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국가 암검진 사업의 대장암 선별검사로 시행한 면역화학 분변잠혈검사의 의의
임준욱 ( Jun Uk Lim ),배나영 ( Na Young Bae ),송원경 ( Won Koung Song ),차재명 ( Jae Myung Cha ),이정일 ( Joung Il Lee ) 대한장연구학회 2010 Intestinal Research Vol.8 No.2
Background/Aims: Colorectal cancer (CRC) is one of the major causes of death and poses a major public health concern. The National CRC Screening Programme (NCSP) provides annual CRC screening using a fecal occult blood test for individuals >50 years of age since 2004. The purpose of the current study was to determine the outcomes and efficacy of a fecal immunochemical test (FIT) based on the NCSP in a quality-controlled university hospital setting. Methods: We retrospectively reviewed the medical records and a standardized questionnaire from the NCSP of 3,852 individuals who underwent a FIT between March and December 2009. All of the subjects submitted a stool specimen for a FIT, while a double-contrast barium enema or colonoscopy was performed as a confirmatory examination for FIT-positive individuals. The CRC screening rate and rate of detection colorectal adenomas, advanced adenomas, and colorectal cancers by FIT were evaluated. Results: The CRC screening rate with FIT was very high (72.3%), but the positive rate of detection by FIT was only 1.3%. The rate of detection for colorectal cancers, adenomas, and advanced adenomas by FIT was 0.08%, 0.39%, and 0.13%, respectively. The quantitative values of FIT in individuals with colorectal adenomas and cancers were significantly higher than other colorectal diseases. Men (P=0.001) and elderly individuals (P=0.039) were significantly more common in the FIT-positive group than the FIT-negative group. Approximately 28% of the subjects with FIT-positive tests did not receive a confirmatory examination. Conclusions: Although the FIT had a low rate of detection, the FIT was a useful screening tool for detection of CRC in the NCSP. It will be important to increase CRC screening rates and confirmatory examination rates. (Intest Res 2010;8:126-134)
조기 간세포암종에서 간동맥 색전술과 경피적 고주파열 병합치료
임준욱 ( Jun Uk Lim ),신현필 ( Hyun Phil Shin ),이정일 ( Joung Il Lee ),박재준 ( Jae Jun Park ),전정원 ( Jung Won Jeon ),임규성 ( Kyu Seong Lim ) 대한간암학회 2012 대한간암학회지 Vol.12 No.1
In most early hepatocellular carcinoma (HCC), surgical resection or liver transplantation is the first choice of treatment. However, surgery is often impossible because of patient`s physical condition such as advanced liver cirrhosis, other comorbidities, and radiofrequency ablation (RFA) can be used as substitute treatment. Recently, it has been reported that clinical outcomes of transarterial chemoembolization (TACE) combined with RFA were similar to that of surgical resection. This report describes a 49-year-old male with 1.5 cm sized HCC. Because the patient could not undergo surgical resection and the tumor was not localized on ultrasonography (US), TACE was performed instead. But the residual tumor was still detected on follow-up contrast enhanced US, we performed additional RFA. After combined treatment with TACE and RFA, viable portion of the tumor was not detected on one month follow-up CT and MRI image. The patient remains well without recurrence, 12 months after combined treatment. It is suggested that TACE combined with RFA can be an alternative choice of early small HCC treatment.
