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박정엽 ( Jeong Youp Park ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.4
Pancreatic cancer is a very lethal cancer. It is the 5th most common cause for cancer related mortality in Korea. Most of patients have unresectable pancreatic cancer, and systemic chemotherapy remains the only treatment option for them. Gemcitabine has been adopted as the standard first-line agent for advanced pancreatic cancer, but the progression free survival with gemcitabine is short. Many of patients need further treatment. We reviewed the clinical trials of second line chemotherapy for gemcitabine refractory pancreatic cancer and tried to show currently available treatment options. (Korean J Gastroenterol 2011;57:207-212)
추가 항암 치료를 거부하는 국소 진행형 췌장암 환자 1례
이희승,정문재,박정엽,방승민,박승우,송시영,Hee Seung Lee,Moon Jae Chung,Jeong Youp Park,Seungmin Bang,Seung Woo Park,Si Young Song 대한소화기암연구학회 2016 Journal of digestive cancer reports Vol.4 No.2
The prognosis for pancreatic cancer patient is very poor. Patients with locally advanced disease have a median survival time of 8 to 12 months, and patients with distant metastases have significantly worse outcomes, with a median survival time of only 3 to 6 months. Approximately 30% of patients with pancreatic cancer present with locally advanced disease defined as unresectable pancreatic cancer without evidence of distant metastatic disease. Primary treatment options in locally advanced pancreatic cancer include chemotherapy and radiotherapy. Here, we reported a patient with locally advanced pancreatic cancer who does not want further chemotherapy because of chemotherapy induced nausea and vomiting. Irreversible electroporation was performed. Irreversible electroporation was well tolerated in this case, and may be a therapeutic modality for selected patients with locally advanced pancreatic cancer.
내시경초음파 세침흡인술을 통한 전이성 미분화육종의 진단
김시영,이희승,정문재,박정엽,방승민,박승우,송시영,Si Young Kim,Hee Seung Lee,Moon Jae Chung,Jeong Youp Park,Seungmin Bang,Seung Woo Park,Si Young Song 대한소화기암연구학회 2017 Journal of digestive cancer reports Vol.5 No.2
A-49-year-old male patient with no specific medical history was admitted to the clinic because of persistent epigastric pain radiating to back for 4 months. He had multiple parenchymal tumors in body and tail of pancreas, para-spinal muscle, and mediastinum on abdomen CT image. Cytologic examination of the pancreas which was done by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) showed adenocarcinoma, whereas histological examination of the para-spinal mass showed undifferentiated sarcoma. Histologic examination of the pancreatic mass was made through endoscopic ultrasound guided fine needle biopsy (EUS-FNB) for accurate diagnosis, and the histologic examination of both the pancreas and posterior mediastinal mass showed the same undifferentiated sarcoma. Therefore, we reviewed the cytopathic tissue obtained from the pancreas for the first time, and it was confirmed to be similar to histologic findings in the mediastinal mass.
궤양성 대장염의 임상경과 진단 첫해의 임상경과에 영향을 미치는 인자 및 5 년간 임상경과의 변화 양상
최창환(Chang Hwan Choi),정혜원(Hae Won Chung),이재훈(Jae Hoon Lee),박정엽(Jeong Youp Park),이현웅(Hyun Woong Lee),박영수(Young Soo Park),김태일(Tae Il Kim),김원호(Won Ho Kim) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.3
Background/Aims: Previous reports on ulcerative colitis in Korea were mostly about clinical features at the time of diagnosis. In this study, we analyzed not only clinical features of Korean patients with ulcerative colitis at the time of diagnosis, but also clinical courses during 5 years after diagnosis. Methods: The yearly sum of monthly symptom scores (annual disease burden index, ADBI), annual symptomatic period, and clinical severity were evaluated during 5 years after diagnosis, and factors affecting the clinical courses during first year were also analyzed. Results: The averages of ADBI, symptomatic period, and the proportion of patients in remission during the first follow-up year were 5.8±4.4, 4.0±3.1 months, and 22.1%, Those were 3.7±4.1, 3.0±3.4 months, and 32.4%, during the fifth year. The average of ADBI during the second year was significantly higher in patients with high ADBI (>4) during the first year compared with that in patients with low ADBI (6.3±5.5 vs. 2.6±3.8, p<0.01). Conclusions: From these results, we can conclude that the clinical course of ulcerative colitis, assessed by ADBI and symptomatic period, tends to improve with time and the preceding clinical course is significantly correlated to subsequent course. (Korean J Gastroenterol 2001;38: 169-176)
기관지 천식에서 impulse oscillometry(IOS)의 유용성
김중선(Jung Sun Kim),김철우(Cheol Woo Kim),박정엽(Jeong Youp Park),정혜원(Hye Won Chung),박중원(Jung Won Park),홍천수(Chein Soo Hong) 대한내과학회 2000 대한내과학회지 Vol.59 No.5
