http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
풍선 확장술과 보툴리눔 독소 주입의 복합 치료로 호전된 격렬형 아칼라시아
권혁춘 ( Hyeok Choon Kwon ),이광재 ( Kwang Jae Lee ),명보현 ( Bo Heon Meong ),정재연 ( Jae Yeon Jung ),함기백 ( Ki Biak Hahm ),김진홍 ( Jin Hong Kim ),조성원 ( Sung Won Cho ) 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.2
Achalasia is a relatively uncommon primary motility disorder of the esophagus that is characterized by aperistalsis of the esophageal body and incomplete relaxation of the LES upon swallowing Vigorous achalasia is a subset of achalasia that show a higher contraction amplitude, minimal esophageal dilatation, prominent tertiary contractions and a higher incidence of chest pain. There is some debates over vigorous achalasia`s the response to treatment. We report here on a patient with vigorous achalasia, and the patient showed high amplitude simultaneous contractions of the esophageal body with severe chest pain and dysphagia. This patient was successfully treated by combined treatments with pneumatic balloon dilatation and botulinum toxin injection on the esophageal body and the lower esophageal sphincter. (Kor J Neurogastroenterol Motil 2005;11:161-165)
식도열공 헤르니아가 동반된 위암 환자에서 위아전절제술 1년 후에 발생된 단분절 바렛식도
권혁춘 ( Hyeok Choon Kwon ),이광재 ( Kwang Jae Lee ),김장희 ( Jang Hee Kim ),유준환 ( Jun Hwan Yoo ),최재명 ( Jae Myung Choi ),신성재 ( Sung Jae Sin ),정재연 ( Jae Yeon Chung ),함기백 ( Ki Baik Hahm ),김진홍 ( Jin Hong Kim ),조성 대한소화기기능성질환·운동학회 2006 Journal of Neurogastroenterology and Motility (JNM Vol.12 No.1
Barrett`s esophagus is characterized by replacement of esophageal squamous epithelium with specialized intestinal metaplasia as a consequence of long standing gastro-esophageal reflux. It is a major risk factor for esophageal adenocarcinoma. With regard to the pathogenesis of Barrett`s esophagus other than acid reflux, hiatal hernia and duodenogastroesophageal bile reflux are implicated. According to several previous reports, acid reflux associated with bile reflux has been suggested to be a major risk factor for Barrett`s esophagus. This case study reports a patient with Barrett`s esophagus which developed one year after subtotal gastrectomy with gastroduodenostomy due to gastric cancer. Before the operation, the patient had a hiatal hernia but no Barrett`s esophagus. This case represents a significant model for the development of Barrett`s esophagus when acid reflux is combined with duodenogastroesophageal bile reflux. (Kor J Neurogastroenterol Motil 2006;12:77-80)
원저 : 한국인 비당뇨 성인에서 대사증후군과 관련된 인슐린 저항성 지표의 기준치
권혁춘 ( Hyeok Choon Kwon ),우성일 ( Seong Ill Woo ),김연경 ( Yeon Kyeong Kim ),안상미 ( Sang Mi Ahn ),송경은 ( Kyoung Eun Song ),정선혜 ( Sun Hye Jung ),김대중 ( Dae Jung Kim ),정윤석 ( Yoon Sok Chung ),이관우 ( Kwan Woo Lee ) 대한비만학회 2005 The Korean journal of obesity Vol.14 No.2
