상부위장관질환 환자에서 H . pylori 감염에 의한 위점막의 조직학적 변화와 혈청 Gastrin 및 혈청 IgG항체가의 상관관계

손호상(Ho Sang Shon),최정윤(Jung Yoon Choe),김지희(Chi Hui Kim),김태석(Tae Sug Kim),김채기(Chae Gi Kim),김이근(Ih Geun Kim),안기성(Ki Sung Ahn),김호각(Ho Gak Kim),오훈규(Hoon Kyu Oh),김용진(Yong Jin Kim),배정동(Jung Dong Bae) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.3

N/A Background/Aims: This study was performed to investigate the relationship between Helicobacter pylori infection and degree of gastric mucosal inflammation, IgG antibody titer against H. pylori, and fasting serum gastrin level. Methods: Patients were divided into 2 groups(H. pylori positive and negative) by identification of H. pylori in biopsied specimens with special staining. In H. pylori positive group, the density of gastric K. pylori colonization was further graded semiquantitatively from 1 to 3. The severity of gastritis in each group was scored according to the Sydney system from 0 to 3. Serum IgG antibody titer against H. pylori was detected by second-generation antigen based enzyme immunoassay(Cobas Core Anti-Helicobacter pylori EIA). Fasting serum gastrin level was measured by standard radioimmunoassay technique. Results: The severity of gastritis in H. pylori positive group was significantly higher than H. pylori negative group in mononuclear cell infiltration(pC0.001), activity of PMNL(pC0.001), and glandular atrophy(pC0.01). In H. pylori positive group, the density of H. pylori colonization was significantly correlated with mononuclear cell infiltration(r=0.67, p0.001), activity of PMNL(r=0.70, p0.001), and grandular atrophy (r=0.38, pC0.001). Neither density of H. pylori colonization nor severity of gastritis was correlated with fasting gastrin level and IgG antibody titer against H. pylori. Conclusions: H. pylori infection results in localized inflammatory reaction in gastric mucosa with relation to density of H. pylori colonization, but serum H. pylori IgG antibody titer does not reflect the severity of gastritis. Fasting serum gastrin level also has no relation with the density of H. pylori colonization and severity of gastritis. These findings suggest that the factor which cause inflammation in gastric mucosa may be different from that cause gastrin secretion or formation of IgG antibody. (Korean J Gastroenterol 1996; 28:311 - 319)

장천공과 Enteritis Cystica Profunda를 동반한 Peutz-Jeghers 증후군

안기성(Ki Sung Ahn),배정동(Jung Dong Bae),김호각(Ho Gak Kim),손호상(Ho Sang Shon),최정윤(Jung Yoon Choe),김지희(Chi Hui Kim),김이근(Ih Geun Kim),김태석(Tae Sug Kim),김채기(Chae Gi Kim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5

The Peutz-Jeghers syndrome is an autosornal dominant condition characterized by mucocutaneous pigmentation and hamartomatous polyps of the gastrointestinal tract. This syndrome is clinically important because of complications caused by gastrointestinal polyps, such as abdorninal pain, gastrointestinal bleeding and intussusception often leading to intestinal obstruction. The possibility of malignant change in the polyp has been a controversial issue. In the recent reviews of soe cases of Peutz-Jeghers syndrome, the reported lesions of small intestinal adenocarcinoma are regarded as the benign process of enteritis cystica profunda. We present herein a case of Peutz-Jeghers syndrome with small bowel perforation, a previously unreported instance, and enteritis cystica profunda. (Korean J Gastroenterol 1997; 29:677-682)

성인 상부위장관 질환군에서의 H . pylori 검출에 이용되는 검사법의 상호비교

한길성(Gil Sung Han),서대규(Dae Gyu Seo),신왕식(Wang Sik Shin),정재군(Jae Gun Jung),손호상(Ho Sang Shon),최정윤(Jung Yoon Choe),안기성(Ki Sung Ahn),배정동(Jung Dong Bae),박재복(Jae Bok Park),강민모(Min Mo Kang) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1

