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내시경적 유두괄약근 절개술후 발생한 기종격증 및 피하기종
조영덕(Young Deok Cho),봉형근(Hyung Keun Bong),김진오(Jin Oh Kim),조주영(Joo Young Cho),김연수(Yun Soo Kim),이준성(Joon Seong Lee),이문성(Moon Sung Lee),황성규(Seong Gyu Hwang),심찬섭(Chan Sup Shim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3
Perforation, bleeding, cholangitis, and pancreatitis are common complications of endoscopic sphincterorny(EST) that is considered a common effective method for treatment of distal bile duct obstruction and removal of bile duct stones. Perforation of duodenutn complicates endoscopic sphincterotomy in approximately 1% of cases. But, retroperitoneal, mediastinal and subcutaneous emphysema are very rare complications of endoscopic sphincterotomy. A 50-year-old woman was admitted to our hospital due to right upper quadrant abdominal pain for 1 week. An ERCP revealed markdly dilated commom bile duct and rnultiple ductal filling defects. For removal of' stones, EST was performed with pull type papillotome. About 1 hour later after procedure, she complained of chest pressure, shortness of breath and abdominal distension. The chest X-ray film revealed a pneumomediastinum, segmental atelectasis of left lower lung fields and subcutaneous emphysema. The simple abdominal X-ray showed mottled air densities in the right midabdomen and crescentic air densities in the right perirenal space. We report on a rare case of retroperitoneal duodenal perforation, pneumomediastinum and subcutaneous emphyserna following endoscopic sphinctero- tomy, in a patient with common bile duct stones. (Korean J Gastroenterol 1997; 29:399-403)
기획종설 : 췌장암 ; 췌장암의 증상 경감을 위한 보존요법
조영덕 ( Young Deok Cho ) 대한소화기학회 2007 대한소화기학회지 Vol.51 No.2
Unfortunately, only a minority of patients with pancreatic cancers are suitable for resection and potential cure. Despite recent advances in systemic treatment of patients with advanced pancreatic cancer, the prognosis still remains poor. The median survival of patients in whom pancreatic cancers are surgically unresectable is 6 months. Thus, optimal palliation of symptoms to maximize remaining quality of life is of primary importance to most patients. Common problems include pain, unexplained weight loss, nausea, vomiting, streatorrhea, dyspepsia, depression, and jaundice. Management is directed at the palliation of symptoms. Treatment of patients with locally unresectable, recurrent, or metastatic disease is individualized, cosidering the patient age, patient wishes, family influence, and insurance constraints. Success in managing progressive symptoms is needed to palliate patients with advanced pancreatic cancer. (Korean J Gastroenterol 2008;51:119-126)
조영덕 ( Young Deok Cho ),차상우 ( Sang Woo Cha ) 대한소화기학회 2016 대한소화기학회지 Vol.68 No.2
Tumors of the major duodenal papilla are being recognized more often because of the increased use of diagnostic upper endoscopy and ERCP. The standard of management for ampullary tumor is local surgical excision or pancreaticoduodenectomy, but these procedures are associated with significant mortality, as well as post-operative and long-term morbidity. Endoscopic snare papillectomy was introduced as an alternative to surgery, but post-procedure complications are serious drawback. The most serious complications are perforation, delayed bleeding and pancreatitis. Identification of high risk patients, early recognition of complications, and aggressive management abates frequency and severity. Prevention and management of endoscopic duodenal papillectomy-induced complications will be reviewed in this article. (Korean J Gastroenterol 2016,68:64-69)
조영덕(Young Deok Cho) 한국간담췌외과학회 2008 한국간담췌외과학회지 Vol.12 No.2
Benign biliary strictures constitute about 25% of all biliary strictures. Benign biliary strictures are a heterogenous group of lesions with variousvariable pathogenesis. The majority of benign biliary strictures occur as a result of bile duct injury during surgery or as a consequence of bile duct repair after accidental injury, performing , choledochotomy, or performing duct-to-duct anastomosis after liver transplantation. However, bile duct strictures are also typical of other diseases, such as chronic pancreatitis, primary sclerosing cholangitis, and other uncommon cholangiopathies. The aim of treatment is to relieve the symptoms of biliary obstruction or cholangitis, and to prevent of secondary biliary cirrhosis. The Management of benign biliary stricture remains a challenge for both the surgeons and the therapeutic endoscopists. Surgery is, though traditionally considered as the mainstay of treatment, but this is associated with significant morbidity and variousvariable long-term outcomes. Endoscopic management, i.e., stricture dilatation and stent placement, is more appealing because it is less invasive, better tolerated, and it may be safer than operative management in selected patients. Recently, benign biliary strictures are now being increasing treated with endoscopic techniques. The Outcome of endoscopic management depends on both the etiology and location of the stricture. The benign nature of the stricture should be first confirmed in order to ensure appropriate therapy. The Current data suggest that the long-term results with using multiple plastic stent are superior to those with using a single plastic stent. Removable covered metal stents are also a good alternative. The role of bio-absorbable self-expanding stents for treating benign biliay strictures needs to be evaluated further.
