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      • SCOPUSKCI등재

        관류법과 비관류법 식도내압검사의 성적 비교

        김경민(Kyoung Min Kim),송치욱(Chi Wook song),엄중식(Joong Sik Aum),진윤태(Yoon Tae Jeen),문정섭(Jeong Seop Moon),엄순호(Soon Ho Um),김창덕(Chang Duck Kim),류호상(Ho Sang Ryu),현진해(Jin Hae Hyun) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.5

        Background/Aims: Esophageal manometry is regarded as the gold standard in diagnosing the esophageal motility disorders. As manometric results are variable according to the methods and systems employed, we have had difficulty in comparing the manometric results measured by different methods and/or systems. To compare the results of esophageal manometry between infusion and non-infusion systems, we performed infusion manometry and non-infusion manometry. Methods: In 32 healthy volunteers and 108 patients with esophageal symptoms, we performed both low compliance pneumohydraulic capillary infusion manometry using 8 channel PVC catheter and non-infusion manometry using solid catheter in random order. Results: In healthy volunteers the manometric results were not significantly different between the two systems except the lower esophageal sphincter pressure, which was significantly higher in infusion system than in non-infusion system. In 108 patients complaining esophageal symptoms, the manometric diagnoses were different in 12 cases between the two systems; 5 cases were normal and nonspecific esophagea1 motility disorder, 3 cases were nonspecific esophageal motility disorder and nc>rmal, and 4 cases were hypertensive lower esophageal sphincter and normal by infusion system and non-infusion system respectively. Conclusions: In healthy volunteers the measured lower esophageal sphincter pressure was significantly higher in infusion system than in non-infusion system. In some symptomatic patients, the different diagnoses were observed between infusion and non-infusion systems, We think that we should consider a possible variation in manometric results derived from the different manometric systems employed in different studies. (Korean J Gastroenterol 1996; 28: 611 - 616)

      • SCOPUSKCI등재

        담낭 결핵 1예

        현진해(Jin Hai Hyun),송치욱(Chi Wook song),류호상(Ho Sang Ryu),김창덕(Chang Duck Kim),진윤태(Yoon Tae Jeen),이홍식(Hong Sik Lee),엄중식(Joong Sik Aum) 대한소화기학회 1998 대한소화기학회지 Vol.31 No.3

        Despite the marked decrease in frequency of tuberculosis in the world by advent of effective chemotherapy, gastrointestinal tuberculosis is relatively frequent in developing countries, Tuberculosis of the gallbladder is rarely reported in the literature. Definitive diagnosis will require surgical biopsy because of inconsistent clinical findings. Recently, we experienced a case of gallbladder tuberculosis, masquering as a carcinoma of gallbladder, and diagnostic confirmation was attained by histologic findings of laparoscopic biopsy and surgical specimen. A 69-year-old woman was admitted with right upper quadrant pain. Abdominal ultrasonography and computed tomography revealed a 2*2 cm sized soft tissue mass at the neck portion of the gallbladder. Cholecystectomy was done and the surgical specimen revealed tuberculosis of the gallbladder. (Korean J Gastroenterol 1998;31:383 - 386)

      • 용혈성 빈혈을 일으킨 풍진 1예

        정희진,김우주,김진용,엄중식,김민자,박승철 대한감염학회 1997 감염 Vol.29 No.4

        국내에서 1995년 이후 청소년 층에서 후천성 풍진이 유행되고 있는 상황에서 저자들은 풍진으로 진단되고 일시적 증상의 호전을 보였으나 수일후 발열, 두통, 어지러움증 등의 증상과 함께 발현된 용혈성 빈혈 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Rubella is a viral disease usually characterized by a benign febrile exanthem, manifested with fever, posterior occipital lymphadenopathy and Pinkish rash in children. Most cases are recovered without any sequelae. However, it may lead to serious cardiac and ocular congenital malformation and fetal death in pregnant woman. Additionally postnatal rebella can be unusually complicated by encephalitis, meningitis, thrombocytopenic purpura, pneumonia and multiple organ disorder. Especially, hemolytic anemia following postnatally acquired rebella is very rare. Of the world, only twenty cases were reported in Japan during rebella outbreak from 1975 to 1977 and majority were Cooms' positive cases. But no case was reported until now in Korea. Resurgence of rubella hag been recognized among adolescences in Korea since 1995. We experienced an adolescent patient with Coombs'-negative hemolytic anemia following rebella infection who has recorverd by conservative management. We report the case with a review of literatures.

      • SCOPUSKCI등재

        내시경적 유두괄약근절개술과 담췌관조영술시 침형절개도의 효율성과 안전성

        이정용,김진호,김진용,김재선,변관수,박영태,김종극,엄중식 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3

        Background: Conventional endoscopic sphincterotomy with papillotome(CES) is an established method of management for patients with biliary obstruction from various causes. However, an alternative treatment to CES must be considered when antecedent cholangiagraphy is unsuccessful or when cannulatian with the conventional papillotome fails. The needle-knife papillotomy(NKP) is one of the alternative methods to CES. Recently, it has been suggested that NKP can be used to achieve diagnostic cholangiography. But NKP is controversial because results from studies assessing its efficacy and safety are conflicting. The current study was undertaken to assess retrospectively the efficacy and safety of NKP and CES. Methods: All enrolled patients(CES group 113, NKP group 105) underwent ERCP between September 1993 and August 1996 at Korea Univeisity Guro Hospital. NKP for cannulation was used only when biliary tract disease was suspected but deep canulation failed inspite of several attempts. The efficacy and safety of NKP and CES were evaluated according to the rate of success of performing purposes(removal of common bile duct stones, inser tion of endoscopic nasobiliary drainage or endoprosthesis, treatment of sphincter of Oddi dysfunction, and cannulation) and complications(bleeding, perforation, pancreatitis). Results: 1. Overall success rates of performing purposes were 92.9% in CES group(removal of common bile duct stones 95.2%, insertion of endoscopic nasobiliary drainage ar endoporsthesis 84.6%, treatment of sphincter of Oddi dysfunction 100%) and 80.0% in NKP group(removal of common bile duct stone 86.7%, insertion of endoscopic nasobiliary drainage or endoprasthesis 80.6%, treatment of SO dysfunction 100%, cannulation 70.6%). The success rate of CES was significantly higher than that of NKP(p=0.04). 2. The morbidity rate of NKP was 10.5%(8 bleeding cases, 1 perforation case, 2 pancreatitis cases) but was not significantly different from that of rate for CES 8.0%(9 bleeding cases). 19 patients with camlrlicatias recovered uneventfully with corvative treatment. Only 1 pexient(arttpollary carcinoma) undertwent opexation due to severe bleedg afrer NKP. There was no procedure-related mortality in both groups. Conclusion: NKP is an effective endoscopic tool allowing successful endoscopc sphincrerotomy whem conventional technique fails. And, in carefully seleiected cases, NKP is a useful aid for a successful diagnostic Gholangiography.

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