급성췌장염 중증도의 예측인자 분석

양서윤 외 중앙대학교 의과대학 의과학연구소 2010 中央醫大誌 Vol.35 No.1/2

Background/Aims: Acute pancreatitis (AP) is an inflammatory disease which comes from various etiologies. The mortality rate is high in severe AP. Therefore, early intensive management is important to decrease complications and mortality in severe AP. There are several scoring systems are proposed to determine the severity in AP. However these scoring systems are complex and time-consuming to determine the severity of AP. The aim of this study was to determine the factors correlated with severity in patients with acute pancreatitis. Methods: This study was conducted from January, 2005 to February, 2009 at Chung-Ang University hospital, using retrospective analysis. Between two groups, mild pancreatitis and severe pancreatitis, we compare gender, age, etiology, vital sign, body mass index (BMI), complete blood count (CBC), serum chemistries, Ranson criteria and computed tomography (CT) severity index. Results: Eighty patients (34.6%) among the enrolled cases had severe pancreatitis and the remaining 151 patients (65.4%) had mild pancreatitis. There was no difference in gender. The two most common causes of AP are gallstone and alcohol. Age, White blood cell, blood glucose, lactate dehydrogenase (LDH), asparate aminotransferase (AST), blood urea nitrogen (BUN), blood calcium, CT grade and C-reactive protein (CRP) are severity predictors of AP in univariated analysis. However, CT grade and CRP were significant predictors in multivariated analysis. Conclusion: CT grade and CRP are important severity predictors in AP.

성인 막성신병증의 임상적 고찰

양종오,이상주,박기현,장윤경,이강욱,서광선,신영태 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2

Membranous nephropathy (MN) is a glomerular disease characterized by diffuse thickening of the glomerular basement membrane without significant mesangial proliferative change and is usually manifested by the nephrotic syndrome. To evaluate the clinical and pathologic characteristics of this disease in adults, we analyzed 65 patients with primary membranous nephropathy who were diagnosed at Department of Internal Medicine, Chungnam National University Hospital from February 1986 to February 2001. The results are as follows: 1) Of total 96 patients with membranous nephropathy, 67.7% was primary MN. Hepatitis B-associated MN and lupus MN were 22.9%, and 9.4%, respectively. Median duration of follow-up was 35.1 months(0.3∼177) in primary MN, 49.6 months(2.5∼103) in lupus MN, and 35.6 months(0.5∼108) in hepatitis B-associated MN. 2) Mean age of the patients with primary MN at the time of diagnosis(43.3 years) was significantly higher than that of lupus MN(30.4 years) and HBV-associated MN(36.2 years). Male to female ratio of primary MN was 1.03:l. 3) At the time of diagnosis, 89.2% of primary MN was presented with nephrotic syndrome. Twenty seven percent of patients showed hypertension. Hematuria was found in 58.5% of primary MN patients. Azotemia was noted in 3.1 %. 4) Global sclerosis, tubular atrophy and interstitial fibrosis were noted in 39.8, 16.1 and 11.3% of primaty MN, respectively. IgG and C3 were deposited on the glomerular capillary loop in 92.7% and 29% of primary MN patients. There was no significant correlation between the electron microscopic pathologic stage and clinical findings. 5) Of 56 patients with primary MN followed more than 6 months, 50(90.9%) patients were treated with prednisolone, cyclophosphamide or cyclosporin. Complete remission was obtained in 29 patients(51.8%), partial remission in 6 patients(10.7%), and no response in 18 patients(32.1%). Of 6 patients who were not treated with immunosuppressive drugs, 3 patients showed spontaneous complete or partial remission. Three patients who did not show clinical improvement progressed to end-stage renal failure. There were no significant clinical difference including renal pathology at the time of diagnosis between the patients who showed complete or partial remission and patients who did not. In conclusion, it was difficult to predict the long-term prognosis of primary MN at the time of diagnosis, clinically. The response to therapeutic modality would be the most important to predict long-term prognosis of primary MN.

Cybex를 이용한 8주간의 isokinetic training이 하지근력이 저하된 사람의 근력 및 대퇴위 변화에 미치는 효과

김양수,김창환,임영조,서수진,윤진환,강성철 최신의학사 1995 最新醫學 Vol.38 No.4

A comparison of survival outcome of open, total laparoscopic and laparoscopy-assisted vaginal radical hysterectomy in patients with early cervical cancer of stage IB2

