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방기배 ( Ki Bae Bang ),조용균 ( Yong Kyun Cho ),이상혁 ( Sang Hyuk Lee ),박은혜 ( Eun Hye Park ),설지수 ( Ji Soo Seol ),채승완 ( Seoung Wan Chae ),조상원 ( Sang Won Jo ) 대한내과학회 2013 대한내과학회지 Vol.84 No.2
영아 간혈관내피종은 양성 혈관 질환으로 성인에서 진단되는 경우는 매우 드물다. 저자들은 일반적인 종양의 자연경과와 달리 69세 성인에서 진단된 영아 간혈관내피종을 경험 하였으며 이에 대한 국내보고가 없어 문헌고찰과 함께 보고 하는 바이다. Infantile hepatic hemangioendothelioma is a rare disorder. It is a benign entity and usually resolves spontaneously. Most patients present in infancy and early childhood. Because of its natural course and symptom onset, most cases are discovered during childhood. We experienced a rare case of infantile hepatic hemangioendothelioma in an adult. (Korean J Med 2013;84:259-264)
내시경괄약근절개술과 담낭절제술은 급성 담석성 췌장염의 재발을 줄일 수 있는가?
방기배 ( Ki Bae Bang ),김홍주 ( Hong Joo Kim ),조용균 ( Yong Kyun Cho ),전우규 ( Woo Kyu Jeon ) 대한소화기학회 2015 대한소화기학회지 Vol.65 No.5
Background/Aims: Practice guidelines from international societies have recommended cholecystectomy during the same hospitalization for acute biliary pancreatitis (ABP). The aim of this study is to investigate the question of whether endoscopic sphincterotomy (EST) and/or cholecystectomy during the same hospitalization can reduce the recurrence rate of ABP. Methods: A total of 119 patients with ABP admitted to our institution between May 2005 and May 2010 who had complete follow-up data until May 2012 were enrolled. Results: No significant differences in initial CT severity index and Charlson comorbidity index were observed between EST (n=64) and non-EST group (n=55) and among subgroups classified according to interventions performed. In Kaplan Meier analyses, significantly higher recurrence rates of ABP were observed in the non-EST group compared to the EST group (p<0.01), and in the conservative treatment group compared to other intervention groups (p<0.01). The frequency of complications from ABP was significantly higher in the conservative treatment group (35.7%) and lowest in the EST plus cholecystectomy group (5.0%, p=0.008). In multivariate analysis, conservative treatment without EST and/or cholecystectomy, and non-EST group were independent risk factors for recurrence after the initial attack of ABP. Conclusions: ERCP with EST and cholecystectomy during the index admission is associated with reduced recurrence rates of ABP. (Korean J Gastroenterol 2015;65:297-305)
위장관 , 입원환자에서 Polyethylene Glycol 용액을 이용한 대장내시경 전처치 시 Bisacodyl을 병행하여 복용했을 경우의 효과 비교: 전향적 무작위 비교연구
방기배 ( Ki Bae Bang ),정은행 ( Eun Haeng Jeong ),정우신 ( Woo Shin Jeong ),채현범 ( Hyun Beom Chae ),김남희 ( Nam Hee Kim ),이태훈 ( Tae Hoon Lee ),김지연 ( Ji Yeon Kim ),정윤숙 ( Yoon Suk Jung ),박정호 ( Jung Ho Park ),손정일 ( 대한소화기학회 2014 대한소화기학회지 Vol.64 No.5
Background/Aims: Inpatient status can cause inadequate bowel preparation. The majority of previous studies regarding bowel preparation have focused on comparing the effects of different purgative regimens in outpatients. However, data on bowel preparation for inpatients are lacking. The aim of this study was to investigate whether bisacodyl plus polyethylene glycol (PEG) can improve bowel preparation in hospitalized patients. Methods: A prospective, randomized and observer-blind study was performed. A total of 196 hospitalized patients undergoing colonoscopy were randomized to receive 4 L PEG (PEG only group) or 4 L PEG+bisacodyl 10 mg (bisacodyl added group). The adequacy of bowel preparation was scored using the Ottawa bowel preparation scale. Results: One hundred and eighty-three subjects completed the study, 96 in the bisacodyl added group and 87 in the PEG only group. There were no significant differences between the bisacodyl added group and the PEG only group with respect to the score of bowel cleansing (3.59±2.81 vs. 3.82±3.03, p=0.607), quality of bowel cleansing (adequate preparation 89.6% vs. 85.1%, p=0.380), and overall adverse events (66.7% vs. 52.9%, p=0.057). However, a larger proportion of patients in the PEG only group were able to ingest the entire solution as prescribed than in the bisacodyl added group (98.9% vs. 75.0%, p<0.001). Conclusions: In hospitalized patients, the quality of bowel preparation did not differ depending on whether bisacodyl is added or not. In addition, patient compliance based on consumption of cleansing agent was better in the PEG only group. (Korean J Gastroenterol 2014,64:268-277)
이두혁 ( Doo Hyuck Lee ),한규형 ( Kyu Hyung Han ),안선영 ( Sun Young Ahn ),김상선 ( Sang Sun Kim ),신현성 ( Hyun Sung Shin ),방기배 ( Ki Bae Bang ),최준호 ( Jun Ho Choi ),김석배 ( Suk Bae Kim ),이원애 ( Won Ae Lee ),송일한 ( Il Ha 대한간암학회 2016 대한간암학회지 Vol.16 No.2
Sarcomatoid carcinoma arising from intrahepatic cholangiocyte, an extremely rare primary liver cancer, has highly invasive and metastatic potential. The pathogenesis of this tumor is unclear, although histogenetic mechanisms, such as transdifferentiation/dedifferentiation (epithelialmesenchymal transition or metaplastic transformation), biphasic differentiation (combination and collision), and redifferentiation, might be suggested to explain the simultaneous coexistence of carcinoma and sarcoma components in the same tumor. Immunohistochemical staining might be necessary to differentiate whether sarcomatous component is originated from hepatocyte or cholangiocyte. We report a case of sarcomatoid intrahepatic cholangiocarcinoma in a 58 year-old man presenting as an incidentally detected liver mass on regular health examination, which was diagnosed by an application of immunohistochemical methods after surgical resection, with a review of the literature based on 9 cases reported in Korea. (J Liver Cancer 2016;16:139-144)
이상혁,김병익,전창욱,방기배,정은행,서정연,박은혜,설지수 영남대학교 의과대학 2012 Yeungnam University Journal of Medicine Vol.29 No.1
Hepatocellular carcinoma(HCC) is the second leading cause of cancer-related deaths in South Korea. To decrease its mortality rate, its early detection is very important. Screening for HCC detection has been accepted as the management modality for patients with chronic liver disease. Reported herein is a case involving the marked rapid growth of HCC detected at an advanced stage in a screening test with a 3 months interval. A 49-year-old male patient with chronic hepatitis B was admitted to the hospital due to a liver mass detected on CT scan. The patient underwent a first CT scan 3 months earlier, and no tumor was detected. Follow-up CT scan was performed and showed a 9.1cm HCC with portal vein thrombosis. Percutaneous liver biopsy was performed, and the diagnosis of hepatocellular carcinoma was confirmed. In the pertinent guidelines, the recommended screening interval for HCC is 6-12 months, but the screening interval and additional diagnostic methods should be considered due to the variation in the HCC growth rate according to the patient’s clinical characteristics.