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[2015³â ´ëÇÑ»óºÎÀ§Àå°üÇ︮ÄÚ¹ÚÅÍÇÐȸ Ãß°èÇмú´ëȸ]

2015³â 12¿ù 12ÀÏ ¿©Àǵµ ÄÜ·¡µå È£ÅÚ¿¡¼­ Ãß°èÇмú´ëȸ°¡ ¿­·È½À´Ï´Ù. À̹ø Çмú´ëȸÀÇ ¸ðÅä´Â 'Find the way to the reliable Helicobacter eradication therapy'¿´½À´Ï´Ù. ¿©Àǵµ ±¤ÀåÀÇ °¡À»ÀÌ Àú¹°¾î°¡°í ÀÖ¾ú½À´Ï´Ù. ¾ÆÁ÷ °Ü¿ï ´À³¦Àº ¾Æ´Ï¾ú½À´Ï´Ù. ÄÜ·¡µå È£ÅÚ ¾Õ Parc1 °ø»çÀåÀº 3³â° ±×´ë·Î¿´½À´Ï´Ù. ÀÚº»ÁÖÀÇÀÇ ÃßÇÑ ±¸¼®ÀÔ´Ï´Ù.

¿¬¼¼´ë ÀÌ»ó±æ ±³¼ö´ÔÀÇ ¸ÚÁø ¹ßÇ¥¿´½À´Ï´Ù. ±×·¯³ª Àú´Â ³»¿ëÀ» ÀÌÇØÇÒ ¼ö ¾ø¾ú½À´Ï´Ù. ±×³É non-coding RNA°¡ ¼û¾î¼­ ¹º°¡ º¹ÀâÇÑ ÀÏÀ» ²Ù¹Ì°í ÀÖ´Ù´Â ´À³¦ Á¤µµ... 2007³â Seattle ¿¬¼ö ½ÃÀý °øºÎÇÑ ÈÄ ÀÌ ºÐ¾ß¸¦ follow up ÇÏÁö ¾ÊÀº °á°úÀÔ´Ï´Ù. ÀÌÁ¨ °øºÎ Á» ÇØ¾ß ÇÒ µí.

¿©·¯ ÇÐȸ¿¡¼­ Ä¿ÇǸ¦ ¸¶¼Åº¸¾ÒÁö¸¸ ¿À´Ã Ä¿ÇÇ°¡ Best ¿´½À´Ï´Ù. Acidic dz¹Ì°¡ »ì¦ ´ã°ÜÀÖ¾î ÁÁ¾Ò½À´Ï´Ù. Ä¿ÇÇ ¼ö¹éÀÜÀ» ÁغñÇϸ鼭 ÀÌ Á¤µµ ¸ÀÀ» ³»±â´Â ½±Áö ¾Ê½À´Ï´Ù.

EndoTODAY ¾Öµ¶Àڵ鿡°Ô ¼³¹®ÇÑ °á°ú¸¦ ÇÐȸÁö¿¡ ¹ßÇ¥ÇÑ ¹Ù Àִµ¥ ±ÝÀÏ ¿ì¼ö³í¹®»óÀ» ¹Þ¾Ò½À´Ï´Ù.

¿ÀÈÄ 5½Ã 30ºÐ¿¡ ÃÔ¿µÇÏ¿´½À´Ï´Ù. ¸¶Áö¸·±îÁö ÀÚ¸®¸¦ ÁöÄÑÁֽŠȸ¿ø ¿©·¯ºÐµéÀ» Á¸°æÇÕ´Ï´Ù.


1. Á¦±ÕÄ¡·á ±¸¿¬ ¼¼¼Ç - sequential therapy¿Í concomitant therapy¿¡ ´ëÇÑ ¹ßÇ¥°¡ ¸¹¾Ò½À´Ï´Ù.

±è½Â¿µ (OS-1). Clarithromycin ³»¼ºÀÌ ÀÖ´Â °æ¿ì µ¿½Ã Ä¡·á°¡ ¼øÂ÷ Ä¡·á¿¡ ºñÇÏ¿© ´õ ³ôÀº Á¦±ÕÀ²À» º¸¿´´Ù.

