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위십이지장질환에서 Helicobacter Pylori 의 DNA Variation 에 관한 연구
노임환(Im Hwan Roe),김창인(Chang In Kim),하동렬(Dong Ryul Ha),진영주(Young Joo Jin),송일한(Il Han Song),임창영(Chang Young Lim),김정원(Jung Won Kim),김정택(Jung Taik Kim),이종화(Jong Hwa Kim),염정선(Jung Sun Yeom) 대한내과학회 1997 대한내과학회지 Vol.53 No.4
N/A Background: The evidence for H. pylori as a gastrointestnal pathogen is now very strong, if not overwhelming. Among the pathogenic factors of H. pylori, flagella and urease are considered to be major factors causing the gastrododenal disease. We observed the gene diversity of H. pylori using the PCR-amplified 1.4Kb fla A gene and 0.9Kb ure B gene and examined the relationship between the gene pattern and the gastroduodenal disease. Method: Fifty-one cases of isolated strains were cultured at the Helicobacter-selective blood agar plates. To compare the gene diversity among the isolates of gastroduodenal disease genotypes was analyzed by PCR-based RFLP. 1.4Kb fla A gene and 0.9Kb ure B genes from isolates were amplified by PCR and digested with Hae 3 restriction enzymes to observe the restriction fragment length polymophysm. Protein patterns were also compared to examine the antigenic variations. Total cell proteins, and octyl-glucose extracts from isolates were analyzed by SDS-PAGE gel electrophoresis. Results: 41 cases (80.4%) of H. pylori were isolated in the 51 cases of gastroduodenal diseases. We could classify theses isolates 3 types of PCR-RFLP in the fla A gene, 900+500bp, 500+500+400bp, 600+800bp, and 9 types in the ure B gene. PCR-RFLP in the fla A gene and ure B gene of the isolates was different from the standard strain of Australia and the genetic diversity was not related to the types of the gastroduodenal disease. We demonstrated variations in the protein pattern and antigenic profiles among the isolates by SDS-PAGE analysis. These data also did not show any relationship between protein pattern and types of gastroduodenal diseases. Conclusion: Tese studies showed many different gene diversity in the flagella and urease gene without any relationship with the types of gastoduodenal disease. And variable protein pattern were noted among the strains of H. pylori. Further studies to demonstrate the pathgenecity of H. pylori should be continued even if there was no relationship between the genomic diversity of the flagella or urease and the types of gastroduodenal disease.
폐쇄성 담관질환의 담즙에서의 Helicobacter 검출에 관한 연구
노임환(Im Hwan Roe),이문숙(Moon Suk Lee),진영주(Young Joo Chin),임창영(Chang Young Lim),송일한(Il Han Song),김정원(Jung Won Kim),신지현(Ji Hyun Shin),이학성(Hak Sung Lee),이종화(Jong Hwa Lee) 대한내과학회 1998 대한내과학회지 Vol.55 No.3
N/A Objective: Several newly recognized Helicobacter spp. such as H. hepaticus, H. bilis, H, cholecystus, H. rappini, H. pullorum, can cause persistent hepatitis, hepatoma, cholangiopancreatitis, and cholecystitis in animals. Recently same studies have been reported that Helicobacter DNA can be found in the bile from the patients with diseased bile duct, although its clinical significance is still unclear. We aim of this study is to investigate the existence, and character of Helicobacter in the bile from the obstructed bile duct, and the relationship with pH and the other bacteria found in the bile. Methods: Twenty-eight bile samples (15 from bile duct cancer, 6 from pancreatic head cancer, 7 from bile duct stones) were obtained from the PTBD route. Bile pH measurement, and Helicobacter culture in microaerophilburic and anaerobic conditions were performed. The primers chosen for polymerase chain reaction(PCR) amplification for detection and characterization were ureA (411 bp) and cagA gene (298 bp), respectively. And primer of 16s rRNA for all known bacteria including Helicobacter was used, and the kinds of bacteria were identified by RFLP. Results: Helicobacter DNA was detected in 39.3%. The bile pH was not related with presence of Helicdxxter (7.83±0.41 vs 7.78±0.48). The prevalence of cagA was 35.7%, and 16s rRNA was found in 46.4%. The specific 16s rRNA band for Helicobacter was observed in 14.3%. All the culture were not successful. Conclusion: Although the Helicobacter spp. were not cultured, Helicobacter exists obviously in the bile from the diseased bile duct, and coexist with other bacteria. These results should stimulate studies to ascertain whether these Helicobacter play a role in the pathogenesis of bile duct diseases in human.
