난치성 복수를 동반한 간경변증 환자의 혈장 Aldosterone 치

서정일(Jeong Ill Suh),김영진(Young Jin Kim),이태일(Tae Il Lee),이재성(Jae Sung Lee),김기덕(Ki Duk Kim),권준영(Jun Young Kweon),김병훈(Byeong Hun Kim),김기윤(Ky Yun Kim),박종원(Jong Won Park),이헌주(Heon Ju Lee) 대한내과학회 1994 대한내과학회지 Vol.46 No.5

N/A Objectives: Hyperaldosteronism is the most important factor in sustaining salt and water retention in patients with cirrhosis and aldosterone antagonists or loop natriuretic agents are used for the treatment of ascites. But some patients do not respond to the dietary diuretic regime and the cause or mechanism of refractory ascites complex. To evaluate the difference in response after treatment of ascites and the importance of plasma aldosterone level in refractory ascites, pretreatment plasma aldosterone concentration and the degree of cirrhosis by Child-Pugh classification were investigated among cirrhotic patients. Methods: Plasma renin activity (PRA), plasma aldosterone concentration (PAC) and 24 hour urinary Na+ excretion (Una+V) were tested in 16 normal control (group I), 16 cirrhotic patients without ascites (group II), 29 cirrhotic patients with ascites who responded to aldosterone antagonist (group III) and 12 cirrhotic patients with refractory ascites (group IV). Results: The amount of Una+ in group IV (19.1±13.0 mmol/day) was much lower than that of group I (81.8±42.2mmol/day), group II (75.1±12.5mmol/day), and group III (74.9±47.8 mmol/day) (p<0.01). PRA and PAC in group III (10.8±4.1ng/ml/hr, 359.8±196.8pg/ml) and group IV (12.5±8.7ng/ml/hr, 585.9±323.7pg/ml) were significantly elevated as compared to group I (1.5±0.8ng/ml/hr, 127.0±69.1pg/ml) (p<0.01 and p<0.05, respectively) and group II (4.3±2.1ng/ml/hr, 198.8±50.8pg/ml) (p<0.01 and p<0.05, respectively). But no remarkable differences were noted between group III and group IV in PRA and PAC. No negative correlations were noted between Una+V and PRA, or between Una+V and PAC in cirrhotic patients. According to Child-Pugh classification, the majority of the group IV were in C. Conclusion: Hyperaldosteronism itself is not the main cause of low sodium excretion in cirrhosis with refractory ascites. Some other factors related to the advanced cirrhosis may play a major role in the mechanism of diuretics resistance in refractory ascites.

급성 췌장염의 예후판정에 있어 복부전산화 단층촬영의 의의

서정일(Jeong Ill Suh),장병익(Byeong Ik Jang),김태년(Tae Nyeun Kim),정문관(Moon Kwan Chung),이현우(Hyun Woo Lee),변우목(Woo Mok Byun) 대한내과학회 1995 대한내과학회지 Vol.48 No.2

N/A Objectives: The purpose of this study is to evaluate the usefulness of computed tomography (CT) in the prognosis of acute pancreatitis. Methods: 70 patients with acute pancreatitis visited to Yeungnam University hospital emergency room between March 1991 and April 1993 were studied prospectively with early computerized tomography. The diagnosis of pancreatitis was based on typical clinical presentation and elevation of serum amylase levels. Prognostic score, fasting days and hospital days were record. The initial computerized tomograpic findings were graded A to E and we studied the correlation of CT grade and prognostic score and fasting days and hospital days. And also we studied the correlation of CT grade and prognostic score. Result: 1) Prognostic score of acute pancreatitis correlated with fasting days and hospital days (p<0.05). 2) There was no correlation between CT grade and prognostic score (p>0.05). 3) CT grade correlated well with fasting days and hospital days (p<0.01). Conclusion: In conclusion, we suggest that both prognostic score (Ranson score, Glasgow score) and early CT examination of patients with acute pancreatitis are useful prognostic indicator.

