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만성 HBsAg보유자에서 중합효소 연쇄반응법에 의한 혈청 HBV DNA의 검출
정일권(Il Kwun Jung),주재학(Jae Hak Joo),차상우(Sang Woo Cha),봉형근(Hyung Keun Bong),김진오(Jin Oh Kim),박찬욱(Chan Wook Park),이준성(Joon Seong Lee),이문성(Moon Sung Lee),조성원(Sung Won Cho),심찬섭(Chan Sup Shim) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.6
N/A Background/Aims: The purpose of this study was to investigate the serum HBV DNA status and clinical significance of polymerase chain reaction(PCR) in patients with chronic hepatitis B and asymptomatic HBsAg carriers. Methods: The subjects of this study were 80 patients with chronic hepatitis B(53 HBeAg posiiive patients, 27 HBeAg negative patients), 19 asymptomatic HBsAg carriers(8 HBeAg positive patients, l l HBeAg negative patients). Serum HBV DNA was measured by Dot blot hybrydization with a ' P labeled HBV DNA in all patients studied, and the PCR was used to detect serum HBV DNA in Dot blot negative patients. The PCR was performed with 2 primers in the C gene region of HBV. Amplified sequences were detected with ethidium bromide staining(PCR-EB) and southern blot hybridization(PCR-SBH). Dot blot allowed the detection of 10 ' pg of cloned HBV DNA, while 10 pg and 10' pg were detected by PCR-EB and PCR-SBH, respectively. Results: In the 80 patients with chronic hepatitis, 76patients(95%) were positive for HBV DNA by Dot blot or PCR. All 53 HBeAg positive chronic hepatitis patients had HBV DNA detectable by Dot blot(77.4%) or PCR(18.97c by PCR-EB, 3.7% by PCR-SBH). Out of 27 HBeAg negative patients, 23(85.2%) were positive for HBV DNA by Dot blot (40.8/o) or PCR (29.61o by PCR-EB, 14,8% by PCR-SBH). In the 19 asymptomatic HBsAg carriers, 13(68.4%) were positive for HBV DNA by Dot blot or PCR. All 8 HBeAg positive asymptomatic carriers had sufficient HBV DNA detectable by Dot blot. Out of 1 l HBeAg negative carriers, 5(45.5 7c) were positive for HBV DNA by Dot blot (9.1%) or PCR(36.4%). The positive rate for HBV DNA in patients with chronic hepatitis was significantly higher than that in asymptomatic HBsAg carriers(P=0.002 by Fisher exact test) and there is a significant difference in serum HBV DNA between HBeAg positive and negative asymtomatic HBsAg carriers(P=0.02 by Fisher exact test). Conclusions: These results suggest that minute amount of HBV DNA detected by PCR may have pathogenic relevance in chronic hepatitis B, and PCR may be used as a prognostic factor in asymptomatic HBsAg carriers. (Korean J Gastroenterol 1995;27: 651 - 658)
위막성 장염 환자에서 의식수준과 내시경 소견과의 연관성
정일권 ( Il Kwun Chung ),이석호 ( Suck Ho Lee ),박정훈 ( Jung Hoon Park ),박도현 ( Do Hyun Park ),김홍수 ( Hong Soo Kim ),박상흠 ( Sang Heum Park ),김선주 ( Sun Joo Kim ) 대한장연구학회 2006 Intestinal Research Vol.4 No.2
Background/Aims: Unconsciousness can create problems in diagnosing and treating pseudomembranous colitis (PMC). While early recognition of clostridium difficile infection and immediate medical therapy can lead to a good prognosis, delayed diagnosis can lead to complex, recurrent and even fatal PMC. The relationships between endoscopic clinical features and unconsciousness are not well documented. The aim of this study was to determine the relationships between PMC endoscopic clinical features and the level of consciousness. Methods: Fifty three patients with confirmed PMC during the past 2 years were analyzed retrospectively. Patients were categorized as being in either a conscious state (CS) (i.e. alert) or an unconscious state (US) (i.e. drowsy, stupor, semicoma or coma). Endoscopic patterns of pseudomembranous plaques were classified as grade I=only friability or erosion without plaque, grade II=granular