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약제 유발 소화성궤양에서 Helicobacter pylori 감염의 역할
고진성,주문경 대한상부위장관ㆍ헬리코박터학회 2018 Korean Journal of Helicobacter Upper Gastrointesti Vol.18 No.2
Nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin (LDA) are the main causes of peptic ulcer (PU), and cause major complication such as bleeding and perforation. The interaction of Helicobacter pylori infection with NSAIDs or LDA is complex and remains unclear. However, H. pylori infection may play additive, synergistic, or antagonistic roles in the development of drug-induced PU. H. pylori infection and NSAID use are independent risk factors for the development of PU, which is thought to be a synergistic effect. Eradication of H. pylori significantly reduces the incidence of PU in NSAID-naïve patients. However, the effect of secondary prevention is controversial, especially in chronic NSAID users. The use of a gastroprotective agent such as a proton pump inhibitor (PPI) is mandatory to prevent the recurrence of PU in patients with a previous history, especially in chronic NSAID users. H. pylori infection may also increase the risk of LDA-associated complicated and uncomplicated PU, including the risk of upper gastrointestinal bleeding. In patients taking LDA, H. pylori eradication alone may prevent the recurrence of PU bleeding. However, PPI maintenance is necessary with concomitant use of an NSAID, steroid, anticoagulant, or other antiplatelet agent. (Korean J Helicobacter Up Gastrointest Res 2018;18:89-94)
직장-구불 결장부 거대 표재성 종양의 내시경 점막하 박리술 치료 성적
고진성,박종재,정원호,이준영,임상아,권민정,노혜진,주문경,이범재,김지훈,연종은,김재선,변관수,박영태 대한소화기내시경학회 2011 Clinical Endoscopy Vol.42 No.4
Background/Aims: Endoscopic submucosal dissection (ESD) of a colorectal tumor is technically difficult. This study aimed to analyze the clinical outcomes of superficial large rectosigmoid tumors after ESD. Methods: Medical records of 15 patients with large rectosigmoid tumors (more than 30 mm), in which ESD performed, were reviewed retrospectively. Results: The mean tumor size was 42.5±14.3 mm (range, 30∼78 mm). A histological examination revealed a well-differentiated adenocarcinoma in five cases (33.3%), adenoma with high-grade dysplasia in six cases (40%), and low-grade dysplasia in four cases (26.7%). The mean procedural time was 90.5±60.7 min (range, 22∼246 min). The en bloc resection rate was 86.7%, and the complete resection rate 100%. The lateral resection margin was positive in four cases (26.6%), but no cases with a positive vertical margin were observed. Bleeding occurred in three cases (20%), and all were treated successfully using endoscopic measures. Perforations occurred in three cases (20%); two cases were treated by clipping and the other by a laparotomy. Conclusions: ESD is a treatment option for superficial large rectosigmoid tumors. Further studies with larger cases and a longer term follow-up are needed to establish the efficacy and safety of ESD for colorectal tumors. 목적: 대장의 거대 종양의 경우 기술적인 어려움으로 인해 내시경 점막하 박리술이 보편적으로 이루어지고 있지 않다. 이번 연구에서는 직장-구불 결장부의 표재성 거대 종양에서 시행한 내시경 점막하 박리술 성적을 알아보고자 하였다. 대상 및 방법: 고려대학교 구로병원에서 크기가 30 mm 이상인 직장-구불 결장부 종양에 대하여 내시경 점막하 박리술을 시행한 15명을 대상으로 병리결과, 시술성적, 합병증에 대하여 후향적으로 의무기록을 조사하였다. 결과: 병변의 평균 크기는 42.5±14.3 mm(30∼78)이었다. 조직병리 검사에서 고분화 선암 1명(6.6%), 고도 이형성을 동반한 선종 4명(26.7%), 그리고 저도 이형성을 동반한 선종 10명(66.7%)이었다. 평균 시술시간은 90.5±60.7분(22∼246)이었다. 일괄절제율은 86.7%이었고 완전절제율은 100%이었다. 측방 절제연 양성은 4명(26.6%), 수직 절제연 양성은 없었다. 합병증으로 조기출혈이 3예(20%)에서 발생하였으나 내시경으로 모두 치료하였다. 천공은 3명(20%)에서 발생하였고 이중 2명은 내시경 클립술, 1명은 개복수술을 시행하였다. 결론: 직장-구불 결장의 표재성 거대 종양에서 내시경 점막하 박리술은 높은 일괄절제율을 기대할 수 있는 치료법 중 하나이다. 향후 많은 증례와 장기 추적 관찰에 의한 내시경 점막하 박리술의 안전성과 유용성에 대한 연구가 필요하다.
