151종 생약제 추출물이 B형 간염 바이러스 표면 항원(HBsAg)과 항체(HBsAb)의 결합반응 그리고 HBV DNA polymerase 활성에 미치는 효과 : 한국산 각종 생약제를 이용한 B형 간염치료제의 개발

정태호,김정철,김문규,이인선,채성철,김승래,정준모,이인수,김승호,함경수 慶北大學校 醫科大學 1992 慶北醫大誌 Vol.33 No.3

세계인구 43억명 중 B형 간염 바이러스 보균자는 2억 1천 5백만명이며 이중 78%인 1억 6천만명 이상이 아시아 대륙에 집중되어 있다. 한국도 B형 바이러스 간염의 침윤지대이다. 본 연구는 B형 바이러스 보균자 혹은 만성간염을 치료할 수 있는 생약제를 탐색할 목적의 일환으로 한국에서 시판하는 생약제 151종을 구입하여 증류수로 추출하고 여과한 후 냉동건조하여 HBs 항원에 대한 결합능, HBV DNA polymerase억제능, tumor necrosis factor(TNF) 유리에 미치는 영향, 그리고 galactosamine 유발 간염에 대한간장보호 작용을 조사하였다. 151종의 생약제중 0.16㎍/㎖ 농도에서 간염 vaccine 내에 함유된 HBs 항원과 결합하는 생약제는 지유, 가자, 복분자, 대황, 정향, 빈량, 산수유, 소목, 마황, 쇄양, 후박, 목과, 양강, 오약, 산사, 목단피 등 16종이었다. 이들 생약제중 대황(Rheum palmatum L. 大黃), 가자(Terminalia chebula R. 訶子), 지유(Sanguisorba officinalis L. 地楡), 복분자(Rubus coreanus M. 覆盆子)는 HBV DNA polymerase 활성도를 비교적 강하게 억제하였으며 빈량(Areca catechu L. 빈랑), 정향(Eugenia caryophyllata T. 丁香), 목과(Chaenomeles japonica L. 木瓜), 산수유(Cornus officinalis S. 山茱萸)는 약하게나마 HBV DNA polymerase 활성을 억제하였다. 또한 HBV DNA polymerase를 억제한 대황, 가자, 지유, 복분자, 빈량, 정향, 마황, 소목, 산수유를 대상으로 TNF 유리에 미치는 영향을 조사한 결과 소목을 제외한 8종의 생약제 모두가 대식세포를 자극하여 TNF를 유리시켰다. 그리고 장차 임상에 사용함을 전제로 HBV DNA polymerase를 억제한 대황, 가자, 지유, 복분자, 빈량, 정향, 마황, 소목, 산수유를 galactosamine 유발 간염(백서)에 투여하여 간기능 검사에 미치는 효과를 조사하였으나 간기능 검사상으로는 특별한 보호작용을 나타내지 못하였으며 생약제 단독 투여로서는 간기능에 대하여 나쁜 영향을 주지 않았다. Hepatitis B virus infection is major cause of acute and chrome hepatitis, cirrhosis of liver, and hepatocellular carcinoma. There are over 200 million carriers of hepatitis B virus in the world, nearly 80 % of whom live in the South East Asia, Korea is also highly endemic area of hepatitis B virus infection. This study was performed to evaluate the effect of extracts of traditional Korean herbal medicines on hepatitis B virus. 151 traditional herbs were extracted, filtered and lyophilized. Using 151 herbal extracts we tested binding capability to the HBs Ag, inhibition of HBV DNA polymerase, release of tumor necrosis factor (TNF), and protection against galactosamine induced liver damage. Among 151 herbs, 16 herbs (Sanguisorba officinalis L., Terminalia chebula R., rubus coreanus M., Rheum palmatum L., Eugenia caryophyllata T., Areca catechu L., Cornus officinalis S., Caesalpinia sappan L, Ephedra sinica S., Cynomorium songaricum R., Machilus thunbergii S., Chaenomeles japonica L., Alpinia officinarum H., Lindera strychnifolia V., Crataegus pinnatifida B., Paeonia suffruticasa A. ) had binding capability to HBs Ag which contained in the commercial hepatitis vaccine, at 16 ug/㎖ of concentratioa Among the above 16 herbs, Rheum palmatum L., Terminalia chebula R., Sanguisorba officinalis L., Rubus coreanus M. significantly inhibited the HBV DNA polymerase activity, and Areca catechu L., Eugenia caryophyllata T., Ephedra sinica S., Caesalpinia sappan L., Chaenomeles Japonica L., Cornus officinalis S. also inibited the HBV DNA polymerase activity but less effective. All of the herbs, except Caesalpinia sappan L., which inhibited the HBV DNA polymerase activity, actively stimulated the mononuclear cells to release tumor necrosis factor(TNF) in whole blood culture system. The herbs which inhibited the HBV DNA polymerase activity, did not show any protective effect in galactosamine-induced hepatitis in rats, but there was no direct toxic effect when herbs were administered alone.

