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- 저자 : 권진우 ( Chin Woo Kwon ) (검색결과 4 건)
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위선종과 조기위암의 내시경적 점막 절제술 후 추적관찰에 대한 연구
권진우 ( Chin Woo Kwon ),박철희 ( Cheol Hee Park ),조재현 ( Jai Hyun Cho ),정재원 ( Jae One Jung ),문준호 ( Joon Ho Moon ),신운건 ( Woon Geon Shin ),김종표 ( Jong Pyo Kim ),김경오 ( Kyung Oh Kim ),유교상 ( Kyo Sang Yoo ),한태호 ( 대한내과학회 2006 대한내과학회지 Vol.71 No.5
목적: 내시경 점막 절제술은 위암의 선행병변으로 알려진 위선종과 조기위암의 치료로 보다 덜 침습적이고 안전한 방법으로 널리 주목받고 있다. 저자들은 EMR 시술 후 1년간의 추적관찰을 통해 위 선종과 조기 위암에 대한 EMR 치료의 효과와 유용성에 대하여 알아보고자 하였다. 방법: 2000년 6월부터 2004년 9월까지 위선종 또는 조기위암으로 진단된 환자 중 EMR을 시행하고 이후 6개월 이상 추적관찰이 가능했던 환자 54명, 54예를 대상으로 하여, 내시경 생검 조직과 EMR 후 조직 소견을 비교한 뒤, 이후 1년간 3개월 마다 내시경 및 조직 검사를 시행하여 국소 재발 여부를 추적관찰 하였다. 결과: 환자는 남자가 42명, 여자가 12명으로 평균 연령은 60세였고, 조직 소견에서는 위 선종이 42예, 조기위암이 12예였다. EMR 전후의 병리학적 진단에 차이가 있었던 경우는 총 9예로 그 중 2예는 위선종에서 조기위암으로 진단이 바뀐 경우였다. 완전 절제는 총 48예로 일괄 절제시 34예 중 33예(97%), 부분 절제시 20예 중 15예(75%)였고, 일괄 절제시 완전 절제율이 높았다. 재발은 총 4예(7.1%)로 평균 재발 기간은 7개월이었으며, 위선종에서 42예 중 3예(7.1%), 조기위암에서 12예 중 1예(8.3%)였고, 이를 절제 방법에 따라 나누면 일괄 절제 34예 중 1예(2.9%), 분할 절제 20예 중 3예(15%)였다. 결론: EMR은 위선종과 일부 조기위암의 치료법으로 안전하고 효과적인 방법으로 인식되고 있으나 조기위암의 림프절 전이 가능성과 다발성 병변의 가능성 면에서는 한계가 있다. 그러므로 이에 대한 시술 후 정기적인 추적검사는 필수적이다. 그러나 향후 지속적인 연구와 임상 경험이 축적된다면, 위선종 및 조기 위암에 대한 표준 치료로서 그 가치가 확립될 수 있으리라 기대한다. Background: Endoscopic mucosal resection (EMR) is now widely accepted as a useful treatment method for gastric adenoma and early gastric cancer (EGC) because of its minimal invasiveness and satisfactory post-procedure results. The purpose of this study is to define the follow-up results and usefulness of EMR. Methods: We analyzed 54 cases from June 2000 through September 2004. Endoscopy with histological examination was carried out every 3 months for 1 year after EMR. Results: The patients consisted of 42 men and 12 women, and the mean age was 60 years old. The histological results were 42 gastric adenoma and 12 EGC cases. There were 9 cases that had the histological diagnosis changes after EMR. Complete resections was performed for 48 cases and the en block resections were 33 of 34 cases (97%) and piecemeal resections were done in 15 of 20 cases (75%). Recurrence was seen in 4 cases (7.1%), and the mean recurrence period was 7 months. There were 3 gastric adenomas of 42 cases (7.1%), one case of EGC of 12 cases (8.3%), one en block resection of 34 cases (2.9%) and three piecemeal resections of 20 cases (15%). Conclusions: EMR is a safe and useful treatment method for gastric adenoma and EGC. However, EMR has some limitations that EGC may have lymph node metastases or multiple tumors. So, periodic follow-up is very important. As we acquire more clinical experience, EMR may be accepted as the standard treatment method for gastric adenoma and EGC.(Korean J Med 71:483-490, 2006)
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다수의 정맥용 도관의 피하삽입과 지속흡인을 이용한 다량의 자발성 피하공기증 치료
김선영 ( Sun Young Kim ),엄광석 ( Kwang Seok Uom ),이영석 ( Young Seok Lee ),허경림 ( Kyung Rim Huh ),권진우 ( Chin Woo Kwon ),장승훈 ( Seung Hun Jang ),김동규 ( Dong Gyu Kim ),정기석 ( Ki Suck Jung ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.2
A-61-year-old COPD patient was hospitalized due to dyspnea and was diagnosed with acute exacerbation of COPD. During the hospital stay, the patient`s dyspnea was aggravated by massive spontaneous subcutaneous emphysema. Multiple 16 gauge intravenous catheters were inserted at the midclavicular line for drainage. Although subcutaneous catheter drainage was carried out, respiratory failure developed with an increased in massive subcutaneous emphysema. Continuous suction drainage with wall suction was applied resulting in the rapid resolution of the subcutaneous emphysema. We report a case of the that effective management of massive subcutaneous emphysema using multiple 16 gauge intravenous catheters with continuous suction. (Tuberc Respir Dis 2006; 61: 178-183)
