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방병욱,박동선,권계숙,이돈행,장민정,Sun Kyu Park,김점용 한국식품영양과학회 2019 Journal of medicinal food Vol.22 No.2
The gastroprotective effects of BST-104 (a water extract of Lonicera japonica) and the mechanisms involved were investigated in murine models of gastritis and peptic ulcer. The gastroprotective effects of BST-104 and its active components were evaluated in rat models of HCl/ethanol-induced gastritis and acetic acid-induced gastric ulcer. After orally administering BST-104, chlorogenic acid, rebamipide (positive control), or vehicle to each animal model, gastric lesion sizes, gastric mucus statuses, proinflammatory cytokine levels, and oxidative stress were measured. Superoxide dismutase (SOD), catalase, and malondialdehyde (MDA) levels and oxidized/reduced glutathione (GSH) ratios in gastric mucosal tissues were measured to evaluate oxidative stress. To clarify the action mechanism of BST-104, we investigated nuclear factor (NF)-κB pathway involvement by real-time polymerase chain reaction (PCR). In the acetic acid-induced ulcer model, oral administration of BST-104 at 50, 100, or 200 mg/kg significantly reduced gastric lesions by 38%, 43%, and 55%, respectively, compared with vehicle controls. BST-104 significantly increased gastric mucus contents and this was accompanied by higher levels of hexosamine, sialic acid, and prostaglandin E2 in gastric mucus. Furthermore, BST-104 treatment increased antioxidant activities, as evidenced by higher levels of catalase, SOD, and oxidized/reduced GSH and lower MDA levels. In addition, BST-104 significantly suppressed proinflammatory cytokine (tumor necrosis factor-α, interleukin [IL]-6, and IL-1β) increases, and real-time PCR showed that BST-104 significantly downregulated NF-κB expression. In summary, BST-104 and its active component, chlorogenic acid, were found to have gastroprotective effects by virtue of their antioxidant and anti-inflammatory properties through downregulation of NF-κB expression.
Peroral Endoscopic Myotomy for Treating Achalasia in an Animal Model: A Feasibility Study
방병욱,최영철,김형길,권계숙,신용운,이돈행,김준미 대한소화기내시경학회 2013 Clinical Endoscopy Vol.46 No.1
Background/Aims: Laparoscopic Heller myotomy with antireflux procedure is considered to be a standard treatment for achalasia. Recently,peroral endoscopic myotomy (POEM) was developed and performed on patients with achalasia. However, there is no report on POEM use in South Korea. The aim of this study was to evaluate the technical feasibility of POEM in a porcine model. Methods: POEM was performed on two mini pigs. We performed upper endoscopy under general anesthesia. A submucosal tunnel was created and the circular muscle layer was incised using several knives. The mucosal entry was closed using resolution clips. We performed a follow-up endoscopy and sacrificed the pigs 2 weeks after the POEM. The myotomy site was evaluated grossly and histologically. Results: POEM was successfully performed on the two mini pigs. No injuries to any abdominal or mediastinal structures occurred. Two weeks after the POEM, the esophageal mucosa healed without any endoscopic evidence of complications. Necropsy revealed that the circular muscle layer was completely lost and replaced with fibrotic tissue. Conclusions: We found that POEM is a technically feasible method which can be performed on an animal model. However, to ensure safe use on patients with achalasia, further studies on technical methods and long-term follow-up examinations are required.
방병욱,이태훈,송태준,한정호,최현종,문종호,권창일,정석 대한소화기내시경학회 2015 Clinical Endoscopy Vol.48 No.1
Background/Aims: Endoscopic papillary balloon dilation (EPBD) has been advocated as an alternative therapy to endoscopic sphincterotomy for the treatment of common bile duct (CBD) stones. However, there is no established consensus on the optimal balloon dilation duration (BDD). We prospectively evaluated the efficacy and post-endoscopic retrograde cholangiopancreatography (ERCP) complications between the 20- and 60-second EPBD groups. Methods: A total of 228 patients with small CBD stones (≤12 mm) were randomly assigned to undergo EPBD with a 20- or 60-second duration at six institutions. We evaluated baseline patient characteristics, endoscopic data, clinical outcomes, and procedure-related complications. In addition, we analyzed risk factors for postprocedural pancreatitis. Results: CBD stones were removed successfully in 107 of 109 patients (98.1%) in the 20-second group and in 112 of 119 patients (94.1%) in the 60-second group (p=0.146). Post-ERCP pancreatitis developed in seven patients (6.4%) in the 20-second group and nine patients (7.5%) in the 60-second group (p=0.408). In multivariate analysis, contrast dye injection into the pancreatic duct is a significant risk factor for post-EPBD pancreatitis. Conclusions: Based on the data showing that there were no significant differences in safety and efficacy between the two BDD groups, 20 seconds of BDD may be adequate for treatment of small CBD stones with EPBD.
