담낭절제술이 오디조임근의 운동에 미치는 영향

류권호 ( Kwon Ho Ryu ),이준성 ( Joon Seong Lee ),천영국 ( Young Koog Cheon ),송해정 ( Hae Jung Song ),김연수 ( Yeon Soo Kim ),은수훈 ( Soo Hoon Eun ),김상균 ( Sang Gyun Kim ),장재영 ( Jae Young Jang ),홍수진 ( Su Jin Hong ),김영석 대한소화기기능성질환·운동학회 2007 Journal of Neurogastroenterology and Motility (JNM Vol.13 No.1

목적 : 오디조임근에 대한 통상적인 짧은 시간동안 측정하는 내시경적 내압검사법은 전반적인 오디조임근의 운동을 대변할 수 없다. 이러한 제한점을 극복하고 오디조임근 운동에 대한 담낭절제술의 효과를 평가하기 위해, 경피경간 담도배액관을 유치하고 있는 간내 담석만 있는 환자에서 오디조임근 내압검사를 시행하였다. 대상 및 방법 : 26명의 환자를 대상으로 금식상태에서 오디조임근 경피경간 내압검사를 시행하였다. 17명은 담낭절제술을 시행받은 간내 담석 환자였고, 9명은 정상대조군으로 이전에 담도계의 수술을 받은 적이 없는 간내 담석 환자였다. 4명의 환자에서는 처음 내압검사를 시행한 후 1-2주 지나 경피경간 오디조임근 내압검사와 동시에 위소장 내압검사를 시행하였다. 결과 : 평균 기록 시간은 108±51분이었다. 오디조임근 기저압은 담낭절제술을 시행한 군과 시행하지 않은 군에서 차이가 없었다. 오디조임근의 위상파 수축의 평균횟수, 위상파 수축의 형태에 따른 분포에 있어 담낭절제술을 시행한 군과 정상대조군 간의 차이는 없었다. 오디조임근 위상파 수축의 고빈도 수축은 18명의 환자에서 총 40회 관찰되었다. 담낭절제술을 시행한 군에서 고빈도 수축간의 평균 간격은 40.1±21.9분으로 정상 대조군 69.9±19.0분에 비해 유의하게 짧았다(p<0.05). 담낭절제술을 시행한 군에서 고빈도 수축이 지속되는 평균 기간은 6.1±2.1분으로 대조군의 5.0±1.6분에 비해 길게 나타났다(p<0.05). 동시에 위소장 내압검사를 시행한 4명의 환자에서는 기록된 오디괄약근의 총 20회 고빈도 수축이 모두 십이지장의 MMC III기와 동시에 나타났다. 결론 : 담낭절제술 환자군에서 고빈도 수축 시간이 대조군에 비해 더 길고, 고빈도 수축 간의 간격은 대조군에 비해 짧았다. 또한, 오디조임근의 고빈도 수축과 십이지장 MMC III기가 연관성이 있게 나타나 이들간의 상호작용에 대한 연구가 필요할 것으로 생각한다. Background/Aims: The perendoscopic manometry of the sphincter of Oddi (SO) may not represent the overall SO motility. To assess the effect of cholecystectomy on SO motility, SO manometry was performed via the percutaneous transhepatic route. Methods: Percutaneous transhepatic SO manometry was performed in 26 patients with IHD stones. Seventeen patients had undergone cholecystectomy, and the others had not (the control group). We performed antroduodenal manometry simultaneously in 4 patients. Results: There was no significant difference of basal pressures, the mean frequency of phasic contractions, and the distribution of phasic contraction types of SO between the cholecystectomy group and the control group. Forty occasions of high frequency type phasic contractions were observed in 18 patients. The mean interval of high frequency contractions in the cholecystectomy group was shorter than that in the control group (40.1±21.9 vs. 69.9±19.0 min, respectively, p<0.05), and the mean duration of high frequency contractions in the cholecystectomy group was longer than that in the control group (6.1±2.1 vs. 5.0±1.6 min, respectively, p<0.05). Twenty high frequency contractions of SO coincided with duodenal MMC III on the antroduodenal manometry. Conclusions: A longer duration and shorter intervals of high frequency contractions were observed in the cholecystectomy group. High frequency contractions of SO were observed periodically without biliary pain and these coincided with duodenal MMC III. (Kor J Neurogastroenterol Motil 2007;13:61-67)

