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Cigarette Smoking-Induced Acute Eosinophilic Pneumonia: A Case Report Including a Provocation Test
복진현,김양기,이영목,김기업,어수택,황정화,김동원 대한의학회 2008 Journal of Korean medical science Vol.23 No.1
The mechanism and cause of acute eosinophilic pneumonia are largely unknown. Many factors including the smoking of cigarettes have been suggested, but none have been proven to directly cause acute eosinophilic pneumonia. The authors report a case of acute eosinophilic pneumonia in a young Asian male who recently started smoking. The diagnosis was made based on his clinical course and results of chest radiography, lung spirometry, bronchoalveolar lavage, and transbronchial lung biopsies. After administration of methylprednisolone, his clinical course rapidly improved. A provocation test was designed to establish a connection between cigarette smoking and the development of acute eosinophilic pneumonia. After the provocation test, the patient showed identical symptoms, increase in sputum eosinophils, and worsening of pulmonary function. The results of the provocation test suggest that smoking may directly cause acute eosinophilic pneumonia, and support previous reports of cigarette smoking-induced acute eosinophilic pneumonia.
Endoscopic Resection of Hypopharyngeal Squamous Cell Carcinoma
복진현,조원영,조주영,진소영,안지호,천창균,이태희,김현건 대한소화기내시경학회 2013 Clinical Endoscopy Vol.46 No.2
Hypopharyngeal cancers are often diagnosed at an advanced stage and have a poor prognosis. Even when they are diagnosed at an operable stage, surgery often results in substantial morbidity and decreased patients’ quality of life. Although the endoscopic diagnosis of early hypopharyngeal cancer is difficult, recent developments in advanced imaging endoscopy have enabled easier diagnosis of these lesions. Endoscopic resection of early hypopharyngeal cancer is a potential minimally invasive treatment that can preserve the function and quality of life of patients. Reports of this procedure are limited, however. We report a case of hypopharygeal cancer treated with endoscopic resection.
간내담관암으로 오인된 간세포암종과 담관상피암종의 중간형
복진현 ( Gene Hyun Bok ),홍중락 ( Zoong Rock Hong ),노미오 ( Mi Oh Roh ),장재영 ( Jae Young Jang ),심찬섭 ( Chan Sup Shim ),김정훈 ( Jung Hoon Kim ),진소영 ( So Young Jin ) 대한내과학회 2008 대한내과학회지 Vol.75 No.3
저자들은 간내 종괴로 내원하여 방사선적 검사상 담도암으로 생각되었으나 수술 및 면역조직화학염색 후 간세포암종과 담관상피 암종의 중간형으로 진단된 증례를 경험하여 보고하는 바이다. Primary liver cancer has traditionally been classified as either hepatocellular carcinoma (HCC) or cholangiocarcinoma (CCC). However, primary liver cancer occasionally consists of elements from both HCC and CCC. Intermediate hepatic carcinoma and primary liver cancer of the intermediate type are extremely rare subtypes of primary liver cancer that show features intermediate between HCC and CCC. First reported in 1998, the clinical, radiologic, and histopathologic characteristics of this entity remain unclear. In this case report, we describe the clinical, magnetic resonance imaging, histopathological, and immunohistochemical findings in a patient with intermediate hepatic carcinoma who was initially thought to have intrahepatic cholangiocarcinoma. (Korean J Med 75:327-332, 2008)
만성 B형 간염 환자에서 간세포암종으로 오인되었던 1 cm 크기의 간내담관상피암종
복진현 ( Gene Hyun Bok ),정승원 ( Soung Won Jeong ),장재영 ( Jae Young Jang ),심광연 ( Kwang Yeun Shim ),이세환 ( Sae Hwan Lee ),김상균 ( Sang Gyune Kim ),김영석 ( Young Seok Kim ),김홍수 ( Hong Soo Kim ),김부성 ( Boo Sung Kim 대한간암학회 2012 대한간암학회지 Vol.12 No.1
Morphologically, intrahepatic cholangiocarcinoma (ICC) presents as a parenchymal mass, and it is occasionally resectable and potentially curable. In some cases, differentiation from other hepatic neoplasms such as metastatic lesions and hepatocellular carcinoma (HCC) can be extremely difficult, both clinically and histologically, and definitive diagnosis often needs correlation with clinical and radiologic finding.Contrasted computed tomography (CT) is useful in the diagnosis of ICC and in determining the extent of tumor involvement. Although the majority of liver tumors can be diagnosed by modern imaging modalities such as contrast CT, some cases of ICC show tumor enhancement in the arterial phase the same as that in HCC, or a biliary dilatation without stenosis by intraductal tumor growth. Differences in these patterns of tumor enhancement and status of the bile ducts in ICC may also reflect differences in cellular characteristics, clinical features, and prognosis after treatment. We present a case of a small ICC showing similar clinical and radiologic characteristics to HCC.
