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김병관 ( Byeong Gwan Kim ),김유선 ( You Sun Kim ),김주성 ( Joo Sung Kim ),정현채 ( Hun Chae Jung ),송인성 ( In Sung Song ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<목적> ASCA는 크론병에, 그리고 pANCA는 궤양성대장염에 비교적 특이한 자가항체로 알려져 있으나 아직 논란이 있는 실정이다. 본 연구에서는 크론병, 궤양성 대장염, 베체트 장염 그리고 장결핵환자와, 그 가족들을 대상으로 ASCA와 pANCA를 측정하여 진단적 유용성에 대하여 평가하고자 하였다. <방법> 1999년 1월부터 2000년 12월까지 서울대학교병원에서 치료를 받고 있는 크론병 85명, 궤양성 대장염 77명, 베체트 장염 36명, 장결핵
김병관 ( Byeong Gwan Kim ),김지원 ( Ji Won Kim ),이국래 ( Kook Lae Lee ),이재경 ( Jae Kyung Lee ),정지봉 ( Ji Bong Jeong ) 대한장연구학회 2012 Intestinal Research Vol.10 No.2
Background/Aims: We investigated the clinical features, and treatment outcomes in patients with non-traumatic small bowel perforations and compared these results to the previous study with patients who were diagnosed between 1997 and 2002. Methods: Patients who diagnosed non-traumatic small bowel perforation between January 2003 and December 2008 were reviewed retrospectively. Results: Of 38 patients of non-traumatic small bowel perforation, the most common etiologies were Crohn’s disease (CD) (36.8%), followed by intestinal tuberculosis (ITB) (28.9%) and primary malignancy (15.8%). In the study of 2002, however, the most common etiologies were idiopathic (39.3%), followed by mechanical obstruction (28.6%) and infectious enteritis (14.3%). Of 38 cases, 8 perforation sites were found in the jejunum and 30 in the ileum. The number of perforations was single in 20, two in 15, and over 2 in 3 cases. Twenty-five patients were treated with resection and anastomosis, nine patients with primary closure, and four patients with both procedures. The site and number of perforations, surgical methods, and post-operative complication rates were similar to those of 2002. The perforation patients with ITB had more frequent night sweats and pulmonary tuberculosis findings than those with CD. Conclusions: Although the clinical features and surgical outcomes in the 2009 study were similar to those of the previous study conducted in 2003, the etiologies of perforations were different; CD and ITB were two most common etiologies. In addition, clinical characteristics such as night sweats or pulmonary tuberculosis were suggestive findings for the diagnosis of ITB. (Intest Res 2012;10:189-195)
유당분해효소 결핍증의 진단을 위한 십이지장 점막의 자당분해효소 대 유당분해효소 활성도 비
김병관(Byeong Gwan Kim),김선미(Sun Mi Kim),김유선(You Sun Kim),문선희(Sun Hi Moon),이국래(Kook Lae Lee),정현채(Hyun Chae Jung),송인성(In Sung Song),김정룡(Chung Yong Kim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.2
N/A Background/Aims: Jejunal biopsy with direct quantitative analysis of mucosal enzyme activities is the standard diagnostic method of lactase deficiency. But this test is seldom used in the clinical setting, because it is incovenient and cumbersome. On the contrary, sucrase to lactase activities ratio in duodenal mucosa is easy to measure and comp]iant with patients. We performed this study to investigate the value of sucrase to lactase activities ratio in duodenal mucosa as a diagnostic method of lactase deficiency. Methods: The 36 cases(22 men, 14 women) of this study were selected from healtby adults free from gastrointestinal symptom. We performed H breath test and syptom analysis after lactose load. And then, we obtained the duodenal mucosa by endoscopic biopsy and measured enzyme activities of the duodenal mucosa. Results: In 36 subjects, there were 21 subjects(58%) who had the intolerant symptoms and had more than a 20ppni increase in breath hydrogen. Sucrase to lactase activities ratio of the 21 subjects was more than 8. By the definition of sucrase to lactase activities ratio, the prevalence of lactase deficiency was 86 percent. This result was sirnilar to the previous prevalence(84%) defined by jejunal mucosa enzyme assay in Korean adults. Conclusion: Sucrase to lactase activities ratio of duodenal mucosa is a useful diagnostic tool for lactase deficiency. (Korean J Gastroenterol 1997;29:175 -181)
