한국인 만성위염예에서 (慢性胃炎例) 병변의 (病變) 분포양상과 (分布樣相) 공복시 (空腹時) 혈청 gastrin 치 및 secritin 식 측정

송인성 ( In Sung Song ) 대한소화기학회 1981 대한소화기학회지 Vol.13 No.1

Histopathologic findings of gastroscopic biopsy under direct vision were made in 178 patients who complained vague gastrointestimal symptoms withont any focal lesions such as peptic ulcer, benign or malgnant growth etc in gastrointestinal tracts between February, 1979 and May,:1980. Fasting serum gastrin and secretin levels were also determined in those patients by radioimmunoassay. The resuls were as follows; 1) Overall incidence of histopathologically proven chronic gastritis was 79. 2% in Korean adults. Of all chronic gastritis(141 cases), the incidence of superficral, superficial atrophic, atrophic gastritis and gastric atrophy were 27. 7%, 86. 2%, R4% and2. 1% respectively. 2) Superficial inflammatory lesions in superfical atrophic gastritis were distributed more diffusely than those in superficial gastritis. Atrophic lesins were distributed diffusely in 24. 2 % of cases with atrophic gastritis, but only locally in all cases of supeificial atrophic gas- tritis. These fidings strongly suggest that the superficial gastritis may result in atrophic gastritis. 3) Fasting serum gastrin and secretin levels in various chronic gastritis revealed no sign- ificant difference comparing with normal control group.

악성위질환의 (惡性胃疾患) 감별에 있어서 위액 (胃液) CEA 치 측정의 진단적 (診斷的) 의의

송인성 ( In Sung Song ),김정용 ( Chung Yong Kim ),유병철 ( Byung Chun Yoo ) 대한소화기학회 1981 대한소화기학회지 Vol.13 No.1

Recently, carcinoembryonic antigen (CEA) assays of body fluids directly bathing tumor tissues were performed to increase the sensitivity and specificity of this tumor marker. The present study analyzed carcinoembryonic antigen levels of serum and gastric juice in gl patients with benign or malignant gastric diseases,,'who were dignosed by gastroscopy and histologic examination, and the results were as followings. In the gastric carcinoma group, gastric juice CEA was elevated in 95% of patients, whereas serum CEA was elevated only in 56%. Gastric juice CEA levels in patients with gastric cancer(median level with 892 ng/ml) were significantly higher than in other patient groups with gastritis(median; 22 ng/ml) or gastric ulcer (median; 14. 2 ng/ml), and gastric juice CEA was never elevated in patients with no gastric pathology. 2. In the gastric carcinoma group, gastric juice CEA levels in patients with well differe- ntiated adenocarcinoma were higher than those with poorly differentiated adenocarcinoma. In patients with benign disorders, elevated levels of gastric juice CEA were highly well correlated with presense of intestinal metaplasia. 3 Gastric juice CEA levels were elevated in cancer patients regardless of the extent of disease, whereas elevation of serum CEA levels were directly proportional to the degree of extent of the disease. 4, Serum CEA values returned to normal, 3 to 5 days after curative resection in patients with gastric cancer, but those of gastric juice were persistantly elevated or increased in these selected intervals of observation period. We concluded from these results that CEA assay of gastric juice is valuable as a diagno- stic adjunct to distinguish between benign and malignant conditions, and may be useful in screening populations for detection of gastric cancer.

내시경적 (內視鏡的) 역행성 췌담관조영술의 (膵膽管造影術) 합병증에 (合倂症) 대한 Gabexate mesilate ( FOY ) 의 예방적 (豫防的) 효과

송인성(In Sung Song),김정용(Chung Yong Kim),윤영범(Yong Bum Yoon),배순기(Soon Kie Bae),송제일(Je Il Song) 대한소화기학회 1981 대한소화기학회지 Vol.13 No.2

