위장관 ( 胃腸管 ) : 약년자 대장 및 직장암의 임상적 고찰

강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),정재복(Jae Bock Chung),김원호(Won Ho Kim),김경희(Kyung Hee Kim),노성훈(Sung Hoon Noh),김도영(Doe Young Kim) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.1

N/A Colorectal carcinoma in young patients reportedly has a poor prognosis. Several reviews have suggested multiple explantations, including a low index of suspicion, delay in diagnosis or uniquely virulent tumor cells. However, some recent articles have suggested that the outlook is not necessarily dismal. To identify any distinctive characteristics of colorectal cancer in young patients, we studied the difference of incidence, initial symptoms, duration of symptoms, the location, gross types and size of the tumor, depth of invasion, resectability, lymph node involvement, distant metastasis, tumor stage by Astler-Coller classification, histologic types and five-year survival rates between 91 cases of young patients (less than 35 years of age) with colorectal cancer and 915 cases of eldly patients (35 years of age or more) as control, who were operated at Yonsei University Medical College, Severance Hospital during the 18 year period between January 1971 and December 1988. The results obtained are as follows: 1) The incidence of colorectal carcinoma in the young among total colorectal cancer patients was 9.0% (91/1,006 cases). There were 44 males and 47 females in the young age group, and the male to female ratrio was 0.93 : l. 2) There were no differences in the clinical symptoms, location, size, gross types of tumor and resectability between the two groups. 3) The duration of symptoms was longer in the younger age group than in the older age group. 4) The incidence of lymph node involvement was significantly higher in the younger age group than in the older age group (62.8% vs 39.2%; p<0.001). 5) The incidence of modified Dukes C cases was significantly higher in the younger age group than in the older age group (49.5% vs 33.49% p<0.001). 6) The incidence of mucinous carcinoma was significantly higher in the younger age group than in the older age group (32.5% vs. 10.1%; p<0.001). 7) The cumulative five-year survival rate was significantly lower in the younger age group than in the older age group (34.1% vs. 58.0%; p<0.005). 8) Even in the same stage or in the same status of lymph node involvement or with the same histologic type, the five-year survival rate was significantly lower in the younger age group than in the older age group. We conclude that the colorectal caricr in younger patients is worse than older patients. This unfavorable prognosis in young patients with colorectal cancer may be related to delayed diagnosis, more malignant histologic feature and other unidentified causes such as host factor. We suggest that a high degee of index of suspicion and aggressive treatment is mandatory even in young patients.

건강 성인에서 삼차원 초음파검사를 이용한 위배출시간 측정에 관한 연구

김도영 ( Doe Young Kim ),정혜경 ( Hye Kyung Jung ),이유현 ( You Hyun Lee ),정성애 ( Sung Ae Jung ),문일환 ( Il Whan Moon ),백진영 ( Jin Young Paek ) 대한소화기학회 2004 대한소화기학회지 Vol.44 No.2

Background/Aims: Three dimensional (3-D) ultrasonography is definitely more accurate than conventional 2-D ultrasonography in volume measurement of intra-abdominal organs. However, its application in measuring gastric emptying time has been limited. Thus,

간경변증 환자 혈장 Endothelin 측정의 임상적 의의

김도영(Doe Young Kim),임석아(Seok Ah Im),심기남(Ki Nam Shim),유승기(Sung Kee Ryu),최희정(Hee Jung Choi),최규복(Gyu Bog Choi),문일환(Il Hwan Moon),윤견일(Kyun Il Yoon) 대한내과학회 1994 대한내과학회지 Vol.47 No.4

N/A Background: Endothelin is a newly discovered 21-aminoacid polypeptide that has been shown to produce marked vascoconstriction. Elevated plasma concentration of endothelin has been reported in patients with acute and chronic kidney failure, cardiogenic shack, hypertension, sepsis, acute myocardial infarction, subarachnoid hemorrhage and Raynaud`s phenomenon, and the reports suggest that endothelin plays a contrib- utnry role in the pathogenesis of those diseases. However, plasma levels of endothelin in patients with liver cirrhosis have rarely been reported. This study was conducted to investigate the clinical significance of plasma endothelin concentrations in patients with liver cirrhosis. Methods: Eleven patients with liver cirrhosis and ten healthy control subjects were included in this study. Plasma and random urine endothelin concentrations were measured by radioimmunoassay. Results: 1) The plasma endothelin concentration was significantly higher in patients with cirrhosis than in control subjects (15.5±5.1pg/ml vs. 3.9±2.4 pg/ml, mean±S. D, p<0.01). The urine endothelin concentration was also significantly higher in patients with cirrhosis than in control subjects (47.9±26.6 pg/ml vs. 15.3±9.2 pg/ ml, p<0. 05). 2) In patients with cirrhosis, the plasma endothelin concentration showed a significant negative correlation with creatinine clearance (r=0.76, p<0.01), and a significant positive correlation with fractional excretion of sodium (FENa) (r=0. 75, p<0. 01). Conclusion: From these results, elevated plasma endothelin may play a contributory role in kidney dysfunction in patients with cirrhosis.

