http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
식도 암육종 환자에서 이시적으로 발생한 식도 편평상피세포암
차라리 ( Ra Ri Cha ),정운태 ( Woon Tae Jung ),오혜원 ( Hye Won Oh ),김희진 ( Hee Jin Kim ),하창윤 ( Chang Yoon Ha ),김홍준 ( Hong Jun Kim ),김태효 ( Tae Hyo Kim ),고경혁 ( Gyung Hyuck Ko ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.6
Esophageal carcinosarcoma is a rare malignant esophageal neoplasm consisting of both carcinomatous and sarcomatous elements, with an incidence of 0.5%. There have been only a few case reports of carcinosarcoma and squamous cell carcinoma coexisting in the esophagus. However, all of these are cases of synchronous or metachronous development of carcinosarcoma after chemoradiotherapy in patients of esophageal squamous cell carcinoma. A 53-year-old man underwent esophagogastroduodenoscopy because of chest pain for several months. Endoscopic examination revealed a huge pedunculated esophageal polypoid mass. Endoscopic submucosal dissection (ESD) was performed and histopathologic examination confirmed spindle cell carcinoma (carcinosarcoma). He refused additional esophagectomy. After 21 months, third follow-up endoscopy showed poorly-demarcated flat, faint discolored lesions at different location from the previous ESD site and endoscopic biopsies confirmed squamous cell carcinoma. To the best of our knowledge, this is the first case of metachronous development of esophageal squamous cell carcinoma in a patient with esophageal carcinosarcoma. (Korean J Gastroenterol 2014;64:364-369)
위장관 ; 알파 태아단백 생성 위암 환자들의 임상적, 병리학적 특성과 예후
유동훈 ( Dong Hoon Lew ),정운태 ( Woon Tae Jung ),김홍준 ( Hong Jun Kim ),민현주 ( Hyun Ju Min ),하창윤 ( Chang Yoon Ha ),김현진 ( Hyun Jin Kim ),김태효 ( Tae Hyo Kim ),고경혁 ( Gyung Hyuck Ko ) 대한소화기학회 2013 대한소화기학회지 Vol.62 No.6
목적: AFP 생성 위암은 조기 간전이 및 이에 따른 불량한 예후가 몇몇 연구에서 보고되어 있다. 대상 및 방법: 이번 연구에서는 단일 기관에서 2005년 1월부터 2013년 3월까지 혈청 AFP가 측정되고 조직학적으로 위암으로 확진된 909예의 환자에 대하여 임상적 특징과 예후를 조사하였다. 혈청 AFP가 10 ng/mL 이상인 경우를 AFP 생성 위암으로 정의하였으며, 간질환이 있는 환자는 제외하였다. 결과: AFP 생성 위암은 진단 당시 진행성 위암인 경우가 많고, 수술 후 간전이 발생률이 높으며, 생존기간이 유의하게 짧았다. 다변량 분석에서 생존율에 유의하게 영향을 미치는 요소는 AFP 생성 위암 여부와 병기 및 흡연력이었다. 같은 병기 내에서 AFP 생성 위암 환자군과 AFP 비생성 위암 환자군을 비교하였을 때 AFP 생성 위암 환자군에서 유의하게 생존율이 짧은 것을 확인할 수 있었으며, 간전이가 있는 경우에도 통계적으로 유의하지는 않았지만 AFP 생성 위암 환자군에서 생존율이 짧은 것을 확인할 수 있었다. 이번 연구는 후향적 연구라는 점과 몇 가지 제한점이 있었으며, 향후 AFP 생성 위암에 대한 추가적인 연구가 필요하다. 결론: AFP 생성 위암은 빠른 간전이를 보이고 수술 후에도 간전이 발생률이 높아 예후가 좋지 않다. 위암 환자에 있어서 혈청 AFP 수치가 증가되었을 경우에 이 암종을 의심하고 조직학적 진단의 재확인 및 간전이 여부 확인이 필요하다. Background/Aims: Several studies reported a subgroup of gastric cancer patients showing elevated serum alpha-fetoprotein (AFP) at the time of diagnosis. We investigated the clinicopathological characteristics and prognostic factors of AFP producing gastric cancer (AFPPGC) by comparing with AFP non-producing gastric cancer (AFPNPGC). Methods: A total of 909 patients were diagnosed with gastric cancer from January 2005 to March 2013 at Gyeongsang National University Hospital and their AFP levels were measured at the time of diagnosis. After excluding 138 patients with underlying liver diseases, 34 patients with elevated serum AFP level over 10 mg/mL were assigned to AFPPGC group and the remaining 737 patients with serum level of AFP below 10 ng/mL were assigned to AFPNPGC group. Results: The median survival length was shorter in AFPPGC group than AFPNPGC group (18.3±25.5 months vs. 30.0±22.0 months, p=0.004). The incidence of liver metastasis (47.1% vs. 