연구배경: 본 연구에서는 한국인 성인에서 대사증후군과 관련된 인슐린 저항성 지표의 기준치에 대해 알아보고자 하였다. 방법: 본 연구는 한국 대사증후군 연구(Korean Metabolic Syndrome Study)의 일환으로 수행되었으며, 30세에서 79세까지 976명(남자 484명과 여자 492명)의 비당뇨 성인을 연구대상으로 하였다. 나이, 성별, 체질량지수를 보정한 후 독립변수로서 공복 인슐린, homeostasis model assessment for insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI)의 사분위에 따라 대사증후군 이환에 대한 교차비를 조사하였다. 대사증후군의 이환율이 증가하는 공복 인슐린, HOMA-IP, QUICKI의 기준치를 알기 위해 receiver-operating characteristic (ROC) 분석을 하였다. 결과: 전체 대상자의 상위 사분위에 해당하는 값을 인슐린 저항성으로 볼 때 공복 인슐린이 12.94 μU/mL, HOMA-IP 이 3.04, QUICKI의 하위 사분위에 해당하는 기준치는 0.32였다. 최하위 사분위와 비교하였을 때, 공복 인슐린, HOMA-IR, QUICKI의 최상위 사분위에서 대사증후군의 이환율에 대한 보정 교차비는 각각 1.95(1.26~3.01), 2.27(1.45~3.56), 2.27(1.45~3.56)이었다. ROC 분석에 의하면 대사증후군과 관련된 인슐린 저항성 지표로서 공복 인슐린의 기준치는 10.57 μU/mL (민감도 58.5%, 특이도 66.8%), HOMA-IR의 2.34(민감도 62.8%, 특이도 65.7%), QUICKI의 기준치는 0.33 (민감도 61.2%, 특이도 66.8%)였다 (P<0.001). 결론: 공복 인슐린, HOMA-IP, QUICKI는 한국인 비당뇨 성인에서 인슐린 저항성에 대한 좋은 지표로 활용할 수 있으며, 이 연구를 통해 만들어진 기준치를 한국인 비당뇨 성인에서 인슐린 저항성을 조사하고 대사증후군을, 예측하는데 적용할 수 있을 것으로 사료된다. Objective: We investigated the cutoff values of surrogate measures of insulin resistance for diagnosing metabolic syndrome in Korean adults. Research Design and Methods: This study was conducted as part of the Korean Metabolic Syndrome (KMS) Study. The data from 976 non-diabetic individuals (484 men and 492 women) aged 30~79 years were analyzed. We determined the odds ratios for the prevalence of metabolic syndrome according to the quartiles of fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) as independent variables, while adjusting for age, sex, and body mass index. The areas under the receiver-operating characteristic (ROC) curves for fasting insulin, HOMA-IR, and QUICKI for increased metabolic syndrome were compared, and the cutoff values of fasting insulin, HOMA-IR, and QUICKI were estimated. Results: The cutoff points for defining insulin resistance are a fasting insulin level of 12.94 μU/mL, HOMA-IR=3.04 as the 75th percentile value, and QUICKI = 0.32 as the 25th percentile value. Compared with the lowest quartile, the adjusted odds ratios for the prevalence of metabolic syndrome in the highest quartiles of fasting insulin, HOMA-IR, and QUICKI were 1.95(1.26~3.01), 2.27(1.45~3.56), and 2.27(1.45~3.56), respectively. The respective cutoff values for fasting serum insulin, HOMA-IR, and QUICKI by ROC analysis were 10.57μU/mL (sensitivity 58.5%, specificity 66.8%), 2.34(sensitivity 62.8%, specificity 65.7%), and 0.33(sensitivity 61.2%, specificity 66.8%). Conclusions: Fasting insulin, HOMA-IR, and QUICKI are good surrogate measures of insulin resistance in Korean non-diabetic adults. We suggest that the cutoff values using these simple methods could be applied to evaluate insulin resistance and predict metabolic syndrome in Korean non-diabetic adults.
