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위식도역류질환에서 십이지장위식도역류 - 장시간 보행성 식도내 pH및 빌리루빈의 동시측정에 의한 평가
최명규(Myong Gyu Choi),박수헌(Soo Heon Park),방춘상(Choon Sang Bang),한준열(Joon Yul Han),김재광(Jae Kwang Kim),최규용(Kyu Yong Choi),정인식(In Sik Chung),정규원(Kyu Won Chung),선희식(Hee Sik Sun),박두호(Doo Ho Park) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4
N/A Background/Aims: Esophageal reflux damage may be produced by agents other than acid and the term alkaline esophagitis has been applied. Methods using esophageal pH monitoring to assess duodenogastroesophageal reflux have been suggested but gastric neutralization has made these methods difficult to prove conclusively. The purpose of this study were to investigate the role of duodenogastroesophageal reflux in gastroesophageal reflux disease(GERD) and to understand the relationship between pH and duodenogastroesophageal reflux. Methods: we performed simul- taneous esophageal pH and bilirubin rnonitoring(Bilitec 2000, Synetics) in 14 symptomatic patients with gastroesophageal reflux and 10 healthy controls. Abnormal gastroesophageal reflux was defined when the percent total time of pHC4 or bilirubin absorbance 0.14 exceeded the 95th percentile of the range obtained in healthy volunteers. Results: Abnormal gastroesophageal reflux was diagnosed in 12(85.7%) of 14 patients, who could be categorized into 3 acid refluxers, 1 bile refluxer or 8 combined acid and bile refluxers. All 6 patients with severe esophagitis(grade 2 by Savary Miller classification) were combined acid and bile refluxers and had markedly prolonged acid and bile reflux compared to 8 patients with normal or mild esophagitis(% total time of pH 4(mean+SE): 13.4+2.96 vs 5.0+1.8, p<0.05; % total time of bilirubin absorbance 0.14(mean+SE): 25.2+4.6% vs 7.9+3.8%, p<0.05). Mean pH of esophageal refluxate during bile reflux episode lasting longer than 5 minutes was 6.0(7.1% for pH C4, 8.8% for pH 4 5, 26.6% for pH 5-6, 47% for pH 6-7 and 8.3% for pH7). 4) 8 patients with a symptom index greater than 25% experienced 24 reflux symptoms of which 12(50.0%) were associated with acid reflux, 5(20.8%) were associated with bile reflux and 7(29.2%) were not associated with bile or acid reflux. Conclusions: Alkaline esophageal reflux is a misnomer. Esophageal pH monitoring does not adequately identify symptomatic non-acidic duodenogastroesophageal reflux. Patients with com- bined acid and bile reflux are more likely to develop severe esophagitis. (Korean J Gastroenterol 1996; 28:469 - 476)
남관우 ( Kwan Woo Nam ),백명기 ( Myong Ki Baeg ),권정현 ( Jung Hyun Kwon ),조성훈 ( Soung Hoon Cho ),나수진 ( Soo Jin Na ),최명규 ( Myung Gyu Choi ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.5
tissue lymphoma. This study was to determine whether H. pylori was associated with colorectal neoplasms in Korean subjects undergoing routine checkup. Methods: A total of 10,082 subjects underwent routine checkups from January 2004 to April 2005. A H. pylori IgG test and stool occult blood test were included in the routine checkup program. Colonoscopy was performed if the stool occult blood test was positive or under subject request. Patients who underwent colonoscopy and had histologically confirmed cases of colorectal neoplasms were designanted as the subject group and those without as the control group. Results: Of the 10,082 subjects, 597 had full colonoscopy. The results identified 9 colorectal carcinomas and 118 adenomas. H. pylori seropositivity was identified in 6 (66%) subjects with colorectal carcinoma, 81 (68.6%) with colorectal adenoma and 248 (52.8%) controls. Subjects having colorectal neoplasms had a significantly higher H. pylori seropositivity rate compared with the controls (OR 1.94, 95% CI 1.28-2.95). This remained significant after adjusting for age, sex, body mass index, HbA1c and total cholesterol (OR 1.90, 95% CI 1.23-2.93). Patients with distal neoplasms also had a significantly higher H. pylori seroposivity rate (OR 1.88, 95% CI 1.17-3.01) which persisted after multivariate adjustment (OR 1.79, 95% CI 1.10-2.94). Conclusions: Subjects with colorectal neoplasms present an increased H. pylori seroprevalence compared with controls. (Korean J Gastroenterol 2013;61:259-264)
