Cyclophosphamide에 의해 유발된 미만성 폐포 손상

배상수 ( Sang Su Bae ),배문희 ( Mun Hee Bae ),박형석 ( Hyung Suk Park ),박정웅 ( Jeong Woong Park ),서지영 ( Gee Young Suh ),정만표 ( Man Pyo Chung ),한정호 ( Joung Ho Han ),권오정 ( O Jung Kwon ),이경수 ( Kyung Soo Lee ),이종헌 ( 대한결핵 및 호흡기학회 1998 Tuberculosis and Respiratory Diseases Vol.45 No.2

Helicobacter pylori 감염과 대장 신생물 발생의 관련성

홍은정 ( Eun Jung Hong ),박동일 ( Dong Il Park ),손희정 ( Hee Jung Sohn ),배문희 ( Mun Hee Bae ),김화목 ( Hwa Mock Kim ),김용성 ( Yong Sung Kim ),변선정 ( Sun Jeong Byun ),박정호 ( Jung Ho Park ),김홍주 ( Hong Joo Kim ),조용균 ( Y 대한내과학회 2008 대한내과학회지 Vol.74 No.6

목적: Helicobacter pylori 감염은 만성 위염, 소화성 궤양 뿐 아니라 위암의 원인으로도 알려져 있다. 최근 대장암과 H. pylori 감염과의 연관성에 대한 연구결과들이 발표되면서 이에 대한 관심도 높아지고 있는 실정으로 아직까지는 서로 상반된 의견이 공존하고 있다. 이에 H. pylori 감염률이 높은 한국인에서 H. pylori 감염과 대장의 신생물 발생과의 관련이 있는지 알아보고자 하였다. 방법: 2004년 1월부터 2005년 11월까지 강북삼성병원과 삼성서울병원에서 건강검진을 받은 수진자 중 대장내시경과 H. pylori 혈청 항체검사를 동시에 받은 1,590명을 대상으로 후향적 연구를 시행하였다. 대상자들 모두. H. pylori 양성군과 음성군으로 분류하여 각각 대장용종과 대장암의 발생빈도를 비교하였다. 결과: 1,590명의 대상자 중에서 남자는 1,297명, 여자는 293명이었으며 이들의 평균 나이는 49.9세로 남자는 50세, 여자는 49세였다. H. pylori 혈청 검사 양성인 군은 893명으로 H. pylori 감염 빈도는 56.2%이었고, 남자에서는 56.1%, 여자에서는 56.3이었다. H. pylori 감염 여부에 따른 대장 용종의 발생률은 두 군에서 의미있는 차이를 보이지 않았다. 결론: H. pylori 감염과 대장 용종 발생과는 상관관계가 없는 것으로 보인다. Background/Aims: Helicobacter pylori infection is a recognized cause of chronic gastritis, peptic ulcer and gastric adenocarcinoma. However, both positive and negative associations with colorectal neoplasia have been reported. The aim of this study was to determine whether H. pylori infection is associated with an increased risk of colonic neoplasia in a Korean population. Methods: We examined 1,590 subjects (1,297 men and 293 women) who underwent colonoscopy and serologic testing for IgG antibodies against H. pylori at the Health promotion Center in Kangbuk Samsung Hospital and at Samsung Medical Center. We compared the prevalence of colonic neoplasia in the seropositive subjects with that of the seronegative subjects. Results: The overall prevalence of H. pylori in our study population was 56.2%. There were no significant differences of the baseline characteristics between the two groups. There was no statistically significant difference in the prevalence of colonic neoplasia between the seropositive group and the seronegative group (p=0.090). Conclusions: These findings suggest that there is no significant association between H. pylori infection and colonic neoplasia.(Korean J Med 74:605-610, 2008)

