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유광현(Kwnag Hwon You),김태현(Tae Hyeon Kim),나용호(Yong Ho Nah),장명규(Myoung Kyu Jang),김형언(Hyeong Eon Kim),진경민(Kyung Min) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.3
N/A Background/Aims: Defecography is a useful diagnostic method that demonstrates the physiolo- gical, dynamic and anatomic features involved when rectum evacuates semisolid barium contrast media. In Korea, there has recently been increased interest in the use of defecography for the investigation of problems of defecation and pelvic floor dysfunction. Interpretations of abnormal findings, however, are questionable because of the absence of suitable control subjects to define the state of normality. The present study was carried out to determine the normal range of defecographic findings encountered in healthy Koreans. Methods: Fifty healthy volunteers(men:25, women:25) (mean age: 32.6yrs) underwent defecographic examinations. Results: The mean resting centroid anorectal angle was 1l9, decreasing to 108 during squeeze and increasing to l39 on defecation. The mean perineal floor position in the resting state was 6 cm, descending 3 cm in men and 3.5 cm in women during defecation, taking account of the magnification of the X-ray film. All subjects had a closed anal canal in the resting state and the anal canal was widely opened to 2.5 cm during defecation. Loss of the impression of puborectalis sling on the posterior wall of the distal rectum during straining was observed in the all subjects. Conclusions: The anorectal angle increases by 20 on straining and decreases by lO on squeeze from 120 at rest, The anorectal junction lies less than 6 cm below the pubococcygeal line and the descent of pelvic floor during defecation not more than 3 cm in men and 3.5 cm in women below the resting position, wide opening of anal canal(2.5 cm) on evacuation, and loss of impression of puborectalis sling on the posterior wall of distal rectum during defecation. Rectoceles or rectal intussusception may be present in the asymptomatic healthy individuals. But the rectocele is small (less than 4cm in length) and does not have barium trapping. The intussuscepting rectal folds are not thick(less than 0.7 cm in width) and short(less than 4.5 cm in length). (Korean J Gastroenterol 1995;27:309 - 316)
내시경적 식도정맥류 결찰요법의 식도하부 운동과 식도내 pH에 대한 영향
최석채(Suck Chei Choi),김형언(Hyeong Eon Kim),유광현(Kwnag Hwon You),류준형(Jung Hyung Ryu),김태현(Tae Hyeon Kim),김학철(Haak Cheoul Kim) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.2
N/A Background/Aims: A recently developed method that uses sma11 rubber bands for treating bleeding varices, endoscopic variceal ligation(EVL), may affect the lower esophageal motility. The aim of this study was to assess the effects of EVL on esophageal motility and gastroesophageal reflux. Methods: We prospectively performed lower esophageal manometry and 24-hour ambulatory esophageal pH monitoring before and after EVL therapy in 34 patients with esophageal varices. Results: The EVL caused considerable decrease in the size of esophageal varix by mean 7.8(range 3 21) ligations in mean 1.5(range l -3) sessions. There were no significant changes in the length, pressure, relaxation percent and duration of the lower esophageal sphincter(LES), in the speed of peristaltic wave in the lower esophagus and all pH parameters after EVL. Conclusions: Endoscopic variceal ligation therapy may cause little motility dysfunction in thc lower esophagus, even though there were significant differences in the contraction amplitude and duration in the lower esophagus after EVL. (Korean J Gastroenterol 1995;27: 151 - 158)