Comparison of intraductal ultrasonography-directed and cholangiography-directed endoscop­ic retrograde biliary drainage in patients with a biliary obstruction

( Soo-jung Rew ),( Du-hyeon Lee ),( Chang-hwan Park ),( Jin Jeon ),( Hyun-soo Kim ),( Sung-kyu Choi ),( Jong-sun Rew ) 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.5

Background/Aims: Endoscopic retrograde biliary drainage (ERBD) has become a standard procedure in patients with a biliary obstruction. Intraductal ultraso­nography (IDUS) has emerged as a new tool for managing extrahepatic biliary diseases. IDUS-directed ERBD can be performed without conventional cholan­giography (CC). The goal of this study was to assess the effectiveness and safety of IDUS-directed ERBD compared to CC-directed ERBD in patients with an extra­hepatic biliary obstruction. Methods: A total of 210 patients who had undergone IDUS-directed ERBD (IDUS-ERBD, n = 105) and CC-directed ERBD (CC-ERBD, n = 105) between Oc­tober 2013 and April 2014 were analyzed retrospectively. The primary outcome measure was the procedural success rate. Secondary outcome measures included clinical outcomes, total procedure time, radiation exposure time, and overall complication rates. Results: The total technical success rate of ERBD was 100% (105/105) in the IDUS-ERBD and CC ERBD groups. Mean procedure time was slightly prolonged in the IDUS-ERBD group than that in the CC-ERBD group (32.1 ± 9.9 minutes vs. 28.4 ± 11.6 minutes, p = 0.023). Mean radiation exposure time was one-third less in the IDUS-ERBD group than that in the CC-ERBD group (28.0 ± 49.3 seconds vs. 94.2 ± 57.3 seconds, p < 0.001). No significant differences in complication rates were detected between the groups. Conclusions: IDUS-ERBD was equally effective and safe as CC-ERBD in patients with an extrahepatic biliary obstruction. Although IDUS-ERBD increased total procedure time, it significantly decreased radiation exposure.

위암에서 KIP군 Cyclin Dependent Kinase Inhibitor 발현

이수정 ( Soo Jung Lee ),주영은 ( Young Eun Joo ),김현수 ( Hyun Soo Kim ),최성규 ( Sung Kyu Choi ),유종선 ( Jong Sun Rew ),박창수 ( Chang Soo Park ),김세종 ( Sei Jong Kim ) 대한소화기학회 2005 대한소화기학회지 Vol.46 No.2

Pulmonary Mycobacteria Tuberculosis infection in Multiple myeloma patients treated with Bortezomib (초)

( Rew Sung Yoon ),( Jae Sook Ahn ),( Soo Young Bae ),( Yeo Kyeoung Kim ),( Deok Hwan Yang ),( Hyeoung Joon Kim ),( Je Jung Lee ) 대한내과학회 2010 대한내과학회 추계학술대회 Vol.2010 No.-

위암종에서 Epidermal Growth Factor Receptor 의 발현에 관한 연구 - 면역조직화학적 염색 및 in situ Hybridization -

조정곤(Jung Kon Cho),류도현(Do Hyun Rheu),최성규(Sung Kyu Choi),유종선(Jong Sun Rew),윤종만(Chong Mann Yoon),박창수(Chang Soo Park) 대한내과학회 1996 대한내과학회지 Vol.51 No.1

