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양석균 ( Suk Kyun Yang ) 대한장연구학회 2005 Intestinal Research Vol.3 No.1
Behcet`s disease is a multisystem disease characterized by recurrent oral and genital ulcerations in association with skin and ocular lesions. Gastrointestinal involvement of Behcet`s disease is one of the major causes of morbidity and mortality in this disease, as it often results in serious complications such as perforation and bleeding. However, much remains unknown about the epidemiology, clinical characteristics, treatment, and prognosis of intestinal Behcet`s disease. In this brief review, the author summarized the differences in epidemiology and clinical characteristics of intestinal Behcet`s disease among different regions, the problems in its diagnosis and treatment, and its clinical course and long-term prognosis. (Intest Res 2005;3:1-10)
양석균(Suk Kyun Yang),명승재(Seung Jae Myung),정훈용(Hwoon Yong Jung),홍원선(Weon Seon Hong),김진호(Jin Ho Kim),심기남(Ki Nam Shim),최재원(Jae Won Choe),김해경(Hae Kyung Kim),박무인,이미헌(Mi Hun Lee),김동일(Dong Il Kim),박의련(Eui Ryun 대한내과학회 2001 대한내과학회지 Vol.60 No.6
N/A Background: The current diagnosis of hereditary non-polyposis colorectal cancer (HNPCC) is dependent on a detailed family history based on the Amsterdam criteria proposed by the International Collaborative Group on HNPCC (ICG-HNPCC) in 1990. On recognizing the shortcomings of the ICG-HNPCC criteria, the Korean Hereditary Colorectal Cancer Registry (a subdivision of the Korean Hereditary Tumor Registry) designated the term uspected HNPCC for families who do not fullfill the criteria of the ICG-HNPCC but in whom a genetic basis for colon cancer is strongly suggested. The present study was designed to determine the frequency and define the clinical characteristics of suspected HNPCC. Methods: We analysed the clinical characteristics of 42 suspected HNPCC patients and their family members and compared these characteristics with that of 1,692 non-hereditary colorectal cancer patients. Results : The frequency of suspected HNPCC was 2.4% in our study. The mean age of suspected HNPCC patients at the time of diagnosis was 45.1±9.6 years and that of non-hereditary colorectal cancer patients was 57.4±11.9 years. The incidence of synchronous colorectal cancers in HNPCC was 7.1% and that of non-hereditary colorectal cancers was 0.9%. In suspected HNPCC families, 18 patients had extracolonic malignancies and the stomach cancer was the most common (55.5%). Conclusion : The frequency of suspected HNPCC among total colorectal cancer cases was 2.4% in our study. Tumors in suspected HNPCC differed from non-hereditary colorectal cancers in an early age of onset.(Korean J Med 60:507-513, 2001)
99mTc - RBC SPECT 를 이용한 간혈관종의 진단
홍기석(Kee Suk Hong),문대혁(Dae Hyuk Moon),이명혜(Myung Hae Lee),조시만(Shee Man Cho),양석균(Suck Kyun Yang),정영화(Young Hwa Chung),이영상(Yung Sang Lee),신성해(Sung Hae Shin) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.1
N/A The value of 99mTc-RBC scintigraphy and SPECT in the diagnosis of hepatic hemangioma was evaluated in 27 patients with 38 hemangiomas and 13 patients with 15 nonhemangiomas. Twenty four (63.2%) of 38 hemangiomas were detected by planar delayed RBC imaging, whereas 30 (78.9%) hemangiomas were detected by the delayed RBC SPECT. Increase in sensitivity was noted in nodules less than 2 cm in diameter. The smallest hemangioma shown by delayed RBC SPECT was 0.9 cm in diameter. All of nonhemangiomatous lesions show normal or decreased activity in delayed blood pool images. We concluded that 99mTc-RBC SPECT is an accurate method for the detection of hepatic hemangioma and is more sensitive than planar imaging in depicting small lesions.
