http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
최기돈 ( Kee Don Choi ) 대한내과학회 2011 대한내과학회지 Vol.81 No.1
Endoscopic resection has become accepted as a standard treatment in selected patients with early gastric cancer (EGC) with negligible risk of lymph node metastasis. Endoscopic resection preserves the stomach and therefore improves quality of life compared with surgery. And it allows accurate histological staging of the tumor, which is critical in deciding whether additional treatment is necessary. The endoscopic submucosal dissection (ESD) method has been widely used with higher en bloc resection and complete resection rates than conventional endoscopic mucosal resection (EMR) with acceptable complication rates. Long-term clinical outcomes of these techniques are promising in terms of disease-free and overall survival. Recently, the expanded indication of endoscopic resection for early gastric cancer has been proposed because of technical advances of ESD. Long-term outcome data of the expanded indication are needed for the clinical application of the expanded criteria of ESD. (Korean J Med 2011;81:40-46)
증례 : 소화기 ; 종격동 기종과 공기후복막증이 발현된 신경성 식욕부진 1예
김태협 ( Tae Hyup Kim ),최기돈 ( Kee Don Choi ),김민경 ( Min Kyung Kim ),김순주 ( Soon Joo Kim ),송호준 ( Ho June Song ),정훈용 ( Hwoon Yong Jung ),김진호 ( Jin Ho Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.3
신경성 식욕부진은 정신과적인 문제뿐만 아니라 여러 계통의 합병증을 유발한다. 월경이상, 혈액학적 이상, 간 기능 이상 등은 흔하게 알려져 있는 합병증이고, 원인은 정확히 알려지지는 않았으나, 신체 내 비정상적인 공기 축적을 보일 수 있는데, 종격동 기종, 피하 공기증, 공기후복막증 등이 나타날 수 있다. 이러한 합병증은 드물게 발생하는 것이라 소화기계의 천공 같은 다른 이차적인 문제는 없는지 확인해 보아야 할 것이다. 저자들은 이차적인 문제없이 신경성식욕부진과 병발된 종격동 기종, 공기후복막증, 피하공기증을 보인 환자 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Since anorexia nervosa is a multi-systemic disorder, as well as a psychiatric disorder, it needs a multidisciplinary approach. It causes many medical problems, including irregular menstruation, hematologic problems, decreased bone density, electrolyte imbalance, and dysrhythmias. Sometimes, this disorder also causes rare, unexpected complications, including abnormal air collections, such as pneumomediastinum, retropneumoperitoneum, or subcutaneous emphysema. The cause of these phenomena is unknown, although fragile parenchymal tissue that is disrupted easily when the local pressure is increased by coughing, vomiting, or defecation is a suggested cause. We experienced a case of anorexia nervosa complicated with abnormal air collections. After we excluded other possible causes, such as perforation of the gastrointestinal tract, and ordered the patient to undergo a short fast and inhale oxygen, the abnormal air collections resolved. We report this case because of its rarity and benign course. (Korean J Med 76:338-342, 2009)
십이지장 궤양 출혈로 발현한 CD 56+ NK/T 세포 림프종
유지희 ( Ji Hee Yu ),최기돈 ( Kee Don Choi ),고영화 ( Young Wha Koh ),최원정 ( Won Jung Choi ),송호준 ( Ho June Song ),이진혁 ( Gin Hyug Lee ),정훈용 ( Hwoon Yong Jung ),김진호 ( Jin Ho Kim ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.3
