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조기위암 및 불완정 십이지장 횡격막과 동반된 선천성 중복유문 1 예
이명석(Myung Seok Lee),전훈재(Hoon Jai Jeon),현진해(Jin Hai Hyun) 대한내과학회 1986 대한내과학회지 Vol.31 No.1
N/A A rare case of congenital double pylorus with early gastric cancer was observed in a 50-yr-old female patient by gastrofiberscopy. The mucosal septum in the pylorus and a large k small membrane-like structure under the openings were noted in postoperative gross specimen. We report a very rare and interesting case of congenital double pylorus with early gastric cancer and incomplete duodenal diaphragm that was confirmed by postoperative specimen and microscopic finding.
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이상우,김창덕,류호상,송치욱,현진해,김광택,전훈재 대한내과학회 1994 대한내과학회지 Vol.47 No.4
Epiphrenic diverticula are relatively rare, but are more frequently of clinical importance than the common traction diverticula of the mid-esophagus because they may be associated with some esophageal motility disorders. Indeed, if the associated motility disorder is not recognized, removal of the diverticulum may bring no relief or, worse, the diverticulum may recur. Esophageal motility study should be done in patient with epiphrenic diverticulum to document esophageal motor dysfunction prior to performing the operation. We are presenting our experience of epiphrenic diverticulum associated with diffuse esophageal spasm in a 57-year old woman. After diverticulopexy and long myotomy with esophagoeardiomyotomy, she showed clinical improvement.
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이상우,최재현,이홍식,강동훈,김창덕,류호상,송치욱,현진해,김종웅,전훈재 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.2
Cystic dilatation of the biliary tree, so called choledochal cyst, is an uncommon disease and is not uncommonly associated with carcinoma. The most symptoms on. presentation are abdominal pain, weight loss, jaundice, and palpable mass. The prognosis of these lesions is dismal. Recently we experienced a case of carcinoma arising in a choledochal cyst in 27-year-old male complaining jaundice and fever. ERCP revealed marked dilated the CBD and obstruction of the proximal portion of the CHD. A computerized tomographic scan and percutaneous cholangiogram showed cystic dilatation of both intrahepatic ducts and solid mass in the left hepatic duct. The patient was treated with surgical resection. Pathologic studies disclosed an adenosquamous carcinoma.
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이상우,이홍식,김창덕,진윤태,최재현,엄순호,류호상,송치욱,현진해,전훈재 대한소화기학회 1998 대한소화기학회지 Vol.30 No.3
Background/Aims: Esophageal manometry has gradually become a widely available diagnostic test. However, there are few reports of esophageal manometric results because the standardization of methods has not yet been established. To evaluate prevalence and clinical manifestation of primary esophageal motility disorder(EMD) in Korea, we performed a manometric study and analyzed the results in a large number of patients with esophageal symptoms. Methods: Records from 2,092 patients referred to our manometric laboratory for evaluation of esophageal symptoms between March 1993 and September 1996 were enrolled. Evaluation included baseline esophageal manometry with low compliance pneumohydrau]ic capillary infusion system and provocation test for esophageal chest pain witb edrophonium and acid infusion. Results: Among 2,092 patients, 1,205(58%) patients had normal esophageal moti]ity and 887(42%) had abnormal motility. Achalasia was present in 5% of abnormal tracings and most frequently associated with dysphagia. Diffuse esophageal spasm(DES) was present in 4% and associated with dysphagia and noncardiac chest pain. Nutcracker esophagus(NUT), hypertensive lower esophageal sphincter(HLES) and nonspecific esophagea] motility disorder(NEMD) were present in 16%, 27% and 48% of the patients respectively and associated with chest pain as the predominant symptom. Provocative testing with acid infusion and edrophonium improved the specificity of a diagnosis of esophageal chest pain. Conclusions: Primary EMDs were observed in 42% of patient with esophageal symptoms. The most common symptom of achalasia was dysphagia. In the case of DES, dysphagia and noncardiac chest pain were frequent, with NEMD, HLES and NUT the main causes of noncardiac chest pain. However, further studies for the pathogenesis and clinical implications of primary EMDs are necessary.
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이정환,이상우,이홍식,김창덕,진윤태,최재현,엄순호,류호상,송치욱,현진해,허병원,강창돈,전훈재 대한소화기학회 2000 대한소화기학회지 Vol.36 No.1
Background/Aims : It has been considered that motor abnormalities of the oropharynx might play some roles in the pathogenesis of globus sensation. This study was aimed to evaluate motor abnormality of the upper esophageal sphincter (UES) and pharynx. Methods : Fifty-three patients with globus sensation in throat and twenty healthy subjects underwent a circumferential solid state manometry. The measured manometric parameters were as follows : basal UES pressure, % UES relaxation, timing of UES relaxation (T1, time interval from the onset of hypopharyngeal contraction to the onset of UES relaxation; T2, time interval from the onset to the completion of UES relaxation), contracting tongue base pressure, contracting hypopharyngeal pressure, intrabolus pressure area (IBPA), prevalence of peristalsis (POP), amplitude of distal esophageal contraction, and basal LES pressure. Then, differences of these parameters in both groups were analysed. Results : The mean values of T2 and IBPA were high and POP was decreased in the patients group. Moreover, there was a significant correlation between T2 and IBPA. Conclusions : Globus sensation might be associated with a prolonged time interval from the onset to completion of UES relaxation, an increased IBPA, and a decreased POP of the esophageal body.
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