Mechanism of drug-induced liver injury

서정일 ( Jeong Ill Suh ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1

약물에 의한 간손상은 임상에서 흔히 접할 수 있는 문제이며, 발생 기전은 복잡하고 매우 다양하다. 급성 간세포 손상 기전을 내인성과 특이반응으로 나누어 설명하는 전통적인 접근방법에서 최근에는 초기 간세포 손상, 미토콘드리아 투과성 전이 및 세포자멸사/괴사 3단계로 나누어 설명하는 쪽으로 개념이 바뀌었고 각 단계별로 여러 가지 유전인자와 환경인자가 관련되어 개인간 차이를 보여준다. 최근 수많은 유전자를 한꺼번에 밝힐 수있는 광범위 유전자 연관 연구(gen Drugs can cause a wide range of drug induced liver injury, from mild elevated liver enzymes without symptoms to fulminant hepatic failure. The spectrum of drug induced liver injury are hepatitis, necrosis, cholestasis, steatosis, vascular/sinusoidal disease as well as neoplasia. The exact mechanism of drug induced liver injury remains largely unknown and complicated. Direct hepatotoxicity, immune reactions including both innate and adaptive immune responses, and mitochondrial injury and so on are involved in mechanism of drug induced liver injury. Environmental risk factors and underlying individual genetic factors also influence susceptibility to drug-induced liver injury. Recently, several research studies using pharmacogenomics, toxicogenomics, transcriptomics, proteomics and metabonomics are ongoing to further understand the mechanism of drug-induced liver injury.

Helicobacter pylori에 의한 위세포독성 및 interleukin-8 생성에 미치는 무의 억제효과

손윤희,서정일,박인경,황철원,김철호,남경수,Shon Yun Hee,Suh Jeong Ill,Park In Kyung,Hwang Cher Won,Kim Cheorl Ho,Nam Kyung Soo 한국생명과학회 2005 생명과학회지 Vol.15 No.4

무(한국 품종 및 일본 품종)를 사용하여 H. pylori에 의한 위세포독성 및 IL-8생성에 미치는 영향을 살펴보았다. 그 결과 무는 H. pylori에 의한 위세포독성을 농도의존적으로$(2\~10 mg/ml)$ 억제하였으며 또한 위암세포인 KATO III에서 분비되는 IL-8의 생성을 억제시킴$(5\~10mg/ml)$을 알았다. 이러한 사실은 무가 H. pylori감염에 의한 위점막세포의 손상을 방지할 수 있음을 나타낸다. The efforts of Korean and Japanese radishes on the viability and interleukin (JL)-8 production by Helicobacter pylori were investigated in human gastric epithelial cell. Cell viability was significantly decreased when they were incubated with H. pylori toxin (p <0.05, p<0.01 and p<0.005). Co-incubation with Korean or Japanese radish increased H. pylori toxin-inhibited cell growth in a concentration-dependent manner. The production of IL-8 was greatly increased in H. pylori-infected gastric epithelial cell in concentration- and time-dependent manners. The increased production of IL-8 was significantly inhibited by Korean (p<0.05 and p<0.01) or Japanese (p<0.05) radishes $(5\~10mg/ml)$. These results indicate that Korean and Japanese radishes have protective effects on H. pylori-inhibited cell growth and H. pylori-induced gastric mucosal cell inflammation by suppressing the production of inflammatory cytokine (IL-8) from gastric epithelial cell.

사람 위 상피세포의 염증반응에 대한 무의 효과

손윤희,정유선,서정일,박인경,남경수,Shon, Yun-Hee,Chung, Yoo-Sun,Suh, Jeong-Ill,Park, In-Kyung,Nam, Kyung-Soo 한국생명과학회 2006 생명과학회지 Vol.16 No.1

The effects of Korean and Japanese radishes on inflammatory reaction that involves arachidonic acid cascades were investigated in human epithelial gastric cell. The activities of type I (porcine pancreas) and type II (Crotalus atrox) phospholipase $A_2(PLA_2$) were inhibited by radish. Cyclooxygenase-2 (COX-2) activity was significantly suppressed by radish (p<0.05, p<0.01 and p<0.005). The nitric oxide production was also inhibited by radish. The Korean radish was more effective in inhibition of $PLA_2$ and COX-2 activities and nitric oxide production than Japanease radish. These results indicate that radish has a protective effect on gastric epithelial cell inflammation by suppressing the activities of $PLA_2$ and COX-2 activities and nitric oxide production from gastric epithelial cell.

