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소화성궤양과 위암에서 Helicobacter pylori 의 검출빈도
성자원(Ja Won Sung),육은주(Eun Ju Yook),임의혁(Euyi Hyeog Im),김병호(Byeong Ho Kim),이기천(Ki Cheon Lee),허승식(Seoung Sik Heo),정현용(Hyun Yong Jeong),이헌영(Heun Young Lee),김영건(Young Kun Kim) 대한내과학회 1993 대한내과학회지 Vol.45 No.1
N/A Background: It is clear that gastric colonization by H. pylori is extremely common among patients with peptic ulcer, particularly when this involves the duodenal mucosa. The precise frequency of H, pylori in various gastroduodenal conditions varies somehow, but there is unanimity in confirming a strong association among H. pylori, chronic gastritis, and ulceration. Furthermore atrophic gastritis has been reported to be a precursor lesion for gastric cancer. So we estimated the prevalences of H. pylori infection, and serum gastric level in peptic ulcer and gastric cancer. Methods: The specimens were obtained by endoscopic biopsy of the gastric antrum from 40 patients with duodenal ulcer, 38 patients with gastric ulcer and 47 patients with gastric cancer. The urease activity was analyzed for 24 hours on the basis of Campylobacter-like organism test(CLO test). A change in color of the urea broth from yellow-gold to pink-red was interpreted as a positive result. Results: 1) The prevalence of H. pylori infection was significantly higher in duodenal ulcer (75.0%) than in gastric ulcer (52.6%) and in gastric cancer (38.3%, p<0.05). 2) The mean age of positive groups of CLO test among total 125 cases was significantly younger (49 years) than the negative groups (63 years, p<0.05), In each diseases, gastric cancer and duodenal ulcer were also significantly younger in the positive groups than the negative groups(p<0.05). But there was no significant difference between two groups in gastric ulcer. 3) Duodenal ulcer patients with positive CLO test had significantly the lower gastrin level when compared to patients with negative CLO test (p<0.05). In contrst, patients with gastric cancer or gastric ulcer with positive CLO test had trend of higher gastrin level when compared to patients with negative CLO teat. Conclusions: There is a strong association between H, pylori and duodenal ulcer, The influence of H. pylori infection on serum gastrin may be different between gastric disease and duodenal ulcer.
위선종과 위암에서 면역조직화학적 염색을 이용한 p53 단백 발현율의 비교
김진희(Jin Hee Kim),서광식(Kwang Sik Seo),김성걸(Seong Gul Kim),임의혁(Euyi Hyeog Im),육은주(Eun Ju Yook),정현용(Hyun Yong Jeong),이헌영(Houn Young Lee),김영건(Young Kun Kim),이충식(Choong Sik Lee) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.5
N/A Backgrounds: The mutation of p53 gene and p53 protein accumulation is discovered in dysplasia of stomach and gastric cancer. We compared p53 protein expression rate with gastric adenoma and gastric cancer using the immunohistochemical stain and tried to know the correlation of the malig- nant potential of gastric adenoma with p53 protein expression. Methods: We obtained 52 tissues from 22 gastric cancers and 30 gastric adenomas. Accumulation of p53 protein was detected by immunohistochemistry using Anti-Human p53 monoclonal antibody(Pab 1801; Pharmingen). Results: p53 immunoreactivity was detected in 33.3% of gastric adenomas and in 59.l% of gastric cancers. But, threre was no significant difference between two groups(p=0.065). The rate of p53 expression according to various stages, differentiations, cell types in gastric cancers was not significantly different. Also, p53 expression rate according to cell types, size in gastric adenomas showed no significant difference. Conclusions: We suggest that mutation of the p53 gene is an early event in stomach tumorigenesis. But there is to be required more research about the correlation of the malignant potential of gastric adenoma with p53 protein expression. (Korean J Gastroenterol 1995;27: 509 - 516)
