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이은학(Eun Hag Lee),주재학(Jae Hak Joo),이명렬(Myung Lyel Lee),박찬욱(Chan Wook Park),송동화(Dong Hwa Song),이준성(Joon Seong Lee),이문성(Moon Sung Lee),조성원(Sung Won Cho),심찬섭(Chan Sup Shim) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.1
Primary sclerosing cholangitis characterized by inflammation and fibrosis of the biliary tree with diffuse multifocal stricture formation is a chronic cholestatic liver disease that often progresses to cirrhosis and premature death from liver failure. Because histologic findings are not diagnostic in the majority of patients, the gold standard for diagnosis of primary sclerosing cholangitis is cholangiography. We present two cases of primary sclerosing cholangitis diagnosed by typical cholangiographic findings through the endoscopic retrograde cholangiography(ERC). (Korean J Gastroenterol 1995;27:138-143)
간경변증 환자의 말초혈액단핵구에서 중합효소연쇄반응법을 이용한 Cytomegalovirus DNA 의 검출
문종호(Jong Ho Moon),유창범(Chang Beom Ryu),박철호(Cheol Ho Park),류권호(Kwon Ho Ryu),박찬욱(Chan Wook Park),이준성(Joon Sung Lee),이문성(Moon Sung Lee),조성원(Sung Won Cho),황승덕(Seung Deok Hwang),심찬섭(Chan Sup Shim),이희발(Hi Ba 대한내과학회 1995 대한내과학회지 Vol.49 No.6
N/A Objectives: Human cytomegalovirus(CMV) infections are common and usually asymptomatic, but fatal infections occur frequently in immunocompromised patients. In Korea, CMV infection is common and patients with liver cirrhosis are frequently in a condition of immunosuppression, may predispose to the frequent occurrence of CMV infections. The purpose of this study was to investigate the prevalence of CMV infection in patients with liver cirrhosis and to evaluate the relationship between the status of C3:IV infection and liver function. Methods, The subjects of this study were 36patients with liver cirrhosis, 4patients with non A, non B, non C(NANRNC) hepatitis, and 13normal controls. IgG and IgKI antibodies to CMV were measured using a microparticle enzyme immunoassay(MEIA). Specimens of urine were cultured for CMV using shell vial culture method. Peripheral blood mononuclear cells(PBMC) were investigated for the presence of CMV-DNA using PCR. Rusults: In CMU antibody test, IgM and IgG antibodies were detected in 7(19.4%) of 36patients with liver cirrhosis, IgG antibody was detected in the other 29patients and all control subjects. In shell vial culture, CMV was cultured in 1(2.8%) of 36patients with liver cirrhosis(IgM and IgG positive). CMV DNA was detected by PCR in 19(52.8%) of 36patients with liver cirrhosis, but 1(7.7%) of 13 control subjects (p<0.05). CMV DNA was detected in 6(85.7%) of 7cirrhotic patients with IgM and IgG antibodies positive, 13(44.8%) of 29cirrhotic patients with IgG antibody positive. CMV DNA positive cirrhotic patients show 5(26.3%) in Child A, 6(31.6%) in Child H, 8(42.1%) in Child C. CMV DNA negative cirrhotic patients show 4(23.5%) in Child A, 12(70.6%) in Child B, 1(5.9%) in Child C(p<0.05). CMV DY:A positive cirrhotic patients showed the tendency of more frequent detection of HBsAg and HBeAg than CMU DNA negative cirrhotic patients(p<0.05). Conclusion: These results suggest that CMV infection is common in cirrhotic patients and the CMV DNA positive patients with liver cirrhosis have more impairment of liver function than the CMV DNA negative patients with liver cirrhosis.
