Cytotoxic scalarane sesterterpenes from a Korean marine sponge Psammocinia sp.

( Dongyup Hahn ),( Dong Hwan ),( Bora Mun ),( Hiyoung Kim ),( Chulkyeong Han ),( Weihong Wang ),( Taeho Chun ),( Sunhee Park ),( Dajeong Yoon ),( Hyukjae Choi ),( Sang Jip Nam ),( Merrick Ekins ),( Ju 영남대학교 약품개발연구소 2013 영남대학교 약품개발연구소 연구업적집 Vol.23 No.0

Three novel scalarane sesterterpenes were isolated from a Korean marine sponge, Psammocinia sp., along with four known derivatives. Their structures were elucidated on the basis of NMR, MS and IR spectroscopic data. The three new compounds are 12-deacetoxy-23-hydroxyscalaradial (1), 12-dehydroxy-23-hydroxyhyrtiolide (2) and 12-O-acetyl-16-deacetoxy-23-acetoxyscalarafuran (3), respectively, and the four known compounds are 12-deacetoxy-23-hydroxyheteronemin (4), 12-deacetoxy-23-acetoxy-19-O-acetylscalarin (5), 12-deacetoxy-23-O-acetoxyheteronemin (6) and 12-deacetoxyscalaradial (7). They exhibited cytotoxicity against intractable human cancer cell lines A498, ACHN, MIA-paca and PANC-1, with an IC50 range of 0.4-48 μM. ⓒ2013 Elsevier Ltd. All rights reserves.

Direct observation of the conformational transitions of single pyridine molecules on a Ag(110) surface induced by long-range repulsive intermolecular interactions

Lee, Insup,Son, Seungbae,Shin, Taeho,Hahn, Jae R. American Institute of Physics 2017 The Journal of Chemical Physics Vol.146 No.1

Clinical Features and Prognosis of Spontaneous Bacterial Peritonitis in Korean Patients with Liver Cirrhosis: A Multicenter Retrospective Study

( Jeong Heo ),( Yeon Seok Seo ),( Hyung Joon Yim ),( Taeho Hahn ),( Sang Hoon Park ),( Sang Hoon Ahn ),( Jun Yong Park ),( Ji Young Park ),( Moon Young Kim ),( Sung Keun Park ),( Mong Cho ),( Soon Ho 대한소화기기능성질환·운동학회 2009 Gut and Liver Vol.3 No.3

Background/Aims: Although early recognition and treatment with effective antibiotics have lead to improvements in the prognosis of patients with spontaneous bacterial peritonitis (SBP), it remains to be a serious complication in cirrhotic patients. This study was designed to evaluate the clinical manifestations and prognosis of patients with liver cirrhosis and SBP in Korea. Methods: This was a multicenter retrospective study examining 157 episodes of SBP in 145 patients with cirrhosis. SBP was diagnosed based on a polymorphonuclear cell count in ascitic fluid of > 250 cells/mm3 in the absence of data compatible with secondary peritonitis. Results: The mean age of the cohort was 56 years, and 121 (77%) of the 157 episodes of SBP occurred in men. Microorganisms were isolated in 66 episodes (42%): Gram-negative bacteria in 54 (81.8%), Gram-positive in 11 (16.7%), and Candida in 1. Isolated Gram-negative organisms were resistant to third-generation cephalosporin in 6 cases (17%), to ciprofloxacin in 11 (20.8%), and to penicillin in 33 (62.3%). The treatment failure and in-hospital mortality rates were 12.1% and 21%, respectively. A high Model of End-Stage Liver Disease (MELD) score, SBP caused by extended-spectrum β-lactamase-producing organisms, and hepatocellular carcinoma were independent prognostic factors of high in-hospital mortality. Conclusions: SBP remains to be a serious complication with high in-hospital mortality, especially in patients with a high MELD score. (Gut and Liver 2009;3:197-204)

