Journal of Yeungnam Medical Science

Heon Ju Lee

29 Articles

Imatinib-induced hepatitis treated by corticosteroids in a patient with metastatic gastrointestinal stromal tumor: Min Kyu Kang, Heon Ju Lee, Joon Hyuk Choi; Yeungnam Univ J Med. 2019;36(2):155-158. Published online January 21, 2019; DOI: https://doi.org/10.12701/yujm.2019.00115

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Imatinib mesylate is currently used as the first-line treatment for metastatic gastrointestinal stromal tumors (GISTs). Imatinib-induced hepatotoxicity in patients with GIST is very rare. Its features vary from subclinical elevation of serum aminotransferase to clinically apparent acute hepatitis, which is associated with immunologic reactions. Imatinib-induced hepatotoxicity with autoimmune-like features can be treated by the discontinuation of imatinib mesylate and the administration of oral steroids. Here, we report a case of late-onset imatinib-induced hepatitis with autoimmune-like features in a patient with metastatic GIST, which was improved by oral corticosteroids.

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Antioxidant-Based Preventive Effect of Phytochemicals on Anticancer Drug-Induced Hepatotoxicity
Ji Eon Park, Chi-Hoon Ahn, Hyo-Jung Lee, Deok Yong Sim, Su Yeon Park, Bonglee Kim, Bum Sang Shim, Dae Young Lee, Sung-Hoon Kim
Antioxidants & Redox Signaling.2023; 38(16-18): 1101. CrossRef

A Case of Colchicine-Induced Neutropenia in Liver Cirrhosis Patient.: Ho Chan Lee, Heon Ju Lee, Yong Gil Kim, Jae Hyun Park, Sung Joon Kim, Jun Seok Park; Yeungnam Univ J Med. 2009;26(2):125-129. Published online December 31, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.2.125

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Abstract PDF: Colchicine is an alkaloid that has been used for treating acute gouty arthritis, psoriasis, scleroderma and Behcet's syndrome. Colchicine decreased liver fibrosis in rats with carbon tetrachloride induced cirrhosis and in patients with many liver diseases. Therapeutic oral doses of colchicine may cause nausea, vomiting, abdominal pain and diarrhea. The adverse effect of colchicine associated with the dose is bone marrow suppression, and especially neutopenia. Neutropenia has often been reported in patients have taken an overdose of colchicine. We describe a 64-year-old female liver cirrhosis patient with neutropenia that was induced by a therapeutic dose of colchicine.

A Case of Hepatocellular Carcinoma with intradural growth Presenting as Obstructive Jaundice.: Sung Bum Kim, Tae Nyeun Kim, Sung Jun Kim, Ho Chan Lee, Jae Hyun Park, Jong Ryul Eun, Byung Ik Jang, Heon Ju Lee, Sung Su Yun, Young Kyung Bae; Yeungnam Univ J Med. 2008;25(2):165-170. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.165

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Abstract PDF: The incidence of hepatocellular carcinoma presenting as obstructive jaundice is 0.7~9%. The mechanisms of obstructive jaundice include bile duct invasion by tumor, tumor thrombi, blood clots, direct bile duct compression by tumor, and intraductal tumor growth. We report a rare case of hepatocellular carcinoma with intraductal growth. A 46-year-old woman was admitted due to colicky right upper abdominal pain and jaundice for 4 days. Computed tomography showed dilatation of the left intrahepatic duct, and endoscopic retrograde cholangiography showed a filling defect in the left main intrahepatic duct. We performed a left lobectomy with a Roux-en-Y hepaticojejunostomy. The tumor was diagnosed as a hepatocellular carcinoma with intraductal growth.

The Short Term Efficacy of Entecavir Therapy in Chronic Hepatitis B.: Hyun Kim, Hee Bok Chae, Won Joong Jeon, Seon Mee Park, Sei Jin Youn, Jong Ryul Eun, Heon Ju Lee; Yeungnam Univ J Med. 2008;25(1):31-40. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.31