권태근 ( Tae Geun Gweon ),임철현 ( Chul Hyun Lim ),변성욱 ( Seoug Wook Byeon ),백명기 ( Myong Ki Baeg ),이종율 ( Jong Yul Lee ),문성진 ( Sung Jin Moon ),김진수 ( Jin Su Kim ),최명규 ( Myung Gyu Choi ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.6
Celiac disease is a chronic absorptive disorder of the small intestine caused by gluten. The prevalence rate of celiac disease is 1% in Western countries. But, it is rare in Asian countries, and there is no celiac disease reported in Korea. Here, we report a case of celiac disease. An 36-years-old woman complained non-specific abdominal pain and diarrhea. She had anemia and was taking medication for osteoporosis. Colonoscopy showed no abnormality except shallow ulcer at the terminal ileum. Gastroduodenoscopy showed micronodularity at the duodenum 2nd and 3rd portion. Capsule endoscopy and enteroscopy showed villous atrophy and blunting of villi from the duodenum. Small intestinal pathology showed villous atrophy with lymphocyte infiltration. After gluten free diet, diarrhea, abdominal pain, anemia and osteoporosis were improved. And, she felt well-beingsensation. This is a first case of celiac disease in Korea.
정규원(Kyu Won Chung),선희식(Hee Sik Sun),심상인(Sang In Shim),강창석(Chang Suck Kang),박수헌(Soo Heon Park),한혁준(Hyeok Jun Han),노대근(Dae Keun Lo),박진노(Jin No Park),방춘상(Chun Sang Bang),최명규(Myong Gyu Choi) 대한소화기학회 1997 대한소화기학회지 Vol.30 No.1
Hepatocellular carcinoma is one of the most common malignancies reported in ost of the Africa and South-east Asia. As hepatocellular carcinoma metastases well to distant site, half of the cases metastases to distant site at diagnosis. Hepatocellular carcinoma usually spread to regional lymph nodes around porta hepatis via lyphatics and venous metastasis can occur via intrahepatic vein. The usual sites of extrahepatic metastasis are lung, local lymph nodes, adrenal glands and bones, but epidural metastasis is very rare. Although the prognosis of the hepatocellular carcinoma was very poor in the past, the survival time seemed to be prolonged by early diagnosis and improvement of medical therapy. Therefore the importance of metastatic lesion of the hepatocellular carcinoma might be reemphasized. Recently we experienced a case of the hepatocellular carcinoma who developed paraplegia suddenly. MRI revealed ovoid epidural rnass at 6th and 7th dorsal vertebra level posteriorly. After emergency operation, the resected mass was confirmed metaststic hepatocellular carcinoma. (Korean J Gastroenterol 1997;30:119-125)
정승은,양진모,김재광,김승남,이인석,정규원,최황,선희식,최명규,오귀염,김원우 대한소화기학회 1999 대한소화기학회지 Vol.33 No.4
Congenital mesocolic hernia is a rare disease which resulted from abnormal rotation of midgut during development period. It is classified by the site of mesocolic defect and hernia sac. The transverse mesocolic hernia is extremely rare. A 57-years-old man was admitted due to nausea, epigastric pain and abdominal distension. He had been diagnosed as duodenal ulcer with pyloric deformity 18 months ago. Simple abdomen X-ray with gastrografin swallowing and abdominal CT highly suggested internal hernia. Surgical exploration was done under the diagnosis of internal hernia. There was a 3 cm sized defect at transverse mesocolon and nearly total small intestine, which was herniated into the lesser sac and retroperitoneal space without strangulation. After simple resection of transverse mesocolic defect and transverse colon, reduction of herniated bowel and simple closure of transverse colon were done.