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RISS 인기검색어
- 검색키워드
- 저자 : 손정민(Jeoung Min Son) (검색결과 5 건)
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손정민(Jeoung Min Son),양석균(Suk Kyun Yang),명승재(Seung Jae Myung),김영민(Young Min Kim),김희철(Hee Cheol Kim),유창식(Chang Sik Yu),김진천(Jin Cheon Kim),김기락(Ki Rhack Kim),정훈용(Hwoon Yong Jung),홍원선(Weon Seon Hong),김진호(Ji 대한내과학회 2001 대한내과학회지 Vol.60 No.5
N/A Background : In Korea, the incidence of ulcerative colitis has been very low, but there are few pidemiologic studies about ulcerative colitis. The aim of the present study is to obtain basic epidemiologic information about the diagnostic course of ulcerative colitis in Korea. Methods : The diagnostic course and methods of 150 patients with ulcerative colitis were analyzed by standard questionnaire and interview. Results : The median time between the onset of symptoms and diagnosis was 5 months (2 weeks-10 years). The initial diagnosis made at the institution first visited was ulcerative colitis in 31.3%, hemorrhoid in 16.7%, dysentery in 8.7%, irritable bowel syndrome in 9.3%, enteritis in 12.0%, and others in 22.0%. The diagnostic rate of ulcerative colitis among institutions was 13.0% in clinics (14/108), 28.6% in hospitals (8/28), 47.9% in general hospitals (23/48), and 83.3% in academic medical centers (105/126). Among 39 patients who have received both barium study and endoscopic evaluation at the time of diagnosis at Asan Medical Center, the overall sensitivity of barium study was 76.9% (30/39) (p=0.001). Depending on the extent of the disease, the diagnostic sensitivity of barium study was 50.0% in proctitis (5/10), 69.2% in left-sided colitis (9/13), and 100% in extensive colitis (16/16).
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내시경적으로 제거가 어려운 췌관 결석의 치료에서 체외충격파 쇄석술의 유용성
김현영,손정민,김명환,이성구,서동완,이상수,박주상,김기락,민영일 대한소화기학회 2002 대한소화기학회지 Vol.39 No.3
목적: 최근 외국에서는 내시경적으로 제거가 어려운 췌관결석의 분쇄 목적으로 ESWL을 활발히 사용하고 있으나 국내에서는 그 보고가 드물다. 이에 저자 등은 췌관결석 환자를 대상으로 ESWL을 시행하여 그 유용성과 안전성 여부를 조사하였다. 대상 및 방법: 1991년 4월부터 2001년 7월까지 내시경을 이용한 결석제거술을 시행받았으나 성공적인 제거가 어려웠던 만성췌장염환자 40명을 대상으로 하였다. 이들의 평균 연령은 48세(16∼77)였으며 모두 주췌관내에 결석이 있었고 췌장질환이 원인으로 추정되는 복통을 호소하고 있었다. ESWL 시행 전에 모든 예에서 ERCP 및 EPST를 시행하였고, 예방적으로 항생제를 투여하였다. 충격파 쇄석기는 독일 Dornier사의 MPL 9,000 (Spark-gap type)을 이용하였으며, 초음파 유도하에 결석을 포착하였다. 전 예에서 ESWL 후 추가로 내시경을 이용한 결석제거를 시도하였다. 결과: ESWL은 평균 15.8±0.8 kv (14∼18)의 에너지로 평균 3.3회 (1∼5)로 시행하였고, 한번 치료시 평균 1,856.8회 (1,281∼2,370)의 충격파를 발사하여 평균 총 6,764.7회(1,709~15,308)의 충격파를 발사하였다. 총 38예(95%)에서 결석이 제거되었고 이중 22예(55 %)에서는 결석이 완전히 제거되었다. ESWL 시행전 후로 23예(57.5 %)에서 내시경적 경비췌관배액술이 시행되었으며, 주췌관의 협착이 있었던 31예 중 18예(58%)에서 췌관내로 플라스틱 배액관을 삽입하였고 이 중 4예에서는 풍선 확장술을 함께 시행하였다. ESWL 후 일시적인 혈청아밀라제치의 상승이 10예(25%)에서 있었으며, 일시적인 동통이 7예(17.5%)에서 관찰되었으나 시술에 따른 급성췌장염은 없었다. 평균 25개월의 추적검사 기간동안 25예(62.5%)에서 동통이 소실되었으며 체중 증가도 11예(27 .5 %)에서 관찰되었고, 6예(15 %)에서 반복되는 동통(5예)과 췌장암(1예)으로 수술을 시행하였다. 결론: ESWL은 내시경적으로 제거가 어려운 췌관결석환자에서 보조적으로 사용하여 결석의 제거율을 현저히 높일 수 있고 동통의 소실등 임상증상의 호전을 가져올 수 있는 효과적이면서도 안전한 방법으로 생각된다. Background/Aims: Upstream hypertension due to calculous obstruction of the main pancreatic duct is a cause of pain in patients with chronic pancreatitis. Extracorporeal shockwave lithotripsy (ESWL) may be needed when pancreatic duct stones cannot be removed by endoscopic procedure alone. We present the results of ESWL in combination with interventional endoscopy in the treatment of endoscopically unretrievable pancreatic duct stones. Methods: Between April 199 1 and July 2001, 40 patients were treated with ESWL for endoscopically unretrievable stones. In all patients, ESWL was performed with an electrohydraulic lithotriptor ultrasound focusing system after endoscopic