소화성궤양과 위암에서 Helicobacter pylori 의 검출빈도

성자원(Ja Won Sung),육은주(Eun Ju Yook),임의혁(Euyi Hyeog Im),김병호(Byeong Ho Kim),이기천(Ki Cheon Lee),허승식(Seoung Sik Heo),정현용(Hyun Yong Jeong),이헌영(Heun Young Lee),김영건(Young Kun Kim) 대한내과학회 1993 대한내과학회지 Vol.45 No.1

N/A Background: It is clear that gastric colonization by H. pylori is extremely common among patients with peptic ulcer, particularly when this involves the duodenal mucosa. The precise frequency of H, pylori in various gastroduodenal conditions varies somehow, but there is unanimity in confirming a strong association among H. pylori, chronic gastritis, and ulceration. Furthermore atrophic gastritis has been reported to be a precursor lesion for gastric cancer. So we estimated the prevalences of H. pylori infection, and serum gastric level in peptic ulcer and gastric cancer. Methods: The specimens were obtained by endoscopic biopsy of the gastric antrum from 40 patients with duodenal ulcer, 38 patients with gastric ulcer and 47 patients with gastric cancer. The urease activity was analyzed for 24 hours on the basis of Campylobacter-like organism test(CLO test). A change in color of the urea broth from yellow-gold to pink-red was interpreted as a positive result. Results: 1) The prevalence of H. pylori infection was significantly higher in duodenal ulcer (75.0%) than in gastric ulcer (52.6%) and in gastric cancer (38.3%, p<0.05). 2) The mean age of positive groups of CLO test among total 125 cases was significantly younger (49 years) than the negative groups (63 years, p<0.05), In each diseases, gastric cancer and duodenal ulcer were also significantly younger in the positive groups than the negative groups(p<0.05). But there was no significant difference between two groups in gastric ulcer. 3) Duodenal ulcer patients with positive CLO test had significantly the lower gastrin level when compared to patients with negative CLO test (p<0.05). In contrst, patients with gastric cancer or gastric ulcer with positive CLO test had trend of higher gastrin level when compared to patients with negative CLO teat. Conclusions: There is a strong association between H, pylori and duodenal ulcer, The influence of H. pylori infection on serum gastrin may be different between gastric disease and duodenal ulcer.

복수에서 Carcinoembryonic Antigen ( CEA ) , Cholesterol 및 Albumin 치의 진단적 의의

허승식(Seoung Sik Heo),성자원(Ja Won Sung),김병호(Byeong Ho Kim),이기천(Ki Cheon Lee),이종선(Jong Sun Lee),안정기(Jeong Ki Ahn),정현용(Hyun Yong Jeong),이헌영(Heun Young Lee),김영건(Young Kun Kim) 대한내과학회 1992 대한내과학회지 Vol.43 No.1

N/A Background: Although ascites in most often caused by chronic liver disease or neoplasms metastatic to peritonium, a complete seperation between these two mechanisms has not been possible using simple and reliable ascitic fluid laboratory parameters. Ascitic fluid lactic acid dehydrogenase, protein, carcinoem- bryonic antigen, cholesterol, glucose concentration and PH have been investigated, but none has provided a complete distinction between malignant and benign ascites. Methods: To evaluate the diagnostic values of ascitic CEA, cholesterol and albumin to differentiate malignant from nonmalignant Ascites, the authors studies 96 patients with ascites (43 with benign ascites and 53 with clinical or pathologic malignant ascites). Results: 1) The mean values of CEA, cholesterol and albumin in benign ascites were 1.32ng/ml, 39.53 mg/dl and 0.39 gm/dl, and the upper limites of parameters in benign ascites were 3.26ng/dl, 106.79mg/dl and 1,65gm/dl. 2) The mean values of CEA, cholesterol and albumin in pathologic malignant ascites were 46. 80 ng/ml, 99. 35 mg/dl and 2,19 gm/dl, and the mean values of parameters in clinical malignant ascites were 58,49 ng/ml, 81. 37 mg/dl and 1 41 gm/dl. Ascites CEA, cholesterol and albumin levels were significantly higher in malignant ascites than benign ascites, but no significant difference between clinical and pathologic malignant ascites. 3) In diagnosis of malignant ascites, sensitivity, specificity and diagnostic efficacy of CEA, cholesterol and albumin were 60% 93% 75%, 35% 92% 69% and 56% 81% 71%. 4) The sensitivity, specificity and diagnostic efficacy of cholesterol plus albmin, cholesterol plus CEA and albumin plus CEA were 26% 96% 71%, 30% 100% 76%, 52% 100% 82%. 5) Significantly positive correlation were found be tween CEA/cholesterol, CEA/albumin. Conclusion: CEA, cholesterol and albumin, especially CEA plus albumin, were parameters valuable for differential diagnosis of ascites.