에스자결장암에 의한 성인 장중첩증: 복부 전산화단층촬영의 삼차원 재구성

문준호 ( Joon Ho Moon ),박철희 ( Cheol Hee Park ),김경오 ( Kyoung Oh Kim ),한태호 ( Taeho Hahn ),유교상 ( Kyo Sang Yoo ),박상훈 ( Sang Hoon Park ),김종혁 ( Jong Hyeok Kim ),박충기 ( Choong Kee Park ) 대한장연구학회 2006 Intestinal Research Vol.4 No.1

Intussusceptions in adults are relatively rare. About 70% to 90% of cases have demonstrable etiologies, and 40% of them are caused by malignant neoplasm. Diagnosis may be difficult with conventional diagnostic techniques due to the low incidence and the rare consideration to intussusception in adults. Computed tomography (CT) is now widely used in the evaluation of abdominal mass and nonspecific abdominal pain that may be the first presentation of an intussusception. But, CT is often not successful in determining the specific causes of the intussusception, as the lead point in many cases is small and often hidden within the intussuscepted mass. We report two cases of adult intussusceptions by sigmoid colon cancer with three-dimensional reconstruction of conventional CT. (Intestinal Research 2006;4:69-73)

수면 대장내시경에서 Propofol 단독요법과 Midazolam, Propofol 병합요법의 효과 비교 연구

박철희 ( Cheol Hee Park ),장성훈 ( Soung Hoon Chang ),정재원 ( Jae One Jung ),문준호 ( Joon Ho Moon ),신운건 ( Woon Geon Shin ),김종표 ( Jong Pyo Kim ),김경오 ( Kyung Oh Kim ),한태호 ( Taeho Hahn ),유교상 ( Kyo Sang Yoo ),박상훈 ( 대한장연구학회 2006 Intestinal Research Vol.4 No.2

목적: 최근 대장 질환의 발생 빈도가 증가함에 따라 환자가 두려움 없이 편안하게 검사를 받을 수 있으면서 시술 의사가 안심하고 검사할 수 있는 수면 대장내시경이 요구되고 있다. 저자는 수면 대장내시경에서 propofol 단독요법과 midazolam, propofol 병합요법을 서로 비교하여 보다 좋은 전처치법을 개발하고자 하였다. 대상 및 방법: 2004년 8월부터 2005년 5월까지 한림대성심병원에서 수면유도법에 의한 대장내시경을 시행한 환자를 대상으로 propofol 단독요법군(108예)과 midazolam, propofol 병합요법군(102예)으로 나누어 연구를 시행하였다. 단독요법군은 propofol을 2-2.5 ml/kg/hr로 정주하였고, 병합요법군은 midazolam 3 mg을 정주 후 propofol을 2-2.5 ml/kg/hr로 정주하였다. 검사 중 지속적으로 심전도, 혈압, 맥박, 산소포화도 등을 감시하였다. 진정상태까지의 propofol 용량, 전체 propofol 용량, 수면유도시간, 내시경소요시간, 회복시간, 환자만족도, 시술자 만족도를 측정하여 두 군 간의 결과를 비교하였다. 결과: 시술 전과 시술 중의 혈압, 분당 심박수, 호흡횟수, 산소포화도 변화에 있어서 두 군간에 유의한 차이는 없었다. 진정상태까지의 propofol 용량과 전체 propofol 용량은 병합요법군에서 단독요법군에 비해 유의하게 적었다(p<0.001). 수면유도시간은 병합요법군에서 단독요법군에 비해 유의하게 짧았다(p<0.001). 회복시간과 환자 만족도에서 두 군간에 유의한 차이는 없었다. 시술자만족도는 병합요법군에서 유의하게 높았다(p=0.04). 두 군 모두에서 치명적인 부작용을 보인 예는 없었다. 결론: 수면 대장내시경에서 midazolam, propofol 병합요법은 propofol 단독요법에 비해 propofol 용량을 줄일 수 있었고, 부작용 발생의 증가없이 수면유도시간을 단축할 수 있었다. Background/Aims: Recent studies showed that propofol and midazolam act synergistically in combination and therefore it may be superior to sedation with propofol alone in terms of sedating efficacy. We compared the effect of propofol alone and combined use of propofol and midazolam during colonoscopy. Methods: P (propofol alone) group received propofol (2-2.5 ml/kg/hr) plus normal saline (3 ml) and MP (propofol/midazolam) group received propofol (2-2.5 ml/kg/hr) plus midazolam (3 mg). We compared followings in both groups; 1) induction and total propofol dosage 2) induction and procedure time 3) recovery time 4) satisfaction of patients and doctors 5) adverse effects. Results: Induction (9 vs. 12 ml) and total (17 vs. 22 ml) propofol dosage were lower in MP group than P group (p<0.05). Induction (3.6 vs. 5.5 min) time was shorter in MP group than P group (p<0.05). In both groups, significant difference was not observed in the change of blood pressure, heart rate, respiration rate, and peripheral blood oxygen saturation rate. Fatal adverse effect was not found in both groups. Conclusions: Combined use of propofol and midazolam is more effective sedative method than the use of propofol alone because of rapid induction and lower propofol dosage without increasing adverse effects. (Intestinal Research 2006;4:87-94)

