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증례 : 소화기 ; Klebsiella oxytoca에 의한 간농양 1예
조현진 ( Hyun Chin Cho ),김현진 ( Hyun Jin Kim ),이재민 ( Jae Min Lee ),김수경 ( Soo Kyoung Kim ),강민경 ( Min Kyung Kang ),이옥재 ( Ok Jae Lee ),김선주 ( Sun Joo Kim ) 대한내과학회 2009 대한내과학회지 Vol.77 No.2
Klebsiella은 광범위한 기회감염의 원인균으로 대부분이 Klebsiella pneumoniae에 의한 것으로 Klebsiella oxytoca는 사람에서 동정되는 경우가 흔치 않고, 아직까지 균의 특성을 정확하게 알고 있지 못하다. 저자들은 원위부 총 담관암으로 유문부 보존 췌십이지장 절제술의 과거력이 있는 환자에서 간농양으로 내원하여 혈액에서 Klebsiella oxytoca가 동정되었고, 적절한 항생제로 교체 후에 증상이 호전되던 중에 혈액담즙증이 발생하여 농양 내 가성동맥류에 의한 출혈로 진단하고 방사선적 중제술로 성공적으로 치료한 예를 보고한다. Klebsiella are opportunistic pathogens that cause a wide spectrum of severe diseases, such as septicemia, pneumonia, urinary tract infection, and soft tissue infection. Klebsiella oxytoca is rarely isolated from human clinical specimens, and bacteremia due to Klebsiella oxytoca remains relatively uncommon. We experienced a case of liver abscess due to Klebsiella oxytoca in a 71-year-old male with a history of pylorus-preserving pan-creaticoduodenectomy (PPPD) 4 years earlier. The patient was diagnosed with hemobilia secondary to a pseudo-aneurysm at the lower pole of the abscess cavity during antibiotic treatment and was treated successfully with selective percutaneous transcatheter embolization. (Korean J 77:218-222, 2009)
Cons: Discontinuing NUCs[nucleos(-t)ide] treatment before HBsAg loss
조현진 ( Hyun Chin Cho ) 대한간학회 2017 간학회 싱글토픽 심포지움 Vol.2017 No.1
Treatment against hepatitis B virus (HBV) has dramatically improved over the last 10 years, but HBV eradication remains a rearly attainable goal. Oral antiviral agents, NUVs[nucleos(-t)ide], represent the main therapeutic option for the majority of chronic hepatitis B (CHB) patients. The need for long-term NUCs therapy reises safety issues for some patients along with increases in treatment costs. For these reasons, several groups have started discontinuing NUCs, but the possibility of safe discontinuation of therapy with NUCs remains one of the most controversial topics in the management of CHB. In this chapter, data about discontinuation of NUCs treatment before HBsAg loss will be discussed.
특징 선택을 활용한 머신 러닝 기반의 위암 컴퓨터 보조 진단 시스템
김윤지(Yun-ji Kim),이신애(Sin-ae Lee),김동현(Dong-hyun Kim),채정우(Jung-woo Chae),함현식(Hyun-sik Ham),조현진(Hyun Chin Cho),조현종(Hyun-chong Cho) 대한전기학회 2020 전기학회논문지 Vol.69 No.1
Gastric cancer is a kind of cancer that is difficult to detect at an early stage because it has almost no symptoms at the beginning. In this study, we propose a Computer-aided Diagnosis(CADx) system that detects gastric cancer from the endoscopy. The data set we used consist of 93 normal images and 93 gastric images. We extracted 6 features in 449 dimensions from the gastric endoscopy images and reduced them to 10 dimensions through feature selection algorithms. Algorithms that we use to dimension reduction are Pearson Correlation, Chi-Squared Test, Recursive Feature Elimination, and Model-based Feature Selection, which are provided by the Sci-kit Learn library. A method was also used to select the top 10 features with a higher number of times selected by these four algorithms. Normal images and gastric cancer images were classified using support vector machine(SVM). Recursive feature elimination algorithm has the highest performance among the five feature selection algorithms, with an accuracy of 0.92.
위내시경 영상에서 위암 분류에 최적화된 데이터 증대방법 연구
이정남(Jeong-nam Lee),조현진(Hyun Chin Cho),조현종(Hyun-chong Cho) 대한전기학회 2021 전기학회논문지 Vol.70 No.12
Gastric cancer is the most common cancer in Korea and an effective way to treat gastric cancer is early treatment. Gastroscopy is being performed for early detection of gastric cancer, and this paper proposes Computer-aided Diagnostics(CADx) system that can help gastroscopy. As a model for classifying gastric cancer, we use Xception, which reduces computation and improves performance. Due to the nature of medical images, data augmentation was used to solve the lack of data and overfitting could occur. The data augmentation methods used were AutoAugment and Variational AutoEncoder(VAE). AutoAugment is a data augmentation method using color changes, shear, rotation, etc., and VAE learns to standardize the probability distribution of the data, helping to generate data similar to the original data to capture features. The data augmentation method with the best performance is the augmentation method through VAE, and the recall showed 94.84% of the performance. The data augmentation method optimized for the gastroscopy data set is the augmentation method through VAE. It can help the endoscopy specialist diagnose and increase the gastric cancer complete cure rate.
성인 환자에서 위와 결장에 동시 침범한 랑게르한스 세포 조직구증: 증례 보고
김성제 ( Seong Je Kim ),하세인 ( Se In Hah ),곽지윤 ( Ji Yoon Kwak ),최정우 ( Jung Woo Choi ),조현진 ( Hyun Chin Cho ),하창윤 ( Chang Yoon Ha ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ),이창민 ( Chang Min Lee ) 대한소화기학회 2022 대한소화기학회지 Vol.80 No.3
Langerhans cell histiocytosis (LCH) is reported less frequently in adults than in children. The most common site of involvement in adults is the bone, accounting for 30-50% of cases. The gastrointestinal tract is very rare, accounting for approximately 2%. We present a case of Langerhans cell histiocytosis that simultaneously invaded multiple organs, including the stomach and colon, in an adult. A 37-year-old woman with no underlying disease complained of chest discomfort and a palpable right submandibular mass. A right Level II neck mass and mediastinal LN enlargement were confirmed on the pharynx and chest CT scan. Multiple subepithelial masses with central ulceration and erosion were observed in the corpus and fundus on the esophagogastroduodenoscopy and in the right colon on the colonoscopy. The histopathology findings were the same in each tissue biopsied from the stomach, colon, and right neck lymph nodes. Langerhans cells with classical reniform nuclei and prominent eosinophils invaded the normal glands, and S100 and CD1a were positive in the immunohistochemical stain. Gastrointestinal involvement of LCH in adults is rare, asymptomatic,and can involve multiple digestive organs simultaneously, so upper endoscopy and colonoscopy should be considered for a diagnosis. (Korean J Gastroenterol 2022;80:149-153)