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기능성 소화불량증 환자에서 자율신경 기능장애에 관한 연구
박동일(Dong Il Park),이풍렬(Poong Lyul Rhee),이용욱(Yong Wook Lee),김지은(Jee Eun Kim),현재근(Jae Geun Hyun),김창섭(Chang Sup Kim),장재권(Jae Kwon Jang),심상군(Sang Goon Shim),성인경(In Kyung Sung),김영호(Young Ho Kim),손희정(Hee Jun 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.2
N/A Background/Aims : The role of autonomic dysfunction in patients with functional dyspepsia has not been completely understood. The purposes of our study are (1) to prospectively assess the abnormalities of the autonomic function in patients with functional dyspepsia and (2) to assess whether the presence of autonomic dysfunction in patients with functional dyspepsia correlates with the presence of visceral hypersensitivity or with the severity of dyspeptic symptoms. Methods : Twenty eight patients with functional dyspepsia (4 men and 24 women; age range, 29-57) and 14 healthy volunteers without gastrointestinal symptoms (6 men and 8 women; age range, 23-61) were included in this study. All patients and controls were submitted to a battery of five standard cardiovascular autonomic reflex tests and gastric barostat tests. A modified version of the Glasgow Dyspeptic questionnaire was used in this study. Results : (1) Autonomic function tests showed that both sympathetic and parasympathetic scores of dyspeptic patients were significantly higher than those of the control group. (2) Visceral hypersensitivity could be confirmed in some of our dyspeptic patients in response to proximal gastric distension, demonstrating lower pain threshold in this group. (3) We could not find significant association between the presence of autonomic dysfunction and the presence of visceral hypersensitivity or severity of dyspeptic symptoms in patients with functional dyspepsia. Conclusion: Autonomic dysfunction was more prevalent in dyspeptic patients than in the control group. However, it did not correlate with the presence of visceral hypersensitivity or severity of dyspeptic symptoms. It is suggested that a defect in the spinal region or at the CNS level may be a major mechanism of visceral hypersensitivity in functional dyspepsia.
이종철,김영호,이상수,문원,박동일,김재준,최규완,백승운,이풍렬,심상군,이경수,성인경,구진하,류봉춘 대한소화기내시경학회 2000 Clinical Endoscopy Vol.21 No.6
Gastric tuberculosis is quite rare and usually combined with pulmonary tuberculosis. Its diagnosis is so difficult as it is often unsuspected, We report a patient with gastric tuberculosis who presented with hematemesis in Korea, Upper endoscopy showed large, deep penetrating ulcer containing an exposed vessel and adherent clot in the body. Gastric biopsies revealed only chronic inflammation and no evidence of granuloma or malignancy. Diffuse mural thickening was noted on abdominal CT. The diagnosis was made postoperatively following gastrectomy for bleeding gastric ulcer. Microscopic examination of resected stomach showed peptic detritus and noncaseating granulomas. However, multiple caseating granulomas with Lagerhan's giant cells were found on the examination of lymph nodes. The patient was treated with antituberculous therapy for 12 months without any complications.
기능성 소화불량증 환자에서 자율신경 기능 이상과 위배출시간의 연관성
이종철,김영호,김창섭,손희정,박동일,김재준,최규완,백승운,고광철,이풍렬,이문규,김지은,심상군,현재근,성인경,장재권,이경한 대한소화기학회 2000 대한소화기학회지 Vol.36 No.5
Background/Aims: Autonomic nerve dysfunction may be responsible for the pathophysiologic mechanisms of various functional gastrointestinal disorders including functional dyspepsia. We evaluated whether the autonomic nerve dysfunction is related with delayed gastric emptying time. Methods: Forty patients (M:F=11:29, mean age=42.9 years) with functional dyspepsia and 14 asymptomatic controls (M: F=6:8, mean age=41.9 years) were enrolled in this study. Autonomic nerve function was measured by a standardized battery of five cardiovascular reflex tests. Gastric emptying time of solid meal was measured by scintigraphic method and expressed as the retention rate at 120 minutes (RR120). Results: RR120 was greater in the patients group than in the controls (48.1±19.7% vs 28.3±14.1%). Definite, severe, and atypical abnormal autonomic nerve functions were observed in 45% (18/40) of the patients group but not in the controls. The controls showed normal or early abnormality (5/14). Autonomic nerve dysfunction was not reted to delayed gastric emptying (p=0.42) and there was no significant correlation between the autonomic score and RR120 (p=0.55). Conclusions: Patients with functional dyspepsia had significant autonomic nerve dysfunction, as compared to asymptomatic controls. However, autonomic nerve dysfunction was not related with delayed gastric emptying time.