Helicobacter pylori 제균 후 위축위염과 장상피화생의 변화

이용구 ( Yong Gu Lee ),전용철 ( Yong Cheol Jeon ),구태연 ( Tai Yeon Koo ),조현석 ( Hyun Seok Cho ),변태준 ( Tae Jun Byun ),김태엽 ( Tae Yeob Kim ),이항락 ( Hang Lak Lee ),은창수 ( Chang Soo Eun ),이오영 ( Oh Young Lee ),한동수 ( D 대한소화기학회 2007 대한소화기학회지 Vol.50 No.5

목적: Helicobacter pylori 감염이 장기간 지속될 경우 위축위염과 장상피화생을 초래하여 위암 발생 위험이 증가한다. 그러나 H. pylori를 제균하는 것이 위축변화나 장상피화생을 회복시킬 수 있을지는 아직 이견이 많다. 따라서 저자들은 H. pylori 제균 후에 위축과 장상피화생의 변화 여부를 조사하였다. 대상 및 방법: 2001년 3월부터 2006년 4월까지 방문한 107명의 H. pylori 제균에 성공한 환자들을 대상으로 하였다. 전정부 조직검사를 통해 H. pylori 감염 여부를 판단하였으며 동시에 위축변화와 장상피화생의 정도를 updated Sydney System에 따라 점수화하였다. 전정부 조직검사는 제균 후 일정기간 후에 위내시경검사를 통해 재시행하였고, H. pylori 제균 여부도 조직검사로 확인하였다. 결과: 대상환자의 평균 연령은 55.3±11.3세였으며, 평균 추적기간은 28.7±13.9개월이었다. 내시경 진단은 위궤양, 십이지장궤양, 비궤양 전정부위염의 3가지로 구분하였다. 위축변화는 누락된 자료를 제외한 91명 중 41명에서 관찰되었고, 평균 점수는 0.73±0.92였다. 추적한 위축변화 점수는 0.38±0.70로 제균 후 회복되었다(p=0.025). 그러나 107명 중 49명에서 관찰된 장상피화생은 다소 호전되어 보였으나 통계적인 의미는 없었다. 새로이 발생한 위축변화와 장상피화생이 관찰되었으며 그 평균 점수는 제균 전 위축변화나 장상피화생이 있는 환자에서의 평균보다 낮았으나 통계적인 의미는 없었다. 결론: H. pylori 제균 후에 위축변화는 호전되지만 장상피화생은 호전 정도가 미약하여 호전을 확인하기 위해서는 더 오랜기간 관찰이 필요할 것이다. H. pylori 제균과 위 점막의 위축변화 및 장상피화생 사이의 관계를 확립하기 위해서는 추후 더 큰 규모의 대조군 연구가 필요할 것으로 생각한다. Background/Aims: Long-term Helicobater pylori infection results in atrophic gastritis and intestinal metaplasia, and increases the risk of gastric cancer. However, it is still controversial that eradication of H. pylori improves atrophy or metaplasia. Therefore, we investigated histological changes after the H. pylori eradication in patients with atrophy or metaplasia. Methods: One hundred seven patients who received successful eradication of H. pylori infection in Hanyang University, Guri Hospital from March 2001 to April 2006, were enrolled. Antral biopsy was taken before the eradication to confirm the H. pylori infection and grade of atrophy or metaplasia by updated Sydney System. After a certain period of time, antral biopsy was repeatedly taken to confirm the eradication and investigate histological changes of atrophy or metaplasia. Results: Mean age of the patients was 55.3±11.3, and average follow-up period was 28.7±13.9 months. Endoscopic diagnosis included gastric ulcer, duodenal ulcer, non-ulcer antral gastritis. Atrophy was observed in 41 of 91 and their average score was 0.73±0.92. After the eradication of H. pylori, atrophy was improved (0.38±0.70, p=0.025). However, metaplasia which was observed in 49 of 107, did not significantly improve during the follow-up period. Newly developed atrophy (7 of 38) or metaplasia (18 of 49) was observed in patients who without atrophy or metaplasia initially. Their average scores were slightly lower than those of cases with pre-existing atrophy or metaplasia without statistical significance. Conclusions: After the eradication of H. pylori infection, atrophic gastritis may be improved, but change of intestinal metaplasia is milder and may take longer duration for improvement. (Korean J Gastroenterol 2007;50:299-305)

