원발담즙간경변증(해설논문(Review Article))

전재윤 ( Chae Yoon Chon ),박준용 ( Jun Yong Park ) 대한간학회 2006 Clinical and Molecular Hepatology(대한간학회지) Vol.12 No.3

간세포암 환자에서 간동맥화학색전술 후 발생한 간십이지장 누공

박윤혜 ( Yoon Hea Park ),강세훈 ( Se Hun Kang ),김승업 ( Seung Up Kim ),김도영 ( Do Young Kim ),박준용 ( Jun Yong Park ),안상훈 ( Sang Hoon Ahn ),한광협 ( Kwang Hyub Han ),전재윤 ( Chae Yoon Chon ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.3

Transarterial chemoembolization (TACE) is recommended as one of the first line therapy for unresectable hepatocellular carcinoma (HCC). Rupture of HCC following TACE is a rare and potentially fatal complication. We report a case of hepaticoduodenal fistula with ruptured HCC and liver abscess complicated by TACE. A 52-year-old male was treated by TACE three times, followed by radiation therapy and systemic chemotherapy. 30 days after the last TACE, right upper quadrant pain of abdomen was developed. About 1 month later, computed tomography of abdomen showed ruptured HCC with debris containing liver abscess and hepaticoduodenal fistula. Esophagogastroduodenoscopy revealed hepaticoduodenal fistula and hepatic parenchyme covered with exudate. The patient was managed with supportive care, but the hepaticoduodenal fistula persisted. (Korean J Gastroenterol 2011;58:149-152)

대한간학회 제 8 차 춘계학술대회 초록집 : 구연 - 표면항원이 소실된 만성 B 형 간질환 환자의 간조직학적 소견

박준용,전재윤(Chae Yoon Chon),방승민,박영년,한광협(Kwang Hyub Han),장혜영,김균환,문영명(Young Myoung Moon) 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.3(S)

만성 염증성 장질환 환자에서 항호중구 세포질 항체의 의의

문윤재(Yoon Jae Moon),배희동(Hee Dong Bae),박효진(Hyo Jin Park),김원호(Won Ho Kim),정석훈(Suk Hoon Chung),김현숙(Hyun Sook Kim),전재윤(Chae Yoon Chon),박인서(In Suh Park) 대한내과학회 1997 대한내과학회지 Vol.52 No.5

Objective: Anti-neutrophil cytoplasmic antibody (ANCA), known as a useful diagnostic marker in patients with ulcerative colitis (UC), are specific for granule proteins of granulocytes and monocytes and induce distinct fluorescence patterns. To evaluate the significance of ANCA in chronic inflammatory bowel disease (IHD), the presence of ANCA in chronic IBD was studied using indirect immunofluorescent test (IIF), Methods: Between March, 1994 and September 1995, 51 patients with chronic inflammatory bowel disease were subjected in this study. We had analysed the correlation between duration, disease activity, location by colonoscopy and radiologic examinations, steroid treatment. Results: 1) Among 34 patients with ulcerative colitis (UC), ANCA was demonstrated in 23 patients (67.6%). Among 19 patients with other chronic IBD (4 Crohn's disease, 6 Behcet's colitis, 7 intestinal tuberculosis and 2 radiation colitis) 2 patients (10.5%) had ANCA. The positivity of ANCA in patients with UC was significantly higher than in patients with other chronic IBD. 2) In patients with UC, c-ANCA was positive in 2 (5.9%) patients and p-ANCA was positive in 21 (61.8%) patients. In patients with other chronic IBD, ANCA was positive in one patient with Behcet's colitis or one patient with intestinal tuberculosis but negative in all patients with Crohn's disease or radiation colitis. 3) The mean duration of disease in ANCA positive patients was 42.4±39.4 months and the mean duration of disease in ANCA negative patients was 44.9±36.8 months, but there was no significant difference. 4) The number of patients in clinically mild, moderate and severe group were 23 (37.6%), 6 (83.2%) and 5 (14.7%) respectively. Among these groups the number of ANCA positive patients were 15 (65.2%), 5 (83.2%) and 3 (60%) respectively, but there was no significant difference. 5) The number of patients with proctitis, left side colitis and pancolitis were 9 (26.5%), 14 (41.2%) and 11 (32.4%) respectively, Among these groups the number of ANCA positive patients were 4 (44.4%), 10 (71.4%) and 9 (81.8%) respectively, but there was no significant difference. 6) Among 13 patients with steroid treatment 9 patients (69.2%) were ANCA positive. Among 21 patients without steroid treatment 16 patients (76.2%) were ANCA positive, but there was no significant difference. Conclusion: Although there was no correlation between ANCA and duration, disease activity, location or steroid treatment in UC patients, ANCA could be a diagnostic marker of UC in chronic IBD patients.

