국내 분리 흉막폐렴균의 apxIA, IIA, IIIA 유전자 Cloning, 염기서열 분석 및 단백질 발현

신성재,조영욱,유한상,Shin, Sung-jae,Cho, Young-wook,Yoo, Han-sang 대한수의학회 2003 大韓獸醫學會誌 Vol.43 No.2

Actinobacillus pleuropneumoniae causes a highly contagious pleuropneumoniae in swine. The bacterium produces several virulence factors such as exotoxin, LPS, capsular polysaccharide, etc. Among them, the exotoxin, called Apx, has been focused as the major virulence factor, and the toxin consists of 4 gene cluster. apx CABD. apxA is the structural gene of toxin and has four different types, I, II, III, and IV. As the first step of development of a new subunit vaccine, the three different types of apxA gene were amplified from A. pleuropneumoniae isolated from Korea by PCR with primer designed based on the N- and C-terminal of the toxin. The sizes of apxIA, IIA and IIIA were 3,073, 2,971 and 3,159bps, respectively. The comparison of whole DNA sequences of apxIA, IIA and IIIA genes with those of the reference strain demonstrated 98%, 99% and 98% homology, respectively. In addition, the phylogenetic analysis was performed based on the amino acid sequences compared with 12 different RTX toxin family using the neighbor-joining method. ApxA proteins of Korean isolates were identical with reference strains in this study. All ApxA proteins were expressed in E. coli with pQE expression vector and identified using Western blot with polyclonal antibodies against culture supernatants of A. pleuropneumoniae serotype 2 or 5. The sizes of each expressed ApxA protein were about 120, 110, 125 kDa (M.W.), respectively. The results obtained in this study could be used for the future study to develop a new vaccine to porcine pleuropneumoniae.

국내 사육돼지에서의 Yersinia enterocolitica 38 kDa outer membrane protein에 대한 항체가 분포

신성재,박주연,최인수,신나리,유한상,Shin, Seong-jae,Park, Joo-youn,Choi, In-soo,Shin, Na-ri,Yoo, Han-sang 대한수의학회 2001 大韓獸醫學會誌 Vol.41 No.1

Yersinia enterocolitica is an inhabitant in the lower intestinal tract of many domestic and wild animals as well as in the nature. Of the several forms of diseases caused by Y. enterocolitica, an acute enteritis, especially in young children, is the most common form. Infection of the bacteria usually occurs through fecal-oral route by contaminated foods or water, especially mountainspring water. Of the domestic animals, swine has been known as one of the most important carrier in the human infection. Based on the knowledge, prevalence of antibody against Y enterocolitica was investigated with swine sera collected from Korea for the survey of Y enterocolitica infection in swine. As the first step of this survey, we analyzed outer membrane protein (OMP) profiles of the representative strains of Y enterocolitica isolated from the feces of piglets and mountainspring water in Korea. Thirty-eight kDa OMP was identified as the common OMP regardless of origin, serotype, or biotype of Y enterocolitica isolates. Presence of antibody specific for 38 kDa OMP of Y enterocolitica in 1,076 swine sera collected from November 1999 to October 2000 was analysed with ELISA. Antibody titer in sows was significantly higher than that in piglets, growing pigs and finishing pigs (p<0.05). Also, there was seasonal difference in the prevalence of antibody against Y enterocolitica. These results would provide the basic knowledge for controlling the Y enterocolitica infection in human as well as swine.

아스피린 혹은 와파린 복용 중 진단된 대장암의 임상 특징

신성재 ( Sung Jae Shin ),김병창 ( Byung Chang Kim ),박수영 ( Soo Young Park ),김성애 ( Sung Ai Kim ),김태일 ( Tae Il Kim ),김원호 ( Won Ho Kim ) 대한소화기학회 2005 대한소화기학회지 Vol.46 No.6

