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명승재 ( Seung Jae Myung ),김인화 ( In Hwa Kim ) 대한소화기학회 2008 대한소화기학회지 Vol.51 No.5
Colon cancer is one of the major leading causes of cancer-related deaths in the Western countries. In Korea, the incidence of colon cancer is increasing due to changes in environment and lifestyle such as diet. Chemoprevention strategy using non-steroidal anti-inflammatory drugs (NSAIDs) has been under intensive clinical and epidemiological research as these drugs suppress colorectal cancer. The best known targets of NSAIDs are cyclooxygenase (COX) enzymes, which convert arachidonic acid to prostaglandins (PGs) and thromboxane. Among these PGs, prostaglandin E2 (PGE2) can promote tumor growth by binding its receptors and activating signal pathways which control cell proliferation, migration, apoptosis, and angiogenesis. Therefore, COX inhibition is promising approach for chemoprevention of colorectal cancer. However, the prolonged use of COX-2 inhibitors is associated with unacceptable cardiovascular side effects. Thus, new targets involved in PGs metabolism are under investigation. 15-hydroxyprostaglandin dehydrogenase (15-PGDH), a key metabolic enzyme of PGE2, was up-regulated in normal colonic epithelium, but decreased in colon cancer. Recent findings suggest that 15-PGDH is involved in the neoplastic progression of initiated colonic epithelial cells. Also, new players related with PGs metabolism including prostaglandin transporter (PGT) and microsomal prostaglandin E synthase (mPGES) were reported to play a role in colorectal cancer development. This review presents current knowledge about the role of prostaglandins and associated proteins in colorectal cancer development and progression. (Korean J Gastroenterol 2008;51:274-279)
명승재 ( Seung Jae Myung ),이태희 ( Tae Hee Lee ),허규찬 ( Kyu Chan Huh ),최석채 ( Suck Chei Choi ),손정일 ( Chong Il Sohn ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.5
To diagnose constipation accurately in self-reported constipated patients is very important not to miss organic disease and prevent therapeutic abuse. To investigate the etiology of functional constipation is also important to determine the therapeutic modality of constipation. In this systemic review, the clinical usefulness of symptom evaluation, diagnostic tests to rule out organic and systemic disease, and functional tests to discriminate underlying pathophysiology in the diagnosis of constipation were discussed. No specific symptoms or tests were available to predict organic versus functional constipation or differentiate slow transit constipation versus evacuation disorder. Therefore, collaborative studies are necessary to determine the pathophysiology of this disorder. (Korean J Gastroenterol 2010;55:316-324)
급성 B형 간염의 회복 후 말초혈액 단핵구에서의 HBV DNA 검출
명승재(Seung Jae Myung),이영상(Yung Sang Lee),김형건(Hyung Gun Kim),이근찬(Geun Chan Lee),박능화(Neung Hwa Park),정영화(Young Hwa Chung),서동진(Dong Jin Suh) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.1
N/A Background/Aims: Negative seroconversion of HBsAg with the appearance of anti-HBs and normalization of serum transarninase level have been generally accepted as an evidence of a cure of hepatitis B, and viral clearance. However, there are growing evidences that the hepatitis B virus (HBV) genome persists after those events. HBV DNA could be detected from the serum, peripheral blood mononuclear cells (PBMC) and liver tissue by sensitive PCR method, even when HBsAg is undetectable from the serum during the course of chronic hepatitis B. The aim of this study is to demonstrate whether HBV might persist in the circulation after complete serologic and clinical recovery from acute hepatitis and its clinical manifestations implications. Methods: We tried to detect HBV DNA from the serum and PBMC of 24 healthy individuals (male 16, female 8) with a history of self-limited acute hepatitis B infection using the PCR-Southern hybridization. Results: The mean duration from the onset of acute hepatitis to the time of sampling was 19+11 months, and HBV DNA was undetectable from sera of the individuals with PCR and Southern hybridization. HBV PCR was performed after the separation of PBMC and DNA isulation. HBV DNA was amplifiable in 4 of 24 individuals (17%). By Southem hybridization, HBV DNA was confirmed in 4 positive samples. The duration from the onset of acute hepatitis to the sarnpling time in positive group was 7.0 3.2 montks, and was significantly shorter than DNA negative counterpart (21.5 10.5 months)(p<0.01). Conclusions: Hepatitis B virus DNA can persist in peripheral blood mononuclear cells after resolution of acute hepatitis, and it may persist only for a certain period after clearance of virus in the serurn. The role of HBV DNA in PBMC should be elucidated in the future. (Korean J Gastroenterol 1997; 29:74-84)
