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유교상 ( Kyo-sang Yoo ) 대한소화기학회 2018 대한소화기학회지 Vol.71 No.5
Gallstones are one of the most common diseases worldwide. Recently, the incidence of gallstones has increased and the pattern of gallstones has changed in Korea. Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstones. Expectant management is considered the most appropriate choice in patients with asymptomatic gallstones. The dissolution of cholesterol gallstones by oral bile acid, such as ursodeoxycholic acid, can be considered in selected patients with gallstones. Although the advent of laparoscopic cholecystectomy has moved interest away from the pharmacologic treatment of gallstones, several promising agents related to various mechanisms are under investigation. (Korean J Gastroenterol 2018;71:253-259)
유교상 ( Kyo Sang Yoo ) 대한내과학회 2012 대한내과학회지 Vol.83 No.1
Chronic pancreatitis is an inflammatory disease characterized by the progressive destruction of pancreatic tissue and resulting in pancreatic exocrine and endocrine insufficiency. Although a lot of efforts have been made in managing chronic pancreatitis, treatment of chronic pancreatitis is still challenging and remains mostly empirical. Medical treatment of chronic pancreatitis focuses on chronic abdominal pain, pancreatic exocrine insufficiency and also pancreatic endocrine insufficiency. Chronic disabling abdominal pain is the main symptom of chronic pancreatitis, which could be managed by analgesics and non-enteric coated pancreatic enzymes as well as adjunctive agents such as antidepressants, duolexitine and pregabalin. Pancreatic exocrine insufficiency is commonly associated with weight loss, steatorrhea and malnutrition. Adequate pancreatic enzyme replacement therapy can significantly improve not only exocrine insufficiency related symptoms but also nutritional status. Several problems affecting the efficacy of pancreatic enzyme replacement can be avoided by the use of enteric-coated enzyme microspheres with or without proton pump inhibitors.
유교상 ( Kyo Sang Yoo ) 대한내과학회 2008 대한내과학회지 Vol.75 No.6
Gallstones are often suspected on history and clinical examination alone but symptoms may be variable ranging from asymptomatic to complications such as biliary pain, cholecystitis, jaundice, cholangitis, or pancreatitis. The clinical presentation of gallstone disease may depend on ongoing complications. Patient with gallstone usually present with characteristic biliary pain which is often situated in the right upper quadrant or epigastrium lasting more than thirty minutes to several hours. Diagnostic investigations aimed to predict the presence and location of stones include history, laboratory tests, and imaging studies. Imaging studies such as transabdominal ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and endoscopic ultrasonography, frequently confirm the diagnosis and identify the location and etiology of the obstruction. (Korean J Med 75:616-623, 2008)
유교상 ( Sang Yoo Kyo ) 대한내과학회 2014 대한내과학회지 Vol.87 No.3
Pancreatic cystic neoplasms are frequently recognized on routine screening cross-sectional imaging studies, such as computed tomography (CT) and magnetic resonance imaging (MRI), which can be used in their diagnosis and management when characteristic features are present. However, not all such neoplasms can be evaluated completely with CT or MRI and the diagnosis and risk of malignancy are often unclear. Despite recent advances in these diagnostic modalities, the preoperative diagnosis of pancreatic cystic tumors remains difficult. Endoscopic ultrasonography (EUS) has been used increasingly for the diagnosis of pancreatic cystic tumors, as it provide high-resolution images of pancreatic cystic tumors and EUS-guided fine needle aspiration (EUS-FNA) can enable the analysis of cystic fluid for cytology and tumor markers. EUS-FNA provides useful information for the differential diagnosis of mucinous cystic lesions, although it has limited diagnostic accuracy. Other techniques and markers are needed to improve the diagnostic accuracy of mucinous cystic lesions. (Korean J Med 2014;87:251-260)
