자발 천공을 일으킨 에스상 결장의 편평세포암종

박선영 ( Seon Young Park ),이완식 ( Wan Sik Lee ),서경원 ( Kyoung Won Seo ),박형천 ( Hyeong Cheon Park ),김현수 ( Hyun Soo Kim ),최성규 ( Sung Kyu Choi ),유종선 ( Jong Sun Rew ) 대한내과학회 2008 대한내과학회지 Vol.74 No.1S

위암종에서 Glutathione S - Transferase π 에 대한 면역 조직화학적 연구

지미선(Mi Seon Jee),류도현(Do Hyun Rhew),백강우(Kang Woo Baek),문범(Beom Moon),주영은(Young Eun Joo),김태두(Tae Du Kim),유종선(Jong Sun Rew),윤종만(Chong Mann Yoon),박창수(Chang Soo Park) 대한내과학회 1995 대한내과학회지 Vol.48 No.6

N/A Objectives: Glutsthione S-Transferases (GSTs) are a family of isoenzymes which catalyse the conjugation of glutathione to a variety of electrophilic compounds which include carcinogens and cytotoxic drugs. These enzymes probably form part of an inherent, protective mechanism against the development of tumors. There is also evidence to suggest s role for GST in drug resistance in cancer chemotherapy. Three classes of cytosolic GST isoenzymes exist in man. These are identified as basic(a), neutral(μ), acidic(π) GST. GSTπ has been studied recently because of its high level in biliary or colon carcinoma. To assess the relation of the expression of GSTπ with malignant index on human gastric carcinoma, this study was designed. Methods: Immunohistochemical study for GSTπ was performed in paraffin sections of 85 primary gastric carcinomas. Results: 1) Strong positive reaction for GST was observed mainly in the nuclei and cytoplasms of tumor cells and normal mucosal epithelium around cancer nest revealed weak positive reaction. 2) The positivity of GSTπ in gastric carcinoma was 94.1%. By the histological differentiation, the positivity was 84.2% in well-differentiated adenocarcinoma, 100% in moderately-differentiated adenocarcinoma, 100% in poorly-differentiated adenocarcinoma, 93.89o in mucinous adenocarcinoma, 90% in signet-ring cell carcinoma. Moderately-differentiated adenocarcinoma and poorly-differentiated adenocarcinoma revealed the most high positivity ratio. 3) Positivity of GSTπ in cancer nest had a increased trend in poorly-differentiated than well-differentiated adenocarcinoma. Conclusion: The results suggest that GSTπ may be a useful tumor marker of human gastric carcinoma.

비심장성 흉통을 가진 환자에서 식도 Scintigraphy 의 의의

조정곤(Jung Kon Cho),구철(Cheol Koo),유종선(Jong Seon Rew),윤종만(Chong Mann Yoon),김지열(Ji Yeoul Kim) 대한내과학회 1989 대한내과학회지 Vol.37 No.5

N/A In order to evaluate the diagnostic value of esophageal scintigraphy in patients with sustained angina like chest pain of noncardiac origin, we performed esophageal scintigraphy in 25 normal subjects and 25 patients with chest pain of noncardiac origin. All the patients who complained of chest pain were studied with exercise ECG and/or coronary angiography to exclude the cardiac origin. Esophageal transit time (ETT) was significantly longer in the patient group (19.4±15.1 sec) than in the control group (7.2±3.9 sce). Cases of abnormal transit time and pattern were 11/25 (44%) in the patient group and 2/25 (8%) in the contn1 group, respectively. Cases of the markedly prolonged transit time more than 40 sec were 8 (32%) in the patient group, but there were none in the control group. Abnormal patterns of esophageal transit were divided into two groups: incoordinate movement (24%) and adynamic movement (20%) of radioisotope. These results suggest that esophageal scintigraphy could be used as a diagnostic modality in angina like chest pain of noncardiac origin.

대장 종양 발생과정에서 c - erbB - 2 암유전자 , / p53 유전자 , PCNA 에 대한 면역조직화학적 연구

안영주(Young Joo An),지미선(Mi Seon Ji),최성규(Sung Kyu Choi),유종선(Jong Sun Rew),윤종만(Chong Mann Yoon),이민철(Min Cheol Lee) 대한내과학회 1996 대한내과학회지 Vol.50 No.6