방병욱,정석,김철현,이돈행,김준미,이정일,이진우,권계숙,김형길,신용운,김영수 대한소화기내시경학회 2008 Clinical Endoscopy Vol.36 No.1
신경절신경종은 신경절세포, 신경섬유와 버팀세포로 구성된 양성종양으로 신경능에서 기원한다. 주로 교감신경절을 따라 분포하나 매우 드물게 소화관에서 발생할 수 있다. 소화관에 발생한 신경절신경종은 폴립모양 신경절신경종(polypoid ganglioneuroma), 신경절신경종성폴립증(ganglioneuromatous polyposis) 그리고 미만성 신경절신경종(diffuse ganglioneuromatosis)으로 분류한다. 폴립모양 신경절신경종은 전신질환과 관련이 없는 반면 신경절신경종성폴립증이나 미만성 신경절신경종은 전신질환과 연관성이 높다. 저자들은 복부 불편감을 주소로 내원한 33세 여자에서 대장내시경검사 도중 우연히 하행결장에서 단일 폴립을 발견하여 폴립절제술을 시행하였다. 절제된 폴립의 병리학적 검사에서 신경절신경종에 합당한 소견을 보이고 연관된 전신질환이 없어서 폴립모양 신경절신경종으로 진단한 1예를 경험하였기에 보고한다.
증례 : 대장 샘암종 환자에서 이시성으로 발생한 간의 샘편평세포암종 1예
방병욱 ( Byoung Wook Bang ),임미진 ( Mie Jin Lim ),임주한 ( Joo Han Lim ),김은주 ( Eun Joo Kim ),정석 ( Seok Jeong ),최석진 ( Suk Jin Choi ),박인서 ( In Suh Park ) 대한내과학회 2007 대한내과학회지 Vol.72 No.1
간의 원발성 샘편평세포암종은 드물게 발생하며, 간의 다른 원발성 종양보다 불량한 예후를 가지고 있다. 저자들은 상행결장암으로 수술 후 항암화학요법 중 우연히 발견된 간의 원발성 샘편평세포암종을 경험하였기에 보고한다. A primary adenosquamous carcinoma of the liver is a rare subtype of a cholangiocarcinoma. Adenosquamous carcinoma is known to have an aggressive biologic behavior and is associated with a poor prognosis. Recently, we experienced a case of a primary adenosquamous carcinoma of the liver. A 69-year-old man was subjected to a right hemicolectomy five months ago due to an ascending colon cancer. At a periodic check-up, abdominal ultrasonography and magnetic resonance imaging showed a ~1.1 cm-sized hepatic mass which was highly suspicious of being a hepatic metastasis from the ascending colon cancer. A hepatic segmentectomy was performed. The tumor was microscopically composed of an adenocarcinoma and a squamous cell carcinoma, and it was different from the previous colon cancer as determined by immunohistochemistry. Three months after the hepatic segmentectomy, multiple hepatic metastasis was found and the patient has been treated as an outpatient with capecitabine. (Korean J Med 72:74-78, 2007)
난치성, 재발성 Clostridium difficile 감염에서 대변세균총이식: 9예의 임상증례보고
방병욱 ( Byoung Wook Bang ),박진석 ( Jin-seok Park ),김형길 ( Hyung Kil Kim ),신용운 ( Yong Woon Shin ),권계숙 ( Kye Sook Kwon ),권해윤 ( Hea Yoon Kwon ),백지현 ( Ji Hyeon Baek ),이진수 ( Jin-soo Lee ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.4
Background/Aims: Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory and recurrent Clostridium difficile infection (CDI). Despite its excellent efficacy and recent widespread use, FMT has not been widely used in South Korea thus far. We describe our experience with FMT to treat refractory/recurrent CDI. Methods: We conducted a chart review of patients who underwent FMT for refractory/recurrent CDI at Inha University Hospital, between March 2014 and June 2016. The demographic information, treatment data, and adverse events were reviewed. FMT was administered via colonoscopy and/or duodenoscopy. All stool donors were rigorously screened to prevent infectious disease transmission. Results: FMT was performed in nine patients with refractory/recurrent CDI. All patients were dramatically cured. Bowel movement was normalized within one week after FMT. There were no procedure-related adverse events, except aspiration pneumonia in one patient. During the follow-up period (mean 11.4 months), recurrence of CDI was observed in one patient at one month after FMT due to antibiotics. Conclusions: FMT is a safe, well-tolerated and highly effective treatment for refractory/recurrent CDI. Although there are many barriers to using FMT, we expect that FMT will be widely used to treat refractory/recurrent CDI in South Korea. (Korean J Gastroenterol 2017;69:226-231)
A Case of Esophageal Fibrovascular Polyp That Induced Asphyxia during Sleep
박진석,방병욱,신준영,권계숙,김형길,신용운,최석진 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.1
Esophageal fibrovascular polyps are rare, benign, submucosal tumors of the upper digestive tract that usually have an indolent course until the lesion attains a very large size. The most frequent complaints associated with these tumors include dysphagia and foreign body sensation. However, a long pedunculated polyp can regurgitate into the pharynx or oral cavity and cause asphyxia and sudden death if the larynx is occluded. We describe the case of a 51-year-old man who experienced snoring and occasional asphyxia during sleep. Upper endoscopy was performed, which indicated the presence of a pedunculated esophageal polyp that regurgitated into the vocal cords. The polyp was removed using a polypectomy snare and was confirmed to be a fibrovascular polyp based on pathologic examination findings. Three months after the excision of the polyp, the patient was found to be doing well without any further occurrence of asphyxia or sleep disturbances.