N/A The development and prevalence of endoscopic retrograde cholangiopancreatography(ERCP) has resulted in great progress in the diagnosis of the disease of the pancreas, and biliary tract. At the same time, however, the rise of serum amylase level has been often point out as the complication of ERCP. To assess the effect of synthetic protease inhibitor, Gabexate mesilate(FOY), in hyperamylasemia following ERCP, the authors carried out a controlled trial in 39 patients who were underwent ERCP under the impression of pancreatic or biliary system disease. Of them 20 patients were allocated to FOY@ treated group and 10 patients to control group. The following results were obtained: 1) There was no significant difference in serum amylase level between FOY treated group and control group before ERCP, however significant difference was observed in seram amylase level at 2 hour and 2 day after ERCP between FOY treated group and control group Before ERCP the serum amylase level was 107. 6 45. 1 I.U./dl in control group and 105. 7+-42.1 I.U./dl in FOY treated group.At 2hour after ERCP the serum amylase level was 186.7 +-150.1 I.U./dl in control group and 103.2+-47.9 I.U./dl in FOY treated group. On 2nd day after ERCP, the serum amylase level was 167.7+-84. 1 I.U,/dl in control group and 109.6+-59.1 I.U./dl in FOY treated group 2) The change in serum amylase levels at 2 hour and 2 day after ERCP by the extent of visualization showed a tendency that a greater extent of visualization was associated with a higher incidence of serum amylase levels. Such a tendency was more pronounced in control group and the mean serum amylase level was significantly higher in the control group. 3) FOY did not cause any serious side effect such as shock, fall of blood pressure, itching, eruption, chest pain etc. in all cases. 4) There was some report that FOY has a relaxant action on the Oddis sphincter and helps the cannulation to the opening of Papilla of Vater, however it more depended upon the skill of the endoscopist, anatomical variation of the Papilla of Vater and FOY did not give any great advantage to the cannulation.

한국인에서의 크론병

송인성(In Sung Song),장동경(Dong Kyung Chang),김정룡(Chung Yong Kim) 대한내과학회 1998 대한내과학회지 Vol.55 No.2

N/A Objectives: Recently, incidence of Crohn`s disease appears to increase in Korea rapidly. To know the current status of Crohn`s disease and to disclose characteristic clinical features in Korea, we performed this study. Methods: We retrospectively reviewed medical records of 117cases of Croh`s disease registered in Seoul National University Hospital spanning between 1975 and 1996. Results: The number of the annually diagnosed cases has increased upto 10-folds since 1987 than before. The male to female ratio was 1.6: 1 and the mean age of onset was 22. With regard to location, small intestinal disease was 23%; colonic, 21%; and mixed, 56%. Abdominal pain (97%) was a major symptom, and weight loss (88%), diarrhea (85%), and arthralgia (12%) followed it. However, other extraintestinal manfestations were very rare. Forty five percent of cases had a history of anti-tuberculous medication. medical treatment was applied in 73% at the time of diagnosis; the outcomes of medical treatment were improvement (81%), switch to operation (9%), stationary (9%) and death (l%). Shortterm outcome was worse in cases with internal fistula and elevated ESR. Symptomatic cumulative relapse rates were 20% in 1 year, 34% in 2years, and 62% in 5years. In view of long-term course, remission was in 17%; low-grade symptom, 31o', and actively altemating relapse-remission, the rest. Conclusion: Crohn`s disease in Korea seemed to be apparently increasing. The extraintestinal manifestations and rectal involvement were rare as compared with previous reports of Western countries. Forty five percent of cases had history of antituberculous medication under the impression of intestinal tuberculosis at initial diagnosis.

Guinea Pig 에서 가수분해된 Carrageenan 으로 유발된 궤양성 대장염의 병태생리에 관한 연구

송인성(In Sung Song),김나영(Na Young Kim),정현채(Hyun Chae Jung),이효석(Hyo Suk Lee),윤용범(Yong Bum Yoon),김정룡(Chung Yong Kim),김우호(Woo Ho Kim) 대한내과학회 1992 대한내과학회지 Vol.43 No.3

