임상 난제 진단에 있어 Google 검색의 활용 (국외논문 논평)

고광철 ( Kwang Cheol Koh ) 대한간학회 2007 Clinical and Molecular Hepatology(대한간학회지) Vol.13 No.1

B 형 만성 간염 환자에서 HBeAg / anti - HBe 전환 전후에 HBV Precore 변종의 발생과 만성 간염 활동성과의 관계

고광철(Kwang Cheol Koh),이효석(Hyo Suk Lee),김정룡(Chung Yong Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.3

Objectives: To determine the most common type of precore mutant of hepatitis B virus (HBV) and the relationship between the emergence of precore mutant and the severity of chronic hepatitis B, we compared the prevalence and the emerging pattern of the precore mutant during the natural course in chronic-hepatitis-B patients, with us well as without biochemical remission, along with HBeAg/anti-HBe seroconversion. Methods: A total number of 39 sera obtained serially from 12 patients with chronic hepatitis B, all of whom experienced HBeAg/anti-HBe seroconversion during natural course were studied. The patients were divded into two groups according to the subsequent biochemical remission after HBeAg/anti-HBe seroconversion; Group I included 8 patients who accompanied biochemical remission and group II 4 patient-s who showed persistent elevation of ALT. The prevalence rates of precore mutant of these two groups and the rates before and after HBeAg/anti-HRe seroconversion were compared with each other. The sera were analysed for the presence of mutation at the precore region of HBV using the direct sequencing of DNA amplified by polymerase chain reaction. Results: The precore mutants were found in 10 patients (83.3%) of a total number of 12 patients; 6 of 8 (75.0%) in group I and 4 of 4 (100%) in group II. The difference in the detection rates between the two groups was not statistically significant (p=0.52). The precore mutant having a G-A mutation at the nucleotide 1896 was most commonly found (9/10), and the precore mutant with G-A mutations both at the nucleotide 1896 and 1899 was also found in the remaining one patient. The detection rates of wild type were 75.0% (9/12) during HBeAg-positive period and 0% (0/7) during anti-HBe-positive period. In contrast, those of precore mutant were 66.7% (8/12) during HBeAg-positive period and 100g (7/7) during anti-HBe-positive period. In 2 patients, the courses of whom were closely followed up for longer period of time, wild type was the predominant population of HBV in sera during HBeAg-positive period when the values of ALT fluctuated, and precore mutant began to emerge just before the disappearance of HBeAg and was the main population after the ALT level normalized and anti-HBe became positive. Conclusion: The most common type of precore mutant of HBV in Korea was the mutant with a G-A mutation at nt 1896. The emergence of precore mutant was frequently associated with the HBeAg/anti-HBe seroconversion irrespective of ALT levels; therefore, precore mutant is unlikely to bear direct causal relation to the severity of chronic hepatitis B.

문맥압항진증의 실험 동물모델

고광철(Kwang Cheol Koh) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.4

Pathophysiologic studies in patients with portal hypertension face many methodologic and ethical difficulties. Therefore, the knowledge of the pathophysiology of portal hypertension is largely based on the results of studies in experimental models. The most commonly used models are rat and murine. It should be emphasized that these models are extremely useful to enhance our understanding of the mechanism and pharmacology of portal hypertension, but they still have limitations and inconvenience. Some of these problems are related to the conditions in which the experiments are performed, the techniques used for hemodynamic measurements, or model-related limitations. These differences should be carefully considered when the results of experimental studies are analyzed, because they may influence the findings of some investigations. (Korean J Gastroenterol 2001;38: 227-232)

혈관 CB1 수용체에 작용하는 Endocannabinoids 의 간경변 과역동성 증후 발현에의 관여

고광철(Kwang Cheol Koh) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.6

N/A

기능성 소화불량증에서 위하수의 임상적 의의

고광철(Kwang Cheol Koh),백승운(Seung Woon Paik),이풍렬(Poong Lyul Rhee),김재준(Jae Jun Kim),이종철(Jong Chul Rhee),최규완(Kyoo Wan Choi),박상종(Sang Jong Park),김영호(Young Ho Kim),최상희(Sang Hee Choi),이순진(Soon Jin Lee),김지은(Je 대한내과학회 1999 대한내과학회지 Vol.57 No.3

