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김명환,김영환,김효정,이성구,서동완,최호순,이승규,유병무,민영일,고문수,민병철,이미화,임미경,김표년 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.1
Background/Aims: Choledochal cyst is a congenital dilatation of extraor intrahepatic bile duct . Recently, anomalous union of pancreaticobiliary duct(AUPBD) is supposed to be one of the major causes of choledochal cyst. The aims of this study are to assess the association ratio of AUPBD in choledochal cyst and whether the AUPBD in choledochal cyst have a clinical significance. Methods: The study subjects were 35 adult patients who were diagnosed by ERCP in Asan Medical Center from August, 1990 to July, 1995. We have classified the type of choledochal cyst and AUPBD according to Todani and Kimura, respectively. Result: The number of choledochal cyst was 14 cases(40%) in type I, I case(3%) in type II, 6 cases(17%) in type Ⅲ, 11 cases(31%) in type IVA. Three cases were unclassified. Among the 35 cases, 22 cases(63%) of choledochal cyst were associated with AUPBD. AUPBD was only seen in type I, IVA and unclassified form of choledochal cyst. The number of patients with type 1 AUPBD was 10(45%) and type 2 was 12(55%) by Kimura's classification. 'Che mean age was younger in patients with choledochal cyst and AUPBD(36.2 16 years) than in choledochal cyst aione(49.3 19 years). Acute inflammation and malignancy of biliary tree 8z pancreas were more commonly seen in patients with choledochal cyst and AUPBD than choledochal cyst alone. Conclusion: In patients with choledochal cyst, the association of AUPBD was not uncommon and they had more grave clinical course. AUPBD may be a contributing factor to develop mali~ancy in patiehts with choledochal cyst.
Kim, Kyoung Won,Kim, Min Ju,Lee, Seung Soo,Kim, Hyoung Jung,Shin, Yong Moon,Kim, Pyo-Nyun,Lee, Moon-Gyu American Roentgen Ray Society, etc.] 2008 American Journal of Roentgenology Vol.190 No.4
<P>The purposes of this study were to illustrate the sonographic features of focal hepatic lesions with peritumoral sparing of fatty infiltration in patients with hepatic steatosis, to correlate the sonographic findings with CT and MRI findings, and to discuss the possible mechanisms.</P>
중추신경자극제를 사용할 수 없는 주의력결핍과잉행동장애 아동에서의 Modafinil 효과 : 예비 연구
유한익,김진용,박수진,전정원,왕희령,김붕년,홍진표,김성윤,김창윤 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.6
Objectives : This study was aimed to examine the efficacy and safety of modafinil in psychostimulant-inapplicable children with attention deficit hyperactivity disorder (ADHD) due to insufficient treatment response or intolerable adverse effects. Methods : Fifteen children (8.8±1.8 years, 14 boys, total IQ 107.22±13.4) were recruited for this study. ADHD was confirmed by K-SADS-PL. The efficacy was assessed by ADHD rating scale (ADHDRS), Conner's parental rating scale-revised(CPRS-R), ADHDRS school version, clinical global impression (CGI) and computerized neurocognitive function test. Mean dose of modafnil was 250. 0±103.3 mg. Results : Total score (p=0.012) and hyperactive/impulsive score (p=0.021) of ADHDRS for investigator, as well as CPRS-R score (p<0.01) and CGI-severity score (p<0.01) were significantly reduced after 39.2±8.7 days of modafmil administration. Response time of word color test was also significantly decreased after medication. Decreased appetite (2 subjects), insomnia (2 subjects), irritability (1 subject) and alopecia (1 subject) were observed during this study period. Conclusion : Modafinil was effective and well-tolerated for the psychostimulant-inapplicable children with ADHD.
