Salmonella typhi Group D로 인한 장티푸스에 병발된 접형동염의

안득수(Deuk Soo Ahn),이창환(Chang Hwan Lee),이수택(Soo Taek Lee),서재석(Jae Seok Seo),김대곤(Dae Gon Kim),최수미(Su Mi Choi) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.3

Typhoid fever is bacterial disease caused by Salmonella typhi. It is characterized by prolonged fever, abdominal pain, diarrhea, delirium, rose spot, and splenomgaly, and occasionally complicated with intestinal bleeding and perforation. We experienced a case of peculier type of typhoid fever associated with sphenoid sinusitis.

급만성 간질환에서 혈청 LCAT 활성도와 HDL - C 치 변동

안관용(Kwan Young Ahn),허영상(Yeoung Sang Heo),이용기(Young Gi Lee),이남심(Nam Sim Lee),김대곤(Dae Ghon Kim),안득수(Deuk Su Ahn) 대한내과학회 1988 대한내과학회지 Vol.34 No.3

N/A Serum lecithin-cholesterol acyltransferase(LCAT) activity was assayed for evaluation of the hepatocellular dysfunction in acute and chronic liver disease. Furthermore the relationships between serum LCAT and each change of serum high density lipoprotein (HDL) level, cholesterol ester fraction, alanine aminotransferase (ALT), aspartate aminotransferase (AST) activity, or albumin level were comparativerly investigated, then the applicability to a index of liver function test was considered. As a result these following conclusions were obtained. LCAT activity in normal control was 26.5±5.7 ㎍/ ml/hr and LCAT activities were decresed in patients with acute and chronic liver disease, especially significantly (p<0.05) decreased in patients with drug induced hepatitis, chronic hepatitis, cirrhosis, and hepatoma. In correlation between serum HDL-C level and LCAT activity, serum LCAT activity trend to decrease with decreased HDL-C level but these is no significancy in patients with acute liver disease. On the contrary serum LCAT activity showed very significant (p=0.001) correlation (r=0.542) according to decreasing HDL-C level in patients with chronic liver disease. Between serum cholesterol ester fraction and LCAT activity. At first in patients with acute liver disease, serum LCAT activity decreased with significant (p<0.001) correlation (r=0.762) to cholesterol ester fraction, also very significant (p=0.002) correlation (r=0.512) was noted in patients with chronic liver disease. Between serum ALT, or AST and LCAT activity, No significant correlation was found in patients with acute and chronic liver disease. In serum albumin level and LCAT activity, no significant correlation was showed in patients with acute liver disease but very significant (p<0.001) correlation (r=0. 609) in patients with chronic liver disease. From above results, it was suggested that measurements of serum LCAT acitivity and cholesterol ester fraction may be better indices for liver function test in patients with acute and chronic liver disease, and HDL-C level be better index in patients with chronic liver disease.

Helicobacter pylori 제균치료 후의 위전정부 뮤신 발현의 변화

마명신 ( Myun Sin Ma ),황진수 ( Jin Su Hwang ),나성일 ( Sung Il Na ),이길홍 ( Kil Hong Lee ),최정기 ( Jeong Ki Choi ),이승옥 ( Seung Ok Lee ),강명재 ( Myoung Jae Kang ),김대곤 ( Dae Ghon Kim ),안득수 ( Deuk Soo Ahn ),이수택 ( Soo 대한내과학회 2003 대한내과학회지 Vol.64 No.1

목적 : 만성 위염과 소화성궤양, 위암 그리고 말트림프종의 발생과 관련이 있는 H. pylori는 위점막표면에 기생하면서 점액의 주요성분인 뮤신에 변화를 일으킨다고 알려져 있다. 본 연구는 성공적으로 제균치료가 되었던 H. pylori에 감염된 환자들을 대상으로 위의 표재성 세포 중 표재성 점액세포와 유문선 세포에서 각각 뮤신분비에 어떤 변화가 일어나는지 알아보고자 하였다. 대상 및 방법 : 1998년 3월부터 1999년 12월까지 전북대학교 병원 소화 Background : Helicobacter pylori colonizes the gastric surface epithelium and the mucus gel layer. It has been known that H. pylori infection decreased the gastric mucin expression. The aim of this study was to determine the effect of H. pylori eradicatio

B 형 간염 바이러스 ( HBV ) 감염 후 B 형 간염 바이러스 표면 항원 ( HBsAg ) 에 대한 세포 면역성 반응

김대곤(Dae Ghon Kim),이남심(Nam Sim Lee),류완희(Wan Hee Yoo),안득수(Deuk Su Ahn),양두현(Doo Hyun Yang),조백환(Baik Hwan Cho) 대한내과학회 1996 대한내과학회지 Vol.51 No.1

