비궤양성 소화불량증 환자에서 십이지장위 역류의 역할에 관한 연구

성인경(In Kyung Sung),이종철(Jong Chul Rhee) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.2

N/A Backgieund/Aims: Delayed gastric emptying has been considered primary mechanism for the pathogenesis of non-ulcer dyspepsia(NUD). And duodenogastric reflux(DGR) could be involved in the pathogenesis of non-ulcer dyspepsia. But there is some controversy surrounding the role of DGR in NUD. The objective of the present prospective study was to investigate the prevalence of DGR, a possible correlation between DGR and dyspeptic symptoms and the association between DGR and delayed gastric emptying in NUD patients. Methods: Cholescintigraphy with technetium 99m 0- diisopropyl iminodiacetic acid(DISIDA) was used to study duodenogastric reflux in 105 patients with NUD and in l l normal controls. Also, in order to identify the gasric emptying rate in patients with NUD, a gastric emptying scan using solid test meal(Tc-99m-tin-colloid labeled chicken liver) was performed. Symptoms were quantified using a clinical score. Results: DISIDA scanning revealed abnorma1 findings in l(9%) of l 1 of normal controls and 31(30%) of lOS patients with NUD. The gastric emptying time of solid meal was delayed in 55(52%) of 105 patients with NUD. In the SS patients with delayed GET, DGR positive were lO(l8%) and in the 50 patients with normal GET, DGR positive were 21(42%)(p<0.05). In the 31 patients with DGR positive, patients with delayed gastric emptying were 10(32%), and in the 74 patients with DGR negative, patients with delayed gastric emptying were 45(60%). The mean symptom score was not significantly different between the patients with DGR positive and negative(8.9 ' 3.6 vs 8.3 ' 3.6). The frequency of DGR in total patients with NLJD was about 30%. And the frequency of DGR in patients of NUD with normal GET was 42%, comparing with 9% in controls(p<0.05). Conclusion: Duodenogastric retlux may be involved in the pathogenesis of non-u1cer dyspepsia with normal gastric emptying time. (Korean J Gastroenterol 1995;27:159 - 166)

미숙아의 신생아 경련

박주형(Joo Hyung Park),정인아(In Ah Jung),한지윤(Ji Yoon Han),성인경(In Kyung Sung),이주영(Ju Young Lee),윤영아(Young Ah Youn),이인구(In Goo Lee) 대한소아신경학회 2012 대한소아신경학회지 Vol.20 No.3