23 오심 및 구토의 발생으로 Azathioprine투여를 중단했던 크론병 환자에서 6-Mercaptopurine의 사용
이현주 ( Hyun Ju Lee ),양석균 ( Suk Kyun Yang ),명승재 ( Seung Jae Myung ),이장교 ( Chang Gyo Lee ),김태훈 ( Tae Hun Kim ),이진혁 ( Gin Hyug Lee ),정훈용 ( Hwoon Yong Jung ),홍원선 ( Weon Seon Hong ),김진호 ( Jin Ho Kim ),민영일 ( 대한소화기학회 2002 대한소화기학회 추계학술대회 Vol.2002 No.-
김세희 ( Sai Hui Kim ),양석균 ( Suk Kyun Yang ),김경조 ( Kyung Jo Kim ),김은희 ( Eun Hee Kim ),윤순만 ( Soon Man Yoon ),예병덕 ( Byong Duk Ye ),변정식 ( Jeong Sik Byeon ),명승재 ( Seung Jae Myung ),김진호 ( Jin Ho Kim ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.2
Background/Aims: Infliximab has been proven to be effective for refractory luminal and fistulizing Crohn`s disease (CD). We performed this study to demonstrate the efficacy of infliximab in Korean CD patients. Methods: Medical records of 40 CD patients who had been treated with infliximab were reviewed retrospectively. Results: Among 40 patients, 11 (27.5%) patients were treated for refractory luminal disease, 14 (35%) for fistulizing disease, and 15 (37.5%) for both types. Clinical response rate was higher in 26 patients with refractory luminal disease (Complete response (CR), 73.1%; Partial response (PR), 23.1%) than in 29 patients with fistulizing disease (CR, 41.4%; PR, 31%) (p=0.024). The clinical response rate tended to be higher in 28 patients with external fistulas (CR, 46.4%; PR, 32.2%) than 4 patients with internal fistulas (PR, 25%; NR, 75%) (p=0.064). Among patients with external fistulas, the response rate of 8 patients with enterocutaneous fistulas (CR, 50%; PR, 12.5%) was not different from 20 patients with perianal fistulas (CR, 45%; PR, 40%). Among 20 patients with perianal fistulas, the response rate of 6 patients with perianal fistulas without a history of operation (CR, 83.3%; PR, 0%) was higher than 14 patients with perianal fistulas resistant to previous surgical treatment (CR, 28.6%; PR, 57.1%) (p=0.044). As for adverse reaction, 7 patients experienced mild infusion reaction, and 2 patients developed serious infection. Conclusions: Infliximab is more effective for refractory luminal disease than for fistulizing disease. In addition, clinical responses to infliximab are different according to subtypes of fistulas. These findings should be considered for the proper use of infliximab. (Korean J Gastroenterol 2009;54:108-116)
베체트 장염의 임상 양상과 경과: 진단 아형에 따른 분석
김대겸 ( Dae Kyoum Kim ),양석균 ( Suk Kyun Yang ),변정식 ( Jeong Sik Byeon ),명승재 ( Seung Jae Myung ),조지윤 ( Ji Yun Jo ),최기돈 ( Kee Don Choi ),이진혁 ( Gin Hyug Lee ),정훈용 ( Hwoon Yong Jung ),홍원선 ( Weon Seon Hong ),김 대한장연구학회 2005 Intestinal Research Vol.3 No.1
목적: 베체트 장염은 치료에 대한 반응이 나쁘며 장천공, 출혈 등의 심각한 합병증을 야기하므로 베체트병의 중요한 유병 및 사망의 원인이 된다. 하지만 베체트 장염의 역학, 치료방법, 장기적 임상경과에 대해서는 아직 자세한 연구가 되어 있지 않으며 진단기준 또한 매우 다양하다. 이에 저자들은 일본 베체트병 연구회의 진단 기준에 의한 베체트 장염 환자들의 임상양상과 장기적 경과를 알아보고자 하였으며 의심형 베체트 장염 환자들의 임상양상이 완전형 및 불완전형 베체트 장염 환자들과 다른지 알아보고자 하였다. 대상 및 방법: 1989년 6월부터 2005년 1월까지 서울아산병원에 내원한 환자 중 1987년 일본 베체트병 연구회의 베체트병 진단기준에 부합하면서 대장내시경을 통해 베체트 장염을 확인한 87명을 대상으로 전신증상, 소화기증상, 대장내시경소견, 누적수술률 등의 임상양상을 후향적으로 조사하였고 의심형 베체트 장염 환자들의 임상양상을 완전형 및 불완전형 베체트 장염 환자들과 비교하였다. 결과: 남녀 비는 2:1이었으며 진단 당시의 평균 나이는 38.4세(14-66)였다. 베체트병의 전신증상으로 구강궤양 87예(100%), 음부궤양 64예(73.6%), 피부병변 52예(59.8%), pathergy 검사 양성률 14/60 (23.3%), 안구병변 7예(8.0%)였다. 