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서욱장,정선미,고수진,이창근,김재승,임주혁,유빈,문희범 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.5
Purpose: We describe a 54-year-old woman with systemic lupus erythematosus (SLE) who suddenly presented with chorea and had positive antiphospholipid antibodies. F-18 FDG PET showed abnormally increased glucose metabolism in bilateral putamen and primary motor cotex. Tc-99m ECD SPECt also showed abnormally increased regional cerebral blood flow in bilateral putamen. She was treated with corticosteroid and aspirin after which the symptoms improved. Four months later, follow up F-18 FDG PET showed improvement with resolution of hypermetabolism in bilateral putamen. This case suggests that striatal hypermetabolism is associated with chorea in SLE.
베체트병 환자에서 TNF-α와 TNF 수용체 유전자의 다양성
서욱장 ( Wook Jang Seo ),김용길 ( Yong Gil Kim ),양석균 ( Suk Kyun Yang ),박경숙 ( Kyung Sook Park ),이창근 ( Chang Keun Lee ),유빈 ( Bin Yoo ),문희범 ( Hee Bum Mon ) 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.2
Objective: TNF-α has a pivotal role in the development of inflammation on mucous lesion in Behcet`s disease like Crohn`s disease. We examined three single nucleotide polymorphisms (SNPs) of TNF receptor gene of intestinal Behcet`s disease and Behcet`s disease without gastrointestinal involvement. Methods: DNA of peripheral blood samples was obtained from 43 patients with intestinal Behcet`s disease, 59 patients with Behcet`s disease without gastrointestinal involvement and 60 healthy controls. After polymerase chain reaction (PCR), we examined SNPs of TNF-α gene (-308, -238) and TNF receptor gene (-1493, -196, -1466) by SNaPshot assay. We also analyzed reconstruction of haplotypes of three TNF receptor genes. Results: No significant difference was observed in the distribution of TNF-α gene (-308, -238) and TNF receptor gene (-1493, -196, -1466) polymorphisms among the groups. Haplotype reconstruction analysis of three TNF receptor genes showed difference in allele group of (T-T-G) (-1493/-196/-1493) between patients with intestinal Behcet`s disease and Behcet`s disease without gastrointestinal involvement (p<0.05). However, other allele groups revealed no difference among the groups. Conclusion: The role of TNF-α gene (-308, -238) polymorphisms and TNF receptor gene (-1493, -196, -1466) polymorphisms in the pathogenesis of Behcet`s disease is not supported by this data. Haplotype reconstruction analysis showed that haplotype of T-T-G (TNFR2, -1493/-196/-1466) in Behcet`s disease may have protective effect on gastrointestinal involvement of this disease.
십이지장 주유두 선종의 내시경적 점막절제술 후 발생한 유두부 협착 및 담관염
최정준,김명환,김기덕,김정권,박진태,오동렬,서욱장,김원장,이성구,민영일,유은실,김미정 대한소화기내시경학회 2003 Clinical Endoscopy Vol.27 No.4
Adenomas of the major duodenal papilla are rare but clinically important since they are a premalignant condition. Endoscopic mucosal resection has emerged as the first line therary for ampullary adenoma. However, various complications such as pancreatitis, bleeding or duodenal perforation have been reported after endoscopic mucosal resection. To our knowledge, cholangitis has not been reported as a complication of the procedure in the literature. We report a case of papillary stenosis and cholangitis caused by endoscopic mucosal resection of ampullary adenoma. We performed the endoscopic biliary spincterotomy followed by biliary stenting and cholangitis was successfully controlled. (Korean J Gastrointest Endosc 2003;27:249-253) 십이지장 유두부에서 발생하는 선종은 드물게 발생하지만 전암 병변이라는 점에서 임상적 중요성을 가진다. 최근 유두부 선종의 치료로 개복 수술보다는 덜 침습적인 내시경적 점막절제술을 일차적인 치료로 시도하는 경향이 증가하고 있다. 그러나 유두부 선종의 내시경적 점막절제술 후에는 췌장염, 출혈, 천공 등의 합병증이 보고되고 있다. 그러나 이제까지의 문헌고찰에서 담도염이 그 합병증으로 보고된 바가 없다. 저자 등은 유두부 선종의 내시경적 점막절제술 후에 유두부 협착을 동반한 담관염을 경험하였고, 이를 내시경적 담도 괄약근 절개술 및 배액관 삽입을 이용하여 성공적으로 치료한 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
송진우 ( Song Jin U ),김명환 ( Kim Myeong Hwan ),서욱장 ( Seo Ug Jang ),오동렬 ( O Dong Lyeol ),김기덕 ( Kim Gi Deog ),문성훈 ( Mun Seong Hun ),양동훈 ( Yang Dong Hun ),송문희 ( Song Mun Hui ),이상수 ( Lee Sang Su ),서동완 ( Seo D 대한소화기학회 2003 대한소화기학회지 Vol.42 No.5
Eosinophilic pancreatitis is a rare disorder that may only be diagnosed after pancreatic resection under the suspection of a pancreatic tumor. We experienced a 65-year-old female patient whose initial presentation suggested pancreatic cancer. Radiologic evaluation revealed a pancreatic mass-like lesion which was obstructing the main pancreatic duct. Endoscopic retrograde cholangiopancreatography (ERCP) showed double duct strictures involving the distal common bile duct and the main pancreatic duct. Serum IgE level was elevated. Percutaneous core needle biopsy with an 18-gauge needle was performed targeting the pancreatic lesion. The biopsy specimen revealed fibrotic interlobular septum and intralobular fibrosis with prominent eosinophilic infiltration. The patient was treated with oral prednisolone (40 mg/day). A plastic stent was inserted into the narrowed common bile duct. After three months of oral steroid therapy, symptoms and signs improved rapidly and serum IgE level was decreased. Abdominal computed tomography and ERCP revealed remission of pancreatic mass-like lesion. (Korean J Gastroenterol 2003;42:444-449)