국내 대장폴립절제 시 치료 행태에 대한 설문조사

신성재 ( Sung Jae Shin ),이석호 ( Suck Ho Lee ),박동일 ( Dong Il Park ),홍성노 ( Sung Noh Hong ),김성은 ( Seong Eun Kim ),양동훈 ( Dong Hoon Yang ),홍성필 ( Sung Pil Hong ),이보인 ( Bo In Lee ),김현수 ( Hyun Soo Kim ),김영호 ( You 대한장연구학회 2011 Intestinal Research Vol.9 No.3

Background/Aims: There are no evidence-based, procedural guidelines to appropriately perform a colon polypectomy. Thus, we investigated the treatment modality for colon polypectomy in Korea, using a web-based e-mail survey. Methods: A questionnaire of preferred treatment modality for colon polypectomy was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians who performed colonoscopies as a screening or surveillance program nationwide. Among 425 colonoscopists who were sent the e-mail, 263 replied. We analysed data from 252 colonoscopists who had performed colon polypectomies. Results: The stopping time for antiplatelet and anticoagulation therapy before a colon polypectomy had a tendency to increase and the restarting time for these drugs was delayed as polyp size increased. Colonoscopists preferred cold biopsy removal for polyps <5 mm in size and a hot snare polypectomy after injecting normal saline and epinephrine mixture for polyps ≥5 mm in size. More than half of colonoscopists preferred observation rather than additional procedures for adenomas with incomplete resection. In contrast, most colonoscopists recommended additional procedures, such as endoscopic mucosal resection, endoscopic submucosal dissection or surgery for an advanced adenoma with incomplete resection. The most preferred prophylactic treatment for immediate postpolypectomy bleeding was hemoclipping. Conclusions: Various treatment modalities were used for a colon polypectomy because there are few guidelines for performing a colon polypectomy based on a critical review of the available data. Further well-designed, prospective studies are needed to develop evidence-based guidelines for colon polypectomy. (Intest Res 2011;9:196-205)

국내 분리 흉막폐렴균의 _apxⅠA, ⅡA, ⅢA 유전자 Cloning, 염기서열 분석 및 단백질 발현

신성재(Sung Jae Shin),조영욱(Young Wook Cho),유한상(Han Sang Yoo) 대한수의학회 2003 大韓獸醫學會誌 Vol.43 No.2

대장 종양 발견 향상을 위한 새로운 대장 내시경 기구

신성재 ( Sung Jae Shin ) 대한소화기학회 2016 대한소화기학회지 Vol.68 No.6

Early detection and removal of adenomatous polyps can prevent the development of colorectal cancer. However, it is fairly common―up to 20%―for polyps to be undetected in a colonoscopy due to poor visualization of the proximal aspect of colonic folds and anatomical flexures. To overcome these limitations, many new endoscopes and accessories have been developed. A wide-angle colonoscopy did not improve the detection of adenoma compared with the standard colonoscopy. An extra-wide angle and Retroview colonoscopies showed a significantly lower miss rate of polyps in the colon model. However, clinical trials are mandatory in the future. The recently introduced full spectrum endoscopy system showed a significantly higher adenoma detection rate than the standard forward-viewing colonoscopy. In accessories, The cap-assisted colonoscopy showed only a marginal or no benefit on the detection of polyps and adenomas. In contrast, a colonoscopy with Endocuff, EndoRings, and G-eye have showed significantly lower adenoma miss rates. The Third Eye, which provides additional retrograde viewing, has revealed a significant improvement in the detection of adenoma and polyp. However, the Third Eye Retroscope was limited by its deployment through the working channel of the scope. Recently, the Third Eye Panoramic cap, which was designed to overcome the limitation of the Third Eye Retroscope, was introduced. In the future, this would be needed to evaluate the effectiveness, efficiency and safety for these new colonoscopies and accessories. (Korean J Gastroenterol 2016;68:293-296)

궤양성 대장염에서 위 유문부 폐쇄를 일으킨 거대세포바이러스 감염 1예

강성환 ( Sung Hwan Kang ),이기명 ( Kee Myung Lee ),신성재 ( Sung Jae Shin ),임선교 ( Sun Kyo Lim ),황재철 ( Jae Chul Hwang ),김진홍 ( Jin Hong Kim ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.6

