광주,전남 지역의 A형 간염바이러스 유전자형 변화 및 임상 분석

노두영 ( Du Young Noh ),조성범 ( Sung Bum Cho ),김연주 ( Yeon Joo Kim ),이완식 ( Wan Sik Lee ),박창환 ( Chang Hwan Park ),주영은 ( Young Eun Joo ),김현수 ( Hyen Soo Kim ),유종선 ( Jong Sun Rew ),최성규 ( Sung Kyu Choi ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.6

Background/Aims: Dominant genotype of hepatitis A virus (HAV) in Korea had been known to be genotype 1A in 1990s. Recently, the epidemiologic change of HAV genotype was reported with an upsurge of acute hepatitis A in Korea. The aim of this study was to investigate the change of HAV genotypes and clinical characteristics in Gwangju and Jeonnam province. Methods: From November 2008 to October 2009, a total of 82 patients with acute hepatitis A were enrolled prospectively. HAV genotype was determined using reverse transcriptase polymerase chain reaction and sequencing of the PCR products of VP1/2A region of HAV. Results: HAV RNA was detected in 82% (67/82). The genotype IIIA (88%, 59 cases) was significantly more frequent than genotype IA (12%, 8 cases) (p≤0.01). The subtypes of genotype IIIA were AJ299467 Norway (49%), HA-JNG04-09 Japan (27%), HS-14-12-00 Spain (22%) and H-122 Sweden (2%). The subtypes of IA were FH1 Japan (50%) and HA J04-3 Japan (50%). The substitutions of amino acid were more frequent in genotype IIIA than IA (p≤0.01). There was no difference in the clinical characteristics between the patients with genotype IIIA and IA. Conclusions: Genotype IIIA was a dominant genotype of recent HAV infection in Gwangju and Jeonnam province. This study provides valuable epidemiologic information of genetic distributions of HAV in Korea. (Korean J Gastroenterol 2011;57:346-351)

단일기관 40세 이하 병원 직원에서의 IgG Anti-HAV 항체 양성률

노두영 ( Du Young Noh ),조용찬 ( Yong Chan Cho ),전원정 ( Won Jung Jun ),김성균 ( Sung Kyun Kim ),윤경원 ( Kyoung Won Yun ),박선영 ( Seon Young Park ),이완식 ( Wan Sik Lee ),주영은 ( Yeong Eun Ju ),김현수 ( Hyun Soo Kim ),최성규 ( 대한소화기학회 2010 대한소화기학회지 Vol.55 No.3

목적: A형 간염은 경구감염으로 전파되는 급성 감염 질환이다. 최근 A형 간염의 발병률이 광주 전남지역에서 증가함에 따라 전남대학교병원 직원에서도 A형 간염 발생이 증가하였다. 이에 A형 간염에 대한 위험도를 평가하기 위해 전남대학교병원에서 근무하는 40세 이하 직원에서의 IgG anti-HAV 항체 양성률을 조사하였다. 대상 및 방법: 2008년 7월부터 2008년 8월까지 전남대학교병원에서 근무하는 40세 이하의 직원 1,486명 중 1,002명(남성 190명, 여성 812명)에서 IgG anti-HAV 검사를 시행하였다. 연령대를 5세 간격으로 분류하였으며, 21-25세 199명(19.9%), 26-30세 426명(42.5%), 31-35세 215명(21.5%), 36-40세 162명(16.1%)이었다. 결과: IgG anti-HAV 양성은 1,002명 중 329명으로 항체 양성률은 32.8%였으며, 성별 항체 양성률은 남성 40.5%(77/190), 여성 31.0% (252/812)였다. 각 연령대별 항체 양성률은 21-25세 1.5%(3/199), 26-30세 21.4%(92/426), 31-35세 48.4%(104/215), 36-40세 80.2%(130/162)였다. 직접 환자와 접촉하는 직종(의사, 간호사, 보건기사)에서의 IgG anti-HAV 양성률은 28.9%(234/809)였으며, 20대 초반 21-25세 1.7%(3/176), 26-30세 20.7%(78/376), 31-35세 45.5%(71/156), 36-40세 81.2%(82/101)였다. 결론: 20대 초반 병원 직원에서 IgG anti-HAV 보유율이 가장 낮았으며, 연령대가 증가할수록 항체 보유율이 높았으나 30대 초반까지는 항체 보유율이 50% 이하였다. 따라서 A형 간염 환자와 직접 접촉할 수 있는 30대 초반 이하의 병원 직원에서는 A형 간염 백신의 접종이 필요하리라 생각한다. Background/Aims: Hepatitis A is an acute infectious disease transmitted by fecal-oral route. As the incidence of hepatitis A has been increased in Gwangju and Chonnam province of Korea recently, the number of hepatitis A patients in hospital employees has also increased. Thus, we investigated the seroprevalence of IgG anti-HAV in hospital employees below 40 years old. Methods: We analysed the seroprevalence of anti-HAV IgG from 1,002 Chonnam national university hospital empolyees (men: 190, women: 812) who were below 40 years old. The age group was divided by 5 years; 21-25 years old 199 (19.9%), 26-30 years old 426 (42.5%), 31-35 years old 215 (21.5%), 36-40 years old 162 (16.1%). Results: Overall seropositive rate of IgG anti-HAV was 32.8% (329/1,002). The seropositive rate of men was 40.5% (77/190) and that of women was 31.0% (252/812). The seropositive rates of each age group were 1.5% (3/199) in 21-25 years old, 21.6% (92/426) in 26-30 years old, 48.4% (104/215) in 31-35 years old, and 80.2% (130/162) in 36-40 years old. The seropositivity rate of the high risk group (doctors, nurses, technicians) was 28.9% (234/809). Conclusions: The seropositive rate of IgG anti- HAV was the lowest in early twenties of hospital employees and below 50% in early thirties. Therefore, hepatitis A vaccination may be warranted in the hospital empolyees below the early thirties. (Korean J Gastroenterol 2010;55:183-188)

