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융모상피암의 (絨毛上皮癌) 소장전이에 (小腸轉移) 의한 대량 장출혈 (腸出血) 2예
정재복,문영명,강진경,김기환,최흥재 ( Jae Bock Chung,Yong Myung Moon,Jin Kyung Kang,K Whan Kin,Heung Jai Choi ) 대한소화기학회 1980 대한소화기학회지 Vol.12 No.1
Choriocarcinoma may occur with or without any gynecological symptoms and commonly presents with a variety of medical proolem resulting from metastasis in the lungs, central nervous system, or alirnentary tract. However choriocarcinoma presenting with massive intestinal bleeding is very rare. We have presented two cases of unusual choriocarcinoma presenting with massive intest- inal bleeding due to metastasis.
정재복(Jae Bock Chung),송시영(Si Young Song),강진경(Jin Kyung Kang),박인서(In Suh Park) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.5
N/A Pancreatic pseudocysts are a complication of underlying pancreatic inflammation, most commonly alcohol induced pancreatitis, or of trauma. Pseudocysts present a broad spectrum of clinical findings and management must be individualized. To evaluate the factors influencing the outcome of pancreatic pseudocydts, we analysed the 41 cases of pancreatic pseudocysts who admitted to the Severance hospital from January 1980 to December 1989. The rnean age was 42.1 years and male to female ratio 2.7:1. The causes of pancreatic pseudocysts were pancreatitis in 48.8%, trauma in 36.6%, pancreatic cancer in 2.4% and unknown in 12.1%. The clinical symptoms were abdominal pain, nausea and/or vomiting, and fever and/or chill- ness', the physical signs were abdominal tenderness, palpable rnass and abdominal distension in the order of frequency. Complications were noted in 28 cases(68.3%) of the 41 cases and pleural effusion was the most commonly encountered in 34.1%, followed by ascites, infection of pseudocyst and obstructive jaundice in the order of frequency. The complications according to the cause of pseudocysts were 75.0% in those due to pancreatitis and 53.5% in trauma. Ac- cording to the size of pseudocyst there were 60.0% complications in those less than 10 cm and 81.2% in those above 10cm, and by location 75.0% in head, 73.7% in body and 50.0% in tail respectively. Surgical treatment was performed in 25 cases, improvement by conservative management in 8 cases and 5 cases were lost to follow up. Mean duration of disappearance of pseudocyst was 59.2(14 98)days and the mean size of the pseudocyst was 8.7(5 15)cm in pa- tients with improvement by conservative care. Comparison between patients with improve- ment by conservative treatment and others(except 5 cases lost to follow up) shows that spon- taneous improvement was commonly encountered in pancreatic pseudocysts causes by pancre- atitis and those less than 10cm in size. In conclusion, the pancreatic pseudocyst which is due to pancreatitis and less than 10 cm in size may be treated with conservative treatment for 2 months. However, additional study is necessary in many cases. (Korean J Gastroenterol 1994; 26: 859 868)
위장관 소화성 궤양의 재출혈에서 반복적인 내시경적 지혈술의 유용성과 치료 실패의 예측인자
정재연(Jae Youn Cheong),이용찬(Yong Chan Lee),장혁재(Hyuk Jae Chang),송시영(Si Young Song),김원호(Won Ho Kim),한광협(Kwang Hyub Han),정재복(Jae Bock Chung),전재윤(Jae Yoon Chon),강진경(Jin Kyung Kang),박인서(In Suh Park),문영명(Young 대한소화기학회 2001 대한소화기학회지 Vol.37 No.5
Background/Aims: After endoscopic treatment of peptic ulcer bleeding, rebleeding occurs in 15 to 20 percent of patients. We investigated the factors predicting the failure of initial endoscopic treatment in patients with peptic ulcer bleeding and the usefulness of repeated endoscopic treatment in peptic ulcer patients with rebleeding after initial endoscopic treatment. Methods: Clinical data were retrospectively collected from 376 patients (311 males and 65 females, mean age 53.9 years) with peptic ulcer bleeding between June 1995 and May 1999. Results: Of 376 patients, rebleeding after initial endoscopic treatment occurred in 50 patients (13.3%). Eight patients who failed to initial endoscopic hemostasis underwent operation immediately. The presence of major stigmata on endoscopy (p=0.001) and shock at admission (p=0.001) were two significantly independent factors predictive of rebleeding after initial endoscopic treatment. Among the patients with rebleeding, repeated endoscopic treatment was successful in 26 patients (61.9%), but 16 patients (38.1%0 underwent salvage surgery due to the failure of hemostasis. Patients who did not respond to endoscopic retreatment were more likely to have ulcers ≥2 cm in diameter (p=0.027). Conclusions: Repeated endoscopic treatment can reduce the need for surgery. Ulcer size ≥2cm is an independent factor in predicting the failure of repeated endoscopic treatment in peptic ulcer patients with rebleeding. Therefore, surgery should be considered in the case. (Korean J Gastroenterol 2001;37:319-326)