In patients with inflammatory bowel disease (IBD), cytomegalovirus (CMV) infections could aggravate the course of IBD but it is difficult to distinguish CMV infection from IBD exacerbation endoscopically. Usually, CMV tends to localize to the colon and other organic in-volvements were reported very rare in the IBD patients. Herein, we report a case that CMV gastric ulcer complicated with pyloric ob-struction in a patient with ulcerative colitis during ganciclovir therapy, which was resolved by surgical gastrojejunostomy with review of literature. (Korean J Gastroenterol 2017;69:359-362)

베체트장염 진단 가이드라인

천재희 ( Jae Hee Cheon ),신성재 ( Sung Jae Shin ),김상우 ( Sang Woo Kim ),이강문 ( Kang Moon Lee ),김주성 ( Joo Sung Kim ),김원호 ( Won Ho Kim ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.3

Due to similar manifestations of intestinal Behcet`s disease (BD) to those of other colitis such as Crohn`s disease or intestinal tuberculosis, it is still challenging for gastroenterologist to accurately diagnose intestinal BD in patients with ileo-colonic ulcers. Moreover, no reliable diagnostic criteria for intestinal BD have been developed yet. Therefore, IBD Study Group of KASID was formulated to establish the guideline for the diagnosis of intestinal BD using a modified Delphi process. The novel diagnostic criteria for intestinal BD were developed based on two aspects; colonoscopic findings and extra-intestinal systemic manifestations, in which patients were categorized into 4 groups including definite, probable, suspected, and non-diagnostic for intestinal BD. Furthermore, Disease Activity Index for intestinal BD was developed through a Korean multicenter study. These diagnostic and disease activity guidelines will contribute to understand intestinal BD. (Korean J Gastroenterol 2009;53:187-193)

폴립절제 후 추적대장내시경검사 가이드라인

홍성노 ( Sung Noh Hong ),양동훈 ( Dong Hoon Yang ),김영호 ( Young Ho Kim ),홍성필 ( Sung Pil Hong ),신성재 ( Sung Jae Shin ),김성은 ( Seong Eun Kim ),이보인 ( Bo In Lee ),이석호 ( Suck Ho Lee ),박동일 ( Dong Ii Park ),김현수 ( Hyu 대한소화기학회 2012 대한소화기학회지 Vol.59 No.2

