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대한소화기학회지 update

The Korean Journal of Gastroenterology

  • : 대한소화기학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCOPUS
  • : 연속간행물
  • : 월간
  • : 1598-9992
  • : 2233-6869
  • : 대한소화기병학회잡지(~1989)→대한소화기병학회지(1990~)→대한소화기학회지(1995~)

수록정보
수록범위 : 1권1호(1968)~70권5호(2017) |수록논문 수 : 5,278
대한소화기학회지
70권5호(2017년 11월) 수록논문
최근 권호 논문
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KCI등재 SCOPUS

1간섬유화와 Rifaximin

저자 : 석기태 ( Ki Tae Suk )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 70권 5호 발행 연도 : 2017 페이지 : pp. 215-217 (3 pages)

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KCI등재 SCOPUS

2간경변증 환자에서 항응고제 치료

저자 : 정재연 ( Jae Youn Cheong )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 70권 5호 발행 연도 : 2017 페이지 : pp. 218-222 (5 pages)

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Cirrhotic patients have bleeding tendencies due to the lack of coagulation factors and thrombocytopenia. However, decreased levels of procoagulants are also accompanied by decreased levels of natural anticoagulants. However, there have been contrasting reports. It has been reported that patients with cirrhosis are at risk for thrombotic complications, including portal vein thrombosis and venous thromboembolism. Physicians consider active anticoagulation for prophylaxis and treatment of portal vein thrombosis and/or venous thromboembolism in cirrhotic patients with high risk of thrombosis. Concurrently, there are safety concerns regarding the risk of bleeding from anticoagulants in people with advanced liver disease. Further prospective studies are required to determine not only if cirrhotic patients benefit from receiving anticoagulation therapy for preventing thrombotic complications, but also to determine which prophylactic regimen is most appropriate. (Korean J Gastroenterol 2017;70:218-222)

KCI등재 SCOPUS

3Development of Metachronous Tumors after Endoscopic Resection for Gastric Neoplasm according to the Baseline Tumor Grade at a Health Checkup Center

저자 : GohEunChung ( 정고은 ) , SuJinChung ( 정수진 ) , JongInYang ( 양종인 ) , EunHyoJin ( 진은효

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 70권 5호 발행 연도 : 2017 페이지 : pp. 223-231 (9 pages)

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Background/Aims: Endoscopic resection (ER) procedure has been performed widely to treat gastric neoplasms. Here, we compared the long-term prognosis based on the clinical features of three types of recurred gastric neoplasms after ER, including low-grade dysplasia (LGD), high-grade dysplasia (HGD), and early gastric carcinoma (EGC). Methods: Between 2003 and 2014, subjects who were diagnosed with gastric neoplasm during screening endoscopy were included. The baseline clinicopathologic and tumor recurrence were analyzed. Results: Of the 316 patients enrolled, 170 patients (53.8%) were categorized into the LGD group, 34 patients (10.8%) into the HGD group, and 112 patients (35.4%) into the EGC group. The median follow-up duration was 4.2 years. Among the total, 14 patients experienced a development of metachronous gastric cancer; 4 patients (2.3%) in the LGD group, 3 patients (8.3%) in the HGD group, and 7 patients (6.1%) in the EGC group. Metachronous gastric neoplasm had developed in 17 LGD patients (10.0%), 5 HGD patients (14.7%), and 14 EGC patients (12.5%). There was no significant difference in the incidence of metachronous gastric cancer and neoplasm among the three groups (p=0.15 and p=0.72, respectively). Conclusions: We identified that the incidence rates of gastric neoplasm and cancer after endoscopic treatment were not significantly different between the LGD, HGD, and EGC groups. (Korean J Gastroenterol 2017;70:223-231)

KCI등재 SCOPUS

4경기서부지역 단일기관에서 최근 10년간의 헬리코박터 파일로리 제균율의 변화

저자 : 박종설 ( Jong Seol Park ) , 박지은 ( Ji-eun Park ) , 오병수 ( Byoung Soo Oh ) , 윤병욱 ( Byu

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 70권 5호 발행 연도 : 2017 페이지 : pp. 232-238 (7 pages)