GLP-1이 위의 용적, 배출능, 최대섭취용적 및 식후 소화기증상에 미치는 영향

김도영 ( Doe Young Kim ) 대한소화기기능성질환·운동학회 2003 Journal of Neurogastroenterology and Motility (JNM Vol.9 No.1

요약 : Glucagon-like peptide-1 amide (이하 GLP-1으로 약함)는 장점막의 L세포에서 proglucagon의 처리에 의해서 합성되는 내인성 물질로 최근 당뇨병과 비만증의 치료에 이용되고 있다. GLP-1은 뇌에 작용하여 공복감을 줄이고 반대로 위에 가득찬 느낌(fullness)을 늘려 음식물의 섭취량을 줄이는 효과를 갖고 있다. 또한 GLP-1은 정상인과 당뇨병 환자에서 위의 배출시간을 지연시키는 효과가 있음이 알려졌다. 이

노년층 당뇨병의 임상적 특성에 관한 연구

김도영(Doe Young Kim),임승길(Sung Kil Lim),이현철(Hyun Chul Lee),조용욱(Yong Wook Cho),김현만(Hyeon Man Kim),허갑범(Kap Bum Huh) 대한내과학회 1987 대한내과학회지 Vol.33 No.2

N/A The population is aging, primarily because of a decline in the birth rate and an increase in longevity. With advancing age, the prevalence of diabetes and abnormal glucose tolerance increase, We compared clinical characteristics of 76 patients of eldery diabetes with those of 288 patients of adult diabetes who all had been admitted to Severance hospital Yonsei University, College of Medicine from Jan. 1984 to Feb. 1986, The results obtained were as followings. 1) The mean age of eldery and adult diabetes was 69.6, 53.7 years old respectively, The distribution of eldery and adult diabetes were 63.2, 64.9% in nonobese-IDDM, and 25.0, 20.2% in obese-NIDDM, and 11.8, 14.9% in atypical group respectively. 2) The creatinine level was significantly higher and creatinine clearance significantly lower in eldery group than that of adult group (p<0.05), 3) The prevalence of retinopathy was higher in eldery group than that of adult group (p<0.05). 4) Hypertension, CVA, and cataract were more frequently associated in eldery group (p<0.05).

만성 간염에서 Interleukin-6의 간내발현

김성숙(Sung Sook Kim),김도영(Doe Young Kim),문일환(Il Whan Moon),변광호(Kwang Ho Pyun),최인표(In Pyo Choi) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.4

N/A Rackground/Aims: Interleukin-6 (lL-6), also known as B cell stimulatory factor 2(BSF-2), induces the final maturation of B cells to antitxxiy-producing cells. IL-6 has many biologic properties including the immune and intlammatory responses. This study wos aimed to evaluate the role of local interleukin 6(IL-6) in the pathogenesis of chronic hepatitis. Methods; We examined the cellular site and grade of IL-6 staining in paraffin sections of the liver from 24 patients with liver disease, using immunohistochemistry with a polyclonal antitwdy. The patient. Were divided into two groups; Group A(n=l3) with high histologic uctivi1y consisted of CAH-type B(n=10) ond active cirrhosis(n=3), whilc Group B(n= l l) with low hi.itologic activity consisted of CPH-type B(n=4), inactive cirrhosis(n=2) and fatty liver(n=S). Results: There was no staining of IL-6 in normal liver tissue. Thv grade.I of IL-6 staining in Group A were three positive in seven cases (53.81o), two positive in five ca.ics(38.3%) and one positive in only one case(7.7%), while those in Group B were one positivc in three cases(27.3%) ancl trace in eight case.(72.7ln). IL-6 stained cells in chronic hepatitis were hepatocytcs, cspecially in the areu ot' piecemeol necrosi.I, bilc duct cel1., infiltrating inflammatory cells and endothelial cell.I. The score of histological activity index(HAJ), piecemeal necrosis and fibrasis and thc gradv. Of 1L-6 staining of Group A were ull significantly higher than those of Group B. The grade of IL-6 staining and HAI werc well correlated(r =0.74, p 0.0l), Conclusion: Locally produced IL-6 in the liver may contribute to the inflammatory process and immunological response in chronic hepatiti.. (Korean 3 Gastroenterol 1995;27:403-411)

