위점막에서 Helicobacter pylori 분포의 내시경적 진단

주영은(Young Eun Joo),김신묵(Sin Mook Kim),김태두(Tae Du Kim),신동현(Dong Hyun Sin),성종호(Jong Ho Seong),안영주(Young Joo Ahn),정용환(Yong Hwan Jeong),양대현(Dae Hyun Yang),유종선(Chong Sun Rew),윤종만(Chong Mann Yoon) 대한내과학회 1994 대한내과학회지 Vol.46 No.1

N/A Background: Since the successful isolation of Helicobacter pylori from the human gastric mucosa by Warren and Mashall, biosy studies have shown that this organism is closely related to chronic gastritis and peptic ulcer. However the distribution of this organism has been proved to be uneven and patchy on the gastric mucosa. The aim of this paper is to assess the distribution of this organism on human gastric mucosa in vivo by endoscopy. Method: To control the gastric pH around 4.0 to 6.0, premedication by the intravenous injection of ranitidine 50mg one hour before the endoscopy, was performed. And thereafter, 0.1% phenol red solution containing 0.5M urea was sprayed onto the mucosal surface of the stomach through the endoscope. A red color change was observed in a few seconds after spraying the phenol red solution. The red color change pattern was classified into three types: diffuse, regional and patchy type. Two biopsies were taken from the red color changed area and the unstained area for hitological and bacteriological study. Results: l) In 26 out of 33patients with chronic gastritis, the red color change was observed after spraying the phenol red solution. The diffuse, regional and patchy type in chronic gastritis patients were observed in 17, 5, 4 patients respectively. In peptic ulcer group, the diffuse type was observed in 6 and the regional and patchy type were observed in 3, 1 patients. 2) The bacteriological and histological identification of Helicobacter pylori was observed in 17 of 26patients (65.4%) With Chronic gastritis and 7 Of 10patiCIltS (70%) with peptic ulcer in the biopsy materials taken from the gastric mucosa showing a red color change with phenol red solution. But the organism was not found in the unchanged and unstained mucosa except for one case of chronic gastritis. Conclusion: These results suggest that this endoscopic spraying technique may be useful to determining the distribution of Helicobacter pylori in human gastric mucosa.

철 이온의 전기적 산화,환원 반응과 과산화수소수를 이용한 산업폐수의 1,4-Dioxane 처리에 관한 연구

김판수(Pan Soo Kim),손한형(Hang Hyung Son),이상호(Sang Ho Lee),신동현(Dong Hyun Sin) 대한환경공학회 2006 대한환경공학회 학술발표논문집 Vol.2006 No.12

O3/H2O2 반응 및 철 이온의 전기적 산화,환원 반응과 과산화수소수를 이용한 산업폐수의 1,4-Dioxane 처리에 관한 연구

김판수 ( Pan Soo Kim ),손한형 ( Han Hyung Son ),이상호 ( Sang Ho Lee ),신동현 ( Dong Hyun Sin ) 한국물환경학회 2006 한국물환경학회·대한상하수도학회 공동 춘계학술발표회 Vol.2006 No.-

한국 성인에서 C 형 간염바이러스 항체 양성율에 관한 고찰

한상우(Sang Woo Han),박용욱(Yong Uk Park),김신묵(Sin Mook Kim),신동현(Dong Hyun Shin),서순팔(Soon Pal Suh),양동욱(Dong Wook Ryang),김세종(Sei Jong Kim) 대한내과학회 1994 대한내과학회지 Vol.47 No.6

N/A Objectives : HCV, which is well known major cause of posttransfusion hepatitis, is single strand RNA virus. ELISA to anti-HCV was developed in 1989 and has been used widely after that. There were a lot of studies about positivity of anti-HCV which supposed the prevalence of HCV in Korea. Subjects of previous studies were restricted in healthy blood donor or patients with liver diseases. It was hard to evaluate the prevalence of HCV in whole population. We studied the positivity of anti-HCV in Korean adults, Methods : We studied the positivity of anti-HCV (by EIA method) and the relationship with HBsAg, ALT or age in 1,D13 Korean adults. Results : 1) The positivity of anti-HCV was 0.9% (9 of 1013). 2) There was no difference in the positivity of anti-HCV by the sex: 0.9% in male (6/695) and female (3/318). But it increased with age: 0.4% in 3rd decade, 0.6% in 4th decade, 0.8% in 5th decade, and 2.5% in 6th decade. 3) Of 9 anti-HCV positive cases, serum ALT level was up to 40 U/L in 8 cases, but serum ALT was 65 U/L in one case. 4) The positivity of HBsAg was 59 (51 of 1,013), but HBsAg was negative in 9 anti-HCV positive cases. Conclusion : The positivity of anti-HCV in Korean adults was regarded to be lower than l% and it in- creased with age.

