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진윤태 ( Yoon Tae Jeen ) 대한소화기학회 2002 대한소화기학회지 Vol.40 No.4
Crohn's disease and ulcerative colitis known as inflammatory bowel diseases, are chronic inflammatory disorders involving the gastrointestinal tract. Because the cause of both disease remains unknown, a curative therapy has been lacking. Until recently, conventional treatments have focused on nonspecific suppression of the inflammatory process and are often effective in achieving symptomatic control, but frequently fail to prevent relapse when administered over time. Recent advances in basic research have provided new insights into the role of specific immune cells and their mediators in intestinal inflammation. Such understanding has led to the development of biologic treatments directed at altering specific pathogenic mechanisms that have the potential to modifiy the natural course of these disorders. The compounds directed against important regulatory cytokines such as tumor necrosis factor-alpha ( TNF-α ) have demonstrated the greatest clinical efficacy to date. These clinical findings are consistent with scientific observations that have suggested a central role of TNF-α in chronic intestinal inflammation. It is probable that biologic therapy will play an important role in the future treatment of inflammatory bowel diseases. ( Korean J Gastroenterol 2002; 40: 219-227)
진윤태(Yoon Tae Jeen),송치욱(Chi Wook song),엄순호(Soon Ho Um),김창덕(Chang Duck Kim),류호상(Ho Sang Ryu),현진해(Jin Hae Hyun) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4
Priary cricopharyngeal dysfunction is a rare motility disease of the esophagus having a prominent cricopharyngeal bar on barium study in patient with oropharyngeal dysphagia. Abnormal findings of esophageal manometry such as hypertensive upper esophageal sphincter, or failure of relaxation are detectable in only minority of patients suggestive of cricopharyngeal dysfunction. We used radionuclide oropharyngeal transit study which has been proposed as a diagnostic tool for esophageal motility disorder recently. Drug therapy or cricopharyngeal myotomy has been used to treat primary cricopharyngeal dysfunction, We report a case of a 61-year-old woman who presented with oropharyngeal dysphagia and prominent cricopharyngeal bar on barium study. Manometric finding shows a markedly increased pressure of upper esophageal sphinter in the anterior and posterior direction. Radionuclide oropharyngeal transit study shows delayed transit of radioisotope in the oropharynx(Korean J Gastroenterol 1996; 28:602-604.
진윤태 ( Yoon Tae Jeen ),김주형 ( Ju Hyung Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.6
Ulcerative colitis is an idiopathic inflammatory bowel disease characterized by colonic mucosal inflammation and chronic relapsing episodes. The initial therapeutic approach depends on both the extent of colonic involvement and the severity of the disease process at presentation. The mainstay of ulcerative colitis therapy is the administration of 5-aminosalicylic acid (5-ASA) or steroid. Additional medical therapy or colectomy should be considered if the patient remains symptomatic despite conventional therapy, regardless of the extent of colonic involvement. Cyclosporins are effective as a short-term rescue therapy for steroid-refractory ulcerative colitis. Recently, new 5-ASA and steroid formulations with altered delivery, dosing regimens, and less frequent administration have been introduced and demonstrated to be efficacious in active mild to moderate colitis. Infliximab is given to try to avoid the need for colectomy and has proven efficacious in ulcerative colitis. This review outlines the standard therapy for ulcerative colitis and discusses new insights into the recent trend focusing on new therapies, including biological agents and leukocytapheresis. (Korean J Med 76:654-660, 2009)
진윤태 ( Yoon Tae Jeen ),권용대 ( Yong Dae Kwon ) 대한장연구학회 2006 Intestinal Research Vol.4 No.2
