가족성 선종성 용종증 수술 후 발생한 복강 내 유건종 1예

정인두,방성조,신정우,박능화,최대화,차희정,김도하 대한소화기내시경학회 2006 Clinical Endoscopy Vol.33 No.1

Familial adenomatous polyposis (FAP) arises from germline mutations of the adenomatous polyposis coli (APC) gene. FAP is characterized by the occurrence of hundreds to thousands of adenomas throughout the colorectum, and there is nearly a 100% risk of colorectal cancer. In addition to polyposis coli, patients with FAP can develop a variety of extracolonic manifestations. Recent advances in screening and surgery have reduced the colon cancer occurrence and death in FAP patients, leaving desmoid tumors as a leading cause of their morbidity and mortality. Treatment of desmoid tumors is generally considered to be challenging for both the doctor and the patient. We report here on an 18 year old man with resectable intra-abdominal desmoid tumor that developed after total colectomy due to FAP and we include a review of the relevant literature. (Korean J Gastrointest Endosc 2006;33:50-53) 가족성 선종성 용종증의 치료로 전대장 절제술이 시행되지만 절제술 이후에도 여러 가지 장외 병변이 나타난다. 이러한 것으로는 문합부의 대장암 발생이나 췌장, 십이지장의 암 발생 같은 악성 종양의 발생이나 장간막, 후복막 등에 유건종의 발생 등이 있다. 이 중 유건종의 발생은 전대장 절제술을 시행한 가족성 선종성 용종증 환자의 예후를 결정하는 중요한 인자가 된다. 국내에서 가족성 선종성 용종증으로 전대장 절제술을 시행 후 복강 내 유건종의 발생에 대한 보고는 있었으나, 모두 완전 절제가 불가능하였던 예였다. 저자 등은 완전 절제가 가능하였던 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

조기위암의 내시경 절제술 확대 적응증 분류에 따른 림프절 전이의 분석

정인두,정석원,방성조,신정우,박능화,김도하 대한소화기학회 2006 대한소화기학회 추계학술대회 Vol.2006 No.-

The Degree of Disease Knowledge in Patients with Gastroesophageal Reflux Disease: A Multi-center Prospective Study in Korea

정인두,박무인,김성은,김범진,김상욱,김지현,성혜영,오태훈,김연수 대한소화기 기능성질환∙운동학회 2017 Journal of Neurogastroenterology and Motility (JNM Vol.23 No.3

Background/AimsPatient education has been shown to be beneficial in several diseases. To properly educate patients with gastroesophageal reflux disease (GERD), it is necessary to understand how much they already know about their disease. However, no study has examined the degree of disease knowledge in Korean patients with GERD. Therefore, we conducted this study to assess the degree of knowledge in such patients. MethodsThis multicenter prospective study was conducted from January 2014 to January 2015. A total of 746 patients (mean age, 52 years; 57.6% female) were enrolled from 7 hospitals in Korea. Inclusion criteria were diagnosis of GERD and ability to properly complete a survey. Degree of disease knowledge was assessed using the translated, validated Korean Urnes questionnaire, which consists of 22 items related to GERD. ResultsMean percentage of correct answers was 46.3% and mean GERD knowledge score was 9.6. Degree of knowledge (mean percentage of correct answers) regarding etiology, prognosis, and treatment of GERD were 49.5%, 36.7%, and 37.5%, respectively. Degree of disease knowledge differed significantly according to age (P < 0.001), education (P < 0.001), income (P = 0.028), and occupation (P < 0.001). In multivariate analysis, using multiple logistic regression, the higher knowledge score group tended to have higher education and professional occupation. ConclusionsThe surveyed Korean patients had relatively low disease knowledge, suggesting that a GERD educational program may be beneficial in Korea. Formulation of a program is underway.

