간행물

대한소화기학회> 대한소화기학회지

대한소화기학회지 update

The Korean Journal of Gastroenterology

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

수록정보
수록범위 : 1권1호(1968)~78권6호(2021) |수록논문 수 : 5,784
대한소화기학회지
78권6호(2021년 12월) 수록논문
최근 권호 논문
| | | |

KCI등재

1발열을 동반한 급성 췌장염 환자에 대한 임상적 접근

저자 : 조인래 ( In Rae Cho )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 6호 발행 연도 : 2021 페이지 : pp. 311-312 (2 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재

2표재성 식도암의 치료

저자 : 신철민 ( Cheol Min Shin )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 6호 발행 연도 : 2021 페이지 : pp. 313-319 (7 pages)

다운로드

(기관인증 필요)

초록보기

Superficial esophageal squamous cell carcinoma (SESCC) is an esophageal squamous cell carcinoma confined to the mucosa or superficial submucosa. Recent Korean Guidelines recommend an endoscopic resection as the first-line treatment for SESCC without a distant or lymph node metastasis (LNM) after excluding those with an obvious submucosal invasion. Before endoscopic treatment of SESCC, Lugol chromoendoscopy or image-enhanced endoscopy is recommended to define the extent of the lesion, and endoscopic ultrasound is recommended to determine the T stage. The tumor size, macroscopic type of tumor, pathologic differentiation, depth of tumor, and lymphovascular invasion (LVI) are risk factors of LNM in SESCC. No additional treatment is necessary after an en bloc complete resection of SESCC invading no more than the lamina propria without LVI. Although the risk of LNM in a SESCC invading into muscularis mucosa without LVI is low, a close follow-up is recommended without additional treatment. On the other hand, additional treatment is recommended in the case of a tumor with submucosal invasion or an LVI positive or positive vertical resection margin. Adjuvant therapy includes esophagectomy or chemoradiotherapy (CRT), but it is unclear which treatment is better. The 5-year overall survival rates were reportedly 90-100% for esophagectomy and 75-85% for CRT. Nevertheless, patients with high-risk features including poorly differentiated histology, LVI positive, perineural invasion positive, T1b-SM2/T1b-SM3 cancer, and vertical resection margin positive need to be treated with an additional esophagectomy. Elderly patients, those with a physical condition and co-morbidities, and those with LNM or cancer-specific mortality require additional treatment after a non-curative endoscopic resection of SESCC. (Korean J Gastroenterol 2021;78:313-319)

KCI등재

3원발성 하부위장관 B세포 림프종의 임상 특징 및 예후

저자 : 차라리 ( Ra Ri Cha ) , 백동훈 ( Dong Hoon Baek ) , 이경원 ( Gyeong Won Lee ) , 박선자 ( Seun Ja Park ) , 이종훈 ( Jong Hoon Lee ) , 박종하 ( Jong Ha Park ) , 김태오 ( Tae Oh Kim ) , 이상훈 ( Sang Heon Lee ) , 김형욱 ( Hyung Wook Kim ) , 김현진 ( Hyun Jin Kim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 6호 발행 연도 : 2021 페이지 : pp. 320-327 (8 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: This multicenter study reviewed the clinical features and prognosis according to the primary site of involvement and the treatment modality in patients with B-cell primary intestinal lymphoma (PIL).
Methods: Among 125 consecutive patients diagnosed with PIL, 100 patients were analyzed.
Results: The median age was 59 years, and the male to female ratio was 1.86:1. Diffuse large B-cell lymphoma (66/100, 66.0%) was the most common histological subtype. The estimated 5-year survival rate (5-YSR) was 48.5%. The 5-YSR was similar regardless of the type of primary treatment (chemotherapy alone vs. surgery/chemotherapy, 50.7 vs. 45.3%, p=0.582). A comparison of the survival according to the primary site of involvement revealed a 5-YSR of 32.5% (p=0.027), 64.3% (reference), 46.5% (p=0.113), and 49.8% (p=0.024) for the small intestine, ileocecal region, large intestine, and multiple sites, respectively. Multivariate analysis, however, revealed a low hemoglobin level, advanced Ann Arbor stage, and aggressive histological type to be independent prognostic factors for shorter survival but not ileocecal region involvement.
Conclusions: The Ann Arbor stage, hemoglobin level, and histological type were independent prognostic factors for survival, while the primary site of involvement and treatment modality did not affect the prognosis in patients with B-cell PIL. (Korean J Gastroenterol 2021;78:320-327)

