Helicobacter pylori 일차 삼제 제균요법의 연도별 제균율 분석: 단일 기관의 최근 8년 성적

최유식 ( You Sik Choi ),천재희 ( Jae Hee Cheon ),이종열 ( Jong Yeul Lee ),김상균 ( Sang Gyun Kim ),김주성 ( Joo Sung Kim ),김나영 ( Na Young Kim ),이동호 ( Dong Ho Lee ),김정목 ( Jung Mogg Kim ),정현채 ( Hyun Chae Jung ),송인성 ( 대한소화기학회 2006 대한소화기학회지 Vol.48 No.3

목적: 최근 H. pylori의 항생제 내성률이 증가하고 있으나, H. pylori 일차 삼제요법에 의한 제균율의 변화 추세에 대한 연구는 없다. 이번 연구에서 단일기관의 최근 8년간 H. pylori 제균율의 변화 추세를 조사하였다. 대상 및 방법: 1998년 1월부터 2005년 10월까지, H. pylori 양성인 소화성 궤양을 진단 받고 일주일간 일차 제균요법을 시행한 525명의 환자의 제균율을 연도, 사용 약제, 궤양 위치에 따라 후향으로 조사하였다. 결과: 전체 환자의 H. pylori 제균율은 78.7%였다. 질병 상태와 치료 약제에 따른 제균율의 차이는 없었다. Per-protocol 분석에 의한 연도별 제균율은 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005년에 각각 83.7%, 80.4%, 81.4%, 78.8%, 75.3%, 77.6%, 78.9%, 77.6%였다. 최근 8년간 현저한 제균율의 감소를 나타내는 통계적인 증거는 없었으나(p=0.419), 최근 5년간의 H. pylori 제균율은 그 이전 3년에 비해 낮았다. 결론: 최근 8년간 H. pylori 제균율의 현저한 감소를 나타내는 통계적인 증거는 없었으나, 최근 5년간 제균율은 80% 미만으로서 향후 지속적인 제균율 감소가 예상되므로 제균율 감소 추세에 대한 면밀한 관찰이 필요할 것으로 생각한다. Background/Aims: The prevalence of antibiotic resistance in Helicobacter pylori (H. pylori) infection has been reported to be increasing. However, the recent trend of eradication rates of H. pylori using first-line triple regimens has been rarely issued. Therefore, we aimed to determine the trend of H. pylori eradication rates in single center for recent eight years. Methods: From January 1998 through October 2005, H. pylori eradication rates in 525 patients with H. pylori-positive peptic ulcer disease who received one-week triple regimens were retrospectively evaluated according to years, regimens, and ulcer locations. Results: The overall H. pylori eradication rate was 78.7%. Yearly eradication rates from the year 1998 to 2005 were 83.7%, 80.4%, 81.4%, 78.8%, 75.3%, 77.6%, 78.9% and 77.6% consecutively by per-protocol analysis, However, no definite evidence of decreasing tendency of eradication rate was seen during the past eight years (p=0.419). Furthermore, there was no significant difference in the eradication rates according to the ulcer locations and regimens. Conclusions: Although it is found that there is no definite statistical evidence of decreasing trend for H. pylori eradication rate during past eight years, those for recent 5 years were lower than 80%, which suggests that we should scrutinize the trend of first-line H. pylori eradication rate, and concern for the expected lower rates in the near future. (Korean J Gastroenterol 2006;48:156-161)

췌장의 Somatostatinoma 1예

최유식 ( You Sik Choi ),박주경 ( Joo Kyung Park ),이상협 ( Sang Hyub Lee ),윤원재 ( Won Jae Yoon ),이준규 ( Jun Kyu Lee ),류지곤 ( Ji Kon Ryu ),김용태 ( Yong Tae Kim ),윤용범 ( Yong Bum Yoon ) 대한소화기학회 2006 대한소화기학회지 Vol.48 No.5

Somatostatinoma is a rare neoplasm usually arising from the pancreas and duodenum which typically presents with indolent, nonspecific symptoms in the absence of systemic neuroendocrine manifestations that characterize somatostatinoma syndrome. It accounts for less than 1% of all gastrointestinal endocrine tumors with an annual incidence of 1 per 40 million. It is often associated with regional and/or portal metastasis at the time of diagnosis, and complete tumor resection is possible only in 60% to 70% of cases. We experienced a case of pancreatic somatostatinoma recently. A 51-year-old woman presented with right upper quadrant abdominal pain and loose stool for one month. A hypermetabolic lesion in the pancreatic head was detected on positron emission tomography-CT (PET-CT) scan. The tumor was resected by pylorus preserving pancreaticoduodenectomy. Immunohistochemical staining of the tumor tissue exhibited diffuse positivity for somatostatin, but was negative for insulin and glucagon. Herein, we report a case of pancreatic somatostatinoma diagnosed postoperatively. (Korean J Gastroenterol 2006;48:351-354)