plaque, grade III=nodular plaque, or grade IV=confluent plaque. Clinical features including diagnostic interval (from initial prescription of antibiotic to confirming PMC), endoscopic severity, treatment method, treatment duration and prognosis were compared in between CS and US groups. Results: Mean patient age was 65.7±14.9 (male 47.2%, female 52.8%). The overall diagnostic interval was 9.37±4.35 days. Frequently causative antibiotics were cephalosporin (52.8%, 28/53), clindamycin (13.2%, 7/53) and imipenam (9.4%, 5/53). Of the 53 patients, 60.4% (32/53) were categorized as CS, and 39.6% (21/53) as US. In terms of pseudomembranous plaque endoscopic patterns, 18.9% (10/53) were grade I, 28.3% (15/53) were grade II, 32.1% (17/53) were grade III, and 20.8% (11/53) were grade IV. Treatment involved oral administration only. The overall complete treatment rate was 94.3% (50/53). The overall recurrence rate was 5.7% (3/53), and of these one patient died, and two patients were successfully managed by re-treatment. One recurrent and the fatal case occurred in the US group. The US group was positively correlated with longer diagnostic interval, and showed more severe endoscopic features and longer treatment duration compared to the CS group (p<0.05). Conclusions: Endoscopic and clinical features were more serious in unconscious PMC patients. Compared to conscious patients, unconscious patients being administrated antibiotics must be given greater attention in terms of early diagnosis and successful management of PMC. (Intestinal Research 2006;4:101-105)
Infliximab으로 호전된 장관 증상없이 발생한 구강-안면 크론병
정보용 ( Bo Yong Jung ),이석호 ( Suck Ho Lee ),정승규 ( Seung Kyu Chung ),이창균 ( Chang Kyun Lee1 ),이태훈 ( Tae Hoon Lee ),정일권 ( Il Kwun Chung ),김선주 ( Sun Joo Kim ),조현득 ( Hyun Deuk Cho ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.6
Crohn`s disease is a chronic inflammatory bowel disease that can involve the whole gastrointestinal tract. The orofacial manifestation of Crohn`s disease, which is rare, can develop irrespective of intestinal involvement. These orofacial lesions are often misdiagnosed as simple oral ulcers. Corticosteroids are the mainstay of therapy for orofacial Crohn`s disease. However, infliximab, the chimeric monoclonal antibody to tumor necrosis factor-α, is now considered as a primary treatment because of the disease`s relatively high rate of steroid resistance. We present a case of deep oral ulcer and periorbital swelling in a 65-year-old woman. She was diagnosed with intestinal Crohn`s disease 7 years ago, which was in remission after treatment with an immunosuppressive agent (azathioprine). The patient was given the diagnosed with orofacial Crohn`s disease and successfully treated with infliximab. (Korean J Gastroenterol 2012;59:437-440)
급성 식도 정맥류 출혈시 내시경적 결찰술과 Octreotide 및 Terlipressin 병용요법의 치료효과와 부작용 비교
김세형 ( Se Hyung Kim ),함정호 ( Jung Ho Ham ),박진우 ( Jin Woo Park ),이석호 ( Suck Ho Lee ),김홍주 ( Hong Joo Kim ),김현준 ( Hyun Jun Kim ),정일권 ( Il Kwun Chung ),김홍수 ( Hong Soo Kim ),박상흠 ( Sang Heum Park ),김선주 ( Sun 대한내과학회 2005 대한내과학회지 Vol.68 No.2
목적 : 급성 식도정맥류 출혈을 동반한 간경변증 환자에서 내시경적 결찰요법과 대표적인 혈관 작용성 약물인 octreotide 및 terlipressin을 병용 치료하였을 때 각각의 치료효과와 부작용을 비교하였다. 대상 및 방법 : 1999년 1월부터 2001년 2월까지 순천향의과대학 천안병원에 내원한 식도정맥류 출혈환자 73명을 대상으로 내시경적 결찰술과 함께 무작위로 octreotide 병용치료군과 terlipressin 병용치료군으로 분류하여 초기 Background : In patients with liver cirrhosis, acute esophageal variceal bleeding is a life-threatening event with high mortality and subsequent recurrent bleeding despite of endoscopic therapy. So the effect of vasoactive agents used in combination with
내시경적 식도정맥류 결찰요법 ( EVL ) 이 식도운동에 미치는 영향 - 식도내압검사를 중심으로