3.3%, p<0.001) and lymph node metastasis (91.2% vs. 31.6%, p<0.001) was significantly higher in AFPPGC group. The probability of encountering metachronous liver metastasis after the operation was higher in AFPPGC group (44.4% vs. 2.0%, p<0.001). Multivariate analysis revealed that patients in the AFPPGC group who received chemotherapy (p=0.037) or underwent operation (p=0.001) had a better survival rate. Conclusions: AFPPGC behaves more aggressively and shows a worse prognosis. Therefore, serum AFP level should be routinely checked in all patients diagnosed with gastric cancer. (Korean J Gastroenterol 2013;62:327-335)
위궤양환자에서 Rebamipide의 자유산소유리기제거에 의한 궤양치료효과
박수헌(Soo Heon Park),정운태(Woon Tae Jung),서정한(Jung Han Suh),정명희(Myung Hee Chung),정인식(In Sik Chung),이용찬(Yong Chan Lee),박인서(In Suh Park),송근암(Guen Am Song),양웅석(Ung Suk Yang),유종선(Jong Sun Rew),윤종만(Chong Mann 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5
N/A Background/Aims: Helicobacter pylori has been shown to be an important pathogen of gastric disorder including gastritis and gastric ulcer. One of the potential toxic factors involving gastric mucosal cell injury is reactive oxidants, which are released from activated neutrophils. Rebamipide had been reported to promote mucus synthesis, mucosal prostaglandin content, and rapid ulcer healing, It has recently been reported to inhibit the production of oxygen derived free radicals from stimulated neutrophils. We conducted this study to evaluate the effects of rebamipide on gastric ulcer healing and reactive oxygen metabolite production. Methods: In this multicenter study conducted in Korea, combination treatment of rebamipide and ranitidine was compared with ranitidine alone in 108 patients with gastric ulcer patients. Pre- and post-treatment endoscopic findings and concentration of reactive oxygen metabolite produced were used to evaluate efficacy. The efficacy of rebamipide and ranitidine versus ranitidine was evaluated using endoscopy results, and tissue lipid peroxides by thiobarbituric acid and myeloperoxide concentration. Results: The percentage of ulcer size reduction was significantly higher with rebamipide and ranitidine group than with placebo and ranitidine group(size reduction: 71.5% vs 58.3% P=0.04556). The myeloperoxidase activities at ulcer margin in rebamipide and ranitidine group patients were 96.7+-13.4 unit/mg protein in baseline and 53.8+9.9 unit/mg protein in follow up (P=0.0065). The myeloperoxidase activities at ulcer margin in placebo and ranitidine group patients were 90.2+9.1 unit/mg protein in baseline and 63.1+6.7 unit/mg protein in follow up (P=0.0668). The thiobarbituric acid activities at ulcer margin in rebamipide and ranitidine group patients were 34.7+5.3 nmol of MDA/mg protein in baseline and 24.1W3.1 nmol of MDA/mg protein in follow up. The thiobarbituric acid activities at ulcer margin in placebo and ranitidine group patients were 14.8+1.5 nmol of MDA/mg protein in baseline and 24.3+2.7 nmol of MDA/mg protein in follow up (P=0.0059). The thiobarbituric acid activities at ulcer margin in H. pylori positive and negative patients were 28.1+2.1 nmol of MDA/mg protein and 25.3+4.7 nmol of MDA/mg protein, respectively. The myeloperoxidase activities at ulcer margin in H. pylori positive and negative patients were 79.9+5.3 unit/mg protein and 40.4+25.3 unit/mg protein, respectively (P=0.0001). The cumulative relapse rate was examined starting at 24 week after ulcer treatment. The rate was lower in rebamipide and ranitidine group patients, but insignificantly(19.2% vs 27.3%, P=0.0857). Conclusions: These results suggest that rebamipide promote gastric ulcer healing by decreasing reactive oxygen metabolite production in patients with gastric ulcer. (Korean J Gastroenterol 1997;29:569-578)