( Sul Lee ),( Hyung Joon Yoon ),( Eun Hye Jeon ),( Juseok Yang ),( Yong Jung Song ),( Hyun Jin Roh ),( Sang Hun Lee ),( Byung Su Kwon ),( Ki Hyung Kim ),( Dong Soo Suh ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: The aim of this study is to evaluate oncologic outcomes of total abdominal radical hysterectomy (TARH), total laparoscopic radical hysterectomy (TLRH) and laparoscopic-assisted radical vaginal hysterectomy (LARVH) in early cervical cancer patients (stage IB2-3, tumor size≥2cm), analyzing the risk factors that may affect the clinical results. Methods: A total of 756 patients underwent radical hysterectomy between 2000 and 2019 from three university hospitals (Pusan National University Hospital, Yang-san Pusan National University Hospital, Ulsan University Hospital) were enrolled. Among them, 172 patients with stage IB2-3 were analyzed retrospectively. Results: Seventy-seven patients were treated with TARH, and 95 were managed via minimally invasive surgery (MIS), consisting of 35 with TLRH and 60 with LARVH. TARH group had better disease five-year disease free survival (DFS) and overall survival (OS) compared with MIS group (86.4% vs. 73.4 for DFS and 91.7 vs. 82.2 for OS), but not statistically significant in both (p=0.058 for DFS and p=0.119 for OS). When TARH and the LARVH group were compared, both five-year DFS and OS were not significant different (86.4 vs 82.2%; p=0.288 for DFS and 91.7 vs 84.4%; p=0.206 for OS). However, when TARH and the TLRH group were compared, TLRH group had significantly worse five-year DFS than TARH (86.4 vs 54.5%; p=0.008), but five-year OS was not significant different (91.7 vs 77.5%; p=0.127). Multivariate analysis showed that LN metastasis and TLRH surgical approaches were an independent prognostic factor for DFS in IB2-3 cervical cancers. Conclusion: Our findings provided the evidence that TLRH surgical approach was associated with worse DFS in IB2-3 cervical cancers but that of LARVH was not. Such results may have important implications of colpotomy method for MIS in cervical cancer.

전신성 홍반성 낭창의 임상적 고찰

신영태,김종학,장윤경,양종오,구영선,강민규,황평주,나기량,이강욱,서광선 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

The epidemiology, diagnostic criteria, clinical features, symptoms and signs laboratory findings, kidney pathology, and clinicopathologic correlation of systemic lupus erythematosus(SLE) were analyzed. The 63 patients studied were managed at the Department of Internal medicine, CNUH, from January 1983 to December 1997. Kidney biopsy was performed in 53 patients out of 63 patients with SLE. The results were as follows: 1. The ratio of male to female was 1:26. They were 12 to 71 years old and mean age was 32.1 years old. The peak age incidence was 4th decades(30%). 2. The most frequent chief complaint on admission was generalized edema. Most patients complain two or more symptoms. 3. Immunologic and renal disorders were the most frequently observed in the ARA criteria of SLE. And the positive ANA, hematologic disorder, malar rash, and arthritis, were observed in order of frequency. 4. Among the 53 patients with renal biopsy, 30 patients revealed class Ⅳ lupus nephritis(56%), class II in 12 patients(23%), class V in 8 patients(15%) and class III in 2 patients(6%). 5. The cases of lupus nephritis represented as nephrotic syndrome were high in the class IV with 68% and class V with 86%. 6. Of 30 patients who can be followed up, 5 patients resulted in death(17 % of mortality). They "were 14 to 57 years old and mean age was 28 years old. Follow up duration were from 1 month to 6 years and 3 months, and mean duration was 1 year and 1 month, but 3 cases 7. The causes of death were as follows: Two cases were due to seizure and coma resulted from CNS involvement. One was sepsis due to miliary the & pneumonia. One was dilated cardiomyopathy and heart failure due to cardiac ac involvement. And the other one was sepsis and acute renal failure resulted from cellulitis. 8. Prednisolone was used in all patients basically, and methyl-prednisolone pulse therapy, antimalarials and alkylating agents were used in some cases. In the cases of combined therapy, the activity of SLE was well controlled.

Basic : A case of hepatic angiomyolipoma misdiagnosis as hepatocellular carcinoma (초)

( Suh Yoon Yang ),( Hyung Joon Kim ),( Hyun Woong Lee ),( Bong Ki Cha ),( Beom Jin Kim ),( Hyoung Chul Oh ),( Chang Hwan Choi ),( Jeong Wook Kim ),( Jae Hyuk Do ),( Jae Gyu Kim ),( Sae Kyung Chang ) 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3(S)

Hepatitis B : Efficacy of three years of continuous entecavir therapy in treatment-naive chronic hepatitis B patients (초)

( Suh Yoon Yang ),( Hyung Joon Kim ),( Hyun Woong Lee ),( Bong Ki Cha ),( Beom Jin Kim ),( Hyoung Chul Oh ),( Chang Hwan Choi ),( Jeong Wook Kim ),( Jae Hyuk Do ),( Jae Gyu Kim ),( Sae Kyung Chang ) 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.3(S)

Original Articles : Highly effective peginterferon α-2a plus ribavirin combination therapy for chronic hepatitis C in hemophilia in Korea

( Suh Yoon Yang ),( Hyun Woong Lee ),( Youn Jae Lee ),( Sung Jae Park ),( Ki Young Yoo ),( Hyung Joon Kim ) 대한간학회 2015 Clinical and Molecular Hepatology(대한간학회지) Vol.21 No.2