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Abstract PDF: BACKGROUND
/AIMS: Entecavir is a synthetic nucleoside analogue, cyclopentyl guanine nucleoside, which has a potent antiviral effect and the least viral breakthrough in hepatitis B virus (HBV) replication. Entecavir has been available in Korea since 2007 but there are few reports on its effects. The aim of this study was to evaluate the virological response (VR) and biochemical response (BR) to entecavir in HBV patients at 3, 6 and 9 months after treatment with entecavir. MATERIALS AND METHODS: Thirty-three chronic hepatitis B patients who took entecavir for at least 9 months were enrolled. We investigated VR and BR by retrospectively reviewing medical records. Patients who satisfied the following criteria were chosen: 1) initial alanine aminotransferase (ALT) levels = 1.5upper limit of normal (ULN) and 2) initial HBV DNA levels = 5 log10 copies/ml. We measured ALT levels every 3 months until month 9. HBV DNA was measured every 2 or 3 months by polymerase chain reaction (PCR) method. RESULTS: Most patients taking entecavir showed good BR (ALT < 40 IU/L). The BR rates were 61%, 73% and 67% at months 3, 6 and 9, respectively. VR (HBV DNA < 5 log(10) copies/ml or 2 log lower than initial HBV DNA) rates were 82%, 91% and 91% at months 3, 6 and 9, respectively. Undetectable HBV DNA (HBV DNA < 4 log(10) copies/ml) rates were 49%, 73% and 85% at months 3, 6 and 9, respectively. Two patients presented with virological breakthrough without adverse effects until month 9. CONCLUSIONS: Entecavir showed good BR and VR from month 3 and these effects continued through the 9-month observation period. This suggests that entecavir is also a good choice for the first line treatment of chronic hepatitis B (CHB). Further studies are needed to determine the long-term efficacy and drug resistance of entecavir in Korean CHB patients.

Long Term Effects of Lamivudine and Adefovir dipivoxil in Chronic Hepatitis B Patients on the Development of Hepatocellular Carcinoma.: Heon Ju Lee; Yeungnam Univ J Med. 2008;25(1):1-18. Published online June 30, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.1.1

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Abstract PDF: Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of 10(4) copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the 21st century.

Clinical Characteristics of Adult Patients with Acute Hepatitis A.: Jong Ryul Eun, Heon Ju Lee, Tae Nyeun Kim, Byung Ik Jang, Hee Jung Moon; Yeungnam Univ J Med. 2007;24(2):170-178. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.170

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BACKGROUND
The incidence of acute hepatitis A in adults has recently been increasing. This study was conducted to investigate the epidemiology and clinical characteristics of acute hepatitis A in Daegu province over the past 10 years. MATERIALS AND METHODS: We reviewed the medical records of 55 patients (male/female: 34/21), who were diagnosed with acute hepatitis A by confirmation of the IgM anti-HAV between January 1998 and June 2007. RESULTS: The mean age was 29.7+/-10.3 years (range; 17-65 years). The incidence was most common between March and June (56.1%), in the third and fourth decades of life (78.2%) and 90.9% (50/55) of the patients were diagnosed from 2003 to present. The common symptoms included anorexia, nausea or vomiting (69.1%), fever and chills (49.1%), myalgia (47.3%), weight loss (47.3%), fatigue (40.0%), abdominal pain (36.4%), diarrhea (9.1%) and pruritus (5.5%). The mean duration of hospital stay was 8.6+/-3.4 days (range; 3-20 days). The route of transmission was identified in only 11 patients (20.0%); 7 patients (12.7%) traveled (abroad or domestic), 2 patients (3.6%) ingested raw food and 2 patients (3.6%) had friends with acute hepatitis A. Fifty four patients recovered without complication; one patient developed fulminant hepatitis and recovered after a liver transplantation. CONCLUSION: The incidence of acute hepatitis A in adults is increasing. Because of the cost of treatment and potential for serious disease, persons, under 40 are recommened to have hepatitis A vaccination and confirmation of IgG anti-HAV.

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Pattern of Hepatitis A Incidence According to Area Characteristics Using National Health Insurance Data
Joo Youn Seo, Jae Hee Seo, Myoung Hee Kim, Moran Ki, Hee Suk Park, Bo Youl Choi
Journal of Preventive Medicine & Public Health.2012; 45(3): 164. CrossRef

Gastric Phytobezoar Treated by Oral Intake and Endoscopic Injection of Coca-Cola.: Hee Jung Moon, Sang Hoon Lee, Jun Young Lee, Dong Hee Kim, Ji Eun Lee, Chang Hun Yang, Jong Ryul Eun, Tae Nyeun Kim, Heon Ju Lee, Byung Ik Jang; Yeungnam Univ J Med. 2006;23(2):247-251. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.247