관상동맥 조영술을 시행한 환자에서 신동맥 협착의 유병율과 이에 연관된 위험인자 분석
유교상(Kyo Sang Yoo),강재영(Jae Young Kang),장재원(Jae Won Jang),서장원(Jang Won Seo),정영옥(Young Ok Jung),유혜승(He Sung Yoo),박성욱(Seong Wook Park),박승정(Seung Jung Park),박정식(Jung Sik Park) 대한내과학회 1998 대한내과학회지 Vol.54 No.3
N/A Objectives: The distributive pattern of atherosclerotic vascular disease is known to be different among the races. In Caucasian population, renal artery stenosis (RAS) was reported to be a frequent finding in the patients with ischemic heart disease (IHD), ranging from 5% to 29%. We investigated the prevalence of RAS and the risk factors in Korean patients. Methods: Over a 12-month period, 574 patients (M:F, 407:167) with clinical ND underwent cardiac catheterization. Before the procedure, demographic data, medical history, physical findings, and blood chemistries were obtained. During the procedure, selective renal arteriogram was also obtained. The degree of renal artery stenosis was quantitated with automatic edge detection technique, and narrowing of diameter greater than 50% was considered to be significant. Results : RAS was identified in 42 patients (7%), of whom 5 patients (1%) had bilateral disease. Angiographically significant coronary artery disease was present in 473 patients. The prevalence of RAS in patients with single, double and triple vessel disease of coronary artery were 4% (9/235), 13% (20/154), and 12% (10/84), respectively, Among the 101 patients with normal coronary arteries, 3 (3%) had RAS. By univariate analysis, there was significant difference between RAS and non-HAS in age (66±8 yrs vs 59±10 yrs, p<0.0001), duration of hypertension (73±13 yrs vs 3.40.3 yrs, p=0.0002), and the frequency of double or triple ±coronary artery disease (p=0.004). However, no association was found between RAS and serum lipids, lipoprotein(a), creatinine, sex, smoking, diabetes mellitus, or peripheral vascular disease. By multivariate logistic regression analysis, the following parameters were independent risk factors for RAS: age over 65 years (p<0.001), duration of hypertension (p=0.003), and coronary artery disease involving double or triple vessels (p=0.004). Conclusion : The prevalence of RAS in Koreans is somewhat lower than in western population. However, in patients with high degree coronary heart disease, old age over 65 years, or long history of hypertension, the possibility of combined RAS should be considered.
전침 자극에 의한 오디 괄약근 운동성 변화에 관한 연구
이성구(Sung Koo Lee),김명환(Myung Hwan Kim),김홍자(Hong Ja Kim),서동완(Dong Wan Seo),이상수(Sang Soo Lee),김동일(Dong Il Kim),유교상(Kyo Sang Yoo),주연호(Yun Ho Joo),민영일(Young Il Min),김지훈(Ji Hoon Kim),민병일(Byung II Min) 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.1
N/A Background/Aims: This study was designed to evaluate the effects of electroacupuncture on the sphincter of Oddi (SO) motility in humans and to correlate the manometric findings with plasma cholecystokinin (CCK) levels. Methods: Eleven patients (M: F= 5: 6) who had various kinds of biliary disorders were enrolled. SO motility was monitored with a conventional low-compliant continously perfused technique using ERCP (n=9) or percutaneous transhepatic cholangioscope (n 2). After baseline monitoring for phasic wave contractions of SO, electroacupuncture was applied at a specific acupoint, GB 34, in these 11 patient.. A nonspecific acupoint 5 cm away from GB 34 was selected as a control. Manometric parameters of SO were also checked in 6 subjects during stimulation of the control acupoint. CCK plasma levels were measured during the time course of electroacupuncture stimulation, Results: All the manometric parameters including the