좌심실 유출로 폐쇄를 동반한 비후성 심근증 환자에서 두심강 심박조율을 통한 치료 1예

최유식,한성식,권나영,박태진,이무용,김영권,이명용 대한순환기학회 2002 Korean Circulation Journal Vol.32 No.2

복수의 자율이동로봇의 협조운동에 관한 연구

정원갑,최유식,서호철,이석규,이달해 영남대학교 공업기술연구소 1999 工業技術硏究所論文集 Vol.27 No.2

This paper proposes a fuzzy algorithm for cooperative behaviors of multiple autonomous mobile robots. Each robot makes decision of his behavior based on the information obtained by ultrasonic sensors to measure the position and angles of other robots. To enhance the industrial applicability of the suggested algorithm, we add disturbances of error angle caused by wheel steering when autonomous mobile robot navigates toward next destination point. This algorithm uses the position and velocity information of both the nearest robot and other robots within the detective radius of sensor with different weighting. Based on the fuzzy rule table and fuzzy inference, we obtain the rotational angle of the robots. The effectiveness of the proposed algorithm is shown by some computer simulations where a group of mobile robots encircles with equi-interval. In addition each robots is given weighting value to avoid the wall. Finally, the suggested algorithm shows that the more robots exist, the more effective it is.

궤양성 대장염에서 확대색소내시경술 (Magnifying Chromoscopy)의 유용성

임창영,신정우,최유식 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.1

Background/Aims: Ulcerative colitis is an inflammatory bowel disease with unknown etiology, which has waxed and waned course. It is diagnosed by colon study, pathology, and especially colonoscopy. It is difficult to differentiate between ulcerative colitis and other infectious colitis, especially amebic colitis, and to confirm of remnant lesion by endoscopic findings. Methods: Magnifying colonoscopy has 100 time magnifying power compared to 30 time of conventional colonoscopy, By spraying 0,2% indigo carmine dye, we evaluated the magnifying and microscopic findings of 31 colonic mucosa of 23 patients with ulcerative colitis. Results: Initial and magnifying chromoscopic findings in ulcerative colitis were loss of cryptal opening 72% (13/18), loss of submucosal vessel 89% (16/18), mucosal denudation (or microscopic erosion) 83% (15/1S), and mucosal unevenness 94% (17/18). Recovery rate of magnifying chromoscopic findings after treatment in ulcerative colitis were in crytal opening S0% (+8/10), submucosal vascularity 60% (6/10), mucosal denudation (microscopic erosion) 30% (3/10), and in mucosal unevenness 40% (4/10). Conclusions: It is suggested that magnifying chromoscopic findings in ulcerative colitis may be useful in initial diagnosis and confirmation of remnant lesion, but, not in prediction of clinical severity.

양측성 신우신염에 동반된 급성 신부전 1 예

윤성철,김병하,조종태,탁우택,최유식 대한내과학회 2002 대한내과학회지 Vol.62 No.3

Acute renal failure is a rare complication of acute pyelonephritis. Therefore, acute pyelonephritis is not usually considered in the differential diagnosis of acute renal failure. However, it is import ant to consider this entity because of potential for recovery of renal function if appropriate early antibiotics are instituted. We report a case of biopsy pr oven acute pyelonephritis which was manifested as acute renal failure. A 38-year-old women was admitted to this hospital owing to abdominal distension and generalized edema. On admission she was started on hemodialysis because of severe hyperkalemia and marked uremic symptoms. She had pyuria and hematuria, but no organism was isolated at urine. We initially don't know the cause of renal failure. She was improved with antimicrobial therapy and hemodialysis. A kidney biopsy was performed on the 26th hospital day because of persistent proteinuria. Microscopic examination revealed focal tubular atrophy, necrosis or loss wit h heavy infilteration of leukocytes and histocytes in interstitium. Atrophic tubules contain pus casts. The patient was treated with ciprofloxacin for 4 weeks. At about 2 month follow up, proteinuria completely disappeared and serum creatinine level decreased to 1.0 mg/dL. (Korean J Med62:297- 301, 2002)

급성 신우신염에서 발생한 신피막하 혈종 2 예

박태진,윤성철,이연희,한성식,조종태,탁우택,최유식 대한내과학회 2001 대한내과학회지 Vol.61 No.6

Subcapsular renal hematoma without a history of trauma is uncommon, which has been reported with the association of underlying renal tumor, vascular or inflammatory disease. Recently, subcapsular renal hematoma has been reported to be a rare complication of acute pyelonephritis. If abdominal pain is acutely aggravated or hematocrit is rapidly decreased in the patient of acute pyelonephritis, subcapsular renal hematoma as a complication of acute pyelonephritis should be considered and confirmed by subsequent imaging studies. We report two cases of subcapsular renal hematoma as a complication of acute pyelonephritis.(Korean J Med 61:669-673, 2001)