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간흡충 감염가토의 간내 담관에 대한 병리조직학적 및 조직화학적 연구
송근암(Geun Am Song),김진도(Jin Do Kim),이동완(Dong Wan Lee),손춘희(Choon Hee Son),양웅석(Ung Suk Yang),허윤(Yoon Hue),문한규(Han Gue Moon),유방현(Bang Hyun Liu),이선경(Sun Kyung Lee) 대한내과학회 1989 대한내과학회지 Vol.37 No.3
N/A This study was undertaken to examine the histopathological changes of the bile duct in rabbits heavily infested with Clonorchis sinensis for 6-18 months, and then to investigate the histochemical properties and compositions of epithelial mucosubstances. In 9 rabbits, each rabbit was orally infested with about 500 metacercariae and was sacrificed when general conditions were poor. The specimens were stained with H-E, PAS, alcian blue (pH 2.5), alcian blue (pH 1.0), alcian blue (pH 2.5) -PAS, and FITC- conjugated lectins. The results obtained were as follow 1) The pathological changes in the infested rabbits were papillary and adenomatous hyperplasia, goblet cell and mucus-cell metaplasia, ductal wall fibrosis, and infiltration of eosinophils in the ductal wall, and then the metaplasia of ductal epithelium was more marked in the deep gland than in the surface. 2) The epithelial mucosubstances in the normal intrahepatic bile duct were produced in the border and supranuclear portion of the epithelium. The histochemical composition of these was a mixture of neutral and acid mucosubstances with a predominant acid group. 3) In infested rabbits, the epithelial mucosubstances were produced in the border and supranuclear portion of the covering epithelium, goblet cell, and hyperplasia and metaplasia cells of the deep gland. The mucosubstances were much more produced in the goblet cell, hyperplasia and metaplasia cell of deep gland, and the composition was mixture of neutral and acid substances with a predominance of the neutral group in goblet cell and adenomatous hyperplasia, and a predominance of the acid group in mucus-cell metaplasia of the deep gland. 4) In the normal intrahepatic bile duct, labeling of FITC-conjugated lectins of WGA and Con-A was weakly localized in the border of the epithelium and its grade was trace. 5) In infested rabbits, F1TC-WGA and FITC-Con-A labeling was seen in the border and supranuclear portion of the covering epithelium, goblet cell, and hyperplasia and metaplasia cells of the deep gland, but FITC-PNA and FITC-SBA labeling was graded from zero to trace. 6) Mucin secreting cell metaplasia stained by PAS and AB showed very significant labeling of E1TC-WGA and FITC-Con-A, which are lectins that are highly specific in their recognition of glycosylated residues.
Mallory-Weiss syndrome의 내시경적 진단과 치료
송근암(Geun Am Song),김태오(Tae Oh Kim),강대환(Dae Hwan Kang),조몽(Mong Cho),양웅석(Ung Suk Yang),배상문(Sang Moon Bae),류수형(Soo Hyung Ryu),안준협(Jun hyup An),이성훈(Seong Hwun Lee) 대한내과학회 2000 대한내과학회지 Vol.58 No.5
N/A Background : Mallory-Weiss syndrome is a laceration of gastroesophageal junction due to abruptly increased intraabdominal pressure. Bleeding from Mallory-Weiss tears stops spontaneously within 2-3 days without specific therapy in 80-90% of cases, but in some cases, aggressive treatment is required due to massive bleeding. Methods: Among two hundreds and fifteen cases of upper gastrointestinal bleeding from January 1997 to January 1999, twenty three cases (10.7%) were diagnosed as Mallory-Weiss syndrome by endoscopy. We assessed the site, number, coexisting diseases, precipitating factors and bleeding lesion according to the time interval after the tears. After supportive care or specific therapy, we performed follow-up endoscopy to evaluate the healing of the lesions. Results: The mean age was 49.1 years and male:female ratio was 4.8:1. The most common precipitating factors were nausea, vomiting and alcohol drinking. In twenty cases, coexisting diseases such as gastritis and esophageal varix were detected. As for the number of tears, one tear was the most common (69.6%), while two tears were identified in five cases and three were in two cases. Thirteen cases of the Mallory-Weiss tears were located on the gastroesophageal junction, seven cases on the lower esophagus, one case on the cardia and two cases from lower esophagus to cardia. Eighteen cases were diagnosed by endoscopy within 24 hours after bleeding, of whom fourteen cases had active bleeding. Among four cases diagnosed after 24 hours, endoscopic finding revealed active bleeding in two cases and blood clots in the other two cases. We treated thirteen cases with supportive care, one case with hypertonic saline injection and nine cases who had active bleeding or deep and long tears with endoscopic band ligation. One or two weeks later, we performed follow-up endoscopy, and no bleeding was detected in all cases. Conclusion: We diagnosed twenty three cases of Mallory-Weiss syndrome by endoscopy and treated all cases with supportive care or endoscopic band ligation successfully.(Korean J Med 58:542-547, 2000)
