기능성 소화불량증에서 13C - 요소호기검사의 DOB30 와 위근위부 운동기능과의 상관관계

심상군(Sang Goon Shim),이풍렬(Poong Lyul Rhee),현재근(Jae Gun Hyun),김지은(Jee Eun Kim),성인경(In Kyung Sung),장재권(Jae Kwon Jang),류광현(Kwang Hyun Ryu),김영호(Young Ho Kim),김재준(Jae J . Kim),고광철(Kwang Cheol Koh),백승운(Seung 대한소화기학회 2001 대한소화기학회지 Vol.38 No.6

Background/Aims: 13C-urea breath test (UBT) is accepted as an accurate test to detect Helicobacter pylori (H. pylori) infection. The results of UBT could be correlated with the extent of H. pylori colonization density or the severity of the gastric mucosal inflammation. We examined whether UBT values correlated with some parameters for proximal gastric motor functions in functional dyspepsia (FD). Methods: Twelve patients with FD and H. pylori infection confirmed by UBT were included. Breath samples were taken before and 30 min after 75 mg 13C-urea ingestion and analyzed by isotope mass spectrometry. The results of UBT were expressed as the difference between value at 30 min and value at baseline (DOB30). Gastric emptying scintigraphy and gastric barostat study were performed to measure the proximal gastric motor functions. Results: No significant correlation was found between DOB30 and proximal half-emptying time (r=-0.34, p=0.28), DOB30 and proximal gastric distribution of meal at 1 min images (r=0.03, p=0.93). According to the gastric barostat study, basal tone (r=0.53, p=0.07), compliance (r=-0.05, p=0.86), and gastric accommodation (r=-0.08, p=0.79) were not associated with DOB30. Conclusion: DOB30 does not correlate with proximal gastric motor parameters in patients with FD. (Korean J Gastroenterol 2001;38:405-410)

’96 군정례신검자에서의 C형 항체(anti-HCV) 양성률

심상군 ( Sang Goon Shim ),이성계 ( Sung Gye Lee ),김록권 ( Rock Kwon Kim ) 국군의무사령부 1998 대한군진의학학술지 Vol.29 No.1

모틸린에 의한 사람 위 평활근의 수축 기전에 관한 연구

심상군(Sang Goon Shim),이종철(Jong Chul Rhee),이풍렬(Poong Lyul Rhee),최규완(Kyoo Wan Choi),전성국(Sung Kook Jeon),강동묵(Tong Mook Kang),엄대용(Dae Yong Uhm),이종석(Jong Seok Lee),성인경(In Kyung Sung),김현서(Hyun Seo Kim) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.1

Background/Aims: Motilin is an intestinal peptide that stimulates the contraction of gut smooth muscle. A discrepancy exists between the in vivo (neurally mediated) and in vitro (direct action on a smooth muscle receptor) mechanisms of motilin action in many species. We investigated in vitro mechanisms of motilin action on human gastric smooth muscle. Methods: Antral cirular muscle strips of the surgical tissue obtained during gastrectomy, were used to measure contractile force and electrical activity. Dispersed muscle cells were used to measure L-type Ca2+ current and electrical activity. Results: Motilin of 1-100nM contracted smooth muscle in a concentration-dependent manner. Motilin-induced contractions were unaffected by tetrodotoxin or atropine treatment. Nifedipine or Ca2+-free bath solution blocked motilin (10nM)-induced contractions. Low concentration of motilin (1nM) resulted in an increase in acetylcholine (0.1~100M)-induced contractions. By patch clamp recording technique, motilin (1 or 10nM) did not modify the L-type Ca2+ current, but motilin-induced membrane depolarization was detected. Erythromycin also contracted smooth muscle with membrane depolarization but verapamil inhibited the contraction. Conclusions: These results suggest that motilin contracts smooth muscle through a direct action on smooth muscle receptor and Ca2+ influx through the L-type Ca2+ channel, which is due to membrane depolarization, also mediates motilin-induced contractions. (Korean J Gastroenterol 2002;39:4-12)

건강검진 수진자에서의 담낭용종의 유병률 및 위험인자 분석

심상군(Sang Goon Shim),이규택(Kyu Taek Lee),이종균(Jong Kyun Lee),박정호(Jung Ho Park),류광현(Kwang Hyun Ryu),이풍렬(Poong Lyul Rhee),김재준(Jae Jun Kim),고광철(Kwang Cheol Koh),백승운(Seung Woon Paik),이종철(Jong Chul Rhee),최규완(K 대한내과학회 1999 대한내과학회지 Vol.57 No.6

