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담도 폐쇄로 인한 담도염 환자에 있어서의 담즙 내 세균에 대한 연구
성인경(In Kyung Sung),이규택(Kyu Taek Lee),이종균(Jong Kyun Lee),김영호(Young Ho Kim),이석호(Seok Ho Lee),송희정(Hee Jung Son),이준혁(Joon Hyoek Lee),이풍렬(Poong Lyunl Rhee),김재준(Jae Jun Kim),고광철(Kwang Chul Koh),백승운(Seung Wo 대한내과학회 1998 대한내과학회지 Vol.55 No.1
N/A has been focused on the Enterococcus due to increasing in incidence of nosocomial infection and resistance to broad range of antimicrobial agents of this organism The purpose of this study was to analyse the bacteriologic features of bile in patients with cholangitis. Methods : Bacteriological examination was made of bile from 356 patients with cholangitis due to biliary tract obstruction, 105 of them with common bile duct stone and 251 of them with malignant disease. Bile specimens were taken during percutaneous transhepatic biliary drainage of endoscopic nasobiliary drainage. The specimens were cultured aerobically and anaerobically and then the anti- biotic sensitivity test was done. Results: The overall positive culture rates was 81.4%. There was significant difference in positive culture rates between the patients with common bile duct stone and the patients with malignant disease,(88.5% vs 78.4%, p<0.05) But there was no significant difference in bacteriological features between the patients with common bile duct stone and the patients with malignant disease. The commonly isolated organisms were Enterococcus (21.6%), E.coli(19.7%), and Klebsiella(17.2%) respectively. The isolation rate of anaerobes were only 2%. The rate of polymicrobial infection was 78.1%. The rates of 3rd cephalosporins-resistant Klebsiella were over 30%. The rate of ampicillin-resistant Enterococcus was 35%. The rate of gentamicin-resistant Enterococcus was 28%. Conclusion : This study shows that 1) many micro- organisms have resistance to a broad range of antimicrobial agents, and 2) the antibiotic coverage against Enterococcus should be considered for the treatment of cholangitis due to the increasing tendency to Enterococcus infection.
경미한 담석췌장염 환자에서 복상경 담낭 절제술 시행전 역행성 담췌관 조영술은 필요한가?
이규택 ( Kyu Taek Lee ),이종균 ( Jong Kyun Lee ),박형석 ( Hyung Suk Park ),박상종 ( Sang Jong Park ),김지은 ( Jee Eun Kim ),김창섭 ( Chang Seop Kim ),성인경 ( In Kyung Sung ),심상군 ( Sang Ken Sim ),최윤호 ( Uoon Ho Choi ),백승운 대한췌담도학회 1999 대한췌담도학회지 Vol.4 No.1
The large majority of patients with gallstone pancreatitis have a mild course that is not altered by ERCP and endoscopic sphincterotomy, a more selective use of ERCP might be advisable. This study is designed to evaluate the efficacy of preoperative endoscopic retrograde cholangiopancreatography (ERCP) in patients with mild gallstone pancreatitis and to determine criteria predictive of common bile duct stones (CBDS). Methods: We analyzed the value of serum biochemical tests and findings of ERCP in patients with mild gallstone pancreatitis. Preoperatively, ERCP revealed CBDS in 6 of 47 (12.8%) patients with mild gallstone pancreatitis. Laboratory values on admission did not predict CBDS. Persistent hyperamylasemia and increased serum ALT were associated with CBDS. It is unnecessary to perform preoperative ERCP in patients with mild gallstone pancreatitis who have a normalization of serum amylase and liver function tests.
