTP elevation, two cases of loose stool, one case of drowsiness, and one case of skin rash, but not severe enough to stop or change medications. In conclusion, we thought that niperotidine was effective, safe and convenient to use in the treatment of duodenal ulcer.
간외담관 낭선종 ( Extrahepatic Biliary Cystadenoma )
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),정재복(Jae Bock Chung),전재윤(Chae Yoon Chon),김원호(Won Ho Kim),박찬일(Chan Il Park),송시영(Si Young Song),박영년(Young Nyun Park),이경식(Kyoung Sik Lee) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.3
Cystic tumor of the intra- or extra- hepatic bile ducts is a rare but distinctive neoplasm, similar to that occurring in the pancreas or ovary. The cystadenomas of the extrahepatic biliary tree are extremely rare, and most of them are usually intrahepatic, and rarely diagnosed preoperatively. We report a 63-year-old woman admitted because of intermittent abdominal pain for 1 month. Abdominal ultrasonography revealed a 2.5 cm hypoechoic oval mass with hyperechoic rim in dilatecl common hepatic duct and common bile duct. Abdominal computerized tomography revealed a hypodense mass surrounded by a thick dense outer rim. A 2.5*1.5 cm filling defect hanging from the right hepatic duct with a stalk was noticed on endoscopic retrograde cholangiography (ERC). Under the diagnosis of benign tumor originating from extrahep:,stic bile duct, laparotomy was performed. A 2.5* 1.8 * 0.6 cm mass, clinged with stalk from the right hepatic duct was noted and could be removecl by segmcntal resection of the common bile duct and the common hepatic duct. On cut section, greenisherous fluid containing multilocular cysts surrounded by a smooth wall with 0.3 cm thickness was seen. Microscopic findings revealed a cystadenoma lined by a single layer of columnar epitheliuni containing intracellular mucin pools without evidence of cellular atypism or mitosis.
이상인(Sang In Lee),조준구(Jun Koo Cho),전재윤(Chae Yoon Chon),함기백(Ki Baek Ham),정재복(Jae Bock Chung),최흥재(Heung Jai Choi) 대한내과학회 1988 대한내과학회지 Vol.34 No.3
N/A The liver has been recognized as an important site in the peripheral metabolism of thyroid homone, particularly in the mondeiodination of thyroxine to triiodothyronine. It is also the source of serum T, binding proteins. As is to be expected, disease of the liver has marked effects on serum thyroid hormone concentrations and bindings. In order to evaluate the change of thyroid hormones in various liver diseases and to elucidate the relationship between thyroid hormone status and severity of liver diseases, both thyroid hormones and liver functions were measured and analyzed in 110 patients with various liver diseases who were admitted to Yonsei University Severance Hospital during the period from April 1986 to October 1986. The results were as follows: 1) In various liver disease, acute hepatitis, fatty liver, chronic persistent hepatitis and chronic active hepatitis showed no significant difference in serum T3; T4, FT4, TSH and T3/T4 compared to normal controls. 2) The serum T3, T4 and FT4 of liver cirrhosis were signficantly lower than those of control group. but serum TSH, T3/T4 were within normal limits in liver cirrhosis. 3) The serum T3 and T4 and of hepatoma was significantly lower than those of control group, but mean serum FTTSH and T3/T4 showed no significant difference between hepatoma and control group. 4) The mean serum T3 level of seven patients with Child's class A was 100.73±25.44ng/dl, thirteen patients with class B 76.42±14.40ng/dl, and eighteen patients of class C 65.18±23.19ng/dl. There was a significant statistical difference among Child's class A, B and C. 5) There was no significant correlation between serum T3 and liver functions in Child's class A of liver cirrhosis. Serum T3 was significantly correlated with-total protein and albumin in Child's class B, with total protein, albumin and prothrombin time in Child class's C. 6) In liver cirrhosis, low serum T3 group (T3 <80 ng/dl) had a significant decrease in total protein, albumin and prolonged prothrombin time than normal serum T3 group (80 ng/dl < T3 < 220 ng/dl). 7) Serum T3 decreased significanlty in liver cirrhosis with ascites than in those without ascites. In conclusion, in liver cirrhosis and hepatoma, significant decrease in serum T3 and T4 level were observed and particularly serum T3 level may be useful in assessing the severity of hepato-cellular damage in liver cirrhosis.
