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비장에 이식된 간세포의 조직학적 특성과 알부민 유전자의 발현
권상옥(Sang Ok Kwon),이동기(Dong Ki Lee),김준명(Jun Myeong Kim),박의련(Eui Ryun Park),심광용(Kwang Yong Shim),정필호(Phil Ho Jung),조미연(Mee Yon Cho),허만욱(Mann Uk Hur) 대한내과학회 1997 대한내과학회지 Vol.53 No.4
N/A Background: The morphological characteristics of hepatocytes transplanted into the spleen have been studied. However few attempts has been made to determine the expression of genes in intrasplenically transplanted hepatocytes. The aim of this study was to explore whether the pattern of expression of albumin gene in intrasplenically transplanted hepatocytes is similar to that in adult liver, resulting in the long-term expression of this hepatocyte-specific gene. Methods: Hepatocytes isolated from liver of syngeneic Fischer 344 rats and transplanted into the spleen of rats from the same strain survived for 12 months in the absence of immunosuppressive drugs. Microscopic examination of intrasplenic hepatocytes and Northern blotting for albumin gene expression of RNA extracted from liver and spleen was performed. Results: Microscopy demonstrated that hepatocytes attached themselves only in the red pulp of the spleen and isolated hepatocytes preserved the fine structures characteristic of normal hepatic parenchymal cells. Throughout the 12 months period, intrasplenically transplanted hepatocytes expressed albumin mRNA. Conclusions: Intrasplenically transplanted hepatocytes represent a unique in vivo system of extrahepatic maintenance of hepatocytes. This novel transplantation system could be used to investigate hepatocyte engraft, proliferation and gene expression.
간장 ( 肝臟 ) 및 담도 ( 膽道 ) : 알콜성 간질환에 있어서 혈청 Procollagen Type III Peptide 및 Laminin의 측정
권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),장우익(Woo Ik Jang),이동기(Dong Ki Lee),김호근(Ho Guen Kim),김현수(Hyun Soo Kim),윤갑준(Kap Jun Yoon) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.1
N/A To evaluate if serum procollagen type III peptide (P-III-P) and laminin levels reflect the extent of liver fibrosis or inflammation, we have studied 67 patients with histologically proven alcoholic liver disease and 12 non-alcoholic control with normal liver function test. The result showed that P-III-P values were significantly elevated in the patients with alcoholic hepatitis (1.87 +- 2.01 U/ml), alcoholic chronic active hepatitis (1.16 +- 1.20) and alcoholic liver cirrhosis (1.26 +- 1.50) compared to fatty liver (90.76 +- 0.49), alcoholic hepatic fibrosis (0.68 +- 0.60) and healthy controls (0.67+- 0.34 U/ml) (p<0.05). When the cut-off value for P-III-P is set at 1.25 U/ml (mean of the fatty liver+2 SD), nearly all (94.1%) of the case with elevated values above the cut-off were alcoholic hepatitis, alcoholic chronic active hepatitis and liver cirrhosis. Furthermore, a close correlation (r= 0.60) was found between the serum P-III-P and laminin (p<0.001). Although P-III-P and laminin did not appear to be particularly useful for differentiating various types of alcoholic liver disease, their concentrations seemed to be related to a degree of hepatic inflammation. And it is evident from our finding that an unexpected increase in serum P-III-P and laminin values could indicate the presence of alcoholic hepatitis, alcoholic chronic active hepatitis and alcoholic liver cirrhosis.
급성 간부전과 용혈성 빈혈로 증상 발현을 보인 Wilson 씨병
권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),심영학(Young Hak Shim),박진현(Jin Hyun Park),장우익(Woo Ik Jang),전근제(Geun Jae Jeon),최승옥(Seoung Ok Choi) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.1
The first manifestations of Wilsons disease are usually neuropsychiatric disorders and less fre- quently, hepatic disorders (cirrhosis or chronic hepatitis) or transient hemolytic anemia. The purpose of this work is to describe a less well known mode of onset of the disease characterized by the association of intravascular hemolysis and acute liver failure. The diagnosis of Wilson's disease was based in the presence of the Kayser-Fleischer ring and decreased serum ceruloplasmin, and acute intravascular hemolysis was based in the sudden develop- ment of anemia, the high value for the reticulocyte count, the absence of demonstrable bleeding, unconjugated hyperbilirubinemia. Necropsy revealed active liver cirrhosis, micronodular type with marked cholestasis. The mechanism of this syndrome is unknown. A hypothetical explanation might result from hepatic cell necrosis due to accumulation of copper, the consequences being acute liver failure and destruction of erythrocytes by the large amounts of copper released from the necrotic hepatic cells to the plasma. In conclusion: 1) The syndrome of acute intravascular hemolysis and acute liver failure is very suggestive of Wilsons disease. 2) This association can be the first clinical manifestation of the disease. 3) The treatment is generally unsuccessful, and the outcome is usually fatal.
권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),장우익(Woo Ik Jang),조한선(Han Seon Cho),차신웅(Sin Woong Cha),민병철(Byoung Chul Min),진춘조(Choon Jo Jin) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4
Pregnancy is rarely encountered in women with cirrhosis since cirrhosis is less common in women and usually developes after the childbearing years. Additionally, cirrhosis in young women is often accompanied by severe menstrual irregularities and infertility with disturbance of estrogen metabo- lism. The managernent of the liver disease in pregnant patients is the sarne as that of normal people. Studies have shown that while pregnancy may result in a normal healthy infant, the risk of variceal hemorrhage is high, especially in the second and third trimesters. Cirrhosis seems to have an adverse effect on fetal outcome with a high incidence of stillbirths and prematurity in pregnant women. We report our experience of three episodes of pregnancy in two cases of liver cirrhosis and ascites with brief review of literatures.
