Virus 성 간염의 (肝炎) 임상적 (臨床的) 관찰

김종극(Jong Guk Kim),고광도(Kwang Do Koh) 대한소화기학회 1971 대한소화기학회지 Vol.3 No.2

N/A Author has studied 100 subjects of the viral hepatitis who admitted to the department of Gast- roenterology 'of Woo!Sok University Medical College frorn August, 1969 to August, 1971. In this 100 subjects, men were 53 and v:omen 47 in number. Blood collection for liver functiorz tests were performed after an over night fast, The results vvere as follows; Of 100 subject diagnosed viral hepatitis, chronic hepatitis contained 43 subjects (43%), infectious hepatitis 38(38%), cholangiolitic hepatitis 8(8%), nonicteric hepatitis 6(6%), fulminant hepatitis 4(4%) and serum hepatitis 1(1%). 2, Seasonal trend: The most frequent onsets were observed in May and June with 12% and 13% each in frequency. The lowest frequency was observed in January (4%). 3, Age: The most of the cases were noted at 30 to 39 years of age (26%), 4, Sex: The difference between both sexes in frequency was not observed. 5. Symptoms and signs: Upper abdominal pain and discomfort were most frequently complainect of 37% and hepatomegaly were the commomest physical signs 49%. G. Serum alpha-l, alpha-2, beta and gamma globulins were increased and had frequencies of 16%, 21%, 13% and 31% each. 7. Stab, neutrophils were increased in 58% of cases and lymphocytes were also increased in 51% of cases.

반복되는 담도성 산통을 호소하는 환자에서 담관내압검사와 담낭스캔의 의의

김재선(Jae Seon Kim),정문기(Moon Gi Chun),이성준(Seong Jun Lee),김경민(Kyoung Min Kim),변관수(Kwan Soo byun),박영태(Young Tae Bak),김진호(Jin Ho Kim),김종극(Jong Guk Kim),이창홍(Chang Hong Lee) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.5

N/A Background/Aims: Tbis study was aimed to evaluate the clinical significance of the sphincter of Oddi manometry (SOM), cholescintigraphy, endoscopic sphincterotomy(EST), and cholecystectomy in patients complaining of recurrent biliary-type abdominal pain. Methods: 20 patients with recurrent biliary-type abdominal pain not explained by conventional diagnostic studies were sampled. All the patients with manometrically verified sphincter of Oddi dystunction(SOD) and some patients with normal or failed manometry underwent EST. Among those with normal or failed manometry laparoscopic cholecystectomy was performed to patients with acalcu)ous cholecystopathy(ACP) diagnosed by cholescintigraphy. Results: Of 26 sessions of SOM tried in all the 20 cases, 2l sessions in 17 cases were technically successful. Among those 17 patients, SOM was abnormal in 9 cases(6:sphincter of Oddi dyskinesia; 3:sphincter of Oddi stenosis). Four of five patients undergoing cholescintigraphy in patients with normal or t'ailed manometry were verified as ACP. The procedure-related pancreatitis occurred in 7/26 sessions after SOM and in 3/12 sessions after EST. In 1 case, a micro-perforation followed EST. All these patients with complications recovered uneventfully. Mean duration of fo]low-up was 13.5(range 7 -24) months. EST was of benefit to 7 of 9 patients with manometrically verified SOD and also to all 3 patients with normal or failed manometry undergoing EST. Laparoscopic cholecystectomy was of henefit to all 3 patients with ACP undergoing cholecystectomy. Conclusions: Extensive diagnostic procedures such as SOM and cholescintigraphy and proper therapy according to their results should be considered with patients complaining of recurrent biliary-type abdominal pain not explained by other conventional diagnostic studies. (Korean J Gastroenterol 1995;27: 563 - 572)

내시경 검사시 Phenol Red 분무에 의한 Helicobacter pylori 감염 진단의 의의

김종극(Jong Guk Kim),이창홍(Chang Hong Lee),박영태(Young Tae Bak),김진호(Jin Ho Kim),원남희(Nam Hee Won),김재선(Jae Seon Kim),변관수(Kwan Soo byun) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.1

N/A A strong association between Helicobacter pylori (H. pylori) and chronic active inflammation of the gastric antrum and duodenal ulceration has been recognized. Although various rnethods have been proposed to detect this microorganism, no unanimity exists among investigators concerning which method represents a gold standard. H. pylori producee urease that converts urea to ammonia which then raises the pH, therefore we have utilized an endoscopic spray technique using phenol red (pH indicator) in vivo to assess H. pylori infection itself and its distribution. 87 patients with dyspepsia were pre-medicated with ranitidine 150 mg p.o. 3 houre before endoscopy to maintain a gastric pH between 3-6. During endoscopy, 20 ml of a mixture containing 0.05% phenol red and 0.5% urea was sprayed over the antral mucosa using a spray catheter. It was defined as positivc if any area of the mucosa turned red within 3 min after spraying. Antral biopsies were taken from all patients. Biopsies were assessed in a blind fashion after H&E, Giemsa and Warthin-Starry silver stain. The phenol red positive patients were 54.0%, and diffuse pattern of positive staining was 85.1% and regional pattern was 14.9%. Diagnostic sensitivity and specificity of the endoscoic spray technique were 87.2%. and 85.0% respectively. In conclusion, the endoscopic phenol red spray technique may be one of the simple and useful screening tests for diagnosis of H. pylori infection and for dilineating its probahle pattern of distributionvn gastric mucosa in vivo, but this method seems not useful for confirmatory diagnosis of H. pylori infection and needs further study.

