위막성 대장염에 대한 임상적 고찰

정문호(Moon Ho Chung),현명수(Myung Soo Hyun),이헌주(Heon Ju Lee),정문관(Moon Kwan Chung),심민철(Min Chul Shim),이태숙(Tae Shuk Lee) 대한내과학회 1988 대한내과학회지 Vol.34 No.5

N/A Pseudomembranous enterocolitis has been recognized since the 1880s as a severe intestinal lesion associated with a variety of conditions, In recent years, the majority of cases have been ascribed to antimicrobial treatment. Several studies have shown that C. difficle is the major cause of antibiotic associated pseudomembranous enterocolitis, Clinically, the disease is manifested by the diarrhea, abdominal pain, and fever. We wish to report our experience of 24cases of pseudomembranous enterocolitis associated with antibiotics, diagnosed by identifying characteristic yellow-white plaques, using with sigmoidoscopy that showed a pseudomembrane or summit lesion on a biopsy. The results were as follows: 1) There were 11 male and 13 female patients. Seventy-nine percent of the patients were over 50 years old at the time the diagnosis was made. 2) Various symptoms were assoicated with the onset of the disease, the most common being diarrhea (100%), abdominal pain (63%), and fever (54%). 3) Seventy-nine percent of patients developed diarrea within 15 days of antimicrobial chemotherapy. 4) Underlying medical illness were malignant tumor (21%), chronic renal failure (21%), colitis (12.5%), sepsis (8.3%), diabetes mellitus (8.3%), pneumonia (8.3%) and others. 5) Causes of antimicrobial therapy were prophylatic purpose (21%), pneumonia (21%), urinary tract infection (16.7%), enterocolitis (12.5%) and others. 6) Implicated antibiotics were ampicillin (45.8%), cephalosporin (29.1%), clindamycin (16.7%), penicillin (4.2%) and rifampin (4.2%) 7) Symptoms were improved with in 7 days, with medical agents such as vancomycin, metronidazole, lactobacillus, cholestyramine, and with only discontinuation of implicated antibiotics.

소화성 궤양 환자에서 위식도 역류

서중산,김종혁,정문관,Suh, Joong-San,Kim, Jong-Hyeok,Chung, Moon-Kwan 영남의대학술지편집위원회 1999 Yeungnam University Journal of Medicine Vol.16 No.2

1998년 5월부터 1999년 4월까지 상부소화기내시경 검사상 위궤양 또는 십이지장 궤양으로 진단된 환자 중 24시간 보행성 식도산도검사를 완료한 57명을 대상으로 하여 다음과 같은 결과를 얻었다. 1) 전체 57명 중 31명(54.2%)에서 병적 산역류가 관찰되었다. 반면 대조군에서는 22명 중 5명으로 22.7%였다. 2) 소화성 궤양에서 역류의 양상은 대조군과 다른 경향이 있으며 3) 소화정 궤양 환자에서 증상만으로 위식도 역류의 유무를 평가하기는 어렵다. 4) 십이지장 궤양, 남자, H. pylori가 위식도 역류의 의미 있는 변수로 생각된다. 이상의 결과로 소화정 궤양의 진단시와 치료 후 역류성 식도염 외에 위식도 역류의 유무를 확인하는 것이 H. pylori 제균치료 후 소화기 증상이 남아 있는 환자들의 치료에 도움이 될 것으로 생각되며, 이 경우 24시간 보행성 식도산도검사가 유용할 것이다. Background: It is well known fact to the patients of duodenal ulcer that their condition is frequently accompanied with reflux esophagitis. Therefore this condition is called an "acid-related disorder" because it is commonly associated with increased acidity. But there has been disputes on the effect of Helicobacter pylori eradication in these two conditions and whether H. pylori infection may have a protective role in reflux esophagitis. Only few reports have dealt with the prevalence of reflux esophagitis and gastroesophageal reflux in patients with peptic ulcer The aim of this study is to estimate the prevalence of gastroesophageal reflux and to analyze the pattern of the pathologic reflux in peptic ulcer patients. Materials and Methods: The study population consisted of 57 patients with endoscopically confirmed duodenal and/or gastric ulcer who all underwent 24hr ambulatory esophageal pH monitoring. Results: The prevalance of gastroesophageal reflux in peptic ulcer patients was 54.2% and 54,5% in gastric ulcer, and 62.5% in duodenal ulcer, 50% in combined ulcer, respectively. The prevalence of gastroesophageal reflux in the control group was 22.7% Conclusion: We discovered significantly higher prevalence of gastroesophageal reflux in patients with peptic ulcer disease than in those without it. In conclusion, the presence or absence of gastroesophageal reflux must be considered in the setting of peptic ulcer disease management.

