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흡수장애 증후군으로 나타난 악성림프종과 동반된 유전분증
김태헌(Tae Hun Kim),김재규(Jae Gyu Kim),장유현(Yoo Hyun Jang),송상용(Sang Yong Song),정현채(Hyun Chae Jung),송인성(In Sung Song),조한익(Han Ik Jo),김용일(Yong Il Kim),최규완(Kyoo Wan Choi),김정룡(Chung Yong Kim) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.4
Amyloidosis is known as a disease that affects almost all organs, and may especially cause wides- pread damage to the gastrointestinal tract. Intestinal amyloid may cause motility disturbances with diarrhea or constipation, malabsorption, bleeding, and perforation. We report a case of systemic amyloidosis presenting as a malabsorption syndrome. A59-year old woman with abdominal pain and chronic diarrhea turned out to have malignant lymphoma, GI amyloidosis, monoclonal gammopathy, and malabsorption syndrome. Well differentiated lymphocytic lymphoma was diagnosed by bone marrow biopsy. Endoscopic biopsy tissues from duodenum and rectum showed typical electron microscopic and staining features of amyloidosis. Serum protein electrophoresis revealed IgG k monoclonal gammopathy. D-xylose test and a- anti-trypsin clearance test confirmed malabsorption and protein-losing enteropathy, respectively. (Korean J Gastroenterol 1995;27: 481-487)
김병관 ( Byeong Gwan Kim ),김유선 ( You Sun Kim ),김주성 ( Joo Sung Kim ),정현채 ( Hun Chae Jung ),송인성 ( In Sung Song ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<목적> ASCA는 크론병에, 그리고 pANCA는 궤양성대장염에 비교적 특이한 자가항체로 알려져 있으나 아직 논란이 있는 실정이다. 본 연구에서는 크론병, 궤양성 대장염, 베체트 장염 그리고 장결핵환자와, 그 가족들을 대상으로 ASCA와 pANCA를 측정하여 진단적 유용성에 대하여 평가하고자 하였다. <방법> 1999년 1월부터 2000년 12월까지 서울대학교병원에서 치료를 받고 있는 크론병 85명, 궤양성 대장염 77명, 베체트 장염 36명, 장결핵
소간세포암의 분화도와 혈관분포 양상에 따른 종괴 및 비종괴 부위에서 Insulin-like Growth Factor-II 발현 차
김태헌,송인성,정현채,이효석,김정룡,윤정환,이준성,우광훈,윤용범,장자준 대한소화기학회 2000 대한소화기학회지 Vol.36 No.1
Background/Aims : The precise mechanisms of insulin-like growth factor-II (IGF-II) in hepatocarcinogenesis have not been clarified yet. Recently, it was suggested that IGF-II might be closely related to angiogenesis. This study was designed to verify mechanisms of IGF-II in hepatocarcinogenesis and its relation to angiogenesis. Methods : For seventeen patients with small hepatocellular carcinoma (HCC) (≤3 cm in diameter), tissues were obtained from both tumorous and nontumorous area. We analyzed the degree of histological differentiation by Edmonson and Steiner's criteria and vascularity shown on spiral computed tomography (CT). The level of IGF-II expression was analyzed by immunohistochemical staining. Results : The histological differentiation of HCCs in the 17 patients were observed as follows : grade I in 3, grade II in 7, grade III in 7. Eleven patients showed hypervascular tumors on spiral CT. There was a significant correlation between the relative expression patterns of IGF-II and the degree of histlogical differentiation of HCCs. That is, in case of the more differentiated HCCs, IGF-II was more expressed in in tumorous tissues than in nontumorous tissues (r=0.609, p=0.010). Conclusions : These results suggest that IGF-II might play a role in an early stage of hepatocarcinogenesis.
김태헌,송인성,정현채,최규완,김정룡,한철주,이동수,장유현,신건성,조창락 대한내과학회 1996 대한내과학회지 Vol.50 No.1
Hypoalbuminemia due to gastrointestinal loss of protein has been reported in association with many pathologic conditions of stomach and bowel. We have recently experienced a 63 year old man with stomach cancer presenting with generalized edema. The patient .had severe hypoalbuminemia and we confirmed protein loss through the gastric mucosa as its cause by ^(99m)Tc labled albumin scan and alpha 1 antitrypsin clearance test. The possiblility of other coincidental gastrointestinal lesion was excluded. After total gastrectomy, hypoalbuminemia was corrected to normal range without replacement of albumin and follow up albumin scan revealed no albumin loss. To our knowledge there have been a few case reports of protein losing gastroenteropathy due to stomach cancer. Therefore, it is recommended to exclude cancer at first, when an etiologic diagnosis is scheduled for the differentiation of protein losing enteropathy in this country.
김태헌,송인성,정현채,최규완,이준행,김정룡,한철주,장유현,신건성,조창락,임영석 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.3
The endoscopic diagnosis of gastric carcinoid has been considered difficult. Reported cases of this tumor diagnosed by endoscopic examination are rare. And the gastric carcinoid with massive upper gastrointestinal bleeding is a rare disease entity. We experienced a case of gastric carcinoid admitted to the hospital because of hematemesis, melena and syncope. And it was diagnosed by endoscopic biopsy, although it resembled type IIa+IIc early gastric cancer at endoscopic examination. To our knowledge, this is the first case report of gastric carcinoid tumor mimicking early gastric cancer. So we report this case with a review of relevant literatures.