N/A Objectives: Gastric carcinoma is the leading cause of death among cancer patients in Korea. The etiologic factors of gastric carcinoma were suggested to chronic gastritis, genetic defect, food and environmental factor. Recently, the studies for oncogene and tumor marker have been actively performed to investigate the causes of gastric carcinoma. Epidermal growth factor receptor(EGFR) has homology in amino acids with c-erb B2 oncogene product. EGFR was identified in the placenta, chorionic villi and gastrointestinal mucosa. But it was more expressed in tumor cells, and it may be usedas a tumor marker. Methods: To investigate the correlation between EGFR and malignant potentiality in gastric carcinoma, we performed in situ hybridization of EGFR mRNA and immunohistochemistry of c-erb B2 and EGFR in 127 cases of formalin fixed paraffin embedded tissue sections of gastric carcinoma. Results: The positive reaction for c-erb B2, EGFR protein and EGFR mRNA was identified in the cytoplasm of tumor cells. The positive ratio was 44.196 in c-erb B2, 63.8% in EGFR, and EGFR mRNA was expressed in 72.4% of cases. The expression of c-erb B2 was not related with differentiation of cells, tumor size, invasiveness and metastasis. However the expression of EGFR and EGFR mRNA was related to the invasion of primary tumor and lymph node metastasis (p<.0.05). And expression of EGFR mRNA was increased in the advances of clinical stage. Conclusion: These above results suggest that the expression of EGFR mRNA is related with malignant potentiality of gastric carcinoma. EGFR mRNA might be used as tumor marker and prognostic factor of gastric carcinoma.

간경변증과 동반된 간세포암종에서 Microsatellite Instability와 DNA 복제오류 교정유전자들의 메틸화

박정호 ( Jung Ho Park ),조성범 ( Sung Bum Cho ),이완식 ( Wan Sik Lee ),박창환 ( Chang Hwan Park ),주영은 ( Young Eun Joo ),김현수 ( Hyen Soo Kim ),최성규 ( Sung Kyu Choi ),유종선 ( Jong Sun Rew ),이재혁 ( Jae Hyek Lee ),김세종 ( S 대한소화기학회 2006 대한소화기학회지 Vol.48 No.5

