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For the regulation of energy balance in various internal organs including gut, pancreas and liver, visceral adipose tissue and brain perform important sensing and signaling roles via neural and endocrine pathway. Among these, adipose tissue has been known as a simple energy-storing organ, which stores excess energy in triglyceride. However, it became apparent that adipocytes have various receptors related to energy homeostasis, and secrete adipocytokines by endocrine, paracrine and autocrine mechanisms. In this review, basic roles of adipocytes in energy homeostasis and the correlation between adipocyte signals and digestive diseases are discussed. (Korean J Gastroenterol 2006;48:67-74)
이범재 ( Beom Jae Lee ),전훈재 ( Hoon Jai Chun ),구자설 ( Ja Soul Koo ),금보라 ( Bo Ra Keum ),박상훈 ( Sang Hoon Park ),김두랑 ( Du Rang Kim ),권용대 ( Yong Dae Kwon ),김용식 ( Yong Sik Kim ),진윤태 ( Yoon Tae Jean ),이홍식 ( Hong 대한소화기학회 2007 대한소화기학회지 Vol.49 No.2
목적: 원인 불명의 위장관출혈은 대부분 소장 병변으로 전체 위장관출혈의 5-10%를 차지한다. 캡슐내시경은 원인 불명의 위장관출혈을 비롯한 소장질환의 진단에 매우 유용한 진단 방법으로 기존 검사에 비해 높은 진단율을 보고하고 있다. 이번 연구에서는 원인 불명의 위장관출혈 환자에서 진단율에 영향을 미치는 인자를 분석하여 캡슐내시경 시행에서 세분화된 적응증을 규명하고자 하였다. 대상 및 방법: 2002년 9월부터 2004년 9월까지 원인 불명의 위장관출혈을 주소로 고려대학교 안암병원에 내원하여 캡슐내시경 검사를 시행받은 116명을 대상으로 후향 연구를 진행하였다. 캡슐내시경 소견에 따라 비정상군과 정상군으로 환자를 분류하여 임상 특성, 검사 방법에 의한 진단율 차이를 분석하였다. 결과: 원인 불명의 위장관출혈 환자에서 캡슐내시경 진단율은 69%였고, 비스테로이드 항염증 약물에 유발된 궤양 병변이 19예, 혈관형성이상이 15예로 가장 흔한 소견이었다. 단변량 분석 및 다변량 분석에서 활동 출혈이 유의하게 진단을 예측할 수 있는 인자였다(p<0.05). 결론: 원인 불명의 위장관출혈을 진단할 때 캡슐내시경의 진단율은 69%였으며, 현성 출혈 환자군에서 진단율이 유의있게 높았다. 반복적인 검사에 따른 불편감 등을 고려할 때, 캡술내시경의 시행 시기와 대상은 혈변 및 흑색변의 증상이 있는 환자를 대상으로 시행하는 것을 우선적으로 고려해야 한다. Background/Aims: Capsule endoscopy (CE) has become a valuable modality for the detection of small bowel lesions. The usefulness of CE for obscure gastrointestinal (GI) bleeding has been established with an overall diagnostic yield of 60%. It is unknown whether CE is of equal value in all the patients or of greater benefit in selected groups in Korea. We evaluated the factors that affect the diagnostic yields of CE in patients with obscure GI bleeding. Methods: CE was performed in 126 consecutive patients [74 men and 52 women mean age:52.5 years (25-75 yrs), 23 with active bleeding] with obscure GI bleeding between September 2002 and July 2004. Patients were divided into two groups: those with documented bleeding lesions and those with non specific CE findings. We analyzed the clinical characteristics and other parameters that influenced the diagnostic yields of CE. Results: A definite or probable cause for obscure GI bleeding was found in 69% (80/116) of the patients. NSAID induced ulcer (16.4%) and angiodysplasia (12.1%) were the most common diagnoses. In patients with active bleeding, the diagnostic yield was significantly greater than that of the patients with occult bleeding (80% vs. 68.3%, p<0.05). However, there was no significant difference in parameters between patients with abnormal CE and those with normal CE in respect to gender, age, previous bleeding history, need for transfusion, cecum imaging, and bowel preparation. Conclusions: The diagnostic yield of CE in patients with obscure GI bleeding is 69%. It is significantly higher in patients with active bleeding. (Korean J Gastroenterol 2007;49:79-84)
박동규(Dong Kyu Park),전훈재(Hoon Jai Chun),천황래(Hwang Rae Chun),박재홍(Jae Hong Park),오용열(Yong Leul Oh),박철희(Chul Hee Park),진윤태(Yoon Tae Jin),이홍식(Hong Sik Lee),이상우(Sang Woo Lee),엄순호(Soon Ho Um),최재현(Jai Hyun Cho 대한내과학회 2002 대한내과학회지 Vol.63 No.1
N/A Background: Gastrointestinal stromal tumors (GISTs) have the subject of debate and controversy regarding their histogenesis, criteria on malignancy, prognostic features, site-specificity and their nomenclature. These tumors have various phenotypical features and are generally divided into (1) tumors showing differentiation toward smooth muscle cells (2) tumors showing apparent differentiation toward neural elements (3) tumors showing dual differentiation toward smooth muscle and neural elements (4) tumors lacking differentiation toward either cell type (uncommitted type). This study was performed to identify the possible origin and differentiation of gastric stromal tumor. Methods: This study was performed on 38 patients who had gastric stromal tumors on endoscopy or endoscopic ultrasonography and confirmed by endoscopic or surgical resection between January 1994 and June 1999 at Department of Internal Medicine, Korea University College of Medicine. Formalin-fixed, paraffin-embedded tissues were studied by