이대희,이동호,송인성,정현채,최규완,김정룡,한철주,윤용범,장유현,신건성,조창락,황경국,김태현,전재석 대한내과학회 1996 대한내과학회지 Vol.50 No.6
The most common complications of chronic pancreatitis are pancreatic calcification, diabetes mellitus, steatorrhea, pancreatic pseudocyst and upper gastrointestinal bleeding. Pesudoaneurysm whether with pseudocyst or nat may cause gasrointestinal bleeding and it is a serious complication. Erosion of visceral artery with pseudoaneurysm formation may bleed into pancreatic duct which is known as $quot;emosuccus Pancreaticus$quot;. On rare occasions, pseudoaneurysm may bleed into adjacent organs (stomach, duodenum, colon). A 56-year-old man was admitted to Seoul National University Hospital with repeaoted hematemesis. With repeated gastroscopy, we found submucosal tumor like lesion in the stomach. Computed tomography and celiac angiography showed splenic artery pseudoaneurysm, which at operation was found to have ruptured into the stomach. The pseudoaneurysm and spleen were removed and the patient has had no further bleeding. When gastrointestinal bleeding is associated with chronic pancreatitis and the usual sources of bleeding are not detected by endoscopy, the rupture of a pseudoaneurysm schould be considered as one of the causes.
한상욱,박재갑,김태헌,송인성,정현채,최규완,김정룡,한철주,윤용범,장유현,신건성,조창락 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.3
The prevalence of colon cancer is increasing in Korea and the principal strategy of its management is early detection and surgical resection. For the early detection of colon cancer, endoscopic evaluation is important and the ability to find out early stage small lesion is needed for the endoscopist. To find out encloscopic features of early colon cancer, we reviewed 17 cases of early colon cancer who have admitted to Seoul National University Hospital from January 1982 to December 1993. 1)59% of the lesions were located in rectum and the size ranged from 0.7cm to 9cm, all of the 17 cases showed polypoid mass contour and the surface of them had erosion, hyperemia, ulceration and easy touch bleeding tendency. 2) Colon cancer was diagnosed by endoscopic gross findings in 41% and endoscopic biopsy could confirm colon cancer in 70%. However, barium enema could diagnose only 41% of early colon cancer. 3) Five cases were operated under the diagnosis of colonic adenoma which were large($gt;3 cm) villous type or contained severe dysplasia 4) Submucosal tumor infiltration was found in 10 cases and 65% had associated adenoma 5) Lymph node involvement was none and there was no recurrence in 47 month follow up period after various surgical treatments.
하대정맥 막성폐쇄 환자의 간세포암 누적발생률과 누적장기생존율
이대희,김태헌,송인성,정현채,이효석,김정룡,윤정환,우광훈,이진혁,이광현,김진욱 대한소화기학회 2000 대한소화기학회지 Vol.35 No.3
Background/Aims: Membranous obstruction of inferior vena cava (MOIVC) has been known as one of the risk factors for hepatocellular carcinoma (HCC). However, the incidence of HCC in patient with MOIVC or the effect of treament on the natural history of the patients has not yet been evaluated. The present study was to analyze the incidence of HCC and the survival rate, and then, to determine whether treatment may modify the clinical course. Methods: The medical records of 39 patients diagnosed as MOIVC at Seoul National University Hospital from December 1984 to November 1997 were retrospectively analyzed. Results: Seven patients had HCC at the time of diagnosis. We performed angioplasty for 21 of the rest patients, surgery for 4, and supportive care for 7. The 5- and 10-year survival rates of all patients were 90% and 69%, respectively. The 1-, 2- and 7-year incidence of HCC was 5%, 11% and 26%, respectively. The 10-year survival rates of treated and non-treated patients were 75% and 66%, respectively (p$gt;0.05). The 5-year incidence of HCC in treated and non-treated patients was 14% and 0%, respectively (p$gt;0.05). Conclusions: The treatment of MOIVC did neither increase survival rate nor prevent the development of HCC. Therefore, the efficacy of treatment for MOIVC should be reevaluated and patients should be followed up for the detection of HCC.
표면평탄형 조기위암 (EGC IIb) 의 내시경적 소견
이동호,김태헌,송인성,김용태,정현채,김용일,최규완,김정룡,한철주,윤용범,장유현,김선미,신건성,조창락 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.3
Early gastric cancer(EGC) has been proved to be a malignant tumor with favorable prognosis in contrast to the advanced one, thus early diagnosis has always been the emphasis regardless its type. In particular, diagnosis of superficial flat type EGC(IIb) is extremely difficult on gross inspection. The aim of this study is to review the clinical features of the patients with EGC type IIb, with special reference to the endoscopic appearance of tumor. We reviewed the medical records and endoscopic findings of 13 patients which were thereafter surgically resected and pathologically proven EGC type IIb at SNUH from 1989 to 1993. The depressed lesion was observed most frequently in EGC type IIb. The endoscopic suggestion of EGC type IIb were given initially with mucosal bleeding and discoloration. In 3 cases (20%), tumor extended to the submucosa and in only 1 case, lymph node metastasis was found. Four patients(30.9%) had another coincidental EGC or peptic ulcer. Every possible effort is needed not to omit the resectable cancer when the mucosal bleeding and discoloration is observed. Careful observation is recommended not to overlook coincidental lesions.