담낭절제술후 발생한 절단신경종

유승기(Sung Kee Ryu),김도영(Doe Young Kim),문일환(Il Hwan Moon),최용만(Yong Man Choi),조민선(Min Sun Cho),김성숙(Sung Sook Kim) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.1

Amputation neuroma always occurs at the distal ends of proximal segments of severed nerves and is characterized by a neural enmeshment in an overgrowth of the Schwannian sheath cells. The usual 1ocation of amputation neuroma is in amputed extremities. However, amputation neuroma can occur following cholecytectomy due to a rich choledochal nerve plexus. Amputation neuroma following cholecystectomy may produce biliary-tract pain, a symptom of postcholecystectomy syndrome and occasionally jaundice caused by biliary tract obstruction. Surgical excision of the neuroma may relieve the symptoms. Since the cholecystectomy including laparoscopic approach is such a common surgical procedure, it is important that the knowledge of these sequelae be known. The possibility of an amputation neuroma should be kept in mind when patients with postcholecystectomy symptoms are seen clinically after an exclusion of the usual causes of these symptoms. We had experienced a 62 year old woman who comp1ained of right upper quadrant pain and jaundice with a past history of a cholecystectomy due to multiple gall stones at l 1 years before admission, and she was diagnosed as an amputation neuroma in the hepatic duct bifurcation area by operation. So we report it with some review of articles. (Korean J Castroenterol 1995;27:144-149)

Desferrioxamine이 사람 간암 세포주의 DNA 합성에 미치는 영향

강진경(Jin Kyung Kang),김원호(Won Ho Kim),송시영(Si Young Song),김도영(Doe Young Kim),문일환(Il Hwan Moon),윤견일(Kyun Il Yoon) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6

N/A Desferrioxamine (DFO), an iron chelator, has been sbown to have antiproliferative activity in a variety of malignant cells including hepatocellular carcinoma. The antiproliferative effect of DFO's known to be caused by decreased activity of ribonucleotide reductase, a key enzyme in DNA synthesis. This study was conducted to investigate the effect Of DFO on the DNA synthesis of cultured hepatoma cells. The proliferation of hepatocellular carcinoma (Hep 3B) as well as hepatoblastoma (Hep G2) cells was measured by trypan blue dye exclusion method and the DNA synthesis was measured by [3H] thymidine incorporation. The results obtained were as follows: The proliferation of hepatoma cells was slightly inhibited by 2 ug/ml and markedly inhibited by 6 ug/ml of DFO. This antiproliferative effect was not enhanced any more by higher dose of DFO. The percent viability of Hep 3B and Hep G2 cells was above 90%. after 96 hours of incubation with 60 ug/ml of DFO and that of Hep 3B and Hep G2 cells was 88.0% and 89.6% respectively after l6 hours of culture with 120 ug/ml of DFO. DNA synthesis of hepatoma ceils was decreased by DFO in a dose dependent manner up to 20 ug/ ml. The decrease of DNA synthesis was not enhanced any more by higher dose of DFO. In conclusion, the antiproliferative effect of DFO on cultured human hepatoma cell lines was caused by the inhibition of DNA synthesis rather than by direct cytocidal effect.

Desferrioxamine이 사람 간암 세포주의 세포주기에 미치는 영향

강진경(Jin Kyung Kang),박인서(In Suh Park),김원호(Won Ho Kim),김도영(Doe Young Kim),권오헌(Oh Hun Kwon),홍성근(Seong Keun Hong),이정운(Jung Woon Lee) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6

N/A Desferrioxamine (DFO), an iron chelator, has been known to have an antiproliferative activity in a variety of malignant cell lines including human hepatoma cell lines. This study was conducted to investigate the effect of DFO on the cell cycle of hepatoma cells. Using Hep 3B cells as the hepatoma cell lines, bivariate DNA flow cytometry, after staining with propidium iodide and antibromodeoxyuridine following bromodeoxyuridine labelling, was performed to analyze the cell cycle. The following results were obtained. The proportion of S phase cells increased and that of GO/Gl phase cells decreased after the addition of DFO in the culture media in a dose dependent manner up to 20 ug/ml. The S phase duration (Ts) was 9.9 hours when cultured without DFO, but after the addition of 20 pg/ml of DFO, the increment in the proportion of early-S phase continued without shift to the mid-S and late-S phase, and Ts was markedly prolonged (54.1 hours). After removal of DFO from the culture media, a sequential increase from early-S through mid-S and late-S to G2/M phase was observed. In conclusion, the antiproliferative effect of DFO on cultured human hepatoma cell lines was caused by a block in the early-mid S interface or mid S phase of the cell cycle.