목적: 최근 간세포암종 발생과정에서 DNA 복제오류 교정유전자의 관련성을 시사해 주고 있으며 그 중에서도 DNA 복구과정에서 복제오류 교정계(mismatch repair system)와 O6-methylguanine-DNA methyltransferase (MGMT)의 중요한 연관성이 있음이 제시되었다. 대상 및 방법: 2000년부터 2003년까지 간세포암종으로 수술을 시행 받아 병리조직학적으로 진단된 환자들 중에서 간경변증이 동반된 40예를 대상으로 하여 hMLH1, MGMT, hMSH3과 같은 DNA 복제오류 교정유전자의 프로모터 부위 메틸화유무와 그 빈도를 조사하고 microsatellite instability (MSI)와 면역조직화학염색을 통한 이들 유전자 산물의 발현 여부와의 상관성 및 임상 특징과 연관성을 조사하였다. 결과: 수술 후 절제된 간세포암종의 평균 크기는 4.2±2.6㎝였다. 간세포암종 병기분류에서 BCLC stage A1은 12예(30%), A2는 3예(8%), A3는 8예(20%), A4는 3예(8%), B는 8예(20%), C는 6예(15%)였고, TNM stage I은 4예, II는 24예(60%), III는 7예(18%), IVa는 5예(13%)였다. 간세포암종의 조직 분화도 등급에 따라 고분화도 8예(20%), 중분화도 19예(48%), 저분화도 13예(32%) 보였다. 수술 후 간세포암종 재발은 총 25예(63%)에서 발생하였으며, 수술 후 간세포암종 재발 또는 간기능 저하로 사망한 경우는 15예(38%)였다. hMLH1, MGMT, hMSH3 유전자의 메틸화를 보이는 경우가 동반된 간경변증에서 각각 3예(8%), 27예(68%), 28예(70%)였고, 간세포암종에서 각각 2예(5%), 29예(73%), 30예(75%)로 간경변증과 간세포암종에서 높은 빈도를 보이는 DNA 복제오류 교정유전자는 hMSH3, MGMT였고 낮은 빈도를 보이는 것은 hMLH1이었다. MSI 상태는 대부분의 증례들이 안정 MSI였으며 단지 3예(8%)에서만 MSI가 관찰되었다. MGMT, hMLH1, hMSH3 단백에 대한 면역조직화학염색결과 양성반응을 보인 경우가 6예(15%), 16예(40%), 11예(28%)였다. MGMT의 경우 유전자 메틸화에 따라 MGMT 단백 소실이 있는 경향을 보였으나 의미있는 상관관계는 보이지 않았다(p=0.10). 간세포암종의 조직 분화도, 수술 후 재발 및 예후 등 임상 특징과 유전자 메틸화와는 의미있는 상관관계를 보이지 않았다(p>0.05). 결론: 간경변증과 동반된 간세포암종 환자에서 DNA 복제오류 교정유전자 중 MGMT와 hMSH3 유전자 메틸화 빈도가 높게 나타났다. 또한 간세포암종에서 낮은 빈도의 MSI를 보였으며 DNA 복제오류 교정유전자와 MSI는 서로 상관관계가 없었다. 수술 후 재발이나 예후와 같은 임상적인 특징과 DNA 복제오류 교정유전자들의 메틸화는 의미있는 상관관계는 보이지 않았다. Backgrounds/Aim: Epigenetic silencing of DNA repair genes, O6-methylguanine-DNA methyltransferase (MGMT), hMLH1 and hMSH3, by promoter hypermethylation have been observed in various cancers. However, the relationship between hypermethylation of DNA mismatch repair genes and microsatellite instability (MSI) has not been studied in hepatocellular carcinoma (HCC) associated with cirrhosis. Methods: We investigated the methylation pattern of CpG islands of 3 genes using methylation-specific PCR (MSP) and MSI in 40 patients with paired hepatocellular carcinoma and associated cirrhosis. Results: hMSH3 and MGMT were the most methylated genes in both cirrhosis (70% and 68%, respectively) and HCC (75% and 73%, respectively). The methylation of hMLH1 was rarely found in both cirrhosis (8%) and HCC (5%). Gene promoters methylated in cirrhosis were also methylated in HCC with the exception of 9 cases found to be methylated either in cirrhosis or HCC. Of 40 cases of HCC associated with cirrhosis, three had MSI-positive phenotype in which two were MSI-low and one was MSI-high. One MSI-positive phenotype was present both in cirrhosis and in HCC, while two were only in HCC. There was no significant correlation between aberrant DNA methylation of mismatch repair genes and MSI status in HCC associated with cirrhosis. Immunohistochemical expressions of hMLH1, MGMT, and hMSH3 proteins were present in 16 (40%), 6 (15%), and 11 (28%) of 40 cases of HCC respectively. There was no significant correlaton between the aberrant DNA methylation of mismatch repair genes and clinical characteristics such as histological differentiation, postoperative recurrence and mortality. Conclusions: The methylation of MGMT and hMSH3 among DNA repair genes are frequent, but those of hMLH1 and MSI is very rare in both cirrhosis and HCC. There is no significant correlation between the methylation of DNA repair genes and clinical characteristics of HCC. (Korean J Gastroenterol 2006;48:327-336)

포스터 전시 : 간 8 ; 중국산 다이어트 식품 "미황" 에 의한 급성간손상 1예

이수정 ( Soo Jung Lee ),주소영 ( So Young Joo ),윤경원 ( Kyeong Won Yoon ),손영해 ( Young Hai Sohn ),박창환 ( Chang Hwan Park ),이완식 ( Wan Sik Lee ),주영은,최성규 ( Sung Kyu Choi ),유종선 ( Jong Sun Rew ),김세종 ( Sei Jong Kim ) 대한소화기학회 2002 대한소화기학회 추계학술대회 Vol.2002 No.-

위궤양환자에서 Rebamipide의 자유산소유리기제거에 의한 궤양치료효과

박수헌(Soo Heon Park),정운태(Woon Tae Jung),서정한(Jung Han Suh),정명희(Myung Hee Chung),정인식(In Sik Chung),이용찬(Yong Chan Lee),박인서(In Suh Park),송근암(Guen Am Song),양웅석(Ung Suk Yang),유종선(Jong Sun Rew),윤종만(Chong Mann 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5