김성걸(Seong Gul Kim),최지영(Jee Young Choi),임의혁(Euyi Hyeog Im),김진희(Jin Hee Kim),육은주(Eun Ju Yook),김병호(Byeong Ho Kim),성자원(Ja Won Sung),김남재(Nam Jae Kim),정현용(Hyun Yong Jeong),이헌영(Heon Young Lee),김영건(Young Kun 대한소화기학회 1995 대한소화기학회지 Vol.27 No.2
Primary small intestinal lymphomas are a hetorogenous group of tumors ortginating from the lymphoid cells of the mucosa and submucosa of the small bowel. The ileum and jejunum are most frequently affected, whereas duodenal involvement is less common. There is a himodal age distribution with peak incidences below the age of 10 and in the fifth and sixth decados, with a slight male prodominance. And it is very difficult to diagnose until the dovelopment of any complications such as obstruction, perforation ancl hemorrahage because of the insidious onset of disense and relative inaccuracy of the diagnostic tools as in all the small bowel tumor. Optimal treatment choices for lymphoma remain controversial. Surgical resection, in many cases, is considered the first line of defense. Primary malignant lymphoma of the small intestine has poorer prognosis due to the delay of the diagnosis than any other extra-intestinal malignancy, but has the better prognosis than any other small intestinal malignancy. The histologic type, the extent of the intestinal disease, and the prosence or absence of extraintestinal involvement are the important factors in prognosis. Patients with resectable disease typically have a 40/r, to 507r, S-year survival. Recently the authers diagnosed the primary small intestinal lymphoma associated with a large amount of bleeding confirmed by intraoperative biopsy. So we report this case with the review ot literatures. (Korean J Gastroenterol 1995;27:251-255)
다양한 위장관 합병증과 요근 농양을 보인 Henoch-Schonlein 자반증 1예
이희정 ( Hee Jung Lee ),김선문 ( Sun Moon Kim ),윤성로 ( Sung Ro Yun ),이태희 ( Tae Hee Lee ),임의혁 ( Euyi Hyeog Im ),허규찬 ( Kyu Chan Huh ),최용우 ( Young Woo Choi ),강영우 ( Young Woo Kang ) 대한소화기학회 2007 대한소화기학회지 Vol.49 No.2
Henoch-Schonlein purpura (HSP)는 피부, 관절, 위장관과 신장의 소혈관에 염증을 유발하는 질환으로 복통, 혈뇨, 관절염과 전형적인 피부 자반을 보인다. HSP는 환자의 50-85%에서 소화기 증상을 보이지만, 14-40%가 자반증보다 소화기 증상이 앞서 나타나 진단을 어렵게 한다. 이번 증례는 위장관 출혈, 소장의 천공으로 인한 패혈 쇼크, 소장폐쇄 후 회장 협착과 요근 농양을 보였다. Henoch-Schonlein purpura (HSP) is a vasculitis involving small vessels of skin, joints, gastrointestinal (GI) tract, and kidneys. The patients typically show palpable purpura with one or more characteristic manifestations including abdominal pain, hematuria or arthritis. HSP shows gastrointestinal symptoms in 50~85% of patients, and in 14~40% of patients GI symptoms precede purpuric rash which makes the diagnosis of HSP difficult. We present a case of Henoch-Schonlein purpura with GI bleeding, septic shock by ileal microperforation, small bowel obstruction as a result of ileal stricture and psoas muscle abscess. (Korean J Gastroenterol 2007;49:114-118)
이태희 ( Tae Hee Lee ),김용석 ( Yong Seok Kim ),강영우 ( Young Woo Kang ),김성태 ( Sung Tae Kim ),임의혁 ( Euyi Hyeog Im ),허규찬 ( Kyu Chan Huh ),최용우 ( Young Woo Choi ),김선문 ( Sun Moon Kim ),박주호 ( Joo Ho Park ),정장한 ( J 대한소화기학회 2010 대한소화기학회지 Vol.56 No.2
