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한국에서 원인 미상의 급성간염 환자와 건강인에서의 E형 간염 표지자의 발현상
변관수(Kwan Soo byun),연종은(Jong Eun Yeon),권오상(Oh Sang Kwon),박영태(Young Tae Bak),김진호(Jin Ho Kim),권소영(So Young Kwon),이창홍(Chang Hong Lee) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.5
N/A Background/Aims: Recently hepatitis E virus(HEV) has been cloned and the enzyme immuno- assay(EIA) for anti-HEV has been useful in diagnosis and epidemiological studies for HEV infection. Hepatitis E has not still been reported in Korea, therefore the clinical significance of anti-HEV detected in the population is uncertain. This study was performed to investigate the clinical HEV infection in Korea and to evaluate the reliability of anti-HEV for the diagnosis and epidemiological study of HEV infection. Methods: Sera were collected from the patients with acute hepatitis(31 non-A, non-B, non-C, 20 toxic or drug induced, 9 fulminant hepatitis), 199 healthy adults and 30 patients with acute hepatitis B as control groups. Testing for IgG and IgM anti-HEV was done by EIA. Results: IgG anti-HEV was detected in 9.7% of non-A, non-B, non-C hepatitis, 15% of toxic hepatitis and none of fulminant hepatitis. IgG anti-HEV was also detected in 9.5% of healthy adults and in 3.3% of acute hepatitis B and the detection rates among acute hepatitis groups were not significantly different from controls. Only 1 case among acute hepatitis groups was positive for both IgG and IgM anti-HEV and the IgM antibody was sustaindly detected but IgG antibody was not detected within 2 months follow up. 2 cases of healthy adults were positive for IgM anti-HEV without IgG anti-HEV. Conclusions: Sporadic hepatitis E seems to be rare in Korea. Anti-HEV EIA is incomplete for the diagnosis of HEV infection and IgM anti-HEV might be nonspecific for the diagnosis of acute hepatitis E. Therefore, careful interpretation of anti-HEV is needed in the diagnosis or epidemiological study of HEV infection. (Korean J Gastroenterol 1996; 28:661 - 668)
변관수 ( Kwan Soo Byun ) 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.2(S)
The epidemiology of acute viral hepatitis (AVH) is dynamic and influenced by various factors including hygiene, socioeconomic changes and vaccination strategies. Of cases of AVH in Korea, acute hepatitis A accounted for 77%, acute hepatitis B for 4%, acute hepatitis C for 3%. During recent years, acute hepatitis A incidence has increased remarkably up to 14,966 cases in 2009. It suggests that the incidence of hepatitis A might be higher than 30 cases per 100,000 population. This finding urges to promote vaccination for childhood and high risk groups. The incidence of acute hepatitis B has declined dramatically in nearly all countries since 1992 when hepatitis B vaccine be included in all infant immunization programs. Antiviral treatment is only indicated for patients with fulminant hepatitis B and protracted, severe acute hepatitis B. An accurate diagnosis of acute hepatitis C can often be elusive. Patients with acute hepatitis C should be considered for interferon-based antiviral therapy. In recent years, autochthonous hepatitis E has been reported in many non-endemic developed countries. During recent years, in Korea, over a hundred cases of presumed hepatitis E has been reported. The diagnosis in majority of these cases depended on only IgM anti-HEV test, however, serologic test did not correlate completely with viremia in the diagnosis of acute HEV infection. Detection of HEV RNA in sera or feces together with seropositivity for IgM anti-HEV and seroconversion to IgG anti-HEV should be included in the diagnosis for HEV infection.
한국인에서 Mitochondrial Aldehyde Dehydrogenase ( ALDH2 ) 의 유전적 결핍이 알코올성 간질환 발생에 미치는 영향
변관수(Kwan Soo Byun),권소영(So Young Kwon),박상훈(Sang Hoon Park),구양서(Yang Suh Koo),연종은(Jong Eun Yeon),김재선(Jae Seon Kim),박영태(Young Tae Bak),김진호(Jin Ho Kim),김종극(Jong Guk Kim),이창홍(Chang Hong Lee) 대한내과학회 1993 대한내과학회지 Vol.45 No.3
N/A Background: Deficiency of mitochondrial aldehyde dehydrogenase (ALDH2) is an inborn error of metabolism that is responsible for acute alcohol sensitivity (flushing response) observed only in Orientals of Mongoloid origin. The subjects with the mutant ALDH2 gene are at much lower risk than homozygotes of normal ALDH2 genes for alcoholic liver disease presumably because of their sensitivity to alcohol. However, the role of the mutant ALDH2 gene in the development of alcoholic liver disease had not yet been we11 analyzed. In this study, genotypes of ALDH2 were compared between normal controls and patients with alcoholic liver disease to clarify the role of ALDH2 deficiency in the development of alcoholic liver disease. Method: Genotyping of ALDH2 was performed in 33 normal controls and 30 patients with alcoholic liver disease using the polymerase chain reaction and Southern blot hybridization by allele-specific oligonucleotide probes. Result: In 33 normal controls, 19 cases (57.6%) were homozygotic for the normal ALDH2 gene, 13 cases (39.4%) were heterozygotic for the normal and mutant ALDH2 genes and 1 caw (3.0%) was homozygotic for the mutant ALDH2 gene. All normal controls who had the mutant ALDH2 gene experienced facial flushing response after drinking. Amount of alcohol intake each time in controls who had the mutant ALDH2 gene was much smaller than that in normal ALDH2 homozygotes (p<0.001). All patients with alcoholic liver disease were homozygotic for the normal ALOH2 gene. The frequency of ALDH2 deficiency in patients with alcoholic liver disease was significantly lower than that in normal controls (p<0.001). Conclusion: These results suggest that ALDH2 deficiency is one of the important genetic factors in regulating alcohol consumption and plays a protective role against alcoholism and alcoholic liver diseases.