대장에 발생하여 대장-위 루를 형성한 이소성 위점막과 99mTcO4 스캔 소견
박석건(Seok Gun Park),이연희(Yeon Hee Lee),임창영(Chang Young Im),조정희(Jung Hee Cho) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.2
We report a case of gastro-colic fistula caused by ectopic gastric mucosa developed at transverse colon. Fistula was detected by colonofiberscopy. And fistulous tract was proved by barium enema. Meckel's diverticulum scan finding was similar to that of GI bleeding; e.g. injected radioactivity was secreted into the lumen and moved along the lumen. There was no bleeding. And there was no diverticulum in the colon. Absence of diverticular pouch may explain this unusuaal GI bleeding-like scan finding rather than focal collection of radioactivity, which is typical of ectopic gastric mucosa found in the Meckel's diverticulum. Ectopic gastric mucosa was confirmed by colonfiberscopic biopsy. We suggest GI bleeding-like pictures should be included differential diagnosis of Tc-99m-O4 (ectopic gastric mucosa or Meckel's diverticulum) scan.
송승호 ( Seung Ho Song ),남승우 ( Seung Woo Nam ),노임환 ( Im Hwan Roe ),김정원 ( Jung Won Kim ),임창영 ( Chang Young Lim ),장효식 ( Hyo Shick Chang ),신기철 ( Ki Chul Shin ),신현덕 ( Hyun Deok Shin ),김정택 ( Jung Taik Kim ),신 대한소화기학회 2003 대한소화기학회지 Vol.41 No.2
Background/Aims: Xanthogranulomatous cholecystitis (XGC) is an uncommon inflammatory disease of the gallbladder (GB), It is characterized by foamy histiocyte infiltration and increasing fibrosis. The purpose of this study was to evaluate clinical features
비 미란성 역류 질환의 치료에 주석산 시사프리드와 돔페리돈 말레이트의 비교 임상 연구 ( 다기관 연구 )
장병익(Byung Ik Jang),김태년(Tae Nyun Kim),정문관(Moon Kwan Chung),김성국(Sung Kook Kim),허정욱(Jung Wook Huh),임창영(Chang Young Im),김호각(Ho Gak Kim),서정일(Jung Il Suh),이문호(Moon Ho Lee),김남재(Nam Jae Kim),윤세진(Sei Jin Youn) 대한소화기기능성질환·운동학회 2002 Journal of Neurogastroenterology and Motility (JNM Vol.8 No.1
N/A The therapeutic requirements of patients with non-erosive reflux disease (NERD) are similar to those with erosive esophagitis. The pharmacological action mechanism of prokinetics is quite different; domperidone is a peripheral dopamine D2-antagonist and cisapride is a HT4-agonist. This study was performed to evaluate the therapeutic effect of these two different prokinetics in patients with NERD. Methods: 178 patients, with heartburn and/or regurgitation, without reflux esophagitis were enrolled and divided into 2 groups by randomization code. In this prospective multicenter trial, 178 patients (93 patients in cisapride group, 85 patients in domperidone group) received 10 mg of cisapride three times a day or 10 mg of domperidone three time a day for 2 or 4 weeks. Symptom assessment was performed in each patients before treatments, 2 and 4 weeks after treatment. Results: Of the 133 patients available for final analysis, 65 were allocated to the cisapride group and 68 to the domperidone group. After 2 weeks treatment, heartburn was reduced in 81.1% of cisapride group, 56.7% of domperidone group (p<0.05) and regurgitation was reduced in 89.7% of cisapride group, 77.7% of domperidone group. After 4 weeks treatment, heartburn was reduced in 94.3% of cisapride group, 88.7% of domperidone group and this difference was not significant. The proportion of adverse events in cisapride group was 9.4% and was 5.5% in domperidone group. Conclusions: Cisapride tartrate was more effective in relieving heartburn in NERD patients than domperidone maleate after 2 week treatment. However, this superior effect dose not persist longer than 2 weeks.(Korean Journal of Gastrointestinal Motility 2002;8:3-13)
문맥압항진증에 의한 식도정맥류와 울혈성 위병변에서 Inducible Nitric Oxide Synthase mRNA 발현양상
임창영,송일한,노임환,진영주,김정원,최정 대한소화기학회 1998 대한소화기학회지 Vol.32 No.2
Background/Aims: Chronic portal hypertension is associated with hyperdynamic splanchnic circulation, leading to collateralization of portal system and bleeding of gastrointestinal tracts. Nitric oxide (NO) induced by NO synthase (NOS) is endothelium-derived relaxing factor. Constitutive NOS (cNOS) is normally present in vascular endothelia and produces NO in response to physiologic stimuli. On the other hand, inducible NOS (iNOS) induces NO in response to bacterial endotoxins and cytokines. In addition, the endotoxemia is frequently observed in portal hypertension. Thus, to clarify the role of NO in development of esophageal varix and congestive gastropathy in patients with portal hypertension by measuring the expression of