알코올에 의한 간손상시 적혈구막 지질 과산화현상의 역할

함기백,김원호,전재윤,문영명,강진경,박인서,최홍재,장학철,김한수,백승운,신용운 ( Ki Baik Hahm,Won Ho Kim,Chae Yoon Chon,Young Myung Moon,Jin Kyung Kang,In Suh Park,Heung Jai Choi,Hak Chul Jang,Han Soo Kim,Seung Woon Paik,Yong Woon Shin 대한소화기학회 1992 대한소화기학회지 Vol.24 No.2

The question of whether or not ethanol-induced liver injury is related to or accompanied by lipid peroxidation has been a subject of controversy. Short-term ethanol administration was shown by some to produce hepatic lipid peroxidation in rats, but very large doses of ethaol had to be used. Furthermore, some investigators failed to confirm these effects of ethanol. Fewer studies have explored the relationship between alcohol consumption and lipid peroxidation. In order to study this question and clarify the role of oxygen derived free radicals and lipid peroxidation of the RBC in inducing the alcoholic liver diseases, we measured the thiobarbituric acid reactivities in normal controls and patients with alcoholic liver disease. The subjects were divided into three groups according to the liver function tests and the amounts of alcohol drinking: group I-normal controls, group II-cases showing normal liver function test in spite of frequent alcohol drinking over 3 days per week and 45 g alcohol per one time, group III-patients with alcoholic liver disaesae, drinking alcohol over 4 times per week. The thiobarbituric acid reactive substances were measured as a marker of lipid peroxidation by the method of Uchiyama and Mihara. The colorimetric method was used by a measurment of malonyldialdehyde [MDA, nmole/ml (packed cells)] concentration. The results were as follows; (continue...)

만성 간질환 환자에 대한 고덱스 캅셀의 유효성.안정성에 관한 다기관, 무작위할당, 이중맹검 3상 비교임상시험

박문승,강주섭,전재윤,백승운,임규성,곽민정,전용철,이민호,Park, Moon-Seung,Kang, Ju-Seop,Chon, Chae-Yoon,Paik, Seung-Woon,Rim, Kyu-Sung,Kwak, Min-Jung,Jeon, Yong-Cheol,Lee, Min-Ho 대한임상약리학회 2001 臨床藥理學會誌 Vol.9 No.2

Background/Aims : Godex is a mixture of PMC(diphenyl-dimethyl-dicarboxylate) and Hepadif, each of which has been used for managing chronic liver disease in Korea and other countries. The purpose of this study was to evaluate the efficacy and safety of Godex in Korean patients with chronic liver disease. Methods : In this study, 154 patients with chronic hepatitis, who showed increased level of serum alanine aminotransferase(ALT), were randomly allocated into three groups. Fifty-two patients were administered 100mg/day of PMC, 48 patients were administered low dose of Godex(PMC 100mg+hepadif 600mg/day) and 53 patients were administered high dose of Godex(PMC 150mg+hepadif 900mg/day) orally for 8 weeks. To evaluate the efficacy and safety of Godex capsule, we considered primary variable as the proportion of patients who showed normal ALT blood level after treatment for 8 weeks and second variable as a proportion of patient who showed normal ALT at 4 weeks, the degree of difference of serum ALT level between 0 and 8 weeks, and incidence of adverse events during treatment period. Results : The percentage of subjects whose serum ALT levels decreased below upper normal level in control, low-dose and high-dose group were 64.54%, 67.35%, 81.13% after 8 weeks-treatment(p=0.0407) and 59.62%, 63.27%, 81.13% after 4 weeks-treatment of Godex(p=0.0790) using ITT analysis. There were no significant difference in incidence of adverse events among three groups. Conclusions : Response rate of high-dose group was significantly higher than those of low-dose group and control group. It is suggested that Godex 6 capsules per day(PMC 150mg+hepadif 900mg/day) is optimal dose for Korean patients with chronic liver disease who show elevated serum alanine aminotransferase(ALT) level.

