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정태엽 ( Tae Yeob Jeong ),김유선 ( You Sun Kim ),박경준 ( Kyung Jun Park ),이종성 ( Jong Sung Lee ),허진국 ( Jin Gook Huh ),류수형 ( Soo Hyung Ryu ),이정환 ( Jung Hwan Lee ),문정섭 ( Jeong Seop Moon ) 대한소화기학회 2008 대한소화기학회지 Vol.51 No.3
Leiomyosarcoma is a rare tumor of the liver. It usually arises from many other organs including uterus, gastrointestinal tract, retroperitoneum, and soft tissues. Primary hepatic leiomyosarcoma progresses very slowly and is not associated with chronic liver disease. When the tumor is detected early enough to be treated by operation, the prognosis is favorable. While several cases of primary hepatic leiomyosarcoma have been reported in Korea, there was no case associated with acute bleeding. We report a 80-year old male patient with huge primary hepatic leiomyosarcoma, who presented with acute bleeding and IVC obstruction. The patient was treated by embolization and IVC stenting. (Korean J Gastroenterol 2008;51:194-198)
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유지혈액투석을 받고있는 당뇨병과 비당뇨병 환자에서 혈중 총 이산화탄소량의 의미
정태엽 ( Tae Yeob Jeong ),박원도 ( Won Do Park ) 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.1
목적 : 신기능이 감소됨에 따라 다양한 정도의 대사성 산증 동반하게 되며, 대사성 산증은 투석 환자의 장기적 예후 및 합병증의 발생과 관련이 있는 것으로 알려져 있다. 일반적으로 투석 환자에서 심한 산증은 교정하여야 하는 것으로 알려져 있으나, 정도의 산증이 있는 혈액투석환자가 오히려 영향상태가 좋다는 보고도 있었다. 그러나, 투석 환자에서 당뇨병 환자가 차지하는 비율에 비해서 당뇨병 환자를 대상으로 하는 연구 결과는 미미한 실정이다. 이에 장기혈액투석 환자에서 당뇨병 환자의 혈청 총 이산화탄소량과 기타 영양지표를 측정하여 비당뇨병 환자와 비교 분석하여 그 의미를 알아보고자 하였다. 방법 : 1999년 1월 부터 2000년 12월까지 3개월 이상 혈액투석을 받았던 50명의 환자들을 대상으로 당뇨병 환자 21명과 비당뇨병 환자 29명으로 나누어 매월 초 시행한 혈액검사를 바탕으로 TCO_2 및 여러 지표를 측정하여 비교분석 하였다. 결과 : 전체 대상 환자에서 TCO_2는 nPCR, 혈철 알부민, 요소질소, 그리고 크레아티닌과 역상관관계가 있었으며, 다중 희귀분석을 이용한 독립 인자 분석에서는 혈중 요소질소와 연령이 TCO_2에 영향을 주는 독립인자이었다. 전체 대상 환자를 당뇨병 환지에 비당뇨병 환자로 나누어 비교해 보았을 때 각종 영양지표와 투석지표 사이에는 차이가 없었으며, 당뇨병 환자에서 TCO_2가 nPCR과 역상관관게가 있었고 nPCR이 독립인자이었으며, 비당뇨병 환자에서 TCO_2가 혈청크레아티닌과 역상관관계가 있었고 혈청 크레아티닌이 독립인자이었다. 결론 : 단백질 섭취의 증가가 대사성 산증을 일으키는 중요한 원인의 하나이지만, 본 연구에서는 당뇨병 환자에서 충분한 단백질의 섭취로 인해 TCO_2와 개선된 영양상태를 유지하였다. 그러므로, 또한 당뇨병 환자에서 비당뇨병 환자보다 충분한 단백질의 섭취가 산-연기 평형에 중요한 역할을 함으로서, 당뇨병 환자에서 영양상태 및 단백질 섭취에 대한 감시가 더욱 필요할 것으로 사료된다. Objective : Various degrees of metabolic acidosis are accompanied by the decrease in the kidney function. It is known that dialysis patients` long-term convalescences and complications are related to metabolic acidosis. It is generally known that the extreme acidosis of the dialysis patients should be corrected but on the contrary, there are reports on hemodialysis patients with slight acidosis have better nutritional condition. However, the research results are rare compared to the ratio of diabetic patients among dialysis patients. Therefore, in this paper we tried to reach a conclusion by comparing and analyzing the total carbon dioxide of the serum and other nutrition parameters of the diabetic patients among long-term hemodialysis patients with the non-diabetic patients. Methods : We divided 50 patients, who have been hemodialysis for longer than three months, into 21 patients with diabetes and 29 patients with nondiabetes. And compared and analyzed the TCO_2 in addition to measuring other parameters based on the blood tests carried out on the beginning of every month from January of 1999 to December of 2000. Results : TCO_2 showed a inverse correlation with nPCR, serum albumin, blood urea nitrogen, and creatinine on the correlation analysis of the total target patients. And blood urea nitrogen and