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Intramural Gastric Abscess Caused by a Toothpick Presenting as a Subepithelial Tumor
Wang Guk Oh,Mun Chul Kim,Hyun Ju Yoon,Jae Woo Park,Min A Yang,Cheon Beom Lee,Ji Woong Kim,조진웅 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.3
In the present report, we describe an unusual case of an intramural gastric abscess caused by a foreign body, detected in the form of a subepithelial tumor. A 64-year-old woman was referred to our gastroenterology clinic for further evaluation of a gastric subepithelial tumor. The patient presented with a 1-month history of sustained dull epigastric pain. Esophagogastroduodenoscopy revealed an ill-demarcated, round, smooth, protruding lesion with a small central erosion on the great curvature of the proximal antrum. Endoscopic ultrasonography indicated the presence of an ovoid, heterogeneous, hypoechoic lesion with small echogenic foci located in the submucosa and muscularis propria layers. An abdominal computed tomography scan showed focal gastric wall thickening and regional lymph node enlargement. Endoscopic submucosal dissection was performed for definite diagnosis and management. Thus, we detected a toothpick and removed it using grasping forceps. The final diagnosis was an intramural gastric abscess caused by a toothpick.
( Mi Young Jang ),( Jin Woong Cho ),( Wang Guk Oh ),( Sung Jun Ko ),( Shang Hoon Han ),( Hoon Ki Baek ),( Young Jae Lee ),( Ji Woong Kim ),( Gum Mo Jung ),( Yong Keun Cho ) 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.6
Background/Aims: Endoscopic submucosal dissection (ESD) has become accepted as a minimally invasive treatment for gastric neoplasms. However, the development of synchronous or metachronous gastric lesions after endoscopic resection has become a major problem. We investigated the characteristics of multiple gastric neoplasms in patients with early gastric cancer (EGC) or gastric adenoma after ESD. Methods: In total, 512 patients with EGC or gastric adenoma who had undergone ESD between January 2008 and December 2011 participated in this study. The incidence of and factors associated with synchronous and metachronous gastric tumors were investigated in this retrospective study. Results: In total, 66 patients (12.9%) had synchronous lesions, and 13 patients (2.5%) had metachronous lesions. Older (> 65 years) subjects had an increased risk of multiple gastric neoplasms (p = 0.012). About two-thirds of the multiple lesions were similar in macroscopic and histological type to the primary lesions. The median interval from the initial lesions to the diagnosis of metachronous lesions was 31 months. The annual incidence rate of metachronous lesions was approximately 3%. Conclusions: We recommend careful follow-up in patients of advanced age (> 65 years) after initial ESD because multiple lesions could be detected in the remnant stomach. Annual surveillance might aid in the detection of metachronous lesions. Large-scale, multicenter, and longer prospective studies of appropriate surveillance programs are needed.
( Mi Young Jang ),( Jin Woong Cho ),( Wang Guk Oh ),( Sung Jun Ko ),( Shang Hoon Han ),( Hoon Ki Baek ),( Young Jae Lee ),( Ji Woong Kim ),( Yong Keun Cho ),( Gum Mo Jung ) 대한장연구학회 2013 Intestinal Research Vol.11 No.3
Endoscopic submucosal dissection has been a useful treatment of selected colorectal neoplasia cases. The incidence of perforation related to colorectal endoscopic submucosal dissection is 5-20%. However, while there have been numerous reports regarding retroperitoneal, mediastinal, pleural and subcutaneous emphysema after therapeutic colonoscopy, pneumoscrotum is a relatively rare manifestation of perforation associated with colorectal endoscopic submucosal dissection. In particular, pneumorrhachis, or air within the spinal cord, following therapeutic colonoscopy, is extremely rare. Herein, we report a conservatively treated perforation case as having pneumorrhachis, penumoscrotum, and pneumoperitoneum after colorectal endoscopic submucosal dissection. (Intest Res 2013;11:208-212)
( Moon Sik Park ),( Jae Un Lee ),( So Hee Yun ),( Shang Hoon Han ),( Wang Guk Oh ),( Young Jae Lee ),( Gum Mo Jung ),( Yong Keun Cho ),( Jin Woong Cho ),( Ji Woong Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: There are few data that compare among the three widely used bowel preparations: conventional 4L polyethylene glycol (4L PEG); sodium picosulfate and magnesium citrate(SPMC); and low-volume PEG plus Ascorbic acid(2L PEG+Asc). The aim of this study is to compare among the three bowel preparations in the efficacy, tolerability, and safety. Methods: 126 patients undergoing outpatient elective colonoscopy were randomly assigned to one of the three bowel preparations by computerized randomization in a single blinded prospective study. The three bowel preparations were as follows: Group A(n=43), 4L PEG solution; Group B(n=40), 3 sachets of SPMC as a split dose; or Group C(n=43), 2L PEG+Asc as a split dose. All colonoscopy images were recorded into computed video files. One Endoscopist blinded to the type of preparation gave a bowel cleansing score using recorded video fi les according to the Aronchick bowel preparation scale and Boston bowel preparation scale. And tolerability and safety were evaluated by a questionnaire immediately before the procedure. Results: Data analysis showed that efficacy by Aronchick bowel preparation scale and Boston bowel preparation scale was not different significantly among three groups. There were no significant differences among the three groups in tolerability such as overall satisfaction by visual analogue score, consumed volume, willingness to repeat the same preparation. But, taste in SPMC group was significantly better than that in other two groups(p<0.001). The factors associated with safety such as abdominal distension, nausea, vomiting, general weakness were not significantly different among the three groups. Conclusions: There were no significant differences among three bowel preparations in colon cleansing efficacy. But, taste in SPMC group was significantly better than that in other two groups.
