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표준용량 양성자펌프억제제에 반응을 보이지 않는 비미란성 역류질환 환자에서 Esomeprazole 40 mg 단일 요법의 유효성: 다기관 공개 연구
성재규,김태호,홍수진,김상균,정훈용,이용찬,장병익,박수헌 대한상부위장관ㆍ헬리코박터학회 2016 Korean Journal of Helicobacter Upper Gastrointesti Vol.16 No.4
Background/Aims: Despite the efficacy of proton pump inhibitor (PPI) treatment, a considerable number of patients with non-erosive reflux disease (NERD) are resistant to treatment with a PPI at the standard dose. In these patients, doubling the dose of PPI is one of the potential therapeutic strategies. However, only few studies support this therapeutic strategy. The aim of this study was to assess the efficacy and safety of 40 mg esomeprazole once daily in patients with persistent symptoms of NERD despite standard daily PPI therapy. Materials and Methods: A total of 92 patients with NERD who had persistent symptoms of NERD despite standard dose (half dose) of PPI for more than 4 weeks, were enrolled in this multicenter (eight centers) open-label study. Efficacy and safety of a daily dose of 40 mg esomeprazole were evaluated after 4 weeks in all the patients. Results: The sum score of two symptoms (heartburn and regurgitation) decreased significantly from 72.51 to 32.55 after 4 weeks of treatment (P<0.001). The percentage of patients with ≥50% improvement in symptom score (heartburn +acid regurgitation), during the study period was 66.7%. Patients with severe symptoms at baseline had significantly higher symptom improvement rate in comparison to patients who had milder symptoms. Adverse effects related to the treatment were reported by 3 (3.3%) patients. Conclusions: Esomeprazole 40 mg once daily is an effective and safe strategy to treat NERD patients with persistent symptoms despite standard daily PPI therapy.
성재규,강진구,Sung, Jae-Gyu,Kango, Jin-Ku 한국전기전자학회 2006 전기전자학회논문지 Vol.10 No.1
본 논문은 PLL구조에서 새로운 버니어 지연 VCO구조를 이용한 다중위상 발생회로를 서술하였다. 제안하는 기법은 VCO의 지연단의 지연보다 더 미세한 타이밍신호를 만들어낸다. 0.18um CMOS공정을 이용하여 칩 제작 후 측정결과 1GHz에서 약 62.5ps의 위상정밀도를 갖는 신호를 만들었고 지터는 14ps로 측정되었다. This paper shows a vernier delay technique for generating precise multiphase clocks using PLL structure. The proposed technique can achieve the finer timing resolution less than the gate delay of the delay chain in VCO. Using this technique, 62.5ps of timing resolution can be achieved if the reference clock rate is set at 1GHz using 0.18um CMOS technology. Jitter of 14ps peak-to-peak was measured.
근치적 치료로서 조기위암의 내시경적 점막절제술에 대한 검토
성재규,문희석,이엄석,김선문,양현웅,서승원,나병규,이병석,노승무,신경숙,조준식,김재성,송규상,정현용 대한소화기내시경학회 2002 Clinical Endoscopy Vol.24 No.5
Background/Aims: Endoscopic mucosal resection (EMR) has been accepted as a treatment option for cases of early gastric cancer (EGC) where the probability of lymph node metastasis is low. The purpose of this study was to define the indication and limitation of EMR of EGC. Methods: We studied thirty-five cases of EGC treated by EMR in Chungnam National University Hospital from January, 1999 to July, 2001. Results: The rate of complete resection on EGC was 94.3% (33/35). The size affected the curability; 94.4% (17/18) of lesions less than 10 mm, 93.3% (14/15) of lesions 11 to 20 mm and 100% (2/2) of those larger than 20 mm were resected completely. The depth of cancer invasion also affected the curability; 100% of lesion was confined to mucosa while 71.4% of those invaded submucosa. Of the thirty-three lesions which were completely resected, twenty-seven lesions had no recurrences during the follow-up period, four lesions were residual cancers and two developed local recurrences. Conclusions: In curative treatement for EGC with EMR, although follow-up period was short there is a possibility that indications for EMR could extend to the elevated lesion which is larger than 20 mm and to the superficial submucosal (sm1) cancer. (Korean J Gastrointest Endosc 2002;24:255-260) 목적: 조기위암에서 근치적 치료로서 내시경적 점막절제술의 적응증과 한계에 대하여 알아보고자 하였다. 대상 및 방법: 1999년 1월부터 2001년 7월까지 2년 6개월 동안 충남대학교 병원을 방문하여 내시경적 점막절제술을 시행 받은 후에 조기위암으로 확진된 35명을 대상으로 하였고, 완전 절제된 33예는 3개월에서 30.1개월까지 평균 8.3개월 동안 추적검사를 하였다. 결과: 완전 절제율은 35예 중 33예로 94.3%였다. 병변의 크기에 따른 완전 절제의 성적을 보면 장경이 10 mm 이하인 경우는 18예 중 17예(94.4%), 11~20 mm인 경우는 15예 중 14예(93.3%), 20 mm를 초과하는 경우는 2예 중 2예(100%)였다. 병변이 점막내에 국한된 경우는 모두 완전 절제되었다. 점막하층까지 침윤이 있었던 경우는 7예 중 5예(71.4%)에서 완전절제가 되었고 그 중 4예는 모두 표층 점막하층(sm1) 침윤암였다. 완전 절제된 33예 중 27예는 추적 관찰하는 동안에 재발이 없었고 나머지 6예 중 4예는 잔유암으로 판정받았고, 다른 2예는 국소 재발하였다. 결론: 조기위암의 내시경적 점막절제술에 의한 근치적 치료에 있어서 비록 추적기간이 짧은 한계가 있지만 20 mm 이상의 융기형 및 표층 점막하층(sm1) 침윤암의 경우에 기존의 적응증에 비해서 확대 적응의 가능성이 있다고 생각한다. 또한 향후 잔유암과 재발 예를 줄이기 위해서 보다 정확한 시술 전 심달도 진단, 병변의 위치에 따른 시술법의 발전, 엄격한 병리학적 완전 절제 기준 적용 등 문제해결을 위한 노력이 필요할 것이다.
성재규 ( Jae Kyu Sung ) 대한내과학회 2015 대한내과학회지 Vol.89 No.2
Helicobacter pylori affects nearly half of the world’s population and is a major pathogen associated with prevalent gastrointestinal disorders, including peptic ulcer and gastric cancer. Various diagnostic methods are available to detect infection, and the choice of method depends on factors such as their accessibility, advantages and disadvantages and cost. New treatment options for eradicating H. pylori have emerged as a result of the decreased efficacy of standard triple therapy due to increasing antibiotic resistance. This work reviews the main diagnostic methods used to identify H. pylori infection and to confirm the eradication of infection. We also provide a comprehensive overview of current and emerging strategies for the treatment of H. pylori infection. (Korean J Med 2015,89:149-156)