중합효소 연쇄반응법 ( Polymerase Chain Reaction ) 을 이용한 Helicobacter pylori 의 검출
이준성(Joon Seong Lee),송동화(Dong Wha Song),박찬욱(Chan Wook Park),이문성(Moon Sung Lee),조성원(Sung Won Cho),심찬섭(Chan Sup Shim),진소영(So Young Jin) 대한내과학회 1995 대한내과학회지 Vol.49 No.3
N/A Objectives: Helicobacter pylri (H. pylori) infection is now known to be the major cause of chronic gastritis, and is strongly associated with peptic ulcer disease and gastric cancer. But no unanimity exists among investigators about which method represents an appropriate gold standard for diagnosing H. pylori infection. Polymerase chain reaction(PCR) has great potential for improving the ability to diagnose infectious diseases caused by fastidious or slow growing bacterias. But its clinical usefulness as a diagnostic tool for H. pylori is uncertain. Methods: We performed endoscopic biopsy of stomach (>3 pieces, at antrum) for the rapid urease test (CLO stain) and PCR in 11 patients with duodenal ulcer, 2 patients with gastric ulcer, 3 patients with combined gastric and duodenal ulcer, 2 patients with gastric cancer, and 12 patients with gastritis. In preliminary study, endoscopic instruments were tested for residual H. pylori using PCR after combined manual and machine-cleaning and ultrasonic washing with disinfection in 5 patients with positive CLO test. Gastric biopsy tissues were digested in proteinase K(F.C.: 500pl/ml) for DNA extraction, and PCR amplification was performed by using 20 base oligonucleotide primers(CAM 2, CAM 4) homologous to a portion of the 1.9-kb fragment. PCR assay amplified a 203 bp product which was analyzed by agarose gel electrophoresis. Results: 1) in preliminary study, H. pylori were detected by PCR in 4 postendoscopic samples of working channels and biopsy forceps of 2 patients, and 1 preendoscopic sample of biopsy forceps, 2) Of the 30 patients, 19(63.3%) were positive for H. pylori by PCR, 17(56.7%) were positive by CLO test and silver staining. 3) The grade of severity of gastritis on H-E stain was well correlated with the grade of H. pylori infection on Warthin-Starrry silver stain(r=0.651, p<0.01). 4) Discordant results between PCR & other diagnostic tools were 3 cases. Repeat PCR tests disclosed the same results. Conclusion: PCR test of H. pylori is the most sensitive and reproducible test and can overcome the disadvantages of other diagnostic techniques showing less sensitivity and specificity, but it must be dealt with caution of instrumental contamination.
아칼라지아 환자에서 보툴리늄 독소주입 치료 후 미만성 식도경련 , 호두까기 식도로의 이행에 관여하는 인자에 대한 연구
차상우(Sang Woo Cha),이준성(Joon Seong Lee),임희혁(Hee Hyuk Im),황경란(Kyung Ran Hwang),정인섭(In Sup Jung),천갑진(Gab Jin Cheon),김진오(Jin Oh Kim),조주영(Joo Young Cho),이문성(Moon Sung Lee),심찬섭(Chan Sup Shim),김부성(Boo Sung Ki 대한소화기기능성질환·운동학회 2001 Journal of Neurogastroenterology and Motility (JNM Vol.7 No.2
N/A Backgroud/Aims: To evaluate the factors which are related to the transition from achalasia to diffuse esophageal spasm (DES) or nutcracker esophagus (NE) after botulinum toxin inj ection to lower esophageal sphincter (LES). Methods: This study included the 23 patients with achalasia who received an intrasphincteric injection of botulinum toxin. Stational esophageal manometry, 24-hour ambulatory esophageal manometry with Ph monitoring, barium esophagogram and endoscopic ultrasonography were performed before and after treatment. We analyzed the parameters from these studies between the cases that transformed to DES or NE within a week and the cases that do not transit. Result: Five patients (21.7%) transformed to DES (1) or NE (4) within a week. There were significant differences in contraction amplitude of esophageal body (median, 31mmHg vs 23 mmHg, p<0.05) and maximal diameter of esophageal body (median, 2.6 cm vs 4.4 cm, p<0.05) between these five patients and the remaining patients. There were no significant differences in sex, LES pressure and thickness of muscle layer between two groups. Conclusion: Factors involved in transition to NE or DES after botulinum toxin injection to LES of achalasia appears as high amplitude contractions in body of esophagus and less dilation of esophageal body. (Korean Journal of Gastrointestinal Motility 2001;7:188-196)
한상훈 ( Sang Hoon Han ),홍수진 ( Su Jin Hong ),박정호 ( Jeong Ho Park ),박선아 ( Sun Ah Park ),이준성 ( Joon Seong Lee ),이문성 ( Moon Sung Lee ),성기범 ( Ki Bum Sung ),심찬섭 ( Chan Sup Shim ) 대한소화기기능성질환·운동학회 2008 Journal of Neurogastroenterology and Motility (JNM Vol.14 No.1
Mitochondrial DNA disorder is a heterogenous group of diseases that is related to disorders of mitochondrial (mt) energy metabolism. MELAS (mitochondrial encephalopathy with lactic acidosis and stroke-like episode) is a major maternally inherited multi-systemic disorder, in which 80% of cases are associated with mt DNA A3243G point mutation. The clinical course of MELAS is highly variable, ranging from asymptomatic to progressive muscle weakness, seizures, stroke-like episodes, encephalopathy with lactic acidosis and premature death. However, gastrointestinal symptoms in patients with MELAS are seldom documented. We report a 17-year-male with MELAS presenting chronic gastrointestinal pseudo-obstruction. We confirmed that he had the classical A3243G mt DNA point mutation.