배 경 : 신생아기에는 뇌의 미성숙으로 인하여 경련이 일생 중 가장 흔히 발생하며, 특히 미숙아에서 경련의 발생 빈도가 높다. 신생아 집중 치료가 발전하면서 미숙아의 생존율이 향상되었지만, 생존한 미숙아들의 신경학적 후유증의 빈도 역시 증가되었다. 이에 저자들은 미숙아로 출생하여 경련을 일으킨 환아들을 대상으로 병력, 임상 양상과 검사 소견을 분석하고 그에 따른 예후를 관찰함으로써 미숙아 경련의 특징과 위험인자들을 알아보고자 하였다. 방 법 : 2009년 3월에서 2012년 2월까지 서울성모병원 신생아 중환자실에 입원한 재태 연령 37주미만으로 출생한 환아 중 경련이 발생한 환아 16명을 대상으로 후향적 조사를 시행하였다. 결 과 : 재태 연령 30주 미만의 환아에서 신생아 경련 발생률이 높았고, 경련의 발생 시기는 생후 1주일 이내가 많았으며, 경련 형태는 비정형적 경련이 많아 일반적인 신생아 경련과 동일하였다. 뇌파검사에서는 75%에서 비정상 소견을 보였는데, 대부분이 간질모양파를 보였고(77.8%) 나머지는 배경파가 억제되어 있었다. 뇌 영상 검사에서는 62.5%에서 이상 소견을 보였는데, 대부분이 뇌실 내 출혈(80%) 이었다. 경련의 위험인자로는 절반의 환아에서 출생 시 가사가 관찰되었고, 주산기 병력을 가진산모인 경우도 43.8%를 차지하고 있었다. 경련을 조절하기 위하여 phenobarbital, phenytoin, 그리고 midazolam을 사용하여 대부분(76.9%)은 조절되었고, 조절 될 때까지의 기간은 평균 4.3±4.2일 이었으나 3명은 사망 시까지 경련이 조절되지 않았다. 항경련제의 투약을 중지할 때까지 걸린 시간은 평균 53.4±28일 이었다. 그리고 추적 관찰 기간 중 경련을 경험한 미숙아의 절반 이상이 정상 발달을 보이고 있었다. 결 론 : 출생 시 가사가 미숙아의 신생아 경련 발생에서 가장 중요한 인자로 생각 되지만 산모의 주산기 병력 역시 신생아 경련 발생과 밀접한 연관성이 있을 것으로 추정된다. 따라서 산모가 주산기 병력이 있는 경우에는 출생 미숙아에 대한 면밀한 관찰과 검사를 통해 경련을 조기에 발견하여 치료할수 있도록 하여야 하며, 이를 위해 뇌파검사가 보다 더 적극적으로 이용되어야 한다. Purpose : Neonatal seizures are the most prominent feature of neonatal neurologic dysfunction, and the lifespan risk for seizures is highest in the neonatal period, especially in preterm infants. This study was aimed to find and analyze the risk factors and clinical profiles of seizures in preterm infants. Methods : Sixteen cases of preterms with seizures were retrospectively reviewed between Mar. 2009 and Feb. 2012. Results : The average gestational age was 30.3±4.1 weeks and 11 patients (68.7%) experienced seizures within 1 week after the birth. Eight cases (50%) had a perinatal asphyxia during the delivery and 7 cases (43.8%) had a history of perinatal maternal illness. Various types of seizures were observed of which subtle seizures were the most common (50%). Electroecephalographies were performed in 12 cases, which showed abnormal findings in 9 cases (75%). Neuroimaging studies were performed in 16 cases and showed abnormal findings in 10 cases (62.5%). Thirteen patients were discharged in the improved state and 3 patients expired. Eight cases had normal outcome, while 3 cases showed developmental delay. Prognosis was unknown in 2 cases due to follow up loss. Conclusion : Neonatal asphyxia is the most important risk factor. Furthermore, infants with a history of perinatal maternal illness appear to be at risk for neonatal seizures. EEG is a sensitive method for assessing seizure activity and prognosis. Monitoring high risk infants with asphyxia and a history of perinatal maternal illness, and early postnatal tracing with EEG is required to detect and manage high risk preterms.

정상 대장 점막에서의 Sonic Hedgehog 발현과 대장종양 재발 간의 연관성

이지영 ( Ji Young Lee ),이선영 ( Sun Young Lee ),한혜승 ( Hye Seung Han ),김소영 ( So Young Kim ),홍성노 ( Sung Noh Hong ),김정환 ( Jeong Hwan Kim ),성인경 ( In Kyung Sung ),박형석 ( Hyung Seok Park ),심찬섭 ( Chan Sup Shim ),진 대한장연구학회 2012 Intestinal Research Vol.10 No.3

Background/Aims: The expression of sonic hedgehog (Shh) in the colon cancer cell has been implicated in colorectal carcinogenesis. However, the association between Shh expression in the normal colonic mucosa and the recurrence of colorectal neoplasm after tumor resection has not been well documented. The aim of the study was to determine the association between Shh expression in the normal colonic mucosa and in the recurrence of colorectal neoplasm. Methods: Fifty-five patients who underwent a long-term follow-up colonoscopy after the colorectal neoplasm resection were included. At the time of the tumor resection, Shh expression in the normal colonic mucosa was examined. The association between Shh expression in the normal colonic mucosa and the recurrence of colorectal neoplasm was analyzed. Results: In total, 97 colorectal neoplasms were detected among 41 subjects after a mean follow-up period of 63 weeks (range 27-254 weeks). Of 55 subjects, 26 (47.3%) exhibited positive Shh expression in the normal colonic tissue, and the recurrence rate did not differ with the degree of Shh expression (P=0.238). The degree of Shh expression was not associated with the number (P=0.389), size (P=0.928), location (P=0.410), pathologic types (P=0.127), or time of recurrence (P=0.711) of the recurred colorectal neoplasm. Conclusions: Most colorectal neoplasm patients show recurrence after the resection and exhibit Shh expression in the normal colonic tissue. The degree of Shh expression in the normal colonic mucosa does not predict the recurrence of colorectal neoplasm. (Intest Res 2012;10:265-271)

기능성 소화불량증 환자에서 자율신경 기능장애에 관한 연구

박동일(Dong Il Park),이풍렬(Poong Lyul Rhee),이용욱(Yong Wook Lee),김지은(Jee Eun Kim),현재근(Jae Geun Hyun),김창섭(Chang Sup Kim),장재권(Jae Kwon Jang),심상군(Sang Goon Shim),성인경(In Kyung Sung),김영호(Young Ho Kim),손희정(Hee Jun 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.2

