기능성 소화불량증 치료에 관한 임상진료지침

지삼룡 ( Sam Ryong Jee ),정혜경 ( Hye Kyung Jung ),민병훈 ( Byung Hoon Min ),최기돈 ( Kee Don Choi ),이풍렬 ( Poong Lyul Rhee ),강영우 ( Young Woo Kang ),이상인 ( Sang In Lee ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.2

Functional dyspepsia (FD) is defined as the presence of symptoms thought to originate in the gastroduodenal area, in the absence of any organic, systemic, or metabolic disease that is likely to explain the symptoms. Based on the available evidence and consensus opinion, thirteen consensus statements for the treatment of FD were developed using the modified Delphi approach. Proton pump inhibitor, prokinetics, and histamine 2 receptor antagonists are effective for the treatment of FD. Mucosal protecting agents, fundus relaxant, and drugs for visceral hypersensitivity can improve symptoms in FD. Antacids and antidepressants may help improving symptoms in FD. Comparing endoscopy with ``test and treat`` of Helicobacter pylori, endoscopy may be more effective initial strategy for managing patients with FD in Korea given high incidence of gastric cancer and low cost of endoscopy. Helicobacter pylori eradication can be one of the therapeutic options for patients with FD. Psychotherapy is effective for those who have severe symptoms and refractoriness. Further studies are strongly needed to develop better treatment strategies for Korean patients with FD. (Korean J Gastroenterol 2011;57:67-81)

증식성 위용종에 발생한 고분화 선암 1 예

지삼룡(Sam Ryong Jee),최석렬(Seok Reyol Choi),유승훈(Seung Hoon Ryu),박은희(Eun Hee Park),장진석(Jin Seok Jang),이종훈(Jong Hun Lee),한상영(Sang Young Han),신우원(Woo Won Shin) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.3

The hyperplastic gastric polyps comprise approximately 75% of all gastric epithelial polyps. However, coincidental gastric carcinoma has been rarely reported, being found in 1.5%-2.1% of patients with hyperplastic polyps. The size and the pathology of polyps seem to be important in the application of endoscopic removal. We present a 58-year-old female with well differentiated adenocarcinoma arising from a 1.0cm-sized hyperplastic polyp in the stomach. On the gastroscopic examination, five polyps were noted and their sizes ranged from 0.3cm to 1.0cm. She underwent the endoscopic polypectomy with snare or strip biopsy. Microscopically, focal cancerous change was observed in the largest one (1 cm size, Yamada’s type IV) on the greater curvature of the lower body. (Korean J Gastroenterol 2001;38:207-210)

위장판 : 역류 식도염에 대한 Rabeprazole과 Ranitidine 유지요법의 효과 비교 연구

지삼룡 ( Sam Ryong Jee ),설상영 ( Sang Young Seol ),김도하 ( Do Ha Kim ),박선자 ( Seun Ja Park ),한상영 ( Sang Young Han ),엄상화 ( Sang Hwa Urm ),이종태 ( Jong Tae Lee ) 대한소화기학회 2005 대한소화기학회지 Vol.45 No.5

Background/Aims: Reflux esophagitis is a recurring condition for which many patients require maintenance therapy. This comparative, randomized multicenter study was designed to evaluate the effect of long-term maintenance treatment comparing proton pump i

저등급 점막연관림프조직형 위 림프종

지삼룡 ( Sam Ryong Jee ),설상영 ( Sang Young Seol ) 대한소화기학회 2005 대한소화기학회지 Vol.45 No.5

Stomach is the most common site of primary extranodal lymphoma. Mucosa-associated lymphoid tissue (MALT) lymphoma is a unique type of extranodal lymphoma which is associated with Helicobacter pylori (H. pylori). The development of low-grade MALT lymphoma

기도 내 종양의 형태로 나타난 비호지킨 림프종 1례

지삼룡(Sam Ryong Jee),김재석(Jae Seok Kim),손춘희(Choon Hee Son),이기남(Ki Nam Lee),정진숙(Jin Sook Jeong) 대한내과학회 1999 대한내과학회지 Vol.56 No.6

Endobronchial involvement in non-Hodgkin's lymphoma is rare. We experienced 36-year-old woman with endobronchial non-Hodgkin's lymphoma whose first presentation was breathless ness due to the total atelectasis of the left lung. The patient underwent fiberoptic bronchoscopy and the histologic finding with immunohistochemical staining confirmed CD30(+), EMA(+) anaplastic large cell lymphoma. Although the patient showed dramatic response to radiation therapy and combination chemotherapy, subsequently she died of disease progression.