N/A Background: Ulcerative colitis is a inflammatory bowel disease, of which characteristics are diarrhea, hematochezia, weight low, and the incidence of this disease is rising tendency in Korea, But the causes or pathophysiology of this disease have not been yet clear and the animal model has not been yet established. This paper is concerned with an experimentalnimal odel of ulcerative colitis wherein the ultimate goal is to study the causes and pathopohysiology of ulcerative colitis. Method: For the animal model, we use guinea pigs to observe whether the carrageenan extracted from the seaweed, causes the lesion to large and small intestine, and whether this lesionis similar to human ulcerative colitis clinically and anatomically. We classified the 82guinea pigs into three groups, the first group (the control group) which consisted of 11guinea pigs were given the tap water as drinking water, the 2nd group of 11 guinea pigs were given the 1.5% native carrageenan (1.5% NCG group) and the 3rd group of 60guinea pigs (1.5% HCG group) were given the 1.5% hydrolyzed carrageenan for 40days. In order to identify the pathophysiology of this lesion, we measured the PG4 and LTB4 at the cecal mucosa where the lesion existed. Xanthine oxidase, superoxide dismutase and catalase activity, all of which are closely related to superoxide radical system, were also measured, Results: 1) During experimental period of 40 days, the weight of 11 guinea pigs of the control group increased by 110g to 180g and the weight of 8guinea pig of the 1,5% native carrageenan group increased by 40g to 100g. However, the twenty eight guinea pigs of the 1.5% hydrolyzed carrageenan group lost 10g to 130g during experimental period. All of the 28guinea pigs of the 1.5% HCG group showed diarrhea and loose stools till the end of experiment, the fifty percent of 8 guinea pigs of the l. 5% NCG group showed loose stool, but none of the control group showed loose stool. All of the control group and the 1.5% NCG group showed negative occult blood when the hematest was taken at the end of experiment, but twenty seven guinea pigs (93.3%) of the 1.5% HCG group were positive and 12guinea pigs (43%) showed grossly hematochezia. By the way, the time of onset of clinical symptom in the 1.5% HCG group was very variable among the guinea pigs from 3weeks to 40days after the beginning of HCG intake. Moreover the guinea pig tended to die within 10days once the symptom developed. 2) There was no abnormal finding from the treiz ligament to the rectum in the control group but half of the 1.5% NCG group showed hemorrhagie erosions at the cecum and the twenty seven of 28 guinea pigs of l. 5% HCG group showed hemorrhagic erosions at the cecum. The two guinea pigs of the 1.5% HCG group showed 0.2×0.8cm and 0.3×1.0cm sized ulcerations grossly. 3) When the cecal mucosa was observed with light microscope, the six of the 8guinea pigs of the 1.5% NCG group showed mucosal atrophy and the four of these 6guinea pigs showed mild degree erosions and infiltration of inflammatory cells, but none of 1.5% NCG group showed metachromasia in the toludine blue stain. In the cecal mucosa of the twenty seven of the 28 guinea pigs of the 1.5% HCG group, multiple mucosal confined ulcerations from the shallow and small ulcerations to deep and broad ulcerations were found, and in the 2 of theae 27guinea pigs, the ulcerations were extended to submucosa though the muscularis mucosae. Inflammatory cells such as polymorphonuclear cells, machrophages, lymphocytes and plasma cells were found on the base and margin of the ulcers. Among these inflammatory cells, the infiltration of mechrophages was prominent and definite metachromasia in the toluidine blue stain was found in the machrophages. 4) The mean PGE2 level of the control group was 292.08pg/mg mucosa, and those of the 1.5% NCG group and the 1.5% HCG 281.25pg/mg mucosa, and 429.87pg/mg mucosa, respectively. The mean PGE2 value of 1.5% HCG group was highest among three

자당분해효소 (蔗糖分解酵素) 측정에 의한 위암에서의 (胃癌) 장형화생의 (腸形化生) 의의

송인성 ( In Sung Song ),오인혁 ( In Hyeog Oh ),이계희 ( Kye Heui Lee ),김해련 ( Hae Ryeon Kim ),정형배 ( Hyeong Bae Jung ),김정룡 ( Chung Young Kim ) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.2

