항헬리코박터 IgY 항체의 위염(위궤양) 치료효과에 관한 연구

배만종(Man-Jung Bae),김수정(Soo-Jung Kim),김병기(Byung-Ki Kim),박창호(Chang-Ho Park),서정일(Jung-Ill Suh),김욱년(Wook-Nyeon Kim),장태정(Tae-Jung Jang),권상호(Sang-Ho Kweon) 한국식품영양과학회 2003 한국식품영양과학회지 Vol.32 No.8

면역물질인 IgY가 함유된 다기능성 계란 섭취로 인체에서 H. pylori 제균 치료에 어떠한 효과를 나타내는지 알아보고자 H. pylori 양성인 위염 환자 63명을 대상으로 임의로 IgY 함유 계란 투여군(17명), 항생제 투여군(17명) 및 항생제와 IgY 함유 계란 병합투여군(16명)으로 나누고 2주간 치료하였고 IgY 정제투여군(13명)은 1개월간 치료하였다. 치료후 H. pylori 박멸률, ¹³CO₂ 변화율(Δ¹³CO₂) 및 updated sydney system에 따른 H. pylori 균체 밀도, 급만성 염증 활성도, 장상피화생을 비롯한 위축도 등의 조직학적 변화에 대한 시험결과는 다음과 같다. IgY 함유 계란 투여군, 항생제 투여군, 항생제와 IgY 함유 계란 병합투여군 및 IgY 정제 투여군에서 H. pylori 박멸률은 각각 0%, 88%, 94% 및 0%로 IgY 함유 계란을 항생제와 병합투여했을 때 항생제만 투여할 때보다 H. pylori 박멸률이 높게 나타났지만 유의성은 없었다. IgY 함유 계란 투여군 17명중 1명이 Δ¹³CO₂이 감소하는 경향을 보였지만 나머지는 변함이 없었다. 항생제와 IgY 함유계란 병합투여군 16명중 15명에서 치료 1주째 Δ¹³CO₂이 모두 4이하로 치료전보다 유의하게 감소하였으며(p<0.05), 나머지 1명도 치료 1주와 2주째 Δ¹³CO₂이 치료전에 비해 감소하는 경향을 보였다. IgY 함유 계란 투여군과 IgY 정제 투여군에서 위전정부의 급성 염증 활성도가 유의하게 감소하였다 (p<0.01). IgY 함유 계란 투여군과 IgY 정제 투여군에서 위전정부의 H. pylori 균체 밀도가 유의하게 감소하였다 (p<0.05). IgY 정제 투여군에서 위체부의 만성 염증 활성도가 감소하는 경향을 보였다. IgY 함유 계란 투여군에서 위전정부 및 위체부의 장상피화생과 위축도는 치료전후 변화가 없었다. IgY 정제 투여군의 1예에서만 치료전 위전정부에 경도의 장상피화생이 관찰되었으며 치료후 정상으로 호전되었다. 위점막 위축은 대상환자 모두에서 치료전후 변화가 없었다. This study was conducted to investigate the effect of chiken egg containing IgY againt H. pylori in patients with gastritis. Sixty three H. pylori-infected volunteers (20~43 year, Male : Female=49 : 14) were randomized into four groups which were treated with one chiken egg containing IgY b.i.d. (IgY group; n=17) or omeprazole 20 mg b.i.d., amoxicillin 1.0 g b.i.d. and clarithromycin 500 mg b.i.d. (OAC group; n=17) or omeprazole 20 mg b.i.d., amoxicillin 1.0 g b.i.d., clarithromycin 500 mg b.i.d. and one chicken egg containing IgY b.i.d. (OAC with IgY group; n=16) for 2 weeks or lyophilized IgY 1 g b.i.d (lyophilized IgY group) for 1 month. Δ¹³CO₂ before and after treatment, the eradication rate of H. pylori and histologic change including H. pylori density, acute and chronic inflammation activity, intestinal metaplasia and glandular atrophy by updated sydney system were evaluated. Eradication rate of OAC with IgY group (94%) was higher than IgY group (0%), lyophilized IgY group (0%) and OAC group (88%). Δ¹³CO₂ at 2 weeks after treatment in one patient of IgY group was decreased. But that was not changed in the other patients. Δ¹³CO₂ at 1 week after treatment in 15 patients of OAC with IgY group was significantly lower than pretreatment level (p<0.05), and Δ13CO2 at 1 week and 2 week after treatment was decreased in the other patient. Acute inflammation activity at antrum was significantly decreased after treatment in IgY and lyophilized IgY group (p<0.01). H. pylori density at antrum was significantly decreased after treatment in IgY and lyophilized IgY group (p<0.05). Chronic inflammation activity at body was decreased after treatment in lyophilized IgY group. Intestinal metaplasia and grandular atrophy at antrum and body were not changed after treatment in IgY group. Mild intestinal metaplasia in one patient of lyophilized IgY group changed to normal after 1 month treatment. Gandular atrophy at antrum and body were not changed after treatment in lyophilized IgY group.