구두발표 : 고도산화처리 ; O3/H2O2 반응 및 철 이온의 전기적 산화,환원 반응과 과산화수소수를 이용한 산업폐수의 1,4-Dioxane 처리에 관한 연구

김판수 ( Pan Soo Kim ),손한형 ( Hang Hyung Son ),이상호 ( Sang Ho Lee ),신동현 ( Dong Hyun Sin ) 대한상하수도학회 2006 공동춘계 학술발표회 논문집 Vol.2006 No.-

갈색세포종의 임상적 고찰

신동현,김신곤,김동림,김난희,최경묵,백세현,최동섭,서성옥 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.4

연구배경: 갈색세포종은 부신 수질과 교감신경절 또는 침크롬성조직이 있는 곳에서 발생하는 종양으로 카테콜아민을 생성, 저장 및 분비를 함으로 고혈임이나 심계항진, 발한, 두통 등 발작 증상을 특징적으로 나타낸다. 정확한 진단 및 적절한 약물, 수술 요법으로 효과적인 치료를 할 수 있으나 비특이적인 증상들로 인해 진단, 치료에 어려움을 겪는 질환이기도 하다. 이에 본 교실에서 최근 10년간 경험한 갈색세포종 환자들을 대상으로 임상적 소견 및 수술 후 혈압변동 등을 검토하였다. 방법: 부신에서 발생한 갈색세포종 29예와 부신경절종 16예 등 총 45예에 대해 임상 증상, 생화학적 검사, 수술전 처치 및 수술후 결과를 검토하였다. 결과: 총 45예 중 남자가 20예, 여자가 25예였으며, 평균 연령 43세로 30∼40대에 가장 많이 발생하였다. 임상 양상은 부신 종양은 고혈압, 두통, 심계항진, 내당능장애 순으로 많았고 부신외 종양은 복부통증, 고혈압 순이었다. 생화학 검사에서는 부신 종양에서 소변내 카테콜아민 및 그 대사물질의 민감도가 65에서 88%의 소견을 보였다. 종양은 우측 부신이 16예, 좌측 부신이 12예, 양측성이 1예였으며, 부신외 종양이 16예로 전체의 36%를 차지했다. 수술 전 고혈압을 보이던 환자 중 76%가 수술 후에 혈압이 정상화되었다. 결론: 갈색세포종은 고혈압 등 다양한 임상 형태로 나타날 수 있고 수술로써 증상 치료가 가능함으로 임상적인 의심과 정확한 진단, 적절한 수술 전 처치 및 수술이 필수적인 질환이다. 향후 더 많은 예를 대상으로 연구를 진행하여 다양한 갈색세포종의 임상양상과 생화학적 검사의 유용성 및 수술 후 결과를 확인하는 것이 필요하리라 생각된다. Background: Pheochromocytoma may arise within the adrenal medulla, or in other locations where sympathetic ganglia or chromaffin tissues are known to exist. Approximately 0.1% of hypertensive patients have pheochromocytoma. Most of this hypertension can be cured by surgical removal of the tumor, but lethal complication can develop if proper treatment is not prepared. Therefore, accurate diagnosis and preoperative preparation is very important. The objective of this study was to evaluate the clinical characteristics of pheochromocytoma and the blood pressure change following tumor removal. Method: The medical records of 445 patients [29 cases of intra-adrenal, 16 cases of extra-adrenal(paraganglioma)] diagnosed with of pheochromocytoma at Korea University Medical Center between 1991 and 2001 were reviewed. Results: Twenty of the cases were male and 25 were female. The mean age of these patients was 43 years old. Hypertension, headaches, palpitations and impaired glucose tolerance were observed more frequently in cases of intra-adrenal tumor than in those of extra-adrenal. In the extra-adrenal, group, abdominal pain, hypertension and nausea were more frequently observed. A biochemical study showed that the sensitivity of the test for catecholamines and metabolites in 24 hours urine was over 80%. For the localization of tumors we used abdominal CT and MIBG. The sensitivities of the CT and MIGB for the tumor localization were 97 and 91%, respectively. Blood pressures during the operations were effectively controlled by preoperative treatment with phenoxybenzamine (non-competitive, non-selective α-adrenoreceptor antagonists). Conclusion: Surgical treatment cured 23 of the 30 cases of hypertension with pheochromocytoma. We have to take careful approaches in the care of the patient who may have phechromocytoma, due to the various clinical signs and symptoms (J Kor Soc Endocrinol 17:554∼563, 2002).