Enzyme histochemistry of the gastric surface epithelium has been found to be valuable in diagnosing atrophic lesions with intestinal metaplasia of gastric mucosa. And interest in intestinal metaplasia of gastric mucosa as the origin of gastric carcinoma has increased considerably. To identify the type of intestinal metaplasia of stomach in gastric cancer by direct measurement of surcrase activity from gastric mucosa, we conducted this study. We obtained following results; 1) Intestinal metaplasia in atrophic gastritis showed two types, small intestinal type (46.1%) and colonic type (53.9%). Which was judged by direct measurement of sucrease activities from gastric mucosa. 2)In remnant stomach small intestinal type of metaplasia was observed in 55.6%, and 16.6% of gastric mucosa in benign gastric ulcer showed small intestinal type of metaplasia. 3)In gastric cancer, 37% of non-tumor bearing mucosa showed samll intestinal type of metaplasia. Our results suggest that degree of differentiation of intestinal metaplasia has no direct relationship with malignant potential in stomach.

소화성 궤양 환자에서 Helicobacter pylori 의 약제 내성률과 재발현 및 재감염률을 고려한 H . pylori 박멸요법의 수립

송인성(In Sung Song),김나영(Na Young Kim),임채남(Chae Nam Lim),임선희(Sun Hee Lim),이계희(Kye Heui Lee),구명숙(Myung Sook Koo),정현채(Hyun Chae Jung),김정룡(Chung Yong Kim) 대한내과학회 1999 대한내과학회지 Vol.56 No.3

N/A Objective : This study was conducted to establish an ideal treatment regimen for H. pylori eradication in three aspects: clinical, microbiological, and reinfection. Methods : Four hundred thirty two patients with H. pylori positive peptic ulcer were randomized to receive two types of triple therapy: one includes colloidal bismuth subcitrate, metronidazole and tetracycline (BMT), and the other includes omeprazole, amoxicillin and clarithromycin (OAC). Results : More than 50% of symptom reduction within 1 week was 94.4% both in OAC and in BMT group. The percentages of side effects were 21.6% and 27.1% in OAC and BMT regimen, respectively. Good compliance with at least 85% intake was 99.0% and 95.2% in OAC and BMT regimen. The eradication rates of H. pylori were 85.9% and 89.1% in OAC and BMT regimen. Resistance rates to metronidazole and clarithromycin were 40.6% and 10.2% by E test, 74.3% and 27.0% by broth microdilution, and 45.3% and 10.9% by disk diffusion method. The eradication rates for H. pylori was 100% and 77.8% by BMT in patients with metronidazole-sensitive and -resistant strains, and 100% and 80.0% by OAC with clarithromycin- sensitive and -resistant strains, without significance by their resistances. The recrudescence rate within 1 year after eradication was 21.2% and 14.2% for OAC and BMT regimen without significant difference. The reinfection rate after 1 year was 4.0% and 5.0% for OAC and BMT regimen. Conclusion : Because the eradication rate of BMT regimen is 89.1% in spite of high metronidazole resistance rate, and there was no statistical difference in the aspects of symptom reduction, side effect, compliance, recrudescence and reinfection rate, BMT regimen is as favorable as OAC to eradicate H. pylori.

한국인 궤양성 대장염의 임상적 관찰

송인성(In Sung Song),최규완(Kyoo Wan Choi),백승운(Seung Woon Paik) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.1

