Reinfection rate and endoscopic changes after successful eradication of Helicobacter pylori.

Ryu, Kum Hei,Yi, Sun Young,Na, Youn Ju,Baik, Su Jung,Yoon, Su Jin,Jung, Hae-Sun,Song, Hyun Joo WJG Press 2010 WORLD JOURNAL OF GASTROENTEROLOGY Vol.16 No.2

<P>To determine the long-term outcomes regarding reinfection with Helicobacter pylori (H. pylori) and endoscopic changes after successful H. pylori eradication.</P>

장중첩증으로 발현한 회장 말단의 외투 세포 림프종 1예

유금혜 ( Kum Hei Ryu ),심기남 ( Ki Nam Shim ),송현주 ( Hyun Joo Song ),나윤주 ( Yoon Ju Na ),백수정 ( Su Jung Baik ),윤수진 ( Su Jin Yoon ),정해선 ( Hae Sun Jung ),염혜정 ( Hye Jung Yeom ),정성애 ( Sung Ae Jung ),김태헌 ( Tae Hun 대한장연구학회 2006 Intestinal Research Vol.4 No.1

Although the gastrointestinal tract is one of the major sites of primary extranodal malignant lymphoma, the colon and small bowel are less frequently involved than the stomach. Mantle cell lymphoma comprising only 6% of the malignant non-Hodgkin lymphomas. Mantle cell lymphoma usually distributes from the esophagus to rectum, with advanced stages of peripheral lymphadenopathy, splenomegaly, and bone marrow infiltration. We report a case of ileocolic intussusception due to ileal mantle cell lymphoma. (Intestinal Research 2006;4:61-63)

금속 수은의 경구 섭취 1예

유금혜 ( Kum Hei Ryu ),심기남 ( Ki Nam Shim ) 대한소화기학회 2007 대한소화기학회지 Vol.50 No.3

수술 전 위암조직에서의 Cadherin과 혈관내피 성장 인자 농도의 의의

유금혜 ( Kum Hei Ryu ),심기남 ( Ki Nam Shim ),정성애 ( Sung Ae Jung ),유권 ( Kwon Yoo ),주양희 ( Yang Hee Joo ),이주호 ( Joo Ho Lee ) 대한소화기학회 2012 대한소화기학회지 Vol.60 No.4

Background/Aims: The aims of this study were to examine the expressions of endothelium specific VE-cadherin, intestine specific LI-cadherin, and vascular endothelial growth factor (VEGF), and to determine their relationships with the clinicopathological parameters of gastric cancer. Methods: A total 47 patients with gastric cancer who underwent surgery were enrolled. Endoscopic biopsies were obtained from the cancer and normal mucosa, respectively. Using semiquantitative RT-PCR, the mRNA expression levels of VE-cadherin, LI-cadherin and VEGF were measured by tumor/normal (T/N) ratios. The protein expressions of VE-cadherin, LI-cadherin and VEGF were examined by Western blot and immunohistochemical stain in surgically resected tissues. The clinicopathological variables were reviewed and analyzed, retrospectively. Results: Twenty two cases (46.8%) of VE-cadherin, 25 cases (53.2%) of LI-cadherin and 27 cases (51.1%) of VEGF mRNA expressions were overexpressed in gastric cancer compared to normal tissue. There was a tendency for T/N ratio of VE-cadherin mRNA to correlate with the lymphatic invasion (p=0.07) and the lymph node metastasis (p=0.099) in advanced gastric cancer. The T/N ratio of LI-cadherin mRNA showed significant association with distant metastasis (p=0.031) and lymphatic invasion especially in advanced gastric cancer (p=0.023). There was a tendency for the T/N ratio of VEGF mRNA to correlate with the distant metastasis (p=0.073) in advanced gastric cancer. Conclusions: As increased mRNA expression of LI-cadherin was associated with distant metastasis and lymphatic invasion especially in the biopsy specimen of advanced gastric cancer before surgery, it may provide useful preoperative information on tumor aggressiveness.

Haemophilus parainfluenzae에 의한 감염성 심내막염 2예

유금혜,최희정,박시훈,박성훈,이미애 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

저자들은 정상 판막을 가진 25세 남환 및 22세 여환에서 전자는 호흡기 감염에 의한 H. parainfluenzae에 의해 감염성 심내막염과 폐색전증이 합병되었고, 후자는 심부전이 합병되어 인공판막대치수술을 시행한 경우를 문헌 고찰과 함께 보고하는 바이다. HACEK organisms are the normal flora of upper respiratory tract and orophaynx. They infect abnormal cardiac valves, causing subacute native valve endocarditis or prosthetic valve endocarditis more than one year after valve surgery. Haemophilus species are responsible for only 0.5-1% of all infectious endocarditis cases. Embolization occurs in 60% and the mortality rate ranges from 16-45% of cases of infective endocarditis caused by H. parainfluenzae. We report two cases of H. para-influenzae endocarditis, one of them is a 25-year-old male with tricuspid valve vegetations complicated with pulmonary embolism and the other is a 22-year-old female presented with heart failure.