제1형 신경섬유종증 환자의 파열된 위십이지장동맥 동맥류에서 발생한 위중한 십이지장 궤양 출혈
임규성 ( Kyu Sung Im ),김선용 ( Sun Yong Kim ),임준욱 ( Jun Uk Lim ),전장원 ( Jung Won Jeon ),신현필 ( Hyun Phil Shin ),차재명 ( Jae Myung Cha ),주광로 ( Kwang Ro Joo ),이정일 ( Joung Ll Lee ),박재준(교신저자) ( Jae Jun Park ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.3
Vasculopathy is rarely reported in neurofibromatosis type 1, but when it occurs it primarily involves the aorta and its main branches. Among vasculopathies, aneurysmal dilatation is the most common form. Although several case reports concerning aneurysms or pseudoaneurysms of visceral arteries in neurofibromatosis type 1 patients have been reported, there are no reports describing gastroduodenal artery aneurysms associated with neurofibromatosis type 1. We experienced a case of life-threatening duodenal ulcer bleeding from a ruptured gastroduodenal artery aneurysm associated with neurofibromatosis type 1. We treated our patient by transarterial embolization after initial endoscopic hemostasis. To our knowledge, this is the first reported case of its type. High levels of suspicion and prompt diagnosis are required to select appropriate treatment options for patients with neurofibromatosis type 1 experiencing upper gastrointestinal bleeding. Embolization of the involved arteries should be considered an essential treatment over endoscopic hemostasis alone to achieve complete hemostasis and to prevent rebleeding. (Korean J Gastroenterol 2015;66:164-167)
성인에서 장중첩증을 유발한 회장의 염증성 섬유양 용종 1예 Running title: 장중첩증을 유발한 회장의 염증성 섬유양 용종
김대호 ( Dae Ho Kim ),차재명 ( Jae Myung Cha ),이정일 ( Joung Il Lee ),주광로 ( Kwang Ro Joo ),신현필 ( Hyun Phil Shin ),박재준 ( Jae Joon Park ),전정원 ( Jung Won Jeon ),임준욱 ( Jun Uk Lim ),김교영 ( Gyo Young Kim ) 전북대학교 의과학연구소 2012 全北醫大論文集 Vol.36 No.1
성인에서 관찰되는 대부분의 장중첩증은 장의 양성 또는 악성 종양에 의해서 발생한 다. 염증성 섬유양 용종은 매우 드물게 관찰 되는 양성 종양이며 소장에서 발생할 경우 에 장중첩중, 복통, 또는 설사를 유발한다. 본 증례에서는 37세의 남자가 3개월 동안 지 속된 수양성 설사와 우하복부 통증을 주소로 본원에 방문하였다. 혈액검사에서 C 반응 성 단백수치의 상승 및 백혈구 수치의 상승 외에 특별한 이상은 없었다. 대장내시경검사 에서 말단 회장의 종양이 보였으며 컴퓨터 복부촬영을 통해 이 종양에 의한 회맹부의 장중첩증을 진단하였다. 수술적인 장절제술을 시행하였으며 조직검사에서 염증성 섬유 양 용종으로 판명되었다. 이 증례를 바탕으로 임상의사들은 회맹부의 장중첩증 진단시, 특히 염증성 증상과 징후가 동반되어 있을 때, 염증성 섬유양 용종의 가능성을 고려해 야 할 것으로 본다. Most of intussusception cases in the adult are caused by benign or malignant neoplasms as a lead point. Inflammatory fibroid polyp, which is a rare, benign neoplasm, may provoke intussusceptions, abdominal pain, or diarrhea when it is located in the small bowel. In this case, a 37-year-old man visited our hospital with complaints of chronic watery diarrhea and right lower quadrant abdominal pain which developed 3 months ago. Laboratory findings were non-specific, except elevated C-reactive protein and shift to the left in the differential count of white blood cell. Colonoscopy showed movable terminal ileal mass and abdominal computed tomography showed an ileocecal intussusception caused by this mass. After a surgical resection, histopathologic diagnosis was inflammatory fibroid polyp. This case suggests that physicians should consider the possibility of an inflammatory fibroid polyp in the differential diagnosis of an ileocecal intussusception, especially when the intussusception is associated with inflammatory symptoms and signs.
홍인택 ( In Taik Hong ),차재명(교신저자) ( Jae Myung Cha ),이정일 ( Joung Ll Lee ),주광로 ( Kwang Ro Joo ),백일현 ( Ll Hyun Baek ),신현필 ( Hyun Phil Shin ),전정원 ( Jung Won Jeon ),임준욱 ( Jun Uk Lim ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.3
Lymphangioma is a benign vascular lesion with characteristics of subepithelial tumor which can proliferate in the lymphatic system. Lymphangioma of the small-bowel mesentery is rare, having been reported in less than 2% of all lymphangiomas. Lymphangioma does not require any specific treatment because it is absolutely a benign tumor. However, surgical exploration is rarely required for cases with disease-related symptoms or complications, or for those misdiagnosed as a malignant lesion. We recently experienced a case of mesenteric cavernous lymphangomas in a 53-year-old female who was misdiagnosed as having a liposarcoma. The final diagnosis was confirmed by a pathologic examination of the specimen that was obtained via laparoscopic exploration. Herein, we report a very rare case of mesenteric cavernous lymphangioma along with a brief review of relevant literature. (Korean J Gastroenterol 2015;66:172-175)