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송일한,최정,전용,윤윤수,임창영,김정원,노임환,김흥태,김태훈,명나혜,정민 대한내과학회 1997 대한내과학회지 Vol.53 No.3S
저자등은 상복부 동통 및 체중감소를 주로로 내원한 55세 남자 환자에서 췌장미부, 비장피막, 위주위지방조직 및 림프절의 일부를 침범한 원발성 위내 순수편평세포암 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Primary squamous cell carcinoma of the stomach is a extremely rare tumor, described in only about 80cases in the literature since 1905. It occurs mostly in males, affects a slightly younger group as compared to adenocarcinoma, and has a predilection for the proximal stomach, especially along the lessor curvature side. The pathogenesis of this neoplasm is controversial, but squamous metaplasia resulting from any injury to the gastric mucosa appears to have a role in the pathogenesis of this cancer. The prognosis of squamous cell carcinoma of the stomach is probably less favorable than that of adenocarcinoma due to its higher frequency of lymphovascular invasion. We report a case of primary squamous cell carcinoma of the stomach in a 55-year-old male with a review of the literature,
특집 - 당뇨병환자가 소홀히하기 쉬운 간 - 당뇨병환자의 지방간 -
송일한,Song, Il-Han 사단법인 한국당뇨협회 2008 당뇨 Vol.220 No.-
이번 특집에서는 최근에 관심이 높아지면서 그 발병률이 증가하고 있는 비알코올성 지방간 질환의 발병 원인과 기전을 알아보고, 당뇨병환자에서의 지방간질환의 임상증상, 진단 등에 대해 살펴보고, 현재 응용되고 있는 치료방향에 대해서 알아보고자 한다.
송일한,이무용,박석건,신정우,기명주 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.2
Background/Aims: Hypoxemia is often associated with liver cirrhosis without cardiopulmonary diseases. Pulmonary vascular impairments including intrapulmonary shunt have been considered as a major mechanism of hypoxemia. The aim of this study was to determine the incidence and pathophysiologic basis of hypoxemia in cirrhotic patients without respiratory symptoms. Methods: In fourty three cirrhotic patients without heart and lung diseases, we performed the arterial blood gas analysis and calculated alveolar arterial oxygen gradient (A-aO2). According to the A-aO2, the patients were divided into hypoxemic and normoxemic groups. In each group, a Tc-99m-macroaggregated albumin (Tc-99m-MAA) scan, a contrast-enhanced echocardiography and a pulmonary function test were performed. Results: Twenty-eight of 43 patients (65%) showed hypoxemia. Hypoxemic patients showed significantly more increased shunt fraction of 3.1±1.4% than normoxemic one of 2.1±1.1% in the Tc-99m-MAA scan (p$lt;0.05). However, only two of hypoxemic patients had shunt fraction above physiologic shunt range. By contrast-enhanced echocardiography, an intrapulmonary shunt was confirmed in one patient. There was no significant correlation between the shunt fraction and the hepatic reserve based on the Child-Pugh classification in hypoxemic patients. In the results of pulmonary function test, only DLco decreased more significantly in hypoxemic group than in normoxemic group (58.4 ± 14.2 % vs 75.3 16.5% of predicted, p$lt;0.05). Conclusions: Hypoxemia is not infrequently observed in cirrhosis, but incidence of significant intrapulmonary shunt is low. Therefore, other mechanism such as diffusion defect may be suggested to play a role in the development of hypoxemia in cirrhotic patients without respiratory symptoms. (Korean J Hepatol 2000;6:197-204)
Therapeutic challenges in clinical application : Viral hepatitis B: emerging therapies
송일한 대한간학회 2014 간학회 싱글토픽 심포지움 Vol.2014 No.2
만성 B형간염에서 항바이러스치료의 단기 치료목표는 간염바이러스의 완전제거(clearance of serum HBV DNA/nucleus HBV cccDNA) 및 면역획득(seroconversion of HBsAg to antiHBs)이다. 현재 사용되고 있는 B형간염 바이러스 치료제인 경구용 뉴클레오시(티)드와 주사제 인터페론(페그인터페론) 알파는 그동안 지속적으로 진화하여 바이러스적, 혈청학적, 생화학적, 그리고 조직학적 반응에서 놀랄만한 치료효과를 보여왔으나 상기한 치료목표에는 미치지 못하고 있다. 최근 기존의 치료표적을 달리하여 B형간염 바이러스 복제의 각 단계를 제어할 수 있는 항바이러스제 뿐만 아니라, B형간염 바이러스의 전사 후 과정에 관여하여 바이러스유전자발현을 차단할 수 있는 RNA (small RNA) 및 인체의 면역체계를 강화할 수 있는 면역조절제 등의 개발을 통해 만성 B형간염을 치료하려는 노력이 활발히 진행되고 있다. 이에 현재 진행되고 있는 만성 B형간염에 대한 항바이러스제 및 면역조절제 등을 알아보고 항바이러스 효과와 함께 향후 B형간염의 치료방향을 전망 해 보고자 한다.
HBsAg 음성인 알코올성 간염, 간경변 및 간세포암 환자에서 중합효소연쇄반응을 이용한 혈청 내 Hepatitis B Virus DNA의 검출
송일한,노임환,최정,양미라 대한소화기학회 1999 대한소화기학회지 Vol.34 No.2
Background/Aims: Risk factors for the development of alcoholic liver disease (ALD) are the duration and magnitude of alcohol ingestion, gender, hepatitis B or C viral (HBV or HCV) infection, nutritional status, and genetic factors. The aim of the present study was to evaluate the role of HBV infection in the development of HBsAg-negative ALD in Korea. Methods: Fifty eight controls and one hundred thirty ALD patients were included in this study. The ALD patients consumed alcohol more than 80 g daily for at least 5 years and were negative for HBsAg and anti-HCV. In addition, they had no other factors for developing liver disease and showed positive biochemical parameters for ALD. The detection of serum HBV-DNA was performed by polymerase chain reaction. Results: The overall detection rate (16.9%) of HBV-DNA in ALD patients was higher than that (6.9%) in normal controls, but the difference was not statistically significant. Detection rate of HBV-DNA was 9.8%. in patients with alcoholic hepatitis, 19.8% in the patients with cirrhosis and 25% in the patients with hepatocellular carcinoma. The rate of cirrhotic patients was significantly higher than that of normal controls (p=0.033). The HBV-DNA detection rate (25%) in ALD patients positive for anti-HBc was significantly higher than that (6.9%) in ALD patients negative for anti-HBc (p=0.006). Conclusions: HBV infection may be involved in the development of ALD of patients who were HBsAg- negative chronic alcoholics in Korea.