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CASE REPORT : A Case of Ulcerative Colitis Patient with Colonic Stenosis and Enterocutaneous Fistula
( Seong Yeon Jeong ),( You Sun Kim ),( Kyeong Sam Ok ),( Sun Ok Kwon ),( Jin Nam Kim ),( Jeong Seop Moon ),( Yun Kyung Kang ),( Seong Woo Hong ) 대한장연구학회 2012 Intestinal Research Vol.10 No.4
Ulcerative colitis (UC) is one of the chronic inflammatory bowel diseases (IBD), characterized by a diffuse mucosal inflammation limited to the colon. Complications of UC include stricture, colorectal cancer, and toxic colitis. UC patients rarely present with a stenosis or fistula, and strictures develop in less than 5% of patients with UC. We present a patient with UC, accompanied by unusual complications that involved not only a stricture but also a fistula and abscess. A 49-year-old female was presented with a left flank pain and fever that had begun two weeks before admission. She had received a diagnosis of UC 20 years ago and had it treated for 2 years in a local hospital. However, she arbitrarily stopped visiting the hospital and relied on home remedies. An abdominopelvic CT scan revealed luminal narrowing and extra-peritoneal fistula formation in the descending colon. Fistula was connected with a subcutaneous abscess in the left flank. She had undergone total colectomy and ileo-anal anastomosis. On the pathologic exam, the long standing UC with severe stenosis was observed without malignant change. It cannot be emphasized enough that a correct therapeutic approach and an appropriate follow-up schedule are very important for patients with UC. (Intest Res 2012;10:388-391)
Clinical Implication of Hepatogenous Diabetes in Liver Cirrhosis
( Seong Hee Kang ),( Min Sun Park ),( Yoon Ok Jang ),( Soon Koo Baik ),( Moon Young Kim ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Disorders of glucose metabolism, namely glucose intolerance and hepatogenous diabetes (HD), are frequent in cirrrhosis. HD and impaired glucose tolerance (IGT) usually present with normal fasting plasma glucose (FPG) and HbA1c level, thus, can be diagnosed by only performing an oral glucose tolerance test (OGTT). Therefore, HD and IGT has not been received enough attention and underestimated when FPG levels are taken into account. We aim to determine if an abnormal glucose tolerance has influence on prognosis of patients with cirrhosis. Methods: This prospective observational study included 719 patients with cirrhosis, either compensated or decompensated, who underwent a 75-g OGTT. All patients were divided into 3 groups: group I - patients with normal glucose tolerance (NGT), group II - patients with IGT (140mg/dL ≤ OGTT < 200mg/dL), group III - patients with newly diagnosed HD (200mg/dL ≤ OGTT). Results: Among 719 patients, NGT was diagnosed in 144 (20.0 %), IGT in 222 (30.9%) and HD in 353 (49.1 %). During median follow-up period of 42.0 months (interquartile range, 21.0-66.0 months), the cumulative survival rates of patients with NGT were 18.1%; IGT, 23.9%; HD, 32.0%. In total patients, HD (adjusted hazard ratio (aHR) =1.712, 95% CI=1.112-2.636, P=0.015) was independent predictor of mortality after adjustment for Child-Pugh score and MELD scores. And IGT (aHR=2.226, P=0.028) and HD (aHR=2.582, P=0.006) were associated with variceal bleeding. However, risk of other complication including hepatic encephalopathy, spontaneous bacterial peritonitis and hepatorenal syndrome were not significantly different between three groups. In patients with compensated cirrhosis (n=179, 24.9%), those with IGT (aHR=4.023, P=0.040) and HD (aHR=4.028, P=0.030) showed a worse survival rate than NGT. In contrast, in patients with decompensated cirrhosis (n=540, 75.1%), neither IGT nor HD conferred higher risk for mortality. Conclusions: Abnormal glucose tolerance including IGT and HD is associated with unfavorable prognosis in patients with cirrhosis, particularly in compensated state.