N/A Objectives Colon tumors appear to occur as a result of the mutational activation oncogenes coupled with the inactivation of tumor suppressor genes. Cell proliferation is a great importance in gastrointestinal tumorigenesis. Overexpression of c-erbB-2 oncogene and mutated p53 gene have been demonstrated in a number of adenocarcinomas, PCNA has been shown to be available as a single histologic marker of proliferative activity, Methods: To investigate the role of c-erbB-2 oncogene, p53 gene and cell proliferation in colon tumorigenesis, expression of c-erbB-2, p53 and PCNA was evaluated immunohistochemically in paraffinembedded sections of 80 colon carcinomas, 10 adenomas and 10hyperplastic polyps. Results: 1) The positivity for c-erbB-2 oncogene was 77.3% (61 of 80) in carcinoms, 60.0% (6 of 10) in adenomas and 10.0% (1 of 10) in hyperplastic polyps. The difference of reactivity for c-erbB-2 oncogene was statistically significant(p=0,001). 2) p53 expression was detected in 45 of 80(56.3%) cases of colon carcinomas, but all in adenomas and hyperplastic polyps was negative. 3) PCNA index was 12.8±4.9% in hyperplastic polyps, 20.3±8.2% in adenomas and 35.9±19.8% in carcinomas. PCNA index of adenomas and carcinomas was higher than that of hyperplastic polyps (p<0.05, p<0.001). 4) Coexpression of c-erbB-2 oncogene and p53 occurred together in 30 of 80colon carcinomas. Thirty-one carcinomas expressed only c-erbB-2 oncogene, 15expressed only p53 and 4expressed neither. Conclusion: These results suggest that cell proliferation is important in tumorigenesis of the colon and c-erbB-2 oncogene may be associated with early stages of colon tumorigenesis. Expression of p53 may occur as late events in colon tumorigenesis.

간경변증 환자에서 동반된 장관포상기종 1예

이정수 ( Jeong Soo Lee ),주소영 ( So Young Joo ),박창환 ( Chang Hwan Park ),박선영 ( Seon Young Park ),박형천 ( Hyeong Cheon Park ),김현수 ( Hyun Soo Kim ),최성규 ( Sung Kyu Choi ),유종선 ( Jong Sun Rew ) 대한소화기학회 2006 대한소화기학회지 Vol.50 No.1

Pneumatosis cystoides intestinalis (PCI) is a relatively rare condition in which gas is found as a linear or cystic form in the submucosa or subserosa of bowel wall. PCI is usually found incidentally on an imaging study. Treatment is usually conservative including oxygen and antibiotics therapy. So far, etiology and pathogenesis of PCI remain uncertain. PCI is associated with various medical conditions including various pulmonary diseases, connective tissue diseases, and endoscopic procedures. However, there are only few reports on lactulose causing PCI in patients with cirrhosis. Oral lactulose or enema is one of the main treatment modalities in hepatic encephalopathy. Here, we report a case of PCI which was found during the treatment with lactulose therapy in a patient with liver cirrhosis and hepatic encephalopathy. (Korean J Gastroenterol 2007;50:56-60)

급성췌장염과 동반된 간문맥 내 가스 2예

박형천 ( Hyeong Cheon Park ),이완식 ( Wan Sik Lee ),주소영 ( So Young Joo ),박선영 ( Seon Young Park ),주영은 ( Young Eun Joo ),김현수 ( Hyun Soo Kim ),최성규 ( Sung Kyu Choi ),유종선 ( Jong Sun Rew ) 대한소화기학회 2007 대한소화기학회지 Vol.50 No.2

간문맥 내 가스는 임상에서 흔하지 않으며 대부분 예후가 좋지 않다. 이는 대부분 장괴사와 연관되어 발생하는 것으로 알려져 있으나, 이 외에도 궤양성 대장염, 크론병, 게실염, 내시경 치료시술, 복부 외상 등의 다양한 원인으로 인해 발생할 수 있다. 현재까지 급성췌장염에서 동반된 간문맥 내 가스에 대한 보고는 드물다. 저자들은 급성췌장염 환자에서 발생한 간문맥 내 가스 2예를 경험하였다. 다량의 음주력을 가진 환자가 내원하였다. 임상 경과 및 생화학혈청 검사, 혈액가스검사, 전산화단층촬영에서 중증의 괴사 췌장염 소견이었다. 간문맥 내 가스와 함께 장벽 내 가스를 보였으며 보존 치료에도 불구하고 두 예 모두 다발 장기부전으로 사망하였다. 급성췌장염은 복강 내 및 전신적인 합병증을 유발할 수 있다. 간문맥 내 가스는 중증의 췌장염에서 동반될 수 있으며, 특히 장허혈과 동반되었을 경우에는 주의 깊은 관찰과 수술과 같은 적극적인 치료가 필요하다. Hepatic portal venous gas (HPVG) is an uncommon disease entity that usually has grave prognosis. It is generally associated with bowel necrosis, and has been reported in a wide variety of conditions such as ulcerative colitis, Crohn`s disease, diverticulitis, intestinal ischemia, or infarction. We experienced two cases of HPVG associated with acute pancreatitis. HPVG was found in patients with severe necrotizing pancreatitis and concurrent bowel ischemia. Despite aggressive resuscitation with fluids and broad spectrum antibiotics, each patient developed multiorgan failure, and died within few days. Acute pancreatitis is a potential cause of severe intraabdominal systemic catastrophe. Moreover, HPVG is associated with bowel ischemia in the setting of acute pancreatitis which could lead to rapid aggravation of symptom and complicated clinical course. Therefore, vigilant and aggressive management should be warranted in such condition. (Korean J Gastroenterol 2007;50:131-135)