허혈성 대장염의 예후 인자와 고해상도 초음파의 유용성

신운건 ( Woon Geon Shin ),박철희 ( Cheol Hee Park ),정재원 ( Jae One Jung ),문준호 ( Joon Ho Moon ),김경오 ( Kyoung Oh Kim ),정용우 ( Yong Woo Chung ),백광호 ( Gwang Ho Baek ),한태호 ( Taeho Hahn ),유교상 ( Kyo Sang Yoo ),박상훈 ( 대한장연구학회 2006 Intestinal Research Vol.4 No.1

목적: 허혈성 대장염은 허혈성 장질환 중에 가장 흔한 질환으로 자연 치유되는 경우부터 수술이 필요한 경우까지 다양한 임상 경과를 나타낸다. 하지만 보존적 치료에 반응하지 않는 환자를 예측할 수 있는 인자에 대한 연구는 부족한 실정이다. 본 연구에서는 허혈성 대장염의 예후 인자를 알아 보고 허혈성 대장염에서 고해상도 초음파의 유용성에 대해 알아보고자 하였다. 대상 및 방법: 1999년 4월부터 2004년 3월까지 대장에 국한된 허혈성 대장염을 진단 받은 60명의 환자를 대상으로 하였다. 보존적 치료로 호전된 예후가 좋은 군과 수술적 치료가 필요했거나 사망한 예후가 나쁜 군으로 나누어 나이, 성별, 증상, 복수의 유무, 재원기간, 동반 질환, 침범한 결장의 위치를 비교하였고 고해상도 초음파로 얻은 병변의 위치와 심한 정도를 대장내시경 소견과 비교하여 고해상도 초음파 검사의 민감도, 특이도, 양성예측도, 음성예측도를 계산하였다. 결과: 수술하거나 사망한 군의 평균 나이는 72세로 보존적 치료군의 56세보다 통계학적으로 의미 있게 많았고(p=0.017), 병변 부위가 우측 대장인 경우에 수술하거나 사망한 환자들이 많았다(p=0.001). 혈변이 있었던 환자는 보존적 치료로 호전되는 경우가 많았다(p=0.017). 로그회귀분석 결과에서 병변부위가 우측 대장에만 국한된 경우가 독립적인 불량한 예후 인자였다(95% confidence interval), 1.7- 46.4; p=0.01). 고해상도 초음파는 민감도 85%, 특이도 82%였는데 특히 맹장과 상행결장의 병변에 대한 민감도는 100%였다. 양성예측도와 음성예측도는 각각 74%와 90%이었다. 결론: 우측 대장을 침범한 허혈성 대장염은 독립적인 불량한 예후 인자였으며 고해상도 초음파는 우측 결장의 허혈성 병변을 평가하고 추적 관찰하는데 유용한 검사법이었다. 따라서 심한 허혈성 대장염이 의심되는 환자의 초기 검사로 S상결장경 검사와 고해상도 초음파 검사를 병행하는 방법도 유용할 것이라고 생각한다. Background/Aims: Although the majority of ischemic colitis have excellent prognosis by supportive management, there are a lot of controversies in relation to the prognostic factors. Lately, role of sonography has been emphasized in colonic ischemia. The aim of this study is the identification of the prognostic factors and the usefulness of high-resolution ultrasonography in detecting involved site and severity of ischemic colitis. Methods: The clinical databases were reviewed between April 1999 and March 2004. 60 cases were diagnosed as ischemic colitis. Clinical characteristics, coexisting illness, segment of colon involved, and sonographic finding were analyzed. Results: The poor prognosis group was significantly older than the good prognosis group (p=0.017). The difference in involved colonic segment between the two groups was statistically significant (p=0.001). However, in logistic regression, only right colonic involvement was an independent poor prognostic factor (95% confidence interval, 1.7-46.4; p=0.01). Ultrasonography had a sensitivity of 85% and a specificity of 82%. Conclusions: Only right colonic involvement was an independent poor prognostic factor. Noninvasive high-resolution ultrasonography was a valuable technique for the detection and the follow-up of colonic ischemia. Therefore, sigmoidoscopy and sonography are preferable to heavy going colonoscopy in severe colonic ischemia. (Intestinal Research 2006;4:32-38)