위내시경으로 진단된 Gastric Red Spots(GRS)의 병태생리 및 임상적 의의

박경남,이민호,강인구,양석철,조석신,함준수,이종철,기춘석,성인경 대한소화기학회 1992 대한소화기학회지 Vol.24 No.5

The incidence of GRS in the proximal part of the stomach was investigated in patients with various liver diseases. 477 patients with biopsy proven chronic liver disease underwent endoscopic study and GRS were obaerved in 38 (20.3%) out of 187 patients with liver cirrhosis, in 21 (16.8%) out of l25 patients with chronic active hepatitis, in 9 (15. 5%) out of 58 patients with chronic persietent hepatitis, and in 12 (14.3%) out of 84 patients with other chronic liver pathologies. There were no statistical differences among the groups. The incidence of chronic liver disease among patients with normal liver function tests and abdominal ultrasonography, but exhibiting GRS upon endoscopic study, was also prospectively studied by liver biopsy. 11 of 23 such patients had chronic liver disease: 2 had liver cirrhosis, 3 with chronic persistent hepatitis, and 6 with chronic reactive hepatitis, while 12 patients with no conclusive pathology in liver biopsy in spite of minimal disarray of hepatic lobular architecture and mild inflammatory cell infiltration into periportal area. The heart to liver radioisotope uptake ratios measured by Thallium-201 scan to estimate the portal pressure were 13±3% (mean± SD) in 15 control subjects, 22±7% in 20 patients with chronic persistent hepatitis, 28±13% in 15 patients with chronic active hepatitis, 59±41% in 18 patients with liver cirrhosis, and 27±14% in 50 patients with GRS, but with normal liver function test results and normal abdomial ultrasonography. These results showed statistical difference from normal control (p$lt;0.05). It can thus be concluded that GRS in the proximal part of the stomach could be a stigma of chronic liver disease, and would also indicate the presence of high portal pressure.

만성 간질환 및 원발성 간세포암 환자의 혈청 α1 - Antitrypsin 표현형의 변화

강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),문영명(Young Myung Moon),정재복(Jae Bock Chung),한광협(Kwang Hyub Han),전재윤(Chae Yoon Chon),김원호(Won Ho Kim),임대순(Dae Soon Yim),함기백(Ki Baik Hahm),신용준(Yong 대한소화기학회 1993 대한소화기학회지 Vol.25 No.2