IgA 신병증 환자에서 발생한 신장을 침범한 전신홍반루푸스
송지은 ( Ji Eun Song ),장미영 ( Mi Young Jang ),오왕국 ( Wang Guk Oh ),김정관 ( Jeong Gwan Kim ),박성현 ( Sung Hyun Park ),김기회 ( Ki Hoi Kim ),황민호 ( Min Ho Huang ) 대한류마티스학회 2010 대한류마티스학회지 Vol.17 No.3
Renal involvement in systemic lupus erythematosus (SLE) is a typical manifestation of the disease. The occurrence of non-lupus nephritis, especially IgA nephropathy (IgAN), in patients with SLE has rarely been reported. We describe the case of a 21-year-old woman who was diagnosed with IgAN and subacute necrotizing lymphadenitis, and her renal lesion biopsy was typical of lupus nephritis (ISN/RPS Class III). Although IgAN and lupus nephritis share some common physiopathological characteristics, their laboratory, histopathologic findings, and the extra-renal clinical manifestations are different and support a different pathogenesis. Our case highlights the importance of a renal biopsy in patients with lupus and urinary alterations despite underlying IgAN. A correct diagnosis would permit the most appropriate immunosuppressive treatments to be considered.
( Shang Hoon Han ),( So Hee Yun ),( Jae Un Lee ),( Moon Sik Park ),( Wang Guk Oh ),( Young Jae Lee ),( Gum Mo Jung ),( Ji Woong Kim ),( Yong Keun Cho ),( Jin Woong Cho ),( Seol Bong Yoo ),( Myoung Jin 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: We decide whether to perform endoscopic submucosal dissection (ESD) or gastrectomy for early gastric cancer (EGC) by endoscopic examination. We cannot estimate the correct tumor size with naked eye during upper endoscopic examination. And endoscopic size of gastric tumor is different from histologic size of it. The goal of this prospective study is to compare macroscopic and pathologic diameters of gastric tumors resected by ESD. Methods: We prospectively enrolled gastric adenomas and adenocarcinomas and performed ESD for the tumors from July 2013 to November 2013. The tumor diameter was measured macroscopically by the same investigator with a hand ruler just after removal. Thereafter, it was measured pathologically by the same pathologist on mapping charts after processing specimen. Results: We included 50 gastric tumors (gastric adenomas were 39 and gastric adenocarcinomas were 11). In all tumors, mean of the macroscopic diameter (20.44 ± 8.28 mm) was signifi cantly larger than mean of the pathologic diameter (14.92 ± 8.33 mm, p < 0.001). But, in adenocarcinoma group, there was not signifi cant difference between mean of two diameters (19.80 ± 6.41 mm, 16.80 ± 5.73 mm, p > 0.05). The lesions of adenocarcinoma in adenoma were signifi cant difference (n=5, 19.80 ± 6.41 mm, 16.80 ± 5.73 mm, p < 0.05). Conclusions: In adenocarcinoma, tumor size was not decreased significantly after formalin fixation and slicing. But, the lesions of adenocarcinoma in adenoma was decreased signifi cantly. This study showed that ESD may be performed for adenocarcinoma in adenoma that crosses absolute indication of ESD for tumor size.
