우린라 성인 건강 검진자에서 배변습관에 관한 연구

이풍렬(Poong Lyul Rhee),이종철(Jong Chul Rhee),최규완(Kyoo Wan Choi),김은주(Eun Joo Kim),박창영(Chang Young Park),손정일(Jong Chul Rhee),전우규(Woo Kyu Cheon),김병익(Byeong Ik Kim),정을순(Eul Sun Jung),전성국(Seong Gook Cheon),박기호 대한내과학회 1999 대한내과학회지 Vol.57 No.1

N/A To estimate bowel patterns in the Korean, we surveyed routine check-up subjects about their bowel habits, using self-reported questionnaire. Methods : We analyzed 2939 subjects (male 1430, female 1509; age range 25 - 65 years) who had visited health promotion center for routine check-up. Subjects were given a validated self-report questionnaire, which measured the defecation frequency; stool consistency; self-report of constipation; straining to defecate; and levels of laxative use. Results : Of the whole subjects 96.4% had defecation frequency between three per week and three per day. The prevalence of two or less bowel movements per week (4.1% compared to 0.6%), straining to defecate (20.8% compared to 13.0%) and hard stool (18.0% compared to 9.3%) was higher in women than men (p<0.01). The prevalence of self-reported constipation was higher in women than men (9.0% compared to 2.9%, p<0.01). Women were more likely to use laxatives than men (5.5% compared to 0.6%, p<0.01). Conclusions : Defecation frequency in most of routine check-up subjects is between three per week to three per day. Bowel dysfunction is a greater problem in women.

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.

경련성 골반저 증후군에서 풍선 배출검사와 회음부 계측검사의 의의

손정일,이화영,전성국,이풍렬,김재준,고광철,백승운,이종철 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.31 No.3

미만성 식도 경련증(Diffuse Esophageal Spasm)의 임상 고찰

전성국,손정일,이풍렬,김재준,고광철,백승운,이종철,최규완 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.31 No.6

미만성 식도 경련증(Diffuse Esophageal Spasm)의 임상 고찰

김재준,최규완,백승운,고광철,이풍렬,이종철,손정일,전성국 대한소화기학회 1998 대한소화기학회지 Vol.31 No.6

Background/Aims: Diffuse esophageal spasm (DES) was known to be a rare esophageal motility disorder and only few data related to the clinical and manometric characteristics were available in Korean patients. The aim of this study was to evaluate the clinical and manometric charactetistics of DES. Methods: Eleven patients, 4 males and 6 females, who underwent esophageal manometry ia Samsung Medical Center between February 1995 to June 1997 and met the criteria for DES, were selected. The mean age of the patients was 51.6 years (28-75 years). The clinical symptoms, gastroscopic findings, esophagographic findings, esophageal manometric findings and therapeutic response of the patients were retrospectively analyzed. Results: The chief complaints of the patients were chest pain (n=5), dysphagia (n=3), globus (n=1), acid regurgitation (n=1) and indigestion (n=1). The tertiary contractions on esophagography were found in 3 patients. The findings of esophageal manometry were repetitive contractions (≥3 peaks/wave) in 4 patients (36%), contractions of prolonged duration ($gt; 6 seconds) in 3 patients (27%), spontaneous contractions in 4 patients (36%), nontransmitted contractions in 7 patients (64%), high LES pressure (≥ 45 mmHg) in 1 patient (9%) and incomplete relaxation of LES in 1 patient (9%). High amplitude (≥ 180 mmHg) contraction was not found. The prevalence of simultaneous contractions was 42% (13-100%) and it was higher in patients with dysphagia (75%) than in patients with other symptoms (10-30%). There was symptomatic improvement in 3 out of 5 patients treated with caleium channel blockers and in 1 patient treated with nitrates. Conclusions: The DES was manifestated with chest pain or dysphagia. The prevalence of simultaneous contractions was high in patients with dysphagia. High amplitude contraction was not found. There was symptomatic improvement in some patients teated with calcium channel blockers or nitrates.

