점적 정주 담도조영법에 관한 검토 - 76예에 있어서 - ( Drip - Infusion Cholangiogram - An Analysis of 76 Consecutive Cases -

나용호,조국현,윤종만 ( Young Ho Nah,Kook Hyun Cho,Chong Mann Yoon ) 대한소화기학회 1980 대한소화기학회지 Vol.12 No.2

A total of 7o consecutive drip-infusion cholangiography v as performed in the Chonnam licdical University Hospital during periods of 1976 to 1979. The ages of the patients ranged from 21 to 73 years with the highest rank fifth decade. Of the patients 44 were male and 32 were female. In these patients a diagnostic evaluation of drip-infusion cholangiography was possible in 43 cases resulting in a diagnostic success rate of 56 percent. The gallbladder and the ductal systems were visualized with a equal success rate. The total bilirubin levels ranged from 0.4 mgA to 22.4mgZo In pstients with bilirubin levels below 1mg%, 29 of 38 cases in which biliary systems ivere visualized, and in the cases ivith bilirubin levels ranged from ll mgJo to 5. 2mgA 14 of 22 cases, were visualized. In the p.esent stdy the the highest level of serum bilirubin in a patients with adequate opacification of biliary systems was 5. 2mg%. Twenty-one patients were examined by both the conventional and drip-infusion cholangiogra- phy, and the results were compared. The drip-infusion cholangraphy offers a higher success rate over the conventional technic. Drip-infusion cholangiography using premedication with hyphertonic glucose solution and insulin rather causes nonvisulization of biliary systems in some cases. In only two cases developed dizziness.

경피내시경하 위루술

나용호(Yong Ho Nah),송주흥(Ju Hung Song),최인태(In Tae Choi),채수인(Soo In Chae),김영준(Young June Kim) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1

We performed the percutaneous endoscopic gastrostomy in 7 patients who were unable to swallow. Feeding via with the PEG was carried out in a bolus fashion requiring no additional equipment. In our experience no aspiration occurred and only one case of skin care problem arose. The PEG appeared to be safe and effective means of nonvolitional feeding in the home, hospital or in an extended care facility.

호도까기 식도증 환자에서 Edrophonium 유발시험

나용호(Yong Ho Nah),김영준(Young June Kim) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1

N/A The nutcracker esophagus is the most frequent defect of the esophageal motility disorders. But it is unknown whether nutcracker esophagus, as assessed by standard motility testing, bears close relationship to the patients symptoms. To evaluate efficacy and possible relationship between manometric abnormalities and patients symptoms, prospective edrophonium tests were studied in 11 patients with nutcracker esophagus and in 33 age matched controls. To provoke symptoms and motility abnormalities after baseline evaluation, all subjects had administration of normal saline (1 ml i.v.) and edrophonium (80 ug/kg i.v.). Tracings were coded, read and interpreted by two blind observers. Because of efficacy and relative safety, edrophonium provocative test can be simply done with or without manometric findings. The mechanism of edrophonium induced chest pain may be due to accompanying other abnormal waves, but remains an intriguing question. However, no single manometric finding reliably characterizes the patients with edrophonium induced pain. But it seems likely that high frequency of abnormal waves (over 50% of wet swallows) and a significant increase in mean wave duration (over 7.0 sec) may be considered as the probable positive signs.

대량 장출혈과 뇌 전이를 유발한 원발 십이지장 융모막암

조은영 ( Eun Young Cho ),최창수 ( Chang Soo Choi ),김지웅 ( Ji Woong Kim ),권지혜 ( Ji Hye Kweon ),김태현 ( Tae Hyeon Kim ),서검석 ( Geom Seog Seo ),조향정 ( Hyang Jeong Jo ),최석채 ( Suck Chei Choi ),나용호 ( Yong Ho Nah ) 대한소화기학회 2006 대한소화기학회지 Vol.48 No.2

Duodenal choriocarcinoma, either primary or metastatic, is very rare. Early diagnosis and prompt initiation of chemotherapy improve the prognosis of this neoplasm. We herein present, together with the referred literatures, a case of a 47-year-old female patient who visited to our hospital with upper intestinal bleeding. She was diagnosed as duodenal choriocarcinoma by operation. Brain metastasis was found soon after the operation and combination chemotherapy was done. (Korean J Gastroenterol 2006;48:128-131)

건강한 한국인에서 보행성 24시간 식도내압 검사

최석채(Suck Chei Choi),나용호(Young Ho Nah),임종채(Jong Chae Lim) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.1