N/A Background : Gallbladder (GB) polyps are now increasingly detected by ultrasonography. We investigated the prevalence and risk factors of GB polyps in health screening population. Methods : An ultrasonographic study of GB polyps were conducted in 35,012 subjects who received a paid health screening examination at Samsung Medical Center. Controls, twice the subjects with GB polyp, were randomly selected from the cases with normal GB. The demographic characteristics and biochemical parameters were recorded. Results : The overall prevalence of GB polyps was 2.94% (1,330/15,573). Among them, 3.63% were men, 2.09% were women. In both males and females, the prevalence was highest in their 40s. The diameter of GB polyps ranged from 2 mm to 20 mm (mean 4.5 mm). Most polyps (98.3%) were less than 10 mm in diameter. Of 1,030 subjects, 64% had a single polyp and 36% had multiple polyps. Multiple logistic regression, with reference group of body mass index (BMI, <22.5 kg/m2), showed odds ratio of 1.074 and 1.864 for BMI groups of 22.5-24.9 and 25 or more respectively. In contrast, other demographic characteristics and biochemical parameters, such as age, smoking, alcohol use, glucose, liver function tests, lipid profiles and HBsAg carriage were lack of any relation to GB polyps. Conclusions : GB polyps are not likely to be rare in Korean adults despite their low prevalence compared to other reports. The body mass index may be a risk factor for GB polyps. (Korean J Med 57:1014-1020, 1999)

발기부전에 처방된 Sildenafil이 식도 증상을 유발할 수 있다

심상군 ( Sang Goon Shim ),김범진 ( Beom Jin Kim ),이풍렬 ( Poong Lyul Rhee ),이성원 ( Seong Won Lee ) 대한소화기기능성질환·운동학회 2004 Journal of Neurogastroenterology and Motility (JNM Vol.10 No.2

목적: 발기부전의 치료제로 흔히 사용되는 sildenafil은 제5형 phosphodiesterase를 선택적으로 억제 시킨다. 최근 Sildenafil은 식도의 운동능에 변화를 일으키는 것으로 알려져 있으며, 이전의 우리연구에서도 하부식도괄약근의 기저압 및 식도 원위부 수축파의 진폭이 감소됨을 보였다. 그러나 sildenafil에 의한 식도운동이상이 증상을 유발하는 지는 확실치 않다. 본 연구는 sildenafil 복용에 의해 유발될 수 있는 식도증상 Background/Aims: Sildenafil, which is commonly prescribed for erectile dysfunction, is a potent and selective inhibitor of cGMP-specific phosphodiesterase type 5. Recently, sildenafil has been found to induce changes in esophageal motility. However, it re

A Study on Stable Grasping Control of Dual-Fingers with Soft-tips

Shim Jae-goon,Park Kyung-Taek,Yang Soon-Yong,Han Hyun-Yong,Lee Byung-Ryon,Ahn Kyung-Kwan,Kim Sung-Su 제어로봇시스템학회 2002 제어로봇시스템학회 국제학술대회 논문집 Vol.2002 No.10

시사프라이드의 대장내시경 전처치 용액의 감량 효과

이성호,김현수,박찬원,이현택,이홍석,조대현,박정호,심상군,김현서,권정훈,장재권,성인경 대한소화기내시경학회 2000 Clinical Endoscopy Vol.21 No.5

Background/Aims: Polyethylene glycol (PEG) electrolyte lavage solution is now commonly used for peroral colonic preparation. However, the need to ingest a large volume reduces patient acceptance and may limit compliance, thereby resulting in improper preparation. This study was designed to assess whether adding of magnesium oxide or cisapride to PEG solution decreased the volume of PEG solution required without compromising the quality of the preparation. Methods: One hundred thirty seven patients undergoing outpatient colonoscopy were randomly chosen to receive one of three preparations (Group A: 4 L PEG; Group B: 2 L PEG plus cisapride 20 mg; Group C: 2 L PEG plus magnesium oxide 2 g). Endoscopist was blinded as to the method of preparation and scored the degree of colonic preparation (1 to 4). Results: Mean scores of preparation in group A, B, and C were 2.85, 2.69, and 2.20, respectively (p=0.001). There were significant differences of the degree of preparation between group A and group C, between group B and group C, but not between group A and group B. Conclusions: Two liters of PEG plus cisapride induced equally effective colonic preparation compared to four liter PEG solution. This results show that the addition of cisapride to PEG solution can reduce volume of PEG solution during colonoscopy preparation.

