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Factors associated with the risk of colorectal neoplasia in young adults under age 40
Ilsoo Kim,Han Hee Lee,Young Jae Ko,Ho Eun Chang,Dae Young Cheung,Bo-In Lee,Young-Seok Cho,Jin Il Kim,Myung-Gyu Choi 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.5
Background/Aims: Recent epidemiologic studies have shown a continued increase in colorectal cancer incidence among younger adults. Little is known about the factors that contribute to the development of young-onset colorectal neoplasia (CRN). Methods: A cross-sectional analysis was performed for individuals younger than 40 years who underwent colonoscopy in Seoul St. Mary’s Hospital and its affiliated health screening center. High-risk CRN was defined as adenoma or sessile serrated lesion ≥ 10 mm, with three or more adenomas, villous histology, high grade dysplasia, or carcinoma. Results: Of these 13,621 included participants, 2,023 (14.9%) had one and more CRN. Young patients with CRN tended to be elderly, male, obese, smoker, having a habit of drinking, and having comorbidities such as hypertension, dyslipidemia, diabetes, and chronic kidney disease. In a multivariate analysis adjusted for age, sex, obesity, smoking status, and alcohol intake, old age (odds ratio [OR], 1.086; 95% confidence interval [CI], 1.054 to 1.119), male sex (OR, 1.748; 95% CI, 1.247 to 2.451), obesity (OR, 1.439; 95% CI, 1.133 to 1.828), and smoking (OR, 1.654; 95% CI, 1.287 to 2.127) were independent risk factors for overall CRN. Obesity and smoking as two modifiable factors increased the risk for high-risk CRN even more than for overall CRN (OR, 1.734; 95% CI, 1.168 to 2.575 and OR, 1.797; 95% CI, 1.172 to 2.753, respectively). Conclusions: Obesity and smoking were modifiable risk factors for CRN in young adults. They increased the risk for highrisk CRN even more than for overall CRN. A colonoscopy might be beneficial for young individuals with these factors.
( Dae Young Cheung ),( Hyung Keun Kim ),( Young Seok Cho ),( Sung Soo Kim ),( Jin Il Kim ),( Soo Heon Park ),( Hiun Suk Chae ),( Jae Kwang Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background and aim: Small rectal neuroendocrine tumors (NETs) can be treated with endoscopic resection. Endoscopic submucosal dissection (ESD) has been accepted as a reliable technique, but very diffi cult to do. This study aimed to evaluate the feasibility and effi cacy of precut and endoscopic mucosal resection (CSI-EMR) for rectal NETs comparing to ESD. Materials and Methods: From January 2011 to March 2013, patients with rectal NETs were enrolled consecutively. ESD or CSI-EMR was performed on operator`s discretion. Histological and clinical outcomes were measured and compared between the two treatment modalities. Results: A total of 33 patients were enrolled during the study periods. Seventeen NETs were treated in ESD method and 16 were in CSI-EMR. Both groups had similar mean tumor diameters (ESD 7.53 ± 1.94 vs. CSI-EMR 6.63 ± 1.99 mm; p = 0.197). En bloc resection was achieved in 100% of ESD group and 87.5% of CSI-EMR group. Lateral margin involvement occurred in 1 patient in ESD group and 2 in CSI-EMR group. Histologically complete resection rate was 88.2% (15 of 17) in the ESD group and 81.2% (13 of 16) in CSI-EMR group (p = 0.592). One case of perforation occurred in both group. Delayed bleeding did not happen. All measured outcomes above were not different between the two groups. Operation time was signifi cant shorter in CSIEMR group than in ESD group, 9.69 minutes and 20.12 minutes respectively (p-value = 0.004). Conclusion: CSI-EMR results in reliable clinical outcomes for small rectal NETs comparable to that of ESD. The CSI-EMR is technically feasible and more time saving.