포스터 전시 : 하부위장관 2 ; 호산구성 장염에 의한 소장천공 1예

도윤정 ( Yun Jeong Doh ),윤병구 ( Byung Goo Yoon ),김남일 ( Nam Ill Kim ),서정일 ( Jeong Ill Suh ),양창헌 ( Chang Heun Yang ),이창우 ( Chang Woo Lee ) 대한소화기학회 2002 대한소화기학회 추계학술대회 Vol.2002 No.-

원저 : 간 ; 만성 B형 간염 환자에 대한 재조합형 인터페론 alpha-2b(Reaferon(R))의 치료 효과

이헌주 ( Heon Ju Lee ),서정일 ( Jeong Ill Suh ),장병익 ( Byeong Ik Jang ) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.6

목적: 만성 B형 간염 환자에 비병원성의 Pseudomonas putida를 숙주로 이용하여 생산된 인터페론 alpha-2b(Reaferon(R))를 이용하여 그의 치료 효과와 안정성을 보고자 본 연구를 시행하였다. 대상 및 방법: 조직 생검상 만성 B형 간염으로 확진되고 HBsAg이 최소한 1년 이상 양성이면서, 혈청-ALT치가 최소한 6개월 이상 정상 상한치의 3~5배 이상을 보인 환자 20명을 대상으로 재조합형 인터페론 alpha 2b(Reaferon(R))를 주당 3회에 걸쳐 300만 IU을 총 12주(최하 3개월)이상을 피하 주사로 투여하였으며 환자의 혈청검사상 HBe Ag 음전이 3개월 이내에 되지 않은 경우에는 1~2개월동안 연장 투여하였다. 총투여용량은 49.5±14.6 vial(300MU/vial)이었다. 고식적 치료를 받아 온 만성 B형 간염 환자 10명을 대조군으로 하여 치료군과 비교 분석하였다. 결과: 치료전 대조군과 치료군 사이의 나이, 성별, 혈청 ALT, HBV-DNA에는 서로 유의한 차이는 없었다. 치료 군의 혈청ALT는 치료전 195.5±147.6 IU/L이었으며, 치료 직후, 치료 종료 1개월후 각각 63.94±91.74, 62.2±70.6 IU/L으로 치료 전과 비교시 의미있게 감소하였으며(p<0.05), 치료 종료후 2개월 째는 104.3±152.2 IU/L로 치료전과 비교시 감소는 하였지만 통계학적인 의미는 없었다(p>0.05). 치료군에서의 HBV-DNA의 양은 치료전 23.3±28.7pg/mL이었으며, 치료 직후, 치료 종료후 1개월째와 2개월째 9.42±16.6, 9.9±18.9, 7.7±12.6pg/mL으로 치료전과 비교시 의미있게 감소하였다(p>0.05). HBe Ag 음전은 치료 직후 치료군의 20명의 환자중 10명(50%)에서, 대조군의 10명중 1명(10%)에서 관찰되어 유의한 차이가 있었으나, 치료 종료후 2개월째 치료군의 10명중 5명에서 재양전되어 대조군과 비교시 유의한 차이는 없었다. 인터페론 투여에 따른 부작용으로는 전신 근육통과 피로감, 미열 등이 빈번히 관찰되었고, 두통, 탈모 등이 종종 관찰되었으며, 가려움, 백혈구 감소증의 부작용은 드물게 관찰되었다. 결론: 이상의 결과로 만성 B형 간염에서의 인터페론 alpha-2b의 투여는 혈청 ALT, HBV-DNA의 감소 및 HBe Ag 음전에 있어 단기간의 치료 효과는 인정되나 지속적이며 더 나은 치료 성적을 위해서는 광범위한 인터페론의 치료 결과의 분석 또는 기전이 다른 치료제의 등장이 시급한 것으로 사료된다. Background/Aims: To evaluated the efficacy and safety of recombinant interferon β-2b(Reaferon(R)) which was made by Pseudomonas putida as nonpathogenic host, in the patients with chronic hepatitis B, recombinant interferon β-2b was given to 20 patients with biopsy-proven chronic hepatitis who were HBs Ag(+) over 1 years and elevated serum-ALT for 6 months at least(treated group). Ten patients with chronic hepatitis B were managed with conservative treatment(control group). Methods: Interferon β-2b(Reaferon(R)) was given 3 times weekly by subcutaneous injection at a dose of 300MU for 12 week. The total doses were 49.5±14.6 vials (300MU/vial). Results: There was no significant difference in age, sex, serum ALT activity and HBV-DNA in the treated and control group before interferon therapy. Serum ALT activity was decreased significantly in treated group(194.45±147.6, 63.94±91.74IU/L: before and after therapy) compared to control group(p<0.05). HBV-DNA was markedly decreased in treated group (23.33±28.7, 9.42±16.6pg/ml before and after therapy) after interferon therapy(p<0.05). The rate of HBe Ag/anti-HBe seroconversion was 50% in treated group, 10% in control group at after therapy(p<0.05). but HBe Ag became positive again in half cases of seroconversion(50%) in treated group at 2 months after therapy. Side effects such as myalgia, fatigability, mild fever and/or chilling were frequently noted. But, tolerable. Conclusions: The administration of recombinant interferon β-2b in the patients with chronic hepatitis B seems to be effective, safe treatment method, But further studies with large number of patients are necessary to evaluate the duration and the dose of interferon.(Korean J Gastroenterol 1997;29:777-785)

