경피내시경하 위루술

나용호(Yong Ho Nah),송주흥(Ju Hung Song),최인태(In Tae Choi),채수인(Soo In Chae),김영준(Young June Kim) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1

We performed the percutaneous endoscopic gastrostomy in 7 patients who were unable to swallow. Feeding via with the PEG was carried out in a bolus fashion requiring no additional equipment. In our experience no aspiration occurred and only one case of skin care problem arose. The PEG appeared to be safe and effective means of nonvolitional feeding in the home, hospital or in an extended care facility.

기능성 소화장해증에서 위 , 소장 내압 검사 소견

나용호(Yong Ho Nah),정양호(Yang Ho Jeong),손봉국(Bong Gook Shon),임종채(Jong Chae Lim) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.1

N/A The aim of this study was to determine gastrointestinal manometric patterns of functional dyspepsia. We studied 10 healthy volunteers and 19 patients with functional dyspepsia during fasting and 2 hour after a 650-Kcal meal. This results showed: 1) Healthy subjects: During fasting, the migrating motor complex (MMC) was present in all subjects and at all levels of upper small intestine and propagated aborally. Migrating motor cornplex occurred each 103+32 min (grand mean for all loci), but intervals between MMC varied markedly (63-360). Rates of continuous, rhythmic contractions during activity fronts were 11.5+0.5 cpm and the duration of activity fronts was 7.0+3.6 min. The velocity of aboral migration was 11.2+5.7 cm/min. Eating disrupted the cycle of interdigestive motor activity at levels of the stomach and the upper gut. Progression of MMC was interrupted and a postcibal pattern of motility was established. This consisted of short bursts of irregular, randorn contractions, interspersed with transient periods of quiescence. 2. Functional dyspepsia: Manometric abnormalities were found in 12 patients (63%). In the upper intestine, unpropagated bursts of phasic and tonic contractile activity were a relatively frequent abnormalities (37%) but a number of other altered manometric patterns also were observed. In one patients, there were good corelation between manometric abnormalities and symptoms. Ive conclude that in patients with functional dyspepsia gastrointestinal manometry is a useful technique to evidence the underlying gut motor disturbance that is present in a relatively high proportion of these patients. This sudy suggests also that there are several subtypes of gastrointesti- nal motility in functional dyspepsia.

위장관 ( 胃腸管 ) : 일차성 Achalasia 에서 풍선 확장술의 효과 판정 기준

나용호(Yong Ho Nah),이건화(Keon Hwa Lee),박옥규(Ock Kyu Park) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2

N/A Pneumatic dilation of the esophagus is an effective form of therapy to be available to achalasia. To evaluate the criteria predicting the therapeutic effects of pneumatic dilation, the manometric and radiographic appearances of the esophagus with achalasia were analyzed in 32 achalasia patients immediately following pneumatic dilation. A comparison of dysphagia grading and the parameters of the manometric and radiographic studies was made. 1) The pretreatment manometric findings of vigorous achalasia were associated with the significant irriprovement of dysphagia grading score and with high rate of reappearance of peristalsis after pneumatic dilatation. 2) The fall of LES pressure or intraesophageal pressure compare with pretreatment values noted no close relationship to the dysphagia grade after 6 months postdilation. 3) The level of barium fleck (no more than 1 cm) showed a close relationship to the dysphagia grade after pneumatic dilation. 4) The caliber of the esophagogastric channel (more than 8 mm) after dilation showed a close relationship to the dysphagia grade after pneumatic dilation. 5) Reduction of the diameter of the esophageal body was not well correlated with the dysphagia grade after pneumatic dilation. In conclusion, in predicting the clinical response of pneumatic dilation, the esophagogastric diameter or the level of barium fleck in the distal esophagus is the useful criteria to evaluate the effects of pneumatic dilation in achalasia.

