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이풍렬 ( Poong Lyul Rhee ),김재준 ( Jae J. Kim ),고광철 ( Kwang Cheol Koh ),백승운 ( Seung Woon Paik ),이종철 ( Jong Chul Rhee ),최규완 ( Kyoo Wan Choi ),오영륜 ( Young Lyun Oh ),김경희 ( Kyung Hee Kim ),김영호 ( Young Ho Kim ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<목적> 궤양성 대장염 환자의 대장 점막에서는 정상점막에서 거의 발현되지 않는 cyclooxyegnase-2(COX-2)의 발현이 관찰된다. 궤양성 대장염으로 COX-2의 발현이 가지는 의의는 잘 알려져 있지 않은데 COX-2가 염증 매개체의 생성을 통하여 대장염을 악화시키거나 반대로 대장점막의 증식을 촉진시키고 아포토시스를 억제하여 점막병변의 치유에 도움을 줄 가능성을 모두 생각할 수 있다. 최근 대장염 동물 모델에서 COX-2를 선택적으로 억제하면
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The effects of noradrenaline on the contractile and electrical activities were investigated using the circular muscle strips with intact mucosa prepared from the antrum and fundus of guinea-pig stomach. Electrical responses of circular muscle cells were recorded using glass capillary microelectrodes filled with 3 M KCI. All experiments were performed in tris-buffered Tyrode solution which was aerated with 100% O<sub>2</sub> and kept at 35℃. The results obtained were as follows: 1) The spontaneous contractions recorded from the antral and fundic circular muscle strips with intact mucosa were suppressed dose-dependently by the application of noradrenaline, whereas those recorded from the mucosa-free strips were potentiated in a dose-dependent manner. 2) The inhibitory influences on the contractile activities in the normal intact strips were developed via both α-adrenoceptors and β-adrenoceptors, while the excitatory influences in the mucosa-free strips resulted from the strong excitatory effect via α-adrenoceptors and the weak inhibitory effect via β-adrenoceptors. 3) Noradrenaline produced hyperpolarization of membrane potential, and increased the amplitude and the maximum rate of rise of slow waves in the mucosa-free strips of antral and fundic circular muscle. 4) Apamin blocked the appearance of the component of initial suppression of spontaneous phasic contractions observed in the mucosa-free strips of antral circular muscle after the application of noradrenaline. 5) The inhibitory influences on the contractile activities in the normal strips with intact mucosa remained unaffected even in the strip with separate mucosa, in which mucosa and muscle layer were mechanically disconnected . From the above results, following conclusions could be made. (1) There are no regional differences between the effects of noradrenaline on the antral circular muscle and those on the fundic circular muscle. (2) Excitatory responses to noradrenaline observed in the mucosa-free strip result from the dominant α-excitatory and tile weak β-inhibitory action of noradrenaline. (3) Inhibitory responses to noradrenaline in the normal strips with intact mucosa develop via both α-inhibitory and β-inhibitory actions.
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.
Objectives : Non-cardiac chest pain (NCCP) can be divided into gastroesophageal reflux disease (GERD) related NCCP and non-GERD related NCCP. Our study was designed to examine the differences in clinical characteristics and psychological mood states between the two clinical syndromes. Methods : After some cardiologic evaluations such as treadmill exercise, coronary angiography, and echocardiography, 27 patients with NCCP were enrolled in this study. They were divided into patients with GERD related NCCP (12 patients) and those with non-GERD related NCCP (15 patients) using the upper gastrointestinal endoscopy and the ambulatory 24 hour esophageal pH monitoring. Clinical characteristics such as typical reflux symptoms and psychological mood states were measured. Patients who showed scores more than 10 on the Beck Depression Inventory (BDI) or Beck Anxiety Inventory (BAI) were defined as depressed or anxious group. Anxiety sensitivity Index (ASI) was also measured in all patients. All parameters were compared between patients with GERD related NCCP and those with non-GERD related NCCP. Results : The two groups showed a difference in typical reflux symptoms. Patients with non-GERD related NCCP had higher scores on the BDI, BAI and ASI than those with GERD related NCCP. Among all NCCP patients, 14 patients (51.9%) were suggested to have possible depression or anxiety disorders. Conclusion : The non-GERD related NCCP was shown to be associated with psychological mood states such as anxiety and depression. Thus, we suggest that routine measurement of psychological mood states should be necessary in the evaluation and treatment of NCCP.
