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최은경,장혜숙,서처원,이규형,이정신,김상희,김명환,민영열,김진천,이승규,박건춘,Choi, Eun-Kyung,Chang, Hye-Sook,Suh, Cheol-Won,Lee, Kyoo-Hyung,Lee, Jung-Shin,Kim, Sang-Hee,Kim, Hae-Ryun,Kim, Myung-Hwan,Min-Young-Il,Kim, Jin-Cheon,Lee, S The Korean Society for Radiation Oncology 1991 Radiation Oncology Journal Vol.9 No.2
수수로가 항암요법만으로 치료한 국소 진행된 위암환자에서 치료실패의 양상을 분석해봄으로써 수술후 방사선치료의 가능성을 알아보기 위하여 1989년 6월부터 1990년 8월까지 치료받은 107명의 환자를 대상으로 후향적 분석을 시행하였다. 제2기 ($T_2N_1,\;T_3N_0$)환자는 20이었으며 제3기 ($T_3N_1,\;T_3N_2$(환자는 87명이었다 16명은 수술후 추적이 어려워 91명에 대한 분석을 시행하였다. 모든 환자는 근치적 절제술을 시행받았고 이중 57명은 수술후 항암요법을 시행하고 24명은 계속적 추적 관찰만을 하였다. 국소재발율은 항암 요법 시행군에서는 $321\%$, 추적관찰군에서는 $24\%$로 차이가 없었고 원격전이는 항암요법 시행군에서는 $12\%$ 추적관찰군에서는 $26\%$로 항앙요법 시행군에서 원격 전이가 적어지는 것을 관찰할 수 있었다. 국소 재발환자의 $52\%$는 anastomosis site에서 재발하였고 원격 전이시 가장 많이 침범되는 장기는 간이었다. 아직 추적 관찰 기간이 짧으나 수술후 방사선 치료가 최소한 $20\%$이상의 환자에서 도움이 될것으로 생각된다. A Retrospective study to analyze the failure pattern in locally advanced stomach cancer, treated with radical surgery and post-op chemotherapy was perfomed. Among 107 patients who underwent radical gastrectomy in Asan Medical Center between June 1989 and August 1990. there were 20 stage II(T2NO, T2N1) and 87 stage III(T3N1, T3N2) and 91 patients were eligible for study. 57 patients treated with 6 cycles of postop adjuvant chemotherapy. Among 57 patients treated with postop adjuvant chemotherapy, local failure occurred in $21\%$ and distant failure in $12\%$. Among 34 patients who were not treated with postop chemotherapy, local failure occurred in $24\%$ and distant failure in $26\%$. Among 29 failures including 13 locoregional, 9 distant metastasis and 7 locoregional and distant metastasis, 11 cases recurred in the anastomotic site, 3 in the gastric bed,7 in the regional lymph nodes and peritoneal seeding occurred in 6 cases. The true incidences of gastric bed, nodal and peritoneal failures may be higher in the longer follow-up or reoperative or autopsy series. Our data sugest that postop chemocherapy is beneficial by reducing distant failure rate. Our data suggest that postop chemocherapy is beneficial by reducing distant failure rate. Postop adjuvant locoregional radiotherapy in addition to the systemic adjuvant therapy may reduce the local failure rate and potentially benefit in at least $20\%$ of patients who developed the local failure only.
장혜숙,이상오,홍원선,민영일,정훈용,이영수,김해련,양석균,정성애,송병철,-- 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.6
Pyoderma gangrenosum is a painful, chronic, ulcerating skin disease of unknown cause. It commences as an erythematous papulopustule and rapidly evolves to form an area of frank ulceration with undermined, violaceous edges and a bright outer halo of erythema. Diagnosis is clinical, there being no accepted histological diagnostic criteria. An underlying systemic illness is present in more than 50 percent of patients. Pyoderma gangrenosum develops in 0.8-5.0 percent of patients with inflammatory bowel disease, which is the most frequent underlying disease of pyoderma gangrenosum. There is no report of pyoderma gangrenosum associated with Crohn's disease in Korea. We recently experienced two cases of pyoderma gangrenosum, a 52-year old man with Crohn's disease and a 30-year old man with ulcerative colitis. The cases are presented with the review of literature.
부유두내 스텐트 삽입으로 호전된 재발성 췌장염을 동반한 분할 췌 1예
김현숙,김명환,장혜숙,서동완,민영일,정시정,김연석,명승재,나주옥,김해경,신은석 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.3
A 50-year-old woman presented with recurrent pancreatitis and pancreas divisum. Minor papilla sphincterotomy and endoscopic stent placement were done for the drainage of dorsal pancreatic duct. After stenting of the minor papilla, abdominal pain has disappeared and pancreatitis has not developed during 9 month follow-up.
대장내시경으로 확인된 악성 림프종의 내시경적 분류와 임상병리학적 고찰
김진호,김해경,박종범,장혜숙,홍원선,민영일,주광로,정훈용,김영민,김도하,양석균,최재원,명승재 대한소화기내시경학회 2001 Clinical Endoscopy Vol.23 No.1
Background/Alms: There have been only a few endoscopic s0dies of lower intestinal lesions of malignsnt lymphoma. The aims of this study were to classify the ileocolonic 1ymphomas according to the colonoscopic fhgdings and to reveal the dinicopathological relationship according to the classes. Methods: Subjects were 24 cases of ileocolonic lymphomas. We evaluated the clinicopathological features according to their endoscopic fmdings. Results: The chief complaints were abdominal pain, bleeding, and abdomina1 mess, Twenty-six lesions from 22 patients, excluding 2 multiple lymphomatous polyposis, were endoscopically classfled as follows. Fungating (10 lemons), ulcerofungating (7 lesions), inflltrative (5 lesions), ulceroinfiltrative (3 lesions), and ulcerative (1 lesion). The 1ocafim of the lesions was the terminal ileum in 11 lesions, the colon in 10 lesions, and both regions in 5 lesions. Within the 1arge bowel, the cecum was involved most frequently, followed by the ascending colon and the remainder. Most of pathological types were the diffuse large cell and the large cell immunoblastic. There was no relationship between the endoscopic findings and the histologic types. Eight eases were manifested as intussusceptlon. Conclasions: Ileocolonic lymphomas can be classified endoscopically into five types. Among the types, fungating and ulcerofungating types axe the most frequent.