면역기능이 정상인 환자에서 칸디다 식도염에 병발한 헤르페스 식도염

현우진 ( Woo Jin Hyun ),김석현 ( Seok Hyun Kim ),이숭한 ( Soong Hwan Lee ),윤상정 ( Sang Jeong Yoon ),정성희 ( Sung Hee Jung ),송기룡 ( Ki Ryong Song ),조성연 ( Sung Yeon Cho ) 대한내과학회 2004 대한내과학회지 Vol.67 No.3

Random amplified polymorphic DNA 분석에 의한 Helicobacter pylori의 분자적 형별분석

이숭(Soong Lee),신명근(Myung Geun Shin) 대한내과학회 2001 대한내과학회지 Vol.60 No.2

Background : Genetic diversity among Helicobacter pylori strains isolated from different patients has been debated. This study was undertaken to determine molecular types and genetic diversity among 20 isolates of H. pylori obtained from various gastroduodenal diseases, and also examined the association between molecular types of H. pylori and these diseases. Methods : Antral biopsies were taken for culture from 38 patients with chronic gastritis, gastric ulcer and duodenal ulcer at the time of endoscopy. Biopsy specimens were primarily inoculated on chocolate agar and incubated microaerophilically at 37℃ for up to 7 days. H. pylori was identified by typical Gram stain morphology and biochemical tests. Random amplified polymorphic DNA (RAPD) fingerprinting was performed by 4 primers (OPA-07, 5'-GAAACGGGTG-3'; OPA-10, 5'-GTGATCGCAG-3'; OPA-11, 5'-CAATCGCCGT-3'; OPA-12, 5'-TCGGCGATAG-3'; Operon Technologies, Atlanta, GA). We used the NTSYS-pc (numerical taxonomy system and multivariate analysis system, version 1.50, Applied Biostatistics Inc., CA, USA) program to compose the phenogram for the differentiation of H. pylori strains. Results : Twenty strains (52.6%) of H. pylori were isolated from 38 biopsy specimens. All isolates were divided into five molecular types (I-V) at similarity (S) value of 0.63; 7 strains (35%), 4 strains (20%), 4 strains (20%), 3 strains (15%) and 2 strains (10%) belonged to type II, III, IV, V and I, respectively. The distribution of genetic S value was 0.24 to 0.91 in all isolates, thus the isolates had a wide range of S values. The mean S values of all isolates, type I, II, III, IV and V were 0.69, 0.69, 0.73, 0.75 and 0.65, respectively. There was no specific correlation between molecular types and gastroduodenal diseases. Conclusion : H. pylori isolates had high level of genetic diversity. The RAPD molecular types of H. pylori were not disease-specific since the types were diverse in the isolates from various gastroduodenal diseases.(Korean J Med 60:115-122, 2001)

위암종에서 p53 , Rb 및 PCNA 발현의 비교연구

이숭(Soong Lee),문범(Beum Moon),최성규(Sung Kyu Choi),유종선(Chong Sun Rew),윤종만(Chong Man Yoon),박창수(Chang Soo Park) 대한내과학회 1997 대한내과학회지 Vol.52 No.6

Objectives: Recently, the studies for oncogene and tumor marker have been actively performed to investigate the carcinogenesis of gastric carcinoma, but it is not clearly understood. We investigated the expression of tumor suppressor gene and proliferation activity in gastric carcinoma. Methods: Immunohistochemistry for p53 protein (wild and mutant type), retinoblastoma protein(wild type), and PCNA was performed in 131 cases of formalin fixed paraffin embedded tissue sections of gastric carcinoma. We compared that expression with tissue invasiveness, lymph node metastasis, staging and, Lauren classification, and that expression with each other. Results: 1) The positive ratio of p53 protein, Rb protein, also PCNA in gastric carcinoma was 64.9%, 98.5%, 99.2%, 2) The expression of p53 protein was related to invasiveness, lymph node metastasis, staging, and Lauren classification(p<0.05). 3) The positive reaction for Rb gene was identified in tumor cells as well as proliferating cells. 4) There was a close relationship between Rb gene expression and PCNA in gastric carcinoma (p<0.05). Colclusion: Theses results suggested that the expression of p53 gene is related to invasiveness, lymph node metastasis, staging and Lauren classification in gastric carcinoma. Expression of retinoblastoma gene is a closely related to proliferating activity.

