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정록선 ( Rok Son Choung ),최재현 ( Jai Hyun Choi ),장윤정 ( Yun Jung Chang ),김민정 ( Min Jung Kim ),김용식 ( Yong Sik Kim ),진윤태 ( Yoon Tae Jeen ),이홍식 ( Hong Sik Lee ),전훈재 ( Hoon Jai Chun ),이상우 ( Sang Woo Lee ),김창덕 대한장연구학회 2003 Intestinal Research Vol.1 No.1
Localized giant pseudopolyposis is an interesting but unuusal manifestation of both ulcerative colitis and Crohn``s disease. It is not regarded as being premalignant, but it may mimic villous adenoma or adenocarcinoma by radiographic and endoscopic picture. and also, it may precipitate obstrucrion by stricture formation or give rise to major hemorrhage. We report a case of localized giant pseudopolyposis of the rectum complicating ulcerative colitis with reviews of other cases in the literatue. (Intestinal Research 2003;1:55-58)
구강 - 인두성 연하곤란 환자에서 구강 - 인두의 운동기능 장애
김효정(Hyo Jung Kim),송치욱(Chi wook Song),정록선(Rok Son Choung),김윤배(Yoon Bae Kim),이정환(Jung Whan Lee),진윤태(Yoon Tae Jeen),전훈재(Hoon Jai chun),엄순호(Soon Ho Um),김창덕(Chang Duck Kim),류호상(Ho Sang Ryu),현진해(Jin Hai Hyu 대한소화기학회 2001 대한소화기학회지 Vol.38 No.1
Nonalcoholic fatty liver disease (NFLD) shows broad spectrum of disease entities such as steatosis (fatty liver), steatohepatitis and steatohepatitis with fibrosis. NFLD observed commonly in human liver biopsies, is mostly attributed to the obesity, diabetes or drugs. Nonalcoholic steatohepatitis (NASH), one entity of NFLD, is characterized by liver biopsy findings similar to those observed in alcoholic hepatitis without alcohol consumption. Although NASH is generally a benign disorder, it may be progressive, leading to cirrhosis and end-stage liver disease. There is no doubt that macrovesicular steatosis is associated with the development of necroinflammation, fibrosis and cirrhosis. However, the pathogenesis of progression to advanced disease in NFLD is obscure. Recently, it has emerged that oxidative stress-lipid peroxidation, endotoxin-mediated cytokine release, and mitochondrial dysfunction play a role in the progression of NASH. We will discuss how these mechanisms might be involved in the progression from steatosis to advanced NFLD. (Korean J Gastroenterol 2001;38:1-8)
김민정 ( Min Jeong Kim ),이홍식 ( Hong Sik Lee ),김경진 ( Kyung Jin Kim ),정록선 ( Rok Son Choung ),임형준 ( Hyung Joon Yim ),이상우 ( Sang Woo Lee ),최재현 ( Jai Hyun Choi ),김창덕 ( Chang Duck Kim ),류호상 ( Ho Sang Ryu ),현진해 대한소화기학회 2005 대한소화기학회지 Vol.46 No.3
목적: 횡문근융해증은 다양한 비외상 원인에 의해 발생할 수 있고 급성신부전 등의 합병증이 동반될 수 있는 질환이다. 그러나 간경변 환자들에서 발생한 비외상 횡문근융해증은 몇몇 산별적인 보고가 있을 뿐이고 임상 특성은 잘 알려져 있지 않은 상태이다. 저자들은 알코올 및 비알코올 간경변 환자들에게 병발된 비외상 횡문근융해증의 임상 특성을 알아보았다. 대상 및 방법: 2001년 10월부터 2004년 9월까지 고려대학교 안산병원 소화기내과에 간경변으로 입원한 환자 중 외상 없이 자발적인 횡문근융해증의 소견을 보인 19예를 대상으로 임상 특성, 검사 소견 및 치료 성적을 분석 하였다. 결과: 대상 환자 19예 중 남자 14예, 여자 5예였고, 평균연령은 49.6세(32-74세)였다. 알코올 간경변에 병발한 횡문근융해증군은 알코올(50.0%)이, 비알코올 간경변에 병발한 횡문근융해증군은 분명한 원인이 없는 자발적인 경우(69.2%)가 주된 원인이었다. 알코올 간경변에 병발한 횡문근융해증군은 대체로 비특이 증상을, 비알코올 간경변에 병발한 횡문근융해증군은 전형적인 증상을 호소하는 경우가 많았다. 대상 간경변군에서는 사망한 환자가 없었으나, 비대상 간경변군에서는 8명(57.1%)이 사망하여, 비대상 변화 유무에 따른 사망률의 유의한 차이를 보였다(p=0.04). 핍뇨는 8예(42.1%), 급성신부전은 12예(63.2%)에서 발생하였고, 전체 사망 환자 수는 8예(42.1%)였다. 핍뇨와 급성신부전이 발생하였을 때 사망률이 유의하게 증가하였다. 결론: 간경변 환자에서 비외상 횡문근융해증은 치명적인 결과를 초래할 수 있는 질환으로 특히 비대상 간경변 환자와 경과 중 핍뇨와 급성신부전이 발생한 경우에서 사망률이 높았다. 