소화기 증상으로는 복통 77예(88.5%), 체중감소 36예(41.4%), 설사 35예(40.2%), 복부압통 20예(23.0%), 장관출혈 18예(20.6%), 구역, 구토 16예(18.4%)의 순이었다. 대장내시경소견상 회맹부에 국한된 원형 또는 타원형의 단일궤양이 가장 흔한 소견이었다. 24명의 환자가 베체트 장염과 연관되어 한 차례이상의 수술을 시행 받았으며 누적수술률은 1년 20.7%, 2년 25.6%, 5년 27.2%, 10년 30.9%였고 누적 재수술률은 1년 9.0%, 2년 13.8%, 5년 29.3%, 10년 38.2%였다. 의심형 베체트 장염 환자의 임상양상을 완전형 및 불완전형 베체트 장염 환자의 비교하였을 때 베체트병 전신증상을 제외한 소화기증상, 대장내시경소견, 검사실 소견, 누적수술률에 있어서 차이를 보이지 않았다. 결론: 베체트 장염 환자는 10년 내에 30.9%의 환자가 수술을 경험하며 이 중 38.2%는 재수술을 경험하므로 장기적인 추적관찰이 요구된다. 의심형 베체트 장염 환자는 국제 진단기준을 충족시키지 못하지만 완전형 및 불완전형 베체트 장염 환자와 베체트병 전신증상을 제외한 임상양상에 차이가 없으므로 베체트 장염으로 간주되어야 한다. Background/Aims: Intestinal Behcet`s disease (BD) is one of the main causes of morbidity and mortality of BD because it frequently results in serious complications such as perforation and bleeding. But clinical course of intestinal BD is not well-known. The aim of this study was to review clinical manifestations of intestinal BD, and to compare clinical findings of complete and incomplete types with those of suspected type. Methods: From June 1989 to January 2005, 87 patients who had colonoscopic evidence of intestinal BD and met the criteria proposed by BD Research Committee of Japan were enrolled in this study. Clinical manifestations were collected by retrospective review of medical records. Results: Mean age at diagnosis was 38.4 years (14-66) and sex ratio was 2:1. Abdominal pain was the most frequent gastrointestinal symptom. A single, round ulcer localized at the ileocecal area was the most common colonoscopic finding. Cumulative incidence of first and second operation in 10 years was 30.9% and 38.2%, respectively. Clinical manifestations of suspected type were not different from those of complete and incomplete types. Conclusions: Long-term follow up and close observation is needed for patients with intestinal BD. Although suspected type does not meet the criteria proposed by International Study Group for BD, it should be considered as BD. (Intest Res 2005; 3:48-54)
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).
변정식 ( Jeong Sik Byeon ),양석균 ( Suk Kyun Yang ),이윤정 ( Yun Jung Lee ),최재원 ( Jae Won Choe ),이진혁 ( Gin Hyug Lee ),명승재 ( Seung Jae Myung ),정훈용 ( Hwoon Yong Jung ),홍원선 ( Weon Seon Hong ),김진호 ( Jin Ho Kim ),민 대한장연구학회 2003 Intestinal Research Vol.1 No.1
The pathogenesis of ulcerative colitis is complicated and both the genetic and environmental factors contribute to its development. Familial occurrence is an example indicating that both the genetic and environmental factors play some parts in the development of ulcerative colitis because family members have similar genetic characteristics and have been exposed to similar environment. Familial ulcerative colitis is observed in about 10% to 20% of patients. Most such families contain only 2 affected members and families containing more than 2 affected members are relatively rare. We experienced a case of familial ulcerative colitis in which all 4 members (both spouses and their 2 sons) were affected. They had lived together for 29 years before all 4 members were affected. The first patient was diagnosed after 14 years of cohabitation and the rest were affected 13, 14, and 15 years after the first diagnosis. We report this case with a review of literature. (Intestinal Research 2003;1:72-77)