위 십이지장 내압검사상 동시성 반복성 수축을 보인 되새김 증후군 1 예

류권호(Kwon Ho Ryu),이준성(Joon Seong Lee),임희혁(Hee Hyuk Lim),유창범(Chang Bum Yoo),김진오(Jin Oh Kim),조주영(Joo Young Cho),이문성(Moon Sung Lee),심찬섭(Chan Sup Shim),김부성(Boo Sung Kim) 대한소화기기능성질환·운동학회 2001 Journal of Neurogastroenterology and Motility (JNM Vol.7 No.2

Rumination syndrome is defined as a regurgitation of recently ingested food into the mouth with subsequent remastication and reswallowing or spitting out, and absence of structural disease. This is infrequent in adults of normal mental capacity. The true prevalence of rumination syndrome is unknown because few people have medical attention and most of physicians do not recognize this syndrome as a disease. Upper gastrointestinal manometry has been reported to show a characteristic pattern that confirms the diagnosis, namely, the occurrence of synchronous pressure spikes termed R waves at all levels in the stomach and small intestine. We assessed a 49-year-old male patient who complained of frequent effortless regurgitation of food. Ambulatory short-segment antroduodenal manometry with pH-metry showed simultaneous repeatetive contractions in all segments associated with regurgitation. (Korean Journal of Gastrointestinal Motility 2001;7:239-244)

간경변증 환자의 말초혈액단핵구에서 중합효소연쇄반응법을 이용한 Cytomegalovirus DNA 의 검출

문종호(Jong Ho Moon),유창범(Chang Beom Ryu),박철호(Cheol Ho Park),류권호(Kwon Ho Ryu),박찬욱(Chan Wook Park),이준성(Joon Sung Lee),이문성(Moon Sung Lee),조성원(Sung Won Cho),황승덕(Seung Deok Hwang),심찬섭(Chan Sup Shim),이희발(Hi Ba 대한내과학회 1995 대한내과학회지 Vol.49 No.6

N/A Objectives: Human cytomegalovirus(CMV) infections are common and usually asymptomatic, but fatal infections occur frequently in immunocompromised patients. In Korea, CMV infection is common and patients with liver cirrhosis are frequently in a condition of immunosuppression, may predispose to the frequent occurrence of CMV infections. The purpose of this study was to investigate the prevalence of CMV infection in patients with liver cirrhosis and to evaluate the relationship between the status of C3:IV infection and liver function. Methods, The subjects of this study were 36patients with liver cirrhosis, 4patients with non A, non B, non C(NANRNC) hepatitis, and 13normal controls. IgG and IgKI antibodies to CMV were measured using a microparticle enzyme immunoassay(MEIA). Specimens of urine were cultured for CMV using shell vial culture method. Peripheral blood mononuclear cells(PBMC) were investigated for the presence of CMV-DNA using PCR. Rusults: In CMU antibody test, IgM and IgG antibodies were detected in 7(19.4%) of 36patients with liver cirrhosis, IgG antibody was detected in the other 29patients and all control subjects. In shell vial culture, CMV was cultured in 1(2.8%) of 36patients with liver cirrhosis(IgM and IgG positive). CMV DNA was detected by PCR in 19(52.8%) of 36patients with liver cirrhosis, but 1(7.7%) of 13 control subjects (p<0.05). CMV DNA was detected in 6(85.7%) of 7cirrhotic patients with IgM and IgG antibodies positive, 13(44.8%) of 29cirrhotic patients with IgG antibody positive. CMV DNA positive cirrhotic patients show 5(26.3%) in Child A, 6(31.6%) in Child H, 8(42.1%) in Child C. CMV DNA negative cirrhotic patients show 4(23.5%) in Child A, 12(70.6%) in Child B, 1(5.9%) in Child C(p<0.05). CMV DY:A positive cirrhotic patients showed the tendency of more frequent detection of HBsAg and HBeAg than CMU DNA negative cirrhotic patients(p<0.05). Conclusion: These results suggest that CMV infection is common in cirrhotic patients and the CMV DNA positive patients with liver cirrhosis have more impairment of liver function than the CMV DNA negative patients with liver cirrhosis.