Background/Aims: Chronic hepatitis C (CHC) is a major comorbidity in patients with hemophilia. However, there are no published data on the effi cacy of antiviral therapy in Korea. We assessed the safety and effi cacy of combination therapy with peginterferon α-2a plus ribavirin for CHC in hemophilia. Methods: Patients (n=115) were enrolled between March 2007 and December 2008. Seventy-seven patients were genotype 1 or 6, and 38 patients were genotype 2 or 3. We evaluated rapid virologic responses (RVRs), early virologic response (EVRs), end-of-treatment response (ETRs), sustained virologic response (SVRs), and relapses. Safety evaluations included adverse events and laboratory tests. Results: Eleven patients were excluded from the study because they had been treated previously. Among the remaining 104 treatment-naive patients, RVR was achieved in 64 (60.6%), ETR was achieved in 95 (91.3%), and SVR was achieved in 89 (85.6%). Relapse occurred in eight patients (8.9%). Common adverse events were hair loss (56.7%) and headache (51.0%). Common hematologic adverse events were neutropenia (22.1%), anemia (27.9%), and thrombocytopenia (3.8%). However, there were no serious adverse events such as bleeding. RVR was the only predictor of SVR in multivariate analysis. Conclusions: Peginterferon α-2a plus ribavirin combination treatment produced a favorable response rate in CHC patients with hemophilia without serious adverse events. (Clin Mol Hepatol 2015;21:125-130)

Highly effective peginterferon α-2a plus ribavirin combination therapy for chronic hepatitis C in hemophilia in Korea

Suh Yoon Yang,이현웅,Youn Jae Lee,Sung Jae Park,Ki Young Yoo,김형준 대한간학회 2015 Clinical and Molecular Hepatology(대한간학회지) Vol.21 No.2

Background/Aims: Chronic hepatitis C (CHC) is a major comorbidity in patients with hemophilia. However, there are no published data on the efficacy of antiviral therapy in Korea. We assessed the safety and efficacy of combination therapy with peginterferon α-2a plus ribavirin for CHC in hemophilia. Methods: Patients (n=115) were enrolled between March 2007 and December 2008. Seventy-seven patients were genotype 1 or 6, and 38 patients were genotype 2 or 3. We evaluated rapid virologic responses (RVRs), early virologic response (EVRs), end-of-treatment response (ETRs), sustained virologic response (SVRs), and relapses. Safety evaluations included adverse events and laboratory tests. Results: Eleven patients were excluded from the study because they had been treated previously. Among the remaining 104 treatment-naïve patients, RVR was achieved in 64 (60.6%), ETR was achieved in 95 (91.3%), and SVR was achieved in 89 (85.6%). Relapse occurred in eight patients (8.9%). Common adverse events were hair loss (56.7%) and headache (51.0%). Common hematologic adverse events were neutropenia (22.1%), anemia (27.9%), and thrombocytopenia (3.8%). However, there were no serious adverse events such as bleeding. RVR was the only predictor of SVR in multivariate analysis. Conclusions: Peginterferon α-2a plus ribavirin combination treatment produced a favorable response rate in CHC patients with hemophilia without serious adverse events. (Clin Mol Hepatol 2015;21:125-130)

증례 : 소화기 ; 췌장의 파골세포양 거대세포 미분화 암종 1예

양서윤 ( Suh Yoon Yang ),도재혁 ( Jae Hyuk Do ),오인수 ( In Soo Oh ),이현웅 ( Hyun Woong Lee ),최창환 ( Chang Hwan Choi ),장세경 ( Sae Kyung Chang ),반언섭 ( Eon Sub Park ) 대한내과학회 2011 대한내과학회지 Vol.80 No.1

저자들은 상복부 불편감과 소화불량을 있는 환자에서 췌장 미부에 선암종을 동반한 파골세포양 거대세포 미분화 암종을 진단하였고, 수술적 절제 후 방사선 치료와 항암화학요법을 시행한 예를 경험하였기에 문헌고찰과 함께 보고한다. Undifferentiated carcinomas with osteoclast-like giant cells are rare pancreatic and periampullary neoplasms that mimic giant cell tumors of bone morphologically. Recently, we experienced an osteoclast-like giant cell tumor arising in the tail of the pancreas. A 76-year-old male was admitted with epigastric discomfort and indigestion. Abdominal computed tomography (CT) and abdominal magnetic resonance imaging (MRI) showed a 3×3-cm mass containing necrotic and hemorrhagic areas in the tail of the pancreas. A distal pancreatectomy and splenectomy were performed. Histological examination showed tumor cell components consisting of mononuclear pleomorphic cells admixed with osteoclastic giant cells. The final diagnosis was undifferentiated carcinoma with osteoclast-like giant cells with ductal adenocarcinoma in the pancreas. (Korean J Med 2011;80:82-86)