B 형 간염 환자에서의 Delta agent 의 감염상

이헌주(Heon Ju Lee),정문관(Moon Kwan Chung),김종설(Chong Suhl Kim),최정규(Jung Gyu Choi),강찬규(Chan Kyu Kang),박화종(Wha Chong Park),최수봉(Soo Bong Choi) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A Delta agent is known to be highly infectious to HBV carriers. Despite of the high prevalence of HBV infection in Korea, only few studies of delta infection has been reported and its results are different from foreign study. Therefore authors evaluated the prevalence of delta infection by the sera from 40 HBsAg positive patients with various liver diseases, who consist of 15 patients with chronic active hepatitis, 10 with chronic persistent hepatitis, 3 with liver cirrhosis, 3 with hepatocellular carcinoma and 9 with acute viral hepatitis. Following results were obtained: 1) Anti-delta was detected in only 1 case of 40 cases. 2) It is suggested that delta infection is still rare in Korea despite of high endemicity of HBV infection.

직장 출혈을 동반한 Peutz - Jeghers 증후군

이헌주(Heon Ju Lee),정문관(Moon Kwan Chung),김종설(Chong Suhl Kim),이용원(Yong Won Lee),박영복(Young Bok Park),이명우(Myung Wo Lee),김홍진(Hong Jin Kim),권굉보(Koin Bo Kwun) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1

The Peutz-Jeghers Syndrome has three cardinal features; gastrointestinal polyposis, mucocutaneous pigmenation and transmission of autosomal dominant trait. A case of Peutz-Jeghers Syndrome was experienced in the department of Internal Medicine, Yeung Nam University Hospital. This 14 years old female patient was admitted, because of severe abdominal pain with rectal bleeding for one day. On physieal examination, melanin pigmentations were revealed on lip, oral mucosa, face and digits and child fist sized movable mass was palpated on lower abdomen. Upper G-I series, colon study, gastrofiberscopy, and colonoscopy revealed multiple intestinal polyposis. Polypectomy was done under the colonoscopy, and then rectal bleeding was stopped and abdominal mass was disappeared. A case of Peutz-Jegher Syndrome was reported here with the review of the literature.

비 미란성 역류 질환의 치료에 주석산 시사프리드와 돔페리돈 말레이트의 비교 임상 연구 ( 다기관 연구 )

장병익(Byung Ik Jang),김태년(Tae Nyun Kim),정문관(Moon Kwan Chung),김성국(Sung Kook Kim),허정욱(Jung Wook Huh),임창영(Chang Young Im),김호각(Ho Gak Kim),서정일(Jung Il Suh),이문호(Moon Ho Lee),김남재(Nam Jae Kim),윤세진(Sei Jin Youn) 대한소화기기능성질환·운동학회 2002 Journal of Neurogastroenterology and Motility (JNM Vol.8 No.1