Background/Aims: Pyogenic liver abscess remains a major diagnostic and therapeutic challenge, despite advances in diagnostic technology and new strategies for treatment. This study was conducted to compare the differences in clinical features and outcomes of pyogenic liver abscess according to age. Methods: In total, 166 patients were enrolled and included 63 (<65 years old, group 1), 62 (65-74 years old, group 2), 41 (>75 years old, group 3) patients in each group. We reviewed the medical records retrospectively including etiology, underlying diseases, characteristics of the liver abscess, laboratory and microbiologic findings, treatment, and outcome of the patients. Results: Group 1 had higher prevalence rates of male patients and chronic alcoholics, but lower prevalence rates of biliary disease, hypertension, and malignancy. In laboratory findings, group 2 had higher incidence of thrombocytopenia, elevated blood urea nitrogen and creatinine. There were no differences in symptoms and microbiologic findings in blood and pus among the three groups. Liver abscesses were more common in right liver in Group 1. The lengths of stay and the treatment modalities were similar in three groups. Conclusions: Although there were differences in sex ratio, etiology, underlying disease among the different age groups, they did not cause difference in treatment and clinical outcome of pyogenic liver abscess. Thus, we recommend active treatments in patients of all age. (Korean J Gastroenterol 2010;56:90-96)
경피 내시경하 위루술 시행 후 발생한 buried bumper syndrome 2예
김성민 ( Sung Min Kim ),김선문 ( Sun Moon Kim ),양성욱 ( Seong Wook Yang ),이태희 ( Tae Hee Lee ),임의혁 ( Euyi Hyeog Im ),최용우 ( Young Woo Choi ),강영우 ( Young Woo Kang ) 대한내과학회 2009 대한내과학회지 Vol.76 No.6
PEG 후 2주 만에 발생한 buried bumper syndrome 2예를 진단하고 내시경을 시행하면서 재 고정을 실시한 경우 1예와 수술로 제거한 경우 1예를 경험하였기에 문헌고찰과 함께 보고한다. Percutaneous endoscopic gastrostomy (PEG) is used for nutritional support in patients who require prolonged tube feeding. However, numerous complications have been reported since its introduction. Buried bumper syndrome is an uncommon, but well-documented, complication of PEG placement. The condition often results from excessive pressure exerted on the gastric mucosa by the tight anchorage between the internal and external bumpers. This leads to mucosal erosion and embedding of the internal bumper in the gastric wall, which obstructs feeding. We report two cases of buried bumper syndrome: one was corrected using the push technique and the other was removed surgically. (Korean J Med 76:722-726, 2009)
김기홍 ( Ki Hong Kim ),이태희 ( Tae Hee Lee ),양정경 ( Jung Kyung Yang ),김선문 ( Sun Moon Kim ),임의혁 ( Euyi Hyeog Im ),허규찬 ( Kyu Chan Huh ),최용우 ( Yong Woo Choi ),강영우 ( Young Woo Kang ) 대한소화기학회 2007 대한소화기학회지 Vol.50 No.2
We report two cases of acute renal failure in patients with nonfulminant acute hepatitis A. First case is a healthy 25 year-old man complained of myalgia and jaundice. Initial laboratory results showed BUN 40 mg/dL, creatinine 5.23 mg/dL, AST 2,220 IU/L, ALT 3,530 IU/L, total bilirubin 6.26 mg/dL, and positive anti-HAV IgM antibody. Supportive treatments including fluid therapy were started Serum creatinine and total bilirubin levels were 7.98mg/dL and 7.66 mg/dL respectively on the 5th hospital day, and decreased gradually. He was discharged on the 12th hospital day, and was being followed up in outpatient department Second case is a 33 year-old woman who admitted for bilateral flank pain, high fever, nausea, and vomiting. She was diagnosed as acute pyelonephritis and acute hepatitis A On admission, BUN 13 mg/dL, creatinine 0.74 mg/dL, AST 3,720 IU/L, ALT 2,280 IU/L, total bilirubin 09 mg/dL were noted, and acute renal failure developed next day. Fluid therapy with antibiotics administration were started, and maximal BUN and creatinine was 41.7 and 8.09 mg/dL respectively on the 8th day. She recovered without dialysis and was discharged on the 19th hospital day. Proper and prompt comprehensive supportive measures would decrease the need for dialysis in patient of acute renal failue associated with acute hepatitis A. (Korean J Gastroenterol 2007;50:116-120)