immunohistochemical method for detecting the presence of CD 34, CD 117, Vimentin, SMA, Desmin, S-100, PGP 9.5 and NSE. Results: The patients' age ranged from 26 to 81 years old, with an average age of 53.8 years. The male to female ratio was 1:1.2. Endoscopic resections were performed on 22 patients and surgical operations on 16 patients. The average tumor size was 25.3 mm in diameter. On immunohistochemical staining method, the uncommitted type was found in 18 patients (47.4%), of which 17 patients (94.4%) were CD117 (+), CD34 (+), Vimentin (+), 12 patients (31.6%) had muscular differentiation, 7 patients (18.4%) showed neural differentiation and 1 patient (2.6%) showed differentiation toward both neural and muscular immunohistochemical pattern. Conclusion: Gastric stromal tumors showed phenotypical diversity in immunohistochemical staining suggesting different histogenesis. Most uncommitted type had a phenotype of intersititial cells of Cajal (ICC) and this evidence supports the hypothesis that uncommitted type has the origin of ICC.(Korean J Med 63:14-22, 2002)
김열홍(Yeul Hong Kim),전훈재(Hoon Jai Chun),현진해(Jin Hai Hyun),윤소영(So Young Yoon),서재홍(Jae Hong Seo),최철원(Chul Won Choi),김병수(Byung Soo Kim),목영재(Young Jae Mok),김종석(Chong Suk Kim),김준석(Jun Suk Kim) 대한내과학회 1999 대한내과학회지 Vol.56 No.6
N/A Objective : UFT plus leucovorin treatment had favorable activity and tolerable toxicity in patients with advanced stomach cancer. Recently, high response rates have been reported in patients with advanced stomach cancer with a schedule of epirubicin, cisplatin, and protracted infusion of 5-fluorouracil (5-FU). The advantage of long term oral administration of UFT is that this treatment might be used to mimic protracted infusions of 5-FU. Instead of inconvenience of infusion pump and intravenous catheter for protracted infusion of 5-FU, we administered UFT plus leucovorin in this treatment. Methods : Thirty-seven patients with locally advanced or metastatic stomach cancer received epirubicin, cisplatin, oral UFT plus leucovorin. Epirubicin 50 mg/m2 and cisplatin 60 mg/m2 were administered on day 1 by intravenous injection. UFT 360 mg/m2/day in conjunction with leucovorin administered at 25 mg/m2/day per os in divided daily doses for 21 days followed by a 7-day rest period. Courses were repeated every 4 weeks. The median age of the patients was 55 years with a median World Health Organization (WHO) performance status of 1. Patients received a median of four courses of treatment (range, 2 to 10). Results : Among 37 evaluable patients, two patients achieved complete response, and eighteen had partial responses, for an overall response rate of 54% (95% confidence interval; 39% to 70%). Stable disease was reported in 12 patients (32.5%) and another 5 (13.5%) showed disease progression. The median duration of survival was 10 months (range, 2 to 15+). The main toxicity was nausea/vomiting, leukopenia, diarrhea and oral mucositis. Significant toxicity (WHO grade 3 or 4) included leukopenia in fourteen patients (39.8%), nausea/ vomiting in eleven (29.7%), oral mucositis in five (13.5%), and diarrhea in four (10.8%) patients. Conclusion : We conclude that epirubicin, cisplatin, oral UFT plus leucovorin, a convenient out-patient regimen, has a significant activity in patients with stomach cancer and has tolerable toxicities.
정록선 ( Rok Son Choung ),전훈재 ( Hoon Jai Chun ),조남영 ( Nam Young Jo ),김용식 ( Yong Sik Kim ),박철희 ( Chul Hee Park ),김영선 ( Young Sun Kim ),진윤태 ( Yoon Tae Jeen ),이홍식 ( Hong Sik Lee ),이상우 ( Sang Woo Lee ),엄순호 ( 대한소화기학회 2002 대한소화기학회 추계학술대회 Vol.2002 No.-
김영선 ( Young Sun Kim ),전훈재 ( Hoon Jai Chun ),조남영 ( Nam Young Jo ),김경오 ( Kyung Ho Kim ),정록선 ( Rok Son Choung ),김용식 ( Yong Sik Kim ),박철희 ( Chul Hee Park ),진윤태 ( Yoon Tae Jeen ),이홍식 ( Hong Sik Lee ),엄순호 ( 대한소화기학회 2002 대한소화기학회 추계학술대회 Vol.2002 No.-
박철희 ( Chul Hee Park ),전훈재 ( Hoon Jai Chun ),정록선 ( Rok Sun Jeong ),김경오 ( Kyung Ho Kim ),김용식 ( Yong Sik Kim ),김영선 ( Young Sun Kim ),진윤태 ( Yoon Tae Jeen ),이홍식 ( Hong Sik Lee ),엄순호 ( Soon Ho Um ),이상우 ( Sa 대한내과학회 2003 대한내과학회지 Vol.64 No.4
목적 : 최근 식도 정맥류에 대한 내시경적 치료의 결과를 주변부의 측부혈관에 대한 변화와 연관해서 평가하는 추세이다. 본 연구에서는 비침습적이며 문맥체순환계의 전체구조를 관찰하기 용이한 자기공명 혈관조영술을 이용하여 좌위정맥, 단위정맥, 비신단락, 위신단락 등의 측부 혈관들의 식도 정맥류 경화 요법 이후 변화에 대하여 평가하고자 하였다. 방법 : 식도정맥류를 동반한 문맥압 항진증 환자 30명을 대상으로 자기공명 혈관조영술을 식도정맥류에 대한 경화요법 전 Background : This study was aimed at evaluating the changes of collateral circulation, using MR angiography (MRA), which is a non-invasive and a useful tool for viewing the porto-systemic circulation as a whole, following endoscopic injection sclerotherap