베타카리오필렌의 Helicobacter pylori 감염 억제 효능을 평가하기 위한 무작위 배정, 양측 눈가림, 위약 대조군 연구

심현익,송동진,신철민,윤혁,박영수,김나영,이동호 대한소화기학회 2019 대한소화기학회지 Vol.74 No.4

Background/Aims: Helicobacter pylori (H. pylori) infections, which cause a variety of gastrointestinal symptoms, are common in South Korea. Recent reports have shown a decline in the H. pylori eradication rates. β-caryophyllene is a natural bicyclic sesquiterpene that occurs in a wide range of plant species, such as cloves, basil, and cinnamon. β-caryophyllene has been reported to have anti-inflammatory and anti-bacterial effects. This study investigated the inhibitory effects of β-caryophyllene on H. pylori and its potential role as an alternative gastrointestinal drug. Methods: This 8-week, randomized double-blind, placebo-controlled trial categorized subjects into a β-caryophyllene group (33 patients who received 126 mg/day of β-caryophyllene) and a placebo group (33 patients who received a placebo preparation). The inflammation level of H. pylori infiltration and the eradication rates were evaluated endoscopically and with the urea breath test (UBT) in both groups before and after administering the medication. The serum cytokine levels (tumor necrosis factor-α, and interleukin [IL]-1β and IL-6) were compared in both groups before and after administering the medication. Results: Complete eradication was not observed in either group. Moreover, there was no significant change in the UBT and updated Sydney score. On the other hand, the β-caryophyllene group showed significant improvement in nausea (p=0.025) and epigastric pain (p=0.018), as well as a decrease in the serum IL-1β levels (p=0.038). Conclusions: β-caryophyllene improves dyspepsia symptoms and can be considered a useful supplementary treatment for gastrointestinal disease.

SAPHO 증후군에서 경구 Alendronate로 치료한 1예

심현익 ( Hyun Ik Shim ),박원 ( Won Park ),김여주 ( Yeo Ju Kim ),정경희 ( Kyong Hee Jung ),백지현 ( Ji Hyeon Baek ),임미진 ( Mie Jin Lim ),주고운 ( Kowoon Joo ),권성렬 ( Seong Ryul Kwon ) 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.5

본 저자들은 손가락의 골절과 감염이 동반된 SAPHO 증후군에서 경구 bisphosphonate로 성공적으로 치료하였기에 이를 보고하는 바이다. SAPHO syndrome, characterized by synovitis, acne, pustulosis, hyperostosis, and osteitis is rare compared to other spondyloarthropathies. It is also difficult to diagnose, and treatment methods have not yet been fully identified. Approximately 72% of patients are diagnosed with at least one other disease before a final diagnosis of SAPHO syndrome. In addition, SAPHO syndrome is subject to a delayed diagnosis period of 4.5 to 9.1 years. Medications such as non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, and tumor necrosis factor inhibitors are used in treatment of SAPHO syndrome. Bisphosphonate is also used for refractory SAPHO syndrome; however, most reports on this relate to intravenous injection of medication. The authors experienced and subsequently reported on a case involving a patient with SAPHO syndrome accompanied by fracture and infection of the left second finger who was treated with the oral biphosphonate, alendronate. (J Rheum Dis 2015;22:313-316)

위식도 역류 질환에 의한 비심인성 흉통 환자에서 에소메프라졸 20 mg 1일 2회 용법의 치료 효과 평가를 위한 공개, 무작위 배정 예비 연구

최재균,심현익,신철민,윤혁,박영수,김나영,이동호 대한소화기학회 2020 대한소화기학회지 Vol.75 No.6

Background/Aims: Non-cardiac chest pain (NCCP) is defined as recurrent angina pectoris-like pain without evidence of coronary heart disease, and is usually related to esophageal diseases, such as gastroesophageal reflux disease (GERD). Proton pump inhibitors (PPIs) are important for diagnosis and treatment. Many studies have been conducted on the use of PPIs in patients with GERD-related NCCP. In contrast to standard-dose esomeprazole, the efficacy of half-dose esomeprazole twice daily (BD) has not been established. This study compared the efficacies of the two esomeprazole regimens in GERD-related NCCP. Methods: In this prospective, open-label study, 37 participants with GERD-related NCCP were randomized to receive either 20 mg of esomeprazole BD (n=21) (esomeprazole BD group) or 40 mg once daily (n=16) (esomeprazole once daily [OD] group) for 4 weeks. In both groups, the chest pain score, which was calculated based on the frequency and severity, was evaluated before and 2 and 4 weeks after administering the medication. Results: The chest pain score significantly improved in both groups (p<0.001). The proportion of patients with chest pain score improvement >50% was 7.7% higher in the esomeprazole BD group than in the esomeprazole OD group (95.2% vs. 87.5%), but the difference was not significant. Conclusions: Esomeprazole BD was as effective as esomeprazole OD in improving GERD-related NCCP. Although statistically insignificant, the percentage of patients with >50% reduction in the chest pain score was higher in the esomeprazole BD group than in the esomeprazole OD group. Large-scale studies will be needed to assess these findings further.