Extranodal NK/T-cell lymphoma is a recently recognized distinct entity within the World Health Organization classification of lymphoid tumors. It is relatively prevalent in Asian and South American populations. It most commonly occurs in the nasal or paranasal areas and less frequently in the skin, the soft tissue, and the gastrointestinal tract. Among these, extranodal NK/T-cell lymphoma of the gastrointestinal tract has shown an aggressive clinical course. We report a case of CD56+ extranodal NK/T-cell lymphoma presenting as a duodenal ulcer bleeding. A 62-year-old male patient presented with melena and abdominal pain. Endoscopic examination of the upper gastrointestinal tract showed the duodenal ulcer covered by blood clot. Pathologic examination revealed the diffuse infiltration of atypical lymphocytes with an angiocentric growth pattern, which was positive for CD3, CD56, and granzyme. The patient showed rapid deteriorating clinical course and died on day 14 after admission. Thus, we report this case with the review of literatures. (Korean J Gastroenterol 2009;54:174-179)
소장 병변 진단에서 이중풍선소장내시경과 소장조영술의 비교
조지윤 ( Ji Yun Jo ),변정식 ( Jeong Sik Byeon ),최기돈 ( Kee Don Choi ),박혜원 ( Hye Won Park ),이진혁 ( Gin Hyug Lee ),명승재 ( Seung Jae Myung ),정훈용 ( Hwoon Yong Jung ),양석균 ( Suk Kyun Yang ),홍원선 ( Weon Seon Hong ),김진 대한소화기학회 2006 대한소화기학회지 Vol.48 No.1
목적: 소장 질환의 진단과 치료에서 이중풍선소장내시경의 역할은 아직 정립되어 있지 않다. 이번 연구에서는 소장질환이 의심되는 환자에서 소장조영술과 이중풍선소장내시경의 진단 가치를 비교 분석해 보고자 하였다. 대상 및 방법: 2005년 1월부터 2005년 5월까지 소장 병변이 의심되는 환자들을 대상으로 하였다. 연구에 포함된 환자들에 대해 이중풍선소장내시경과 소장조영술을 모두 시행하였고 그 결과를 비교하였다. 결과: 모두 18명(남:여=12:6, 14-82세)의 환자가 포함되었다. 이중풍선소장내시경과 소장조영술을 시행한 적응증은 원인 불명 위장관 출혈 10예, 원인 불명 복부 통증 5예, 만성 설사 2예, 복부 전산화단층촬영에서 소장벽 비후가 있었던 1예였다. 원인 불명 위장관 출혈 10예 중 소장조영술에서 정상이었던 4예에서 이중풍선소장내시경을 통해 궤양이나 미란과 같은 의미 있는 병변을 찾을 수 있었다. 나머지 6예는 두 검사에서 진단의 차이가 없었다. 원인 불명 복통이 있었던 5예 중 3예는 림프종, 공장 협착, 베체트 병으로 두 검사에서 같은 진단을 내릴 수 있었다. 한편, 2예에서는 서로 다른 소견을 보였는데, 소장조영술에서 크론병을 의심하였던 1예는 이중풍선소장내시경에서 정상으로 확인하였고, 소장조영술에서 악성 병변으로 생각하였던 1예는 이중풍선소장내시경에서 원인 미상의 만성 양성 궤양으로 추정되었으나 확진하지는 못했다. 만성 설사가 있었던 2예 중 1예는 두 검사에서 모두 크론병으로 진단하였고, 나머지 1예는 소장조영술에서 장결핵이 의심되었으나 이중풍선소장내시경을 통해 림프관확장증으로 확진하였다. 복부 전산화단층촬영에서 이상 소견을 보였던 1예는 두 검사 모두 정상이었다. 결론: 이중풍선소장내시경은 소장 질환의 진단에서 소장조영술보다 우수하였으며 향후 소장 질환의 진단과 치료에 중요한 역할을 담당할 것으로 생각한다. Background/Aims: The role of double balloon enteroscopy (DBE) is still evolving. The aim of this study was to compare the diagnostic yield of DBE with that of small bowel series (SBS). Methods: We enrolled patients with suspected small bowel disease consecutively, and performed both DBE and SBS in all patients. Results: Eighteen patients (M:F=12:6, 14-82 years) were included. Indications for small bowel evaluation were obscure gastrointestinal bleeding (10), abdominal pain (5), diarrhea (2) and abnormal CT finding (1). Of 10 obscure gastrointestinal bleeding patients, 6 showed the same findings in both studies. However, 4 showed negative findings in SBS while DBE detected erosions or ulcerations. Of 5 abdominal pain patients, 3 showed the same results in both studies. However, 2 demonstrated different results. One was suspected of early Crohn`s disease in SBS, but proved to be normal in DBE, and the other was suspected of malignancy in SBS but was suspected of benign ulcers in DBE. Of 2 chronic diarrhea patients, one was diagnosed as Crohn`s disease in both studies. The other was suspected of tuberculosis in SBS but diagnosed as lymphangiectasia by DBE with biopsy. One patient with jejunal wall thickening in CT proved to be normal in both DBE and SBS. There were no serious complications associated with DBE and SBS. Conclusions: DBE is better than SBS in terms of diagnostic accuracy. DBE may become an important method for the evaluation of small bowel diseases. (Korean J Gastroenterol 2006;48:25-31)
내시경초음파 유도하 미세침 흡인생검으로 진단된 위점막하 종양 유사 부비장
안지용 ( Ji Yong Ahn ),정훈용 ( Hwoon Yong Jung ),김도훈 ( Do Hoon Kim ),최기돈 ( Kee Don Choi ),송호준 ( Ho June Song ),이진혁 ( Gin Hyug Lee ),김진호 ( Jin Ho Kim ),황희상 ( Hee Sang Hwang ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.6