N/A In parallel with the discovery of nev alleies inceasing the complexity of the Pi system, technical refinements have made the classification of an individual with respect to his Pi system relativeiy simple. Isoelectrofocusing in polyacrylamide gels is advantageous method in analyzing pisystem because of ease of performance, high resolution and reproclucibility. Most individuals have the PiMM phenotype resulting in normal plasma a1-antitrypsin (a,-AT) levels. The classical a1-AT deficiency is designated as Pizz in its homogygous form and has 15% of normal plasma a1-AT level, which is known to be associated with increased risk of cirrhosis and primary liver cancer But there is stilJ debate as the cause of this associated liver disease. This study is aimed to know the distribution and contribution of structural variants of a1-AT in South Korean patients with chronic liver diseases inr.uding hepatocellular carcinoma. One hundred thirty nine patients with chronic liver diseases or hepatocellular carcinoma were studied. Rlood sarnples were taken frorn each. Phenotypes of a1-AT were determined by electrofocusing in polyacrylamide gel electrophoresis. The results obtained were as folloas, None of the cases showed deficiency or null variant of a1-AT in patients with chronic liver diseases, hut two cases with hepatocellular carcinoma showed MS phenotype. About half of the cases with chronic liver disease and hepatocellular carcinoma showed homologcius polymorphism of a1-AT phenotype suballeles such as M1M1. M2M2 and M3M3. The distribution of the structural variants of a1-AT phenotype in patients with chronic liver diseases and hepatocellular carcinoma were in order as tollows; M1M1 (51.8%), M1M2(24.5%), M2M2 (7.9%), M3M3 (6.5%), M1M3, (5.8%),M3M3 (2.2%) and M1S (1.3%). In con, lusion, none of the cases with chronic liver diseases showed deficiency or null typed structural variants of a1-AT, but there were two cases with MS phenotype among the 39 patients with hepatocellular carrcinoma. Therefore, genetically determined a1-AT. deficiency seems to be not etiological]y important in South Korean patients with chronic liver disease.

해방 이후 충남 서산 지역의 지방사 : 역사적 담론에 대한 인류학적 접근 Ethnographic Representations of Historical Discourse, 1945-1995

유철인,김성례,성시정,송도영,윤택림,한경구,함한희 한국문화인류학회 1996 韓國文化人類學 Vol.29 No.1

This research is to mainly reconstruct a local history of the Sosan area during the post-liberation era. The local history conveys distinct features of social and cultural changes. This study emphasizes the following ; firstly, villagers' own experiences are to be highly respected. Secondly, each village is a basic unit for study and yet is analyzed in relation to other higher order of the society as the state. Thirdly, an individual's life is crucial for a better understanding of the local history. The villagers had communicated with the outside world in a restricted way through marketing and maintaining marriage ties until the early 1960's. Thereafter, the sphere of village life has increasingly expanded : due to the development of mass transportation and spread of public education. Networks for marketing have been widened, and migration of family members have formed a currency. Accordingly communications of the villagers with larger cities has become more important compared to the one with neighboring villages. The villagers currently enjoy easier access to larger cities like Inch' on and Seoul and stronger social ties with those cities. Expansion of the sphere of village life has transformed the nature of political, economic, social and cultural nexuses in the village. What deserves most notice is that such nexuses have changed. Before the implementation of the land-to-tiller program in the 1950's, landlords had ruled over tenant-peasants. The land-to-tiller program enabled the former tenants to be petty landowners. In this process, villagers experienced clash of contradictory ideological pursuits. Some villagers preserved the traditional moral code and others tried to follow a new ideological trend of the day. Whichever the way villagers took in the process of land reform, they struggled with themselves in the choice of economic advantages and moral justification for their behavior and thought. As the influence of the central government and capitalists increased, the tone of local dignitaries were softened. The government implemented agricultural development programs to enhance living standards of villagers. Capitalists endorsed the government's developing policy. To this end, the corporations participated in various projects regarding economic development including land reclamation. The Hyundai Corporation played a key role in the Sosan Land Reclamation. While some villagers benefitted from this project, others, particularly the former fishermen in Pusok-myon, were faced with negative effects of the same project. The fishermen were deprived of their means of livelihood. They launched s series of movements for the compensation of for their loss. The development of such movements witnessed the emergence of new leadership. New leaders were armed with their own ability and achievement, and they were instrumental in success of the movements supported by the mass. The villagers also started movements against both the state and the corporation in a cultural way. They invented new rituals to cope with social change caused by the land reclamation, and restored some traditional rituals in a new form and spirit. However, invention or restoration of the rituals was not necessarily a product of unanimity in decisions and actions among the populace. The government and some prominent figures of the village also took part in such rituals with their own interest. Life histories reveals how social changes have affected individuals and a families. and at the same time, how individuals have interpreted such changes. Subjects in life histories were largely concerned with economic survival rather than social change unless those changes caused them troubles. life histories exhibit not only individuals' experience but also social and cultural characteristics of the Sosan area. In an area like Sosan, while has been dominated by the non-yangban or the weaker residents to seek for humble yet profitable jobs rather than to rely on yangban (a traditional class of nobility since the Choson dynasty) ideologies. Family members, who are in charge of their families' livelihood took pride in themselves. And their sacrificial attitudes toward parents and siblings were highly praised by their neighbors. However, in recent years some of them began to give in such pride and regret the fact that they had neglected schooling of their children. It reflects values and world-views newly forming within their minds. Life histories collected in this area can be valued as texts and contexts that helps us to grasp the depth of the local history.