Helicobacter pylori 감염에서 CagA 및 VacA 발현과 위 상피세포 증식과의 관계

김남일(Nam Il Kim),이중현(Jung Hyun Lee),이영실(Yeoung Sil Lee),이재욱(Jae Uk Lee),이구(Goo Lee),서정일(Jeong Ill Suh),양창현(Chang Heon Yang),이창우(Chang Woo Lee),윤환중(Hwan Jung Yun),장태정(Tae Jung Jang),김정란(Jung Ran Kim),하경 대한내과학회 2000 대한내과학회지 Vol.58 No.5

N/A Background : Infection with Helicobacter pylori (H. pylori) has been associated with an increased risk for developing gastric cancer. This risk is further enhanced with CagA positive H. pylori strains. Increased epithelial cell proliferation is associated with an increased risk for gastric cancer. The aim of the study was to investigate whether the gastric epithelial cell proliferation was related to the expression of CagA and VacA in H. pylori infection. Methods : The subjects were 77 patients who had undergone diagnostic esophagogastroduodenoscopy with biopsy; 18 gastritis, 18 gastric ulcer, 17 duodenal ulcer and 24 gastric cancer. The expression of cytotoxic genes was determined indirectly by assaying serum IgG antibodies to specific antigens of H. pylori. Gastric epithelial cell proliferation was assessed using immunohistochemical method using Ki-67 monoclonal antibody. Acute and chronic inflammation, intestinal metaplasia and glandular atrophy were scored according to the updated Sydney system. Results : Ki-67 labeling index, acute and chronic inflammation were significantly higher in H. pylori infected persons (n=70, 90.9%) than in uninfected persons (n=7, 9.1%) (p<0.05), but the difference in intestinal metaplasia and glandular atrophy between the two groups was not statistically significant. Ki-67 labeling indices in persons infected with CagA positive strains (n=56, 80.0%) were significantly higher than in persons infected with CagA negative strains (n=14, 20%) (0.55±0.13 vs 0.37±0.17, p<0.05), but the differences in acute and chronic inflammation, intestinal metaplasia and glandular atrophy between the two groups were not statistically significant. No significant difference was found in Ki-67 labeling index, acute and chronic inflammation, intestinal metaplasia and glandular atrophy according to expression of VacA. Conclusion : Gastric mucosal cell proliferation, which might be closely involved in the pathogenesis of gastric carcinoma, was significantly higher in CagA positive H. pylori infected persons.(Korean J Med 58:516-525, 2000)

제 2형 Cirgler-Najjar 증후군

이돈행(Don Haeng Lee),최정현(Jung Hyun Choi),안홍석(Hong Suk Ahnn),윤일국(Il Kuk Youn),장태정(Tae Jung Chang) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.4

Type 2 Crigler-Najjar syndrome is a rare hereditary disorder characterized by chronic, nonhe- molytic and modest unconjugated hyperbilirubinemia. There are currently reported three types ot' syndrome: Gilbert, Type 1 and 2 Crigler-Najjar syndrome. Type 2 Crigler-Najjar syndrome is cau- sed by hereditary glucuronosyl transferase deficiency and it can be differentiated from the Gilbert and Type 1 Crigler-Najjar syndrome by the severity of hyperbilirubinemia and its response to phenobarbital administration. We expierienced a 22 year-old male patient who had shown persistent jaundice and unconjugated hyperbilirubinemia from adolescence. It was noted that several persons had shown jaundice among his maternal family. The plasma bilirubin concentration was elevated after fasting for 48 hours and was decreased dramatically by phenobarbital treatment. (Korean J Gastroenterol 1995;27:4S8 - 492)

위암종 및 위암종의 전구병변에서 p27Kip1 의 발현

김남일(Nam Il Kim),강혁주(Hyeock Joo Kang),정희철(Hee Chul Jung),김성자(Sung Ja Kim),이구(Goo Lee),서정일(Jeong Il Suh),이창우(Chang Woo Lee),이규춘(Kyu Chun Lee),김한식(Han Sik Kim),장태정(Tae Jung Jang),양창헌(Chang Heon Yang) 대한내과학회 2002 대한내과학회지 Vol.62 No.4