KCI등재

4한국의 1차 의료기관에서 발견된 대장용종: 발견율 및 가이드라인 적용 시 문제점

저자 : 박상현 ( Sang Hyun Park ) , 홍광일 ( Kwang Il Hong ) , 박현철 ( Hyun Chul Park ) , 김영선 ( Young Sun Kim ) , 복진현 ( Gene Hyun Bok ) , 김경호 ( Kyung Ho Kim ) , 신동석 ( Dong Suk Shin ) , 한재용 ( Jae Yong Han ) , 김영관 ( Young Kwan Kim ) , 최윤종 ( Yeun Jong Choi ) , 은수훈 ( Soo Hoon

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 6호 발행 연도 : 2021 페이지 : pp. 328-336 (9 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: There have been few multicenter studies on colonic polyps conducted by primary medical institutions. This study examined the detection rate of colonic polyps in primary health care institutions and the related factors while following the guidelines.
Methods: The medical records of 14,029 patients who underwent colonoscopy between January-June 2020 at 40 primary medical institutions in Korea were analyzed. High-risk adenoma was defined as advanced adenoma, carcinoma, or ≥3 adenomas.
Results: Most patients (71.2%) aged ≥50 years underwent re-colonoscopy within 5 years (51.3%) for diagnostic purposes (61.3%) in Korean primary medical institutions. The detection rates of colon polyps, adenoma, advanced adenoma, high-risk adenoma, and carcinoma was 59.9%, 38.9%, 5.9%, 11.4%, and 0.3% in all subjects and 59.8%, 37.5%, 8.5%, 12.9%, and 0.3% in average-risk patients, respectively. The incidences of adenoma in average-risk patients increased significantly with age (30s/40s/50s: 20.1%/29.4%/43% for adenoma, 4.4%/6.7%/10.3% for advanced adenoma, and 5.6%/9.5%/14.6% for high-risk adenoma; p<0.05). Before 50 years of age, high-risk adenoma was detected in 9.1% of patients in the first-time screening group, and the significant risk factors were being male and ≥40 years of age. The detection rate of high-risk adenoma in the normal index colonoscopy group within 5 years was 9.0%. The significant risk factors included older age, male sex, positive fecal occult blood test, stool form changes, and nonspecific symptoms (gas and indigestion).
Conclusions: More colonic adenoma studies targeting real-world clinical practice will be needed to revise the Korean guidelines for colorectal cancer screening and surveillance. (Korean J Gastroenterol 2021;78:328-336)

KCI등재

5초기 비담석 급성 췌장염 환자에서 발열과 고중성지방혈증의 연관성

저자 : 이상훈 ( Sang Hoon Lee ) , 박진명 ( Jin Myung Park ) , 김지현 ( Ji Hyun Kim ) , 김태석 ( Tae Suk Kim ) , 강창돈 ( Chang Don Kang )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 6호 발행 연도 : 2021 페이지 : pp. 337-343 (7 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: Fever is a common symptom of acute pancreatitis (AP). This study examined the factors associated with fever due to pancreatic inflammation in the early stages of non-biliary AP.
Methods: This study analyzed the AP database from Kangwon National University Hospital from January 2018 until April 2021 and identified patients who developed fever within 1 week of hospitalization. Patients with gallstone pancreatitis, pseudocyst, walled-off necrosis, chronic pancreatitis, bacteremia, and other site infections were excluded. The febrile group was compared with the afebrile group.
Results: One hundred and fifty-two patients were analyzed, and fever was diagnosed in 79 patients (52.0%). Based on multivariate analysis, fever was positively correlated with hypertriglyceridemia-induced AP (OR 16.8, 95% CI 4.0-70.7, p<0.01) and computed tomography severity index (OR 1.7, 95% CI 1.2-2.6, p<0.01). Recurrent AP was negatively associated with fever (OR 0.3, 95% CI 0.1-0.8, p=0.01). Fever was more frequent in patients with higher initial serum triglyceride (TG) levels than those with lower levels (TG <200 mg/dL; 35.1%, 200≤TG<500 mg/dL; 42.3%, TG ≥500 mg/dL; 88.6%, p<0.01).
Conclusions: Hypertriglyceridemia and CT severity index are associated with fever in early non-biliary AP. (Korean J Gastroenterol 2021;78:337-343)