N/A Background/Aims: For the evaluation of recent reports that H. pylori infection plays a causative ro1e in the pathogenesis of upper gastrointestinal diseases, we studied the relationship between the presence of H. pylori infection in patient and asymptomatic volunteer groups, using histologic demonstration of the bacteria, CLO test, and serum H. pylori antibody titer. Calculation of sensitivity, specificity, and predictive value of CLO test and antibody detection rate in relation to histologic demonstration were also performed. Methods: We evaluated the detection rate of H. pylori infection by direct demonstration with special stain, CLO test, and IgG antibody titer by EIA method in 80 symptomatiq patients who were categorized by endoscopic findings into 24 patients with chronic gastritis, 22 patients with gastric ulcer, 20 patients with duodenal ulcer, 14 patients with gastric cancer, and 20 asymptomatic volunteers. Four or more biopsy specimens of gastric and duodenal mucosa were taken from each of the total 100 cases with gastrofibroscopy and then blood samples were also taken. Results: In sections stained by Warthin-Starry method, H. pylori was found 62.5% in the 80 patients group and 30.0% in the 20 asymptomatic volunteers group. The prevalence of H. pylori was the highest in gastric cancer group(71.4%). The prevalence of H. pylori in the patients with peptic ulcer and gastric cancer was significantly higher than the asymptomatic volunteer group(p0.05). Positive CLO test in the patient group was 77.5% and 35.0% in the 20 asymptomatic volunteers group. The positive rate was the highest in gastric cancer group. The positive rate of the CLO test in patients with peptic ulcer and gastric cancer groups was significantly higher than the asymptomatic volunteer group(p0.05). The positive rate of IgG antibody test in the patient group was 82.5% and 45% in the 20 asymptomatic volunteer group. The rate of positivity was the highest in duodenal ulcer group. The positive rate of the serum IgG antibody test in all patient groups was significantly higher than asymptomatic volunteer group(p 0.05). Sensitivity and specificity of CLO test and IgG antibody test in relation to direct H. pylori smear was 94.6%, 76.7%, 96.4%, and 53.47o respectively. Conclusions: The positive rate of the H. pylori infection in patients with peptic ulcer and gastric cancer groups was significantly elevated compared with control and chronic gastritis groups for each of the 3 tests. For clinical purpose, CLO test can be used as a single guide for the treatment of H. pylori infection for its rapidity and efficacy. (Korean J Gastroenterol 1996;28: 19 - 27)

이달의 X-선 : 폐장의 원발성 악성 섬유성 조직구종 1예

양전호 ( Jeon Ho Yang ),최정윤 ( Jung Yoon Choe ),손호상 ( Ho Sang Shon ),장성국 ( Sung Gug Jang ),배정동 ( Jung Dong Bae ),이상채 ( Sang Chae Lee ) 대한결핵 및 호흡기학회 1997 Tuberculosis and Respiratory Diseases Vol.44 No.3

류마티스 관절염 환자에서 Phospholipase A2 활성도

오동호 ( Dong Ho Oh ),최정윤 ( Jung Yoon Choe ),송용호 ( Yong Ho Song ),손호상 ( Ho Sang Shon ),장성국 ( Sung Guk Chang ),김상경 ( Sang Gyung Kim ),이종명 ( Jong Myung Lee ),김능수 ( Nung Soo Kim ),장현욱 ( Hyeun Wook Chang ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.2