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김수진 ( Su Jin Kim ),박철희 ( Cheol Hee Park ),김용민 ( Yong Min Kim ),김성열 ( Seong Yeol Kim ),천승연 ( Seung Yeon Chun ),권진우 ( Chin Woo Kwon ),박지원 ( Ji Won Park ),김경오 ( Kyoung Oh Kim ),백일현 ( Il Hyun Baek ),유교상 ( 대한장연구학회 2012 Intestinal Research Vol.10 No.2
Background/Aims: Intussusception is uncommon in adults compared with children. The present study aimed to review our experience of adult intussusceptions and discuss the preoperative diagnosis and management. Methods: A retrospective review was performed for 25 patients, at least 18 years old. These patients were diagnosed as intestinal intussusceptions at Hallym University Sacred Heart Hospital from January 1999 to October 2010. Results: There were 14 male and 11 female with a mean age of 55 years. The most common symptom was abdominal pain. The preoperative diagnostic rate was 92% because of the use of an abdominal computed tomography (CT) and an ultrasound. A total of 9 (36%) patients had enteroenteric intussusception, 8 had ileocolic, 1 had ileocecal and 7 patients had colocolic intussusception. A discrete pathologic process was present in 22 (88%) patients and the remaining 3 (12%) patients were idiopathic. There were 12 small bowel lesions and 10 colonic lesions. Neoplasms were the most common etiology of intussusceptions. Of the cases with a defined colonic cause, 8 (80%) were malignant. Overall, 12 (48%) patients underwent primary resection of the intussusception without prior reduction, 11 (44%) patients had reduction of their intussusception followed by resection. Conclusions: Adult colonic intussusception is usually associated with malignancy. All patients with obstruction of unknown cause or lead point on CT should consider surgical exploration. (Intest Res 2012;10:183-188)
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장간막 림프절염으로 발현된 Kikuchi-Fujimoto병 1예
최원섭,이승순,권진우,이영석,김선영,전선영,김민정,정두련 대한감염학회 2006 감염과 화학요법 Vol.38 No.5
Kikuchi-Fujimoto 병은 주로 경부 림프절을 침범하는 질환이지만, 드물게 회맹부 장간막 림프절을 침범하여, 발열을 동반한 우하복부 통증과 반발압통을 나타내는 장간막 림프절염을 일으킬 수 있다. 급성 충수돌기염과 유사한 양상의 급성 복증을 호소하는 젊은 성인의 경우, 장간막 림프절염 여부를 확인하여야하며, 그럴 경우 Kikuchi-Fujimoto 병을 감별 진단에 포함시켜야 한다. 저자 등이 경험한 장간막 림프절염으로 발현된 성인의 KikuchiFujimoto 병 1예는 국내에서는 최초로 발견된 것이기에 문헌 고찰과 함께 보고하는 바이다. Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a benign, rare, self limitimg disease presenting with mainly cervical lymphadenopathy and fever unresponsive to antibiotics or medical treatment. A 28-year old man presented with fever and right lower quadrant abdominal pain. Physical examination showed abdominal tenderness and rebound tenderness mimicking acute appendicitis. Imaging studies showed normal appendix and other abdominal organs except enlarged multiple mesenteric lymph nodes. Symptoms persisted despite antimicrobial therapy. Multiple tender lymph nodes were palpable on bilateral cervical area at the 7th hospital day. The biopsy of the neck node showed large areas of patchy, irregular necrosis with prominent nuclear debris surrounded by T lymphocytes, histiocytes without neutrophils and granuloma, so he was diagnosed as Kikuchi- Fujimoto disease. With conservative management, clinical improvement was observed. We suggest that Kikuchi-Fujimoto disease with mesenteric lymphadenitis should be added to the differential diagnosis of acute abdomen mimicking acute appendicitis in young adults.
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