위선종과 조기위암에서 내시경 점막절제술의 연구 -완전절제율에 영향을 미치는 인자와 점막 절제술 전후의 조직학적 차이-

고강훈 ( Kang Hun Koh ),정혜진 ( Hey Jin Jung ),김상욱 ( Sang Wook Kim ) 전북대학교 의과학연구소 2007 全北醫大論文集 Vol.31 No.1

Objectives: The endoscopic mucosal resection of gastric adenomas or early gastric cancers is now widely accepted as a useful radical treatment method. We studied that the rate of successful treatment by the endoscopic mucosal resection of gastric adenomas or early gastric cancers and the factors related to the rate of the complete resection. Methods: We analysed, retrospectively, 118 lesions in 114 patients diagnosed early gastric cancer or gastric adenoma at the Chonbuk National University Hospital from January, 2005 to June, 2006. Of the 118 lesions, there were 107 adenomas and 11 early gastric cancers. We tried to follow up the lesions of resection by the endoscopic biopsy later. Results: The lesions were diagnosed 107 adenomas, 6 early gastric cancers type IIa, 5 type IIb, and the rate of complete resection was 85%(91), 84%(5), 80%(4), each. The sites of the lesions were divided antrum, angle, body, pylorus and each 60 cases, 14 cases, 42 cases, 2cases was reported. The rate of complete resection for the site was each 83%(50), 85%(12), 81%(34), 100%(2). The size of the lesions was divided ≤10 mm, 11~15 mm, 16~20 mm, 21~25 mm, 26~30 mm, ≥31 mm and each 14 cases, 21 cases, 41 cases, 6 cases, 31 cases, 5 cases were reported. The rate of complete resection for the size was each 86%, 86%, 90%, 100%, 71%, 60%. Of the 14 cases which were diagnosed as high grade dysplastic adenoma, early gastric cancer was diagnosed in 4 cases after the biopsy by endoscopic mucosal resection. Conclusion : We concluded that the site, size and the other factors of the lesions were related to the rate of complete resection after endoscopic mucosal resection, and the abnormal gastric mucosal lesions should be diagnosed with the biopsy by endoscopic mucosal resection.

증예(症例) : 자연적으로 치유된 위암 1예

고강훈 ( Kang Hun Koh ),백경현 ( Kyung Hyun Paeck ),이석 ( Seuk Lee ),오호준 ( Ho Jun Oh ),박승용 ( Seung Yong Park ),문희 ( Hee Moon ),강선미 ( Seon Mi Kang ),김인희 ( In Hee Kim ),김상욱 ( Sang Wook Kim ),김성훈 ( Seong Hun Ki 전북대학교 의과학연구소 2006 全北醫大論文集 Vol.30 No.1

악성 종양의 자연 치유는 어떠한 치료도 받지 않거나 일반적으로 확립되지 않은 치료법으로 악성 질환의 소실을 야기하는 것을 말하는 것으로 매우 드문 현상으로 알려져 있다. 대개 이러한 현상은 모든 암종에 걸쳐 일어날 수는 있지만 소화기계 관련된 암종의 자연 치유의 예는 극히 드물며 본 저자들은 내사경적, 조직학적 진단으로 위암을 진단받은 뒤 약 1년 반 동안 별다른 증상 없이 지냈으며 추적 관찰하여 시행한 내시경적, 조직학적 검사상 악성 소견을 발견할 수 없어서 위암의 자연 치유로 결론 짓고 잦은 외래 추적관찰을 결정한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Spontaneous regression is shown to occur in malignancies such as neuroblastoma, Wilms` tumor, leukemias, melanoma and retinoblastoma and is extremely rare in carcinoma of the stomach. Many theories exist regarding the possible factors such as genetic, hormonal, immunological and psychological factors. Some reports of spontaneous regression have implicated surgery or operative trauma as an element that can increase immunological resistance to tumor growth. We here report one case of spontaneous regression of carcinoma of the stomach with review of the literature.