양석균(Suk Kyun Yang),명승재(Seung Jae Myung),정훈용(Hwoon Yong Jung),홍원선(Weon Seon Hong),김진호(Jin Ho Kim),심기남(Ki Nam Shim),최재원(Jae Won Choe),김해경(Hae Kyung Kim),박무인,이미헌(Mi Hun Lee),김동일(Dong Il Kim),박의련(Eui Ryun 대한내과학회 2001 대한내과학회지 Vol.60 No.6
N/A Background: The current diagnosis of hereditary non-polyposis colorectal cancer (HNPCC) is dependent on a detailed family history based on the Amsterdam criteria proposed by the International Collaborative Group on HNPCC (ICG-HNPCC) in 1990. On recognizing the shortcomings of the ICG-HNPCC criteria, the Korean Hereditary Colorectal Cancer Registry (a subdivision of the Korean Hereditary Tumor Registry) designated the term uspected HNPCC for families who do not fullfill the criteria of the ICG-HNPCC but in whom a genetic basis for colon cancer is strongly suggested. The present study was designed to determine the frequency and define the clinical characteristics of suspected HNPCC. Methods: We analysed the clinical characteristics of 42 suspected HNPCC patients and their family members and compared these characteristics with that of 1,692 non-hereditary colorectal cancer patients. Results : The frequency of suspected HNPCC was 2.4% in our study. The mean age of suspected HNPCC patients at the time of diagnosis was 45.1±9.6 years and that of non-hereditary colorectal cancer patients was 57.4±11.9 years. The incidence of synchronous colorectal cancers in HNPCC was 7.1% and that of non-hereditary colorectal cancers was 0.9%. In suspected HNPCC families, 18 patients had extracolonic malignancies and the stomach cancer was the most common (55.5%). Conclusion : The frequency of suspected HNPCC among total colorectal cancer cases was 2.4% in our study. Tumors in suspected HNPCC differed from non-hereditary colorectal cancers in an early age of onset.(Korean J Med 60:507-513, 2001)
골반저 근실조 환자의 직장항문내압검사에 따른 분류와 그 임상적 의의
정성희 ( Sung Hee Jung ),명승재 ( Seung Jae Myung ),양석균 ( Suk Kyun Yang ),정훈용 ( Hwoon Yong Jung ),김대현 ( Dae Hyun Kim ),김태훈 ( Tae Hun Kim ),장혜숙 ( Hye Sook Chang ),윤인자 ( In Ja Yoon ),권오련 ( Oh Ryoun Kwon ),홍원선 대한소화기학회 2003 대한소화기학회지 Vol.41 No.6
Background/Aims: The pathophysiology of pelvic floor dyssynergia (PFD) is unclear and heterogenous. The PFD patient could be classified according to several manometric patterns. However, its clinical significance is not known. The aims of this study were to classify PFD patients according to manometric patterns and to evaluate its clinical meaning including response to biofeedback therapy. Methods: Seventy patients (M:F 21:49, mean age 51±18) with PFD who fulfilled Rome criteria were examined with anorectal manometry. These patients were classified into 4 groups according to manometric patterns. The types were defined as follows: Type 1, adequate propulsive force with paradoxical anal contraction (n=49); type II, inadequate propulsive force with inappropriate anal contraction (n=3); type III, adequate propulsive force with failure to relax (n=13); type IV, inadequate propulsive force with failure to relax (n=5). We compared the clinical findings, parameters of manometry, and responses to biofeedback therapy of the 4 groups. Results: Clinical findings including subjective symptoms were not different among the 4 groups. On anorectal manometry, squeezing pressure was low in type II and type IV compared to type I and type III (p<0.05). Only forty patients underwent biofeedback therapy, and there was no difference in the biofeedback response rate among the 4 groups. Conclusions: Pelvic floor dyssynergia could be classified into four groups according to manometric patterns. However, the significance of this classification system is dubious because clinical features including responses to biofeedback therapy are not different among groups. (Korean J Gastroenterol 2003;41:456-464)
궤양성 대장염에서 대장암의 조기진단을 위한 Telomerase 및 hTERT의 임상적 유용성울산대학교 의과대학 서울아산병원 소화기내과
김규종 ( Kyu Jong Kim ),명승재 ( Seung Jae Myung ),홍성수 ( Seong Soo Hong ),이선미 ( Sun Mi Lee ),변정식 ( Jeong Sik Byeon ),양석균 ( Suk Kyun Yang ),홍원선 ( Weon Seon Hong ),김진호 ( Jin Ho Kim ),민영일 ( Young Il Min ) 대한장연구학회 2004 Intestinal Research Vol.2 No.1
