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유연화 ( Yeon Hwa Yu ),손병관 ( Byoung Kwan Son ),전대원 ( Dae Won Jun ),김성환 ( Seong Hwan Kim ),조윤주 ( Yun Ju Jo ),박영숙 ( Young Sook Park ),홍부환 ( Boo Whan Hong ),주종은 ( Jong Eun Joo ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.5
Desmoid tumor is a rare benign tumor derived from fibrous sheath or musculoaponeurotic structure. The tumor is benign histologically but considered as malignant clinically because it has high propensity on infiltrative growth with local invasion and tendency to recurrence after local excision. Especially, when this tumor happens to be in the intra-abdomen, the prognosis is worse because it can cause intestinal obstruction, ureter obstruction and, fistula formation. It also can invade major vessels in abdomen. This tumor occurs more frequently in patients with familial adenomatous polyposis (FAP), in post-partume women, and at old surgical incision site. However, in this case, the patient had neither previous surgery nor a FAP history. We report a rare case of the young male patient who presented with an acute abdomen and underwent laparotomy and was found to have an intra-abdominal desmoid tumor with abscess formation. (Korean J Gastroenterol 2009;53:315-319)
증례 : 알코올 지방간 환자에서 폭음 후 발생한 타액선증 1예
유연화 ( Yeon Hwa Yu ),박영숙 ( Young Sook Park ),김성환 ( Seong Hwan Kim ),손병관 ( Byoung Kwan Son ),전대원 ( Dae Won Jun ),조윤주 ( Yun Ju Jo ),류용석 ( Yong Suk Ryu ),김현숙 ( Hyeon Suk Kim ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.1
Sialadenosis is a unique form of non-inflammatory, non-neoplastic bilateral salivary gland disorder characterized by recurrent painless swelling which usually occurs in parotid glands. Alcoholism is one of the main causes of sialadenosis along with diabetes, bulimia, and other idiopathic causes. The prognosis is verified according to the degree of liver function. We present a case of a 46 year-old man who had alcoholic fatty liver disease diagnosed as alcoholic sialadenosis based on clinical points of recurrent bilateral parotid swelling after heavy alcohol drinking, computed tomography, and fine-needle aspiration biopsy. After stopping alcohol drinking and treated with conservative treatment, he got improved without specific sequela. (Korean J Gastroenterol 2009;54:50-54)
삼킴곤란과 위식도 역류 증상을 가진 환자에서 호산구 식도염의 유병률
유연화 ( Yeon Hwa Yu ),조윤주 ( Yun Ju Jo ),정미연 ( Mi Yeon Jung ),손병관 ( Byoung Kwan Son ),전대원 ( Dae Won Jun ),김성환 ( Seong Hwan Kim ),박영숙 ( Young Sook Park ),이원미 ( Won Mi Lee ),김은경 ( Eun Kyoung Kim ) 대한소화기기능성질환·운동학회 2009 Journal of Neurogastroenterology and Motility (JNM Vol.15 No.1
목적: 성인에서의 호산구 식도염은 삼킴곤란과 음식 막힘, 치료가 잘되지 않는 위식도역류질환 환자에서는 반드시 고려해야 할 질환이다. 본 연구의 목적은 삼킴곤란과 위식도 역류질환과 관련된 증상에서 호산구 식도염의 빈도를 고찰하는 것이다. 대상 및 방법: 을지의과대학 을지병원에서 2007년 7월부터 2009년 2월까지 삼킴곤란, 음식 막힘, 양자펌프 억제제에 반응없는 위식도역류질환이 의심이 되는 환자를 대상으로 중부식도를 포함하여 조직 검사를 시행하였다. 결과: 연구에 포함된 환자는 108명이었으며, 호산구 식도염으로 진단받은 환자는 2명(1.8%)이었다. 그 외, 호산구 위장관염 2예, 약제 의인성 호산구 위장관염 1예가 있었다. 주된 증상은 삼킴곤란(37.9%), 상복부 통증(25.9%), 역류(23.1%) 순이었다. 대상 환자의 내시경 소견은 Z-line blurring (28.7%), 정상(17.5%), 발적(16.6%) 등 이었으나, 호산구 침착을 보이는 경우는 동심원 주름, 종축 방향의 골, 다수의 점막 결절 혹은 흰색 반점 등이 보였다. 조직 소견은 경한 만성 염증(33.3%), 상피 세포 증식(16.6%), 호산구 침착(3.7%) 등이었다. 