N/A Objectives: The immune reaction of host, esp., cell-mediated, is provided as an important factor to determine the progression of disease after hepatitis H virus infection. The change of suppressor cell that control T cells, decrease of lymphocytic proliferation, or production of IL-2 production in PBMC is reported. Thus we were undertaken this study to investigate cell-mediated immunopathogenic mechanism in hepatitis B virus infection. Methods: 5 groups were studied; non-immune donors, immune donors, asymptomatic HBsAg carriers, patients with chronic active hepatitis (CAH) and patients with acute hepatitis (AH). The present study was tried to estimate the proportional variation of T cell subsets of the peripheral blood mononuclear cells (PBMC), proliferative responses of PBMC which was cultured with rIL-2, concanavalin (Con A) and phytohemagglutinin (PHA), or hepatitis B surface antigen (HBsAg), and changes of HLA-DR and IL-2R expression of stimulated lymphocytes as lymphocyte-activation markers in each groups. Results: There were no proportional changes of CD3 positive cells in subjects of each group, but the proportion of CD4 positive cells (18.4±2.9%) was signifiantly(p<0.01) reduced in patients with CAH. The CD4: CDH ratio was significantly decreased in carriers, in patients with CAH, and in patients with AH. Also the proliferative responses of cultured lymphocyes after stimulation with exogenous rIL-2 were not significantly changed in above three groups compared with that of unstimulated control culture. Enhanced HBsAg-specific proliferation was not detected after stimu1ation with rI1-2+HBsAg. HLA-DR and IL-2R expression of unstimulated lymphocytes were significantly decreased in patients with CAH and patients with AH. The HBsAg-specific HLA-DR expression was not demonstrated in subjects of each group. But, increased HLA-DR expressions after stimulation with rIL-2+HBsAg were observed, 48±6.2% in asymptomatic carriers, 34.5±5.0% in patients with CAH and 43.7±3.3% in patients with AH, compared with that of nonimmune donors. A weak HBsAg-specific IL-2R expression was demonstrated in patients with CAH, but there were no HBsAg-specific IL-2R expression in subjects of other 8 groups. After stimulation with rIL-2 or rIL-2+ HBsAg, there were increased IL-2R expression in asymptomatic HBsAg carriers, in patients with CAH, and in patients with AH, compared with that of nonimmune donors. Conclusion: These results suggested that impaired HLA-DR and IL-2R expression would be associated with HBsAg immunogenicity or/and IL-2 activity, and may be important immunogenetic role in the course of post-HRV infection.

소화성 위장질환에 사용하는 Cimetidine , Ranitidine , Proglumide 및 Clebopride 의 면역반응조절

김대곤(Dae Ghon Kim),허영상(Yeong Sang Heo),안관용(Kwan Yong Ahn),이용기(Yong Gi Lee),안득수(Deuk Su Ahn) 대한내과학회 1987 대한내과학회지 Vol.33 No.1

N/A It has been reported that among many drugs used for the treatment of peptic gastrointestinal disorder, a few drugs exerts a variety of modulating effects on immune responsiveness. This study was undertaken to investigate the effect of four of the drugs on immune response of mice to sheep red blood cells (SRBC). Four drugs used in this experiment are cimetidine, a imidazole derivative of histamine type 2 (H₂) receptor antagonist; ranitidine, a furan derivative of H₂, antagonist; proglumide, a gastrin antagonist; and clebopride, a dopamine antagonist. Mice were pretreated with daily oral administration of varying concentration of each drugs for 30 days and were immunized with 10(8) SRBC. Each mouse was challenged 4 days after the sensitization, Immune response were evaluated by measuring footpad swelling reaction at 3 hr (Arthus reaction) and 24hr (delayed type hypersensitivity, DTH) after challenge, rosette forming reaction, hemagglutinin (HA) and hemolysine (HE) titers to SRBC. The pretreatment of mice with cimetidine inhibited Arthus and rosette forming reactions, but enhanced DTH to SRBC. The pretreatment of mice with proglumide suppressed both DTH and rosette forming reaction. The pretreatment of mice with clebopride enhanced DTH, but decreased rosette forming reaction. In contrast to cellular immune response, there was not any significant difference between the drug treated and untreated control groups in HA and HE reactions. These results suggest that cimetidine, ranitidine and clebopride enhance cellular immune response, but proglumide suppress the above response and all of the drugs do not significantly change the humoral immune response.

