Symposium: Current and future issues in hepatitis C treatment : Side effects of peginterferon and ribavirin treatment for hepatitis C and their management

Seung Woon Paik 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.4(S)

설명되지 않는 비심인성 흉통 환자의 식도 내장 과민성과 팽창성에 관한 연구

백승운(Seung Woon Paik),이종철(Jong Chul Rhee),김재준(Jae Jun Kim),고광철(Kwang Cheol Koh),이화영(Hwa Young Lee),이풍렬(Poong Lyul Rhee),전성국(Seong Gook Jeon),강인구(In Koo Kang) 대한소화기학회 1998 대한소화기학회지 Vol.31 No.3

Background/Aims: Reduced visceral pain threshold as a cause of noncardiac chest pain is a subject of controversy. Compliance and pain perception are different in the smooth and striated muscle segments of the esophagus. The aim of this study is to evaluate the difference in visceral pain threshold and compliance of the upper and lower esophagus between patients with unexplained noncardiac chest pain and healthy controls. Methods: We examined 8 healthy controls (3 male, rnean age: 24.5 years) and 8 patients with chest pain (3 male, mean age: 51.5 years) who were normal in coronary angiography or exercise myocardium perfusion scan and show normal finding on EGD, esophageal manometry and 24-hr esophageal pH monitoring. Intraesophageal balloon was placed at 5 cm above LES. Symptoms and intraballoon volumes were recorded while intaballoon pressure was increased in 1 mmHg increments using Barostat system (Distender series II). The above measurernents were repeated after the balloon was positioned 5 cm below UES. Compliance was also measured. Results: 1) At initial perception, intraballoon pressure (mmHg) of the upper and lower esophagus was not significantly different between the patients group (3.9+-2.0, 6.5+-4.7 respectively) and the control group (3.8+-1.3, 6.5+-3.0). Intraballoon volumes (ml) were not significantly different between patients (14.5+-6.5, 22.0+-10.2) and controls (11.5+-2.8, 18.8+-11.7). 2) During chest pain, intraballoon pressure (mmHg) of the upper and lower esophagus was not significantly different between patients (9.0+-3.9, 17.6+-9.6 respectively) and the controls (8.5+-3.2, 12.9+-3.2). Intraballoon volume (ml) was not significantly different between the patients (30.8+-17.0, 62.9+-32.0) and the controls (27.6+-10.6, 44.6+-15.4). 3) Esophageal compliance (ml/mmHg) of the upper and lower esophagus was not significantly different between patients (3.6+-1.3, 3.9+-2.3) and controls (3.1+-0.3, 3.2+-0.9). Conclusions: There was no difference in the visceral sensitivity and compliance of the upper and lower esophagus between patients with unexplained noncardiac chest pain and healthy controls. (Korean J Gastroenterol 1998;31:269-274)

의학강좌 - 개원의를 위한 모범처방전 : 만성 B 형 간염에서 항바이러스 약제 처방원칙

백승운(Seung Woon Paik) 대한내과학회 2002 대한내과학회지 Vol.62 No.6

N/A

간암의 치료

백승운(Seung Woon Paik) 대한내과학회 2001 대한내과학회지 Vol.61 No.6

N/A

우리나라 간암 환자에서의 Cytochrome p450 2E1유전자의 다형성에 관한 연구

백승운(Seung Woon Paik),윤정환(Jung Hwan Yoon),황유진(You Jin Hwang),장유현(Yoo Hyun Jang),이효석(Hyo Suk Lee),김정룡(Chung Yong Kim) 대한소화기학회 1998 대한소화기학회지 Vol.30 No.4

