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권영오(Young Oh Kweon),박재용(Jae Yong Park),김은영(Eun Young Kim),김호각(Ho Gak Kim),이관호(Kwan Ho Lee),곽규식(Kyu Sik Kwak),최용환(Young Hwan Choi),정준모(Joon Mo Chung),김용주(Yong Joo Kim) 대한내과학회 1988 대한내과학회지 Vol.35 No.6
N/A TAE is now a well-known easy, safe therapeutic modality in unresectable hepatocellular carcinoma. To evaluate the therapeutic effect of TAE in patients with hepatocellular carcinoma, we analysed 159 cases of hepatocellular carcinoma for survival and tumor detection rates according to diagnostic modalities and causes of death concurrently, The patients were divided into two groups, ie TAE treated group and non-TAE group. The results obtained were as follows: 1) The TAE group had a greater number of survivals than the non-TAE group and also the cumulative survival rate till 18 months was significantly higher. 2) The cumulative survival rate from 4 to 18 months was significantly higher in encapsulated hepatoma than diffuse hepatoma in patients who underwent TAE. 3) A declining AFP level was shown in 6 out of 13 cases who underwent TAE, and also tumor size was decreased in 8 out of 13 cases. These results suggest that TAE is an effective and useful therapeutic modality in treating and prolonging the survival of patients with unresectable hepatocellular carcinoma.
박영대 ( Young Dae Park ),정윤진 ( Yun Jin Chung ),전성우 ( Seong Woo Jeon ),조창민 ( Chang Min Cho ),탁원영 ( Won Young Tak ),권영오 ( Young Oh Kweon ),김성국 ( Sung Kook Kim ),최용환 ( Yong Hwan Choi ) 대한소화기학회 2007 대한소화기학회지 Vol.49 No.3
관강 내 십이지장 게실(intraluminal duodenal diverticulum, IDD)은 십이지장 제2부 내에 주머니 모양의 가로막을 가지는 드문 선천 이상이다. 환자는 무증상인 경우도 있으나, 반복적인 복통, 급성 췌장염 및 위장관 출혈을 동반할 수 있다. 저자 등은 급성췌장염과 위장관 출혈을 나타낸 IDD 1예를 경험하였다. 진단은 상부위장관조영술과 관상면 재구성 CT 영상에서 IDD의 특징적인 형태를 확인하여 진단하였다. 증상이 있는 IDD는 일반적으로 수술 절제를 일차적으로 고려하나, 이번 증례에서는 내시경을 이용하여 침형 절개도로 IDD 개구부를 절개한 후 박리 올가미를 이용한 결찰술을 시행하여 성공적인 결과를 얻었다. An intraluminal duodenal diverticulum (IDD) is a rare congenital anomaly consisted of a sac-like mucosal projection within the second portion of the duodenum. Even though most of cases are asymptomatic, patients may develop recurrent abdominal pain, pancreatitis, and gastrointestinal bleeding. We report a case of symptomatic IDD which presented as acute pancreatitis and obscure gastrointestinal bleeding. Diagnosis was made by typical findings of upper GI series and coronal reformatted CT images. Although surgical resection is the treatment of choice, endoscopic incision and ligation with detachable snare was performed which led to a good result. (Korean J Gastroenterol 2007;49:177-182)
위 또는 식도 정맥류 출혈에 대한 경내경정맥 간내문맥간정맥 단락술후 생존율에 영향을 미치는 인자
김영탁 ( Young Tak Kim ),탁원영 ( Won Young Tak ),권영오 ( Young Oh Kweon ),김성국 ( Sung Kook Kim ),최용환 ( Yong Hwan Choi ),정준모 ( Joon Mo Chung ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<목적> 위 및 식도 정맥류출혈의 치료방법 중 하나로 알려져 있는 경내경정맥 간내문맥간정맥 단락술(TIPS) 후 생존율 및 재출혈율에 영향을 미치는 인자를 조사하는 데 목적이 있다. <방법> 1991년 9월부터 2001년 3월 사이에 간경변증에 의한 식도 및 위 정맥류 출혈로 본원에 내원하여 내시경을 이용한 고무밴드 결찰술 등의 다른 치료 방법이 효과적이지 못하던지 또는 시술상 어려움이 있어서 TIPS를 시행한 155예를 최고 약 8년 10개월간 추적관
식도기관지누공 환자에서 실리콘 피막형 인공식도관을 이용한 보존적 치료
이창형(Chang Hyeong Lee),권영오(Young Oh Kweon),김성국(Sung Kook Kim),최용환(Yong Hwan Choi),정준모(Joon Mo Chung) 대한내과학회 1998 대한내과학회지 Vol.54 No.1
N/A Background: Implantation of esophageal stents is nowadays considered as the method of choice for the management of esophagorespiratory fistula. However, implantation of conventional plastic prosthesis is inconvenient for the patient and associated with relatively high mortality and complicaitons. Silicone coated self expandable metal stents have been developed to overcome these limitations of plastic tubes. And then, the efficacy of siliconecoated self expandable metal stents in esophagorespiratory fistulas was investigated. Methods: Six patients with esophagorespiratory fistulas were treated with silicone-coated self expandable metal stents(Song's esophageal stents). All six patients were unable to swallow food or water before treatment due to aspiration via esophagorespiratory fistula. The stents were inserted under endoscopic and fluoroscopic guidence. Clinical improvement was determined by grading food intake capacity on five-point scale none, liquid, soft food, solid food, or all food. Results: The stents were successfully inserted in all patients. All stents spontaneously showed sufficient expansion without further endoscopic control. After procedure, all fistulas were sealed and symptoms due to bronchial aspiration were disappeared. Dysphagia improved by at least two grades in 5 of the 6 patients(83.3%). One patient died due to massive hemoptysis 11 days after stent placement, which could be regarded as a complication, Retro-sternal and epigastric pain were observed in three patients. In the follow-up, tumor overgrowth at the end of the stent was found in one patient, who was retreated with implantation of another stent. Conclusion: These results suggest that implantation of silicone-coated self expandable metal stents is a rapid, and effective procedure for the palliative treatment of malignant esophagorespiratory fistulas and other cause of esophagorespiratory fistula.
