기능성 위장관장애에서 비만세포

윤세진 ( Sei Jin Youn ) 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.1

과민성 및 스트레스 모델을 이용한 연구에서 비만세포가 장점막기능의 조절에 관여하는 근거를 얻게 되었다. 점막 비만세포는 매개체를 유리하여 상피 이온분비를 유발하고 장의 투과성을 강화시킨다. 비만세포가 점막기능에서 변화를 매개하는 기전은 상피세포에 비만세포 매개물질의 직접적인 작용과/또는 신경을 경유하는 간접적인 작용이 있다. 특이한 항원에 감작된 동물의 내장에서 장운동과 분비반응 등이 보이는 것으로 보아 장신경계와 면역계 사이에 직접적인 교류가 있음을

결장운동에서 Peptide YY의 작용기전

최기원 ( Ki Won Choi ),윤세진 ( Sei Jin Youn ),한정호 ( Joung Ho Han ),전원중 ( Won Joong Jeon ),채희복 ( Hee Bok Chae ),박선미 ( Seon Mee Park ) 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.2

목적: Peptide YY (PYY)는 장관에서 작용이 다양하며 운동에 미치는 기전은 명확하지 않다. 관류가 유지되고 혈관 및 신경이 보존된 상태의 흰쥐 결장을 이용하여, PYY가 결장운동에 미치는 영향을 관찰하여 위치에 따른 차이 및 그 작용기전을 알아보고자 하였다. 대상 및 방법: 상장간막동맥을 포함하여 분리한 흰쥐 결장에서 PYY를 12 pM, 60 pM, 240pM을 단계적으로 동맥을 통해 투여하여 근위부와 원위부 결장 내압을 측정하였다. 운동성은 각 농도별 약물투여 시 운동지수를 계산하여 백분율 변화로 표시하였다. 억제 실험은 근위부는 240 pM의 PYY 투여 때와 비교하였고, 먼저 phentolamine, propranolol, hexamethonium, atropine, tetrodotoxin 각각을 관류시킨 후 PYY를 같이 투여하면서 운동성 변화를 측정하였다. 결과: PYY를 12, 60, 240 pM 농도로 순서대로 투여할 때 근위부 결장에서 수축지수는 각각 22.53±6.12, 27.31±6.07, 33.93±8.55%이었고, 원위부 결장에서 수축지수는 각각 6.74±4.45, 37.79±11.53, 52.77±11.36%로 기저치에 비해 근위부와 원위부 결장에서 모두 수축지수가 유의하게 증가하였다(p<0.05). 결장 수축지수의 증가 정도는 근위부와 원위부 결장 사이에 유의한 차이가 없었으나 원위부에서는 주입된 PYY의 용량이 증가함에 따라 수축지수가 용량 의존적으로 증가하였다(p<0.05). PYY (240 pM)에 의해 증가되는 결장운동은 atropine, propranolol, tetrodotoxin 전처치에 의해 통계적으로 유의하게 억제되었지만(p<0.05), phentolamine과 hexamethonium 전처치에는 억제되지 않았다. 결론: PYY는 흰쥐 결장운동을 촉진시키는 작용이 있으며, 이러한 결장 평활근 수축 촉진 작용은 무스카린수용체를 통한 콜린성 신경 또는 베타 아드레날린성 신경의 국지적인 영향 하에 있음을 확인하였다. Background/Aims: The mechanism by which peptide YY (PYY) stimulates colonic motility has not yet been fully elucidated. The aim of this study was to investigate PYY`s mechanism of action on isolated rat colon. Methods: An isolated rat colon was perfused with Krebs solution via the superior mesenteric artery. After a basal period, PYY was administered at concentrations of 12, 60 and 240 pM, respectively, and the intraluminal pressures were then monitored. After a pre-infusion of phentolamine, propranolol, hexamethonium, atropine, and tetrodotoxin, PYY was infused at a concentration of 240 pM and the pressures were then monitored. The contractile response was expressed as the % changes of the motility indices over the basal rates. Results: The colonic motility increased significantly at the concentration of PYY of 12, 60 and 240 pM at the proximal colon (22.53±6.12%, 27.31±6.07%, and 33.93±8.55%, respectively) and the distal colon (6.74±4.45%, 37.79±11.53%, and 52.77±11.36%, respectively). PYY displayed a dose-dependent increment on distal colonic motility. The stimulatory effect of PYY was almost completely abolished by a pre-treatment with atropine, propranolol, and tetrodotoxin; However, the effect of PYY was not inhibited by hexamethonium and phentolamine. Conclusions: PYY increased the colonic motility, and the stimulatory action of PYY requires local cholinergic input via the muscarinic receptors or adrenergic input via the beta-receptors. (Kor J Neurogastroenterol Motil 2005;11:142-151)

