1996년도 제35차 대한소화기학회 추계학술대회 / 담낭결핵 1예

현진해(Jin Hai Hyun),이상우(Sang Woo Lee),송치욱(Chi Wook song),류호상(Ho Sang Ryu),김창덕(Chang Duck Kim),진윤태(Yoon Tae Jeen),이홍식(Hong Sik Lee),전훈재(Hoon Jai Chun),엄순호(Soon Ho Um),엄중식(Joong Sik Aum) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1

궤양과 점막하종양을 동반한 위결핵

현진해(Jin Hai Hyun),송치욱(Chi Wook song),김열홍(Yeul Hong Kim),심경보(Kyung Bo Sim) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.2

Tuberculosis of stomach is very rare disease and diagnosis is difficult without histologic examination. This study is a case report of tuberculosis of the stomach, of which diagnosis was confirmed by histologic finding of biopsy specimen obtained from the site of ulceration and cytologic finding of sonoguided fine needle aspiration from the intraabdominal mass. Patient is a 50-year-old female who was admitted with a chief complaint of poor appetite and weight loss. Submucosal tumor and ulceration was found at antrum of the stomach by both endoscopy and upper GI study. Multiple cystic masses were found at periaortic, retroperitoneal and pancreatic area by sonogram and CT scan. Histologic finding of biopsied specimen and cytologic finding of aspirated tissue was compatible with that of tuberculosis. Administration of antituberculous agent resulted in good response.

급성 담낭염의 임상적 고찰

현진해(Jin Hai Hyun),김열흥(Yeul Hong Kim),이형호(Hyung Ho Lee),황일순(Il Soon Whang),송치욱(Chi Wook song),류호상(Ho Sang Ryu),최진학(Jin Hak Choi) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.2

N/A Clinical observation was performed of 229 cases of acute cholecystitis who admitted to Department of Internal Medicine Korea University Hospital for 5 years from Jan. 1980 to Dec. 1984. The following results were obtained: 1) The total number of cases of acute cholecystitis was 229 which was 0.46% of total admission cases during the same period. 2) The age incidence was the highest in 6th decade. The ratio of male and female was 1: 1.3. 3) On admission the most common clinical symptom was pain in the R.U.Q. and epigastrium(75.5%), the remainders were fever(40.2%), chill(36.2%), indigestion (34.1%), and nausea with vomiting(28.0%) in order of frequency. 4) The most common physical finding was tenderness on the R.U.Q ((81. 2%), and the remainders were tenderness on the epigastrium(33. 6%), jaundice(27.l%), and fever with palpable liver(23.6%) in order of frequency. 5) Laboratory examination showed leukocytosis(45.4%), elevated E.S.R. (91.0%), elevated alkaline phosphatase(55.9%), and elevated serum total bilirubin(36.9%). 6) On the radiological examinations the gallstones were presented in 9.3% by plain abdomen. On the sonographic examination of abdomen gallbladder stones were noted in 54.2% common bile duct stone in 15.O%, and intrahepatic duct stone in 6.0% 7) The 46.3% percent were improved by the medical conservative treatment. The 49.8% percent were improved by the surgical treatment and the 1.7percent was expired. 8) The complications of acute cholecystitis were 3. 1 percent.

정상 한국성인의 식도내압검사 소견

송치욱(Chi Wook Song),김창덕(Chang Duck Kim),현진해(Jin Hai Hyun) 대한내과학회 1994 대한내과학회지 Vol.47 No.6

