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RISS 인기검색어
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- 저자 : 강진경 (검색결과 801 건)
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강진경,박인서,문영명,정재복,이세준,양우익,박찬일,송시영,이명래 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.2
Primary gastric lymphorna represents one to 7% of all gastric cancer and is the most common type of extranodal lymphoma. In attempt to evaluate the endoscopic characteristics, we analysed clinical and endoscopic findings in 35 patients with primary gastric lymphoma between January 1980 and August 1994 at the Yonsei Medical Center. The results were as follows: 1) The mean age of patients was 47.1 years with male to female ratio of 1.5:1. 2) Gastroscopy was performed in all 35 patienits, which revealed polypoid lesion in one case(2.9%), ulcerative lesion in 15 cases(42.9%), ulcero-infiltrative lesion in 6 cases(17.1%) and diffuse infiltrative lesion in 2 cases(5.7%). Gastric lymphoma was suggested in 6 cases, advanced gastric cancer in 21 cases, early gastric cancer in 5 cases and benign gastric ulcer in 3 cases. Pathologic diagnosis of biopsy specimens were gastric lymphoma in 24 cases, adenocarcinoma in 5 cases and chronic superficial gastritis in one case. 3) The characteristics of the endoscopic findings in gastric lymphoma were intractable or recurrent ulcer in 10 cases, thickened and mounded ulcer margin in 9 cases, multiple ulcers in 9 cases, giant rugae in 7 cases and polypoid or depressed lesion with central ulceration in 4 cases. In conclusion, recognition of specific endoscopic findings such as intractable or recurrent ulcer, volcano-like ulcer, multiple ulcers, giant rugae and combined lesion, the possibility of a lymphoma should be considered and vigorous biopsy attempts should be carried out. Then if the first microscopic report does not suggest this diagnosis, a second investigation including jumbo biopsies, perhaps by diathermy, should be undertaken.
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Barrett`s Esophagus 에서 발생한 식도 선암 : 1예 보고
강진경,심정연,김충배,김호근 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.2
Barrett's esophagus is a metaplastic process in which the squamous epithelium of the lowet esophagus is replaced by columnar epithelium. Most cases are believed to be related to prolonged gastroesophageal reflux. Detection of Barretts esophagus is important in that it results in adenocarcinoma in about 10% of patients. We report a case of adenocarcinoma arising from Barrett's esophagus in a 56 year-old man, diagnosed incidentally at a physical check-up. Grossly, the esophagogastric junction was irregular and there were two small ulcers in the lower esophagus. Microscopically, ihe squamous epithelium of the lower hagus was replaced by specialized intesinal mucosa with a small focus of adenocarcinona confined to the submucosa in one area. Many separate dysplastic foci were also present in the nearby esophageal mucosa.
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HBsAg 양성 간질환 환자의 간 우엽 및 좌엽의 조직학적 소견의 비교
강진경,박인서,문영명,전재윤,한광협,정재복,이세준,정준표,조미연,박찬일 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.1
We compared the histological diagnosis and activity between the right and left lobes in order to assess the sampling variability in HBsAg(+) chronic: liver diseases. From May 1987 to September 1991, we prospectively evaluated 23 patients(male 19, female 4, mean age: 32.0±8.8)with HBsAg(+) chronic liver diseases. Peritoneoscopic liver biopsies of the right and left lobes were performed using Vim Silverman needle. Peritoneoscopic diagnosis and histologic diagnosis were compared and histologic diagnosis of the right and left lobes were compared. Also, histological activities of the right and left lobes were compared using numerical scoring system. Results were as follows; 1) Peritoneoscopic gross findings in bath lobes were different in 10 patients(43.5%). Of these 10 patients, 7 patients showed more severe findings in the left lobe. 2) In comparison with histologic diagnosis, peritoneoscopic diagnosis were correct in 56.5% in the right lobe, and in 60.0% in the left lobe. 3) Histologic diagnosis between the right and left lobes were different in 8 patients(34.8%). Among these, 4 patients revealed more severe findings in the right lobe, and 4 patients in the left lobe. 4) Of 10 patients with different peritoneoscopic gross findings, 5 patients revealed different histologic diagnosis. Different histologic diagnosis in spite of the same peritoneoscopic gross findings was noted in 3 patients. 5) The scores of each category and total score were almost the same between lobes. However, 13 of the 23 patients(56.5%) showed 1 point or more of the score difference between the right and left lobes. Among these patients, 6 patients showed 2 points or more of the score difference. According to the results obtained, we concluded that simultaneous biopsies an both lobes of the liver are necessary in order to minimize sampling variability, even in patients undergoing peritoneoscopy.
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강진경,박인서,문영명,정재복,이세준,송시영,이천균 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.2
Background: Peroral cholangioscopy (PCS) was usually conducted for a differential diagnosis in cases which were difficult to diagnose on a routine endoscopic retrograde cholangiogram (ERC) or during fragmentation of a large bile duct stone with electrohydraulic lithotripsy. This study was conducted to evaluate the clinical utility of a PCS in biliary diseases. Method: We retrospectively reviewed the clinical records of 31 patients in whom a PCS was performed to evaluate various biliary diseases from July 1991 to Aug. 1996. Result: A peroral cholangioscope was successfully inserted into the bile duct in 90.3% (28/31) of the patients. The underlying diseases included bile duct stones (11 cases), bile duct cancer (9 cases), benign bile duct strictures (2 cases), benign bile duct turnors (2 cases), biliary cystadenocarcinoma (2 cases), emboli of the HCC in the bile duct(1 case), and common bile duct polyposis (1 case). Most PCSs were performed for the differential diagnosis between benign and malignant bile duct strictures or obstructions (14 cases) and fragmentation of large bile duct stone with electrohydraulic lithotripsy (10 cases). Overall, the success rate was 78.6% (22/28) in achieving the purpose 88.9% (16/18) in diagnostic aim and 60.0% (6/10) in therapeutic aim. Complications from the PCS occurred in 4 cases (14.3%). Cholangitis and acute pancreatitis was found in 1 case and asymptomatic hyperamylasemia were discovered in 2 cases. Conclusion: PCS plays a major role in confirming difficult cases to diagnose using on ERC and fragment to remove large cornmon bile duct stones.
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