http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
송주형 ( Ju Hyung Song ),예병덕 ( Byong Duk Ye ),윤용식 ( Yong Sik Yoon ),김미정 ( Mi Jung Kim ),양동훈 ( Dong Hoon Yang ),정기욱 ( Kee Wook Jung ),김경조 ( Kyung Jo Kim ),변정식 ( Jung Sik Byeon ),명승재 ( Seung Jae Myung ),양석 대한장연구학회 2011 Intestinal Research Vol.9 No.1
Ganglioneuromas of the gastrointestinal tract are rare, but have an established association with genetic disorders, such as the multiple endocrine neoplasia (MEN) syndrome (type 2b) and neurofibromatosis (type 1). However, solitary ganglioneuromas are not associated with an increased risk for MEN 2b, neurofibromatosis type 1, or any other systemic conditions. Ganglioneuromas of the gastrointestinal tract have been reported to predominantly involve the colon and rectum, and are thereby occasionally detected during colonoscopy or surgery. Although there are no characteristic symptoms of solitary ganglioneuromas, symptoms can be induced by solitary ganglioneuromas, such as abdominal pain, bleeding, or obstruction, depending on the location and size. Herein we report a case of a solitary ganglioneuroma of the ileum. A 34-year-old man sought evaluation at our hospital for anemia. The medical and family histories were benign and there was no history of genetic disorders. The evaluation for anemia revealed iron-deficiency anemia and CT enterography revealed a single mass in the ileum. Laparoscopic resection of the lesion was performed and the pathologic examination confirmed an ileal ganglioneuroma. (Intest Res 2011;9:46-50)
송주형 ( Ju Hyung Song ),서동완 ( Dong Wan Seo ),변승운 ( Seung Woon Byun ),구동회 ( Dong Hoe Koo ),배정호 ( Jung Ho Bae ),이상수 ( Sang Su Lee ),이성구 ( Sung Koo Lee ),김명환 ( Myung Hwan Kim ) 대한소화기학회 2006 대한소화기학회지 Vol.48 No.5
목적: 중증 괴사췌장염 환자에서 괴사 조직의 감염은 50% 이상의 높은 사망률의 주요 원인이며, 이 경우 즉각적인 수술 치료를 추천하고 있다. 그러나 감염의 초기에 수술치료를 하는 것은 높은 사망률을 보이기 때문에 보다 안전한 치료 방법을 모색하는 것이 필요하다. 대상 및 방법: 이번 연구에서는 지난 16년간 입원했던 중증 괴사췌장염 환자를 대상으로 후향 연구를 시행하였고, 감염이 의심된 경우 세침흡입 검사를 통해 균 동정을 시도하였고 경피배액술을 포함한 적극적인 내과 치료를 시행하였다. 결과: 총 71예의 중증 괴사췌장염 환자 중 46예에서 감염이 의심되었고 21예에서 세침흡입 검사로 균이 동정되었다. 이 중 19예에서 초기 적극적인 내과 치료를 시행하였으나, 4예에서 치료 도중 감염이 조절되지 않아 수술 치료로 전환하였다. 내과 치료의 성공률은 79% (15/19)였고, 사망률은 5% (1/19)였다. 결론: 이번 연구에서는 감염 초기에 적극적인 내과 치료를 하는 것이 수술 치료와 비슷하거나 우수한 결과를 보여주었다. 이는 감염이 동반된 괴사췌장염의 치료로 조기 수술이 아닌 내과 치료가 바람직한 방법으로 이용될 수 있음을 시사한다. Background/Aims: Infection of pancreatic necrosis is one of the leading cause of death in patients with severe necrotizing pancreatits. Because of high mortality rate up to 50%, immediate surgical debridement including pancreatectomy is recommended. However, early surgical treatment still showed high mortality rate and better treatment strategy is required. This study was conducted to evaluate the outcomes of early intensive non-surgical treatments in patients with infected necrotizing pancreatitis. Methods: This study was based on retrospective analysis of 71 patients with acute severe necrotizing pancreatitis (APACHE II score≥8, or Ranson`s score≥3, and pancreatic necrosis on CT scan), who were admitted to medical center during past 16 years. Infection of pancreatic necrosis was confirmed by fine needle aspiration, and early intensive medical treatments comprised of prophylactic antibiotics coverage, fluid resuscitation, organ preserving supportive measures, and percutaneous catheter drainage were carried out. Results: Among the enrolled patients, infections were suspected in 46 patients, but fine needle aspirations were done only in 32 patients. In 21 patients, infections of necrotic tissue were confirmed by bacteriology, while other 11 patients showed no evidence of bacterial growth. Of 21 patients with infected necrosis, initial surgical interventions were performed in 2 patients, while initial medical treatments were performed in 19 patients. The success rate of medical treatment group in infected necrotizing pancreatitis was 79% (15/19). The mortality rate of medical treatment group and surgical treatment group was 5% (1/19) and 50% (1/2). Conclusions: Early intensive medical treatment seems to be a good therapeutic strategy, even if the infection has developed in pancreatic necrosis. Further prospective randomized studies are required to confirm this finding. (Korean J Gastroenterol 2006;48:337-343)