Clinical Features and Treatment Outcomes of Upper Gastrointestinal Bleeding in Patients with Cirrhosis

Seo, Yeon Seok,Kim, Youn Ho,Ahn, Sang Hoon,Yu, Sang Kyun,Baik, Soon Koo,Choi, Sung Kyu,Heo, Jeong,Hahn, Taeho,Yoo, Tae Woo,Cho, Se Hyun,Lee, Hyun Woong,Kim, Ju Hyun,Cho, Mong,Park, Sang Hoon,Kim, Byun The Korean Academy of Medical Sciences 2008 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.23 No.4

<P>With recent progress in treatment modalities, mortality from upper gastrointestinal (UGI) bleeding has decreased appreciably. The aim of this study was to establish how UGI bleeds are managed in Korean patients with cirrhosis and to evaluate treatment outcomes. A total of 479 episodes of acute UGI bleeding in 464 patients with cirrhosis were included during a six-month period at nine tertiary medical centers. Treatment outcomes were assessed by failure to control bleeding, rebleeding and mortality. The source of bleeding was esophagogastric varices in 77.7% of patients, nonvariceal lesions in 15.9%, and undefined in 6.5%. For control of bleeding, endoscopic and pharmacologic treatments were used in 74.7% and 81.9% of patients, respectively. Variceal ligation was a major technique for endoscopic treatment (90%), and terlipressin and somatostatin were the main pharmacologic agents used (96.4%). Initial hemostasis was achieved in 86.8% of cases, but rebleeding occurred in 3.8% and 16.8% of cases within five days and six weeks of hemorrhage, respectively. Five-day and six-week mortality were 11.3% and 25.9%, respectively. Survival of patients with variceal bleeding seems to be remarkably improved than previous reports, which may suggest the advances in hemostatic methods for control of variceal hemorrhage.</P>

연구논문 : 비알코올성 지방간질환에서 nonalcoholic fatty Liver diseases activity score (NAS)의 유용성 평가 및 임상적 요소와의 상관성