N/A Objectives: Although esophageal manometry is widely used in clinical practice, there are little reliable reports concerning the normal values for esophageal manometry in Korea. Methods: 70 healthy volunteers (mean age: 42 years; range 18~68 years) were studided with a low compliance infusion system and ESR3 HR catheter. All subjects were given more than 10 wet swallows (5 cc Water). Results: 1) Mean LES pressure measured by RPT is 28.5±5.1 mmHg. Mean LES pressure measured by SPT is 24.1± 7.5 mmHg at midrespiration. Age had no effect on LES pressures whereas female subjects showed higher LES pressure (RPT) than male (p<0.05). 2) Mean amplitude and duration of peristaltic contractions in proximal esophagus were 62.4±21.6 mmHg, 2.8+-0.6 sec and in distal esopahgus 92.4±32.6 mmHg, 3. 2±0.8 sec, respectively. The prevalence of peristalsis, velocity of peristalsis, number of abnormal contractions were 98.5±5.2%, 3.5±0.9cm/sec, 0.0±0.1 respectively. Age and sex had no effect on amplitude, duration, velocity of peristaltic contractions. Conclusions: Our study of 70 healthy Koreans, ranging in age from 18 to 68 years, should help to establish standards for normal manometric findings and provide a guide line for the diagnosis of esophageal motility disorders.

비심인성 흉통환자에서 식도운동검사의 의의

송치욱(Chi Wook song),구양서(Yang Suh Koo),이홍식(Hong Sik Lee),이상우(Sang Woo Lee),최재현(Jai Hyun Choi),김창덕(Chang Duck Kim),류호상(Ho Sang Ryu),현진해(Jin Hai Hyum) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.4

N/A Background/Aims: Recently the esophagus is considered a major source of recurrent noncardiac chest pain to patients in whom exercise stress test and/or cardiac catheterization have excluded a cardiac etiology. To investigate the esophageal origin of noncardiac chest pain, esophageal motility tests including manometry, provocation test, and radioisotope esophahgeal transit study(RETS) were studied in patients with noncardiac chest pain. Methods: A total of l26 patients with noncardiac chest pain were assessed;they included 41 patients with normal coronary angiogram and 85 patients with normal noninvasive cardiac tests such as echocardiogram and exercise stress test done in Korea University Hospital from Feb. l993 to Aug. 1994. Results: 56 out of 126 patients(44.4%) with noncardiac chest pain had abnormal manometric findings which included 20(35.7%) nonspecific esophageal motility disorder, 17(30.4%) hypertensive lower esophageal sphincter, 9(16.1%) hypo- tensive lower esophageal sphincter, and 2(3.6%) nutcracker esophagus. Thirty eight out of 126(30.1 %) patients had abnormal manometric findings but no reproducible chest pain by provocation test and were considered to have a probable esophageal chest pain. When patients having positives for both provocation tests are counted as a single positive, 39 out of l26(3l /o) patients had their chest pain reproduced and were considered to have a defini(e esophageal chest pain. The combination of patients with definite esophageal chest pain(31%) and probable(30.17c) gave an overall diagnostic yield of 61.1% for our esophageal laboratory. There was no significant difference between invasive cardiac test group and noninvasive cardiac test group in the results of esophageal motility tests. RETS merely reflected the peristaltic abnonnalities with no more informations for esophageal chest pain. Conclusions: These results reveal that esophagus is considered a source of noncardiac chest pain in 61.1%. Provocation test complements esophageal manometry alone and increases diagnostic yield. RETS can be used in diagnosis of noncardiac chest pain accompanied by peristaltic abnormality of the esophagus. (Korean J Gastroenterol 1995;27:381-387)

아칼라지아 치료에서 풍선확장술과 보툴리늄 독소 주사요법의 비교연구

송치욱(Chi Wook song),엄순호(Soon Ho Um),현진해(Jin Hai Hyun) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.4