Dae Young Cheung,Byung Ik Jang,김상욱,김지현,김현건,Jeong Eun Shin,윤원재,Yong Kang Lee,정광현,조수정,신현필,조선영,신운건,Kee Don Choi,김병욱,권중구,양희찬,권태근,Hyun Gun Kim,안동원,Kwang Bum Cho,Sun Hee Kim,Kyong Hwa Hwang,Hee Hyuk Im 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.3
The area of endoscopic application has been continuously expanded since its introduction in the last century and the frequency ofits use also increased stiffly in the last decades. Because gastrointestinal endoscopy is naturally exposed to diseased internal organsand contact with pathogenic materials, endoscopy mediated infection or disease transmission becomes a major concern in this field. Gastrointestinal endoscopy is not for single use and the proper reprocessing process is a critical factor for safe and reliable endoscopyprocedures. What needed in these circumstances is a practical guideline for reprocessing the endoscope and its accessories whichis feasible in the real clinical field to guarantee acceptable prevention of pathogen transmission. This guideline contains principlesand instructions of the reprocessing procedure according to the step by step. And it newly includes general information and updatedknowledge about endoscopy-mediated infection and disinfection. Multiple societies and working groups participated to revise;Korean Association for the Study of the Liver, the Korean Society of Infectious Diseases, Korean College of Helicobacter and UpperGastrointestinal Research, the Korean Society of Gastroenterology, Korean Society of Gastrointestinal Cancer, Korean Associationfor the Study of Intestinal Diseases, Korean Pancreatobiliary Association, the Korean Society of Gastrointestinal Endoscopy Nursesand Associates and Korean Society of Gastrointestinal Endoscopy. Through this cooperation, we enhanced communication andestablished a better concordance. We still need more researches in this field and fill up the unproven area. And our guidelines will berenewed accordingly.
Capsule endoscopy in small bowel tumors: A multicenter Korean study
Cheung, Dae Young,Lee, In‐,Seok,Chang, Dong Kyung,Kim, Jin Oh,Cheon, Jae Hee,Jang, Byung Ik,Kim, Yong‐,Sik,Park, Cheol Hee,Lee, Kwang Jae,Shim, Ki‐,Nam,Ryu, Ji‐,Kon,Do, Jae Blackwell Publishing Asia 2010 Journal of gastroenterology and hepatology Vol.25 No.6
<P><B>Abstract</B></P><P><B>Background and Aim: </B> Capsule endoscopy (CE) has proven to be highly effective at detecting small bowel lesions in a variety of clinical conditions, but studies concerning the practical impact of CE on small bowel tumors are still scarce, especially in the Asian population. The aim of this study was to evaluate the diagnostic and therapeutic impact of CE in the field of small bowel tumors.</P><P><B>Methods: </B> CE records consecutively pooled from the beginning of use of CE in Korea, October 2001 until April 2008, in 14 centers throughout Korea were reviewed. Clinical information and CE video images of small bowel tumors were analyzed.</P><P><B>Results: </B> A total of 1332 cases undergoing CE were reviewed with all clinical indications. Small bowel tumors were diagnosed with CE in 57 (4.3%) of 1332 patients. The tumors were malignant in 33 cases, and included three adenocarcinomas, eight lymphomas, 20 gastrointestinal stromal tumors, and two metastatic cancers. The most frequent indications for CE in malignant tumors were obscure gastrointestinal bleeding, followed by abdominal pain and weight loss. Thirty of 57 tumors were identified exclusively by CE (diagnostic impact = 30/57), and they were smaller in size (mean, range: 14.3 mm, 2–35 mm) compared to the other tumors detected in radiological studies (48.7 mm, 10–110 mm). Seven patients underwent surgical resection (therapeutic impact = 7/57).</P><P><B>Conclusion: </B> CE effectively identifies small bowel tumors that are undetectable by conventional radiological studies (diagnostic impact = 52.6%) and can critically change the therapeutic course (therapeutic impact = 12.3%).</P>
정대영 ( Dae Young Cheung ),김재광 ( Jae Kwang Kim ),김진일 ( Jin Il Kim ),한준열 ( Joon Yeol Han ),정규원 ( Kyo Won Chung ),선희식 ( Hee Sik Sun ) 대한소화기학회 2005 대한소화기학회지 Vol.45 No.4
Background/Aims: As a preliminary study to test the possibility of oral transmission of hepatitis C virus (HCV), many investigations in order to detect the extrahepatic localization of HCV have been performed. In this study, we examined the presence of HC
