증례 : 혈액종양 ; 항암 치료 후 발생한 급성B림프모구백혈병 2예

신석표 ( Suk Pyo Shin ),송상희 ( Sang Hee Song ),고은정 ( Eun Jung Ko ),김지수 ( Ji Su Kim ),박치영 ( Chi Young Park ),오도연 ( Do Yeun Oh ),정소영 ( So Young Chong ) 대한내과학회 2013 대한내과학회지 Vol.85 No.1

치료관련 골수성 백혈병은 잘 알려져 있으며 치료와의 연관성이 정립되어 있으나 치료관련 급성B림프모구백혈병은 드물고 이전의 악성 종양의 항암 치료와 방사선 치료가 급성B림프모구백혈병 발생에 영향을 미치는지는 아직 논란이 많다. 최근에 세포독성 치료와 연관된 급성B림프모구백혈병의 보고가 있으며 국내에서도 드물게 보고되고 있다. 이에 저자들은 과거 세포독성 치료를 한 뒤 급성B림프모구백혈병이 발병한 증례 2예를 경험하였기에 보고하는 바이다. Therapy-related myeloid neoplasms have been well characterized. However, precursor B-cell acute lymphoblastic leukemia in patients with prior malignancies is uncommon, and the effect of prior cytotoxic therapy on development of precursor B-cell acute lymphoblastic leukemia is controversial. Therapy-related precursor B-cell acute lymphoblastic leukemia has been reported occasionally. However, cytotoxic therapy-related precursor B-cell acute lymphoblastic leukemia has been reported in Korea only rarely. We herein describe two cases of therapy-related precursor B-cell acute lymphoblastic leukemia. (Korean J Med 2013;85:96-100)

길버트 증후군 환아에서 조영제 사용 후 발생한 지속적 황달 증례

신우철 ( Woochul Shin ),신석표 ( Suk Pyo Shin ),한상학 ( Sang Hak Han ),유정경 ( Jung Kyung Yoo ) 대한췌장담도학회 2021 대한췌담도학회지 Vol.26 No.3

저자들은 길버트 증후군 환아에서 조영제 사용 후 발생한 지속적 황달 증례를 보고하는 바이다. 이는 비교적 드문 증례로, 임상에서의 꾸준한 관찰이 필요하다. This paper reports a child with Gilbert's syndrome who underwent cholecystectomy and endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreaticography to removal of the gallstones, then experienced increase in bilirubin of unknown cause. Korean J Pancreas Biliary Tract 2021;26(3):200-204

간동맥주입 화학요법과 체외 방사선 치료의 병행요법으로 치료한 국소 진행성 간세포암종 1예

양태영 ( Tae Young Yang ),신석표 ( Suk Pyo Shin ),이주호 ( Joo Ho Lee ),이윤빈 ( Yun Bin Lee ),박하나 ( Ha Na Park ),황성규 ( Seong Gyu Hwang ),임규성 ( Kyu Sung Rim ) 대한간암학회 2015 대한간암학회지 Vol.15 No.1

Patients with advanced hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) have an extremely poor prognosis. Although the Barcelona Clinic Liver Cancer guideline recommends sorafenib in advanced HCC with PVT, which has provided survival benefits of 2 or 3 months compared to the placebo group, many liver cancer centers in Asia still select multimodality approaches including transarterial chemoembolization, radiofrequency ablation, radiation therapy (RT) as well as systemic/intra-arterial chemotherapy. Recently advanced RT technologies have shown potential to improve survival without severe radiation-related toxicity. For locally advanced HCC patients with PVT, concurrent chemoradiotherapy (CCRT) has been applied as a loco-regional treatment and provides potential cures. We herein report our recent experience of a patient accompanying large HCC with PVT who successfully undergone CCRT followed by hepatic arterial infusion chemotherapy. (Journal of Liver Cancer 2015;15:52-56)

COVID-19 기간 대한췌장담도학회의 대면-비대면 학술행사에 대한 만족도 설문 조사

이재민 ( Jae Min Lee ),이희승 ( Hee Seung Lee ),신석표 ( Suk Pyo Shin ),이윤나 ( Yun Nah Lee ),전형구 ( Hyung Ku Chon ),장성일 ( Sung Ill Jang ),이준규 ( Jun Kyu Lee ) 대한췌장담도학회 2021 대한췌담도학회지 Vol.26 No.1