증례 : 소화기 ; 췌장의 신경내분비종양으로 오인한 고형 변이성 장액성 낭종 1예
장현정 ( Hyun Jeong Jang ),김태효 ( Tae Hyo Kim ),이제운 ( Jae Un Lee ),김현식 ( Hyeon Sik Kim ),주지현 ( Ji Hyeon Ju ),정운태 ( Woon Tae Jung ),이옥재 ( Ok-jae Lee ) 대한내과학회 2015 대한내과학회지 Vol.89 No.1
췌장에서 발생하는 장액성 낭종 중에서 고형 변이성 장액 성 낭종은 매우 드물게 발생하는 질환이지만 악성 혹은 전 암성 병변과의 감별이 어려워서 수술이 필요한 다른 질환으 로 오인되는 경우가 매우 많다. 이에 저자들은 췌장의 신경 내분비종양으로 오인하고 수술을 시행하여 고형 변이성 장 액성 낭종으로 진단된 매우 드문 증례를 경험하였기에 문헌 고찰과 함께 보고한다. Rapid advancements, access to and use of imaging techniques have increased the frequency of identification of pancreatic cystic neoplasms in clinical practice. However, a diagnostic dilemma among pancreatic cystic neoplasms remains. Solid variant serous cystadenoma is extremely rare and difficult to accurately diagnose preoperatively, as they are commonly mistaken for malignant solid tumors of other types. Here, we present a case of a solid variant serous cystadenoma preoperatively misdiagnosed as a neuroendocrine tumor of the pancreas with a review of the relevant literature. (Korean J Med 2015;89:69-73)
위장관염과 장간막 림프절병증으로 발현한 제한성 베게너 육아종증 1예
정용근 ( Yong Geun Jeong ),김태효 ( Tae Hyo Kim ),이창민 ( Chang Min Lee ),심기식 ( Ki Shik Shim ),문인규 ( In Kyu Moon ),이상일 ( Sang Il Lee ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.5
Wegener`s granulomatosis (WG) is a disease characterized by a granulomatous necrotizing vasculitis of small vessels. Although any organ systems can be involved, gastrointestinal involvement in WG is notably uncommon. We present a case of 67-year-old man who was admitted with abdominal pain and diarrhea lasting for 3 weeks. Colonoscopy and abdominal CT scan revealed vasculitis and multiple mesenteric lymphadenopathy. Jejunum and mesenteric lymph nodes biopsies confirmed limited form of WG. The present case indicates that WG might involve only gastrointestinal tract and the histological confirmation is important for diagnosis. (Korean J Gastroenterol 2010;55:331-335)
안연정 ( Yeon Jeong Ahn ),김태효 ( Tae Hyo Kim ),문성원 ( Sung Won Moon ),최수녕 ( Su Nyoung Choi ),김현진 ( Hyun Jin Kim ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ),고경혁 ( Gyung Hyuck Ko ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.3
Xanthogranulomatous cholecystitis is an unusual inflammatory disease of the gallbladder characterized by severe proliferative fibrosis and the accumulation of lipid-laden macrophages in areas of destructive inflammation. Its macroscopic appearance may occasionally be confused with gallbladder carcinoma. We present a case of perforated xanthogranulomatous cholecystitis presenting as biloma. An 80-year-old woman was referred to our hospital with a 1-week history of abdominal pain and febrile sensation. Abdominal CT showed a biloma in the subhepatic area. The follow-up CT showed that the biloma increased in size. Therefore, ultrasonography-guided aspiration was performed. The aspirated fluid/serum bilirubin ratio was greater than 5, which was strongly suggestive of bile leakage complicated by perforated cholecystitis. She underwent a laparoscopic cholecystectomy with cyst aspiration and adhesiolysis. A histological diagnosis of perforated xanthogranulomatous cholecystitis was made. (Korean J Gastroenterol 2011;58:153-156)