N/A The therapeutic requirements of patients with non-erosive reflux disease (NERD) are similar to those with erosive esophagitis. The pharmacological action mechanism of prokinetics is quite different; domperidone is a peripheral dopamine D2-antagonist and cisapride is a HT4-agonist. This study was performed to evaluate the therapeutic effect of these two different prokinetics in patients with NERD. Methods: 178 patients, with heartburn and/or regurgitation, without reflux esophagitis were enrolled and divided into 2 groups by randomization code. In this prospective multicenter trial, 178 patients (93 patients in cisapride group, 85 patients in domperidone group) received 10 mg of cisapride three times a day or 10 mg of domperidone three time a day for 2 or 4 weeks. Symptom assessment was performed in each patients before treatments, 2 and 4 weeks after treatment. Results: Of the 133 patients available for final analysis, 65 were allocated to the cisapride group and 68 to the domperidone group. After 2 weeks treatment, heartburn was reduced in 81.1% of cisapride group, 56.7% of domperidone group (p<0.05) and regurgitation was reduced in 89.7% of cisapride group, 77.7% of domperidone group. After 4 weeks treatment, heartburn was reduced in 94.3% of cisapride group, 88.7% of domperidone group and this difference was not significant. The proportion of adverse events in cisapride group was 9.4% and was 5.5% in domperidone group. Conclusions: Cisapride tartrate was more effective in relieving heartburn in NERD patients than domperidone maleate after 2 week treatment. However, this superior effect dose not persist longer than 2 weeks.(Korean Journal of Gastrointestinal Motility 2002;8:3-13)

위염 및 소화성 궤양과 Campylobacter Pylori 와의 상관관계에 대한 연구

권경순(Kyeong Soon Kwon),신동구(Dong Gu Shin),정문관(Moon Kwan Chung),이현우(Hyun Woo Lee),홍석일(Suk Ill Hong),김미진(Mi Jin Kim) 대한내과학회 1989 대한내과학회지 Vol.37 No.5

N/A Light microscopic and microbiological studies of 222 consecutive endoscopic biopsy specimens were performed. Endoscopic and histological findings showed evidence of normality in 11 specimens, chronic gastritis in 169 specimens, gastric ulcer in 24 specimens, and duodenal ulcer in 18 specimens. Of these, 131 who indicated evidence of gastritis (77.6%) contained C.pylori. of the 11 normal specimens, only one specimen (9.1%) contained this bacteria (p<0.05). The C.pylori bacteria were found to be confined to the surface of the epithelial cells and just under the layer of mucus, but were rarely found inside the epithelial cells. the presence of C.pylori is significantly associated with gastritis and peptic ulceration. But there is not a significant difference between gastritis and peptic ulceration. Further studies are needed to determine if there is a causal relationship or merely an association between the occurrence of C. pylori and gastritis. However, it seems C,pylori is not the primary cause of the peptic ulceration.

60 cm flexible sigmoidofiberscope 로 관찰된 대장 폴립 및 종양의 임상적 관찰

김영조(Young Jo Kim),이헌주(Heon Ju Lee),정문관(Moon Kwan Chung),최재성(Heon Ju Lee),이영현(Moon Kwan Chung),김종설(Chong Suhl Kim) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.1

N/A The author had an opportunity to study 480 cases with chief complaints of various gastrointestinal symptoms who subsequently underwent to 60cm flexible sigmoidofiberscope examination during the period June 1983 to July 1984 at Department of Internal Medicine, School of Medicine, Yeung-Nam University and the following results were obtained. 1) The incidence of lesions through endoscopy were following that, 48 patients (10%) had colonic polyps, 13 patients (2.7%) had ulcerating cancers among 480, the ratio of male and female was 59:41, the most common range of age was sixth decade, 27.9% of 61 cases (17 cases) and above fifth decade was 86.9% (43 cases). 2) Analysis of histopathological finding revealed that the most common polyps were adenoma, 40% of 42 cases (17 cases), the most common size was less than 1cm of 48 cases(38 cases) and synchronous polyps were 21% of 48 cases (10 cases). 3) The size of malignant changed polyps was l. 5cm and 2cm respectively in 2 cases 4) The seven cases among present series were found at above 25cm from conventional 25cm rigid sigmoidoscopy is not being reached.

AntiHBc 단독양성인 검진자에서 혈청 GOT , GPT 치의 변화

김영조(Young Jo Kim),이헌주(Heon Ju Lee),정문관(Moon Kwan Chung),이영현(Young Hyun Lee),양창현(Chang Heon Yang),김종설(Chong Cuhl Kim) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.1

N/A It is well known that Anti HBc may be causative agent of HBU infection and means viral replication. To evaluate the clinical significance of anti-HBc, serum transaminases was checked and screening test for hepatitis B surface antigen(HBsAg), antihody to hepatitis core antigen(anti-HBc) and antibody to hepatitis B surface antigen(anti-HBs) was made by radioimmunoassay technique in 419 consecutive subjects. Both groups were healthy clinically and had neither past history of liver diseases nor other causes that may change the level of serum transaminases. Followings are results of authors observation of present series; 1) The difference in incidence of elevated serum transaminases between control and anti- HBc(+) groups statistically was not significant. 2) The incidence of elevated serum transaminases among male was higher than among female in anti -HBc(+) group. 3) The incidence of elevated serum transaminases tended to be higher as ages progress in both groups. 4) The values of elevated serum transaminases in both groups were generally within the two fold upper normal values.