대장암세포주 HT-29에서 Peroxisome Proliferator-activated Receptor-γ 리간드가 Fas 매개 세포자멸사에 미치는 영향

정용우 ( Chung Yong Woo ),한동수 ( Han Dong Soo ),강은경 ( Kang Eun Kyung ),이진숙 ( Lee Jin Sook ),이항락 ( Lee Hang Rak ),김진배 ( Kim Jin Bae ),박준용 ( Park Jun Yong ),김용석 ( Kim Yong Seok ),이오영 ( Lee Oh Young ),손주현 ( 대한소화기학회 2003 대한소화기학회지 Vol.42 No.1

Background/Aims: Peroxisome proliferator-activated receptor-γ (PPAR-γ) plays a critical role in adipocytes differentiation and insulin sensitivity and is also related to regulation of inflammation and cell proliferation. The aim of this study was to investigate the PPAR-γ agonist-induced apoptosis and effects of PPAR-γ agonist on Fas-mediated apoptosis in a human colon cancer cell line. Methods: Cell survival and apoptosis of HT-29 cells were measured by trypan blue exclusion method and FACScan after treatment with 15d-PGJ2, ciglitazone and IgM anti-Fas antibody (CH11), respectively or simultaneously. Also, activation of caspase-3 and caspase-8 was analyzed to assess the effects of PPAR-γ and Fas on apoptosis signaling pathways. Results: CH11 induced apoptosis of HT-29 cells. 15d-PGJ2 or ciglitazone alone did not induce apoptosis, but combined stimulation with CH11 synergistically induced apoptosis. Also, 15d-PGJ2 alone did not activate caspase-3, but CH11 and 15d-PGJ2 synergistically activated caspase-3. CH11 activated procaspase-8, but 15d-PGJ2 did not. Conclusions: PPAR-γwas not an enough condition to induce apoptosis of HT-29 cells. Apoptosis was induced by high dose Fas, and was enhanced with PPAR-γ agonist. PPAR-γ agonist seems to enhance Fas-mediated apoptosis by affecting the way between caspase-8 and caspase-3. Further research is needed to use PPAR-γ agonists as chemopreventive and therapeutic agent for colon cancer and to find the pathways of PPAR-γ on apoptotic cascade of colon cancer cells. (Korean J Gastroenterol 2003;42:35-41)

한국인에서 위상피하 종양의 유병률에 대한 연구: 단일기관 경험

이정훈 ( Jung Hoon Lee ),이항락 ( hang Lak Lee ),안영우 ( Yong Woo Ahn ),이강녕 ( Kang Nyeong Lee ),전대원 ( Dae Won Jun ),이오영 ( Oh Young Lee ),한동수 ( Dong Soo Han ),윤병철 ( Byung Chul Yoon ),최호순 ( Ho Soon Choi ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.5

Background/Aims: The incidental finding of gastrointestinal subepithelial tumors (SETs) is increasing with national cancer screening endoscopy. In a Swedish population, screening endoscopy found a prevalence of SETs of 0.36%. However, the prevalence of gastric SETs in Korean patients has not been described. Therefore, this study evaluated the prevalence of SETs of the stomach in a Korean patient population. Methods: We reviewed endoscopic reports of 11,712 subjects who underwent screening esophagogastroduodenoscopy (EGD) at Hanyang University Hospital between July 2012 and June 2013. Results: Among 11,712 patients, 194 (1.7%) had SET of the stomach. Of these, 71 (prevalence, 0.6%) were male and 123 (prevalence, 1.1%) were female. When grouped by age, the prevalence of SET was as follows: 1.0% for patients in their twenties, 6.2% for those in their thirties, 19.1% for those in their forties, 33.0% for those in their fifties, 30.4% for those in their sixties, and 10.3% for those over 70 years of age. Conclusions: The overall prevalence of gastric SET among healthy examinees was 1.7%. The prevalence of gastric SET increased with age and was higher in female. (Korean J Gastroenterol 2015;66:274-276)

