Association of variant in PPAR-γ2, IGF2BP2 with susceptibility to gestational diabetes mellitus in Korean population

( Seung Joo Chon ),( Suk Young Kim ),( Dle Lae Min ),( Nu Ri Cho ),( You Jin Hwang ),( Mizuko Mamura ) 대한산부인과학회 2011 대한산부인과학회 학술대회 Vol.97 No.-

Esophageal Cancer in Esophageal Diverticula Associated with Achalasia

Choi, Ah Ran,Chon, Nu Ri,Youn, Young Hoon,Paik, Hyo Chae,Kim, Yon Hee,Park, Hyojin The Korean Society of Gastrointestinal Endoscopy 2015 Clinical Endoscopy Vol.48 No.1

<P>The simultaneous occurrence of achalasia and esophageal diverticula is rare. Here, we report the case of a 68-year-old man with multiple esophageal diverticula associated with achalasia who was later diagnosed with early esophageal cancer. He initially presented with dysphagia and dyspepsia, and injection of botulinum toxin to the lower esophageal sphincter relieved his symptoms. Five years later, however, the patient presented with worsening of symptoms, and esophagogastroduodenoscopy (EGD) was performed. The endoscopic findings showed multifocal lugol-voiding lesions identified as moderate dysplasia. We decided to use photodynamic therapy to treat the multifocal dysplastic lesions. At follow-up EGD 2 months after photodynamic therapy, more lugol-voiding lesions representing a squamous cell carcinoma <I>in situ</I> were found. The patient ultimately underwent surgery for the treatment of recurrent esophageal multifocal neoplasia. After a follow-up period of 3 years, the patient showed a good outcome without symptoms. To manage premalignant lesions such as achalasia with esophageal diverticula, clinicians should be cautious, but have an aggressive approach regarding endoscopic surveillance.</P>

The Effects of an Extract of Atractylodes Japonica Rhizome, SKI3246 on Gastrointestinal Motility in Guinea Pigs

( Jae Jun Park ),( Nu Ri Chon ),( Young Ju Lee ),( Hyojin Park ) 대한소화기기능성질환·운동학회 2015 Journal of Neurogastroenterology and Motility (JNM Vol.21 No.3

Background/Aims: There are limited therapeutic options available for irritable bowel syndrome with diarrhea (IBS-D). We tested the effects of Atractylodes japonica rhizome, a perennial plant native to North Asia, on both upper and lower gastrointestinal (GI) motility in guinea pigs. Methods: The extract of A. japonica rhizome was administered orally at different doses to test its effects on upper GI motility as determined from charcoal transit in native guinea pigs and in guinea pigs pretreated with thyrotropin-releasing hormone or mustard oil. Regarding its effect on lower GI motility, the removed guinea pig colon was suspended in a chamber containing Krebs-Henseleit solution and the transit time of artificial feces was measured with various dilutions of the extract. As for in vivo assay, weight and number of fecal pellets expelled were determined under the same drug preparation used in upper GI motility experiment. Results: The extract of A. japonica rhizome had no significant effect on upper GI motility in either normal or altered physiological states. However, the extract increased colonic transit time in the in vitro model. In the fecal expulsion study, the cumulative weight and number of pellets did not differ significantly between the control group and groups treated with the extracts. In the animals pretreated in vivo with thyrotropin-releasing hormone, however, the weight and number of fecal pellets were significantly decreased in animals treated with 300 mg/kg and 600 mg/kg doses of extract. Conclusions: Our findings suggest that the extract of A. japonica rhizome can be a potential agent for IBS-D. (J Neurogastroenterol Motil 2015;21:352-360)

기니 픽의 수술 후 장 폐색 모델에서 위장관 운동에 대한 Itopride Hydrochloride의 효과

임현철 ( Hyun Chul Lim ),전누리 ( Nu Ri Chon ),최은주 ( Eun Ju Choi ),이영호 ( Young Ho Lee ),이민구 ( Min Goo Lee ),박효진 ( Hyo Jin Park ) 대한소화기기능성질환·운동학회 2008 Journal of Neurogastroenterology and Motility (JNM Vol.14 No.1