Ethnic Giving Versus Mainstream Giving by Foreign-Born Korean Immigrants in California
Moon, Seong-gin,Choi, Sang Ok SAGE Publications 2013 Nonprofit and voluntary sector quarterly Vol.42 No.4
<P>Based on a large-scale philanthropic survey conducted in California, this paper empirically examines the determinants of <I>ethnic giving</I> versus <I>mainstream giving</I> practices and the interactive relationships between the two observed among foreign-born Korean immigrants. The results of our bivariate probit regression analysis suggest several interesting findings. First, acculturation serves significant functions in immigrants’ decisions to give to mainstream organizations, but does not appear to affect ethnic giving decisions as profoundly. Second, U.S. educational experiences and gender are strong predictors of mainstream giving practices, whereas household incomes and religiosity figure significantly in terms of explaining ethnic giving practices. Additionally, citizenship is related weakly to ethnic giving practices. Finally, two distinctive giving practices are negatively interrelated, meaning that immigrants who donate to ethnic organizations are less likely to give to mainstream organizations, and vice versa.</P>
Impact of Sarcopenia in Patients with Cirrhosis: A Systematic Review and Meta-Analysis
( Seong Hee Kang ),( Gaeun Kim ),( Min Sun Park ),( Yoon Ok Jang ),( Moon Young Kim ),( Soon Koo Baik ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Skeletal muscle wasting, sarcopenia, which is a common syndrome in chronic diseases such as liver cirrhosis, is a key feature of frailty. The association between sarcopenia and outcomes, such as complications and survival has recently been described in various patient groups. However, study results remain inconclusive. Therefore, the aim of this study was to systematically review the impact of sarcopenia on outcome in patients with cirrhosis. Methods: We conducted a systematic review (SR) and meta-analysis (MA) on the impact of sarcopenia on outcome in liver cirrhosis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Results: Of the 322 studies identified, 20 were eligible according to our inclusion criteria. Most of the studies used CT to diagnose sarcopenia. Two studies used bioelectrical impedance analysis, 10 studies used skeletal muscle index and 8 studies used total psoas muscle area. Seven studies included Asian participants and the remaining 13 studies included Western participants. The prevalence rate of sarcopenia among participants was mean 48.1%, and appeared more among men with a rate of 61.6% whereas the rate was 36% for women. With respect to clinical outcomes, patients with sarcopenia had poorer survival rates and an increased risk of complications such as infection compared to those without sarcopenia. According to the analysis of race subgroup, Asians had a HR 2.45 (95% con fidence interval (CI) =1.44-4.16, p=0.001, I<sup>2</sup> =0%) of mortality whereas Westerners had a HR 1.45 (95% CI=1.002-2.09, p<0.05, I<sup>2</sup> =70%). Conclusions: Based on this SR and MA, the presence of sarcopenia is related to a poor prognosis and occurrence of cirrhotic complications and could be used for risk assessment. Moreover, Asian participants had higher mortality related to sarcopenia compared to the Western participants.
A Case of Benign Stricture and Extraperitoneal Fistula Presenting in Ulcerative Colitis
( Seong Yeon Jeong ),( You Sun Kim ),( Sun Ok Kwon ),( Jeong Seop Moon ),( Jin Nam Kim ),( Yun Kyung Kang ),( Seong Woo Hong ),( Hyun Gul Jung ),( Su Min Hong ) 대한내과학회 2011 대한내과학회 추계학술대회 Vol.2011 No.1
Ulcerative colitis (UC) is a chronic disease characterized by diffuse mucosal inflammation limited to the colon. UC complications are bleeding, Toxic colitis and colon cancer. UC patient rarely presented with stenosis or fistula. Strictures develop in 5 to 10 percent of patients with UC. We report a rare case of an unusual complication with UC benign stricture and fistula. Case: 49-year-old female who is Jehovah`s Witness presented with left flank pain and fever that had begun two weeks ago. She had been diagnosed with UC 20 years ago. However she arbitrarily had stopped visiting hospital and relied on home remedies. When she visited the hospital, blood pressure was 130/80 mmHg, heart rate was 110/min, and temperature was 38.1℃. Physical examination showed that tender mass accompanied by heating sense, redness was touched in her left flank. Laboratory records showed reduced hemoglobin and leucocytosis as hemoglobin 5.0 g/dL WBC 16100/mm3 ESR 70 mm/hr, CRP 6.7 mg/dl. Abdominopelvic computed tomography scan revealed haustral marking loss in T-colon, luminal narrowing and, extraperitoneal fistula formation in descending colon. She was started on intravenous antibiotics and the abscess was drained percutaneously. She was treated transverse colostomy because of severe stricture. 6 month later, colonoscopy showed shortening of the colon and severe stricture. Reconstructive surgery seemed impossible. She was treated with total colectomy with ileal pouch-anal anastomosis 13 month after she had been treated colostomy. Pathological finding showed that there was no malignant cell and no granuloma lesion. It seemed typical ulcerative colitis. In conclusion, untreated UC patient presented with severe stricture, fistula and abscess. We treated with antibiotics and total colectomy and ileal pouch-anal anastomosis.
