목포지역에서의 C형 간염 바이러스 항체의 양성율

김건형,최요안,민귀환,안기석,박찬웅,김지운 大韓消化器病學會 1996 大韓消化器病學會誌 Vol.28 No.5

내시경적 결찰요법으로 치유한 Dieulafoy 궤양 2예

안기석,박찬웅,김기중,민귀환,윤태용,정준성,김영용,이진웅,최관수 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.2

A dieulafoy ulcer is rarely recognized but is not an uncommon cause of massive, recurrent and frequently fatal gastrointestinal bleeding resulting from the erosion of an unusually large submucosal artery. Although the lesion has been predominantly found in the proximal stomach, it has also been detected throughout the gastrointestinal tract. Diagnosis can be made by observation of protruding and eroded arteries with pulsatile bleeding, or through detection of an adherent thrombus using an endoscopy. In the past, surgical intervention was believed to be the best treatment, but currently, therapeutic endoscopy is more favored, due to its recent success in achieving permanent hemostasis. We experienced 2 cases of Dieulafoy's ulcer of the stomach. Endoscopic ligations using an O ring were performed successfully.

내시경으로 진단된 Mallory-Weiss 증후군 35예

김영용,이진웅,김지운,안기석,박찬웅,김기중,민귀환,윤태용,정준성 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3

35 cases of Mallory-Weiss syndrome among 277 cases of upper gastrointestinal bleeding were ascertained by endoscopy at department of internal medicine St. Columban's hospital. The mean age was 41.6 years. All of 35 cases were found in male. Combined disease were gastritis(15 cases), peptic ulcer(7 cases) and esophageal varix(3 cases). The most common precipitating factor was vomiting, 22 cases among the 28 cases of vomiting(80%) developed after drinking. Endoscopic finding revealed active bleeding in 5 cases, blood clot without active bleeding in 22 cases, and scar change without bleeding evidence in 8 cases. Most cases had had hematemesis after active bleeding but 5 cases had had only melena without hematemesis. The Mallory-Weiss lacerations were located at stomach in 16 cases(46%), at esophagogastric junction in 11 cases(31%) and at esophagus in 8 cases. On the view of gastric direction, 14 cases were on anterior wall side, 9 cases were on posterior wall side, 11 cases were on lesser curvature side and one case was on great curvature side. Single lacerations were more common than multiple lacerations.

척추 측만에 의한 압박 부위를 한 번 생검후 발생한 식도 파열 1예

김지운,안기석,박찬웅,김기중,최요안,민귀환,정준성,김건형 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.4

The esophagus or stomach can be perforated during diagnostic upper endoscopy in 0.03 to 0.1 percent. Instrumentation injury, as a whole, is probably the most common single cause of all cases of esophageal perforation. Most of the esophageal perforation result from either therapeutic maneuvers(dilation, sclerotherapy, foreign-body removal etc.) or underlying esophageal lesion(such as strictures or diverticular or neoplasm). Endoscopic perforation of the esophagus may be obvious immediately or within a few hours. Cervical pain, subcutaneous emphysema, fever, tachycardia, and characteristic radiographic appearances make the diagnosis easy, but some distal esophageal injuries are subtler, An immediate esophagogram should be obtained if peirforation is suspected. To select an appropriate course of management, precise delineation of location and the extent of perforation is necessary. The esophageal perforation can be managed conservatively by close observation, esophageal rest, and antibiotic coverage, but the mortality rate of medical treatment is near 12%. Causes of death are sepsis and multisystem organ failure. So we report a case of esophageal perforation by an endoscopic biopsy.

위에 박힌 바늘과 이쑤시개 각 1예

안기석,김지운,박찬웅,김기중,김건형,최요안,민귀환,정준성 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3

Foreign bodies in the stomach are usually ingested by children under 5 years of age, persons with dentures, alcoholics, mentally disturbed individuals or prisoners with a purpose of secondary gain. Many patients will be asymptomatic and will be brought in by parents with a history of having swallowed something. The ingested foreign bodies are mainly coins, particles of metals, fish bones and etc. A needle or a toothpick in the stomach has been rarely reported in an adult.. We present two cases of patients: one case of patient with needle stuck in the stomach, who swallowed for the purpose of secondary gain, and the other case of patient with toothpick stuck in the stomach, who did not realize having swallowed it. A 23-year-old man, prisoner, was admitted to hospital due to epigastric pain after ingestion of a needle. Endoscopy showed a black needle, 1.2cm long stuck at the prepyloric antrum. It was removed by the endoscopic biopsy forceps through the overtube used in endoscopic variceal ligation and proved to be a needle with a length of 4.9 cm and a diameter of 0.1 cm. A 58-year-old woman developed an acute onset of hematemesis and epigastralgia, and presented to the emergency room. On admission, her blood pressure was 60/40 mmHg. An emergency endoscopy showed a yellowish, thin, stiff material 3.5cm long stuck at the greater curvature of the antrum with meat materials. It was removed by the above method and proved to an wooden tooth pick with a length of 6.5 cm and a diameter of 0.2 cm. No active bleeding was noted from the removed site. She did not realized she had swallowed the toothpick. She was discharged without complication.

Candidiasis 를 동반한 식도 bezoar 1 예

이진웅,김지운,안기석,박찬웅,김기중,민귀환,윤태용,정준성,김영용 대한내과학회 1998 대한내과학회지 Vol.54 No.5

Bezoars are persistent concretions of indigestible matter, usually in the stomach, But very rarely have bezoars been reported in the esophagus. Most esophageal bezoars are either phytobezoars or medication bezoars occuring usually in the middle aged & elderly associated with underlying anatomical or functional abnormalities of esophagus. A variety of techniques has been developed recently in diagnostic and therapeutic endoscopy. So endoscopic management is safe and successful in most cases those required surgical management. We experienced an esophageal bezoar consisted with esophageal candidiasis in a patient who underwent esophago-gastric anastomosis and proximal gastrectomy due to early gastric cancer. The bezoar was removed by endoscopy and the esophago-gastric stenosis was treated with balloon dilator without any significant complication.

목포지역에서의 C형 간염 바이러스 항체의 양성율

김건형(Kun Hyung Kim),최요안(Yo An Choi),민귀환(Kwi Hwan Min),안기석(Ki Seok Ahn),박찬웅(Chan Woong Park),김지운(Ji Woon Kim) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.5

N/A Background: Hepatitis C virus has an important etiologic role in hepato-cellular carcinoma in HBsAg negative patients in Korea. Superinfection of hepatitis C virus is not infrequent and may modify the natural course of chronic HBV infection.This study was aimed to investigate the prevalence of anti-HCV among the general population in Mokpo, Korea. Methods: We evaluated the anti-HCV seropositivity from 1,299 persons who visited the Health Clinic Center, Anti-HCV was detected by enzyme immunoassay method. Results: Twenty three (1.77%) were positive for anti-HCV, and twenty (1.54%) persons were male. Male to female ratio was 6.7:1. The prevalence of anti-HCV among male subjects (1.54%) was higher than that of female subjects (0.237o). Among twenty three persons who had anti-HCV positivity, 14(61%) had normal values of serum AST and ALT and 8 (35%) had two fold elevated values of serum AST and ALT. Twenty three persons who had anti-HCV positivity were negative for HBsAg. But 14 (617c) persons were positive for IgG anti-HBc. Conclusions: Anti-HCV prevalence increased with age through the fifth decade of life. The prevalence of antibody to HCV in Mokpo, Korea was 1.77%. And it was predominant in ma]e. (Korean J Gastroenterol 1996;28:677 - 682)