따라서, 간경변증 환자에서 횡문근 융해증의 발생 가능성을 항상 염두에 두고 의심될 경우 신속히 진단하여 적극적인 치료를 시행해야 한다. Background/Aims: Rhabdomyolysis is a serious and lethal condition that can be induced not only by traumatic causes but also by a variety of nontraumatic causes. However, there are few reports about rhabdomyolysis developed in patients with liver cirrhosis. We carried out this study to elucidate the clinical characteristics and courses of rhabdomyolysis in patients with liver cirrhosis. Methods: We analyzed 19 cases of nontraumatic rhabdomyolysis in patients with liver cirrhosis who had admitted at Korea University Ansan Hospital between October 2001 and September 2004. Results: Alcohol (50%) was the main etiology of rhabdomyolysis in alcoholic liver cirrhosis patients, and the precipitating factors were not apparent (69.2%) in majority of nonalcoholic liver cirrhosis patients with rhabdomyolysis. Nonalcoholic liver cirrhosis patients had complaints of pain referable to the musculoskeletal system, but alcoholic liver cirrhosis patients had no typical complaints. Mortality of rhabdomyolysis in liver cirrhosis patients was high (42.1%), especially in decompensated liver cirrhosis patients (p=0.04). In nonalcoholic liver cirrhosis patients, the development of oliguria (p=0.007) and acute renal failure (p=0.049) in the course of rhabdomyolysis increased the mortality significantly. Conclusions: In cirrhosis patients, rhabdomyolysis showed a poor prognosis, especially in nonalcoholic liver cirrhosis with oliguria, acute renal failure, or decompensated liver cirrhosis. It is believed that a high clinical suspicion for the occurrence of rhabdomyolysis in liver cirrhosis patients can lead to quicker recognition and better patient care. (Korean J Gastroenterol 2005;46:218-225)
손수민(Soo Min Shon),송치욱(Chi Wook Song),구자설(Ja Soul Koo),정록선(Rok Son Choung),신정호(Jeong Ho Shin),김윤배(Yun Bae Kim),전훈재(Hoon Jai Chun),이상우(Sang Woo Lee),최재현(Jai Hyun Choi),김창덕(Chang Duck Kim),류호상(Ho Sang Ry 대한소화기기능성질환·운동학회 2001 Journal of Neurogastroenterology and Motility (JNM Vol.7 No.2
N/A Aims: Gastroesophageal reflux disease (GERD) is known to be one of the contributing factors to cause epigastric soreness, which we often experience after intake of flour-based meals. The aim of this study was to evaluate gastroesophgeal reflux (GER) and its mechanism according to intake of different ingredients of meals. Methods: We investigated the effect of meals of different ingredients on the lower esophageal sphincter (LES) pressure, the frequency of transient LES relaxation (Tlesr) and GER in seven healthy volunteers. The meals used in this study were either rice cakes or flour cakes, which were isocaloric and isovolumetric. A mylohyoid electromyogram, LES pressure and esophageal Ph were simultaneously recorded for 3 hours after ingestion of each meal on two different occasions. Results: There was no significant difference in incidence of GER between two meals. Conclusion: The intake of isocaloric and isovolumetric meals of either flour or rice cake did not result in significant discrepancies in frequency of GER. The increase in the frequency of swallow- and strain-associated GER observed in the case of a flour cake may be caused by reduced LES pressure after ingestion. (Korean Journal of Gastrointestinal Motility 2001;7:181-187)