십이지장 팽대부의 융모성선종

최석채(Suck Chei Choi),송승렬(Seung Ryel Song),임동석(Dong Suk Lim),조규혜(Kyoo Hye Cho),유재규(Jae Kyu Ryu),김학철(Hak Chel Kim) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.4

Villous adenoma of the ampulla of Vater Which is sometimes the cause of extrahepatic obstructive jaudice is uncommon disease. But they are important in spite of their rarity, because of frequent malignant change in the tumor as a focal or all occult tumor. Recently, the early diagnosis of ampullary tumors has become possible due to the ide application of fiberoptic endoscopy and increasing knowledge about the ampullary tumors. Although the biopsies were taken during the endoscopy, sometimes one might miss the area of malignant degeneration. But, it could increase the diagnostic accuracy by performing a hiopsy at the highly suspected site ofl malignancy, like our case in which fixed and discolorecl areas in the lesion were biopsied. So we recommed an affn.ssive endoscopic study and hypotonic duodenogram. Even thought it is diagnosed as benign, and can be treated with endoscopic pelypectorny, but we recommend the complete resection of the tumor because of high incidence of recurrence and malign ant transformati on.

기능성 상부 위장관 증상을 호소하는 환자의 스트레스, 불안 및 우울

이상열,신성훈,최석채,Lee, Sang-Yeol,Shean, Sung-Hun,Choi, Suk-Chei 한국정신신체의학회 1998 정신신체의학 Vol.6 No.1

Objective : The sensation of dysphagia, heartburn, globus hystericus, and functional dyspepsia are common symptoms of the functional upper gut disorders. This study was designed to investigate quantity of perceived stress, depression, and anxiety in the patients with functional upper gut symptoms whose esopahgeal manometry(EM) and gatroesophageal reflux (GERT) test were normal. Methods : A total of 38 patients who complained of the symptoms had been tested with 24-hour ambulatory EM and conventional GERT in our gastrointestinal clinic. Thirty patients whose tests had been normal(patients group) were assessed with Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), and Spielberger Stait-Trait Anxiety Inventory(STAI) and compared with 30 patients(control group) without functional upper gut symtpoms in the hepatobiliary clinic. The two groups were also assessed by quantity of perceived stress during the last year through self-report. Results: 1) These patients tended to be predominently female, older, and possessed a lower education than control group. 79% of 38 patients who had been tested were normal. 2) Compared to the control group, the patients had significantly higher mean scores on four subscales(somatization, depression, anxiety, and positive symptom distress index). 3) The patient group had significantly more perceived stress than the control group. 4) The patients group had significantly higher levels of depression than the control gorup, but there was not any significant difference in the STAI. 5) There were significant positive correlations between the BDI score and the STAI-trait, the STAI-stait and the STAI-trait, the quantity of perceived stress and the STAI-trait. Conlusion : The patients with functional upper gut symptoms displayed more, psychological distress, sornatization, anxiety, and deperssion. Among them, patients had higer depression than control group. Functional upper gut symtoms could be more appropriately viewed as somatic symptoms of depression. These findings suggest that such patients need to have psychiatric intervention and treatment.

정신질환자들에 동반된 기능성 위장질환에 영향을 미치는 정신사회적 요인에 관한 연구

강등현,장승호,류한승,최석채,노승호,백영석,이혜진,이상열,Kang, Deung-Hyun,Jang, Seung-Ho,Ryu, Han-Seung,Choi, Suck-Chei,Rho, Seung-Ho,Paik, Young-Suk,Lee, Hye-Jin,Lee, Sang-Yeol 한국정신신체의학회 2018 정신신체의학 Vol.26 No.1

