위암세포주에서 Recombinant Human Interferon-r와 Adriamycin의 투여순서가 항암효과에 미치는 영향

홍원선,손영숙,김창민,강윤구,이춘택,김유철,임영혁,남현석,이진오,강태웅 大韓免疫學會 1993 大韓免疫學會誌 Vol.15 No.-

Numerous previous studies, both in vitro and in vivo, have demonstrated that the cytotoxicity can be enhanced by the combination of chemotherapeutic agent and interferons(IFNs) in various types of cancer cells. We have previously reported that combined treatment of MKN-45, human gastric adenocarcinoma cells, with adriamycin(ADM) and recombinant human interferon-r(rh-IFN-r) increased in the cytotoxicity. In this study, the effects of combination timing of rh-IFN-r and ADM on the cytotoxicity against MKN-45 were investigated using MTT assay. MKN-45 was treated with rh-IFN-r and ADM in vitro on three schedules : Treat A ; rh-IFN-r and ADM were treated simultaneously, Treat B ; rh-IFN-r was treated 24 hours after the treatment with ADM, Treat C ; rh-IFN-r was treated for 72 hours and followed by the treatment with ADM. The survival of MKN -45 was inhibited by ADM dose-dependently. 102 and 103U/ml of rh-IFN-r significantly inhibited the survival of MKN-45(% survival : 35.1 ±-1.2% and 34.4 ±1.1% in Treat A and 42.5 ± 2.1% and 45.9-±2.5% in Treat C, respectively). However no difference in the survival was observed between 102 and 103U/ml of rh-IFN-r. Combined treatment with rh-IFN-r and ADM significantly augmented the cytotoxicity at low concentrations of ADM. Combined effects of rh-IFN-r and ADM were evaluated using IC30(,ag/ml) to ADM. IC30s of MKN-45 in Treat A, B and C at 102 U/ml of rh -IFN-r _ were 0.019 -?- 0.003, 0.045 :I:0.001 and 0.054 ± 0.012, respectively, while IC30 of MKN-45 treated with ADM alone was 0.052±0.004. IC30s of MKN-45 in ADM alone group, Treat A, Treat B and Treat C at 103U/ml of rh-IFN-r were 0.047 ±0.003, 0.004 -±0.001, 0.031 ±0.004 and 0.056 0.008, respectively. These results indicate IC30s of Treat A and B were significantly lower than those of ADM alone(p<0.05) and IC30s of Treat A was significantly lower than those of Treat B(p <0.01). IC30s of Treat C, however, were not different from those of ADM alone. From these results demonstrating that cytotoxic effects were increased by the combination of rh-IFN-r and ADM in the order, Treat A > Treat B> Treat C, it can be concluded that the simultaneous administration of rh-IFN-r and ADM may be the most effective method to combine these two therapeutic modalties.

Alpha-Fetoprotein이 증가한 만성 간질환의 임상적 특성

김창민,홍석일,조희준,이영현,김봉석,홍원선,이진오,김유철,강태웅,김서운 대한소화기학회 1992 대한소화기학회지 Vol.24 No.4

In an attempt to investigate the factors influencing the specificity of serum level of alphafetoprotein (AFP) for hepatocellular carcinoma, serum levels of AFP were analyzed in 33 patients treated at the department of gastroenterology in the Korea Cancer Center Hospital between January 1989 and December 1991. All patients entered into the study had chronic liver disease with increased serum level of AFP, more than 50 ng/ml. Clinical and; laboratory parameters, such as HBsAg, Anti-HCV, GOT and GPT and image studies with ultraonograpy and computed tomography were sequentially evaluated, every two or three months, in 2Z' patients. Among 33 patients, 30 had liver cirrhosis and three had chronic hepatitis. The median level of serum AFP was 189 ng/ml in 33 patients. Thirty (90.9%) out of 33 patients were positive for HBsAg. Anti-HCV was tested in 14 patients, among whom four (28.6%) were positive. No significant correlation was observed between serum AFP levels and age, sex or positive rates for HBsAg, anti-HCV and cirrhosis. In 32 among 33 patients, no evidence of the development of hepatocellar carcinoma was found after the follow-up period of six to 36 months, when hepatocellar carcinoma teas diagnosed as the space occupying lesion in the liver by ultrasonograpy and computed tomography. Another one patient was also suggested not to develop hepatocellar carcinoma, when clinically evaluated, because liver function and serum AFP level were markedly improved. The follow-up period in 22 patients was determined as the period until the AFP level decreased below the cut-off value, 50 ng/ml, or the end of study period. The serum AFP level and liver function were sequentially tested during the median follow-up period of 7.5 months (range, 3-30), demonstrating that the median serum AFP level significantly decreased from 376.6 ng/ ml to 57.6 ng/ml (p$lt;0.05). With the decrease in serum AFP levels, serum levels of GOT and GPT also decreased (p$lt;0.01). In 20 out of 22 patients, serum level of AFP decreased to less than 50% of the inital level of AFP after the follow-up period. In eight and seven patients, serum levels of AFP decreased to the normal level, less than 20 ng/ml, after tile median follow-up period of 14.5 months (range, 5-30) and 20-49 ng/ml during 4.5 months (range, 3.11), respectively. In two patients, however, change in the serum AFP levels was not observed. In seven patients who had the initial serum AFP level of more than 100 ng/ml and tested serum AFP level and liver function test every two months. serum levels of AFP, GOT and GPT concurrently decreased during the follow-up period. These results demonstrating that serum AFP level increased in benign liver diseases, such as liver cirrhosis and chronic hepatitis, suggest that, in order to increase the clinical usefulness of serum level of AFP for the diagnosis of hepatocellular carcinoma, serum AFP level should be reevaluated for the specificity for hepatocellular carcinoma according to the cut-off value. Because serum AFP level decreased in most of the patients after the follow-up period, tit is also suggested that AFP elevated in benign liver disease might be different from that in hepatocellular carcinoma in molecular characteristics.

