원발성 위 림프종의 임상연구

황일란(Il Ran Hwang),김정원(Jung Won Kim),박선미(Sun Mi Park),김해련(Hae Ryun Kim),민영일(Young Il Min) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1

N/A Background/Aims: Primary gastric non-Hodgkins lymphoma is rare and represents a minority of 1-7% of all gastric malignancy. Prognosis and early diagnosis remains important. Methods: We analysed clinical and endoscopic findings in 27 patients with primary gastric non-Hodgkins lymphoma between June 1989 and July 1994 at the Asan Medical Center. Results: The prevalence of primary gastric lymphoma occupied 1.2% of all gastric cancers. The most frequent chief complaint was epigastric pain(74%), followed by postprandia] epigastric discomfort (19%), abdominal mass(15%) and gastrointestinal bleeding(11%). Initial endoscopic findings suggested gastric lyrnphoma in 6 cases(22%), advanced gastric cancer in 14 cases(52%) and benign gastric ulcer in 2 cases(7%). The macroscopic type of 15 cases(56%) was ulcerative, while 5(19%) were superficial, 5(19%) giant mucosal fold, and 2(6%) polypoid. Pathologic findings of initial endoscopic biopsy specimens in 18 operated cases were gastric lymphoma in 7 cases, atypical lymphocyte infiltration in 3 cases, adenocarcinoma in 4 cases and ulcer or erosion in 3 cases. Conclusions: A definite diagnosis of primary gastric non-Hodgkins lymphoma was difficu]t to be confirmed by endoscopic examination and biopsy. Recognition of specific endoscopic findings with a high index of suspicions is essential for early diagnosis, and multiple biopsies with/without submucosa are required. (Korean J Gastroenterol 1996;28: 11 - 18)

인슐린 비의존형 당뇨병환자에서의 사구체 여과율

황일란(Il Ran Hwang),이기업(Ki Up Lee),양원석(Won Seok Yang),문대혁(Dae Hyuk Mun),김기수(Ghi Su Kim),김순배(Sun Bae Kim),박수길(Su Kil Park),박정식(Jung Sik Park) 대한내과학회 1992 대한내과학회지 Vol.43 No.6

N/A Background: Glomerular hyperfiltration is found in 30 to 40% of patients with IDDM at the onset of disease. Several lines of evidence suggest that this may be responsible for the progression of diabetic nephropathy. Whether glomerular hyperfiltration is a frequent finding in patients with NIDDM is controversial. Methods: To define the prevalence of glomerular hyperfiltration in patients with NIDDM without clinical proteinuria, we measured GFR in 79 patients with NIDDM and 33 healthy subjects using 51Cr-EDTA clearance. Urine albumin level was determined by radioimmunoassay. Results: GFR in 58 normoalbuminuria group and 21 microalbuminuria group were 129±24 and 127±34ml/ min/1. 73 m' respective1y, which were significantly higher than that in control group (113±20). Hyperfiltration, as defined by a GFR of more than 140 ml/min/1.73 m, was found in 32% (25/79) of NIDDM without clinical diabetic nephropathy. There was no difference in GFR or the prevalence of hyperfiltration between the normoalbuminuria (29%, 17/58) and the microalbuminuria (38%, 8/21) group. Fasting plasma glucose level in patients with hyperfiltration was significantly higher than that in those without hyperfiltration. Conclusion: Glomerular hyperfiltration is frequently found in Korean NIDDM patients without clinical diabetic nephropathy. This finding is similar to the previous reports in Pima Indians and Black Americans

소화기질환에서 cDNA microarray 연구의 응용 및 전망

황일란 ( Il Ran Hwang ),조성원 ( Sung Won Cho ),함기백 ( Ki Baik Hahm ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.4

The human genome project has afforded huge amounts of DNA sequence data. A future challenge will be to determine how genes or their products actually interact with each other and response to many chemical or biological stimuli. They would respond by specifically changing in gene expression patterns. Altered expression patterns of genes are expected to accompany many or all human diseases. Such functional genomics will lead to understanding complex disease pathways and biological processes. cDNA microarray is emerging as a powerful tool to measure simultaneously the level of steady-state mRNA for every gene in human genome. It is applied to the study of functional genomics. In contrast to the traditional approach by studying a single gene, they permit massive parallel data of gene expression patterns in a single reaction based on hybridization. Now bioinformatics is capable of managing the high-throughput data with the great advance in computer science. The success of microarray depends on how we analyze and visualize data. This article reviews the methodology involved in cDNA microarray and its clinical application. Microarray is becoming increasingly useful in understanding pathogenesis in digestive diseases and also in refining patients` management in terms of disease prognosis and diagnosis, individual disease susceptibility, drug discovery, and toxicology. (Korean J Gastroenterol 2003;41:241-249)