증예(症例) : 위 -담도계 누공을 통한 담즙 역류증에 동반된 위선암 1례

이동민 ( Dong Min Lee ),나성일 ( Soung Il Na ),윤일용 ( Il Yong Yun ),이상일 ( Sang Il Lee ),이승옥 ( Seung Ok Lee ),이수택 ( Su Tak Lee ),김대곤 ( Dae Kon Kim ),안득수 ( Deuk Soo Ahn ) 전북대학교 의과학연구소 2001 全北醫大論文集 Vol.25 No.2

Multiple host and environmental factors are involved in gastric carcinogenesis. Studies in animal models have shown that bile acids are related to gastric carcinogenesis. In man, distal gastric carcinoma is associated with increased duodenogastric reflux mainly in the stomach after surgery. Internal biliary fistulae are either spontaneous or due to operations on biliary tract. The common cause of spontaneous internal biliary fistula is cholelithiasis, but rarely chronic gastric ulcer may also cause gastrobiliary fistula. We experienced a case of gastric adenocarcinoma on the fundus associated with bile reflux by the gastrobiliary fistula. This gastrobiliary fistula was developed from gastic ulcer that was detected 3 years ago. Because we consider that bile reflux is related to the genesis of gastric adenocarcinoma, we present this case with review of literatures.

간의 국소 결절성 과형성 1 예

안득수,조백환,김대곤,유희철,임철수,이수택 대한간학회 1997 Clinical and Molecular Hepatology(대한간학회지) Vol.3 No.4

Focal nodular hyperplasia(FNH) is a rare, benign hepatic tumor which was usually discovered incidentally by imaging procedure performed for some other reasons. FNH is typically asymptomatic and, it seldom bleeds. There is no evidence to support say relation with primary liver cancer. Accordingly, the preferred management is conservative, and excision reserved for large symptomatic and complicated lesion, or when the diagnosis remains uncertain. Although many cases of FNH has been described to date in the other countries, only four cases of FNH has been reported in Korean Literature. In the present report we describe a 7 cm sizes asymptomatic lesion of FNH in a 23-year-old women, that was disclosed by various kinds of imaging procedure. The left lateral segmentectomy was performed. The mass was firm and showed areas of localizes growth of mature hepatocytes and septal fibrosis accompanied with marginal ducral proliferation, consistent with FNH. It also displayed an incomple stellate architectual configration consisted of a central fobrosis scar.

자연퇴행 후 재발한 간세포암 1 예

이승옥,안득수,김대곤,임철수,이수택 대한소화기학회 1999 대한소화기학회지 Vol.33 No.4

Spontaneous regression of cancer is a rare phenomenon which is seldom described in patients with hepatocellular carcinoma. A 62-year-old man was diagnosed as a hepatocellular carcinoma by abdo minal computerized tomography (CT) and the elevated serum alpha-fetoprotein (αFP) concentration. He refused further evaluation involving biopsy and was treated with conventional drug, silymarin and ursodeoxycholic acid. In abdominal CT performed 2 months after initial diagnosis, tumor mass markedly regressed and serum αFP level was remarkably decreased, too. At the 6th month from the initial diagnosis, tumor subsequently regressed to near-normal state and αFP level was normalized Thereafter, he felt good and continued conventional medication. At the 21st month from the initia diagnosis, the 15th month after tumor regression, multiple liver masses were found on abdominal CT at different site from the initial tumor. However, serum αFP was within normal range. We performed transcatheter arterial chemoembolization three times. At present, 26 months after the initial diagnosis the patient is living well.

중증 급성 췌장염의 치료에서 Octreotide의 후향성 비교 연구

김남수,임철수,이승옥,김정권,이수택,김대곤,안득수 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.5

중증 급성 췌장염 치료에서 Ortreotide 의 후향성 비교 연구

김남수,이승옥,안득수,김대곤,임철수,이수택,김정권 대한소화기학회 1999 대한소화기학회지 Vol.32 No.5

Background/Aims: Somatostatin and its long acting analogue octreotide have been proposed for the treatment of patients with acute pancreatitis. But neither agents has been adequately assessed in patient with severe attacks, Retrospective study was carried out to assess the effect of octreotide in the treatment of patients with severe acute pancreatitis. The patients had been admitted between January, 1991 and August, 1996. Methods: Twenty two patients with severe acute pancreatitis were examined. We compared the differences in complication rate, mortality, mean hospital day between the conservative treatment group (nine patients) and the octreotide-treatment group (thirteen patients). For the octreotide treated group, octreotide 0.1 mg were injected subcutaneously every twelve haurs for average eleven days (11.38±7.43). Results: Complications occurred in 46% (6/13) of the octreotide-treatment group and 56% (5/9) of the control group. There was no significant difference in the incidence of complication (P=0.66). Mean hospital day of the octreotid.e-treatment group was 23±8.3 days and that of the control group was 15±10.8 days. However, these results were not statistically significant (P=0.09), There was one death due to sepsis in octreotide-treatment group. Conclusions: Octreotide was not effective in the treatment of severe acute pancreatitis.