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고영선 ( Young Sun Ko ),유기덕 ( Ki Deok Yoo ),현일식 ( Yil Sik Hyun ),정해룡 ( Hae Ryoung Chung ),박수역 ( Soo Yuk Park ),김선민 ( Sun Min Kim ),전용철 ( Yong Cheol Jeon ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.3
Hepatitis A virus (HAV) infection is common in developing countries, including Korea. It can be accompanied by extrahepatic complications such as renal failure, arthritis, and vasculitis. Pleural effusion is a very rare complication of HAV infection, which has been reported usually in children, and has benign clinical courses. Here we report a case of pleural effusion with ascites which occurred in an adult hepatitis A patient. A 26-year-old-woman presented generalized myalgia and fever and was diagnosed as acute hepatitis A. Despite of the improvement of laboratory findings, fever and cough persisted. Pleural effusion newly appeared on the serial chest radiologic images. After the fever settled down, the pleural effusion resolved spontaneously at 13th day of admission. (Korean J Gastroenterol 2010;55:198-202)
경구 Nitrate 제재 투여로 호전된 Biliary Dyskinesia
민영일(Young Il Min),이영상(Yung Sang Lee),김해련(Hae Ryun Kim),이성구(Sung Koo Lee),김명환(Myung Hwan Kim),정영화(Young Hwa Joung),양석균(Suk Kyun Yang),전용철(Yong Cheol Jeon) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2
Biliary dyskinesia is a functional disorder of the biliary tracts, especially spasm of the sphincter of Oddi (SO). It is sometimes impossible to differentiate patients with true biliary dyskinesia from those patients with papillay stenosis, which is a structual narrowing of SO segment. We report a case of biliary dyskinesia diagnosed and treated by nitrates. The paitent has suffered from chronic liver disease and admitted to our hospital due to biliary pain and aggravated liver function. On biliary manometry, the basal pressure of SO phasic contractions and common bile duct pressure were increased. Also tachyoddia and increased retrograde propagation of phasic contractions were observed. After intravenous injection of nitrate, the basal pressure of SO were decreased and phasic contractions disappeared within 30 seconds. She was diagnosed as biliary dyskinesia and treated by long acting oral nitrates. And then, her symptoms were disappeared and liver function was improved.
간장 ( 肝臟 ) , 담도 ( 膽道 ) 및 췌장 ( 膵臟 ) : Expandable Metallic Stent를 이용한 담도 협착의 치료
민영일(Young Il Min),이성구(Sung Koo Lee),김명환(Myung Hwan Kim),이승규(Sung Gyu Lee),전용철(Yong Cheol Jeon),성규보(Kyu Bo Seong),민병철(Pyung Cheol Min) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3
N/A Expandable metallic stents were implanted in 9 patients with malignant (4 patients) or benign (5 patients) biliary stenoses. Five patients with benign strictures (intrahepatic stones with intrahepatic strictures, n=4; intrahepatic and extrahepatic stones with common bile duct stricture, n= 1) and four with malignant biliary strictures (cholangiocarcinoma, n=4) were treated with expandable metallic stents via percutaneous or transpapillary route. The patients with benign disease had failed treatment with surgical reconstruction and transhepatic balloon dilatation. In the three of the four patients with cholangiocarcinoma, relief of jaundice was observed. Patients with benign strictures have done very well. Our experience shows that expandable metallic stents can be inserted with little discomfort for the patients and with relatively few complications. They will provide good palliation in patients with malignant obstructive jaundice and benign strictures.
간장 ( 肝臟 ) , 담도 ( 膽道 ) 및 췌장 ( 膵臟 ) : 급성 담낭염의 치료에 있어서 경피적 담낭루 설치술의 이용
민영일(Young Il Min),이성구(Sung Koo Lee),안세현(Sei Hyun Ahn),김명환(Myung Hwan Kim),이승규(Sung Gyu Lee),전용철(Yong Cheol Jeon),성규보(Kyu Bo Seong),조경식(Kyung Sik Cho),이문규(Mun Gyu Lee) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3
N/A Percutaneous cholecystostomy is a techniue to obviate cholestectomy or surgical cholecystostomy in high risk patients. We evaluated 12 relatively high risk patients who underwent percutaneous cholecystostomy in recent 1 year. Overall success rate of percutaneous cholecystostomy was 92%(12/ 13). Relief of pain and defervescence could be observed promptly in almost all patients. In 4 cases of acalculous cholecytstitis, the catheters were removed successfully after resolution of acute inflammation. 3 cases of calculous cholecystitis were treated with elective cholecystectomy after resolution of septic condition. Percutaneous stone removal was performed via the enlarged tract with stone basket or other mechanical devices in 3 cases of calculous cholecystitis. Two cases of tube dislodge and 1 case of mild bile leakage were the complications of this procedure without significant mortality or morbidity. Percutaneous cholecystostomy is a fast, low risk and effective treatment of acute cholecystitis in poor surgical risk patients.