복부 체표명 위전도술을 이용한 위 수축의 추정

김인영,이화영,김재준,백승운,고광철,이종철,손정일,이풍렬,전성국,한완택 대한소화기학회 1998 대한소화기학회지 Vol.32 No.1

Backgroud/Aims: The aim of this study was to identify gastric contraction by surface electrogastrography (EGG). Methods: Ten functional dyspeptic patients were included. Antropyloroduodenal manometry and EGG for functional dyspeptic patients were simultaneously recorded during two hours of the fasting peroid. For EGG signal acquisition, the high cutoff frequency was set on 8 Hz and the signal sampling frequency was 16 Hz. For EGG signal analysis, fast Fourier transformation of running spectral analysis was used. Results: During motor quiescence period, the EGG showed normal smooth sine wave, and on time domain frequency analysis, there was a single dominant wave of three cycles per minute (3 cpm). During gastric contraction, the slow wave increased in its amplitude and changed its configuration into a late peak on its wave form. On time domain frequency analysis, there was also dominant frequency of 3 cpm, and a marked increment in the first harmonic during the contraction compared with the motor quiescence period. There were rough correlations between the power of the first harmonic and the gastric contractions. Conclusions: Gastric contractions could be assessed by changes in waveform and power of first harmonic in addition to change in amplitude on surface EGG.

건강 검진자에서 역류성 식도염의 유병률 및 위험 인자에 대한 환자 -대조군 연구

이화영,김재준,최규완,백승운,고광철,이풍렬,이종철,손정일,신명희,전성국,현재근 대한소화기학회 1999 대한소화기학회지 Vol.32 No.6

Background/Aims: There were few epidemiological data on reflux esophagitis in Korea. The aim o this study was to estimate the prevalence and risk factors of reflux esophagitis in Korea. Methods We examined 8314 subjects (male 4,876, female 3,438, age: 18-83 year) visiting health promotion center for routine check-up including EGD. All of them were given a questionnaire about smoking alcohol consumption, exercise, diet habits, use of drugs and medical history. We estimated the prevalence of reflux esophagitis and performed a case-control study to evaluate the risk factors of reflux esophagitis. We recruited 200 cases with reflux esophagitis and 400 controls without reflux esophagitis on EGD. Results: The prevalence of reflux esophagitis was 3.73% in male and 0.81% in female. The age-adjusted prevalence was 3.19% in male and 1.66% in female. The prevalence in male was significantly higher than that in female (p$lt;0.01). On the monovariate analysis, smoking and body mass index were significantly related with reflux esophagitis (p$lt;0.05). On the multivariate analysis, smoking was a significant risk factor of reflux esophagitis (p$lt;0.05). Conclusions: The prevalence of reflux esophagitis in subjects who had routine check-up was 3.73% in male and 0.81% in female. Smoking is suggested to be a significant risk factor of reflux esophagitis.

