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서승원(Seung Weon Seo),정현용(Hyun Yong Jeong),이승민(Seug Min Lee),이병석(Byoung Seok Lee),김진희(Jin Hee Kim),김남재(Nam Jae Kim),노승무(Seung Moo Rho),송규상(Kyu Sang Song),신경숙(Kyung Sook Shin),조준식(June Sik Cho) 대한내과학회 2001 대한내과학회지 Vol.60 No.4
N/A Background: In order to decide on a strategy of the treatment against gastric cancer, an accurate preoperative evaluation of the depth of tumor invasion is essential. We have studied the depth of invasion in early gastric cancer by endoscopic findings. Methods: The preoperative endoscopic diagnosis of the depth of invasion was compared with pathologic findings in a total of 108 cases with early gastric cancers (EGC) which were confirmed pathologically in resected specimen. Results: Of one hundred eight EGCs, forty-one were elevated type, others were flat-depressed type. There was no relationship between the depth of invasion and macroscopic type of EGC. All of the elevated typed EGCs were differentiated carcinoma. In the depressed typed EGCs, Forty-five percent was differentiated carcinoma and fifty-five percent was undifferentiated carcinoma. The incidence of lymphnode metastasis in submucosal cancers (14.8%) was significantly more than in mucosal cancers (1.6%). Among the submucosal cancers, the incidence of nodal metastasis in double lesions (100%) was significantly more than in single lesions (14.8%). In the elevated typed EGCs, mucosal cancers were small in size less than 3.0 cm (83%), and contained whitish patches, and showed uneveness and erosion. Submucosal cancers were large in size, and contained ulcers, and showed submucosal tumor-like shapes and bridging folds. In the depressed typed EGCs, it was difficult to determine endoscopically the depth of invasion. Submucosal cancers showed the fusion of converging folds and unevenness of the depressed base. The regularity of the depressed base without ulcer was primarily found in mucosal cancer. Conclusion: When the tumor was elevated, the endoscopic diagnosis for the depth of invasion was determined easily by size of the lesion and features of the elevated surface. For the depressed tumor, diagnostic clues were the pattern of the base of the depression and the converging fold, and the endoscopic diagnosis of the depth of invasion was much more difficult than the elevated type EGC.(Korean J Med 60:330- 336, 2001)
성재규(Jae Kyu Seong),서승원(Seung Weon Seo),양현웅(Hyeon Woong Yang),이상우(Sang Woo Lee),이승민(Seung Min Lee),이경태(Kyeong Tae Lee),이병석(Byung Seok Lee),임의혁(Euyi Hyeog Im),김남재(Nam Jae Kim),정현용(Hyun Yong Jeong) 대한내과학회 2000 대한내과학회지 Vol.59 No.6
N/A Background : The purpose of this study is to compare the difference of the symptom, sign and laboratory findings among chronic inflammatory bowel diseases such as ulcerative colitis, Crohn's disease and tuberculous colitis in Korea. Methods : We studied in Chungnam National University Hospital from March, 1990 to December, 1998. Seventy-eight cases of ulcerative colitis, fifteen cases of Crohn's disease, and thirty-nine cases of tuberculous colitis were analyzed in terms of age, sex, symptomatology, laboratory findings, radiologic findings and consequence of treatment. Results : The sex ratio of ulcerative colitis, Crohn's disease and tuberculous colitis were 1.17:1, 1.14:1, and 1.29:1, respectively, and the mean age were 39.3, 26.5 and 36.0 years, respectively. The most common symptoms of ulcerative colitis, Crohn's disease and tuberculous colitis were bloody stool, diarrhea, and abdominal pain, respectively. In terms of symptoms and signs, we found that significant differences were bloody stool, diarrhea, and weight loss. Patients with tuberculosis colitis revealed significantly high rate of tuberculous lesion on chest X-ray. Among them, 14(35.9%) of the cases showed active tuberculous lesions. In terms of anatomical distribution of the lesion, the most frequently involved sites of ulcerative colitis, Crohn's disease and tuberculous colitis were rectosigmoid colon. descending colon, and ileocecal valve, respectively. Conclusion : In differential diagnosis of ulcerative colitis, Crohn's disease and tuberculous colitis, we should consider clinical findings, laboratory findings, colonoscopic appearance, histologic assessment, anatomical distribution of the lesions, and treatment course.(Korean J Med 59:618-625, 2000)
김선문(Sun Moon Kim),나명규(Beung Kyu Na),양현웅(Hyeon Woong Yang),성재규(Jae Kyu Seong),서승원(Seung Weon Seo),이병석(Byung Seok Lee),정현용(Hyun Yong Jeong) 대한소화기기능성질환·운동학회 2002 Journal of Neurogastroenterology and Motility (JNM Vol.8 No.1
Achalasia is an uncommon esophageal motility disorder in which affected patients present with progressive dysphagia. Various causes were known in this disease. Esophageal achalasia is diagnosied by barium esophagogram, endoscopy and esophageal manometry. Treatment of esophageal achasia are pharmacotherapy, pneumatic dilatation, or botulinum toxin injection and surgical therapy. Balloon dilatation is a safe effective first line treatment. We report two cases of achalasia with normal lower esophageal sphincer pressure, typical endoscopic and typical esophagogram findings, which was treated successfully with pneumatic balloon dilatation.(Korean Journal of Gastrointestinal Motility 2002;8:58-62)
나병규 ( Byung Kyu Nah ),김선문 ( Sun Moon Kim ),이엄석 ( Yeum Seok Lee ),양현웅 ( Hyeon Woong Yang ),서승원 ( Seung Weon Seo ),성재규 ( Jae Kyu Sung ),이병석 ( Byung Seok Lee ),정현용 ( Hyun Yong Jeong ) 대한소화기학회 2004 대한소화기학회지 Vol.44 No.4
Background/Aims: After colorectal cancer surgery, colonoscopic surveillance should be done for prevention and early detection of secondary cancer. This study aimed to identify the group with high risk of developing colorectal adenoma after curative surger
Salmonella Typhi 감염에 의한 비결석성 급성 담낭염과 급성 간염이 병발된 1예
이상우,김남재,이승민,이병석,성재규,이현영,이경태,임의혁,서승원,양현웅 대한간학회 1999 Clinical and Molecular Hepatology(대한간학회지) Vol.5 No.2