송지은 ( Ji Eun Song ),김기회 ( Ki Hoi Kim ),김정관 ( Jeong Gwan Kim ),박성현 ( Sung Hyun Park ),오왕국 ( Wang Guk Oh ),문경철 ( Kyung Chul Moon ),김정화 ( Jung Hwa Kim ),이광영 ( Kwang Young Lee ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.1
Thin basement membrane nephropathy (TBMN) is characterized by persistent hematuria, mild proteinuria, normal renal function and family history of hematuria. Many studies report that TBMN commonly occurs together with other glomerular diseases such as minimal change nephrotic syndrome, membranous nephropathy, IgA nephropathy and focal segmental glomerulosclerosis. Especially, the case of TBMN with minimal change nephrotic syndrome has been rare. We report a case of adult minimal change nephrotic syndrome with TBMN in a 44-year-old female with general edema and microscopic hematuria. On renal biopsy, electron microscopic examination demonstrated diffuse thinning of glomerular basement membrane with the thickness less than 250nm and diffuse foot process effacement. Treatment with corticosteroid resulted in complete remission of proteinuria.
증예(症例) : 모야모야 병과 동반된 관상동맥질환 4 예
박성현 ( Sung Hyun Park ),김기회 ( Ki Hoi Kim ),김정관 ( Jeong Gwan Kim ),송지은 ( Ji Eun Song ),오왕국 ( Wang Guk Oh ),장미영 ( Mi Young Jang ),박종필 ( Jong Pil Park ) 전북대학교 의과학연구소 2010 全北醫大論文集 Vol.34 No.2
현재까지 한국에서 모야모야 병과 동반된 관상동맥질환은 매우 드물며 단 4례만이 보고되어 저자들은 이러한 환자 4례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 본 증례들은 모야모야 병이 전신 혈관 질환이라는 주장을 뒷받침할 수 있으며 모야모야 병을 추적관찰 할 때 관상동맥질환의 가능성에 대해 점검할 필요가 있을 것으로 생각하는 바이다. Moyamoya disease is an occlusive intracranial arteriopathy with an abnormal cerebrovascular collateral network at the base of brain. Although the etiology and pathogenesis remains unknown, there are several reports that moyamoya disease should be regarded as a progressive systemic disease. There are many reports which showed this disease is correlated with renal artery stenosis. However, it is rare for it to be associated with coronary artery disease. We experienced four cases of coronary artery disease associated with moyamoya disease in our center. The coronary angiography showed significant stenosis of coronary artery. Three of these patients were underwent percutaneous coronary intervention. One patient had three vessel disease and have been doing medical treatment. We concluded that the patient with moyamoya disease can be affected coronary artery and should be evaluated about the coronary artery disease.
증예(症例) : 수은 증기 흡입 후 발생한 화학성 폐렴 1예
김기회 ( Ki Hoi Kim ),김정관 ( Jeong Gwan Kim ),박성현 ( Sung Hyun Park ),송지은 ( Ji Eun Song ),오왕국 ( Wang Guk Oh ),이중철 ( Joong Chul Lee ),김영 ( Young Kim ),곽진영 ( Jin Young Kwak ) 전북대학교 의과학연구소 2010 全北醫大論文集 Vol.34 No.2
Mercury has been used widely in many industries and medicines throughout the centuries. Three forms of mercury exist as elemental, inorganic and organic. Mercury poisoning can result from vapor inhalation, ingestion, injection, or absorption through the skin. The pulmonary system is most affected in acute inhalation exposure of elemental mercury vapor. The reports of acute poisoning after inhalation of mercury vapor are rare. We report a case of a 63-year old man with chemical pneumonitis after inhalation of mercury vapor as folk remedy. After d-penicillamine as chelating agent and steroid treatment, symptoms and radiologic findings are improved.
막성 장염과 함께 발생한 반코마이신 내성 장구균 요로감염 예 1
김정관 ( Jeong Gwan Kim ),김기회 ( Ki Hoe Kim ),박성현 ( Sung Hyun Park ),송지은 ( Ji Eun Song ),오왕국 ( Wang Guk Oh ),김정화 ( Jeong Hwa Kim ),이광영 ( Kwang Yeong Lee ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.1
Infections are the second leading cause of mortality among patients with end-stage renal disease (ESRD). Recently, colonization or infection with vancomycin-resistant enterococci (VRE) is increasing in prevalence at many institutions and is often reported in dialysis patients. Enterococci are generally considered to be of low pathogenicity but may cause urinary tract infection, bacteremia, endocarditis or meningitis in debilitated patients. Three cases of VRE peritonitis in patients on CAPD were reported, but there was no report of VRE urinary tract infection (UTI) in hemodialysis patients in Korea. We present a case of VRE UTI with pseudomembranous colitis (PMC) in an ESRD patient with anal VRE colonization. The VRE UTI was treated successfully with linezolid.