수술로 확진된 췌장 낭성종양의 임상적 고찰

강태욱(Tae Wook Kang),이규택(Kyu Taek Lee),류민규(Min Kyu Ryu),문원(Won Moon),배문희(Mun Hee Bae),이경수(Kyung Su Lee),이상수(Sang Soo Lee),이지민(Ji Min Lee),조건영(Gun Young Cho),이종균(Jong Kyun Lee),백승운(Seung Woon Paik),이종철(J 대한내과학회 2001 대한내과학회지 Vol.60 No.4

N/A Background: Cystic tumors of the pancreas are uncommon, and frequently mistaken for pancreatic pseudocysts. Recently if the patient is a good surgical candidate and is symptomatic, resection is the treatment of the choice without the cytological and chemical analysis by the fine needle aspiration. But, we have no data in Korean population. The aim of this study was to evaluate the subclassification of the cystic tumors of the pancreas and the differential points between pancreatic pseudocysts and cystic tumors of the pancreas which had to be operated. Methods: fifty-nine patients with cystic lesions of the pancreas have been operated at the Samsung Seoul Hospital from 1994 to 1999 and evaluated about the subclassification, frequency and the difference between pseudocysts and cystic tumors retrogradely. Results: There were 14 mucinous cystic neoplasms (mucinous cyst adenomas: 11 cases, mucinous cyst-adenocarcinomas : 3 cases), 10 serous cyst adenomas, 9 solid and papillary epithelial neoplasms, 8 intra-ductal papillary mucinous neoplasms, 5 pseudocysts, 4 retention cysts, 3 endocrine tumors, 1 pancreatic ductal adenocarcinoma with cystic change, 1 solid pseudopapillary tumor, 1 pancreatic ductal adenocarci-noma with pseudocyst , 1 cavernous lymphangioma, 1 lymphoepithelial cyst and 1 simple cyst. 57.6% of the patients were females and the mean age was 50.0 years (16 year s-77years). The characteristics between pseudocysts and cystic tumors of the pancreas (sex differentiation, mean age, previous history of alcohol drinking and pancreatitis, communication with the main duct on the pancreatogram and the sign of the pancreatitis on the radiologic study) had no differences. Conclusion: We conclude there were no other methods to differentiate accurately the pseudocyst from the cystic tumor of the pancreas other than the operation.(Korean J Med 60:349- 357, 2001)

Morphine 과량 복용 후 발생한 횡문근융해증 1예

문원,김대중,이지민,배문희,오하영,정숙인,강태욱,오동진,허우성,김윤구 대한내과학회 2001 대한내과학회지 Vol.60 No.2

Drugs are important causes of rhabdomyolysis. Opiate drugs are one of the important causes of rhabdomyolysis in foreign countries. In Korea, however, there is no report of opiate-induced rhabdomyolysis. We experienced a case of rhabdomyolysis developed after a morphine overdose for suicidal intent. The patient was a 27-year-old man presenting with comatose mentality. He initially suffered from the manifestations of acute opiate intoxication including central nervous system depression, respiratory depression and hyperthermia. He was treated with intravenous naloxone and mechanical ventilator for one day. Results of further investigations showed evidence of rhabdomyolysis. After he was treated with general supportive care including hydration, urine alkalinization, and cold blanket, his condition was fully recovered. This case highlights the importance of the suspicion of opiate overdose as a cause of rhabdomyolysis in any rhabdomyolysis patient with no definite etiology.(Korean J Med 60:183-187, 2001)

간이식 대기 중인 간경변 환자에서 의미 있는 폐내 단락의 빈도와 이와 연관된 인자에 관한 연구

이지민,최문석,이상철,박승우,배문희,이준혁,고광철,백승운,이풍렬,김재준,이종철 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.3