김영석(Young Seok Kim),권강호(Kwang Ho Kwun),정일권(Il Kwun Jung),이은학(Eun Hag Lee),봉형근(Hyung Keun Bong),송동화(Dong Hwa Song),박찬욱(Chan Wook Park),이준성(Joon Seong Lee),이문성(Moon Sung Lee),조성원(Sung Won Cho),심찬섭(Chan 대한소화기학회 1995 대한소화기학회지 Vol.27 No.1
N/A Background/Aims: For treating and eradicating bleeding esophageal varices, endoscopic variceal ligation(EVL) is currently acceptable practiced method, however esophageal motility change associated with endoscopic variceal ligation is uncertain. Although Longterm follow-up for rebleeding rate, recurrence rate, complication and survival rate after endoscopic variceal ligation are reported, there is a few report of esophageal motility change after endoscopic variceal ligation. To assess the effect of endoscopic variceal ligation on esophageal function prospectively, parameters measured by pneumohydraulic capillary infusion system, included lower esophageal sphincter(LES) pressure, % LES relaxation, amplitude, duration, velocity and progression of peristaltic waves and dysmotility, were compaired hetween before and after endoscopic variceal ligation in 12 patients with csophngeal varix. Results: Endoscopic variceal ligation has no impact on lower Esophageal sphincter(LES) tone. However, a significant increase in the amplitude of peristaltic waves was observed in the patients at'ter endoscopic variceal ligation in the mid-esophagus(8cm above lower esophageal sphincter: 57.2 ' 19.4 versus 65.7 ' 20.3, l3cm above lower esophageal sphincter; 5S,7 ' 23.8 versus 62.l ' 2I.S). There was no modification of duration, velocity and progression of peristaltic waves or dysmotility. Conclusions: Endoscopic variceal ligation is associated with a increasing esophageal body pressure without the other esophageal motility change. (Korean J Gastroenterol 1995;27:9 -17)
고암모니아혈증을 동반한 성인형 Citrullinemia 1 예
박현준(Hyun Jun Park),임현진(Hyun Jin Lim),정인섭(In Seop Jung),김영훈(Young Hoon Kim),김인호(In Ho Kim),정일권(Il Kwun Chung),김홍수(Hong Soo Kim),박상흠(Sang Heum Park),이문호(Moon Ho Lee),김선주(Sun Joo Kim),이동환(Dong Hwan Lee) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.5
Adult type citrullinemia is a urea cycle enzymopathy, which is characterized by hyperammonemia, high citrulline level in serum and decreased activity of argininosuccinic acid synthetase in liver biopsy. Clinical symptoms are vomiting, lethargy, seizure, and coma. It can lead to death if the hyperammonemia is not controlled. We should consider this rare metabolic disease for adult patient who has mental change and hyperammonemia without liver disease and brain disease. We experienced a 55-year-old female with generalized weakness, insomnia and lethargy, who was diagnosed as having citrullinemia by high elevated plasma citrulline, ammonia level. We report this unusual case of adult type citrullinemia with a brief review of the related literature. ( Korean J Gastroenterol 2002; 39: 379-385)
박상흠(Sang Heum Park),김선주(Sun Joo Kim),이문호(Moon Ho Lee),문수남(Soo Nam Moon),정일권(Il Kwun Jung),백진기(Jin Ki Paik),김도진(Do Jin Kim),황성규(Seung Gyu hwang),김의한(Eu Han Kim) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6
Bengn solitary neurilemmoma of the retroperitoneum is a rare disease of nerve sheath origin. A 40-year-old male patient was admitted to our hospital for evaluation of retroperitoneal mass. Abdominal ultrasonography and computed tomogaphy (CT) revealed a solid tumo in the retroperitoneum. On exploratory laparatomy, this mass turned out to be an baseball sized mass of the retroperitoneum. The mass was excised surgically in an encapsulated state. Histological section and immunohistochemical stain revealed a typical neurilemmoma. We report it with a review of literature.