간장 ( 肝臟 ) 및 담도 ( 膽道 ) : 만성 간질환에서 SGD - F의 효과

나용호(Yong Ho Nah) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.1

N/A The single blind clinical trials of SGD-F (complex capsule of UDCA 100 mg and vitamin B1 10 mg and B, 10 mg) were carried out in 30 patients with chronic liver disease (and 10 received the placbo) T.I.D. for 4 weeeks. In the SGD-F treated group, subjective symptoms (nausea, anorexia and fatigue) proved to be improved in a statistically significant manner than those of placebo. And the bio- chemical parameters (SGOT & SGPT) were improved significantly in the SGD-F groups. Untoward side effects were not significant and easily controlled by discontinuing the drugs. In conclusion, ursodeoxycholic acid 100 mg with vitamin B1 10 mg and B2 10 mg (t.i.d. for 4 weeks) appears to be effective for reliefing symptoms and safe for the treatment of patients with chronic liver disease.

경피내시경하 위루술이 하부식도 괄약근에 미치는 영향

나용호(Yong Ho Nah),채수인(Soo In Chae) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.2

N/A Aspiration pneumonia, a recognized complication of enteral feeding via a nasogastric tube, is considered uncommon with percutaneously placed gastrostorny tube feeding. But the specific influ- ence of PEG on the LES has not been studied well. To evaluate PEG effects on the LES in long-term period, we conducted a prospective study in 10 neurologically compromised patients. The mean LES pressure was 21.6 (+2.4) mmHg before PEG: 22.0 (+3.4) mmHg at 10 days and 1:3.8 (+2.6) mmHg at 6 months post-PEG. Following PEG, either the location of pressure inversion point or the length of LES remained unchanged. This study suggests that PEG does not affect the LES pressure in short- term period, but reduces it in long-term follow-up period. The observed decrease in LES pressure after PEG may be explained mechanically, based upon the intraluminal pressure changes accounted for by the law of Laplace. The PEG exerts the gastric fixation to the abdominal wall. This, in turn, tends to widen the diameter of the LES, leading to a drop in intraluminal pressure.

위십이지장궤양에서 Famotidine 의 효과

나용호 ( Yong Ho Nah ),박석 ( Suk Park ),김혁제 ( Won Sup Cho ),조원섭 ( Hyuk je Kim ) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A We conducted a single-blind randomized controlled study of 60 patients with endoscopically proven duodenal or gastric ulcers to study the efficacy and safety of famotidine, a new potent histamine H2-receptor antagonist, in accelerating healing and pain relief as compared with placebo. The famotidine group, comprising 16 cases of gastric ulcers and 20 cases of duoderial ulcers, received famotidine 20mg twice daily (after breakfast and befor bedtime). Pretreatment characteristics were similar in all four treatment groups. The duration of treatment was eight weeks for gastric ulcer and six weeks for duodenal ulcer. Healing was determined by endoscopy after completion of the trial. By the end of study, 87.5% of gastric ulcers and 90% of duodenal ulcers were healed in the famotidine group compared to 36% of gastric ulcers and 38% of duodenal ulcers in the placebo group, respectively. Famotidine 20mg bid was superior to placebo in healing ulcers. The time until relief of pain was significantly less for patients on famotidine than for those on placebo. Relief of ulcer pain usually occurred within the first week of famotidine treatment in gastric or duodenal ulcers. Therapy was generally well tolerated and there was few side effects with famotidine treatment. These results indicate that famotidine 20mg bid is effective and safe for the treatment of gastric or duodenal ulcer.

호도까기 식도증 환자에서 Edrophonium 유발시험

나용호(Yong Ho Nah),김영준(Young June Kim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A The nutcracker esophagus is the most frequent defect of the esophageal motility disorders. But it is unknown whether nutcracker esophagus, as assessed by standard motility testing, bears close relationship to the patients symptoms. To evaluate efficacy and possible relationship between manometric abnormalities and patients symptoms, prospective edrophonium tests were studied in 11 patients with nutcracker esophagus and in 33 age matched controls. To provoke symptoms and motility abnormalities after baseline evaluation, all subjects had administration of normal saline (1 ml i.v.) and edrophonium (80 ug/kg i.v.). Tracings were coded, read and interpreted by two blind observers. Because of efficacy and relative safety, edrophonium provocative test can be simply done with or without manometric findings. The mechanism of edrophonium induced chest pain may be due to accompanying other abnormal waves, but remains an intriguing question. However, no single manometric finding reliably characterizes the patients with edrophonium induced pain. But it seems likely that high frequency of abnormal waves (over 50% of wet swallows) and a significant increase in mean wave duration (over 7.0 sec) may be considered as the probable positive signs.

