Effects of angiotensin peptides on colonic motility in rats

하기원,김종훈,Kim Suhn Hee 대한대장항문학회 2023 Annals of Coloproctolgy Vol.39 No.3

Purpose: Renin-angiotensin system (RAS) is involved in the pathophysiology of colonic inflammation. The aim of this study was to investigate whether small angiotensins (Angs) peptides play a role in the regulation of colonic motility and their roles are modulated in colitis. Methods: Experimental colitis was induced by an intake of 5% dextran sulfate sodium (DSS) dissolved in tap water for 7 days in Sprague-Dawley rats. After sacrifice, plasma hormone concentrations and messenger RNAs (mRNAs) for RAS were measured. Functional analysis of colonic motility in response to Angs peptides was performed using Taenia coli. Results: DSS-treated colon showed an increased necrosis with massive infiltration of inflammatory cells. The mRNA level of colonic angiotensin II receptor type 2 (AT2R) in DSS-treated rats was higher than that in control rats whereas the mRNA levels of angiotensin II converting enzyme (ACE), ACE2, AT1R, AT4R, and Mars receptor were not different from those in control rats. Ang III, Ang IV, and Ang-(1-9) (1, 3 μM) increased the frequency of basal colonic motility. Ang-(1-7) did not cause any significant changes in frequency and amplitude of basal motility. The order of potency for an increased frequency of basal motility seems to be Ang II>>Ang IV>Ang III=Ang-(1-9). The increased frequency of basal motility by Ang-(1-9) but not Ang IV was significantly enhanced in DSS-treated rat colon. Conclusion: In conclusion, these data suggest that small Angs peptides are partly involved in the pathophysiological regulation of colonic motility in experimental colitis.

Clinical Outcome of Magnetic Resonance Imaging-Detected Additional Lesions in Breast Cancer Patients

하기원,이미숙,이병길,윤현조,정성후 한국유방암학회 2011 Journal of breast cancer Vol.14 No.3

Purpose: The aim of this study was to investigate the clinical outcome of additional breast lesions identified with breast magnetic resonance imaging (MRI) in breast cancer patients. Methods: A total of 153 patients who underwent breast MRI between July 2006 and March 2008 were retrospectively reviewed. Thirty-three patients (21.6%) were recommended for second-look ultrasound (US) for further characterization of additional lesions detected on breast MRI and these patients constituted our study population. Results: Assessment for lesions detected on breast MRI consisted of the following: 25 benign lesions (73.5%), two indeterminate (5.9%), and seven malignant (20.6%) in 33 patients. Second-look US identified 12 additional lesions in 34 lesions (35.3%) and these lesions were confirmed by histological examination. Of the 12 lesions found in the 11 patients, six (50.0%) including one contralateral breast cancer were malignant. The surgical plan was altered in 18.2% (six of 33) of the patients. The use of breast MRI justified a change in treatment for four patients (66.7%) and caused two patients (33.3%) to undergo unwarranted additional surgical procedures. Conclusion: Breast MRI identified additional multifocal or contralateral cancer which was not detected initially on conventional imaging in breast cancer patients. Breast MRI has become an indispensable modality in conjunction with conventional modalities for preoperative evaluation of patients with operable breast cancer.

유방암에서 수술 전 항암화학요법이 생물학적 예후인자들에 미치는 영향

하기원(Gi Won Ha),윤현조(Hyun Jo Youn),정성후(Sung Hoo Jung) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.6

Purpose: The selection of systemic therapy for breast cancer is based on the expression pattern of biological prognostic markers. Neoadjuvant chemotherapy has been considered the standard care for locally advanced breast cancer. However, its effect on the expression of biological prognostic markers is controversial. The aim of this study was to determine whether neoadjuvant chemotherapy may alter these expression patterns in patients suffering with breast cancer. Methods: We determined the protein expression levels of estrogen receptor (ER), progesterone receptor (PR), p53 and HER-2/neu in the preoperative core needle biopsies and the final surgical specimens from 15 patients who received neoadjuvant chemotherapy between January 2002 and June 2007. As a control group, we analyzed the samples from patients who did not receive neoadjuvant chemotherapy. Results: The pathologic complete tumor response rate (pCR) of the neoadjuvant chemotherapy group was 6.7% (1/15). Of those patients who did not achieve a pCR (n=14), no significant differences in the biological prognostic markers expression were observed between the two groups. Alteration of the ER or PR status occurred in 42.8% (6/14) of the patients after neoadjuvant chemotherapy and in 14.3% (2/14) of the control patients, showing there was no significant difference between the two groups (P=0.210). The hormonal receptor status was changed in 3 cases (21.4%) after neoadjuvant chemotherapy. Conclusion: There were no significant differences for the changes in the expression of ER, PR, p53 and HER-2/neu from the preoperative core needle biopsy to the final surgical specimens between those patients who had received neoadjuvant chemotherapy and those patients who didn’t. However, changes of the ER or PR status and the hormonal receptor status occurred in 42.8% and 21.4%, respectively, of the patients who underwent neoadjuvant chemotherapy. As these changes may impact treatment, we suggest that immunohistochemical assay is necessary before and after neoadjuvant chemotherapy in patients with breast cancer.