생체외 ( In - Vitro ) 에서 직접 용해제에 의한 간내 담석 용해도의 고찰

박찬욱(Chan Wook Park),류권호(Kwon Ho Ryu),권강호(Kang Ho Kwon),이종태(Jong Tae Lee),이준성(Joon Seong Lee),김연수(Yun Soo Kim),이문성(Moon Sung Lee),황성규(Seong Gyu Hwang),김선주(Sun Joo Kim),심찬섭(Chan Sup Shim),(H . Igimi) 대한내과학회 1996 대한내과학회지 Vol.50 No.4

N/A Objectives: The incidence of intrahepatic duct (IHD) stone is higher in east Asia including Korea than western contries. IHD stone has been regarded as a troublesome disease with poor surgical results. Recently, percutaneous transhepatic choledochoscopic lithotripsy with electrohydraulic lithotripsy of IHD stones showed good success rate, but it also couldn't remove stones in case of severe stenosis, acute angulation or peripheral impacted stones. A MTBE, widely used for dissolving cholesterol stone, was considered to be little effect for dissolving pigment stones. So we analysed IHD stones and dissolved them by direct solubilizer to investigate the dissolution rate of IHD stones. Methods. We have analyesd the compositions of 13 IHD stones removed during the percutaneous transhepatic cholangioscopy or pos-operative cholangioscopy by infrared spectrophotometer and dissoluted by direct solubilizer. Dry intact IHD stones were weighed and then inserted into 50ml glass tube. Within an 8hours incubation time, the 25ml of solvent were exchanged every 30minutes. After 2 and 8hours of incubation, the stone residue was dried-up at 60℃ for check weight reduction and compare to the initial dry weight. The solvent A medium was a 0.1M boric acid/sodium carbonate buffer (pH 9.4), EI)TA 1%(w/v), 1 M urea and solvent B was solvent A medium plus 0.04 M Lubrol PX and N-acethylcysteine. Results: The sites of dissolved IHD stons were both IHD stones 8cases(61.5%), left IHD stones 3(23.1%) and right IHD stones 2(15.4%), The components of IHD stones were calcium bilirubinate stones in 11cases(84.6%), followed by mixed stones 2 (15.4%). The dissolution rates after 2 and 8hours dissolution by solvent A is 11.7%, 24.7% and by solvent B is 25.7%, 62.7% respectively. The dissolution rates after 8hours in solvent B is higher than solvent A (p<0.05). Conclusion: In order to improve dissolution rates of IHD stones, the development of new solvent and the improvement of currently used solvents and methodology should be considered.

한국 소방관에서 보이는 외상 후 스트레스 증상과 음주의 연관성

이문인(Moon-In Lee),류권호(Kwon-Ho Ryu),김학렬(Hack-Ryul Kim),박상학(Sang-Hag Park),김상훈(Sang-Hoon Kim),이 진(Jin Lee) 한국중독정신의학회 2010 중독정신의학 Vol.14 No.1

Objectives:This study aimed to assess the relationship bet-ween Korean firefighters’ posttraumatic symptoms and alcohol use problems. Methods:Study participants were 59 firefighters working in Kwangju in 2009. We collected information about the participants’ demographic and job-related characteristics, and we administered the Alcohol dependence scale (ADS), Clinician Ad-ministered PTSD Scale (CAPS), and the Symptoms checklist 90-Revised version (SLC 90-R) to them. Statistical analyses utilized the Wilcoxon rank-sum test & and the Kruskal-Wallis test. Results:We used the CAPS scores to divide the participants into a PTSD (Post Traumatic Stress Disorder) symptom group (total score ≥20, n=7) and a “no symptoms” group (total score ≤19, n=52). We estimated the PTSD symptoms prevalence in fire-fighters as 11.86% by CAPS score. Participant ADS scores were independent of PTSD symptoms, but 16.94% of the firefighters showed moderate to severe alcohol-use problems. Conclusion:PTSD symptoms had no correlations with alcohol problems. However, alcohol problems are more common than PTSD symptoms among firefighters, so clinicians should carefully evaluate such patients’ alcohol problems, not just their post-trauma symptoms.

진단 및 치료 대장 내시경의 합병증으로 발생한 대장 천공의 치료에 대한 임상적 고찰순천향대학교 의과대학 내과학교실 소화기 연구소, 대전 속편한 내과

정성원 ( Song Won Jung ),유창범 ( Chang Beom Ryu ),송민수 ( Yon Soo Kim ),김연수 ( Min Soo Song ),고봉민 ( Bong Min Ko ),차상우 ( Sang Woo Cha ),류권호 ( Kwon Ho You ),홍수진 ( Soo Jin Hong ),김영석 ( Young Seok Kim ),문종호 ( Jon 대한장연구학회 2004 Intestinal Research Vol.2 No.1

Colonoscopy is used increasingly because the indication for therapeutic colonoscopy has been increased and the technique has been developed continuously as well as colonosopy is useful for diagnosis of colonic disease. Therefore, It is important understanding precisely about the complication of colonoscopy and managing the complication immediately and properly. In particular, colon perforation is the most fatal, emergency case and have needed surgical treatment, generally. Recently, the case treated with endoscopic clipping and conservative management has been reported. but until now, when perforated, wheather the endoscopic clipping or the surgical management at each other case is beneficial is not confirmed.

