위장관 ( 胃腸管 ) : 우리나라에서 흉골하작열감 내지 흉통의 원인으로서 식도운동성질환의 중요성에 관한 연구

윤용범(Yong Bum Yoon),송인성(In Sung Song),김정룡(Chung Yong Kim),최상운(Sang Woon Choi),최규완(Kyu Wan Choi),노임환(Im Hwan Roe),윤세진(Sei Jin Youn),정현채(Hyun Chae Jung),김용태(Yong Tae Kim),김나영(Na Young Kim) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.1

N/A Aims of this study are to investigate the proportion of esophageal motility disorder as the cause of heartburn and/or chest pain, to evaluate the relationship among the diagnostic tools for gastroeso-phageal reflux disease(GERD) such as manometry, esophagoscopy, Bernstein test and 24 hour esophageal pH monitor and to evaluate the usefullness of each test in the diagnosis of gastroeso-phageal reflux disease by estimating its sensitivity and specificity based on 24 hour esophageal pH monitor. For this study, 106 patients with heartburn and/or chest pain and 32 controls were enrolled. The results were as follows; 1) Of 106 patients with heartburn and/or chest pain, 36 patients (34#%) have GERD and 6 patients (5.6%) have Nutcracker esophagus as a cause of this symptom. 2) One hundred and six patients were divided into the two groups on the basis of LES pressure, one comprising 14 patients with LES pressure lower than 11 mmHg and the other 92 patients with the higher LES pressure; then the group of the lower LES pressure was found to have the smaller amplitude and the shorter duration of peristaltic waves, and the higher positive rates of esophagos-copic finding. Bernstein test and 24 hour esophageal pH monitor than the other group. On the basis of reflux esophagitis finding in esophagoscopy the same 106 patients were divided into two groups, one comprising 18 patients with positive esophagoscopic finding and the other 88 patients with negative esophagoscopic finding; then the group of positive esophagoscopic finding was found to have the smaller amplitude and shorter duration of peristaltic waves, the lower LES pressure and the higher positive rate of Bernstiein test and 24 hour esophageal pH monitor than the other group. 3) The sensitivity and the specificity, evaluated with reference to the 24 hour esophageal pH monitor, were 53.6% and 90% respectively for Bernstein test, and 25% and 90% respectively for the low LES pressure. From these results, we are led to the conclusions that firstly the occupying rate of the esophageal motility disorder was 39.6% as a cause of heartburn and/or chest pain, secondly there was a relationship among the diagnostic tools for GERD, and thirdly the 24 hour esophageal pH monitor is not needed only for the diagnosis of GERD when the LES pressure was below 11 mmHg or Bernstein test was positive.

위장관 ( 胃腸管 ) : 한국인에 있어서 대장용종

윤용범(Yong Bum Yoon),송인성(In Sung Song),최규완(Kyoo Wan Choi),김정룡(Chung Yong Kim),이효석(Hyo Suk Lee),윤세진(Sei Jin Youn),정현채(Hyun Chae Jung),김용태(Yong Tae Kim),김나영(Na Young Kim) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2

N/A The present report analyzed a series of 767 polyps from 15,000 cases who wore undogone colonos- copy or sigmoidoscopy at the dept, of internal medicine, Seoul National Universily Hospital from June 1976 to Dec. 1989. The results are as follows. 1) The prevalence of colorectal polyp was 5,1% (767 cases out of 15,000 cases) and increased from 1976 to 1989. 2) The most common symptom was anal bleeding (27%). 3) The 43 cases out of 203 cases (21%) revealed a positive finding in occult blood examination of stool, and 88 cases out of 158 cases (55%) turned out to have polyps in colon study. 4) The most common histologic type of polyp was adenomatous (49%) and the most common gross iype was Yamada type II (30.%). 5) Eleven cases out of 30 cases (36.9%) whose polyps were over 2 cm in diameter were villous adenoma, and 4 cases out of 11 cases (36%) had a foci of cancer. Ten cases out of 245 cases (4%) whose polyps wore under 1 cm in diameter were villous adenoma, and the foci of cancer were not seen. These figure suggest that as polyps grow, the risk of villous adenoma and cancer increase. 6) When we compared endoscopic findings with histologic types in polypectomized specimens, 9 cases (64%) out of 14 cases were diagnosed as hyperplastic polyp by only endoscopy, and 68 cases (91%) out of 75 cases were diagnosed as adenomatose polyp by only endoscopy. 7) Six cases (4.4%) out of 135 cases in tubular, four cases (16.6%) out of 24 cases in villotubular, four cases (19%) out of 21 cases in villous adenoma, were colorectal cancer with polyp remnant, respectively. The annual prevalence of colorectal polyp increased and endoscopy was superior to Barium enema in diagnosing colorectal polyps. For prevention of colorectal cancer, more effort should be done in detecting and eradicating colorectal polyps.