Effect of Radiofrequency Induced Local Hyperthermia on Normal Canine Liver
Chang Ok Suh(서창옥) , John J.K.Loh(노준규) , Jin Sil Seong(성진실) , Sun Rock Moon(문성록) Hyung Sik Lee(이형식) , Hyun Soo Shin(신현수) , Sung Sil Chu(추성실) , Gwi Eon Kim(김귀언) , Chan Il Park(박찬일) ,Eun Kyung Han(한은경) 대한방사선종양학회 1991 Radiation Oncology Journal Vol.9 No.1
간조직에 온열치효를 시행시 출현하는 조직병리학적 소견 및 혈액의 생화학적 소견을 관찰하고자 13마리의 정상 간에 8MHz 라디오파를 이용한 온열치료를 시행하였다. 42.5±0.5°C로 30분간 온열치료를 받은 군 (제1군, n=5), 45±0.5°C로 30분간 온열치료를 받은 군 (제2군, n=5) 및 온열치료를 받지않은 대조군(n=3)으로 나누어 분석하였을때, 혈액의 SGOT의 SGPT는 온열치료를 시행한 두군 공히 증가된 소견을 보였고 제 1군에서는 간세포의 부종소견의 특이한 조직병리학적소견이 관찰되지않아 가역성 변화로 생각되었지만 제2군에서는 간 세포의 심한 괴사소견이 관찰되어 있는 불가역성의 가조직 손상으로 생각되었다. 이상의 결론으로 유추할 때 임상에서 행하여지는 간암의 온열치료시에 정상 가조직의 손상을 가능한 방지하기위하여는 정확한 종괴의 구역에 치료온도의 주의깊은 관찰이 요구된다. In order to assess the effects of radiofrequency-induced local hyperthermia on the normal liver, histopathologic findings and biochemical changes after localized hyperthermia in canine liver were studied. Hyperthemia was externally adminsitered using the Thermotron RF-8 (Yamamoto Vinyter Co., Japan; Capacitive type heating machine) with parallel opposed electrodes. Thirteen dogs were used and allocated into one control group (N=3) and two treatment groups according to the treatment temperature. Group I (N=5) was heated with 42.5±0.5°C for 30 minutes, and Group Ⅱ (N=5) was heated with 45±0.5°C for 15-30 minutes. Samples of liver tissue were obtained through a needle biopsy immediately after hyperthermia and 7, 14, and 28 days after treatment. Blood samples were obtained before treatment and 1, 3, 5, 7, 14 and 28 days after treatment and examined for SGOT, SGPT and alkaline phosphatase. Although SGOT and SGPT were elevated after hyperthermia in both groups (three of five in each group), there was no liver cell necrosis or hyperthermia related mortality in Group Ⅰ. A hydropic swelling of hepatocytes was prominent histologic finding. Hyperthermia with 45°C for 30 minutes was fatal and showed extensive liver cell necrosis. In conclusion, liver damage dy heat of 42.5±0.5°C for 30 minutes is reversible, and liver damage by heat of 45±0.5°C for 30 minutes can be fatal or irreversible. However, these results cannot be applied directly to human trial. Therefore, in order to apply hyperthermic treatment on human liver tumor safely, close observation of temperature with proper thermometry is mandatory. Hyperthermic treatment should be confined to the tumor area while sparing a normal liver as much as possible.