HBeAg 음성 만성 B형 간질환에서 Lamivudine의 치료 효과

정인두,박능화,김병철,박지현,서광원,김대현,주광로,김도하 대한간학회 2003 Clinical and Molecular Hepatology(대한간학회지) Vol.9 No.2

HBeAg 음성 만성 B형 간질환에서 Lamivudine의 치료 효과

정인두,박능화,김병철,박지현,서광원,김대현,주광로,김도하 대한간학회 2003 Clinical and Molecular Hepatology(대한간학회지) Vol.9 No.2

목적: HBeAg 음성 만성 B형 간질환 환자에서 라미부딘 치료 효과, 내성 발생률, 치료 종료 후 재발률 및 각각의 예측 인자를 알아보고자 하였다. 대상과방법: HBeAg 음성, anti-HBe 양성이나 HBV DNA가 양성인 HBeAg 음성 만성 B형 간질환으로 진단 받은 환자 중에서 혈청 ALT치가 상승되어 있는 59명을 대상으로 라미부딘을 1일 100mg씩 6개월(평균 14개월)이상 투여하였다. 평균 연령은 42.1세였고 남녀 비는 52:7이였다. 치료 전 혈청 ALT평균치는 368 IU/L, HBV DNA평균치는 494 pg/mL였다. 치료 전, 치료 개시 후 및 종료후 1-2개월 간격으로 간기능 검사, HBeAg, anti-HBe, HBV DNA를 측정하였다. 치료 반응군은 반응이 일어난 시점을 기준으로 1-2개월 간격으로 2번 이상 반응이 유지되는 것을 확인한 후 투약을 중지하고 재발 유무를 추적 관찰하였다. 결과: 라미부딘 투여 후 50명 중 56명(94.9%)에서 혈청 HBV DNA가 음전되었으며 누적 음전율은 1개월후 27%, 2개월 후 71%, 3개월 후 90%, 5개월 후 95%였다. 혈청 ALT치는 52명(88.2%)에서 정상으로 회복되었으며 대부분 6개월 내에 이루어졌다. 혈청 ALT치의 누적 정상화율은 2개월 후 30%, 3개월 후 47%, 6개월 후 78%, 10개월 후 86%였다. 혈청 HBV DNA가 음전되고 혈청 ALT치가 정상으로 유지된 치료 반응은 52예(88.1%)에서 일어났으며, 누적 치료반응률은 2개월 후 10%, 4개월 후 49%, 6개월 후 66%, 10개월 후 80%, 18개월 후 88%였다. 라미부딘 총 투여 기간이 유일한 치료 반응 예측 인자였다(p=0.000). 변이형의 출현은 5예(8.5%)에서 일어났고 누적 발생률은 10개월 후 8%, 16개월 후 13%였다. Breakthrough발생 예측인자와 관련된 유의한 인자는 없었다. 치료 반응군중 투여 중지한 34명 중 17명(50%)에서 재발하였으며(평균추적기간: 6개월, 범위: 1-22개월) 대부분 투여중지 6개월 내에 재발하였다. 누적 재발률은 3개월 후 24%, 6개월 후 47%, 10개월 후 66%였다. 재발과 관련된 예측 인자는 치료 반응후 추가적인 라미부딘 누여만이 유의한 인자였다(p=0.019). 특히 12개월 이상 유지한 7명 모두에서 재발하지 않았다. 결론: 라미부딘은 HBeAg 음성 만성 B형 간질환에서 높은 치료효과와 낮은 breakthrough를 보였으며 라미부딘 투여 기간만이 유일한 치료 반응 예측 인자이었다. 그러나 치료 종료 후 많은 예에서 재발하였으며 치료 반응 후 추가적인 라미부딘 투여 기간만이 유일한 재발 예측 인자였으며 재발을 막기 위해서는 장기간의 추가적인 라미부딘 투여가 필요할 것으로 사료된다. Background/Aims: Lamivudine therapy is effective in inhibiting HBV replications in patients with HBeAg-negative chronic liver disease. However, the sustained response rate appears to be particularly poor, because the vast majority of patients relapse soon after cessation of therapy. The aim of this study was to evaluate the efficacy of lamivudine, the breakthrough rate, and the relapse rate of discontinuing therapy after response in patients with HBeAg-negative chronic liver disease. Methods: Fifty-nine patients with HBeAg-negative chronic liver disease who have received lamivudine for at least 6 months, were studied. The mean duration of treatment was 14 months. Complete response was defined as undetectable serum HBV DNA by bDNA and normalization of ALT levels. Once HBV DNA disappearance and ALT normalization were observed, lamivudine therapy was continued for at least two additional months. The mean follow-up after cessation of treatment was 6 (1-22) months. Results: Fifty-six patients were undetectable HBV DNA. The cumulative HBV DNA loss rates at 3 months and 5 months were 90% and 95%, respectively. The ALT normalization was observed in 52 patients. The cumulative ALT normalization rates at 6 months and 10 months were 78% and 86%, respectively. The complete response was observed in 52 patients. The cumulative rates of complete response at 10 months and 18 months were 80% and 88%, respectively. A predictive factor for complete response was only the duration of lamivudine treatment. Virological breakthrough was observed in 5 (8.5%). Thirty-four patients stopped taking lamivudine after 7.7 (2-15) months of the additional therapy. Seventeen of those patients (50%) experienced relapse. The cumulative relapse rates at 3 months, 6 months and 10 months were 24%, 47% and 66%, respectively. The only predictive factor for relapse was the duration of additional lamivudine treatment after response. Conclusions: Lamivudine was an effective treatment of HBeAg negative chronic liver disease. Relapse, however, was usually observed after cessation of lamivudine. Our results showed that long-term lamivudine therapy is required in order to decrease the high relapse rates in patients with HBeAg-negative chronic liver disease.