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Bezoars are collections or concretions of indigestible foreign material that accumulate and coalesce in the gastrointestinal tract; they usually occur in patients who have undergone gastric surgery and have delayed gastric emptying. Treatment options include dissolution with enzymes, endoscopic fragmentation with removal or aspiration, and surgery. Recently, the efficacy of nasogastric lavage or endoscopic infusion of Coca-Cola for the dissolution of phytobezoar have been reported. We report a case of phytobezoar successfully treated by oral administration and endoscopic injection of Coca-Cola. A 62-year-old woman was referred to Yeungnam University Hospital for epigastric pain. Upper gastrointestinal endoscopy revealed one very large, dark-greenish, solid bezoar in the stomach with gastric ulcer and duodenal bulb deformity. We performed endoscopic injection of Coca-Cola into the bezoar. The patient was instructed to drink four liters of Coca-Cola per day. At endoscopy two days later, the phytobezoar was easily broken into pieces. At endoscopy on the 11th day of admission, the phytobezoar was decreased in size and removed by endoscopic fragmentation with a polypectomy snare. At follow up endoscopy after 13 days, the bezoar was completely dissolved.

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Systematic review: Coca-Cola can effectively dissolve gastric phytobezoars as a first-line treatment
S. D. Ladas, D. Kamberoglou, G. Karamanolis, J. Vlachogiannakos, I. Zouboulis-Vafiadis
Alimentary Pharmacology & Therapeutics.2013; 37(2): 169. CrossRef

A Clinical Case Report of Hydatid Cyst of Liver.: Jung Mi Kim, Kyo Won Choi, Heon Ju Lee; Yeungnam Univ J Med. 2001;18(1):138-143. Published online June 30, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.1.138

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In humans, echinococcal species produce cystic lesions primarily involving the liver and lung. Echinococcal infection is caused far more commonly by Echinococcus granulosa than by E. multilocularis, which accounts for less than 5 percent of all cases of hydatid liver disease. Hydatid disease occurs principally in sheep grazing areas, particularly in the Australia, New Zealand, Greece, Yugoslavia, Middle East, and South American countries, but with increasing migration and traveling, this disease now has a worldwide distribution. This disease is rare in Korea and only few cases have been reported. This is a clinical case report of hydatid cyst of liver caused by Echinococcus granulosus in a 52-year-old man who had been dispatched in the Vietnam from 1966 to 1968.

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Hepatic Hydatid Cyst: A Case Report
Wan Chul Kim, Jae Uk Shin, Su Sin Jin
The Korean Journal of Gastroenterology.2021; 77(1): 35. CrossRef
Clinical Update on Parasitic Diseases
Min Seo
Korean Journal of Medicine.2013; 85(5): 469. CrossRef
An Imported Case of Echinococcosis of the Liver in a Korean Who Traveled to Western and Central Europe
Sun-Ju Byun, Kyung Chul Moon, Kyung-Suk Suh, Joon Koo Han, Jong-Yil Chai
The Korean Journal of Parasitology.2010; 48(2): 161. CrossRef

The Role of Radiotherapy in Treatment of Hepatocellular Carcinoma.: Jong Ryul Eun, Kyo Won Choi, Heon Ju Lee, Mung Se Kim; Yeungnam Univ J Med. 2000;17(2):137-145. Published online December 31, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.2.137

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Abstract PDF: BACKGROUND
Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and METHODS: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. RESULTS: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. CONCLUSIONS: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.

The effect of Transarterial Chemoembolization(TAE) on Lung metastasis of Hepatocellular Carcinoma.: Heon Ju Lee, Jong Ryul Eun, Young Doo Song, Chan Won Park; Yeungnam Univ J Med. 2000;17(1):66-74. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.66

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Abstract PDF: BACKGROUND
During follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. METHODS: From march 1991 to march 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic method at Yeungnam university hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months, and divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated the age, sex, child-pugh score, liver cirrhosis, and the level of AFP. RESULTS: Pulmonary metastasis was found in 18.0% (26/144), of witch 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of thepatients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. there was more likelihood for lung metastasis after TAE, but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. CONCLUSIONS: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. child-pugh class was the only related clinical precipitating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-up may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.

Effect of alpha-Interferon 2b on Chronic Hepatitis B Patients with High Serum ALT.: Heon Ju Lee, Young Doo Song; Yeungnam Univ J Med. 1998;15(2):237-245. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.237

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Abstract PDF: No abstract available.