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)

Helicobacter pylori 감염과 관련된 전암성 및 암성 위병변에서 상피세포 증식에 관한 연구

박선영,주영은,노두영,주소영,이완식,박창환,김현수,최성규,유종선,박창수,김세종 대한내과학회 2004 대한내과학회지 Vol.66 No.4

목적 : H. pylori 감염이 위상피세포 증식의 증가와 관련되어 있다는 많은 연구 보고들이 있으며, 이러한 상피세포의 증식은 위암 발암과정 중 초기단계에 관여한다고 알려져 있다. 본 연구의 목적은 만성 위염에서 위암으로 진행하는 각 단계에 있어 H. pylori 감염이 상피세포 증식에 미치는 영향에 대해 알아보고자 하였다. 방법 : 상부 위장관 증상으로 내원하는 상부위장관 내시경 및 조직생검을 시행 받았던 129예(만성위염 29예, 장형화생을 동반한 만성 위축성 위염 26예, 저등급 형성이상 31예, 고등급 형성이상 18예, 위선암 25예)를 대상으로 하고, H. pylori 감염 여부를 신속요소분해효소검사, 변형 Giemsa 염색, 요소호기검사를 이용하여 평가하였고, 상피세포의 세포 증식능은 항 PCNA 항체를 이용한 면역조직호학염색을 통해 평가하였다. 결과 : 위상피세포 증식능의 정도는 H. pylori 양성군이 음성군에 비해 통계학적으로 유의하게 더 높았으며(p=0.007), 대상군을 위염군, 형성이상군, 그리고 위선암군으로 나누었을 때 위염군에서 위선암군으로 진행할수록 유의하게 증가하였다(P<0.001). 각각의 조직학적인 군별로 H. pylori 감염에 따른 세포증식능을 비교한 결과 위선암군을 제외한 나머지 군에서 모두 H. pylori 양성이 음성인 경우보다 세포 증식능이 높았다. 결론 : H. pylori 감염은 상피세포 증식증가에 관여하며, 위암의 발암과정 중 초기에 관여할 것으로 생각된다. Background : Many studies have demonstrated that increased cell proliferation in gastric epithelium is associated with Helicobacter pylori (H. pylori) infection. Increased epithelial proliferation is one of the earliest mucosal changes observed in gastric carcinogenesis. The aim of this study was to evaluate the influence of H. pylori infection for epithelial proliferation at different stages of gastric carcinogenesis from chronic gastritis to adenocarcinoma. Methods : Gastric biopsy specimens were collected from 129 patients who underwent esophagogastroduodenoscopy with biopsy. Histologically, there were 29 patients with chronic gastritis, 26 chronic gastritis with intestinal metaplasia, 31 low grade dysplasia, 18 high grade dysplasia, and 25 gastric adenocarcinoma. status of H. pylori infection was determined by rapid urease test, modified Giemsa stain and ^(13)C-urea breath test. Epithelial cell proliferation was assessed by immunohistochemical method using anti-PCNA antibody. Results : The grade of epithelial proliferation was in H. pylori infected patients than uninfected patients (p=0.007) and progressively increased at different stages from chronic gastritis to gastric adenocarcinoma (p<0.001). The analysis of epithelial proliferation according to H. pylori infection satus in each histologic group showed that the grades of epithelial proliferation were higher in H. pylori infected patients than uninfected patients in all group except adenocarcinoma group. Conclusion : H. pylori infection causes increased gastric epithelial cell proliferation and may play an important role in gastric carcinogenesis.