pancreatic sphincterotomy. Results: The procedure was well tolerated in all patients. The mean session of shockwave treatments was 3.3 (1~5). The patients received 1,856.8 (1,281~2,370) shockwave discharges per session using an mean energy of 15.8 kv (14~18). Fragmentation and clearance of the stones were achieved in 38 patients (95 %). In 22 patients (55 %), the stones were completely removed. Relief of pain occurred in 25 patients (62.5 %). Conclusions: ESWL is a safe and effective treatment for endoscopically unretrievable main pancreatic duct stones. ESWL combined with interventional endoscopy can increase the success rate of nonsurgical removal of pancreatic duct stones.
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이승환,김현영,김명환,이성구,서동완,민영일,유교상,손정민,나비석,이석수,심선진,전병민 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.3
A Pancreaticobiliary fistula is a rare complication of acute necrotizing pancreatitis or pancreatic abscess. One case is herein reported of pancreaticobiliary fistula that was found following removal of pancreatic duct stones by extracorporeal shock-wave lithotripsy and endoscopic sphincterotomy. The patient was a 53-year old woman who was admitted with epigastric pain and fever. Endoscopic retrograde pancreatography revealed multiple stones in the main pancreatic duct. Pus from the pancreatic duct was drained through the major papilla during cannulation. On balloon cholangiogram obtained after removal of the stones, a direct fistulous connection between the main pancreatic duct and distal common bile duct was noted. It is speculated that pancreatic abscess or mechanical compression of pancreatic duct stones may contribute to the destruction of the intrapancreatic bile duct, which leads to the formation of a pancreaticobiliary fistula.
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담도경을 통한 알코올 주입술이 유용했던 활달형 간세포암
이상수,이영상,김명환,이현주,이성구,서동완,민영일,성규보,손정민,송문희,서동대 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.3
Hepatocellular carcinoma often invades the portal or hepatic veins, but rarely proliferates in the bile duct. Since curative resection is rarely possible in these cases, conservative therapy has been the sole modality. Herein, we report a case of icteric type hepatocellular carcinoma for which cholangioscopic ethanol injection was effective. By only transcatheter arterial chemoembolization in this patient, obstructive jaundice and intermittent cholangitis were not relieved. Therefore, we performed ethanol injection into the intraductal hepatoma mass under percutaneous transhepatic cholangioscopic guidance. As a result of therapy, he had been well without jaundice and cholangitis for 9 months until die.
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김준,신정현,윤영진,김은경,김종철,김명환,장우영,민영일,손정민,고관호,박경하,정선미,유은실 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.1
Villous adenoma of the extrahepatic duct is a rare disease, Even though it is benign, it has malignant potential and is considered a premalignant lesion. We here report one case of villous adenoma with foci of adenocarcinoma arising in the common hepatic duct. A 60-year-old male was admitted to our hospital because of epigastric pain. The cholangiogram revealed a large filling defect in the right intrahepatic and common hepatic duct with intrahepatic bile duct dilatation, The patient underwent right lobectomy. Grossly, stalked papillay tumor originated in the common hepatic duct was overriding the right intrahepatic duct. Microscopically, the tumor was composed of stratified tall columnar cells with various dysplasia and there were foci of invasive adenocarcinoma.
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