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- 저자 : 정재연(Jae Youn Cheong) (검색결과 49 건)
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위장관 소화성 궤양의 재출혈에서 반복적인 내시경적 지혈술의 유용성과 치료 실패의 예측인자
정재연(Jae Youn Cheong),이용찬(Yong Chan Lee),장혁재(Hyuk Jae Chang),송시영(Si Young Song),김원호(Won Ho Kim),한광협(Kwang Hyub Han),정재복(Jae Bock Chung),전재윤(Jae Yoon Chon),강진경(Jin Kyung Kang),박인서(In Suh Park),문영명(Young 대한소화기학회 2001 대한소화기학회지 Vol.37 No.5
Background/Aims: After endoscopic treatment of peptic ulcer bleeding, rebleeding occurs in 15 to 20 percent of patients. We investigated the factors predicting the failure of initial endoscopic treatment in patients with peptic ulcer bleeding and the usefulness of repeated endoscopic treatment in peptic ulcer patients with rebleeding after initial endoscopic treatment. Methods: Clinical data were retrospectively collected from 376 patients (311 males and 65 females, mean age 53.9 years) with peptic ulcer bleeding between June 1995 and May 1999. Results: Of 376 patients, rebleeding after initial endoscopic treatment occurred in 50 patients (13.3%). Eight patients who failed to initial endoscopic hemostasis underwent operation immediately. The presence of major stigmata on endoscopy (p=0.001) and shock at admission (p=0.001) were two significantly independent factors predictive of rebleeding after initial endoscopic treatment. Among the patients with rebleeding, repeated endoscopic treatment was successful in 26 patients (61.9%), but 16 patients (38.1%0 underwent salvage surgery due to the failure of hemostasis. Patients who did not respond to endoscopic retreatment were more likely to have ulcers ≥2 cm in diameter (p=0.027). Conclusions: Repeated endoscopic treatment can reduce the need for surgery. Ulcer size ≥2cm is an independent factor in predicting the failure of repeated endoscopic treatment in peptic ulcer patients with rebleeding. Therefore, surgery should be considered in the case. (Korean J Gastroenterol 2001;37:319-326)
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정재연 ( Jae Youn Cheong ) 대한간학회 2006 간학회 싱글토픽 심포지움 Vol.12 No.4
Progressive hepatic fibrosis with development of cirrhosis is a feature of almost all chronic liver diseases. As novel therapies for liver fibrosis evolve, non-invasive measurement of liver fibrosis will be required to help management of patients with chronic liver disease. An ideal noninvasive diagnostic test for hepatic fibrosis should be simple, inexpensive and accurate. Although liver biopsy is the current gold standard for the diagnosis of liver fibrosis, it is invasive, stressful and subject to sampling error. Here we will review our current knowledge of methods used to assess both the stage of fibrosis and the activity of extracellular matrix turnover, and we discuss the radiological and serum tests that have been proposed as potential alternatives to liver biopsies. We discuss the indirect markers of liver fibrosis that reflect alterations in liver function or inflammation well be discussed. Future trends for staging liver disease must not only focus on cross sectional diagnosis, but on utilizing novel techniques to stratify the risk for disease progression over time.
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간문맥 혈전이 동반된 진행성 간세포암에서 간동맥내 항암제 주입요법
정재연 ( Jae Youn Cheong ),이기명 ( Kee Myung Lee ),조성원 ( Sung Won Cho ),원제환 ( Jae Han Won ),김재근 ( Jai Keun Kim ),왕희정 ( Hee Jung Wang ),함기백 ( Ki Baik Hahm ),김진홍 ( Jin Hong Kim ) 대한내과학회 2004 대한내과학회지 Vol.67 No.1
Background: Advanced hepatocellular carcinoma (HCC) with portal vein thrombosis has a poor prognosis and has little hope for meaningful therapy. Transarterial chemoembolization has been performed as a treatment for advanced HCC, but some patients die from
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Thromboprophylaxis in liver cirrhosis: No
정재연 ( Jae Youn Cheong ) 대한간학회 2017 간학회 싱글토픽 심포지움 Vol.2017 No.2
Most of clinical practitioners have believed that patients with liver cirrhosis have a bleeding tendency related to lack of coagulation factors that occur as a consequence of the liver dysfunction. However, decreased levels of the procoagulants are also accompanied by decreases in levels of natural anticoagulants such as antithrombin, protein C and protein S. Therefore, the coagulation system in cirrhotic patients is re-balanced by these two opposing factors. To date, there are no well-established assays for correctly evaluating the coagulability status in cirrhotic patients. Now it is believed that patients with cirrhosis are not naturally anticoagulated and at risk for thrombotic complications. Physicians consider the active anticoagulation for the prophylaxis and treatment of portal vein thrombosis and/or venous thromboembolism (VTE) in cirrhotic patients with high risk of thrombosis. Simultaneously, they have safety concerns regarding the risk of bleeding related to anticoagulants when used in people with advanced liver disease, especially if there is significant thrombocytopenia, and/or the presence of varices. Therefore, the decision about the use of VTE prophylaxis in patients with cirrhosis should be made on a case-by-case basis after consideration of risk factor assessment for VTE. Further prospective studies are required to determine not only if cirrhotic patients benefit from receiving anticoagulation therapy in preventing VTE, but also which prophylactic regimen is most appropriate.
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