Acute Exacerbation with Severe Jaundice in Chronic Hepatitis B Patient.: Heon Ju Lee; Yeungnam Univ J Med. 1997;14(2):483-496. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.483

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Abstract PDF: No abstract available.

Acute Exacerbation with Severe Jaundice in Chronic Hepatitis B Patients.: Heon Ju Lee; Yeungnam Univ J Med. 1997;14(2):329-336. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.329

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Abstract PDF: No abstract available.

Detection of Serum Hepatitis B Virus DNA According to HBV Markers in Chronic Hepatitis B Liver Disease.: Dong Jun Lee, Jin Su Choi, Joon Hwan Kim, Heon Ju Lee; Yeungnam Univ J Med. 1997;14(1):155-167. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.155

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Abstract PDF: The identification of serum HBV DNA is very important for the assessment of the disease activity in persistent infection, for the evaluation of the infectivity of an individuals blood. The dot blot, however, has limited sensitivity and sometimes inconsistent with other serological markers and clinical settings. Using the most important recent advance in molecular biology, the polymerase chain reaction(PCR), specific DNA sequences can be amplified more than a million-fold in a few hours and with this technique the detection of the extreme low level of DNA is possible. This study was to determine sensitivity of the PCR for the detection of serum HBV DNA in comparison with dot blot analysis and to investigate the serum HBV DNA status and clinical significance of PCR in patients with chronic HBsAg positive liver disease. The subjects of this study were 17 patients with asymptomatic HBsAg carriers(9 HBeAg positive patients, 8 anti-HBe positive patients), 91 chronic hepatitis B(50 HBeAg positive patients, 41 anti-HBe positive patients), 57 liver cirrhosis(21 HBeAg positive patients, 36 anti-HBe positive patients), 27 hepatocellular carcinoma(10 HBeAg positive patients, 17 anti-HBe positive patients). The results were summerized as following; The detection rates of HBV DNA by dot blot, PCR were 58.9%, 72.2% in HBeAg positive patients, 34.3%, 53.9% in anti-HBe positive patients. The detection rates of HBV DNA by PCR in HBeAg negative patients were 25.0% in asymptomatic HBsAg carriers, 61.0% in chronic hepatitis B, 52.8% in liver cirrhosis, 52.9% in hepatocellular carcinoma. The positive rate for HBV DNA is a significant difference between HBeAg positive and negative asymptomatic HBsAg carriers, but not significantly difference in other groups. In conclusions, this study confirmed that the PCR is much more sensitive than the dot blot analysis in detecting the HBV DNA in the sera of patients with chronic liver disease. The presence of HBV DNA in the serum was detected by PCR with higher sensitivity and it suggested that active viral replication is still going on in most patients with chronic HBsAg positive liver disease irrespective of HBeAg/anti-HBe status, and PCR may be used as a prognostic factor in asymptomatic HBsAg carriers.

A Case of Rhabdomyosarcoma in the Liver.: Dong Jun Lee, Ji Sung Yoon, Joon Hwan Kim, Chan Won Park, Jeong Ill Suh, Heon Ju Lee, Ki Kweon Kim; Yeungnam Univ J Med. 1996;13(2):360-366. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.360

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Abstract PDF: Pure primary hepatic rhabdomyosarcoma in adult is very uncommon. There have been only five previous case of primary rhabdomyosarcoma of the adult liver. A case of hepatic ihabdomyosarcoma was diagnosed in a 52 year-old female. She was admitted to the hospital due to the epigastric pain and weight loss. A CT scan of the abdomen showed a large hypodense mass with focal calcification occupies most of the both lobes of the liver. The liver biopsy showed massive liver tumor composed entirely of oval shaped cells showing light microscopic and immunohistochemical evidence of rhabdomyoblastic differentiation. We report a case of hepatic rhabdomyosarcoma with review of literature.