목적: Phospholipase A2(PLA2)는 세포막 구성성분인 인지질로부터 각종 eicosanoid의 전구물질인 arachidonic acid 생성에 관여하는 속도조절효소(rate-limiting enzyme)로서, 저자들은 류마티스 관절염 환자에서 PLA2의 활성도를 측정하고 이를 질병활동도와 비교검토함으로써 그 의의를 조사하였다. 방법: 대상환자군은 1987년 미국류마티스학회가 제정한 류마티스 관절염의 진단기준에 부합되는 총 25명의 환자를 대상으로 하여 그들의 혈청과 슬관절에서 뽑은 관절액내 PLA2 활성도를 측정하였다. 정상대조군은 병력이나 직장신체검사상 특별한 이상이 없는 병원직원 14명을 대상으로 하였다. 결과: 1. 류마티스 관절염 환자군에서 혈청 PLA2의 활성도는 정상대조군에 비하여 유의하게 증가되어 있었다(p<0.001). 2. 류마티스 관절염 환자에서 혈청 PLA2 활성도는 관절액에서 측정한 PLA2와 유의한 상관관계를 보였다(p<0.05). 3. 치료 3개월 후 질병활동도(임상 및 검사실 소견)의 유의한 호전(p<0.001)과 함께 혈청 PLA2 활성도는 유의하게 감소하였다(p<0.001). 4. 혈청 PLA2의 유의한 감소는 임상적 호전이 있는 군에서만 관찰되었다. 또한 혈청 PLA2 활성도는 질병활동도와 관련이 있는 각종 지표들 중, ESR과 가장 좋은 상관관계를 보였다(r=0.493, p<0.05). 결론: 류마티스 관절염 환자군에서 혈청 PLA2의 활성도는 정상 대조군과 비교하여 증가되어 있었으며 이는 관절액에서 측정한 PLA2 활성도와 유의한 상관관계를 보였고, 치료 후에는 임상증상의 호전과 함께 감소하였다. 이상의 소견으로 PLA2는 이질환의 병태생리에 관여하며 질병의 활동도를 반영 할 수 있는 지표의 하나로 생각된다. Objectives: A limited retrospective study of patients with rheumatoid arthritis(RA) found that serum phospholipase A2(PLA2) activity correlates with disease activity. To assess the strength of this relationship we investigated prospectively 25 patients with RA using a double blind approach. Methods: Twenty five patients who fulfilled the 1987 American College of Rheumatology criteria for RA had clinical and laboratory assessments. PLA2 activity was measured before and after treatment of 3 months in patients with RA. Fourteen healthy individuals were also enrolled as controls. PLA2 activity was assayed using E. coli membrane phospholipid substrate labelled with [14C]-oleic acid. Results: 1) Serum PLA2 activity was significantly higher in patients with RA than that of normal healthy controls(p<0.001). 2) In patients with RA, synovial fluid PLA2 activity was higher than serum PLA2 activity, and a positive correlation between PLA2 in synovial fluids and matched sera was found in these patients(p<0.05). 3) After treatment, PLA2 activity was significantly decreased with improvement of clinical(morning stiffness and Ritchie index) and laboratory(ESR, CRP and rheumatoid factor) assessments(p<0.001). 4) Among the clinical and laboratory markers of disease activity, ESR showed the best correlation with serum PLA2 activity(r=0.493, p<0.05). 5) In the patients who did not respond clinically to treatment (n=5), there was no significant decrease in PLA2 activity. Conclusion: PLA2 activity significantly correlates with RA activity and may serve as an index of disease activity in RA.

저칼륨성 주기성 마비와 신세뇨관성 산증을 동반한 원발성 Sjogren 증후군

최정윤 ( Jung Yoon Choe ),손호상 ( Ho Sang Shon ) 대한류마티스학회 1995 대한류마티스학회지 Vol.2 No.2

A 36-year old woman with Sjogren`s syndrome, distal renal tubular acidosis and hypokalemic muscle paralysis is described. The main manifestation was muscle paralysis due to hypokalemia secondary to renal tubular acidosis. Review of English literatures revealed 13 cases of hypokalemic paralysis due to Sjogren`s syndrome. The data from those reports have indicated that hypokalemic paralysis was seen more often in patients with primary Sjogren`s syndrome than secondary one and that it might precede the classic sicca comple. Hypokalemic paralysis may serve as a clinical marker for more severe renal disease in patients who have primary Sjogren`s syndrome and renal tubular acidosis, even though it is a rare manifestation of Sjogren`s syndrome.

