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증례 : 대장 샘암종 환자에서 이시성으로 발생한 간의 샘편평세포암종 1예
방병욱 ( Byoung Wook Bang ),임미진 ( Mie Jin Lim ),임주한 ( Joo Han Lim ),김은주 ( Eun Joo Kim ),정석 ( Seok Jeong ),최석진 ( Suk Jin Choi ),박인서 ( In Suh Park ) 대한내과학회 2007 대한내과학회지 Vol.72 No.1
간의 원발성 샘편평세포암종은 드물게 발생하며, 간의 다른 원발성 종양보다 불량한 예후를 가지고 있다. 저자들은 상행결장암으로 수술 후 항암화학요법 중 우연히 발견된 간의 원발성 샘편평세포암종을 경험하였기에 보고한다. A primary adenosquamous carcinoma of the liver is a rare subtype of a cholangiocarcinoma. Adenosquamous carcinoma is known to have an aggressive biologic behavior and is associated with a poor prognosis. Recently, we experienced a case of a primary adenosquamous carcinoma of the liver. A 69-year-old man was subjected to a right hemicolectomy five months ago due to an ascending colon cancer. At a periodic check-up, abdominal ultrasonography and magnetic resonance imaging showed a ~1.1 cm-sized hepatic mass which was highly suspicious of being a hepatic metastasis from the ascending colon cancer. A hepatic segmentectomy was performed. The tumor was microscopically composed of an adenocarcinoma and a squamous cell carcinoma, and it was different from the previous colon cancer as determined by immunohistochemistry. Three months after the hepatic segmentectomy, multiple hepatic metastasis was found and the patient has been treated as an outpatient with capecitabine. (Korean J Med 72:74-78, 2007)
난치성, 재발성 Clostridium difficile 감염에서 대변세균총이식: 9예의 임상증례보고
방병욱 ( Byoung Wook Bang ),박진석 ( Jin-seok Park ),김형길 ( Hyung Kil Kim ),신용운 ( Yong Woon Shin ),권계숙 ( Kye Sook Kwon ),권해윤 ( Hea Yoon Kwon ),백지현 ( Ji Hyeon Baek ),이진수 ( Jin-soo Lee ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.4
Background/Aims: Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory and recurrent Clostridium difficile infection (CDI). Despite its excellent efficacy and recent widespread use, FMT has not been widely used in South Korea thus far. We describe our experience with FMT to treat refractory/recurrent CDI. Methods: We conducted a chart review of patients who underwent FMT for refractory/recurrent CDI at Inha University Hospital, between March 2014 and June 2016. The demographic information, treatment data, and adverse events were reviewed. FMT was administered via colonoscopy and/or duodenoscopy. All stool donors were rigorously screened to prevent infectious disease transmission. Results: FMT was performed in nine patients with refractory/recurrent CDI. All patients were dramatically cured. Bowel movement was normalized within one week after FMT. There were no procedure-related adverse events, except aspiration pneumonia in one patient. During the follow-up period (mean 11.4 months), recurrence of CDI was observed in one patient at one month after FMT due to antibiotics. Conclusions: FMT is a safe, well-tolerated and highly effective treatment for refractory/recurrent CDI. Although there are many barriers to using FMT, we expect that FMT will be widely used to treat refractory/recurrent CDI in South Korea. (Korean J Gastroenterol 2017;69:226-231)
증례 : 소화기 ; 토혈을 주소로 내원한 고형 가유두상 종양 1예
천웅 ( Woong Cheon ),김준미 ( Joon Mee Kim ),방병욱 ( Byoung Wook Bang ),이돈행 ( Don Haeng Lee ),한지영 ( Jee Young Han ),신용운 ( Yong Woon Shin ),김영수 ( Young Soo Kim ) 대한내과학회 2011 대한내과학회지 Vol.80 No.5
고형 가유두상 종양은 췌장에 발생하는 저등급의 악성종양으로 주로 모호한 복통이나 복부덩어리를 주소로 내원하다. 대부분 우연히 발견하는데 저자들은 위장관 출혈로 내원한 환자에서 위내시경 등 여러 검사를 했으나, 정확한 출혈 병소를 찾지 못하였다. 우연히 췌장에 고형 가유두상 종양을 발견하여 절제하였고, 십이지장에 종양이 침범하여 형성된 궤양출혈을 확인하였다. 저자들은 토혈을 주소로 내원한 고형 가유두상 종양 1예를 경험하였기에 문헌고찰과 함께 보고한다.