The Efficacy and Safety of Sofosbuvir and Ribavirin Treatment for Genotype 2 Chronic Hepatitis C Patients

( Ik Sung Choi ),( Kil Jong Yu ),( Dae Hyeon Cho ),( Ji Enu Oh ),( Chang Wook Jeong ),( Kwang Min Kim ),( Hyoun Soo Lee ),( Jung Won Lee ),( Dong Kyu Lee ),( Byung Soo Kwan ),( Sang Goon Shim ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: A direct-acting antiviral (DAA) drug is in the spotlight for the treatment of patients with chronic hepatitis C. The combination of sofosbuvir and ribavirin is more effective than the peg IFN and ribavirin in patients with genotype 2 HCV. The aim of this study was to evaluate the treatment efficacy and safety for GT2 HCV patients treated with sofosbuvir and ribavirin in a single center. Methods: The study was performed retrograde from May 2016 to December 2017 in GT2 HCV patients treated with sofosbuvir (400mg) plus ribavirin (800-1200mg; based on body weight) treatment. The primary endpoint was sustained virologic response at 12 weeks (SVR12). The secondary endpoint was the occurrence of side effects during treatment. Results: A total of 95 patients with GT2 HCV infection were enrolled, of which 92 were genotype 2a (96.8%) and 3 were 2b (3.2%). 2 patients were follow up loss, 1 patient discontinued treatment voluntarily. SVR12 was confirmed in 91 of 92 patients (98.91%). 1 patient with failed treatment were combined LC and HCC, HCV RNA was not detected at 4 weeks and 8 weeks after initiation of treatment, but HCV RNA detected at 12 weeks. Liver cirrhosis was diagnosed on the imaging studies or clinical manifestations and 24 patients were included (CTP-A; n=23, C; n=1). SVR12 with cirrhotic patients was 95.83%. The average HCR RNA titer was 2.46x10⁶ IU/ml. Hemoglobin decrease (Mean ± SD; 2.95±1.19 g/dl) occurred in 21 patients during treatment and ribavirin dose reduction was required. Conclusions: This study was performed on a small group of patients compared with other studies, but showed that treatment with sofosbuvir and ribavirin was highly effective in patients with GT2 HCV infection. In aspect of safety, there was no serious side effects about treatment although hemoglobin decrease.

위식도역류질환에 대한 국내 인터넷 의료 정보 평가

이준상 ( June Sang Lee ),문태건 ( Tae Gun Moon ),김회진 ( Hoi Jin Kim ),이현정 ( Hyun Jeong Lee ),이준행 ( Jun Haeng Lee ),심상군 ( Sang Goon Shim ),이풍렬 ( Poong Lyul Rhee ),김재준 ( Jae J. Kim ),이종철 ( Jong Chul Rhee ) 대한소화기학회 2007 대한소화기학회지 Vol.49 No.4