증예(症例) : 좌측 아래엽 위구역 기관지에 발생한 샘낭암종 1례

최영훈 ( Young Hun Choi ),김소영 ( So Young Kim ),정치량 ( Chi Ryang Chung ),박승용 ( Seung Yong Park ),황정환 ( Jeong Hwan Hwang ),문희 ( Hee Moon ),고강훈 ( Kang Hun Koh ),이석 ( Seok Lee ),이태환 ( Tae Hwan Lee ),강선미 ( Seo 전북대학교 의과학연구소 2005 全北醫大論文集 Vol.29 No.2

샘낭암종은 선암의 조직학적 변형으로서 대부분 침생, 눈물샘 또는 다른 외분비샘에서 발생하며 호흡기계에 드물게 발생하는 경우에도 주로 기관과 주기관지에 발생하며, 주 기관지 이하의 말초에서 발생하는 경우는 매우 드물다. 본 저자들은 좌측 아래엽 위구역 기관지의 페쇄를 초래한 샘낭암종으로 진단된 31세 남자 증례를 보고하는 바이다. 내원 1개월 전부터 시작된 마른 기침과 심호흡시의 흉부 불쾌감으로 내원한 환자는 흉부 전산화 단층촬영에서 좌측 아래엽에 경계가 명확하고 분엽화된 침상 종괴가 관찰 되었고, 종괴는 좌측 아래엽 위구역 기관지를 폐쇄시키고 있었으며, 좌측 페동맥의 좌측 아래엽 위구역 분지를 침범하고 있었다. 기관지내시경에서 좌측 아래엽 위구역 기관지는 혈액 공급이 풍부한 종양으로 폐쇄되어 있었다. 조직검사에서 특징적인 샘낭암종 소견이 관찰되었고, 원격전이 평가를 위한 검사 후 Stage IB로 병기 결정되었다. 환자는 수술적 치료를 적극 권고하였으나, 치료를 거부하고 퇴원하였다. Adenoid cystic carcinoma is rare malignant tumor that usually arise from major salivary gland, and can be found in lower respiratory tract. Adenoid cystic carcinoma of the lower respiratory tract usually arise in the mainstem bronchus and often presents as an endobronchial mass lesion causing bronchial obstruction with atelectasis and pneumonia. But, tumor originated from more distal branch of bronchus is extremely rare, and can be confounded with other primary lung malignancy. Adenoid cystic carcinoma is considered to be a low grade malignant neoplasm and its characteristics are infiltrative nature with tendency of local recurrence and long natural course. Treatment modality and prognosis is different from other lung malignancy. We report a 30 year old male patient with adenoid cystic carcinoma that found in left lower lobe bronchus and will discuss the biologic behavior of this unusual primary lung tumor as it relates to management considerations.

증예(症例) : Hemoclip요법으로 치료한 직장 Dieulafoy 병변 1예

이기훈 ( Ki Hoon Lee ),고강훈 ( Kang Hun Koh ),박승용 ( Seung Yong Park ),오호준 ( Ho Jun Oh ),황정환 ( Heong Hwan Hwang ),이태환 ( Tae Hwan Lee ),김상욱 ( Sang Wook Kim ),이승옥 ( Seung Ok Lee ),이수택 ( Soo Teik Lee ) 전북대학교 의과학연구소 2005 全北醫大論文集 Vol.29 No.1

직장의 Dieulafoy 병변은 하부 위장관 출혈의 매우 드문 원인이다. 최근 대장내시경의 발달로 진단과 치료가 용이하여 성공적인 지혈이 가능하게 되었다. 내시경적인 치료 방법에는 전기응고, hemoclip요법, 에피네프린과 경화제 주입, 밴드 결찰술 등이 있으며 상부위장에서의 지혈술과 크게 다르지 않다. 저자들은 68세 남자에서 직장의 Dieulafoy 병변으로 인한 대량 출혈을 내시경으로 진단하고 hemoclip요법으로 성공적으로 치료하여 문헌고찰과 함께 보고하는 바이다. Dieulafoy`s lesion is an uncommon cause of gastrointestinal bleeding that occurs after rupture of an exposed submucosal artery. The majority of lesions are found in the stomach, but less commonly similar lesions have also been identified in the duodenum, jejunum, colon, and in rare cases, the rectum. A 68-year-old man with chronic renal failure who presented with massive hematochezia was subsequently found to have a Dieulafoy lesion in the rectum. The bleeding was successfully managed by endoscopic hemoclipping. We report a case of rectal Dieulafoy lesion in which bleeding was comtrolled by endoscopic hemoclipping.