N/A Background/Aims: Helicobacter pylori has been shown to be an important pathogen of gastric disorder including gastritis and gastric ulcer. One of the potential toxic factors involving gastric mucosal cell injury is reactive oxidants, which are released from activated neutrophils. Rebamipide had been reported to promote mucus synthesis, mucosal prostaglandin content, and rapid ulcer healing, It has recently been reported to inhibit the production of oxygen derived free radicals from stimulated neutrophils. We conducted this study to evaluate the effects of rebamipide on gastric ulcer healing and reactive oxygen metabolite production. Methods: In this multicenter study conducted in Korea, combination treatment of rebamipide and ranitidine was compared with ranitidine alone in 108 patients with gastric ulcer patients. Pre- and post-treatment endoscopic findings and concentration of reactive oxygen metabolite produced were used to evaluate efficacy. The efficacy of rebamipide and ranitidine versus ranitidine was evaluated using endoscopy results, and tissue lipid peroxides by thiobarbituric acid and myeloperoxide concentration. Results: The percentage of ulcer size reduction was significantly higher with rebamipide and ranitidine group than with placebo and ranitidine group(size reduction: 71.5% vs 58.3% P=0.04556). The myeloperoxidase activities at ulcer margin in rebamipide and ranitidine group patients were 96.7+-13.4 unit/mg protein in baseline and 53.8+9.9 unit/mg protein in follow up (P=0.0065). The myeloperoxidase activities at ulcer margin in placebo and ranitidine group patients were 90.2+9.1 unit/mg protein in baseline and 63.1+6.7 unit/mg protein in follow up (P=0.0668). The thiobarbituric acid activities at ulcer margin in rebamipide and ranitidine group patients were 34.7+5.3 nmol of MDA/mg protein in baseline and 24.1W3.1 nmol of MDA/mg protein in follow up. The thiobarbituric acid activities at ulcer margin in placebo and ranitidine group patients were 14.8+1.5 nmol of MDA/mg protein in baseline and 24.3+2.7 nmol of MDA/mg protein in follow up (P=0.0059). The thiobarbituric acid activities at ulcer margin in H. pylori positive and negative patients were 28.1+2.1 nmol of MDA/mg protein and 25.3+4.7 nmol of MDA/mg protein, respectively. The myeloperoxidase activities at ulcer margin in H. pylori positive and negative patients were 79.9+5.3 unit/mg protein and 40.4+25.3 unit/mg protein, respectively (P=0.0001). The cumulative relapse rate was examined starting at 24 week after ulcer treatment. The rate was lower in rebamipide and ranitidine group patients, but insignificantly(19.2% vs 27.3%, P=0.0857). Conclusions: These results suggest that rebamipide promote gastric ulcer healing by decreasing reactive oxygen metabolite production in patients with gastric ulcer. (Korean J Gastroenterol 1997;29:569-578)

부식제에 의한 상부 위장관 손상의 임상적 고찰

김현수,박민호,주영은,윤경원,김세종,유종선,박근수,정필진 대한소화기내시경학회 2001 Clinical Endoscopy Vol.23 No.2

Background/Aims: The incidence of corrosive injury has been decreased, compared with past years. However, the ingestion of corrosive agent for suicidal attempt is on an increasing trend. Though corrosive injury on gastrointestinal tract is very common, there are few clinical studies on this field. Methods: Retrospective study was performed on 48 patients who ingested corrosive agent from 1992 to 1998. The kinds of corrosive agent, cause of ingestion, symptoms, gastroscopic findings, treatment and compli- cations were analyzed. Results: The most common agent of ingestion was acetic acid (47.9%), followed by hydrocholoric acid (18.8%), cresol (10.4%), lye (10.4%), sulfuric acid (4.2%). Ingestion for suicidal attempt (60.4%) was more frequent than accidental ingestion (39.6%). The frequent symptoms were sore throat (31.3%), dysphagia (27.1%), epigastric pain (22.9%), vomiting (18,8%), chest pain (18.8%), GI bleeding (12.5%), dyspnea (12.5%) and hematuria (8.3%). The esophagus was the most common site of corrosive injury and Grade Iia injury was the most frequent finding on gastroscopy. In most cases, pro- phylactic antibiotics with or without steroid was administered for conservative treatment. For long-term sequelae, there were 7 cases (14.6%) of esophageal stricture, and 2 cases (4.2%) of gastric outlet obstruction. Conclusions: Corrosive injury on gastrointestinal tract is frequently observed on early gastroscopy and can cause significant late sequelae, such as stricture. Therefore, it is necessary to evaluate regular follow up gastroscopy for the management of late sequelae.