위의 다발성 Carcinoid 종양

이숭(Soong Lee),강헌석(Heon Seok Kang),백종철(Jong Cheir Back),김윤미(Yun Mee Kim) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.5

Gastric multiple carcinoids with bleeding is very rare disease. A 62-year-old male patient was admitted to the hospital because of hematemesis and melena. On the gastrofiberoptic examination, blood clots, multiple small round polypoid masses in fundus and large round submucosal tumor-like polypoid mass in lesser curvature side of body were noticed. The biopsy specimen of small polypoid mass in gastric fundus by polypectomy snare showed carcinoid tumor in submucosa covered by atrophic mucosa with intestinal metaplasia and positive immunohistochemical stain for chromogranin A, neuron-specific enolase, cytokeratin. So we report a case of gastric multiple carcinoids with a review of relevant literature. (Korean J GastroenteroJ 1996;2S:721 - 726)

암성 복수의 감별진단에 있어 복수내 Fibronectin , Sialic Acid , 혈청 - 복수간 알부민 농도차 측정의 임상적 의의

이숭(Soong Lee),윤경환(Kyung Whan Yoon),최성규(Sung Kyu Choi),유종선(Jong Sun Rew),윤종만(Jong Mann Yoon),김미정(Mi Jung Kim) 대한내과학회 1990 대한내과학회지 Vol.39 No.1

N/A The differential diagnosis of ascites remains a problem in clinical practice, Although ascites is most often caused by chronic liver disease, by neoplasms metastatic to the peritoneum, and by tuberculous peritonitis, a complete differentiation has not been possible using simple and reliable parameters in ascitic fluid. Cytologic examination, despite its high specificity, also has limitations in differentiating ascites because of its low sensitivity. We measured the ascitic fluid concentration of fibronectin, sialic acid and the serum-ascites albumin difference in order to assess the diagnostic significance of these parameters for defferentiating ascites of various causes in 49 patients, 33 with liver cirrhosis and 16 with peritoneal metastasis. The results were as follows: 1) The mean concentrations of ascitic fibronectin (122.50±96.09ug/ml) and sialic acid (52.00±22.23 mg/dl) in malignant ascites were significantly higher the those of the liver cirrhosis group (p<0,001). The mean serum-ascites albumin difference (1.14±0.59 g/dl) in the malignant ascites group was significantly different from that of the liver cirrhosis group (2.67±0.54 g/dl), (p<0.001). 2) The highest diagnostic accuracy in malignancy was the value of serum-ascites albumin difference (97.8%) rather than ascitic sialic acid and fibronectin (83.7%, 80.0% respectively). 3) The highest specificity in differentiating liver cirrhosis with hepatocelluar carcinoma from peritoneal metastasis was ascitic fibranectin. These results suggested that the measurement of ascitic fibronectin, sialic acid, and serum-ascites albumin difference, combined with conventional parameters such as ascitic lactic dehydrogenase and total protein, may be useful for differentiating various causes of ascites.

원발성 간암에 있어서 종양표지자로서 이상 Prothrrombin ( PIVKA - 2 ) 측정의 유용성

이숭(Soong Lee),윤경환(Kyung Whan Yoon),구철(Chul Koo),최성규(Sung Kyu Choi),유종선(Jong Sun Rew),윤종만(Jong Mann Yoon) 대한내과학회 1990 대한내과학회지 Vol.39 No.1