목적 : 수술 후 장 폐색(postoperative ileus)은 복부 수술 후에 발생하는 일시적인 위장관 운동의 장애로 인한 장내내용물의 이동 장애로 정의할 수 있다. 장 폐색은 수술 후 장관의 억제성 교감 신경의 반사가 활성화되고, 카테콜아민과 염증성 매개체가 분비되어 장 운동이 억제되어 나타나는 것으로 알려져 있다. Itopride는 도파민(D2) 수용체에 대한 길항 작용과 아세틸콜린 분해효소 억제 작용으로 소화관 운동을 항진시켜 기능성 소화 불량증 환자 치료에 적용되고 있다. 본 연구는 기니 픽에서 수술 후 장 폐색을 유발한 후 itopride를 투여하였을 때 위장관 운동에 미치는 영향을 알아보고자 한다. 대상 및 방법 : 기니 픽의 복부절개를 시행하고 장 폐색을 유발한 후 경구 위도관을 삽입후 charcoal을 투여하고, itopride 1, 3, 10, 그리고 30 mg/kg을 주입하고, 3시간 후 위의 유문부에서 charcoal의 이동 거리를 측정하였다. Itopride의 위장관 운동 효과의 기전을 확인하기 위하여 dopamine과 atropine을 병행하여 투약한 군에서 charcoal 이동 거리를 측정하였다. 결과 : 장 폐색을 유발한 군에서 sham operation 군에 비하여 charcoal의 이동거리가 유의하게 감소하였다. Itopride를 투여한 군에서 약제 비투약군에 비하여 charcoal 이동 거리가 유의하게 증가하였으며, 농도 증가에 따라서 charcoal 이동 거리가 증가하였다. Dopamine 또는 atropine을 itopride와 병행하여 투여하였을 때, itopride 단독 투여군에 비하여 charcoal의 이동 거리가 유의하게 감소하였다. 결론 : 수술 후 장 폐색 모델에서 위장관 운동이 감소하고, itopride를 투여하였을 때 위장관 운동이 증가하는 것을 확인할 수 있었다. 본 연구 결과를 통하여 수술 후 초기 장 폐색의 해소 목적으로 itopride의 임상적 적용에 대한 실험적 근거를 마련하였다고 생각된다. Backgrounds/Aim: Postoperative ileus (POI) is characterized by a transiently impaired propulsive function of the entire gastrointestinal tract which results from activated inhibitory sympathetic neural reflexes in the gut after abdominal surgery. Itopride hydrochloride (itopride) has been known as a gastroprokinetic agent which inhibits acetylcholinesterase and as antagonizes dopamine D2 receptor. The aim of this experiment is to clarify gastrointestinal motility effect of itopride in POI in guinea pigs. Methods: Open laparatomy was performed on guinea pig to induce POI. Charcoal was administered through orogastric tubes. The distance of charcoal migration from pylorus to the distal intestine was measured after administration of itopride 1, 3, 10, and 30 mg/kg. Additional experiments with infusion of dopamine and atropine was done to investigate its mechanism. Results: The gastrointestinal transit was significantly decreased in POI group compared with sham operation group. Itopride showed significant increase in the charcoal movement through the intestine compared with the POI group. A combination of dopamine or atropine with itopride displayed considerable decrease in the migration distance compared with that of itopride alone. Conclusions: POI group exhibited decrease in gastrointestinal motiliy, and conversely, administration of itopride promoted it through anti-dopaminergic and cholinergic mechanism.

특발성 가성 장폐색과 동반된 자발성 기복증 1예

김혜원 ( Hye Won Kim ),전누리 ( Nu Ri Chon ),김영신 ( Young Shin Kim ),김지현 ( Jie Hyun Kim ),박효진 ( Hyo Jin Park ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.6

Pneumoperitoneum, free intra-abdominal air, usually results from the perforation of a hollow viscous. In approximately 10% of cases, however, pneumoperitoneum is not caused by gastrointestinal perforation. These cases of "spontaneous pneumoperitoneum" generally follow more benign course and may not require surgical intervention. Examples include cardiopulmonary resuscitation (CPR), malrotation, mechanical ventilator support, gynecologic manipulation, blunt abdominal trauma, and chronic intestinal pseudoobstruction in infancy (Sieber syndrome). But, it is extremely rare of spontaneous pneumoperitoneum secondary to idiopathic intestinal pseudoobstuction in adult. We herein report a patient with chronic idiopathic intestinal pseudoobstuction who developed a pneumoperitoneum. (Korean J Gastroenterol 2009;54:395-398)

An agonistic anti-Tie2 antibody suppresses the normal-to-tumor vascular transition in the glioblastoma invasion zone

Lee Eunhyeong,Lee Eun-Ah,Kong Eunji,Chon Haemin,Llaiqui-Condori Melissa,Park Cheon Ho,Park Beom Yong,Kang Nu Ri,Yoo Jin-San,Lee Hyun-Soo,Kim Hyung Seok,Park Sung-Hong,Choi Seung-Won,Vestweber Dietmar 생화학분자생물학회 2023 Experimental and molecular medicine Vol.55 No.-