Management of Colonic Diverticulitis Tailored to Location and Severity: Comparison of the Right and the Left Colon

정병훈,하기원,이민로,김종훈 대한대장항문학회 2016 Annals of Coloproctolgy Vol.32 No.6

Purpose: This study assessed optimal management of colonic diverticulitis as functions of disease location and severity and factors associated with complicated diverticulitis. Methods: This retrospective review analyzed 202 patients diagnosed between 2007 and 2014 at Chonbuk National University Hospital, South Korea, with colonic diverticulitis by using abdominopelvic computed tomography. Diverticulitis location was determined, and disease severity was categorized using the modified Hinchey classification. Results: Patients included 108 males (53.5%) and 94 females (46.5%); of these, 167 patients (82.7%) were diagnosed with right-sided and 35 (17.3%) with left-sided colonic diverticulitis. Of the 167 patients with right-sided colonic diverticulitis, 12 (7.2%) had complicated and 155 (92.8%) had uncomplicated diverticulitis; of these, 157 patients (94.0%) were successfully managed conservatively. Of the 35 patients with left-sided colonic diverticulitis, 23 (65.7%) had complicated and 12 (34.3%) had uncomplicated diverticulitis; of these, 23 patients (65.7%) were managed surgically. Among patients with right-sided diverticulitis, those with complicated disease were significantly older (54.3 ± 12.7 years vs. 42.5 ± 13.4 years, P = 0.004) and more likely to be smokers (66.7% vs. 32.9%, P = 0.027) than those with uncomplicated disease. However, among patients with left-sided diverticulitis, those with complicated disease had significantly lower body mass index (BMI; 21.9 ± 4.7 kg/m2 vs. 25.8 ± 4.3 kg/m2, P = 0.021) than those with uncomplicated disease. Conclusion: Conservative management may be effective in patients with right-sided diverticulitis and patients with uncomplicated left-sided colonic diverticulitis. Surgical management may be required for patients with complicated left-sided diverticulitis. Factors associated with complicated diverticulitis include older age, smoking and lower BMI.

Prognostic scoring system influencing long-term survival in patients with hepatic metastasis of colorectal cancer

유희철,황시은,하기원,이민로,김종훈,조백환 대한외과학회 2009 대한외과학회 학술대회 초록집 Vol.2009 No.11

Fournier Gangrene in a Patient With Type 2 Diabetes Mellitus Treated With Dapagliflozin: A Case Report

문재영,이민로,김종훈,하기원 대한대장항문학회 2021 Annals of Coloproctolgy Vol.37 No.S

Rare cases of Fournier gangrene (FG) possibly associated with sodium-glucose cotransporter 2 inhibitors have been reported. We present a case of a 66-year-old male patient with type 2 diabetes mellitus on oral metformin, glimepiride, and dapagliflozin therapy. He presented with pain in the perineum and scrotum for 5 days. The clinical finding, computed tomography finding, and laboratory data were matched with FG. Emergency surgical drainage, debridement of necrotic tissue, and diverting loop ileostomy formation were performed by a urologist and a surgeon. The patient had no complications from diabetes before the onset of FG, and serum glucose management was good at the onset of FG. This case shows an FG patient with good glucose management taking dapagliflozin and suggests a possible association between dapagliflozin and FG. Further evaluation and additional research on this relationship are needed.

Multifunctional Indocyanine Green Applications for Fluorescence-Guided Laparoscopic Colorectal Surgery

손경모,Ahn Hong-min,In Young Lee,하기원 대한대장항문학회 2021 Annals of Coloproctolgy Vol.37 No.3

Indocyanine green (ICG) could be applied for multiple functions such as fluorescent tumor localization, fluorescence lymph node mapping (FLNM), and intraoperative angiography in colorectal cancer surgery. With the near-infrared (NIR) systems, colonoscopic ICG tattooing can be used to define the early colorectal cancer that cannot be easily distinguished through the serosal surface. The lymphatic pathways can be visualized under the NIR system when ICG is injected through the submucosal or subserosal layer around the tumor. Intraoperative ICG angiography can be applied to find a favorable perfusion segment before the colon transection. Although all fluorescence functions are considered essential steps in image-guided surgery, it is difficult to perform multifunctional ICG applications in a single surgical procedure at once because complex protocols could interfere with each other. Therefore, we review the multifunctional ICG applica- tions for fluorescent tumor localization, FLNM, and ICG angiography. We also discuss the optimal protocol for fluores- cence-guided colorectal surgery.

Effects of Storage Buffer and Temperature on the Integrity of Human DNA

김윤태,최은희,손보경,서은희,이은경,유제권,하기원,김진선,권미란,김영진,이경율 대한임상검사과학회 2012 대한임상검사과학회지(KJCLS) Vol.44 No.1

In this study, we have examined the effects of the storage time and temperature on DNA quality and have also studied the effects of the hydration buffer in which DNA is dissolved. This study was performed using 160 human blood samples collected with informed consent from 2007 to 2008 in the hospital where this cohort study was performed. The DNA extracted was dissolved using distilled water (DW) or Tris-EDTA (TE) buffer, and stored in the deep freezer or refrigerator for up to 10 weeks at -70℃, -20℃, 4℃, and 25℃, respectively. DNA integrity was determined by the degree of smearing of DNA on the gel. After four weeks, all of the 20 DNA samples dissolved in DW and stored at 25℃ were entirely degraded. After 10 weeks, 6 of the 20 DNA samples dissolved in TE buffer and stored at 25℃ were fairly degraded, and 4 of the 20 DNA samples dissolved in DW and stored at 4℃ were fairly degraded. The 20 DNA samples dissolved in TE buffer and stored at 4℃ were stable for 10 weeks. DNA samples stored at -20℃ and -70℃ did not appear to degrade in either DW or TE buffer, even at the 10-week point. We suggest that TE buffer should use for DNA elution, in order to protect against degradation and to preserve DNA for a long period of time, and the samples should be stored at -20℃ or -70℃. .