Background/Airns: Cytochrome P450 2E1(CYP2EI) is the only enzyme that rnetabolizes very low doses of N-nitrosodimethylamine(NDMA) and is characterized by its ethanol inducibility. Recently, it has been shown in an animal-experimental study that NDMAinduced hepatocarcinogenes was facilitated by chronic alcohol ingestion. CYP2E1 expression in human beings was reported to be about 10 times higher in genotype c2/c2 than in genotype cl/cl. Bacause CYP2El gene expression is the highest in the liver, we hypothesized that the polymorphi:;m of CYP2E1 may affect the risk of hepatocellular carcinoma(HCC), especially in patients with chronic alcohol consumption. Methods: We enrolled 46 HCC patients and 32 age-sex-matcied healthy controls without liver disease or cancer in any other organ. The genotypes in the 5-flanking region of CYP2E1 gene were determined by restriction fragment length polymorphisms using two endonucleases: PstI and RsaI. Results: The frequencies of genotype A(cl/cl), B(cl/c2) and C(c2/c2) were 56.5%, 39.1%, 4.4% in HCC patients, and 62.5%, 28.1%, 4.4% in controls, regiectively. The frequency of allele c2 was 23.9% in HCC patients and 23.4% in control, re.;pectively. The difference in the frequencies of both CYP2E1 genotyps and alleles was not statistically significant between the HCC patients and controls. The HCC patients with a history of ckonic alcohol ingestion were more like]y to carry genotype B and C than in patients without such tii.;tory, even though the differences are not statistically significant(p=0.077). Conclusions: Although polymorphisms of CYP2E1 gene is not a major genetic risk factor for the development of HCC, it might increase the risk of HCC in patients with chronic HBV or HCV infection and chronic alcohol consumption. Further study to test this bypothesis on a large number of patients and on patients of different ethnic groups is warranted. (Korean J Gastroenterol 1997; 30:503-512)

간의 원발성 평활근육종 1예

백승운(Seung Woon Paik),이종철(Jong Chul Rhee),김재준(Jae Jun Kim),고광철(Kwang Cheol Koh),이준혁(Joon Hyeok Lee),이종균(Jong Kyun Lee),이규택(Kyu Taek Lee),이풍렬(Poong Lyul Rhee),오영륜(Young Lyun Oh),안홍준(Hong Joon Ahn) 대한소화기학회 1998 대한소화기학회지 Vol.31 No.5

Primary hepatic leiomyosarcoma of the liver is a rare tumor, with fewer than 70 previously reported cases. There was only one case reported in Korea. We present the case of a 54-year-old man who presented with a mass in the right hepatic lobe on CT scan. Percutaneous biopsy was consistent with leiomyosarcoma. The patient was treated successfully by right lobectomy, and has been disease free for 19 months. We report the case of primary leiomyosarcoma of the liver with review of relevant literatures. (Korean J Gastroenterol 1998;31:691-695)

전형적인 위식도역류 증상을 가진 환자에서 십이지장위식도역류와 위배출능과의 상관관계

백승운(Seung Woon Paik),이종철(Jong Chul Rhee),김재준(Jae Jun Kim),고광철(Kwang Cheol Koh),이풍렬(Poong Lyul Rhee),전성국(Seong Gook Jeon) 대한소화기학회 1998 대한소화기학회지 Vol.31 No.2

Background/Aims: Duodenogastroesophageal reflux (DGER) has been reported to occur in gastroesopahgeal retlux disease (GERD) and has been known to have a synergistic role in the development of esophageal mucosal injury. There is controversy on the role of delayed gastric emptying in the pathophysiology of GERD. The aim of this study is to evaluate the correlation between DGER and gastric emptying (total and proximal) in patients with typical symptoms of gastroesophageal reflux (GER). Methods: Simultaneous monitoring of ambulatory 24-hr esophageal pH and biIirubin (using Bilitec 2000) and esophagogastroduodenoscopy were done in 38 patients with typical symptoms of GER (19 male, mean age: 44.1 years). Gastric emptying scan was performed using 99mTc-DTPA labelled solid meal in the above patient group and 10 healthy controls (6 male, mean age: 32.5 years), and then total gastric emptying time (T1/2) and proximal gastric emptying time (PT1/2) were measured. Results: 1) Abnormal acid reflux without abnormal bile reflux was diagnosed in 8 (21.1%) of 38 patients (Group I). Abnormal bile reflux was diagnosed in 10 (26.3%) of 38 patients (Group II). There was neither acid nor bile reflux in 20 (52.6%) of 38 patients (Group III). 2) Total gastric emptying time (T1/2) was not significantly different between controls and each groups. 3) Proximal gastric emptying time (PT1/2) was significantly delayed in Group II (94.2+-37.6 min) when compared with controls (59.9.+-24.2 min)(p<0.05). Conclusions: Delayed proximal gastric emptying could be a contributing factor in the pathophysiology of duodenogastroesophageal reflux in gastroesophageal reflux disease. (Korean J Gastroenterol 1998;31:153 - 159)

