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H . pylori 감염과 관련된 다발성 위 용종증에 대한 제균요법의 임상적 고찰
하정수(Jung Su Ha),김성목(Sung Mok Kim),장윤식(Yun Sick Chang),이연재(Youn Jae Lee),이상혁(Sang Hyuk Lee),김영주(Young Ju Kim),윤혜경(Hye Kyoung Yoon),설상영(Sang Yong Seol),정정명(Jung Myung Chung) 대한내과학회 2001 대한내과학회지 Vol.61 No.1
N/A Background: Little has been known about the incidence, the relationship with H. pylori infection and the prognosis of the multiple gastric polyposis. Recently, it was suggested that the eradication of H. pylori infection led the disappearance of the gastric polyps associated with H. pylori. We carried out a prospective study to determine the effect of H. pylori eradication on multiple gastric polyposis associated with H, pylori. Methods-From July 1997 through August 2000, 13 patients who had multiple gastric polyposis on upper gastrointestinal endoscopy were recruited for this study. After eradication of H. pylori, we performed follow-up endoscopy at 2-3 months and 5-6 months later. Results : The topographical distributions of gastric polyps were as following : antrum only in 7 cases, antrum and lower body in 4 cases, antrum and fundus area in 1 case, and entire stomach in 1 cases, respectively. The histopathological findings were as following : 13 cases showed chronic active gastritis, 2 cases with hyperplastic polyps, and 1 case with adenomatous polyps. After eradication of H. pylori infection, regression of multiple gastric polyps occurred in 7 cases (53.8%). In 7 cases with regression, regression was observed in 5 cases with chronic active gastritis alone, 1 case with hyperplastic polyps, and 1 case with adenomatous polyps. The re-biopsy specimens in 7 cases with regression revealed that the grade of inflammation decreased from 2.2 to 1.5 by the histological index of the updated Sydney system. Conclusion : With these results, we may conclude that the development of multiple gastric polyposis might be closely related with chronic H. pylori infection, and the eradication of H. pylori could lead to the regression of polyposis. (Korean J Med 61:24-32, 2001)
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상부위장관 용종성 병변 265예의 내시경 및 병리조직 소견에 대한 연구
설상영,장윤식,윤상조,주남영,김민기,이상욱 인제대학교 1998 仁濟醫學 Vol.19 No.2
저자는 1988년 7월부터 1997년 12월까지 부산백병원에서 내시경 검사를 통해 상부 위장관의 용종성 병변이 확인된 265명 환자의 274 용종성 병변에서 용종을 올가미법, 박리 생검술, "O" ring 결찰술을 이용하여 절제술을 시행하였으며, 이들을 대상으로 임상적 및 조직학적 소견을 분석하였다. The gastrointestinal polyp is a premalignant lesion in varying degree. Polyps in the gastrointestinal tract can be removed by surgical excision, electrosurgical method, cryotherapy, regional radiotherapy and laser therapy with some limitations. Advance in fibroptic endoscopy have improved diagnostic capabilities and management in patients with gastrointestinal polyps and endoscopic polypectomy is the most simple and safe method in removal of these polyps. We have underwent endoscopic snare polypectomy, strip biopsy and "O"ring ligation on upper gastrointestinal tract polyps in 274 lesions of 265 patients who visited in Pusan Paik hospital from July 1988 to December 1997, and the clinical characteristics including histopathology has been evaluated. The results obtained were as follows : 1) The age distribution of patients were from 28-year old to 78-year old. The ratio of male to female was 1:1.45. 2) The common clinical symptoms presented were epigastric discomfort (38.4%), epigastric pain (28.1%) and indigestion (19.6%). 3) The number of patient wish single gastric polyp was 225(85%), and that of multiple gastric polyps was 40(15%). 4) The most common location of gastric polyps was antrum(47.2%) and followed by body(37.5%) and fungus(9.1%). 5) The removed polyps were mostly 0.5∼1cm(44.8%) in size and in the gross findings by Yamada classifications type II(41.9%) was most common. 6) Histological examinations of gastric polypoid lesions revealed that 63.1% of removed polyps were hyperplastic polyps and 24% of 7hose were adenomatous polyps. 7) Almost all cases showed no significant complication, but there were postpolypectomy abdominal pain in 20 cases(7.5%) and minor bleeding in 8 cases(3.0%). Finally, we concluded that endoscopic polypectomy is a safe and relatively simple procedure and postpolypectomy complication can be considerably reduced by conservative antiulcer therapy, So. most of polypoid lesions of upper gastrointestinal tract should be removed and meticulous pathological review is mandatory.
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정정명,임대건,이원식,최봉기,장윤식,이연재,이상혁,설상명,최하진 인제대학교 1996 仁濟醫學 Vol.17 No.2
1991년 1월부터 1993년 12월까지 인제의대 부산백병원에서 6개월 이상 HBsAg 및 HBeAg 양성이며 간조직 검사상 만성간염을 보인 환자들(활동성;26례, 지속성;3례)을 대상으로 알파 인터페론 치료시 혈청 전환 및 간기능 정상화율과 인터페론 투여에 따른 효과에 대해 분석하여 보았다. In order to evaluate the therapeutic efficacy and safety of recombinent alpha-interferon, we studied 29 patients proven to have chronic hepatitis B(CAH : 26 cases, CPH : 3 cases) through biopsy from January 1991 to December 1993. All patients were seropositive for HBeAg and HBsAg, and recieved alpha-interferon with tonal dosage up to 120 million units. The results were as follows ; 1) HBeAg sero-conversion rate was 51.7%(Total 15 cases including 3 cases in chronic per-sistant hepatitis group), and all these patients have showed normalized transaminase levels continously. 2) In response group, the serum transaminase level began to decrease at average 4.7th week after initiation of interferon. But in non-response group, the serum transaminase level began to decrease at 2nd to 4th week transiently after interferon, and then increased again. 3) Several adverse effects were noted during interferon treatment. General ache and myalgia were most common(65.5%), followed by fever and chillness(37.9%), headache(37.9%), leukopenia(17.2%) etc. But they were relatively tolerable. 4) Peripheral blood leukocyte counts showed slight reduction within 1 week after initiationof interferon treatment but rapidly recovered to normal level within 5 days after temporary withdrawal. And after completion of interferon treatment, no significant differences were remained compared with initial level. With these results, it suggests that α-interferon therapy may be effective and safe in chronic hepatitis B. However, further study will be required in non-responsive group thereafter.
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