증례 : 선천성 비용혈성 고비포합 Bilirubin 혈증의 일가족례 - 일계내에서의 제 2 형 Crigler - Najjar 증후군 일예와 Gilbert 증후군 2 예

김정용 ( Chung Yong Kim ),김노경 ( Noe Kyeong Kim ),윤용범 ( Yong Bum Youn ),박의양 ( Seon Yang Park ) 대한내과학회 1978 대한내과학회지 Vol.21 No.1

정맥류내 주사법에 의한 식도정맥류경화술의 임상적 경험

윤석주(Suk Joo Youn),정원재(Won Jae Jung),최상운(Sang Woon Choi),정현채(Hyun Chai Chung),김해련(Hae Ryun Kim),이효석(Hyo Suk Lee),윤용범(Yong Bum Youn),송인성(In Sung Song),김정룡(Chung Yong Kim) 대한내과학회 1987 대한내과학회지 Vol.33 No.5

N/A Between Nov. 1985 to Mar. 1987, we have administered endoscopic injection sclerotherapy to 54 patients who had bled from esophageal varices by intravariceal method and obtained following results: 1) In 27 patients who had reached complete sclerosis of esophageal varices, it took 4.7±1.9 (mean+SD) sessions (range 1-11 sessions) for complete sclerosing to occur. And taking the drop-out rate into consideration, complete sclerosis might be obtained in about 72% of patients with upto 7 sessions of treatment. 2) The failure rate of sclerotherapy representing death due to uncontrollable variceal hemorrhage and resort to operative management due to poor sclerosing response was below 10%. 3) Among those who have reached complete sclerosis, 11 patients were followed up for 1-11 months and in five of them (45%) further episodes of variceal bleeding were observed all of which were related to re-appearance of varices. 4) To prevent rebleeding from esophageal varices, it is important to maintain complete obliteration of varices and we recommend follow-up after complete sclerosis at 3 months` interval at least for the first one year. 5) Fatal complications have occurred at a rate of 1% on terms of treatment sessions in 5.5% of patients but with proper medical management no mortality has resulted. In conclusion, the endoscopic sclerotherapy using flexible endoscope and intravariceal injection method seems to be highly safe and may be an effective way of managing the patients with variceal hemorrhage both in acute control and long term prevention of variceal bleeding and therefore shou1d be considered as first line therapy prior to resort to operative measures.

간기능 검사 이상을 보이는 건선환자에서 비알코올성 지방간의 유병률 및 임상양상

이재인 ( Jae In Lee ),서현이 ( Hyun Yi Suh ),배주윤 ( Joo Yoon Bae ),정혜정 ( Hye Jung Jung ),안지영 ( Jiyoung Ahn ),박미연 ( Mi Youn Park ),윤용범 ( Yong Bum Yoon ),윤성환 ( Sung Hwan Youn ),윤재일 ( Jai Il Youn ) 대한피부과학회 2020 大韓皮膚科學會誌 Vol.58 No.10

Background: Non-alcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Evidence supporting a strong relationship between psoriasis and NAFLD exists. NAFLD is significantly higher in psoriatic patients than in matched controls and psoriatic patients with NAFLD have more severe forms of psoriasis than those without NAFLD. Objective: To evaluate the prevalence and clinical features of NAFLD among Korean psoriatic patients with abnormal liver function tests. Methods: We evaluated the laboratory results of psoriatic patients who visited the Department of Dermatology, National Medical Center, between September 2012 and June 2017. Those who had abnormal liver function tests were consulted by a hepatologist to confirm the diagnosis of NAFLD using ultrasonography. Results: A total of 307 psoriatic patients underwent liver function tests (LFTs), and 46 patients (15.0%) had abnormal LFT values. A hepatologist consulted psoriatic patients with abnormal LFTs, and hepatic ultrasonography was performed; 34 patients (73.9%) were diagnosed with NAFLD. Among psoriatic patients with abnormal LFTs, those with a Psoriasis Area and Severity Index (PASI) ≥10 had a significantly higher rate of NAFLD than psoriatic patients with PASI <10 (87.5% vs 59.1%). Conclusion: Among psoriatic patients with abnormal LFTs, 34 patients (73.9%) were diagnosed with NAFLD. Psoriatic patients with PASI ≥10 had a significantly higher rate of NAFLD than those with PASI <10. (Korean J Dermatol 2020;58(10):650∼655)

