금식시 흰쥐 소장 점막 유당분해효소에 대한 갑상선 호르몬의 영향 및 이의 유전적 조절 기전

이국래(Kook Lae Lee),이동호(Dong Ho Lee),이한주(Han Ju Lee),윤정환(Jung Hwan Yoon),김재규(Jae Gyu Kim),정운태(Woon Tae Jeong),정현채(Hyun Chae Jung),송인성(In Sung Song),김정룡(Chung Yong Kim) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.6

N/A Background/Aims: We perforrned this experiment to investigate the effect of thyroid hormone on the ]actase activity of rat small intestine by observing the change of lactase level according to the application of thyroid hormon: during fasting. Methods: Forty five male Wistar rats weighing about 260 gram were divided into three groups. The rats of control group(n=5) were sacrificed at 0 hour. The rats of first group(n=20) were starvated with intraperitoneal injection of 0.01 M NaOH 0.1 cc/100 gm body weight daily. The rats of second group(n=20) were starvated with intraperitonea] injection of triicdothyronine(T3) 30 ug disso]ved in 0.01 M NaOH 0.1 cc/100 gm body weight daily. The rats of first and second group were sacrificed at 12 hour, 1 day, 3 day, 5 day respectively, After sacriticing we measured T3 and free T4 level in serum, and intestinal lactase activity from three equally divided segments of removed small intestine. Ancl lactase mRNA were also measured. Results: The T3 and free T4 levels decreased in the NaOH injected groups, especially 3 day or 5 day groups, and T3 level increased in all the thyroid horrnone injected poups but free T4 level decreased. Lactase activity of proxima! Intestine was elevated with fasting, but not elevated in T3 application group. Lactase activity of middle and distal intestine showed similar changes. There was no statistically significant corre1ation between lactase activity and rnRNA level. Con< lusions: Lactase activity is controlled by thyroid hormone. Lactase expression may be regulated at the posttranscription level. (Korean J Gastroenterol 1996; 28:7S7-797)

대장상피세포에서 IL-10 유전자 전달의 CXC 케모카인에 대한 억제 효과

이국래 ( Kook Lae Lee ),김찬규 ( Chan Kyu Kim ),김병관 ( Byung Kwan Kim ),이동호 ( Dong Ho Lee ),김주성 ( Joo Sung Kim ),정현채 ( Hyun Chae Jung ),송인성 ( In Sung Song ),이연 ( Yeon Lee ),박종상 ( Jong Sang Park ) 대한소화기학회 2002 대한소화기학회 추계학술대회 Vol.2002 No.-

Helicobacter pylori 감염 진단에서 QuickVue H . pylori 검사와 기존의 IgG ELISA 검사와 비교 , 검토

이국래(Kook Lae Lee),임창영(Chang Young Lim),이동호(Dong Ho Lee),윤정환(Jung Hwan Yoon),이한주(Han Ju Lee),정현채(Hyun Chae Chung),송인성(In Sung Song),김정룡(Chung Yong Kim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.1

N/A Background/Aims: To evaluate and compare the efficacy of QuickVue H. pylori test and IgG ELISA test in diagnosis of Helicobacter pylori infection. Methods: One hundred patients(46 gastritis patients, 18 gastric ulcer patients, 18 duodenal ulcer patients, 15 nonulcer dyspepsia patients, 3 others including gastric cancer and adenoma) were enrolled in this study. Endoscopic gastric antral biopsy specimens were obtained for microscopic examination of the bacteria and rapid urease test(CLO test). Bio-Rad GAP IgG ELISA test(Bio-Rad Chemical Division, U.S.A.) and QuickVue H. pylori test(Quidel, U.S.A.) were also performed for serologic diagnosis of H. pylori infection. Detection of H. pylori by microscopy was considered as true positive for H. pylori infection. Absence of H. pylori by microscopy and positive CLO test was considered as equivocal and these cases were exc]uded in the analysis of the data. Results: 57 patients(57%) were positive, 36 patients(36%) were negative and 7 patients(7%) were equivocal in H. pylori infection. The sensitivity of IgG ELISA test was 84.2% and the specificity was 52.8%. The sensitivity of QuickVue H. pylori test was 87.7% and the specificity was 61.1%. Conclusions: Both serologic tests for the diagnosis of H. pylori infection are comparable in sensitivity and specificity.(Korean J Gastroenterol 1997; 29:35 -40)