한국인의 급성 및 만성 간질환에서 C 형 간염 바이러스 항체 ( anti - HCV ) 의 발현상
변관수(Kwan Soo Byun),서동진(Dong Jin Sah) 대한내과학회 1991 대한내과학회지 Vol.40 No.4
N/A Since the development of diagnostic tests for hepatitis A and B viruses in 1975, it was apparent that most cases of post-transfusion hepatitis are not caused by these agents or any other known hepatotropic virus such as cytomegalovirus or Epstein-Barr virus. Termed non-A, non-B hepatitis, the causative agent has remained frustratingly elusive despite intensive research for over a decade. However, a major causative agent of non-A, non-B hepatitis (hepatitis C virus) was characterized recently by using efficient nucleic acid extraction and cloning techniques coupled with an immunoscreening approach, and then a capture assay for circulating viral antibody (anti-HCV) to the recombinant-based antigen was developed. So we detected anti-HCV in the sera of 335 patients with various liver diseases using enzymelinked immunosorbent assay to evaluate the prevalence of anti-HCV in patients with acute and chronic liver diseases in Korea. In 69 patients with presumed acute non-A, non-B hepatitis, 9 cases (13.0%) were positive for anti-HCV, while 11 (30.6%) among 36 patients with HBsAg positive acute viral hepatitis, who had neither IgM anti-HAV nor IgM anti-HAV, were anti-HCV positive. Anti-HCV was detected in the sera of 13 (44. 8%) out of 29 patients with HBsAg negative chronic active hepatitis. In patients with HBsAg positive chronic active hepatitis, the positive rate of anti-HCV was significantly different (p<0.05) between those with HBeAg (13.3%) and without HBeAg (46.4%). The highest positive rate (50%) of anti-HCV was found in patients with HBsAg negative hepatocellular carcinoma, while 25% of patients with HBsAg negative liver cirrhosis were anti-HCV positive. These results suggest that hepatitis C virus has an important etiologic role in HBsAg negative chronic hepatitis and hepatocellular carcinoma in Korea, and superinfection of hepatitis C virus is not infrequent and may modify the natural course of chronic HBV infection.
장윤정 ( Yun Jung Chang ),변관수 ( Kwan Soo Byun ) 대한소화기학회 2004 대한소화기학회지 Vol.44 No.6
Chronic infection with HCV represents second most common cause of end-stage liver diseases and hepatocellular carcinoma in Korea. The introduction of new agents and regimens for the treatment of chronic hepatitis C, such as pegylated forms of interferon-α
한국인 원인미상의 급, 만성 간질환 환자와 건강 대조군에서 Transfusion-transmitted Virus 감염률 - PCR 시발체에 따른 검출률의 차이 -
박상훈 ( Sang Hoon Park ),변관수 ( Kwan Soo Byun ),송진원 ( Jin Won Song ),연종은 ( Jong En Yeon ),박충기 ( Choong Kee Park ),이창홍 ( Chang Hong Lee ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.2
Background/Aims: The pathogenic role of transfusion-transmitted virus (TTV) isolated from a cryptogenic posttransfusion hepatitis patient remains unclear. Thus, we evaluated the prevalence and the clinical impact of TTV infection in Korean patients with a
만성신부전의 신경전도 검사에서 속도 , 진폭 및 잠복기간
김형규(Hyoung Kyu Kim),변관수(Kwan Soo Byun),권희규(Hee Kyu Kwon),노정우(Jung Woo Noh) 대한내과학회 1987 대한내과학회지 Vol.33 No.1
N/A With modern methods of treatment, overt clinical neuropathy of CRF is rare and a subclinical form is commoner in which only nerve conduction studies are abnormal. It should however be realized that for many such patients the conduction velocity would still be within the normal range, Furthermore, motor conduction velocity by itself gives an incomplete picture of the neurophysiologic abnormality. The amplitude and latency of peripheral nerve may reveal abnormalities when motor nerve conduction velocity values are within normal limits. The development of uremic neuropathy is related to decreasing renal function and accumulating uremic toxins. By the way, the authors examined the nerve conduction study such as velocity, amplitude and latency of the peripheral nerves of which 18 chronic renal failure have been treated only the supportive method. Serum BUN, Creatinine, Creatinine clearance, iPTH and vitamine B(12) which were examied with correlation of the resul1 taking from ulnar, radial, median, tibial and peronea nerves were investigated. The results obtained are as follows: 1) Frequency of abnormal nerve conduction involved to be in order the tibial 61.1%, peroneal 50% in motor nerves and tibial 44.4%, peroneal 42.9% and median 37.5% in sensery nerves. 2) The most frequent abnormalities are a decreased amplitude 55.8% in motor nerves and a delayed latency 40.5% in sensory nerves, 3) The mator nerve conduction velocities and latencies of CRF are delayed longer than those of normal controls significantly. 4) The motor nerve conducting tibial nerve has a negative correlation with serum vitamin-B(12) level significantly (r=-0,57, p<0.05). By the metioned results, we may suggest that not only velocity, amplitude and latency of motor nev , 4W also sensory nerves in upper and lower extrimities should be measured simultaneously in chronic renal failure probably complicated uremic neuropathy.