N/A Background/Aims: The aim of thi study was to documcnt the circadian rhythmic variation of esophageal motor functions, and the effects of food on esophageul peristalsis. Methods: Standard esophageal manometry and 24-hour ambulatory esophageal pressure monitoring were done in 20 healthy volunteers(male: 14, female: 6, mean age: 26.5 years), using a newly developed miniaturized electronic pressure transducers and portable digital data recorders. Results: Compared to the wet swallow, the food elicited a significant increae in the amplitude of contractions. With 24-hour monitoring, approximately 1,000 contractions were recorded over a 24-hour period. Meals were ass<x.iated with increase in contraction frequency and amplitude. During night, when the subjects were in supine position, esophageal motor activity was markedly decreased and disorganized, with a large percentage of the contractions being simultaneous and of high amplitude. However, even during the upright and meal periods there was a high incidence of simultaneous contractions, l7% and S% respectively. Conclusions: There are circadian rhythmic variotions in esophageal motor pattern and the normal values in a healthy Korean are: contraction amplitude; greater than 25mmHg and less than 100mmHg, simultaneous contractions; less than 40fo in upright position and less than 55% in supine position, multipeaked contraction; less than 10%. (Korean J Gastroenterol 1995;27: 1-8)

건강한 성인에서 콩가루 호기수소 검사법을 이용한 구강 맹장 통과시간의 측정

최석채(Suck Chei Choi),나용호(Young Ho Nah) 대한내과학회 1996 대한내과학회지 Vol.51 No.4

Objectives: The hydrogen breath test has been widely used as a noninvasive and simple method of determining orocecal transit time after ingestion of unabsorbable disaccharide lactulose. But there are several disadvantages in using such a low molecular weight, and hence osmotically active substance. Raked bean contains sufficient poorly absorbable carbohydrate to yield a rise in breath hydrogen of 30-40 pm starting after 3-4 hours after ingestion and this meal more closely resembles normal food and also gives reproducible responses. But the time of arrival of baked bean in the cecum is variable by different researchers. The most common criteria of transit is a sustained rise of > 10 ppm above baseline, though other authers used a rise of sustained 3 ppm or double baseline. The aim of this study was to determine whether changes of test meal aftect the oracecal transit time. The orocecal transit time using baked bean was measured in 20 healthy volunteers and was compared with the orocecal transit time using lactulose. Medthods: Subjects were instructed to not eat any foods containing unabsorbable carbohydrates the day before the test and not smoke for at least 1 hour prior to the test. After an overninght fast subjects brush their teeth and rinse their mouth, the basal end-expiratory breath sample is obtained and assayed for hydrogen using a gas chromatograph (12i MicroLyzer, Quintron, Milwaukee). The test meal containing 120g of baked bean and water (513 kCal) were taken, and then every 10 minitues the sample were collected and measured until they dropped to a level of 10 ppm. The all subjects returned one months later, at which time 15 gm of the lactulose was administered following the same protocol. Transit time were defined as the time at which there were 3 ppm sustained increase, 10 ppm and twofold rise in breath hydrogen over baseline. Results: Orocecal transit time using baked bean rising above 10, 3 ppm sustained increase above baseline and double baseline were 324.5(±87.15), 254.5(±96.38), and 244.5(±111.83) minutes, respectively. Bat orocecal transit time using lactulose were 125.38(±28.47), 97.69(±40.86), and 110.77(±35.7) minutes, respectively. Orocecal transit time was significantly delayed in the method using baked bean than in the method using lactulose. Conclusion: Based on these study, baked bean hydrogen breath test is more accurate modality then lactulose hydrogen breath test in evaluating orocecal transit time. Transit time should be defined as the time of 10 ppm rise over baseline. In healthy adult Korean, upper limit of OCTT is about 5 hours.

증례 : 대량의 소장 출혈 후 발생한 저산소성 뇌손상

서검석 ( Geom Seog Seo ),조은영 ( Eun Young Cho ),최창수 ( Chang Soo Choi ),김지웅 ( Ji Woong Kim ),김태현 ( Tae Hyeon Kim ),최석채 ( Suck Chei Choi ),나용호 ( Yong Ho Nah ) 대한내과학회 2006 대한내과학회지 Vol.71 No.1S

풍선 확장술을 시행받았던 식도 이완불능증 환자에서 발생한 식도암

염주진 ( Joo Jin Yeom ),심미령 ( Mi Ryeong Sim ),조은영 ( Eun Young Jo ),최창수 ( Chang Soo Choi ),서검석 ( Geom Seog Seo ),김상욱 ( Sang Wook Kim ),김태현 ( Tae Hyeon Kim ),최석채 ( Suck Chei Choi ),나용호 ( Yong Ho Nah ) 대한소화기기능성질환·운동학회 2004 Journal of Neurogastroenterology and Motility (JNM Vol.10 No.1

