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이석호,이상구,류광현,고광철,이규택,김재준,최규완,이남용,백승운,이종균,이준혁,이종철,심상군,이풍렬,조승렬 대한소화기학회 1999 대한소화기학회지 Vol.34 No.4
Intestinal capillariasis is caused by Capillaria philippinensis. Among them, only 4 species have been found in humans: Capillaria hepatica, C. aerophila (Eucoleus aerophilus), C. plica and C. philippinensis. Reports of human infections with C. hepatica, C. aerophila and C. plica are rare, but reports of C. philippinensis infections are increasing and spreading geographically. Human infestation by C. philippinensis is a rare parasitic disease. We experienced a case of intestinal capillariasis which was misdiagnosed for intestinal tuberculosis or Crohn's disease at first but correctly diagnosed later by detection of numerous eggs of C. philippinensis on the stool examination. The eggs were found in stool only after ingestion of prednisolone for treatment of misdiagnosed Crohn's disease. The 42 year-old patient had a journey to Saipan island in Pacific ocean 6 months ago and ate sliced raw eels. Abdominal pain, watery diarrhea were subsided after therapy of albendazole.
이석호,이화영,이규택,강인구,최규완,백승운,이종균,이준혁,고광철,이종철,오영륜,현재근,이풍렬,김재준,채종일 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.2
Strongyloidiasis is a parasitic disease caused by Strongyloides stercoralis which exists in two forms : the free living and parasitic forms. It exists in warm, moist climate in areas where there is frequent fecal contamination of the soil. After cutaneous invasion by the filariform larvae, petechial hemorrage, pruritus, papular rashes, edema, and urticaria occur. Infection commonly occurs in the proximal intestine of the gastrointestinal (G-I) tract but may extend from the stomach to the anus. Once the worm is established in the small intestine, the physical findings may include epigastric tenderness to palpation. The mucosal biopsy is an inefficient way of making the diagnosis because the worm is found in the biopsy specimen in only 2% of patients. Gastric strongyloidiasis is rare. We experienced a case of gastric strongyloidiasis diagnosed by the endoscopic biopsy and serologic test for parasite specific IgG antibody by micro-ELISA.
Protective effect of yeoldahanso-tang on radiation-induced oral mucositis in mice
Lee, Jong Hyun,Lim, Sung-Lyul,Lee, Seok-Geun,Ryu, Seung-Hee,Lee, Sang-wook,Kim, Kwanil,Jung, Jinhong,Kong, Moonkyoo,Lee, Jung-woo,Lee, Junhee,Eun, Young-Gyu,Ahn, Kwang Seok Kyung Hee Oriental Medicine Research Center, Kyung 2016 Oriental Pharmacy and Experimental Medicine Vol.16 No.1
Radiation-induced oral mucositis is probably the most common toxicity for head and neck cancer patients. This adverse effect potentially leads to various lesions such as erythema, ulcerations, pain, opportunistic infections, and weight loss. Although there are many experimental studies and clinical trials related to novel therapies for radiation-induced oral mucositis, we here evaluate the protective effect of orally administrated Yeoldahanso-tang (YDHS) on radiation-induced oral mucosal damage in a mouse model. YDHS is a traditional Korean herbal formula, containing 7 herbs: Pueraria thunbergiana Benth., Angelica tenuissima Nakai, Platycodon grandiflorum (Jacq.) A. DC., Raphanus sativus var., Angelica dahurica Benth. et Hooker f., Cimicifuga heracleifolia Kom., and Scutellaria baicalensis Georgi. Oral mucosal damage was induced by irradiation (17 Gy) throughout the head and neck area in male BALB/c mice. YDHS (400 or 800 mg/kg/day for consecutive 12 days) was administered orally, and the protective effect was determined by histological evaluation of the oral mucosa. We found that irradiation highly increased COX-2 expression in salivary glands and its expression was suppressed by YDHS. Histologically, the irradiated mice exhibited the epithelial thickness from the basement membrane to the stratum granulosum significantly decreased as compared to the vehicle group. YDHS-treated mice showed significantly recovered epithelial cell layer thickness compared to irradiated group. Similarly, YDHS-treated group also showed the expression of Ki-67, cell proliferation maker, in the basal layer compared to the irradiated group in both dorsal and ventral surface. From these results, we suggest that YDHS is a promising candidate for preventing or treating radiation-induced oral mucositis during radiation therapy.
소화성 궤양 출혈에서 열탐침 지혈법 후 재출혈의 위험인자
김영호,이석호,이상구,손희정,이규택,최규완,백승운,이종균,이준혁,고광철,이종철,김재준,류광현,이풍렬 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.6
Background/Aims: The precise rebleeding rate and risk factors of rebleeding after heat probe thermocoagulation in peptic ulcer patients with bleeding are not clear and still need to be evaluated. If we could identify the pre-dictors for rebleeding, the mortality rate might be loweted with early retreatment or surgery in these high risk group. Methods: The 94 patients in whom heat probe was applied were enrolled and the 18 patients with bleeding tendencies. Initial hemostasis was defined as hemostasis persisting for 24 hours post-treatment and permanent hemostasis as absence of bleeding for 7 days after therapy. Rebleedig was defined as oozing or spurting hemorrhage in the ulcer base and/or unstable vital signs and continuting tarry or bloody stool or hematemesis after therapy. Results: In 35 patients with active bleeding sign, initial hemostasis was obtained in 30 (85.7%) patients. After having achieved initial hemostasis, 9 (30.0%) patients rebled. In 41 ulcer patients with non-bleeding visible vessel, 40 cases (97.6%) achieved successful pre-vention of rebleeding. No evident complication was observed. With univariate analysis, bleeding ulcer patients with spurting and oozing hemorrhage had a higher re-bleeding rate than those with non-bleeding visible vessel. Conclusions: The heat probe thermocoagulaton is relative safe and effective procedure to protect bleeding in pectic ulcer patients with non-bleeding visible vessel, but insufficient to hemostasis in bleeding peptic ulcer patients with spurting or oozing in ulcer base. Spurting and oozing hemorrhage are the only risk factors of rebleeding after initial hemostasis with heat probe thermocoagulation in peptic ulcer patients with bleeding.