이창형(Chang Hyeong Lee),권영오(Young Oh Kweon),김성국(Sung Kook Kim),최용환(Yong Hwan Choi),정준모(Joon Mo Chung) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1
N/A Background/Aims: There have been some studies concerning prognostic factors in hepatocellular carcinoma (HCC) patients undergoing transcatheter arterial embolization (TAE), but they reported different prognostic factors from each other. The aim of this study was to re-evaluate the prognostic factors in those patients. Methods: Eighty eight patients with HCC who had undergone TAE (TAE with gelfoam embolization or without embolization) were analyzed retrospectively. Results: The overall cumulative survival rates at 6,12,18,24,30,36 months were 69.9%, 56.3%, 52.7%, 41.9%, 30.9%, and 26.5%, respectively. According to univariated analysis (log-rank test), variables significantly associated with survival were tumor size, tumor type, Anti-HCV Ab, serum AST, mode of TAE (with or without gelfoam embolization), serum ALP, ascites, Childs classification, serum AFP level, serum total bilirubin, and portal vein thrombosis. Multivariated analysis (cox regression model) for significant variables in univariated analysis revealed that tumor size is statistically significant (p =0.05). Conclusions: These findings suggest that tumor size is a significant and independent prognostic factor in patients with hepatocellular carcinoma undergoing transcatheter arterial embolization. (Korean J Gastroenterol 1996;28: 57 - 65)
간세포암종의 고주파 열 치료 후 발생한 장-농양 누공에 대해 Histoacryl 색전술로 성공적으로 치료한
김지연 ( Ji Yeon Kim ),권용환 ( Young Hwan Kwon ),이상직 ( Sang Jik Lee ),장세영 ( Se Young Jang ),양해민 ( Hae Min Yang ),전성우 ( Seong Woo Jeon ),권영오 ( Young Oh Kweon ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.5
Hepatocellular carcinoma (HCC) is one of the most common malignant neoplasms occuring worldwide. Although surgical resection still remains the treatment of choice for HCC, radiofrequency ablation (RFA) has emerged as reliable alternatives to resection. It is less invasive and can be repeated after short intervals for sequential ablation in case of multiple lesions. The most common complication of RFA is liver abscess, and bile duct injury such as bile duct stricture has been reported. This is a case report of a rare complication of abscesso-colonic fistula after RFA for HCC. The case was treated by percutaneous abscess drainage and antibiotics and occlusion of abscesso-colonic fistula with n-butyl-2-cyanoacrylate embolization. (Korean J Gastroenterol 2011;58:270-274)
경피 경정맥 간내 문맥전신성 단락술로 치료한 췌장의 동정맥 기형에 의한 간문맥 고혈압
현동우 ( Dong Woo Hyun ),박수영 ( Soo Young Park ),박진형 ( Jin Hyung Park ),박창근 ( Chang Kun Park ),윤영미 ( Young Mi Yun ),조창민 ( Chang Min Jo ),탁원영 ( Won Young Tak ),권영오 ( Young Oh Kweon ),김성국 ( Sung Kook Kim ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.6
Pancreatic arteriovenous malformation is very rare. However, it silently progresses and frequently brings about serious condition such as portal hypertension. The removal of pancreatic arteriovenous malformation is difficult once portal hypertension has developed. Surgery is the definitive treatment of choice, but it carries high risks when the patient`s condition is poor. The transjugular intrahepatic portosystemic shunt (TIPS) is a well-accepted procedure for the treatment of intractable portal hypertension. We experienced a case in which TIPS was used for the treatment of intractable portal hypertension caused by pancreatic arteriovenous malformation. The patient suffered from ascites and intractable gastrointestinal bleeding. The portal hypertension caused by pancreatic arteriovenous malformation was diagnosed by color Doppler ultrasonography, computed tomography (CT), and angiography. TIPS might be another treatment of choice for this rare disease, when the patient`s condition is too risky for surgical treatment. (Korean J Gastroenterol 2003;41:514-518)