Áß¾Ó´ëÇб³ ±èÀç±Ô ±³¼ö´Ô comment. Clarithromycin ³»¼º°ú °ü·ÃµÈ point mutationÀÇ Á¾·ù°¡ ´Ù¾çÇϹǷΠ¸î °¡Áö point mutation¸¸ ÃøÁ¤ÇÏ´Â PCR kit°¡ clarithromycin ³»¼º Àüü¸¦ ¹Ý¿µÇÏÁö ¸øÇÕ´Ï´Ù. Clarithromycin ³»¼º¿¡ ´ëÇÑ º¸´Ù Àû±ØÀûÀÎ °Ë»ç°¡ ÇÊ¿äÇÕ´Ï´Ù.

Á¤¼º¹Î (OS-3).

¿ï»ê´ëÇб³ Á¤ÈÆ¿ë ±³¼ö´Ô comment. Compliance°¡ Áß¿äÇÒ °Í °°½À´Ï´Ù. Sequential therapyÀÇ °æ¿ì ù 5ÀÏ°£Àº ºÎÀÛ¿ëÀÌ °ÅÀÇ ¾ø´Ù°¡ µÎ¹ø° 5ÀÏ°£ classic triple therapyÀÇ ºÎÀÛ¿ëÀÌ ³ªÅ¸³³´Ï´Ù. Concomitant therapy´Â óÀ½ºÎÅÍ ¾àÁ¦°¡ ¸¹±â ¶§¹®¿¡ Ãʱ⿡ ºÎÀÛ¿ëÀÌ ¹ß»ýÇÒ ¼ö ÀÖ½À´Ï´Ù.


2. Best strategy of Hp eradication regimen (ÇѸ²´ëÇб³ ¹é±¤È£ ±³¼ö´Ô °­ÀÇ)

Sequential therapy1-5ÀÏ: amoxicillin 1g + PPI (bid)
6-10ÀÏ: clarithromycin 500 mg + metronidazole 500 mg + PPI (bid)
Concomitant therapyamoxicillin 1 g + clarithromycin 500 mg + metronidazole 500 mg (bid) 7ÀÏ

¹é±¤È£ ±³¼ö´ÔÀÇ Á¦¾È
PCRÀ̳ª ¹è¾ç°Ë»ç°¡ ºÒ°¡´ÉÇÑ °æ¿ì»ïÁ¦¿ä¹ý 14ÀÏ
PCR positiveÀÎ °æ¿ì1) ClarithromycinÀ» metronidazole·Î º¯°æÇÑ »ïÁ¦¿ä¹ý
2) Quadruple therapy
3) Sequential therapy, Concomitant therapy
Culture °Ë»ç°¡ °¡´ÉÇÑ °æ¿ìTailored therapy


3. Ç︮ÄÚ¹ÚÅÍ Á¦±ÕÄ¡·á¸¦ À§Ç× »õ·Î¿î ¹«±â - »õ·Î¿î ¾à¹°°ú ½Å¹«±â (°í·Á´ëÇб³ Á¤¼º¿ì ±³¼ö´Ô)

1) Ç×»ýÁ¦ - levofloxacin, moxifloxacin, sitafloxacin, rifabutin, fosfomycin, moenomycin A

2) »ý±ÕÁ¦ (probiotics)

3) ½Ä¹°¿ä¹ý (phytotherapy)

4) Ç×±ÕÆéŸÀ̵å

5) ÀúºÐÀÚ ¾ïÁ¦Á¦ (small molecule inhibitor)

6) Áö¹æ»ê (fatty acid) - Áö¹æ»êÀº ¼¼Æ÷¸·À» ±¸¼ºÇÏ´Â Áß¿äÇÑ ¿ä¼Ò·Î Áö¹æÀ¸·ÎºÎÅÍ ºÐÇØµÇ¾î ¼¼Æ÷ ³» ¿©·¯ °¡Áö »ý¹°ÇÐÀû ±â´ÉÀ» °®´Â ¹°Áú·Î ±¤¹üÀ§ÇÑ ±ÕÁÖ¿¡ ´ëÇÑ Á÷Á¢ÀûÀÎ »ì±ÕÀÛ¿ë°ú ¼ºÀåÀ» ¾ïÁ¦ÇÏ´Â ÀÛ¿ëÀÌ ÀÖ´Ù. ±×·¯³ª polyunsaturated fatty acid ¼·Ã븦 ÅëÇÑ H. pylori Á¦±Õ¿¡ ´ëÇÑ ÀÓ»ó ¿¬±¸µéÀÇ °á°ú´Â ½Ç¸ÁÀûÀ̾ú´Ù. Áö¹æ»êÀº °æ±¸·Î Åõ¿©½Ã esterificationÀ̳ª oxidationµÇ¾î È°¼ºÀ» ÀÒÀ» ¼ö ÀÖ°í Áö¹æÀ̳ª ´Ü¹éÁú µî°ú °áÇÕÇÏ¿© Á¡¸· ³»·ÎÀÇ Àü´ÞÀÌ ¾î·Á¿ï ¼ö ÀÖ´Â Á¡ÀÌ Àӻ󿬱¸¿¡¼­ ÁÁÀº °á°ú¸¦ ¾òÁö ¸øÇÏ´Â ÀÌÀ¯·Î »ý°¢µÈ´Ù.