Helicobacter pylori 제균 후 위축위염과 장상피화생의 변화
이용구 ( Yong Gu Lee ),전용철 ( Yong Cheol Jeon ),구태연 ( Tai Yeon Koo ),조현석 ( Hyun Seok Cho ),변태준 ( Tae Jun Byun ),김태엽 ( Tae Yeob Kim ),이항락 ( Hang Lak Lee ),은창수 ( Chang Soo Eun ),이오영 ( Oh Young Lee ),한동수 ( D 대한소화기학회 2007 대한소화기학회지 Vol.50 No.5
목적: Helicobacter pylori 감염이 장기간 지속될 경우 위축위염과 장상피화생을 초래하여 위암 발생 위험이 증가한다. 그러나 H. pylori를 제균하는 것이 위축변화나 장상피화생을 회복시킬 수 있을지는 아직 이견이 많다. 따라서 저자들은 H. pylori 제균 후에 위축과 장상피화생의 변화 여부를 조사하였다. 대상 및 방법: 2001년 3월부터 2006년 4월까지 방문한 107명의 H. pylori 제균에 성공한 환자들을 대상으로 하였다. 전정부 조직검사를 통해 H. pylori 감염 여부를 판단하였으며 동시에 위축변화와 장상피화생의 정도를 updated Sydney System에 따라 점수화하였다. 전정부 조직검사는 제균 후 일정기간 후에 위내시경검사를 통해 재시행하였고, H. pylori 제균 여부도 조직검사로 확인하였다. 결과: 대상환자의 평균 연령은 55.3±11.3세였으며, 평균 추적기간은 28.7±13.9개월이었다. 내시경 진단은 위궤양, 십이지장궤양, 비궤양 전정부위염의 3가지로 구분하였다. 위축변화는 누락된 자료를 제외한 91명 중 41명에서 관찰되었고, 평균 점수는 0.73±0.92였다. 추적한 위축변화 점수는 0.38±0.70로 제균 후 회복되었다(p=0.025). 그러나 107명 중 49명에서 관찰된 장상피화생은 다소 호전되어 보였으나 통계적인 의미는 없었다. 새로이 발생한 위축변화와 장상피화생이 관찰되었으며 그 평균 점수는 제균 전 위축변화나 장상피화생이 있는 환자에서의 평균보다 낮았으나 통계적인 의미는 없었다. 결론: H. pylori 제균 후에 위축변화는 호전되지만 장상피화생은 호전 정도가 미약하여 호전을 확인하기 위해서는 더 오랜기간 관찰이 필요할 것이다. H. pylori 제균과 위 점막의 위축변화 및 장상피화생 사이의 관계를 확립하기 위해서는 추후 더 큰 규모의 대조군 연구가 필요할 것으로 생각한다. Background/Aims: Long-term Helicobater pylori infection results in atrophic gastritis and intestinal metaplasia, and increases the risk of gastric cancer. However, it is still controversial that eradication of H. pylori improves atrophy or metaplasia. Therefore, we investigated histological changes after the H. pylori eradication in patients with atrophy or metaplasia. Methods: One hundred seven patients who received successful eradication of H. pylori infection in Hanyang University, Guri Hospital from March 2001 to April 2006, were enrolled. Antral biopsy was taken before the eradication to confirm the H. pylori infection and grade of atrophy or metaplasia by updated Sydney System. After a certain period of time, antral biopsy was repeatedly taken to confirm the eradication and investigate histological changes of atrophy or metaplasia. Results: Mean age of the patients was 55.3±11.3, and average follow-up period was 28.7±13.9 months. Endoscopic diagnosis included gastric ulcer, duodenal ulcer, non-ulcer antral gastritis. Atrophy was observed in 41 of 91 and their average score was 0.73±0.92. After the eradication of H. pylori, atrophy was improved (0.38±0.70, p=0.025). However, metaplasia which was observed in 49 of 107, did not significantly improve during the follow-up period. Newly developed atrophy (7 of 38) or metaplasia (18 of 49) was observed in patients who without atrophy or metaplasia initially. Their average scores were slightly lower than those of cases with pre-existing atrophy or metaplasia without statistical significance. Conclusions: After the eradication of H. pylori infection, atrophic gastritis may be improved, but change of intestinal metaplasia is milder and may take longer duration for improvement. (Korean J Gastroenterol 2007;50:299-305)
김재훈 ( Jae Hoon Kim ),전용철 ( Yong Cheol Jeon ),이길우 ( Gil Woo Lee ),윤지영 ( Ji Young Yoon ),표주연 ( Ju Yeon Pyo ),오영하 ( Young Ha Oh ),한동수 ( Dong Soo Han ),손주현 ( Joo Hyun Sohn ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.2