원발성 경화성 담관염, 궤양성 대장염 및 담관암종이 병발해 나타난 1예

김경현,김창민,정숙향,정진행,김연경,김유철,이병희,양정훈,최병국,최택희 대한소화기학회 1999 대한소화기학회지 Vol.34 No.2

Primary sclerosing cholangitis (PSC) is a progressive, inflammatory disease affecting extra- and intra- hepatic bile ducts with characteristic radiologic and histologic findings. PSC is frequently associated with ulcerative colitis (UC) and the incidence of cholangiocarcinoma is increased in those patients with PSC and UC. We experienced a case in which primary sclerosing cholangitis, ulcerative colitis, and peripheral cholangiocarcinoma were combined. The patient was a 37-year-old female and complained of jaundice. To our knowledge, this is the first report which has presented the association of three disease entities in Korea.

간경변증 환자에서 간의 조직 괴사로 인해 공간점유병변을 보였던 중례 2예

김창민,김성배,정숙향,이진오,김유철,강태웅,남승모,김재학 대한소화기학회 1998 대한소화기학회지 Vol.32 No.1

Ischemic necrosis of the cirrhotic liver is rare because the liver has dual blood supply and an extensive collateral system. However, it may occur in the condition of sudden reduction of hepatic arterial flow such as acute blood loss or shock Recently, we experienced two cases of ischemic necrosis of the liver assoicated with cirrhosis. Those were presented as space-occupying lesions on the radiological study. In contrast with hepatocellular carcinoma, these lesions showed neither hypervascularity nor deposition of injected lipiodol. Repeated percutaneous fine needle cytology revealed no evidence of malignant cells, Furthermore, short-term follow-up examination showed decrease in size and/or extent of the lesions, It is important to differentiate these lesions from tumorous condition because interventional trial such as transarterial chemoembolization may further aggravate the ischemic lesion and unnecessary surgery under false impression of hepatocellular carcinoma in cirrhotic patients should be avoided.

간세포암 환자에서 경동맥 Lipiodol-항암제 투여술 후 합병증에 대한 전향적 연구

김경현,김창민,김성배,김성환,최두환,정숙향,이진오,한철주,김유철,강태웅,이병희,양정훈,송은정,최병국 대한소화기학회 1999 대한소화기학회지 Vol.33 No.6

Background/Aims: Transarterial chemolipiodolization (TAC) is a therapeutic option for unresectable hepatocellular carcinoma (HCC). The aims of this study were to analyze types and frequencies of post-TAC complications, to evaluate the necessity of prophylactic antibiotics, and to identify risk factors associated with complications. Methods: One hundred thirty five patients treated with TAC were analyzed prospectively. The patients' status was evaluated daily during the admission period Patients were followed up for 4 weeks by weekly phone interview. Results: Complications were fever in 38%, epigastric pain in 33%, right upper quadrant (RUQ) pain in 24%, nausea and vomiting in 13%, abdominal fullness in 11%, acute cholecystitis in 1.5%, liver abscess in 0.7% and hepatic failure in 0.7% of the 135 patients. Statistically significant risk factors were the amount of infused lipiodol and the number of treatment for fever and the location and the number of tumors for RUQ pain. Conclusions: Various post-TAC complications were observed in 70.4% of the patients. However , infectious complications were rare, and thus prophylactic antibiotic treatment is not necessary. Careful clinical observation and early symptomatic management for fever and abdomina pain are desirable.

