간세포암과 주위 조직에서의 Transforming Growth Factor-beta 1과 그 수용체의 발현

최규완,백승운,최문석,김소정,이준혁,고광철,이풍렬,이종철,박상종,안병훈,김재준 대한소화기학회 2001 대한소화기학회지 Vol.37 No.4

Background/Aims: Transforming growth factor-beta 1 (TGF-β1) is a potent inhibitor of hepatocyte proliferation and its receptor is known to be involved in the carcinogenesis. This study was designed to compare the expression levels of the TGF-β1 and its receptor in neoplastic cells and its surrounding tissue and to assess their role in hepatic carcinogenesis. Methods: We measured the levels of TGF-β1 mRNA and TGF-β1 receptor II mRNA by semiquantitive RT-PCR for the tumor and its surrounding tissue of 30 patients with hepatocellular carcinoma (HCC). We analyzed the relationship between the expression of TGF-β1 mRNA, TGF-β1 receptor II mRNA and clinicopathological characteristics of HCC. Results: The expression of TGF-β1 mRNA showed no difference between HCC and its surrounding tissue, but the expression of TGF-β1 receptor II mRNA was lower in HCC than in its surrounding tissue (2.47±1.08 vs 3.53±1.50, p=0.00). There was no difference in the expression level of TGF-β1 mRNA and TGF-β1 receptor II mRNAo the clinicopathological characteristics of HCC. However, the ratio of TGF-β1 receptor II mRNA in HCC to that in surrounding tissue was more decreased in HCC with portal vein invasion (0.49±0.22 vs 0.77±0.21, p=0.01). Conclusions: Our data suggest that the loss of TGF-β1 receptor II may play an important role in carcinogenesis and tumor progression of HCC.

췌장암에서 Cyclooxygenase - 2 발현의 역할

김은경,이용욱,이규택,최규완,박동일,백승운,이준행,이종균,고광철,이풍렬,이종철,김재준,김완선,공구 대한소화기학회 2001 대한소화기학회지 Vol.38 No.3

Background/Aims: Accumulating evidence suggests that the use of NSAID may reduce the incidence of colorectal cancer. The likely mechanisms of these effects by NSAID is cyclooxygenase-2 (COX-2)-related inhibition of tumor proliferation and induction of apoptosis. The aim of our study was to examine possible roles and clinical significance of COX-2 expression in pancreatic cancer. Methods: Seventy-two pancreatic adenocarcinoma tissue specimens were obtained from surgical resection. After the immunohistochemical staining of the specimens, we examined proliferation activity (assayed by Ki-67 expression), apoptosis (by TUNEL stain), and microvessel density (by CD34 expression). We also investigated the relationship between the immunohistochemical expression of COX-2 and various clinicopathological characteristics. Results: The COX-2 positive rate in pancreatic epithelial cells was 41.7%. Proliferation index (PI) was significant higher in COX-2 positive specimens comparing to negative specimen (p=0.015) and the increase in intensity of COX-2 expression correlated with increasing PI (p=0.036). Apoptotic index (AI) was significantly higher in positivee COX-2 expression than in negative expression (p=0.044), but there was no significant difference in AI/PI between the COX-2 positive and negative specimens (p=0.44). The expression of COX-2 protein did not correlate with microvessel density, sex, age, differentiation, tumor size, stage, metastasis or patients survival. Conclusions: The expression of COX-2 enzyme in pancreatic cancer contributes to tumor proliferation, but is not related to apoptosis, angiogenesis or clinical characteristics. Further study is needed to examine the clinical usefulness of NSAID and COX-2 selective inhibitors.

역류성 식도염 환자에서 Helicobacter pylori 치료 1 년 후 증상과 내시경적 변화

김영호,손희정,최규완,박동일,백승운,이준행,고광철,이풍렬,이종철,임윤정,김재준 대한소화기내시경학회 2001 Clinical Endoscopy Vol.24 No.1

활동성 크론병에서 초기 스테로이드 치료 반응에 따른 임상적, 생화학적, 병리학적 인자들에 관한 연구

김영호,장재권,김지은,최규완,박동일,도재혁,백승운,고광철,이풍렬,이종철,현재근,안병훈,김재준,류민규 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.6

Background/Aims: The predictory factors of the response to initial steroid therapy in active Crohn's disease has been controversial in numerous literature reviews. We evaluated any predictory faetor of the response to initial steroid therapy in active Crohn`s disease patients, Methods: The medical records of 32 patients with active Crohn`s disease who clinically responded to oral steroid therapy were retrospectively reviewed. The steroid responsive group was defined as the one showing maintenance of response for more than one month from steroid withdrawal and the steroid dependent group as the one showing relapse or exacerbation during steroid tapering or within 30 days from steroid withdrawal. The clinical, biochemical, and pathologic factors were evaluated. Results: There were 22 male and 10 female patients. The mean age was 28.9 years. The number of steroid responsive and dependent group was 22 (68.8%) and 10 (31.2%), respectively. There were no significant differences between these two groups in age, sex, time to diagnosis, perianal lesion, extent of disease, extraintestinal manifestations, presence of granuloma, presenting features, hemoglobin, ESR, and CRP, except serum albumin level. Conclusions: Serum albumin level was significantly lower in steroid dependent group than steroid responsive group, reflecting severe inflammation in steroid dependent group.