N/A Abnormal prothrombin, known as PIVKA-II (protein induced by vitamin K absence or antagonist-II) or DCP (des-γ-carboxyprothrombin), is released from the liver into the blood of patients with vitamin K deficiency or vitamin K antagonist users (wafarin sodium), or patients with various liver diseases, especially hepatocellular carcinoma. Recently. abnormal prothrombin has been reported to be as good a marker of hepatocellular carcinoma as alpha-fetoprotein (AFP), and its production may be due to the reduction of vitamin K-dependent carboxylase activity. In order to assess the usefulness of abnormal prothrombin and the correlation between abnormal prothrombin and AFP in hepatocellular carcinoma, we measured the plasma abnormal prothrombin using enzyme immunoassay in 60 patients with liver diseases and in 15 healthy controls. The results were as follows: 1) The mean value of plasma abnormal prothrombin in the normal controls was 0,06±0.02 AU/ml. 2) The mean value of plasma abnormal prothrombin in patients with hepatocellular carcinoma was 5.82±4.78 AU/ml, and there were significant differences between hepatocellular carcinoma and liver cirrhosis, chronic hepatitis and other non-tumorous liver diseases. The positivity of abnormal prothrombin in hepatocellular carcinoma was 70.6% 3) The sensitivity and specificity of plasma abnormal prothrombin as a marker of hepatocellular carcinoma with a diagnostic cut-off value of 0.13 AU/ml were 70.6% and 90.7%, and they were 58.8%, and 97.7% with a cut-off value of 3.0 AU/ml, respectively. The sensitivity and specificity of AFP with a diagnostic cut-off value of 20 ng/ml werC 64.7% and 76.6% and they were 35.3% and 95.3% with a cut-off value of 400 ng/ml, respectively 4) 1 here was no significant correlation between the plasma abnormal prothrombin and serum AFP in patients with hepatocellular carcinoma (r=0.45 p>0. 05). 5) There was no significant correlation between the tumor size and plasma abnormal prothrombin (r=0.04, p>0.05) or the serum AFV level (r=0.01, p>0.05). These results suggest that plasma abnormal prothrombin could be employed as a useful tumor marker together with AFP in patients with hepatocellular carcinoma.

성인 식도이물의 내시경적 치료

장민희,이숭,Jang Min Hee,Lee Soong 대한기관식도과학회 2004 大韓氣管食道科學會誌 Vol.10 No.1

The majority of esophageal Foreign body ingestions occur in the pediatric population. In adults, true foreign object ingestion occurs more commonly among those with psychiatric disorders, mental impairment. The management of esophageal foreign bodies is influenced by the age, clinical condition of ingested material, anatomic location and technical abilities of the endoscopist. Recently the therapeutic endoscopy is becoming wider and more rational in application. We evaluated the role of endoscopy for removal of esophageal foreign bodies during the period of 4 years from January 2000 to December 2003 at the Department of Otolaryngology and Gastroenterology, Seonam University Hospital. The results were as follow, 1) The age ranged from 21 to 74 years old (mean 50.5), most frequent age group was between 61-70 years old and male to female ratio was 1:1.4. 2) Fish bone was the most frequent foreign body in the esophagus ($47.1\%$), food material ($23.5\%$) and meats ($17.6\%$) were next frequent foreign bodies. The most frequent site of lodgement was the first ($78.4\%$), second ($17.6\%$) and third narrowing ($3.9\%$) in order. 3) The most common symptom was foreign body sensation (28.6%). the next common symptoms were chest discomfort($23.8\%$) and dysphagia($19\%$). 4) In duration of lodgement, 49cases ($96.1\%$) were lodged for less than one day. 5) The foreign bodies of esophagus were removed successfully by flexible endoscope with basket, snare, forceps, overtube and endoscopic variceal ligation cap. There were only 3 cases of minimal complications, esophageal mucosal tearing. In conclusion, endoscopic esophageal foreign body removal is useful and safe with minimal or no complications.

