Successful closure of a bronchoesophageal fistula with vascular occlusion coils and cyanoacrylate glue

서기현,류지원,이호성,최재성,나주옥,김용훈 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-

Bronchoesophageal fistulas carry a high morbidity and mortality rate, and thus prompt diagnosis and treat-ment are crucial. Surgical repair is the treatment of choice in cases of benign BEF, although endoscopic palliation is usually being another option of treatment when BEF is secondary to malignancy. Here is a benign case of successful closure with coils and cyanoacrylate glue. A 56-year-old female with BEF who always had shortness of breath and productive cough by eating refused surgery with cosmetic cause. The patient had received multiple procedures with gastroendoscopy, such as hemoclipping, over the scope clip, overstitch. However, she complained of the development of recurrent BEF despite endoscopic therapy. Bronchography was planned to localize the fistula site and embolize the fistula. We successfully treated a patient by insertion of coils and cyanoacrylate glue into the fistulous tract from esophagus under fluoroscopic guidance.

우리나라 갑상선암의 치료양상 분석(2008-2012년)

서기현,정재훈 대한갑상선학회 2014 International Journal of Thyroidology Vol.7 No.2

Backgrounds and Objectives: The incidence of thyroid cancer has been increasing in Korea as well as in other countries. The majority of thyroid cancers are papillary thyroid carcinomas and follicular thyroid carcinomas, both of which are classified as differentiated thyroid carcinoma (DTC). Total or near-total thyroidectomy followed by administration of radioactive iodine (RAI) constitutes the initial treatment for DTC. This study was conducted to investigate the therapeutic modalities of surgery and RAI for the treatment of DTC in Korea using claims data provided by the Health Insurance Review and Assessment Service. Materials and Methods: This study was performed in 170,131 (men 29,002, women 141,129) Korean patients with thyroid cancer treated from January 2008 to December 2012. Patients with past history of thyroid cancer prior to 2008 were not included. Results: Total or near total thyroidectomy was done in 83.4%, lobectomy in 14.4%, and subtotal thyroidectomy in 2.2%. Postoperative RAI treatment was performed in 52.7%. Median 100 mCi of RAI was administered at median 89 days after operation, and it was completed with one dose in 66.0%. Thirty mCi was mostly preferred as an initial dose in 35.6%, and subsequently 150 mCi in 25.7%, 100 mCi in 17.5%, and more than 150 mCi in 10.1%. Median cumulative RAI dose was 130 mCi. RAI treatment rate was decreasing during recent 5 years. Conclusion: This is the first nationwide report to investigate the therapeutic modalities of surgery and RAI for the treatment of DTC in Korea.

일반연제발표 : 구연 ; 마우스 천식 모델에서 pranlukast 투여에 따른 기도내 MMP-9의 변화

서기현,최재성,나주옥,김용훈 대한결핵 및 호흡기학회 2006 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.103 No.-

Mineral dust-induced bronchioltis 3예의 임상적 고찰

서기현,황헌규,주재학,김도진,기신영,어수택,김용훈,박춘식 대한내과학회 1999 대한내과학회 추계학술대회 Vol.57 No.-

F-123 6년간 관찰한 석면 환자의 임상적, 영상의학적 변화

서기현,오지현,류지원,이호성,최재성,나주옥,김용훈,이용진 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.-

목적: 석면 노출과 폐질환의 연관성 및 영향을 주는 인자에 대한 연구는 많은 편이나 과거 석면에 노출된 후 석면질환이 동반된 환자에서 건강에 미치는 정도는 잘 알려져 있지 않다. 방법: 본원에 내원하는 전체 388명의 석면 환자 중 1년 이상 추적 관찰된 267명을 대상으로 6년간 확인된 호흡기 증세, 동반된 질환, 폐기능, 흉부 HRCT 소견을 비교하였다. 성적: 276명의 석면 환자에서 남자는 174명이었고 평균 연령은 70.5±7.6세이었고, 흡연력은 14.0±18.4 갑년이었다. 대부분 30년 이상 석면광산 인근에 거주한 주민이었고 처음 석면 노출 후 경과된 기간은 49.1±16.8년이었다. 6년간 추적 관찰하는 동안 66명(30.9%)에서 호흡기 질환이 확인되었고 이 중 천식 36명, 결핵 8명, 폐암 8명, COPD 6명이었다. 처음 폐기능 검사에서 평균 FVC 91.4±18.31%, DLCO 78.2±18.9%이었고 5년 후 폐기능 검사를 시행한 39명의 환자에서 FVC 차이가 4.2±12.1%, DLCO는 7.0±14.9%로 의미 있게 감소하였다.(p=0.039, 0.017) 흉부 CT에서 흉막반은 262명(98.1%), 흉막하 점이나 가지 음영은 220명(82.4%), 소엽간 및 소엽내 중격 비후 70명(26.2%), 봉와상폐 19명(7.1%)이었고 석면폐 변화가 보이는 경우는 33명(12.4%)이었으며 이 중 흉막하 점이나 가지 음영의 악화가 40.8%로 가장 많았다. 석면폐증이 동반된 경우는 흉막반만 있는 환자에 비해 2년째, 3년째 DLCO가 의미있게 감소하였다. (p=0.030, 0.015) 석면노출 강도가 강할수록 호흡곤란, 기침 등의 호흡기 증세가 심하였고 증세도 악화되었으며 제한성 폐기능 저하도 심하였다. 결론: 6년간 관찰한 석면환자에서 30.9%에서 호흡기 질환이 확인되었고 제한성 폐기능 저하가 관찰되었으며 12.4%에서 영상의학적 변화가 보였다. 석면폐증이 동반된 경우 폐확산능 감소가 많았고, 석면노출 강도가 강할수록 호흡기 증세와 제한성 폐기능 악화가 관찰되었다.