이규택(Kyu Taek Lee),이풍렬(Poong Lyul Rhee),손희정(Hee Jung Son),이종균(Jong Kyun Lee),이준혁(Joon Hyeok Lee),김재준(Jae Jun Kim),고광철(Kwang Cheol Koh),백승운(Seung Woon Paik),이종철(Jong Chul Rhee),신명희(Myung Hee Shin) 대한내과학회 1997 대한내과학회지 Vol.53 No.6
N/A Objectives: Although prognosis for pancreatic cancer is generally poor, it is well known that the survival rate for resected pancreatic cancer is much higher than that for more conservative treatment. The importance of early detection is emphasized for resection of pancreatic cancer. Measurement of serum CA 19-9 has shown satisfactory sensitivity and predictive value in symptomatic patients, but there was no available data in healthy asymptomatic subjects. Thus, we aimed to determine the clinical usefulness of CA19-9 for screening of pancreatic cancer in asymptomatic subjects. Methods: 11,974 asymptomatic persons visiting Samsung Health Promotion Center from December 1994 to July 1996 participated in this study. All subjects underwent ultrasonography and CA19-9 as initial screening tests. We analyzed sensitivity, specificity, and predictive values in detecting pancreatic cancer of CA 19-9 using statistical methods. Results: Mass screening of 11,974 asymptomatic persons resulted in the detection of only 2 cases of pancreatic cancer. 179 subjects had CA 19-9 values above the cutoff of 37u/ml, including the 2 cases diagnosed with pancreatic cancer. The prevalence of pancreatic cancer over the age of 30 in Korea is 14.8 per 100,000 population. Therefore, sensitivity is 100% and specificity is 98.5%. However, positive predictive value of CA19-9 for detection of pancreatic cancer is only 0.98% in asymptomatic population. Conclusion: Mass screening of pancreatic cancer using CA 19-9 in asymptomatic subjects is ineffective due to low predictive value, despite high sensitivity and specificity.
Gastroesophageal reflux disease (GERD) is the most common cause of noncardiac chest pain (NCCP) and is present in up to 60% of patients with NCCP in the West. In Korea, GERD is reported to cause 41% of cases of NCCP, after a reasonable cardiac evaluation. In a recent prospective study in Korea, an empirical trial of a proton pump inhibitor (PPI) was diagnostic for patients with GERD-related NCCP, as elsewhere in the world, and its optimal duration was reported to be at least two weeks in Korea, which is unlike the situation in the West. The report of Choi et al. showed that about 40% of NCCP in non-erosive reflux disease patients had esophageal disorders, including GERD and esophageal motility disorders, and that the standard dose or a low dose of PPI was effective for managing GERD-related NCCP. However, the retrospective nature of the study has limitations, such as an insufficient systemized symptom analysis and the standardization of the dose and interval of the PPI. A large-scale prospective study is needed to assess the accurate diagnosis and effective treatment of NCCP. (Korean J Med 79:13-15, 2010)
유민규 ( Min Kyu Yu ),이풍렬 ( Poong Lyul Rhee ),정현욱 ( Kyun Wook Jung ),문원 ( Won Moon ),정규 ( Gyu Jeong ),이준행 ( Jun Haeng Lee ),손희정 ( Hee Jung Son ),김재준 ( Jae J. Kim ),백승운 ( Seung Woon Paik ),이종철 ( Jong Chul 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.1
목적: 고압성 하부식도괄약근은 주로 흉통이나 연하장애 등의 식도관련증상을 주소로 하는 비교적 드문 일차성 식도운동질환으로, 비정상적인 위식도역류와의 연관성에 대해 알려진 바가 많지 않다. 이에 본 연구에서는 고압성 하부식도괄약근의 임상적 특징 및 위식도역류와의 연관성에 대하여 알아보고자 하였다. 대상 및 방법: 1995년 3월부터 2004년 8월까지 본원 소화기내과를 방문하여 표준 식도내압검사에서 고압성 하부식도괄약근으로 진단된 69명을 대상으로 임상적 Background/Aims: A hypertensive lower esophageal sphincter (HLES) is an uncommon primary esophageal motility disorder that has been associated with chest pain and dysphagia, and the association of HLES and abnormal gastroesophageal reflux (GER) has not be
N/A Background/Aims: Increased bile duct pressure is the major factor responsible for acute cholangi- tis and bacteremia. Therefore, prompt medical or surgical decompression of bile under high pressure should be accomplished as fast as possible. But, measuretnent of bile duct pressure is invasive. So, the present study was undertaken to find out the clinical factors to predict the increased biliary pressure in patients with bile duct obstruction. Methods: Thirty-three patients with bile duct obstruction underwent percutaneous transhepatic biliary drainage(PTBD). Intraductal pressure was measured as soon as bile duct pucture was performed. Bile cultures were performed in 24 patients and blood cultures were performed in 21 patients. Correlation of bile duct pressure and severity of pain, duration of symptom, fever, leukocytosis, serum bilirubin, serurn alkaline phosphatase, or bile duct diameter were statistically analyzed. Results: Bacteremias were noticed in 5 of the 17 patients with positive bile culture. Bacteremia was associated with the increased biliary pressure. Bacteremia was demonstrated when the biliary pressure was 22 cmHyO or more. Biliary pressure was associated with the severity of pain and body temperature. Significant correla- tion was not found between the duration of symptom, leukocytosis, serum bilirubin, serum alkaline phosphatase, or bile duct diameter and biliary pressure. Conclusions: Increased biliary pressure in patients with bile duct obstruction is more likely to be associated with severity of pain and fever than leukocytosis, bilirubin level, alkaline phosphatase level, or bile duct diameter. (Korean J Gastroenterol 1996; 28:409 - 414)