The purposes of this study were to assess the relationship between functional dyspepsia (FD) and the gastroptosis which was considered as one of the causes of FD by some physicians in Korea and to evaluate the possibility that gastroptosis was directly related to the relatively decreased abdominal fat content. Methods : 442 subjects taken upper gastrointestinal barium series (UGIS) for routine check-up were interviewed about symptoms of FD by physicians on the basis of Rome criteria. Various parameters of obesity were also collected from 366 subjects. Gastroptosis was diagnosed by radiologists when the gastric angle was located below the Jacobys line. Results : Gastroptosis was found in 23 (5.2%) of 442 subjects. Relationship between gastroptosis and FD was rejected statistically because 3 (5.8%) of 52 subjects with FD had gastroptosis but 20 (5.1%) of 390 subjects without FD also showed gastroptosis. Various parameters of obesity such as body mass index (20.6±2.6, 23.8±2.8), % body fat (23.4±6.1%, 28.2±6.6%), % ideal body weight (97.9±12.6%, 112.6±14.0%), waist to hip ratio (0.855±0.096, 0.900±0.070) and weight (53.5±8.2 kg, 62.5±9.6 kg) in subjects with and without FD showed that the gastroptosis was more frequent in subjects with low values in parameters of obesity. But on multivariate analysis, only body mass index was the independent factor related to gastroptosis. Conclusion : Gastroptosis is not a cause of FD but is thought to be a constitutional problem related to low values in parameters of obesity. (Korean J Med 57:298-303, 1999)

최근 3년간 급성 바이러스성 간염의 원인 분석

유병철 ( Byung Chul Yoo ),고광철 ( Kwang Cheol Koh ) 대한내과학회 2005 대한내과학회지 Vol.68 No.3

약인성 간염에 동반된 일과성 순수 적혈구 형성부전증 및 자가면역 용혈빈혈

이지인 ( Ji In Lee ),고광철 ( Kwang Cheol Koh ),김민영 ( Min Young Kim ),손관협 ( Gwan Hyeop Sohn ),정해원 ( Hae Won Jeong ),최원석 ( Won Seok Choi ),김기현 ( Ki Hyun Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.2

Pure red cell aplasia is a rare hematopoietic complication of drug-induced hepatitis, with only five cases reported worldwide. Moreover, pure red cell aplasia associated with autoimmune hemolytic anemia in the setting of drug-induced hepatitis is exceedingly rare. We recently experienced a case of drug-induced hepatitis complicated by pure red cell aplasia and autoimmune hemolytic anemia without parvovirus B19 infection. Here, we report the case and review the literature. (Korean J Med 76:199-202, 2009)

혈액투석 중인 만성 신부전 환자에서 TT Virus의 감염률과 임상적 의의

이준행(Jun Haeng Lee),고광철(Kwang Cheol Koh),최문석(Moon Seok Choi),김소정(So Jeong Kim),이용욱(Yong Wook Lee),박상종(Sang Jong Park),임윤정(Yoon Jeong Lim),도재혁(Jae Hyuk Do),이준혁(Joon Hyeok Lee),이풍렬(Poong Lyul Rhee),김재준(J 대한소화기학회 2001 대한소화기학회지 Vol.37 No.1

Background/Aims: TT virus (TTV) is a unenveloped, single-stranded and circular DNA virus isolated from the serum of a patient with posttransfusion hepatitis of unknown etiology. We evaluated the prevalence, risk factors, and clinical significance of TTV in patients with chronic renal failure(CCRF) undergoing maintenance hemodialysis (HD). Methods: We examined TTV DNA in serum of HD-undergoing patients and healthy controls using the nested polymerase chain reaction. Results: TTV DNA was detected in 15 (20.0%) of 75 HD-undergoing patients and 10 (13.2%) of 76 healthy controls (p>0.05). The prevalence of TTV did not differ according to the duration of HD or transfusion history of the patients. The prevalence of TTV was higher in IgG anti-HBc positive patients than IgG anti-HBc negative patients (27.5% vs. 4.2%, p=0.03). There was no relationship between TTV infection and liver diseases. Conclusions: The prevalence of TTV infection in CRF patients undergoing HD was similar with that of healthy controls. These results suggest that TTV infection may share the route of transmission with HBV infection in adults. (Korean J Gastroenterol 2001;37:14-20)