담도 협착에서 종양 특성과 솔질세포검사 순서에 따른 진단 정확도
조영걸 ( Yeong Geol Jo ),이태훈 ( Tae Hoon Lee ),조현득 ( Hyun Deuk Cho ),박상흠 ( Sang Heum Park ),박재만 ( Jae Man Park ),조영신 ( Young Sin Cho ),정윤호 ( Yunho Jung ),정일권 ( Il Kwun Chung ),최현종 ( Hyun Jong Choi ),문종호 ( 대한소화기학회 2014 대한소화기학회지 Vol.63 No.4
Background/Aims: There are few data supporting the diagnostic yield of brush cytology depending on the order of cytologic reparation method or the location or shape of tumors in biliary strictures. We investigated diagnostic yields and variations n brush cytology with direct smear and cell-block preparations according to sampling preparation sequence and tumor location nd shape in biliary strictures. ethods: Patients who had undergone ERCP with tissue sampling between August 2009 and April 2013 were analyzed etrospectively. Group A was examined using brush cytology with direct smear followed by cell-block with or without biopsy, hile the reverse order was performed for group B. esults: Among 138 enrolled patients, 92 patients (A: 36, B: 56) underwent both brush cytology with direct smear and cell-block reparations. No differences in sensitivity, specificity, or accuracy were observed according to the sampling preparation method nd the location or shape of tumors in biliary strictures. The cellularity observed from brush cytology with direct smear was etter than that from cell-block according to the location of the tumor (p<0.01). The diagnostic yield was increased in both roups with addition of an endobiliary biopsy. onclusions: No difference in diagnostic accuracy was observed between the sequences of preparation for brush cytology ith direct smear and cell-block techniques. Brush cytology showed better cellularity for diagnosis.
김은주,김홍수,이문호,김선주,정일권,정인섭,박상홈 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.3
Duodenal divertula are relatively frequent findings in the adult gastrointestinal tract. The majority of them are asymptomatic, but vague gastrointestinal complaints have often been attributed to these lesions. These diverticula occasionally result in the obstruction of the biliary and pancreatic ducts, which leads to jaundice and pancreatitis. Other complications such as hemorrhage, perforation, sepsis, and death can occur. With the advent of therapeutic endoscopy, the diagnosis and primary treatment of duodenal diverticula associated with bleeding has changed dramatically since its first reported occurrence. Effectiveness of therapeutic endoscopy is very high in patients with diverticular bleeding in the medial aspect of sencond portion of the duodenum because of its high operative mortality. A cases of a patient suffering from gastrointestinal bleeding in the duodenal diverticulum who was diagnosed and managed by endoscopy alone is herein reported with review of relevant literature.
이태영,이문호,김대중,김홍수,김선주,최우봉,정일권,박상흠,이낙원 대한내과학회 1997 대한내과학회지 Vol.53 No.6
Carcinoma of the gallbladder is relatively rare malignancy usually found in an elderly, predominantly female population. Histologically, adenocarcinoma predominate, with only 10% to 15% being of other varieties(small cell carcinoma and others). Small cell carcinoma of the gallbladder is a rare lesion and predominantly a disease of older women with clinical history of stones. These tumors show an aggressive clinical course and death usually occurs with in a few months of the diagnosis. The diagnosis of small cell carcinoma should be based on cell morphology, histologic pattern and immunohistochemical study. Correct diagnosis is important not only because these tumors give rise to endocrine syndromes, but also because the chemotherapeutic approach to small cell carcinoma differs from that for adenocarcinoma.