Kyung Ho Kim,Yong Sik Yoon,Chang Sik Yu,Tae Won Kim,Hye Jin Kim,Pyo Nyun Kim,Hyun Kwon Ha,Jin Cheon Kim 대한외과학회 2011 Annals of Surgical Treatment and Research(ASRT) Vol.81 No.1
Purpose: To evaluate the comparative therapeutic efficacy of radiofrequency ablation (RFA) and hepatic resection for the treatment of colorectal liver metastasis (CRLM). Methods: Between 1996 and 2008, 177 patients underwent RFA, 278 underwent hepatic resection and 27 underwent combination therapy for CRLM. Comparative analysis of clinical outcomes was performed including number of liver metastases, tumor size, and time of CRLM. Results: Based on multivariate analysis, overall survival (OS) correlated with the number of liver metastases and the use of combined chemotherapy (P < 0.001, respectively). Disease-free survival (DFS) also correlated with the number of liver metastases (P < 0.001). In the 226 patients with solitary CRLM < 3 cm, OS and DFS rates did not differ between the RFA group and the resection group (P = 0.962 and P = 0.980). In the 70 patients with solitary CRLM ≥ 3 cm, DFS was significantly lower in the RFA group as compared with the resection group (P = 0.015). Conclusion: The results indicate that RFA may be a safe alternative treatment for solitary CRLM less than 3 cm, with outcomes equivalent to those achieved with hepatic resection. A randomized controlled study comparing RFA and resection for patients with single small metastasis would help to determine the most efficient treatment modalities for CRLM.
( Gil-sun Hong ),( Jae Ho Byun ),( Heon-ju Kwon ),( Ji Yeon Kim ),( So Yeon Kim ),( Hyung Jin Won ),( Kyung Won Kim ),( Young Moon Shin ),( Pyo Nyun Kim ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: To identify imaging characteristics that differentiate small (£2 cm) HCCs from small (£2 cm) benign nodules in cirrhotic liver on gadoxetic acidenhanced and diffusion-weighted (DW) magnetic resonance (MR) images. Methods: On gadoxetic acid-enhanced and DW MR images, we analysed signal intensity of 222 small HCCs and 61 benign nodules (diameter, 0.5-2 cm) at each sequence and rim enhancement during portal or equilibrium phases. Univariate and multivariate logistic regression analyses identified predictors of HCC. Combinations of significant MR findings in multivariate analysis were compared with American Association for the Study of Liver Disease (AASLD) practice guidelines. Results: In multivariate analysis, arterial enhancement (adjusted odds ratio [aOR], 8.6), T2 hyperintensity (aOR,5.8), and hyperintensity on DW images (aOR, 3.8) were significant for differentiating small HCCs from benign nodules (p £ 0.004). When two or all three findings were applied as diagnostic criteria for differentiating small HCCs from benign nodules, sensitivity and accuracy were significantly higher compared with AASLD practice guidelines (91% vs. 78% and 89% vs. 81%, respectively;each P<0.0001). Conclusions: On gadoxetic acid-enhanced MR imaging, arterial enhancement and hyperintensity on T2-weighted and DW MR images are helpful for differentiating small HCCs from benign nodules in liver cirrhosis.
Kim, Il-Young,Kim, Pyo-Nyun,Cho, Won-Soo,Bae, Won-Kyung,Hwang, Sung-Gyu,Yang, Seng-Ha,Lee, Kyung-Soo 순천향의학연구소 1995 Journal of Soonchunhyang Medical Science Vol.1 No.1
초음파검사에의한 만성활동성간염과 지방간의 감별점은 명확히 정립된 것이 없다. 본연구자들은 상기의 만성활동성간염과 지방간의 감별점을 초음파검사에 의해 찾아보고자 본연구를 시행하였다. 저자들은 간실질의 에코의 정도와 간문맥의 벽의 불명확정도를 분석하였다. 간의 에코의 정도는 우측신장의 피질과 비교하여 그정도를 분류하였다. 간문맥의 불명확정도를 분류하였으며 가장 않보일때를 그레이드 3으로 정하였다. 정상소견 13례를 포함하여 11례의 지방간과 32례의 만성활동성간염의 초음파필림을 2명의 방사선과전문의가 병리적진단에 대한 정보없이 판독하였다. 지방간에 있어서는 간실질의 에코는 그레이드 Ⅱ가 6례, 그레이드 Ⅲ이 5례였다. 문맥의 불명확정도는 전례에서 그레이드 Ⅲ이었다. 만성활동성간염에서는 간실질의 에코는 그레이드 Ⅰ이 29례, 그레이드 Ⅱ가 2례, 그레이드 Ⅲ이 1례였다. 간문맥의 불명확정도는 그레이드 Ⅱ가 18례, 그레이드 Ⅲ가 14례였다. 초음파소견에 의한 진단의 평균 정확도는 64%였다. 평균 예민도는 60%, 평균 특이도는 77%였다. 본연구의 결과는 두질환을 감별하는데 통계적으로 유의하였다 (p=.0458).