위암 환자에서의 Helicobacter pylori IgG 항체 양성률과 혈청 Pepsinogen 1 및 2 농도

황일란(Il Ran Hwang),이상인(Sang In Lee),박효진(Hyo Jin Park),민영일(Young Il Min) 대한내과학회 1995 대한내과학회지 Vol.49 No.4

N/A Objectives: Helicobacter pylori(H. pylori) infection, thought to causally related to peptic ulcer and chronic antral gastritis, may also be associated with gastric cancer. A considerable number of normal subjects in Korea were infected with H. pylori infection. In gastric carcinogensis serum pepsinogen I and II levels may be indicator of precancerous lesions such as atrophic gastritis and intestinal metaplasia, which were known to associated with gastric cancer and may be induced by H, pylori infection. Methods: The levels of serum H. pylori IgG antibody were measured using enzyme-linked immunosorbent assay and the levels of serum pepsinogen I and II using immunoradiometric assay in 174 gastric cancer patients and 165 controls. Results: There was no statistically significant difference between the positive incidence of H. pylori infection in gastric cancer patient (60.3%) and in control group (70.9%). Antibodies to H. pylori were detected in 64.8% of non-cardiac gastric cancer patients but in only 12.5% of cardiac gastric cancer patients (p<0.05). The positive incidences of H, pylori infection in intestinal and diffuse histologic type of gastric cancer were similar. Serum pepsinogen I and II levels were higher in H. pylori-infected controls than in uninfected controls (p<0.05). Serum pepsinogen I levels was lower in gastric cancer patients than control group (p<0.05). However, there was no difference in serum pepsinogen I and II levels between H. pylori-infected and uninfected gastric cancer patients. Conclusion: The positive incidence of H. pylori infection in gastric cancer was similar to that in controls and there was no evidence of the direct relationship between H, pylori infection and gastric carcinogensis.

운동장애형 기능성 소화불량증 환자에서의 식도내압검사 성적

황일란,김진홍,이광재,김정민,함기백,조성원 대한소화관운동학회 1998 Journal of Neurogastroenterology and Motility (JNM Vol.4 No.1

인슐린의존형 당뇨병 환자를 대상으로 한 사구체 여과율의 단기 추적 관찰

황일란,문대혁,이기업,박중열,김김수 대한당뇨병학회 1993 Diabetes and Metabolism Journal Vol.17 No.2

간경변증 환자에서 발생한 특발성 세균성 농흉

이영상,김용태,정영화,민영일,황일란,김우성,김원동,양석균 대한소화기학회 1992 대한소화기학회지 Vol.24 No.1

Spontaneous bacterial empyema is defined as an infection of preexisting pleural effusion in the absence of any obvious intrathoracic source, Criteria for diagnosis include positive pleural fluid culture or polymorphonuclear leukocyte concentration more than 500 cells/㎟ in pleural fluid and evidence of pleural dffusion before an infectious episode. We experienced a case of spontaneous bacterial empyema with liver cirrhosis in a 52-year-old man treated with antibiotics and closed thoracostomy.