대장상피세포에서 Interleukin-10 유전자 전달의 CXC 케모카인에 대한 억제 효과

이국래 ( Kook Lae Lee ),김찬규 ( Chan Gyoo Kim ),김병관 ( Byeong Gwan Kim ),장동경 ( Dong Kyung Chang ),이동호 ( Dong Ho Lee ),김주성 ( Joo Sung Kim ),정현채 ( Hyun Chae Jung ),이연 ( Yeon Lee ),박종상 ( Jong Sang Park ),송인성 ( 대한소화기학회 2003 대한소화기학회지 Vol.41 No.6

Background/Aims: Cytokine plays an important role in initiation and continuation of inflammatory bowel disease. However, cytokine protein has some limitation as a therapeutic tool because of low bioavailability, poor pharmacokinetics and chemical instability. Thus, we studied the effect of interleukin 10 (IL-10) gene transfection on murine colon cancer cell line by using non-viral gene carrier. Methods: Therapeutic gene and plasmid was pCAGGS mouse IL-10 and gene carriers were polyethyleneimine (PEI) and 3β[L-ornithinamide-carbamoyl] cholesterol (O-chol). After IL-10 gene transfection, we measured the level of IL-10 in supernatant of cultured CT-26 cells. The chemokine cytokine-induced neutrophil chemoattractant (KC) and macrophage inflammatory protein (MIP)-2, which were treated with lipopolysaccharide (LPS) or tumor necrosis factor-alpha (TNF-α), were measured after IL-10 gene transfection. Results: The IL-10 values were increased significantly by using PEI, but not by using O-chol. The KC and MIP-2 values were increased when LPS or TNF-α were treated. When PEI was used, KC and MIP-2 values increased by LPS or TNF-α were decreased. When O-chol was used, the KC values increased by TNF-α were decreased but those treated by LPS were not decreased, and the MIP-2 values were not decreased. Conclusions: After IL-10 gene transfection in colon cancer cell, IL-10 cytokine was efficiently expressed. The increased chemokine values by LPS or TNF-α were suppressed by IL-10 gene transfection, but which was not constant because of carrier efficiency. (Korean J Gastroenterol 2003;41:447-455)

HBV 에 의한 후괴사성 간경화환자들에서 조영 심초음파도를 이용한 폐내 단락에 관한 연구

이재호(Jae Ho Lee),이경미(Kyung Mi Lee),조주희(Joo Hee Zo),이동호(Dong Ho Lee),정경해(Kyung Hae Jung),김원배(Won Bae Kim),이국래(Kook Lae Lee),김철호(Cheol Ho Kim),정희순(Hee Soon Chung) 대한내과학회 1998 대한내과학회지 Vol.54 No.6

N/A Background: Liver cirrhosis is a common disease and mainly postnecrotic by the infection of hepatitis B virus (HBV) in Korea, and arterial hypoxemia is not a rare finding in liver cirrhosis. But there were few studies about hepatopulmonary syndrome which is defined as liver dysfunction, hypoxemia and intrapulmonary vascular dilatation, and one of the causes of arterial hypoxemia. Method: We examined the presence of dyspnea and stigmata of chronic liver disease in 35 patients who were diagnosed as Child class C, liver cirrhosis by HBV and had no evidence of intrinsic cardiopulmonary disease at Seoul Municipal Boramae Hospital (from January 1996 to October 1996). To diagnose hepatopulmonary syndrome, contrast-enhanced echocardiography was done for detecting intrapulmonary shunt in association with pulmonary function test, arterial blood gas analysis, chest roentgenogram and EKG. Result: 1) Twenty nine patients (82.9%) complained of exertional dyspnea, and the six from these patients also complained of resting dyspnea. Tachypnea was observed in 15 patients (42.9%/normal respiration rate defined as 12 to 16 per min), while platypnea was not found. 2) Splenomegaly and ascites were universal findings in all while clubbing of finger and cyanosis were observed in only 1 case (2.9%) and 2 cases (5.7%), respectively, and esophageal varix was found in the thirty two (91.4% / grade I in 9, grade II in 20 and grade III in 3 patients). Spider angioma was observed in the twenty one (70.0% among 30 patients). 3) Seven patients (20.0%) showed mild ventilatory defect of restrictive type since forced vital capacity decreased to 65-79% of predicted value. Diffusing capacity for carbon monoxide decreased below 70% of predicted value in 4 patients (11.4%). In addition, there were small amount of pleural effusion in 5 patients (14.3%) and nonspecific arrhythmia in 3 patients (8.6%). 4) Six cases (17.1%) had intrapulmonary shunt, which showed significantly lower arterial oxygen tension (72.2±15.1 vs 90.2±7.4 mmHg, p<0.05) and increased alveolar- arterial oxygen difference (43.1±16.2 vs 22.4±7.4 mmHg, p<0.05). 5) Only the cyanosis had a significant correlation with intrapulmonary shunt. Conclusion - 1) Intrapulmonary shunt was detected by contrast- enhanced echocardiography in the six from 35 cases of Child class C, liver cirrhosis by HBV 2) But only two patients of six positive intrapulmonary shunt patients showed significant hypoxemia (PaO2<70mmHg). Our results suggest that subclinical hepatopulmonary syrdrome may be exist.