간경변증 환자의 비정형 선종성 증식성 결절 ( Atypical Adenomatous Hyperplastic nodule ) 에서 발생한 소 간세포암
권상옥(Sang Ok Kwon),노병선(Byoung Seon Rhoe),장우익(Woo Ick Jang),이동기(Dong Ki Lee),이용규(Yong Gyu Lee),한병근(Byoung Geun Han),심영학(Young Hak Sim),조미연(Mi Yeon Cho) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.4
Adenornatous hyperplasia (AH), defined as a sizable parenchymal nodules that may follow acute or chronic liver injury, has been reported as precursor lesion of hepatocellular carcinoma in the cirrhotic liver. These lesions often coexist with obvious rnalignant foci as small nodule-in-nodule. Morphologically AH can be divided into 'ordinary' and atypical (AAH)' types. The former consisted of hepatocytes similar to those of the surrounding liver. The latter type was composed of hepatocytes showing nuclear, cellular and structural atypia relative to the surrounding liver, and shoved irregular or sparse portal tracts. Cytological and structural pattens are characteristically heterogenous within a nodule. Now AAH are considered to be precancerous lesion evolving to early hepatocellular carcinoma. Authots report one case of hepatocellular carcinoma eithin an atypical adenomatous hyperplastic nodule in 55-years-old male with a review of literatures.
권상옥(Sang-Ok Kwon) 한국의철학회 2008 의철학연구 Vol.6 No.-
유럽 의철학은 100년 이상의 역사를 갖고 있으며, 후에 생겨난 생명의 료 윤리학을 포함하고 있다. 이에 비하여 40년 정도의 짧은 역사를 지닌 미국의 의철학은 생명의료 윤리학과 같은 시대에 태어났지만, 별개의 학문으로 시작하여 점진적으로 수렴되어 가는 점이 유럽과 다르다. 학제간 분야인 생명의료 윤리학이 발전하는데 의철학 및 철학 지식은 많은 기여를 하였다. 의철학이나 철학 지식이 생명의료 윤리학 이론에 적극 도입된 대표적인 예로는 인간에 대한 존경이라는 칸트 이론과 법철학의 권리 이론, 자아 동일성 이론과 생물 철학, 언어 분석, 몸과 마음의 관계에 관련된 심리 철학, 인격 이론 등을 들 수 있다. 또한 의철학은 의료 윤리의 정당성을 확보하는 데에도 기여하였다. 초기에는 ‘의사와 환자의 치유 관계’에서 의료의 본질을 파악하여, 이 위에 생명의료 윤리학을 정초하고자 하는 토대주의가 관심을 끌었다. 하지만 최근에는 의료의 본질이나 의료윤리의 정당성을 의료 내적인 가치나 규범뿐만 아니라 의료 외적인 사회문화적 전통과 가치 위에 세워져야한다는 주장이 호응을 받고 있다. 의철학을 의학에 대한 철학적 성찰이라고 정의할 때, 최근 의철학 분야에서 가장 많이 연구된 분야는 생명의료 윤리학이며, 형이상학과 인식론이 뒤를 잇고 있다. European philosophy of medicine has come from a philosophical reflection on medicine in the nineteenth century, and regarded the biomedical ethics as part of philosophy of medicine. But the philosophical interest of medicine in the United States has burgeoned over the last three decades. The philosophy of medicine and biomedical ethics were thought of as quite separate fields of study. Currently philosophy of medicine includes all sorts of philosophical reflection on medicine, and is dominated by biomedical ethics The philosophy of medicine has supported the critical examination of the concepts and argument underlying the field of biomedical ethics. The philosophy of medicine has helped biomedical ethics to solve the ethical dilemma, clarifying the value-context and to construct the grounding, analysing the goals of medical practice. The core issues of philosophy of medicine and other specialities in philosophy has penetrated into discussion of biomedical ethics. Both field has evolved from debates about ethical conduct(primarily conduct of physician) to a basic reformulation of what medicine is about. There is the gradual convergence of themes in philosophy of medicine with specific issues in biomedical ethics.
수술로 치유된 간성수흉증 ( Hepatic Hydrothorax )
권상옥(Sang Ok Kwon),홍인수(In Soo Hong),이동기(Dong Ki Lee),배선우(Sun Woo Bae),이성우(Sung Woo Lee),오중환(Joong Hwan Oh) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.4
Hepatic hydrothorax is defined as the presence, in approxirnately 6% of patients with cirrhosis, of a large pleu, al effusion in the absence of primary pulmonary or cardiac disease. Clinical ascites is almost always evident and the pleural effusion is usually right-sided. A 36-yr-old woman with clinical and labolatory evidence of hepatitis B surface antigen-positive liver cirrhosis was admitted hecause of respiraton distress. A moderate amount of ascites w noted on physical i xamination arid the right hydrothorax was re:ealed on the chest X-ray film. Diagnosis was confirmed by the intraperitoneal and intrapleural injction of radioisotope Tc-tin colloid that demonstratcd the one-way transdiaphragmatic flow of fluid from the peritoneal to pleural cavity. We report on a casw of refractory hepatic hydrothroax, wiiich was succesfully treated with surgical closure of diaphragmatic defect and chemical pleurodesis.