허혈성 대장염의 임상 양상과 예후 인자

이미숙,손희정,강태욱,최규완,박동일,백승운,이준행,고광철,이종철,임윤정,이풍렬,김갑철,김재준 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.2

Background/Aims: Colonic ischemia is recognized as the most common vascular disorder of the intestines in the elderly. The severity of the disease may vary considerably with the prevalent benign transient forms, being amenable to conservative treatments and the severe gangrenous forms, requiring surgery. Correct diagnosis is usually made after the ischemic episode is over and colonic ischemia is frequently misdiagnosed. The aim of this study is to identify the clinical patterns and prognostic factors of ischemic colitis. Methods: We found 60 patients with nonoccusive ischemia of the large intestine, We analyzed age, sex, symptoms, signs, associated disease, location, endoscopy, hematologic, histologic, radiologic finding and treatment, retrospectively. Results: The mean age was 60.2±6.3 years. The most common symtoms were abdominal pain or bloody diarrhea. The most common sign was diffuse abdominal tenderness. The most common hematologic findings were anemia and leukocytosis. Associated medical illnesses wer diabetes, rhematoid arthritis and cerebrovascular accident, et al. Both computed tomography (CT) and endoscopy were useful diagnostic tools. The most common involved site was sigmoid colon. 46 patients were treated conservatively and 14 patients were managed surgically. Conclusions: Male gender, those with rebound tenderness, severe anemia, right or total colon involvement as well as rheumatoid arthritis had a poor prognosis. Both CT and endoscopy were useful in predicting prognosis.

Glutaraldehyde 와 자동 세척기를 이용한 내시경 소독방법의 임상에서의 유용성

김영호,손희정,윤성원,최규완,이남용,백승운,이준행,고광철,이풍렬,이종철,송재훈,안병훈,김재준,최원혁,홍일철 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.6

Background/Aims: Safety of endoscopic procedures has been a major issue over the last 10 years. Most endoscopy units use 2% glutaraldehyde and automated endoscope reprocessors (AERs) for disinfecting gastrointestinal endoscopes. We attempted an in-use evaluation of the current reprocessing procedures. Methods: Thirty flexible endoscopes were randomly collected just after upper endoscopic examinations and were disinfected using 2% glutaraldehyde in an AER. Cultures were taken from biopsy channels (S-l), tip of the insertion tubes (S-2), umbilical cords (S-3), and angulation knobs (S-4). Results: In 63,3% (19/30) of endoscopes, there was no microbial contamination after disinfection procedures. The culture positive rates of S-l, S-2, S-3, and S-4 samples were 20,0%, 0.0%, 3.3%, and 20.0%, respectively. Microorganisms of 13 species were identified, but there was no pathogen related with reported infectious complications after endoscopic procedures. Conclusions: Current disinfection procedure using 2% glutaraldehyde and an AER appears to be very effective in decontaminating patient-used endoscopes. Low level microbial contamination of endoscopes after conventional reprocessing methods may not impose great risk on patients.

위장관 간질종양의 임상 및 병리학적 고찰

김영호,장우영,이순진,손희정,최규완,도재혁,백승운,이준행,이풍렬,이종철,박철근,임윤정,김갑철,김재준,임효근 대한소화기학회 2001 대한소화기학회지 Vol.37 No.3

Background & Aims: Gastrointestinal stromal tumor (GIST) constitutes primary nonepithelial neoplasms of the gastrointestinal tract and includes most tumors previously designated as leiomyomas/leiomyosarcomas. GIST is pathologically divided into benign, borderline and malignanct tumor. This study was carried out to delineate the clinical and pathologic features of GIST and to establish the features predicting malignancy. Methods: Clinicopathologic data of 84 patients who had GIST from 1995 to 1999 were reviewed. Results: The subjects were 42 men and 42 women, and their mean age was 59.3±13.2 years. We located fifty-two tumors in the stomach, 28 tumors in the small intestine and 4 tumors in the colorectum years. Histopathology revealed benign tumors in 23 of the 84 patients, borderline tumors in 22, malignant tumors in 39. The average size of tumors was 6.23 cm in diameter (range, 0.6-26 cm). Metastasis was noted in 15.5% of the patients at diagnosis. On endoscopy, ulceration was more common in malignancy. Endsonographic findings except size were not significant statistically. On contrast enhanced computed tomography, malignancy showed more irregular shape and variable attenuation than benign lesions, which seemed to be valuable factor. Conclusions: The variables predicting malignancy were large tumor size (≥5 cm), location of the colorectum, palpable abdominal mass, ulceration on endoscopy, and less uniformity in shape and variable attenuation on computed tomography.

