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[Á¦2ȸ ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª] - End

¼øõÀÇ °³¾÷°¡ ¼±»ý´ÔµéÀÌ À§¾ØÀå ³»°ú ¼­Á¾¿Á ¼±»ý´ÔÀ» Áß½ÉÀ¸·Î Á¤±âÀûÀ¸·Î ³»½Ã°æ °øºÎ¸ðÀÓÀ» ÇÏ°í ÀÖ½À´Ï´Ù. À۳⿡ ÀÌ¾î ¿ÃÇصµ Á¤±â ¼¼¹Ì³ª¸¦ °³ÃÖÇÏ¿´´Âµ¥ Á¦°¡ ÃÊ´ëµÇ¾ú½À´Ï´Ù. 'ESD ½Ã´ëÀÇ Áø´Ü ³»½Ã°æ'°ú 'GERD¿Í acid pocket'À̶ó´Â µÎ °­ÀǸ¦ ÁغñÇß½À´Ï´Ù. À̹ø Çà»ç¸¦ ÁغñÇϽŠ¼øõ À§¾ØÀå ³»°ú ¼­Á¾¿Á ¼±»ý´Ô²² °¨»çÇÕ´Ï´Ù.


ÀϽÃ: 2014³â 5¿ù 17ÀÏ Åä¿äÀÏ 18:00-22:00

Àå¼Ò: ¼øõ¸¸Á¤¿ø ±¹Á¦½ÀÁö¼¾ÅÍ 2Ãþ ÄÁÆÛ·±½º Ȧ

¾Æ¸§´Ù¿î ¼øõ¸¸ Á¤¿ø (¼¼¹Ì³ªÀå ¾Õ). À۳⿡ ¼øõ¸¸ Á¤¿ø¹Ú¶÷ȸ¸¦ °³ÃÖÇÏ¿´´ø Àå¼Ò°¡ ±×´ë·Î °ø¿øÀÌ µÇ¾ú½À´Ï´Ù. ÆÜ ¾Æ¸§´ä½À´Ï´Ù. ¸ðµç °ÍÀÌ »ç¶óÁ®¹ö¸° ´ëÀü EXPO¿Í ºñ±³µË´Ï´Ù. Áö¼Ó°¡´É¼ºÀ̶ó´Â °ÍÀÌ ÀÌ·¸°Ô Áß¿äÇÕ´Ï´Ù.

2014-6-29. »ï¼º¼­¿ïº´¿ø ¼ÒÈ­±â½ÉÆ÷Áö¾ö¿¡¼­ ¼­Á¾¿Á ¼±»ý´ÔÀÌ ÀüÇØÁØ CD


1. Ç×¹®Áúȯ. ¼øõ Ç×µµ¿Ü°ú °­±â¿ø

ÇغÎÇÐÀ» ÀÚ¼¼È÷ ¼³¸íÇϽŠÈÄ ´ëÇ¥Àû ÁúȯÀ» ¼Ò°³ÇÏ¿© Áּ̽À´Ï´Ù. Á÷Àå¼öÁö°Ë»çÀÇ Á߿伺À» °­Á¶Çϼ̽À´Ï´Ù. Sono¿Í Áø´ÜÀ²ÀÌ ºÎÁ·ÇÏ´Ù°í ÇÕ´Ï´Ù. Ç×¹®ÁúȯÀ¸·Î ³»¿øÇÑ È¯ÀÚ Áß AIDS¸¦ 3¸í Áø´ÜÇϼ̴ٰí ÇÕ´Ï´Ù. Anal sex¿Í °ü·ÃÇÏ¿© Ç×¹®ÁúȯÀÌ ÀÖÀ» ¼ö ÀÖ´Â ¸ð¾çÀÔ´Ï´Ù. Á¦°¡ °¡Áö°í ÀÖ´ø »çÁøÀ¸·Î ¼³¸íµå¸³´Ï´Ù.