연구목적 본 연구에서는 기능성 위장질환(Functional gastrointestinal disorder, 이하 FGID)이 동반된 정신질환자들의 정신사회적 특성을 알아보고자 하였다. 방 법 일 대학병원 정신건강의학과 외래를 방문한 환자를 대상으로 Rome III questionnaire - Korean version에 따라 FGID를 선별하여 144명의 자료를 분석하였다. 인구학적 요인을 조사하였으며, 정신사회적 요인을 평가하기 위해 Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, State-Trait Anger Expression Inventory를 사용하였다. 통계분석은 독립표본 t-검정(independent t-test)과 교차분석(chi-square test)을 사용하였다. 결 과 FGID에 따른 집단간 비교에서 학력에 따른 차이가 나타났다(${\chi}^2=10.139$, p=0.017). FGID 집단에 따른 정신질환의 차이에서는 과민성 대장증후군(Irritable bowel syndrome, 이하 IBS) 집단에서 유의한 차이가 있었다. (${\chi}^2=11.408$, p=0.022) IBS 집단은 불안(t=-3.106, p=0.002), 우울증상(t=-2.105, p=0.037), 신체증상(t=-3.565, p<0.001), 특성분노(t=-3.683, p<0.001), 분노-억제(t=-2.463, p=0.015), 분노-표출(t=-2.355, p=0.020)에서 높은 점수를 나타냈다. 기능성 소화불량(Functional dyspepsia) 집단에서는 불안(t=-4.893, p<0.001), 우울증상(t=-3.459, p<0.001), 신체증상(t=-7.906, p<0.001), 특성분노(t=-4.148, p<0.001), 상태분노(t=-2.181, p=0.031), 분노-억제(t=-2.684, p=0.008), 분노-표출(t=-3.005, p=0.003)지표가 유의하게 높았다. 비미란성 위식도 역류증(Nonerosive reflux disease) 집단에서는 불안(t=-4.286, p<0.001), 우울증상(t=-3.402, p<0.001), 신체증상(t=-7.162, p<0.001), 특성분노(t=-2.994, p=0.003), 상태분노(t=-2.259, p=0.025), 분노-억제(t=-2.772, p=0.006), 분노-표출(t=-2.958, p=0.004)에서 유의미하게 높은 수준을 나타냈다. 결 론 본 연구에서는 정신질환자에서 FGID의 유병률이 매우 높고, 다양한 정신사회적 변인들이 이에 영향을 미치는 것으로 나타났다. 따라서 이러한 정신의학적 접근은 FGID 환자를 더 잘 이해하고 치료하는데 있어서 도움이 될 것으로 생각된다. Objectives : This study aimed to investigate the psychosocial characteristics of functional gastrointestinal disorder (FGID) in patients with psychiatric disorders. Methods : This study was conducted with 144 outpatients visiting the psychiatric clinic at a university hospital. FGIDs were screened according to the Rome III questionnaire-Korean version. Demographic factors were investigated, and psychosocial factors were evaluated using the Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, and State-Trait Anger Expression Inventory. Chisquared test and student's t-test were used as statistical analysis methods. Results : There were differences in education level between two groups divided according to FGID status (${\chi}^2=10.139$, p=0.017). Comparing the psychiatric disorder by FGID group, irritable bowel syndrome (IBS) group showed significant differences (${\chi}^2=11.408$, p=0.022). According to FGID status, IBS group showed significant differences for anxiety (t=-3.106, p=0.002), depressive symptom (t=-2.105, p=0.037), somatic symptom (t=-3.565, p<0.001), trait anger (t=-3.683, p<0.001), anger-in (t=-2.463, p=0.015), and anger-out (t=-2.355, p=0.020). Functional dyspepsia group showed significant differences for anxiety (t=-4.893, p<0.001), depressive symptom (t=-3.459, p<0.001), somatic symptom (t=-7.906, p<0.001), trait-anger (t=-4.148, p<0.001), state-anger (t=-2.181, p=0.031), anger-in (t=-2.684, p=0.008), and anger-out (t=-3.005, p=0.003). Nonerosive reflux disease group showed significant differences for anxiety (t=-4.286, p<0.001), depressive symptom (t=-3.402, p<0.001), somatic symptom (t=-7.162, p<0.001), trait anger (t=-2.994, p=0.003), state anger (t=-2.259, p=0.025), anger-in (t=-2.772, p=0.006), and anger-out (t=-2.958, p=0.004). Conclusions : Patients with psychiatric disorders had a high prevalence of FGID, and various psychosocial factors contributed to such differences. Therefore, the psychiatric approach can offer better understandings and treatments to patients with FGID.