십이지장-위 역류의 진단에 있어서 24-Hour Ambulatory Bile Reflux Monitoring(Bilitec)의 문제점

김홍식,이화영,윤길원,고광철,김재준,백승운,이종철,손정일,이풍렬,전성국 대한소화기학회 1998 대한소화기학회지 Vol.30 No.2

Background/Aims: Duodenogastric reflux is thought to be a potential cause of functiona] dyspepsia but this point is still in debate. Many types of tests were used to diagnose duodenogastric reflux but none was accepted as the gold standard. In recent years, a 24-hour ambulatory bile reflux monitoring(Bilitec^(R)) was introduced. This study was done to analyze the amount and the frequency of duodenogastric reflux and to investigate the efficacy and prnblems of Bilitec^(R) in functional dyspeptic patients and normal controls. Methods: We first measured optical absorbance of 20 common Korean foods. We exarnined 10 functional dyspeptic patients with endoscopic evidence of bile regurgitation, 10 gastritis or peptic ulcer disease patients and 10 asymptomatic normal controls with Bilitec^(R). Duodenogastric reflux was considered as positive when bile absorbance exceeded 0.14 during Bilitec^(R) examination. We also investigated technical difficulties and patients tolerance during the Bilitec^(R) examination. Results: Among the 20 Korean foods, kimchi, soybean paste, cabbage, apple, and egg gave false positives on the Bilitec examination. Technically, the probe was located optimally on the antrum in only 23 out of 30 subjects, but the probe was located on the body in two, the fundus in three and the probe could not be inserted due tv poor cooperation in three. At the end of the examination, 54% of subjects complained of more discomfort when compared to endoscopy. There was no significant difference in duodenogastric reflux between functional dyspeptic patients and asymptomatic normal controls. There was one case which failed the Bilitec^(R) exam due to probe malfunction. Conclusions: Bilitec^(R) examination is thought to be the best method in the diagnosis of duodenogastric reflux yet. However, some protilems such as false positivity influenced by food material, technical difficulty in locating the probe, probe malfunction and patients discomfort exist. In this study, the role of duodenogastric reflux as a cause of functional dyspepsia is not certain.

체표면 위전도를 이용한 잡견 위 수축의 추정

김인영,박경남,김종성,이민호,박헌진,함준수,이풍렬,이종철,손정일,임헌길,한완택 대한소화기학회 1998 대한소화기학회지 Vol.32 No.2

Background/Aims: The aim of this study was to assess canine gastric contraction by surface electrogastrography (EGG). Methods: Serosal EGG, surface EGG and measurement of gastric contraction by strain gauge were performed simultaneously in 20 unconscious dogs during the motor quiescence period and the contraction period induced by bethanechol. Amplitude, wave form, frequency and vector analysis of EGG were performed. Results: During motor quiescence period, normal smooth sine wave was maintained. During gastric contraction, the amplitude of slow wave was increased and the wave form of it changed into a late peak and descending arm in cutaneous wave was dominated. On the frequency analysis of the motor quiescence period, a single dominant wave of three cycles per minute (3 cpm) was observed. During the contraction, the dominant frequency was 3.5 cpm, and a marked increment was observed in first harmonic compared to motor quiescence period. There was rough correlation between the power of first harmonic and gastric contractions. In the vector analysis of motor quiescence period, the average axis of EGG vector was 62.7, y=0.00512+1.935x and the coefficient of determination was 0.476. During gastric contraction, the average axis of EGG vector was 12.6, y=0.00377+0.228x, and the coefficient of determination was 0.00281 (p$lt;0.05). Conclusions: Gastric contractions could be assessed by surface EGG in terms of such parameters.

경련성 골반저 증후군에서 풍선 배출검사와 회음부 계측검사의 의의

이화영,김재준,백승운,고광철,이풍렬,이종철,손정일,전성국 대한소화기학회 1998 대한소화기학회지 Vol.31 No.3

Background/Aims: We investigate the usefulness of balloon expulsion test and perineometry in the diagnosis of defecation disorder, especially spastic pelvic floor syndrome. Methods: Patients with defecation disorder were tested to identify the cause with balloon expulsion test in left lateral decubitus position and sitting position, perineornetry, colon transit time test, defecography, anorectal manometry and sigmoidoscopy. Ten asymptomatic persons were also examined as normal control. Results: Among 91 patients with defecation disorder the spastic pelvic floor syndrome was the most common cause. The weight that was needed to expel the balloon in the left lateral decubitus position in spastic pelvic floor syndrome patients was significantly higher than in the normal controls and other disease groups (p$lt;0.05). The time that was needed to expel the balloon in the sitting position in spastic pelvic floor syndrorne patients was also significantly longer than in the normal controls and other disease groups (p$lt;0.05). Perineal movement in patients with spastic was significantly shorter than in the normal controls and other disease groups (p$lt;0.05). The weight and time needed to expel the balloon in pelvic floor syndrome were inversely related to the ejection fraction on defecogram (r=-0.303, p=0.027 and r=-0.305, p=0.026 respectively). Conclusions: Balloon expulsion test and perineometry are good diagnostic tests for spastic pelvic floor syndrome.