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궤양성 대장염 수술 방법으로써 회장낭-항문문합술과 영구회장조성술 후 경과와 삶의 질에 대한 비교
정용희 ( Yong Hee Joung ),김효종 ( Hyo Jong Kim ),이길연 ( Kil Yeon Lee ),이병욱 ( Byoung Wook Lee ),한요셉 ( Yo Seb Han ),동석호 ( Seok Ho Dong ),김병호 ( Byung Ho Kim ),장영운 ( Young Woon Chang ),이정일 ( Joung Il Lee ),장린 ( 대한장연구학회 2003 Intestinal Research Vol.1 No.1
Background/Aims: Ileostomy (IL) and ileal-pouch anal anastomosis (IPAA) are treatment of choice in ulcerative colitis. We investigate the complications and quality of life after operation according to the operative methods. Methods: We analyzed patients experienced total proctocolectomy. We divided them in two groups according to the operation methods. We analyzed the characteristics and outcomes after IL or IPAA group for evaluation quality of life and evaluated the characteristics of patients preoperative and postoperative state retrospectively. Results: Fourteen patients were enrolled this study. IPAA was done at eight of them and IL was done at the six of them. There were no difference in sex, age, frequency of use of immunosuppressive agent, duration of medication of steroid and duration of ulcerative colitis according to the operation methods. Most common indication of operation was medical intractability. Similar incidence of postoperative complication in both operation methods. According to the questionnares for evaluating of quality of life, we compared both operation method. There was no difference. But in IPAA, antidiarrheal medication was more needed. Conclusions: In IL and IPAA, quality of life was improved. There was no difference in quality of life in IL and IPAA. (Intestinal Research 2003;1:39-44)
간세포 장기 보존을 위한 적정 냉동보존에 관한 연구-2
정용희 ( Yong Hee Joung ),김병호 ( Byung Ho Kim ),이병욱 ( Byoung Wook Lee ),한요셉 ( Yo Seb Han ),동석호 ( Seok Ho Dong ),김효종 ( Hyo Jong Kim ),장영운 ( Young Woon Chang ),이정일 ( Joung Il Lee ),장린 ( Rin Chang ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.1
Background/Aims: The cryopreservation of primary hepatocytes could avoid unnecessary isolation of hepatocytes and supply them on demand. We compared two programs of computer-controlled freezing methods on the efficacy of hepatocyte cryopreservation. Methods: Rat hepatocytes were cryopreserved by computer-controlled freezing methods. In program I, the overall cooling rate was 1.33℃/min and single-step shock cooling was used to reduce the latent heat of fusion. In program II, the cooling rate of 2℃/min and two-step shock cooling were used. Two programs were compared in regard to hepatocyte viability and long-term cryopreservation and thawing temperature were also evaluated. Results: The hepatocyte viability showed the highest value of 74.5 2.5% when cryopreserved using the program II and at 2×106/mL cell concentration in cryopreservation medium. The hepatocyte attachment rate on culture was similar in every occasion, more or less 50%. The hepatocyte viability was improved by 10% when thawed at 40℃, compared to the value at 37℃ in the program I. The hepatocyte viability was decreased to 38.2 5.5% in the program I and 45.4 1.6% in the program II after long-term cryopreservation. Conclusions: The program II showed better survival of hepatocytes at 2×106/mL cell concentration. However, overall efficacy of hepatocyte cryopreservation was less than 35% and decreased more after long-term cryopreservation. Further studies are needed to develop a more effective program for hepatocyte cryopreservation. (Korean J Gastroenterol 2003;41:41-48)