Diclofenac에 의한 백서의 장손상 모델에서 젖소초유의 효과
김정욱 ( Jeong Wook Kim ),전우규 ( Woo Kyu Jeon ),전한별 ( Han Byul Chun ),김영춘 ( Young Choon Kim ),윤중원 ( Jung Won Yun ),박동일 ( Dong Il Park ),조용균 ( Yong Kyun Cho ),성인경 ( In Kyung Sung ),박창영 ( Chang Young Park ) 대한내과학회 2004 대한내과학회지 Vol.67 No.1
목적: 비스테로이드성 항염제는 만성관절염, 통증, 발열 등에 가장 흔히 사용되는 약물이지만 소장을 포함한 전 위장관에 걸쳐 손상을 유발하여 출혈이나 단백소실 등이 발생한다. 비스테로이드성 항염제에 의한 소장손상을 유발하는 인자로는 소장 상피의 장벽 장애와 장내세균의 과증식 등이 제시되어 왔으며 초유는 출산 후 처음으로 얻어지는 우유로 각종 성장인자들과 면역글로불린 및 항균성 펩티드들이 풍부하게 함유되어 있다. 본 연구에서는 실험동물에서 지방질을 제거한 Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed medicine but induce damage throughout the entire gastrointestinal tract including small intestine with protein and blood loss. Impaired epithelial barrier function, overgro
김정욱 ( Jeong Wook Kim ),전우규 ( Woo Kyu Jeon ),장세경 ( Sae Kyung Chang ),이정안 ( Jung Ahn Lee ),박동일 ( Dong Il Park ),조용균 ( Yong Kyun Cho ),성인경 ( In Kyung Sung ),손정일 ( Chung Il Sohn ),김병익 ( Byung Ik Kim ),김은정 대한내과학회 2004 대한내과학회지 Vol.67 No.6
목적 : 장관장벽 이상은 폐색성 담관질환에서 발생하며 장내세균전위나 장관내독소혈증과 같은 감염성 합병증을 유발 한다. 본 연구에서는 폐색성 담관질환에서 장관장벽 이상과 임상양상과의 관계를 알아보았다. 방법 : 건강대조군 18명, 양성질환에 의한 폐색성 담관질환자 20명, 악성질환에 의한 폐색성 담관질환자 21명에서 장투과성 검사를 실시하였으며 질환군간 차이와 각종 임상양상과 연관성을 비교하였다. 장투과성 검사는 51Cr-EDTA (51Cr-ethylen Background : Gut barrier dysfunction occurs in experimental models and humans of obstructive biliary disease. This phenomenon promotes infectious complications including bacterial translocation and intestinal endotoxemia. The aims of this study were to ex
위장관 11 : Helicobacter pylori 의 치료에 있어서 일주일간이 3 제병합요법의 제균 효과에 관한 전향적 무작위 연구
김영호(Y . H . Kim),김재준(J . J . Kim),성인경(I . K . Sung),손희정(H . J . son),이규택(Kyu Taek Lee),이풍렬(Poong Lynl Rhee),고광철(K . C . Kho),백승운(Semg Woon Paik),이종철(Jong Chul Rhee),최규완(Kyoo Wan Choi) 대한소화기학회 1998 대한소화기학회 추계학술대회 Vol.1998 No.-
위장암 : 대장암에서 HER-2/neu 발현에 관한 연구
박동일 ( Dong Il Park ),오석중 ( Suk Joong Oh ),박승하 ( Seung Ha Park ),윤중원 ( Jung Won Yun ),김홍주 ( Hong Joo Kim ),조용균 ( Yong Kyun Cho ),성인경 ( In Kyung Sung ),손정일 ( Chong Il Sohn ),전우규 ( Woo Kyu Jeon ),김병익 ( B 대한소화기학회 2004 대한소화기학회지 Vol.44 No.3
목적: HER-2/neu 단백은 상피성장인자 수용체와 구조가 거의 일치하기 때문에 정상 세포의 성장과 증식 과정에 관여한다. 유방암에서 HER-2/neu의 과발현은 나쁜 생존율을 예상할 수 있는 예후인자일 뿐 아니라 항암화학요법이나 호르몬요법에 잘 반응하지 않는 등 치료에 대한 반응을 예측할 수 있는 인자이며 HER-2/neu에 대한 단일클론 항체인 Herceptin(R)은 림프절에 전이된 유방암 환자에서 장기 생존율을 향상시켜 임상에서 활발히 사용되고 Background/Aims: The HER-2/neu protein is involved in normal cell proliferation and tissue growth because it is extensively homologous and related to epidermal growth factor receptor. As a prognostic marker, HER-2/neu is used to forecast the clinical cour
건강검진 수진자에서 비알코올성 지방간 및 간기능 장애 인슐린 저항성과의 관계
박승하 ( Seung Ha Park ),김병익 ( Byung Ik Kim ),유태우 ( Tae Woo Yoo ),김정욱 ( Jeong Wook Kim ),조용균 ( Yong Kyun Cho ),성인경 ( In Kyung Sung ),박창영 ( Chang Young Park ),손정일 ( Chong Il Sohn ),전우규 ( Woo Kyu Jeon ),이원 대한소화기학회 2003 대한소화기학회지 Vol.41 No.5
Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is one of the major causes of the elevation of aminotransferase when other causes of liver disease are excluded. Insulin resistance is an essential pathophysiologic factor in the development of NAFLD and metabolic syndrome. We hypothesized that there would be an association between the elevation of aminotransferase and metabolic syndrome. Methods: A total of 6,244 health screen examinees (3,975 men, 2,269 women) with no evidence of viral hepatitis and alcohol abuse were enrolled in this study. We assessed the clinical characteristics using liver function test (LFT) and ultrasonography. Homeostatic model assessment (HOMA) was used as an index of insulin resistance. Results: According to the increment of HOMA, the prevalence of abnormal liver function significantly increased after adjustment with age, sex, and obesity (p<0.01). Abnormal liver function remained as an independent risk factor for metabolic syndrome in both sexes after logistic multiple regression analysis with age and body mass index (p<0.001 in male, p<0.05 in female). Conclusions: The abnormal liver function was closely associated with insulin resistance. Thus, it can be an independent risk factor for metabolic syndrome. Index of insulin resistance such as HOMA may serve as a good parameter for follow-up during the treatment of NAFLD. (Korean J Gastroenterol 2003;41:366-373)
기능성 소화불량증 환자의 위내용물 배출시간에 대한 연구
함준수(Joon Soo Hahm),박경남(Kyung Nam Park),이민호(Min Ho Lee),기춘석(Chun Suhk Kee),이종철(Jong Chul Rhee),강인구(In Koo Kang),성인경(In Kyung Sung),김종필(Jong Pil Kim),이규택(Kyu Teak Lee) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.3
N/A It has been reported that more than three-quarters of patients with dyspepsia were diagnosed to have functional dyspepsia. But the causes of this syndrome are unknown. Therefore, to evaluate the relationship between the gastric motor activity and functional dyspepsia, we compared the gastric emptying time (GET) in patients with functional dyspepsia with that in normal contrals. The study population consisted of 165 patients with functional dyspepsia admitted to or attending Hanyang University Hospital and 20 volunteers from the the beginning of Feb. 1989 to the end of June 1991. We measured gastric emptying rate for 150 minutes using radionuclide scintiscan of an Tc-labeled chicken liver. The m#ean GET (T1/2) was 84.9+-16.4 min in normal controls. In 165 patients, 94 patients (57%) showed delayed gastric emptying, whereas 71 patients (43%) showed normal gastric emptying. The median age for patients with functional dyspepsia was 41 years. Women outnumbered men in patients with functional dyspepsia (2:1). There were no statistical differences in scores of upper gastrointestinal symptoms. Gastric emptying time was delayed in 57% of patients with functional dyspepsia and women outnumbered men two folds. Also our results showed the.t the scores of upper abdominal symptoms cannot be helpful in diagnosing the underlying gastric motility disturbances.
