역류성 식도염환자의 산청소능

박효진(Hyo Jin Pack),김범수(Pum Soo Ki m),이정운(Jung Woon Lee),박인서(In Suh Park) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.3

N/A Background/Aims: Esophageal acid clearance is an important mechanism protective against the development of reflux esophagitis. Acid clearance from the esophagus after gastro-esophageal reflux depends on two important mechanisms: esophageal peristalsis to return the displaced gastric content to the stomach and swallowed saliva to neutralize the residual acid that coats the esopha- gea1 mucosa. The present study aims to investigate acid clearance and determine the contributions of esophageal peristalsis, salivation, and gravity. Methods: We performed the acid clearance test, ambulatory 24 hour esophageal pH study, esophageal manometry and saliva study in 16 consecutive patients with reflux esophagitis, and then compared them with normal controls. Results: The clearance of acid instilled into the esophagus was markedly delayed in patients with reflux esophagitis as compared with controls(p0.05). There was a trend towards a lower peristaltic amplitude in patients with reflux esophagitis, but this was statistically not significant. Of the motor events analyzed, there were simultaneous contractions in 4 patients(25.0%), poor wave progression in 4 patients(25.0%), and non-transmitted contraction in 2 patients(12.5%). In patients with reflux esophagitis, the number of reflux episodes, the mean number of reflux episodes greater than 5 minutes, and the percentage of time when the pH was less than 4 were significantly increased compared with controls(p <0.05). The basal and stimulated salivary pH and concentration of bicarbonate in patients with reflux esophagitis did not show a significant difference compared with controls. Conclusions: We found a significant impairment of acid clearance in patients with reflux esophagitis, and some alterations in esophageal peristalsis but no change in salivary functions. (Korean J Gastroenterol 1995;27:275 - 282)

장중첩증이 (腸重疊症) 동반된 대장지방종 (大腸指肪腫)

박인서 ( In Suh Park ),박찬일 ( Chan Il Park ),이경식 ( Kyung Sik Lee ),김기황 ( Ki Whang Kim ),최흥재 ( Heung Jae Choi ),양주영 ( Joo Young Yang ),박창윤 ( Chang Yoon Park ),윤용광 ( Yong Dwang Yoon ) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.1

Excluding adenomataus polyps, lipomas represent the most common benign tumor of the colon. But lipomas of gastrointestinal tract are rarely encountered, and when seen they are usually an incidental finding at autopsy or operation. When small, these tumors are frequently asymptomatic. Constipation and colicky abdominal pain in wax and wane pattern are frequent symptoms in the larger tumor and intussusception is the main complication of the lipomas. A few hundreds of gastrointestinal lipomas were reported in the world, but only 6 cases of it were found in the literature in Korea. A case of lipomas in colon associated with intussusception in a 36-year-old woman and a brief review of the literature were presented.

기니 픽 회장 운동 기능에 미치는 Phosphodiesterase 4 형과 5 형 억제제의 효과

박효진(Hyo Jin Park),최성우(Sung Woo Choi),이영호(Yong Ho Lee),임정현(Jung Hyun Lim),이상인(Sang In Lee),박인서(In Suh Park) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.5

Background/Aims: Intracellular cAMP or cGMP is degraded by cyclic nucleotide phosphodiesterase ( PDE) . We hypothesized that PDE inhibitors modulate the peristalsis and nerve- induced responses of the smooth muscle of the guinea pig ileum. Methods: To examine the effect of rolipram ( type 4 inhibitor of PDE) and zaprinast ( type 5 inhibitor of PDE) , we measured peristaltic amplitude, area under curve ( AUC) , and frequency of contractions from ileal preparation using the peristaltic bath. The mechanical activity of the circular muscle was measured with a clip attached, via the three sites of serosal surface, to the underlying circular muscle of intact ileum in the peristaltic chamber. In another set of experiment, muscle strips from the ileum were stimulated by an electrical field. The effects of rolipram, and zaprinast, on peristalsis and nerve- induced contraction were explored. Results: The amplitude and AUC of peristaltic contractions were significantly decreased in rolipram or zaprinast-treated group and frequency of contractions was significantly delayed in rolipram or zaprinast-treated group. The nerve- induced contraction of smooth muscle was significantly decreased in rolipram-treated group. Conclusions: These observations suggest that PDEs may play a role in the modulation of peristaltic behavior of the ileum and PDE inhibitors may be used in the treatment of hyperkinetic bowel disorders. ( Korean J Gastroenterol 2002; 39: 343- 349)

