자발성 뇌실내출혈 환자에서 임상적 -전산화단층촬영상소견의 상관관계

황선철,김범태,장재칠,주교성,신원한,최순관,변박장 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.6

CASE REPORT : Primary Pulmonary Malignant Melanoma: An Unexpected Tumor

( Kyo Bum Hwang ),( Ki Eun Hwang ),( Jae Wan Jung ),( Su Jin Oh ),( Mi Jeong Park ),( Young Hoon Jeong ),( Keum Ha Choi ),( Eun Taik Jeong ),( Hak Ryul Kim ) 대한결핵 및 호흡기학회 2015 Tuberculosis and Respiratory Diseases Vol.78 No.3

Malignant melanoma occurs most frequently on the skin. However, it can also arise in other organs and tissues of the body. Primary pulmonary malignant melanoma is a very rare non-epithelial neoplasm accounting for 0.01% of all primary pulmonary tumors. The treatment of choice is surgical resection of the tumor with an oncologically adequate margin as in lobectomy or pneumonectomy. The prognosis of this condition is rather poor. Based on previous data, its 5-year survival is at least 10%. Here, we report a case of an 82-year-old woman whose primary pulmonary melanoma was detected incidentally.

Primary Pulmonary Malignant Melanoma: An Unexpected Tumor

Hwang, Kyo-Bum,Hwang, Ki-Eun,Jung, Jae-Wan,Oh, Su-Jin,Park, Mi-Jeong,Jeong, Young-Hoon,Choi, Keum-Ha,Jeong, Eun-Taik,Kim, Hak-Ryul The Korean Academy of Tuberculosis and Respiratory 2015 Tuberculosis and Respiratory Diseases Vol.78 No.3

Malignant melanoma occurs most frequently on the skin. However, it can also arise in other organs and tissues of the body. Primary pulmonary malignant melanoma is a very rare non-epithelial neoplasm accounting for 0.01% of all primary pulmonary tumors. The treatment of choice is surgical resection of the tumor with an oncologically adequate margin as in lobectomy or pneumonectomy. The prognosis of this condition is rather poor. Based on previous data, its 5-year survival is at least 10%. Here, we report a case of an 82-year-old woman whose primary pulmonary melanoma was detected incidentally.

Poster Session : PS 0639 ; Respiratory Medicine ; Primary Pulmonary Malignant Melanoma; The Expected

( Kyo Bum Hwang ),( Ki Eun Hwang ),( Eun Taik Jung ),( Hak Ryul Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Malignant melanoma is a malignant tumor, arising from the pigment producing cells of the deeper layers of the skin. It accounts for 1.5% of all reported cancer. It occurs most frequently on the skin, but also occurs in other organs and tissues of the body. However, Melanoma of the lung without evidence of extra-pulmonary disease, primary pulmonary melanoma, is very rare. Herein, we report a case of 82-year-old woman in whom primary pulmonary melanoma was detected incidentally. A 82-year-old woman was found to have an incidental fi nding of a solitary mass in right lower lobe of the lung. Chest CT showed an about 8cm sized heterogeneous enhancing mass lesion in the right lower lobe. Bronchoscopic examination showed a black pigmented mass in right lower lobe posterobasal segment, and biopsy was performed. Histopathological examination of the biopsy specimen showed melanoma cells containing melanin granules and “nesting” of melanoma cells just beneath the bronchial epithelium. The melanoma cells are round or spindled shape with melanin pigmentation and these tumor cells are positive for HMB-45, vimentin. The patient had no past history of skin lesion, and did not have any skin, ear or occular lesions. Gastrointestinal endoscopy, colonoscopy and gynecologic examination were performed, and no possible primary tumor was detected. Therefore, she was fi nally diagnosed with primary malignant melanoma when considering these currently proposed criteria for primary pulmonary melanoma. Although rare, primary pulmonary malignant melanoma should be considered in the differential diagnosis of primary bronchial tumor of the lung as an extremely rare alternative.