위장관 ( 胃腸管 ) : 위암 환자에 있어서 말초혈액 단핵구 및 국소 림프절 단핵구의 NK 및 LAK 활성도에 관한 연구

강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),김원호(Won Ho Kim),노성훈(Sung Hoon Noh),함기백(Ki Baik Hahm),김태수(Tae Soo Kim),안신기(Shin Ki Ahn),윤정구(Jung Koo Youn) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2

N/A Several lymphocytic subpopulations, such as natural killer (NK) cells and lymphokine-activated killer (LAK) cells, are involved in immunosurveillance against tumors. Whereas the biological significance of the regional lymph node as a tumoral barrier remains unclear, the clinical prognostic relevance of the neoplastic infiltration of these nodes is accepted. Although there is general agreement that the NK and LAK activities of peripheral blood mononuclear cells (PBMC) decreases in patients with various solid and leukemic tumors, this decrease remains unclear with regard to the NK and LAK activities of their regional lymph node mononuclear cells (LNMC). We measured NK and LAK activities of PBMC and LNMC in 10 patients with resectable gastric cancer by 4 hour Cr-release assay using K562, Raji cell and allogenous gastric cancer cell as a target cell. The results obtained are as follows: l) Recombinant interleukin-2 induced strong cytotoxic activities against various target cells in PBMC and LNMC. 2) In patients with gastric cancer, NK and LAK activities of LNMC against K56Z and Raji cell were lower than those of PBMC. 3) However, NK ad LAK activities against the allogenous gastric cancer cell did not differ between LNMC and PBMC. 4) NK and LAK activities of PBMC and LNMC against K562 and Raji cell were not different betveen in patient with early gastric cancer and in patients with advanced gastric cancer. 5) However, NK and LAK activities of PBMC ad LNMC against the allogenous gastric cancer cell were lower in patients with advanced gastric cancer than in patients with early gastric cancer.

백서의 허혈성 위손상에 대한 Misoprosto1의 위점막 보호 효과

강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),문영명(Young Myoung Moon),이상인(Sang In Lee),이동기(Dong Ki Lee),함기백(Ki Baik Hahm) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.1

A study was undertaken to unvestigate the rele of prostaglandin E. ( misprostol) on the protective effect of the ischemic and/or acldic mucosal amage in rat stomack using a electrophysiolgic method. The result were as follows.1) A significant graded reduction of potential difference was noted after the blood withdrawal.2) The intragastric instillation of NaHCos did not attenuate the PD decline produced by the blood withdrawal and the PD decline was aggravated after the intragastric instillation of 0.1 NHCl 3) Misoprostol pretreatment tended to suppress the PD decline produced by the ischemia and/or acid gastric injury.4) Sudden potential drop was noted in the blood withdrawal with acidic gastric injury group, however, it was hot observed in the misoprostol pretreatment group. 5) The blood withdrawal did not induce the grow and microscopic lesions in the stomach in the absence of exogenous acid, in spite of a reduction in nofantial difference. In conclusion, Prostaglanding it seems to play a role in attenuating the potaneal difference decline caused by the iachemia and/or acid gastric injury, that is, cytoprotecting from gastrin mucosal damege.