관상동맥질환 환자 , 운동선수 및 정상 대조군에서 혈청지질 및 Apolipoproteins 에 대한 연구

박정의(Jeong Euy Park),김우주(Woo Joo Kim),최인석(In Suok Choi),김대원(Dae Won Kim),이갑노(Kap No Lee),김성수(Sung Soo Kim),유원상(Won Sang Yoo),최석구(Suck Koo Choi),이건주(Kun Joo Rhee),서순규(Soon Kyu Suh),이영(Young Lee),고영박(You 대한내과학회 1991 대한내과학회지 Vol.40 No.5

To investigate the usefulness of serum lipids and apolipoproteins as indices of risk factors for coronary artery disease (CAD) and to know the effects of regular exercise on the serum lipids and apolipoproteins, we measured the serum lipids and apolipoproteins in the patients with coronary artery disease, athletes and normal control persons. The study subjects included 67 patients with CAD (57. 8±11.2yr), 22 athletes (21.5±2.1yr) and 62 normal control persons (34.3±11.4yr). 1) In the patients with CAD the serum total cholesterol (TC) was 177. 2±38.5 mg/dl and the HDL-cholesterol (HDL-C) was 39.0±11.2mg/dl. In the normal control persons TC was 162.5±33.5 mg/dl and HDL-C was 42.4±12.6mg/dl, which were not significantly different from the values of CAD patients. 2) The serum apolipopratein A (Apo-A) was significantly lower (201.9±39.6mg/dl, p<0.05), and the apolipoprotein B (Apo-B) was significantly higher (132.3±29.7 mg/dl, p<0.05) in the patients with CAD, compared with normal control persons (age over 40 years; Apo-A: 246.3±39.9 mg/dl, Apo-B: 117.9±26.4 mg/dl). 3) The TC/HDL-C ratio and Apo B/A ratio were significantly higher (4.9±1.6, 0.67±0.17, p<0.005 for TC/HDL-C ratio and p<0.05 for Apo B/A ratio) in the CAD patients compared with normal control persons (age over 40 years; 3.6±1.1, 0.49±0.10). 4) The TC/HDL-C ratio ≥4.0 and Apo B/A ratio ≥0.55 were the good discriminating criteria separating the CAD patients from the normal control persons. 5) In the athletes, the serum triglyceride (TG) was significantly lower (65.7±20.7mg/dl, p<0.001), and the HDL-C was significantly higher (57.8±11.2 mg/dl, p<0.001) compared with normal control persons (age under 30 years; TG; 119.8±94.3 mg/dl, HDL-C: 44.6±11.0mg/dl). The Apo-A, Apo-B, TC/HDL-C ratio and Apo B/A ratio were all significantly lower (p<0.01) compared with those in the normal control persons. 6) Among the athletes, the HDL-C was highest and the TG was lowest in the swimmers compared with fencing players and wrestlers. The Apo B/A ratio and TC/HD1-C ratio were better discriminating indices of risk factors for CAD compared with individual lipids or apolipoprotein values. The Apo-A and Apo-B were considered to be good indices of risks for CAD. The athletes had lowest risks for CAD.

경피 내시경하 위루술을 이용한 위감압 치험

박인서(In Suh Park),이상인(Sang In Lee),이관식(Kwan Sik Lee),박효진(Hyo Jin Park),신준한(Joon Han Shin),최홍재(Heung Jai Choi),권선옥(Seon Og Kweon),정준표(Jun Pyo jeong) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.2

Percutaneous endoscopic gastromy (PEG) and percutaneous endoscopic jejunostomy (PEJ) are used commonly for enteral feeding. Rut there were some reports of using PEG as an alternative to naso-gastrointestinal tube for decompression in parients with mechanical obstruction, particularly obstraction with malignancies involving the upper gastrointesrinal tract. Palliation is usually achieved by the placement of a nasogastric or nasointestinal tube. Hower these tubes tend to have some disadvantages which can be overcome with drainage PEG. In our experience, a 65 years old male patiert with pyloric obstruction due to advanced gastric cancer was successfly decompressed by drainage PEG. Thus, we present this case with supporting literatures.