목적: 간폐증후군은 간질환이 있는 환자에서 저산소증이 유발되는 상태로서, 폐내 단락이 그 주된 기전으로 알려져있다. 간이식은 간폐증후군의 유일한 치료 방법으로 알려져 있고, 이식 후에 폐내 단락의 정상화가 일어날 수 있다. 그러나 간이식을 시행할 경우 가역성을 미리 예측할 수 없는 것이 문제이다. 국내에서는 이식 대기중인 간경변증 환자에서의 폐내 단락의 유병률에 관한 연구가 아직 없는 실정이다. 저자 등은 간이식 대기중인 간경변증 환자에서 의미 있는 폐내 단락의 유병률과 폐내 단락과 연관된 위험 인자를 알아보고자 하였다. 대상과 방법: 1999년 11월부터 2001년 2월까지 삼성서울병원 에서 간경변증이나 이에 동반된 간암으로 간이식 대기 중인 환자 57명 (남 : 여 = 38 : 19, 연령 18∼71 세, 중앙값 49세)을 대상으로 하였다. 간경변증의 원인은 B형 간염이 47명, C형 간염이 4명, 그 외 알코올과 윌슨병, 원발성 담도성 간경변증 등이 6명이었고, 전체 환자 중에 간암이 동반된 환자는 13명이었다. 이들에게 조영 증강 심초음파를 시행하여 폐내 단락의 유무 및 정도를 평가하였으며, Ⅱ등급 이상의 단락을 의미 있는 단락으로 보았다. 대상 환자를 의미 있는 단락을 가진 군과 그렇지 않은 군으로 나누어, 양 군 간의 간기능, 식도 정맥류 유무, 위 정맥류 유무, 복수, 간성 뇌증 유무를 비교하였다. 결과: 총 57명의 환자 중 의미 있는 폐내 단락을 가진 군 은 30명(52.6%)이었다. 의미 있는 폐내 단락은 Child- Pugh분류 C군에서 38명 중 24명(63.2%), A, B군에서 19명 중 6명(31.6%)으로 관찰되었다(p< 0.05). 의미 있는 폐내 단락이 있는 군과 없는 군 간의 성별, 나이, 간경변증 원인, 식도 정맥류 유무, 위 정맥류 유무, 복수, 간성 뇌증 유무 등에는 유의한 차이가 없었다. 결론: 이상의 결과로 폐내 단락은 간이식 대기중인 간경변증 환자에서 흔히 관찰되는 소견이며, Child-Pugh 분류 C군은 의미 있는 폐내 단락의 위험 인자임을 알 수 있었다. Backgrounds/Aims: Hepatopulmonary syndrome is a condition of severe hypoxia with intrapulmonary shunt (IPS) in the setting of hepatic dysfunction. Liver transplantation has been suggested as a definite treatment for hepatopulmonary syndrome with reversal of IPS in some patients. Inconsistency of response and inability to predict reversibility, however, are significant problems. We performed this study to evaluate the prevalence of significant IPS in pretransplantation cirrhotic patients and to find any risk factors of IPS. Methods: Fifty-seven patients (M:F = 38:19, median age 49 years (range 18 - 71)) with liver cirrhosis awaiting liver transplantation were serially included. Their IPS status was evaluated using contrastenhanced echocardiography. Significant shunt was defined as a shunt of grade ≥2. Results: Significant IPS was detected in 30 (52.6%) among 57 patients. Significant shunt was found in 24 (63.2%) of 38 Child-Pugh class C patients and in 6 (31.6%) of 19 Child-Pugh class A or B patients (p<0.05). No significant difference in prevalence of significant shunt was seen according to age, sex, presence or absence of hepatocellular carcinoma, ascites, hepatic encephalopathy, and gastroesophageal varix. Conclusion: Significant intrapulmonary shunt is a common finding in cirrhotic patients awaiting liver transplantation. Child-Pugh class C is the risk factor associated with high prevalence of significant shunt. (Korean J Hepatol 2002;8:271-276)

대장 선종과 Apolipoprotein E 유전형과의 관계

김영호,최윤호,손희정,강태욱,최규완,최봉준,이종철,박상종,이지민,배문희,김재준,이풍렬 대한소화기내시경학회 2001 Clinical Endoscopy Vol.23 No.1