거치상 선종의 조직학적 및 대장내시경적 특징과 p53 단백의 과발현
김상균(Sang Gyune Kim),이문성(Moon Sung Lee),김진오(Jin Oh Kim),천갑진(Gab Jin Cheon),정인섭(In Seop Jung),천영국(Young Koog Cheon),조주영(Joo Young Cho),이준성(Joon Seong Lee),진소영(So Young Jin),심찬섭(Chan Sup Shim) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.5
Background/Aims: Serrated adenomas (SA) is a distinct form of colorectal neoplasia, in which adenomatous glands have a serrated epithelial arrangement observed in hyperplastic polyps. SA is defined as a neoplastic lesion composed of a monotonous cell population with atypical nuclei proliferating in a serrated glandular architecture. The aims were to clarify colonoscopic and histologic features, p53 protein overexpression of SA. Methods: One hundred and five SAs were obtained from 50 patients. We examined the location, size, colonoscopic findings, dysplasia, combined lesions. Twenty randomly selected cases of SA were compared with 24 cases of hyperplastic polyp and 21 cases of tubular adenoma for p53 protein overexpression. Results: Twenty-five patients (50%) had a single SA. The most common site was the sigmoid colon (30.5%). Out of 105 SAs, 83 (79%) were less than 5 mm in diameter. The endoscopic appearance showed that 52 cases of (49.5%) SAs were sessile type. The p53 protein overexpression was noted in none of hyperplastic polyps, in 55% of SAs (11/20), and in 76.2% of tubular adenomas. Conclusions: According to this study, SAs are generally sessile type sized less than 5 mm and commonly observed in the sigmoid colon. Moreover, SAs show higher overexpression rate of p53 protein than hyperplastic polyps. Thus, the careful observation is required considering its malignant potential. ( Korean J Gastroenterol 2002; 39: 350-355)
차상우(Sang Woo Cha),천갑진(Gab Jin Chun),박용순(Yong Soon Park),송동화(Dong Hwa Song),조영덕(Young Deok Cho),김진오(Jin Oh Kim),봉형근(Hyung Keun Bong),조주영(Joo Young Cho),김연수(Yun Soo Kim),이준성(Joon Seong Lee),이문성(Moon Sun 대한소화기학회 1996 대한소화기학회지 Vol.28 No.2
N/A Background/Aims: Gallstone is uncommon before adolescence, and its incidence increases v:ith age. In elderly patients, one of the important characteristics of the ga]lstone disease is that they often have bile duct stones causing acute obstructive cholangitis. Another is that they could be accompained by other diseases. Methods: We analyzed 2,154 patients surgical]y or radiologically proven gallstone patients at the Soon Chun Hyang University Hospita] from l984 to 1994 and compared the clinical characteristics of elderly patients group(over 60 years) with younger patients group(under 60 years). Results: The peak incidence of gallstone (fisease wos noted in the 6th decade and the mean age was 55 years. Elderly patients group were 40.6%(874 cases) and younger patients group were 59.4%(l,280 cases'). Male to female ratio of eler]y patients vras I:1.IO. The location of stones was gallbladder(GB) in l,395 cases(64.9%), multiple sites in 416 cases(19.3%), common bile duct(CBD) in 214 cases(9.9%) and intrahepatic duct(IHD) in 129 cases(5.9%). In elderly patients group, the ]ocation of stones was multiple sites in l86 cases(2l.3%)and CBD in 120 cases(l3.7%). Frequency of stones in multiple sites and GB was significontly higher in elderly patients group than younger patients group(pO.OJ). The prominent clinical manifestations were right upper quadrant abdominal pain(24.5%), epigastric pain(19.4%), and no symptoms(l0.8%). In elderly patients group, chilling and jaundice were significantly higher than younger patients group(p 0.01). The associated