정용희 ( Yong Hee Jung ),동석호 ( Seok Ho Dong ),김병호 ( Byung Ho Kim ),정성훈 ( Sung Hoon Jung ),이창균 ( Chang Kyun Lee ),장재영 ( Jae Young Jang ),김효종 ( Hyo Jong Kim ),장영운 ( Young Woon Chang ),장린 ( Rin Chang ) 대한내과학회 2007 대한내과학회지 Vol.72 No.2
목적: 간세포이식에서 복강은 대량의 세포를 안전하게 투여할 수 있다는 점에서 급성 간부전 치료를 위한 매력적인 이식 장소이지만, 복강 자체는 간세포 생착에 적합한 환경은 아니다. 간세포는 부착성장을 하는 세포로서 세포외 간질이나 비실질간세포와의 상호작용이 생존에 중요한 것으로 알려져 있다. 본 연구에서는 복강 내 이식된 간세포가 얼마나 빨리 기능을 발현하는지, 또한 비실질간세포를 동시에 이식함으로써 간세포 생존을 연장시킬 수 있는지 알아보고자 하였다. 방법: 빌리루빈 결합 효소에 결함이 있어 선천적으로 황달이 발생하는 Gunn 쥐의 복강 내로 정상 Wistar 쥐의 간세포를 단독(kg당 10(9)개, 1군, 10마리) 또는 비실질간세포(kg당 5×10(8)개, 2군, 10마리)와 동시에 이식하였다. 대조를 위하여 Gunn 쥐의 간세포 및 비실질간세포를 Gunn 쥐의 복강 내로 이식하여 비교하였다(n=5). 이식 후 6시간, 1일, 4일, 1주, 2주, 3주, 4주, 5주, 6주에 담즙, 혈액, 복강 내 조직을 채취하였다. 담즙으로 결합형 빌리루빈이 배설되는지에 대해서 고작위액체크로마토그래피로 확인하였고, 혈청 빌리루빈의 농도를 측정하여 변화를 관찰하였다. 복강 내 간세포 존재는 형태학적 관찰, 면역조직화학염색, 제자리부합법으로 확인하였다. 결과: 복강 내 간세포이식 후 6시간째 담즙에서 결합형 빌리루빈이 나타나기 시작하였고, 4일째 정점을 이룬 후 점차 감소하였다. 담즙 내 검출량은 간세포만을 투여 받았던 1군이나 비실질간세포를 동시에 투여 받았던 2군간에 차이가 없었으나, 검출기간은 1군이 2주까지 검출된데 비하여 2군은 4주까지 검출되었다. 혈청 총 빌리루빈은 1군이 이식 전 7.05±0.24 mg/dL에서 이식 2주째 5.98±0.46 mg/dL로 15.1% 유의하게 감소하였고(p=0.0395), 2군은 이식 전 6.92±0.20 mg/dL에서 2주째 5.62±0.35 mg/dL로 18.9%(p=0.0036), 3주째 6.08±0.37 mg/dL로 12.1% 감소되었다(p=0.0478). 형태학적 관찰에서는 알부민 mRNA 발현세포가 1군에서 2주까지만 관찰된 반면 2군에서는 4주까지 관찰이 가능하였다. 결론: 복강 내 이식된 간세포는 수 시간 내 기능이 나타났고 이식 4일째 최대로 발현되었으나, 점차 감소하기 시작하여 2주 이후에는 기능이 관찰되지 않았다. 그러나 비실질간세포를 동시에 이식한 경우 간기능 발현은 3주까지, 간세포의 생존은 4주까지 연장시킬 수 있었다. Background: Transplantation of primary hepatocytes (PH) has been shown to provide metabolic support during acute liver failure. However, PH are known to be subject to necrosis in the peritoneal cavity. This is because cell-cell interaction plays an important role in their survival, but the peritoneal cavity can not provide such an environment. We tried to improve the survival of PH by simultaneously transplanting nonparenchymal liver cells (NPL). Methods: PH from normal Wistar rats, either alone (10(9) cells/kg, group 1, n=10) or mixed with NPL (5×10(8) cells/kg, group 2, n=10) were transplanted into the peritoneal cavity of hyperbilirubinemic Gunn rats which are congenitally devoid of bilirubin glucuronidation. Liver cells from Gunn rats were transplanted as a control. Results: Bilirubin glucuronides (BG) were detected in the bile of both group 1 and 2 rats collected at 6 hours after transplantation, and reached peak levels in 4 days. However, in the third and fourth week, BG could be detected only in group 2 animals. The serum bilirubin levels were decreased by 12.1~18.9% of basal levels in the second and third week for group 2 rats, but decreased by 15.1% only in the second week for the group 1 rats. Using in situ hybridization, albumin mRNA positive cells could be detected until the fourth week for the group 2 animals, but only until the second week for the group 1 rats. Conclusions: PH start functioning in a short time after intraperitoneal transplantation and simultaneous transplantation of NPL with PH can prolong the survival and function of transplanted hepatocytes. (Korean J Med 72:162-171, 2007)
위암의 예후인자로서 혈장 혈관내피 성장인자와 염기성 섬유모세포 성장인자의 의의
장영운 ( Young Woon Chang ),장은정 ( Eun Jeong Jang ),장재영 ( Jae Young Jang ),정용희 ( Yong Hee Jung ),이병욱 ( Byoung Wook Lee ),한요셉 ( Yo Seb Han ),동석호 ( Seok Ho Dong ),김효종 ( Hyo Jong Kim ),김병호 ( Byung Ho Kim ),이 대한소화기학회 2003 대한소화기학회지 Vol.41 No.5