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Background/Aims: The eradication rate of Helicobacter pylori (H. pylori) has been decreasing recently in Korea due to antibiotics resistance. The aim of this study was to investigate the trend of eradication rate and clinical factors affecting the eradication rate of H. pylori in the last 10 years in west Gyeonggi-do, Korea. Methods: The trends of eradication rate of H. pylori, gender, age, concomitant mediations, and clinical factors were retrospectively evaluated in patients with H. pylori infection between 2006 and 2015 (n=2,485). Results: The overall H. pylori eradication rate for the standard triple therapy was 82.5%. The annual eradication rates from 2006 to 2015 were 90%, 77.9%, 75.8%, 83.2%, 85.6%, 90.1%, 81.3%, 81.1%, 78.7%, and 78.8%, respectively, showing a significant decrement during the last five years (p<0.001). Higher eradication rate was observed in males than in females (p<0.001). Esomeprazole showed a higher eradication rate compared with pantoprazole between 2006 and 2010 (p<0.022). Age and the use of probiotics and mucosal protective agents played no significant role in the H. pylori eradication rate. The overall eradication rate for bismuth- based quadruple therapy was 94.4%. Conclusions: The eradication rate of H. pylori over the last 10 years for first-line therapy ranged from 75.8 to 90.1%; the eradication rate for triple therapy has declined. However, the eradication rate for quadruple therapy has remained unchanged over the last 10 years. (Korean J Gastroenterol 2017;70:232-238)

KCI등재 SCOPUS

5Effect of Rifaximin on Hepatic Fibrosis in Bile Duct-ligated Rat Model

저자 : SeungKakShin ( 신승각 ) , OhSangKwon ( 권오상 ) , JongJoonLee ( 이종준 ) , YeonHoPark ( 박

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 70권 5호 발행 연도 : 2017 페이지 : pp. 239-246 (8 pages)

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Background/Aims: The translocation of bacteria and their lipopolysaccharides from the gut can promote fibrosis in cirrhotic patients. The aim of this study was to investigate the effects of rifaximin on hepatic fibrosis in a bile duct-ligated rat model. Methods: The bile duct ligation (BDL) was carried out for eight days (acute injury model: sham-operated rats [G1], BDL rats [G2], and BDL rats treated with rifaximin [G3]) or 22 days (chronic injury model: sham-operated rats [G4], BDL rats [G5], and BDL rats treated with rifaximin [G6]). Rifaximin (50 mg/kg/day) was administered daily via gavage after BDL. Liver function, serum tumor necrosis factor-alpha (TNF-α), and hepatic hydroxyproline levels were measured. Moreover, a histological analysis of fibrosis contents was performed using sirius red stain. Results: In the acute injury model, the liver function and TNF-α level were not improved after the rifaximin treatment. The hydroxyproline levels (μg/g liver tissue) in G1, G2, and G3 were 236.4±103.1, 444.8±114.4, and 312.5±131.6, respectively; and fibrosis contents (%) were 0.22±0.04, 1.64±0.53, and 1.66±0.44, respectively. The rifaximin treatment did not ameliorate acute BDL-induced fibrosis. In the chronic injury model, the hydroxyproline levels in G4, G5, and G6 were 311.5±72.9, 1,110.3±357.9, and 944.3±209.3, respectively; and fibrosis contents (%) were 0.19±0.03, 5.04±0.18, and 4.42±0.68, respectively (G5 vs. G6, p=0.059). The rifaximin treatment marginally ameliorated chronic BDL-induced fibrosis. Conclusions: Rifaximin did not reduce inflammation and fibrosis in bile duct-ligated rat model. (Korean J Gastroenterol 2017;70:239-246)

KCI등재 SCOPUS

6Feasibility of Temporary Pancreatic Stenting after Early Endoscopic Retrograde Cholangiopancreatography in Patients with Acute Biliary Pancreatitis

저자 : JunKyuLee ( 이준규 ) , DongKeeJang ( 장동기 ) , HyunWooKang ( 강현우 ) , SangHyubLee ( 이상

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 70권 5호 발행 연도 : 2017 페이지 : pp. 247-252 (6 pages)