내시경적 역행성 담췌관 조영술후 발생하는 고아밀라제혈증의 병인에 산소유리기의 역할

강진경,서창희,박인서,문영명,함기백,정재복,이동기,문희용 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.1

There is growing evidence that oxygen-derived free radicals(OFR's) play a role in the pathogenesis of pancreatic diseases, especially of acute paetcreatitis. Many types of experimental ex vivo and in vitro pancreatitis can be inhibited by superoxide dismutase and catalse. Allopurinol also ameliorates the injury response. While these experiments strongly suggest the involvement of OFR's in some forms of experimental acute pancreatitis, their clinical significance is still unknown. Clinical trials with free radical scavengers or allopurinol are clearly needed to answer the question of free radical initiation of acute or chronic pancreatitis. The aim of this study was to know the role of OFR's on the ERCP-induced hyperamylasemia. Total forty-two patients who underwent ERCP for diagnostic purposes were included and randomly divided into two group6, non-pretreatment group(NP group 19 patients) and pretreatment group(P group, 23 patients pretreated with vitamin E 1000 I.U. and allpurinol 300 mg for 5 days before ERCP orally). 15 ml of venous bloods were drawn in EDTA treated tubes. Serial changes of serum amylase levels(U/ml), washed RBC malonyDdialdehyde levels(MDA, nmol/ml RBC), buffy coats myeloperoxidase activites(MPO, U/ml buffy coats), and plasma superoxide dismutase levels(SOD, U/ml) were measured before, 2 and 24 hours after ERCP, respectively. Serum amylase levels in P group were decreased than NP group, but without statistical significance. The mean RBC MDA levels of P group measuted 2 hr after FRCP were 3.43±1.13, which were significantly decreased than those of NP group(5.27±1.53)(p$lt;0.05). The plasma SOD levels of P group were 17.71 1.8, 20.41±1.3, 19.4±2.2 at before, 2 and 24 hr after FRCP, respectively, which were all significantly decreased than those of NP group(p$lt;0.05). The huffy coats MPO activities were not changed at all in spite of pretreatment. In conclusion, OFR's might be in volved in the pathogenesis of ERCP-induced hyperamylasemia, but do not play a major role. A protective effect of allopurinol and vitamin E could be expected.

기능성 소화불량증 환자의 위내용물 배출시간에 대한 연구

함준수(Joon Soo Hahm),박경남(Kyung Nam Park),이민호(Min Ho Lee),기춘석(Chun Suhk Kee),이종철(Jong Chul Rhee),강인구(In Koo Kang),성인경(In Kyung Sung),김종필(Jong Pil Kim),이규택(Kyu Teak Lee) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.3

N/A It has been reported that more than three-quarters of patients with dyspepsia were diagnosed to have functional dyspepsia. But the causes of this syndrome are unknown. Therefore, to evaluate the relationship between the gastric motor activity and functional dyspepsia, we compared the gastric emptying time (GET) in patients with functional dyspepsia with that in normal contrals. The study population consisted of 165 patients with functional dyspepsia admitted to or attending Hanyang University Hospital and 20 volunteers from the the beginning of Feb. 1989 to the end of June 1991. We measured gastric emptying rate for 150 minutes using radionuclide scintiscan of an Tc-labeled chicken liver. The m#ean GET (T1/2) was 84.9+-16.4 min in normal controls. In 165 patients, 94 patients (57%) showed delayed gastric emptying, whereas 71 patients (43%) showed normal gastric emptying. The median age for patients with functional dyspepsia was 41 years. Women outnumbered men in patients with functional dyspepsia (2:1). There were no statistical differences in scores of upper gastrointestinal symptoms. Gastric emptying time was delayed in 57% of patients with functional dyspepsia and women outnumbered men two folds. Also our results showed the.t the scores of upper abdominal symptoms cannot be helpful in diagnosing the underlying gastric motility disturbances.