성인에서 반복적인 위장관출혈로 발현한 공장 거대 중복성 낭종

김영호,이경수,이상수,문원,강태욱,최규완,박동일,도재혁,백승운,이풍렬,이종철,김재준,류민규 대한내과학회 2001 대한내과학회지 Vol.61 No.3

Duplication of the alimentary tract is an unusual congenital anomaly which may occur at any level, from the oral cavity to the rectum. Jejunal duplication cyst is quite rare and most of them are presented in infancy with the symptoms of abdominal mass, obstruction, hemorrhage and perforation. But some cases has not been diagnosed till adult if duplication cyst was too small enough to cause symptoms. We report a case of a 28-year-old woman who presented with recurrent gastrointestinal hemorrhage as a result of an ulceration without ectopic mucosa in jejunal duplication cyst and was successfully treated with surgery.(Korean J Med 61:264-269, 2001)

Impact of Interferon-Based Treatment on Quality of Life and Work Related Productivity from the Korean Cohort in the MOSAIC Study

( Sang Hoon Ahn ),( Won Hyeok Choe ),( Yoon Jun Kim ),( Jeong Heo ),( Dorota Latarska-smuga ),( Jiho Kang ),( Seung Woon Paik ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Chronic Hepatitis C Virus (HCV) infection increases the risk for progressive liver disease, hepatocellular carcinoma and negatively impacts the patient’s quality of life. HCV treatment is evolving with direct acting antivirals but IFN based therapy has been the standard of care for many years and remains available in some countries. The MOSAIC study aims to characterize patients with chronic HCV infection and assess the impact of IFN-containing treatment on health-related quality of life, work related productivity and health care utilization. Methods: MOSAIC is an international prospective multicenter observational study that has been conducted in 20 countries. Consecutive patients with chronic HCV infection were enrolled and those who initiated an IFN based regimen were prospectively followed for 48 weeks. We report results from the Korean cohort Results: 100 patients were enrolled: 86 were treatment naïve and 14 were treatment experienced. 33 patients initiated an IFN based regimen: 6 patients started IFN + RBV, 26 patients started Peg-IFN + RBV, none started Peg-IFN + RBV + DAA and 1 patient received other treatment. Among the treated cohort, demographic and disease characteristics were the following: the mean age was 54.5 years; 14 patients were male. 14 had minimal or no fibrosis, 2 portal fibrosis, 3 bridging fibrosis and 6 patients suffered from cirrhosis. HCV Genotype distribution was as follows: genotype 1: 11; genotype 2: 19 and genotype 3: 3. Table 1 describes the results at baseline and changes over 4, 12 and 48 weeks and end-of-treatment (EOT) for the quality of life and work productivity outcome measures (EQ-5D-5L, HCV-PRO and WPAI). Conclusions: Results from the Korean cohort of the MOSAIC study show a moderate trend for deterioration of health-related quality of life and work productivity associated with IFN based treatment for patients with chronic HCV infection during treatment period. Acknowledgements: The design, study conduct, analysis, and financial support of MOSAIC study were provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the content of the abstract. All authors had access to all relevant data and participated in writing, review, and approval of this abstract. Medical writing support was provided by Olivier Van de Steen of Medeor-consulting, funded by AbbVie. Disclosures: Sang Hoon Ahn: served as an advisor and lecturer for Bristol-Myers Squibb, Gilead Sciences, F.Hoffmann-La Roche, Merck, AbbVie, and has received unrestricted grants from Bristol-Myers Squibb, Gilead Sciences, and F. Hoffmann-La Roche for investigator- initiated trials Won Hyeok Choe: Nothing to disclosure Yoon Jun Kim: Nothing to disclosure Jeong Heo: received a grant from GSK; Research support from BMS, and Roche; Advisor for Abbvie, BMS, Gilead Sciences, Pharma Essentia, SillaJen, and Johnson & Johnson. Dorota Latarska-Smuga, Jiho Kang: are employees of AbbVie, Inc. and may hold stock or stock options. Seung Woon Paik: received grant and research support from AbbVie, BMS, Gilead, GSK, Merck, Novartis, and Roche

Pleomorphic Adenoma of the Trachea

Seung Sam Paik Korean Academy of Medical Science 1997 Journal of Korean medical science Vol.12 No.6