Haemophilus parainfluenza에 의한 감염성 심내막염 2예

유금혜,최희정,박시훈,박성훈,이미애 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

Irritable Bowel Syndrome Is Associated With Gastroesophageal Reflux Symptom but Not Erosive Esophagitis

( Su Youn Nam ),( Kum Hei Ryu ),( Bum Joon Park ) 대한소화기기능성질환·운동학회 2013 Journal of Neurogastroenterology and Motility (JNM Vol.19 No.4

Background/Aims Although several studies have suggested overlaps between gastroesophageal reflux symptom and irritable bowel syndrome (IBS), the studies for the association between erosive esophagitis and IBS are rare. The aim of this study was to evaluate the association among IBS, non-erosive reflux disease (NERD), and erosive esophagitis. Methods A total of 2,769 participants completed questionnaires and underwent esophagogastroduodenoscopy and colonoscopy. IBS was diagnosed by Rome III; NERD was defined as heartburn or acid regurgitation occurring at least once per week without erosive esophagitis. Erosive esophagitis was defined by Los Angeles classification. Psychological distress was evaluated with modified 4 dimensions from revised Hopkins symptom checklist 90. Results Psychological distress was associated with both IBS and NERD, but not with erosive esophagitis. IBS was associated with somatization (adjusted OR, 2.88; 95% CI, 1.55-5.36; P < 0.001), anxiety (adjusted OR, 2.82; 95% CI, 1.36-5.88; P = 0.005), and hostility (adjusted OR, 2.06; 95% CI, 1.10-3.87; P = 0.024) and NERD was associated with somatization (adjusted OR, 5.65; 95% CI, 2.92-10.98; P < 0.001) and anxiety (adjusted OR, 3.29; 95% CI, 1.47-7.34; P = 0.004). Erosive esophagitis was associated with somatization (adjusted OR, 2.69; 95% CI, 1.26-7.91; P < 0.001). Hiatal hernia and male sex were related with erosive esophagitis but not with IBS or NERD. H. pylori had an inverse relationship with erosive esophagitis, but had no association with IBS. Whereas IBS was positively associated with NERD (adjusted OR, 2.72; 95% CI, 1.84-4.03; P < 0.001), it had no association with erosive esophagitis. Conclusions IBS shared many risk factors with NERD but not with erosive esophagitis. It partially explains why IBS was associated with NERD, but not with erosive esophagitis. (J Neurogastroenterol Motil 2013;19:521-531)

A Case of Ectopic ACTH Syndrome Associated with Small Cell Lung Cancer

Song, Hyun-Ju,Ryu, Kum-Hei,Kim, Su-Hyun,Yoon, Su-Jin,Kim, Do-Yeun,Im, Seock-Ah,Seong, Chu-Myong,Koo, Heasoo,Lee, Soon-Nam 이화여자대학교 의과대학 2003 EMJ (Ewha medical journal) Vol.26 No.2

We report a case of extensive stage SCLC with EAS confirmed by immunohistochemical stain of ACTH in tumor cells who died early due to rapidly progressive acute respiratory distress and pneumonia before the start of chemotherapy and corticosteroid blocking agent. Through our case, we learn how important early diagnosis and treatment of EAS associated with SCLC are and hope to apply to other cases from now on. 이소성 ACTH(adrenocorticotropic hormone)증후군은 ACTH를 분비하는 비뇌하수체종양으로 고코르티졸혈증을 보인다. 소세포폐암에서 ACTH를 분비하는 부종양 증후군은 비교적 흔하지만, 임상적으로 의미있는 고코르티졸혈증은 1~5% 정도로 매우 드물다. 이소성 ACTH 증후군은 소세포폐암이 전형적인 쿠싱증후군이 나타나기도 전에 빨리 진행하므로 전형적인 월상안, 복부비만, 골다공증 등의 증상을 나타낼 때까지 생존하는 경우가 매우 드물며, 체중 감소, 부종, 근위축 등 비전형적인 임상 양상을 나타내어 신속히 진단하여 치료하기가 어렵다. 도한 이소성 ACTH 증후군에 의한 고코르티졸혈증은 항암제에 잘 반응하지 않고 치료 중에 소화기 궤양, 출혈, 천공, 폐렴 등의 치명적인 합병증이 동반되므로평균 수명이 4개월 미만으로 예후가 매우 불량하다. 따라서, 소세포폐암에서 이소성 ACTH 증후군의 조기 발견 및 치료는 예후 향상을 위해 매우 중요하다. 이에 저자들은 61세의 비전형적인 쿠싱 증후군의 증상으로 발현된 진행성 소세포폐함의 환자에서 급격히 악화되는 임상 경과를 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