Background/Aims: Apolipoprotein B polymorphism plays an important role in the metabolism of cholesterol. And bile acids, which may be related to the development of colorectal adenomas, An association between apolipoprotein B genotype and colonic adenomas bas been reparted in a western country. This study was designed to determine whether the apolipopratein S was genotype would be associated with proximal or distal colonic adenomas in Koreans. Methods: On the colonoscopy, colonic adenomas were found in 132 patients. Proxima1 colonic adenoma was found in 35 patients and distal colonic adenoma was found in 97 patients. Serum leveis of total cholesterol, LDL-cholesterol, HDL-cholesterol and trlglyceride were measured. Apolipoprotein E genotype was determined by PCR and allele specific oligonucleotide hybridization. 279 contro1 subjects without an adenoma on the screening sigmoidoscopy were se1ecfed randomly. Results: The serum levels of total choles0'rol, LDL-cholesterol, HDL-cholesterol and triglyceride did not significantiy differ between each adenoma group and control group. The individual frequencies of ε2, ε3 and ε4 alleles in patients with colonic adenomas did not differ from those in control subjects. The frequency of either heterozygote or homozygote for g 4 allele in patients with proximal adenoma was lower than that in control subjects (0.029 vs O.I68, p $lt; 0.05). Conclnsions: The data suggest that g 4 allele may be associated with a lower risk for the development of proximal colonic adenoma in Korean men.

에나멜 상피종성 및 유두상 두개인두종의 임상상과 자기공명영상 ( MRI ) 소견의 비교

강태욱,양태영,김광원,이문규,민용기,이명식,정재훈,김종현,나동규,정인경,함종렬,권성욱,조건영,이지민,배문희,서연림,유재욱 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.2

Background : Craniopharyngioma is a suprasellar or intrasellar epithelial neoplasm that occurs in both children and adults. It accounts for 1.2 to 3 % of intracranial tumors with an incidence of 0.5 to 2 cases per one million populations each year. Recently, it has been postulated that it may have two pathogenetically separate subtypes, which are adamantinous and papillary craniopharyngioma, and that their clinical features may be different. However, there are some disagreements in this postulation. Therefore, we studied 22 consecutive patients with craniopharyngioma to evaluate the differences in clinical features and MRI findings between two subtypes. Methods : We studied 22 patients with histologically proven craniopharyngioma after surgery at Samsung Medical center from 1995 to 1999. Thirteen patients were male, and nine patients were female. The average age was 30 years, with a range from 1 to 58 years. We divided 22 patients into two histopathologically separate subtypes; adamantinous and papillary subtypes. We compared the clinical features and MRI findings of two subtypes by reviewing medical records. Results : Out of 22 patients with craniopharyngioma, 19 patients had an adamantinous subtype and 3 patients had a papillary subtype. The adamantinous subtype occurred frequently in the fifth decade and below twenty years, while the papillary subtype occurred predominantly in forth and fifth decades. The adamantinous subtype located in suprasellar or intrasellar portion as well as extrasellar portion, while the papillary subtype was restricted to the suprasellar location. The average tumor size of the adamantinous subtype was 3.7 cm, with a range from 1.4 to 6.0 cm, which was larger than that of the papillary subtype (average size 1.8 cm with a range from 1.5 to 2.3 cm, p $lt; 0.05). The adamantinous subtype was predominantly cystic, while the papillary subtype was predominantly solid (p $lt; 0.05). There were no significant differences in the preoperative clinical features and the postoperative complications between two subtypes. Conclusion : The adamantinous subtype had two peaks of occurrence in the fifth decade and below twenty years, while the papillary subtype occurred predominantly in forth and fifth decades. The adamantinous subtype was larger and had cystic portion, while the papillary subtype was smaller and had solid portion. The preoperative clinical features and the postoperative complications between two subtypes seemed not to be different (J Kor Soc Endocrinol 15:170-178, 2000).