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Background/Aims: To assess the safety and effectiveness of temporary pancreatic stenting after early endoscopic retrograde chol-angiopancreatography (ERCP) in patients with acute biliary pancreatitis regardless of the severity or concomitant cholangitis. Methods: Temporary pancreatic stenting was performed in 79 patients with visualized pancreatic duct during ERCP. The outcomes of 64 patients with adequate pancreatic stenting (PS) and 15 patients with inadequate pancreatic stenting (no PS) were compared in this prospective, observational trial. Results: The baseline characteristics were similar. Development of systemic inflammatory response syndrome (7.8% for PS vs. 13.3% for no PS; p=0.50) and mortality (none for both groups; p=0.99) did not differ. However, fewer local complications occurred in PS than in no PS (4.7% for PS vs. 20.0% for no PS; p=0.04) and the difference was most outstanding in necrosis (1.6% for PS vs. 13.3% for no PS; p=0.03). Conclusions: Temporary pancreatic stenting after early ERCP should be considered safe, as complications did not increase even in cases of inadequate stenting. However, if successful, there appears to be a reduction in local complications. (Korean J Gastroenterol 2017;70:247-252)

KCI등재 SCOPUS

7Superior Mesenteric Artery Syndrome Combined with Renal Nutcracker Syndrome in a Young Male: A Case Report

저자 : MyungJinOh ( 오명진 )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 70권 5호 발행 연도 : 2017 페이지 : pp. 253-260 (8 pages)

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Superior mesenteric artery (SMA) syndrome is one of the rare causes of small bowel obstruction. It develops following a marked decrease in the angle between SMA and the abdominal aorta due to weight loss, anatomical anomalies, or following surgeries. Nutcracker syndrome in the left renal vein may also occur following a decrease in the aortomesenteric angle. Though SMA syndrome and renal nutcracker syndrome share the same pathogenesis, concurrent development has rarely been reported. Herein, we report a 23-year-old healthy male diagnosed with SMA syndrome and renal nutcracker syndrome due to severe weight reduction. The patient visited our outpatient clinic presenting bilious vomiting and indigested vomitus for 3 consecutive days. He had lost 20 kg during military service. We suspected SMA syndrome based on abnormal air-shadow in the stomach and small bowel on abdominal X-ray; we confirmed compression of the third portion of the duodenum with upper gastrointestinal series and abdominal computed tomography (CT). Concurrently, renal nutcracker syndrome was also detected via abdominal CT and Doppler ultrasound. Considering bilious vomiting and no urinary symptoms, SMA syndrome was corrected by laparoscopic duodenojejunostomy, and close observation for the renal nutcracker syndrome was recommended. (Korean J Gastroenterol 2017;70:253-260)

KCI등재 SCOPUS

8Press-through Package에 의한 소장 천공 1예

저자 : 김중석 ( Jung Seok Kim ) , 차재명 ( Jae Myung Cha ) , 곽민섭 ( Min Seob Kwak ) , 윤진영 ( Ji

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 70권 5호 발행 연도 : 2017 페이지 : pp. 261-264 (4 pages)

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With an increased use of the press-through package (PTP) tablet, there has also been an increase in mis-swallowing cases, especially in elderly patients. We report a rare case of PTP-induced small bowel perforation and fistula formation with adjacent small bowel in a healthy elderly patient, who experienced persistent abdominal pain of unknown cause. A 62-year-old healthy man was admitted to our hospital with left abdominal pain that started one month ago. Neither abdominal tenderness nor rebound tenderness was present on physical examination. His vital signs and all other test results were within normal limits. However, a 2.5 cm curved radiopaque material within his thickened small intestine was incidentally detected on an abdominal computed tomography. He underwent laparoscopic small bowel resection, which revealed foreign body in the distal small intestine. Edema, perforation, and adhesions with the surrounding tissues were also noticed in the distal small intestine. Foreign body was turned out to be PTP, and this was considered to be responsible for the small bowel perforation and fistula formation. Precautions regarding PTP usage are necessary to prevent inadvertent PTP ingestion and its related complications, such as perforation, especially in the elderly population. (Korean J Gastroenterol 2017;70:261-264)

KCI등재 SCOPUS

9Esophageal Leiomyoma Originating in the Muscularis Propria Layer Resected by Endoscopic Submucosal Dissection

저자 : JaeHeeKim ( 김재희 ) , InDuJeong ( 정인두 )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 70권 5호 발행 연도 : 2017 페이지 : pp. 265-268 (4 pages)