우재순(Jae Soon Woo),정재복(Jae Bock Chung),송시영(Si Young Song),강진경(Jin Kyung Kang),박인서(In Suh Park) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.2
N/A Although congenital choledochal cyst is a relatively rare developmental anomaly, several re- cent articles have drawn attention to the seemingly increased incidence of rnalignant tumors complicating it. During the period from Mar. 1973 to Mar. 1993, we encountered 5 cases (7.7%) of choledochal cyst with malignant tumors of biliary tract among 65 cases of choledochal cyst. The00 frequency of the associated cancers were in order of GB cancer (3 cases) and extrahepatic bile duct cancer(2 cases) in the cyst. In particular, a close etiologic relationship was suggested between those with associated anomalous pancreaticobiliary ductal union and the gallbladder carcinoma. For this reason, as well as the prevention of later development of cancer in the wall of the cyst, wide excision include cyst combined with reconstructive opera- tion and cholecystectomy is recommended as the treatment of choice for the choledochal cyst. (Korean J Gastroenterol 1994; 26: 316-320)
샘근육종 과증식을 동반한 십이지장 구부 거대 Brunner선 과증식
정주원 ( Joo Won Chung ),서주희 ( Joo Hee Seo ),박승우 ( Seung Woo Park ),송시영 ( Si Young Song ),정재복 ( Jae Bock Chung ),김상겸 ( Sang Kyum Kim ),김호근 ( Ho Keun Kim ),방승민 ( Seung Min Bang ) 대한소화기학회 2008 대한소화기학회지 Vol.52 No.6
Brunner`s gland hyperplasia is a rare tumor of the duodenum and might also be an unusual cause of gastrointestinal bleeding. In symptomatic patients, treatment requires either surgical resection or endoscopic polypectomy. We report a case of upper gastrointestinal bleeding from a pedunculated Brunner`s gland hyperplasia in the duodenal bulb. Endoscopic resection using the detachable snare and hemoclipping was instituted to remove a large pedunculated polyp. The pathologic diagnosis was Brunner`s gland hyperplasia with adenomyomatous hyperplasia.
권혁문(Hyuck Moon Kwon),정재복(Jae Bock Chung),김주항(Joo Hang Kim),전상일(Sang Il Chun),조준구(Jun Koo Cho),박용준(Yong Jun Park),고은희(Eun Hee Koh),노재경(Jae Kyung Roh),서창옥(Chang Ok Suh),김귀언(Gwi Eon Kim),노준규(J . K . Loh) 대한내과학회 1987 대한내과학회지 Vol.33 No.1
N/A There is no acceptable evidence, either in this presentation of in the literature, that the patterns of occurance of multiple primary maligant neoplasms of different organs of tissues are governed by anything more than conincidence. The freqency of occurance of specific types of second primary cancers is probably largely determined by the age of the patient at the time of diagnosis of initial cancer and the expected longevity after treatment of the initial lesion. The absolute number of reported cases of multiple primary malignant tumors has increased in recent years and the freqency of occurance of this phenomenon has increased. There is no factual basis for assuming that the existence of any one malignant neoplasm influence or that it implies any susceptibility of any other organ or organ system to future cancer. But it becomes apparent that existence of one malignant neoplasm implies increased susceptibility to the development of a second lesion but also a malignant lesion in one organ may imply increased susceptibility of another organ to malignant neoplasm, particularly another organ in the same or an associated system. This report deals with the clincal analysis of 42 cases of multiple primary malignant tumors from tumor registry of Severance hospital and yonsei cancer center during 7 years from Jan 1979 to Dec. 1985 and review of the literatures, The following results were abtained. 1) The incidence of multiple primary malignant tumor was 0.26% of tumor registry (42/25, 863) and the mean age of 26 male patients at first cancer was 58.8 years old and 54.9 years old in 16 female patients. 2) The mean time interval between first and second cancer was 34.1 months in 12 metachronous tumors. 3) In male patients, the stomach cancer was the most common first cancer followed by lung cancer. In female patients, the cancer of uterine cervix was the most common first cancer. 4) The ratio between synchronous and metachronous multiple primary was 2.5:1 (30:12).