역류성 식도염환자의 산청소능

박효진(Hyo Jin Pack),김범수(Pum Soo Ki m),이정운(Jung Woon Lee),박인서(In Suh Park) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.3

N/A Background/Aims: Esophageal acid clearance is an important mechanism protective against the development of reflux esophagitis. Acid clearance from the esophagus after gastro-esophageal reflux depends on two important mechanisms: esophageal peristalsis to return the displaced gastric content to the stomach and swallowed saliva to neutralize the residual acid that coats the esopha- gea1 mucosa. The present study aims to investigate acid clearance and determine the contributions of esophageal peristalsis, salivation, and gravity. Methods: We performed the acid clearance test, ambulatory 24 hour esophageal pH study, esophageal manometry and saliva study in 16 consecutive patients with reflux esophagitis, and then compared them with normal controls. Results: The clearance of acid instilled into the esophagus was markedly delayed in patients with reflux esophagitis as compared with controls(p0.05). There was a trend towards a lower peristaltic amplitude in patients with reflux esophagitis, but this was statistically not significant. Of the motor events analyzed, there were simultaneous contractions in 4 patients(25.0%), poor wave progression in 4 patients(25.0%), and non-transmitted contraction in 2 patients(12.5%). In patients with reflux esophagitis, the number of reflux episodes, the mean number of reflux episodes greater than 5 minutes, and the percentage of time when the pH was less than 4 were significantly increased compared with controls(p <0.05). The basal and stimulated salivary pH and concentration of bicarbonate in patients with reflux esophagitis did not show a significant difference compared with controls. Conclusions: We found a significant impairment of acid clearance in patients with reflux esophagitis, and some alterations in esophageal peristalsis but no change in salivary functions. (Korean J Gastroenterol 1995;27:275 - 282)

췌장암에서 p53 단백발현의 임상적 의의

박인서(In Suh Park),정재복(Jae Bock Chung),박찬일(Chan Il Park),송시영(Si Young Song),이돈행(Don Haeng Lee),이우정(Woo Jung Lee),박영년(Young Nyun Park) 대한소화기학회 1997 대한소화기학회지 Vol.30 No.1

N/A Background/Aims: Alteration in the p53 tumor suppressor gene are involved in the pathogenesis of diverse human cancer. Immunohistochemical detection of the p53 protein has been strongly correlated with rnutations in the p53 gene. Although p53 overexpression or mutation have been elucidated in a variety of cancers, there has been no study in pancreatic cancer in Korea. The purpose of this study is to evaluate the expression rate of p53 protein in pancreatic cancer. In addition, we attempted to clarify the association between expression of p53 and clinicopathologic features including survival. Methods: Using immunohistochemistry with monoclonal antibody to p53(Zymed Lab. Clone No. BP53-12), we exained 47 formalin-fixed paraffin-embedded tissues of pancreatic cancer(39 intraductal adenocarcinoma, 8 rnucinous adenocarcinoma) for overexpres- sion of p53 gene product. Results: Positive nuclear p53 immunoreativity was detected in 44.6% of pancreatic cancer. No clear correlation was found between p53-positive immunostaining and clinicopathologic features such as age, sex, tumor size, location, histologic type, differentiation of tumor cells and stage of tumnor, etc. The mean duration of survival was 8.6 months in the group of p53 positive and 9.6 months in the group of p53 negative and no difference was noted between two groups. Conclusions: These results suggest that mutation of p53 tumor suppressor gene may play a role in the pathogenesis of pancreatic cancer. However there was no correlation between the presence of p53 overexpression and clinicopathologic features or survival. (Korean J Gastroenterol 1997; 30:98 - 102)

한국인 위암에서 Survivin과 HIAP-1 유전자 발현

박찬진,류승완,김인호,백원기,서성일,서민호,손수상,Park Chan Jin,Ryu Seung Wan,Kim In Hoo,Baek Won-Ki,Suh Seong-Il,Suh Min-Ho,Sohn Soo Sang 대한위암학회 2003 대한위암학회지 Vol.3 No.1