하부대장 과형성 용종의 의의

김종극(Jong Guk Kim),이창홍(Chang Hong Lee),박영태(Young Tae Bak),김진호(Jin Ho Kim),김재선(Jae Seon Kim),변관수(Kwan Soo byun),지종대(Jong Dae Ji),송훤택(Hwun Taig Song) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.4

N/A Adenomatous polyps are known to be precursors for cancer, and identifying of persons with adenomatous polyps is practically important because these individuals should constitute a disproportionate percentage of persons destined to have colorectal cancer. There is enough reason to believe that regclar endoscopic screening of persons with adenomatous polyps and removal of these polyps can reduce the incidence of colorectal cancer. But hyperplastic colonic polyps are generally regarded as being of little or no clinical consequence. Recentlyl, however, controversy has not been settled down on the significance of distal colonic hyperplastic polyp as a marker for proximal colonic adenomatous polyp (s). To establish the prevalence of proximal neoplasms in subjects with or without hyperplastic polyps in distal colon and to determine whether the presence of hypcrplastic polyps in the distal colon could serve as a market for proximal synchronous adenomatous colonic polyps, we prospectively analyzed 895 consecutive subjects who were examined with colcnoscopy between March 1990 and October l992. 191 of 895 subjects (21.4%) had one or more colonic polyps. The prevalence of adenomatous polyps alone was 10.2% hyperplastic polyps 8.4%, and both 1.9%. The proportion of subjects with both proximal adenomatous polyp and distal hyperplastic polyps (6.0%) was not significantly different from the proportion of those without distal hyperplistic polyps(5.1%), But subjects with distal adenomatous polyps (s) were si!nificantly more likely to have proximal adenomatous polyp (s) than those without distal adenomatous polyp (s). The result of this study suggests that hyperplastir. polyps of distal colon do not serve as a marker for neoplastic polyps of proximai colon.

저용량 Amoxicillin , Metronidazole , Omeprazole 병합투여에 의한 소화성궤양의 치료

김재선(Jae Seon Kim),박영태(Young Tae Bak),김진호(Jin Ho Kim),김종극(Jong Guk Kim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3

N/A Background/Aims: Anti-Helicobacter pylori(H. pylori) therapies with few side effects are needed. We studied the effectiveness of low dose combination of amoxicillin, metronidazole, and omeprazole for treatment of ulcer patients. Methods: Patients with gastric or duodenal ulcer received amoxicillin(500 mg b.I.d.), metronidazole(125 mg b.I.d.), aod omeprazole(20 mg at bedtime) for 2 weeks. Endoscopic examinations were perforrned before treatment and at 4 weeks, 3 months, 6 months, 9 months and 1 year after ending antimicrobial therapy. H. pylori status was confirmed by CLO test. Results: 91 patients(72 men and 19 women) with a mean age of 45.2 years(range 19-81) were enrolled. There were 54 Dus, 32 Gus, and 5 with both. At 2 weeks, the compliance rate was 100%, and no side effects was noted. Of 69 patients(40 Dus, 25 Gus, and 4 with both) who had undergone endoscopy at 4 weeks after ending antimicrobial therapy, the ulcer healed in 55 patients(34 Dus, 19 Gus, and 2 with both), and H. pylori infection was cured in 49 patients(27 Dus, 19 Gus, and 3 with both). And so the healing rate of ulcer and cure rate of H, pylori at 4 weeks after ending antimicrobial therapy was 79.7%(DU 85.0%, GU 76.0%, and Both 50%) and 71.0%(DU 67.5%, GU 76.0%, Both 75%) respectively. 28(18 Dus, 9 Gus, and 1 Both) of the healed ulcer patients in whom H. pylori had been cured had been followed respectively up for 1 year; ulcer recurrence and H. pylori reoccurrence were 2(1 DU, 1 GU) and 3(1 DU, 2 Gus), thus ulcer recurrence and H. pylori reoccurrence was 7.1% and 10.7%, respectively. 8 patients(7 Dus, 1 GU) of the healed ulcer patients in whom H. pylori had not been cured were followed up during 1 year; there were 6 ulcer recurrences(6 Dus), and so ulcer recurrence was 75.0%, but natural eradication of H. pylori was not. Conclusions: The combination of amoxicillin, metronidazole, and omeprazole even at the low dose prescribed may be one of an effective therapy regimen with excellent compliance rate for peptic ulce.r. (Korean J Gastroenterol 1997;29:301 - 309)

제48차 대한내과학회 추계학술대회초록집 : 심포지움 ; Helicobacter pylori의 최신지견 : Helicobacter pylori와 위,십이지장궤양의 치료