Tumor progression is intimately associated with the vasculature, as tumor proliferation induces angiogenesis and tumor cells metastasize to distant organs via blood vessels. However, whether tumor invasion is associated with blood vessels remains unknown. As glioblastoma (GBM) is featured by aggressive invasion and vascular abnormalities, we characterized the onset of vascular remodeling in the diffuse tumor infiltrating zone by establishing new spontaneous GBM models with robust invasion capacity. Normal brain vessels underwent a gradual transition to severely impaired tumor vessels at the GBM periphery over several days. Increasing vasodilation from the tumor periphery to the tumor core was also found in human GBM. The levels of vascular endothelial growth factor (VEGF) and VEGF receptor 2 (VEGFR2) showed a spatial correlation with the extent of vascular abnormalities spanning the tumor-invading zone. Blockade of VEGFR2 suppressed vascular remodeling at the tumor periphery, confirming the role of VEGF-VEGFR2 signaling in the invasion-associated vascular transition. As angiopoietin-2 (ANGPT2) was expressed in only a portion of the central tumor vessels, we developed a ligand-independent tunica interna endothelial cell kinase 2 (Tie2)-activating antibody that can result in Tie2 phosphorylation in vivo. This agonistic anti-Tie2 antibody effectively normalized the vasculature in both the tumor periphery and tumor center, similar to the effects of VEGFR2 blockade. Mechanistically, this antibody-based Tie2 activation induced VE-PTP-mediated VEGFR2 dephosphorylation in vivo. Thus, our study reveals that the normal-to-tumor vascular transition is spatiotemporally associated with GBM invasion and may be controlled by Tie2 activation via a novel mechanism of action.

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients with Coronary Artery Disease and Diabetic Nephropathy: A Single Center Experience

( Ki Sun Bae ),( Hyeong Cheon Park ),( Byung Seung Kang ),( Jong Won Park ),( Nu Ri Chon ),( Kyung Jin Oh ),( Young Won Yoon ),( You Sun Hong ),( Sung Kyu Ha ) 대한내과학회 2007 The Korean Journal of Internal Medicine Vol.22 No.3

Background: Patients with diabetic nephropathy (DN) and coronary artery disease (CAD) represent a subset of patients with high cardiovascular morbidity and mortality. The optimal revascularization strategy using either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) remains controversial. The purpose of this study was to compare the clinical outcomes of PCI to CABG in DN patients with CAD. Methods: The clinical and angiographic records of DN patients with CAD who underwent either CABG (n=52) or PCI (n=48) were retrospectively analyzed. Results: The baseline characteristics were similar in the two groups except for the severity of the CAD. At 30 days, the death rate (PCI: 2.1% vs. CABG: 9.6%, p=0.21) and major adverse cardiac events (MACE) rate (PCI: 2.1 % vs. CABG: 9.6%, p=0.21) were similar in comparisons between the PCI and CABG groups. At three years, the death rate (PCI: 18.8% vs. CABG: 19.2%, p=0.94) was similar between the PCI and CABG groups but the MACE rate (PCI: 47.9% vs. CABG: 21.2%, p=0.006) was higher in the PCI group compared to the CABG group. In addition, the repeat revascularization rate was higher in the PCI group compared to the CABG group (PCI: 12.5% vs. CABG: 1.9%, p=0.046). Conclusions: The CABG procedure was associated with a lower incidence of MACE and repeat revascularization for up to three years of follow-up in DN patients with CAD. However, the overall survival rate was similar in the CABG and PCI groups. Therefore, CABG may be superior to PCI with regard to MACE and repeat revascularization.

Poster Session:PS 0237 ; Gastroenterology : Comparison of I-Scan and Standard White-Light Colonoscopy for Colorectal Polyp Detection

( Kwang Hyun Kim ),( Wook Jin Lee ),( Ik Soo Park ),( Jae Chan Park ),( Nu Ri Chon ),( Tak Geun Oh ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: The aim of this study was to evaluate the usefulness of i-SCAN for colorectal polyp detection, compared with standard white-light colonoscopy. Methods: We retrospectively analyzed the records of 501 patients who had undergone screening colonoscopy with i-SCAN (n = 149) or standard white-light (n = 352) performed by three endoscopists from January 2, 2014 through June 30, 2014. Patient information and inter-endoscopist variation as well as polyp number, endoscopic fi ndings, and pathologic characteristics were reviewed. Results: The detection rates of colorectal and neoplastic polyps were signifi cantly higher using i-SCAN than that using standard white-light colonoscopy (52% vs 38.1%, p = 0.004 and 37.2% vs 27.9%, p = 0.041, respectively). A signifi cantly higher mean number of colorectal and neoplastic polyps were detected by i-SCAN than by standard white-light colonoscopy (mean ± SD, 0.96 ± 1.38 vs 0.71 ± 1.26, p = 0.005 and 0.66 ± 1.24 vs 0.50 ± 1.08, p = 0.044, respectively). Pathologic characteristics analysis of the identified polyps revealed that the rates of neoplastic polyp with i-SCAN and standard white-light colonoscopy were 69.4% and 69.9%, respectively (p = 0.926). Endoscopic fi nding analysis did not reveal a difference in detected polyp size between i-SCAN and standard white-light colonoscopy (4.59 mm ± 2.35 vs 4.82 mm ± 2.81, p = 0.739), but nonprotruding polyps were more commonly detected by i-SCAN than by standard white-light colonoscopy (24.6% vs 13.5%, p = 0.007). Conclusion: Colonoscopy using i-SCAN had a signifi cantly higher detection rate of colorectal polyps, including neoplastic polyps, because of improved sensitivity towards nonprotruding lesions.