대량 출혈을 동반한 공장의 Dieulafoy 병변 1 예

이항락(Hang Lak Lee),윤병철(Byung Chul Yoon),변태준(Tae Jun Byun),한호(Ho Han),전운현(Woon Hyun Jun),박준용(Joon Yong Park),이숭환(Soong Hwan Lee),은창수(Chang Soo Eun),이오영(Oh Young Lee),전용철(Yong Chul Jun),한동수(Dong Soo Han) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.2

Dieulafoy's lesion is an uncommon cause of gastrointestinal bleeding. However, it is clinically important in that it can be associated with recurrent and massive gastrointestinal bleeding. The bleeding results from an abnormal large submucosal artery. On endoscopy, a small mucosal defect with a protruding vessel or fresh clot may be visualized if the patient is actively bleeding. In most cases, the lesion is encountered in the proximal stomach within 6 cm of the gastroesophageal junction, but similar lesions have been described in the antrum, duodenum, colon, and rectum. In particular, jejunal Dieulafoy's lesion is extremely rare. We experienced one case of recurrent and massive bleeding from a proximal jejunal Dieulafoy's lesion, which was confirmed by the pathologic examination of the resected specimen. (Korean J Gastroenterol 2002;39:123-127)

만성간질환에서의 혈청 procollagen 1/3 propeptides 농도비 측정의 의의

유용걸(Yong Keol Yoo),이숭환(Soong Hwan Lee),김병훈(Byoung Hun Kim),조영중(Young Jung Cho),백인규(In Kyu Paik),유병무(Byeong Moo Yoo),이오영(Oh Young Lee),한동수(Dong Soo Han),손주현(Joo Hyun Sohn),최호순(Ho Soon Choi),이동후(Dong Ho 대한소화기학회 1996 대한소화기학회지 Vol.28 No.6

N/A Background/Aims: Most of Ihe chronic liver diseases of variable etiologies are accompanied by a pathobiochemical reaction So-called fibrosis. Liver fibrosis was recently recognized as all the complexity of dynamic changes of the hepatic extracellular matrix(ECM). And ECM consists of four major components: collagen, glycoprotein such as fibronectin and laminin, proteoglycan, and elastin. Among these, collagen I and III are the representatives of disproportion of synthesis and degradation in conjunction with fibrogenesis. To elucidate the clinical significance of procollagen propeptide I(PICP) and III(PIIINP) measurements among the sera out of patients with chronic liver diseases, radioimmunoassay 4vas employed in this investigation. Methods: Sera tested were obtained from pathologically-proven 54 patients; 4 cases of fatty liver, 11 cases of chronic persistent hepatitis, 13 cases df chronic active hepatitis, 15 cases of liver cirrhosis and 11 cases of hepatocellular carcinoma. All:the patients except 4 cases of fatty liver were shown positivity of HBsAg. PICP and PIIINP radioimmunoassay kits(Farmos Diagnostica, Oulunsalo, Finland)were purchased for this study. ResOlts: PICP concentration (mean+standard error) was highest in liver cirrhosis (280.06>39,83 pg/L). PICP in liver cirrhosis was significantly elevated in cornparison to that (109.30+14.58) in fatty:liver(p=0.045), that (122.22>10.26) in chronic persistent hepatitis (p=0.003), and that (158.59>21.58) in chronic active hepatitis(p=0.016), PICP in hepatocellular carcinoma was decreased to 1'94.05+ 29.89. Similarly, PIIINP concentration revealed highest level in liver cirrhosis(17.29+3.58 pg/L). This value was significantly higher than that of chronic persistent hepatitis(5.12+0.59)(p=0.008). Contrarily to these results, concentration ratio of PICP/PIIINP was high in fatty liver (29.27>6.29) and chronic persistent hepatitis (25.04+2.00), These value were statistically higher than that of chronic active hepatitis (17.632.67) (p=0.043). PICP/PIIINP ratio in liver cirrhosis (21.58+3.29) showed no statistical difference. Conclusions: On the basis of these data, it is suggested that the elevation of PICP and PIIINP in the sera of the patients with chronic liver diseases means emerging the liver cirrhosis. And the ratio of these markers can be helpful in differential diagnosis of chronic liver diseases. (Korean J Gastroenterol 1996; 28:815-823)

