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이준욱 ( Joon Wook Lee ),이인석 ( In Seok Lee ),백창렬 ( Chang Nyol Paik ),박재명 ( Jae Myung Park ),오정환 ( Jung Hwan Oh ),조유경 ( Yu Kyung Cho ),김상우 ( Sang Woo Kim ),최명규 ( Myung Gyu Choi ),정인식 ( In Sik Chung ) 대한내과학회 2007 대한내과학회지 Vol.73 No.4
목적: 내시경 점막절제술은 림프절 전이의 가능성이 낮은 조기 위암에서 근치 치료 방법으로 널리 사용되고 있다. 이번 연구는 내시경 점막절제술을 시행 받은 조기위암 환자들의 임상경과에 대해 알아보았다. 방법: 1999년 1월부터 2004년 12월까지 본원에서 내시경 점막절제술을 시행한 환자 214명 중 조기 위암으로 확진된 50명의 환자를 대상으로 후향적으로 분석하였다. 대상 환자의 평균 연령은 67.1 (47~83)세이었고, 남녀의 비는 7:3 (35:15)이었다. 점막절제술 후 평균 추적기간은 20.5개월(1~72개월)이었다. 결과: 병변의 평균 크기는 16.6±7.4 mm이었고, 42예(84%)가 위 하부에 위치하고 육안적 융기형이 28예(56%)였다. 완전 절제는 40예(80%)였는데, 크기가 30 mm보다 작은 경우, 병변의 위치가 위 하부인 경우, 육안소견이 융기형인 경우에서 높은 완전 절제율을 보였고, 시술 방법에 있어 점막하 박리술이 일괄 절제율에서 가장 높았다. 완전 절제된 40예 중 6예(15%)에서 시술 후 평균 12.3개월(2~22개월)만에 재발하였는데, 이 중 4예는 점막절제술 부위에서 나머지 2예는 원발 병소가 아닌 다른 부위에서 재발하였다. 결론: 조기 위암 환자에서 내시경 점막절제술은 높은 완전 절제 성공률을 보인다. 그러나 완전 절제 후에도 일부 환자에서 재발이 관찰되므로 내시경 점막절제술을 조기 위암에 대한 근치 치료 방법으로써 적용하기 위해서는 반드시 정기적인 추적관찰이 장기간 이루어져야 할 것으로 생각한다. Background: Endoscopic mucosal resection (EMR) has been widely accepted as a curative treatment for those cases of early gastric cancer (EGC) that have a low probability of lymph node metastasis. The aim of this study was to evaluate the clinical outcome of EMR for the treatment of EGC. Methods: We retrospectively analyzed the medical records of 50 patients who were finally confirmed to have EGC among the 214 patients who were treated with EMR at Kangnam St. Mary`s Hospital from January 1999 through December 2004. The mean age of patients was 67.1 years (range: 47~83), and the male to female ratio was 7:3 (35/15). The mean follow-up period was 20.5 months (range: 1~72). Results: The mean size of the lesions was 16.6±7.4 mm. Forty-two cases (84%) were located in the lower third of the stomach. There were 28 cases (56%) of endoscopically detected elevated lesions (type I, IIa). Complete resection was achieved in 40 cases (80%). The complete resection rate was higher when the lesions had a diameter not exceeding 30 mm, when they were located in the lower third of the stomach and when they were the elevated macroscopic type. The en bloc resection rate was the highest for endoscopic submucosal dissection. Of the 40 cases with complete resection, 6 cases (15%) developed local recurrence after a mean follow-up period of 12.3 months (range: 2~22). Of these 6 cases, 4 cases developed at previous EMR sites and 2 cases developed at other sites. Conclusions: EMR is an effective method as a curative treatment for EGC with a high complete resection rate, but some cases that are completely resected by EMR will experience recurrence. It is necessary to perform follow up at established intervals for a long time after EMR.(Korean J Med 73:375-383, 2007)
이준욱(Joon Wook Lee),이성수(Seung Su Lee),박영민(Young Min Park),배시현(Si Hyun Bae),신제현(Je Hyun SHin),변병훈(Byung Hun Byun),최종영(Jong Young Choi),윤승규(Seung Kew Yoon),이영석(Young Sok Lee),이창돈(Chang Don Lee),차상복(Sang 대한소화기학회 2001 대한소화기학회지 Vol.38 No.4