age were the independent factors in the independent factor analysis using multiple regression analysis. When we divided and compared the total target patients into diabetic patients and no-diabetic patients, there were no signigicant differences between various kinds of nutrition parameters and dialysis parameters. And TCO_2 showed a inverse correlation with nPCR, nPCR being the independent factor in the diabetic patients. In addition, TCO_2 showed a inverse correlation with serum creatinine, serum creatinine being the independent factor in the non-diabetic patients. Conclusion : Increase of ingestion of protein was one of the important factors in inducing metabolic acidosis, but the TCO_2 and improved nutritional condition resulting from ingesting sufficient protein could be preserved in the diabetic patients. Therefore we think that the diabetic patients` nutritional condition and supervision of their ingestion of protein is more needed as sufficient ingestion of protein is a major factor in balancing acid-base for diabetic patients than non-diabetic patients.
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대장의 거대 용종절제술에서 박리성 올가미의 임상적 유용성
허진국 ( Jin Gook Huh ),김유선 ( You Sun Kim ),권선옥 ( Sun Ok Kwon ),장원철 ( Won Cheol Jang ),옥경선 ( Kyung Sun Ok ),정태엽 ( Tae Yeob Jeong ),류수형 ( Soo Hyung Rye ),이정환 ( Jung Hwan Lee ),문정섭 ( Jeong Seop Moon ) 대한장연구학회 2007 Intestinal Research Vol.5 No.2
Background/Aims: A large colonic polyp is a challenge for endoscopists due to the risk of serious hemorrhage, perforation or incomplete resection. We examined whether endoscopic resection of large polyps using a detachable snare is a feasible and safe procedure. We also examined the sizes of a polyp that could be removed. Methods: We retrospectively reviewed 65 cases of endoscopic resection of large colonic polyps using a detachable snare. Results: The sizes of the polyps included 3.5 cm (n=3), 3.0 to 3.4 cm (n=8), 2.0 to 2.9 cm (n=16) and 1.0 to 1.9 cm (n=38). The mean polyp size was 1.8 cm. The pathologic diagnoses of the resected polyps included 20 adenocarcinomas (30.8%), 38 adenomas (58.5%), three hyperplastic polyps, two inflammatory polyps, one hamartomatous polyp and one lymphangioma. The complete resection rate was 98.5% (64/65). There were no complications such as perforation, delayed bleeding or the need for additional surgery. Six complications of immediate bleeding (9.2%) developed after resection, but the bleeding was easily controlled by endoscopic treatment. Conclusions: According to our study, endoscopic resection of large polyps using a detachable snare can reduce not only complications of bleeding but also incomplete resection. Therefore, polyp size alone is rarely a contraindication to the endoscopic resection of a colonic polyp. (Intest Res 2007;5:151-157)
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정태엽,허웅,최신,한성민,권미란,최원충,김관엽,김영덕 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
While intussusception occurs rarely in adults, it presents almost always secondary to a definable primary lesion. The likelihood of neoplasia as the primary lesion is high particularly in the colon and operative management is thus always necessary. We experienced a case of intussusception, which was induced by lipoma in colon, in 64-year-old man presented with intermittent vague abdominal pain for a month. The patient was diagnosed by ultrasound & colonoscopy and treated with segmental resection of colon.
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