4. Selected oral presentations

Ç¥Á¤ÀÇ (PL-2). A risk model based on LN metastasis in P/D intramucosal cancer

¿¬¼¼´ë ÀÌ¿ëÂù ±³¼ö´Ô comment: external validationÀÌ ÇÊ¿äÇÒ °Í °°½À´Ï´Ù.
ºÎ»ê´ë ±è±¤ÇÏ ±³¼ö´Ô comment: P/D Áß type I (solid)¿Í typd II (non-solid)¸¦ ºñ±³Çغ¸¸é ÁÁÀ» °Í °°½À´Ï´Ù.

¹Ú¼º¹Î (PL-4). Comparison of 4 scoring systems

¿¬¼¼´ëÇб³ ¹ÚÈ¿Áø ±³¼ö´Ô comment: ºñ½ÁÇÑ ¿¬±¸¸¦ ½ÃÇàÇÑ ¹Ù ÀÖ½À´Ï´Ù. ´ç½Ã¿¡´Â 'Ä¡·á³»½Ã°æ ½ÃÇàÀÇÀÇ ¸¸Á·µµ'°¡ Áß¿äÇß½À´Ï´Ù. ³»½Ã°æ Àǻ簡 ÃæºÐÇÏ°í ¿Ïº®ÇÏ°Ô Ä¡·áÇß´Ù°í »ý°¢ÇÏ´Â °æ¿ì outcomeÀÌ ÁÁ¾Ò½À´Ï´Ù.
°¡Å縯´ëÇб³ ÃÖ¸í±Ô ±³¼ö´Ô comment: ÀçÃâÇ÷À̳ª »ç¸Á·üÀÌ ¸Å¿ì ³·¾Ò½À´Ï´Ù. ±¹Á¦ÀûÀ¸·Î À¯·¡°¡ ¾ø´Âµ¥¿ä Ȥ½Ã cohort¿¡ ¹®Á¦°¡ ÀÖ´Â °ÍÀº ¾Æ´Õ´Ï±î?

ºÎ»ê´ëÇб³ Çϵ¿¿ì (PL-5). Patient-positioning device (EZ-FIX) for ESD

ÀÌÁØÇà comment: Procedure timeÀº EX-FIX ±º°ú ´ëÁ¶±º¿¡¼­ °¢°¢ 28ºÐ, 20ºÐÀ̾ú°í, midazolamÀº °¢°¢ 5.6 mg, 5.7 mg Åõ¿©µÇ¾ú½À´Ï´Ù. ºñ±³Àû ªÀº procedure time¿¡ ºñÇÏ¿© midazolamÀÌ ¸¹¾Ò±â ¶§¹®¿¡ fixing device°¡ ÇÊ¿äÇÏÁö ¾Ê¾ÒÀ»±î »ý°¢µË´Ï´Ù. MidazolamÀ» Á¶±Ý Àû°Ô »ç¿ëÇÒ °ÍÀ» Á¦¾ÈÇÕ´Ï´Ù.