A Case of Hepatocellular Carcinoma after Hepatic Artery Ligation.: Jeong Ill Suh, Joon Hwan Kim, Dong Joon Lee, Ki Yoon Kim, Ho Jung Kang, Chan Won Park, Heon Ju Lee; Yeungnam Univ J Med. 1996;13(1):146-151. Published online June 30, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.1.146

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Abstract PDF: Majority of .hepatocellular carcinoma is evolved from a well differentiated cancerous condition such as hypetptastic lesions eg; adenomatous hyperplasia in cirrhotic liver or de no vo carcinogenesis and prolifenation along with dedifferentiation. Adenomatous hyperplasia is may be seen in severe acute hepatic injury, like svhmassive hepatic necrosis, or in chronic liver diseases, particularly liver cirrhosis and it has recently attracted much interest from both clinicians and pathologists because it is regarded as a precursor lesion of hepatocObdar carcinoma. Hepatic. denomatous hyperplasia resembling focal nodular hyperplasia might have developed from localized vascular changes associated with chronic liver disease, pre-existing arterial malformation and early stage of angiogenesis in hepatocarcinogenesis. .fie present a patient who developed hepatocellular carcinoma after hepatic artery ligation.

Serum AST.ALT Activities in the Diagnosis of Liver Diseases.: Heon Ju Lee; Yeungnam Univ J Med. 1995;12(1):10-20. Published online June 30, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.1.10

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No abstract available.

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Anti-Obesity Effects of Black Barley Ferment Extract in 3T3-L1 Adipocytes and Obese Mice Induced by High Fat Diet
Hye Ran Choi, Su Jung Lee, Jong Hyuk Park, Jaeju Kim, Tae Ho Ryu
Journal of the Korean Society of Food Science and Nutrition.2023; 52(5): 482. CrossRef

Effect of alpha-interferon treatment on serum ALT levels in patients with chronic hepatitis C.: Heon Ju Lee; Yeungnam Univ J Med. 1993;10(1):190-196. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.190

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The prognosis of chronic hepatitis C is very variable. In some, the disease is progressive and cirrhosis can develop from chronic hepatitis C. Hepatitis C virus (HCV) may act as a trigger towards hepatocellular carcinoma in patients with cirrhosis. Interferon has been used for the treatment of chronic hepatitis C in abroad. 16 patients with chronic C liver disease were treated with alpha-interferon (alfa-2b : "Intron A" Schering Corp. Kenilworth, NJ). All patients were given alpha-interferon in subcutaneous doses of 3 million units three times weekly for 1 to 9 months. During therapy, CBC and ALT levels were checked weakly to monthly. After therapy,. patients were followed for 1 to 8 months. Among 16 patients treated with alpha-interferon, progressive decrease of ALT levels was observed in 14 (87.5%). In 11 patients (68.8%), ALT levels fell into the normal range during therapy, and in 9 of 11, within one month after therapy. 6 months after the completion of therapy in 4 of 9 patients (44.4%) whose ALT levels were in the normal range. alpha-interferon seems to have effect in controlling disease activity in patients with chronic hepatitis C. But the changes in the usage of alpha-interferon, dose and duration, long term follow up and more convenient and simple tests for HCV detection are recommended for the better effect and the exact evaluation on the effect of alpha-interferon therapy in patients with chronic hepatitis C.

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Chronic hepatitis C healed by peginterferon-α and rivabirin treatment after kidney transplantation
Min Gue Seok, Tae Hee Lee, Sung Ro Yun, Won Min Hwang, Se Hee Yoon, In Soo Choe, Seong Joo Kang, Ju Young Hong, Dae Sung Kim
Yeungnam University Journal of Medicine.2016; 33(2): 150. CrossRef

Intrafamilial transmission of HCV: comparison with HBV.: Heon Ju Lee; Yeungnam Univ J Med. 1992;9(2):407-415. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.407

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Abstract PDF: Among 85 patients with anti-HCV positive chronic liver disease, only 21.2% have past history of blood transfusion and over half the cases, they do not have any suspicious risk factors for HCV infection. 3 of 85 families show anti-HCV positive family members. On the other hand, 40 of 60 patients with HBsAg positive chronic liver disease show HBsAg positive family members. In Korea, HBV is transmitted mainly through vertical and intrafamilial infection but HCV disease might be rather horizontal and sporadic than vertical. To define the evident source of infection in sporadic hepatitis C, first of all, simple test with high sensitivity and specificity for diagnosis of HCV infection would be needed.

A Case of Paroxysmal Nocturnal Hemoglobinuria.: Chung Sook Kim, Kyung Dong Kim, Heon Ju Lee; Yeungnam Univ J Med. 1989;6(1):185-195. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.185

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Abstract PDF: Paroxysmal Nocturnal Hemoglobinuria (PNH) is an uncommon hematologic disease characterized by an abnormal sensitivity of blood cells to the lytic action of serum complement. We experienced one case of PNH in Yeungnam University Hospital from May 1983 to May 1989. The patients was followed up without severe complications of 4 years since diagnosis with the only conservative treatments such as washed blood transfusion, adrenal corticosteroids, androgens, folate and iron preparation, intermittently.