N/A Background/Aims: Preliminary studies have suggested that intrasphincteric injection of the lower esophageal sphincter(LES) with botulinum toxin(BoTx) is a safe and effective alternative to pneumatic balloon dilation(BD) in the treatment of achalasia. We have compared the efficacy between BoTx and BD in an ongoing prospective study. Methods: In a randomized trial, 16 patients with achalasia received either intrasphincteric injection of BoTx(100 units) or BD(Rigiflex 3.0 cm in diameter). Among 8 patients treated with BoTx, 3 to them had been treated unsuccessfu]- ly beforehand with BD. After one month and after three months, Treatment responses were assessed on the basis of changes in the symptom scores and parameters of esophageal manometric study. Results: Both BoTx without prior BD(n=5) and BD group(n=8) showed a decreased symptom score, LES pressure and gastroesophageal pressure gradient(GEPG) at 1 month also decreased. LES pressure at 3 months increased in the BoTx group. No patient treated within the BD group failed at 3 months, but 1(20%)patient in the BoTx without previous BD did fail. The failed BoTx group with prior BD didnt show a decreased symptom score. LES pressure and GEPG also didnt decrease and 2(66.7%) patients failed at 3 months after treatment. No significant complications were seen in both the BoTx and the BD group. Conclusions: Both BoTx injection and BD were effective treatments for achalasia. BD may provide a more effective long term treatment, as compared to BoTx, for achalasia. However BoTx injection in patients who failed prior BD showed a poor response and a high failure rate. Long term evaluation of safety and efficacy will be required to fully understand the utility of BoTx injection vs BD for achalasia. (Korean J Gastroenterol 1997;29:423-429)

아칼라지아 풍선확장술후 증상호전과 재발의 예측인자에 대한 고찰

송치욱(Chi Wook song),진윤태(Yoon Tae Jeen),엄순호(Soon Ho Um),김창덕(Chang Duck Kim),류호상(Ho Sang Ryu),현진해(Jin Hae Hyun) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3

N/A Background/Aims: Pneumatic balloon dilation(BD) is considered to be the first line of treatment in patients with achalasia. However there have been little reports about whether the parameters of esophageal manometry and scintigraphy predict the long-term results after BD. The aims of this study were to determine the relationship between changes in symptom improvetnent and esophageal motor function in response to BD. Methods: 21 patients with primary achalasia treated by BD were included. We used a balloon dilator(Rigiflex, 3.0 cm in diameter) and dilated twice for 1 minute each at a pressure of 7-15 psi, at a 5 minute interval. A comprehensive assessment of their symptoms and esophageal manometry and scintigraphy was performed before, 1 month after wards and again 1 year after BD. Results: 1) One year after BD, four people had recurrence of symptoms and the remaining 17 patients(81%) had been successfully treated. 2) There was no relationship between patients age, sex, duration of symptoms and the symptom improvement scores of a year later. 3) Significant correlation was detected between changes in the symptom score of a year later and parameters of esophageal motor function such as reduction of lower esophageal sphincter pressure, normalized reversed gastroesophageal pressure gradient, and different configuration of simultaneous contractions after BD. Conclusions: We conclude that the changes in objective responses such as lower esophageal sphincter pressure, gastroesophageal pressure gradient and configuration of simultaneous contractions are reliable predictors of symptom irnprovernent and recurrence in patients with achalasia treated by BD. (Korean J Gastroenterol 1997;29: 279 - 288)

1996년도 제35차 대한소화기학회 추계학술대회 / 포스터 발표 : 위장관 ; 임상적 분류법에 따른 식도증상환자 2,143예의 식도내압검사소견

이정용,송치욱,김창덕,류호상,현진해 ( Jeong Yong Lee,Chi Wook Song,Chang Duck Kim,Ho Sang Ryu,Jin Hai Hyun ) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1

기니피그 위저부 윤상근의 비아드레날린성 비콜린성 반응에 관한 연구

황일순(Il Soon Whang),송치욱(Chi Wook song),강동훈(Dong Hoon Kang),이홍식(Hong Sik Lee),이상우(Sang Woo Lee),최재현(Jae Hyun Choi),김창덕(Chang Duck Kim),류호상(Ho Sang Ryu),현진해(Jin Hae Hyun) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.4