간세포암의 경동맥화학색전술 후 추적검사에서 조영증강초음파와 리피오돌 전산화단층촬영의 일치성 비교
복진현 ( Gene Hyun Bok ),정승원 ( Soung Won Jeong ),장재영 ( Jae Young Jang ),이세환 ( Sae Hwan Lee ),김상균 ( Sang Gyune Kim ),차상우 ( Sang Woo Cha ),김영석 ( Young Seok Kim ),조영덕 ( Young Deok Cho ),김홍수 ( Hong Soo Kim ) 대한간암학회 2014 대한간암학회지 Vol.14 No.2
목적: 간세포암의 경동맥화학색전술 후 잔존 간세포암의 추적검사에 있어서 리피오돌 전산화단층촬영과 조영증강 초음파의 일치성을 평가하고자 하였다. 대상과 방법: 간세포암의 경동맥화학색전술 시행 후, 잔존 간세포암의 평가를 위해 조영증강초음파와 리피오돌 전산화단층촬영을 모두 시행 받은 41명 환자의 65개의 병변을 후향적으로 검토하였고, 이중에서 조영증강초음파 검사 후4주 이내에 리피오돌 전산화단층촬영을 시행받았던 31명 환자의 47개 병변을 평가하여 두 검사 사이의 일치율과 일치율에 영향을 주는 인자들을 분석하였다. 결과: 전체 병변에서 조영증강초음파와 리피오돌 전산화 단층촬영의 일치율은 78.7% (37/47)였고, 잔존 간세포암을 대상으로만 비교했을 경우의 일치율은 95.2%, 그리고 비잔존 간세포암을 대상으로만 비교했을 경우의 일치율은 65.4% 였다(P <0.013). 일치율에 영향을 주는 인자의 분석에서는 미만성(diffuse) 간세포암이 경향성을 보였으나 통계적인 의미를 보이지는 못했고, 간의 dome 부위에 위치한 4개의 병변 가운데에서 3개의 병변에서 불일치를 보였으나 표본수가 적어서 통계적인 의미를 보이지는 못하였다. 검사의 일치를 보였던 간세포암과 일치를 보이지 않았던 간세포암의 평균 크기는 각각 2.9 과 3.0 cm 으로 의미를 보이지 않았고, 리피오돌 CT상에서의 잔존간세포암의 여부가 일치율에 있어서의 의미 있는 인자였다. 결론: 잔존 간세포암에 대한 조영증강초음파와 리피오돌 전산화단층촬영의 일치율은 높았지만, 비잔존 간세포암에 대한 일치율은 상대적으로 낮았다. Background/Aims: The aim of this study is to evaluate the concordance of contrast enhanced ultrasonography (CEUS) and lipiodol computed tomography (L-CT) for the assessment of viable hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). Methods: We retrospectively reviewed the post-TACE CEUS and L-CT images of 65 consecutive HCCs in 41 patients to assess the presence of viable tumor tissue. Forty-seven HCCs in 31 patients that underwent post-TACE L-CT within 4 weeks of the CEUS examination were included. The degree of concordance between CEUS and L-CT and factors related to concordance were analyzed. Results: The overall concordance of CEUS and LDCT was 78.7% (37/47). The concordance with L-CT for viable tumor and non-viable tumor tissue on CEUS was 95.2%, and 65.4% respectively (P<0.013). Diffuse tumors had a tendency for non-concordance (P=0.066). Although 3 of 4 lesions located in the hepatic dome were non-concordant, the sample size was too small to establish significance. The mean tumor size for concordant and non-concordant tumors was 2.9 and 3.0 cm, with no significant difference. Conclusions: Although the concordance of CEUS and L-CT for viable tumor tissue was high, the concordance for non-viable tumor tissue was relatively low. Prospective studies using angiography as a gold standard should be performed in the future. (J Liver Cancer 2014;14:115-119)
이태희,조주영,복진현,조원영,진소영 대한소화기내시경학회 2013 Clinical Endoscopy Vol.46 No.1