Congenital non-parasitic splenic cysts comprise approximately 10% of all splenic cysts. Clinical manifestations in patients with splenic cyst are often nonspecific and ultrasound or CT is useful for its diagnosis. Total splenectomy has been the major way of treatment. However, currently, spleen-saving procedures are strongly recommended because of the immunological role of the spleen. One of such procedures, the percutaneous treatment with sclerosing agents has already been reported with a good result. In this report, we present a case of a 12×17 cm sized giant congenital splenic cyst treated with percutaneously using ethanol as a sclerosing agent. Seven-times of injections (total 140mL, 20mL/time, every 3 days) into the cystic cavity through the inserted catheter were performed for 3 weeks. After the treatment, the size of cyst decreased markedly in 8 months. On the basis of these results, we may conclude that the percutaneous ethanol ablation therapy is an alternative to surgical treatment for splenic cyst. (Korean J Gastroenterol 2001;38:300-303)
위선암 환자의 말초혈액에서 역전사 중합효소 연쇄반응을 이용한 Cytokeratin 20 양성 미세 전이 암세포의 진단
이승훈(Seung Hoon Lee),진종률(Jong Youl Jin),송치원(Chi Won Song),이희진(Hee Jin Lee),박재후(Jae Hoo Park),박영세(Young Se Park),백창렬(Chang Nyol Paik),우영식(Yeong Sik Woo),김희정,김춘추(Chun Choo Kim),이준욱(Joon Wook Lee) 대한내과학회 2001 대한내과학회지 Vol.60 No.6
N/A Background : The development of metastasis in cancer is one of the main problems after primary tumor resection. The identification of metastases is only possible in the follow-up investigation when there is already a solid tumor mass. Subclinical tumor cell dissemination can be detected by immunocytological staining of cells or by other molecular biological methods, like PCR. We investigated 22 peripheral blood isolates from gastric cancer patients with a cytokeratin (CK) 20 specific nested reverse transcriptase PCR (RT-PCR) for the detection of disseminated tumor cells at the time of diagnosis. Methods : Fresh heparinized peripheral bloods (about 10 mL) were obtained from 22 gastric cancer patients and 10 healthy doctors as controls. Nucleated cells were isolated by a density gradient method. RNA was isolated and then subjected to RT-PCR with CK 20 specific primers. Results : In gastric cancer, 3 of 22 (13.6%) peripheral blood isolates yielded a CK 20 mRNA positive result in a stage undependent manner. Conclusion : We detected disseminated tumor cells in the peripheral blood isolated using CK 20 specific nested RT-PCR method. Studies on a larger scale are needed for further investigation on the relationship between positive rates of CK 20 mRNA and survival rates of stomach cancer, according to cancer stages.(Korean J Med 60:514-520, 2001)
김대진(Dea Jin Kim),이준욱(Joon Wook Lee),류근호(Keun Ho Ryu) 한국정보과학회 2002 한국정보과학회 학술발표논문집 Vol.29 No.1B
정보화시대에 들어서면서 나날이 급증하는 데이터에 대한 재가용성을 위한 많은 연구가 이루어지고 있다. 이러한 연구들은 의사결정지원, 예측, 추정 등의 분야에서 적용되고 있으나, 실생활에 활발히 적용되기까지 앞으로 많은 연구 및 개발이 요구된다. 이 논문에서는 수집된 데이터로부터 패턴을 추출하여 예측결과를 제공할 수 있는 시스템 모델과 모델에 적합한 점진적 규칙갱신 알고리즘을 제안하였다. 제안하는 예측 모델의 특징은 새로 입력되는 정보에 대한 반복 학습시 수치데이터에 대한 평균근사치 할당방법을 적용하여 규칙갱신을 용이하게 하였으며 각 클래스의 수치데이터에 대한 분류를 용이하도록 하였다.
박종현 ( Jong Hyun Park ),박성환 ( Sung Hwan Park ),김백선 ( Paek Sun Kim ),이준욱 ( Joon Wook Lee ),유완희 ( Wan Hee Yoo ),주영실 ( Yeong Shil Joo ),이신석 ( Shin Seok Lee ),김완욱 ( Wan Uk Kim ),민준기 ( Jun Ki Min ),홍연식 ( Ye 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.3
Dermatomyositis is a clinical entity characterized by a distinctive cutaneous rash and inflammatory myopathy. In this disorder, the pneumomediastinum is quite a rare complication and is assumed to result from air leakage due to vasculitis, lung fibrosis or rarely after bronchoscopic lung biopsy and pulmonary function test. We describe patient with dermatomyositis who developed pneumomediastinum, pneumothorax and massive subcutaneous emphysema after pulmonary function test. She died due to respiratory failure. We think that careful observation is required in performing PFT in dermatomyositis patients with presumed interstitial lung diseases.