Uptake of 99mTc - DISDA in Primary Hepatocellular Carcinoma and Metastatic Nodule in the Lung.: Jun Young Do, Heon Ju Lee, Soo Bong Choi, Hyun Woo Lee; Yeungnam Univ J Med. 1988;5(2):171-174. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.171

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Abstract PDF: Recently, several reports of extrahepatic hepatocellular carcinoma metastasis demonstrated by technetium-99mTc-IDAs scan have shown that 99mTc-IDAs can be used to detect extrahepatic metastasis in hepatocellular carcinoma. We report here a case of hepatocellular carcinoma with pulmonary nodules that were demonstrated as metastasis in nature by the use of the 99mTc-DISIDA. The findings in this case and several reports reviewed here suggest that the 99mTc-DISIDA scan may be a useful diagnostic agent that can detect the extrahepatic metastasis of hepatocellular carcinoma and stage the disease. But more clinical study in needed to establish the position of 99mTc-DISIDA in the field of diagnosis of extrahepatic hepatocellular carcinoma.

Diagnostic Value of the Intradermal Test for the Infection with Clonorchis sinensis.: Jong Ho Kim, Bong Yung Yun, Heon Ju Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1988;5(2):47-52. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.47

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Abstract PDF: The intradermal (ID) test has been widely used in Korea and several reports about the results of the ID test are known. We examined the egg of Clonorchis sinensis (C.s.) by ID test in 443, stool's egg-counting technique in 79 and direct smear (cellophane thick smear technique) in 1204 subjects. The results are as follows: 1. The positive rate of C.s. was 3.8% out of 1304 persons. 2. The sensitivity of ID test was 82.1% out of 39 persons and the specificity was 64.6% out of 404 persons. 3. The false positive of ID test was 35.4% out of 404 persons and, the false negative was 17.9% out of 39 persons. Intradermal test is a rapid, sensitive and useful supplementary diagnostic tool for the detection of Clonorchiasis infection and must be used as screening test with direct smear of stool but cross reaction with other helminth infections and moderate false reaction are the main disadvantages in its practical application.

The Positive Rate for Serum Anti-HBs in Korean since the Universal Carrying Out of HB Vaccination.: Heon Ju Lee, Moon Kwan Chung, Chong Suhi Kim; Yeungnam Univ J Med. 1987;4(1):75-80. Published online August 31, 1987; DOI: https://doi.org/10.12701/yujm.1987.4.1.75

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Abstract PDF: The positive rate for serum anti-Hbs was analized among 424 0f HA vaccinated and 2035 of non-vaccinated cases at the Yeungnam University Hospital, Computed Automated Med-screening Center. Most of them from Kyungbook province and they had the last HB vaccination in the periods of 3 to 42months prior to this study. The followings were obtained. 1. The positive rates for serum HBsAg were 0.7% in the vaccinees, 9.6% in the non-vaccinated and 8.0% in the whole cases. 2. The positive rates for serum ant-HBs were 66.3% in the vaccinees, 47.9% in the non-vaccinated and 51.6% in the whole cases. 3. The positive rates for serum anti-HBs were 51.4% in the cases with one time of vaccination and 68.6% in the cases with two times of vaccination. On the vasis of these findings the positive rate for serum anti-HBs among the vaccines was significantly higher than of non-vaccinated (P<0.05). The positive rate for serum anti-HBs shortly after vaccination was higher than that of present our study which was made relatively long period after vaccination. As the reason a natural decrease of the titers of the serum anti-HBs can be postulated as one of the contributing factors for the discrepancy. In order to keep to serum antibody of perfect protectivity against HBV, it may be better to check the serum anti-HBs just vaccination, follow up and take booster injection when it is needed.