Purpose: Dysregulation of apoptosis may attribute to development of cancer by abnormally prolonging cell viability with accumulation of transforming mutations. Survivin and HIAP (Human Inhibitors of Apoptosis)-1 were recently described as apoptosis inhibitors. Their pathogenic roles in gastric cancer are largely unknown. In the present study, we examined the expression of survivin and HIAP-1 in gastric cancer tissues and cell lines in order to elucidate the roles of survivin and HIAP-1 in the process of gastric carcinogenesis. Materials and Methods: Eight gastric cancer cell lines and five gastric cancer tissues were studied. The expression of survivin and HIAP-1 were evaluated by reverse transcription -polymerase chain reaction (RT-PCR), immunohistochemistry, and Western blot. Results: Western blot and RT-PCR analysis revealed survivin and HIAP-1 expression in all gastric cancer cell lines. Increased expression of survivin and HIAP-1 were found in all cases of gastric cancer tissues compared to normal tissues by Western blot analysis. In immunohistochemical analysis tumor cells were stained with anti-survivin and anti-HIAP-1 antibodies. Cell cycle dependence of survivin expression was preserved in gastric cancer cell lines. Conclusion: The results indicate that increased expression of survivin and HIAP-1 genes may play an important role in gastric cancer.

백서에서 유발시킨 역류성 식도염에서 지질 과산화와 Glutathione 의 의미

박효진(Hyo Jin Park),김정환(Jung Hwan Kim),김혜영(Hye Young Kim),정준근(Joon Keun Jung),이상인(Sang In Lee),박인서(In Suh Park) 대한소화기기능성질환·운동학회 2001 Journal of Neurogastroenterology and Motility (JNM Vol.7 No.2

N/A The role of oxygen-derived free radicals has been studied in acute gastric and esophageal mucosal injury. Objectives: The aim of this study was to determine whether acid reflux causes oxidative stress in the esophageal mucosa and to investigate the correlation between mucosal glutathione (GSH) levels as an endogenous free radical scavenger and lipid peroxidation. Methods: Eight-week-old male Sprague-Dawley rats with a bodyweight of 250-300 g were used for the experiments. Acid reflux was caused by pyloric ligation. The sham operation included a midline laparotomy and served as controls. After 24 hr all rats were killed and esophageal samples were taken for measurement of gross mucosal injury and mucosal GSH level. Lipid peroxidation which is a marker of oxidative stress was determined by measuring the formation of thiobarbituric acid-reactive substances (TBARS) spectrophotometrically. Results: Severe mucosal damage was noted in reflux group. TBARS level was 6 times greater in reflux group compared to the control group (P<0.05), while GSH level was 4 times less in reflux group compared to the control group (P<0.05). Increase of TBARS level and decrease of GSH level showed a strong correlation to the gross findings of esophageal mucosal damage in reflux esophagitis. Conclusions: Oxygen-derived free radicals are of pathophysiologic importance in esophagitis caused by acid reflux. (Korean Journal of Gastrointestinal Motility 2001;7:175-180)

경련성 골반상 증후군의 임상적 연구

박효진(Hyo Jin Park),조재식(Jae Sik Cho),배희동(Hee Dong Bae),정준표(Jun Pyo Chung),이상인(Sang In Lee),박인서(In Suh Park),지훈(Hoon Ji),손승국(Seung Kook Sohn) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.3

N/A The spastic pelvic floor syndrome is a functional disorder due to abnormal contraction in- stead of relaxation of the pelvic floor muscle during straining. This inhibits defecation and gives rise to constipation. We carried out the clinical and psychologic analysis, defecogram, electrophysiologic tests, and treatment in 17 patients with spastic pelvic floor syndrome. The mean age of patients was 48.2+10.1 years. The male to female ratio was 1:7.5. Prirnary com plaints were incomplete evacuation 82.3%, constipation 52.9%, tenesmus 41.2%, straining 41.2 %, and dysuria 29.4%. The patterns of personality using the MMPI showed somatization type in 7 cases and psychophysiologic reaction type in 4 cases. Defecogram revealed paradoxical contraction of puborectalis in 100.0% of cases,incomplete evacuation 76.5%, rectocele 58.8%, incontinence 17.6%, intussusception 5.9%, and excessive pelvic floor descent 5.9%. The ano- rectal angle in patients did not increase during straining and rernained about 90. The mean maximum resting and squeezing anal canal pressures were 94.4 + 48.4mmHg, and 136.4 + 28.8 mmHg. Seven patients(70.0%) were unable to expel a balloon. The pudendal neuropathy re- vealed in 4 patients(40.0%). Seven patients underwent a EMCr-based biofeedback therapy. Four among them(57.1%) had increased bowel frequency and improved the symptom of in- complete evacuation. In conclusion, careful history taking, physical examination and colorectal motility tests perrnit diagnosis of spastic pelvic floor syndrome. This disease is related with incoordination of pelvic floor muscle, so treatment should be aimed at restoration of normal muscle function through biofeedback.(Korean J Gastroenterol 1994; 26: 482 490)

