http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
위장관 ; 장폐쇄를 동반한 크론병 환자에서 내과적 치료에 대한 반응 예측 인자
김은 ( Eun Kim ),윤세효 ( She Yo Yune ),하정민 ( Jung Min Ha ),이우주 ( Woo Joo Lee ),황지원 ( Ji Won Hwang ),민신영 ( Sin Young Min ),홍성노 ( Sung Noh Hong ),장동경 ( Dong Kyung Chang ),이풍렬 ( Poong Lyul Rhee ),김재준 ( Jae J 대한소화기학회 2013 대한소화기학회지 Vol.62 No.4
Background/Aims: Crohn`s disease is a chronic inflammatory bowel disease. Stricture is a very important indication for surgical intervention as strictures can lead to intestinal obstruction. Strictures can be divided into inflammatory and fibrous strictures. Intestinal obstruction due to inflammatory stricture is expected to be resolved with medical treatment. However, factors that can predict the response to medical treatments are unknown. In the present study, we aimed to identify the factors that can predict the response to medical treatments in Crohn`s disease patients with intestinal obstruction. Methods: Data were collected by retrospectively reviewing the medical records of patients with Crohn`s disease who visited the emergency department at Samsung Medical Center in Seoul from January 1, 2000 to December 31, 2010 because of intestinal obstruction. Based on the response to medical treatments, we classified the patients as responders and non-responders and compared the clinical, biochemical, and radiological findings of the two groups. Results: A total of 39 patients were enrolled. Twenty-nine patients responded to medical treatments whereas 10 patients did not. Significant differences were observed between the two groups in terms of vomiting and duration of disease before the development of obstruction. Conclusions: Patients who responded to the medical treatments exhibited a higher incidence of vomiting and longer duration of disease before the development of obstruction. However, further prospective studies are needed to identify the factors that can predict the response to medical treatments. (Korean J Gastroenterol 2013;62:213-218)
김재준(Jae J. Kim),박동일(Dong Il Park) 대한소화기학회 2001 대한소화기학회지 Vol.37 No.4
Cancer developes when mutations accumulate in key growth-regulating genes. The two classes of genes implicated in this malignant transformation are designated oncogenes and tumor-suppressor genes. Recently, a new class of tumor-susceptibility gene which results in a generalized defect in the processes of DNA mismatch repair has been identified. Most patient with hereditary non-polyposis colorectal cancer (HNPCC) syndromes exhibit a mutator phenotype characterized by widespread alterations in the length of repetitive DNA sequences, which is microsatellite instability (MSI). A defect in one or more of the known DNA mismatch repair genes results in the disruption of an enzyme system that maintains the integrity of repetitive sequences which are usually stably inherited. Germline mutations in hMLH1, hMSH2, hPMS1, hPMS2, and possibly hMSH6 may account for over 90% of cases of HNPCC. The literature from the East and West concerning the role of DNA mismatch repair system in gastric carcinoma is conflicting and confusing. It is essential to determine whether DNA mismatch repair system and microsatellite instability in gastric carcinoma are clinically important or purely of academic interest. (Korean J Gastroenterol 2001;37:233-239)
김회진 ( Hoi Jin Kim ),이준행 ( Jun Haeng Lee ),이준상 ( June Sang Lee ),문태건 ( Tae Gun Moon ),김재준 ( Jae J. Kim ),이종철 ( Jong Chul Rhee ),노재형 ( Jae Hyung Noh ),손태성 ( Tae Sung Sohn ),김성 ( Sung Kim ) 대한내과학회 2007 대한내과학회지 Vol.72 No.4
Background: With the progress of limited surgery and endoscopic treatment for early gastric cancer (EGC), multiple synchronous EGCs, a cause of recurrence, become more important. The objective of this study was to elucidate the characteristics of multiple synchronous EGCs with an emphasis on features of preoperatively undiagnosed lesions. Methods: We retrospectively reviewed medical records of 496 patients who underwent a gastrectomy for EGC at our institution between January 2004 and December 2004. Results: Twenty-four patients (4.8%) had multiple synchronous EGCs with 24 main and 27 accessory lesions. Multiple synchronous EGCs showed male predominance (p=0.03). Other characteristics including lymph node metastasis were the same as with single EGC. Out of 27 accessory lesions, six lesions (22%) were not detected preoperatively in six patients (25%). Macroscopically five lesions were flat and one lesion was depressed. Five lesions were located at the anterior or posterior wall of the middle and low third portion and one lesion was located at the lesser curvature side of the upper third portion of the stomach. Two lesions were 4 mm, one lesion was 8 mm, two lesions were 12 mm and one lesion was 15 mm in size (mean diameter = 9.1 mm). Histologically, four lesions were of the differentiated type and two lesions were of the undifferentiated type. Conclusions: Multiple synchronous EGCs have same clinicopathologic features as a single EGC except for male predominance. Considering the possibility of a synchronous lesion, one should examine the entire stomach precisely with special attention to the anterior, posterior wall and lesser curvature side of the same or neighboring area of a known EGC lesion before treatment. (Korean J Med 72:360-367, 2007)