A Graves' Disease Patient Diagnosed as Autoimmune Gastritis with Helicobacter pylori Infection

Yong Hwan Ahn,Kyo Bum Hwang 대한상부위장관ㆍ헬리코박터학회 2022 Korean Journal of Helicobacter Upper Gastrointesti Vol.22 No.4

Autoimmune gastritis (AIG) is a type of atrophic gastritis characterized by destruction of parietal cells in the gastric fundus and body. These changes may be attributable to immune-mediated chronic inflammatory responses. AIG is characterized by extensive atrophy of the gastric body; therefore, endoscopic findings offer useful diagnostic clues. AIG is diagnosed based on serological and histopathological evaluation of endoscopic biopsy specimens; however, this condition may be accompanied by autoimmune diseases including autoimmune thyroid disease (ATD), and the opposite can be suspected. Diagnostic delays and misdiagnosis are common in patients with AIG owing to the nonspecific clinical presentation and accompanying autoimmune diseases. Additionally, confirmation of AIG based on serological atrophy or endoscopic findings is challenging in cases of active Helicobacter pylori (H. pylori) infection. We report a case of Graves’ disease (an ATD) in a patient diagnosed with AIG and concomitant H. pylori-induced gastritis based on the rapid urease and serological test results and endoscopic biopsy findings.

Poster Session : PS 0106 ; Cardiology : Effect of High Dose Rosuvastatin Loading Before Percutaneous Coronary Intervention on Contrast-induced Acute Kidney Injury

( Jae Hong Lim ),( Kyo Bum Hwang ),( Sun Ho Woo ),( Jin Woo Jeong ),( Young Cheol Kim ),( Kyeong Ho Yun ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Contrast-induced nephropathy (CIN) is associated with increased morbidity and mortality. This observational, non-randomized study evaluated the effect of rosuvastatin loading before percutaneous coronary intervention (PCI) on the incidence of CIN in patients with acute coronary syndrome (ACS). Methods: A total of 824 patients underwent PCI for ACS were studied (408 patients of statin group = 40mg rosuvastatin loading before PCI, 416 patients of control group = no statin pretreatment). Serum creatinine concentrations were measured before and 24 and 48 h after PCI. The primary endpoint was the development of CIN, defi ned as an increase in serum creatinine concentration of =0.5mg/dL or =25% above baseline, within 72h after PCI. Results: The incidence of CIN was signifi cantly lower in the statin group than in the control group (18.8 vs. 13.5%, p=0.040). In the statin group, the maximum percentage changes in serum creatinine and estimated glomerular fi ltration rate within 48 h were signifi cantly lower than in the control group (5.84±22.59 vs. 2.43±24.49%, p=0.038; -11.44±14.00 vs. -9.51±13.89, p=0.048, respectively). The effect of rosuvastatin on the prevention of CIN was greater in the subgroups of patients with diabetes, high dose of contrast medium, multivessel stents, high baseline C-reactive protein, and myocardial infarction. Multivariate analysis revealed that rosuvastatin loading was independently associated with a decreased risk of CIN (Odds ratio 0.64, 95% confidence interval 0.43-0.95, p=0.026). Conclusions: High dose rosuvastatin loading before PCI was associated with a signifi - cantly lower incidence of CIN in patients with ACS.

Autoimmune Gastritis Accompanied by a Schwannoma Presenting as a Subepithelial Tumor

Yong Hwan Ahn,Kyo Bum Hwang,Geom Seog Seo 대한상부위장관ㆍ헬리코박터학회 2023 Korean Journal of Helicobacter Upper Gastrointesti Vol.23 No.2