송근암 ( Geun Am Song ) 대한장연구학회 2006 Intestinal Research Vol.4 No.1
The rectum is approximately 10 to 15 cm in length and extends from the sigmoid colon to the anal canal. It contribute to defecation as the rectal walls expand, stretch receptors from the nervous system located in the rectal walls stimulate the desire to defecate. There are some differences between rectum and colon. The rectum is divided into two portion by peritoneal reflection and makes pouch. The pouch is associated with many pathologic conditions, such as rectal shelf in stomach cancer, rectal endometriosis, and spread of pelvic inflammation. The inferior mesenteric arteries and middle, inferior rectal arteries supply the rectum. This dual blood supply system causes different incidence of ischemic inserts and metastatic site in rectum and colon cancer. The function of anal sphincter and rectum in pelvic cavity is significantly important in defecation and its disturbance causes some specific rectal disease. Due to its position, rectum may be injuried by external and internal events and show the initial suggestion of colorectal disease. We describe uncommon specific diseases in rectum classified into inflammatory diseases, functional disease and tumor. (Intestinal Research 2006;4:1-6)
궤양성 대장염에서 대장 점막 Mucin의 조직화학적 특성과 Lectin 반응
송근암(Geun Am Song),김태오(Tae Oh Kim),안진광(Jin Kwang An),이준홍(Jun Hong Lee),강대환(Dae Hwan Kang),조몽(Mong Cho),양웅석(Ung Suk Yang) 대한내과학회 2000 대한내과학회지 Vol.58 No.5
N/A Backgrounds : In the pathogenesis of ulcerative colitis, a defective mucosal barrier to luminal antigens is currently under consideration, and alterations in mucin structure and lectin binding may play an important role in the defect of mucosal barrier. It is also, suggested that the differences in clinical manifestation and complication of ulcerative colitis are associated with the change in glycosylation of colonic mucus glycoconjugates. This study was performed in order to investigate the histochemical properties of the mucin in korean ulcerative colitis. Methods : The histochemical staining (HID-AB, mild PAS, PBT-KOH-PAS) and the binding of lectin (PNA, DBA, UEA-1, RCA-1, WGA, with avidin-biotin peroxidase complex method) to mucin glycoconjugates were analyzed in paraffin-embedded tissue sections obtained from 14 normal colons and 20 ulcerative colitis. Results : In the ulcerative colitis, number of goblet cell and amount of mucin were decreased, but the expression of its sulphomucin was consistently predominant and strong like normal colon. The expression of N-acetylated sialomucin was more common in the ulcerative colitis(80%) than normal colon(50%) and its grading mildly increased in ulcerative colitis. The expression of O-acetylated sialomucin was present in all cases of normal colon and its staining grade decreased in the ulcerative colitis. Compared to normal colonic mucosa, ulcerative colitis showed the increase in PNA and DBA binding in the supranuclear cytoplasm, the decrease in DBA and RCA-1 binding in the goblet cells, and no change in UEA-1 and WGA binding in both. In the ulcerative colitis, the increase in PNA and DBA binding was mild in the supranuclear cytoplasm and the expression of DBA and RCA-1 binding in goblet cells variably decreased. Conclusions : This study demonstrates the changes in the mucosal glycoconjugates between the ulcerative colitis and normal colon. The mucinous glycoconjugate expression of korean ulcerative colitis are different from that of western patients. There may be a genetic, racial variation in the glycoconjugate, which may also play a part in the differences in pathogenesis, clinical manifestation, and complication of ulcerative colitis.(Korean J Med 58:532-541, 2000)
만성 B형 간염 환자에서 조직 활동도와 IL-1β, IL-1RN 유전자 다형성의 관련성
송준현 ( Song Jun Hyeon ),박진홍 ( Park Jin Hong ),이동현 ( Lee Dong Hyeon ),허정 ( Heo Jeong ),김광하 ( Kim Gwang Ha ),강대환 ( Kang Dae Hwan ),송근암 ( Song Geun Am ),조몽 ( Jo Mong ),양웅석 ( Yang Ung Seog ) 대한소화기학회 2003 대한소화기학회 추계학술대회 Vol.2003 No.-
<배경 및 목적> 만성 B형 간염 바이러스 감염자의 일부에서 간의 염증 및 섬유화가 진행하여 간경변으로 진행한다. 만성 B형 간염환자에서 인터루킨-1 (IL-1)의 활동도 증가는 간 섬유화 정도를 증가시키는 것으로 알려져 있다. 만성 HBV 감염자에서 IL-1β와 IL-1RN 유전자 다형성을 분석하여 유전자형 및 대립형질 양상이 생화학 검사, 혈청 HBV DNA 및 간 조직 활동도에 미치는 영향을 조사하고자 하였다. <대상 및 방법> 2001년 8월부터
단일기관에서의 항혈소판제 복용 환자에서 누두절개술의 경험: 결과, 안정성 및 합병증
백동훈 ( Dong Hoon Baek ),송근암 ( Geun Am Song ),김동욱 ( Dong Uk Kim ),김광하 ( Gwang Ha Kim ),이봉은 ( Bong Eun Lee ),전혜경 ( Hye Kyung Jeon ),지준형 ( Joon Hyung Jhi ),배정호 ( Jung Ho Bae ),이현정 ( Hyun Jeong Lee ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.4