김수환 ( Kim Su Hwan ),강현우 ( Kang Hyeon U ),윤원재 ( Yun Won Jae ),김진현 ( Kim Jin Hyeon ),김지원 ( Kim Ji Won ),황진혁 ( Hwang Jin Hyeog ),정지봉 ( Jeong Ji Bong ),김병관 ( Kim Byeong Gwan ),장동경 ( Jang Dong Gyeong ),김진욱 대한내과학회 2004 대한내과학회지 Vol.66 No.1
목적 : 인구의 고령화는 한국에서 상당히 빠른 속도로 진행하고 있고 2030년에는 60세 이상의 인구가 30.8%에 달할 것이라고 보고 되고 있다. 본 연구의 목적은 한국에서 고령층에서의 소화성 궤양의 특징에 대해서 알아보고자 하는 것이다. 방법 : 소화성 궤양으로 진단받은 총 134명 (남성: 89명, 여성: 45명)을 대상으로 하였다. 소화성 궤양은 상부위장관 내시경을 통해 진단하였다. 각 환자에 대해서 주증상, 증상의 지속기간, 궤양의 위치, H. Background:The proportion of the aged (>60 years old) population is increasing in South Korea and it is expected to reach 30.8% in 2030. The aim of this study was to analyze the clinical characteristics of peptic ulcer disease in the aged population in So
한국인 염증성 장질환에서 Tumor Necrosis Factor-α와 Interleukin-10 유전자의 다형성에 관한 연구
김태호 ( Kim Tae Ho ),김병관 ( Kim Byeong Gwan ),신형두 ( Sin Hyeong Du ),김지원 ( Kim Ji Won ),김찬규 ( Kim Chan Gyu ),김주성 ( Kim Ju Seong ),정현채 ( Jeong Hyeon Chae ),송인성 ( Song In Seong ) 대한소화기학회 2003 대한소화기학회지 Vol.42 No.5
Although the importance of genetic susceptibility to inflammatory bowel disease (IBD) has been established by epidemiological studies, the genes involved remain poorly understood. The aim of this study was to assess the role of single nucleotide polymorphisms of tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) genes in genetic susceptibility of IBD. Methods: Blood samples were obtained from 91 patients with ulcerative colitis (UC), 63 patients with Crohn`s disease (CD), and 200 healthy controls (HC). DNA was extracted from blood leukocytes for IL-10 and TNF-α genotyping by single base extension reaction. Genotypes and allelic frequencies were compared between IBD patients and HC, and among subgroups of the patients. Results: The frequency of -308A allele of TNF-α was significantly lower in CD patients than in HC (p=0.005). The frequency of -238A allele of TNF-α was significantly higher in CD patients with perianal lesion than those without perianal lesion. On the other hand, the frequency of -308A allele of TNF-α was significantly higher in ANCA-positive IBD patients than ANCA-negative IBD patients. There were no significant differences in allelic frequencies in the promoter region of IL-10 between IBD patients and HC. Conclusions: The TNF-α gene polymorphisms at positions -308 and -238 may have influences on the susceptibility to CD or the behavior of CD. (Korean J Gastroenterol 2003;42:377-386)
크론병에서 항문 주위 병변의 임상상과 치료에 대한 반응
김현대 ( Kim Hyeon Dae ),김찬규 ( Kim Chan Gyu ),김지원 ( Kim Ji Won ),김상균 ( Kim Sang Gyun ),김병관 ( Kim Byeong Gwan ),김주성 ( Kim Ju Seong ),정현채 ( Jeong Hyeon Chae ),송인성 ( Song In Seong ) 대한소화기학회 2003 대한소화기학회지 Vol.42 No.2
Background/Aims: The aim of this study was to assess the clinical features and therapeutic responses of perianal lesions in Crohn`s disease. Methods: We retrospectively reviewed medical records of 94 cases with perianal lesions among 231 cases registered as Crohn`s disease in Seoul National University Hospital between January 1975 and June 2001. The cases were investigated after dividing into two different groups. One group included the cases registered between January 1975 and December 1996 and the other group between January 1997 and June 2001. Results: The perianal lesions were observed in 41% of the cases. Perianal lesions were more frequent in colonic Crohn`s disease after 1997, but not before 1996. Fistula was significantly prevalent, followed by abscess, fissure, and stricture. Perianal lesions preceded intestinal symptoms such as abdominal pain and diarrhea in 25% of the cases. The remission rate with non-specific conservative treatment (10%) was lower than that before 1996. The remission rate after specific treatment (77%) was higher than that after surgery (53%). In cases of specific treatment, cumulative relapse rates were 7% in 1 year and 39% in 5 years. Conclusions: Crohn`s disease should be considered in young male patients who have the refractory perianal lesions. Perianal lesions should be managed initially with medical treatment. (Korean J Gastroenterol 2003;42:128-133)
식도 정맥류 출혈에 대한 내시경적 정맥류 결찰요법 후 임상경과