일반연제 - 식도 / 기초생리 : Peptide YY ( PYY ) 가 흰쥐 결장운동에 미치는 영향

고병성,최재홍,채희복,윤세진(Sei Jin Youn) 대한소화관운동학회 2002 대한소화관운동학회 춘계학술대회 Vol.13 No.-

소화기종양환자에서 CA19 - 9 과 TPA 의 진단적 의의

이복희(Bok Hee Lee),윤세진(Sei Jin Youn),윤오주(Oh Ju Youn),송민호(Min Ho Song),이헌영(Heon Young Lee),김삼용(Samyong Kim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.2

To evaluate the diagnostic significance of serum CA 19-9 and tissue polypeptide antigen (TPA) in patients with gastrointestinal tumors, serum CA 19-9 levels were measured by radioimmunoassay with monoclonal antibody. Serum levels of CEA, TPA and AFP were measured in 10 patients each of stomach cancer, colorectal cancer, pancreatic cancer, bile duct cancer and hepatoma and in 10 normal control subjects and 10 patients with benign gastric ulcer. The results were as follows: 1) Serum CA 19-9 and TPA levels in normal controls were 16+-5.0 u/ml(M+-SD) and 96+-38 u/1 respectively. Serum CA 19-9 and TPA levels in patients with benign gasric ulcer were 11.9+-7.4 u/ml and 113+-43 u/1 respectively and there were no significant difference between them. 2) Serum CA 19-9 and TPA levels were elevated 60% (30/50) and 54% (27/50) of all gasrointestinal tumors respectively. According to tumor types, serum CA 19-9 and TPA levels were elevated 50% and 60% of stomach caner, 50% and 40% of colorectal cancer respectively. Serum CA 19-9 levels were elevated 70% of pancreatic cancer, 80% of bile duct cancer, most prominently, Serum TPA levels were elevated 70% of hepatoma, and serum AFP were elevated 60% of hepatoma (Cut-off value was 26 u/ml in CA 19-9, 172 u/l in TPA, 4.3 ng/ml in CEA, 100 ng/ml in AFP) 3) Serum CA 19-9 and TPA levels in patients with metastasis (128+-82 u/ml, 430+-326 u/1) were significantly different from that in patients without metastasis (47+-54 u/ml, 190+-470 u/1) 4) There were no correlation between CA 19-9 and CEA, between TPA and CEA as well as AFP in patients with hepatoma and other gastrointestinal disease. 5) The sensitivities of combinations of CA 19-9 and CEA, TPA and CEA were 70% and 90% respectivelty in stomach cancer, and the sensitivities of both combinations in colorectal cancer were 70% and 60% respectively. 6) The sensitivities of combinations of Ca 19-9 and CEA, TPA and CEA were 90% and 60% respectively in pancreatic cancer, In bile duct cancer, the sensitivities of CA 19-9 alone (80%) was equal to the combinations of CEA and TPA, or CA 19-9 and CEA. 7) The sensitivities of combinations of CA 19-9 and AFP, TPA and AFP were 80% and 90% respectively in hepatoma. Thus. It is concluded that CA 19-9 and TPA are useful tumor markers in above mentioned gastrointestinal tumors, especially when used in combination it will increase sensitivity. Assays of serum CA 19-9 and TPA in gastrointestinal tumors may be useful as tumor markers.

팽대부 선근종의 임상적, 병리학적, 면역조직화학염색의 특징

최용혁 ( Yong Hyeok Choi ),김미진 ( Mi Jin Kim ),한정호 ( Joung Ho Han ),윤순만 ( Soon Man Yoon ),채희복 ( Hee Bok Chae ),윤세진 ( Sei Jin Youn ),강민호 ( Min Ho Kang ),성노현 ( Rohyun Sung ),최재운 ( Jae Woon Choi ),박선미 ( Seon 대한소화기학회 2013 대한소화기학회지 Vol.62 No.6