간에 발생한 혈관육종 1 예

박상진(Sang Jin Park),전재윤(Chae Yoon Chon),신현승(Hyun Seung Shin),문희용(Hee Yong Moon),한광협(Kwang Hyub Han),문영명(Yung Myung Moon),강진경(Jin Kyung Kang),박인서(In Suh Park),박찬일(Chan Il Park) 대한내과학회 1993 대한내과학회지 Vol.45 No.6

Primary hepatic angiosarcoma is an extremely rare tumor. It is associated with chronic exposure to thor- otrast, vinyl chloride, arsenic, radium and possibly cop- per and with chronic idiopathic hemochromatosis. However, there are no known causes in about 40% of these patients. Although 40% of patients have hepatic fibrosis or cirrhosis at autopsy, the nature of the association between chronic liver disease and hepatic angiosarcoma is unknown. Only 3% of patients with hepatic angiosarcoma can live longer than 2years. A 44-year-old man was admitted due to right upper quadrant pain. He had no history of exposure to vinyl chloride, thorotrast, or arsenic. Abdominal CT scan showed multiple variable sized low density lesions with tortuous contrast enhancement from the periphery of the tumor in the right lobe of the liver. On the 2nd hospital day, hemoperitoneum was developed and emergency selective angiograpy was performed. In seletive angiography. the vascular puddling and stretching of the hepatic artery due to the enlarged tumor was shown on the right lobe of the liver from early arterial to late venous phase. In spite of double spring coil embolization and conservative care, the patient died. The patient was confirmed to have primary hepatic angiosarcoma by blind liver biopsy. We report a patient of primary hepatic angiosarcoma who came to the hospital because of right upper quad- rant pain and died of spontaneous rupture of the tumor with hemoperitoneum.

경정맥 간내문맥 - 간정맥 단락술로 십이지장정맥류 대량 출혈을 성공적으로 치료한 1 예

윤영준(Young Joon Yoon),한광협(Kwang Hyub Hahn),이도연(So Yun Lee),백용한(Yong Han Paik),정재연(Jae Yeon Chung),김철(Chul Kim),전재윤(Chae Yoon Chon),문영명(Young Myoung Moon) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.4

Duodenal varices can be resulted from either liver cirrhosis or extrahepatic portal hypertension. Bleeding from duodenal varices is rare but often severe and life threatening. Bleeding of duodenal varices can be treated with non-surgical or surgical treatment. Non-surgical treatments include endoscopic variceal ligation, endoscopic sclerotherapy, and transjugular intrahepatic portosystemic shunt (TIPS). Surgical treatments include shunt surgery, variceal ligation, variceal resection, and duodenectomy. However, endoscopic treatments are not so effective and surgical interventions have many limitations. A 68-year-old man with liver cirrhosis was admitted to our department and presented with mental change and melena. He received a large amount of transfusion and it was not possible to perform gastrointestinal endoscopy. Emergency angiography revealed marked dilatation of mesenteric veins, which was treated by TIPS. After TIPS, transfusion requirement was markedly reduced and gastrointestinal endoscopy demonstrated duodenal varices without bleeding. We conclude that TIPS may be an effective therapeutic option for control of hemorrhage from duodenal varices. (Korean J Gastroenterol 2001;38:292-295)

