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지삼룡(Sam Ryong Jee),최석렬(Seok Reyol Choi),유승훈(Seung Hoon Ryu),박은희(Eun Hee Park),장진석(Jin Seok Jang),이종훈(Jong Hun Lee),한상영(Sang Young Han),신우원(Woo Won Shin) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.3
The hyperplastic gastric polyps comprise approximately 75% of all gastric epithelial polyps. However, coincidental gastric carcinoma has been rarely reported, being found in 1.5%-2.1% of patients with hyperplastic polyps. The size and the pathology of polyps seem to be important in the application of endoscopic removal. We present a 58-year-old female with well differentiated adenocarcinoma arising from a 1.0cm-sized hyperplastic polyp in the stomach. On the gastroscopic examination, five polyps were noted and their sizes ranged from 0.3cm to 1.0cm. She underwent the endoscopic polypectomy with snare or strip biopsy. Microscopically, focal cancerous change was observed in the largest one (1 cm size, Yamada’s type IV) on the greater curvature of the lower body. (Korean J Gastroenterol 2001;38:207-210)
지삼룡 ( Sam Ryong Jee ),설상영 ( Sang Young Seol ) 대한소화기학회 2005 대한소화기학회지 Vol.45 No.5
Stomach is the most common site of primary extranodal lymphoma. Mucosa-associated lymphoid tissue (MALT) lymphoma is a unique type of extranodal lymphoma which is associated with Helicobacter pylori (H. pylori). The development of low-grade MALT lymphoma
지삼룡 ( Sam Ryong Jee ),정혜경 ( Hye Kyung Jung ),민병훈 ( Byung Hoon Min ),최기돈 ( Kee Don Choi ),이풍렬 ( Poong Lyul Rhee ),강영우 ( Young Woo Kang ),이상인 ( Sang In Lee ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.2
Functional dyspepsia (FD) is defined as the presence of symptoms thought to originate in the gastroduodenal area, in the absence of any organic, systemic, or metabolic disease that is likely to explain the symptoms. Based on the available evidence and consensus opinion, thirteen consensus statements for the treatment of FD were developed using the modified Delphi approach. Proton pump inhibitor, prokinetics, and histamine 2 receptor antagonists are effective for the treatment of FD. Mucosal protecting agents, fundus relaxant, and drugs for visceral hypersensitivity can improve symptoms in FD. Antacids and antidepressants may help improving symptoms in FD. Comparing endoscopy with ``test and treat`` of Helicobacter pylori, endoscopy may be more effective initial strategy for managing patients with FD in Korea given high incidence of gastric cancer and low cost of endoscopy. Helicobacter pylori eradication can be one of the therapeutic options for patients with FD. Psychotherapy is effective for those who have severe symptoms and refractoriness. Further studies are strongly needed to develop better treatment strategies for Korean patients with FD. (Korean J Gastroenterol 2011;57:67-81)
위장판 : 역류 식도염에 대한 Rabeprazole과 Ranitidine 유지요법의 효과 비교 연구
지삼룡 ( Sam Ryong Jee ),설상영 ( Sang Young Seol ),김도하 ( Do Ha Kim ),박선자 ( Seun Ja Park ),한상영 ( Sang Young Han ),엄상화 ( Sang Hwa Urm ),이종태 ( Jong Tae Lee ) 대한소화기학회 2005 대한소화기학회지 Vol.45 No.5
Background/Aims: Reflux esophagitis is a recurring condition for which many patients require maintenance therapy. This comparative, randomized multicenter study was designed to evaluate the effect of long-term maintenance treatment comparing proton pump i
식도절제술 환자에서 식도내압 및 위배출시간에 대한 고찰
지삼룡 ( Sam Ryong Jee ),최석렬 ( Seok Reyol Choi ),김광진 ( Kwang Jin Kim ),금동주 ( Dong Joo Keum ),홍기봉 ( Ki Bong Hong ),이종훈 ( Jong Hun Lee ),한상영 ( Sang Young Han ),최필조 ( Pill Jo Choi ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
