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전승민 ( Soung Min Jeon ),김도영 ( Do Young Kim ),안상훈 ( Sang Hoon Ahn ),한광협 ( Kwang Hyub Han ),전재윤 ( Chae Yoon Chon ),박준용 ( Jun Yong Park ) 대한간암연구회 2010 대한간암학회지 Vol.10 No.-
Hepatocellular carcinoma (HCC) is the third most common malignancy in Korea. Despite recent advances in the area of HCC, a considerable number of HCC patients require non-surgical treatments and systemic therapies because of poor liver function or intermediate to advanced cancer stages at the time of diagnosis. Unfortunately, chemotherapy for advanced HCC has limited response rates and provides a marginal survival benefit. Several studies have supported potential advantages of hepatic arterial infusion chemotherapy (HAIC), designed to improve chemotherapy benefits by increasing the amount of chemotherapy delivered to the site of the tumor and to minimizes the side-effects of the chemotherapy. However, there hasn`t been any report showing different responses between systemic chemotherapy and HAIC for the same patient. Herein, we report a case of HCC showing progressive disease in systemic chemotherapy, but partial response in HAIC with the same regimen for the same patient with portal vein thrombosis. This case implies HAIC might be alternative option for HCC patient showing ineffective response to systemic chemotherapy, even with the same regimen.
성인 환자에서 자궁근종 수술 후 장유착증과 동반된 Yersinia enterocolitica 장염 1예
현경희 ( Kyung Hee Hyun ),전승민 ( Soung Min Jeon ),김형준 ( Hyung Joon Kim ),이준혁 ( Joon Hyuk Lee ),김배환 ( Bae Hwan Kim ),신현덕 ( Hyun Duk Shin ),신정은 ( Jeong Eun Shin ) 대한내과학회 2012 대한내과학회지 Vol.83 No.6
Yersinia enterocolitica infection in adults in Korea is reported rarely. Therefore, the possibility of Yersinia infection as a cause of abdominal pain may be overlooked. Because its clinical features are similar to those of acute appendicitis or other diseases that require operations, Yersinia enterocolitis should be diagnosed before surgery. We recently experienced a case of Y. enterocolitica enterocolitis accompanied by postoperative colonic adhesion. A 39-year-old female patient with a 5-year history of asymptomatic uterine myoma underwent transabdominal hysterectomy due to abdominal pain. However, the pain worsened. On CT, diffuse swelling of the right colon and adhesion of the sigmoid colon with luminal narrowing were found. Colonoscopy showed multiple aphthous ulcers with mucosal hyperemia from the cecum to the sigmoid colon. Multiplex PCR with stool specimens, a hemagglutination test for Y. enterocolitica O:3, and tissue culture were positive for Y. enterocolitica. After fluids and antibiotic therapy, her symptoms were relieved. (Korean J Med 2012;83:757-763)
소화기 ; 식도 이물 환자에서 중증 합병증의 발생의 위험요인
박성준 ( Seong Jun Park ),전승민 ( Soung Min Jeon ),신현덕 ( Hyun Deok Shin ),신정은 ( Jeong Eun Shin ),김석배 ( Suk Bae Kim ),김홍자 ( Hong Ja Kim ),송일한 ( Ail Han Song ) 대한내과학회 2015 대한내과학회지 Vol.89 No.5
목적: 이물 섭취에 의한 합병증은 드물고, 대부분의 식도 이물은 내시경으로 제거가 가능하다. 그러나 만약 천공과 같은 중증 합병증이 발생한다면 심각한 결과를 초래할 수 있다. 본 연구는 식도 이물 환자에서 중증 합병증을 일으킬 수있는 위험요인을 찾고자 시행되었다. 방법: 2001년 1월부터 2014년 12월까지 단국대학교병원에서 식도 이물 제거를 성공적으로 시행 받은 298명의 환자를 대상으로 그들의 내시경 영상 및 진료기록을 후향적으로 검토하였다. 중증 합병증은 식도열상, 단순세척에도 멈추지 않는 출혈, 그리고 천공으로 정의하였다. 다변량 로지스틱 회귀분석을 통해 중증 합병증의 위험요인을 분석하였다. 결과: 성인과 소아에서 가장 호발하는 식도 이물은 각각 생선 가시(52.0%)와 동전(61.0%)이었다. 식도이물에 의한 합병증은 미란, 궤양, 열상, 출혈, 천공이었다. 다변량 분석에서 식도열상, 출혈, 천공을 포함하는 중증 합병증의 위험요인은 이물의 모양(생선 가시, OR 2.306, p = 0.004), 크기(25 mm 이상, OR 2.614, p = 0.001), 이물 섭취 후 경과한 시간(24시간 이상, OR 1.887, p = 0.035)이었다. 천공은 9명의 환자에서 발생하였고, 이물 섭취 후 24시간이 경과한 경우에 위험요인으로 나타났다(OR 41.700, p = 0.005). 천공 환자 중 2명은 이물제거 후 8시간과 12시간이 경과한 이후에 지연성 천공이 발생하였다. 결론: 식도 이물 환자에서 이물이 생선 가시이거나, 이물의 크기가 25 mm 이상, 이물을 섭취한 후 24시간이 경과한 경우에는 중증 합병증의 위험이 있음으로 치료 시보다 세심한 주의가 필요하다. 