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위궤양환자에서 Rebamipide의 자유산소유리기제거에 의한 궤양치료효과
박수헌(Soo Heon Park),정운태(Woon Tae Jung),서정한(Jung Han Suh),정명희(Myung Hee Chung),정인식(In Sik Chung),이용찬(Yong Chan Lee),박인서(In Suh Park),송근암(Guen Am Song),양웅석(Ung Suk Yang),유종선(Jong Sun Rew),윤종만(Chong Mann 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5
Background/Aims: Helicobacter pylori has been shown to be an important pathogen of gastric disorder including gastritis and gastric ulcer. One of the potential toxic factors involving gastric mucosal cell injury is reactive oxidants, which are released from activated neutrophils. Rebamipide had been reported to promote mucus synthesis, mucosal prostaglandin content, and rapid ulcer healing, It has recently been reported to inhibit the production of oxygen derived free radicals from stimulated neutrophils. We conducted this study to evaluate the effects of rebamipide on gastric ulcer healing and reactive oxygen metabolite production. Methods: In this multicenter study conducted in Korea, combination treatment of rebamipide and ranitidine was compared with ranitidine alone in 108 patients with gastric ulcer patients. Pre- and post-treatment endoscopic findings and concentration of reactive oxygen metabolite produced were used to evaluate efficacy. The efficacy of rebamipide and ranitidine versus ranitidine was evaluated using endoscopy results, and tissue lipid peroxides by thiobarbituric acid and myeloperoxide concentration. Results: The percentage of ulcer size reduction was significantly higher with rebamipide and ranitidine group than with placebo and ranitidine group(size reduction: 71.5% vs 58.3% P=0.04556). The myeloperoxidase activities at ulcer margin in rebamipide and ranitidine group patients were 96.7+-13.4 unit/mg protein in baseline and 53.8+9.9 unit/mg protein in follow up (P=0.0065). The myeloperoxidase activities at ulcer margin in placebo and ranitidine group patients were 90.2+9.1 unit/mg protein in baseline and 63.1+6.7 unit/mg protein in follow up (P=0.0668). The thiobarbituric acid activities at ulcer margin in rebamipide and ranitidine group patients were 34.7+5.3 nmol of MDA/mg protein in baseline and 24.1W3.1 nmol of MDA/mg protein in follow up. The thiobarbituric acid activities at ulcer margin in placebo and ranitidine group patients were 14.8+1.5 nmol of MDA/mg protein in baseline and 24.3+2.7 nmol of MDA/mg protein in follow up (P=0.0059). The thiobarbituric acid activities at ulcer margin in H. pylori positive and negative patients were 28.1+2.1 nmol of MDA/mg protein and 25.3+4.7 nmol of MDA/mg protein, respectively. The myeloperoxidase activities at ulcer margin in H. pylori positive and negative patients were 79.9+5.3 unit/mg protein and 40.4+25.3 unit/mg protein, respectively (P=0.0001). The cumulative relapse rate was examined starting at 24 week after ulcer treatment. The rate was lower in rebamipide and ranitidine group patients, but insignificantly(19.2% vs 27.3%, P=0.0857). Conclusions: These results suggest that rebamipide promote gastric ulcer healing by decreasing reactive oxygen metabolite production in patients with gastric ulcer. (Korean J Gastroenterol 1997;29:569-578)
위장관 ; 알파 태아단백 생성 위암 환자들의 임상적, 병리학적 특성과 예후
유동훈 ( Dong Hoon Lew ),정운태 ( Woon Tae Jung ),김홍준 ( Hong Jun Kim ),민현주 ( Hyun Ju Min ),하창윤 ( Chang Yoon Ha ),김현진 ( Hyun Jin Kim ),김태효 ( Tae Hyo Kim ),고경혁 ( Gyung Hyuck Ko ) 대한소화기학회 2013 대한소화기학회지 Vol.62 No.6
Background/Aims: Several studies reported a subgroup of gastric cancer patients showing elevated serum alpha-fetoprotein (AFP) at the time of diagnosis. We investigated the clinicopathological characteristics and prognostic factors of AFP producing gastric cancer (AFPPGC) by comparing with AFP non-producing gastric cancer (AFPNPGC). Methods: A total of 909 patients were diagnosed with gastric cancer from January 2005 to March 2013 at Gyeongsang National University Hospital and their AFP levels were measured at the time of diagnosis. After excluding 138 patients with underlying liver diseases, 34 patients with elevated serum AFP level over 10 mg/mL were assigned to AFPPGC group and the remaining 737 patients with serum level of AFP below 10 ng/mL were assigned to AFPNPGC group. Results: The median survival length was shorter in AFPPGC group than AFPNPGC group (18.3±25.5 months vs. 30.0±22.0 months, p=0.004). The incidence of liver metastasis (47.1% vs. 3.3%, p<0.001) and lymph node metastasis (91.2% vs. 31.6%, p<0.001) was significantly higher in AFPPGC group. The probability of encountering metachronous liver metastasis after the operation was higher in AFPPGC group (44.4% vs. 2.0%, p<0.001). Multivariate analysis revealed that patients in the AFPPGC group who received chemotherapy (p=0.037) or underwent operation (p=0.001) had a better survival rate. Conclusions: AFPPGC behaves more aggressively and shows a worse prognosis. Therefore, serum AFP level should be routinely checked in all patients diagnosed with gastric cancer. (Korean J Gastroenterol 2013;62:327-335)