김현식 ( Hyeon Sik Kim ),김태효 ( Tae Hyo Kim ),이재민 ( Jae Min Lee ),김현진 ( Hyun Jin Kim ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ),김지은 ( Ji Eun Kim ),배경수 ( Kyung Soo Bae ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.6
Splenic hamartoma is a very rare benign tumor, which is usually found incidentally after splenectomy or autopsy. Although percutaneous needle biopsy can be performed, it carries a high risk of bleeding after the procedure. Therefore, diagnosis is usually made by surgical resection. Herein, we report a case of splenic hamartoma diagnosed by magnetic resonance imaging and contrast-enhanced ultrasonography, which enables visualization of the unique signals of microbubbles in the vessels in real time. Relevant literature is also reviewed. (Korean J Gastroenterol 2014;64:380-386)
다발성 전이를 동반한 후복막강 악성 혈관주위상피모양세포종양
오혜원 ( Hye Won Oh ),김태효 ( Tae Hyo Kim ),차라리 ( Ra Ri Cha ),김나영 ( Na Young Kim ),김현진 ( Hyun Jin Kim ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ),이정희 ( Jeong Hee Lee ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.5
Perivascular epithelioid cell tumors (PEComas) are unusual mesenchymal neoplasms composed of histologically and immunohistochemically distinct perivascular epithelioid cells (PECs). Although PEComas have the potential to behave in a malignant fashion, malignant PEComas arising from the retroperitoneum are extremely rare. A 68-year-old woman presented with a painful palpable mass in her left upper abdomen. Computed tomography of the abdomen showed a 9 cm sized heterogeneous mass in left para-aortic space and multiple hypervascular nodules in the liver. 18F-fludeoxyglucose-PET/CT showed multifocal hypermetabolic lesions in retroperitoneum, liver, and skeletal bones. Percutaneous needle biopsies were done on the retroperitoneal and hepatic mass. Both specimens were positive for human melanoma black-45 (HMB-45) on histological and immunohistochemical staining which was compatible with PEComas. Herein, we report a rare case of retroperitoneal PEComa with multiple metastases involving liver and bone at initial diagnosis that exhibited aggressive behavior and resulted in a devastating prognosis. (Korean J Gastroenterol 2014,64:302-306)
증례 : 소화기 ; 횡문근양 변형을 가지는 간내 육종양 담관암 1예
김완수 ( Wan Soo Kim ),김태효 ( Tae Hyo Kim ),황재진 ( Jae Jin Hwang ),김현진 ( Hyun Jin Kim ),정운태 ( Woon Tae Jung ),이옥재 ( Ok Jae Lee ),이정희 ( Jeoung Hee Lee ) 대한내과학회 2011 대한내과학회지 Vol.80 No.4
간내 육종양 담관암은 원발성 간암 중 매우 드물게 발생하고, 이 중에서도 횡문근양 변형을 가지는 간내담관암은 보고된 예가 거의 없다. 간내 육종양 담관암은 매우 높은 침습성과 전이로 일반적인 선암에 비해 예후가 나쁜 종양으로 알려져 있다. 이에 저자들은 우상복부 동통으로 내원하여 내원 당시 이미 광범위한 국소 및 원격 전이가 있었고, 종양 혈전에 의한 급성 뇌경색증의 합병증으로 불량한 예후를 보인 횡문근양 변형을 가지는 간내 육종양 담관암 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Rhabdoid transformation is an extremely rare occurrence in sarcomatoid cholangiocarcinoma. Only two cases have been reported in the medical literature worldwide, and its clinical and pathological characteristics remain unknown. Published case reports indicate that rhabdoid cholangiocarcinoma grows rapidly, with early metastasis and a particularly poor prognosis. Here, we report a case of rhabdoid transformation in sarcomatoid cholangiocarcinoma that exhibited aggressive behavior and resulted in a devastating prognosis. (Korean J Med 2011;80:453-457)