Clinical Usefulness of Telomerase and hTERT for the Detection of Colon Cancer in Ulcerative Colitis Background/Aims: Telomerase and telomerase reverse transcriptase (hTERT), are specifically expressed in cancer cells, making them candidate markers for the early detection of cancer. The aims of our study were to determine whether these assays may be useful in the diagnosis of colorectal cancer (CRC) developed in ulcerative colitis (UC) patients. Methods: Luminal washings and biopsies were collected during colonoscopy in 66 patients; 34 with CRC, 21 with UC, and 11 controls. Telomerase activity was detected by telomeric repeat amplification protocol (TRAP) and hTERT was assayed by RT-PCR Results: Telomerase activity was detected in biopsies from 33/34 (97%) CRC, 14/21 (67%) UC, and 3/11 (27%) controls. hTERT was positive in biopsies from 32/34 (94%) CRC, 12/21 (57%) UC, and 5/11 (45%) controls. In washing fluid, 21/34 (62%) of CRC patients were positive for telomerase, but UC patients and controls were negative. The sensitivity of telomerase for CRC was 97% in tissues and 62% in washing fluid. The specificity of telomerase in washing fluid was 100%, whereas the specificity of telomerase or hTERT mRNA in tissues was 47% each. Conclusions: The low specificity of telomerase and hTERT in colonic tissue suggest that these are not candidate markers for CRC arising in UC. Telomerase in colonoscopic luminal washings, however, may be a novel marker for early CRC in UC. (Intestinal Research 2004;2:15-20)
박수경 ( Soo Kyung Park ),명승재 ( Seung Jae Myung ) 대한내과학회 2012 대한내과학회지 Vol.83 No.5
Fecal incontinence is a common condition, which leads to impaired quality of life and huge financial cost at an individual and societal level. Recent studies have identified novel and potentially modifiable risk factors. Newer diagnostic modalities are giving more detailed information about underlying disorders, helping to implement targeted treatment. Many therapeutic options exist, and newer treatments are changing outcomes. This article will review recent developments in mechanisms, diagnosis, and treatment of fecal incontinence. (Korean J Med 2012;83:580-584)
기능성 변비 환자에서 골반저 근실조 환자를 구별해 낼 수 있는 임상적 지표
김대현 ( Dae Hyunn Kim ),명승재 ( Seung Jae Myung ),양석균 ( Suk Kyun Yang ),정성희 ( Sung Hee Jung ),장혜숙 ( Hye Sook Chang ),박일권 ( Il Gwon Park ),정훈용 ( Hwoon Yong Jung ),홍원선 ( Weon Seon Hong ),김진호 ( Jin Ho Kim ) 대한소화기기능성질환·운동학회 2002 Journal of Neurogastroenterology and Motility (JNM Vol.8 No.2
N/A PFD is effectively treated by biofeedback therapy. For the definite diagnosis of PFD, defecography, colon transit time study, balloon expulsion testing, and anorectal manometry are needed. However, these methods are of high cost and cause discomfort to patients. Moreover, definite diagnosis cannot be made by a single test due to a high false positive rate. In general, several symptoms linked with problems in defecating, including excessive straining, the sensation of incomplete evacuation, and applying pressure around the anus or the vagina to facilitate defecation, are known to be frequently associated with PFD. The aim of this study was to evaluate whether specific clinical parameters could differentiate patients with PFD from other constipated patients. Methods: An organized questionnaire including 47 questions that contained subjective symptoms, past medical history, and eating habits was designed. The questionnaire was distributed to 132 patients who fulfilled Rome II criteria for functional constipation. Digital rectal examination was conducted by a single gastroenterologist. Results: Among 132 patients, 45 patients were categorized as PFD, 26 patients as slow transit constipation (STC) and 17 patients as normal transit constipation. Among specific questions about constipation, hard stool was more frequently noted in patients with STC than PFD (p<0.05), and the frequency of defecation was lower in patients with STC than PFD (p<0.05). However, the symptoms suggesting difficult defecation were not different between the two groups. The percentage of paradoxical contraction by digital rectal examination was not different between the two groups (PFD: 57.1% vs. STC: 48.0%). Conclusion: The symptoms and signs suggesting difficult defecation could not differentiate PFD from STC and normal transit constipation, although several parameters were different among the three subgroups. Therefore, anorectal physiologic tests are needed for the diagnosis of PFD.(Kor ean J our nal of Gastrointestinal Motility 2002;8:167-176)