갑상선기능저하증과 Ghrelin의 임상적 연관성

김현숙 ( Hyun Sook Kim ),손호상 ( Ho Sang Shon ),정의달 ( Eui Dal Jung ) 대한갑상선학회 2009 International Journal of Thyroidology Vol.2 No.2

Background and Objectives: Ghrelin stimulates growth hormone secretion and food intake. Ghrelin regulates energy expenditure. Thyroid dysfunction is associated with weight changes and metabolism. However, findings between serum ghrelin level and hypothyroidism are conflicting. Materials and Methods: We studied 20 overt hypothyroidism patients, 16 subclinical hypothyroidism patients, and 45 euthyroid controls. Thyroid hormones, thyroid autoantibodies, fasting glucose, acylated ghrelin, insulin, and urine iodide were measured in all subjects. Results: Baseline characteristics (age, sex, BMI, waist circumference) between hypothyroidism (subclinical and overt hypothyroid) patients and controls were similar. Serum acylated ghrelin levels in hypothyroidism patients did not differ from those in controls (15.7±18.9 pg/ml vs 20.2±37.2 pg/ml, p=0.714). Serum insulin levels in hypothyroidism patients did not differ from those in controls. serum acylated ghrelin levels and insulin levels of overt hypothyrodism were not different compared with euthyroid controls (acylated ghrelin; 16.8±20.8 pg/ml vs 20.2±37.2 pg/ml, p=0.43). Conclusion: Serum acylated ghrelin levels in hypothyroidism patients did not differ from those in controls. Further evaluations are needed to clarify relationship between ghrelin levels and thyroid dysfunction.

갑상선결절의 초음파유도하 세침흡인검사에서 Galectin-3의 진단적 유용성

김현숙 ( Hyun Sook Kim ),조창호 ( Chang Ho Cho ),정의달 ( Eui Dal Jung ),윤현대 ( Hyun Dae Yoon ),배종엽 ( Jong Yup Bae ),손호상 ( Ho Sang Shon ) 대한갑상선학회 2008 International Journal of Thyroidology Vol.1 No.2

Background and Objectives: Fine needle aspiration biopsy (FNAB) is considered as the most feasible preoperative diagnostic tool for thyroid lesions. However, indeterminate results of FNAB are common, so many methods were developed as supportive preoperative diagnostic modalities in indeterminate results of FNAB. In our previous studies, galectin-3 was expressed preferentially in thyroid malignancies of postoperative tissue specimen. In the present study, we evaluated whether galectin-3 immunohistochemistry (IHC) is useful as a preoperative diagnostic tool in thyroid nodules. Materials and Methods: A total of 151 thyroid nodules were performed US-guided FNAC and obtained from patients who underwent thyroidectomy were evaluated using papanicolaou-stained slides and cell blocks with galectin-3 IHC. IHC for Galectin-3 was performed. Cytologic diagnoses were correlated with the results of galectin-3 and categorized into 3 groups (benign, indeterminate, malignancy) and compared with the corresponding histologic diagnoses. Results: Of 151 specimens, 113 (74.8%) were malignant. When the histologic diagnoses were compared with the galectin-3 IHC, there were 14 (9.2%) discrepant cases. In the result of US-guided FNAB, sensitivity, specificity, positive-predictive value, and negative predictive value of galectin-3 IHC were 90.2, 92.1, 97.1, 76.1%. In the indeterminate result of US-guided FNAB, sensitivity, specificity, positive-predictive value, and negative predictive value of galectin-3 were 50, 91.4, 60, 96.9%. Conclusion: Galectin-3 IHC is a supplementary marker for the preoperative diagnoses of thyroid nodules in the US-guided FNAB. In the indeterminate of FNAB, galectin-3 IHC is not a reliable method for diagnosis, but negative staining of galectin-3 may raise the possibility of benign thyroid nodules.