Shih-tzu견에서 임신일령에 따른 임신구조물의 초음파상 I.태아 및 태아외 구조물의 최초 관찰시기
고진성,김방실,이순애,조양택,김재평,오기석,김성호,김종택,박인철,김영홍,손창호 한국임상수의학회 2004 한국임상수의학회지 Vol.21 No.1
Serial ultrasonographic examinations were daily performed on 12 Shih-tzu bitches from 15 days after ovulation until parturition to determine the time of first detection and ultrasonographic appearance of the fetal and extra-fetal structures and to determine the size of gestational structures. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0 ng/ml. The gestational length in 12 Shih-tzu bitches was 62.1 (range:60-64) days. The initial detection of the fetal and extra-fetal structures were: gestational sac at days 19.2 (16-21); zonary placenta in the uterine wall at days 25.9 (24-28); yolk sac membrane at days 24.1 (22-26); amniotic membrane at days 26.6 (24-28); embryo initial detection at days 22.3 (21- 24); heartbeat at days 23.8 (23-25); limb buds at days 29.3 (27-31); fetal movement at days 32.3 (31-34); stomach at days 32.6 (29-34); urinary bladder at days 33.1 (29-35); skeleton at days 35.9 (34-38) and kidney at days 45.8 (45-48).
조기위암의 내시경 절제술: 일본과 유럽의 임상지침 비교
고진성 ( Jin Sung Koh ),주문경 ( Moon Kyung Joo ) 대한소화기학회 2018 대한소화기학회지 Vol.72 No.2
An endoscopic resection is performed widely and has been established as a standard therapeutic modality for the treatment of early gastric cancer (EGC) without lymph node metastasis. On the other hand, the selection of suitable patients by a thorough pre-procedural evaluation is mandatory for the successful management of EGC. Moreover, a clear and unified interpretation of a resected specimen and the definition of a curative resection is the mainstay for decision-making of an additional surgical resection and post-procedural surveillance schedule. This paper summarizes the key statements of Eastern (Japan Gastroenterological Endoscopy Society) and Western (European Society of Gastrointestinal Endoscopy) guidelines for an endoscopic resection of EGC, regarding the clinical staging and indication; pre-operative evaluation; definition of a curative resection; and post-procedural surveillance, focusing on the similarities and differences between the two guidelines. (Korean J Gastroenterol 2018;72:79-82)
Shih-tzu견에서 임신일령에 따른 임신구조물의 초음파상 II. 태아 및 태아외구조물의 측정에 의한 임신일려의 추정
김방실,고진성,황순신,이순애,조양택,오기석,김성호,박인철,김종택,김영홍,손창호 한국임상수의학회 2004 한국임상수의학회지 Vol.21 No.2
Serial ultrasonographic examination was daily performed on 12 pregnant Shih-tzu bitches from day 15 until parturition to determine the size of gestational structures. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0 ng/ml. Extrafetal structures were measurable from days 17 to 46. Outer uterine diameter increased from 9.90.4 mm (MeanSD) at day 20 to 44.30.8 mm at day 46 and inner chorionic cavity diameter increased from 7.20.2 mm at day 17 to 36.91.5 mm at day 41. Length of chorionic cavity or zonary placenta increased from 6.60.4 mm at day 21 to 46.4 0.9 mm at day 44. Of the extra-fetal structures, inner chorionic cavity diameter was the most accurate for estimation of gestational age until day 38. Fetal structures were measurable from days 23 to 60. Crown-rump length increased from 3.90.3 mm at day 23 to 55.23.3 mm at day 41, fetal body diameter increased from 7.90.6 mm at day 32 to 47.82 mm at day 60, and fetal head diameter increased from 6.31.1 mm at day 29 to 25.60.2 mm at day 60. Of the fetal structures, fetal head diameter was the most accurate for estimation of gestational age from day 38 until day 60.
Shih-tzu견에서 초음파 검사에 의한 분만일 예시표 확립
김방실,고진성,이순애,조양택,김재풍,오기석,김종택,박인철,김영홍,손창호,Kim, Bang-sil,Ko, Jin-sung,Lee, Sun-ae,Cho, Yang-tak,Kim, Jae-pung,Oh, Ki-seok,Kim, Jong-taek,Park, In-chul,Kim, Young-hong,Son, Chang-ho 대한수의학회 2004 大韓獸醫學會誌 Vol.44 No.2
To establish a prediction table of parturition day real-time B-mode ultrasonographic examinations were performed in 12 pregnant Shih-tzu bitches. Measurement of inner chorionic cavity diameter and fetal head diameter was performed from 15 days of gestation to parturition. These were converted retrospectively based on the day of parturition (Day 0). The data of inner chorionic cavity diameter obtained from Day -44 to Day -25 and fetal head diameter obtained from Day -25 to Day -1 were used to compile a prediction table of parturition day. The 22 pregnant Shih-tzu with unknown mating time were examined to assess an accuracy of the table established in this study. And these results were applied to the prediction of parturition day and compared to actual parturition day. Parturition day prediction based on the inner chorionic cavity diameter and fetal head diameter was 100% accurate within ${\pm}2$ days. In addition, the accuracy for parturition day within 0, ${\pm}1$, and ${\pm}2$ days interval using the prediction table of parturition day were 68, 82, and 100%, respectively. Therefore, the prediction table of parturition day seems to be a useful tool for the prediction of parturition day in practice.