베체트장염으로 오인된 말단회장의 자연살해 유사 T 세포 림프종

주용원 ( Yong Won Joo ),고동희 ( Dong Hee Koh ),이강녕 ( Kang Nyeong Lee ),이항락 ( Hang Lak Lee ),전대원 ( Dae Won Jun ),윤병철 ( Byung Chul Yoon ),최호순 ( Ho Soon Choi ),이오영 ( Oh Young Lee ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.6

Primary natural killer (NK) cell like T cell lymphoma of the terminal ileum is extremely rare. It most frequently occurs in the nasal or paranasal areas and less frequently in the skin, the soft tissue, and the gastrointestinal tract. NK/T cell lymphoma involving gastrointestinal tract has characteristic endoscopic features of Inflammatory bowel disease. We herein describe a first case of primary NK/T cell lymphoma misdiagnosed as Behcet`s enteritis of the terminal ileum colonoscopically and complicated by cecal bleeding and perforation. (Korean J Gastroenterol 2011;57:365-369)

상기도 감염 후 연하곤란을 호소한 제 9, 10 뇌신경 마비

박호용 ( Ho Yong Park ),이오영 ( Oh Young Lee ),양선영 ( Sun Young Yang ),천승민 ( Seung Min Cheon ),이항락 ( Hang Lak Lee ),한동수 ( Dong Soo Han ),전용철 ( Yong Cheol Jeon ),손주현 ( Joo Hyun Sohn ),윤병철 ( Byung Chul Yoon ) 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.1

Oropharyngeal dysphagia is characterized by difficulty in transferring food from the mouth through the upper esophageal sphincter into the upper esophagus. Lesions involving the vagus and glossopharyngeal nerve may cause dysphagia and dysphonia. On rare o

당뇨병환자에서 담석증의 빈도 및 특성에 관한 연구

박준용(Joon Yong Park),한동수(Dong Soo Han),윤병철(Byung Chul Yoon),이오영(Oh Young Lee),손주현(Joo Hun Sohn),함준수(Joon Soo Hahm),박경근(Kyung Geun Park),김정현(Jeogn Hyun Kim),이민호(Min Ho Lee),기춘석(Choon Suhk Kee),박경남(Kyung 대한소화기학회 1995 대한소화기학회지 Vol.27 No.4

N/A Background/Aims: Diabetes mellitus is thought to be a risk factor for gallstone diseases, esopecially cholesterol stone. The risk of cholelithiasis among diabetic persons cou]d be due to several mechanisms, including impaired gallbladder motility and hyperinsulinemia. We investigated the relationship of gallstones in the diabetic patients and analyzed their clinical course and related factors. Methods: A collective review of ] 1,302 diabetic patients from January l979 to December 1993 were carried out at Hanyang University Hospital. Of the 323 cases with gallstones, 180 cases were evaluated for age, body mass index, duration of disease, HbAlc, fasting blood sugar, AST/ALT, cholesterol level and triglyceride level. Results: The prevalence of gallstones in the diabetics studied was 2.86%. The composition of gallstones was not related to age, and pigmented stones were most commonly observed. The incidence c>f cholecystectomy was 0.27% in men, and 0.47% in women. Conclusions: The prevalence of gallstones in diabetic patients was higher than in the normal population, which could be explained by the decreased mcotility of the gallbladder or obesity. No significant difference was found in age, body mass index, cholesterol level, and triglyceride level when compared to patients with or without gallstones. (Korean J Gastroenterol 1995;27:433 - 440)

대장 선종의 위험 인자로 복부 비만 및 인슐린 저항성에 대한 연구

이항락 ( Hang Lak Lee ),손병관 ( Byoung Kwan Son ),이오영 ( Oh Young Lee ),전용철 ( Yong Chul Jeon ),한동수 ( Dong Soo Han ),손주현 ( Ju Hyun Sohn ),윤병철 ( Byung Chul Yoon ),최호순 ( Ho Soon Choi ),함준수 ( Joon Soo Hahm ),이민 대한소화기학회 2007 대한소화기학회지 Vol.49 No.3