식도절제술 환자에서 식도내압 및 위배출시간에 대한 고찰

지삼룡 ( Sam Ryong Jee ),최석렬 ( Seok Reyol Choi ),김광진 ( Kwang Jin Kim ),금동주 ( Dong Joo Keum ),홍기봉 ( Ki Bong Hong ),이종훈 ( Jong Hun Lee ),한상영 ( Sang Young Han ),최필조 ( Pill Jo Choi ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-

〈목적〉 식도절제술은 식도암에 있어서 장기생존 및 증상의 호전을 위하여 치료원칙이 되며, 증상의 호전을 위한 고식적 수술로도 시행된다. 또한, 식도의 양성 협착 질환이나 식도 천공의 치료법으로도 행해진다. 그러나, 식도절제술후의 식도 운동기능의 양상과 위배출능에 대한 국내문헌은 찾아보기 힘든 실정이다, 이에 저자들은 식도절제술후 호소하는 증상과 식도내압 및 위배출시간과의 연관성을 알아보고자 하였다. 〈방법〉 1994년 10월부터 1998년 11월 사이에

위장관 ; 위 점막 연관 림프조직 림프종에서 PET/CT의 유용성

황진원 ( Jin Won Hwang ),지삼룡 ( Sam Ryong Jee ),이상헌 ( Sang Heon Lee ),김지현 ( Ji Hyun Kim ),설상영 ( Sang Yong Seol ),이석모 ( Seok Mo Lee ) 대한소화기학회 2016 대한소화기학회지 Vol.67 No.4

Background/Aims: This study evaluated the diagnostic efficacy of fluorine-18 fluorodeoxyglucose PET/CT (F-18 FDG PET/CT) for patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma and examined the association between FDG avidity and the clinical factors affecting lesions. Methods: Among the patients diagnosed with gastric MALT lymphoma, 16 who underwent a PET/CT for gastric MALT lymphoma were semi-quantitatively and qualitatively tested for FDG avidity of lesions in the stomach. Retrospectively collected data was analyzed to investigate the clinicoradiological factors and endoscopic findings between the patients with positive F-18 FDG PET/CT scans and those with negative scans. Results: Eight of the 16 patients showed FDG avidity. When comparing the size of lesions in the stomach, the patients with FDG avidity had significantly larger lesions than those without (28.8 mm vs. 15.0 mm, p=0.03). The FDG-avid group has a significantly higher rate of positive CT scans than the non-avid group (75% vs. 13%, p=0.03). According to the endoscopic finding of the lesions, FDG avidity was pronounced with 75% of the protruding tumors, and 100% of the erosive-ulcerative types, which are a type of depressed tumors. Conclusions: When gastric MALT lymphoma is large, when lesions are found using abdominal CT scans, and the macroscopic appearance of a lesion is that of a protruding tumor or erosive-ulcerative type of depressed tumor, there is a high probability that such patients may have a positive F-18 FDG PET/CT scan. (Korean J Gastroenterol 2016;67:183-188)

비장 혈관종과 직장 정맥류를 보인 Klippel-Trenaunay Syndrome

최윤정 ( Youn Jung Choi ),지삼룡 ( Sam Ryong Jee ),박관식 ( Kwan Sik Park ),류충헌 ( Choong Heon Ryu ),서효림 ( Hyo Rim Seo ),하승인 ( Seoung In Ha ),이상헌 ( Sang Heon Lee ),옥경선 ( Kyung Sun Ok ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.3