김휘영 ( Hwi Young Kim ),박주경 ( Joo Kyung Park ),심주현 ( Joo Hyun Shim ),이정훈 ( Jeong Hoon Lee ),박영수 ( Young Soo Park ),김지원 ( Ji Won Kim ),황진혁 ( Jin Hyeok Hwang ),김병관 ( Byeong Gwan Kim ),김진욱 ( Jin Wook Kim ) 대한내과학회 2005 대한내과학회지 Vol.68 No.5
목적 : 내시경적 정맥류 결찰요법(EVL)은 정맥류 출혈에 널리 이용되고 있는 치료법이다. 그러나 성공적인 EVL의 시행 후에도 정맥류의 근절이 이루어 지지 않는 경우가 많고, 이로 인한 재출혈이 문제시되고 있다. 본 연구에서는 내시경적 결찰요법의 급성기 지혈 성공률, 결찰술 후 장기간의 정맥류 변화 양상, 재출혈률 및 재출혈의 위험인자 등에 대해 알아보고자 하였다. 대상 및 방법 : 식도정맥류 출혈로 진단받고 내시경적 결찰요법을 시행받은 105명을 대 Background : Endoscopic variceal ligation (EVL) has been widely used to control acute variceal bleeding. However, eradication of varices with EVL is difficult and rebleeding following successful EVL is frequently problematic. Our aims were to assess the e
궤양성 대장염의 발생률, 단기적 치료 반응 및 재발률의 변화 양상
김지원 ( Ji Won Kim ),김찬규 ( Chan Gyoo Kim ),김현대 ( Hyeon Dae Kim ),김병관 ( Byeong Gwan Kim ),장동경 ( Dong Kyung Chang ),김주성 ( Joo Sung Kim ),이동호 ( Dong Ho Lee ),정현채 ( Hyun Chae Jung ),송인성 ( In Sung Song ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.1
Background/Aims: In Korea, there are few studies about the incidence rates and clinical features of ulcerative colitis (UC) in the late 1990s. The aim of this study was to compare the incidence rates, short-term outcome of medical treatment and relapse rates of UC between before and after 1993. Methods: We retrospectively reviewed the medical records of 265 UC patients registered in the Seoul National University Hospital between January 1993 and July 2001. Results: The incidence rates of UC from 1993 to 2001 were relatively steady status, and the average annual incidence rate was 1.6%. There was proctitis in 28.2% and extensive colitis in 31.5%, mild disease in 50.4% and severe disease in 21.8%. Those results were similar to the distribution of UC patients until 1992. The symptomatic remission rates were 75.4%, 75.0%, and 55.1% in order of proctitis, left colitis and extensive colitis, and 80.6%, 53.8%, and 57.1% in mild, moderate and severe disease. The cumulative relapse and operation rates were 24.7% and 3.8% in 1 year, respectively, while 57.3% and 16.1% in 5 years. Conclusions: There seems to be a steady state in the incidence rates of UC since 1993, and the clinical features, short-term outcome of medical treatment of UC since 1993 were similar to those of UC until 1992. (Korean J Gastroenterol 2003;41:15-25)
수용성 단백질로 활성화된 호중구에 대한 Rebamipide 의 효과
김주성(Joo Sung Kim),김정목(Jung Mogg Kim),김병관(Byeong Gwan Kim),김상균(Sang Gyun Kim),김지원(Ji Won Kim),김찬규(Chan Gyoo Kim),정현채(Hyun Chae Jung),송인성(In Sung Song) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.1
Background/Aims: Helicobacter pylori (H. pylori) infection induces persistent neutrophil infiltration in gastric mucosa. The expression of cyclooxygenase (COX)-2 and inhibition of apoptosis in the neutrophils could contribute to the pathogenesis of H. pylori infection. Rebamipide, a mucosal protective and ulcer-healing drug, has been known to inhibit neutrophil activation. The aim of this study was to evaluate the effect of rebamipide on the neutrophils activated by Helicobacter pylori water-soluble proteins. Methods: After neutrophils were stimulated with H. pylori water extract (HPWE) or pretreated with rebamipide, the expression of COX-2 mRNA and protein was assessed by quantitative RT-PCR and Western blotting, respectively. Prostaglandin (PG) E2 synthesis was determined by radioimmunoassay. Neutrophil apoptosis was evaluated by cytosolic oligonucleosome-bound DNA ELISA and caspase-3 activity was measured by the detection of p-nitroanilide after cleavage from labeled substrate. Results: Stimulation with HPWE upregulated COX-2 expression and PGE2 secretion, and inhibited neutrophil apoptosis. Rebamipide suppressed PGE2 secretion from neutrophils in a dose-dependent manner. However, rebamipide did not affect neutrophil apoptosis and caspase-3 activity. Conclusions: Rebamipide effectively suppresses PGE2 secretion from neutrophils activated by H. pylori water-soluble proteins. This is another possible mechanism of gastric mucosal protection by rebamipide. (Korean J Gastroenterol 2002;39:13-21)