KCI등재

6내시경적 절제술로 치료된 직장 Mucosa-associated Lymphoid Tissue 림프종 1예

저자 : 윤백현 ( Baek Hyun Yoon ) , 허철웅 ( Cheal Wung Huh )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 6호 발행 연도 : 2021 페이지 : pp. 344-348 (5 pages)

다운로드

(기관인증 필요)

초록보기

A primary extranodal B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) is a distinct clinical-pathological entity that develops in diverse anatomic locations. However, colorectal involvement is rare. The authors encountered a case of a MALT lymphoma of the rectum in a 69-year-old woman who complained of up to 3 kg weight loss during 3 months. A colonoscopy demonstrated a 1.0×1.0 cm sized subepithelial tumor (SET) at the lower rectum. The patient underwent an endoscopic mucosal resection with ligation for the SET. Pathological analysis revealed marked small to medium-sized lymphocytic infiltration. Immunohistochemistry revealed neoplastic cells positive for CD20 and bcl-2. A polymerase chain reaction detected immunoglobulin H gene rearrangement. Finally, rectal MALT lymphoma was diagnosed. Computed tomography and positron emission tomography scans showed that there was no lymph node metastasis or other organ involvement. A bone marrow biopsy was found to be negative for any neoplastic process. Therefore, the Ann Arbor stage was IeB. Helicobacter pylori (H. pylori) was not detected in the gastric biopsy specimens. Thus far, she has had no relapse since the endoscopic resection. The incidence of rectal MALT is very rare, and treatment is unclear. This paper reports a case of rectal MALT lymphoma treated successfully with only an endoscopic resection. (Korean J Gastroenterol 2021;78:344-348)

KCI등재

7노인 여성에서 발생한 위의 자연살해세포 장병증

저자 : 구예영 ( Ye young Koo ) , 이진 ( Jin Lee ) , 김보미 ( Bomi Kim ) , 정수진 ( Su Jin Jeong ) , 오은혜 ( Eun Hye Oh ) , 박용은 ( Yong Eun Park ) , 박종하 ( Jongha Park ) , 김태오 ( Tae Oh Kim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 6호 발행 연도 : 2021 페이지 : pp. 349-352 (4 pages)

다운로드

(기관인증 필요)

초록보기

Natural killer (NK) cell enteropathy is not well understood. Although NK-cell enteropathy is typically benign, aggressive NK-cell lymphoma is an important differential diagnosis. This paper reports a rare case of NK-cell enteropathy of the stomach presenting with dyspepsia and weight loss. In this case, upper endoscopy revealed an ulcer-like lesion (approximately 7 mm) surrounded by erythema, edema, and mucosal hemorrhage. The biopsy revealed atypical lymphocyte cells expressing CD56 without an Epstein-Barr virus infection, which is consistent with NK-cell enteropathy. Follow-up endoscopy 2 months later revealed lesion regression with mild erythema. The patient was observed closely for 6 months, with no evidence of lymphoma. (Korean J Gastroenterol 2021;78:349-352)

KCI등재

8Acute Necrotizing Pancreatitis and Coronavirus Disease-2019 (COVID-19)

저자 : Ulaş Aday , Ercan Gedik , Mehmet Tolga Kafadar , Erdal Özbek

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 6호 발행 연도 : 2021 페이지 : pp. 353-358 (6 pages)

다운로드

(기관인증 필요)

초록보기

Coronavirus disease-19 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV- 2) and has resulted in increased mortality worldwide. Several studies have identified the involvement of the gastrointestinal tract, respiratory tract, and other tissues. Although it has been reported that the angiotensin-converting enzyme-2 receptor affected by SARS-CoV is expressed more in the pancreas than in the lungs, the issue regarding the occurrence of pancreatitis is controversial. SARS Cov-2 rarely causes acute necrotizing pancreatitis without significantly affecting the respiratory and other systems. This paper presents a patient who underwent laparotomy due to acute necrotizing pancreatitis and hemodynamic instability caused by COVID-19 without any known risk factors. (Korean J Gastroenterol 2021;78:353-358)