Clinical Review of Acute Gastric Anisakiasis.: Pill Young Kim, Moon Kwan Chung, Heon Ju Lee, Chong Suhi Kim; Yeungnam Univ J Med. 1987;4(1):43-47. Published online August 31, 1987; DOI: https://doi.org/10.12701/yujm.1987.4.1.43

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Abstract PDF: 7 cases of acute gastric Anisakiasis have been reviewed at the Department of Internal Medicine, Yeungnam University Hospital from March, 1983 to December 1986. 1. Of 7 cases, the ratio of male and female was 3:4 and the age 30s occupied most (5 cases) the 50s' followed (2 cases). 2. Chief complains were in order of epigastric pain (6 cases), vomiting (3 cases), Nause (2 cases), Ulticaria (1 case) & epigastric fulling sensation (1 case). 3. In all 7 cases, the causative fish in astroconcer myriaster. 4. The onset of symptoms was observed within 5 to 7 hours after eating the causative raw fish. 5. Gastrofiberscopic exam was undergo within 48 hours since onset of symptoms. 6. The gastrofiberscopic findings were gastric mucosal edema and redness in all 7 cases. One case also had mucosal erosion. The involved sites of the stomach were in frequency of order, the body (5 cases), the antrum (2 cases). 7. The symptoms of the patients relieved spontaneously without medical treatment after the extraction of the larva with biopsy forcep during gastrofiberscopy. 8. In Korea, many people take raw fish and there may be many patients of Anisakiasis so if much concern and careful observation are paid to whom with severe cramping epigastric pain after taking of raw marine fish in about 10 hours, we could find out and confirm more patients suffering from Anisakiasis by immediate endoscopic gastrofiberscopy.

A Clinical Study of HBV Markers in Various Liver Diseases Carriers and Controls.: Jung Kyu Choi, Yong Won Lee, Jin Myung Choi, Moon Kwan Chung, Heon Ju Lee, Chong Suhl Kim; Yeungnam Univ J Med. 1985;2(1):211-220. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.211

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Abstract PDF: Serum HBsAg, AntiHBs, HBeAg, AntiHBe, and AntiHBc were detected by radioimmunoassay in 39 patients with acute viral hepatitis, 79 patients with chronic hepatitis, 30 patients with liver cirrhosis, 16 patients with primary hepatocellular carcinoma, 14 patients of HBsAg carriers and 129 cases of controls: 78 cases of normal level of SGOT, SGPT, and 51 cases of elevated level of SGOT, SGPT. Following results were obtained: 1. HBsAg was detected in 66.7% of acute viral hepatitis, 63.3% of chronic hepatitis, 36.7% of liver cirrhosis, 81.3% of primary hepatocellular carcinoma and 27.1% of controls. 2. AntiHBs was positive in 0% of acute viral hepatitis, 21.5% of chronic hepatitis, 36.7% of liver cirrhosis, 31.3% of primary hepatocellular carcinoma, 0% of carrier and 44.2% of controls. 3. HBeAg was detected in 45.6% of chronic hepatitis, 23.3% of liver cirrhosis and 31.3% of primary hepatocellular carcinoma. 4. Among chronic liver diseases, antiHBe was positive in 56.3% of primary hepatocellular carcinoma, 23.3% of liver cirrhosis and 20.3% of chronic hepatitis. 5. AntiHBc was detected in most of all examinees and the significance of presence of AntiHBc does not seem to represent liver disease itself but the evidence of infection of HBV. 6. Among 14 HBV carriers, 6 cases presented with abnormal SGOT, SGPT. 7. All HBV markers were negative in 5.1% of acute viral hepatitis, 5.1% of chronic hepatitis and 14.7% of controls: 17.6% of subjects with abnormal SGOT, SGPT and 12.8% of subjects with normal SGOT, SGPT. 8. Beside of HBV, other causes, such as non A, non B virus, Delta-agent, other viruses or related factors should be excluded among the patients with evidence of HBV infection associated with elevation of SGOT & SGPT.

Cutaneous Manifestations Associated with Liver Diseases.: Young Sup Cho, Jong Soo Choi, Ki Hong Kim, Heon Ju Lee; Yeungnam Univ J Med. 1985;2(1):167-174. Published online December 31, 1985; DOI: https://doi.org/10.12701/yujm.1985.2.1.167

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It has been well recognized that the various cutaneous manifestations associated with liver diseases. A clinical study was made of 255 patients (AVH84, LC70, HC41, CAH26, CPH23, AH11) with the liver diseases at Yeungnam University Hospital during the periods from May to November, 1985. The authors classified the cutaneous manifestations into 7 groups according to pathogenesis, and compared them with other reports. The results were as follows: 1. In 255 patients with various liver diseases, 161 patients (63%) showed the various cutaneous manifestations. 2. The various cataneous manifestations were jaundice and/or pruritus (43.1%), vascular changes (39.6%), allergic manifestations (10.6%), nail changes (5.1%), hormone-induced changes (4.3%), pigmentary changes (3.5%) and others (2.4%) in that order. 3. Cutaneous manifestations were associated most frequently with liver cirrhosis (1.6 groups) and the least with chronic active hepatitis (0.7 group). 4. Allergic manifestations were seen mainly in patients with acute viral hepatitis. Three patients showed the serum sickness-like prodrome. 5. The other cutaneous manifestations were seen mainly in patients with chronic liver diseases.