악성위궤양으로 오인된 거대세포바이러스 위염: AIDS 진단으로 이어진 초기 발현양상으로서의 증례 1예
나수지 ( Su Sie Rah ),권혁춘 ( Hyeok Choon Kwon ),최승준 ( Sung Jun Choi ),남승우 ( Seong Woo Nam ),박상민 ( Sang Min Park ),최한섭 ( Han Seop Choi ),문가슬 ( Ga Seul Moon ),이승훈 ( Seung Hun Lee ),박성균 ( Sung Kyun Park ) 전북대학교 의과학연구소 2011 全北醫大論文集 Vol.35 No.1
CMV 감염은 주로 면역기능이 저하된 환 자에서 흔한 기회감염으로 상부 위장관에서 의 내시경 소견은 경미한 발적에서부터 궤 양까지 다양하다. 저자들은 흑색변을 주소로 내원한 환자에서 내시경적으로는 악성궤양 의 소견을 보였으나 궤양부위 조직검사상 거대세포바이러스 봉입체를 관찰하여 CMV 감염에 의한 궤양으로 진단되었고 면역억제 의 원인을 추적하여 HIV 감염을 확인한 증례가 있어 보고하는 바이다. Cytomegalovirus (CMV) causes a wide spectrum of disorders in immunocompetent and immunocompromised patients, however it is more frequent and raises more clinical concerns in immunocompromised patients due to its severity. Moreover, suspicion or recognition of gastrointestinal CMV infection by routine laboratory tests and endoscopy with biopsy is difficult since blood tests and pathology do not always reveal the clues for immune deficiency such as leukopenia or inclusion bodies-the hallmark of CMV infection and also due to the lack of specific endoscopic findings. We report a case of an HIV infection without leukopenia whose initial presentation was a solitary CMV gastric ulcer, which initially was suspected as an advanced gastric cancer with melena.
증례 : 소화기 ; 간세포암종 환자에서 경동맥화학색전술 후 발생한 폐색전 사망 1예
최한섶 ( Han Seop Choi ),권혁춘 ( Hyeok Choon Kwon ),남승우 ( Seung Woo Nam ),김상용 ( Sang Yong Kim ),박상민 ( Sang Min Park ),진성찬 ( Sung Chan Jin ),박현미 ( Hyun Mi Park ) 대한내과학회 2011 대한내과학회지 Vol.81 No.2
경동맥화학색전술은 진행된 간암환자에서 가장 흔히 시행되는 고식적 치료이다. 경동맥화학색전술 시행 후 다양한정도의 합병증이 발생할 수 있는데, 폐색전증은 매우 드문 합병증이다. 이에 우리는 3번째 경동맥화학색전술 시행 후 폐색전증으로 인한 사망한 환자 1예를 보고하는 바이다. Transcatheter arterial chemoembolization (TACE) is one of the most common palliative treatment modalities for patients with advanced hepatocellular carcinoma (HCC). TACE is an invasive procedure associated with several potential complications of varying severity. A pulmonary embolism after TACE for HCC is a rare complication. We report a case of pulmonary Lipiodol embolism after a third TACE resulting in death. (Korean J Med 2011;81:236-240)
김석원 ( Seok Weon Kim ),권혁춘 ( Hyeok Choon Kwon ),남승우 ( Seung Woo Nam ),최종경 ( Jong Kyung Choi ),정주원 ( Joo Won Chung ),장동원 ( Dong Won Jang ),박수연 ( Soo Yoen Park ) 영남대학교 의과대학 2017 Yeungnam University Journal of Medicine Vol.34 No.1
Amebic liver abscess (ALA) is the most common extraintestinal manifestation of amebiasis. Amebiasis, a parasitic infection caused by Entamoeba histolytica, used to be a prevalent protozoan disease in Korea, however, with an improving sanitary system, it has been among very uncommon etiology of liver abscess. A recent report suggested that ALA is an emerging parasitic infection in human immunodeficiency virus (HIV)-infected patients even in areas where the disease is not endemic and recommended HIV screening in patients in areas where ALA is not endemic, particularly those without history of travel to a disease-endemic area. We report on two patients who were admitted for treatment of ALA and then diagnosed as HIV infec-tion. We also reviewed the etiology and characteristics of ALA in our hospital during the last 5 years.