특히, 이물 섭취 후 24시간이 경과하면 천공의 위험이 증가하는데, 이물 제거 이후에도 지연성 천공의 가능성이 있음으로 주의 깊게 관찰하여야 한다. Background/Aims: Complications by ingested foreign bodies are uncommon, since successful removal by endoscopy occurs in most cases. However, severe complications, such as perforation, can result in death. The aim of this study was to determine the risk factors associated with severe complications in patients with esophageal foreign bodies. Methods: This study involved 298 patients who underwent successful removal of an esophageal foreign body between January 2001 and December 2014 at Dankook University Hospital. Medical records were reviewed retrospectively. Severe complications were defined as laceration, unstoppable bleeding with simple irrigation, or perforation. Risk factors for severe complications were analyzed using multivariate logistic regression. Results: The most common foreign bodies in adults and pediatrics were fish bones (52.0%) and coins (61.0%). Complications included erosion, ulcer, laceration, bleeding, and perforation. Using multivariate analysis, the type (fish bone, odds ratio [OR] = 2.306, p = 0.004) and size (> 25 mm, OR = 2.614, p = 0.001) of the obstruction and duration of impaction (> 24 hours, OR = 1.887, p = 0.035) were risk factors for severe complications including laceration, bleeding, and perforation. For perforation, duration of impaction (> 24 hours, OR = 41.700, p = 0.005) was a statistically significant risk factor. In two patients, delayed perforation occurred despite successful endoscopic removal of the foreign body. Conclusions: Patients with esophageal fish bone foreign bodies, foreign bodies larger than 25 mm, and a duration of impaction longer than 24 hours should be treated carefully considering the possibility of severe complications. Specifically, patients with a duration of impaction longer than 24 hours should be closely observed due to increased risk of perforation and potential delayed perforation even after successful endoscopic removal. (Korean J Med 2015,89:537-547)
증례 : S상 결장암에 동반된 부신생물 말초 호산구증가증 1예
이나리 ( Na Ri Lee ),전승민 ( Soung Min Jeon ),차병효 ( Byung Hyo Cha ),박길효 ( Kil Hyo Park ),이종섭 ( Jong Sup Lee ),문도호 ( Do Ho Moon ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
저자들은 S상 결장암에 동반된 말초 호산구 증가증이 있는 56세 환자에서 간 및 주위 임파선에 다수 전이가 되어 예후가 불량했던 환자 1예를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다. Eosinophilia is most commonly associated with allergic disorders or parasitic infestation. However, collagen vascular diseases, drug reactions, radiation therapy, and many types of human cancer are also associated with extensive eosinophilia. Peripheral eosinophilia associated with malignancy is a marker of extensive metastasis and is thus associated with a poor prognosis. A 56-year-old male presented with history of right upper quadrent pain and weight loss. Total white blood count was 29,800/㎣ with 69.2% eosinophilia. Abdominal ultrasonogram showed multiple metastasis in liver and abdominal CT scan showed paraaortic lymph node enlargement. Colonoscopy and biopsy revealed moderate to poorly differentiated adenocarcinoma in sigmoid colon. (Korean J Med 69:S753-S757, 2005)
김범희 ( Beom Hee Kim ),박희욱 ( Hee Ug Park ),박승근 ( Seung Keun Park ),전승민 ( Soung-min Jeon ),정찬우 ( Chan Woo Jung ),손창목 ( Chang Mok Son ),최현욱 ( Hyun Wook Choi ),김혜숙 ( Hye Sook Kim ) 대한소화기학회 2018 대한소화기학회지 Vol.72 No.1
Human anisakiasis is a disease caused by an infestation of the third stage larvae of family anisakidae. The ingested larvae invade the gastrointestinal wall, causing clinical symptoms that include abdomen pain, nausea, and vomiting. Although enteric anisakiasis is extremely rare, it can induce intestinal obstruction. We report a case in which emergency surgery was needed due to intestinal obstruction that coincided with symptoms related to anisakiasis, along with a brief literature review. (Korean J Gastroenterol 2018;72:33-36)