오정환 ( Jung Hwan Oh ),최명규 ( Myung Gyu Choi ),김혜랑 ( Hye Rang Kim ),박재명 ( Jae Myung Park ),백창렬 ( Chang Nyol Paik ),이준욱 ( Joon Wook Lee ),조유경 ( Yu Kyung Cho ),전은정 ( Eun Jung Jun ),정정조 ( Jeong Jo Jeong ),이 대한소화기기능성질환·운동학회 2006 Journal of Neurogastroenterology and Motility (JNM Vol.12 No.1
목적: 증상이 없는 역류성 식도염의 임상상은 잘 알려져 있지 않다. 연자들은 건강검진에서 내시경으로 진단된 미란성 식도염의 임상상을 조사하였다. 대상 및 방법: 2003년 8월부터 2005년 5월까지 건강 검진자 중 LA 분류 A이상의 역류성 식도염을 대상으로 하였다. 모든 대상자는 설문지를 작성하였다. 미란성 식도염의 임상특징과 위험인자를 조사하기 위해 미란성 식도염이 없는 건강 대조군과 비교하여 조사하였다. 결과: 미란성 식도염군 264명(남 201, 여 63, 평균나이 42.1±9.5), 정상 대조군 245명(남 146, 여 99, 평균나이 41.9±8.8이었다. 미란성 식도염을 가진 모든 수진자는 LA분류 A (85%), B (15%) 이었다. 미란성 식도염 군에서 주 1회 이상의 가슴쓰림은 10.6% (95% 신뢰구간 6.8-14.4), 주 1회 이상의 위산역류는 13.3% (95% 신뢰구간 9.1-17.4) 이었다. 미란성 식도염 군에서 가슴쓰림의 빈도는 건강 대조군과 차이가 없었다. 미란성 식도염 군의 80%에서는 1주일에 1번 이상의 전형적인 증상이 없었다. 다변량 분석으로 흡연력(하루에 담배 피우는 양)(교차비, 2.8; 95% 신뢰구간 1.7-4.4), 과 비만도(교차비, 1.2; 95% 신뢰구간, 1.1-1.3)가 미란성 식도염과 상관관계가 있었다. 역류성 식도염 군에서 정신신체 증상 점수는 증상이 있는 경우가 무증상인 경우보다 높았다. 결론: 미란성 식도염으로 진단된 건강 검진자의 20%만 뚜렷한 역류증상을 가지고 있었다. 증상이 있는 미란성 식도염을 가진 검진자가 높은 정신 신체 증상 점수를 가진다. 담배, 높은 체질량 지수가 미란성 식도염을 일으키는 위험 인자이다. Background/Aims: As little is known about asymptomatic patients with erosive reflux esophagitis, this study aimed to evaluate the characteristics of subjects with erosive reflux esophagitis who were diagnosed by endoscopy in a routine health check-up program. Methods: We prospectively recruited the subjects who had erosive reflux esophagitis (≥LA grade A) among those who visited a health promotion center for routine check-up. We performed a case-control study to evaluate the clinical characteristics and risk factors of reflux esophagitis. Results: The enrolled study participants comprised 264 subjects with erosive reflux esophagitis and 245 healthy controls. All subjects with erosive esophagitis had LA grade A (85%) or B (15%). Eighty percent of all subjects (N=264) with erosive esophagitis did not have frequent reflux symptoms. Using a multiple logistic regression analysis, erosive reflux esophagitis was associated with smoking (odds ratio (OR), 2.8; 95% confidence interval (CI), 1.7-4.4), and BMI (OR, 1.2; 95% CI, 1.1-1.3). Subjects with symptomatic erosive esophagitis had higher psychosomatic symptom scores than asymptomatic subjects did. Conclusions: Only 20% of subjects who were diagnosed with erosive esophagitis at their routine check-up had frequent reflux symptoms. Symptomatic erosive esophagitis was associated with psychological factor. (Kor J Neurogastroenterol Motil 2006;12:12-18)
김기태,김정수,한승호,강성구,현영근,안유배,이준욱,전희경,박훈준,채장성 대한내과학회 2001 대한내과학회지 Vol.61 No.3
Cushing's syndrome is produced by the hypersecretion of adrenal glucocorticoids and is characterized by moon face, central obesity, disappearance of diurnal variation of plasma cortisol and unsuppressibility of plasma cortisol by low-dose dexamethasone. On the other hand, hyperaldosteronism is produced by the hypersecretion of aldosterone and is characterized by hypertension and hypokalemia. We report a rare case of adrenal adenoma with concurrent hypercortisolism and hyperaldosteronism manifestated with hypertension, cushingoid appearance, left adrenal mass with low-normal plasma potassium. Laparoscopic unilateral tumor excision was performed and hypertension disappeared after the operation.(Korean J Med 61:270-275, 2001)