소화성궤양 환자에 대한 Omeprazole(Losec^(�))의 임상 효과

이종선,이기천,허승식,안정기,윤세진,정현용,이헌영,김영건 최신의학사 1990 最新醫學 Vol.33 No.9

胃食道 異物의 內視鏡的 除去

정현용,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Gastrointestinal foreign bodies present a significant problem, causing a surprising amount of morbidity and mortality. The clinician is presented with the problem of expectant management, endoscopy, and surgery, to obtain an optimal outcome. We have assessed the efficacy of endoscopic removal in the gastroesophageal foreign body. A total 19 cases admitted at CNUH hospital from january 1991 to december 1993 were included in this treatment model and the following results were obtained : 1) The age distribution varies 10 months to 74 years old, prevalence rate under 5 years of age was 4 cases(21%). 2) Foereign bodies were :lodged in the esophagus 12 cases(normal anatomy 7 cases, benign stricture 5 cases) and in the stomach 7 cases. 3) Nature of foreign bodies was meat ball, marble, check, coin, fish bone, animal bone, video key and bean. 4) Patients with esophageal foreign body were always complained dysphagia or odynopgagia, patients with stomach foreign body were chiefly asymptomatic. 5) Accessory using in endoscopic removal were grasping forceps, alligator forceps, stone extraction baskets, polypectomy snare and laser equipment. 6) All cases were successfully removed by endoscopy, there were no complication during procedure.

상부위장관출혈에서 Hypertonic Saline-Epinephrine 용액 국소주사의 지혈효과

정현용,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2

We have assessed the hemostatic efficacy of endoscopic HS-E solution injection sclerosis in the upper gasrointestinal bleeding. A total 27 cases admitted to CNUH internal medicine department from november 1989 to october 1990 were included in this treatment model and the following results were obtained : 1. The causes of bleeding were gastric ulcer(44%), duodenal ulcer(25.9%), Dieulafoy's ulcer (18.5%), advanced gastric cancer(3.7%), Mallory-Weiss syndrome(3.7%) and angiodysplasia(3. 7%). 2. The locations of bleeding were high body(25.9%), angle(18.5%), bulb(18.5%), antrum(14.8%), midbody(3.7%), cardia(3.7%), pyloric canal(3.7%) and stoma(3.7%). 3. Endoscopic findings of UGI bleeding showed active bleeding in 51.9% (14/27 cases) as spurting (11.1%). pulsating(22.2%) and oozing(18.9%). Stigmatas of recent bleeding were 48.1% (13/27cases) as denuded vessels(29.6%) and fresh blood clots(18.9%). 4. The hemostatic effect of HS-E solution injection sclerosis was 92.6%(25/27 cases). The sussess rate of first injection was 70.3%(19/27), second injection 14.8% and third injection 7.4%. Two cases(7.4%) were operated for hemostasis. 5. According to bleeding types viewed endoscopically, hemostatic effects were following sussess rate ; spurting cases 67% (2/3), pulsating cases 83% (5/6), oozing 100% (5/5). Others showed 100% of sussess rates.