췌장암에서 p53 단백발현의 임상적 의의

박인서(In Suh Park),정재복(Jae Bock Chung),박찬일(Chan Il Park),송시영(Si Young Song),이돈행(Don Haeng Lee),이우정(Woo Jung Lee),박영년(Young Nyun Park) 대한소화기학회 1997 대한소화기학회지 Vol.30 No.1

N/A Background/Aims: Alteration in the p53 tumor suppressor gene are involved in the pathogenesis of diverse human cancer. Immunohistochemical detection of the p53 protein has been strongly correlated with rnutations in the p53 gene. Although p53 overexpression or mutation have been elucidated in a variety of cancers, there has been no study in pancreatic cancer in Korea. The purpose of this study is to evaluate the expression rate of p53 protein in pancreatic cancer. In addition, we attempted to clarify the association between expression of p53 and clinicopathologic features including survival. Methods: Using immunohistochemistry with monoclonal antibody to p53(Zymed Lab. Clone No. BP53-12), we exained 47 formalin-fixed paraffin-embedded tissues of pancreatic cancer(39 intraductal adenocarcinoma, 8 rnucinous adenocarcinoma) for overexpres- sion of p53 gene product. Results: Positive nuclear p53 immunoreativity was detected in 44.6% of pancreatic cancer. No clear correlation was found between p53-positive immunostaining and clinicopathologic features such as age, sex, tumor size, location, histologic type, differentiation of tumor cells and stage of tumnor, etc. The mean duration of survival was 8.6 months in the group of p53 positive and 9.6 months in the group of p53 negative and no difference was noted between two groups. Conclusions: These results suggest that mutation of p53 tumor suppressor gene may play a role in the pathogenesis of pancreatic cancer. However there was no correlation between the presence of p53 overexpression and clinicopathologic features or survival. (Korean J Gastroenterol 1997; 30:98 - 102)

한국인 위암에서 Survivin과 HIAP-1 유전자 발현

박찬진,류승완,김인호,백원기,서성일,서민호,손수상,Park Chan Jin,Ryu Seung Wan,Kim In Hoo,Baek Won-Ki,Suh Seong-Il,Suh Min-Ho,Sohn Soo Sang 대한위암학회 2003 대한위암학회지 Vol.3 No.1

Purpose: Dysregulation of apoptosis may attribute to development of cancer by abnormally prolonging cell viability with accumulation of transforming mutations. Survivin and HIAP (Human Inhibitors of Apoptosis)-1 were recently described as apoptosis inhibitors. Their pathogenic roles in gastric cancer are largely unknown. In the present study, we examined the expression of survivin and HIAP-1 in gastric cancer tissues and cell lines in order to elucidate the roles of survivin and HIAP-1 in the process of gastric carcinogenesis. Materials and Methods: Eight gastric cancer cell lines and five gastric cancer tissues were studied. The expression of survivin and HIAP-1 were evaluated by reverse transcription -polymerase chain reaction (RT-PCR), immunohistochemistry, and Western blot. Results: Western blot and RT-PCR analysis revealed survivin and HIAP-1 expression in all gastric cancer cell lines. Increased expression of survivin and HIAP-1 were found in all cases of gastric cancer tissues compared to normal tissues by Western blot analysis. In immunohistochemical analysis tumor cells were stained with anti-survivin and anti-HIAP-1 antibodies. Cell cycle dependence of survivin expression was preserved in gastric cancer cell lines. Conclusion: The results indicate that increased expression of survivin and HIAP-1 genes may play an important role in gastric cancer.

식도 운동장애를 동반한 횡격막상부 식도 게실증 3예

박인서(In Suh Park),강진경(Jin Kyung Kain),김충배(Choong Bai Kim),박효진(Hyo Jin Park),문병수(Byung Soo Moon),이천균(Chun Kyun Lee) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5

Three patients with epiphrenic diverticula were reviewed with foci on esophageal dysfuntion and its relation to treatment. All cases were identified by bariurn esophagogram and confirmed by endoscopy. Manoetric studies of esophagus documented as diffuse esophageal spasm-like disorder in 1 case, and nonspecific motor disorder in 2 cases. One case was managed surgically, and the other 2 were treated conservatively. We found that epiphrenic diverticulum were associated with esophageal motility disorders. Treatment should be considered to focus on associated motility disorders as well as a diverticulum. (Korean J Gastroenterol 1997;29:687-693)