소화성 궤양에서 Helicobacter pylori 박멸의 장기적 효과에 대한 후향적 관찰

홍수진(Su Jin Hong),은수훈(Soo Hoon Eun),정준성(Joon Seong Jung),류권호(Kwon Ho Ryu),차상우(Sang Woo Cha),천갑진(Gab Jin Cheon),김진오(Jin Oh Kim),조주영(Joo Young Cho),이준성(Joon Seong Lee),이문성(Moon Sung Lee),심찬섭(Chan Sup Shi 대한내과학회 2002 대한내과학회지 Vol.63 No.1

목적: 소화성 궤양 환자에 있어 H. pylori 박멸은 재발 억제를 위해 시행되고 있으나 박멸 후 장기간 추적에 대한 국내 보고는 드문 실정이다. 본 연구에서는 소화성 궤양으로 H. pylori 박멸요법을 시행받고 박멸이 확인되었던 환자에서 H. pylori 재감염율, 궤양의 재발을 장기간 고찰하고자 하였다. 방법: 상부소화관 내시경검사상 H. pylori 양성인 소화성 궤양 환자 중 H. pylori 박멸요법을 시행하고 6주 이후에 박멸을 확인한 환자 763명 중 4년간 장기간 추적이 가능했던 환자 32명을 대상으로 상부소화관 내시경검사 소견, 13C-요소호기검사를 통한 H. pylori 감염 여부를 확인하여 기록하였다. 결과: 32명 중 남성은 22명, 여성은 10명이었고, 평균 연령은 51.7세 (29∼69세)였으며 내시경적 진단은 위 궤양 9명, 십이지장 궤양 12명, 위 궤양 및 십이지장 궤양 11명이었다. 4년간의 추적 기간 동안 H. pylori 재감염은 2명에서 있었고, 연간 재감염율은 1.6%였다. 32명의 환자 중 3명에서 궤양의 재발이 있어 9.4%의 재발율을 보였다. 결론: H. pylori의 연간 재감염율은 선진국의 재감염율과 유사한 1.6%였으며, H. pylori 박멸치료는 소화성 궤양의 재발 방지에 효과적인 유용한 치료방법으로 생각된다. Background: Eradication therapy for H. pylori infection is known to decrease the recurrence rate of peptic ulcer disease. The aim of this study was to evaluate longterm effect of H. pylori eradication on the recurrence of peptic ulcer disease and the reinfection rate after treatment in Korea. Methods: Between July 1996 and February 1997, 763 patients who were diagnosed peptic ulcer diseases and H. pylori infection after upper endoscopies in Soonchunhyang university hospital. Among those patients, we reviewed 32 patients who achieved eradication of H. pylori after eradication therapy and could be followed for up to 4 years by 13C-urea breath test or endoscopy. Results: The mean age of the patients was 51.7 years (range: 29∼68). Nine patients had gastric ulcer, 12 had duodenal ulcer and 11 had duodenal and gastric ulcer. An annual reinfection rate of H. pylori was 1.6% in our study. After H. pylori eradication, recurrence of peptic ulcer was detected in three patients (9.4%). Conclusion: In our study, the reinfection rate was similar to rates observed in developed countries. H. pylori eradication was effective for preventing recurrent peptic ulcers.(Korean J Med 63:23-28, 2002)

응급실에 내원한 자살기도자들의 특성

임유리(Eu-Ri Lim),김학렬(Hack-Ryul Kim),박상학(Sang-Hag Park),김상훈(Sang-hoon Kim),류권호(Kwon-Ho Ryu) 대한사회정신의학회 2012 사회정신의학 Vol.17 No.2