The four main anatomic types of fistulas. The external sphincter mass is regarded as the keystone, and the prefixes trans, supra, and extra refer to it. The puborectalis muscle has been crosshatched for easy recognition. Type 1, intersphincteric; type 2, trans-sphincteric; type 3, suprasphincteric; type 4, extrasphincteric

À̾¥½Ã°³, »ý¼±°¡½Ã, ´ß»À µîÀÌ Ç×¹®¿¡ °É·Á ÅëÁõÀ» À¯¹ßÇÏ´Â ¿¹°¡ ÀÖ½À´Ï´Ù.

°­±â¿ø ¼±»ý´Ô²²¼­´Â ¾Æ·¡¿Í °°Àº °á·ÐÀ» ³»¸®¼Ì½À´Ï´Ù.


2. Do you believe your initial endoscopic forceps biopsy and diagnosis? ¼øõ Ç÷¯½º³»°ú ¾È¿ëȯ

¾È¿ëȯ ¼±»ý´Ô²²¼­ atypical gland·Î ³ª¿Í ³»½Ã°æÀýÁ¦¼úÀ» ½ÃÇàÇÑ Áõ·Ê¿¡ ´ëÇÏ¿© »ó¼¼È÷ Åä·ÐÇØ Áּ̽À´Ï´Ù.

@ Á¶¼±´ëÇб³ º´¸®°ú ÀÓ¼ºÃ¶ ±³¼ö´Ô comment: ¹®Çå¿¡ ³ª¿À´Â atypical gland¿Í ½ÇÁ¦ ÇöÀå¿¡¼­ º´¸®ÀÇ»çµéÀÌ atypical gland¿Í´Â Â÷ÀÌ°¡ ÀÖ´Â °Í °°½À´Ï´Ù. ºÐ¸íÈ÷ atypicalÇÑ ¼Ò°ßÀÌ ÀÖ°í cancerÀÏ °Í °°Àº ´À³¦ÀÌ À־ sampleÀÌ ºÎÁ·ÇÏ¿© cancer·Î Áø´ÜÇϱ⠾î·Á¿ì¸é ÃßÁ¤ÇÏÁö ¾Ê°í atypia·Î ³»°í ÀÖ½À´Ï´Ù.

@ ÀÌÁØÇà comment: ȯÀÚ°¡ 12¿ù 31ÀÏ °Ë»ç¸¦ ¹Þ¾Ò´Ù°í ÇÏ¿© Á¦°¡ ÇѸ¶µð Çß½À´Ï´Ù. ½ÇÁ¦·Î "°Ç°­°ËÁøÀ» 2014³â¿¡ ¹ÞÀ¸¼¼¿ä"¶ó´Â Å뺸¸¦ ¹ÞÀ¸¸é ¸¹Àº ȯÀÚµéÀÌ ¹Ì·ç°í ¹Ì·ç´Ù°¡ ¿¬¸»ÀÌ µÇ¾î¼­¾ß °Ë»ç¸¦ ÇÏ°í ÀÖ½À´Ï´Ù. °³¿ø°¡/°Ç°­°ËÁø¼¾ÅÍ´Â 12¿ùÀÌ µÇ¸é ´ëÈ¥¶õÀÌ ¹ú¾îÁý´Ï´Ù. ³Ê¹« ¸¹ÀÌ ¿À½Ã±â ¶§¹®ÀÌÁö¿ä. ´ëÇк´¿ø¿¡¼­´Â 1¿ù¿¡ ´ëÈ¥¶õÀÌ ¹ú¾îÁý´Ï´Ù. 12¿ù¿¡ Áø´ÜµÈ ȯÀÚµéÀÌ ¸î ÁÖÀÇ °£°ÝÀ» µÎ°í ã¾Æ¿À±â ¶§¹®ÀÔ´Ï´Ù. ¹Ý´ë·Î °³¿ø°¡/°Ç°­°ËÁø¼¾ÅÍ´Â 1-2¿ù, ´ëÇк´¿øÀº 3-4¿ùÀÌ µÇ¸é »ó´ëÀûÀ¸·Î ÇÑ°¡ÇØÁý´Ï´Ù. º°·Î ÁÁÁö¾ÊÀº Çö»óÀÔ´Ï´Ù. ¿ì¸®³ª¶óÀÇ ÇÑÁ¤µÈ ÀÇ·áÀÚ¿øÀ» È¿°úÀûÀ¸·Î »ç¿ëÇϱâ À§Çؼ­´Â 1³â µ¿¾È ±ÕµîÇÏ°Ô ºÐÆ÷µÇ´Â °ÍÀÌ ÁÁÀ» °ÍÀÔ´Ï´Ù. Àú´Â "»ýÀÏ´Þ¿¡ °Ë»çÇսôÙ"°í Á¦¾ÈÇÏ°í ÀÖ½À´Ï´Ù. 1¿ù»ýÀº 1¿ù¿¡ ³»½Ã°æÀ» ¹Þ°í, 2¿ù»ýÀº 2¿ù¿¡ ³»½Ã°æÀ» ¹Þ°í... ±×·¯¸é 12°³¿ù ±ÕµîÇÏ°Ô ºÐÆ÷µÉ °ÍÀÔ´Ï´Ù. °ø¹«¿øÀ» ¸¸³¯ ¶§¸¶´Ù ±×·¸°Ô Á¦¾ÈÇÏ°í ÀÖ½À´Ï´Ù. ¾ÆÁ÷ Á¤Ã¥¿¡ ¹Ý¿µµÇÁö´Â ¾Ê¾ÒÁö¸¸...