N/A The purpose of this study is to review the clinical and pathological features of the ulcerative colitis in Korea. A total of 39 cases of ulcerative colitis, experienced in the Seoul National University Hospital from June 1976 to January 1985, was analyzed in terms of incidence, symptomatology, laboratory findings, colonoscopic and barium enema findings, and consequence of treatment.1) The disease was most prevalent in the fourth decade with a slight preponderance on the female. 2) In 84.6% of the cases the duration of symptoms was less than 5 years. 2) The most common symptoms were hematochesia, bloody mucoid stool, low abdominal pain and the loss of weight in the order of frequency. 4) The laboratory findings were non-specific, including anemia, leukocytosis, increased erythrocyte sedimentation rate, electrolyte imbalance, hypoalbuminemia, increased serum alkaline phosphatase activity. 5) In terms of the anatomical distribution of the lesion, proctitis was shown in 15. 4% proctosigmoiditis in 10.3% the left-sided colitis in 33 .34% pancolitis in 20.5% ileitis in 10.3% 6) Colonoscopy revealed mucosal friability, diffuse hyperemia, diffuse erosion and ulceration, granularity and pseudopolyposis. 7) The barium enema showed no remarkable abnormality in 45.2% of the cases. But in the other cases granularity, loss of haustral marking, luminal narrowing, foreshortening, and pseudopolyps were noted. 8) The histopathologic examination showed non-specific inflammation in 56.4% of the cases. 9) With the medical treatment 92.1% of the cases showed initial improvement in the symptom. However 48.7% of the improved cases had recurrence in some time. 10) In 5 cases, who did not respond to the medical treatment, the involved segments of the colon were resected.

백서 소장점막의 부위별 Angiotensin Converting Enzyme의 효소 특이활성도차이에 대한 유전적 조절기전에 관한 연구

송인성(In Sung Song),최규완(Kyoo Wan Choi),김정룡(Chung Yong Kim),김재준(Jae Jun Kim),박중원(Joong won Park),윤병철(Byung Chul Yoon),정현채(Hyun Chae Chung),이풍렬(Poong Ryul Lee),임경욱(Kyoung Wook Yim),정숙향(Sook Hyang Chung),유 대한소화기학회 1993 대한소화기학회지 Vol.25 No.1

N/A Recent reports indicate that angiotensin converting enzyme (ACE) in intestinal mucosa may be involved in protein digestion in vivo. The specific activities of intestinal ACE show regional difference. We performed this experiment to define the level of genetic regulation determining the regional difference of ACE specific activities by the relationship between ACE specific activities and ACE mRNA levels. Small intestines of 3 Wistar rats were removed and divided into 3 segments of equal length. Mucosal homogenate and brush border membrane (BBM) were prepared from scraped mucosa and ACE specific activities were measured in both samples by fluorometric method. Total RNA was extracted by guanidinium thiocyanate and isolated by Cesium chloride,ultracentrifugation. Each 6 ug of isolated RNA was transferred to nitrocellulose membrane by dot and slot apparatus. Northern hybridization with radiolabeled ACE 5 cDNA of mouse was performed and ACE mRNA was detected by autoradiography. The means of ACE specific ar.tivities (uM/ug protein/min) in harnogenate and BBM of proximal intestines were 23.4+- 4.8, 286.3+-80.6, in those of middle intestines were 21.3+-2.0, 211.0+-78.8 and those of distal intestines were 8.2+-1.9, 76.4+-10.7. The means of relative amounts of ACE mRNA in proximal, middle and distal intestines were 75%, 96% and 10% respectively. In linear regression analysis between ACE specific activities of BBM and relative amounts of ACE mRNA, R-value was 0.60 (p<0.05). We concluded that transcription was considered as the level of genetic regulation determining the regional difference of ACE specific activities.

내시경검사로 (內視鏡檢査) 확진된 (確診) 십이지장궤양 (十二指腸潰瘍) 예들에서의 상부위장 (上部胃腸) X - 선검사소견의 분석 검토

송인성,최규완,장기현 ( In Sung Song,Kyoo Wan Choi,K H Chang ) 대한소화기학회 1981 대한소화기학회지 Vol.13 No.1

Radiologic findings were analyzed in 338 cases with endoscopically proven duodenal ulcer. The results were as follows; 1} Male to female ratio in duodenal ulcer disease was 4 5: I, and occurrence rate was highest among thirties and forties. 2) In 114 cases with duodenal ulcer in active or healing stage proved by endoscopy, cor- rect diagnosis was made in only 54.4% of cases by radiologic examination. In g cases with duodenal ulcer scar proved by endoscopy, 4 cases(44.4%) was diagnosed as ulcer in active or healing stage by radiologic examination. From these findings, it is suggested that the initial diagnosis and decision of healing in cases with duodenal ulcer disease would have to be made by endoscopic examination.