만성 C형 간질환에서 간내 HCV RNA 농도 측정의 임상적 의의
장재영 ( Jae Young Jang ),김연수 ( Yun Soo Kim ),김상균 ( Sang Gyune Kim ),김영석 ( Young Seok Kim ),조영덕 ( Young Deok Cho ),이준성 ( Joon Sung Lee ),진소영 ( So Young Jin ),이문성 ( Moon Sung Lee ),김주현 ( Ju Hyun Kim ),심찬섭 대한간학회 2006 Clinical and Molecular Hepatology(대한간학회지) Vol.12 No.4
박용순(Yong Soon Park),최우봉(Woo Bong Choi),함정식(Jung Sik Ham),장재영(Jae Young Jang),이영홍(Young Hong Lee),김진오(Jin Oh Kim),조영덕(Young Deok Cho),봉형근(Hyung Keun Bong),김연수(Yun Soo Kim),조주영(Joo Young Cho),이준성(Joon S 대한내과학회 1997 대한내과학회지 Vol.53 No.2
N/A Objectives: To determine accurate diagnosis and proper treatment, we reviewed colonoscopic and histologic findings of flat adenoma of colon, Methods: We studied retrospectively 2148 cases of colonoscopic findings performed in our hospital from March of 1993 to September of 1995. Results: 1) The incidence of adenoma is 9.5%(203 cases), and that of flat adenoma is 1.6%(34 cases). 2) The location of flat adenoma is 3 cases in rectum(8.8%), 15 cases in sigmoid colon(44.1%), 9 cases in descending colon(26.5%), 3 cases in transverse colon(8.8%) and 4 cases in ascending colon and cecum(11.8%). 3) The diameter of flat adenoma was smaller than 5mm in 17 cases(50.0%), between 5-10mm in 8 cases(23.5%) and larger than 10mm in 9 cases (26.5%). Mean size was 9.2mm. 4) In colonoscopic features, type IIa was 25 cases (73.5%), type IIa + IIc was 5 cases(14.7%) and lateral spreading tumor was 4 cases(11.8%). 5) In histologic findings, tubular adenoma was 26 cases(76.5%), tubulovillous adenoma was 6 cases (17.6%) and serrated adenoma was 2 cases(5.9%). 6) The incidence of severe dysplasia or carcinoma was zero in smaller than 5mm, 25.0%(2 case) in 5-10mm and 55.6%(5 cases) in larger than 10mm. 7) The incidence of severe dysplasia or carcinoma was 11.5%(3 cases) in tubular adenoma and 66.7%(6 cases) in tubulovillous adenoma. 8) It was confirmed by abdominal CT scan or operation that lesions were limited to intraepithelium in 4 cases, mucosa in 2 cases submucosa in 1 case and no lymph node metastasis in any case. Conclusion: Even though flat adenoma of colon was smaller than polypoid adenoma, the incidence of malignant change was higher. When it was smaller than 10mm, the incidence of submucosal invasion or lymph node invasion was rare. Therefore endoscopic mucosal resection(EMR) can be the treatment of choice in flat adenoma smaller than 10mm, and after EMR, it is desirable to decide the treatment modality depending on the histologic findings.