바이러스성 간염 C형간염의 치료 목표, 대상 및 치료

백승운 ( Seung Woon Paik ) 대한소화기학회 2008 대한소화기학회지 Vol.51 No.6

Hepatitis C virus (HCV) is a major cause of chronic hepatitis and hepatic fibrosis worldwide. Up to 85% of individuals infected with HCV develop chronic infection, which can progress to cirrhosis and hepatocellular carcinoma. The primary goal in the treatment of HCV infection is to reduce the mortality by preventing liver-related deaths associated with the development of hepatocellular carcinoma and decompensated cirrhosis. Pegylated interferons together with ribavirin are currently the standard of care for patients with chronic hepatitis. Here, I discuss the goals of treatment, indication and treatment of chronic hepatitis C. (Korean J Gastroenterol 2008;51: 368-371)

경련성 골반저 증후군에서 풍선 배출검사와 회음부 계측검사의 의의

백승운(Seung Woon Paik),이종철(Jong Chul Rhee),김재준(Jae Jun Kim),고광철(Kwang Cheol Koh),이풍렬(Poong Lyul Rhee),손정일(Chong Il Sohn),이화영(Wha Young Lee),전성국(Sung Kook Jun) 대한소화기학회 1998 대한소화기학회지 Vol.31 No.3

Background/Aims: We investigate the usefulness of balloon expulsion test and perineometry in the diagnosis of defecation disorder, especially spastic pelvic floor syndrome. Methods: Patients with defecation disorder were tested to identify the cause with balloon expulsion test in left lateral decubitus position and sitting position, perineornetry, colon transit time test, defecography, anorectal manometry and sigmoidoscopy. Ten asymptomatic persons were also examined as normal control. Results: Among 91 patients with defecation disorder the spastic pelvic floor syndrome was the most common cause. The weight that was needed to expel the balloon in the left lateral decubitus position in spastic pelvic floor syndrome patients was significantly higher than in the normal controls and other disease groups (p<0.05). The time that was needed to expel the balloon in the sitting position in spastic pelvic floor syndrorne patients was also significantly longer than in the normal controls and other disease groups (p<0.05). Perineal movement in patients with spastic was significantly shorter than in the normal controls and other disease groups (p<0.05). The weight and time needed to expel the balloon in pelvic floor syndrome were inversely related to the ejection fraction on defecogram (r=-0.303, p=0.027 and r=-0.305, p=0.026 respectively). Conclusions: Balloon expulsion test and perineometry are good diagnostic tests for spastic pelvic floor syndrome. (Korean J Gastroenterol 1998;31:309-318)

백선 ( Dyctamnus dasycarpus ) 복용 후 발생한 간 손상 2예

백승운(Seung Woon Paik),이종철(Jong Chul Rhee),김재준(Jae Jun Kim),고광철(Kwang Cheol Koh),이화영(Hwa Young Lee),이풍렬(Poong Lyul Rhee),이준혁(Joon Hyoek Lee),이종균(Jong Kyun Lee),오영륜(Young Ryun Oh),지영준(Young Joon Chi) 대한소화기학회 1998 대한소화기학회지 Vol.31 No.2

Although drug induced liver injury caused by herbal medicine is considered to be a frequent problem in Korea, there are only a few reports concerning the hepatotoxicity of herbal medicine. We recently experienced two cases of drug induced liver injury caused by ingestion of Dyctamnus dasycarpus, and one of herbal drug used for antipyretic and analgesic purposes. The first patient, a 48 year old man, was admitted due to jaundice after ingestion of the liquor containing Dyctamnus dasycarpus and some other herbal medications for 4 months. All viral markers were negative on admission, and the elevated bilirubin and transamiase levels normalized 5 months later after cessation of all herbal medications. Ten months after the first admission, he ingested only the liquor containing Dyctamnus dasycarpus, with lesser duration and amount, and was readmitted due to general weakness and fatigue and elevated transaminase (>1,000 IU/L). The elevated transaminase level nearly returned to normal after discontinuing the causative agent. The second patient, a 62 year old man, was admitted due to jaundice after ingestion of Dyctamnus dasycarpus. The elevated bilirubin and transamiase levels normalized 4 months later after cessation of the causative agent. Dyctamnus dasycarpus induced liver injury presents with prolonged course lasting more than several weeks to months. Herbal drug induced liver disease should be considered in differential diagnosis of acute liver injury of unknown cause in Korea and we are also suggesting the necessity of a systematic approach for the study of the herbal drugs. (Korean J Gastroenterol 1998;31:251 - 257)