알코올에 의한 간손상시 적혈구막 지질 과산화현상의 역할

김원호,김한수,강진경,백승운,박인서,문영명,전재윤,함기백,신용운,장학철,최홍재 대한소화기학회 1992 대한소화기학회지 Vol.24 No.2

The question of whether or not ethanol-induced liver injury is related to or accompanied by lipid peroxidation has been a subject of controversy. Short-term ethanol administration was shown by some to produce hepatic lipid peroxidation in rats, but very large doses of ethaol had to be used. Furthermore, some investigators failed to confirm these effects of ethanol. Fewer studies have explored the relationship between alcohol consumption and lipid peroxidation. In order to study this question and clarify the role of oxygen derived free radicals and lipid peroxidation of the RBC in inducing the alcoholic liver diseases, we measured the thiobarbituric acid reactivities in normal controls and patients with alcoholic liver disease. The subjects were divided into three groups according to the liver function tests and the amounts of alcohol drinking: group I-normal controls, group II-cases showing normal liver function test in spite of frequent alcohol drinking over 3 days per week and 45 g alcohol per one time, group III-patients with alcoholic liver disaesae, drinking alcohol over 4 times per week. The thiobarbituric acid reactive substances were measured as a marker of lipid peroxidation by the method of Uchiyama and Mihara. The colorimetric method was used by a measurment of malonyldialdehyde [MDA, nmole/㎖ (packed cells)] concentration. The results were as follows. The mean MDA concentrations of group Ⅲ was 1.67±1.01 nmol/㎖ (packed cells), which was significantly higher than those of group Ⅰ [0.73±1.02 nmol/㎖ (packed cells)] and group Ⅱ [1.01±0.39 nmol/㎖ (packed cells)]. The MDA concentrations was significantly correlated with total protein (r=0.47, p$lt;0.05), total cholesterol (r=0.49, p$lt;0.05), and frequency of alcohol drinking (r= 0.49, p$lt;0.05) in group Ⅲ. There was a significant difference in mean MDA concentration between the cases with normal serum albumin and cases with hypoalbumnemia in patients with alcoholic liver cirrhosis. These data suggest that lipid peroxidation might play a contributing role in the pathogenesis of alcoholic liver disease.

한국의 발톱진균증 환자의 삶의 질에 관한 연구

조백기,박종갑,김형옥,김성욱,백승철,김진우,김시용,안규중,전재복,오지원,김낙인,이규석,오칠환,김수남,김상태,손숙자,신용우,김동석,이원우,권경술,서대헌,황규왕,이종석,고재경,강원형,정기양,최응호,김기홍,박석돈,강승주,함정희,명기범,김방순,구상완,김병수,원영호,김한욱,송은섭,정병수,노병인,홍창권,박장규,한지윤,김광중,구대원,김종민,김재홍,유희준,양경미 대한의진균학회 1998 대한의진균학회지 Vol.3 No.2

Background: Onychomycosis, especially toenail onychomycosis has become one of the common fungal infection and has historically been regarded as a cosmetic rather than medical problem by many patients, even by physicians. Recently, however, there are several reports that is a refractory disease which may cause a deleterious effect on patiets quality of life (QOL). Objective: The purpose of this study was to investigate the impact of toenail onychomycosis on QOL in Korea and to assess the chandes of QOL after treatment. Methods: Total 1004 patients with toenail onychomycosis which was confirmed by clinical findings and KOH preparation were were enrolled at 47 dermatologic centers in Korea, and interviewed with standardized QOL questionnaire before and after sytemic antifungal treatment. Responses to the questionnaire were scored by 5-point scale (1∼4) and averaged, and were analyzed for 5 dimensions of emotional impact, social impact, symptorn and functional impact, patients views concerning treatment, and relationship with doctor. Results: 1. Before and after treatment, the most serious impact was emotional dimension showing 1.90 and 1.30 in average score (AS), and social (AS: 1.14 and 0.83) and symptom and functional impact (AS: 1.05 and 0.92) was also affected. 2. In female rather than male, statistically more significant impact on patients QOL was observed in all dimensions. 3. After treatment, 3 of 5 dimensions were improved significantly - emotional dimension (AS : from 1.90 to 1.30), social dimension (AS: from 1.14 to 0.83), patients view concerning treatment (AS: from 1.34 to 1.02). 4. The drgree of patients satisfaction at the therapeutic effect was very high- 62.4% (immediately after treatment) and 65.8% (9 months affer initiation of treatment) of patients answered excellent or good. Conclusion: This study confirms that toenail onychomycosis has significant impact on the overall QOL of patients. Also the effect of antifungal therapy on patients QOL were watisfactory. Therefore, both doctor and patient should pay more attention to the treatment of onychomycosis. [Kor J Med Mycol 3(1): 115∼124]