스테로이드 저항성 궤양성 대장염 환자에 대한 Cyclosporine A의 치료 효과

이대희(Dae Hee Lee),이준행(Jun Haeng Lee),박동영(Dong Young Park),김윤준(Yoon Jun Kim),황진혁(Jin Hyok Hwang),차성덕(Sung Duk Cha),정운태(Woon Tae Jeong),윤정환(Jung Hwan Yoon),이국래(Kook Lae Lee),이동호(Dong Ho Lee),정현채(Hyun Cha 대한소화기학회 1998 대한소화기학회지 Vol.30 No.1

N/A Background/Aims: In refractory severe ulcerative colitis patients who are resistant to intravenous corticosteroids and total parenteral nutrition, new medical therapeutic tools that induce rapid remission is required in order that the patients can avoid colectomy. Since 1990, several western groups reported in their well designed studies that cyclosporine A cou)d induce rapid remission at steroid resistant severe ulcerative colitis patients resulting avoidance of colectomy. We tested the effectiveness of intravenous cyclosporine A therapy at steroid resistant severe ulcerative colitis patients in Korea, which has little experiences in the management of steroid resistant severe ulcerative colitis. Methods: Seven patients were included who were refractory to intravenous corticosteroids and total parenteral nutrition of at least 4 weeks duration. Their liver function tests and creatinine clearance tests were all normal. Cyclosporine A were administered by continuous intravenous methods over 6 hours or 24 hours. The starting doses of cyclosporine A were 4 mg/kg. The blood level was monitored by radioimmunoassay with a monoclonal antibody. The doses were adjusted at blood level from 100 ng/ml to 400ng/ml. In one patient cyclosporine A was administered for only 4 days because of rapid aggravation and consequent emergency operation. In another 6 patients cyclosporine A were administered for 14 days. Results: Four patients revealed scores of less than 10 by clinical activity scores system. But, in spite of improvement by scores, 3 patients of above 4 responders exhibited persistent gross hematochezias at frequencies of more than 3 times a day. Therefore operations were recommended in 6 patients. But one patient refused operation and is under OPD follow up with oral cyclosporine A and corticosteroids medications but he exhibits persistent gross hematochezia at a frequency of 3 or 4 tirnes a day. Out of 5 patients who were operated, 4 patients were cured by operations but 1 patient died because of postoperational sepsis. Conclusions: We found that the intravenous cyclosporine A therapy produced some improvement by clinical activity scores in 4 patients out of 7 patients but induced clinical remission of gross hematochezia in only 1 patient. Therefore operation could be avoided in only 1 patient. This result suggests that the response of Korean patients to intravenous cyclosporine A therapy would be different from that of western people. However, many another studies, especially case control studies are required to clarify this possibility and to assign the proper role of intravenous cyclosporine A therapy in the manageent of patients with ulcerative colitis in Korea. (Korean J Gastroenterol 1997; 30:58-65)

악성 대장 폐쇄 환자에서 고식적 치료로서 자가 팽창성 금속 스텐트의 임상적 유용성

정지봉 ( Ji Bong Jeong ),이국래 ( Kook Lae Lee ),권순범 ( Soon Beom Kwon ),김준석 ( Joon Suk Kim ),이재경 ( Jae Kyung Lee ),김원 ( Won Kim ),정용진 ( Yong Jin Jung ),김지원 ( Ji Won Kim ),김병관 ( Byeong Gwan Kim ) 대한장연구학회 2010 Intestinal Research Vol.8 No.2