Inflammatory bowel disease (IBD) is defined as chronic inflammatory intestinal disorder of unknown origin. Not only Crohn`s disease (CD) and ulcerative colitis (UC) are widely known as such IBD, but Behcet`s colitis and intestinal tuberculosis also belong to IBD. Particularly because intestinal tuberculosis is common disorder in Korea; Crohn`s disease (CD) is on the increase, the differentiation of intestinal tuberculosis from CD is very important. Even though theses diseases have similar clinical feature, their eventual course is quite different. However diagnosis of IBD is intricate because of no pathognomonic feature. Recently introduction of CARD15/NOD2 gene polymorphism which causes increasing of incidence of CD intensifies genetic diagnostic tool research, and new diagnostic approach as systematic analysis of endoscopic findings is suggested. Therefore more advanced and more convenient method to diagnose IBD will be developed in near future. (Intestinal Research 2006;4:75-78)
윤진영 ( Jin Young Yoon ),차재명 ( Jae Myung Cha ),진윤태 ( Yoon Tae Jeen ) 대한소화기학회 2018 대한소화기학회지 Vol.71 No.1
Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rate in population-based screening program. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis and socioeconomic burden. In addition, harmful effect of colonoscopy may increase with age and comorbidity. As the adverse event risk in population-based colonoscopy screening may offset benefit of the screening colonoscopy, the adverse events associated with screening colonoscopy should be well managed and monitored. To adopt population-based colonoscopy screening, consensus for the risk and benefits of screening colonoscopy should be formed for its potential harms, patient preference, socioeconomic considerations, quality improvement of colonoscopy as well as its efficacy for CRC prevention. As the suboptimal colonoscopy quality is a major pitfall of population-based colonoscopy screening, adequate training and provider regulation for screening colonoscopists should be the first step to minimize the variation of quality between colonoscopists. Gastroenterologists should lead quality improvement, auditing, and training associated with colonoscopy in a population-based colonoscopy screening program. (Korean J Gastroenterol 2018;71:3-9)
동시에 발견된 위장관 간질 종양과 점막하 종양 형태의 MALT 림프종의 내시경 치료
유인경,전훈재,진윤태,금보라,김은선,최혁순,남승주,In Kyung Yoo,Hoon Jai Chun,Yoon Tae Jeen,Bora Keum,Eun Sun Kim,Hyuk Soon Choi,Seung Joo Nam 대한소화기암연구학회 2014 Journal of digestive cancer reports Vol.2 No.1
본 증례에서는 우연히 한 환자에서 위장관 간질 종양과 점막하 종양 형태의 MALT 림프종을 동시에 발견하였고, 이를 내시경적 절제술로 치료한 사례이다. 현재 환자는 절제술 후 2년 동안 질병의 진행 없이 외래에서 경과 관찰 중이다. 아직 MALT 림프종과 위장관 간질종양에서 내시경적 점막하 절제술은 정립된 치료 방법이 아니지만, 본 증례처럼 성공적으로 치료될 수 있음을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 아직은 내시경적 절제술로 치료한 사례가 적지만, 향후 내시경적 절제술 후 긴 기간 동안 추적 관찰된 증례들이 모인다면 조기위암처럼 표준화된 치료법으로 시행될 수 있기를 기대한다.
아칼라지아 풍선확장술후 증상호전과 재발의 예측인자에 대한 고찰
송치욱(Chi Wook song),진윤태(Yoon Tae Jeen),엄순호(Soon Ho Um),김창덕(Chang Duck Kim),류호상(Ho Sang Ryu),현진해(Jin Hae Hyun) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3
N/A Background/Aims: Pneumatic balloon dilation(BD) is considered to be the first line of treatment in patients with achalasia. However there have been little reports about whether the parameters of esophageal manometry and scintigraphy predict the long-term results after BD. The aims of this study were to determine the relationship between changes in symptom improvetnent and esophageal motor function in response to BD. Methods: 21 patients with primary achalasia treated by BD were included. We used a balloon dilator(Rigiflex, 3.0 cm in diameter) and dilated twice for 1 minute each at a pressure of 7-15 psi, at a 5 minute interval. A comprehensive assessment of their symptoms and esophageal manometry and scintigraphy was performed before, 1 month after wards and again 1 year after BD. Results: 1) One year after BD, four people had recurrence of symptoms and the remaining 17 patients(81%) had been successfully treated. 2) There was no relationship between patients age, sex, duration of symptoms and the symptom improvement scores of a year later. 3) Significant correlation was detected between changes in the symptom score of a year later and parameters of esophageal motor function such as reduction of lower esophageal sphincter pressure, normalized reversed gastroesophageal pressure gradient, and different configuration of simultaneous contractions after BD. Conclusions: We conclude that the changes in objective responses such as lower esophageal sphincter pressure, gastroesophageal pressure gradient and configuration of simultaneous contractions are reliable predictors of symptom irnprovernent and recurrence in patients with achalasia treated by BD. (Korean J Gastroenterol 1997;29: 279 - 288)