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원저 : 헬리코박터 파일로리의 3차 구제요법에서 리파부틴과 레보플록사신의 비교
정명호 ( Myung Ho Jeong ),정준원 ( Jun Won Chung ),이상진 ( Sang Jin Lee ),하민수 ( Minsu Ha ),정석후 ( Seok Hoo Jeong ),나선영 ( Sunyoung Na ),나병수 ( Byung Soo Na ),박성근 ( Sung Keun Park ),김윤재 ( Yoon Jae Kim ),권광안 ( Kwa 대한소화기학회 2012 대한소화기학회지 Vol.59 No.6
Background/Aims: There is increasing need for third-line therapy of Helicobacter pylori due to increasing level of antibiotics resistance. The aim of this study was to compare rifabutin and levofloxacin rescue regimens in patients with first- and second-line Helicobacter pylori eradication failures. Methods: Patients, in whom a first treatment with proton pump inhibitor-clarithromycin-amoxicillin and a second trial with proton pump inhibitor-bismuth-tetracycline-metronidazole had failed, received treatment with either rifabutin or levofloxacin, plus amoxicillin (1 g twice daily) and standard dose proton pump inhibitor. Eradication rates were confirmed with 13C-urea breath test or rapid urease test 4 weeks after the cessation of therapy. Results: Eradication rates were 71.4% in the rifabutin group, and 57.1% in the levofloxacin group, respectively. Although there was no significant difference in Helicobacter pylori eradication rates between two groups (p=0.656), rifabutin based regimen showed relatively higher eradication rate. Conclusions: Helicobacter pylori eradication rates of rifabutin- or levofloxacin-based triple therapy could not achieve enough eradication rate. Further studies would be needed on combination of levofloxacin and rifabutin-based regimen or culture based treatment. (Korean J Gastroenterol 2012;59:401-406)
유두주위게실이 내시경유두큰풍선확장술을 이용한 총담관 결석 치료에 미치는 영향
이지원 ( Ji Won Lee ),김정호 ( Jung Ho Kim ),김연석 ( Yeon Suk Kim ),최현석 ( Hyun Seok Choi ),김주승 ( Ju Seung Kim ),정석후 ( Seok Hoo Jeong ),하민수 ( Min Su Ha ),구양서 ( Yang Suh Ku ),김연수 ( Yun Soo Kim ),김주현 ( Ju Hyun K 대한소화기학회 2011 대한소화기학회지 Vol.58 No.4
Background/Aims: Periampullary diverticulum (PAD) causes difficulty in the extraction of common bile duct (CBD) stones with conventional endoscopic therapy. Our study was designed to evaluate the effect of PAD on endoscopic large balloon dilation (EPLBD) with/without limited endoscopic sphincterotomy (EST) for CBD stone treatment. Methods: We retrospectively reviewed cases of 141 patients treated CBD stones by EPLBD with/without limited EST at Gachon Gil Medical Center from September 2008 to February 2010. PAD were classified into three groups according to the location of the papilla and diverticulum. Clinical parameters, endoscopic parameters, and procedure outcomes were analyzed. Results: PAD were identified in 46.1% (65/141), with 23 male (35.4%) and 42 female (64.6%) and a mean age of 72.9±11.1 years. Mean diameter of the stones was 14.8±6.0 mm and mean diameter of CBD was 21.6±7.7 mm. PAD group was significantly older than control group (72.9 vs. 68.6, p=0.043) and the incidence of large stone (≥15 mm) was higher in PAD group (60.0% vs. 42.1%, p=0.034). Success rate of complete removal of stones in the first session was 32/65 patients (49.2%) and overall successful complete stone removal rates was 63/65 (96.9%). There was no significant difference between the PAD and control groups in success rate. Major complications were similar between two groups. Conclusions: PAD is associated with an increased incidence of large bile duct stones and older age. PAD seems to not increase technical failure rate or complication risk on EPLBD with/without limited EST. (Korean J Gastroenterol 2011;58:201-207)
위장관 ; Helicobacter pylori 감염 여부에 대한 집합 세정맥 규칙적 배열의 유용성
나선영 ( Sun Young Na ),정준원 ( Jun Won Chung ),박현주 ( Hyun Joo Park ),김윤재 ( Yoon Jae Kim ),권광안 ( Kwang An Kwon ),함기백 ( Ki Baik Hahm ),최덕주 ( Duck Joo Choi ),정석후 ( Seok Hoo Jeong ),하민수 ( Min Su Ha ),김금하 ( Ge 대한소화기학회 2011 대한소화기학회지 Vol.58 No.5
Background/Aims: In the Helicobacter pylori (H. Pylori)-negative normal stomach, collecting venules are visible over all the gastric body as numerous minute points evaluated with standard endoscopy. This finding was termed regular arrangement of collecting venules (RAC), and its absence suggests H. pylori gastritis. The aim of this study was to evaluate the correlation between the RAC and rapid urease test. Methods: Two hundred sixty three consecutive adults undergoing upper digestive endoscopy and rapid urease test were included. The lesser curvature of the lower corpus was evaluated for the RAC pattern using a standard endoscope and different hemoglobin index. Two biopsies from the lesser curvature of the antrum and the greater curvature of the body were collected for rapid urease test. Results: H. pylori were detected in 51.3% (135/263) patients. Of the 57 patients with H. pylori-negative normal stomachs 53 patients (93%) had RAC. As a determinant of the normal stomach without H. pylori infection, the presence of RAC had 41.4% sensitivity, 97.0% specificity, 93.0% positive predictive value and 63.6% negative predictive value. Conclusions: RAC-positive finding by standard endoscopy showed high positive predictive value and specificity of H. pylori-negative normal stomach. RAC-positive finding by standard endoscopy could be an useful finding to predict H. pylori negativity. (Korean J Gastroenterol 2011;58:252-257)