이종철,이석호,이규택,김재준,이종균,고광철,이풍렬,최규완,이준혁,오영륜,박근칠 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.3
Pseudomyxoma peritonei is a benign mucin producing tumor of the peritoneum which is usually diagnosed using a laparotomy. It is uncommon to find a case of pseudomyxoma peritonei which has been diagnosed using a peritoneoscopy in Korea; there are only two cases reported in the literature. We recently experienced a case of pseudomyxoma peritonei in a 61 year old woman who manifested a typical case using a peritoneoscopy. Thick, jelly-like materials were adherent to polypoid nodular masses of the parietal peritoneum, which originated from the mucinous cystadenocarcinoma of an ovary. In this report we discuss the case with relevant review of the literature.
( Jong Lyul Lee ),( Chang Sik Yu ),( Seok Byung Lim ),( Tae Won Kim ),( Jong Hoon Kim ),( Jin Cheon Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background:Precise understanding of recurrence patterns permits effi cient surveillance and effective treatment strategies. The aim of this study was to evaluate recurrence patterns after treatment of rectal cancers, specifi cally with respect to tumor location and chemoradiotherapy (CRT). Methods:A single-institution, retrospective cohort of 2,086 consecutive rectal cancer patients was enrolled between January, 2000 and December, 2007. All the patientsunderwent curative operations (R0). Tumor location was classifi ed into lower (=5cm), middle (>5cm - = 8cm), and upper (> 8cm) groups based on the distance of the inferior tumor border from the anal verge; the patients were also characterized according to whether they received preoperative/postoperative CRT. Results: The lung was the most common recurrence site in the lower group (lower vs. middle/ upper; 14.6% vs. 8.9%/ 8.0%, P = 0.001/ 0.001). Recurrence patterns were not associated with receipt of preoperative/postoperative CRT. Additionally, RT and CRT did not reduce the rate of pulmonary recurrence (no RT/preoperative CRT/postoperative CRT, 37.5/37.9/42.6%; P = 0.13). In a multivariate analysis, preoperative level of serum carcinoembryonic antigen, abdominoperineal resection, advanced T category, N category, and circumferential resection margin were identifi ed as independent risk factors for pulmonary recurrence in all groups. Otherwise, low rectal cancer was associated with unresectable pulmonary recurrence (RR = 2.19; 95% CI = 1.012-3.072; P = 0.04). Conclusions: Neither RT nor CRT affects the pattern and rate of recurrence. Tumor location specifi cally affects recurrence in rectal cancer patients, such that the lower group is a risk factor for unresectable pulmonary recurrences.
식도정맥류에 대한 내시경적 정맥류 결찰요법 후 재출혈 및 재발과 연관된 위험인자들
이석호,이규택,김재준,백승운,최문석,이종균,이준혁,고광철,이풍렬,오성윤,이종철,최규완 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.1
Background/Aims: Rebleeding and recurrence of varices are frequent problems following endoscopic variceal ligation (EVL). However, few data are available on the risk factors associated with rebleeding and recurrence. Our aims were to elucidate the clinical feaNres and risk factors associated with rebleeding and recuuence. Methods: One-hundred and eight patients who had undergone EVL due to bleeding esopltageal varices were included in the study. EVL was performed with the Stiegman-Goff Endoscopic Ligator at 2 week intervals until the varices are eradicated or reduced to grade 1 without red color sign (defined as successful EVL), followed by gastroscopy every 3 months. Rebleeding was defined using the descriptions from the Second Baveno International Consensus Meeting, in 1995. Recurrence was defined as increments of varices to grade 2 or greater or appearance of red color sign on follow-up examinations. The Kaplan-Meier method was used to determine the rebleeding and recurrence rate. The Log-rank lest and Cox regression lest were used for univariale and multivariate analysis of risk factors, respectively. Results: 1) The most common cause of rebleeding within 2 weeks from the EVL was esophageal ulcer (50%); whereas, the most common cause of rebleeding after 2 weeks was recurrent varices (38%). 2) In univariate analysis, persistence of esophageal ulcer at 2 weeks after the first EVL was associated with rebleeding (p=0.01); whereas, age, Child class, grade and extent of varices, presence of gastric varices and/or portal hypertensive gastropathy, total number of bands and sessions for successful EVL were not (p >0.05). Persistence of esophageal ulcer at 2 weeks after the first EVL was associated with rebleeding also in multivariate analysis (relative risk 5.87, p=0.01). 3) In univariate analysis, grade (p=0.01) and extent (p=0.01) of varices were related to recurrence; whereas, age, Child class, presence of gastric varices and/or portal hypertensive gastropathy, total number of bands and sessions for successful EVL were not (p >0.05). In multivariate analysis, grade of varices was the only risk factor associated with recurrence (relative risk 3.76, p=0.01). Conclusions: 1) Persistence of esophageal ulcer at second week after the first EVL was associated with rebleeding. 2) Frequent follow-up endoscopic examinations are necessary in patients who present with high grade of vaces since risk of recurrence is high even after successful EVL.