5. Ư°­: ¶óƾ¾Æ¸Þ¸®Ä«ÀÇ Ç︮ÄÚ¹ÚÅÍ¿Í À§¾Ï ÀÓ»ó°ú ¿¬±¸ ÇöȲ (Catterina Ferreccio. Pontificia Universidad Catolica de Chile)

¶óƾ¾Æ¸Þ¸®Ä«ÀÎÀÇ ±â¿ø¿¡ ´ëÇÑ ½½¶óÀ̵å·Î ½ÃÀÛÇÏ¿© African Enigma, ¾Æ½Ã¾Æ¿Í Ä¥·¹ÀÇ À¯»çÁ¡ ¹× Â÷ÀÌÁ¡¿¡ ´ëÇÑ Èï¹Ì·Î¿î °­ÀÇ¿´½À´Ï´Ù.

H. pylori prevalence is similarly high in some areas in Latin Ameria with large GC differentials, similar to the so-colled "African Enigma". The best studied of these enigmas is in Colombia, where coastal populations with African ancestry have very low GC in contrast with moutain counties of Amerindian (American Indian) ancestry. The Colombian case has been explained by co-evolution of H. pylori and its host; that is individuals of African ancestry infected with Africn HP will not present damage in the gastric niche, whereas people of Ameridian ancestry infected with African Hp are at increased risk of GC (Gastric cancer incidence and mortality is associated with altitude in the mountainous regions of Pacific Latin America. Cancer Causes Control 2013;24:249).

(A) Estimated age-standardized gastric cancer mortality rate per 100,000 in the Americas, (B) map showing that the countries with the higher GC mortality rates follow the Andes mountains and the Sierra Madre in Central America (Cancer Causes Control 2013).

Maps of Colombia showing in a the distribution of the Andes Cordillera and in b the distribution of gastric cancer mortality rates in the different districts of the country (Cancer Causes Control 2013).


6. À§¾ÏÇÐȸ¿Í ÇÕµ¿ ½ÉÆ÷Áö¾ö

1) Longterm outcomes of ESD for EGC (¼º±Õ°üÀÇ´ë ÀÌÁØÇà)


As you know, the proportion of early gastric cancer is increasing. This is how we are doing in my institution. Excluding palliative surgeries, we have endoscopically or surgically treated more than seventeen hundred gastric cancers in 2012. Among them, 72% were early gastric cancers. In early gastric cancers, cases within absolute indications were 25%. So the role of ESD for the treatment of gastric cancer is getting bigger and bigger.

What do you think is the best way of presenting long-term outcome data? There are two types of outcome analysis - one is intention to treat analysis, and the other is per protocol analysis. Of course, data from intention to treat analysis is more realistic. In the survival analysis, the rate of follow-up loss is very important. It should be minimalized, usually less than 15 percent in prospective clinical studies.

Gastric neoplastic lesions can be divided into 6 groups, such as LGD, HGD, AI-EGC, EI-EGC, BEI-EGA and AGC. Diagnostic group classifications before the treatment can be changed after the treatment. The relationship is very complex. So the outcome analysis can be based on either pretreatment diagnostic groups or posttreatment diagnostic groups.

The outcome analysis is usually based on the post-treatment diagnostic groups. In the year 2012, we performed 111 ESDs for post-treatment EI-EGCs. In the beginning, however, the diagnosis was one LGD, 12 HGDs, 67 AI-EGCs and 31 EI-EGCs. So, if you analysis 111 post-treatment EI-EGCs, most of them were actually AI-EGCs before the treatment.

This analysis is based on the pre-treatment diagnostic groups. Among 396 pretreatment AI-EGCs, ESD was done for 355 cases. The final diagnoses were variable. As you can see, the post-treatment diagnosis can be actually everything.

This flow diagram shows how we handled absolute indication early gastric cancers by the pretreatment diagnostic groups. Among 355 early gastric cancers initially treated by ESD, 120 cases, this is 34 percent, belonged to the beyond absolute indication group. Ten percent of patients in the absolute indication group were initially treated by surgery, and you can see the reason in the box at the right hand-side corner. Suspicious lymphadenopathy is the most common reason for surgery. I think this kind of analysis based on the pretreatment diagnostic group has a lot of clinical meanings in the decision making among the treatment options.

ÃßÀû°üÂûÀÌ Âª¾Ò´ø ȯÀÚ¿Í synchronous lesion 13¸í µî Á¦¿Ü±âÁØÀ» Àû¿ëÇÑ ÈÄ 1,306 ȯÀÚ (Á¶±âÀ§¾Ï 1,341 º´¼Ò)¿¡ ´ëÇÏ¿© Áß¾Ó°ª 47 °³¿ù µ¿¾È °æ°ú°üÂûÇÏ¿´½À´Ï´Ù.

