Ki - 1 임파종 1 예

강민모(Min Mo Kang),김경재(Kyoung Jae Kim),이지현(Ji Hyun Lee),최석문(Seog Mun Choi),안기성(Ki Sung Ahn),황기석(Kee Suk Whang),김용진(Yong Jin Kim),박재복(Jae Bok Park) 대한내과학회 1993 대한내과학회지 Vol.45 No.4

A 60-year-old man was admitted to our hospital complaining of fever with chillness and anarexia for 12 weeks. Physical examination revealed supraclavicular lymphadenopathy and left inguinal lymphadenopathy. Abdominal CT scan showed the evidence of maked lymphadenopathy on retraperitoneal, external iliac, obturator, left inguinal, and celiac lymph nodes. A pathologic diagnosis of Ki-1(+) lymphoma was made by the biopsed supraclavicular lymph node because the node consisted of large cells with pleomorphic nuclei, scanty cytoplasm, large basophilic nucleoli, atypical vacuoli and large cells were positive for leukocyte common antigen, Ber-H2, marker, and B-cell marker.

성인 상부위장관 질환군에서의 H . pylori 검출에 이용되는 검사법의 상호비교

한길성(Gil Sung Han),서대규(Dae Gyu Seo),신왕식(Wang Sik Shin),정재군(Jae Gun Jung),손호상(Ho Sang Shon),최정윤(Jung Yoon Choe),안기성(Ki Sung Ahn),배정동(Jung Dong Bae),박재복(Jae Bok Park),강민모(Min Mo Kang) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1

N/A Background/Aims: For the evaluation of recent reports that H. pylori infection plays a causative ro1e in the pathogenesis of upper gastrointestinal diseases, we studied the relationship between the presence of H. pylori infection in patient and asymptomatic volunteer groups, using histologic demonstration of the bacteria, CLO test, and serum H. pylori antibody titer. Calculation of sensitivity, specificity, and predictive value of CLO test and antibody detection rate in relation to histologic demonstration were also performed. Methods: We evaluated the detection rate of H. pylori infection by direct demonstration with special stain, CLO test, and IgG antibody titer by EIA method in 80 symptomatiq patients who were categorized by endoscopic findings into 24 patients with chronic gastritis, 22 patients with gastric ulcer, 20 patients with duodenal ulcer, 14 patients with gastric cancer, and 20 asymptomatic volunteers. Four or more biopsy specimens of gastric and duodenal mucosa were taken from each of the total 100 cases with gastrofibroscopy and then blood samples were also taken. Results: In sections stained by Warthin-Starry method, H. pylori was found 62.5% in the 80 patients group and 30.0% in the 20 asymptomatic volunteers group. The prevalence of H. pylori was the highest in gastric cancer group(71.4%). The prevalence of H. pylori in the patients with peptic ulcer and gastric cancer was significantly higher than the asymptomatic volunteer group(p0.05). Positive CLO test in the patient group was 77.5% and 35.0% in the 20 asymptomatic volunteers group. The positive rate was the highest in gastric cancer group. The positive rate of the CLO test in patients with peptic ulcer and gastric cancer groups was significantly higher than the asymptomatic volunteer group(p0.05). The positive rate of IgG antibody test in the patient group was 82.5% and 45% in the 20 asymptomatic volunteer group. The rate of positivity was the highest in duodenal ulcer group. The positive rate of the serum IgG antibody test in all patient groups was significantly higher than asymptomatic volunteer group(p 0.05). Sensitivity and specificity of CLO test and IgG antibody test in relation to direct H. pylori smear was 94.6%, 76.7%, 96.4%, and 53.47o respectively. Conclusions: The positive rate of the H. pylori infection in patients with peptic ulcer and gastric cancer groups was significantly elevated compared with control and chronic gastritis groups for each of the 3 tests. For clinical purpose, CLO test can be used as a single guide for the treatment of H. pylori infection for its rapidity and efficacy. (Korean J Gastroenterol 1996;28: 19 - 27)

배양된 메산지움세포에서 고농도 포도당, 안지오텐신 II 및 안지오텐신 전환효소 억제제가 TGFβ 유전자 발현에 미치는 효과

이소영,김형규,윤종우,차대룡,조원용,강민모,곽재영,임천규,한상엽,조상경 대한신장학회 1999 Kidney Research and Clinical Practice Vol.18 No.4