식도 암육종 환자에서 이시적으로 발생한 식도 편평상피세포암
차라리 ( Ra Ri Cha ),정운태 ( Woon Tae Jung ),오혜원 ( Hye Won Oh ),김희진 ( Hee Jin Kim ),하창윤 ( Chang Yoon Ha ),김홍준 ( Hong Jun Kim ),김태효 ( Tae Hyo Kim ),고경혁 ( Gyung Hyuck Ko ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.6
Esophageal carcinosarcoma is a rare malignant esophageal neoplasm consisting of both carcinomatous and sarcomatous elements, with an incidence of 0.5%. There have been only a few case reports of carcinosarcoma and squamous cell carcinoma coexisting in the esophagus. However, all of these are cases of synchronous or metachronous development of carcinosarcoma after chemoradiotherapy in patients of esophageal squamous cell carcinoma. A 53-year-old man underwent esophagogastroduodenoscopy because of chest pain for several months. Endoscopic examination revealed a huge pedunculated esophageal polypoid mass. Endoscopic submucosal dissection (ESD) was performed and histopathologic examination confirmed spindle cell carcinoma (carcinosarcoma). He refused additional esophagectomy. After 21 months, third follow-up endoscopy showed poorly-demarcated flat, faint discolored lesions at different location from the previous ESD site and endoscopic biopsies confirmed squamous cell carcinoma. To the best of our knowledge, this is the first case of metachronous development of esophageal squamous cell carcinoma in a patient with esophageal carcinosarcoma. (Korean J Gastroenterol 2014;64:364-369)
김형준 ( Hyung Joon Kim ),김태효 ( Tae Hyo Kim ),이은정 ( Eun Jeong Lee ),김현진 ( Hyun Jin Kim ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ),배경수 ( Gyung Soo Bae ) 대한내과학회 2005 대한내과학회지 Vol.69 No.2
A bronchobiliary fistula is rare disorder, consisting of the abnormal communication between the bronchial tree and the biliary duct. We describe a 78-year-old man who had a bronchobiliary fistula caused by choledocholithiasis. The diagnosis was confirmed by the presence of bilioptysis (bile-stained sputum) and the percutaneous transhepatic cholangiography (PTC). The patient was treated successfully by percutaneous transhepatic biliary drainage (PTBD) with stone extraction and was followed by healing of the bronchobiliary fistula without surgical intervention.(Korean J Med 69:202-205, 2005)
김완수 ( Wan Soo Kim ),김태효 ( Tae Hyo Kim ),황재진 ( Jae Jin Hwang ),김현진 ( Hyun Jin Kim ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ),이정희 ( Jeoung Hee Lee ) 대한내과학회 2011 대한내과학회지 Vol.80 No.4
Rhabdoid transformation is an extremely rare occurrence in sarcomatoid cholangiocarcinoma. Only two cases have been reported in the medical literature worldwide, and its clinical and pathological characteristics remain unknown. Published case reports indicate that rhabdoid cholangiocarcinoma grows rapidly, with early metastasis and a particularly poor prognosis. Here, we report a case of rhabdoid transformation in sarcomatoid cholangiocarcinoma that exhibited aggressive behavior and resulted in a devastating prognosis. (Korean J Med 2011;80:453-457)
위장관염과 장간막 림프절병증으로 발현한 제한성 베게너 육아종증 1예
정용근 ( Yong Geun Jeong ),김태효 ( Tae Hyo Kim ),이창민 ( Chang Min Lee ),심기식 ( Ki Shik Shim ),문인규 ( In Kyu Moon ),이상일 ( Sang Il Lee ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.5
Wegener`s granulomatosis (WG) is a disease characterized by a granulomatous necrotizing vasculitis of small vessels. Although any organ systems can be involved, gastrointestinal involvement in WG is notably uncommon. We present a case of 67-year-old man who was admitted with abdominal pain and diarrhea lasting for 3 weeks. Colonoscopy and abdominal CT scan revealed vasculitis and multiple mesenteric lymphadenopathy. Jejunum and mesenteric lymph nodes biopsies confirmed limited form of WG. The present case indicates that WG might involve only gastrointestinal tract and the histological confirmation is important for diagnosis. (Korean J Gastroenterol 2010;55:331-335)
문인규 ( In Kyu Moon ),김태효 ( Tae Hyo Kim ),장현정 ( Hyun Jeong Jang ),김완수 ( Wan Soo Kim ),황재진 ( Jae Jin Hwang ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ) 대한내과학회 2011 대한내과학회지 Vol.81 No.4
