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)

Helicobacter pylori 감염의 혈청학적 진단 - HM-CAP과 GAP 검사의 진단적 가치 비교

홍성표(Sung Pyo Hong),박효진(Hyo Jin Pack),박인서(In Suh Park),이경원(Kyung Won Lee),김호근(Ho Guen Kim) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.2

N/A Background/Aims: We have compared the sensitivities and specificities of two commercial serological enzyme-linked immunosorbent assays(ELISA) for the diagnosis of Helicobacter pylori infection. Methods: GAP(Bio-Rad) test to detect IgG antibody against H. pylori outer membrane antigen and HM-CAP(Epl) test against high molecular weight cell-associated proteins of H. pylori were used in 87 patients(chronic superficial gastritis 24 patients, gastric erosion 33 patients, gastric ulcer 1S patients, duodenal ulcer 1 l patients, and gastric and duodenal combined ulcer 4 patients). The presence of H. pylori was established when the results of histology of the gastric biopsies taken were positive. Negative for H. pyk>ri infection was determined when H. pylori in histology was abscent and also rapid urease test(CL.O te.t) was negative. When H. pylori was absent microscopically but positive in CLO test, it was regarded as indeterminate. Results: Sixty-three patients(72.4%) were positive f'or H. pylori infection, 16 patients(18.4%) were negative and 8 patients(9.2%) were indeterminate. Sensitivities and specificitie. Were 89% and 50% for HM-CAP test, l00% and 19% for GAP test, respectively. Conclusion: GAP test was very sensitive but non- specific. HM-CAP test was less sensitive than GAP test, but more specific than GAP test. (Korean J Castroenterol 1995;27:167 - 173)

췌장암환자에서 발생된 담즙낭종

조현근(Hyeon Geun Cho),정준표(Jun Pyo Chung),박효진(Hyo Jin Pack),윤영원(Young Won Yoon),신은택(Eun Tack Shin),전재윤(Chae Youn Chon),박인서(In Suh Park),김기황(Ki Whang Kim) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.6

The term Biloma was introduced by Gould and Patel to describe encapsulated extrahepatic collections of bile in 1979, and has subsequently been expanded to include intra- hepatic bile collections. Various imaging modalities have been utilized to identify bilomas, in- cluding computerized tomography, ultrasonography, magnetic resonance imaging and radionucleotide studies. Needle aspiration is essential to confirm the diagnosis. Most of biloma resulted from biliary ductal disruption due to abdominal surgery or trauma. Less frequently bilomas have also been reported in association with hepatoma, gall bladder cancer and bile duct pathology. Recently we experienced a case of biloma developed spontanceously in a pa- tient with pancreatic cancer presenting as acute pancreatitis and report with a review of liter- atures.(Korean J Gastroenterol 1994; 26: 1053 1057)

대망에 발생한 원발성 평활근육종

이상인(Sang In Lee),김기황(Ki Hwang Kim),남수연(Su Youn Nam),박효진(Hyo Jin Pack),이희대(Hee Dai Lee),정우희(Woo Hee Jung) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5

Although the greater omentum is frequently the site of metastatic neoplasm, primary omental tumors are exeedingly rare. The authors report here, a case of primary omental leiomyosarcoma presented initially as a palpable abdominal mass and epigastic discomfort for one year in a 66 year-old rnale patient. At laparotomy, 21*15*2.5 cm rnass weighing 600 gram was found in the omentum which was adherent to the anterior wall of the lower body of the stomach and liver surface. In the histologic findings presence of tumor necrosis, increased cellularity, cellular atypia and pleomorphism as well as large size of mass were indicative of leiomyosarcoma. Surg cal resection has been known to be the principle treatment for this disease, In this case, excision of the tumor with omentectomy, radical subtotal gastrectomy and wedge resection of the liver were performed. Eight months later, a recurrence was detected and chemotherapy with doxorubicin, dacarhazine, vincris- tine, and cyclophosphamide was done.

복통으로 내원한 Behcet병 환자에서 진단된 연중독

남문석(Moon Suk Nam),정준표(Jun Pyo Chung),이홍우(Hong Woo Lee),오제열(Je Yol Oh),박효진(Hyo Jin Pack),이관식(Kwan Sik Lee),이상인(Sang In Lee),박인서(In Suh Park),이안나(An Na Lee),송경순(Kyung Soon Song) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.2

Behcets disease is a systemic disease involving skin, joint, gastrointestinal tract, vascular and nervous systems, characterized by recurrent oral and genital ulcerations and ocular in- flammation. The intestinal Behcets disease has nonspecific abdominal symptoms of colicky pain, constipation, diarrhea, nausea, vomiting, and malabsorption. Therefore, we need to dif- ferentiate with other diseases having nonspecific abdominal symptoms. We have experienced a case of lead intoxication after ingestion of herbal pills believed to contain lead compounds. A 40 year-old female with known Behcet's disaese was admitted due to acute colicky abdominal pain. The cause of abdominal pain and anemia was investigated and intestinal Behcets disease was ruled out. The diagnosis of lead intoxication was made by careful history, clinical manifestations, and various laboratory findings including peripheral blood smear, bone marrow aspiration and biopsy, serum lead and free erythrocyte protoporphyrin levels. W e also used lead mobilization test for measure of chelatable lead level. The treatment was performed with 4 courses of EDTA infusion therapy and the clinical symptoms and chemical data associated with lead intoxication improved.(Korean J Gastroen- terol 1994; 26: 399 404)