건강 성인에서 남녀별 및 생리주기에 따른 대장통과시간의 차이

문일환(Il Hwan Moon),정혜경(Hye Kyung Jung),김도영(Doe Young Kim) 대한내과학회 2002 대한내과학회지 Vol.63 No.2

목적: 대장통과시간은 남자가 여자보다 빠르다는 보고가 많으나 남녀별 차이가 없다는 보고도 있으며, 생리주기에 따른 영향에 대해서도 아직 논란이 있다. 본 연구는 변비나 설사가 없는 건강 성인 남녀 42명을 대상으로 최근 국내에서 개발된 방사선 비투과 표지자인 KolomarkTM를 이용하여 대장통과시간을 측정하여 남녀별 차이 및 생리주기에 따른 영향을 알아보고자 하였다. 방법: 남자 21명(35±7세, 체질량지수 22.8±2.8 kg/m2 , 이하 모든 데이터는 평균±표준편차로 표시함), 여자 21명(34±8세, 체질량지수 21.1±1.8 kg/m2)을 대상으로 방사선 비투과 표지자인 KolomarkTM를 매일 한 캡슐씩 3일 동안 복용시킨 후 4일과 7일째에 단순 복부 X-선 검사를 시행하여 대장통과시간을 측정하였다. 연구 기간 동안 3일간 식이표를 작성하여 일일 평균 식이섬유섭취량을 조사하였고, 여성 대상자는 생리주기에 대한 문진과 함께 혈청 estradiol 및 progesterone을 측정하였다. 결과: 대상자의 전 대장통과시간은 26.5±19.4시간이었다. 남자는 22.3±16.1시간, 여자는 30.1±21.4시간으로 남자가 여자에 비해 전 대장통과시간이 짧았지만 통계적인 차이는 없었고, 부위별로는 좌측 대장통과시간이 여자(12.5±10.7시간)가 남자(6.0±6.1시간)에 비해 유의하게 길었다(p<0.05). 대장통과시간 측정시 황체기에 있던 여자는 10명으로 이들의 평균 전 대장통과시간은 40.9±19.0시간이었고, 이는 여포기에 있던 11명의 여자군(20.6±19.2시간)에 비해 유의하게 길었다(p<0.05). 특히, 황체기군의 직장 및 S결장 통과시간은 18.7±11.0시간으로 6.1±7.9시간인 여포기군에 비해 유의하게 길었다(p<0.05). 식이섬유섭취량, 연령 및 체질량지수는 전 대장통과시간과 유의한 상관관계가 없었다. 혈청 progesterone 치는 황체기군이 4.9±5.0 ng/mL로 2.2±4.0 ng/mL인 여포기 여자군에 비해 유의하게 높았으나(p<0.05), 대장통과시간과는 상관관계가 없었다. 결론: 건강한 성인에서 남녀별 전 대장통과시간의 차이는 없었으나, 황체기의 전 대장통과시간과 직장 및 S상결장 통과시간은 여포기에 비해 느림을 알 수 있었다. Background: Measuring of colon transit time (CTT) by radiopaque marker is simple, widely available and important for the diagnosis of slow transit constipation. In spite of recently increasing use of a domestically manufactured radiopaque marker, KolomarkTM in Korea, we lack normative data about CTT which can be obtained by KolomarkTM. Moreover, the effect of gender or menstrual cycle on CTT seems to be still controversial. We tried to measure CTT in healthy volunteers and to compare the effect of gender and menstrual cycle on CTT. Methods: Forty-two healthy volunteers (21 M, 21 F) were recruited through a hospital advertisement. CTT was measured by a KolomarkTM, according to Metcalf's method. Average daily intake of dietary fiber was estimated and menstrual history was acquired from female volunteers whose serum progesterone and estradiole levels were measured by radioimmunoassay. Results: The mean total CTT of 42 healthy volunteers was 26.5±19.4 hours. The mean total CTT of male volunteers showed a faster trend than that of female volunteers, however, there was no statistical significance. The mean left CTT was significantly longer in female volunteers than in male volunteers. The mean total CTT of 11 female volunteers in luteal phase (40.9±19.0 h) was significantly longer than that of 10 female volunteers in follicular phase (20.6±19.2 h, p<0.05). The serum progesterone level, age, BMI and the average daily intake of dietary fiber were not correlated with total CTT. Conclusion: Even though total CTT was not significantly different between male and female volunteers, female volunteers in luteal phase showed more prolonged CTT than those in follicular phase. (Korean J Med 63:151-157, 2002)