호도까기 식도증에서 Diltiazem 투여 전 , 후의 식도내압검사 소견

나용호(Yong Ho Nah),안태규(Tae Gyoo Ahn),허종(Jhong Heo),김경중(Kyeong Joong Kim),유웅선(Wong Soun Yu) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4

N/A We studied the effects of oral diltiazem (30 mg TII) alone. And combination with diazepam (1 rng Tll) on esophageal manometric chracteristics in 24 patient, with a nucracker esophagus by baseline maotmetry. A 4-week oral administrationn of diltiazem decreased distal esophageal contraction amplitude (205±35.3 mmHg to 150±30.9 mmHg: p<0.01), but had no effect on lower esophageal sphincter pressure and their was poor correlation with chest pain improvement. After 4-week treat- ment with diltiazem and diazepam, contraction amplitude fell from l50±30.9 mmHg to 101±23.4 mmHg (p<0.01) and the relief of symptom was about 90%. This study suggests that diltiazem is demonstrated to result in a reduction of the peristaltic amplitude in patients with nutcrackcr esophagus, but symptomatic benefit is most marked with combination off diazepam.

만성 변비증 환자에 대한 연구 - 병태생리학적 접근

나용호(Yong Ho Nah) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.4

N/A Background/Aims: Constipation or defecatory difficulty is a symptom with multifactorial etiolo- gies, and understanding of the underlying physiologic abnormalities has facilitated successful treatment for patients with constipation. This study was carried out to evaluaie the underlying pathophysiologie. Of colorectal motor functions in patients with chronic constipation or defecatory difficulty. Methods: Between January 1993 and December 1993, 80 patients(M:]S, F:65, mean age 47 years, ranged IS--80) with constipation and/or defecatory difficulty(negative colonoscopy, barium enema, and biochemica1 tests), were evaluated hy questionnaire, office examination, colon transit studies, anorectal manometry, balloon expulsion studies, electromyography of the pelvic floor and defecography. Results: Based on these studies, patients were categorized as follows: slow transit constipation, 4 patients; pelvic tloor disorders, 50 patients; combined slow transit and pelvic flcx>r disorders, 17 patients, and idiopathic constipation, 9 patients. Among 67 patients with pelvic floor disorders, 30 patients were observed to have rectocele; 24 patients, rectal intussusception; 24 patients, descending perineal syndrome; 14 patients, anismus; 14 patients, abnormal rectal .ensation; 8 patients, rectal prolapse. Conclusions: The majority(over 80%) of Korean chronic constipated patients is shown to have pelvic fl<mr disorders. (Korean J Gastroenterol 1995;27:388 - 393)

위장관 ( 胃腸管 ) : 위식도 역류질환에서 Cisapride가 보행성 24시간 식도내 pH 기록에 미치는 영향

나용호(Yong Ho Nah),송주흥(Ju Hung Song) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.3

N/A To evaluate the effect of cisapride on gastroesophageal reflux, 42 patients with gastroesophageal reflux disease were studied. Patients were subdivided into two groups; cisapride group (n=28) and placebo group (n= 14). Tewenty-four hour ambulatory esophageal pH monitoring was done before and after treatment with placebo or 10 mg cisapride QID for 8 weeks. The results were as follows: 1) No significant differences in age, weight, duration of illness, lower esophageal sphincter pressure and amplitude of distal esophageal contractions were found between two groups. 2) In baseline study, no significant differences in 24-hour pH profile were demonstrated between two groups. 3) Cisapride was shown to increase the basal lower esophageal sphincter pressure as well as the amplitude of esophageal peristalsis, compared with placebo (p<0.01). 4) After treatment, 24-hour pH profile (number of reflux episodes lasting longer than 5 min, duration of the longest reflux episode, total percent of time pH less than 4) showed that there was significantly less reflux with cisapride than with placebo and its effect was most marked during supine position (p<0.01). 5) At the end of the treatment, follow-up endoscopy showed that previqus mucosal erosions or ulcers were absent in 8 of 11 patients in the cisapride group and in 1 of 5 patients in the placebo group. In conclusion, cisapride decreases pathologic reflux in gastroesophageal reflux disease. Of major interest is cisapride effect most marked at night.