3. ESD ½Ã´ëÀÇ Áø´Ü³»½Ã°æ. ÀÌÁØÇà

Áú¹®: ¼±»ý´ÔÀº expanded indication¿¡ ´ëÇؼ­´Â ESD¸¦ ÇÏÁö ¾Ê½À´Ï±î?

ÀÌÁØÇà ´äº¯: Poorly differentiated adenocarcinoma¿Í signet ring cell carcinoma¿¡ ´ëÇؼ­´Â ESD¸¦ ÇÏÁö ¾Ê½À´Ï´Ù. Absolute indication¿¡¼­ Å©±â¸¸ ¾à°£ ¹þ¾î³­ °æ¿ì, ¾ÆÁÖ ¾èÀº ÇÔ¸ôºÎ°¡ ÀÖ´Â °æ¿ì(¾î¶² ÀÇ»ç´Â ulcer¶ó°í ÇÏÁö¸¸)´Â ¼±ÅÃÀûÀ¸·Î ½ÃÇàÇϱ⵵ ÇÕ´Ï´Ù. Absolute indicationÀ̶ó°í »ý°¢ÇÏ¿© ESD¸¦ Çߴµ¥ absolute criteria¸¦ ¾à°£ ÃÊ°úÇÏ¿© expanded criteria¿¡ ¼ÓÇϴ ȯÀÚ´Â °æ°ú°üÂûÀ» ÇÏ°í ÀÖ½À´Ï´Ù. ÀÌ·± ȯÀÚ°¡ 1/3Á¤µµ µË´Ï´Ù. ¾Æ·¡´Â À̹ø ÇÐȸ¿¡¼­ º¸°íÇÑ ÀúÈñº´¿ø 2012³â °á°úÀÔ´Ï´Ù.


4. Pathology of ESD, Á¶¼±´ëÇб³º´¿ø º´¸®°ú ÀÓ¼ºÃ¶

TypicalÇÏÁö ¾ÊÀ¸¸é ´Ù atypia¶ó°í ºÎ¸¨´Ï´Ù. º´¸®°úÀÇ»çµéÀÌ »ý°¢ÇÏ´Â atypia¿Í ÀÓ»óÀÇ»çµéÀÌ »ý°¢ÇÏ´Â atypia´Â »ó´çÈ÷ ´Ù¸¥ °Í °°½À´Ï´Ù. 3¸íÀÇ º´¸®Àǻ簡 atypia¶ó°í º¸°íÇÏ¿´À» ¶§, ±× Àǹ̰¡ ¸ðµÎ ´Ù¸¦ ¼ö ÀÖ½À´Ï´Ù. CommunicationÀÌ Áß¿äÇÕ´Ï´Ù. ÀÓ»óÀǻ簡 º´¸®ÀÇ»ç¿Í ÀÚ²Ù ³íÀÇÇØ¾ß ÇÕ´Ï´Ù. Deeper cut¸¦ Çϸé Áø´ÜÀÌ ´Þ¶óÁú ¼ö ÀÖ½À´Ï´Ù.

