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부분 비장색전술로 부분관해된 특발성 문맥압항진증 1 예
김수영(Su Young Kim),김병호(Byung Ho Kim),이승훈(Seung Hoon Lee),오주형(Joo Hyeong Oh),이상목(Sang Mock Lee),김교영(Gyo Young Kim),김윤화(Youn Hwa Kim),이주희(Ju Hie Lee),동석호(Seok Ho Dong),김효종(Hyo Jong Kim),장영운(Young Woon ch 대한소화기학회 2001 대한소화기학회지 Vol.38 No.1
Background/Aims: Hepatolithiasis usually causes critical complications. Particularly, recurrent cholangitis is developed even after treatment. In this study, we aimed to find out the risk factors for recurrent cholangitis after management of hepatolithiasis, Methods: We reviewed the medical records of 196 patients with hepatolithiasis who had been diagnosed newly and treated at Seoul National University Hospital between January 1980 and August 2000. Then, the cumulative rate of cholangitis after treatment of hepatolithiasis and the possible risk factors for cholangitis through univariate and multivariate analysis were evaluated. Results: The cumulative rate of cholangitis of all patients was 9.6%/patient-year. Univariate analysis revealed that the presence of residual stone after treatment (p<0.0001), common bile duct stone before treatment (p=0.0066), stone recurrence after treatment (p=0.0014), and disruption of the sphincter of Oddi (p=0.0046) were significantly associated with recurrent cholangitis. By multivariate analysis using Cox model, the presence of residual stones, recurrence of stones, and the disruption of sphincter of Oddi were turned out to be the independent risk factors, but the presence of common bile duct stones was not. Conclusions: Complete removal of bile duct stone, prevention of recurrent stones, and preservation of the sphincter of Oddi can decrease the rate of cholangitis in patients with hepatolithiasis. (Korean J Gastroenterol 2001;38:42-47)
김범수(Bum-Soo Kim),주선형(Sun-Hyung Joo),차재명(Jae-Myung Cha),김교영(Gyo-Young Kim) 한국간담췌외과학회 2008 한국간담췌외과학회지 Vol.12 No.2
Gastrointestinal stromal tumors (GISTs) are rare tumers of the alimentary tract, and these tumors arise from primitive mesenchymal cells. Duodenal GISTs comprise 4-5% of all GISTs. In this article, we report on a case of duodenal GIST in 35-year-old male who presented with a fistulo in ano and anal bleeding. Abdominal computed tomography and magnetic resonance imaging revealed a huge tumor, about 11 7 cm in size, of the duodenum. Duodenoscopy revealed a protruded mass with central deep ulceration on the third portion of the duodenum. Endoscopic biopsies showed subepithelial spindle cell proliferation of the tumor, and this was consistent with GIST. Pylorus-preserving pancreaticoduodenectomy was then performed. He subsequently underwent the sphincter-preserving modified loose Seton surgical technique. The patient did not have any problems postoperatively and he remained symptom-free at 6 months after surgery.