목적: 대장암은 유전 소인, 흡연, 음주, 식습관 등의 환경인자가 작용하여 발생하며 또한 비만, 고지혈증, 고혈당, 고인슐린 혈증 및 인슐린 저항성이 대장암의 발암과정과 연관이 있다. 다양한 비만 지표를 이용해서 대장 선종과 비만 및 인슐린 저항성과의 연관성을 알아보고자 하였다. 대상 및 방법: 2004년 1월부터 2004년 10월까지 한양대학병원에서 검진 목적으로 대장내시경검사와 기타 검사를 시행 받은 환자를 대상으로 전향적으로 환자 대조군 연구를 시행했다. 크기가 0.5 cm 이상이며 조직학적으로 대장 선종이 증명된 50명의 환자를 대상으로 했으며, 대조군은 동일 기간 중 대장내시경검사를 시행 받았으나 특이 병변이 없었던 자로 정했다. 결과: 인슐린, 공복혈당, 총 콜레스테롤, triglyceride, LDL, HDL 수치, 수축기 및 이완기 혈압은 환자군에서 모두 증가되었으나 환자군과 대조군 사이에 유의한 차이는 없었다. HOMA-IR은 환자군에서 인슐린 저항성 수치가 높았으나 통계적인 유의성은 없었다. 그러나 체질량지수, 복부 비만, 체지방, 비만도는 환자군이 대조군 보다 유의하게 높았다. 다변량 분석에서 복부 비만이 가장 의미 있는 위험 인자였으며 체질량지수가 증가함에 따라 대장 선종의 위험도도 증가했다. 체지방, 비만도 역시 중요한 위험 인자였다. 결론: 비만과 대장 선종의 연관성에서 복부 비만이 가장 중요한 위험 인자였으며 복강 내 지방조직이 중요한 역할을 할 것으로 기대한다. 향후 대규모의 환자 대조군 및 코호트 연구가 필요하며 복강 내 지방의 역할에 대한 분자생물학적인 연구가 필요하다. Background/Aims: Abdominal obesity and hyperinsulinemia or insulin resistance are of interest in connection with colon carcinogenesis. We conducted a prospective case controlled study for the evaluation of relationship between abdominal obesity, insulin resistance, and colorectal adenoma. Methods: Fifty patients with colorectal adenoma and fifty healthy subjects were included in this study. Total colonoscopic examinations were performed in all the subjects. Fasting blood sugar (FBS), insulin, homeostasis model assessment (HOMA-IR), triglyceride (TG), cholesterol (CROL), BMI (body mass index), WHR (waist hip ratio), percent body fat (PBF) and obesity degree (OD) were measured. HOMA-IR was considered to represent insulin resistance. Diabetic patients were excluded from this study. Results: There were no differences in sex, serum insulin, FBS, HOMA-IR, TG, CROL between adenoma and control group. Subjects with high BMI, WHR, percent body fat, and obesity were more likely to have colonic adenoma. Multiple logistic regression analysis after adjusting confounding factors, had revealed that WHR was the most important independent risk factor for colon adenoma. Conclusions: Abdominal obesity was most closely related to colonic adenoma. However, insulin resistance was not related to colonic adenoma. A larger case controlled study is needed. (Korean J Gastroenterol 2007;49:147-151)

위식도역류질환 환자의 식이 위험요인 및 삶의 질

양선영 ( Sun Young Yang ),이오영 ( Oh Young Lee ),김혜은 ( Hye Eun Kim ),장유경 ( Yu Kyoung Chang ),윤병철 ( Byung Chul Yoon ),최호순 ( Ho Soon Choi ),정용건 ( Yong Gun Chung ),조찬호 ( Chan Ho Cho ) 대한내과학회 2006 대한내과학회지 Vol.70 No.6

목적: 우리나라 위식도 역류질환자들의 식습관 실태를 파악하고 질환의 위험 요인으로 생각되는 식품에 대한 섭취 기호도 및 식이습관을 조사하여 질환 정도와의 관련성을 파악하며 건강과 관련된 신체적, 정서적 삶의 질을 평가하였다. 방법: 한양대학교 병원에 내원하여 위식도역류질환의 증상이 있는 환자 중 내시경 병변이 있는 미란성 식도염군과 내시경 병변이 없으나 병적 역류가 증명된 비미란성 식도염군을 대상군으로 하고, 비슷한 시기에 건강 검진을 위해 방문한 수진자 Background: The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea. The aim of this study is to evaluate the dietary habit which is commonly known as risk factor of GERD and the quality of life in GERD patients. Methods: This study