결핵 환자에서 면역학적 지표로서의 sIL-2R, IFN-$\gamma$, Neopterin에 관한 연구

류연주,유금혜,김수현,이종수,천선희,서주영,Ryu, Yon-Ju,Ryu, Kum-Hei,Kim, Su-Hyun,Lee, Jong-Soo,Cheon, Seon-Hee,Seoh, Ju-Young 대한결핵및호흡기학회 2002 Tuberculosis and Respiratory Diseases Vol.53 No.3

연구배경 :결핵은 세포 매개성 면역반응이 병태생리에 중요한 역할을 하는 감염성 질환이다. 결핵균 항원으로 T 림프구가 활성화되면 여러 종류의 cytokine을 분비하며 T 림프구의 분화와 증식, 대식세포의 활성화를 촉진한다. 본 연구에서는 결핵의 중증도, 숙주의 면역상태 및 예후를 반영하는 지표로서 활성화된 T 림프구에서 만들어지는 IL-2의 수용성 수용체인 sIL-2R와 IFN-$\gamma$를 측정하였고 활성화된 대식세포에서 분비되는 neopterin을 측정하여 임상적 유용성을 판정하고자 하였다. 대상 및 방법 :활동성 폐결핵 환자 39명, 결핵성 림프절염 환자 6명의 치료전과 정상 대조군 10명에서 혈청 sIL-2R, neopterin, IFN-$\gamma$를 측정하였고, 결핵성 흉막염 환자 22명에서 치료전 혈청과 흉막액에서 각각 sIL-2R, ADA, neopterin을 측정하였다. 폐결핵 환자 39명을 ATS guidelines에 따라 중증도를 분류하였고, 사망한 1명과 결핵요양소로 전원된 2명을 제외한 36명에서 초치료 2개월 후 혈청 sIL-2R, neopterin과 IFN-$\gamma$를 측정하였다. 결 과 : 1) sIL-2R과 IFN-$\gamma$는 결핵환자에서 대조군에 비하여 증가된 경향을 보였다(p>0.05). Neopterin은 대조군 $4949{\pm}1242.l$ pg/ml, 폐결핵 $29.67{\pm}2132.8$ pg/ml, 결핵성 림프절엽 $3013{\pm}1877.3$ pg/ml, 결핵성 흉막염이 $2035{\pm}1216.4$ pg/ml로 결핵환자에서 대조군에 비하여 감소되는 경향을 보였으며, 폐결핵군과 결핵성 흉막염군에서는 통계적으로 유의하게 감소되어 있었다(p<0.05). 2) 폐결핵의 중증도가 심할수록 sIL-2R와 IFN-$\gamma$는 증가하였고, neopterin은 감소하였다(p<0.01). 3) 폐결핵 환자 36명에서 치료 후 측정한 sIL-2R는 $1071{\pm}l139.4$ U/ml에서 $1023{\pm}1920.9$ U/ml로(p>0.05), IFN-$\gamma$는 $41{\pm}52.8$ pg/ml에서 $22{\pm}23.9$ pg/ml로 각각 감소하였고 (p<0.05), neopterin은 $3158{\pm}2272.6$ pg/ml에서 $3737{\pm}2307.5$ pg/ml로 증가하였다(p>0.05). 이러한 결과는 경증군과 중등증군에 비해 중증군에서 현저한 변화를 보였고 임상적 경과와 상관성을 보였다. 4) 결핵성 흉막염 환자 22명에서 sIL-2R와 ADA는 혈청에 비하여 흉막액에서 유의하게 높은 값을 보였으나(p<0.01), neopterin은 차이가 없었다(p>0.05). 결 론 : 이상의 결과를 바탕으로 특히 중증군에서 치료 후에 sIL-2R, IFN-$\gamma$와 neopterin을 추적 관찰하면 숙주의 면역반응상태, 임상적 중증도 및 치료 반응성을 예측하는데 도움이 될 것으로 생각된다. 또한 결핵성 흉막염 환자에서는 국소적인 변역반웅의 활성화로 흉막액내의 면역학적 지표의 측정이 혈청 검사보다 특이적이며, 흉막액의 sIL-2R의 측정이 결핵성 흉막염의 진단에 유용할 것으로 생각된다. Background : The cell-mediated immune response plays an important role in tuberculosis. After being activated by mycobacterial antigens, T lymphocytes express a high affinity receptor (IL-2R) for interleukin-2 (IL-2) on their own surface and release a soluble fraction of the IL-2 receptor (sIL-2R) from the cell membrane into the circulation. Neopterin is a metabolite of guanosine-triphosphate, which is produced by stimulated macrophages under the influence of IFN-$\gamma$ with a T lymphocyte origin. Therefore, the utility of sIL-2R, IFN-$\gamma$ and the neopterin levels as immunologic indices of the cell-mediated immune response and severity of disease in patients with pulmonary tuberculosis was assessed. Methods : The serum sIL-2R, IFN-$\gamma$ and neopterin levels were measured in 39 patients with pulmonary tuberculosis, 6 patients with tuberculous lymphadenitis prior to treatment and 10 healthy subjects. The serum and pleural sIL-2R, neopterin and ADA levels were measured in 22 patients with tuberculous pleurisy. The patients with pulmonary tuberculosis were divided into a mild, moderate and severe group according to the severity by ATS guidelines. To compare the results from these patients with those of the pretreatment levels, the sIL-2R, IFN-$\gamma$ and neopterin levels were measured in 36 of the 39 patients(1 patient, expired; 2 patients were referred to a sanitarium) with pulmonary tuberculosis after 2 months of treatment. Results : 1) the serum sIL-2R and IFN-$\gamma$ levels were elevated in patients with tuberculosis when compared to those of healthy subjects (p>0.05). The neopterin concentration in the serum was significantly lower in patients with pulmonary tuberculosis($2967{\pm}2132.8$ pg/ml) than in healthy controls($4949{\pm}1242.1$ pg/ml)(p<0.05). 2) In the pulmonary tuberculosis group, the serum sIL-2R and IFN-$\gamma$ levels were higher in patients with severe disease than those in patients with mild and moderate disease. However, the neopterin levels declined as the pulmonary tuberculosis became more severe (p<0.01). 3) The mean serum sIL-2R and IFN-$\gamma$ levels declined from $1071{\pm}1139.4$ U/ml to $1023{\pm}1920.9$ U/ml(p>0.05), $41{\pm}52.8$ pg/ml to $22{\pm}23.9$ gm/ml(p<0.05), respectively, after 2 month of treatment. The mean serum neopterin levels increased from $3158{\pm}2272.6$ pg/ml to $3737{\pm}2307.5$ pg/ml(p>0.05) after a 2 month of treatment. These findings were remarkable in the severe group of pulmonary tuberculosis with a clinical correlation. 4) In the patients with tuberculous pleurisy, the serum sIL-2R and ADA were significantly higher than those in the pleural fluid, However, the neopterin levels in the sera and pleural effusion were similar. Conclusion : On the basis of this study, sIL-2R, IFN-$\gamma$ and neopterin measurements may not only provide an insight into the present state of the cell-mediated immune response, but also serve as parameters monitoring of the prognosis of the disease, particularly in patients with severe pulmonary tuberculosis. In addition, an assay of the pleural sIL-2R levels might signal a stimulated local immunity including T cell activation in the tuberculous pleural effusion.

