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손수민(Soo Min Shon),송치욱(Chi Wook Song),구자설(Ja Soul Koo),정록선(Rok Son Choung),신정호(Jeong Ho Shin),김윤배(Yun Bae Kim),전훈재(Hoon Jai Chun),이상우(Sang Woo Lee),최재현(Jai Hyun Choi),김창덕(Chang Duck Kim),류호상(Ho Sang Ry 대한소화기기능성질환·운동학회 2001 Journal of Neurogastroenterology and Motility (JNM Vol.7 No.2
N/A Aims: Gastroesophageal reflux disease (GERD) is known to be one of the contributing factors to cause epigastric soreness, which we often experience after intake of flour-based meals. The aim of this study was to evaluate gastroesophgeal reflux (GER) and its mechanism according to intake of different ingredients of meals. Methods: We investigated the effect of meals of different ingredients on the lower esophageal sphincter (LES) pressure, the frequency of transient LES relaxation (Tlesr) and GER in seven healthy volunteers. The meals used in this study were either rice cakes or flour cakes, which were isocaloric and isovolumetric. A mylohyoid electromyogram, LES pressure and esophageal Ph were simultaneously recorded for 3 hours after ingestion of each meal on two different occasions. Results: There was no significant difference in incidence of GER between two meals. Conclusion: The intake of isocaloric and isovolumetric meals of either flour or rice cake did not result in significant discrepancies in frequency of GER. The increase in the frequency of swallow- and strain-associated GER observed in the case of a flour cake may be caused by reduced LES pressure after ingestion. (Korean Journal of Gastrointestinal Motility 2001;7:181-187)
젊은 환자에서 이중풍선소장내시경으로 진단한 소장암 1예
최윤지 ( Yoon Ji Choi ),정성우 ( Sung Woo Jung ),엄준원 ( Jun Won Um ),이응석 ( Eung Seok Lee ),구자설 ( Ja Seol Koo ),임형준 ( Hyung Joon Yim ),이상우 ( Sang Woo Lee ),최재현 ( Jai Hyun Choi ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.4
A 17-year old female presented with a chief complaint of melena and epigastric pain. She had a family history of colon cancer, her mother having been diagnosed with hereditary nonpolyposis colorectal carcinoma (HNPCC). After close examination including double-balloon enteroscopy, the patient was diagnosed with small bowel carcinoma, in spite of her young age. Here we report this rare case of small bowel carcinoma in a young patient with a family history of HNPCC. (Korean J Gastroenterol 2011;58:217-220)
하대정맥 및 우심방의 혈전을 동반한 간세포암을 효과적으로 치료한 증례
이현정 ( Hyun Jung Lee ),임형준 ( Hyung Joon Yim ),정환훈 ( Hwan Hoon Chung ),이승화 ( Seung Hwa Lee ),김해림 ( Hae Rim Kim ),현종진 ( Jong Jin Hyun ),정성우 ( Sung Woo Jung ),구자설 ( Ja Seol Koo ),이상우 ( Sang Woo Lee ),최재현 대한간암학회 2012 대한간암학회지 Vol.12 No.2
In patients with advanced hepatocellular carcinoma (HCC), tumor thrombus in inferior vena cava (IVC) and right atrium (RA) are not uncommon findings and are usually associated with extremely poor outcome. Although aggressive surgical interventions such as extracorporeal circulation and tumor excision have been performed, the reported results were still unsatisfactory. Herein, we report the favorable result of combined treatment with radiation therapy and transarterial chemoembolization in a patient with advanced HCC with extensive tumor thrombus through the IVC into the RA. In conclusion, noninvasive combined modalities, such as transarterial chemoembolization and radiation therapy may sometimes provide effective palliation for patients with far advanced HCC with IVC/RA tumor thrombus and who are not candidates for alternative treatment options.
박선민 ( Sun Min Park ),이홍식 ( Hong Sik Lee ),김승영 ( Seung Young Kim ),안재홍 ( Jae Hong Ahn ),김정한 ( Jeong Han Kim ),구자설 ( Ja Seol Koo ),임형준 ( Hyung Joon Yim ),이상우 ( Sang Woo Lee ),최재현 ( Jai Hyun Choi ),김창덕 ( 대한소화기학회 2009 대한소화기학회지 Vol.53 No.4
목적: 만성 췌장염은 점진적으로 췌장 조직의 영구, 비가역적인 손상을 일으키는 염증성 질환으로 원인, 질병의 단계, 국소 합병증 유무에 따라 다양한 임상양상을 보이는 특징을 가지고 있다. 이번 연구는 후향 조사를 통해 만성 췌장염의 전반적인 임상양상에 대하여 고찰하여 보고 과거 췌장염의 병력 유무에 따른 만성 췌장염의 특징들을 조사하여 이들이 임상양상에 미치는 영향을 알아보고자 하였다. 대상 및 방법: 1997년 1월부터 2007년 12월까지 고려대학교 안산병원에서 만성 췌장염으로 진단받은 89명의 환자들을 대상으로 의무기록을 후향 검토하였다. 과거 췌장염의 병력이 확인된 77명을 두 군으로 나누어 I군은 과거 췌장염의 병력이 없는 34명, II군은 1회 이상의 췌장염 병력이 있는 43명으로 하여 임상양상을 비교하였다. 결과: 전체 연구 대상의 평균 연령은 50±13.2세였고 남녀비는 5:1이었다. 원인으로는 알코올 만성 췌장염이 71.9%로 가장 많았고 23.6%에서는 특별한 원인을 찾을 수 없어 특발 만성 췌장염으로 진단하였다. 췌장염의 과거력이 없는 I군과 췌장염의 병력이 있는 II군을 비교하였을 때 진단 당시의 나이 (53.4±15.5 vs. 46.2±11.5, p=0.021), 원인(특발성 41.2% vs. 11.6%, p=0.004)과 복통 유무(73.5% vs. 100%, p=0.030)는 의미 있는 차이를 보였다. 하지만 췌장 석회화의 유무, 합병증의 발생, 내시경 역행췌담관조영술에서 췌관 변화의 중증도는 서로 차이가 없었다. 결론: 최초 임상발현이 만성 췌장염인 환자군도 이미 진행된 경과를 보이는 경우가 많아 이들을 조기에 진단할 수 있는 방법이 더욱 필요하다. Background/Aims: Chronic pancreatitis (CP) is characterized clinically by a broad spectrum of variable features depending on many factors such as etiology, stage of the disease, and the presence of local complications. The aims of this study were to investigate the clinical aspect of CP and to analyze the characteristics according to the history of pancreatitis. Methods: Eighty nine medical records from the patients who were diagnosed as CP at Korea University Ansan Hospital from January 1997 through December 2007 were reviewed retrospectively. After patients were divided into two groups according to the previous history of pancreatitis: the group I (n=34, no history of pancreatitis) and II (n=43, history of pancreatitis more than once), the clinical characteristics of two groups were compared. Results: The mean age was 50±13.2 years and the male to female ratio was 5:1. Alcohol was the cause of CP in 71.9%, and 23.6% had no evident cause. Age (53.4±15.5 vs. 46.2±11.5, p=0.021), etiology (idiopathic 41.2% vs. 11.6%, p=0.004), and the presence of abdominal pain (73.5% vs. 100%, p=0.030) were significantly different between group I and II. However, in comparison of other factors that reflected the advanced stage of CP such as presence of pancreatic calcification, complications, and Cambridge grade on ERCP, there was no significant difference. Conclusions: Since CP which present, as the first manifestation shows much an advanced stage, the method for early diagnosis of CP is particularly needed. (Korean J Gastroenterol 2009;53:239-245)