N/A Background/Aims : The role of autonomic dysfunction in patients with functional dyspepsia has not been completely understood. The purposes of our study are (1) to prospectively assess the abnormalities of the autonomic function in patients with functional dyspepsia and (2) to assess whether the presence of autonomic dysfunction in patients with functional dyspepsia correlates with the presence of visceral hypersensitivity or with the severity of dyspeptic symptoms. Methods : Twenty eight patients with functional dyspepsia (4 men and 24 women; age range, 29-57) and 14 healthy volunteers without gastrointestinal symptoms (6 men and 8 women; age range, 23-61) were included in this study. All patients and controls were submitted to a battery of five standard cardiovascular autonomic reflex tests and gastric barostat tests. A modified version of the Glasgow Dyspeptic questionnaire was used in this study. Results : (1) Autonomic function tests showed that both sympathetic and parasympathetic scores of dyspeptic patients were significantly higher than those of the control group. (2) Visceral hypersensitivity could be confirmed in some of our dyspeptic patients in response to proximal gastric distension, demonstrating lower pain threshold in this group. (3) We could not find significant association between the presence of autonomic dysfunction and the presence of visceral hypersensitivity or severity of dyspeptic symptoms in patients with functional dyspepsia. Conclusion: Autonomic dysfunction was more prevalent in dyspeptic patients than in the control group. However, it did not correlate with the presence of visceral hypersensitivity or severity of dyspeptic symptoms. It is suggested that a defect in the spinal region or at the CNS level may be a major mechanism of visceral hypersensitivity in functional dyspepsia.

한국성인에서 S상결장경검사로 관찰된 대장 용종의 빈도와 특성

이화영(Hwa Young Lee),김재준(Jae Jun Kim),김영호(Young Ho Kim),성인경(In Kyung Sung),전성국(Seong Gook Jeon),손희정(Hee Jung Son),이풍렬(Poong Lyunl Rhee),고광철(Kwang Chul Koh),백승운(Seung Woon Paik),이종철(Jong Chul Rhee),오영륜(Y 대한내과학회 1998 대한내과학회지 Vol.55 No.1

N/A Objectives: Colorectal polyps play an integral role in the development of colon cancer. The prevalence of colorectal polyps in Korea was reported to be 5-12%. However, these results were obtained from retrospective studies, in which the subjects were symptomatic patients. Therefore, we performed a prospective study in asymptomatic Korean adults to determine the prevalence, characteristics, and risk factors of colorectal polyps. Methods Flexible sigmoidoscopy was done during the period between August 1994 to November 1995 in 2,985 aymptomatic individuals who visited Samsung Medical Center for health check-ups. Results : 1) Polyps were found in 590 subjects (20.4%) out of 2,985 individuals. The prevalence rate increased with age. 2) In histologic findings of colorectal polyps, there were 369 cases (45.8%) of adenomatous polyps, 245 cases (30.4%) of hyperplastic polyps and 5 cases of carcinomas. 3) Moderate to severe dysplasia was found in 15.4% of adenomatous polyps and the grade of dysplasia increased with polyp size. 4) The prevalence rate of polyps increased according to obesity, blood cholesterol and triglyceride level, the frequency of alcohol consumption and the amount of smoking in cases. Conclusions: Screening by sigmoidoscopy is considered to be beneficial for detection of colorectal polyps in asymptomatic Korean adults, especially in individuals with risk factors such as obesity, heavy smoking and alcohol consumption.

위장관 ; 위내시경검사에서 간과된 진행성 위암의 특징

성인경 ( In Kyung Sung ),김영춘 ( Young Choon Kim ),윤중원 ( Jung Won Yun ),서현일 ( Hyun Il Seo ),박동일 ( Dong Il Park ),조용균 ( Yong Kyun Cho ),김홍주 ( Hong Joo Kim ),박정호 ( Jung Ho Park ),손정일 ( Chong Il Sohn ),전우규 ( 대한소화기학회 2011 대한소화기학회지 Vol.57 No.5

