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곽재욱 ( Jae Wuk Kwak ),백창렬 ( Chang Nyol Paik ),이강문 ( Kang Moon Lee ),정우철 ( Woo Chul Chung ),정성훈 ( Sung Hoon Jung ),김지은 ( Ji Eun Kim ),백준현 ( Jun Hyun Baik ),양진모 ( Jin Mo Yang ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.1
Isolated spontaneous dissection of the superior mesenteric artery (SMA) without aortic dissection is a rare cause of acute mesenteric ischemia. A sudden decrease of intestinal blood flow can lead to fatal complications such as ischemic necrosis, shock, and death. Therefore, early diagnosis and therapeutic approach before the occurrence of intestinal infarction are the most important factor to determine the patient`s prognosis. A 52-year-old male presented with postprandial periumbilical pain, and isolated spontaneous dissection of the superior mesenteric artery with mural thrombus was detected by abdominal computed tomography with contrast enhancement. By the percutaneous implantation of vascular metallic stent via femoral artery, he was treated successfully. We report a case of isolated spontaneous dissection of the SMA treated by a percutaneous endovascular stent replacement with a review of literature. (Korean J Gastroenterol 2010;55:58-61)
곽재욱 ( Jae Wuk Kwak ),이강문 ( Kang Moon Lee ),정우철 ( Woo Chul Chung ),백창렬 ( Chang Nyol Paik ),장우임 ( U Im Chang ),김진동 ( Jin Dong Kim ),정성훈 ( Sung Hoon Jung ),양진모 ( Jin Mo Yang ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.5
Inflammatory bowel diseases (IBD) is heterogeneous, chronic relapsing disorder. Inappropriate and exaggerated immune response for the luminal antigen is known as a main pathogenesis. Genetic, infectious, and environmental factors are responsible for unbalanced immune response, but the definite pathogenesis is still unclear. Genetic factor is the most important role of all. That is based on high concordance rate of identical twins and family history. The incident rate and prevalence of IBD for the Asian population is relatively lower than Western population, and the lack of NOD2 or TLR4 genetic polymorphisms in Korea and Japanese population suggests the difference in genetic background between Asian and Western population. In Korea, the case of familial aggregation of IBD is pretty rare. We report a case of the daughter with ulcerative colitis and her mother with Crohn`s disease who have a -159C/T promoter polymorphism of CD14 gene for IBD. (Korean J Gastroenterol 2010;55:336-339)
( Woo Chul Chung ),( Bo In Lee ),( Sang Young Roh ),( Jae Wuk Kwak ),( Sun Mee Hwang ),( Yoon Ho Ko ),( Jung Hwan Oh ),( Hyunjung Cho ),( Hiun Suk Chae ),( Young Seok Cho ) 대한간학회 2011 Gut and Liver Vol.5 No.4
Background/Aims: Recent data from Western populations have suggested that patients with sporadic duodenal adenomas are at a higher risk for the development of colorectal neoplasia. In this study, we compared the frequency of colorectal neoplasia in patients with sporadic duodenal adenomas to healthy control subjects. Methods: This retrospective case-control study used the databases of 3 teaching hospitals in Gyeonggi-do Province, South Korea. The colonoscopy fi ndings of patients with sporadic duodenal adenomas were compared with those of age- and gender-matched healthy individuals who had undergone gastroduodenoscopies and colonoscopies during general screening examinations. Results: Between 2001 and 2008, 45 patients were diagnosed endoscopically with sporadic duodenal adenomas; 26 (58%) of these patients received colonoscopies. Colorectal neoplasia (42% vs 21%; odds ratio [OR], 2.8; 95% confi dence interval [CI], 1.1 to 7.4) and advanced colorectal adenoma (19% vs 3%; OR, 9.0; 95% CI, 1.6 to 50.0) were signifi cantly more common in patients with sporadic duodenal adenomas than in healthy control subjects. Conclusions: Compared with healthy individuals, patients with sporadic duodenal adenomas were at a signifi cantly higher risk for developing colorectal neoplasia. Such at-risk patients should undergo routine screening colonoscopies. (Gut Liver 2011;5:432-436)
( Woo Chul Chung ),( Sung Hoon Jung ),( Kang Moon Lee ),( Chang Nyol Paik ),( Jae Wuk Kwak ),( Ji Han Jung ),( Jin Young Yoo ),( Min Kyoung Lee ),( In Sik Chung ) 대한소화기기능성질환·운동학회 2010 Gut and Liver Vol.4 No.2
Background/Aims: The aim of this study was to determine the structural chromosomal aberrations, such as loss of heterozygosity (LOH) and microsatellite instability (MSI), at multiple tumor suppressor gene loci in gastric epithelial neoplasia categorized by the revised Vienna classification. Methods: All tissue samples were excised by endoscopic mucosal resection. Sixty category 3 (low-grade adenoma) tissue samples and 51 category 4 samples (high-grade adenoma and intramucosal carcinoma with adenoma) were examined at the 7 sets of microsatellite loci linked to the tumor suppressor gene locus. Results: For category 3 and 4 tissue samples, there were no differences in the frequencies of LOH-positive chromosomes or the extent of chromosomal loss. The Helicobacter-pylori (H. pylori)-positive rate was significantly higher in MSI-positive category 4 samples than in category 3 samples (p=0.04). The frequency of MSI positivity was significantly higher in category 4 samples than in category 3 samples (p=0.003). Conclusions: H. pylori infection is associated with genetic instability of the premalignant lesion. MSI occurs in the early stages of gastric carcinogenesis and its occurrence increases during malignant transformation. Detection of MSI in premalignant gastric lesions may be a surveillant of risk of malignant transformation. (Gut Liver 2010;4:179-185)
이한희 ( Han Hee Lee ),정승민 ( Seung Min Jeong ),이주하 ( Joo Ha Lee ),곽재욱 ( Jae Wuk Kwak ),강귀영 ( Kwi Young Kang ),주지현 ( Ji Hyeon Ju ),김호연 ( Ho Youn Kim ),박성환 ( Sung Hwan Park ) 대한류마티스학회 2008 대한류마티스학회지 Vol.15 No.3
Sjogren`s syndrome is a chronic autoimmune disorder due to lymphocytes infiltrations of the exocrine glands and is clinically characterized by dry eyes and dry mouth. Though Sjogren`s syndrome can affect the nervous system, acute transverse myelitis is an extremely rare CNS complication that progresses rapidly, and requires early diagnosis and therapy. Here, we report a 49-year-old female who had primary Sjogren`s syndrome that manifested itself as acute transverse myelitis. She presented with motor weakness and hypesthesia of her right lower extremity. During her first attack, MRI of the spine revealed high signal intensities on T2-weighted images in her spinal cord at the levels of C6 through T11. Symptoms improved after 5 days of intravenous methylprednisolone (1 g/day) therapy, but recurred 9 months later. She had another MRI which showed acute transverse myelitis involving the spinal cord at the levels of C2 to T8. Her symptoms remained well controlled with treatment consisting of 5 days of methylpredisolone infusion (1 g/day) and concomitant intravenous cyclophosphamide 750 mg every 4 weeks.