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위종양성 병변에 대한 내시경 절개 점막하 박리법의 임상적 유용성
정윤호,은수훈,조수영,정인섭,유창범,이준성,이문성,김부성,심찬섭,Jung, Yoon-Ho,Eun, Soo-Hoon,Cho, Joo-Young,Jung, In-Seop,Ryu, Chang-Beom,Lee, Joon-Seong,Lee, Moon-Sung,Kim, Boo-Sung,Shim, Chan-Sup 대한위암학회 2006 대한위암학회지 Vol.6 No.2
목적: 최근 위선종 및 조기위암에 대해 새로운 내시경적 치료법인 내시경 절개 점막하 박리법은 기존의 내시경적 점막절제술 보다 더 넓은 적응증을 가지고 있지만 시술의 난이도가 높고 합병증의 위험이 있어 보편적으로 시술되고 있지 않다. 이에 내시경 절개 점막하 박리법으로 치료한 위의 종양성 병변의 치료 성적을 바탕으로 그 임상적 유용성을 알아보고자 하였다. 대상 및 방법: 내시경 절개 점막하 박리법을 시행한 164명의 환자들의 179개의 위종양성 병변에 대하여 완전절제 및 일괄절제 여부, 합병증, 재발 여부 등을 분석하였다. 결과: 179개의 병변은 조기위암 126예(70.3%), 선종 42예 (23.4%)였다. 병변의 침윤 깊이를 확인할 수 있었던 조기위암 420예는 각각 점막1층(sm1) 0.8% (1/120), 점막2층(m2) 38.3% (46/120), 점막3층(m3) 25% (57/120), 점막하1층(sm1) 11.7% (14/120), 점막하2층(sm2) 1.6% (2/120)이었다. 종양의 일괄절제율과 완전절제율은 각각 96.0%, 85.2%였다. 합병증은 천공 8예(4.4%), 출혈 38예(21.2%)가 발생하였으나, 천공 1예를 제외한 나머지는 비수술적으로 치료가 가능하였다. 결론: 본 연구에서 내시경 절개 점막하 박리법은 위종양성 병변의 근치적 치료에 비교적 안전하고 효과적인 술기이고, 향후 보다 장기간의 추적관찰을 통해 그 유용성이 검증되어야 할 것으로 생각한다. Purpose: Endoscopic incision and submucosal dissection (EISD) is a technique that is being implemented for the resection of gastric adenomas and early gastric cancer (EGC). Since EISD requires a high degree of skill and experience, and due to its association with a moderate risk of gastrointestinal bleeding, its use has been limited. The objective of this study is to investigate the clinical benefits of EISD based upon clinical data on the EISD procedure. Materials and Methods: This study was conducted at Soonchunhyang University Hospital and it included 179 gastric adenoma and early gastric carcinoma lesions from 164 patients who had undergone an EISD from February 2003 to May 2005. Results: Among the total of 179 lesions, the distributions of EGC and adenomas were 70.3% (126/179) and 23.4% (42/179) respectively. The sizes of lesions were divided into 10 mm or less, $11{\sim}20\;mm,\;21{\sim}30\;mm$ and greater than 31 mm and each rates are 10.0% (18/179), 46.3% (83/179), 30% (50/179) and 15.0% (28/179). Among 120 cases which could be measured depth of lesion in according to pathologic findings, m1 (0.8%, 1/120), m2 (38.3%, 46/120), m3 (25%, 57/120), sm1 (11.7%, 14/120), sm2 (1.6%, 2/120) were diagnosed as early stages of gastric cancer. The complete resection rate was 85.2% (150/176) and en-bloc resection rate was 96.0% (169/176). Complications as such as perforation and bleeding developed in 4.4%(8/179) and 21.2% (38/179), respectively. Conclusion: EISD is an effective in the endoscopic treatment for gastric adenoma and early gastric cancers. However, further evaluation of this method and long-term follow-up will be necessary for an evaluation of the recurrence rate after resection of a tumor.