basa1 pressure of SO, amplitude, frequency and duration of phasic wave contraction of SO were significantly decreased (p< 0.05) during electroacupuncture stimu1ation. The inhibition of SO contractility was accompanied by increased CCK plasma levels. After removal of electroacupuncture stimulation, restoration of amplitude and duration to basal condition were noted. A tendency towards the return of SO contractility was also observed in basal pressure and frequency. Stimulation of the control acupoint, however, did not affect the SO contractility and plasma CCK levels. Conclusions: Electroacupuncture stimulation of acupoint GB 34 showed reversible inhibition of SO contraction in humans. We speculate that the response of SO to electroacupuncture stimulation may be mediated by some neurohormonal mechanisms including CCK release. (Korean Journal of Gastrointestinal Motility 2000;6:44-5l)
김지연 ( Ji Yeoun Kim ),유교상 ( Kyo Sang Yoo ),오영하 ( Young Ha Oh ),최종민 ( Jong Min Choi ),이상기 ( Sang Ki Lee ),여유미 ( Yoo Mi Yeo ),황순우 ( Soon Woo Hwang ),윤혜진 ( Hye Jin Yoon ) 대한췌장담도학회 2014 대한췌담도학회지 Vol.19 No.1
Autoimmune pancreatitis or IgG4-related sclerosing cholangitis often involves the liver. Most common lesion involving the liver is shown as mass or masses often referred as inflammatory pseudotumor. Inflammatory pseudotumor usually needs to be discriminated with malignancy. Here we report a case of IgG4-related sclerosing cholangitis with liver involvement presented as a mass. It was proven by biopsy and did not show any evidence of autoimmune pancreatitis. The mass infiltrated around the portal tract and portal vein thrombosis was also present. Korean J Pancreatobiliary 2014;19(1):26-30
박광혁 ( Kwang Hyuk Park ),유교상 ( Kyo Sang Yoo ),정용우 ( Yong Woo Chung ),김경오 ( Kyoung Oh Kim ),박철희 ( Cheol Hee Park ),김종혁 ( Jong Hyeok Kim ),박충기 ( Choong Kee Park ) 대한소화기학회 2007 대한소화기학회지 Vol.49 No.3
Groove pancreatitis is a rare form of chronic pancreatitis in which scarring is found mainly in the groove between the head of the pancreas, duodenum, and common bile duct. The pathogenesis of groove pancreatitis is still unclear but seems to be caused by the disturbance of pancreatic outflow through Santorini duct. It is often difficult to differentiate preoperatively between groove pancreatitis and pancreatic head carcinoma. Whereas conservative management is effective, some patients with duodenal obstruction may undergo Whipple`s operation. A few case of groove pancreatitis have been reported in Korea, and they were diagnosed only by clinical and radiological features. We experienced a case of groove pancreatitis who needed a surgical management because of severe duodenal obstruction. We report the case with a review of its characteristic pathologic findings. (Korean J Gastroenterol 2007;49:187-191)
송혜근 ( Hae Geun Song ),유교상 ( Kyo Sang Yoo ),주나래 ( Na Rae Ju ),박진철 ( Jin Chul Park ),정재원 ( Jae One Jung ),신운건 ( Woon Geon Shin ),문준호 ( Joon Ho Moon ),김종표 ( Jong Pyo Kim ),김경오 ( Kyoung Oh Kim ),박철희 ( Che 대한소화기학회 2006 대한소화기학회지 Vol.48 No.2
Adenosquamous carcinoma of the papilla of Vater is a rare tumor and only a few cases have been reported so far. Here, we report a case of adenosquamous carcinoma in a 76-year-old male who presented with jaundice and right upper quadrant abdominal pain. Ultrasonography and enhanced abdominal CT scans showed dilated common bile duct (CBD) and intrahepatic bile duct (IHD) with a suspicious obstructing mass in distal CBD. On endoscopy, obstructing and ulcerated mass was noted on the papilla of Vater. Histopathological inspection of the biopsied specimens from mass showed adenosquamous cell carcinoma of the papilla of Vater. Since the patient refused operation, we inserted a self-expandable metallic stent in distal CBD. This is the first case report on adenosquamous carcinoma of the papilla of Vater in Korea. (Korean J Gastroenterol 2006;48:132-136)