목적 : 위암종은 한국인 남자에서 가장 흔한 악성 종양으로 알려져 있으며 위암종 환자의 예후를 결정하는 요인에 관한 많은 연구가 있어왔다. 또한 사람의 여러 종양에서 CDKI 중 하나인 p27Kip1의 소실이 암의 성장과 연관이 있다고 알려져 있다. 이에 위암종, 위선종 그리고 위암종의 전구병변에서 p27Kip1에 대한 면역조직화학적 염색을 시행하여 p27Kip1의 발현정도를 조사하고 지금까지 알려져 있는 요인들과의 상관관계를 살펴보아 예후인자로서 유용하게 쓰일 수 있을 지에 대해 알아보고자 하였다. 방법 : 위암종으로 진단 받고 위절제술을 시행 받은 진행성 위암종 43예, 조기 위암종 19예, 위선종 22예, 위암인접 비종양조직 110개 및 조직학적으로 염증이 없거나 거의 미미한 정상군 10예를 대상으로 하였으며 위암인접 비종양조직은 다시 만성위염 32개, 장형화생 29개 그리고 위암종에서 1 cm 이내의 범위에 있는 이행상피 49개로 나누어 면역조직화학 염색을 이용하여 p27Kip1의 발현정도를 확인하였다. 결과 : 위암종에서 위암인접 비종양 조직과 위선종에 비해 p27Kip1의 발현이 유의하게 감소하였고 (p<0.05), 위암인접 비종양 조직은 정상군보다 p27Kip1의 발현이 감소하였으며 위암인접 비종양조직중 이행상피군이 만성위염과 장형화생보다 p27Kip1 발현이 감소되었다 (p<0.05). 위암종에서 진행성 위암종이 조기 위암종보다 p27Kip1 발현이 감소하였으며 (p<0.05), 미만형 위암종이 장형 위암종보다 p27Kip1 발현이 감소하였다 (p<0.05). p27Kip1 발현의 감소는 림프절 전이와 관련이 있었지만 (p<0.05), 원격전이와는 관련이 없었다 (p>0.05). 결론 : p27Kip1 발현이 위암종의 다단계 발생에서 초기에 감소됨을 알 수 있었고 위암종의 진행 및 분화와 연관성이 있었지만 예후인자로서의 가치는 더 많은 연구가 필요할 것으로 사료되었다. Background : The cyclin-dependent kinase inhibitor p27Kip1 is a negative regulator of cell cycle progression at G1/S transition. Recently, the expression level of p27Kip1 was decreased in many cancers such as breast, pituitary gland, colon and stomach. We studied the expression of p27Kip1 in gastric cancers, precancerous lesions and normal gastric tissues and analysed its correlation to clinicopathologic data including tumor differentiation, tumor depth, nodal and distant metastasis in gastric cancers. Methods : p27Kip1 were immunohistochemically stained in the tissue specimens of 62 resected cancers, 110 corresponding adjacent non-neoplastic tissues, 22 gastric adenomas and 10 normal gastric tissues. Adjacent non-neoplastic tissues consisted of 32 chronic gastritis, 29 intestinal metaplasia and 49 transitional mucosa. Results : Gastric cancers showed significantly decreased expression level of p27Kip1 when compared with non-neoplastic lesions and adenomas. Labeling index of p27Kip1 were more decreased in chronic gastritis, intestinal metaplasia and transitional mucosa than in normal mucosa. Early gastric cancers showed significantly decreased expression level of p27Kip1 when compared with advanced gastric cancers. In gastric cancers, p27Kip1 labeling index was significantly decreased in diffuse type and presence of nodal metastasis however did not show relationship with distant metastasis and tumor depth of advanced gastric cancers. Conclusion : We suggest that p27Kip1 may be decreased in the early stage of gastric carcinogenesis and play an important role in the progression and differentiation of gastric cancers. More further studies are thought to be necessary in order to evaluate its prognostic factor in gastric cancers.(Korean J Med 62:396-404, 2002)

위암 및 위암의 전구 병변에서 p16INK4A 촉진자의 과메칠화

김남일 ( Nam Il Kim ),김대인 ( Dae In Kim ),김성자 ( Sung Ja Kim ),이구 ( Goo Lee ),서정일 ( Jung Il Suh ),이창우 ( Chang Woo Lee ),장태정 ( Tae Jung Jang ),김한식 ( Han Sik Kim ),이규춘 ( Kyu Chun Lee ),최명규 ( Myung Gyu Choi ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-

<목적> 위암에서 p16INK4A 유전자의 불활성화는 p16INK4A 촉진자의 과메칠화에 의한 불활성화가 중요한 기전으로 보고되었지만 현재까지 위암 주변 조직의 p16INK4A 촉진자의 과메칠화와 위암의 전구 병변에 대한 연구는 없는 실정이다. 따라서 본 연구는 만성위염, 위선종, 위암과 위암에 인접한 비종양성 조직에서 p16INK4A 촉진자의 메칠화를 조사하고 p16INK4A 단백질의 발현을 분석하여 위암의 다단계 발생에서 p16INK4A 촉진자 과메