N/A Background/Aims: The neurogenic responses of gastrointestinal smooth muscles to electrical field stimulation(EFS) is biphasic, consisting firstly of cholinergic contraction, followed by a transient relaxation. It is well known that a transient relaxation does involve the inhibitory non- adrenergic non-cholinergic(NANC) systems. However, the exact nature of the neurotransmitter released by these neurons is controversial. This study was done to investigate the relaxing agents and their action mechanisms by the use of organ bath with platinum electrodes. Methods: In 10 guinea-pigs, muscle strips of fundus, 10mm x 2mm, were prepared in a circular axis. Isometric tension study was performed in 30ml organ baths containing Krebs bicarbonate buffer, tnaintatined at 37 'C and gassed with 5% CO and 95% Oz. Results: The fundic relaxation by EFS was suppressed by NG-nitro-L-arginine methyl ester(L-NAME) and nitric oxide(NO) synthase inhibitor, in a dose-dependent manner and these effects were reversed by L-arginine, precurssar of NO. Nitroprusside, NO-donor, suppressed the fundic basal tension largely. Methylene blue, inhibitor of guanylate cyclase, suppressed the fundic basal tension and decreased EFS-induced relaxations. Forskolin and isoprenaline, which are activators of adenylate cyclase, suppressed the fundic basal tension as rnuch as nitroprusside. Intracellularly permeable cGMP and cAMP pro- duced relaxations in the precontracted fundic muscle with noradrenaline. TEA, non-specific K' channel blocker, and aparnin, Ca ' activated K' channel blocker, increased the fundic basal tension and EFS-induced relaxations. Conclusions: Above results indicate that NO is released upon stimulation of the NANC nerves in the guinea-pig fundic muscle and play a major role in the receptive relaxation of the fundus region. The release of NO is related with K' channel, and some other inhibitory agents may be involved in transient relaxation through modulative effects on cAMP or cGMP. (Korean J Gastroenterol 1997;29:430-441)

건강 성인에서 라니티딘(300mg)과 오메프라졸(10mg, 20mg)의 위식도역류 및 위내 pH에 대한 효과

김영선(Young Sun Kim),송치욱(Chi Wook Song),김윤홍(Yoon Hong Kim),김혜랑(Hye Rang Kim),김윤배(Yun Bae Kim),허병원(Byung Won Hur),이정환(Jung Whan Lee),진윤태(Yoon Tae Jeen),김창덕(Chang Duck Kim),류호상(Ho Sang Ryu),현진해(Jin Hai Hy 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.2

N/A Background/Aims : This study was done to compare the effects of Omeprazole (OMD) 10 or 20 mg with Ranitidine(RAN) 300 mg on intragastric acidity and gastroesophageal reflux in healthy subjects. Methods : Ten healthy male volunteers were studied after administrations of 5 days dosing with either RAN 300 mg, OMD 10 mg or 20 mg, once each morning. On the 5th day, intragastric pH and lower esophageal pH were measured by a dual channel antimony pH catheter for 10 hours. Results : Gastroesophageal reflux was reduced after administrations of RAN 300 mg, OMD 10 mg or 20 mg (p<0.05) and there was no significant difference among the three drugs (p>0.05). The gastric holding time of pH >4 was significantly prolonged over fasting and postprandial periods after RAN 300 mg, OMD 10 mg or 20 mg administrations (p<0.05). OMD 20 mg showed the most potent effect on gastric acid suppression (p<0.05), but there was no significant difference between RAN 300 mg and OMD 10 mg (p>0.05). OMD administrations (10 mg or 20 mg) exhibited a more potent effect on gastric acid suppression during the postprandial period than RAN 300 mg (p<0.05). Conclusions : OMD 10 mg was as potent as RAN 300 mg on inhibition of gastric acid, but less potent than OMD 20 mg. There was no difference among the three drugs in regard to gastroesophageal reflux in healthy subjects.