김종극 ( Jong Guk Kim ) 대한내과학회 1996 대한내과학회지 Vol.51 No.2S

제48차 대한내과학회 추계학술대회초록집 : 심포지움 ; Helicobacter pylori의 최신지견 : Helicobacter pylori와 위,십이지장궤양의 치료

김종극 ( Jong Guk Kim ) 대한내과학회 1996 대한내과학회지 Vol.51 No.-

담관내압 측정검사로 진단한 Oddi 괄약근 협착

김재선(Jae Seon Kim),조은래(Eun Rae Jo),권소영(So Young Kwon),변관수(Kwan Soo byun),박영태(Young Tae Bak),김진호(Jin Ho Kim),김종극(Jong Guk Kim),이창홍(Chang Hong Lee) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.1

Unexplained chronic and recurrent biliary type abdominal pain, with or without prior histo- ry of cholecystectomy, in the absence of structural changes in pancreatobiliary anatomy is often attributed to an abnormal pressure profile of the sphincter of Oddi. This symptom com- plex is often attributed to the syndrome of sphincter of Oddi dysfunction. The diagnosis of this disorder has been suggested by the symptom compex, exclusion of anatomic biliary tract disease, dilatation of common bile ducts or delayed drainage of contrast media from the bile ducts during the endoscopic retrograde cholangiography. But, more recently developed tech- nique, endoscopic manometry of the sphincter of Oddi, appears to be most sensitive for detect- ing increases in biliary sphincter pressures, even in the presence of nondilated bile ducts. This syndrome may be further subdivided into sphincter of Oddi stenosis that indicates a structual narrowing of the sphincter of Oddi and sphincter of Oddi dyskinesia that is defined as abnormal sphincter of Oddi motor activity. The basal pressure, which is elevated in both stenosis and dyskinesia of the sphincter of Oddi, is the most widely agreedupon abnormality. Administration of smooth muscle relaxants may help to distinguish between the two enti- ties; these agents do not have any effect on a fixed stenosis but may inhibit the elevated sphincter tone in dyskinesia. 3Ve report a case of the sphincter of Oddi stenosis diagnosed by biliary manometry. (Korean J Gastroenterol 1994; 26: 200 205)

증례 : Kwashiorkor 1 예

김종극 ( Jong Guk Kim ),고광도 ( Kwang Ko Koh ) 대한내과학회 1973 대한내과학회지 Vol.16 No.11

Authors report a case of kwashiorkor which is very rare in this country. A 13 year-old male child was admitted to Gastroenterology, Medical College of Korea University complaining of abdominal distention for recent 2 months. He has lived about 10 years on

장결핵의 감별진단에 있어서 3 개월 추적 대장내시경 검사의 의의

연종은(Jong Eun Youn),박이병(Ie Byung Park),권소영(So Yung Kwon),김재선(Jae Seon Kim),변관수(Kwan Soo Byun),박영태(Young Tae Bak),김종극(Jong Guk Kim),이창홍(Chang Hong Lee),김진호(Jin Ho Kim) 대한내과학회 1996 대한내과학회지 Vol.50 No.2

N/A Objectives: A therapeutic trial with antituberculous drugs is reasonable if the clinical and colonoscopic features are compatible, in countries with a high prevalence of intestinal tuberculosis. But Crohn's disease, lymphoma and other infectious disease should be differentiated from the disease. There have been no established monitoring modalities to assess the efficacy of the therapeutic trial and to differentiate these diseases yet. Therefore, this study was done to assess the usefulness of follow-up colonoscopy at 3 months of antituberculous treatment as a monitoring modality. Methods: 42 patients with tentative diagnosis of intestinal tuberculosis which was made on the basis of clinical and colonoscopic findings were enrolled, The patients were divided into 2 groups according to the symptomatic improvement after the therapy : (A) 30 patients with improved symptom : (B) 12 patients with persistent symptom. Colonoscopy with biopsy was performed before and at 3 months of therapeutic trial. Standard four-drug antituberculous chemotherapy was done at least for 9 months and patients were followed for more than a year after completion of therapy. Final diagnoses were made on the basis of satisfactory outcome of therapeutic trial, operative findings and another follow-up colonoscopy. Results: 1) colonscopic findings at 3 months of therapy improved in 31 cases. 27 of them were finally diagnosed as tuberculosis, 1 was as ulcerative colitis and 3 were lost. Among 11 endoscopically unimproved cases, 7 were finally diagnosed as Crohn's disease, 2 were as tuberculosis and 2 were lost. 2) 27 of 29 patients with final diagnosis of intestinal tuberculosis improved colonoscopically at 3 months of therapy. 2 unimproved cases had a complicated disease(stenosis) or an atypical mycobacterial infection, respectively. 3) In group A, 1 was diagnosed as ulcerative colitis and in group H, 3 were diagnosed as tuberculosis finally. Conclusion: Follow-up colonoscopy at 3 months of antituberculous therapeutic trial in patients with tentative diagnosis of intestinal tuberculosis seems to be a valuable modality for monitoring the efficacy of therapy and differentiating intestinal tuberculosis from other diseases.