Helicobacter pylori 감염과 관련된 전암성 및 암성 위병변에서 상피세포 증식에 관한 연구

박선영,주영은,노두영,주소영,이완식,박창환,김현수,최성규,유종선,박창수,김세종 대한내과학회 2004 대한내과학회지 Vol.66 No.4

목적 : H. pylori 감염이 위상피세포 증식의 증가와 관련되어 있다는 많은 연구 보고들이 있으며, 이러한 상피세포의 증식은 위암 발암과정 중 초기단계에 관여한다고 알려져 있다. 본 연구의 목적은 만성 위염에서 위암으로 진행하는 각 단계에 있어 H. pylori 감염이 상피세포 증식에 미치는 영향에 대해 알아보고자 하였다. 방법 : 상부 위장관 증상으로 내원하는 상부위장관 내시경 및 조직생검을 시행 받았던 129예(만성위염 29예, 장형화생을 동반한 만성 위축성 위염 26예, 저등급 형성이상 31예, 고등급 형성이상 18예, 위선암 25예)를 대상으로 하고, H. pylori 감염 여부를 신속요소분해효소검사, 변형 Giemsa 염색, 요소호기검사를 이용하여 평가하였고, 상피세포의 세포 증식능은 항 PCNA 항체를 이용한 면역조직호학염색을 통해 평가하였다. 결과 : 위상피세포 증식능의 정도는 H. pylori 양성군이 음성군에 비해 통계학적으로 유의하게 더 높았으며(p=0.007), 대상군을 위염군, 형성이상군, 그리고 위선암군으로 나누었을 때 위염군에서 위선암군으로 진행할수록 유의하게 증가하였다(P<0.001). 각각의 조직학적인 군별로 H. pylori 감염에 따른 세포증식능을 비교한 결과 위선암군을 제외한 나머지 군에서 모두 H. pylori 양성이 음성인 경우보다 세포 증식능이 높았다. 결론 : H. pylori 감염은 상피세포 증식증가에 관여하며, 위암의 발암과정 중 초기에 관여할 것으로 생각된다. Background : Many studies have demonstrated that increased cell proliferation in gastric epithelium is associated with Helicobacter pylori (H. pylori) infection. Increased epithelial proliferation is one of the earliest mucosal changes observed in gastric carcinogenesis. The aim of this study was to evaluate the influence of H. pylori infection for epithelial proliferation at different stages of gastric carcinogenesis from chronic gastritis to adenocarcinoma. Methods : Gastric biopsy specimens were collected from 129 patients who underwent esophagogastroduodenoscopy with biopsy. Histologically, there were 29 patients with chronic gastritis, 26 chronic gastritis with intestinal metaplasia, 31 low grade dysplasia, 18 high grade dysplasia, and 25 gastric adenocarcinoma. status of H. pylori infection was determined by rapid urease test, modified Giemsa stain and ^(13)C-urea breath test. Epithelial cell proliferation was assessed by immunohistochemical method using anti-PCNA antibody. Results : The grade of epithelial proliferation was in H. pylori infected patients than uninfected patients (p=0.007) and progressively increased at different stages from chronic gastritis to gastric adenocarcinoma (p<0.001). The analysis of epithelial proliferation according to H. pylori infection satus in each histologic group showed that the grades of epithelial proliferation were higher in H. pylori infected patients than uninfected patients in all group except adenocarcinoma group. Conclusion : H. pylori infection causes increased gastric epithelial cell proliferation and may play an important role in gastric carcinogenesis.

십이지장 유두부에 발생한 악성 Carcinoid 종양 1예

김경수,최성규,김현수,김세종,유종선,서강석,윤종만,구철,김신묵,지미선 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.1

Carcinoid tumor of the ampulla of Vater comprises about 2.0-8.9% of the gastrointestinal earcinoid tumors and 3-5.5% of the duodenal tumor. The climcal manifestations of the carcinoid tumor of the ampulla of Vater are jaundice, hemorrhage, obstruction of duodenurn, or carcinoid syndrome. But the symptoms of carcinoid tumor are nonspecific and diagnosis is delayed until far advanced state, usually. Recently we experienced one case of carcinoid tienor in a 33-year-old woman who had epigastric pain and intermittent melena, so we report it with a review of the literature.