Background/Aims: Stomach cancer can be easily diagnosed via endoscopy, but also possible to be missed. The aim of this study was to investigate the clinical and endoscopic characteristics of advanced gastric cancers that were not diagnosed based on endoscopic examination. Methods: We evaluated patients who had newly diagnosed advanced gastric cancer that was undetected via endoscopy within the last six months. Results: Sixteen patients were included in this study. The locations of the cancers were the cardia in six cases, the greater curvature side of the body in eight cases and the antrum in two cases. The histological findings were tubular type adenocarcinoma in 11 cases, with ten cases of moderately to poorly differentiated adenocarcinoma and five cases of signet ring cell type adenocarcinoma. Conclusions: Even advanced gastric cancer lesions may not be detected during endoscopy. If a patient continues to complain of upper gastrointestinal symptoms, even though endoscopy does not find abnormal findings, repeated endoscopy and/or additional diagnostic studies should be considered. (Korean J Gastroenterol 2011;57:288-293)

비궤양성 소화불량증 환자의 아형분포에 대한 연구

성인경(In Kyung Sung),강인구(In Ku Kang),심승철(Seung Chul Shim),김종필(Jong Pil Kim),이기창(Kee Chang Lee),손정일(Chong Il Sohn),정철헌(Chul Hun Jung),박동일(Dong Il Park),이종철(Jong Chul Rhee) 대한내과학회 1994 대한내과학회지 Vol.46 No.3

N/A Objectives: It has been proposed that patients with non-ulcer dyspepsia can be classified into symptom subgroups. Subgroups were as follows; those with symptoms suggestive of peptic ulceration (ulcerlike dyspepsia), those with gastric stasis (dysmotilitylike dyspepsia), those with gastroesophageal reflux (refluxlike dyspepsia), and the remainder (unspecified dyspepsia). Methods: The study population consisted of 306 patients with non-ulcer dyspepsia admitted to or attending to Hanyang University Hospital from the beginning of Feb. 1990 to the end of August 1992. We evaluated the gastrointestinal symptoms and measured gastric emptying time for 150min using radionuclide scintiscan of an 99mTc-labeled chicken liver. Results: 1) A total of 306 patients with diagnosed to non-ulcer dyspepsia, 54% had dysmotilitylike dyspepsia, 16% had ulcerlike dyspepsia, 2% had refluxlike dyspepsia and 10% had unspecified dyspepsia. 2) A total of 148 non-ulcer dyspepsia patients with normal gastric emptying time, 48% had dysmotilitylike dyspepsia, 19% had ulcerlike dyspepsia, 2% had refluxlike dyspepsia and 10% had unspecified dyspepsia. 3) A total of 158 non-ulcer dyspepsia patients with delayed gastric emptying time, 61% had dysmotilitylike dyspepsia, 14% had ulcerlike dyspepsia, 2% had refluxlike dyspepsia and 9% had unspecified dyspepsia. 4) Dysmotilitylike dyspepia was more commonly present in patients with delayed gastric emptying time than in patients with normal gastric emptying time(p<0.05) 5) There was a slight female predominance (1:1.3 male-female ratio) in non-ulcer dyspepsia patients with normal gastric emptying and peak incidence was 40 to 49 years of age (40%). 6) There was a female predominance (1:1.9 male-female ratio) in non-ulcer dyspepsia patients with delayed gastric emptying and peak incidence was 40 to 49 years of age(42%). 7) A total of non-ulcer dyspepsia patients, 35% had irritable bowel symptoms and the frequency of accompanied irritable bowel symptoms was statistically significant difference between the patients with normal gastric emptying time (46%) and the patients with delayed gastric emptying time (26%)(p<0.01). Conclusion: Among the non-ulcer dyspepsia patients in Korean, dysmotilitylike dyspepsia was most common subgroup and the refluxlike dyspepsia was very rare and 35% had irritable bowel syptoms.

조기 경구영양이 극소미숙아의 혈중 Gastrin농도 및 임상경과에 미치는 영향

성인경 ( In Kyung Sung ),김소영 ( So Young Kim ),전정식 ( Chung Sik Chun ),조성훈 ( Sung Hoon Cho ) 대한주산의학회 1994 大韓周産醫學會雜誌 Vol.5 No.4

유비쿼터스 기반기술 전자 종이의 분류에 따른 최근 기술 개발 경향

성인경 ( In Kyung Sung ),심나영 ( Na Young Shim ),신선호 ( Sun Ho Shin ) 한국공업화학회 2005 공업화학전망 Vol.8 No.4

대량의 재발성 늑막액을 일으킨 일측성 폐정맥 폐쇄증

성인경 ( In Kyung Sung ),최완영 ( Wan Young Choi ),신동호 ( Dong Ho Shin ),박성수 ( Sung Soo Park ),이정희 ( Jung Hee Lee ),서홍석 ( Heung Suk Seo ) 대한결핵 및 호흡기학회 1992 Tuberculosis and Respiratory Diseases Vol.39 No.1