Background/Aims: Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) are important angiogenic factors. The aim of this study was to measure the plasma level of VEGF and bFGF in patients with gastric cancer and to compare them with those of normal controls. Additionally, we examined the relationship between cancer progression and the levels of VEGF, bFGF, serum CEA and CA19-9. Methods: A total of 108 subjects including 62 normal controls and 46 patients with gastric cancer were recruited. Then, the patients were classified into 3 groups: early cancer group (stage I), advanced gastric cancer group (stage II & III) metastatic gastric cancer group (stage IV). Plasma VEGF and bFGF were measured by ELISA. Serum CEA was measured by radioimmunoassay, and serum CA19-9 was measured by microparticle enzyme immunoassay. Results: Plasma levels of VEGF and bFGF were higher in patients with gastric cancer than in normal controls (p<0.001). Furthermore, patients with metastatic gastric cancer have much higher plasma VEGF and bFGF levels than patients with early and advanced gastric cancer. Serum CA19-9 level was higher in metastatic gastric cancer compared with those of other two groups (p<0.001). The cut-off value of VEGF was 50.5 pg/mL and the cut-off value of bFGF was 19 pg/mL to discriminate the patients with gastric cancer from controls. Conclusions: Plasma VEGF and bFGF as well as serum CA19-9 could be useful markers for gastric cancer progression, especially in metastatic gastric cancer. (Korean J Gastroenterol 2003;41:351-357)
헬리코박터 파이로리 제균 전후의 위액 내 암모니아와 표피성장인자 농도의 변화
장재영 ( Jae Young Jang ),장영운 ( Young Woon Chong ),최선영 ( Sun Young Choi ),김남훈 ( Nam Hoon Kim ),임근우 ( Keun Woo Lim ),정용희 ( Yong Hee Jung ),한요셉 ( Yo Seb Han ),동석호 ( Seok Ho Dong ),김효종 ( Hyo Jong Kim ),김병호 대한소화기학회 2004 대한소화기학회지 Vol.43 No.5
Background/Aims: Helicobacter pylori (H. pylori) infection is the cause of peptic ulcer diseases, and gastric cancer. Hydrolysis of urea generating ammonia may cause cytotoxic effects on the gastric epithelium. The ammonia may induce the synthesis of epidermal growth factor (EGF) in gastric epithelium as an adaptive cytoprotective mechanism. The first aim was to examine the concentration of ammonia and EGF in gastric juice before and after H. pylori eradication in functional dyspepsia patients. The second aim was to examine the correlation among ammonia concentration, EGF concentration, and inflammatory score of gastritis. Methods: The concentration of ammonia and EGF were measured by ELISA. The grade and severity of gastritis were measured according to the updated Sydney system. Results: The concentration of ammonia in gastric juice was much higher in the H. pylori positive subjects (10,787±6,584㎛ol/L) than in the negative subjects (2,339±1,158㎛ol/L, p<0.0001). The concentrations of EGF in gastric juice was much higher in the positive subjects (1,462±393pg/㎖) than in the negative subjects (1,088±499pg/㎖, p<0.005). The concentration of ammonia and EGF in gastric juice showed significant correlation (r=0.63, p<0.0001). The concentrations of ammonia and histologic severities showed significant correlation (r=0.41, p<0.0001). Moreover, the level of EGF in gastric juice and histologic severities showed positive correlation (r=0.20, p<0.005). Conclusions: As the concentration of ammonia in gastric juices increased, the concentration of EGF was also increased in functional dyspepsia with H. pylori infection. The concentration of EGF in gastric juice may play a role in the adaptive cytoprotection in H. pylori- induced gastritis. (Korean J Gastroenterol 2004;43:283-290)