º´¸®°ú ÀÇ»çµéÀÌ Á¶Á÷°Ë»ç¸¦ ´ëÇϴ ŵµ¿Í ESD ȤÀº ¼ö¼ú specimenÀ» ´ëÇϴ ŵµ´Â »ç¹µ ´Ù¸¨´Ï´Ù. Á¶Á÷°Ë»ç´Â ÃÖÁ¾ÀûÀÎ Ä¡·á°¡ ¾Æ´Ï¹Ç·Î ´Ù¼Ò ¾Ö¸ÅÇÑ °æ¿ì Áø´ÜÀ» ¼¼°Ô ³»Áö ¾Ê´Â °æÇâÀÔ´Ï´Ù. ¹Ý¸é ESD ȤÀº ¼ö¼ú specimenÀº ÃÖÁ¾ÀûÀÎ Ä¡·á°¡ µÇ¾ú´Ù°í º¸°í ´Ù¼Ò ¾Ö¸ÅÇÏ´õ¶óµµ Áø´ÜÀ» ¼¼°Ô ³»´Â °æÇâÀÔ´Ï´Ù. ÀÌ·¯ÇÑ ½É¸®ÀûÀÎ ¿ä¼Ò°¡ ESD/¼ö¼ú ÈÄ º´¸®°á°ú°¡ upgradeµÇ´Â ÇÑ ¿äÀÎÀÏ ¼ö ÀÖ½À´Ï´Ù.

¸²ÇÁ°ü ³»ÀÇ Á¾¾çÀÌ ÀǽɵǴ H&E ¼Ò°ß.D2-40 stainingÀ» ½ÃÇàÇϸé lymphatic vessel¿¡ ¿°»öÀÌ µÇ¹Ç·Î lymphatic invasionÀ» È®ÀÎÇÒ ¼ö ÀÖ½À´Ï´Ù.


5. H. pylori eradication. ¼øõº´¿ø ¹ÚÁ¤¼ö

¼øÂ÷¿ä¹ý°ú Ç¥ÁØ 3Á¦¿ä¹ý(7ÀÏ°ú 14ÀÏ)ÀÇ Á¦±ÕÀ²À» ºñ±³ÇÏ¿´½À´Ï´Ù. ITT ºÐ¼®ÀÇ Á¦±ÕÀ²Àº ¼øÂ÷¿ä¹ý 90.2%, 7ÀÏ Ç¥ÁØÄ¡·á 69.5 %, 14ÀÏ Ç¥ÁØÄ¡·á 88.5%¿´½À´Ï´Ù. PP ºÐ¼®ÀÇ Á¦±ÕÀ²Àº ¼øÂ÷¿ä¹ý 92.5%, 7ÀÏ Ç¥ÁØÄ¡·á 71.2 %, 14ÀÏ Ç¥ÁØÄ¡·á 88.0%¿´½À´Ï´Ù. ¼øÂ÷¿ä¹ýÀÌ 7ÀÏ Ç¥ÁØÄ¡·áº¸´Ù Á¦±ÕÀ²ÀÌ ³ô´Ù°í °á·ÐÀ» ³»·È½À´Ï´Ù.


6. Diagnostic rate of GERD by transnasal endoscopy in health screening. À§¾ØÀå³»°ú ¼­Á¾¿Á

We analysed all data of 1,192 patients who had been examined for the purpose of health examination by transnasal endoscopy in the clinic from March 3, 2013 to March 31, 2014.


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¼øõ¸¸ »¹ÀÇ ¸¹Àº »ý¹°µé

¼øõ¸¸ dz°æ (¿ë»ê Àü¸Á´ë¿¡¼­)


[References]

1) ¼øõ¸¸³»½Ã°æ¼¼¹Ì³ª

© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.