A gastric carcinoma with the endoscopic features resembling a submucosal tumor (SMT) is rare, and reportedly accounting for 0.1% to 0.63% of all resected gastric carcinomas in Japan. A diagnosis of a SMT-like gastric carcinoma is often difficult as the tumors are almost entirely covered with normal mucosa. Furthermore mucinous gastric adenocarcinoma is uncommon histologic subtype of gastric cancer. These tumors are detected mostly in an advanced stage and rarely in an early stage. Early mucinous gastric adenocarcinoma is characterized as an elevated lesion resembling SMT due to abundant mucin pools in the submucosa. Here we report one case of SMT-like mucinous gastric adenocarcinoma, diagnosed by the usual endoscopic biopsy and treated with surgery. (Korean J Gastroenterol 2011;57:120-124)
전대원 ( Dae Won Jun ),이오영 ( Oh Young Lee ),조경란 ( Gyeong Lan Jo ),백상현 ( Sang Hyeon Baeg ),양선영 ( Sun Young Yang ),한성희 ( Sung Hee Han ),이항락 ( Hang Lak Lee ),전용철 ( Young Cheol Jeon ),한동수 ( Dong Soo Han ),손주 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.1
목적: 과민성 장증후군은 약 6~10%의 유병율을 가지는 매우 흔한 소화기 질환이며, 정신사회학적 증상과 밀접한 관계를 가지는 것으로 알려져 있다. 그러나 과민성 장증후군 증상을 가지고 있는 사람 중 소수만이 의료기관을 방문하는 것으로 알려져 있다. 본 연구에서는 과민성 장증후군의 증상을 가지고 있는 사람 중 의료기관을 이용하여 치료를 받고 있는 군과 치료를 받지 않는 비치료군 간의 심리적 상태 및 장외증상의 차이에 대하여 알아보고자 하였다. 대상 및 Background/Aims: Only a relatively small portion of those people suffering with IBS, estimated at 25~50%, eventually seeks medical care. Yet little is known about the difference in the characteristics between the consulter and non-consulter IBS patients.
상기도 감염 후 연하곤란을 호소한 제 9, 10 뇌신경 마비
박호용 ( Ho Yong Park ),이오영 ( Oh Young Lee ),양선영 ( Sun Young Yang ),천승민 ( Seung Min Cheon ),이항락 ( Hang Lak Lee ),한동수 ( Dong Soo Han ),전용철 ( Yong Cheol Jeon ),손주현 ( Joo Hyun Sohn ),윤병철 ( Byung Chul Yoon ) 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.1
Oropharyngeal dysphagia is characterized by difficulty in transferring food from the mouth through the upper esophageal sphincter into the upper esophagus. Lesions involving the vagus and glossopharyngeal nerve may cause dysphagia and dysphonia. On rare o
한성희 ( Sung Hee Han ),이오영 ( Oh Young Lee ),양선영 ( Sun Young Yang ),전대원 ( Dae Won Jun ),이항락 ( Hang Lak Lee ),전용철 ( Yong Cheol Jeon ),한동수 ( Dong Soo Han ),손주현 ( Joo Hyun Sohn ),윤병철 ( Byung Chul Yoon ),최호순 대한소화기학회 2006 대한소화기학회지 Vol.48 No.1
In Crohn`s disease, neurologic complications such as cerebrovascular accident, headache, peripheral neuropathy have been reported sporadically. The pathogenesis of these neurologic complications is still unknown and controversial. We experienced a 22-year-old man, with Crohn`s disease accompanied by optic neuritis. Loss of visual acuity was developed during the worsening course of enterocutaneous fistula. After high dose steroid treatment, his visual acuity and neurologic symptoms improved immediately. (Korean J Gastroenterol 2006;48:42-45)
천진옥(Jin Ok Chun),성현주(Hyun Joo Sung),전용철(Young Cheol Jeon),이명석(Myung Seok Lee),김우중(Woo Joong Kim) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.2
Primary gastrointestinal lymphoma primarily confined to gastrointestinal tract is relatively rare disease accounting for approximately 1 4 percent of all gastrointestinal malignant dis- ease, and the concurrent malignant lymphoma of the stomach, duodenum and colon, especially cecum is very rare in reported cases. We had experienced a 43 years old man with malignant lymphoma of the stomach and duode- num and cecum, and he was treated by chemotherapy (MACOP B). So, we reported here with review of literatures. (Korean J Gastroenterol 1994; 26: 353 357)