e항원 양성 B형 만성 활동성 간염에 있어서 말초 혈액내 T 및 B 임파구 분획의 변동에 관한 고찰

김신묵,신동현,주영은,김태두,한상우,박용욱,김세종 全南大醫大 1993 전남의대학술지 Vol.30 No.1

건강한 한국인에서 혈중 렙틴 농도와 비만, 인슐린저항성과의 관계

김동림,김난희,신동현,김신곤,최경묵,김진관,신철,이성관,백세현,최동섭 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.26 No.2

연구배경:동물 실험에서 렙틴은 인슐린 분비를 감소시키고 당대사를 증가신킨다고 알려져 있다. 그러나 사람에서는 흔히 비만이 렙틴 농도의 증가와 함께 고인슐린혈증을 동반하여 렙틴과 인슐린저항성의 상관관계에 대한 가능성이 제시되었다. 본 연구의 목적은 건강한 성인에서 혈청 렙틴 농도와 인슐린 저항성의 상관관계 및 혈중 렙틴 농도에 영향을 주는 인자들을 알아보고자 하였다. 방법:안산 지역 역학 조사에 포함된 20세 이상의 건강한 성인555명을 대상으로 하였다. 대상군에서 체질량지수, 복부/둔부 둘레비(waist­hip ratio)를 측청하였고, 체성분분석(body composition)을 이용하여 체지방량을 측정하였다. 또한, 공복혈당, 총콜레스테롤, 중성지방, HDL­콜레스테롤, LDL­콜레스테롤, 식후 2시간 혈당, 인슐린과 렙틴 농도를 측정하였으며 HOMA 방법으로 인슐린저항성을 계산하였다. SAS 프로그램을 이용하여 혈청 렙틴과 각 변수들 간의 상관관계분석을 시행하였다. 결과:렙틴 농도는 여자에서 남자보다 2배 가량 높았으며 체지방 등의 다른 인자를 고려하고도 통계적으로 유의한 차이를 보였다. 렙틴 농도는 체지방과 가장 강한 상관관계를 보였고 그 외 체질량지수, HOMA­IR, 연령, 총콜레스테롤, LDL­콜레스테롤, 공복혈당, 식수혈당 등과도 통계적을 유의한 양의 상관관계를 보였다. 인슐린저항성이 비만의 영향을 배제하고도 렙틴농도에 독립적인 인자인지를 보기 위해 체질량지수로 보정한 후에도 렙틴은 체지방 및 HOMA­IR과 유의한 상관관계를 보였으며 이런 결과는 남녀 비슷하였다. 다변량 회귀분석 결과 성별, 체지방량, HOMA­IR, 총콜레스테롤 HDL­콜레스테롤 등이 렙틴의 농도에 영향을 주는 독립적 인자로 밝혀졌다. 대상군을 고혈압, 비만, 고지혈증, 내당능장애와 같은 대사성 증후군의 요소 소지에 따라 네 군으로 분류하여 분석하였을 때 대사성 증후군의 구성인자가 많을수록 혈중 렙틴 농도가 유의하게 증가되는 것을 관찰하였다. 결론:당뇨병이 없는 건강한 성인에서 혈청 렙틴농도는 여자에서 남자보다 높았고, 체지방량 및 총콜레?? LDL­콜레스테롤 등과 양의 상관관계를 보였다. 또한 렙틴은 체지방량과 독립적으로 인슐린저항성과 밀접한 관계를 보여 비만에서 렙틴이 인슐린저항성에 중요한 역할을 할 것으로 생각되며 앞으로 이러한 역할을 규명하는 연구가 함께 이루어져야 할 것이다. Background : Leptin is a hormone that regulates food intake and body weight. It has been demonstrated that the plasma leptin levels correlates with body adiposity. Increased adiposity is accompanied by a low insulin sensitivity, which turns into insulin resistance. Recent studies suggest a complex interrelationship between leptin and insuli nor insulin resistance. Therefore, the relationship between leptin and the variables of body adiposity, and insulin resistance in a non-diabetic population was examined. Methods : 555 healthy non-diabetic people aged 20 to 80 were enrolled in this study. Leptin was measured by the mean radioimmunoassay. Multiple logistic regression analysis was performed with leptin as a dependent variable and with age, sex, BP, the lipid profile, the fasting plasma glucose levels, HOMA-IR and the trunk fat contents as independent variables. Results : The plasma leptin concentrations were higher in women than in men. The leptin concentrations correlated with the body fat content, BMI and HOMA-IR but, less so with age, the fasting plasma glucose levels, the postprandial glucose levels, total cholesterol and LDL-cholesterol levels. After adjusting for the body mass index, the leptin levels significantly correlated with both the body fat content and the HOMA-IR. The results between males and females were similar when the data was analyzed after dividing by gender. Gender, the trunk fat content and the HOMA-IR. The results between males and females were similar when the data was analyzed after dividing by gender. Gender, the trunk fat content, HOMA-IR, and the total cholesterol and HDL cholesterol levels were independent variables which influences the log transformed leptin in multiple logistic regression analysis. When the subjects were grouped according to the number of insulin resistance syndrome including dyslipidemia, obesity, hypertension, and glucose intolerance, there was a linear increase in the leptin concentration with an increase n the number of the components of insulin resistance syndrome. Conclusion : The plasma leptin concentrations are related to adiposity, insulin resistance, and dyslipidemia in the non-diabetic Korean population. The relationship between leptin and insulin resistance independent of body fat suggests that insulin resistance might play some role in the development of hyperleptinemia and vice versa (J Kor Diabetes 26: 100~111, 2002).