장중첩증이 (腸重疊症) 동반된 대장지방종 (大腸指肪腫)

박인서 ( In Suh Park ),박찬일 ( Chan Il Park ),이경식 ( Kyung Sik Lee ),김기황 ( Ki Whang Kim ),최흥재 ( Heung Jae Choi ),양주영 ( Joo Young Yang ),박창윤 ( Chang Yoon Park ),윤용광 ( Yong Dwang Yoon ) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.1

Excluding adenomataus polyps, lipomas represent the most common benign tumor of the colon. But lipomas of gastrointestinal tract are rarely encountered, and when seen they are usually an incidental finding at autopsy or operation. When small, these tumors are frequently asymptomatic. Constipation and colicky abdominal pain in wax and wane pattern are frequent symptoms in the larger tumor and intussusception is the main complication of the lipomas. A few hundreds of gastrointestinal lipomas were reported in the world, but only 6 cases of it were found in the literature in Korea. A case of lipomas in colon associated with intussusception in a 36-year-old woman and a brief review of the literature were presented.

만성 특발성 변비증의 임상적 고찰

박효진(Hyo Jin Park),이찬희(Chan Hee Lee),정준표(Jun Pyo Chung),이관식(Kwan Sik Lee),이상인(Sang In Lee),박인서(In Suh Park),손승국(Seung Kook Sohn),지훈(Hoon Ji),강성웅(Seoung Woong Kang) 대한내과학회 1994 대한내과학회지 Vol.46 No.5

N/A Objectives: As nonorganic, or functional factors play an important etiopathogenetic role in chronic constipation, we have reviewed functional tests on patients with chronic idiopathic constipation. Results of investigation and subsequent proper treatment are suggested. Methods: Clinical assessment, colonic transit, defecogram, anorectal manometry and pelvic floor electrophysiologic tests were performed in 30 patients with chronic idiopathic constipation, Results: 1) The ratio of male to female was 1:4, and the mean age was 48.2 years. Primary complaints were incomplete evacuation (83.3%), abdominal fullness (70.0%), abdominal pain (70.0%), rectal bleeding (43.3%), nausea (33.3%), tenesmus (33.3%) and dysuria (20.0%). Hemorrhoids and melanosis coli were present in 70.4% and 11.1% of the patients respectively at colonoscopy. The types of personality using the Minnesota Multiphasic Personality Inventory showed somatization 50.0% and psycho- physiological reaction 41.7%. 2) Colonic transit studies identified three patterns: normal transit 38.9%, colonic inertia 22.2%, pelvic outlet obstruction 16.7%, and mixed type 22.2%. The mean transit time of total colon was 56.4±5.0 hr. in colonic inertia and mixed type. 3) Defecogram revealed rectocele 77.8%, incomplete evacuation 48.1%, paradoxical contraction of puborectalis 40.7%, rectal intussusception 25.9%, parietal rectal rigidity 11.1%, and excessive pelvic floor descent 11.1%. 4) The mean minimal sensory volume, anal sphincter length, maximum resting and squeeze anal pressure was 47.9±17.5 ml, 3.9±0.9 cm, 104.3±17.9mmHg and 156.4±15.0mmHg respectively. The anorectal inhibitory reflex was intact in all patients. 5) Electrophysiologic studies suggested pudendal neuropathy in 5 patients (27.8%). 6) The patients were treated by drug therapy 83.3%, biofeedback therapy 10.0% and operation 6.7%. Conclusion: From the above results, systematic diagnostic evaluation and proper treatment for the patients with chronic idiopathic constipation in view of functional motility disorder are required and treatment can be helpful particularly when directed by a multidisciplinary team approach.

기니 픽 회장 운동 기능에 미치는 Phosphodiesterase 4 형과 5 형 억제제의 효과

박효진(Hyo Jin Park),최성우(Sung Woo Choi),이영호(Yong Ho Lee),임정현(Jung Hyun Lim),이상인(Sang In Lee),박인서(In Suh Park) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.5