Objective:Diabetic nephropathy is an important cause of end stage renal disease in Korea and associated with major morbidity and mortality. The precise pathogenic mechanism of this disease is still controversial, but it has been considered that multiple factors are contribute to the development and progression of diabetic nephropathy. One of these factors, renin-angiotensin system has been proven to be a major mediator of this disease via activation of angiotensin II, which has multiple functions such as induction of production of extracellular matrix protein and various intraglomerular cells, tubulointerstital component and increment of intraglomerular pressure. Transforming growth factor(TGFβ) is a multifunctional cytokine with major profibrotic character, which stimulates the production of extracellular matrx(ECM) protein, inhibit the degradation of ECM and induce the interaction of mesangial cells with ECM via integrin receptors. This study was done to evaluate the role of angiotensin II and angiotensionverting enzyme inhibitor in expression of TGFβ mRNA which is a main mediator in the pathogenesis of diabetic nephropathy. Methods:Human mesangial cells(MCs) were cultured by standard culture techniqne. For this study, cells in the 5th to 7th passage were used. To make a different glucose concentration in culture medium, normal(100mg/dl) or high glucose(450mg/dl) concentrations of D-glucose were added, and cultured in 17% heat inactivated fetal bovine serum. Angiotensin II and ACE inhibitor(captopril) were administered to the culture medium at final concentration of 10-6M. After 72 hours, MCs were harvested to measure the expression of TGFβ mRNA. To measure the mRNA expression of TGFβ in each condition, semi quantitative PCR was done and all results were corrected by β-actin gene. Results:mRNA expression of TGFβ was significantly increased in the high glucose medium(30 mM) compared to normal glucose medium(5.5mM) (3.82±0.465 vs 2.27±0.13, p$lt;0.05). Administration of angiotensin II(10-6M) in high gluum induced a further increase in the TGFβ expression to 4.29±0.476(p$lt;0.05). Angiotensin II(10-6M) in normal glucose medium also showed a significant increase in TGFβ expression as 3.40±1.88(p$lt;0.05). Administration of ACE inhibitor(Captopril, 10-6M) in high glucose medium prevented the increse of TGFβ expression(1.20±0.18 vs 3.82±0.465, p$lt;0.05). Conclusion:From these findings, it suggest that angiotensin II is an important mediator in the pathogenesis of diabetic nephropathy. ACE inhibitor may have a role in the progress of this disease via direct suppression of TGF? system as well as beneficial intraglomerular hemodynamic effect.

식도정맥류 출혈의 경화요법의 대치치료로써 내시경적 정맥류 결찰요법

김경재,이지현,안기성,손호상,배정동,강민모,최석문 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.1

Currently, endoscopic injection sclerotherapy(EIS) is the mast widely used method for treating and eradicating acutely bleeding esophageal vari4~es in repeated sessions, but may be assaciated with some undesirable local and systemic cornplicatians. Endoscopic variceal ligation (EVL), a newly developed method to manage esophageal variceal bleeding alternating EIS, induces mechanical ligation and strangulation of varices by using elastic $quot;O$quot; rings. This study assessed initial control rate of active variceal bleeding, ineidence of rebleeding, changes in grade of varices, survival rate, and complications associated with EVL. Over a 15 months period, EVL was performed on 30 consecutive patients who had visited Taegu Catholic University Hospital by recent esophaigeal variceal bleeding or by actively bleeding varices. Total of 316 varix ligations were performed during 85 separated EVL sessions. Active bleeding varices were initially controlled in all seven(100%)patients. There were a 30% incidence of recurrent bleeding. By a mean of 3.4 times of EVL sessions, variceal eradication or reduction of size to grade I was achieved in thirteen patients. No major complications (perforation, stricture, deep ulceration) were noted and there were no treatment failures or exacerbations. Seven(23%) patients died, two from hepatic failure, one from rebleeding with refusal for repeated ligation, one from hepatic coma, two from hepatorenal syndrome, one from other cause(pancreatic cancer). These results suggest that EVL can be used effectively to control active variceal bleeding, prevent rebleeding and eradicate varices with repeated ligations. We conclude that EVL is a safe and effective alternative treatment to sclerotherapy for esophageal varices.

비식도정맥류 상부위장관 출혈에서 Hypertonic Saline Epinephring 용액의 치료요법 : 지혈성적 및 시간대별 진단율과 지혈율 비교

김경재,이지현,안기성,손호상,배정동,강민모,최석문 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.1

A prospective randomised trial was performed to assess the diagnostic accuracy according to the time interval and the efficacy of endoscopic injection of hypertonic saline-epinephrine(HS- E)solution, consisting of 3.5% sodium chloride with 0.0045% epinephrine, for actively bleeding peptic ulcers, exposed vessel or blood clot on ulcer bed, or Mallory-Weiss tear. Over 24 month, emergency endoscopy in 180 patients admitted for upper gastrointestinal hemorrhage identified 51 patients with nonvariceal hemorrhage. The causes of bleeding were; gastric ulcer in 32; duodenal ulcer in 13; gastric cancer in 4; Mallory-Weiss tear in 2. With this method, the hemostatic effect was permanent in 40 cases(84.3%), temporary in 9 cases(11.8%), and failed in 2 cases(3.9%). By applying this method, the rate of emergency operation for patients with bleeding from the upper gastrointestinal tract was significantly reduced from 20.0% (8/40)to 3.9%(2/51)(p$lt;0.05). Emergency endoscopy in acute UGI bleeding increases the accuracy of detection of actual bleeding sites(p$lt;0.05), but if the endoscopic procedure was performed within 48 hours, the hemostatic rate was not affected(p$lt;0.05). We concluded that hypertonic saline-epinephrine injection method could provide a simple maneuver with reasonable cost, high safety, and satisfactory hemostatic efficacy in the treatment of nonvariceal upper gastrointestinal bleeding.