최용준 ( Yong Jun Choi ),박진석 ( Jin Seok Park ),김경은 ( Gyung Eun Kim ),한지영 ( Jee Young Han ),나소연 ( So Yun Nah ),방병욱 ( Byoung Wook Bang ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.5
Colonoscopic examination is a safe procedure, however, unexpected complications can sometimes occur. Bleeding and perforation of the colon have been reported as the most common complications. Hemoperitoneum after colonoscopy is an unusual complication, but it may be catastrophic. We report on a 20-year-old man who experienced left low quadrant pain after undergoing colonoscopy. Hemoperitoneum was diagnosed using abdominal CT. A laparoscopic exploration was urgently performed, revealing a lacerated mesocolon of the descending colon. Bleeding of the injured site was controlled without complication. The patient recovered fully without signs of recurrent bleeding. This report implies that if the patient has persistent abdominal pain after undergoing colonoscopy, we should consider hemoperitoneum as one of the causes. To the best of our knowledge, no case of isolated laceration of the mesocolon of the descending colon after colonoscopy has been reported.
국내 임상 용량의 양성자펌프억제제에 반응하지 않는 불응성 위식도역류증의 유병률 및 임상양상: 다기관 연구
박홍준 ( Hong Jun Park ),박수헌 ( Soo Heon Park ),심기남 ( Ki Nam Shim ),김용성 ( Yong Sung Kim ),김현진 ( Hyun Jin Kim ),한재필 ( Jae Pil Han ),김용식 ( Yong Sik Kim ),방병욱 ( Byoung Wook Bang ),김광하 ( Gwang Ha Kim ),백광호 ( 대한소화기학회 2016 대한소화기학회지 Vol.68 No.1
Background/Aims: In Korea, there are no available multicenter data concerning the prevalence of or diagnostic approaches for non-responsive gastroesophageal reflux disease (GERD) which does not respond to practical dose of proton pump inhibitor (PPI) in Korea. The purpose of this study is to evaluate the prevalence and the symptom pattern of non-responsive GERD. Methods: A total of 12 hospitals who were members of a Korean GERD research group joined this study. We used the composite score (CS) as a reflux symptom scale which is a standardized questionnaire based on the frequency and severity of typical symptoms of GERD. We defined "non-responsive GERD" as follows: a subject with the erosive reflux disease (ERD) whose CS was not decreased by at least 50% after standard-dose PPIs for 8 weeks or a subject with non-erosive reflux disease (NERD) whose CS was not decreased by at least 50% after half-dose PPIs for 4 weeks. Results: A total of 234 subjects were analyzed. Among them, 87 and 147 were confirmed to have ERD and NERD, respectively. The prevalence of non-responsive GERD was 26.9% (63/234). The rates of non-responsive GERD were not different between the ERD and NERD groups (25.3% vs. 27.9%, respectively, p=0.664). There were no differences between the non-responsive GERD and responsive GERD groups for sex (p=0.659), age (p=0.134), or BMI (p=0.209). However, the initial CS for epigastric pain and fullness were higher in the non-responsive GERD group (p=0.044, p=0.014, respectively). Conclusions: In conclusion, this multicenter Korean study showed that the rate of non-responsive GERD was substantially high up to 26%. In addition, the patients with the non-responsive GERD frequently showed dyspeptic symptoms such as epigastric pain and fullness. (Korean J Gastroenterol 2016;68:16-22)