진행성 간문부담관암 환자에서 내시경 담도배액술 단독 치료와 경피경간 담도배액술을 병행한 담도경하 광역동치료의 생존율의 비교 연구
천영국 ( Young Koog Cheon ),조영덕 ( Young Deok Cho ),백승훈 ( Seung Hoon Baek ),차상우 ( Sang Woo Cha ),문종호 ( Jong Ho Moon ),김연수 ( Yun Soo Kim ),이준성 ( Jun Seong Lee ),이문성 ( Moon Sung Lee ),심찬섭 ( Chan Sup Shim ) 대한소화기학회 2004 대한소화기학회지 Vol.44 No.5
Background/Aims: Photodynamic therapy (PDT) has a promising effect on non-resectable hilar cholangiocarcinoma. The aim of this study was to compare overall survival of PDT plus biliary drainage versus biliary stent alone in advanced hilar cholangiocarcino
췌담관질환에서 담관 솔질세포검사의 유용성 - 통상도말과 $MonoPrep2^{TM}$ 액상세포검사의 전향적 비교연구 -
이동화,김미선,조영덕,천영국,최민성,김동원,진소영,Lee, Dong-Wha,Kim, Mee-Sun,Cho, Young-Deok,Cheon, Young-Koog,Choi, Min-Sung,Kim, Dong-Won,Jin, So-Young 대한세포병리학회 2006 대한세포병리학회지 Vol.17 No.1
Bile duct brush cytology has been employed as a diagnostic tool for the evaluation of pancreatic and biliary tract strictures. The specificity of this method is high however, its sensitivity is quite low. A recent study employing liquid based cytology (LBC) reported results comparable to those achieved via conventional cytology. Therefore, we have attempted to prospectively evaluate the diagnostic utility of bile duct brush cytology in pancreaticobiliary diseases. A total of 46 cases with bile duct stricture were enrolled including 11 cases of benign stricture, 29 cases of bile duct carcinoma, 3 cases of gallbladder cancer, and 3 cases of pancreatic cancer. Both conventional smear and LBC using $MonoPrep2^{TM}$ system were conducted in each case. The cytological diagnosis of each case was classed into the following categories; benign, suspicious for malignancy, and malignancy. The diagnostic accuracy of both cytologic methods was investigated. LBC evidenced a high rate of material insufficiency (13/46), which was attributed to low cellularity. The kappa index of both cytological methods was 0.508. Cytological and tissue diagnoses were correlated in 25 cases conducted from biopsy or operation. The sensitivity, specificity, positive predictive value, and negative predictive value were 41.2% (7/17), 100% (8/8), 100% (7/7), and 44.4% (10/18) in conventional smear; 58.8% (10/17), 87.5% (7/8), 90.9% (10/11), and 50.0% (7/14) in LBC; and 94.1% (16/17), 87.5% (7/8), 94.1% (16/17), and 87.5% (7/8) in any one of both cytological methods, respectively. Based on these results, the sensitivity of LBC was found to be superior to that of conventional smear and we were able to obtain higher positive predictive value upto 94.1% by simultaneously conducting both cytologic methods.
과분극 자극에 대한 mouse 미수정란의 세포막저항과 세포막전압의 변화
홍성근,김익현,조영덕,Hong, Seong-geun,Kim, Ik-hyen,Cho, Young-deok 대한수의학회 1991 大韓獸醫學會誌 Vol.31 No.1
For the observations of both the membrane properties and the excitability on the unfertilized eggs of female mice, changes of the membrane resistance and the membrane potential by hyerpolarizing current stimulation were recorded. As current-voltage relation was linear over the entire range (-180mV~+60mV), membrane resistance($R_m$) was calculated from the amplitude of electrotonic potential to a given stimulus current. Also the presence of anode-break excitation was confirmed. The results were as follows; 1. There was a linear relation between the membrane resistance and resting membrane potential, the expected input resistance was 61. 4M$\Omega$(resting membrane potential was $-18.9{\pm}8.7mV$, mean${\pm}$SD, n=30). 2. Transient depolarization with overshoot was generated just after hyperpolarizing current stimulus and showed the dependency of stimulus duration. 3. Transient depolarization lasted over 30ms, amplitude of these depolarization was increased by high $Ca^{{+}{+}}$(20mM) and inhibited by $Ca^{{+}{+}}$-antagonist, $Mn^{{+}{+}}$. 4. From the above results, it was suggested that the unfertilized mouse egg showed the characteristics of the excitable cell.