Rebamipide Protects Colonic Damage Induced by Trinitrobenzene Sulfonic Acid (TNBS) via Down-Regulation of TNF-α, IL-1β‚ and ICAM-1

김연하(Yeun-Ha Kim),김성중(Sung-Jung Kim),황호근(Ho-Geun Hwang),최석채(Suk-Chei Choi),김유림(Yu-Rim Kim),김경숙(Kyung-Suk Kim),김철(Chul Kim),최덕화(Deok-Hwa Choi),오정택(Jung-Taek Oh),김강득(Gang-Deuk Kim),김혜원(Hye-Won Kim),전창덕(C 대한해부학회 2004 Anatomy & Cell Biology Vol.37 No.2

염증성 장 질환의 병리기전에는 tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) 및 intracellular adhesion molecule-1 (ICAM-1)의 발현 등 수많은 염증반응의 매개 물질들이 관여하고 있다. Rebamipide는 위염과 위궤양 치료제로 개발된 약제로 아직까지 염증성 장 질환의 치료효과를 검증한 연구는 거의 없다. 따라서 본 연구에서는 Rebamipide의 염증성 장 질환에 대한 치료효과를 검증하고 그 기전을 분석하고자 Rebamipide의 TNF-α와 IL-1β, 그리고 세포의 부착에 중요한 역할을 하는 ICAM-1의 발현의 조절에 대한 효과를 조사하였다. 5%의 2, 4, 6-trinitrobenzenesulfonic acid (TNBS)를 실험 첫째날과 7일째에 직장 내로 넣어줌으로써 염증성 장질환의 동물모델을 제작하였고 2mM의 Rebamipide를 실험 0일, 3일, 6일째에 역시 직장 내로 투여하여 염증 억제 효과를 분석하였다. Rebamipide는 TNBS에 의하여 유도되는 체중감소를 현저히 억제하였으며 대장의 충혈과 부종역시 억제하였다. 조직소견에서도 Rebamipide 는 TNBS에 의해 유도되는 염증세포의 침착을 현저히 억제하였다. 또한 Rebamipide에 의해 TNF-α, IL-1β 및 ICAM-1의 발현 역시 현저히 억제되는 것을 면역 조직 화학 염색법을 통하여 확인하였다. 결론적으로 Rebamipide는 TNF-α, IL-1β와, ICAM-1의 발현을 조절함으로써 TNBS에 의해 유도되는 대장의 손상을 억제하리라고 생각되며 염증성 장 질환의 치료에도 좋은 효과가 있을 것으로 생각한다. During inflammation of the colon, cells of the gut mucosa produce or express numerous inflammatory mediators, such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and intercellular adhesion molecule 1 (ICAM-1). These mediators have been implicated as contributory factors to the inflammatory process, which results in colitis during inflammatory bowel disease (IBD). Rebamipide is an anti-gastric ulcer drug with anti-inflammatory properties in vivo and in vitro. The effects of Rebamipide on IBD have not been largely evaluated. Therefore, this study investigated the potential of Rebamipide to regulate the production of inflammatory mediators such as TNF-α, IL-1β, and ICAM-1. Mice with trinitrobenzene sulfonic acid (TNBS)-induced colitis (IBD animal model), were treated intrarectally with 2 mM Rebamipide. Body weight, macro- and micro-histological scores, and activity were evaluated. As an index of tissue edema, the thickness of the colonic wall was measured between the serosal surface and the luminal surface of the mucosa. TNF-α, IL-1β, and ICAM-1 were detected by immunohistochemical staining. Rebamipide treatment of mice exhibiting TNBS-induced colitis dramatically improved the clinical and histopathological findings of inflammation. In addition, Rebamipide suppressed TNF-α, IL-1β, and ICAM-1 expression in TNBS-treated animals. Taken together, these findings suggest that Rebamipide is a potential therapeutic agent for treating patients with IBD.

비만 여중생에서 운동이 신체조성 및 담낭배출에 미치는 영향

최석준,김선호,이춘호,조은영,염주진,최경숙,김태현,나용호,최석채 대한스포츠의학회 2002 대한스포츠의학회지 Vol.20 No.1

식도에 발생한 원발성 악성 흑색종 1예

권지혜,임평숙,김기훈,서승오,최창수,서검석,최석채,윤기중 圓光大學校 醫科學硏究所 2007 圓光醫科學 Vol.22 No.1