Helicobacter pylori 감염과 세포증식 및 세포사멸간의 관계

이상인,박인서,이관식,정상수,정병천,박효진,채보원 대한소화기학회 1998 대한소화기학회지 Vol.32 No.4

Background/Aims: Many studies have shown that Helicobacter pylori (H. pylori) infection is associated with gastroduodenal diseases. The pathogenic effects of H. pylori are associated with cytokine production, cell cycle progression, cellular proliferation and apoptosis. We performed this study to investigate the effect of H. pylori eradication on gastric mucosal cell apoptosis and proliferation. Methods: Gastroduodenoscopy was performed for 42 cases. Twenty two of them showed H. pylori-positive gastritis and the other 20 cases showed H. pylori-negative normal mucosa. H. pylori infection was assessed by rapid urease test and histology of biopsy specimens from gastric antrum. Ki-67 immunostaining of gastric biopsy specimens was used to measure mucosal cell proliferation in H. pylori positive gastritis before and after therapy. DNA frapnentation with terminal deoxynu- cleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling method was used for a marker of apoptosis. Results: Apoptosis was increased in gastric mucosal epithelium of patients with H. pylori-positive gastritis (p$lt;0.05). H. pylori eradication therapy reduced apoptosis in antral mucosa (p$lt;0.05) and the cell proliferation levels (p=0.051). Conclusions: Induction of apoptosis in gastric epithelium by chronic stimulation of H. pylori could be involved in the pathogenesis of gastroduodenal diseases.

개의 실험적 췌외분비부전에서 세균성 Lipase의 용량 및 제형이 위배출에 미치는 영향

이상인,강진경,문영명,정재복,이세준,정준표,이관식,송시영,박효진,DiMagno, eugene P . 대한소화기학회 1999 대한소화기학회지 Vol.34 No.4

Background/Aims: There are few reports about the changes of gastric emptying (GE) in canine exocrine pancreatic insufficiency (EPI). In this study, we would like to determine whether bacterial lipase (BL) containing lipolytic activity alters GE in a dose-dependent way, different formulations of BL have different dose responses, and GE is affected by fat absorption. Methods: Five dogs underwent ligation of pancreatic ducts and insertion of duodenal cannulas. Perfusion and 72-hr fecal balance studies were performed while a high fat meal (fat 43%) was given. Powder or microtablet shaped BL were given at doses ranging from 0 to 400×103 IU. GE of liquid and solid meal markers was evaluated by total delivery (% total amounts delivered to duodenum), AUC (area under curve), T10 and T50 (minutes for 10% or 50% of ingested markers to arrive in duodenum). Results: GE of liquid meal marker was delayed in a dose-dependent way, but showed no formulation dependency. GE of solid meal marker was also delayed in dose-dependen way. Fat absorption was associated with delay of GE of liquid meal marker but it is not associated with GE of solid meal marker (p=0.0013). Conclusions: In dogs with EPI which took a high fat diet, GE of liquid and solid meal is delayed in a dose-dependent way, but not in formulation-dependent way. In addition, delay of GE of liquid meal correlates with fat absorption.

뇌실내 Thyrotropin - releasing Hormone이 위배출 기능에 미치는 영향

김영수,김경환,강진경,박인서,김범수,박효진 대한소화기학회 1998 대한소화기학회지 Vol.32 No.4

Background/Aims: Gastric emptying is dependent on nutritive and physical charaeteristics of the ingested material, and external influences including extrnsic nerve supply, specific peptide hormone and neurotransmitters, Thyrotropin-releasing hormone (TRH) is one of the peptide hormones in the brain and is distributed in the brain part that controls gut motility. Recent studies have suggested the possibility that TRH is involved in central nervous regulation of gastric function. In the present study, we investigated the effects of intracerebroventricular (icv) administration of TRH on the gastric emptying in rats using acetaminophen absorption technique. Methods: Polyethylene tube was inserted into rat lateral ventricle which is restrained by stereotaxic apparatus. TRH was injected into lateral ventricle via tube 5 minutes before acetaminophen administration. Blood samples were collected 15, 30, 45, 60, 90, and 120 minutes after acetaminophen administration. Results: The icv injection of TRH enhanced gastric emptying, whereas intravenous injection exerted no effect. TRH-enhanced gastric emptying was blocked by atropine. Desipramine, which blocks the reuptake of norepinephrine into nerve terminal, exerted no effect on TRH-enhanced gastric emptying. Inhibition of gastric acid secretion by cimetidine exerted no effect on TRH-enhanced gastric emptying. Conclusions: TRH enhances gastric emptying by central nervous action which is mediated, in part, by cholinergic pathway.

정상 성인에서 대장통과시간에 영향을 미치는 인자

이상인,조준식,최준영,이혜리,이송미,박인서,김기황,박효진,조항석 대한소화기학회 1999 대한소화기학회지 Vol.34 No.3

Background/Aims: Measurement of colonic traznsit time with radio-opaque markers is used publically for diagnosis and treatment of the disease caused by constipation. It is well known that sex, age, and dietary fz iber are contributing factors of colonic transit. On the other hand, the body mass index (BMI) affects only on the gastric motility. We aimed to clarify correlation between colonic transit time and sex, age, daily diet or BMI. Methods: Fifty-six healthy volunteers were studied (men 26, women 30, age 39.3±15.6 years). The volunteers recorded the diet diary for 3 days. Then, on basis of the diet diary, we assessed the amount of carbohydrate, protein, fat, fiber, vitamin, minerals. Using the Metcalfs method, the colonic transit time was assessed. Results: Total colonic transit time was 26.6±19.1 hrs (men 15.0±12.9, women 35.9±18.2). Men revealed a significantly shorter colonic transit time than women (p$lt;0.05). There was a tendency to shorten colonic transit time with aging. BMI and the amount of carbohydrate, protein, fat, fiber, vitamin, and minerals showed no correlation with colonic transit time. Conclusions: We conclude that women are found to have a significantly longer colonic transit time than men in the case of healthy normal adults, however the other factors including BMI and diet are not correlated with colonic transit time.