배경/목적: 본 연구는 증증급성호흡기증후군(COVID-19)의 확산에 따라 학술행사의 방식이 직접 참석에서 비대면 온라인 방식으로 점차 변화되는 현재의 경향을 고려하여, 2020년 시행된 학술행사 참석자들의 만족도를 분석한 연구이다. 설문조사를 통해 비대면 온라인 학술대회의 장점과 단점을 분석하고, 이를 토대로 향후 이상적인 학술대회를 준비할 수 있는 자료를 수립하고자 하였다. 방법: 2020년 상반기에 서울에서 개최된 ‘IC-KPBA 2020’ 학술행사의 참석자를 대상으로 18개 문항으로 구성된 설문조사를 시행하였다. 설문조사는 네이버 설문조사의 플랫폼을 이용하여 진행되었다. 결 과 : 비대면 온라인 방식의 학술행사에 대해서 학회 참석자들은 전반적으로 만족 혹은 매우 만족스럽다고 응답하였다. 온라인 참석자들은 네트워크 연결, 화면 및 음향 등의 각각의 항목에서 약 70-85%가 만족 혹은 매우 만족으로 응답하였으며, 직접 참석자들을 대상으로 한 설문에서 방역대책 및 현장의 화면, 음향 시설 등의 각각의 항목에서 약 80-90%가 만족 혹은 매우 만족으로 응답하였다. 향후 학회 참석방식의 선호도 조사에서는 가급적 온라인을 선택하겠다는 답변이 33% 로 가장 높게 나타났다. 결론: 학술행사의 방식이 점차 비대면 온라인으로 변화되는 추세에서 대한췌장담도학회 주관 하에 새로운 방식으로 개최한 국제학술대회에 대한 만족도는 전반적으로 양호-우수한 것으로 확인되었다. Background/Aim: The COVID-19 pandemic has changed the way of traditional conference and meeting. Since social distancing rule was important issue, many conferences across the world were cancelled or postponed indefinitely. In 2020, International Conference of the Korean Pancreatobiliary Association (IC-KPBA) was held as a hybrid online and offline conference. Here, we report the result of a national survey about online and offline medical conference in Korea. Methods: The survey was performed for both online and offline participants after IC-KPBA. The contents of survey included their way to access the hybrid online-offline conference and satisfaction with the conference format. Results: Total of 78 participants answered the survey and there was no technical problem. Most offline participants were satisfied the prevention measures at conference hall as follows; very satisfied-56%; satisfied-34%. The quality of video and audio were generally satisfactory in both conference hall and virtual conference. ‘Live online lectures’ is the most preferred method of lecture delivery and personal computer with LAN network is preferred to access online conference. Eighty seven percent of offline participants and 91% of online participants answered satisfied and very satisfied, respectively. Conclusions: Participants of IC-KPBA 2020 with hybrid online-offline conference showed a high level of satisfaction. Korean J Pancreas Biliary Tract 2021;26(1):49-57

증례 : 혈액종양 ; 다발골수종 환자에서 보르테조밉(bortezomib) 투여 후 발생한 심부전 1예

송지현 ( Ji Hyun Song ),김희경 ( Hee Kyung Kim ),신석표 ( Suk Pyo Shin ),김인재 ( In Jai Kim ),오도연 ( Do Yeun Oh ),정소영 ( So Young Chong ) 대한내과학회 2015 대한내과학회지 Vol.88 No.4

이 증례는 다발골수종으로 진단 후 보르테조밉, 멜팔란 및 프레드니솔론 항암 치료를 시행 중 심부전이 악화되었던 사례이다. 심부전 악화 원인을 감별하기 위해 문진 및 혈액 검사를 시행했으나 특별한 소견은 없었다. 심독성이 보고된 보르테조밉이 그 원인일 가능성도 있다고 판단되어 보르테조밉 중단 및 보존적 치료 후 심부전이 호전되었다. 기존에 심장 질환이 있는 환자는 보르테조밉 투여 이후에 심장 질환이 악화될 수 있으므로 이에 유의해야 하겠다. Bortezomib (Velcade®) came into the spotlight as a target therapy for multiple myeloma. It acts through reversible inhibition of intracellular proteasomes, which triggers apoptosis, with relative selectivity for malignant cells. It has been hypothesized that the accumulation of damaged proteins in myocytes impairs cardiac function. Cardiotoxicity is a rare side effect of bortezomib treatment. We report a case of reversible systolic heart failure that probably occurred after bortezomib treatment in a patient with multiple myeloma. Patients being treated with bortezomib who have previously had cardiac comorbidities should undergo routine cardiac monitoring.

정상 심기능을 보이는 노인 환자에서 정형외과 수술 전 NT-proBNP의 역할

고은정 ( Eun Jung Ko ),문재연 ( Jae Youn Moon ),임영민 ( Yeong Min Lim ),홍원정 ( Won Jung Hong ),신석표 ( Suk Pyo Shin ),김상훈 ( Sang Hoon Kim ),양우인 ( Woo In Yang ),성정훈 ( Jung Hoon Sung ),김인재 ( In Jai Kim ),임상욱 ( San 대한내과학회 2014 대한내과학회지 Vol.87 No.3

Background/Aims: Preoperative N-terminal pro-brain natriuretic peptide (NT-proBNP) is a useful predictor of postoperative cardiovascular complications. The present study investigated whether blood NT-proBNP values are suitable for predicting postoperative cardiovascular complications after non-cardiac surgery in elderly patients showing normal left ventricular (LV) function on preoperative echocardiograms. Methods: This study was performed by analyzing the medical records of elderly patients referred to the cardiology department for the purpose of assessing their cardiac function before orthopedic surgery. Of the patients who underwent echocardiography and NT- proBNP assessment simultaneously, 275 patients aged ≥ 70 years and with an LV ejection fraction of ≥ 55% were included in the study. Results: Major adverse cardiac and cerebrovascular events (MACCEs) occurred in 33 (12%) of the 275 patients, and the NT-proBNP concentration was higher in patients with complications than in those without complications (1,904.20 ± 2,300.23 vs. 530.58 ± 882.27 pg/mL, p < 0.01). The ROC area under the curve was 0.756 (95% confidence interval 0.701-0.805, p < 0.001) with an optimal cutoff of 416.3 pg/mL (69.7% sensitivity, 67.36% specificity). A multivariate analysis showed that a preoperative age of > 80 years (odds ratio, 2.313; p = 0.047) and an increased blood NT-proBNP concentration (odds ratio, 3.189; p = 0.009) were independent risk factors for the prediction of MACCEs. Conclusions: Although elderly patients scheduled to undergo non-cardiac surgery may show normal LV systolic function on echocardiography, measurement of their preoperative blood NT-proBNP concentration is useful for predicting MACCEs occurring after non-cardiac surgery. (Korean J Med 2014;87:302-310)