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초음파 내시경 유도하 조직 검사로 진단된 담낭의 원발성 편평상피암 1예
허원각 ( Won Gak Heo ),전형구 ( Hyung Ku Chon ),최금하 ( Keum Ha Choi ),김태현 ( Tae Hyeon Kim ) 대한내과학회 2019 대한내과학회지 Vol.94 No.4
Squamous cell carcinoma of the gallbladder (GB) is uncommon and often presents at an advanced stage; therefore, it is associated with more aggressive behavior and a worse prognosis than those of adenocarcinoma. Herein, we report the case of an 82-year-old woman presenting a weight loss of 5 kg and epigastric discomfort over the previous 3 months. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed an infiltrative mass in the GB with hepatic invasion. Endoscopic ultrasound-guided fine needle biopsy using a 20-G core needle was performed, and the pathological examination revealed keratin pearls and an intracellular bridge, which are characteristics of squamous cell differentiation consistent with squamous cell carcinoma. Endoscopic ultrasound-guided fine needle biopsy was useful for obtaining an accurate histological diagnosis of GB masses without the need for surgery. (Korean J Med 2019;94:371-374)
조은영 ( Eun Young Cho ),허원각 ( Won Gak Heo ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
There have been many changes in the treatment of chronic hepatitis C since the introduction of new DAA agents in recent years. The standard treatment of chronic hepatitis C was converted to DAA agents from the combination of Pegylated interferon-alpha and ribavirin (PR), and the SVR rate was significantly increased from 50 to 80% for PR combination therapy to 90 to 100% for DAA regimens. However, as drugs have different effective genotypes, the choice of drugs depends on the genotype and subtypes, therefore it is necessary to have an in-depth understanding of each of DAA agents. In addition to the HCV genotype and subtype, several factors should be considered to determine the sort of DAA regimen and duration of treatment, such as the assessment of liver function, history of previous therapy, evaluation of renal function, and drug-drug interaction with concomitant medications. Therefore, despite the use of the DAA regimen with low side effects and excellent therapeutic effect, still, the treatment of chronic hepatitis C is mainly performed by a specialist in the field of hepatology. Pan-genotypic DAA regimens, which are expected to simplify these complex measurements of pre-treatment variables and drug selection criteria, have been approved in the US and Europe since 2016, and use is expected to be available soon. The use of these pan-genotypic DAA regimens simplifies pre-treatment measurement to determine DAA regimen and duration of treatment, and it is likely to make it easier to access the chronic hepatitis C treatment. Thus, as this allows more doctors to contribute to the treatment of hepatitis C, it is expected that it will be closer to the goal of hepatitis C eradication by increasing the interest in chronic hepatitis C and increasing the treatment rate.
허혈성 대장염 없이 전신성 홍반성 루푸스에서 발현한 직장 궤양
손기창 ( Ki Chang Sohn ),허원각 ( Won Gak Heo ),주민수 ( Min Su Chu ),김의중 ( Eui Joong Kim ),정종혁 ( Jong Hyeok Chung ),최석채 ( Suck Chei Choi ),윤기중 ( Ki Jung Yun ),서검석 ( Geom Seog Seo ) 대한소화기학회 2019 대한소화기학회지 Vol.73 No.5
Rectal involvement by systemic lupus erythematosus (SLE) is quite rare. Approximately 14 cases have been reported worldwide, but only one with ischemic colitis has been reported in Korea. A 17-year-old female patient was hospitalized with abdominal pain and hematochezia. Sigmoidoscopy revealed only a simple rectal ulcer without ischemic colitis. cytomegalovirus and bacterial infections were excluded. A sigmoidoscopic rectal biopsy indicated a rectal invasion by SLE, but the patient showed an acute worsening conditions that did not respond to treatment. This paper reports a case of rectal ulcer that developed in SLE without ischemic colitis with a review of the relevant literature. (Korean J Gastroenterol 2019;73:299-302)
증 례 : 정상 면역인 성인에서 위와 소장에 동시에 발생한 무증상의 장결핵
정진수 ( Jin Soo Chung ),조영범 ( Young Bum Cho ),허원각 ( Won Gak Heo ),조동호 ( Dong Ho Jo ),정영훈 ( Young Hun Jeong ),서검석 ( Geom Seog Seo ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.6
Gastrointestinal tuberculosis that is not an unusual form of extrapulmonary tuberculosis and it is usually associated with immunocompromised condition that may present with clinical symptoms including fever, weight loss or pain. Terminal ileum and cecum are the common sites of involvement, but involvement of the stomach is rare. Furthermore, synchronous tuberculosis involving both the stomach and lower gastrointestinal tract has been reported in very few cases. Herein, we report a case of incidentally detected synchronous tuberculosis involving both the stomach and terminal ileum that was successfully treated by antituberculosis therapy in an asymptomatic immunocompetent patient.(Korean J Gastroenterol 2015;66:345-349)
증례 ; 다채널 강내 임피던스 검사로 진단된 공기삼킴증 1예
손기창 ( Ki Chang Sohn ),정영훈 ( Young Hoon Jeong ),조동호 ( Dong Ho Jo ),허원각 ( Won Gak Heo ),염동한 ( Dong Han Yeom ),최석채 ( Suck Chei Choi ),류한승 ( Han Seung Ryu ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.5
Aerophagia is a disorder caused by abnormal accumulation of air in the gastrointestinal tract as a result of repetitive and frequent inflow of air through the mouth. For the diagnosis of this condition, it is difficult to objectively measure the air swallowing. However, multichannel intraluminal impedance monitoring facilitates the differential diagnosis between normal air swallowing and pathologic aerophagia, and can aid in the determination of the frequency and amount of air swallowed. In this report, in addition to a literature review, we describe a case of 36-year-old man with abdominal distension who was diagnosed with aerophagia using esophageal impedance monitoring and was treated with clonazepam. (Korean J Gastroenterol 2015;66:282-285)