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윤건중 ( Gun Jung Youn ),정우철 ( Woo Chul Chung ),이지민 ( Ji Min Lee ),백창렬 ( Chang-nyol Paik ),오정환 ( Jung Hwan Oh ),정성훈 ( Sung Hoon Jung ) 대한소화기학회 2017 대한소화기학회지 Vol.70 No.4
Background/Aims: In recent years, the incidence of acute pancreatitis (AP) has been increasing. A better understanding of the etiology is directly linked to more favorable outcomes. Unfortunately, there have been reports suggesting the variation of etiologies of AP across countries. The objective of this study was to determine the etiology of AP in a general hospital of Seoul-Gyeonggi province in Korea during the past decade. Methods: We retrospectively reviewed the medical records of consecutive patients with AP who were admitted to St. Paul’s Hospital (Seoul, Korea) with an affiliation to the Catholic University of Korea between January 2003 and January 2013. Results: A total of 1,110 patients were enrolled, totaling 1,833 attacks, and the most frequent cause of AP was alcohol consumption. The recurrence rate of AP was 24.5% (272/1,110), and habitual recurrence rate (more than three times) was 12.6% (140/1,110). The rate of severe AP was 4.9% (90/1,833 attacks). The mortality rate of AP was 2.6% (29/1,110 patients). The frequency of an idiopathic cause of AP was 13.3%. The recurrence rate and mortality rate of idiopathic AP were 16.2% and 5.4%, respectively. In 41.7% (10/24) of cases of idiopathic AP, microlithiasis was suspected. Conclusions: Between 2003 and 2013 in Korea, alcohol was the most frequent cause of AP in the general hospital of Seoul-Gyeonggi province of Korea. It appears that alcohol abstinence program may be necessary. Further nationwide studies would be needed to evaluate the etiologies of AP. (Korean J Gastroenterol 2017;70:190-197)
윤건중 ( Gun Jung Youn ),정우철 ( Woo Chul Chung ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.5
Although the incidence and mortality rate of gastric cancer have been steadily declining, gastric cancer is still the fourth most common cancer in the world and more than 50% of cases occur in Eastern Asia. In Korea, gastric cancer is the second most common cancer and third cause of cancer related death. The standard surgical procedure for resectable advanced gastric cancer is D2 lymphadenectomy with radical gastrectomy. Even though R0 resection was completed, recurrence is relatively common, and contributes to the limited survival of the patients in gastric cancer. As a clinically relevant factor for detection of the recurrence, the presence of isolating tumor cells has been introduced and it is so called as `micrometastasis`. Numerous immunohistochemistry and molecular studies have shown that micrometastasis can be demonstrated not only in lymph nodes but also in such body compartments as the bone marrow, peritoneal cavity and blood. Herein, we review the current knowledge and evidence of the prognostic significance of micrometastasis in peritoneal, lymph node, bone marrow. Also, we discuss the current state of research on the circulating tumor cell in peripheral blood. (Korean J Gastroenterol 2017;69:270-277)
윤건중 ( Gun Jung Youn ),최영 ( Young Choi ),김민재 ( Min Jae Kim ),이재신 ( Jae Sin Lee ),고의원 ( Ui Won Ko ),주연호 ( Yeon Ho Joo ) 영남대학교 의과대학 2015 Yeungnam University Journal of Medicine Vol.32 No.1
Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.
증례 : 혈액종양 ; 담낭암 환자에서 발생한 비정형성 베르니케 뇌병증 1예
정윤화 ( Yun Hwa Jung ),유현아 ( Hyun Ah Yu ),윤건중 ( Gun Jung Youn ),이자인 ( Ja In Lee ),우인숙 ( In Sook Woo ),한치화 ( Chi Wha Han ) 대한내과학회 2013 대한내과학회지 Vol.84 No.4
담낭암 환자에서 갑작스럽게 발생한 구음장애와 보행실조에 대한 평가를 위해 시행한 뇌자기공명영상에서 치상핵에 국한된 신호강도 변화를 보여 metronidazole 유발성 뇌병증과의 감별이 어려웠으나 thiamine 선제 치료 후 증상과 영상학적 호전을 보여 비정형성 베르니케 뇌병증으로 진단할 수 있었던 증례를 문헌고찰과 함께 보고한다. Wernicke`s encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from thiamine deficiency. Traditionally, diagnosis of WE rests on a clinical symptom triad consisting of ocular signs, altered consciousness, and ataxia. However, the complete triad is only present in a fraction of cases, which means that WE tends to be under-diagnosed, especially in nonalcoholic patients. Brain MRI of WE patients usually shows symmetrical signal intensity alterations in the thalami, mammillary bodies, and periaqueductal area, because of cytotoxic edema in the same region. These typical findings are useful diagnostic leads in WE patients with atypical symptoms. However, atypical findings can occasionally be seen in the vermis of cerebellum and cerebellar nuclei. Notably, alterations of signal intensity in the cerebellar dentate nuclei, which is a typical finding of metronidazole-induced encephalopathy (MIE), need to be distinguished according to medication history and response to thiamine. (Korean J Med 2013;84:602-607)
김민재 ( Min Jae Kim ),최영 ( Young Choi ),윤건중 ( Gun Jung Youn ),이래석 ( Rae Seok Lee ),박종호 ( Jong Ho Park ),이주용 ( Jue Young Lee ),주연호 ( Yeon Ho Joo ),이윤복 ( Yun Bok Lee ) 대한췌장담도학회 2014 대한췌담도학회지 Vol.19 No.2
Extrahepatic bile duct can be compressed by right hepatic artery (RHA) and cause a variety of hepatobiliary symptoms. This condition is referred to as RHA syndrome. A 20-year-old man was admitted because of jaundice. No stones or tumor were visible on CT scan and endoscopic retrograde cholangiopancreatography. However, RHA was seen traversing and compressing the mid common bile duct (CBD) with resultant upstream dilatation. The patient was diagnosed with obstructive jaundice due to compression of the CBD by variant RHA originating from gastroduodenal artery. After separation and mobilization of the variant RHA, obstructive jaundice was resolved. Herein, we report a case of a variant form of RHA syndrome that was successfully managed by surgery.