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재감염 없이 재발한 저위도 점막연관림프조직형 위림프종 1 예
우열근(Yeol Keun Woo),곽금연(Geum Youn Gwak),박수철(Su Cheol Park),예병덕(Byong Duk Ye),이상협(Sang Hyub Lee),김병관(Byeong Gwan Kim),김주성(Joo Sung Kim),정현채(Hyun Chae Jung),송인성(In Sung Song),김우호(Woo Ho Kim) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.1
More than 90% of low-grade B-cell gastric mucosa-associated lymphoid tissue (MALT) lymphoma is associated with Helicobacter pylori (H. pylori) infection. High remission rates for these lymphomas have been observed after H. pylori eradication. However, 10% of gastric MALT lymphoma treated with H. pylori eradication therapy have been reported to relapse, which is associated with H. pylori reinfection, or transform to high-grade MALT lymphoma or T-cell lymphoma. We experienced a case of low-grade gastric MALT lymphoma which relapsed without H. pylori reinfection. Initially, the patient was diagnosed as having low-grade gastric MALT lymphoma and treated with anti-H. pylori therapy. The patient had a relapse and was retreated with 2nd-line anti-H. pylori therapy, but complete remission was not observed. Thus, we concluded that the relapse was not associated with H. pylori. The patient finally received total gastrectomy. In gastric MALT lymphoma, the eradication of H. pylori is a very effective treatment. However, as shown in this case, gastric MALT lymphoma can relapse without H. pylori reinfection. Therefore, close long-term follow-up is needed even if complete remission is observed after H. pylori eradication therapy. (Korean J Gastroenterol 2002;39:45-49)
성인에서 발생한 대장의 Aganglionosis 1 예
박수철(Su Cheol Park),김병관(Byeong Gwan Kim),김 원(won Kim),우열근(Yeol Keun Woo),이종열(Jong Yeul Lee),이상협(Sang Hyub Lee),예병덕(Byong Duk Ye),김주성(Joo Sung Kim),박규주(Kyu Joo Park),김우호(Woo Ho Kim),정현채(Hyun Chae Jung 대한소화기학회 2001 대한소화기학회지 Vol.37 No.6
Aganglionosis is a rare form of neuronal intestinal malformation, which includes hypoganglionosis, neuronal intestinal dysplasia A (NID type A), B (NID type B) or combined type. Classic aganglionosis, or Hirschsprung’s disease is a neurogenic form of neonatal bowel obstruction characterized by a congenital absence of ganglionic cells in the submucosal and myenteric plexus, and presents in childhood with symptoms of constipation, colonic obstruction or sepsis due to enterocolitis. However, aganglionosis can be diagnosed first in adult due to short segment Hirschsprung`s disease with mild symptom and maybe also due to acquired process. We experienced a case of adult type aganglionosis assumed to be acquired type without malignancy or other neurological involvement. (Korean J Gastroenterol 2001;37:470-474)
예병덕(Byong Duk Ye),곽금연(Geum Youn Gwak),김원(Won Kim),박수철(Su Cheol Park),우열근(Yeol Keun Woo),이상협(Sang Hyub Lee),김병관(Byeong Gwan Kim),정현채(Hyun Chae Jung),송인성(In Sung Song),김우호(Woo Ho Kim) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.3
Esophageal involvement of tuberculosis is rare. It is usually secondary to tuberculous infection of contiguous organs and most commonly presented as ulcerative lesion in esophagoscopy. This report describes the case of a 62-year-old woman who complained of dysphagia and left chest discomfort on swallowing foods. Initial esophagoscopy revealed submucosal tumor of esophagus, and surgical management was planned. But surgery was delayed, and in the meantime, the enlargement of left submandibular lymph node was detected. The aspiration cytology of lymph node revealed chronic granulomatous inflammation. Subsequently, standard anti-tuberculous drug therapy was started. Follow-up esophagoscopy showed decreased size of submucosal mass and the histologic examination of the lesion revealed chronic granulomatous inflammation. Based on this clinical course, the diagnosis of esophageal tuberculosis presented as submucosal tumor with tuberculous submandibular lymphadenopathy was made. We think that in the differential diagnosis of submucosal tumor of esophagus, tuberculous lesion should be included. (Korean J Gastroenterol 2001;38:203-206)
위내시경에서 육안적 이상 없이 진단된 저위도 점막연관림프조직형 위림프종 2예
이상협,송인성,정현채,김철우,김정룡,김주성,이진혁,우열근,예병덕,곽금연,이종열,이준규 대한소화기학회 2001 대한소화기학회지 Vol.37 No.1
Low-grade gastric mucosa associated lymphoid tissue (MALT) lymphoma has a broad spectrum of endoscopic presentations, which ranges from diffuse erosion to ulcerative mass. The bland appearance of this disease in some patients may reflect the early stage of the disease. We report 2 cases of low-grade gastric MALT lymphoma in which the endoscopic presentation consisted with normal appearing mucosa of the stomach. The patients were successfully treated with anti-Helicobacter pylori therapy. Endoscopy is useful to diagnose and follow up low-grade gastric MALT lymphoma. However, in the early stages of the disease, the histologic evaluation of biopsy specimens obtained from all gastric areas can be the more reliable diagnostic procedure to detect this neoplasm.
낭액의 Carcinoembryonic Antigen 및 Carbohydrate Antigen 19-9 증가를 보인 간내담관낭선종 1예
김태호,이동호,이상협,김정룡,이국래,정중기,윤용범,장미수,우열근,예병덕,곽금연 대한소화기학회 2000 대한소화기학회지 Vol.36 No.1
A 39-year-old woman who had a two-year history of right upper quadrant abdominal mass was admitted. Abdominal ultrasonography and computed tomography revealed a large, multiloculated cystic tumor in the liver. This tumor was noted with elevated levels of carcinoembryonic antigen (CEA) (397 ng/mL) and carbohydrate antigen (CA)19-9 (24,000 U/mL) in the cystic fluid and elevated serum CA19-9 level (438 U/mL). A 18×15×6 cm, 1,220 gm cystic mass was removed by cystectomy. The cut section revealed a multilocular cyst containing yellowish mucinous fluid surrounded by a smooth and glistening wall. It was diagnosed histologically as an intrahepatic biliary cystadenoma with mesenchymal stroma, which consisted of single layer of a cuboidal epithelial lining and an ovarian-like stroma. Six weeks after surgery, the serum CA19-9 level was decreased to 59 U/mL. These findings may be useful in the differential diagnosis of intraheptic cystic tumors and thus, we report this case with a review of the literatures.