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10동결 건조 분변 세균총 캡슐 제제를 이용한 재발된 클로스트리디움 디피실 감염의 성공적 치료: 코호트 연구

저자 : 정숙희 ( Sook Hee Chung )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 70권 5호 발행 연도 : 2017 페이지 : pp. 269-271 (3 pages)

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분변 세균총 이식은 항생제 단독 요법으로 치료될 수 없는 재발성 클로스트리디움 디피실(Clostridium difficile)감염에 점점 더 증가하여 사용되고 있다. 이 연구에서는 임상에서 쉽고 편하게 분변 세균총 이식에 사용할 수 있는 동결건조 분변 세균총 캡슐을 제조하여 분변 세균총의 물리화학적 성질을 잘 보존할 수 있는 방법을 만들었다. 또한 이 캡슐을 투여한 후 재발된 클로스트리디움 디피실 환자에게 나타난 세균총의 변화를 분석하였다. 동결 건조된 분변 세균총 캡슐 제제는 물리화학적 특성, 캡슐의 편리성, 다른 온도에서의 안정성, 세균총의 다양성이 시험관 내에서와 생체 내에서의 기준치를 모두 만족하였다. 분변 세균총 캡슐은 2번 이상 클로스트리디움 디피실 감염이 재발한 환자, 6주 이상 광범위 항생제 치료에 효과가 없는 환자, 대변 분변 세균총 이식 3개월 이내의 대변 검사에서 클로스트리디움 디피실이 확인된 49명 환자에게 투여되었다. 이 중 43명(88%)의 환자에서 임상적으로 2개월 동안 클로스트리디움 디피실의 재감염이 없었다. 처음으로 분변 세균총 캡슐을 투여한 환자들에서 클로스트리디움 디피실 감염의 재발 방지 성공률은 89.7% (35명/39명)였다. 이 연구에서는 대장 하제의 사용 없이 분변 세균총 저용량 캡슐 제제(2.1-2.5×1011 박테리아)와 고용량 캡슐 제제(1.25-2.5×1012 박테리아)를 사용하였다. 분변 세균총 저용량 캡슐 제제(2.1-2.5×1011박테리아) 투여 시 클로스트리디움 디피실 감염의 재발 방지 성공률은 28명/30명(93.3%)이었고, 분변 세균총 고용량 캡슐 제제(1.25-2.5×1012 박테리아) 투여 시 성공률은 15명/19명(78.9%)이었다. 이 연구에 참여한 환자 중 2명이 두 달 후 클로스트리디움 디피실 감염의 재발을 경험하였다. 분변 세균총 캡슐을 투여한 후 2개월 동안 사망, 입원, 응급실 방문 또는 의사의 개입이 필요한 문제는 일어나지 않았고, 요로 감염이 한명 있었다. 각 환자들은 분변 세균총 캡슐을 섭취한 후 심미적인 문제를 전혀 호소하지 않았다. 분변 세균총 캡슐을 섭취한 환자 중 1/3 정도가 대장운동 불규칙, 방귀, 속 더부룩함을 호소하였다. 이전 연구와 비슷하게 분변 세균총 이식 전환자들의 분변에서는 공여자에 비해 많은 수의 proteobac-teria (40.7±4.3% vs. 2.0±0.5%, p<0.001), 적은 수의 firmicutes (34.4±3.8% vs. 55.4±3.3%, p=0.443)와 bacteroidetes (8.5±2.7% vs. 39.7±3.4%, p<0.001)를 나타내었다. 분변 세균총 이식 후 장내 세균의 증가된 다양성, proteobacteria 저하, firmicutes와 bacteroidetes의 증가를 보였다. 분변 세균총 이식 후 환자의 분변이 공여자와 비슷해지는 시점은 이식 1개월 후가 최대였다. 프로톤 펌프 억제제 투여가 분변 세균총 이식에 주는 해로운 효과는 이 연구에서 나타나지 않았다. 결론적으로 이 연구에서는 건강한 공여자로부터 만든 분변 세균총 캡슐의 단일 투여는 항생제 저항성 재발성 클로스트리디움 디피실 감염에 대한 치료에 높은 성공률을 보였다.

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