복현정 ( Hyun Jung Bok ),이진하 ( Jin Ha Lee ),신재국 ( Jae Kook Shin ),전승민 ( Soung Min Jeon ),박재준 ( Jae Jun Park ),문창모 ( Chang Mo Moon ),홍성필 ( Sung Pil Hong ),천재희 ( Jae Hee Cheon ),김태일 ( Tae Il Kim ),김원호 ( Wo 대한소화기학회 2013 대한소화기학회지 Vol.62 No.1
목적: 위, 대장암 동반군과 대장암 단독군을 비교하여 위암 동반 대장암의 임상 및 병리적 특성을 알아보고자 하였다. 대상 및 방법: 2000년에서 2009년까지의 대장암 수술 환자 5,288명 중에서, 위, 대장암 동반군 63예와 가장 가까운 수술일을 기준으로 2배수로 선택된 대장암 단독군 126예를 대상으로 임상 및 대장암의 특성을 비교하였고, 위암과 대장암의 진단순서에 따른 환자군 내의 세 군(위암 선행군, 동시성 중복암군, 대장암 선행군) 간에도 그 특성을 비교한 후향적 환자- 대조군 연구이다. 결과: 위, 대장암 동반군은 대장암 단독군에 비해 대장암 진단 연령이 평균 4.3세 높았고, 체질량지수는 낮았으며, 전이성 대장암에서 복막 전이율이 높았다. 두 군 간에 전체 생존율 및 대장암 특이 생존율에 유의한 차이는 없었다. 대장암에 동반된 위암의 병리소견에서 미분화성 위선암의 비율(55.6%)과 인환세포 위암의 비율(30.2%)이 높게 관찰되었다. 결론: 위암 동반 대장암은 연령, 비만도, 전이부위 등에서 대장암 단독군과 임상적 차이를 보였으며, 동반 위암은 인환세포암을 포함한 미분화 위선암의 비율이 높았다. Background/Aims: The purpose of this study was to investigate the clinicopathologic features of double primary cancers of the stomach and colorectum, compared to colorectal cancer alone. Methods: A retrospective analysis was made of 5,288 patients who underwent colorectal cancer surgery between January 2000 and December 2009 at Severance Hospital of Yonsei University. The clinicopathologic features were analyzed between 63 patients of double primary cancers and case-matched 126 patients of colorectal cancer alone. We classified double primary cancers into subgroups as premetachronous, synchronous and postmetachronous gastric cancer to identify differences between the three subgroups also. Results: Double primary cancers group showed 4.3 year-older age, lower BMI, and higher percentage of peritoneal metastasis, compared to colorectal cancer alone group. Overall and colorectal cancer specific survival did not have any significant difference between two groups. In histologic type of gastric cancer, a high percentage of undifferentiated adenocarcinoma (55.6%) and signet ring cell carcinoma (30.2%) were noted. Conclusions: Double primary cancers of the stomach and colorectum had older-age onset, lower BMI and higher metastasis to peritoneum than colorectal cancer alone. Combined gastric cancer consisted of high percentage of undifferentiated and signet ring cell carcinomas. (Korean J Gastroenterol 2013; 62:27-32)
위장관 T 세포 림프종에 대한 소화기내과 의사의 초기 진단 정확도
류성호 ( Sung Ho Ryu ),천재희 ( Jae Hee Cheon ),김진영 ( Jin Young Kim ),김보경 ( Bo Kyung Kim ),윤진영 ( Jin Young Yoon ),정윤숙 ( Yoon Suk Jung ),허현미 ( Hyun Mi Heo ),이진하 ( Jin Ha Lee ),전승민 ( Soung Min Jeon ),홍성필 ( Su 대한장연구학회 2011 Intestinal Research Vol.9 No.1
Background/Aims: Primary T-cell lymphoma of the gastrointestinal tract is a very difficult disease entity to diagnose, and has an extremely poor prognosis. The aim of this study was to determine the early diagnostic accuracy for gastrointestinal T-cell lymphoma by gastroenterologists. Methods: Between January 2000 and October 2010, the clinical features of 15 patients with primary gastrointestinal T-cell lymphomas, including endoscopic findings, radiologic diagnosis, endoscopic biopsy findings, and final diagnosis, were retrospectively reviewed. Results: The most common initial presenting symptoms of primary gastrointestinal T-cell lymphomas was abdominal pain (n=11, 73%). The anatomic location of the primary lesion the small bowel (n=8, 53%), colon (n=5, 33%), and stomach (n=3, 20%). There were no cases of T-cell lymphomas diagnosed based on clinical symptoms, radiologic findings, or endoscopic findings without biopsy alone. Pathologic confirmation of T-cell lymphomas by endoscopic examination was achieved in 7 cases (64%) and the remaining cases (n=8, 53%) were diagnosed with T-cell lymphomas based on pathologic examination after surgery. Conclusions: All of the patients with primary T-cell lymphomas of the gastrointestinal tract were diagnosed exclusively by endoscopic or surgical pathologic examainations, suggesting that gastroenterologists should scrutinize and suspect this disease with caution due to atypical gastrointestinal ulcers. (Intest Res 2011;9:6-26)