백서의 척수에서 GABAB 수용체의 심혈관 조절 작용

이준혁(Joon Hyoek Lee),고광철(Kwang Cheol Koh),백승운(Seung Woon Paik),심상군(Sang Goon Shim),류광현(Kwang Hyun Ryu),이풍렬(Poong Lyul Rhee),김재준(Jae Jun Kim),이종철(Jong Chul Rhee),최규완(Kyoo Wan Choi),이석호(Suk Ho Lee),이규택(K 대한내과학회 1999 대한내과학회지 Vol.56 No.1

Objectives : The purpose of present study is to investigate the influence of a spinal gamma-aminobutyric acid B (GABAB) receptor on a central regulation of blood pressure(BP) and heart rate(HR), and to define its mechanism in the spinal cord. Methods : In urethane-anesthetized, d-tubocurarine- paralyzed and artificially ventilated male Sprague-Dawley rats, intrathecal administration of drugs were carried out using injecton cannula(33-gauge stainless steel) through the guide cannula(PE 10) which was inserted intrathecally at lower thoracic level through the puncture of a atlantooccipital membrane. Results : Intrathecal injection of an GABAB receptor agonist baclofen(30, 60, 100 nmol) decreased both blood pressure and heart rate dose-dependently. Pretreatment with 8-bromo-cAMP(50 nmol), a cAMP analog or glipizide(50 nmol), a ATP-sensitive K+ channel blocker attenuated the depressor and bradycardic effects of baclofen (100 nmol) but not with 8-bromo-cGMP(50 nmol) a cGMP analog. Conclusions : The GABAB receptor in the spinal cord plays an inhibitory role in central cardiovascular regulation and that this depressor and bradycardic actions are mediated by the decrease of cAMP via the inhibition of adenylate cyclase and the opening of K+ channel.

혈액투석 중인 만성 신부전 환자에서 G 형 간염 바이러스의 감염률 및 임상적 의의

이준혁 ( Joon Hyoek Lee ),고광철 ( Kwang Cheol Koh ),백승운 ( Seung Woon Paik ),이종철 ( Jong Chul Rhee ),최규완 ( Kyoo Wan Choi ),이윤하 ( Yun Ha Lee ),김윤구 ( Yun Gu Kim ),오하영 ( Ha Yung Oh ),이효석 ( Hyo-Suk Lee ),김정룡 ( C 대한소화기학회 1999 대한소화기학회지 Vol.33 No.1

Background/Aims: We aimed to elucidate the prevalence and risk factors of HGV infection in patients with chronic renal failure undergoing hemodialysis, and to define the potential etiologic-role of HGV in the development of chronic liver disease. Methods: One-hundred and seventy-eigh patients with chronic renal failure undergoing hemodialysis were included. After extraction of RNA from serum, reverse transcription polymerase chain reaction was performed using the primers from the NS5a region. The PCR products were analyzed by liquid hybridization. Results: The prevalence was 9.0% (16/178). The prevalence rates were not statistically different according to the presence (8.5%) or abscence (10.8%) of past history of blood transfusion, patient' s age or maintenance duration of hemodialysis (p>0.05). Anti-HBc-positive patients (12.4%, 16/129) showed significantly higher prevalence rate (p=0.01) of HGV infection than anti-HBc-negative patients (0%, 0/49). Twelve of the 14 HGV positive patients without co-infection showed persistently normal ALT level during a year of follow-up. Conclusions: The prevalence of HGV in patients with chronic renal failure undergoing hemodialysis is significantly higher than that of volunteer blood donors. HGV may share the route of transmission with adulthood HBV infection. The etiologic-role of HGV in the development of ch ronic liver disease may be considerably poor. (Kor J Gastroenterol 1999;33:78 - 89)