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CT 및 EUS 상 원격전이 소견이 없는 진행위암에서 복강경 검사의 유용성
허병원(Byung Won Hur),전훈재(Hoon Jai Chun),진윤태(Yoon Tae Jeen),강창돈(Chang Don Kang),이정환(Jung Whang Lee),이홍식(Hong Sik Lee),송치욱(Chi Wook Song),엄순호(Soon Ho Um),이상우(Sang Woo Lee),최재현](Jai Hyun Choi),김창덕(Chang Du 대한내과학회 2001 대한내과학회지 Vol.61 No.2
N/A Background : The proper staging of advanced gastric cancer has crucial role in determining resectability and operative method, to prevent unnecessary operation and to predict the prognosis and survival rate. Although marked improvements have been made in computed tomography (CT) technology and endoscopic ultrasonography (EUS) in recent years, reassessment of the laparoscopy for gastric cancer is required as a preoperative staging tool. Therefore, we determined the usefulness of laparoscopy for staging of advanced gastric cancer without distant metastasis in CT and EUS. Methods : Staging laparoscopy was performed in 48 patients with advanced gastric cancer staged T3 or T4 by CT and EUS. Laparoscopy was carried out with the patients under local anesthesia, and included visual inspection of abdomen, and biopsies for suspicious metastatic lesions. Laparoscopic results were compared with the postoperative pathologic findings. Results : Laparoscopy was performed successfully in 48 patients. Laparoscopy disclosed unrecognized distant metastases in 7 patients (14.6%) judged to be eligible for potentially curative resection by CT and EUS. Preoperative laparoscopy showed an accuracy of 74% for serosal infiltration. Conclusion : Our results suggest that laparoscopy is an effective means of evaluating resectability of advanced gastric cancer staged T3 or T4 and can provide valuable help in planning surgical approach.(Korean J Med 61:127-132, 2001)
허병원(Byung Won Hur),송치욱(Chi Wook Song),김혜랑(Hye Rang Kim),김윤배(Yun Bae Kim),강창돈(Chang Don Kang),이정환(Jung Whan Lee),진윤태(Yoon Tae Jeen),전훈재(Hoon Jai Chun),엄순호(Soon Ho Um),이상우(Sang Woo Lee),최재현(Jae Hyun Cho 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.2
N/A Background/Aims : Transient lower esophageal sphincter relaxation (tLESR) is the main cause of gastroesophageal reflux (GER) in both healthy subjects and patients with GER disease. Unfortunately, we have no data on tLESR and its relationship with GER in Korea. Therefore, this study was performed to evaluate the characteristics of tLESR in Korean subjects and the mechanisms of GER after Korean meals. Methods: Eight healthy volunteers (8 men, 23 to 25 yrs) received a Korean meal (laver-rolled rice, fried egg, sweet rice juice, 640 Kcal). A mylohyoid electromyogram, LES pressure using a Dent sleeve and esophageal pH were simultaneously recorded for 1 hour while fasting and 3 hours after the meal. We compared the manometric profile of swallow-induced LES relaxation (sLESR) with the manometric profile of tLESR and evaluated the frequency of tLESR and reflux episodes, and their relationship. Results : Compared with sLESR, tLESR showed longer time onset to completion, slower relaxation rate, longer duration of relaxation, and a lower nadir pressure. Incidence of tLESR increased after the meal, which was mostly accompanied by GER. Also, the frequency of GER increased after the meal, which mostly occurred during tLESR. Conclusions : Our results suggest that tLESR is a main cause of GER in healthy Korean adults, which is a similar result to studies of Westerners.
강남훈,허병원,김희수,김창훈,권영우,김해경,김호정 대한소화기내시경학회 2005 Clinical Endoscopy Vol.30 No.5
Hydrogen peroxide is commonly used for cleansing superficial wounds because of its antimicrobial action attributed to oxidizing capacity. In the past, hydrogen peroxide was used for the management of meconium ileus and fecal impaction because liberated oxygen tend to break up impaction and initiate peristaltic reflux. During 1980s, hydrogen peroxide was also introduced for disinfection of endoscope but this stronger solution has a caustic action. Several authors reported hydrogen peroxide induced colitis. We report a case of hydrogen peroxide induced chemical colitis in a 28-year-old man who complained bloody stools and lower abdominal pain after introducing hydrogen peroxide solution into the rectum to relieve rectal bleeding. His symptoms were improved with conservative treatment. (Korean J Gastrointest Endosc 2005;30:277-280) 과산화수소는 상처의 소독, 신생아의 태변성 장폐쇄증의 치료 및 기구의 소독에 사용되고 있으며, 1950년 대에 과산화수소 관장에 의해 장염이 유발되는 것을 알게 되었고, 1980년대에 과산화수소로 소독한 내시경 에 의해 발생한 장염이 보고되었다. 과산화수소는 대장 내에 적용 시 조직에서 카탈라제(catalase)에 의하여 산소가스를 유리하고, 분자의 변성을 급속하게 초래하여 점막 궤양이나 공기색전증 등을 유발하는 성질이 있으며 궤양성 대장염, 허혈성 대장염, 위막성 대장염과 유사한 증상이나 내시경 소견을 보여 감별이 필요하다. 저자들은 3% 과산화수소를 항문에 주입 후 발생한 혈변, 하복부 동통 및 이급후중을 주소로 내원한 28세 남자 환자를 과산화수소에 의한 대장염으로 진단하고 문헌 고찰과 함께 보고하는 바이다.