Desmoid tumor is rare neoplasm characterized by clonal proliferation of myofibroblasts that do not metastasise, but often exhibit an infiltrative pattern and functional impairment. The etiology of this tumor is unknown, but hormonal, genetic, and physical factors play a role in its development and growth. The clinical behavior and natural history of desmoid tumors remains unpredictable and enigmatic. However, spontaneous regression of desmoid tumors is rare. Here we report spontaneous regression of an intraabdominal desmoid tumor in a patient who underwent total gastrectomy. (Korean J Med 2011;81:487-491)
김현식 ( Hyeon Sik Kim ),김태효 ( Tae Hyo Kim ),이재민 ( Jae Min Lee ),김현진 ( Hyun Jin Kim ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ),김지은 ( Ji Eun Kim ),배경수 ( Kyung Soo Bae ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.6
Splenic hamartoma is a very rare benign tumor, which is usually found incidentally after splenectomy or autopsy. Although percutaneous needle biopsy can be performed, it carries a high risk of bleeding after the procedure. Therefore, diagnosis is usually made by surgical resection. Herein, we report a case of splenic hamartoma diagnosed by magnetic resonance imaging and contrast-enhanced ultrasonography, which enables visualization of the unique signals of microbubbles in the vessels in real time. Relevant literature is also reviewed. (Korean J Gastroenterol 2014;64:380-386)
안연정 ( Yeon Jeong Ahn ),김태효 ( Tae Hyo Kim ),문성원 ( Sung Won Moon ),최수녕 ( Su Nyoung Choi ),김현진 ( Hyun Jin Kim ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ),고경혁 ( Gyung Hyuck Ko ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.3
Xanthogranulomatous cholecystitis is an unusual inflammatory disease of the gallbladder characterized by severe proliferative fibrosis and the accumulation of lipid-laden macrophages in areas of destructive inflammation. Its macroscopic appearance may occasionally be confused with gallbladder carcinoma. We present a case of perforated xanthogranulomatous cholecystitis presenting as biloma. An 80-year-old woman was referred to our hospital with a 1-week history of abdominal pain and febrile sensation. Abdominal CT showed a biloma in the subhepatic area. The follow-up CT showed that the biloma increased in size. Therefore, ultrasonography-guided aspiration was performed. The aspirated fluid/serum bilirubin ratio was greater than 5, which was strongly suggestive of bile leakage complicated by perforated cholecystitis. She underwent a laparoscopic cholecystectomy with cyst aspiration and adhesiolysis. A histological diagnosis of perforated xanthogranulomatous cholecystitis was made. (Korean J Gastroenterol 2011;58:153-156)
궤양성 대장염 환자에서 치료 경과에 따른 대장점막에서의 CXC와 CC Chemokine 유전자의 발현양상
송인성(In Sung Song),정현채(Hyun Chae Jung),이경미(Kyung Mee Lee),진영주(Young Joo Chin),장동경(Dong Kyung Chang),정운태(Woon Tae Jung),김점룡(Chung Yong Kim) 대한소화기학회 1998 대한소화기학회지 Vol.31 No.2
Background/Aims: Cytokines play an important role in the recruitment of neutrophil and monocyte. Expression of mRNA for chemokines such as interleukin-8 (IL-8) and monocyte chernoattractant protein-1 (MCP-1) are known to be increased in the colonic mucosa of ulcerative colitis. However, profile.' of other recently defined chemokines such as epithelial cell-derived neutrophilactivating peptide-78 (ENA-78) and RANTES (regulated on activation, normal T expressed and secreted) remain to be extensive]y studied. Methods: Total tissue RNA was extracted from colonoscopic biopsies from normal controls (NC, n=10) and patients with active ulcerative colitis (n=l7)[from lesion (UCal, n=17) and normal looking mucosa (UCan, n=14)areas] and remissioned ulcerative colitis (n=17)[from lesion (UCrl, n=17) and normal looking mucosa (UCrn, n=12) areas]. The chemokines for the present study were IL-8, MCP-l, ENA-78 and RANTES. Detection of chemokine gene expression was performed by reverse transcriptional PCR. Results: The expression of IL-8 mRNA was increased in UCal than in others (UCan, UCrl, UCrn and NC, p<0.05). The expressions of ENA-78 mRNA were significantly increased in all these 4 groups (UCal, UCrl, UCan and UCrn) than NC (p<0.001) The expression of MCP-1 mRNA was significant]y increased in both UCal and UCrl than its normal looking mucosa respectively and NC (p<0.05). The high expression of RANTES mRNA was noted in all groups (NC, UCal, UCan, UCrl, UCrn)(82%-100%), but there was no statistical significance arnong them. Conclusions: These results suggest that the role of IL-8 confines to only acute inflammed lesion, MCP-1 and ENA-78 play an important role in both acute and remissioned inflammed areas, but the area of expression of ENA-78 was broader than MCP-1. RANTES seems to play an important role in the basic immune system. (Korean J Gastroenterol 1998;31:192-203)