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대장 용종에서 렙틴 발현에 따른 임상병리학적인 특성의 차이
옥경선 ( Kyung Sun Ok ),김유선 ( You Sun Kim ),김형훈 ( Hyung Hun Kim ),류수형 ( Soo Hyung Ryu ),이정환 ( Jung Hwan Lee ),문정섭 ( Jeong Seop Moon ),강윤경 ( Yun Kyung Kang ) 대한소화기학회 2010 대한소화기학회지 Vol.56 No.1
Background/Aims: Colorectal adenoma and cancer are known to be associated with obesity. Leptin, an adipocyte-derived hormone that plays a crucial role in obesity has been suggested as a growth factor in colon cancer. However, the association between adenoma and leptin remains controversial. We evaluated the leptin expression in human colorectal adenoma and its correlation to clinicopathologic factors. Methods: Leptin expression was assessed by immunohistochemistry in 91 samples of colorectal adenoma larger than 5 mm, which were removed by endoscopic polypectomy. All patients underwent colonoscopy for cancer screening at Seoul Paik Hospital from 2007 to 2008 and we only included the patients less than 50 years of age. Leptin expression and its relationship with clinicopathologic features were analyzed. Results: Eighty samples were available for the interpretation of leptin expression and showed positive in 42 (52.5%) cases and negative in 38 (47.5%) cases. As body mass index (BMI) increased based on World Health Organization (WHO) classification the positivity of leptin expression also increased (ptrend=0.02), in leptin positive group, the correlation of leptin expression with adenoma size and histological showed positive tendency without statistical significance. Conclusions: Leptin expression of colorectal adenoma was associated with BMI. The question of whether leptin contributes to colorectal adenoma development is unresolved and will require additional studies. (Korean J Gastroenterol 2010;56:20-26)
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)
김형훈 ( Hyung Hun Kim ),김유선 ( You Sun Kim ),옥경선 ( Kyung Sun Ok ),류수형 ( Soo Hyung Ryu ),이정환 ( Jung Hwan Lee ),문정섭 ( Jeong Seop Moon ),이혁상 ( Hyuck Sang Lee ),이혜경 ( Hye Kyung Lee ) 대한소화기학회 2010 대한소화기학회지 Vol.56 No.6
Chronic non-granulomatous jejunoileitis is a rare disease characterized by malabsorption, abdominal pain, and diarrhea that causes shallow ulcers in the small bowel. The etiology of chronic non-granulomatous jejunolieitis remains unknown. A 69-year-old man complained of abdominal pain and lower extremity edema. A 99m-Tc albumin scan showed increased radioactivity at the left upper quadrant, suggesting protein-losing enteropathy. A small bowel follow-through did not disclose any lesions. Wireless capsule endoscopy revealed several small bowel ulcers and strictures. A jejunoileal segmentectomy with end-to-end anastomosis was performed, and the histologic examination revealed non-granulomatous ulcers with focal villous atrophy. Ruling out all other possible diagnoses, we diagnosed our patient with chronic non-granulomatous ulcerative jejunoileitis. Postoperatively, the patient`s abdominal pain and lower extremity edema improved, and the serum albumin normalized. This is the first case of chronic non-granulomatous ulcerative jejunoileitis localized by wireless capsule endoscopy and treated successfully with segment resection. (Korean J Gastroenterol 2010;56:382-386)
정성모 ( Seong Mo Jeong ),강풍 ( Poong Kang ),최효진 ( Hyo Jin Choi ),옥경선 ( Kyung Sun Ok ),박두관 ( Doo Kwan Park ),주미 ( Mee Joo ),한성훈 ( Seong Hoon Han ),이윤우 ( Yun Woo Lee ),이찬희 ( Chan Hee Lee ) 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.4
Polyarteritis nodosa (PAN) is a disease of small and medium sized muscular arteries, typically involving the skin, kidney, peripheral nerves, muscle and gut. Although its etiology has not been known clearly yet, an immune complex is believed to initiate a vasculitis. Infections, such as hepatitis B virus, hepatitis C virus, and streptococcal infection, may be related with the development of PAN. We experienced a case of PAN preceded by Methicillin resistant staphylococcus aureus-associated otitis media in a 50-year-old woman. This is the first case reported in Korea.