강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),문영명(Young Myung Moon),정재복(Jae Bock Chung),이상인(Sang In Lee),전재윤(Chae Yoon Chon),김상애(Sang Ae Kim),함기백(Ki Back ham),한광혀(Swang Hyub Han) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
N/A For the evaluation of clinical efficacy of famotidine, a new, potent, long-acting histamine H2-receptor antagonist, in patients with gastric and duodenal ulcer, 42patients with endoscopically-proved active gastric ulcer (19 patients) and duodenal ulcer (23 patients) were admitted to this trial. Thirty two patients were treated with famotidine 20 mg b.i.d. and 10 with cimetidine 200 mg q.i.d. up to 8 weeks. The observed results were as follows: 1) The complete healing rates of gastric ulcer by endoscopic examination at 4,6 and 8 weeks were 50.0%, 68.8% and 93.8% in famotidine group, and 33.3%, 66.7% and 100.0% in cimetidine group, respectively. 2) The complete healing rates of duodenal ulcer by endoscopic examination at 4, 6 and 8 weeks were 62.5%, 81.3% and 100.0% in famotidine group, and 57.1%, 71.4% and 85.7% in cimetidine group, respectively. 3) Abnormal laboratory finding after treatment was found only in one case in famotidine group, but 3 cases in cimetidine group. 4) There was no significant difference in symptomatic improvement between two groups and mild side effects were complained of in 5 of 32 famotidine group (15.6%) and 4 of 10 cimetidine group (40. 0%). In conclusion, data from the present ivestigation suggest that Famotidine is effective in the treatment of gastric and duodenal ulcer, and is well tolerated on a short-term basis. Further and more extensive studies are necessary to confirm these findings.
Desferoxamine 이 시험관내 인체 간암세포 성장에 미치는 영향
송시영(Si Young Song),김원호(Won Ho Kim),전미연(Mi Yun Chon),한광협(Kwang Hyub Han),정재복(Jae Bock Chung),전재윤(Chae Yoon Chon),문영명(Young Myung Moon),강진경(Jin Kyung Kang),박인서(In Suh Park),최흥재(Heung Jai Choi),윤정구(Jung 대한내과학회 1994 대한내과학회지 Vol.47 No.3
N/A Objectives: It has been known that excessive iron promote the growth of cancer cells aad suggested that iron oversupply in cancer patients may enhance tumor growth and adversely affect cancer therapy and that desferoxamine (DFO) as a iron chelating agent may have a place in anticancer agents, which acts as a potent inhibitor of DNA synthesis via inhibition of the ribonucleotide reductase. However there have been no reports on the combined effect of DFO with other chemotherapeutics in vitro, This study was done to answer the questions: Does DFO inhibit the growth of cultured hepatoma cells? and Does the combination of DFO and chemotherapeutic agents have a synergistic effect on inhibition of tumor growth? Methods: Using PLC/PRF/5 and Hep G2 cells as hepatoma cells and normal diploid cells of WI-38 as control, the MTT assay was performed for evaluation of the cytotoxicity and an isobologram method to analyze the combined effects of DFO and other chemotherapeutic agents. Results: 1) The hepatoma cells grew faster in an iron-enriched medium than in the medium without additional iron supplementation but the normal diploid cells of WI-38 did not. 2) The 50% inhibitory concentrations (IC50) on PLC/ PRF/5 and Hep 62 cells were 75.1 and 29.1 ㎍/ml, respectively. But the growth of WI-38 was not inhibited below 74.4% with even 200 ㎍/ml of DFO. 3) On both hepatoma cells, the growth inhibitory effects of DFO were reversed with simultaneous administration of stoichiometric doses of ferric citrate. 4) Adriamycin (ADR), 5-fluorouracil (5-FU) and cisplatin (DDP) inhibited the growth of all 3 cell lines, but larger doses were required to inhibit the WI-38 to obtain the same effect. 5) When DFO was combined with chemotherapeutic agents, a marked synergistic effect was observed with the combination of DFO and 5-FU on PLC/PRF/5 cells. The synergistic effect was also noted in Hep G2 cells with all three combinations of DFO-ADR, DFO-5-FU and DFO-DDP. Conclusion: Iron oversupply may enhance the hepatoma growth and this should be taken into consideration treating patients with hepatoma. And the antitumor effect of DFO and its synergistic effect with other chemotherapeutic agents may suggest that iron chelator like the DFO may be a useful treatment for patients with hepatoma in conjuction with other anticancer drugs.