결론: 국내에서 삼킴곤란과 역류 관련 식도 증상을 환자에서 호산구 식도염의 유병률은 1.8%였으며, 증상과 내시경 소견을 염두에 두고, 호산구 관련 위장 질환진단에 생검을 적극 활용하여야겠다. Background/Aims: In adult patients with dysphagia, food impaction and non-responsiveness to proton pump inhibitor, eosinophilic esophagitis (EoE) should be considered. We aimed to investigate the prevalence of EoE in Korean patients. Methods: From July 2007-February 2009, 108 patients presenting with dysphagia and reflux related symptoms were enrolled. The mid-esophageal region was randomly biopsied. Results: Of the 108 patients, two cases of EoE, two cases of eosinophilic enterocolitis and one case of drug-induced eosinophilic enterocolitis were diagnosed. The most frequent symptom was dysphagia (37.9%), followed by epigastric pain (25.9%) and regurgitation (23.1%). Endoscopic findings of eosinophilic infiltration in the esophagus were ring esophagus, linear furrow, nodularities and whitish patches. Histologic findings showed chronic inflammation (33.3%), epithelial cell hyperplasia (16.6%), eosinophilic infiltration (3.7%) and a few eosinophil infiltration (1.8%). Conclusions: EoE was detected in 1.8% in Korean patients with dysphagia and reflux related symptoms. Esophageal random biopsy should be considered especially in young patients with a history of allergic disease and esophageal symptoms. (Kor J Neurogastroenterol Motil 2009;15:15-22)
양동진 ( Dong Jin Yang ),박영숙 ( Young Sook Park ),유연화 ( Yeon Hwa Yu ),조윤주 ( Yun Ju Jo ),김성환 ( Seong Hwan Kim ),정윤영 ( Yoon Young Jung ),황영환 ( Young Hwan Hwang ),전대원 ( Dae Won Jun ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.4
Venous thrombosis and thromboembolism appear to occur more often in patient with inflammatory bowel disease (IBD). The cause of thrombotic complications in IBD is generally considered to be associated with hyper-coagulable conditions. Its prevalence rate ranges from 1% to 8% in clinical studies and rises to 39% in autopsy, but the renal vein thrombosis is very rare complication in ulcerative colitis patient. A 24-year-old man presented with intermittent abdominal pain and hematochezia for 6 months and recently developed pitting edema for few weeks. He was diagnosed as severe ulcerative colitis involving whole colon combined with thrombosis in both renal veins by colonoscopy and computed tomography scan of abdomen. We used steroid for the treatment of ulcerative colitis and both intravenous lower molecular weight heparin and warfarin for renal vein thrombosis. His symptoms were improved after treatment and maintained with mesalazine and warfarin. Follow-up abdominal CT scan showed complete resolution of both renal vein thrombosis. Currently he has been followed up for 2 years with oral mesalazine. (Korean J Gastroenterol 2009;54:248-251)
Streptococcus Constellatus에 의한 농흉
류용석 ( Yong Suc Ryu ),이재형 ( Jae Hyung Lee ),이병훈 ( Byung Hoon Lee ),김상훈 ( Sang Hoon Kim ),양동진 ( Dong Jin Yang ),류상렬 ( Sang Ryol Ryu ),유연화 ( Yun Hwa Yu ),정미연 ( Mi Youn Cheong ),재정돈 ( Jeong Don Chae ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.6
Streptococcus constellatus (S. constellatus) is a commensal microorganism belonging to the Streptococcus milleri group, but may cause infections in different locations in immunocompromised patients. The infection of S. constellatus has high mortality and morbidity due to its tendency to cause abscesses in infected patients, which require immediate surgical drainage for effective treatment. We report on a 72-year-old woman with end stage renal disease, who suffered from dyspnea and general weakness that had developed over 7 days. Chest CT showed loculated pleural effusion. S. constellatus was cultured from exudative pleural effusions and confirmed by an analysis of 16S rRNA sequence. The patient was treated with drainage of pleural effusion and piperacillin/tazobactam for 5 weeks.