성인에서 장중첩증을 유발한 회장의 염증성 섬유양 용종 1예 Running title: 장중첩증을 유발한 회장의 염증성 섬유양 용종
김대호 ( Dae Ho Kim ),차재명 ( Jae Myung Cha ),이정일 ( Joung Il Lee ),주광로 ( Kwang Ro Joo ),신현필 ( Hyun Phil Shin ),박재준 ( Jae Joon Park ),전정원 ( Jung Won Jeon ),임준욱 ( Jun Uk Lim ),김교영 ( Gyo Young Kim ) 전북대학교 의과학연구소 2012 全北醫大論文集 Vol.36 No.1
성인에서 관찰되는 대부분의 장중첩증은 장의 양성 또는 악성 종양에 의해서 발생한 다. 염증성 섬유양 용종은 매우 드물게 관찰 되는 양성 종양이며 소장에서 발생할 경우 에 장중첩중, 복통, 또는 설사를 유발한다. 본 증례에서는 37세의 남자가 3개월 동안 지 속된 수양성 설사와 우하복부 통증을 주소로 본원에 방문하였다. 혈액검사에서 C 반응 성 단백수치의 상승 및 백혈구 수치의 상승 외에 특별한 이상은 없었다. 대장내시경검사 에서 말단 회장의 종양이 보였으며 컴퓨터 복부촬영을 통해 이 종양에 의한 회맹부의 장중첩증을 진단하였다. 수술적인 장절제술을 시행하였으며 조직검사에서 염증성 섬유 양 용종으로 판명되었다. 이 증례를 바탕으로 임상의사들은 회맹부의 장중첩증 진단시, 특히 염증성 증상과 징후가 동반되어 있을 때, 염증성 섬유양 용종의 가능성을 고려해 야 할 것으로 본다. Most of intussusception cases in the adult are caused by benign or malignant neoplasms as a lead point. Inflammatory fibroid polyp, which is a rare, benign neoplasm, may provoke intussusceptions, abdominal pain, or diarrhea when it is located in the small bowel. In this case, a 37-year-old man visited our hospital with complaints of chronic watery diarrhea and right lower quadrant abdominal pain which developed 3 months ago. Laboratory findings were non-specific, except elevated C-reactive protein and shift to the left in the differential count of white blood cell. Colonoscopy showed movable terminal ileal mass and abdominal computed tomography showed an ileocecal intussusception caused by this mass. After a surgical resection, histopathologic diagnosis was inflammatory fibroid polyp. This case suggests that physicians should consider the possibility of an inflammatory fibroid polyp in the differential diagnosis of an ileocecal intussusception, especially when the intussusception is associated with inflammatory symptoms and signs.
전이성 대장암 환자에서 동시성 및 이시성 간전이 종양의 Cyclooxygenase (COX)-1과 Cyclooxygenase (COX)-2 및 E-cadherin 발현의 의의
주선형(Sun Hyung Joo),김범수(Bum Soo Kim),최성일(Sung Il Choi),송정윤(Jeong Yoon Song),이길연(Kil Yeon Lee),김윤화(Yun Wha Kim),김교영(Gyo Young Kim),이석환(Suk Hwan Lee),이상목(Sang Mok Lee),홍성화(Sung Wha Hong) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.3
Purpose: Recent studies have shown that cyclooxygenase (COX)-2 may be involved in colorectal carcinogenesis. In this study, we evaluate the differences of COX-2 expression in patients with synchronous and metachronous hepatic metastasis of colorectal cancer. In addition, the expression of COX-1 and E-cadherin were also evaluated. Methods: Paraffin embedded blocks were obtained from 41 patients who underwent surgery for colorectal cancer with hepatic metastasis. Samples from primary colorectal cancer, synchronous and metachronous hepatic lesions were stained by immunohistochemistry for monoclonal antibody against COX-1, COX-2, and E-cadherin. Results: In colonic COX-1 expression, there was no significant difference in the degree of COX-1 expression between primary colorectal cancer with synchronous hepatic metastasis and that of metachronous hepatic metastasis (P=0.507). In colonic COX-2 and E-cadherin expression, the degree of COX-2 expression was not different between the two groups. But, the patient survival rate in the positive group of COX-1 and COX-2 expression was lower than in the negative group, respectively (P=0.023, P=0.006). Conclusion: The degree of colonic COX-1 and COX-2 expression has an impact on prognosis in synchronous and metachronous hepatic metastasis. Further large-scale study is necessary to determine the meaning of COX-2 expression in colorectal cancer.
신증후군과 출혈성 위염으로 발현된 원발성 유전분증 1예
이재진,김명재,박용구,이태원,김희진,김교영,임천규 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.5
A case of a 58 year old woman who was found to have primary amyloidosis is reported. She was presented with nephrotic syndrome and hemorrhgic gastritis. She was confirmed by showing apple green birefringence under the polarized microscope with Con-go-red stain thraugh renal and stomach biopsy. Immunoelectrophoresis of urine exhibited Bence-Jones protein( λ type) and protein electrophoresis of urine exhibited monoclonal gammopathy. She was treated with cyclophosphamide and prednisolone, and proteinuria and gastrointestinal symptoms were improved. We discussed this case with a brief review of literature.