Risk of Psoriasis in Postgastrectomy Gastric Cancer Survivors: A Nationwide Population-Based Cohort Study

김보리,이동호,김지우,심현익,박상현,신철민,한경도,윤상웅 대한피부과학회 2022 Annals of Dermatology Vol.34 No.3

Background: Although patients with psoriasis have an increased risk of cancers, little is known about the risk of psoriasis in cancer patients. Objective: We aimed to comparatively analyze the incidence and risk factors of psoriasis in gastric cancer patients who underwent gastrectomy and in the general population. Methods: A nationwide retrospective cohort of 52,608 gastric cancer survivors (2007~2015) was compared to 123,438 matched controls from the general population to estimate the incidence and hazard ratio (HR) of new-onset psoriasis. We also calculated the HRs for psoriasis according to adjuvant cancer treatment, obesity, and vitamin B12 supplementa- tion in gastric cancer survivors. Results: During a mean follow-up of 6.85 years, 645 of the 52,608 gastric cancer patients developed psoriasis, while 1,806 in the 123,438 matched control group developed psoria- sis. Gastric cancer patients had a decreased risk of psoriasis (HR, 0.86; 95% confidence interval, 0.79~0.94), especially those who underwent subtotal gastrectomy. We found that vitamin B12 supplementation for more than 3 years had an additive effect on decreasing the risk of psoriasis in gastric cancer patients who underwent subtotal gastrectomy. Total gastrectomy, radio/chemotherapy, and obesity did not affect the risk of psoriasis in gastric cancer survivors. Conclusion: The incidence of psoriasis is slightly lower in gastric cancer survivors than in the general population. Our results suggest that the development of psoriasis may be reduced by removing the source of systemic inflammation caused by infection through subtotal gastrectomy in gastric cancer survivors.

Clinical and Echocardiographic Factors Affecting Tricuspid Regurgitation Severity in the Patients with Lone Atrial Fibrillation

박재형,신성희,이만종,이명동,심현익,윤재웅,오세환,김대혁,박상돈,권성우,우성일,박금수,권준 한국심초음파학회 2015 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.23 No.3

Background: Atrial fibrillation (AF) can be a risk factor for development of significant tricuspid regurgitation (TR). We investigatedwhich clinical and echocardiographic parameters were related to severity of functional TR in patients with lone AF. Methods: A total of 89 patients with lone AF were enrolled (75 ± 11 years; 48% male): 13 patients with severe TR, 36 patientswith moderate TR, and 40 consecutive patients with less than mild TR. Clinical parameters and echocardiographic measurementsincluding right ventricular (RV) remodeling and function were evaluated. Results: Patients with more severe TR were older and had more frequently persistent AF (each p < 0.001). TR severity was relatedto right atrial area and tricuspid annular systolic diameter (all p < 0.001). The patients with moderate or severe TR hadlarger left atrial (LA) volume and increased systolic pulmonary artery pressure (SPAP) than the patients with mild TR (p = 0.04for LA volume; p < 0.001 for SPAP). RV remodeling represented by enlarged RV area and increased tenting height was moreprominent in severe TR than mild or moderate TR (all p < 0.001). Multivariate analysis showed type of AF, LA volume, tricuspidannular diameter and tenting height remained as a significant determinants of severe TR. In addition, tenting height was independentlyassociated with the presence of severe TR (p = 0.04). Conclusion: In patients with lone AF, TR was related to type of AF, LA volume, tricuspid annular diameter and RV remodeling. Especially, tricuspid valvular tethering seemed to be independently associated with development of severe functional TR.

간헐적 저용량 노출에 의하여 발생한 trichloroethylene 과민반응증후군 1예

이승윤,오세환,박재형,심현익,윤재웅,최혁재,한지영,김철우 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

서론: Trichloroethylene (TCE)은 금속제품의 세척제로 널리 사용되는 무색의 휘발성 액체로, 흡입 노출에 의하여 전신 발진, 발열, 간염, 호산구증가증 등을 일으키며 이를 TCE에 의한 과민반응증후군이라 한다. TCE 과민반응증후군은 약물에 의한 과민반응증후군 또는 DRESS (drug reaction with eosinophilia and systemic symptoms) 증후군과 매우 유사한 임상 양상을 보인다. 현재까지 국내외에서 보고된 TCE 과민반응증후군의 대부분은 작업 중 지속적인 노출2-6주후 증상이 나타나는 과정을 보이며, 저용량 노출이나 간헐적인 노출에 의하여 노출 후 많은 시간이 경과 후 발생한 TCE 과민반응증후군은 매우 드물다. 저자들은 저용량의 TCE에 간헐적으로 노출되어, 노출 3년만에 발생한 TCE 과민반응증후군을 경험하였기에 보고하는 바이다. 증례: 32세 남자가 4일전부터발생한 전신 피부발진과 발열로 내원하였다. 몸통과 사지에는 홍반성 반이 관찰되었고 겨드랑과 샅굴에는 농포가 있었으며, 혈액화학검사상 AST 63 IU/L, ALT 300 IU/L, ALP 748 IU/L였다. 간염 및 자가면역질환에 대한 검사 등에서 의미있는 소견은 없었다. 피부조직검사상 림프구와 중성구 세포외유출을 동반된 해면상 피부염 및 호산구가 산재된 진피 부종과 림프구 침윤이 관찰되었다. 환자는 모터 제조회사의 연구원으로 일하고 있었으며, 약 3년전부터 일주일에한 차례, 한번에 10분 정도 모터 세척작업을 하였고 세척액은 TCE로 확인되었다. 전신 발진, 간염, 발열 등의 임상양상과 TCE를 취급한 작업력을 바탕으로 TCE 과민반응증후군으로 진단하였으며, 전신 스테로이드 치료 후 발진과 간염 모두 호전되었다. TCE 및 대사물을 이용한 첩포시험은 환자가 거절하여 시행하지 못하였다. 결론: TCE는 지속적 노출 뿐만 아니라 저용량의 간헐적 노출에 의해서도 과민반응증후군을 일으킬 수 있다. 따라서 DRESS 증후군과 유사한 양상을 보이면서 약물 복용력이 없는 환자에서는 지속적 노출이 없더라도 TCE에 의한 간헐적 노출 등에 의하여도 과민반응증후군이 발생할 수 있음을 염두에 두고 자세한 병력 청취를 해야 한다.