과민성 장증후군 환자에서 생균제의 효과

김영균 ( Young Gyun Kim ),문종태 ( Jong Tae Moon ),이근만 ( Kuen Man Lee ),전누리 ( Nu Ri Chon ),박효진 ( Hyo Jin Park ) 대한소화기학회 2006 대한소화기학회지 Vol.47 No.6

과민성 장증후군은 기능적인 위장 질환으로서 병태생리가 다양하며 복통, 설사, 변비, 복부팽만감 등 여러 가지 증상을 보인다. 다양한 병태생리 기전이 설명되고 있으며, 과민성 장증후군 환자에서 생균제의 투여로 장 세균총의 변화 등을 시도하면 증상이 좋아지리라는 가설도 제시되고 있다. 그러나 생균제 투여를 시행한 다양한 연구들에서 그 효과에 대해서는 이견이 있다. 이번 연구는 생균제가 과민성 장 증후군 환자에서 어떤 효과를 보이는지 알아보고자 하였다. 대상 및 방법: 과민성 장증후군 환자를 대상으로 이중맹검으로 무작위 배정하여 시험약 medilac DS(R)(Bacillus subtilis, Streptococcus faecium)와 위약을 하루 3회 4주간 투약하였고, 약물 투여 1주 전 임상 증상 평균값과 투약 4주째 1주간의 평균값을 비교하였다. 장내 가스 양의 변화와 증상 개선과의 관련성을 알아보기 위해 투약 전, 투약 2주 후, 투약 4주 후에 단순 복부방사선 촬영을 하여 장내가스 양을 비교하였다. 결과: 총 40명의 환자 중 34명이 4주간의 투약을 완료하였다. 임상 증상에서 헛배 부름, 방귀 횟수, 배변 횟수, 대변 굳기는 양 군 간 치료 전후에 차이가 없었다. 복통 정도와 복통의 횟수는 medilac DS(R)군에서 투여 전후에 통계적으로 의미 있게 높은 개선 효과를 나타냈으나, 위약군은 차이가 없었다. 그러나 두 군 간 장내 가스양의 변화는 투여 전후에 유의한 차이가 없었다. 안전성 평가에서 이상 반응은 없었다. 결론: Bacillus subtilis와 Stre-ptococcus faecium의 혼합 균주 제제인 medilac DS(R)는 과민성 장증후군 환자의 치료에 있어서 복통을 감소시키며, 안전하면서도 유용하게 사용할 수 있는 생균제다. Background/Aims: Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) tract disorder that has heterogeneous clinical presentations such as abdominal pain, diarrhea, constipation, and abdominal distension. It is known that several mechanisms are involved in the pathogenesis of IBS. Probiotics may target one or more pathophysiologic pathways in IBS and may improve the symptoms of IBS. However, the results of studies about probiotics on IBS are controversial. Therefore, the aim of this study was to evaluate the effect of probiotics on GI symptoms and intestinal gas volume changes in patients with IBS. Methods: Forty patients were randomly allocated to be treated with medilac DS(R) (Bacillus subtilis, Streptococcus faecium) (n=20) or placebo (n=20) in a double-blind, prospective manner. The change in intestinal gas volume and symptom scores after 4-week treatment were evaluated for the efficacy. Results: There was no significant difference in bloating, frequency of gas expulsion, frequency of defecation, and hardness of stool before and after the treatment. However, the severity of abdominal pain and the frequency of abdominal pain decreased significantly in medilac DS(R) group (2.4±1.3 cm/ day→1.6±1.6 cm/day, 1.7±1.3/day→1.0±1.0/day) (p=0.044, p=0.038), but not in placebo group (2.1±2.0 cm/day →1.8±2.1 cm/day, 1.3±1.2/day→1.4±1.9/day). In both groups, intestinal gas volume at baseline, after 2-week treatment, and after 4-week treatment did not show significant change. Medilac DS(R) was well tolerated without adverse events. Conclusions: Medilac DS(R) is a safe and useful probiotic agent for the treatment of abdominal pain in patients with IBS. (Korean J Gastroenterol 2006;47:413-419)