5³â »ýÁ¸À²Àº Àý´ëÀûÀÀÁõÀÇ °æ¿ì 97.3%, È®´ëÀûÀÀÁõÀÇ °æ¿ì 96.4%¿´½À´Ï´Ù.

Metachronous recurrence´Â 47¸í (3.6%, 47/1306)¿¡¼­ ¹ß°ßµÇ¾ú½À´Ï´Ù. Á¶±âÀ§¾ÏÀÌ 44¿¹ (93.6%), ÁøÇ༺À§¾ÏÀÌ 3¿¹¿´À¸¸ç, 28¿¹(60.0%)´Â ESD·Î 19¿¹(40.0%)´Â ¼ö¼ú·Î Ä¡·áÇÏ¿´½À´Ï´Ù.

°¡Àå Áß¿äÇÑ extragastric recurrence´Â Àý´ëÀûÀÀÁõ¿¡¼­ 1¿¹, È®´ëÀûÀÀÁõ¿¡¼­ 1¿¹°¡ ÀÖ¾ú½À´Ï´Ù. Àý´ëÀûÀÀÁõ 1¿¹´Â Àç¹ßº´¼Ò¸¦ ¼ö¼ú·Î Ä¡·áÇÒ ¼ö ÀÖ¾ú½À´Ï´Ù. ±×·¯³ª È®´ëÀûÀÀÁõÀ̾ú´ø 1¿¹´Â palliative surgery ¹Û¿¡ ÇÒ ¼ö ¾ø¾ú½À´Ï´Ù. µÎ ¸í ¸ðµÎ óÀ½ »çÁøÀ» ´Ù½Ã º¸´õ¶óµµ ESD¸¦ ÇßÀ» °Í °°Àº ȯÀÚÀÔ´Ï´Ù. Âü ¾î·Æ½À´Ï´Ù. ´ÙÇàÀÎ °ÍÀº 1,306¸í¿¡¼­ ´Ü µÎ ¸í¸¸ extragastric recurrence¸¦ º¸¿´´Ù´Â Á¡ÀÌ°í ÀÌ´Â radical subtotal gastrectomyÀÇ ÀϹÝÀûÀÎ surgical mortalityº¸´Ù ³·Àº ¼öÁØÀ̾ú½À´Ï´Ù.


2) ·Îº¿ À§ ÀýÁ¦¼ú (¿¬¼¼´ëÇб³ ±èÇüÀÏ)

3) Endoscopic full thickness resection for EGC (±¹¸³¾Ï¼¾ÅÍ ±èÂù±Ô)

±¹¸³¾Ï¼¾ÅÍ ±èÂù±Ô ¼±»ý´Ô²²¼­´Â 2015³â 12¿ù Endoscope Áö¿¡ ¹ßÇ¥ÇÑ ³»¿ëÀ» Áß½ÉÀ¸·Î °­ÀÇÇØ Áּ̽À´Ï´Ù (Kim CG. Endoscopy 2015).

±âÁ¸ÀÇ Hybrid nodes¹ýÀ¸·Î ½ÃÇàÇÏ´Â EFTRÀº ¾Æ·¡¿Í °°Àº ÀåÁ¡ÀÌ ÀÖÁö¸¸ no touch techniqueÀº ¾Æ´Ï¶ó´Â ´ÜÁ¡ÀÌ ÀÖ¾ú½À´Ï´Ù.

Advantage of EFTR
- No possibility of deep margin positive : full thickness resection
- Accurate resection margin evaluation : no stapler wire
- Visualization of the tumor at resection : endoscopic evaluation

±èÂù±Ô ¼±»ý´ÔÀº µÅÁö¸¦ ÀÌ¿ëÇÏ°í ¿Ü°ú ÀÇ»çÀÇ µµ¿òÀ» ¹Þ¾Æ non-exposure ¹æ¹ýÀ¸·Î full thickness resectionÀ» Çϼ̴ٰí ÇÕ´Ï´Ù.