한국 성인에서 C-reactive Protein과 대사성 증후군의 상관성에 관한 연구

김신곤,김동림,신동현,김난희,최경묵,백세현,최동섭 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.2

Background: Metabolic syndrome (MS) is characterized by insulin resistance accompanied by one or more of the following: obesity, hypertension, impaired glucose tolerance, low HDL cholesterol levels, and/or hypertriglyceridemia. However, the precise underlying pathogenic mechanism of MS is not known. Several recent reports have suggested a positive association between components of MS and markers of the acute-phase response, including C-reactive protein (CRP). These results imply that MS is accompanied by an ongoing inflammatory process. The purpose of our study was to evaluate the association between circulating levels of C-reactive protein, a sensitive systemic marker of inflammation, with components of metabolic syndrome in Korean adults. Methods: A total of 1,461 subjects aged between 20 and 81 years, who visited the Health Management Center at Korea university between November 2000 and February 2001 were studied. We investigated the correlation between CRP levels and components of MS. The components of MS were categorized, and age-sex adjusted mean values of CRP calculated for the categorized components. The BMI was categorized into 5 classes, and the CRP levels examined according to their BMI class. In addition, subjects with a different number of the MS components were grouped as follows: group 1 for 0 components, group 2 for 1 components, group 3 for 2 components and group 4 for ≥ 3 components, and the CRP levels calculated for each group. Results: There were significant positive correlations of CRP levels with age, BMI, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBS), uric acid, insulin, and homeostasis model assessment IR (HOMAIR). A significant inverse correlation was observed between CRP levels and serum HDL. From the multivariate analysis, age and BMI were significantly correlated with CRP levels. The means of the CRP for the categorized components of MS were significantly higher in the BMI categories: ≥25 for female/27 for male, TG ≥200 ㎎/dL, fasting plasma glucose ≥126 ㎎/dL and blood pressure ≥140/90 ㎜Hg, and the CRP levels by BMI class were: 1.19 (BMI <18.5), 1.54 (BMI 18.5∼22.9), 1.59 (BMI 23.0∼24.9), 1.77 (BMI 25. 0∼29.9) and 2.07 (BMI >30.0) ㎎/L. Furthermore, the increase in the CRP levels in relation to the numbers of MS were 1.46 (group 1), 1.70 (group 2), 1.95 (group 3) and 2.11 mg/L (group 4) with statistical significance. Conclusion: The above data showed associations between the CRP levels and the different components of MS. This might suggest that MS in Koreans could be accompanied by a systemic inflammation response

인슐린비의존형 당뇨병 환자에서 알부민뇨, vWF 및 대혈관 합병증과의 상관관계

김수미,김신곤,김난희,최동섭,백세현,신동현,최윤상,박이병 대한당뇨병학회 1997 Diabetes and Metabolism Journal Vol.21 No.2