정대영 ( Dae Young Cheung ),장병익 ( Byung Ik Jang ),김상욱 ( Sang Wook Kim ),김지현 ( Jie-hyun Kim ),김형근 ( Hyung Keun Kim ),신정은 ( Jeong Eun Shin ),윤원재 ( Won Jae Yoon ),이용강 ( Yong Kang Lee ),정광현 ( Kwang Hyun Chun 대한내과학회 2020 대한내과학회지 Vol.95 No.5
목적: 소화기 내시경의 보급과 사용이 증가하면서 내시경의 수행과 관리의 중요성에 대한 인식이 높아지고 있다. 특히, 소화기 내시경에 의한 병원 내 감염은 의료 현장의 매우 주요한 문제이다. 신뢰할 수 있는 내시경 재처리 과정은 소화기 내시경의 안전성에 가장 기본적인 조건이다. 소화기 내시경의 재처리에 관한 진료 지침은 현장에서 보편적으로 적용 가능한 내용이어야 하며, 지침을 준수하였을 때 충분한 수준으로 병원균의 전파를 예방할 수 있어야 한다. 방법: 이번 재처리 지침은 내시경 관련 감염과 소독에 대한 과학적 근거와 전문가의 의견을 토대로 하여 이론과 실무를 아우를 수 있는 포괄적 내용이 되도록 하였다. 결과: 이번 개정에는 대한소화기내시경학회와 함께 대한간학회, 대한감염학회, 대한상부위장관·헬리코박터학회, 대한소화기학회, 대한소화기기능성질환운동학회, 대한소화기암학회, 대한장연구학회, 대한췌장담도학회 그리고 대한소화기내시경간호학회가 함께 참여하였다. 결론: 향후에도 내시경 관련 감염 관리와 재처리 과정에 대한 연구 및 개정 보완은 지속되어야 할 것이며, 이러한 내용은 적절한 시기에 개정된 지침에 반영되어야 할 것이다. Background/Aims: The area of endoscopic application has been continuously expanded since its introduction in the last century and the frequency of its use also increased stiffly in the last decades. Because gastrointestinal endoscopy is naturally exposed to diseased internal organs and contact with pathogenic materials, endoscopy mediated infection or disease transmission becomes a major concern in this field. Gastrointestinal endoscopy is not for single use and the proper reprocessing process is a critical factor for safe and reliable endoscopy procedures. What needed in these circumstances is a practical guideline for reprocessing the endoscope and its accessories which is feasible in the real clinical field to guarantee acceptable prevention of pathogen transmission. Methods: This guideline contains principles and instructions of the reprocessing procedure according to the step by step. And it newly includes general information and updated knowledge about endoscopy-mediated infection and disinfection. Results: Multiple societies and working groups participated to revise; Korean Association for the Study of the Liver, the Korean Society of Infectious Diseases, Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Society of Gastroenterology, Korean Society of Gastrointestinal Cancer, Korean Association for the Study of Intestinal Diseases, Korean Pancreatobiliary Association, the Korean Society of Gastrointestinal Endoscopy Nurses and Associates and Korean Society of Gastrointestinal Endoscopy. Through this cooperation, we enhanced communication and established a better concordance. Conclusions: We still need more researches in this field and fill up the unproven area. And our guidelines will be renewed accordingly. (Korean J Med 2020;95:325-335)
진행성 위암 치료의 전망 분자표적치료제의 도입과 기대 효과
정대영 ( Dae Young Cheung ),김재광 ( Jae Kwang Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.3
The overall survival of patients with gastric cancer has increased markedly in Korea, even higher than those of developed nations in Western world. It is due to the virtue of Korean National Cancer Screening Program and nowadays more than half of patients are diagnosed at the early stage of gastric cancer. However, for patients with unresectable gastric cancer, the outcomes of traditional cytotoxic chemotherapy regimens stay at a median survival of 9-11 months. The knowledge of cancer biology and the data from gene expression profiling has explosively expanded. Alternations in the expression of receptor tyrosine kinases pathways including Human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), phosphatydyl inositol 3 kinase/mammalian target of rapamycin (PI3K/mTOR), hepatocyte growth factor receptor (HGFR/MET), and fibroblast growth factor receptor (FGFR) were proved to be critical in cancer cell survival and biological agents targeting those altered receptor tyrosine kinases, their ligands and downstream effector molecules are developed for anti-cancer purpose. Until now, only trastuzumab succeeded to significantly increase overall survival of patients with HER2 overexpressing gastric cancer. Other agents including bevacizumab, gefitinib, erlotinib, and lapatinib failed to achieve the efficacy in survival gain over standard chemotherapy. Insights about the variations between regions, races, and individuals call for the effort to find reliable predictive biomarkers for drug efficacy and to design finely stratified clinical trials. Compared to current treatment paradigms, it is hoped that molecularly targeted treatment along with conventional cytotoxic chemotherapy will lead to significant gains in survival. (Korean J Gastroenterol 2013;61:117-127)