Helicobacter pylori 제균이 위장 전정부 점막의 세포증식능과 apoptosis 에 미치는 영향

이구(Goo Lee),최석진(Suk Jin Choi),최영환(Young Hwan Choi),박동건(Dong Gun Park),서완다(Wan Da Seo),서정일(Jeong Il Suh),양창헌(Chang Heon Yang),이창우(Chang Woo Lee),장태정(Tae Jung Jang),김정란(Jung Ran Kim) 대한내과학회 1999 대한내과학회지 Vol.57 No.3

N/A Helicobacter pylori (H. pylori) is the principle cause of type B gastritis and peptic ulcer disease and has been classified as group I carcinogen for gastric cancer. H. pylori may affect the normal balance between gastric cell proliferation and epithelial cell death, thus interfering with the maintenance of gastric mucosal integrity. The aim of this study was to investigate the effect of H. pylori on cell proliferation and apoptosis according to the effect of eradication of H. pylori. Methods : The subjects were 45 patients who had undergone diagnostic gastroduodenoscopy; 11 with gastritis, seven with gastric ulcer and 27 duodenal ulcer. H. pylori infection was assessed by H&E and immunohistochemical stain with anti-H. pylori polyclonal antibody and rapid urease test. Acute and chronic inflammation, apoptosis and intestinal metaplasia were scored according to the updated Sydney system. Gastric epithelial cell proliferation was assessed by immunohostochemical method using Ki-67 monoclonal antibody. In situ apoptosis was detected with in situ terminal deoxyribonucleotide transferase (TdT)-mediated dUTP nick end labeling. Results : Acute and chronic inflammation, intestinal metaplasia, Ki-67 labeling index, and apoptosis were significantly higher in H. pylori infected persons (n=45) than in uninfected persons (n=5)(p<0.05). Acute and chronic inflammation, intestinal metaplasia, Ki-67 labeling index and apoptosis in H. pylori eradicated group (n=25) significantly decreased after eradication therapy (p<0.05), but no significant differences of them was observed in H. pylori non-eradicated goup (n=20) after eradication therapy. Ki-67 labeling index was significantly correlated with acute inflammation, chronic inflammation and apoptosis (p<0.05). Apoptosis was significantly correlated with acute and chronic inflammation (p<0.05). Conclusion : In eradicated group, epithelial apoptosis and proliferation closely associated with gastric carcinogenesis are stabilized after treatment, which suggests H. pylori eradication therapymay preven the early step of gastric carcinogenesis. (Korean J Med 57:288-297, 1999)

편평상피세포암과 동반된 소세포폐암에서 발생한 항이뇨호르몬 분비이상 증후군(SIADH) 1 예

이창우,이영현,이창화,이영실,유석동,장태정,구정태,윤병구,장재식,천우정,정희철,강혁주,서영범 대한내과학회 2001 대한내과학회지 Vol.61 No.5

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the term applied to arginine vasopressin (AVP) excess associated with hyponatremia without edema in the absence of physiologic or pharmacologic stimuli to AVP secretion. SIADH is associated with various conditions such as malignant tumors, infection, central nervous system disorders, and different pharmacological agents. The patient was 73-year-old female. She was admitted to the hospit al because of persistent cough, dizziness, gener al weakness and confusion. On admission, her serum osmolality was 253 mOsm/kg, urine osmolality was 416 mOm/ kg, and urine Na concentration was 159 mEq/ L. Her Chest X- ray and CT scan of lung showed about 4×3.5 cm sized mass at posterior basal segment of left lower lobe of the lung, and CT-guided percutaneous needle aspiration revealed small round cell with clusters of malignant squamous cells. She was treated by salt restriction, hypertonic saline infusion and demeclocycline. We planned chemotherapy for advaned combined lung cancer, but she was discharged because of poor general condition and associated pneumonia without cancer chemotherapy. We report a r are case of SIADH in small cell cancer of lung combined with squamous cell cancer of lung.(Korean J Med 61:562-566, 2001)

백서 뇌에서 망간에 의한 기저핵의 자멸사 및 병리조직학적 변화

하창원,이종임,김정란,장태정,김기권,김동훈 대한병리학회 2000 Journal of Pathology and Translational Medicine Vol.34 No.6

방광에 발생한 원발성 아밀로이드증 1례

장혁준,이활,손형규,하달봉,구정태,이정호,장태정,김정란,이경섭 大韓泌尿器科學會 1998 Korean Journal of Urology Vol.39 No.6

고환에 발생한 원발성 T 세포형 림프종

이형일,이활,장혁준,장태정,이경섭 大韓泌尿器科學會 2001 Korean Journal of Urology Vol.42 No.12