내시경으로 확인된 상부소화관 용종의 임상적 고찰

김영건,김병호,성자원,이기천,허승식,이종선,정현용,이헌영 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

From January 1987 to October 1991, we performed 14,333 cases of upper gastrointestinal endoscopy and diagnosed 527 cases with U.G.I polyp. We assesed these 527 cases and obtained following results: 1) The overall incidence of U.G.I. polyps was 3.6%, and there was no sexual difference. The peak incidence was in 6th decades(32.4%). 2) The U.G.I. polyps were located chiefly at stomach(415 cases, 78.7%), among which antrum occupied antrum 43.5%, body 24.0% and funds 5.1%. And the others were esophagus(6.5%) and duodenum(12.3%). 3) The size of U.G.I. polyp was below 1cm in 72.3%, from 1cm to 1.9cm in 20.7% and above 2cm in 7.0%. According to Yamada' classification, type Ⅰ, Ⅱ, Ⅲ and Ⅳ was 31.9%, 51.3%, 13.7% and 3.0%. 4) Histological nature of U.I.G. polyp were hyperplastic polyp(85.8%), adenomatous polyps(9.3%), carcinomatous polyps(3.3%) and etc. The size of neoplastic polyp such as adenomatous polyps(mean 1.0±0.7cm) and carcinomatous polyps(niean 2.0±1.8) were larger man hyperplastic polyp(mean 0.6±0.4) (p<0.05) 5) The gastric polyps were associated with peptic ulcer(7.5%), gastric cancer(3.2%), other malignancy(3.5%), hepatobiliary disease(5.5%), post subtotal gastrectomy(5.5%). And others(75%) werenot associated with specific disease.

과민성 대장증후군에서 Fenoverine(Fexadin^(�))의 임상효과

김영건,성자원,김병호,이기천,허승식,정현용,이헌영 최신의학사 1992 最新醫學 Vol.35 No.4

소화성 궤양 환자에 대한 염산 베넥세이트(울굿^(�)) 임상 효과

정현용,육은주,이헌영,노홍구,김영건 최신의학사 1993 最新醫學 Vol.36 No.8

위암조직에서 Carcinoembryonic Antigen 측정의 의의

정현용,윤세진,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

To estimate tumor CEA expression of stomach cancers in relation to normal mucosa CEA, degree of cellular differentiation, pathologic stage and other clinicopathologic findings, we measured CEA concentrations in tissue extracts by radioimmunoassay for 24 cases of stomach cancer. The results were as follows: 1. Ranges of tissue CEA concentrations in normal stomach mucosa was from 6.Ong/gm to 15.4 ng/gm(mean 10.2ng/gm). 2. Mean conceatrations of cancer tissue CEA was 42.1ng/gm(from 2.9 ng/gm to 414.Ong/gm), 4 times higher than normal mucosa. In 46% of stomach cancers, tissue CEA concentrations was above normal cut off value(18.7ng/gm). 3. Tiuse CEA concentrations of stomach cancer was significantly high as high CEA levels of normal mucosa(r=0.6954), not related to serum CEA concentrations. 4. Tissue CEA concentrations of stomach cancer was high as high TNM stage, but was not related to wall invasion depth, lymph node metastasis, cellular differentiation and other clinicopathologic findings. In conclusion, the production of CEA in stomach cancers was significantly increased in half cases, CEA expression of tumor was related to pathologic stage rather than cellular differentiation. The factors determined CEA production was considered more higher levels such as DNA profile. To estimate prognostic values of tissue CEA concentrations, follow up of included patients and further study should be pursued.

위궤양에 대한 Teprenone(Selbex^�)의 임상효과

정현용,김병호,성자원,이기천,허승식,이종선,이헌영,김영건 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

The study objective was to assess the ulcer healing effects of Teprenone, stimulator of mucus production, given in dose of 50mg tid. We reviewed 25 cases of gastric ulcer proven endoscopically and treated by Teprenone. The results were follows; 1) The healing rate of gastric ulcer was 72% after 8 weeks treatment. 2) Subjective symptoms such as epigastric pain, belching, nausea, anorexia and vomiting were subsided at 86%. 3) There were not developed any symptoms, signs and laboratory abnormality (CBC, liver funtion test, urinalysis) suggesting side effect of drugs. In conclusion, Teprenone was considered an effective and safe drug in the treatment of gastric ulcer diseases.