4) Ongoing trials of organ-preserving surgery (¼­¿ï´ëÇб³ ¿Ü°ú ¾È»óÈÆ)

(1) Pylorus preserving gastrectomy (PPG)

ÀϺ»¿¡¼­´Â 30%°¡ ½ÃÇàµÇ°í Àִµ¥ ¿ì¸®³ª¶ó¿¡¼­´Â 1% ¹Ì¸¸¿¡¼­ ½ÃÇàµÇ°í ÀÖ½À´Ï´Ù. ÀüÇâÀû ¿¬±¸°¡ ÁøÇàµÇ°í ÀÖ½À´Ï´Ù (KLASS-04, PI: ¼­¿ï´ëÇб³ ÀÌÇõÁØ, °£»ç: ºÐ´ç¼­¿ï´ëº´¿ø ¾È»óÈÆ, 2015³â 7¿ù ù ȯÀÚ°¡ enroll µÇ¾úÀ½).

(2) Proximal gastrectom (KLASS-05, PI: ºÐ´ç¼­¿ï´ëº´¿ø ¹ÚµµÁß, °£»ç: ºÐ´ç¼­¿ï´ëº´¿ø ¾È»óÈÆ)

°ú°Å proximal gastrectomy with esophagogastrostomy ÈÄ reflux esophagitis, stricture¿Í °°Àº Èıâ ÇÕº´ÁõÀÌ ¸¹¾Æ¼­ ÃÖ±Ù¿¡´Â total gastrectomy°¡ ´ë¼¼ÀÔ´Ï´Ù. ¿Ü°ú ±³°ú¼­¿¡µµ proximal gastrectomy¸¦ ÃßõÇÏÁö ¾Ê°í ÀÖ½À´Ï´Ù. ÃÖ±Ù ºÐ´ç¼­¿ï´ëº´¿ø¿¡¼­´Â ±ÙÀ§ºÎ Á¶±âÀ§¾Ï¿¡ ´ëÇÏ¿© laparoscopic proximal gastrectomy (LPG) with double tract reconstruction (DTR)À» ½ÃÇàÇÏ°í ÀÖ½À´Ï´Ù.

½Äµµ¿Í À§ »çÀÌ¿¡ 10-15 cm °£°ÝÀ» À¯ÁöÇÏ¸é ¿ª·ù¼º ½Äµµ¿°Àº Å« ¹®Á¦°¡ µÇÁö ¾Ê´Â °Í °°½À´Ï´Ù. 51¿¹ÀÇ LPG with DTR Áõ·Ê¸¦ laparoscopic total gastrectomy¿Í ÈÄÇâÀûÀ¸·Î ºñ±³ÇØ º¸¾Ò´Âµ¥, reflux esophagitis°¡ °ÅÀÇ ¹ß»ýÇÏÁö ¾Ê¾Ò°í ºóÇ÷µµ Àû¾ú½À´Ï´Ù. ÇöÀç ÀüÇâÀû ¿¬±¸ÀÎ KLASS-05¿¬±¸¸¦ ÁøÇàÇÏ°í ÀÖ½À´Ï´Ù.

(3) Sentinel lymph node navigation surgery - ºÐ´ç¼­¿ï´ëº´¿ø¿¡¼­ 2»ó ¿¬±¸, ±¹¸³¾Ï¼¾ÅÍ ÁÖµµÀÇ ´Ù±â°ü 3»ó ¿¬±¸(SENORITA)°¡ ÁøÇàµÇ°í ÀÖ½À´Ï´Ù.


7. ¿ÀÈÄ ±¸¿¬ ¼¼¼Ç

OA-1 (ÁøÁÖ °æ»ó´ë ¹ÚÁö¼÷). Immunoblot for Hp CagA in ÁøÁÖ

20³â°£ ÁøÁÖ Áö¿ªÀÇ anti-CagA IgG Ç×ü ¾ç¼º·üÀÇ º¯È­ ¾ç»óÀ¸·Î º¼ ¶§ 10³â ÈÄ¿¡´Â 30-39¼¼°¡ 50% °¨¿°·üÀ» À¯ÁöÇÏ´Â ÄÚȣƮ È¿°ú°¡ ±â´ëµÈ´Ù.

OA-2 (¼º±Õ°ü´ëÇб³ °­ºÏ»ï¼ºº´¿ø ¾çÈ¿ÁØ). Hp eradication on the promoter methylation of Wnt antagonist genes in gastric cancer

These results suggests that epigenetic silencing of SFRP and DKK family genes may mediate Hp-associated gastric carcinogenesis. Although many of them may persist even after Hp eradication once GC has been developed, methylation of DKK-3 may be reverseved by Hp eradication in GC patients.