〈목적〉 식도절제술은 식도암에 있어서 장기생존 및 증상의 호전을 위하여 치료원칙이 되며, 증상의 호전을 위한 고식적 수술로도 시행된다. 또한, 식도의 양성 협착 질환이나 식도 천공의 치료법으로도 행해진다. 그러나, 식도절제술후의 식도 운동기능의 양상과 위배출능에 대한 국내문헌은 찾아보기 힘든 실정이다, 이에 저자들은 식도절제술후 호소하는 증상과 식도내압 및 위배출시간과의 연관성을 알아보고자 하였다. 〈방법〉 1994년 10월부터 1998년 11월 사이에
한국인 역류 식도염 환자의 식도 상피 세포 사이 간격 확장과 Esomeprazole 투여 후의 변화
김재환 ( Jae Hwan Kim ),지삼룡 ( Sam Ryong Jee ),박성재 ( Sung Jae Park ),양성연 ( Sung Yeun Yang ),박은택 ( Eun Taik Park ),이연재 ( Youn Jae Lee ),이상혁 ( Sang Hyuk Lee ),설상영 ( Sang Yong Seol ),정정명 ( Jung Myung Chung ) 대한소화기기능성질환·운동학회 2006 Journal of Neurogastroenterology and Motility (JNM Vol.12 No.1
목적: 서구에서 역류 식도염 환자의 식도 상피는 세포 사이 간격이 확장되어 있으며, 이는 프로톤 펌프 억제제 치료 후 호전된다고 한다. 이번 연구의 목적은 우리나라 역류 식도염 환자에서 식도 상피 세포 사이 간격이 확장되어 있는지 여부와 프로톤 펌프 억제제 치료 후 세포 사이 간격이 호전되는지 알아보았다. 대상 및 방법: 역류 식도염 증상이 있으며 상부위장관내시경 검사에서 점막 손상이 있는 역류 식도염 환자 10명과 위식도역류의 증상이 없고, 상부위장관내시경 검사에서 점막 손상이 없으며 24시간 보행 식도 산도 검사에서 음성인 정상인 10명을 대상으로 하였다. 모든 대상자에서 상부위장관내시경 검사를 시행하였으며, 위식도 경계부 5㎝ 상방에서 4군데 조직을 생검하여 전자 현미경으로 세포 사이 간격을 측정하였다. 모든 식도 조직의 전자 현미경 소견에서 100 번씩 세포 사이 간격을 측정하였다. 역류 식도염 환자는 8주간 esomeprazole로 치료한 후 내시경 검사를 하고 식도 상피 조직을 생검하여 세포 사이 간격을 다시 측정하였다. 결과: 역류 식도염 환자의 세포 사이 간격(평균 1.49±0.39 ㎛)은 대조군의 식도 상피 세포 사이 간격(평균 0.49±0.10 ㎛)보다 통계적으로 유의하게 확장되었다(p<0.01). 역류 식도염 환자에서 esomeprazole로 치료 후 세포 사이 간격(평균 0.56±0.19 ㎛)은 호전되었다(p<0.01). 결론: 우리나라 역류 식도염 환자의 식도 상피 세포 사이 간격은 정상인에 비해 확장된 소견을 보이며, 프로톤 펌프 억제제 치료 후 호전되었다. Background/Aims: It has been demonstrated that dilated intercellular spaces of esophageal epithelium are a marker of tissue injury in Western gastroesophageal reflux disease (GERD); which heals after proton pump inhibitor (PPI) treatment. The aim of this study was to determine whether dilated intercellular spaces are also a feature of acid damage in Korean GERD patients and are also healed after PPI treatment. Methods: Ten GERD patients with heartburn and esophageal mucosal breaks on endoscopy, and 10 controls with no symptoms, normal mucosa on endoscopy and negative 24-hour pH monitoring were enrolled. During upper gastrointestinal endoscopy, four biopsies from normal mucosa were taken within the lower 5 ㎝ of the esophagus for transmission electron microscopy (TEM) analysis. One hundred computer measurements were taken on TEM photomicrographs of the specimens in each patient. After eight weeks of esomeprazole 40 ㎎/day, patients with erosive esophagitis had another endoscopy with biopsies and the intercellular spaces were measured again. Results: The mean intercellular space diameter, in the erosive esophagitis patients, was greater than in controls (1.49±0.10 ㎛ vs 0.49±0.10 ㎛, p<0.01). The mean intercellular space diameter, in erosive esophagitis patients, improved after PPI treatment. Conclusions: Korean erosive esophagitis patients have dilated intercellular spaces of esophageal epithelium and dilated intercellular spaces can be reversed after esomeprazole treatment. (Kor J Neurogastroenterol Motil 2006;12:19-24)
위선암에서 Helicobacter pylori 독성인자와 유전자 아형의 관련성
신종민,한상영,금동주,김광진,지삼룡,홍기봉,이종훈,최석렬,신우원,Shin Jong Min,Han Sang Young,Keum Dong Joo,Kim Kwang Jin,Jee Sam Ryong,Hong Gi Bong,Lee Jong Hun,Choi Seok Ryeol,Shin Woo Won 대한위암학회 2002 대한위암학회지 Vol.2 No.1