Background/Aims: This study was designed to evaluate the outcomes of self-expanding metal stents (SEMS) as palliative treatment for malignant obstruction of the colon and rectum. Methods: From January 2003 to September 2009, 28 patients (12 men and 16 women) with malignant colorectal obstruction received placement of uncovered or covered stents for palliative purposes under endoscopic or fluoroscopic guidance. The rates of technical success, clinical success, and the complications associated with stent insertion, patient survival, and long-term stent patency were evaluated. Results: The technical and clinical success rates were 100% (28/28) and 89.3% (25/28), respectively. Among the 25 patients with technical and clinical success, seven patients (28%) experienced complications: A case of perforation (n=1) was managed by surgical intervention, cases of tumor ingrowth (n=4), tumor ingrowth and overgrowth (n=1), and tumor overgrowth (n=1) were managed successfully with an additional stent. The median survival duration was 128.0±54.8 days. The median stent patency duration was 93.0±29.1 days, and the patency rates at 30, 90, and 180 days were 92%, 52%, and 25%, respectively. Conclusions: The placement of a self-expanding metal stent was safe and effective palliative treatment for malignant colorectal obstruction. Stent-associated complications can be managed with the placement of additional stents in the majority of the patients and long-term stent patency is favorable. (Intest Res 2010;8:135-141)

양성 식도 협착의 치료에 있어서 내시경적 식도 확장술의 효과

김재규(Jae Gyu Kim),이국래(Kook Lae Lee),최문석(Moon Suk Choi),최일주(Il Ju Choi),김용태(Yong Tae Kim),최상운(Sang Woon Choi),정현채(Hyun Chae Jung),송인성(In Sung Song),최규완(Kyoo Wan Choi),김정룡(Chung Yong Kim) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

N/A Objectives: Dilatation therapy of benign esophageal stricture is now standard therapy. Although bougienage is widely used to treat benign esophageal stricture, the long-term effectiveness and clinical course of bougienage are unknown. Thus, we performed this study to evaluate the long-term effectiveness and clinical course of bougienage in benign esophageal stricture. Methods: We reviewed the medical records of patients with benign esophageal stricture who were treated by bougienage from 1988 to 1991. They were diagnosed as benign esophageal stricture by history, radiologic finding, endoscopic finding and pathology. Results: 1) Bougienage of benign esophageal stricture were effective in terms of improvement of dysphagia in 89 % of 35 paients. The etiology of benign esphageal stricture did not influence the effectiveness of bougienage. 2) Kaplan-Meier analysis showed that cummulative recurrence rate was 79% during a projected 60 months follow-up and the interval of 50% recurrence was 12.2 months. 3) Regardless of severity of stricture, the additional dilatations were needed in 55% of 31 patients impoved by first bougienge and 68% of 22 patients followed 6 months or longer. 4) The perforation rate per patient was 23% and the procedure related perforation rate was 7%. They were treated successfully by surgery or conservative treatment. The bleeding which needed transfusion occurred in 1 patient. He was terated successfully by trans-arterial embolization. Conclusion: Bougienage is safe and short-term effective treatment for benign esophageal stricture and could be utilized as primary therapy for most stricture. But in terms of high recurrence and compliication rate, well-designed controlled studies compared with surgical treatment will be necessary to find out long-term effectiveness of bougienage.

만성 궤양성 대장염의 추적관찰 - 단기적 치료 반응 및 재발율을 중심으로

장동경(Dong Kyung Chang),이국래(Kook Lae Lee),김재규(Jae Gyu Kim),김용태(Yong Tae Kim),정현채(Hyun Chae Jung),송인성(In Sung Song),최규완(Kyoo Wan Choi),김정룡(Chung Young Kim),박재갑(Jae Gahb Park),이풍렬(Poong Lyul Rhee),최상운(Sa 대한소화기학회 1994 대한소화기학회지 Vol.26 No.6