Feeding a Diet with Precise Lysine Level improved Laying Performance and Feed Efficiency of Broiler Breeder Hens at the Early Laying Stage

Kim, Eunjoo,Rew, Han-Jin,Wickramasuriya, Samiru Sudharaka,Lee, Soo Kee,Shin, Taeg Kyun,Cho, Hyun Min,Heo, Jung Min The Korean Society of Poultry Science 2017 韓國家禽學會誌 Vol.44 No.4

A dose-response experiment was conducted to determine the lysine requirement for broiler breeder hens during pre-peak production. Totally, one hundred and twenty-six flock 23-week-old Ross 308 broiler breeder hens with similar body weight were selected ($2,188{\pm}32g$) for a 6-week experiment. Hens were fed with a basal diet of corn-wheat-soybean meal formulated to achieve the Ross 308 breeder nutrient specifications (2016), except for lysine. The 7 graded, daily lysine intake levels used in this experiment were 732, 785, 838, 891, 944, 997, and 1,050 mg, and hens were restricted to 133 g of feed throughout this experiment. Pen based egg production were recorded once a day and all eggs were weighed daily. Age at sexual maturity was determined when the hens attained age at 25% production. Body weight at 23~29 weeks of age was not affected (P>0.05) by lysine levels. By fitting a linear-plateau model, the daily lysine requirements for feed conversion ratio, total produced egg weight, and age at sexual maturity at 23~29 weeks of age were estimated as 865, 907, and 891 mg, respectively. Using a quadratic-plateau model, the daily lysine requirement at 23~29 weeks of age were estimated as 974, 964, and 950 mg for feed conversion ratio, total produced egg weight, and age at sexual maturity, respectively. These results suggested that the daily lysine requirement for modern broiler breeder hens according to the National Research Council (1994) are insufficient for higher total produced egg weight, sexual maturity, and feed efficiency, and 120% of the NRC recommendation level would improve hen productivity when data are fitted under linear- and quadratic-plateau models.

위암에서 신생혈관형성의 예 후인자로서의 의의

박근수(Geun Soo Park),주영은(Young Eun Joo),노두영(Du Young Noh),정필진(Phil Jin Jung),최성규(Sung Kyu Choi),유종선(Jong Sun Rew),김세종(Sei Jong Kim) 대한소화기학회 2002 대한소화기학회지 Vol.40 No.4

Background/Aims: Angiogenesis has been shown to be necessary for tumor growth and metastasis. The degree of the microvessel density (MVD) is thought to reflect the angiogenic activity generated by the neoplastic cells. Thus, the aim of this study was to evaluate the MVD in gastric cancer tissue and to examine the relationship between the MVD and various clinicopathological parameters such as patient survival. Methods: The study included 104 patients who underwent surgery for gastric cancer at Chonnam National University Hospital between 1992 and 1993. Microvessels were stained with anti-CD34 monoclonal antibody by immunohistochemical technique. Results: The mean MVD value was 68.5±31.1 with a range from 23.0 to 182.0. The MVD was significantly higher in patient with higher degree of depth of tumor invasion and distant metastasis. When a mean MVD value of 68.5 was chosen as cut-off point for discrimination of the 104 patients into high MVD and low MVD groups, the survival rate for patients with high MVD (≥68.5) was significantly lower than that of low MVD (<68.5) (p=0.045). The degree of MVD did not correlate with the patients' age, sex, tumor size, differentiation grade, Lauren classification, TNM stage or lymph node metastasis. Conclusions: This study suggests that angiogenesis assessed by the MVD was a marker of prognosis for patients with gastric cancer. (Korean J Gastroenterol 2002;40:228-235)