Salmonella infection is an acute systemic disease that can lead to diffuse organ involvement with septicemia and cause clinically a variety of complications. But acute acalculous cholecystitis and acute hepatitis with jaundice due to Salmonella typhi occurred rarely. A 42 years old female was admitted with fever, chilling sensation and abdominal pain. On admission, the blood, stool, bile acid and bone marrow cultures were positive for Salmonella typhi. The patient had subsequently developed acute acalculous cholecystitis and acute hepatitis with jaundice. Her symptoms and signs resolved after cholecystostomy, parenteral antibiotic (ciprofloxacin) and supportive treatment. We report a case of acute acalculous cholecystitis and acute hepatitis with jaundice in a 42-year-old female, whose conditions were recovered completely after cholecystostomy and administration of ciprofloxacin, with reviewing the literatures. (Korean J Hepatol 1999;5:148-155)
나병규,김연수,문희석,박기오,김선문,이엄석,양현웅,서승원,김석현,이병석,김남재,이헌영 대한간학회 2003 Clinical and Molecular Hepatology(대한간학회지) Vol.9 No.4
목적: 최근의 간농양 환자들의 임상상, 원인 및 치료에 대해 분석하여 기존의보고와 비교함으로써 변화의 유무를 보고자 하였다. 대상과 방법: 1996년 3월부터 2001년 9월까지 5년간 본원에 입원하여 화농성 간농양으로 치료를 받은 94예를 대상으로 연령, 성별, 증상, 신체검사 소견, 검사실 소견, 세균학적 검사, 동반질환, 감염경로, 농양의 특징, 치료법, 합병증 및 예후 등을 분석하였다. 결과: 평균 연령은 60±14세였으며 남자가 55명 여자가 39명으로 남녀 비는 1.4:1이었다. 남자에서는 50대에서 가장 많이 발생했으며 여자인 경우는 60대에서 빈도가 가장 높았다. 임상증상은 발열(79.8%), 오한(43.6%)이 신체검사 소견으로 발열(53.2%), 상복부 압통(44.7%)이 흔하였다. 농양이 단발성인 경우가 85.1%이었고. 우엽에만 있었던 경우가 70.3%이었다. 84예 중 67예에서 배양이 되어서 78.8%의 양성율을 보였고 단일 균주였으며 Klebsiella pneumoniae 44예(65.7%), E. coli 11예(16.4%)였다. 동반질환은 당뇨병이 14예, 악성 종양이 10예(간담도계 7예, 간세포암 2예, 직장암 1예), 담낭 절제술을 시행 받았던 예가 2예, 간경변증 1예, 만성 신부전 1예, 다낭성 신증 1예 및 막성사구체 신염 1예였다. 원인을 찾지 못했던 예가 70예(74.5%)로 가장 흔하였으며, 상행성 전파가 20예(21.3%), 혈행성 3예(3.2%) 및 직접 전파된 경우가 1예(1.1%)였다. 경피적 배액술을 시행한 경우가 69예(73.4%), 경피적 흡인술을 시행한 경우는 15예(16.0%), 경피적 배액술과 경피적 흡인술을 같이 시행한 경우는 2예(2.1%), 항생제 치료만을 시행한 8예(8.5%)였다. 경피적 배액술을 시행한 예중 6예(8.7%), 경피적 흡인술을 시행한 예중 2예(13.3%), 항생제만 쓴 경우는 1예(1.3%), 총 9예(9.6%)에서 사망 도는 가망이 없어서 퇴원하였다. 호흡기 합병증이 23예(24.5%)로 가장 흔하였고 급성 신부전이 4예, 복막염은 3예, 농양의 파열이 2예, 치료적 시술이 필요한 답즙낭 발생이 2예 및 횡경막하 농양의 발생이 1예에서 있었다. 결론: 최근의 화농성 간농양에서 Klebsiella pneumoniae가 가장 흔한 균이며 일차적인 치료로는 경피적 배농술(경피적 도관 배액술, 경피적 흡인 천자)을 선택할 수 있을 것으로 판단된다. Background/Aims: With the advance of antibiotics and the development of newer imaging techniques, marked changes in etiology, diagnosis, treatment and prognosis of liver abscess have been reported. Methods: We reviewed the clinical data related to 94 patients with pyogenic liver abscess. Results: Of the 94 patients in the study group, the male to female ratio was 1.4:1 and the peak incidence of liver abcess was in the 7th decade. About three quaters (74.5%) of the abcesses were of unknown origin. The predominant location was in the right lobe (70.3%). Single lesion was found in 80 patients and multiple lesions in 14 patients. Pathogens were identified in 67 patients, of which Klebsiella pneumoniae (65.7%) and E. coli (16.4%) were the most common. The modalities of treatment were percutaneous drainage with antibiotics (73.4%), percutaneous aspiration with antibiotics (16.0%), or antibiotics alone (8.5%). The case fatality rate, mainly from associated underlying diseases, was 9 cases (9.6%). Associated diseases were diabetes mellitus (14.9%) and malignancy (10.6%). Conclusions: Our study revealed that the most common organism was Klebsiella pneumoniae and percutaneous needle aspiration and/or catheter drainage were safe and effective treatment modalities for pyogenic liver abscess. Prognosis was determined by the underlying condition.(Korean J Hepatol 2003;12:275-283)