낭액의 Carcinoembryonic Antigen 및 Carbohydrate Antigen 19-9 증가를 보인 간내담관낭선종 1예

김태호,이동호,이상협,김정룡,이국래,정중기,윤용범,장미수,우열근,예병덕,곽금연 대한소화기학회 2000 대한소화기학회지 Vol.36 No.1

A 39-year-old woman who had a two-year history of right upper quadrant abdominal mass was admitted. Abdominal ultrasonography and computed tomography revealed a large, multiloculated cystic tumor in the liver. This tumor was noted with elevated levels of carcinoembryonic antigen (CEA) (397 ng/mL) and carbohydrate antigen (CA)19-9 (24,000 U/mL) in the cystic fluid and elevated serum CA19-9 level (438 U/mL). A 18×15×6 cm, 1,220 gm cystic mass was removed by cystectomy. The cut section revealed a multilocular cyst containing yellowish mucinous fluid surrounded by a smooth and glistening wall. It was diagnosed histologically as an intrahepatic biliary cystadenoma with mesenchymal stroma, which consisted of single layer of a cuboidal epithelial lining and an ovarian-like stroma. Six weeks after surgery, the serum CA19-9 level was decreased to 59 U/mL. These findings may be useful in the differential diagnosis of intraheptic cystic tumors and thus, we report this case with a review of the literatures.

한국인의 위 Alcohol Dehydrogenase(ADH)활성도 및 각종 H-2 길항제의 백서 위 ADH에 대한 영향

김나영,이동호,송인성,김용태,정현채,이건욱,이효석,김정룡,최규완,윤세진,최국진,윤용범 대한소화기학회 1992 대한소화기학회지 Vol.24 No.4

We undertook this study to investigate possible sex-related difference of ADH activity and to determine how such a activity might be affected by long-term consumption of ethanol in man and to investigate the effect of H-2 receptor antagonist on gastric and hepatic ADH activities in rats. The subjects were the normal looking mucosa (n=27) and mucosa of lesion (n=21) from 21 male and 8 female at the time of surgery for advanced gastric cancer. In animal study, they were divided into seven different groups of forty-two rats. GrougⅠ were normal control rats receiving water and food ad libitum. The other groups were consisted of GroupⅡ (receiving cimetidine, 40 mg/Kg), GroupⅢ (ranitidine, 10 mg/Kg), GroupⅣ (famotidine, 1.3 mg/Kg);- Group Ⅴ (nizatidine, 10 mg/Kg), GroupⅥ (omeprazole, 1 mg/Kg), GroupⅦl (roxatidine, 5 mg/Kg). Each group was treated by above mentioned drugs for 7 days. The results are as follows: 1) The ADH specific activity levels measured in normal mucosa and mucosa of lesion were respectively 1.77±1.05, 1.98±1.06 unit/mg of protein, and there was not statistically significant difference between two goroups. 2) In nonalcoholic subjects, ADH specific activity levels (ment±S.D) were significantly higher in men (2.86±1.43) than women (1.36±0.52 unit/mg of protein)(p $lt; 0.05). 3) In men subjects, ADH specific activity levels (mean±S.D) were 50% lower in the alcoholic abuser than in the nonalcoholic subject. 4) The ADH specific activity levels measured in mucosa of lesion might be not affected by long-term consumption of ethanol and sex-related difference. 5) The group Ⅱ (receiving cimetidine, 40 mg/Kg) as compared to the group Ⅰ (control rats) showed a significant decrease of gastric and hepatic ADH activities (p$lt;0.05), however other groups did not show a significant decrease of gastric and hepatic ADH activites. So, we conclude that increased bioavaliability of ethanol, resulting from decreased gastric ADH activity levels, may contribute to the enhanced vulnerability of women and alcohol abuser to toxicity of alcohol and systemic effects of alcohol, and the toxicity may be exacerbated in patients receiving cimetidine.