운동장애형 기능성 소화불량증 환자에서 Erythromycin 장기 투여가 위운동지표에 미치는 영향

이광재,김진홍,조성원,황일란,김정민 대한소화기학회 2000 대한소화기학회지 Vol.35 No.3

Background/Aims: Erythromycin (EM) acts specifically on endogenous receptor for motilin, induces migrating motor complex, and increases gastric emptying. We performed this study to assess the effect of EM on gastric motility. Methods: Cutaneous electrogastrography (EGG) and gastric emptying time (GET) using 99mTc sulfur colloid label mixed with a solid food were obtained at baseline and after 8 weeks of oral administration of EM (250 mg, b.i.d) in 25 patients (M:F=10:15, mean age 39.6±10.6 years) with dysmotility-like functional dyspepsia (FD). Results: The patients were divided into responder (R) group (19 patients, 76%) and non-responder (N-R) group (6 patients, 24%) according to symptomatic improvement after EM treatment. On baseline EGG, the mean percentages of normal gastric slow wave for fasting and postprandial period were 90.4±11.3 and 93.6±8.0%, respectively in R group. On the other hand, those in N-R group were 86.1±18.0 and 98.3±2.6%, respectively. EM treatment did not affect significantly the gastric slow wav produced variable effects on the postprandial amplitude increment on EGG in both groups. The mean clearance half time (T1/2) was 128.0±39.6 min in R group and 149.1±29.8 min in N-R group at baseline GET. There was no difference in T1/2 between before and after EM treatment in both groups. Conclusions: Symptomatic improvement was achieved in high percentage of patinets with dysmotility-like FD after oral EM treatment, but it didn't correlate with change in parameters of EGG and GET. It probably results from mechanism other than the mechanism which affects on gastric motility.

젊은 소화불량증 환자에서 비궤양성 소화불량증의 선별 검사로서 Helicobacter pylori 혈청학 검사가 유용한가?

김진홍,이광재,조성원,황일란 대한소화기내시경학회 2000 Clinical Endoscopy Vol.21 No.3

Background/Aims: In western courtry, Helicobacter pylori (H. pylori) serology is a screening test for non-ulcer dyspepsia (NUD) before endoscopy in dyspeptic patients under 45 years old without alarm symptoms The aim of this study was to determine the usefulness of H. pylori serology before endoscopy in Korea Methods: Six hundred and fifteen outpatients (M: F=339: 276, mean age 43.6±13.8, range 15-81) with dyspepsia performed anti-H. pylori IgG (GAP or HM-CAP) and upper gastrointestinal endoscopy with biopsy. Exclusion criteria were alarm symptoms, history of gastrectomy, NSAID use and previous anti-H. pylori treatment. Results: The prevalence of anti-H. pylori IgG was 61.0% in patients under and 40 years old and 63.8% in patients over 40 years old. There was no significant difference between age groups. For patients under and 40 years old, serology predicted all pathology except 5 gastric ulcer, 8 duodenal ulcer, 2 reflux esophagitis and 2 gastric submucosal tumor. The sensitivity and negative predictive vaue (76.7, 85.8%) in patients under and 40 years old were higher than that (61.9, 64.0%) in patients over 40 years old (p=0.037, p=0.001), Conclusions: H. pylori serology seems to be an acceptable screening test for NUD in dyspeptic patients under and 40 years old without alarm symptoms.

호두까기식도증의 24시간 보행성 식도내압검사 성적

이광재,김진홍,조성원,황일란,김정민 대한소화기학회 2000 대한소화기학회지 Vol.35 No.2

Background/Aims: The most common abnormality of esophageal motility in patients with noncardiac chest pain is reported as nutcracker esophagus. However, its manometric finding may be a transient phenomenon accompanying chest pain rather than a diagnosis. We performed this study to evaluate whether the high amplitude peristaltic contraction is persistent in patients with nutcracker esophagus during 24-hour recording. Methods: Sixteen patients (M:F=1:1, mean age; 41.0 years) with nutcracker esophagus which was diagnosed by conventional esophageal manometry with water-perfused catheter, were studied. The 24-hour ambulatory esophageal manometry/pH metry recording was performed with a three-channel solid state microtransducer and a one-channel pH probe. Results: Total 32 episodes of chest pain were identified during the 24-hour recording in 9 out of the 16 patients as compared with no pain episode during conventional manometry. During chest pain, the mean amplitude of distal esophageal contractions was 74.4±23.1 mHg. Thirty (94%) episodes were correlated with the case above 95th percentile of amplitude of all esphageal contractions in each patient. The frequency of high amplitude contraction more than 180 mmHg was 7.9±9.0% in total recording, 12.6±15.4% in meal, 7.2±10.3% in upright position, 8.4±8.9% in supine position, 3.6±7.4% in pain episode. Conclusions: The high amplitude peristaltic contraction in distal esophagus was not persistent in patient with nutcracker esophagus during 24-hour recording. This result supports that the high amplitude peristaltic contractions may be a transient esophageal dysmotility associated with chest pain.