Purpose: The H. pylori cagA gene, vacA gene and iceA gene are considered to be important virurence factors that have been implicated in the development of gastric adenocarcinoma. It was reported that the presence of IS605 elements may be responsible for rearrangements and lead to partial or total deletions of the cag pathogenicity island (PAI) and the virulence of cag PAI may be changed. However, different results regarding the association between these virulence factors and clinical disease have been reported from different geographic regions. This study evaluated the relationship between H. pylori virulence factors such as cagA, vacA, iceA, IS605 and gastric adenocarcinoma. Materials and Methods: H. pylori isolates were obtained from 54 infected patients (24 cases of gastric adenocarcinoma, 30 cases of control). H. pylori isolates were identified by PCR with ureC gene and 16S rRNA. PCR was performed to examine cagA, vacA, iceA and IS605 genotypes. Results: Significant difference was found in the negative rates of cagA between gastric adenocarcinoma group and control ($62.5\%\;vs.\;33.3\%$ P=0.033). No significant difference was found in the prevalence of iceA, vacA between gastric adenocar cinoma and control. The genotype of cagA+ vacA s1-m1 iceA1 was predominant in H. pylori isolates irrespective of the clinical outcome. IS605 in PAI was not found in gastric adenocarcinoma gruop and control. The positive rates of IS605 in genome were $33.3\%$ in gastric adenocarcinoma group and $36.7\%$ in control (P>0.05). In gastric carcinoma, the positive rate of $cagA^{+}/IS605$ was lower than in control ($12.5\%\;vs\;40.0\%$, P=0.025) and the positive rate of cagA-/IS605 was higher than in control ($54.2\%\;vs\;23.3\%$, P=0.02). Conclusion: H. pylori virulence factors had not related significantly with gastric adenocarcinoma. Further study is needed to examine the specificity of H. pylori strains.
비장 혈관종과 직장 정맥류를 보인 Klippel-Trenaunay Syndrome
최윤정 ( Youn Jung Choi ),지삼룡 ( Sam Ryong Jee ),박관식 ( Kwan Sik Park ),류충헌 ( Choong Heon Ryu ),서효림 ( Hyo Rim Seo ),하승인 ( Seoung In Ha ),이상헌 ( Sang Heon Lee ),옥경선 ( Kyung Sun Ok ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.3
Klippel - Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, bone and soft tissue hypertrophy of the extremity and venous malformations. We present a case of KTS with splenic hemangiomas and rectal varices. A 29-year-old woman was referred for intermittent hematochezia for several years. She had history with a number of operations for cutaneous and soft tissue hamangiomas since the age of one year old and for increased circumference of her left thigh during the last few months. Abdominal CT revealed multiple hemangiomas in the spleen, fusiform aneurismal dilatation of the deep veins and soft tissue hemangiomas. There was no evidence of hepatosplenomegaly or liver cirrhosis. Colonoscopy revealed hemangiomatous involvement in the rectum. There were rectal varices without evidence of active bleeding. Upon venography of the left leg, we also found infiltrative dilated superficial veins in the subcutaneous tissue and aneurismal dilatation of the deep veins. The patient was finally diagnosed with KTS, and treated with oral iron supplementation only, which has been tolerable to date. Intervention or surgery is not required. When gastrointestinal varices or hemangiomatous mucosal changes are detected in a young patient without definite underlying cause, KTS should be considered. (Korean J Gastroenterol 2011;58:157-161)
포스터 발표 : 위 ; 위암 환자에서 chronotherapy의 부작용에 대한 고찰
박성욱 ( Seong Wook Park ),지삼룡 ( Sam Ryong Jee ),홍기봉 ( Ki Bong Hong ),이철종 ( Cheol Jong Lee ),김완수 ( Wan Su Kim ),이종훈 ( Jong Hun Lee ),한상영 ( Sang Young Han ),최석렬 ( Seok Reyol Choi ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
〈목적〉 위암은 국내에서 가장 흔한 악성종양으로 암으로 인한 사망 중 가장 높은 빈도를 차지한다. 5-FU, mitomycin C, doxorubicin, cisplatin 등을 사용한 현재까지의 위암의 화학요법은 완전관해는 매우 드물며, 관해 지속기간도 수개월 이내로 짧기 때문에 소수의 환자에서 고식적인 치료효과만 기대할 수 있다. 본 교실에서는 DNA합성이 낮보다 밤 동안에 감소하며, 5-FU의 대사의 관여하는 dihydropyrimidine deh