Dichloroacetate Inhibits the Proliferation of a Human Anaplastic Thyroid Cancer Cell Line via a p53-independent Pathway

Yam Bahadur KC(얌 바하더 케이씨),Sunil Poudel(수닐 포우델),Eon Ju Jeon(전언주),Ho Sang Shon(손호상),Sung June Byun(변승준),Nam Ho Jeoung(정남호) 한국생명과학회 2018 생명과학회지 Vol.28 No.12

Warburg 효과의 발생은 고형암에서 화학적 항암제의 내성을 발생시킨다. 따라서 호기성 해당과정과 같은 에너지 대사과정은 암 치료의 중요한 표적으로 알려져 있다. Pyruvate dehydrogenase kinase (PDK) 활성 억제물질로 알려진 dichloroacetate (DCA)는 많은 암세포에서 포도당의 호기성 해당과정을 산화적인산화 과정으로 전환시킬 수 있음이 보고되었다. 이 연구는 치료가 매우 어렵다고 알려진 인간 역분화 갑상선 암세포주인 8505C의 성장에 미치는 DCA효과를 조사하였다. DCA는 정상 갑상선 세포주의 성장에는 영향을 주지 않은 반면 8505C 세포주의 성장을 특이적으로 저해하였다. DCA의 처리에 의해 8505C 세포주는 HIF1α, PDK1, Bcl-2와 같은 항-세포자살 관련 단백질들의 발현이 감소하고, Bax와 p21과 같은 세포자살 유도 단백질과 세포주기 억제 단백질의 증가로 인하여 세포주기 정지와 세포자살 유도에 의해 성장이 억제되었다. 이런 세포의 변화는 DCA 처리에 의한 활성산소족의 생산이 증가하고, 포도당 대사가 호기성 해당과정에서 산화적인산화 과정으로 전환되었기 때문이란 것을 확인하였다. 흥미롭게도, DCA는 포도당 대사과정의 변화뿐만 아니라 sodium/iodine symporter (NIS)의 발현양도 증가시킨다는 것을 확인하였다. 이 연구의 결과로 PDK 활성 저해제는 치료하기 힘든 역분화 갑상선 암 치료제로 이용할 수 있고, 또한 역분화 갑상선 암에 대한 방사능 치료의 효능을 높일 수 있을 것으로 기대된다. Occurrence of the Warburg effect in solid tumors causes resistance to cancer chemotherapy, and targeting energy metabolisms such as aerobic glycolysis is a potential strategy for alternative treatment. Dichloroacetate (DCA), an inhibitor of pyruvate dehydrogenase kinase (PDK), shifts glucose metabolism from aerobic glycolysis to oxidative phosphorylation (OxPhos) in many cancers. In this study, we investigated the anticancer effect of DCA on a human anaplastic thyroid cancer (ATC) cell line, 8505C. We found that DCA selectively inhibits cell proliferation of the 8505C line but not of a normal thyroid line. In 8505C, the cell cycle was arrested at the G1/S phase with DCA treatment as a result of decreased antiapoptotic proteins such as HIF1α, PDK1, and Bcl-2 and increased proapoptotic proteins such as Bax and p21. DCA treatment enhanced the production of reactive oxygen species which consequently induced cell cycle arrest and apoptosis. Interestingly, DCA treatment not only reduced lactate production but also increased the expression of sodium-iodine symporter, indicating that it restores the OxPhos of glucose metabolism and the iodine metabolism of the ATC. Taken together, our findings suggest that PDK inhibitors such as DCA could be useful anticancer drugs for the treatment of ATC and may also be helpful in combination with chemotherapy and radiotherapy.

심한 저나트륨혈증으로 발현된 항이뇨호르몬 부적절분비증을 동반한 범뇌하수체기능저하증 1예

손호상,최정윤 최신의학사 1996 最新醫學 Vol.39 No.1