소화성 궤양에서 Helicobacter pylori 박멸의 장기적 효과에 대한 후향적 관찰
홍수진(Su Jin Hong),은수훈(Soo Hoon Eun),정준성(Joon Seong Jung),류권호(Kwon Ho Ryu),차상우(Sang Woo Cha),천갑진(Gab Jin Cheon),김진오(Jin Oh Kim),조주영(Joo Young Cho),이준성(Joon Seong Lee),이문성(Moon Sung Lee),심찬섭(Chan Sup Shi 대한내과학회 2002 대한내과학회지 Vol.63 No.1
목적: 소화성 궤양 환자에 있어 H. pylori 박멸은 재발 억제를 위해 시행되고 있으나 박멸 후 장기간 추적에 대한 국내 보고는 드문 실정이다. 본 연구에서는 소화성 궤양으로 H. pylori 박멸요법을 시행받고 박멸이 확인되었던 환자에서 H. pylori 재감염율, 궤양의 재발을 장기간 고찰하고자 하였다. 방법: 상부소화관 내시경검사상 H. pylori 양성인 소화성 궤양 환자 중 H. pylori 박멸요법을 시행하고 6주 이후에 박멸을 확인한 환자 763명 중 4년간 장기간 추적이 가능했던 환자 32명을 대상으로 상부소화관 내시경검사 소견, 13C-요소호기검사를 통한 H. pylori 감염 여부를 확인하여 기록하였다. 결과: 32명 중 남성은 22명, 여성은 10명이었고, 평균 연령은 51.7세 (29∼69세)였으며 내시경적 진단은 위 궤양 9명, 십이지장 궤양 12명, 위 궤양 및 십이지장 궤양 11명이었다. 4년간의 추적 기간 동안 H. pylori 재감염은 2명에서 있었고, 연간 재감염율은 1.6%였다. 32명의 환자 중 3명에서 궤양의 재발이 있어 9.4%의 재발율을 보였다. 결론: H. pylori의 연간 재감염율은 선진국의 재감염율과 유사한 1.6%였으며, H. pylori 박멸치료는 소화성 궤양의 재발 방지에 효과적인 유용한 치료방법으로 생각된다. Background: Eradication therapy for H. pylori infection is known to decrease the recurrence rate of peptic ulcer disease. The aim of this study was to evaluate longterm effect of H. pylori eradication on the recurrence of peptic ulcer disease and the reinfection rate after treatment in Korea. Methods: Between July 1996 and February 1997, 763 patients who were diagnosed peptic ulcer diseases and H. pylori infection after upper endoscopies in Soonchunhyang university hospital. Among those patients, we reviewed 32 patients who achieved eradication of H. pylori after eradication therapy and could be followed for up to 4 years by 13C-urea breath test or endoscopy. Results: The mean age of the patients was 51.7 years (range: 29∼68). Nine patients had gastric ulcer, 12 had duodenal ulcer and 11 had duodenal and gastric ulcer. An annual reinfection rate of H. pylori was 1.6% in our study. After H. pylori eradication, recurrence of peptic ulcer was detected in three patients (9.4%). Conclusion: In our study, the reinfection rate was similar to rates observed in developed countries. H. pylori eradication was effective for preventing recurrent peptic ulcers.(Korean J Med 63:23-28, 2002)
한국인 가와사키병 환자의 피부병변의 특징에 관한 연구(2006~2010)
고재완 ( Jae Wan Go ),은영민 ( Young Min Eun ),김신한 ( Shin Han Kim ),이상윤 ( Sang Yoon Lee ),정진영 ( Jin Young Jung ),조한경 ( Han Kyoung Cho ) 대한피부과학회 2011 대한피부과학회지 Vol.49 No.9
Background: Kawasaki disease (KD) is an acute inflammation of middle-sized arteries such as the coronary artery. KD is an important disease due to its high mortality rate, which approaches 1~2% without appropriate treatment. Since the various mucocutaneous lesions of KD are related to the dermatologic field, dermatologists should take an interest in this disorder and understand the lesions. Objective: To evaluate the characteristics of cutaneous lesions in Korean patients with KD. Methods: A total of 919 patients with KD were assessed at the department of pediatric cardiology and dermatology, Myongji hospital between January 2006 and December 2010. Results: Of the 919 patients, 566 (61.6%) were diagnosed with typical KD and 353 (38.4%) with atypical KD. KD was most frequent in the 4 year-old group (22.7%), and the ratio of male to female was 1.5:1. Among the mucocutaneous manifestations, erythema of the oropharyngeal mucosa (75.7%) occurred most frequently, followed by polymorphous trunk rash (41.7%), and changes of palms and soles (25.6%). A total of 606 patients (65.9%) with KD had associated diseases as follows: pneumonia (211 patients; 34.8%), pharyngotonsilitis (168 patients; 27.7%), gastroenteritis (132 patients; 21.8%), asthma (15 patients, 2.5%), atopic dermatitis (11 patients, 1.8%). Conclusion: Our study shows that change in the lips or oral cavity is the most common mucocutaneous manifestation in both classic and atypical KD. Also, morbiliform rash is the most common pattern of polymorphous rashes. Interestingly, erythema multiforme-like lesions occupied accounted for a considerable portion of KD cases compared to previous studies. (Korean J Dermatol 2011;49(9):795~800)