김병호(Byung Ho Kim),정용희(Young Hee Joung),장영운(Young Woon Chang),민선기(Sun Kee Min),문주영(Ju Young Moon),한요셉(Yo Seb Han),이동근(Dong Keun Lee),동석호(Seok Ho Dong),김효종(Hyo Jong Kim),이정일(Jung Il Lee),장린(Rin Chang) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.4
Alendronate (Fosamax), an aminobisphosphonate and a selective inhibitor of osteoclast-mediated bone resorption, is used to treat postmenopausal osteoporosis and Paget's disease. In recent years, reports of severe esophageal injury in patients who took alendronate have evoked attention to the irritant effects of this drug on the mucosa of the upper gastrointestinal tract. We present a case of gastric ulcer caused by alendronate. The patient chiefly complainted of epigastric pain during 14 days. She had taken mefenamic acid for pain control for 3 years and she took once-weekly 70 mg of alendronate for 2 weeks for treatment of osteoporosis before the symptom started. Upper gastrointestinal endoscopy revealed two active gastric ulcers in the low body. The results of rapid urease test (CLO test) and modified Giemsa test for the detection of Helicobacter pylori infection were negative. After withdrawal of alendronate, the symptom resolved completely in one week. Six weeks later, follow-up endoscopy showed complete healing of the ulcer. (Korean J Gastroenterol 2001;38:284-287)
장재영 ( Chang Jae Young ),김효종 ( Kim Hyo Jong ),김완중 ( Kim Wan Jung ),정용희 ( Jung Yong Hee ),이병욱 ( Lee Byoung Wook ),한요셉 ( Han Yo Seb ),동석호 ( Dong Seok Ho ),김병호 ( Kim Byung Ho ),장영운 ( Chang Young Woon ),이정 대한소화기학회 2003 대한소화기학회지 Vol.42 No.1
Pouchitis, a non-specific acute inflammation occurring in the ileal pouch, is one of the most common complications developed after the restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) performed for the treatment for the patients with ulcerative colitis and familial adenomatous polyposis. The prevalence of pouchitis is known to range from 20% to 50%. One to two percent of the cases are chronic and resistant to the drug therapy. The effective treatment for this chronic resistant pouchitis is to remove the ileal pouch and perform the permanent ileostomy. Hereby, we report one case of chronic pouchitis resistant to multiple drug therapy developed after IPAA performed for the treatment of ulcerative colitis in a patient. (Korean J Gastroenterol 2003;42:72-76)
대뇌 핍지교종이 동반된 Turcot 증후군 1예의 유전학적 분석
김한수 ( Han Soo Kim ),박지영 ( Ji Young Park ),김효종 ( Hyo Jong Kim ),지성길 ( Sung Gil Chi ),김윤화 ( Yoon Hwa Kim ),이길연 ( Kil Yeon Lee ),정용희 ( Yong Hee Joung ),한요셉 ( Yo Seb Han ),동석호 ( Seok Ho Dong ),김병호 ( Byung 대한장연구학회 2003 Intestinal Research Vol.1 No.2
Turcot`s syndrome (TS) is a genetic disease characterized by primary brain tumor, colon cancer and/or multiple colorectal polyps. The mode of genetic transmission of the syndrome still remains unclear because TS is a rare disorder. The majority of central nervous system (CNS) neoplasms associated with TS are glioma, glioblstoma multiformes and medulloblastoma. Other types of CNS tumors related to TS have been noted in a few case reports, and there are only two reports of oligodendroglioma associated with TS. To the authors` knowledge, this is the first case of a patient with TS who had a cerebral oligodendroglioma and a colorectal adenocarcinoma in Korea. Therefore, the authors performed genetic analysis of this patient and her family to determine the genetic variants, including mutations in APC gene and mismatch repair gene, in Turcot`s syndrome. (Intestinal Research 2003;2:192-196)