Intra-abdominal tuberculous lymphadenitis can mimic a variety of other abdominal disorders such as pancreatic cancer, metastatic lymph nodes, or lymphoma, which can make a proper diagnosis difficult. A correct diagnosis of intra-abdominal tuberculous lymphadenitis can lead to appropriate management. Endoscopic ultrasonography (EUS)-guided needle biopsy may be the procedure of choice for tissue acquisition when onsite cytopathology examination is unavailable because it is essential to obtain sufficient material suitable for the examination using an ancillary method, such as flow cytometry, molecular diagnosis, cytogenetics, or microbiological culture. We report a case of intra-abdominal tuberculous lymphadenitis diagnosed using an EUS-guided, 22-gauge histology new needle biopsy without an onsite cytopathology examination.
Peroral Endoscopic Myotomy for Treatment of Achalasia: Initial Results of a Korean Study
이병후,심광연,홍수진,복진현,조준형,이태희,조주영 대한소화기내시경학회 2013 Clinical Endoscopy Vol.46 No.2
Background/Aims: Achalasia is a rare esophageal motility disorder. Recently, a novel endoscopic technique, peroral endoscopic myotomy (POEM), was introduced as an alternative treatment for achalasia. We report the results and short term outcomes of POEM for patients with achalasia. Methods: POEM was performed in 13 patients with achalasia. The procedure consisted of creating a submucosal tunnel followed by endoscopic myotomy of circular muscle bundles. The mucosal entry was closed by conventional hemostatic clips. A validated clinical symptom score (Eckardt score) and high resolution manometry were used to evaluate the outcomes. Results: Both the clinical score of achalasia, as well as the resting lower esophageal sphincter (LES) pressure, were significantly reduced after POEM. Mean post-treatment Eckardt score was 0.4±0.7, compared to 6.4±1.9 prior to the treatment (p=0.001). The mean pre and post-treatment LES pressure was 30.3 and 15.3 mm Hg, respectively (p=0.007). Following POEM, symptomatic relief from dysphagia without reflux symptoms was observed in all patients (13/13). No serious complications related to POEM were encountered. Conclusions: Based upon our initial experience, the authors believe that POEM is a feasible, safe, and effective treatment and may possibly substitute established treatments of refractory achalasia.
Gastric Schwannoma Diagnosed by Endoscopic Ultrasonography-Guided Trucut Biopsy
홍성욱,조원영,김진오,천창균,심광연,복진현,엄욱현,이지은 대한소화기내시경학회 2013 Clinical Endoscopy Vol.46 No.3
Schwannomas of the gastrointestinal (GI) tract are rare subepithelial tumors comprising approximately 3.3% to 12.8% of all mesenchymal tumors of the GI tract. On endoscopic ultrasound (EUS) they are seen as hypoechoic tumors arising most commonly from the 4th proper muscle layer. Although EUS helps to distinguish tumor characteristics, tissue sampling is required for differentiation with other more common tumors such as GI stromal tumors. Both EUS-guided fine needle aspiration and EUS-guided trucut biopsy (EUS-TCB) can be used for tissue sampling. However, only EUS-TCB allows core biopsy and a high yield of immunohistochemical staining. We report a case of a gastric schwannoma diagnosed by EUS-TCB.