소화기 ; 라미부딘 내성 만성 B형 간염 환자에서 라미부딘과 아데포비어 병용치료
이현석 ( Hyun Seok Lee ),박수영 ( Soo Young Park ),최소영 ( So Young Choi ),정민규 ( Min Kyu Jung ),전성우 ( Seong Woo Jeon ),조창민 ( Chang Min Cho ),권영오 ( Young Oh Kweon ),김성국 ( Sung Kook Kim ),최용환 ( Yong Hwan Choi ) 대한내과학회 2009 대한내과학회지 Vol.77 No.6
목적: 라미부딘에 유전형 내성을 보이는 HBe 항원 양성 만성 B형간염 환자에서 96주간의 라미부딘과 아데포비어 병용치료와 아데포비어 단독치료의 임상적 효능에 대해 알아보고자 하였다. 방법: 라미부딘에 유전형 내성을 보이는 134명의 HBe 항원 양성 만성 B형간염 환자를 대상으로 후향적으로 의무 기록을 검토하여 조사하였다. 아데포비어 투여 직전 및 투여 후 12주 간격으로 간기능 검사, 혈청 HBV DNA 수치, HBe항원 및 항체에 대한 검사를 시행하였고, 아데포비어 투여후 생화학적 돌파현상 또는 바이러스 돌파현상을 보이는 환자에 대해 아데포비어에 대한 유전형 내성을 분석하였다. 결과: 34명의 라미부딘과 아데포비어 병용치료 환자와 100명의 아데포비어 단독치료 환자를 대상으로 조사하였다. 아데포비어 치료 96주 후 혈청 ALT의 정상화는 병용치료군에서 82.4%, 단독치료군에서 69.0%에서 나타났다(p=0.132). 혈청 HBV DNA의 음성화는 병용치료군에서 50.0%, 단독치료군에서 37.0%에서 나타났다(p=0.219). HBe 항원 혈청 소실률은 병용치료군에서 23.5%, 단독치료군에서 20.0%로 나타났다(p=0.662). 병용치료군(5.9%)에서 단독치료군(22.0%)에 비해 유의하게 낮은 생화학적 돌파현상(p=0.034) 및 생화학적 돌파현상의 누적 발생률(p=0.043)을 보였다. 아데포비어에 대한 유전형 내성은 병용치료군에서는 1명(2.9%), 단독치료군에서는 11명(11.0%)에서 관찰되었다(p=0.155). 돌연변이의 유형은 병용치료군에서 rtA181V가 1명, 단독치료군에서 rtA181V가 10명, rtN236T가 1명이었다. 결론: 라미부딘 내성인 만성 B형 간염 환자에서 라미부딘과 아데포비어의 병용치료군에서 통계적으로 유의하지는 않으나 혈청 ALT 정상화, 혈청 HBV DNA 음성화, HBe항원 소실 환자의 비율은 높았고 아데포비어에 대한 유전형 내성의 발생은 낮았다. 단독치료군에서 통계적으로 유의하게 생화학적 돌파현상 및 생화학적 돌파현상의 누적발생률이 더 높게 나타났다. 결론적으로 라미부딘과 아데포비어 병용치료가 아데포비어 단독치료에 비해 라미부딘 내성 만성 B형간염 환자에서 더 나은 임상적 효능을 보였다. Background/Aims: This study assessed the clinical efficacy of lamivudine-adefovir combination therapy and adefovir monotherapy for 96 weeks in patients who had hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) with genotypic resistance to lamivudine. Methods: We reviewed 134 patients who had HBeAg-positive CHB with genotypic resistance to lamivudine. We assessed liver function tests, hepatitis B virus (HBV) DNA, HBeAg, and antibody every 12 weeks after adefovir treatment. We searched for adefovir-related mutations in patients with biochemical or virologic breakthrough after adefovir treatment. Results: Data on 34 patients receiving combination therapy and 100 patients receiving monotherapy were analyzed. After 96 weeks, 82.4% of the combination therapy and 69.0% of the monotherapy patients had normalized alanine aminotransferase (ALT) levels (p=0.132). In addition, 50.0% and 37.0% achieved undetectable HBV DNA (p=0.210), respectively, and 23.5% and 20.0% lost HBeAg (p=0.662). The combination therapy group (5.9%) showed significantly lower biochemical breakthrough than the monotherapy group (22.0%, p=0.034) and had a lower cumulative biochemical breakthrough rate (p=0.043). One patient (2.9%) receiving combination therapy and 11 patients (11.0%) receiving monotherapy developed genotypic resistance to adefovir (p=0.155). One rtA181V mutation was detected in the combination therapy group, and ten rtA181V mutations and one rtN236T mutation were detected in the monotherapy group. Conclusions: Combination therapy had higher rates of ALT normalization, undetectable HBV DNA, and HBeAg loss and a lower rate of adefovir resistance. Monotherapy had significantly higher biochemical breakthrough and cumulative biochemical breakthrough rates than combination therapy. Therefore, combination therapy was clinically more effective than monotherapy. (Korean J Med 77:716-722, 2009)