N/A Our retrospective study on 240 cases with chronic ulcerative colitis in Seoul National Uni- versity Hospital spanning from January,1975 to December,1993 revealed the following results. According to the extent of disease, there was 27.5% in proctitis, which was more frequent than that of the previous domestic reports, 15.8% in distal, 22.9% in left and 31.7% in exten- sive colitis. According to the severity of disease, there was 47.5% in mild, 32.9% in moderate and 19.6% in severe disease. There was a positive correlation between severity and extent of disease. The extraintestinal complications were not related with the extent, or severity. Howev- er 3 cases(1.3%) of toxic megacolon appeared in moderate or severe extensive colitis, one of which progressed to perforation. Two cases(0.8%) of mortality were noticed, one caused by perforation, the other by operation related complication. There was not a single case of colon cancer developed during follow up period. Most cases showed excellent short term response to medical treatment; the symptomatic remission rates were 90.3%, 85.7%, 72.9% and 58.9% in order of proctitis, distal, left and extensive colitis, and the endoscopic remission rates were 78.8%, 50.0%, 59.1% and 30.0% respectively. Higher remission rates corresponded with lower extent of the disease. According to the severity, the symptomatic remission rates of milder dis- ease were significantly higher. The cumulative relapse rates were 38.7% in 1 year, 62.4% in 2 years, 73.3% in 3 years and 81.9% in 5 years, which were not related to the extent but in- creased according to the severity. The cumulative operation rates were 5.0% in 1 year, 7.6% in 2 years, 10.2% in 3 years and 15.9% in 6 years. The emergency operation accounted for only 22.2% of all operation and the others were elective ones. The most frequent indication of surgery was medical intractability which was determined after mean 35 days of intensive med- ical therapy. We concluded that severity and extent of ulcerative colitis had predictive value of the responses to medical treatment or relapses, furthermore despite the high relapse rates, medical therapy was the first line treatment because of its high remission rates on a short- term base. (Korean J Gastroenterol 1994; 26: 907 918)

제균 요법과 관련된 항생제 관련 설사 및 위장관 이상반응

권순범 ( Soon Beom Kwon ),이국래 ( Kook Lae Lee ),김준석 ( Joon Suk Kim ),이재경 ( Jae Kyung Lee ),김원 ( Won Kim ),정용진 ( Yong Jin Jung ),정지봉 ( Ji Bong Jeong ),김지원 ( Ji Won Kim ),김병관 ( Byeong Gwan Kim ) 대한소화기학회 2010 대한소화기학회지 Vol.56 No.4

Background/Aims: Helicobacter pylori (H. pylori) is closely related with a wide range of gastrointestinal disease. One-week triple therapy is currently considered as the golden standard for the treatment of H. pylori infection. However, gastrointestinal abnormal responses are major pitfalls in such regimen. The aim of this study was to identify symptoms, frequency and severity of antibiotics-associated gastrointestinal abnormal responses during H. pylori eradication therapy. Methods: Sixty-seven patients with H. pylori infection between September 2005 and March 2006 were included. After 1 week of H. pylori eradication triple therapy (rabeprazol 10 mg, clarithromycin 500 mg, amoxicillin 1 g bid), we evaluated gastrointestinal abnormal responses (diarrhea, bloating, constipation, abdominal pain, borborygmus, flatulence, stool frequency, belching, and nausea) and severities every week for 4 weeks. Results: The incidence of diarrhea was the highest in week 1, which was 41.28% (n=28) and the lowest in week 4, which was 9.52% (n=6) and decreased from week 1 to week 4 with statistical significance (p<0.0001). The most common gastrointestinal abnormal responses were associated with flatulence in week 1 (n=21, 31.34%), week 2 (n=21, 33.33%) and abdominal distention in week 3 (n=16, 25.40%), week 4 (n=15, 23.81%). Most of gastrointestinal abnormal responses were mild, and the most common symptom with higher than moderate grade was abdominal pain (n=4, 40.00%) in week 1. Alcohol consumption and coexisting medical illness were not associated with diarrhea (p=0.0852, 0.9009 respectively). Conclusions: H. pylori eradication therapy is commonly associated with antibiotics-associated gastrointestinal abnormal responses, which may result in antibiotics intolerance and H. pylori eradication failure. Even though those symptoms are not so severe, we have to consider the gastrointestinal abnormal responses associated with H. pylori eradication, especially diarrhea. (Korean J Gastroenterol 2010;56:229- 235)