연구 목적 : 응급실로 내원한 자살 기도자들의 사회인구학적 및 임상적 특성을 파악하여 기존의 연구들과 비교하고자 하였으며 자살 기도자 들의 성별에 따른 특성을 파악해 보고자 하였다. 방 법 : 2008년 1월 1일부터 2010년 7월 31일까지 광주 조선대학교 병원 응급실에 방문한 총 483명의 자살 기도자들의 의무기록을 통해서 성별, 나이, 방법 등의 23개의 항목에 대한 정보를 얻어 분석하였으며 1963년 이후 한국 신경정신의학회에 출간된 기존의 연구들과 비교하였다. 결 과 : 연구 기간 동안 자살 기도로 응급실에 내원한 환자는 총 응급실 환자의 0.7%이었다. 남성과 여성의 비율은 1:0.9로 30대 이하에 서는 여성의 비율이 높았고 40대 이상에서는 남성의 비율이 높았다. 연령별로는 60대, 40대, 50대의 순으로 많았다. 자살 기도자들 에게 가장 많이 나타난 진단, 방법, 계절은 각각 우울증, 약물음독, 봄이었고, 원인으로 여성은 가족 내 갈등, 남성은 신체질환이나 경제적인 문제가 많았다. 성별에 따라서는 여성은 남성에 비해 연령이 더 낮고 거주지가 도시이며 선행 사건이 있고 원인이 가족 내 갈등인 경우가 많았다. 결 론 : 자살 기도자들은 남성이 여성에 비해서 약간 많았고 연령별로는 60대, 40대, 50대 순으로 많았다. 성별로는 여성에서는 남성에 비해서 연령이 더 낮고 선행 사건이 있는 경우가 더 많았다. 원인에서는 여성에서는 가족내 갈등이 많았고 남성에서는 경제적인 문제나 질병이 많았다. 따라서 이런 자살 기도자들의 사회 인구학적 및 임상적 특성에 주의를 기울여야할 필요가 있다. Objectives : The present study aimed to identify the sociodemographic and clinical characteristics of suicide attempters visiting emergency room for comparing to previous studies and to investigate the gender characteristics of suicide attempters. Method : The authors analyzed data obtained through previous studies related to suicide attempters published by Korean Neuropsychiatric Association since 1963, and compared findings of 23 variables obtained from medical record including sex, age, method etc. to 483 cases of suicide attempters visiting emergency room of the chosun university hospital in Gwangju city from January 1,2008 to January to July 31,2010. Result : During the research, patients who visited emergency room by suicide attempt were 0.7% of the total patients visiting emergency room. The ratio between male and female was 1 : 0.9, female was more than male in below 30 years of age, but male was more than female in above 40 years of age. According to age group, 60s, 40s and 50s were high in order. Their most common diagnosis, method, season were depression, drug ingestion and spring respectively. In cause, familial conflict was more in female, physical illness and economic problems was more in male. By gender, female were younger than male, lived in cities, had a precipitating event, and a family conflict was most common. Conclusion : Suicide attempters were slightly more in male than in female, by age, 60s, 40s and 50s was more in descending order. By gender, female was younger and had more precipitating event than male. In cause, familial conflict was more in female, physical illness and economic problems was more in male. So, we may need attention to these Sociodemographic and clinical characteristics of suicide attempters.

감염 진단에서 적외선분광계와 질량분광계를 이용한 13C-요소호기검사의 비교

정준성 ( Jun Sung Jung ),조주영 ( Joo Young Cho ),천갑진 ( Gab Jin Cheon ),홍수진 ( Soo Jin Hong ),장재영 ( Jae Young Jang ),류권호 ( Kwon Ho Ryu ),차상우 ( Sang Woo Cha ),유창범 ( Chang Beom Ryu ),김진오 ( Jin Oh Kim ),이준성 ( J 대한소화기학회 2002 대한소화기학회지 Vol.40 No.5

치은에 전이한 원발성 간세포암 1예

최수정,김영석,김나리,정승원,이선해,정준성,류권호,차상우,홍수진,유창범,문종호,김연수,이문성,심찬섭,김부성,권계원,김병용 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.4

Hepatocellular carcinoma is one of the most common causes of death in Koreans. Most cases of hepatocellular carcinoma are beyond the stage of curative resection at the time of diagnosis due to extrahepatic metastasis as well as wide distribution of tumor in the liver. The lung is the most common site of extrahepatic metastasis but metastasis to gingiva is very rare in hepatocellular carcinoma. We report a case hepatecellular carcinoma with gingival methststasis in a 59 year old male patient.(Korean J Hepatol 2002;8:495-499)