Background/Aims: Ampullary adenomyoma is a benign lesion whose malignant potential has yet to be confirmed. Despite its benign nature, adenomyoma is frequently misdiagnosed as a carcinoma or adenoma and is overtreated by extensive surgery. This study was performed to analyze the clinical, pathological, and immunohistochemical features of adenomyomas in the ampulla of Vater. Methods: Nine cases of adenomyoma in the ampulla of Vater, diagnosed in Chungbuk National University Hospital between 2008 and 2011, were enrolled in this study. We reviewed the clinical data on the symptoms, laboratory data, and radiologic findings of the abdominal computed tomography and endoscopic retrograde cholangiopancreatography. For pathological analysis, all the slides were reviewed by one pathologist, and immunohistochemical stainings with antibodies against cytokeratin 7 (CK7), cytokeratin 20 (CK20), α-smooth muscle actin (α-SMA), and Ki-67 antigen were performed. Results: All the cases were CK7 positive and CK20 negative. A strong cytoplasmic expression of α-SMA was confirmed in all cases. The Ki-67 index was less than 1% in eight cases and 5% in one case. Four cases underwent endoscopic papillectomy, and one case received surgical ampullectomy during colorectal cancer surgery. Five cases that underwent endoscopic or surgical treatment remained symptom-free for three years. Four cases that were closely observed with repeated endoscopic examinations exhibited no interval changes in the papillary lesions. Conclusions: Endoscopic biopsy and immunohistochemistry can aid in the diagnosis of ampullary adenomyomas. Endoscopic papillectomy or surgical ampullectomy is adequate for the treatment of symptomatic ampullary adenomyomas. (Korean J Gastroenterol 2013;62:352-358)

반복적인 급성 담도염으로 내원한 선천 간섬유증 1예

이신영 ( Shin Young Lee ),주혜진 ( Hye Jin Joo ),조영심 ( Young Shim Cho ),전원중 ( Won Joong Jeon ),채희복 ( Hee Bok Chae ),박선미 ( Seon Mee Park ),윤세진 ( Sei Jin Youn ),성노현 ( Ro Hyun Sung ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.6

Acute cholangitis usually develops in congenital hepatic fibrosis (CHF), accompanied by cystic dilated bile ducts. However, it can also develop in simple CHF and may lead to critical course. A 30-year old man presented with recurrent acute cholangitis without bile duct dilatation. He visited the hospital for febrile sense and abdominal pain in the right upper quadrant. He had been admitted several times for hepatosplenomegaly and cholangitis since childhood and received a liver biopsy 15 years ago. Abdominal computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) revealed hepatosplenomegaly and a mildly dilated bile duct without stones or biliary cysts. His condition improved after conservative treatment. However, during a two-month follow up period, the patient experienced three episodes of acute cholangitis. A liver biopsy was performed and showed periportal fibrosis and intrahepatic ductular dysplasia, characteristics of congenital hepatic fibrosis. The periportal fibrosis and the infiltration of inflammatory cells were aggravated compared to 15 years ago. There was no evidence of hepatic cirrhosis. He was diagnosed with congenital hepatic fibrosis with recurrent acute cholangitis without intrahepatic duct dilatation, and conservatively treated with antibiotics. (Korean J Gastroenterol 2009;54:404-408)

종양과 연관되어 발생한 근병증 2예 요약제목: 종양관련 근병증 2예

이효덕 ( Hyo Deok Lee ),김미진 ( Mee Jin Kim ),서의근 ( Eui Geun Seo ),채희복 ( Hee Bok Chae ),한정호 ( Joung Ho Han ),윤순만 ( Soon Man Yoon ),박선미 ( Seon Mee Park ),윤세진 ( Sei Jin Youn ),김대곤 ( Dae Ghon Kim ) 전북대학교 의과학연구소 2012 全北醫大論文集 Vol.36 No.1

저자들은 근병증 2예와 병발한 악성 종양을 경험하였으며, 향후 원인 미상의 간 효소 수치 상승을 가진 환자가 피부 병변과 근력 약화를 호소하는 경우 꼭 근육염 가능성을 염두에 두어야 한다는 교훈을 얻을 수 있었다. 아울러 이러한 환자에서 근육염 확진을 위한 근육 생검, 근염 특이 자가 항체 검사 등을 통해서 IIM으로 진단될 경우 종양의 동반유무를 찾기 위한 종양표지자 및 영상 검사와 함께 PET 등의 첨단 검사도 이용될 필요가 있다는 것을 저자들은 본 2예의 증 례보고를 통해서 주장하는 바이다. 감사의 글 본 증례 환자들의 치료 과정을 함께 해 주시고, 원고를 검토해주신 류마티스 내과 강귀영 교수님께 진심으로 감사 드립니다. It is assumed that malignancy is a part of a clinical course in patients with idiopathic inflammatory myopathy (IIM), as the cancer occurrence in the group have been frequently reported. This paper discusses two cases of IIM associated with cancer either simultaneously or sequentially. The first patient who had diagnosed with colon cancer two weeks prior to the admission presented with polymyositis (PM). The second patient with breast cancer presented dermatomyositis (DM). Both patients were admitted to the hepatology unit because their initial presentation was abnormal liver enzyme levels with muscle weakness. IIM patients can be misdiagnosed as acute hepatitis because of the initial feature. This paper reports two cases of IIM with malignancy.