Prevalence and Risk Factors of Irritable Bowel Syndrome in Healthy Screenee Undergoing Colonoscopy and Laboratory Tests

( Su Youn Nam ),( Byung Chang Kim ),( Kum Hei Ryu ),( Bum Joon Park ) 대한소화기기능성질환·운동학회 2010 Journal of Neurogastroenterology and Motility (JNM Vol.16 No.1

Introduction: The prevalence of irritable bowel syndrome (IBS) after excluding organic disease has not been reported in Korea. Methods: Of 5,605 participants in a health screening program, inclusion criteria were persons who underwent colonoscopy and com -pleted questionnaires. Exclusion criteria were persons diagnosed with colon cancer, inflammatory bowel disease, previous colectomy, and abnormal results of thyroid function tests. IBS was defined by Rome III criteria. Physical and psychological stress was evaluated with visual analogue scales, ranging from 0 to 10. Risk factors for IBS were estimated with odds ratios (OR) and 95% confidence intervals (CI) using Logistic regression analysis. Results: The prevalence of IBS was 8.2% (5,605) in the total population and 9.1% (393/4,296) in the final study sample. IBS had a positive association with female sex (adjusted OR, 1.33; 95% CI, 1.00-1.79; p = 0.05) and current smoking (adjusted OR, 1.31; 95% CI, 1.00-1.71; p = 0.05). The prevalence of IBS increased with increased psychological stress (adjusted p for trend =0.005) and decreased with increasing age (adjusted p for trend 0.001), with adjusted OR of 0.95 (95% CI, 0.68-1.33) for age of 40.0 to 49.9 years; 0.79 (95% CI, 0.54-1.15) for age of 50.0 to 59.9 years; and 0.51 (95% CI, 0.30-0.86) for age of 60 years or more, compared with age Less than 40 years. Drinking status, body mass index, hypertension, diabetes, and use of sedatives had no association with IBS. Conclusions: The prevalence of IBS increased with decreasing age and increasing psychological stress, and was positively associated with female sex and current smoking.(J Neurogastroenterol Motil 2010;16:47-51)