Accessory spleen can be mistaken as a gastric subepithelial mass, and may not be differentiated in CT or endoscopic ultrasonography (EUS). A gastric subepithelial mass was detected on routine endoscopy in a 39-year old woman with history of splenectomy. In subsequent CT and EUS, the subepithelial mass was located on the fourth layer of the stomach. To make a definite diagnosis, EUS-guided fine needle aspiration (FNA) was performed, and a splenic tissue was demonstrated in histologic examination. EUS-guided FNA can be beneficial in the diagnosis of accessory spleen which mimics a gastric subepithelial mass. (Korean J Gastroenterol 2012;59:433-436)
공은정 ( Eun Jeong Gong ),김도훈 ( Do Hoon Kim ),정훈용 ( Hwoon Yong Jung ),최기돈 ( Kee Don Choi ),송호준 ( Ho June Song ),이진혁 ( Gin Hyug Lee ),김진호 ( Jin Ho Kim ),박호섭 ( Ho Seop Park ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.1
A 51-year-old man visited the tertiary-care hospital with a 2-week history of dizziness and dyspnea on exertion. The initial hemoglobin level was 5.8 g/dL, without any history of hematochezia or melena. The esophagogastroduodenoscopy (EGD) was normal. During colonoscopic preparation, the patient experienced hematochezia and became hypotensive. On angiography, no extravasation of contrast media was observed. A CT scan with angiography showed a small high-density area in the jejunal lumen, suggesting extravasation of the contrast media. Capsule endoscopy was performed, and oozing bleeding was suspected in the proximal to mid jejunum. The patient was referred to our hospital. Repeated EGD and CT enterography did not reveal any significant bleeding. An antegrade double balloon endoscopy was performed, and an approximately 2-cm-sized submucosal tumor with ulceration and a non-bleeding exposed vessel was observed in the mid jejunum. The presumed diagnosis was jejunal gastrointestinal stromal tumor. The mass was surgically resected, and the final histopathological diagnosis was arteriovenous malformation. (Korean J Gastroenterol 2014;63:42-46)
제균 치료에 반응하지 않은 유전자 전좌를 동반한 MALT 위림프종 1예
이욱진 ( Wook Jin Lee ),정훈용 ( Hwoon Yong Jung ),윤덕현 ( Dok Hyun Yoon ),최기돈 ( Kee Don Choi ),송호준 ( Ho June Song ),이진혁 ( Gin Hyug Lee ),김진호 ( Jin Ho Kim ) 대한내과학회 2009 대한내과학회지 Vol.76 No.6
H. pylori 음성인 위 MALT 림프종의 치료는 확립되어 있지 않으며 제균 치료의 효과도 예측하기 어렵다. 최근 API2-MALT1 키메라 유전자의 존재가 제균 치료의 유효한 예측인자로 밝혀졌고, 이에 따라 새로운 치료 방법을 고려해야 한다는 주장이 제기되고 있다. 저자들은 H. pylori 제균 치료에 반응하지 않은 API2-MALT1 유전자 전좌를 동반한 위 MALT 림프종 1예를 경험하였기에 문헌 고찰과 함께 보고한다. About 90% of low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphomas are strongly related to Helicobacter pylori infection. The eradication of the H. pylori by antibiotics leads to complete regression of the gastric MALT lymphoma in 80% of cases, and this is currently recommended as the first-line treatment for this tumor. However, no standard treatment for H. pylori-negative and H. pylori-eradication-resistant gastric MALT lymphomas has yet been devised. The association between H. pylori-negative MALT lymphoma and the t(11;18)(q21;q21) translocation, resulting in an API2-MALT1 chimera gene, was reported, and is now considered one of the possible causes of and a reliable predictive marker for unresponsiveness to H. pylori-eradication treatment in patients with low-grade gastric MALT lymphoma. We report a case of H. pylori-eradication-treatment-resistant low-grade gastric MALT lymphoma that was treated successfully with radiotherapy after recognizing the API2-MALT1 chimera gene. (Korean J Med 76:737-741, 2009)