에메랄드 룸 : 일반연제 발표 ; 폐외 결핵(Extrapulmonary Tuberculosis)에 있어서 QuantiFERON-TB GOLD의 유용성

서기현,황원규,최재성,나주옥,김용훈 대한결핵 및 호흡기학회 2007 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.105 No.-

Oral Bisphosphonate and Risk of Esophageal Cancer: A Nationwide Claim Study

서기현,최형진 대한골대사학회 2015 대한골대사학회지 Vol.22 No.2

Background: Epidemiology studies suggest that oral bisphosphonate may increase the risk of esophageal cancer. The present study aimed to investigate the association between exposure of oral bisphosphonate and risk of esophageal cancer. Methods: Using the nationwide medical claim database in South Korea, 2,167,955 subjects, who initiated osteoporosis treatment (oral bisphosphonate, intravenous bisphosphonate or raloxifene) or performed dual energy X-ray absorptiometry (DXA) between 2008 and 2012, were analyzed. Diagnosis of esophageal cancer was estimated from medical claim database. Standardized incidence ratio (SIR) was estimated by comparing with incidence in the general population. Cox proportional hazards modeling was used to investigate age-adjusted hazard ratio (aHR) of esophageal cancer. Results: The present study included oral bisphosphonate group (N=1,435,846), comparator group 1 (intravenous bisphosphonate or raloxifene, N=78,363) and comparator group 2 (DXA, N=653,746). Mean age was 65.6±8.8 years and mean observation duration was 30.9±17.7 months. During 5,503,688 patient-years, 205 esophageal cancer incidences were observed. The annual incidence of esophageal cancer was 3.88, 4.21 and 3.30 for oral bisphosphonate group, comparator group 1 and comparator group 2, respectively. SIR of esophageal cancer was 1.24, 1.38 and 1.40 for oral bisphosphonate group, comparator group 1 and comparator group 2, respectively. Esophageal cancer risk of oral bisphosphonate group was not significantly different from comparator group 1 and comparator group 2 (aHR 0.87; 95% confidence interval [CI] 0.39-1.98 and aHR 0.94; 95% CI 0.68-1.30, respectively). Conclusions: The use of oral bisphosphonate was not associated with increased risk of esophageal cancer in real clinical practice using large scale nationwide database.

항암 치료에 잘 반응하는 악성 중피종 1예

서기현 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Despite many years of clinical research, there is still no effective therapy for malignant pleural mesothelioma (MPM). Untreated, the prognosis is poor, with a median survival of < 1 year. In general, MPM is a disease confined to the pleural cavity for a long time before metastasizing. Therefore, surgical resection has been considered the mainstay of treatment by some. However, surgery alone results in high recurrence rates, and the survival benefit remains questionable. In recent years. the gemcitabin/cisplatin combination is a valid option in the treatment of MPM. In this case, a patient had histologically proven MPM with no previous surgery, chemo- and/or radiotherapy. He underwent the gemcitabin/cisplatin combination chemotherapy. Thereafter he has been free of disease and symptoms for 6 months. I presents a case of malignant mesothelioma showing marked improvement after gemcitabin/cisplatin chemotherapy.

소멸된 고환암의 혈행성 폐전이 1예

서기현 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

The tern 'regressed or burned-out tumor' of the testis describes a spontaneously involuted testicular tumor which presents by its metastases to retroperitoneum, mediastinum, lymph nodes such as supraclavicular, cervical and axillary, lungs, and liver. This is a rare form of testicular germ cell neoplasia. Author presents the findings on scrotal sonography, contrast-enhanced chest CT, and abdominopelvic CT of a testicular regressed tumor in a 29-year-old man presenting with hematogenous lung metastasis.

건강보험심사평가원 자료로 분석한 우리나라 갑상선기능항진증의 발생률/유병률 조사와 치료법 선호도의 분석

서기현,김선욱,정재훈 대한갑상선학회 2013 International Journal of Thyroidology Vol.6 No.1

Background and Objectives: The incidence and prevalence of hyperthyroidism has been reported to be 0.2-0.9/1000 population/year and 5-10/1000 population in foreign countries, respectively. However, there has been no nationwide survey to evaluate them in Korea. Therefore, this study was conducted to investigate the incidence and prevalence of hyperthyroidism in Korea using medicare claims data provided by the Health Insurance Review and Assessment Service. Preference for its therapeutic modalities and its change were also analyzed. Materials and Methods: This study was performed in 308,584 (men 86,460, women 222,124) Korean patients with hyperthyroidism treated from January 2006 to June 2012. Patients with past history of hyperthyroidism were not included. Results: The incidence of hyperthyroidism was 0.72/1000 population/year (men 0.40, women 1.03), and its prevalence was 3.40/1000 population (men 2.09, women 4.70) in Korea. Its peak prevalence was detected between 45 and 49 years of age. Among 177,487 patients with hyperthyroidism treated from 2007 to 2011, anti-thyroid drugs were prescribed in 97.9%, and radioiodine therapy and surgery were finally performed in 8.2% and 0.9%, respectively. The prescription of propylthiouracil (PTU) has been reduced from 63.3% in 2007 to 42.9% in 2011, but the use of methimazole (MMI) increased from 33.9% in 2007 to 54.8% in 2011. Primary physicians preferred PTU to MMI, but physicians in general hospitals preferred MMI to PTU. Conclusion: This is the first nationwide report to investigate the incidence and prevalence of hyperthyroidism in Korea.