송정훈 ( Jung Hoon Song ),허진국 ( Jin Gook Huh ),김유선 ( You Sun Kim ),이진호 ( Jin Ho Lee ),장원철 ( Won Cheol Jang ),옥경선 ( Kyung Sun Ok ),류수형 ( Soo Hyung Ryu ),이정환 ( Jung Hwan Lee ),문정섭 ( Jeong Seop Moon ) 대한장연구학회 2008 Intestinal Research Vol.6 No.2
Background/Aims: Although colonic diverticular disease is less common in Koreans than in Western people, its incidence has been on the increase in Korea. We investigated the clinical characteristics and related complications of colonic diverticular disease in Koreans. Methods: We retrospectively reviewed the medical records of 9,006 patients who underwent colonoscopy at the Seoul Paik hospital between July 2002 and January 2008. Results: Of the 9,006 patients, there were 654 cases (7.3%) of colonic diverticulosis (472 men, 182 women). The mean age of the patients was 54.6±12.0 years. The right colon was involved in 535 cases, the left colon was involved in 86 cases and both the left and right colon was involved in 33 cases. Among the patients, a single diverticulum was seen in 253 cases and two or more diverticuli were seen in 401 cases. Related complications were diverticulitis (11 cases, 1.7%) and diverticular bleeding (3 cases, 0.5%). Conclusions: The incidence of colonic diverticular disease in Korea shows an increasing trend. Colonic diverticular lesions are frequently found in the right colon. (Intest Res 2008;6:110-115)
비장 혈관종과 직장 정맥류를 보인 Klippel-Trenaunay Syndrome
최윤정 ( Youn Jung Choi ),지삼룡 ( Sam Ryong Jee ),박관식 ( Kwan Sik Park ),류충헌 ( Choong Heon Ryu ),서효림 ( Hyo Rim Seo ),하승인 ( Seoung In Ha ),이상헌 ( Sang Heon Lee ),옥경선 ( Kyung Sun Ok ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.3
Klippel - Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, bone and soft tissue hypertrophy of the extremity and venous malformations. We present a case of KTS with splenic hemangiomas and rectal varices. A 29-year-old woman was referred for intermittent hematochezia for several years. She had history with a number of operations for cutaneous and soft tissue hamangiomas since the age of one year old and for increased circumference of her left thigh during the last few months. Abdominal CT revealed multiple hemangiomas in the spleen, fusiform aneurismal dilatation of the deep veins and soft tissue hemangiomas. There was no evidence of hepatosplenomegaly or liver cirrhosis. Colonoscopy revealed hemangiomatous involvement in the rectum. There were rectal varices without evidence of active bleeding. Upon venography of the left leg, we also found infiltrative dilated superficial veins in the subcutaneous tissue and aneurismal dilatation of the deep veins. The patient was finally diagnosed with KTS, and treated with oral iron supplementation only, which has been tolerable to date. Intervention or surgery is not required. When gastrointestinal varices or hemangiomatous mucosal changes are detected in a young patient without definite underlying cause, KTS should be considered. (Korean J Gastroenterol 2011;58:157-161)
위절제술 후 발생한 거적아구성 빈혈 12예에 대한 고찰
강풍,옥경선,김준희 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Objective: The occurrence of megaloblastic anemia, following gastric cancer surgery depends on the surgical procedures and the duration after operation. In Korea only a few studies of anemia following gastrectomy have been reported. Here we present twelve cases of vitamin B12 deficiency megaloblastic anemias following gastrectomy due to gastric cancer. Methods: We studied twelve megaloblastic anemia patients following gastrectomy from January 1993 to December 1999. Clinical manifestations and laboratory findings were checked. Results: Out of 12 cases two patients received subtotal gastrectomy. The mean duration from surgery to megaloblastic anemia occurrence was 73 months. The mean duration of subtotal gastrectomy patient was 37 months. Conclusion: There was no relationship between the type of gastric surgery and interval of anemia occurrence. No common specific laboratory abnormalities were checked except high LDH.