OB-3 (°æºÏ´ëÇб³ ±Ç¿ëÇÑ). Could we predict the metachronous gastric neoplasm after ER for EGC by using serum pepsinogen?

Persistent decreased serum PG I/II ratio (less than 3) during follow up period is a good indicator for predicting development MGN after ER for EGC and persistent Hp infectio could increase the risk of metachronous gastric neoplasm.

OC-1 (Â÷ÀÇ°ú´ëÇб³ Â÷¾Ï¿¬±¸¼Ò). ¾Ï¿¹¹æ±èÄ¡ (cpKimchi = cancer preventive kimchi)

ÁÂÀå µ¿±¹´ëÇб³ ¾çâÇå ±³¼ö´Ô comment: ½ÄÇ°Àº ½ÄÇ°À¸·Î ÇÑ°è°¡ ÀÖ´Ù´Â °ÍÀ» ÀØÁö ¸»¾Æ¾ß ÇÑ´Ù.

OC-2 (Â÷ÀÇ°ú´ëÇб³ Â÷¾Ï¿¬±¸¼Ò). Plastem (placenta-derived mesenchymal stem cells)ÀÌ Hp·Î ÀÎÇÑ gastric damage¿¡ ´ëÇÏ¿© anti-inflammatory, rejuvanating actionÀ» ÇÑ´Ù.

ÁÂÀå µ¿±¹´ëÇб³ ¾çâÇå ±³¼ö´Ô comment: È¿°ú°¡ ÀÖ´Ù´Â °ÍÀº ¾Ë°Ú´Âµ¥, Á¦±ÕÄ¡·á¸¦ ÇÏ¸é °£´ÜÇÏÁö ¾Ê½À´Ï±î?


8. Ư°­. Tips and cues for wonderful presentation with PowerPoint - äÁ¾¼­ (PTIA ´ëÇ¥)

¸Þ¼¼Áö¿¡ ÁýÁßÇÑ´Ù.

±Ù°ÅÀÇ Àü´ÞÀÌ ¾Æ´Ï¶ó ¸Þ¼¼Áö¿¡ ÁýÁßÇÑ´Ù. ¸Þ¼¼Áö´Â ±¸Ã¼ÀûÀ̾î¾ß ÇÑ´Ù. ÃʵîÇб³ ±¹¾î±³½Ç·Î µ¹¾Æ°¡¾ß ÇÑ´Ù. ÁÖ¾î¿Í µ¿»ç°¡ ¸íÈ®È÷ µé¾î°¡¾ß ÇÑ´Ù.

¸ÞÁ÷¾ÆÀÌ´Â °¡Àå ³ª»Û ÇÁ·¹Á¨Å×À̼ÇÀÌ´Ù.

1) Àü´Þ³»¿ë story

2) ½Ã°¢ÀÚ·á visual

Graphic overload¿¡¼­ ¹þ¾î³ª¶ó. ±â¾ï³ª°Ô Çϱâ À§ÇÔÀÌ´Ù. ´Ü¼øÇÔÀÌ Áß¿äÇÏ´Ù. ÇÙ½É ¸Þ¼¼Áö°¡ 3ÃÊ ¾È¿¡ °¡µ¶µÇ¾î¾ß ÇÑ´Ù. ´ëºñ°¡ Áß¿äÇÏ´Ù. Àû±ØÀûÀÎ Â÷À̸¦ ¸¸µé¾î¾ß ÇÑ´Ù. (1) ȸ»öÁ¶, (2) »ö, (3) Å©±â.

Noise¸¦ ã¾Æ¼­ ¾ø¾Ø´Ù. µµÇüÀÇ À±°û¼±Àº »ç¿ëÇÏÁö ¾Ê´Â´Ù. À̹ÌÁö´Â ¹è°æ¿¡ Àá°Ü¾ß ÇÑ´Ù.

3) Àü´Þ±â¼ú techniques


[Âü°íÀÚ·á]

1) ´ëÇÑ»óºÎÀ§Àå°üÇ︮ÄÚ¹ÚÅÍÇÐȸ ÇмúÇà»ç Áö»óÁß°è


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