Klippel - Trenaunay syndrome (KTS) is characterized by a cutaneous vascular nevus of the involved extremity, bone and soft tissue hypertrophy of the extremity and venous malformations. We present a case of KTS with splenic hemangiomas and rectal varices. A 29-year-old woman was referred for intermittent hematochezia for several years. She had history with a number of operations for cutaneous and soft tissue hamangiomas since the age of one year old and for increased circumference of her left thigh during the last few months. Abdominal CT revealed multiple hemangiomas in the spleen, fusiform aneurismal dilatation of the deep veins and soft tissue hemangiomas. There was no evidence of hepatosplenomegaly or liver cirrhosis. Colonoscopy revealed hemangiomatous involvement in the rectum. There were rectal varices without evidence of active bleeding. Upon venography of the left leg, we also found infiltrative dilated superficial veins in the subcutaneous tissue and aneurismal dilatation of the deep veins. The patient was finally diagnosed with KTS, and treated with oral iron supplementation only, which has been tolerable to date. Intervention or surgery is not required. When gastrointestinal varices or hemangiomatous mucosal changes are detected in a young patient without definite underlying cause, KTS should be considered. (Korean J Gastroenterol 2011;58:157-161)

과민성장증후군

김재학 ( Jae Hak Kim ),지삼룡 ( Sam Ryong Jee ) 대한소화기학회 2019 대한소화기학회지 Vol.73 No.2

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. Its diagnosis is based on symptoms, and the Rome IV criteria are recognized as the gold diagnostic standard. The Korean Society of Neurogastroenterology and Motility (KSNM) recently updated their clinical practice guidelines for the treatment of IBS, which were last issued in 2011. In this updated edition, the KSNM defines IBS as a chronic, recurrent symptom complex that includes abdominal pain or discomfort, changes in bowel habits, and bloating for at least 6 months, which is somewhat broader than the previous definition. Four major topics have been changed in the up-dated version in-line with the results of recent studies, that is, colonoscopy; a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; probiotics; and rifaximin. Herein, we review the 2017 revised edition of the KSNM with respect to recommended clinical practice guidelines for IBS and compare these with other guidelines. (Korean J Gastroenterol 2019;73:84-91)

위선암에서 Helicobacter pylori 독성인자와 유전자 아형의 관련성

신종민,한상영,금동주,김광진,지삼룡,홍기봉,이종훈,최석렬,신우원,Shin Jong Min,Han Sang Young,Keum Dong Joo,Kim Kwang Jin,Jee Sam Ryong,Hong Gi Bong,Lee Jong Hun,Choi Seok Ryeol,Shin Woo Won 대한위암학회 2002 대한위암학회지 Vol.2 No.1

Purpose: The H. pylori cagA gene, vacA gene and iceA gene are considered to be important virurence factors that have been implicated in the development of gastric adenocarcinoma. It was reported that the presence of IS605 elements may be responsible for rearrangements and lead to partial or total deletions of the cag pathogenicity island (PAI) and the virulence of cag PAI may be changed. However, different results regarding the association between these virulence factors and clinical disease have been reported from different geographic regions. This study evaluated the relationship between H. pylori virulence factors such as cagA, vacA, iceA, IS605 and gastric adenocarcinoma. Materials and Methods: H. pylori isolates were obtained from 54 infected patients (24 cases of gastric adenocarcinoma, 30 cases of control). H. pylori isolates were identified by PCR with ureC gene and 16S rRNA. PCR was performed to examine cagA, vacA, iceA and IS605 genotypes. Results: Significant difference was found in the negative rates of cagA between gastric adenocarcinoma group and control ($62.5\%\;vs.\;33.3\%$ P=0.033). No significant difference was found in the prevalence of iceA, vacA between gastric adenocar cinoma and control. The genotype of cagA+ vacA s1-m1 iceA1 was predominant in H. pylori isolates irrespective of the clinical outcome. IS605 in PAI was not found in gastric adenocarcinoma gruop and control. The positive rates of IS605 in genome were $33.3\%$ in gastric adenocarcinoma group and $36.7\%$ in control (P>0.05). In gastric carcinoma, the positive rate of $cagA^{+}/IS605$ was lower than in control ($12.5\%\;vs\;40.0\%$, P=0.025) and the positive rate of cagA-/IS605 was higher than in control ($54.2\%\;vs\;23.3\%$, P=0.02). Conclusion: H. pylori virulence factors had not related significantly with gastric adenocarcinoma. Further study is needed to examine the specificity of H. pylori strains.