diseases were cardiac diseases(l3.7%), diabetes me]litus(8.1%), malignancy (7.3%), liver cirrhosis(6.4%), and hepatitis(5.2%). Cardiac diseases, respiratory diseases, diabetes rnellitus and malignancy were more frequently associated in elder]y patients group than in younger group(p0.01). The incidence of complication was 10.7%(230/2,154)and mortality rate was 1.1% (24/2,154). In elderly patients group, the incidence of complication* and mortality* was signifi- cantly higher than younger patients group(*: p0.01; **: p0.05). Conclusions: The incidence of stones in CBD and mutiple sites, complication and morta]ity rate were higher, and chilling and jaundice were more frequently noted in elderly patients group than younger patients group. Our results suggest that ear]y diagnosis and proper treatment migbt be necessary in elderly patients with the gallstone disease. (Korean J Gastroenterol 1996; 28:260-266)
조성원(Sung Won Cho),심찬섭(Chan Sup Shim),이준성(Joon Seong Lee),김진홍(Jin Hong Kim),이문성(Moon Sung Lee),봉형근(Hyung Keun Bong),김진경(Jin Kyung Kim),이세영(Se Young Lee) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6
Although pancreatic pseuclocyst as a sequale to panceatitis or pancreatic injury can occur at a any site in the abdomen, intrahepatic pancreatic pseudocyst is a rare event. With mordern imaging procedures, its detection seems to be increasing, but with our knowledge about 10 reports in English literature published in the past 15 years. Recently, we experienced a case of pancreatic pseudocysts involving left lobe of the liver in a 45 year-old man presenting with epigastric pain. He was diagnosed with abdominal ultrasonography, abdominal computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) and confinned by exploration. So we report this case with a review cf literatures.
알코올간질환 환자에서 간경변 진단을 위한 transient elastography의 유용성
김상균 ( Sang Gyune Kim ),김영석 ( Young Seok Kim ),정승원 ( Seung Won Jung ),김희경 ( Hee Kyung Kim ),장재영 ( Jae Young Jang ),문종호 ( Jong Ho Moon ),김홍수 ( Hong Soo Kim ),이준성 ( Joon Seong Lee ),이문성 ( Moon Sung Lee ) 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.1
비A비B형 만성 간염 환자의 혈청에서 C형 간염 바이러스 RNA의 검출
조성원(Sung Won Cho),심찬섭(Chan Sup Shim),이준성(Joon Seong Lee),김진홍(Jin Hong Kim),이문성(Moon Sung Lee),이희발(Hi Bahl Lee) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.5
N/A Hepatitis C virus is a positive stranded RNA virus which replicates through a negative stranded RNA. To study the role of hepatitis C virus in non-A, non-B chronic hepatitis, serum samples were tested for detection of genomic hepatitis C virus RNA and negative stranded RNA. from 30 patients with non-A, non-B chronic hepatitis using a combination assay of reverse transcription and polymerase chain reaction. Hepatitis C, virus RNA was detected in 28 of 30 patients with non-A, non-B chronic hepatitis. Of these patients, the RNA was detected in 24 of 25 patients positive for antibody to hepatitis C virus and also in 4 of 5 patients negative for antibody to hepatitis C virus. The negative strand was detected in 10 of 30 patients. Of these patients, the negative strand was detected in 9 of 25 patients positive for antibody to hepatitis C virus and in 1 of 5 patients negative for antibody to hepatitis C virus. The presence of the negative strand in serum was not associated with higher serum transaminase levels. These results show that most patients with non-A, non-B chronic hepatitis are infected with hepatitis C virus in Korea, regardless of the presence or absence of antibody to hepatitis C virus.