Achalasia is believed to be a predisposing factor for the development of esophageal cancer in achalasia. Esophageal cancer has been reported as a late complication in 3~7% of patients with achalasia. The presumed mechanism responsible for the development of cancer are food stasis and gastroesophageal reflux. We experienced a case of esophageal carcinoma in a 61-year-old woman, who had been diagnosed as achalasia fourteen years ago, and who had undergone pneumatic balloon dilatation. Esophagogram, esophagoscopy with biopsy, esophageal manometry, and chest computerized tomography scanning revealed achalasia and esophageal carcinoma. (Kor J Neurogastr oenter ol Motil 2004;10:72-75)

장결핵 치료 중 Rifampin으로 유도된 심한 혈소판 감소증 및 백혈구 감소증 1예

김지웅 ( Ji Woong Kim ),정금모 ( Gum Mo Jung ),조은영 ( Eun Young Cho ),최창수 ( Chang Soo Choi ),서검석 ( Geom Seog Seo ),조진웅 ( Jin Woong Cho ),최석채 ( Suck Chei Choi ),나용호 ( Yong Ho Nah ) 대한장연구학회 2006 Intestinal Research Vol.4 No.1

Drug induced thrombocytopenia is a relatively not uncommon and potentially serious side effect of therapy. It`s characterized by thrombocytopenia, petechia, purpuric lesions and occasionally serious bleeding such as intracranial hemorrhage. The patient was 24 year-old female who was given rifampin 600mg daily for treatment of intestinal tuberculosis. Rifampin-induced immune thrombocytopenia was occurred 25 days after initiating therapy. Platelet and leukocyte count were 23,000/mm3, 2,850/mm3, respectively. Two week after discontinuation of antituberculous medication, platelet count was recovered. We report this case with a review of literature. (Intestinal Research 2006;4:64-68)

단핵구의 부착, 분화 및 SR-A 발현에 대한 철 결핍의 영향

서검석(Geom Seog Seo),최석채(Suck Chei Choi),최은영(Eun Young Choi),김태현(Tae Hyeon Kim),나용호(Yong Ho Nah),오재민(Jae Min Oh),김상욱(Sang Wook Kim),전창덕(Chang-Duk Jun) 대한해부학회 2004 Anatomy & Cell Biology Vol.37 No.6

철 항산성의 유지는 세포의 증식 및 분화에 필수적이며, 면역 기능 조절에도 중요한 역할을 한다. 단핵구와 큰포식세포는 급만성 염증에 있어 숙주 방어의 중요 역할을 한다. 또한 단핵구 및 큰포식세포는 세망내피계통의 다른 세포들과 더불어 철의 저장에 있어 중요한 역할을 한다. 이러한 단핵구인 THP-1 세포에서 철 결핍이 발생될 때 형태학적 및 기능적 변화에 대한 연구가 없어 알아보았다. Desferrioxamine (DFO)을 처리한 단핵구에서는 세포 부착능이 증가하였고 미분간섭 현미경(Differential interference contrast, DIC)에서 DFO를 처리한 세포의 거짓발 연장(pseudopodial extension)이 관찰되었다. Giemsa 염색에서 핵세포질 비율(N/C ratio)의 변화를 보였다. 또한 fluorescence-activated cell sorter (FACS)와 rhodamine-phalloidin 염색에서 DFO에 의한 단핵구의 탐식능 증가가 관찰되였다. 세포 분화 인자인 scavenger receptor-A (SR-A)의 발현이 DFO 처리한 단핵구에서 증가되었다. 이러한 결과는 DFO에 의한 철 결핍 상태가 단핵구의 큰포식세포양 세포로 분화를 촉진시키며, 이는 염증에서 숙주 면역 반응을 약화시킬 것으로 추측된다. Maintenance of cellular iron homeostasis is a prerequisite for proliferation and differentiation of cells, and is also a central role in the regulation of immune function. Monocyte-macrophages play an important roles in host defense, particularly in the inflammatory process of acute and chronic disease. The reason that an iron is important in these cell is because an iron is indispensable in a generation of hydroxyl radical for bacterium killing. Because of the role of iron in the monocytic THP-1 cell differentiation is not become clear, we investigated whether THP-1 cell can differentiate to macrophage-like cell using of iron and iron chelator which cause iron depletion. The cell differentiation was not able to observe by iron treatment, by the way, the cell adhesion was increased in DFO treated monocyte and cellular pseodopodial extension, change of a nucleus-cytoplasmic ratio were showed in Differential interference contrast (DIC) and Giemsa staining, and it was inhibited by ferric citrate (FC). Increased polystyrene bead phagocytosis by DFO treatment of THP-1 cell were detected through FACS and rhodamine-phallodin staining. The SR-A expression, which was a cell differentiation marker, was increased by DFO treatment of THP-1 cell. These results suggest that iron depletion by DFO can promote THP-1 cell diffentiation into macrophage-like cell, and this may carrying out important role in the immune response.