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과민성 대장 증후근의 감별 - 감별진단을 위한 대장 생리 검사의 의의 -
나용호(Yong Ho Nah),유준형(June Hyung Lyou),유광현(Kwang Hyen You),최석채(Suck Chei Choi) 대한내과학회 1996 대한내과학회지 Vol.51 No.2
N/A Objectives: Irritable bowel syndrome (IBS) is a diagnosis of exclusion. There are no gold standard test that can yield a positive diagnosis. There has been considerable debate concerning the amount of investigation necessary to exclude organic disease. Certain diagnostic test should be performed routinely, whereas others ore selected on the basis of specific symptoms. The aim of this study was to determine the diagnostic value of the physiology test ot the bowel to exclude the organic disease in the suspected irritable bowel syndrome. Methods: 60 patients (M;34, F;26; mean age 46 years, range 18-67) with irritable bowel syndrome based on Manning criteria (negative colonoscopy, barium enema, biochemical tests, and stool examinadtions) were evaluated by hydrogen breath test, colon transit study, anorectal manometry, and defecography. Results: Based on these study, patients were categorized as having; no abnormalities, 27 patients; lactose intolerance, 16 patients among 24 diarrhea- predominant group, pelvic floor disorders (rectocele, rectal intussusception, anismus, descending perineal syndrome), 14 patients, and colonic inertia, 3 patients among 36 constipation-predominant group. Conclusion: Over 50% patients with the suspected irritable bowel syndrome have other organic or functionally disturbed disease. In addition to the routine studies, it is desirable to perform at least hydrogen breath test, colon transit study, anorectal manometry, and defecography.
조정구,박명선,유광현,장명규,손성식,송승렬 대한내과학회 1994 대한내과학회지 Vol.46 No.2
Malnutrition-related diabetes mellitus is a form of diabetes peculiar to developing countries within the tropical belt, which comprises two subgroups, fibrocalculous pancreatic diabetes (FCPD) and protein-deficient pancreatic diabetes (PDPD). FCPD is a form of diabetes secondary to chronic calcific pancreatitis, which is not due to alcohol consumption and tend to affect younger people and characterized by insulin-requiring but ketosis-resistant and coexisting malnutrition or pancreatic duct stone. FCPD is diagnosed by demonstrating calculi and signs of chronic pancreatitis by radiographic or ultra-sound imaging, together with evidence of pancreatic exocrine insufficiency. We recently experienced the two cases of fibrocalculous pancreatic diabetes. MRDM deserves further study not only because it is now recognized as a major form of the disease but also because it may improve our understanding of other forms of diabetes.
레이저응고술을 이용하여 성공적으로 치료한 위 모세혈관 확장증 1예
나용호,최석채,황호근,유광현 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.6
The routine of endoscopy in the evaluatien of gastrointestinal bleeding demonatratd that telangiectasia in the upper gastrointestinal tract may be responsible for the chronic recurrent bleeding. If the bleeding lesion within the reach of the endoscaiye, it is amenahle to endoscopic therapy, One of the several treatment modalities that has been employed is laser photocoagulation. We report a case of ef fective laser therapy in a 63-years old woman presented with a about 3 years history of recurrent upper gastrointestinal bleeding and persistent iron deficieney anemia in gaatic multiple telangeictasias. An upper gastrointestinal endoscopy demonstrated variable sized multiple bleeding telangectatic lesions in the entire stomach. Nd-YAG laser photocoagulation was appligd in 0.5 seconds pulse of 60-70W power(2300 joules and total 7 sessions). All legions in the stomach were treated. Local epinephrine injection prior to laser treatment was carried out in the telangiectatie lesions greater than 1 cm. Follow-up endoscopy 5 months after laser treatment demonstrated no telangiectatic lesions in the stomach and no episodes of upper gastrointestinal bleeding were noted and the other symptoms improved.