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The use of sub-epidermal moisture measurement in predicting blanching erythema in jaundice patients
Seungmi Park, Chul-Gyu Kim, Ji Woon Ko
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Three Cases of Tetracyclines Induced Esophageal Ulcer.: Heon Ju Lee, Moon Kwan Chung, Chong Suhl Kim; Yeungnam Univ J Med. 1984;1(1):179-183. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.179

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Abstract PDF: In recent years, an increasing number of drugs have been reported to cause direct esophageal damage. More than 30 cases on tetracyclines induced esophageal ulcer have been reported since the first description of tetracycline induced esophageal ulcer by Bokey and Hugh in 1975. In Korea, only one case of doxycycline-unduced esophageal ulcer has been reported. Authors have experienced 3 cases of esophageal ulcer probably caused by tetracyclines. The patients had taken their capsules just before going to bed with little fluid intake. About 6-8 hours later they had felt substernal burning sensation and epigastric discomfort. Gastrofiberscopy revealed relatively well demarcated circular ulcers on the mid esophagus. An esophagogram showed no apparent abnormality. Patients's symptoms became negligible with antacid treatment within 2-5 days. One of the causes of the esophageal ulcer is thought to be the delay in transit time of drugs and direct esophageal damage from mucosal contact when tablets are ingested in the recumbent position without an accompanying proper quantity of fluid. If only physicians endow patients with more concern about drug induced esophageal ulcer, they could find out more increasing number of drug induced esophageal ulcers by gastroscopic examination and thereby could prevent tetracycline induced esophageal ulcer.

A Case of Pseudomembranous Colitis.: Moon Kwan Chung, Chang Heon Yang, Heon Ju Lee, Young Hyun Lee, Chong Suhl Kim, Won Hee Choi; Yeungnam Univ J Med. 1984;1(1):171-178. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.171

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Abstract PDF: Many reports have been made concerning underlying and associated conditions causing pseudomembranous colitis and it has been documented that occurrence of pseudomembranous colitis is related with antibiotics administration. Recent study showed that Clostridium difficile produced enterotoxin by colonization in intestinal wall and leading into pseudomembranous colitis. Diagnosis is based on positive culture of Clostridium difficile, positive test of Clostridium difficile toxin and specific histological findings after observation of whitish plaque on colonoscopic or sigmoidoscopic examination. Authors have experienced one case of pseudomembranous colitis developing after long term ampicillin administration in a case with colon cancer associated with diarrhea and diagnosis was confirmed by typical pseudomembrane on biopsy following classical whitish plaque absevation on sigmoidoscopic examination. Symptoms have been ameliorated by discontinuation of antibiotics and administration of metron-idazole in four days and disappearance of whitish plaque on repeated sigmoidoscopic examination and improvement of clinical symptoms after 9 days of medication.

A Case of Hepatic Hemangioma.: Si Hwan Kim, Young Hyun Lee, Heon Ju Lee, Moon Kwan Chung, Soo Bong Choi, Chong Suhl Kim, Koing Bo Kwun, Mi Soo Hwang, Jae Chun Chang, Tae Sook Lee; Yeungnam Univ J Med. 1984;1(1):161-169. Published online December 31, 1984; DOI: https://doi.org/10.12701/yujm.1984.1.1.161

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Abstract PDF: Hepatic hemangioma is a benign neoplastic disease of the liver and characterized by high vascularity and accompanied with bleeding episode. We report a case of giant hepatic cavernous hemangioma and review the literature briefly. A 44-year old female patient was admitted because of palpable abdominal mass, which growing for 15 years. She was diagnosed as hepatic hemangioma by abdominal CT scan and selective celiac angiography. She was performed the left lateral segmentectomy of liver and the pathological report was cavernous hemangioma of the liver.

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