Autoimmune gastritis (AIG), a chronic inflammatory disease occurs as a result of a complex interaction between host-related and environmental factors. AIG may progress to severe atrophic gastritis secondary autoimmune-mediated parietal cell destruction in the stomach. AIG can be diagnosed based on anti-parietal cell antibody tests and endoscopy, which reveals widespread gastric corpus atrophy in patients with low serum pepsinogen I levels, a low pepsinogen I/II ratio, and elevated serum gastrin levels on serological testing. Tissue biopsy findings, which include mucosal atrophy and lymphocytic infiltration of the lamina propria may be useful for diagnostic confirmation. Decreased gastric acid secretion causes hypergastrinemia and enterochromaffin-like (ECL) cell proliferation, which can lead to neuroendocrine tumor development. Additionally, an autoimmune response results in parietal and chief cell injury, and proliferating ECL cells are detected in the deep mucosal layers in patients with AIG. Therefore, this condition may easily be misdiagnosed as a subepithelial tumor, and establishing a differential diagnosis for other types of subepithelial tumor accompanied by AIG is challenging. We present the case of a 54-year-old woman who was diagnosed with AIG with a concomitant subepithelial tumor based on serologic tests and biopsy findings and underwent wedge resection, which confirmed diagnosis of a schwannoma.

쇄골 간부 분쇄 골절에서 최소 침습 금속판 고정술의 유용성

강태욱(Tae Wook Kang),황현정(Hyun Jung Hwang),이동기(Dong Ki Lee),한승범(Seung Bum Han),정웅교(Woong Kyo Jeong) 대한정형외과학회 2017 대한정형외과학회지 Vol.52 No.5

목적: 본 연구의 목적은 전위된 쇄골 간부 분쇄 골절에 있어서 고식적 수술법(conventional open plating, COP)과 최소 침습적 금속판 고정술(minimally invasive plate osteosynthesis, MIPO) 사이의 임상적, 영상의학적 결과를 비교하고 MIPO의 유용성을 평가하고자 하였다. 대상 및 방법: 쇄골 간부 골절로 수술을 시행한 39예 중 COP 20예, MIPO 19예를 대상으로 후향적으로 조사하였다. 영상의학적 평가는 골유합 기간과 쇄골 길이를 건 측과 비교하여 길이의 변화를 비교하였고, 임상적 평가는 simple shoulder test score, American Shoulder and Elbow Surgeons score, quick disability of the arm, shoulder and hand score를 이용하여 비교하였다. 또한 두 군 간의 평균 수술 시간과 방사선 조사 시간, 조사량을 비교하였다. 결과: 모든 환자에서 골유합을 얻었으며 골유합까지 걸린 시간은 MIPO에서 12.1주로 COP의 14.6주보다 짧았으나 유의한 차이는 보이지 않았다(p=0.587). 2년 추시 시 임상적, 영상의학적으로 만족스러운 결과를 보였고 두 군 간에 통계적으로 유의한 차이를 보이지 않았다. MIPO의 경우 COP보다 통계적으로 유의하게 수술 시간이 적게 걸렸으며(75.8분 vs. 106.9분, p=0.002) 방사선 조사 시간과 조사량이 많았다(52.8초 vs. 37.1초, p=0.002; 209.4 mGy vs. 43.1 mGy, p=0.005). 결론: 쇄골 간부 분쇄 골절에서 MIPO는 임상적, 영상의학적으로 모두 우수한 결과를 보였고 수술 시간이 짧으며 골이식술이 불필요한 효과적인 치료법으로 판단된다. 하지만 방사선 피해를 줄이는 노력을 간과하지 말아야 한다. Purpose: The purpose of this study was to compare the clinical and radiological outcomes of minimally invasive plate osteosynthesis (MIPO) with those of conventional open plating (COP) for treating comminuted mid-clavicular fractures and to evaluate the usefulness of MIPO. Materials and Methods: Thirty-nine patients who underwent surgical treatment for mid-clavicular comminuted fractures were analyzed retrospectively. Nineteen patients were treated with MIPO and twenty patients with COP. Radiological evaluation included time to union, fracture healing, and clavicular length difference measured as the proportional length difference with the unaffected side. Clinical assessment was performed using the simple shoulder test score, American Shoulder and Elbow Surgeons score, and quick disability of the arm, shoulder and hand score. Moreover, the mean operation and radiation times, as well as exposure were compared. Results: All clavicles achieved bone union. The mean time to union was 12.1 weeks in the MIPO group, and 14.6 weeks in the COP group (p=0.587). There was no significant difference between the two groups regarding the functional and radiological outcomes at 2-year follow-up. A significantly shorter operation time was observed in the MIPO group than in the COP group (75.8 min vs. 106.9 min, p=0.002). More radiation time and exposure were identified in the MIPO group (52.8 s vs. 37.1 s, p=0.002; 209.4 mGy vs. 43.1 mGy, p=0.005). Conclusion: Both COP and MIPO were shown to be effective treatment options for mid-clavicular comminuted fractures. MIPO may be a better alternative to COP due to shorter operation time and no need for a bone graft, although the functional and radiological outcomes were not significantly different. However, all surgeons should pay close attention to minimize radiation hazard.