김재준 ( Jae J. Kim ),김범진 ( Beom Jin Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.3
Endoscopic mucosal resection (EMR) has become a standard treatment for selected cases of early gastric cancer (EGC) because of its minimal invasiveness and comparable survival outcomes to surgical resection. The currently recognized indications of EMR for EGC are differentiated mucosal tumor <2 cm for elevated and <1 cm for flat and depressed type lesions. Recently, expanded criteria have been proposed in Japan. However, its wide acceptance is being limited in Korea by the lack of long-term outcome data and difficulty in pathological interpretation. In Korean multicenter study including 514 EGC cases resected by EMR, en bloc and complete resection rates were 71.8% and 77.6%, respectively. Local recurrence was detected in 24 cases (6.0%) after complete resection during the median 23.5 months of follow-up. Bleeding and perforation rates were 13.8% and 0.6%. Recently, endoscopic submucosal dissection (ESD) method was introduced to overcome the size limitation of EMR and consequently to improve en bloc resection rate. This technique has been widely accepted in Korea these days. In Korean multicenter study including 534 EGC cases treated by ESD, en bloc and complete en bloc resection rates were 95.3% and 87.7%, respectively. Bleeding and perforation rates were 15.6% and 1.2%. To make EMR and ESD more reliable and safer methods of treating EGC, more long-term follow-up data and standardization of techniques and pathological interpretation were required. (Korean J Med 76:291-295, 2009)
이재욱 ( Jae Uk Lee ),김영호 ( Young Ho Kim ),이선영 ( Sun Young Lee ),김갑현 ( Kap Hyun Kim ),정정환 ( Chung Hwan Chung ),김경희 ( Kyung Hee Kim ),손희정 ( Hee Jung Son ),이풍렬 ( Poong Lyul Rhee ),김재준 ( Jae J. Kim ),이종철 ( 대한소화기학회 2004 대한소화기학회지 Vol.43 No.5
Background/Aims: Ascites that can be induced by various causes is not a rare finding in Crohn`s disease. The clinical implication of ascites in Crohn`s disease remains unknown in the cases without any specific cause of ascites except Crohn`s disease itself. The purpose of this study was to investigate the clinical implication and characteristics of ascites in Crohn`s disease. Methods: We reviewed the medical records of the patients with Crohn`s disease who underwent abdominal CT scan. Patients were categorized into two groups: patients with ascites (22 cases) and without ascites (23 cases). We compared clinical features, disease activities and clinical courses of the two groups. Results: Serum albumin level was significantly lower and the C-reactive protein level was significantly higher in the ascites group than in the control group. Harvey & Bradshaw index was significantly higher in the ascites group (8.32±2.51) than in the control group (6.09±2.07) (p=0.002). The average dose of prednisolone was higher in the ascites group. On the other hand, there was no significant difference in the number of cases requiring surgery due to complication between two groups. Conclusions: Our results suggest that the presence of ascites in Crohn`s disease is associated with increased disease activity and inflammations requiring more aggressive treatment. (Korean J Gastroenterol 2004; 43:304-308)
소화성 궤양 출혈에서 Rockall 점수의 임상적 유용성
오영재 ( Young Jae Oh ),이준행 ( Jun Haeng Lee ),김갑현 ( Kap Hyun Kim ),임윤정 ( Yun Jeong Lim ),박정호 ( Jung Ho Park ),손희정 ( Hee Jung Son ),이풍렬 ( Poong Lyul Rhee ),김재준 ( Jae J. Kim ),이종철 ( Jong Chul Rhee ) 대한소화기학회 2004 대한소화기학회지 Vol.44 No.2
Background/Aims: The Rockall risk assessment score was developed to predict the risk of rebleeding and death in patients with upper GI hemorrhage. The validity of this score, however, was not established in Korea. We tried to assess the reliability of the
김주성(Joo Sung Kim),이준행(Jun Haeng Lee),손희정(Hee Jung Son),이순진(Soon Jin Lee),이풍렬(Poong Lyul Rhee),김재준(Jae J . Kim),고광철(Kwang Cheol Koh),백승운(Seung Woon Paik),이종철(Jong Chul Rhee),최규완(Kyoo Wan Choi) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.2
Background/Aims: Primary epiploic appendagitis (PEA) is an uncommon cause of abdominal pain due to either appendageal torsion or spontaneous thrombosis of an appendageal draining vein. PEA is frequently misdiagnosed as either appendicitis or diverticulitis depending on its locations. Methods: Clinical and radiological characteristics of 8 cases of PEA were retrospectively reviewed. Results: All the patients were male and the mean age was 34.9±13.0 years. The chief complaint was sudden left (7 cases) or right (1 case) low quadrant pain. The patients did not appear ill and well-localized tenderness with or without rebound tenderness was usual physical finding. The results of blood tests were normal except leukocytosis in one patient. PEA was diagnosed by radiological examinations. CT scan showed pedunculated oval fatty masses with surrounding streaky densities connected to the serosal surface of the adjacent colon, The symptoms were disappeared within one week (mean 4.7 days) with or without antibiotic treatment. None of the patients underwent operation. Conclusions: Though PEA presents nonspecific symptoms, it is a self-limiting disease which can be confirmatively diagnosed by CT scan and treated medically without antibiotics. (Korean J Gastroenterol 2001;38:106-111)