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( Hong Kyu Lim ),( Jung Boom Hong ),( Cheol Woong Choi ),( Dae Hwan Kang ),( Hyung Wook Kim ),( Ja Jun Goo ),( Peel Jung ),( Sook Kyoung Oh ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: This study compares the effi cacy and safety between the endoscopic direct vision technique self expanding metal stent (endoscopy group) and fi uoroscopy guided self expanding metal stent (fi uoroscopy group) in malignant stricture. Methods: A total of 118 patients, 94 from the fi uoroscopy group and 24 from the endoscopy group, who underwent self expanding metal stent (SEMS) between January 2009 and December 2013, were reviewed retrospectively on single center experience. Each procedure time and fiuoroscopic guided time were measured. Early and late complications, such as tumor, tissue overgrowth, migration, retrosternal pain and perforation, were recorded. Dysphagia before and after stent placement was scored on a 5-point scale. Results: We analyzed 118 patients (18 women: mean age 69±10. 7) with dysphagia due to inoperable esophageal stricture of which 58 for squamous cell carcinoma, 58 for adenocarcinoma and 2 for extrinsic compression. The mean procedure time of endoscopy and fi uoroscopy group were 6. 0±1. 2 min and 15. 0±4. 8 min (p Conclusions: It is safe to perform SEMS under endoscopic control without fi uoroscopy. This confi rms the endoscopic direct vision technique SEMS as an effective method for palliative treatment of malignant esophageal dysphagia.
Poster Session:PS 1096 ; Gastroenterology (Gastrointestinal Tract) : A Case Report: Rectal Tonsil
( Peel Jung ),( Joung Boom Hong ),( Yuyi Choi ),( Sook Kyoung Oh ),( Dong Ku Kang ),( Hyung Wook Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
The rectal tonsil is a reactive proliferation of lymphoid tissue located in the rectum. This lesion is benign lymphoid hyperplasia, but must be prevent a misdiagnosis from the polypoid type of mucosa-associated lymphoid tissue (MALT) lymphomas. We report a case of rectal tonsil. Case Report : A 59-year-old woman admitted for suspicious tuberculous colitis. Tuberculin test was negative. Micobacterium tuberculosis interferon test on blood was positive. Colonoscopy showed ulcerous lesions in the ascending colon and cecum, and the ileocecal valve was totally destroyed with ulcer and pseudopolyp formation. Furthermore, a hard, solitary sessile mass (5 mm) was noted at 10 cm from the anal verge (fig 1); endoscopic ultrasound showed a 5 mm homogenous hypoechoic mass located in the submucosa and without defi nite lymph node enlargement (fig 2). We performed cap-endoscopic mucosal resection (C-EMR). Histopathologically, a dense lymphoid infi ltrate mainly located in the submucosa and extened to mucosa that was a disc of yellow white mucosal tissue, measuring 0. 8 x 0. 5 x 0. 5 cm in dimensions. The lesion was characterized by follicles with well-formed reactive germinal centers of different size; there were abundant macrophages inside the germinal follicles. Immunohistologic study demonstrated that typical lymphoid follicles and suggested follicular type of proliferation with B cells markers were positive for CD20+ (B cells), and intraepithelial lymphocytes were positive for CD3+ (T cells). These studies confi rmed a reactive lymphoid proliferation, and excluded lymphoma. The patient was a tuberculostatic therapy with isoniazid, rifampicin, pyrazinamid, and ethambutol for 6 month. After 3 month of tuberculostatic therapy and C-EMR, follow-up colonoscopy showed grossly normal healed mucosa in cecum, ascending colon and rectum.
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홍정범,허 진,조진혁,박민규,함영희,정성규,김수형,최재영 고신대학교 의과대학 2011 고신대학교 의과대학 학술지 Vol.26 No.2
Variant angina is a syndrome of cyclical chest pain at rest caused by vasospasm and associated with ST-segment elevation. Most of these cases are induced by the provocation with ergonovine or acetylcholine, and mechanical irritation of coronary artery by catheter, but spontaneous migrating spasm in right coronary artery is very rare. We report a fifty one year old male patient presenting as a variant angina due to spontaneous migrating spasm in right coronary artery during diagnostic coronary angiogram. The spasm was relieved spontaneously or by the administration of intracoronary nitroglycerin. No chest pain was documented after medication with calcium-channel blocker and nitrates on 6 month clinical follow-up. This paper presents our experience with a patient presenting with migrating coronay vasospasm of right coronary artery.
허진,최원혁,조진혁,함영희,홍정범,정성규,김현,허동 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2
Two men were admitted to hospital with flank pain, hematuria, which was diagnosised as ureteral stone. Elevation of aspartate aminotransferase (AST) without typical pattern of toxic hepatitis was observed. Careful history taking, several laboratory tests, abdominal and pelvis computered tomography was done. Findings from theses examinations supported the clinical diagnosis of ureteral stone complicated of exercised induced rabdomyolysis. Early recognization of rhabdomyolysis in clinical setting is important, because clinical manifestations have ranged from asymtomatic elevation of creatine kinase to acute renal failure which is a life threating medical emergency. Authors report two cases of exercised induced rhabdomyolysis initially admittied as ureteral stone managed with hydration