Background/Aims: The diagnostic and therapeutic utility of endoscopic retrograde cholangiopancreatography (ERCP) has been well demonstrated for biliary and pancreatic diseases. Biliary access can be allowed by infundibulotomy if failed by using the standard cannulation methods. However, no data are available regarding ERCP-related complications in patients taking antiplatelet agents who are undergoing infundibulotomy. Therefore, we aimed to assess the frequency of ERCP-related complications after infundibulotomy in patients taking antiplatelet agents. Methods: We performed a retrospective study, and enrolled 835 patients who underwent ERCP at Pusan National University Hospital from January 2011 to December 2012. Seventy-two patients had been taking antiplatelet agents prior to the procedure. Patients were classified into two groups according to the utilization of infundibulotomy: 20 patients underwent infundibulotomy (group 1), and 52 patients did not undergo infundibulotomy (group 2). Complications after ERCP were defined as bleeding, post-ERCP pancreatitis, and perforation according to Cotton`s criteria. Results: Between group 1 and 2, there were no significant differences in baseline characteristics. ERCP was successfully performed in all cases. Clinically significant bleeding was observed in one patient in group 1 (5%, 1/20) versus none in group 2. Post-ERCP pancreatitis was observed in 2 patients (10.0%, 2/20) in group 1, and 7 patients (13.5%, 7/52) in group 2 (p=0.691). However, none of these differences were statistically significant. No perforation occurred in both groups. Conclusions: Considering the low incidence of bleeding after infundibulotomy in patients taking antiplatelet agents, infundibulotomy may be safely performed in this group of patients.
아칼라지아 환자에서 성공적인 풍선확장술의 기대인자 - 연동운동이 희복된 환자를 중심으로 -
송철수(Chul Soo Song),유영일(Young Il Yu),박승근(Seung Keun Park),강대환(Dae Hwan Kang),송근암(Geun Am Song),조몽(Mong Cho),양웅석(Ung Suk Yang) 대한내과학회 1998 대한내과학회지 Vol.54 No.5
N/A Objectives: Achalasia is primary esophageal motility disorder characterized by aperistalsis in body and incomplete lower esophageal sphincter (LES) relaxation. The aim of this study was to evaluate the parameters of successful balloon dilatation predicting long term outcome Methods: 17 patients with primary esophageal achalasia from March 1995 to December 1996 were included in this study. 5 patients were performed re-balloon dilatation due to recurrenee of symptoms, We used Rigiflex Achalasia Balloon with diameter of 30 and 35mm and balloon is dilated for 1 minute at a 5 minute interval. Esophageal manometry and scintigraphy before and after 1 month of balloon dilation were compared between groups with good long term results and relapsed Results: 1) After balloon dilatation, LES pressure, basal esophageal pressure and retention rate were significantly decreased 2) After 6 months of dilatation, 12 patients were successfully treated and 5 patients were recurred 3) No significant pre-dilatation parameters were found to predict the recurrence 4) After 1 month of dilatation, patients with recurrence of symptoms showed significant higher LES pressure and retention rate 5) 2 patients showed recovery of the peristasis, and in these patients, amplitude of esophageal body contraction of pre- and post-balloon dilatation were significantly high Conclusion: After 1 month of dilatation, LES pressure and retention rate can predict the outcome after balloon dilatation and high amplitude of esophageal body contraction predict recovery of peristalsis and long term good result
편성익 ( Sung Ik Pyeon ),송근암 ( Geun Am Song ),백동훈 ( Dong Hoon Baek ),김광하 ( Gwang Ha Kim ),이봉은 ( Bong Eun Lee ),이성준 ( Seong Jun Lee ),윤정빈 ( Jung Bin Yoon ),한성용 ( Sung Yong Han ),박도윤 ( Do Youn Park ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.2
The gastrointestinal tract is the most common site of extra-nodal non-Hodgkin lymphoma. However, the incidence of primary rectal lymphoma is extremely rare. Among the primary gastrointestinal lymphomas, follicular lymphoma has been described as a rare disease. It is difficult to diagnose rectal lymphoma due to its variable growth patterns and inadequate biopsies. Majority of patients with rectal lymphoma have non-specific symptoms or negative biopsies, often delaying the diagnosis. Our patient is a 62-year-old female. Two sessile and smooth subepithelial lesions with a yellowish normal mucosa were found on a screening colonoscopy. The initial mucosal biopsy finding was chronic inflammation, but we were highly suspicion of malignancy; we performed an endoscopic mucosal resection. Herein, we present a rare case of rectal follicular lymphoma diagnosed by endoscopic mucosal resection with a literature review. (Korean J Gastroenterol 2017;69:139-142)