재발성 급성 담관염을 보인 담도 과오종과 선천성 간섬유증을 동반한 1예

김기배 ( Ki Bae Kim ),지명진 ( Myoung Jin Ji ),양지열 ( Ji Youl Yang ),한정호 ( Joung Ho Han ),채희복 ( Hee Bok Chae ),박선미 ( Seon Mee Park ),강민호 ( Min Ho Kang ),성노현 ( Ro Hyun Sung ),윤세진 ( Sei Jin Youn ) 대한췌담도학회 2015 대한췌담도학회지 Vol.20 No.2

담도 과오종과 선천성 간섬유증은 태생기에 간판 기형에 의해 생기는 섬유 낭성 질환에 속한다. 담도 과오종은 증상을 유발하지 않고 우연히 발견되는 질환이지만, 선천성 간섬유증은 25%에서 담관염이 발생하고 증상이 발생하면 항생제 투여부터 수술까지 적극적 치료가 필요하다. 저자들은 복부 영상 소견으로 담도 과오종으로 진단하고 경과 관찰하던 64세 남자가 2년간 반복적인 담관염이 발생한 원인을 찾기 위해 시행한 간 생검에서 담도 과오종과 선천성 간섬유증이 병합된 것으로 진단한 증례를 경험하여 문헌고찰과 함께 보고한다. Biliary hamartoma and congenital hepatic fibrosis belong to fibrocystic disorders originating from ductal plate malformation. A 66-year-old man who had incidentally been diagnosed with biliary hamartoma two years ago presented to us with recurrent acute cholangitis. In the first episode, he had presented with septic shock and was treated with endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy under the diagnosis of acute cholecystitis and cholangitis. However, during a two-month follow-up period, the patient experienced four episodes of acute cholangitis. Because he showed normal ERCP, and biliary hamartoma is usually asymptomatic, a liver biopsy was performed. Pathology revealed combined features of biliary hamartoma and congenital hepatic fibrosis, characterized as periportal fibrosis and intrahepatic ductular dysplasia. During follow-up for the last six months, he had experienced two episodes of acute cholangitis and was treated with antibiotics. A follow-up abdominal CT scan revealed aggravated hepatosplenomegaly compared to that of two years ago. We report a case of combined congenital hepatic fibrosis and biliary hamartoma and a literature review. Korean J Pancreatobiliary 2015;20(2):105-110

식도 편평상피 유두종 5예

이현숙(Hyeon Suk Lee),김대수(Dae Soo Kim),진영주(Young Joo Chin),윤세진(Sei Jin Youn),송형근(Hyeong Keun Song),성노현(Ro Hyun Sung),이동호(Dong Ho Lee) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.3

Squamous cell papilloma of the esophagus that originates from esophageal mucosa is rare, benign tumor. The etiology is unknown. The endoscopic appearance of the squamous cell papilloma is seen as a benign sessile lesion projecting from the esophageal wall. Patients are free of symptoms directly attributable to the lesion and usually is an incidental finding at endoscopy. We observed endoscopically 5 cases of squamous cell papilloma of the esophagus and endoscopical therapy was performed 3 cases. So, the relevant literatures on the subject were reviewed. (Korean J Gastroenterol 1995;27:356 - 360)

포스터 발표 : 간 ; 알코올과 CCl4 동시투여에 의한 간경변증 유도와 저용량 LPS의 간손상 보호효과

채희복 ( Hee Bok Chae ),박선미 ( Seon Mee Park ),윤세진 ( Sei Jin Youn ),장이찬 ( Lee Chan Jang ),최재운 ( Jae Woon Choi ),성노현 ( Ro Hyun Sung ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-

〈목적〉 알코올과 CCl4를 동시에 투여할 때 간독성의 상승효과가 둘다 중심정맥부위에 괴시와 지방변성이 특징적이다. 두가지 약물을 투여하여 간경변이 유도되는 기간을 조사하여 보고자 하였다. 또한 저용량의 lipopolysaccharide(LPS)가 NO를 생산하여 간손상에 대한 세포보호효과가 있다고 Kamiya등이 보고한 바대로 동시에 위의 모델에 저용량의 LPS를 투여하여 그 효과를 알아 보고자 하였다. 〈방법〉 태령 5주된 250g 가량의 Sprag