급성 췌장염과 위출혈이 합병된 Henoch - Schonlein Purpura 1 예

김성욱(Sung Wook Kim),서정일(Jeong Ill Suh),김남일(Nam Il Kim),이구(Goo Lee),양창헌(Chang Heon Yang),이창우(Chang Woo Lee),김기권(Ki Kwon Kim) 대한소화기학회 2002 대한소화기학회지 Vol.40 No.1

N/A

문맥압 항진증의 혈역학적 특성

김태년(Tae Nyeun Kim),서정일(Jeong Ill Suh),장병익(Byeong Ik Jang),정문관(Moon Kwan Chung),이현우(Hyun Woo Lee) 대한내과학회 1997 대한내과학회지 Vol.53 No.1

N/A Objectives: Hemodynamic measurements of chronic portal hypertension were done to study the mechanisms that maintain high portal pressure despite well developed collateral circulations. Methods: A prehepatic portal hypertensive rat model was produced by partial portal vein ligation. Cardiac output, organ blood flow and porto-systemic shunt were measured by radioisotope labeled microsphere methods, and vascular resistance was calculated by standard equation. Results: There was a significant reduction in the weight of the liver and increase in the weight of the spleen in the portal stenotic rats. Porto-systemic shunting, representing development of the collateral circulations, was 96.7±0.6% in the portal stenosis group compared with 0.9±0.2% in the control group (p<0.01). Portal pressure was significantly increased in the portal stenosis group compared with the control group(12.8±1.4 vs. 6.5±0.6mmHg; p<0.01). Mean arterial pressure was significantly decreased in portal stenosis group compared with control group(101.4±2.5 vs, 129.9±3.9mmHg; p<0.01). In the portal stenosis group, cardiac output(135.7±8.0 vs. 111.0±4.2ml/min; p<0.01) and splanchnic organ blood flow (28.97±2.03 vs. 17.90±1.27ml/min, p<0.01) were significantly increased, with concomitant decrease in total peripheral vascular resistance(58.0±3.3 vs. 88.2±4.8 dyne sec/cm5×105; p<0.01) and splanchnic vascular resistance(2.54±0.20 vs. 5.47±0.33 dyne sec/cm5×105; p<0.01), However, the portal venous resistance was not significantly different in both groups of rats (3.57±0.31 vs. 3.03±0.38 dyne sec/cm5×105; p>0.05). Conclusion: The hemodynamic results of this study indicate that hyperdynamic status of systemic and splanchnic circulation was present in chronic portal hypertension and that the primary factor contributing to the persistently elevated portal venous pressure was the markedly increased portal venous inflow.

Prostenoglycine ( Hevapol Cap ) 투여중 동반된 부작용 및 간기능 이상

이헌주(Heon Ju Lee),서정일(Jeong Ill Suh) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.5

Liver is the primary site of drug metabolism and all drugs have the potential for hepatic injury and drug-induced hepatotoxicity. Prostenoglycine(Hevapol cap.) is one of the hepatotonic drugs which is not used for any fundamental or etiological therapy and acts only as a supportive agent for hepatic disease. Prostenoglycine(Hevapol cap.) induced adverse reactions in for patients and their liver injury was analized. Prior to administration, liver function tests were normal in two patients, while the other two had underlying liver injury and abnormal liver function tests. Hypersensitivity reactions manifested were fever, chills, skin rash, pruritus and general aches. The types of liver injury for 4 patients were cholestatic, mixed, hepatocellular and mixed, respectively. However classification of liver injury according to the International Consensus Meeting on definition of drug-induced liver disorder is difficult for the patients with underlying liver disease. Even hepatotonic drugs can aggravate the liver function tests and physicians should pay more careful attention in prescription to the patients with liver disease.(Korean J Gastroenterol 1996; 28:743 - 749)