병사용 진단서 발급을 위해 복강경검사에서 간조직검사를 시행한 젊은 성인 남자의 간침생검 소견 : 새로운 만성간염병리분류를 기준으로

백용한(Yong Han Paik),전재윤(Chae Yoon Chon),박영년(Young Nyun Park),한광협(Kwang Hyup Han),문영명(Young Myoung Moon),박찬일(Chan Il Park) 대한소화기학회 2000 대한소화기학회지 Vol.36 No.2

Background/Aims: This study was designed to assess the etiology and characteristics of chronic liver disease among the young male adults. It was also investigated whether grades of activity and status of fibrosis defined by the new histopathologic classification system of chronic hepatitis are related with alanine aminotransferase (ALT) level and HBeAg status in HBsAg-positive case. Methods: Peritoneoscopic findings, clinical features and histopathologic features of liver were investigated for 140 young men who received liver biopsy for military medical certificate from January 1994 to December 1997. These features were evaluated according to the grade and stage of chronic hepatitis. Results: In Korea, hepatitis B virus was the main cause of chronic hepatitis (87.7%) in young male adults and the infection of hepatitis C virus was rare (1.4%). Among HBsAg-positive cases with normal ALT level, 82.2% of them revealed chronic liver disease, and 48.3% of them showed chronic active hepatitis/cirrhosis in biopsy specimens. The grade of chronic hepatitis showed weak correlation with ALT level and the stage did not. There was no significant difference in the grade and stage of chronic hepatitis according to the serum HBeAg status. Conclusions: The most common cause of chronic liver disease in Korean young male adults was hepatitis B virus, and most (92.6%) of HBsAg-positive cases were proved to have chronic liver diseases histologically, regardless of the serum ALT level. According to new histopathologic classification system of chronic hepatitis, serum ALT level correlated with necroinflammatory activity of chronic hepatitis B, but not with fibrosis in HBsAg-positive cases. (Kor J Gastroenterol 2000;36:224 - 234)

기능성 소화불량증과 역류성 식도염에서 위배출능 및 위 내 분포의 평가

박인서(In Suh Park),전재윤(Chae Yoon Chon),이관식(Kwan Sik Lee),박효진(Hyo Jin Park),김태일(Tae Il Kim),이종두(Jong Doo Lee),정준표(Jun Pyo Chung) 대한소화기학회 1998 대한소화기학회지 Vol.31 No.4

Background/Aims: Delayed gastric emptying and postprandial antral hypomotility are observed in patients with functional dyspepsia. These gastric motility abnormalities can be also associated with pathophysiology of reflux esophagitis. Thus, we studied intragastric food distribution and gastric emptying to examine food maldistribution in functional dyspepsia and reflux esophagitis. Methods: The patients with functional dyspepsia were categorized by prevalent discomfort patients (Group I, 10) and prevalent pain patients (Group II, 12). These two groups of patients ingested test meal labelled with technetium-99m. Patients with reflux esophagitis (Group IIl, 11) and healthy volunteers (Control, 2) ingested the same meal. Serial images of the gastric area were taken for 90 minutes and parameters of gastric emptying and intragastric distribution were examined for the regions of proximal, distal and total stomach. Results: Parameters of total gastric emptying (T1/2, retention at 30 min and 90 min, total gastric residence) in patients with functional dyspepsia and reflux esophagitis were not significantly different from those of controls. In the group II, all parameters of intragastric distribution were not different from those of controls. However, in the group I, initial activity (75.0%) in proximal gastric area after ingestion was significantly lower than that in controls (86.7%). Food distribution [maximal distal content (41.1%), distal gastric residence (41.1%)] in distal gastric area was significantly higher than that in controls [maximal distal content (28.5%), distal gastric residence (28.8%)]. In the Group III parameters of intragastric distribution are similar to those of the group I . Conclusions: Prevalent discomfort group of functional dyspepsia showed abnormal intragastric distribution of ingested food. On the other hand, they did not show delayed gastric emptying. The group of reflux esophagitis showed similar results. (Korean J Gastroenterol 1998;31:411 - 420)