위점막에서 조직화학적 및 면역조직화학적 염색을 이용한 Helocibaxter pylori 의 검출

백종철(Jong Cheul Baek),강헌석(Heon Seok Kang),이숭(Soong Lee),명재일(Jae Il Myung),김완(Wan Kim),박창수(Chang Soo Park) 대한내과학회 1997 대한내과학회지 Vol.53 No.5

logic test (ELISA, BIO-RAD GAP method), histochemical stain (Warthin-Starry silver stain), immunohistochemical stain (Avidin biotin conjugate method, ABC method) were performed to identify the presence of H. pylori infection. H. pylori infection was defined that 2 of 3 studies were positive. Results: Positive result to H. pylori infection by serologic test, Warthin-Starry silver stain and immunohistochemical stain were 82% (28/34 cases), 65% (22/34 cases), 68% (23/34 cases). Sensitivity and specificity were 68%, 20% in serologic test, 95%, 83% in Warthin-Starry silver stain, 100%, 100% in immunohistochemical stain. Correlation among these tests was best between Warthin-Starry silver stain and immunohistochemical stain. Conclusion: By the above results, we can conclude that histochemical stain and immunohistochemical stain are the most accurate diagnostic method to identify the infectivity of R. pylori.

여천공단지역의 아이소시아네이트 노출작업자에서 기도과민성

장안수(An Soo Jang),최인선(Inseon-s Choi),이숭(Soong Lee),서정평(Jeong Pyeong Seo),양승원(Seung Won Yang),문재동(Jai Dong Moon),이강진(Kang Jin Lee) 대한천식알레르기학회 1999 천식 및 알레르기 Vol.19 No.3

Objective: To investigate the prevalence of airway hyperresponsiveness induced by isocyanate at one petrochemical industry complex in Yeochon, Korea. Methods: Questionnaires, allergic skin prick test, toluene diisocyanate (TDI)-specific IgE, and non-specific airway hyperresponsiveness (AHR) were studied in 73 exposed workers and 27 control subjects. Methacholine challenge tests were done and bronchial responsiveness (BR index) was defined as log (% fall of FEV1)/ log (last concentration of methacholine +10). Results: Twenty-three workers (31.5% ) had respiratory symptoms, 21 had nasal symptoms, and eight had skin symptoms. Exposed workers with respiratory symptoms (n=22) had significantly higher BR index than those without them (0.82+-0.06 vs 0.60+-0.02, p<0.05). Exposed workers tended to have higher BR index than controls (0.67+-0.03 vs 0.62+-0.02). Three exposed workers had PC20 methacholine <2.0 mg/ml. There were no significant differences in atopy score between exposed workers and controls (p)0.05). Specific IgE antibodies were found in 19.7% of exposed workers. FEV, showed a significant negative correlation with BR index (r =-0.25, p<0.05). Poor correlation was noted between BR index and atopy, smoking status, or exposure duration. Conclusion: These findings suggest that workers exposed to isocyanates are at higher risk of airway hyperresponsiveness.

기관지내에 발생한 양성 고립성 신경초종 1 예

백종철(Jong Cheul Baek),명재일(Jae Il Meong),강헌석(Heon Suk Kang),김용록(Yong Rok Kim),이숭(Soong Lee),김완(Wan Kim),김윤미(Yun Mee Kim),오봉석(Bong Suk Oh) 대한내과학회 1997 대한내과학회지 Vol.53 No.2

Intrabronchial nerilemmoma is very rare disease. Neurilemmoma has been thought to arise from schwann cell, has been reported to occur in almost any anatomic location. The incidence of primary neurogenic tumors of the lung has been estimated to be 0 to 2 percent of all lung tumors. These tumors are predominantly(75%) associated with neurofibromatosis of von Recklinghausen's disease. To our knowledge, no case of benign solitary endobronchial neurilemmoma has been reported in Korea. This paper presents a case of benign solitary endobronchial neurilemmoma with a brief review of the pertinent literature. A 19 year old female visited our medical hospital with the symptoms of chest discomfort and pain. Bronchoscopy and chest CT scan revealed a mass on the left upper 1obar bronchus. Left upper lobectomy was performed successfully and histological section revealed a neurilemmoma.