포스타 전시 발표 : 감염, 알레르기, 류마티스 ; Cyclophosphamide 충격요법으로 호전된 전신성 홍반성 루푸스에 병발된 폐고혈압증

정인두,박종호,윤제헌,이종수,김진우,최승원 대한내과학회 2001 대한내과학회 추계학술발표논문집 Vol.61 No.-

대한간학회 제 8 차 춘계학술대회 초록집 / 포스터 전시 : 만성 B 형 간질환 환자에서 라미부딘 장기 투여의 치료효과

정인두,박능화,김도하,주광로,김대현 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.3(S)

위식도역류질환의 진단검사에 대한 고찰

정인두 ( In Du Jeong ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.2

The prevalence of gastroesophageal reflux disease (GERD) and the incidence of some of its complications have risen strikingly over the last few decades. With the accumulation in our understanding on the pathophysiology of GERD along with the development of proton pump inhibitors, the diagnostic and therapeutic approaches to the GERD have changed dramatically over the past decade. However, The GERD still poses a problem to many clinicians since the spectrum of the disease has evolved to encompass more challenging presentations such as refractory GERD and extraesophageal manifestations. The aim of this article was to provide a review of available current diagnostic tests of the GERD, includes proton pump inhibitor test, ambulatory pH monitoring, impedance pH monitoring, mucosa impedance, and high resolution manometry. This review discusses different modalities for the work up of GERD. (Korean J Gastroenterol 2017;69:96-101)

최신 연구 소개 : 점막 임피던스 검사가 위식도역류질환과 비역류성질환을 구별할 수 있을까?

정인두 ( In Du Jeong ) 대한소화기학회 2015 대한소화기학회지 Vol.65 No.4

Mucosal Impedance Discriminates GERD from Non-GERD Conditions (Gastroenterology 2015;148:334-343)

위식도역류질환과 연관된 중개연구 현황

정인두 ( In Du Jeong ),박무인 ( Moo In Park ) 대한소화기학회 2016 대한소화기학회지 Vol.68 No.3

The prevalence of gastroesophageal reflux disease (GERD) and the incidence of some of its complications have risen strikingly over the last few decades. With the increase in our understanding of the pathophysiology of GERD along with the development of proton pump inhibitors, the diagnostic and therapeutic approaches to GERD have changed dramatically over the past decade. However, GERD still poses a problem to many clinicians since the spectrum of the disease has evolved to encompass more challenging presentations such as refractory GERD and extra-esophageal manifestations. The aim of this article is to provide a review of available current translational research on GERD. This review includes acid pocket, ambulatory pH monitoring, impedance pH monitoring, mucosa impedance, and high resolution manometry. This article discusses current translational research on GERD. (Korean J Gastroenterol 2016;68:127-131)