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최신 연구 소개 : 비알코올 지방간염의 조직학적 호전이 약물 치료로 가능한가?
허내윤 ( Nae Yun Heo ) 대한소화기학회 2016 대한소화기학회지 Vol.67 No.5
Farnesoid X Nuclear Receptor Ligand Obeticholic Acid for Non-cirrhotic, Non-alcoholic Steatohepatitis (FLINT): a Multicentre, Randomised, Placebo-controlled Trial (Lancet 2015;385:956-965) Liraglutide Safety and Efficacy in Patients with Non-alcoholic Steatohepatitis (LEAN): a Multicentre, Double-blind, Randomised, Placebo-controlled Phase 2 Study (Lancet 2016;387:679-690)
C형간염 관련 간세포암종 환자에게서 경구 직접작용 항바이러스제 치료의 위험과 이득
허내윤 ( Nae-yun Heo ) 대한간학회 2020 Postgraduate Courses (PG) Vol.2020 No.1
Since the introduction of direct-acting antiviral agents (DAA) for chronic hepatitis C, sustained virologic response rate has steeply elevated. Theoretically, effective antiviral treatment may pose a positive impact in the patients with hepatocellular carcinoma who had a curative treatment because virologic cure can result in the regression of fibrosis and improvement of portal hypertension. However, a few recent studies suggested the unexpected high HCC recurrence after DAA treatment, which induced a hot issue, and subsequent studies showed inconsistent results. Although considering the many limitations of available studies, there is no strong evidence of increased risk of HCC recurrence after DAA treatment right now. Therefore, at present, it is prudent to perform DAA treatment in the patients with curative treatment for HCC at the point that their complete response becomes more certain.
허내윤 ( Nae-yun Heo ) 대한내과학회 2023 대한내과학회지 Vol.98 No.2
An evaluation of liver fibrosis severity during the initial examination is essential for the determination of chronic liver disease prognosis. Although liver biopsy is the gold standard for evaluation of liver fibrosis, bleeding can occur. Therefore, several non-invasive approaches have been introduced, including an equation with clinical variables and assessments of liver stiffness (e.g., elastography). Most patients with chronic liver disease can undergo evaluation of liver fibrosis severity without a liver biopsy using these alternative methods. (Korean J Med 2023;98:84-87)
허내윤 ( Nae-yun Heo ) 대한간학회 2017 Postgraduate Courses (PG) Vol.2017 No.1
Wilson`s disease is a metabolic disorder in which copper is accumulated in several organs, especially liver and brain. It has been proved to be an autosomal recessive hereditary disease due to the ATP7B gene mutation, which prevent the extra copper from excreting via bile duct. Nowadays, molecular genetic analysis is easily available with biochemical laboratory findings such as serum ceruloplasmin and 24-hr copper urinary excretion, and Kayser-Fleischer ring, which may lead to early diagnosis for presymptomatic patients more effectively. Although there are limited clinical trial data dealing with major medications with D-penicillamine, trientine, and zinc, some experts suggests the combination of chelating agents with zinc in severe symptomatic patients. In the future, it is necessary to validate this treatment strategy to improve the survival in this rare reversible disease.
간동맥화학색전술 후 외과적 절제가 가능하였던 담관 침범 간세포암종 종양 병기 축소 후 근치적 치료
허내윤 ( Nae Yun Heo ),이한주 ( Han Chu Lee ),심주현 ( Ju Hyun Shim ),김강모 ( Kang Mo Kim ),임영석 ( Young Suk Lim ),정영화 ( Young Hwa Chung ),이영상 ( Yung Sang Lee ),서동진 ( Dong Jin Suh ) 대한간암학회 2011 대한간암학회지 Vol.11 No.1
A surgical resection is a major curative treatment of hepatocellular carcinoma (HCC) in Korea. However, the respectability of HCC at the time of diagnosis is low (10-30%) because the cancer is often identified as advanced stage. Nevertheless, some of the patients were known to have a curative resection after successful downstaging therapy. We report a HCC with bile duct invasion which was successfully downstaged by the transarterial chemoembolization and treated by surgical resection.
간외 전이로 처음 발견된 간세포암종 두개골 전이로 발현한 진행성 간세포암종
허내윤 ( Nae Yun Heo ),이한주 ( Han Chu Lee ),심주현 ( Ju Hyun Shim ),임영석 ( Young Suk Lim ),정영화 ( Young Hwa Chung ),이영상 ( Yung Sang Lee ),서동진 ( Dong Jin Suh ) 대한간암학회 2010 대한간암학회지 Vol.10 No.-
Hepatocellular carcinoma is known to spread to distant organ via hematogenous or osseous route in about 15% of the patients during its clinical course. However, it is rare that the distant metastatic symptom and sign are the diagnostic clues to find the primary hepatocellular carcinoma, because most of the patients are likely to expire due to rapid disease progression before the presentation of the clinical findings of metastasis. Detection of early hepatocelluar carcinoma through surveillance of the high risk population will reduce the chance of initial presentation of metastatic symptom. In spite of this trend, we experienced a case of hepatocellular carcinoma presenting as skull metastasis at diagnosis, which suggests that some patients still complain of metastatic symptom as initial presentation of hepatocellular carcinoma.