이경훈 ( Kyung Hun Lee ),박상훈 ( Sang Hoon Park ),김유진 ( Yu Jin Kim ),허경림 ( Kyung Rim Huh ),민광선 ( Kwang Seon Min ),전선영 ( Sun Young Jun ),김경오 ( Kyoung Oh Kim ),박철희 ( Cheol Hee Park ),한태호 ( Taeho Hahn ),유교상 ( 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.1

목적: NASH란 비만, 인슐린저항성, 2형 당뇨병, 고혈압, 고지혈증 등이 포함되는 대사증후군에서 나타나는 간질환으로 진단에 있어서 알코올 섭취 병력과 간생검 조직검사가 매우 중요하다. 그 동안 간생검 조직검사의 진단에 있어서 1999년 Brunt 등이 제시한 분류 체계를 사용해 왔는데, 2005년 NAS가 Kleiner등에 의해 제안되었다. 본 연구는 한국인 NASH환자에 대하여 NAS의 유용성 및 임상지표와의 연관성에 대하여 알아보고자 하였다. 대상 및 방법: 1999년부터 2007년까지 임상적으로 NASH로 진단 받고 초음파 유도하 간조직생검을 시행한 56예의 환자를 대상으로 분석을 시행하였다. 두 명의 병리의사가 같은 조직을 서로 다른 각각의 분류 체계를 이용하여 평가하였다. 중성지방을 포함한 혈청 지질과 CRP, 허리둘레, 체질량지수, 수축기혈압, 이완 기혈압, HOMA-IR 같은 대사증후군의 인자들과 공복 시 포도당, leptin, ferritin, 인슐린, C-peptide 비율 등의 생화학적 요소들을 측정하였다. 결과: 환자들의 평균 나이는 32.1±12.5세였으며 44명(78.6%)이 남자였다. 두 분류 체계에서 차이를 보이는 환자들은 약간의 지방 변성과 풍선양 변화와 섬유화를 동반한 환자들이었다. NAS 3, 4점의 borderline은 전체 판독 예 중 36.6%였다. 두 병리의사의 진단 일치도는 카파 값이 0.748(P<0.001)로 우수하였다. NAS가 높을수록 공복 시 혈당과 ALT, 중성지방이 증가되어 있었다. 결론: NAS는 한국인의 NASH진단에 있어서 간단하고 재연성이 좋은 분류 체계이다. Background/Aim: Nonalcoholic steatohepatitis (NASH) is commonly diagnosed using the semi-quantitative grading and staging system proposed by Brunt et al. in 1999. The Pathology Committee of the NASH established the nonalcoholic fatty liver diseases (NAFLD) activity score (NAS) in 2005. The aim of this study was to elucidate the validity and reliability of the NAS in Korean NAFLD patients. Methods: Fifty-six patients on whom sonography-guided liver biopsy for well-defined NAFLD was performed between 1999 and 2007 were identified retrospectively. Two pathologists evaluated each biopsy sample. NAFLD was evaluated using both the grading system developed by Brunt et al. and the NAS. Each pathologist was blinded to the patients` clinical data and scored independently. We evaluated the body mass index (BMI), liver enzymes, lipid profile, peripheral insulin resistance, leptin, insulin/c-peptide ratio, ferritin, and fasting blood glucose. Results: The patients were aged 32.1±12.5 years (mean±SD) and comprised 44 males (78.6%). Patients with different grades at the two grading systems had mild steatosis or ballooning changes with fibrosis, and 36.6% of them were borderline cases (NAS of 3 or 4). The interobserver agreement on diagnostic category was 0.748 (P<0.001) for the NAS (using weighted κ statistics). Elevated fasting glucose, ALT, and triglyceride were associated with the NAS. Conclusions: The simple and reproducible NAS was found to be a useful pathologic grading system in Korean NAFLD patients. However, the proportion of borderline cases based on the NAS was high. The "wait and see" strategy is necessary for evaluating the long-term prognosis. (Korean J Hepatol 2010;16:29-37)