iNOS mRNA, we carried out this study. Methods: We compared the expression of iNOS mRNA in esophageal variceal and congestive gastric mucosa of 16 patients with portal hypertension with that in distal esophageal and gastric mucosa of 10 normal controls. The expression of iNOS mRNA was measured using reverse transcription-polymerase chain reaction (RT-PCR) in biopsied esophageal variceal and congestive gastric mucosa after endoscopic variceal ligation. Results: There was no expression of iNOS mRNA in distal esophageal and gastric mucosa of normal controls. In the 16 patients with portal hypertension, the expression of iNOS mRNA of esophageal variceal and congestive gastric mucosa was observed in 9 (56.3%) and 8 (50%) patients, respectively. Additionally, in all cases except one, iNOS gene was concurrently expressed in both variceal and congestive gastric mucosa. There was no difference in biochemical data and endoscopic finding between the patients with or without iNOS mRNA expression. Conclusions: The iNOS mRNA was activated in some patients with portal hypertension. Thus, we suggest that NO induced by iNOS may be associated with hyperdynamic circulation and development of collaterals in these patients.
임창영,이명인,김인호,조정희,박상현,노임환,김석배,양미라,오형태,허재형 대한소화기학회 1999 대한소화기학회지 Vol.34 No.3
Background/Aims: Cellular calcium, a key physiological signaling element in cell function and also a crucial pathological intracellular messenger in cell injury, appears to be involved in the initiation and development of acute pancreatitis. The aim of this study was to evaluate the role of cellular calcium and the effect of a calcium channel blocker (nicardipine) as an antioxidant in acute necrotizing pancreatitis in rats. Methods: In male Sprague-Dawley rats, pancreatitis was induced by intraductal infusion of 3% sodium taurocholate. Then, nicardipine was administrated 1 hour before and after induction of pancreatitis. The level of serum-amylase, glutathione (GSH) and malondialde-hyde (MDA) in the pancreatic tissue, and the histologic damage were examined 6 hours after inducing pancreatitis. Results: Nicardipine administration reduced the amount of serum-amylase Moreover, pre- or post- ztreatment with nicardipine had a significant protective effect on free radical induced injury. Pre-treatment with nicardipine was better than the post-treatment. In addition, nicardipine treatment minimized pancreatic necrosis and hemorrhage. Conclusions: The oxygen free radicals and the intracellular calcium are major factors in the pathogenesis of acute necrotizing pancreatitis, and the administration of calcium channel blocker ameliorates pancreatic injury and exerts an antioxidant effect.
김정원,김화영,임창영,이명인,이종화,송일한,노임환,진영주,양미라,황희창,조정희 대한소화기학회 1999 대한소화기학회지 Vol.33 No.1
Background/Aims: The mechanism of gastric mucosal injury by ammonia, one of the toxic products of Helicobacter pylori, is still unclear. We investigated the role and protective effect of glutathione in the ammonia-induced gastric mucosal injury. Methods: The male Sprague Dawley rats were sacrified after intragastric administration of 1 ml of 1% ammonia with pretreating intragastric cysteamine (Cys-am group), or intraperitoneal buthionine sulfoximine (BSO-am group), or without any pretreatment (Cont-am group). Additional groups of rats were pretreated with equivalent cysteamine (Cys group) or eqivalent BSO (BSO group) and without any treatment (Cont group) and then, sacrified. The gastric mucosal glutathione (GSH) and malondialdehyde (MDA) were measured and the severity of gastric mucosal damage was evaluated microscopically. Results: Gastric mucosa GSH was considerably increased in the Cys group and the Cys-am group (p$lt;0.001 and p$lt;0.0001 v Cont group, respectively). Gastric MDA was increased significantly in the Cont-am group or in the BSO-am group. However, the MDA levels in the Cys-am group did not markedly change compared to that of the control. The pathologic results of the Cys-am group showed minimal injuries, but extensive hemorrhage and erosions were observed in the Cont-am or the BSO-am group. Conclusions: GSH depletion was an important factor in the pathogenesis of ammonia-induced gastric mucosal injury. This results suggest that the pathogenetic role of H. pylori is related with gastric diseases and cysteamine have a strong protective effect against those gastric damages. (Kor J Gastroenterol 1999;33:11 - 19)