오공약침의 안전성에 대한 임상적 연구

소기숙,최회강,박소영,고강훈,김성남,이옥자,윤민영,문형철,김성철,이정훈,나원경,So, Ki-suk,Choi, Hoi-kang,Park, So-young,Koh, Kang-hun,Kim, Sung-nam,Lee, Ok-ja,Yun, Min-young,Mun, Hyung-chul,Kim, Sung-chul,Lee, Jung-hun,Na, Won-kyung 대한침구의학회 2004 대한침구의학회지 Vol.21 No.1

Objective: Recently scolopendrid aquacupuncture has been a good effect on pain control but it has not been known about clinical safety. So, In order to prove the clinical safety of scolopendrid aquacupuncture, We have observed the physical reac-tion and clinical pathology test after scolopendrid aquacupuncture treatment. Methods: We analyzed physical reaction and clinical pathology test before and after Scolopendrid aquacupuncture treatment of 30 patients suffering from pain, who admitted department of Acupunture and Moxibustion, College of Oriental Medicine, Won-Kwang University Kwangju hospital. Results & Conclusions: The results were summarized as follows. 1) The distribution of sex was 14 males and 16 females, and the average of patients age was 46.2 years. 2) The distribution of symptom was lumbago, lumbago with radiating pain, nuchal pain and knee joint pain. 3) In the 30 patients treated with Scolopendrid aquacupuncture, hematologic test did not show remarkable change. 4) In the 30 patients treated with Scolopendrid aquacupuncture, Liver function test(AST, ALT, ALP) showed a slight decrease on the contrary, and abnormal rate showed a decrease of 1.0%(from 3.3% to 2.3%) compared with previous study. 5) In the 30 patients treated with Scolopendrid aquacupuncture, Renal function test(BUN, Cr) and abnormal rate(from 2.5% to 2.0%) showed a slight decrease on the contrary. 6) In the 30 patients treated with Scolopendrid aquacupuncture. Electrolyte were normal range before & after treatment. 7) In the results of the Urine analysis of 30 patients, Leukocyte, Protein. Glucose, Keton, Bilirubin, U-bilinogen were not detected before and after Scolopendrid aquacupuncture treatment, and the rest almost made no difference. 8) In the Physical reactions, all of the patients complained of pain of body partially, only one patient showed reddish and itch, but symptoms like those were entirely disappeared within 24 hours and whole body pain, swelling, headache, dizziness, fatigue and nausea was not observed.

요추간판탈출증(腰椎間板脫出症) 치료(治療)에 미치는 오공약침(蜈蚣藥針)에 대한 임상적(臨床的) 고찰(考察)

박소영,최회강,소기숙,황우준,이건목,김성철,고강훈,Park, So-Young,Choi, Hoi-Kang,So, Ki-Suk,Kang, Woo-Jung,Lee, Gun-Mok,Kim, Sung-Chul,Koh, Kang-Hun 대한약침학회 2003 Journal of pharmacopuncture Vol.6 No.1

Objective : This study is perfonned for the purpose of examining the efficacy of the scolopendrid (Scolopendra morsitans L.) which has been used to low back pain as a folk remedy. Methods & Results : Seventy patients with H.I.V.D. treated with the scolopendrid aquacupuncture and examined 4 tests; D.I.T.L., physical test, Oswestry disability index, and self-conscious pain rate were studied. There was $50{\sim}100\%$ of efficacy rate in each tests. Moreover, statistically valuable change in 5 to 7 D.I.T.I. points and in self-conscious pain rate was showed. Conclusion : The scolopendrid aquacupuncture is possible to be effective treating the H.I.V.D patients. So we suggest the possibility using this new remedy to the H.I.V.D. patients.