대장 흑색소증의 임상적 고찰

박인서(In Suh Park),문영명(Young Myoung Moon),정재복(Jae Bock Chung),이상인(Sang In Lee),김원호(Won Ho Kim),이관식(Kwan Sik Lee),정현주(Hyeon Joo Jeong),박효진(Hyo Jin Park),정준표(Jun Pyo Chung),박경아(Kyung Ah Park),남문석(Moon Suk 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5

N/A Melanosis coli associated with ingestion of anthraquinone compounds in laxatives is due to accumulation of macrophages containing brown lipofuscin-like pigments in the lamina propria. We analyzed the clinical, endoscopic, and pathologic findings and colonic motor functions of melanosis coli and performed electronmicroscopic study to know the ultrastructural changes of neural elements. We studied 13 cases (mean age 48.1 +- 18.5 years, male to female cases 6:7). The vegetable laxatives containing anthraquinone derivatives, aloe or bisacodyl were used mainly and the mean duration of laxative abuse was l.5 +- 1.2 years. Endoscopically, dark brownish mucosal disoloration showed polyhedral forms divided by fine striae of lighter color. Melanosis was more intense in the more oral part of the bowel. Pathologically, no relationship was found between grade of melanosis and kind of drugs, daily dose, or durat.ion of addiction. Ultrastructural features on nerve structure were ballooning of axon. reduction of nerve specific cell organelles, and increased lysosomal activity. The alterations of these neural elements are assumed to he associated with impaired colonic motility. In conclusion, vegetable laxatives such as aloe, seem to be an important causes of melanosis coli in Korea. melanosis coli have a tendency to damage nerve fibers. We should avoid laxative abuse in order to prevent pragressing to cathartic colon.

Nitric Oxide와 Vasoactive Intestinal Peptide가 기니 픽 위저부 평활근 이완에 미치는 영향

박효진(Hyo Jin Park),이영호(Hyo Jin Park),이혜영(Hye Young Lee),정준표(Jun Pyo Chung),이관식(Kwan Sik Lee),전재윤(Chae Yoon Chon),강복순(Bok Soon Kang),박인서(In Suh Park) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3

N/A Background/Aims: The autonomic nervous system distributed throughout the stomach consists of adrenergic, cholinergic, and non-adrenergic, non-cholinergic (NANC) nerves. Of these, NANC nerve fibers are known to be distributed all throughout the gastrointestinal tract and they provide the main inhibitory nerve supply to the gut smooth muscle. NANC nerve is known to release neurotransrnitters such as nitric oxide (NO), adenosine 5-triphosphate (ATP) and vasoactive intestinal peptide (VIP). However, the effect produced by each of the NANC neurotransmitter depends on an animal species and parts of gastrointestinal tract. Therefore, this experiment applied electrical field stirnulation at the circular musc]e of a guinea pigs gastric fundus to observe any relation of NANC nerve in muscu]ar relaxation. Methods: The effect of ATP, VIP, and NO on muscle re)axation was determined through the electrical field stimulation, and each neurotrans- mitters ability to regulate the muscle relaxation was compared. Results: Muscle strips were relaxed in response to electrical field stimulation that was applied. The relaxation was not inhibited by atropine or guanethidine, but was completely inhibited by tetrodotoxin. The muscle relaxation caused by NANC nerve stimulation was inhibited by L-NNA, VIP antagonist, and suramin. L-NNA was the most potent inhibitor among them. The muscle relaxation caused by electrical field stimulation was not further inhibited by VIP antagonist after the pretreatment of L-NNA, however, it was further inhibited by L-NNA following the treatment of VIP antagonist. The electrically stimulaed induced muscle relaxation was almost complete]y abolished by coadministration of L-NNA with VIP antagonist and suramin, The exogenous VIP-induced muscle relaxation was not affected by presence or absence of L-NNA. Oxyhemoglobin or methylene blue treatment inhibited the muscle relaxation induced by electrical field stimulation. Conclusions: Non-adrenergic and non-cholinergic nerve has an inhibitory neurotransmission in a guinea pigs gastric fundus circular muscle and NO is the principal inhibitory neurotransmitter of NANC nerve. NO mediated muscle relaxation is thought to be associated with increase of cGMP in muscle cells. (Korean J Gastroen- terol 1997;29:2S9 - 300)