다발성 골수종 환자에서 Bortezomib에 의한 급성 췌장염

임재홍 ( Jae Hong Lim ),황교범 ( Kyo Bum Hwang ),임병훈 ( Byung Hun Lim ),정영훈 ( Young Hoon Jeong ),손기창 ( Ki Chang Sohn ),김태현 ( Tae Hyeon Kim ) 대한췌장담도학회 2015 대한췌담도학회지 Vol.20 No.3

Bortezomib is a proteasome inhibitor used for the treatment of patients with multiple myeloma. Recently, several case reports about acute pancreatitis caused by Bortezomib were published in the international literature. But Bortezomib induced pancreatitis case was not reported in Korea. Herein, we report a case of acute pancreatitis caused by Bortezomib therapy in a 76-year-old female with multiple myeloma. On three months after the first administration of Bortezomib, the patient visited the hospital with symptoms of acute pancreatitis. The common etiological factors for acute pancreatitis were all excluded. Then the patient was diagnosed as Bortezomib-induced pancreatitis. After cessation of Bortezomib, she showed clinical and laboratory improvement.

Review of 67 Patients With Autoimmune Pancreatitis in Korea: A Multicenter Nationwide Study

Ryu, Ji Kon,Chung, Jae Bock,Park, Seung Woo,Lee, Jong Kyun,Lee, Kyu Tack,Lee, Woo Jin,Moon, Jong Ho,Cho, Kwang Bum,Kang, Dae Whan,Hwang, Jin-Hyeok,Yoo, Kyo-Sang,Yoo, Byung Moo,Lee, Don Hang,Kim, Hae K Lippincott Williams Wilkins, Inc. 2008 Pancreas Vol.37 No.4

OBJECTIVES:: The ideal diagnostic criteria of autoimmune pancreatitis (AIP) are still challenging. Therefore, we investigated the clinical features of AIP in Korea and assessed the clinical use of new Korean diagnostic criteria. METHODS:: We reviewed 67 patients with AIP enrolled in 16 hospitals via a multicenter study. The diagnosis was confirmed according to the Korean diagnostic criteria that included pancreatic imaging, laboratory findings, histopathology, and response to steroid. RESULTS:: Mean age of the patients was 56 years, and 73% were men. Obstructive jaundice (52%) was the most common symptom, and 14 patients (21%) had other organ involvement. Fifty-four patients (81%) revealed diffuse swelling of the pancreas. Either immunoglobulin (Ig)G or IgG4 was elevated in 76%. According to the Korean criteria, 65 patients had definite diagnostic criteria, and 2 patients had probable criteria. Fifteen patients were fulfilled with image, serological, and histopathologic criteria, and 4 patients could be diagnosed with image and steroid responsiveness. Ten patients experienced recurrent attacks of AIP during the mean 20-month follow-up. CONCLUSIONS:: Among 67 cases of AIP, either IgG or IgG4 was elevated in 76% of patients, and 14 patients (21%) had other organ involvement. New Korean diagnostic criteria are useful for diagnosis of AIP.