급성 췌장염의 예후판정에 있어 복부전산화 단층촬영의 의의

서정일(Jeong Ill Suh),장병익(Byeong Ik Jang),김태년(Tae Nyeun Kim),정문관(Moon Kwan Chung),이현우(Hyun Woo Lee),변우목(Woo Mok Byun) 대한내과학회 1995 대한내과학회지 Vol.48 No.2

N/A Objectives: The purpose of this study is to evaluate the usefulness of computed tomography (CT) in the prognosis of acute pancreatitis. Methods: 70 patients with acute pancreatitis visited to Yeungnam University hospital emergency room between March 1991 and April 1993 were studied prospectively with early computerized tomography. The diagnosis of pancreatitis was based on typical clinical presentation and elevation of serum amylase levels. Prognostic score, fasting days and hospital days were record. The initial computerized tomograpic findings were graded A to E and we studied the correlation of CT grade and prognostic score and fasting days and hospital days. And also we studied the correlation of CT grade and prognostic score. Result: 1) Prognostic score of acute pancreatitis correlated with fasting days and hospital days (p<0.05). 2) There was no correlation between CT grade and prognostic score (p>0.05). 3) CT grade correlated well with fasting days and hospital days (p<0.01). Conclusion: In conclusion, we suggest that both prognostic score (Ranson score, Glasgow score) and early CT examination of patients with acute pancreatitis are useful prognostic indicator.

문맥압 항진증의 혈역학적 특성

김태년(Tae Nyeun Kim),서정일(Jeong Ill Suh),장병익(Byeong Ik Jang),정문관(Moon Kwan Chung),이현우(Hyun Woo Lee) 대한내과학회 1997 대한내과학회지 Vol.53 No.1

N/A Objectives: Hemodynamic measurements of chronic portal hypertension were done to study the mechanisms that maintain high portal pressure despite well developed collateral circulations. Methods: A prehepatic portal hypertensive rat model was produced by partial portal vein ligation. Cardiac output, organ blood flow and porto-systemic shunt were measured by radioisotope labeled microsphere methods, and vascular resistance was calculated by standard equation. Results: There was a significant reduction in the weight of the liver and increase in the weight of the spleen in the portal stenotic rats. Porto-systemic shunting, representing development of the collateral circulations, was 96.7±0.6% in the portal stenosis group compared with 0.9±0.2% in the control group (p<0.01). Portal pressure was significantly increased in the portal stenosis group compared with the control group(12.8±1.4 vs. 6.5±0.6mmHg; p<0.01). Mean arterial pressure was significantly decreased in portal stenosis group compared with control group(101.4±2.5 vs, 129.9±3.9mmHg; p<0.01). In the portal stenosis group, cardiac output(135.7±8.0 vs. 111.0±4.2ml/min; p<0.01) and splanchnic organ blood flow (28.97±2.03 vs. 17.90±1.27ml/min, p<0.01) were significantly increased, with concomitant decrease in total peripheral vascular resistance(58.0±3.3 vs. 88.2±4.8 dyne sec/cm5×105; p<0.01) and splanchnic vascular resistance(2.54±0.20 vs. 5.47±0.33 dyne sec/cm5×105; p<0.01), However, the portal venous resistance was not significantly different in both groups of rats (3.57±0.31 vs. 3.03±0.38 dyne sec/cm5×105; p>0.05). Conclusion: The hemodynamic results of this study indicate that hyperdynamic status of systemic and splanchnic circulation was present in chronic portal hypertension and that the primary factor contributing to the persistently elevated portal venous pressure was the markedly increased portal venous inflow.