N/A Background : Impulse oscillometry(IOS) is a method to characterize the mechanical properties of respiratory system over wide range of frequency. It's most important advantage is to require minimal cooperations from subject. Therefore it is used to estimate pulmonary function of young children and to study epidemiology of occupational asthma. This study was performed to evaluate the usefulness for the clinical applications of IOS in bronchial asthmatics by estimating the associations between asthma severity and IOS parameters, and the relationships between IOS parameters and conventional spirometry. Methods : 216 subjects with bronchial asthma were enrolled in this study. Subjects were grouped to 3 different groups according to their symptoms and pulmonary functions. Respiratory impedance, resistance (at 5Hz, 20Hz, 35Hz) and resonant frequency were measured by IOS. FEV1, FVC and MMEF were measured with conventional spirometry. Results : There were significant difference of resonant frequency, resistance at 5Hz and 20Hz, resistance difference at 5Hz and 20Hz according to asthma severity(p<0.05, respectively). Resonant frequency, resistance at 5Hz, impedance were significantly correlated with FEV1 (r= -0.55, 0.48, 0.49, p<0.05, respectively). And resistance at 5Hz had similar reproducibility compared to FEV1 (resistance at 5Hz, r= 0.78 vs FEV1, r= 0.79). Conclusion : IOS is an useful and alternative method to evaluate clinical status of brnochial asthmatics. And further studies will be needed to clarify its values for wide range of clinical applications.(Korean J Med 59:522-528, 2000)
Gemcitabine/cisplatin 항암치료 후 완전관해가 보고된 전이성 췌장암 환자 2례
조중현 ( Jung Hyun Jo ),정문재 ( Moon Jae Chung,),박정엽 ( Jeong Youp Park ),방승민 ( Seun Gmin Bang ),박승우 ( Seung Woo Park ),정재복 ( Jae Bock Chung ),송시영 ( Si Young Song ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.1
Pancreatic ductal adenocarcinoma has a very poor prognosis. Patients with this type of tumor have a median overall survival of 9 months in locally advanced pancreatic cancer and 3-6 months in metastatic disease. However, there have been rare cases of patients with advanced pancreatic cancer who survived unexpectedly longer without curative surgery. We report two cases of metastatic pancreatic cancer in patients who presented complete remission after receiving gemcitabine/cisplatin chemotherapy and survived for about 10 years. The first case is that of a 51-year-old Korean woman who was diagnosed with pancreatic body cancer with invasion of the celiac artery and supraclavicular lymph node metastasis. The patient received gemcitabine/cisplatin systemic chemotherapy and achieved complete remission after the 12th cycle of chemotherapy. At present, the patient has survived for 10 years and 2 months after diagnosis. The second case is that of a 69-year-old Korean woman who was diagnosed with pancreatic head cancer with liver metastasis. The patient received gemcitabine/cisplatin chemotherapy and achieved complete remission after the 6th cycle of chemotherapy. At present, the patient has survived for 9 years and 2 months after diagnosis. Our study is the first case report of patients who achieved long-term survival with complete remission after receiving chemotherapy alone for metastatic pancreatic cancer.
증례 : 소화기 ; 광역학 치료 후 간 좌엽절제술이 가능하였던 담관 내 유두상 점액 종양 1예
이희승 ( Hee Seung Lee ),오탁근 ( Tak Geun Oh ),정문재 ( Moon Jae Chung ),박정엽 ( Jeong Youp Park ),방승민 ( Seung Min Bang ),송시영 ( Si Young Song ),박승우 ( Seung Woo Park ) 대한내과학회 2015 대한내과학회지 Vol.88 No.1
IPMN은 매우 드문 질환으로 내시경상 IPMN이 의심될 경우 조직학적 진단을 통해 악성 종양의 가능성을 항상 고려해야 하고 정확한 감별 진단이 필요하다. 또한 IPMN이 담관계 내 수술 범위가 넓은 경우에는 치료 방침이 명확하지 않은 실정이다. 이에 저자들은 수술적 절제가 어려운 광범위한IPMN에 대해 PDT 후 간 좌엽절제술을 시행한 증례를 보고한다. Mucin-hypersecreting bile duct tumors, which closely resemble intraductal papillary mucinous neoplasms of the pancreas, arerare, and both the clinical features and management thereof are poorly understood. As the biliary tract and the pancreas share a commonorigin, the two diseases may exhibit homologous histopathological features. Certain intraductal papillary tumors of the bileduct are associated with production of large amounts of mucin that disturb bile flow and cause severe biliary dilatation, obstructivejaundice, and cholangitis. Herein, we report on a patient with an extensive intraductal papillary mucinous neoplasm of the bile duct,involving both the right and left intrahepatic ducts. The ducts were subjected to photodynamic therapy, followed by lefthepatectomy. The surgical specimen revealed an adenocarcinoma with a negative resection margin. Photodynamic therapy of theintrahepatic ducts was well-tolerated in the present case, and may serve as a useful therapeutic option for selected patients with intraductalpapillary mucinous neoplasms of the bile duct.