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원인 미상 간세포암이 갖는 비알코올 지방간의 임상적 특징
임민영 ( Min Young Rim ),권오상 ( Oh Sang Kwon ),하민수 ( Minsu Ha ),김주승 ( Ju Seung Kim ),고광일 ( Kwang Il Ko ),김동규 ( Dong Kyu Kim ),장필규 ( Pil Kyu Jang ),한정윤 ( Jung Yoon Han ),박평화 ( Pyung Hwa Park ),정영걸 ( Young 대한소화기학회 2014 대한소화기학회지 Vol.63 No.5
Background/Aims: Nonalcoholic fatty liver disease (NAFLD) may be one of the important causes of cryptogenic hepatocellular carcinoma (HCC). The aim of this study was to evaluate whether patients with cryptogenic HCC share clinical features similar to that of NAFLD. Methods: Cryptogenic HCC was defined as HCC that occurs in patients with the following conditions: HBsAg(-), anti-HCV(-), and alcohol ingestion of less than 20 g/day. All patients diagnosed with cryptogenic HCC from 2005 to 2012 (cryptogenic HCC group), and all patients diagnosed with HBV associated HCC between 2008 and 2012 (HBV-HCC group) were enrolled in the present study. Clinical features, BMI, lipid profiles, presence of diabetes mellitus, hypertension, and metabolic syndrome were compared between the two groups. Results: Cryptogenic HCC group was composed of 35 patients (19 males and 16 females) with a mean age of 70±11 years. HBV-HCC group was composed of 406 patients (318 males and 88 females) with a mean age of 56±7 years. Patients in the cryptogenic HCC group were older (p=0.001) and female dominant (p=0.042) than those in the HBV-HCC group. There were no differences in the laboratory test results including lipid profiles and Child-Turcotte-Pugh class between the two groups. Patients in the cryptogenic HCC group had higher prevalence of diabetes (37% vs. 17%, p=0.015), hypertension (49% vs. 27%, p=0.051), metabolic syndrome (37% vs. 16%, p=0.001), and higher BMI (25.3 kg/m2 vs. 24.1 kg/m2, p=0.042) than those in the HBV- HCC group. The tumor stage was more advanced (stage III and IV) at diagnosis in the cryptogenic HCC group than in the HBV-HCC group (60% vs. 37%, p=0.007). Conclusions: Cryptogenic HCC has clinical features similar to that of NAFLD and is diagnosed at a more advanced tumor stage.
만성 C형간염 환자에서 페그인터페론과 리바비린 병합요법의 치료효과: 통합 분석
박수용 ( Soo Yong Park ),임민영 ( Min Young Rim ),여인구 ( In Ku Yo ),하민수 ( Min Su Ha ),김주승 ( Ju Seung Kim ),이지원 ( Ji Won Lee ),정영걸 ( Young Kul Jung ),권오상 ( Oh Sang Kwon ),김연수 ( Yun Soo Kim ),최덕주 ( Duck Joo Ch 대한소화기학회 2012 대한소화기학회지 Vol.60 No.5
A combination of peginterferon and ribavirin is the standard therapy for chronic hepatitis C (CHC). However, the respective study has not been carried out in a large scale in Korea. The purpose of this study was to collect the studies that have been reported in Korea in order to analyze the therapeutic effect of combination therapy and compare to find racial difference. Methods: Twenty-eight papers related to the therapeutic effect of combination therapy in CHC patients were analyzed based on pooled analysis. Results: Based on the analysis for genotype 1 in Korea, early virologic response (EVR), end of treatment response (ETR), and sustained virologic response (SVR) were 79.6% (125/157), 80.1% (166/207), and 62.7% (341/543). The EVR, ETR, and SVR for genotype 2 and 3 were 89.4% (119/133), 92.2% (203/220), and 84.1% (434/516). Data from other Asians showed that EVR and SVR for genotype 1 were 88.9% (290/326) and 64.4% (491/762) respectively and 88.8% (135/152), and 79.4% (151/190) for genotype 2 and 3 respectively. In Western, EVR and SVR for genotype 1 were 51.3% (1,981/3,860) and 42.4% (1,798/4,231) respectively, and for genotype 2 and 3 were 87.7% (350/399) and 77.8% (533/685) respectively. Based on the comparative analysis, no statistical difference in SVR between Koreans and other Asians (p=0.955) was observed; However, the SVR of Koreans was higher with significance than that of Westerns (p<0.001) On the other hand, there was no difference what so ever, in SVR for genotype 2 amongst the different races. Conclusions: The SVR of combination therapy for the Korean chronic hepatitis C patients was similar to other Asians but higher than Westerns. (Korean J Gastroenterol 2012;60:306-314)
내시경적 Unroofing 방법으로 진단한 직장 Mucosa-associated Lymphoid Tissue 림프종
박현수 ( Hyeon Su Park ),정준원 ( Jun Won Chung ),김애진 ( Ae Jin Kim ),박수용 ( Soo Yong Park ),임민영 ( Min Young Rim ),장영락 ( Young Rak Jang ),이재훈 ( Jae Hoon Lee ),박상희 ( Sang Hui Park ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.6
Mucosa-associated lymphoid tissue (MALT) lymphoma is a typical primary gastrointestinal lymphoma, particularly in the stomach. Although primary rectal lymphoma is rare, it may present as a subepithelial tumor. Several techniques have been proposed for a tissue diagnosis in subepithelial tumor, including endoscopic ultrasonography (EUS)-guided fine needle aspiration (EUS-FNA), EUS-guided trucut biopsy (EUS-TCB), and tacked biopsy. However the diagnostic efficacy of these techniques appears to be limited. The unroofing technique involves removal of the overlying mucosa, thereby exposing the subepithelial lesion. It was originally reported as a method for endoscopic treatment of colorectal lymphangioma. In this case, a subepithelial tumor of the rectum was diagnosed using the endoscopic unroofing technique. This is a useful modality for the diagnosis of subepithelial tumor, because it provides histologic results in a safe and rapid manner. (Korean J Gastroenterol 2012;59:428-432)