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조영관,김성환 대한상부위장관ㆍ헬리코박터학회 2014 Korean Journal of Helicobacter Upper Gastrointesti Vol.14 No.2
Achalasia is a rare primary motor disorder of the esophagus. Achalasia is characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. The patients present with symptoms such as dysphagia, regurgitation and chest pain. The diagnostic tools of achalasia include esophageal manometry, esophagogram, and endoscopy. Esophageal manometry is the gold standard however endoscopy and esophagogram plays complementary roles for diagnosis of achalasia. Endoscopy is essential to rule out pseudoachalasia and mechanical obstruction before diagnosis of achalasia. Esophagogram is recommended to assess esophageal emptying and gastroesophageal junction morphology in those with equivocal esophageal manometry findings.
응급센터에 내원한 음성 혈뇨 요로 결석 환자군의 임상양상 및 경과
조영관,이정훈,김종원,김진용,이경룡,홍대영,백광제,박상오 대한응급의학회 2013 大韓應急醫學會誌 Vol.24 No.5
Purpose: To determine the clinical features of urolithiasispatients;specifically negative hematuriapatients (NHP) versus positive hematuria patients (PHP) in an emergency department (ED). Methods: Patients with urolithiasis who had visited an ED over the past two years were retrospectively analyzed. Only patients analyzed through both urinalysis and computed tomography were included (1005 patients). NHP was present in 125(12.4%) of these patients. The clinical features of NHP and PHP were assessed in regard to several factors:sex, age, onset to ED visit time, associated symptoms, costovertebral angle tenderness (CVAT), stone size, stone location, length of stay in the ED, repeated drug rate,admission rate, and revisit rate within 72 hours. Results: There were no significant differences in sex, age,onset to ED visit time, associated symptom, CVAT, and stone size between NHP and PHP. However, in NHP there was a slight dominance in renal and ureterovesical junction (UVJ) according to stone location. Compared with PHP,NHP increased the length of stay in the ED (150.0±52.3min vs. 132.7±48.6 min; p=0.001), repeated drug rate (80% vs. 69.4%; p=0.015) and admission rate (12.8% vs. 6.4%; p=0.015). There was no significant difference in revisit rate within 72 hours between NHP and PHP (8.3%vs. 4.7%; p=0.161). Conclusion: Compared with the conventional PHP, NHP increased the length of stay in an ED, increased the repeated drug rate, and was associated with a high admission rate in an ED setting.