결절성 갑상선종을 동반한 선천성 간섬유증 1 예

김창민,이영현,장자준,홍원선,이진오,김유철,강태웅,강윤구,김서운,임영혁,김용조 대한내과학회 1994 대한내과학회지 Vol.47 No.1

Congenital hepatic fibrosis is a relatively rare disease which is characterized by bile ductular proliferation and prominent fibrosis in the portal area of liver resulting in portal hypertension. The patients usually present with esophageal varix bleeding or repeated episodes of acute cholangitis which both are the major determinants of the long-term prognosis. Congenital hepatic fibrosis is frequently associated with other abnormalities such as polycystic kidney, Caroli`s syndrome, cystic dysplasia of the pancreas, intestinal lymphangiectasia, pulmonary emphysema, hemangioma and cleft palate. We report here a case of congenital hepatic fibrosis associated with nodular nontoxic goiter, which has not been reported previously, pancytopenia due to hypersplenism and polycystic kidney in a 24-year-old female patients.

간경변증 환자에서 간의 조직 괴사로 인해 공간점유병변을 보였던 증례 2예

남승모,김재학,김성배,정숙향,김유철,김창민,이진오,강태웅 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.1

Poster Exhibition : The Relation Among Hepatitis B Virus DNA, Histological Hepatitis Activity and Prognosis in Patients with Hepatitis B Virus Related Hepatocellular Carcinoma (초)

Su Cheol Park,Ho Jin Lee,Ki Young Yang,Yeon Joo Kim,Jin Kim,Chul Ju Han,You Cheoul Kim,Sun Hoo Park,Eung Ho Cho,Sang Beom Kim,Yong Jin Jung,Sang Hyub Lee 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.4(S)

간세포암종 환자의 종양 조직 내 P-glycoprotein 및 p53 단백의 발현이 항암화학요법의 반응률에 미치는 영향

김영호,정진모,조광희,조현호,정진행,이승숙,이진오,한철주,김유철,정숙향,이진혁,최대현,조상형 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.4

Background / Aims : Hepatocellular carcinoma(HCC) is a drug -resistant tumor. The expression of a multidrug resistant gene, P-glycoprotein(P-gp) is a major mechanism of drug resistance. The aims of our study were, firstly, to observe the expression rate of P-gp in HCC tissue obtained by percutaneous fine needle aspiration(PCNA) from stage IV HCC patients; secondly to examine the association between P-gp and chemotherapeutic response ; and finally to investigate the correlation between p53 protein expression and P-gp expression. Subjects and Methods : We studied 29 cases of stage IV HCC treated by systemic chemotherapy. Expression of P-gp and p53 were evaluated by immunohistochmical staining of HCC tissue with human monoclonal anti body, JSB-1(Anti P-gp ) and DO-7(Anti p53), respectively. We analyzes the results of immunohistochmical staining of HCC tissues of the patients in relation to chemotherapeutic response and other clinical charateristics. Results : The expression rate of P-gp was 27.5%. Partial response to anti-cancar chemotherapy was observed in 16.7% of the to chemotherapeutic response, none of the response to anti-caner chemotherapy was observed in 16.7% of the patients. Although we could not see a statisrically significant association between to chemotherapeutic response expression and chemotherapeutic response , none of the response patients showed chemotherapeutic response P-gp expression. p 53 protein expression was found in 45% of the patients. There was no significant correlation between p 53 protein expression and P-gp expression. Conclusions : Although the number of our study subjects was small, chemotherapy- responsive patients didn't show P-gp expression. P-gp expression might be used as a predictor of response to potentially toxic anti-cancer chemotherapy in HCC patients. Futher study is warranted to confirm our results.

Non - B, Non - C 간세포암종의 임상적 특징과 B형 간염바이러스, C형 간염바이러스 및 TT Virus 바이러스혈증의 빈도

김영호,김창민,조광희,조현호,이진오,한철주,김유철,정숙향,이진혁,최대현,정진모,조상형 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.4

Background/Aims: About 15% of Korean hepatocellular carcinoma(HCC) are negative both of Hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus (anti-HCV)in their sera. They can be classified as a non-B, non-C hepatocellular carcinoma group(NBNC group). The aims of our study were, firstly, to describe the clinical characteristics of Korean NBNC HCC and compare them with those of HBsAg-positive HCC(HBV group) and anti-HCV-positive HVV(HCV group). Secondly we wanted to assess the frequency of viremia of HBV, HCV and transfusion-transmitted virus(TTV)in NBNC HCC patients. Methods : we prospectively collected clinical data and sera from 113 NBNC HCC patients and performed PCR for HBV DNA, HCV RNA and TTV DNA. We also collected clinical data from 125 HBsAg-positive HCC patients during a similar period. Results : The mean age of the NBNC HCC group was 59 years, in-between that of the HBV and the HCV groups. A History of heavy alcohol drinking was found in 48% of the NBNC HCC group. This was significantly higher than that of the HBV group, but similar to that of the HCV group. Serum α FP level in the NBNC HCC group was more frequently in the normal range compared to that in the HBV and HCV groups. The detection rates of HBV DNA, HCV RNA and TTV DNA in the NBNC HCC group were 17%, 13% and 67% respectively. Conclusions : The NBNC HCC patients seemed to comprise a heterogeneous group of various etiologies and clinical presentations. About one third of these patients displayed evidence of viremia of HBV or HCV.