KCI등재

9이중 십이지장 주 유두

저자 : 강화평 ( Huapyong Kang )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 6호 발행 연도 : 2021 페이지 : pp. 359-361 (3 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재

10조직학적으로 진단된 비알코올 지방간질환에서의 악성 종양 발생 위험

저자 : 김희언 ( Hee Yeon Kim )

발행기관 : 대한소화기학회 간행물 : 대한소화기학회지 78권 6호 발행 연도 : 2021 페이지 : pp. 362-363 (2 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

최근 비알코올 지방간질환에서 간세포암종이나 간 외악성 종양의 발생 빈도가 높아진다는 연구 결과가 많이 보고되고 있다.1-3 그러나, 연구 대상수가 적거나 비알코올 지방간질환의 중증도를 평가하는 표준이 되는 간 조직 소견이 없는 경우가 많았다. 이에 Simon 등4은 스웨덴에서 1966년부터 2016년까지 조직학적으로 진단된 비알코올 지방간질환 환자 8,892명을 대상으로 코호트 연구를 시행하였다. 지방간질환은 조직학적 소견에 따라 단순 지방간(5,959명, 66.8%), 섬유화가 없는 지방간염(1,050명, 11.8%), 간경변증이 없는 섬유화(1,400명, 15.7%), 간경변증(503명, 5.7%)으로 분류하였다. 각각의 비알코올 지방간질환 환자는 연령, 성별, 연도, 주(county)에 따라 비알코올지방간질환이 없는 일반 인구 대조군 39,907명과 매칭되었다. 13.8년의 중앙 관찰 기간 동안 비알코올 지방간질환 환자에서는 1,691건, 대조군에서는 6,733건의 악성 종양이 발생하였다. 대조군에 비해 비알코올 지방간질환 환자에서 악성 종양 발생위험도가 유의하게 높았는데(10.9 vs. 13.8/1,000인년; 보정위험비 1.27 [95% 신뢰구간 1.18-1.36]), 주로 간세포암종 발생 위험도가 높았다(보정위험비 17.08 [95% 신뢰구간 11.56-25.25]). 간세포암종 발생 비율은 단순 지방간, 섬유화가 없는 지방간염, 간경변증이 없는 섬유화, 간경변증 그룹으로 갈수록 증가하였고(각각 0.8/1,000인년, 1.2/1,000인년, 2.3/1,000인년, 6.2/1,000인년; Ptrend<0.01), 당뇨가 있을 때 발생 위험도가 더욱 높아졌다(각각 1.2/1,000인년, 2.9/1,000인년, 7.2/1,000인년, 15.7/1,000인년). 반면에, 비알코올 지방간질환은 췌장암, 신장 및 방광암, 흑색종의 위험도는 약간이지만 통계적으로 유의하게 증가시키고, 다른 종류의 악성 종양의 위험도는 증가시키지 않았다. 이러한 대규모의 연구로 비알코올 지방간질환의 존재 및 조직학적 중등도에 따른 악성 종양 발생 위험도를 정량적으로 추정할 수 있었다. 결론적으로 조직학적으로 증명된 비알코올 지방간질환 환자는 대조군에 비해 악성 종양 발생 빈도가 유의하게 증가하였는데, 주로 간세포암종 발생 위험이 증가하는 것과 관련되었고, 간 외 악성 종양이 기여한 바는 그리 크지 않았다. 간세포암종의 위험도는 간경변증에서 가장 높았지만, 간경변증이 없는 섬유화와 당뇨병이 동반된 경우에도 상당히 위험도가 높았다. 이러한 내용을 근거로 하여 비알코올 지방간질환 환자에서 간세포암종 발생 위험도가 높은 환자군에서는 개별화된 간세포암종 선별 검사가 필요할 것으로 보인다.

1
권호별 보기

내가 찾은 최근 검색어

최근 열람 자료

맞춤 논문

보관함

내 보관함
공유한 보관함

1:1문의

닫기