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조기위암의 근치적 치료로서 내시경적 점막절제술의 유용성
현동효 ( Hyeon Dong Hyo ),정석 ( Jeong Seog ),이진우 ( Lee Jin U ),정봉주 ( Jeong Bong Ju ),류성태 ( Lyu Seong Tae ),이창근 ( Lee Chang Geun ),김명식 ( Kim Myeong Sig ),권계숙 ( Kwon Gye Sug ),이돈행 ( Lee Don Haeng ),김범수 ( Ki 대한소화기학회 2003 대한소화기학회지 Vol.42 No.6
Background/Aims: Endoscopic mucosal resection (EMR) has been widely accepted as a curative treatment of early gastric cancer (EGC). The aim of this study was to determine the usefulness and limitations of EMR for treatment of EGC by analyzing our own experience. Methods: We retrospectively evaluated 51 EGC lesions (45 mucosal and 6 submucosal cancers) from 49 patients who had undergone EMR between Oct. 1997 and Aug. 2002 at Inha Universtiy Hospital. Results: Among 45 lesions of mucosal cancer, enbloc resection was performed in 13 lesions and piecemeal resection in 32 lesions. Complete resection rates of enbloc and piecemeal resection were 84.6% and 43.8%, respectively (p=0.012). Complete resection rate of the lesions smaller than 1 cm in size was 71.4%, 1 to 2 cm in size 52%, and greazter than 2 cm in size 37.5%. Complete resection rates of well, moderately, and poorly differentiated EGC were 59.4%, 71.4%, and 16.7%, respectively (p=0.048). Thirty-three patients underwent a follow-up endoscopy at I month after EMR and two were found to have residual cancers. One patient who had a piecemeal EMR showed cerical and abdominal lymph node metastasis 10 months after EMR. Conclusions: In selected patients with EGC, EMR can be a curative treatment modality. However, complete resection rate is low in large sized and poorly differentiated EGCs and when piecemeal resection is performed. (Korean J Gastroenterol 2003;42:453-460)
현동효 ( Dong Hyo Hyun ),송정수 ( Jung Soo Song ),이문희 ( Moon Hee Lee ),이선영 ( Sun Young Lee ),김영신 ( Young Shin Kim ),김인호 ( In Ho Kim ),박원 ( Won Park ),김철수 ( Chul Soo Kim ) 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.4
Dermatomyositis (DM) is an autoimmune disorder characterized by inflammatory muscular and cutaneous disease. DM may present before, during, or after the appearance of malignancies. There have been two reported cases of DM associated with breast cancer in Korea. But there is no reported case of DM associated primary cancer recurrence. We describe the first case of DM associated with breast cancer recurrence in Korea. A 50-year-old woman was admitted to our hospital because of proximal muscle weakness and multiple skin rashes. She had undergone a mastectomy, adjuvant chemotherapy and radiotherapy for left breast cancer 25 months ago and thereafter no physical or radiology evidence of recurrent breast cancer appeared clinically. She was finally diagnosed as having recurrent breast cancer with DM. This case emphasizes the importance of evaluation for recurrence of previous malignancy with newly developed DM patient.
정봉주 ( Jeong Bong Ju ),현동효 ( Hyeon Dong Hyo ),이경욱 ( Lee Gyeong Ug ),류성태 ( Lyu Seong Tae ),이진우 ( Lee Jin U ),이정일 ( Lee Jeong Il ),정석 ( Jeong Seog ),이돈행 ( Lee Don Haeng ),김범수 ( Kim Beom Su ),김형길 ( Kim Hy 대한소화기학회 2004 대한소화기학회지 Vol.43 No.1
Combined hepatocellular-cholangiocarcinoma (HCC-CC) with sarcomatoid features is an extremely rare primary liver cancer, of which only four cases have been reported. We report a case of sarcomatoid combined HCC-CC in a 60-year-old woman who complained of right upper quadrant pain and presented with a 7 cm mass in the S4 region of the liver in abdominal CT. Ultrasonography-guided needle biopsy diagnosed it as HCC, and left lobectomy of the liver followed. Microscopically, the tumor consisted of two portions: HCC portion showing trabecular pattern, which had partially sarcomatous area with spindle-shaped tumor cells, and CC portion with glandular pattern. Immunohistochemically, HCC portion reacted positively with α-fetoprotein while CC portion demonstrated positive reactivity with carcinoembryonic antigen and mucicarmine. Sarcomatoid cells reacted positively for cytokeratin. She died of tumor recurrence and hepatic failure 12 months after the operation. Combined HCC-CC has poor prognosis, and sarcomatoid HCC has high metastatic potential and poor prognosis compared with ordinary HCC. (Korean J Gastroenterol 2004;43:56-60)
이창근,서정기,김덕영,정봉주,현동효,김은실,신재인,권준,박금수,이우형 대한심장학회 2004 Korean Circulation Journal Vol.34 No.5
심방 내 점액종의 전신 색전증은 비교적 흔하나, 관 상동맥 색전증은 극히 드물고 특히 우관동맥과 좌전하 행 관동맥에 같이 발생한 색전증은 보고 된 바 없다. 이 에 저자 등은 좌심방 점액종이 관상동맥의 좌전하행지 원위부와 우 관동맥의 후하행분지 원위부로 색전증을 일으켜 전중격과 하벽 심근 경색증이 발생된 환자를 경 험하였기에 문헌 고찰과 함께 보고 하는 바이다. Coronary artery embolization is an extremely rare and potentialy lethal complication of atrial myxomas. We -tion. A transthoracic echocardiographic study revealed the presence of an echogenic, mobile mas, compatible with myxoma in the left atrium. Coronary angiography disclosed abrupt occlusions of the distal left anterior descending artery and the right coronary artery. The tumor was successfully removed surgically after medical treatment and the patient was doing well post operatively at 6-month follow -up.
이경욱,홍성빈,한승백,정봉주,박휘라,김은실,현동효,남문석,김용성 대한내분비학회 2003 Endocrinology and metabolism Vol.18 No.3
저자들은 심한 오심 이후 부적절한 항이뇨호르몬의 분비로 저나트륨혈증이 발생한 뒤 횡문근융해증이 생긴 경우를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Hyponatremia is a frequent condition of body fluid and electrolyte imbalance encountered in clinical practice. However, rhabdomyolysis has rarely been reported in association with hyponatremia. We experienced a 56-year-old woman who had developed symptomatic hyponatremia after prolonged nausea and subsequent rhabdomyolysis. Hyponatremia was probably mediated by hypersecretion of antidiuretic hormones. The woman had developed severe hypotonic hyponatremia with an alternation in mental status after suffering from severe nausea and vomiting for x months/years. She recovered with intensive supportive therapy, including hypertonic saline administration. One day after hospitalization, she complained of thigh pains; furthermore her serum creatine phosphokinase level had increased. She was treated with alkaline diuresis. Renal failure or compartment syndrome did not complicate the clinical course. The patient was discharged and returned to her normal daily activities. The possibility of rhabdomyolysis should be considered in patients with acute hyponatremia who have developed muscle pain (J Kor SOC Endocrinol 18:306-310, 2003).