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외래에서 우연히 발견된 췌장 낭성 종양에 대한 임상적 접근
우용식 ( Young Sik Woo ),이규택 ( Kyu Taek Lee ) 대한소화기학회 2017 대한소화기학회지 Vol.70 No.1
Cystic lesions of the pancreas are increasingly observed due to increased use of abdominal images. The malignant rate of pancreas cystic lesion varies widely between various types. Identification of malignant or high-risk lesions is important when determining the appropriate course of management. Using these image findings, including cyst size, presence of solid components, and pancreatic duct involvement, the 2012 International Association of Pancreatology (IAP) and the 2015 American Gastroenterological Association (AGA) guidelines provide a rationale in identifying higher risk patients requiring further workups using an endoscopic ultrasound (EUS). EUS with fine needle aspiration and cytology allows confirmation of the cyst type and determines the risk of malignancy. Small cysts with no suspicious features may undergo the regular imaging study for regular surveillance due to low risk for malignancy. In this re-view, the differences between the 2012 IAP and 2015 AGA guidelines are presented, In addition to possible recommendations for management and surveillance. (Korean J Gastroenterol 2017;70:13-20)
단일 2차 종합병원에서 출혈성 소화성궤양 환자의 임상 양상과 빅데이터 분석을 위한 조작적 정의에 관한 연구
이재원 ( Jae Won Lee ),김현기 ( Hyun Ki Kim ),우용식 ( Yong Sik Woo ),장재훈 ( Jaehoon Jahng ),진영란 ( Young Ran Jin ),박종헌 ( Jong Heon Park ),김용성 ( Yong Sung Kim ),정훈용 ( Hwoon Yong Jung ) 대한소화기학회 2016 대한소화기학회지 Vol.68 No.2
Background/Aims: Peptic ulcer bleeding (PUB) is the most common cause of upper gastrointestinal bleeding in Korea but there has been no research done using big data. This study evaluates the optimal operational definition (OD) for big data research by analyzing clinical characteristics of PUB. Methods: We reviewed the clinical characteristics of 92 patients with PUB confirmed on endoscopy in Wonkwang University Sanbon Hospital (January 2013 to December 2014). We calculated sensitivity and positive predictive value (PPV) to detect confirmed PUB patients using ODs developed by combining clinical features of patients with PUB. Results: The mean patient age was 63 years. Men had higher prevalence of PUB than women. Bleeding gastric ulcer was proportionately common in the age range of 40s to 60s in men, while a significantly higher rate of bleeding occurred in women older than 70s. The rate of drug-induced ulcer was 28.2%, whereas the prevalence of Helicobacter pylori was 47.8%. Among the hospitalized patients with diagnostic code of PUB, we ruled out patients with endoscopic removal of gastric adenoma or peritonitis, and selected patients who had been administered intravenous proton pump inhibitor. The sensitivity in this setting was 82.6%, and PPV was 88.4%. Conclusions: PUB was more common in older patients, and there was a clear gender difference in gastric ulcer bleeding by age. With a proper OD using PUB diagnostic codes, we can identify true patients with sufficiently high sensitivity and PPV. (Korean J Gastroenterol 2016,68:77-86)
경기서부지역 단일기관에서 최근 10년간의 헬리코박터 파일로리 제균율의 변화
박종설 ( Jong Seol Park ),박지은 ( Ji-eun Park ),오병수 ( Byoung Soo Oh ),윤병욱 ( Byung Wook Yoon ),김현기 ( Hyun Ki Kim ),이재원 ( Jae Won Lee ),김남호 ( Nam Ho Kim ),조원석 ( Won Seok Cho ),우용식 ( Young Sik Woo ),장재훈 ( Jae 대한소화기학회 2017 대한소화기학회지 Vol.70 No.5
Background/Aims: The eradication rate of Helicobacter pylori (H. pylori) has been decreasing recently in Korea due to antibiotics resistance. The aim of this study was to investigate the trend of eradication rate and clinical factors affecting the eradication rate of H. pylori in the last 10 years in west Gyeonggi-do, Korea. Methods: The trends of eradication rate of H. pylori, gender, age, concomitant mediations, and clinical factors were retrospectively evaluated in patients with H. pylori infection between 2006 and 2015 (n=2,485). Results: The overall H. pylori eradication rate for the standard triple therapy was 82.5%. The annual eradication rates from 2006 to 2015 were 90%, 77.9%, 75.8%, 83.2%, 85.6%, 90.1%, 81.3%, 81.1%, 78.7%, and 78.8%, respectively, showing a significant decrement during the last five years (p<0.001). Higher eradication rate was observed in males than in females (p<0.001). Esomeprazole showed a higher eradication rate compared with pantoprazole between 2006 and 2010 (p<0.022). Age and the use of probiotics and mucosal protective agents played no significant role in the H. pylori eradication rate. The overall eradication rate for bismuth- based quadruple therapy was 94.4%. Conclusions: The eradication rate of H. pylori over the last 10 years for first-line therapy ranged from 75.8 to 90.1%; the eradication rate for triple therapy has declined. However, the eradication rate for quadruple therapy has remained unchanged over the last 10 years. (Korean J Gastroenterol 2017;70:232-238)