조현석 ( Hyun Seok Cho ),변태준 ( Tae Jun Byun ),안상봉 ( Sang Bong Ahn ),김태엽 ( Tae Yeob Kim ),은창수 ( Chang Soo Eun ),전용철 ( Yong Cheol ),김용석 ( Yong Seok Kim ),한동수 ( Dong Soo Han ) 대한소화기학회 2008 대한소화기학회지 Vol.52 No.4
Crohn`s disease (CD), one of the major forms of idiopathic inflammatory bowel disease (IBD), is thought to be related to genetic susceptibility coupled with environmental factors. A positive family history is the strongest risk factor for the development of CD. The 10-fold increase in the familial risk of CD strongly suggests that these disorders have a genetic background. The prevalence of IBD in Asian populations is lower than in Western populations, which may be due to genetic influences, environmental factors, or a combination of both. In a Korean study, only 0.25% of parents had IBD in CD probands and all of them had ulcerative colitis. The term of familial CD was used only for those with one or more first-degree relatives with confirmed CD. There are few case reports about familial Crohn`s disease in Korea. We report a case of familial CD that the father, the first degree relative was diagnosed as small bowel CD after confirming his son as having CD. (Korean J Gastroenterol 2008;52:247-250)
박재현,윤석준,이희영,조희숙,이진용,은상준,박종혁,김윤,김용익,신영수,Park, Jae-Hyun,Yoon, Seok-Jun,Lee, Hee-Young,Cho, Hee-Sook,Lee, Jin-Yong,Eun, Sang-Jun,Park, Jong-Hyock,Kim, Yoon,Kim, Yong-Ik,Shin, Young-Soo 대한예방의학회 2006 예방의학회지 Vol.39 No.1
Objectives: This study estimated the burden of disease especially caused by psychiatric disorders in Korea by using DALY, a composite indicator that was recently developed by the Global Burden of Disease study group. Methods: First, 11 of the major psychiatric disorders in Korea were selected based on the ICD-10. Second, the burden of disease due to premature death was estimated by using YLLs (years of life lost due to premature death). Third, for the calculation of the YLD (years lived with disability), the following parameters were estimated in the formula: the incidence rate, the prevalence rate and the disability weight of each psychiatric disorder. Last, we estimated the DALY of the psychiatric disorders by adding the YLLs and YLDs. Results: The burden of psychiatric disorder per 100,000 people was attributed mainly to unipolar major depression (1,278 person-years), schizophrenia (638 person-years) and alcohol use disorder (287 person-years). For males, schizophrenia (596 person-years) and alcohol use disorder (491 person-years) caused the highest burden. For females, unipolar major depression (1,749 person-years) and schizophrenia (680 person-years) cause the highest burden. As analyzed by gender and age group, alcohol use disorder causes a higher burden than schizophrenia in men aged 40 years and older. For females, unipolar major depression causes the highest burden in all age groups. Conclusions: We found that each of the psychiatric disorders that cause the highest burden is different according to gender and age group. This study's results can provide a rational basis to plan a national health policy regarding the burden of disease caused by psychiatric disorders.
김정수 ( Jung Su Kim ),조재환 ( Jae Hwan Cho ),조무성 ( Moo Seong Cho ),동경래 ( Kyung Rae Dong ),박훈희 ( Hoon Hee Park ),은성종 ( Sung Jong Eun ),박창희 ( Chang Hee Park ) 조선대학교 공학기술연구원 2011 공학기술논문지 Vol.4 No.4
In order to secure the patients clinical information we developed a method by transmitting the electrocardiogram (ECG) images from smart phone. As a result, it took about three to five second for ECG viewer from a smart phone to display an image on the mobile server to user`s phone. For image valuation, we magnified the ECG image to 100% or 200% at a resolution of 480 × 320 for checking the PQRST wave. This result showed that it was both possible to see an accurate PQRST wave with all the trial data and to divide it into the 1mm level of grid.