1. 기준대장내시경검사에서 샘종이 3개 이상 발견된 환자는 추적대장내시경검사에서 진행신생물이 발견될 위험이 증가한다. 2. 기준대장내시경검사에서 10 mm 이상 크기의 샘종이 발견된 환자는 추적대장내시경검사에서 진행신생물이 발견될 위험이 증가한다. 3. 기준대장내시경검사에서 관융모 또는 융모샘종이 발견된 환자는 관샘종이 발견된 환자에 비해 추적대장내시경검사에서 진행신생물이 발견될 위험이 증가한다. 4. 기준대장내시경검사에서 제거한 샘종이 고도이형성을 동반한 경우, 저도이형성을 동반한 경우에 비해 추적대장내시 경검사에서 진행신생물이 발견될 위험이 증가한다. 5. 기준대장내시경검사에서 10 mm 이상의 톱니모양폴립이 발견된 환자는 추적대장내시경검사에서 진행신생물의 발생위험이 증가한다. 6. 추적검사에서 진행신생물 발생의 고위험군은 기준대장 내시경검사에서 샘종의 개수가 3개 이상, 가장 큰 샘종의 크기가 10 mm 이상, 관융모 또는 융모샘종, 고도이형성을 동반한 샘종, 또는 크기 10 mm 이상의 톱니모양폴립 중 한 가지 이상의 소견이 진단된 경우이다. 7. 일정한 자격을 갖춘 대장내시경의사가 양호한 대장정결 상태에서 양질의 기준대장내시경검사를 시행하였음을 전제로, 기준대장내시경검사 소견이 폴립절제 후 진행신생물의 발생 고위험군에 해당되지 않는 경우 추적대장내시경검사를 폴립절제 후 5년에 시행할 것을 권고한다. 그러나, 상기의 전제 조건이 만족되지 않거나 기준대장내시경검사 이전의 대장내 시경검사에서 고위험군에 해당하는 소견을 보였던 경우에는 기준대장내시경 소견이 고위험군에 해당되지 않더라도 추적 검사 기간을 단축할 것을 권고한다. 8. 일정한 자격을 갖춘 대장내시경의사가 양호한 대장정결 상태에서 양질의 기준대장내시경검사를 시행하였음을 전제로, 기준대장내시경검사 소견이 폴립절제 후 진행신생물의 발 생 고위험군에 해당하는 경우는 추적대장내시경검사를 폴립 절제 후 3년에 시행할 것을 권고한다. 그러나, 상기의 전제조건이 만족되지 않거나 기준대장내시경검사 소견, 샘종의 절제상태, 환자의 전신 상태, 가족력 및 과거력 등을 고려하여 추적검사 기간을 단축할 수 있다. Post-polypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. However, because the medical resource is limited, and the first screening colonoscopy produces the greatest effect on reducing the incidence and mortality of colorectal cancer, there is a need to increase the efficiency of postpolypectomy surveillance. In the present report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy. Based on the results of review of the evidences, we elucidated the high risk findings of the index colonoscopy as follows: 1) 3 or more adenomas, 2) any adenoma larger than 10 mm, 3) any tubulovillous or villous adenoma, 4) any adenoma with high-grade dysplasia, and 5) any serrated polyps larger than 10 mm. In patients without any high-risk findings at the index colonoscopy, surveillance colonoscopy should be performed five years after index colonoscopy. In patients with one or more high risk findings, surveillance colonoscopy should be performed three years after polypectomy. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polyp removal, the patient`s general condition, and family and medical history. This practical guideline cannot totally take the place of clinical judgments made by practitioners and should be revised and supplemented in the future as new evidence becomes available.

국내 대장 폴립 절제 후 추적검사 현황

홍성노 ( Sung Noh Hong ),양동훈 ( Dong Hoon Yang ),김영호 ( Young Ho Kim ),김성은 ( Seong Eun Kim ),신성재 ( Sung Jae Shin ),홍성필 ( Sung Pil Hong ),이보인 ( Bo In Lee ),이석호 ( Suck Ho Lee ),박동일 ( Dong Il Park ),김현수 ( Hyu 대한장연구학회 2011 Intestinal Research Vol.9 No.2

Background/Aims: There is a paucity of information on postpolypectomy surveillance currently practiced in Korea. Thus, we investigated the present state of postpolypectomy surveillance in Korea using a web-based survey. Methods:A multiple choice questionnaire was used to determine the preferred surveillance modality, the colonoscopic surveillance interval used in 11 case scenarios, and clinical factors influencing surveillance intervals. The form was sent via e-mail to members of the Korean Association for the Study of Intestinal Diseases and primary care physicians involved in a colonoscopy surveillance program. Of 425 colonoscopists contacted, 263 replied (response rate, 62%). Of the respondents, 94% were internists and 54% practiced in tertiary referral hospitals. Results: All respondents chose colonoscopy as a preferred surveillance modality following polyp removal. Colonoscopy at 3 years was the most frequent answer after removal of 1 or 2 tubular adenoma(s) <1 cm in size, while 1 year was the most frequent answer after removal of an advanced adenoma or ≥3 adenomas, and 6 months was the most frequent choice after removal of adenoma with high-grade dysplasia or a sessile polyp ≥2 cm. The agreement rate for the time of first surveillance between preferred guideline recommendations and respondent answers was in the low range at 14-43%. Conclusions: A significant disagreement exists between current postpolypectomy surveillance practices of Korean colonoscopists and preferred guideline recommendations. This discrepancy may be due to the fact that the guidelines do not reflect recent studies and the specific medical environment in Korea. Thus, there is a need to develop new evidence-based Korean guidelines for postpolypectomy surveillance. (Intest Res 2011;9:118-128)