Background/Aims: Intracellular cAMP or cGMP is degraded by cyclic nucleotide phosphodiesterase ( PDE) . We hypothesized that PDE inhibitors modulate the peristalsis and nerve- induced responses of the smooth muscle of the guinea pig ileum. Methods: To examine the effect of rolipram ( type 4 inhibitor of PDE) and zaprinast ( type 5 inhibitor of PDE) , we measured peristaltic amplitude, area under curve ( AUC) , and frequency of contractions from ileal preparation using the peristaltic bath. The mechanical activity of the circular muscle was measured with a clip attached, via the three sites of serosal surface, to the underlying circular muscle of intact ileum in the peristaltic chamber. In another set of experiment, muscle strips from the ileum were stimulated by an electrical field. The effects of rolipram, and zaprinast, on peristalsis and nerve- induced contraction were explored. Results: The amplitude and AUC of peristaltic contractions were significantly decreased in rolipram or zaprinast-treated group and frequency of contractions was significantly delayed in rolipram or zaprinast-treated group. The nerve- induced contraction of smooth muscle was significantly decreased in rolipram-treated group. Conclusions: These observations suggest that PDEs may play a role in the modulation of peristaltic behavior of the ileum and PDE inhibitors may be used in the treatment of hyperkinetic bowel disorders. ( Korean J Gastroenterol 2002; 39: 343- 349)

간암세포주를 대상으로 한 체외 복합 항암제 감수성 검사

박인서(In Suh Park),정재복(Jae Bock Chung),김병수(Byung Soo Kim),김주항(Joo Hang Kim),노재경(Jae Kyung Roh),유내춘(Nae Chun Yoo),조재용(Jae Yong Cho),최진혁(Jin Hyuk Choi),임호영(Ho Yeong Lim) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.2

N/A Primary hepatocellular carcinoma(HCC) is one of the most common malignancies in Korea due mainly to high incidence of chronic hepatitis B virus infection. Most of the HCC are inoperable even at first presentation. So chemotherapy could be one of the major therapeutic modalities, but HCC is seldom chemosensitive. This type of chemoresistance is explainesd by high level of expression of multidrug resistance(MDR) gene and p-glycoprotein. We initiated this study to establish the in vitro model of drug selection and combination for HCC. Three human HCC cell lines and five cytotoxic drugs were used. MTT assays for cytotoxicity test were performed with single chemotherapeutic agent and various two drug combinations. Slot blot analysis for measuring the expression levels or MDR1 RNA was performed and demon strated that 2 HCC lines show moderate to high degree of MDRI expression, The ranges of drug concetration which causes 50% inhibition of the cell lines(IC50) are in the clinically achievable concentrations for the 5-fluorouracil in two HCC lines, and adriamycin in one cell line. Two cell lines which showed positive MDRI exression were resistant to adriamycin. But all three cell lines were sensitive to etoposide irrespective of MDR1 expression. In thelinically achievable concentration ranges those we tested, singnificantly improved cytotoxic effects are demonstrated in combinations of etoposide plus cisplatin, and etoposide plus mitomycin-C out of 10 possible two drug combinations. These data indicate the need for in vivo trials with the combination chemotherapy of etoposide plus cisplatin or etoposide plus mitomycin-C for HCC.

대장 흑색소증의 임상적 고찰

박인서(In Suh Park),문영명(Young Myoung Moon),정재복(Jae Bock Chung),이상인(Sang In Lee),김원호(Won Ho Kim),이관식(Kwan Sik Lee),정현주(Hyeon Joo Jeong),박효진(Hyo Jin Park),정준표(Jun Pyo Chung),박경아(Kyung Ah Park),남문석(Moon Suk 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5

N/A Melanosis coli associated with ingestion of anthraquinone compounds in laxatives is due to accumulation of macrophages containing brown lipofuscin-like pigments in the lamina propria. We analyzed the clinical, endoscopic, and pathologic findings and colonic motor functions of melanosis coli and performed electronmicroscopic study to know the ultrastructural changes of neural elements. We studied 13 cases (mean age 48.1 +- 18.5 years, male to female cases 6:7). The vegetable laxatives containing anthraquinone derivatives, aloe or bisacodyl were used mainly and the mean duration of laxative abuse was l.5 +- 1.2 years. Endoscopically, dark brownish mucosal disoloration showed polyhedral forms divided by fine striae of lighter color. Melanosis was more intense in the more oral part of the bowel. Pathologically, no relationship was found between grade of melanosis and kind of drugs, daily dose, or durat.ion of addiction. Ultrastructural features on nerve structure were ballooning of axon. reduction of nerve specific cell organelles, and increased lysosomal activity. The alterations of these neural elements are assumed to he associated with impaired colonic motility. In conclusion, vegetable laxatives such as aloe, seem to be an important causes of melanosis coli in Korea. melanosis coli have a tendency to damage nerve fibers. We should avoid laxative abuse in order to prevent pragressing to cathartic colon.