B형 간염바이러스 감염에서 불투명 유리상 간세포(Groundglass hepatocyte)의 원인으로서 pre-S1 변이종의 의의
조용균 ( Yong Kyun Cho ),김병익 ( Byung Ik Kim ),배지철 ( Ji Cheul Pae ),박승하 ( Seung Ha Park ),김상훈 ( Sang Hoon Kim ),박정호 ( Jung Ho Park ),김홍주 ( Hong Joo Kim ),박동일 ( Dong Il Park ),김향 ( Hyang Kim ),성인경 ( In Kyu 대한내과학회 2005 대한내과학회지 Vol.69 No.4
목적 : 불투명 유리상 간세포는 만성 간염 환자에서 나타나는 독특한 조직학적 특징이다. HBV의 LHBs 중 pre-S1 지역은 HBsAg의 조립(assembly), 처리(processing) 및 분비를 조절하는 것으로 알려져 왔다. 본 연구의 목적은 간세포 내에서 HBV pre-S1 유전자의 변이가 정상 분비 경로의 영향과 불투명 유리상 간세포의 반응에 대해 알아보고자 하였다. 방법 : 만성 B형 간염 판정을 받은 HBeAg 양성 환자로부터 pre-S1 region을 포함한 HBV 염기 배열을 조사하였다. 환자의 간조직과 혈액내 존재하는 바이러스 유전자를 조사하고자 간조직을 얻어 파라핀으로 고정시켰고, 환자의 간조직내 불투명 유리상 간세포를 분리하기 위해 파라핀으로 고정된 간조직으로부터 일부 조직을 anti-HBs 항체로 염색 후 laser capture microdissection (LCM) 방법을 이용하여 불투명 유리상 간세포를 추출하였다. 추출된 anti-HBs 항체에 염색된 불투명 유리상 간세포와 정상 세포를 각각의 HBV DNA 유전자 서열을 분석하였다. 변이형의 HBsAg 분비를 측정하기 위해 변이형을 야생형의 클론에 삽입하였고 ELISA에 의해 transfected된 세포의 부유물에서 HBsAg의 발현을 관찰하였다. 결과 : 혈청에서 분석된 12 클론 중 9개의 클론은 HBV envelope 단백의 분비와 축적에 중요한 역할을 하는 pre-S1 단백 중 N-terminal 지역에서 염기서열이 모두 동일한 야생형으로 나타났다. 이런 야생형 클론의 하나에서 pre-S2 지역 안에 결실은 가지고 있었다. 불투명 유리상 간세포에서 정상 간세포에 비해 변이형이 우세하였고, 정상 간세포에서는 야생형이 더 우세하였다. 결론 : HBV pre-S1 단백의 변이형이 불투명 유리상 간세포의 형성에 영향을 주는 것을 알 수 있었다. 비정상적인 pre-S1 단백의 표현은 간세포 안에 이들 단백질의 축적 및 간세포 손상을 야기 시킬 것으로 생각되며 좀 더 많은 연구가 필요할 것으로 사료된다. Background : Ground glass hepatocytes are unique histological feature of chronic hepatitis B viral infection. The pre-S1 region of large surface protein has been shown to regulate assembly, processing, and secretion of HBsAg. The purpose of this study was to elucidate that a mutant form of pre-S1 affects this normal secretory pathway and is responsible for ground glass hepatocyte. Methods : We examined HBV sequences spanning the pre-S region from a patients with HBeAg positive chronic HBV infection. HBV DNA was extracted from serum, cloned, and sequenced and determined the intrahepatic viral composition by extracting HBV DNA from paraffin embedded liver tissue. To analyze the viral population of single groundglass hepatocytes, we used the technique of laser capture microdissection to isolate individual hepatocytes from biopsy specimen. Groundglass hepatocytes that stained positively with anti-HBs and normal hepatocytes were harvested individually and their subjected HBV DNA sequences were analyzed. To define the responsible mutations for the HBsAg secretion, we introduced the mutant gene into molecular clone of wildtype (adwR9) and assayed their HBsAg amounts in the transfected cell supernatants by ELISA. Results : Of 12 clones in serum analyzed, 9 clones had identical wild type sequences in the N-terminal region of the pre-S1 protein which plays an important role in the secretion and retention of HBV envelope proteins. One of the wild type clones has deletion within pre-S2 region. 3 identical mutant clones were isolated. Mutant type clones were predominant groundglass hepatocytes. Conclusions : We speculate that a mutant form of the HBV pre-S1 protein may result in the formation of ground-glass hepatocytes. Expression of abnormal pre-S1 may lead to its retention and accumulation within hepatocytes.(Korean J Med 69:357-363, 2005)