목적: 인터넷상에서 위식도역류질환에 대해서 검색되는 웹사이트들이 정확한 의료 정보를 제공하고 있는지 평가하였으며 이를 통해 위식도역류질환에 대한 인터넷 정보의 지향점을 제시하고자 하였다. 대상 및 방법: "위식도역류질환"과 "역류(성) 식도염"을 핵심 단어로 2006년 7월 1일부터 9월 2일까지 7개의 검색엔진에서 검색된 각각 상위 15개 웹사이트(총 108개)를 대상으로 JAMA 핵심기준과 대한소화기 운동학회의 위식도역류질환의 진단, 치료 가이드라인을 참조하여 만든 점검표를 이용해서 평가하였다. 결과: 전체 108개의 사이트 중 개인 병의원의 검색 빈도가 가장 높았고(21.3%) 대부분 환자나 일반인을 대상으로 하고 있었다(87.0%). JAMA 기준에 3개 이상 부합하는 사이트는 11개(9.3%)였고 3개 미만으로 만족시킨 웹사이트보다 정보의 불확실성이 유의하게 더 낮았다(p=0.002). "Heartburn"에 대한 정의는 50%의 웹사이트에서 비교적 정확히 언급되었고 진단 시 초기에 위내시경 검사를 시행한다고 언급한 사이트는 48.1%, 내시경 검사 없이 24시간 pH 검사 등을 초기에 시행한다는 언급은 26.9%, 식도내압 검사나 번스타인 검사, 식도조영술을 일반적으로 시행한다고 언급한 웹사이트는 28.7%였다. 치료에서는 65.7%에서 생활습관 조정을 언급하였고 생활습관 조정 단독만으로 증상 관해를 유도할 수 있다는 웹사이트는 47.2%였다. 치료약물 중 양성자펌프억제제를 언급한 웹사이트는 57.3%였는데 임상적으로 가벼운 경우에 양성자펌프억제제 4주 투여 후 필요 시 투여나 단계적 하향 투여에 대한 언급은 8.3%, 임상적으로 심한 경우에 양성자펌프 억제제 8주 투여 후 지속 투여에 대한 언급은 11.1%의 웹사이트에서 있었다. 결론: 일반인들이 검색엔진을 통하여 접근할 수 있는 인터넷에서 사이트에서 제공되는 위식도역류질환 진단과 치료에 대한 정보는 대부분 기초적인 수준에 머물러 있었고, 구체적인 부분에서는 사이트마다 정보의 양과 내용에서 차이가 많았다. 이는 인터넷에서 정보를 구하고자 하는 환자에게 적지 않은 혼란을 초래할 수 있을 것으로 판단한다. Background/Aims: Internet has become an important source of medical information not only for medical personnels but also for patients. The aim of this study was to evaluate the quality of internet based medical information about ``gastroesophageal reflux`` or ``reflux esophagitis`` in Korea. Methods: The first 15 internet sites using the key words ``gastroesophageal reflux`` or ``reflux esophagitis`` were retrieved from the 7 most frequently used internet search engines. The quality of information from a total of 108 websites was evaluated using a checklist. Results: Among total 108 sites related to ``gastroesophageal reflux`` or ``reflux esophagitis``, fifty-six sites (51.8%) were made by hospitals or clinics and 94 sites (87.0%) were made for patients. Of the 108 sites, eleven web sites (10.1%) had more than three JAMA benchmarks (authorship, references, currency, and disclosure). Higher quality sites (at least three JAMA benchmarks) were less likely to contain inaccurate information than lower quality sites (fewer than three JAMA benchmarks)-3/11 (27.2%) vs. 60/97 (61.9%) (p<0.01). Despite the fact that articles in the literature emphasized an insufficient evidence to support an association between the lifestyle, dietary behaviors, and GERD, such guidelines continue to be recommended as first-line therapy in most websites. Conclusions: Informations about gastroesophageal reflux disease were incomplete in the majority of medical web sites. These would bring about confusion to patients seeking for an information about GERD through the internet. There is a need for better sources in evidence based informations about gastroesophaeal reflux diseases on the web. (Korean J Gastroenterol 2007;49:231-237)

Poster Session:PS 1112;Gastroenterology (Gastrointestinal Tract):Scrub Typhus Associated Hepatic Dysfunction and Abdominal CT Findings

( Weon Jae Lee ),( Sang Goon Shim ),( Kil Jong Yu ),( Chang Uk Jeong ),( Ji Eun Oh ),( Kwang Min Kim ),( Hyun Jin Cho ),( Dae Hyun Jo ),( Hyoun Su Lee ),( Man Je Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: This retrospective study investigated abnormal hepatic dysfunction and abdominal computed tomography (CT) fi ndings in scrub typhus, and severity of hepatic dysfunction according to the number of CT fi ndings. Methods: 349 adult patients were diagnosed with scrub typhus. 94 underwent abdominal CT. The CT images were reviewed by the attending radiologist. Patient data of history, symptoms, signs, and results of laboratory tests were collected from the electronic medical records. Results: In 349 patients with scrub typhus, elevation of AST (78. 5%) and ALT (63. 0%) were dominant compared to ALP (27. 2%) and total bilirubin (16. 1%) (Table 1). Abdominal CT fi ndings of 94 patients were, in descending order of frequency, enlarged lymphnode (53. 2%), inhomogenous enhancement of liver (47. 9%), splenomegaly (46. 8%), ascites (28. 7%), low attenuation of periportal areas (27. 7%), gallbladder wall thickening (17. 0%), and splenic infarct (6. 4%) (Table 2) (figure 1). Also, the level of aspartate transaminase tended to be elevated according to the number of CT fi ndings (P= 0. 028). Conclusions: When scrub typhus is suspected in an endemic area, the hepatocellular pattern of hepatic dysfunction and the aforementioned fi ndings of abdominal CT may be helpful to the accurate diagnosis and improvement the patient prognosis, such as by the appropriate selection of antibiotics.