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건강한 성인에서 Sulfate Free Polyethylene Glycol로 대장내시경 전처치 후 발생한 저나트륨혈증 1예
옥경선,김유선,장원철,정태엽,허진국,류수형,이정환,문정섭 대한소화기내시경학회 2008 Clinical Endoscopy Vol.37 No.4
Polyethylene glycol (PEG) 용액은 대장내시경의 전처치제로서 대장정결도가 우수하고 Sodium Phosphate (NaP) 용액에 비해 전해질 불균형을 유발하지 않는다는 점에서 널리 사용되어 왔다. 그러나 양이 많고 짠 맛으로 환자의 순응도가 좋지 않아 기존의 PEG 용액에서 sodium sulfate를 제거해 짠 맛을 줄인 sulfate free PEG (SF-PEG) 용액이 최근 국내에도 도입되어 임상에서 사용되고 있다. SF-PEG 용액은 기존의 PEG 용액에 비해 맛은 개선되었으나 여전히 양이 많고 아직까지 부작용에 대한 연구가 부족하다. 지난 수년간 기존의 PEG 용액으로 전처치 후 저나트륨혈증이 유발된 증례가 드물게 보고되고 있으며 대부분 선행요인을 동반하고 있다. 저자들은 국내에서는 처음으로 건강한 성인 여자에서 SF-PEG 용액(Colyte-FⓇ) 4 L로 전처치 후 발생한 심각한 저나트륨혈증을 경험하였기에 문헌고찰과 함께 보고한다.
옥경선,김광하,박도윤,이현정,전혜경,백동훈,이봉은,송근암 거트앤리버 소화기연관학회협의회 2016 Gut and Liver Vol.10 No.4
Background/Aims: Magnifying endoscopy with narrow band imaging (ME-NBI) is a useful modality for the detailed visualization of microsurface (MS) and microvascular (MV) structures in the gastrointestinal tract. This study aimed to determine whether the MS and MV patterns in ME-NBI differ according to the histologic type, invasion depth, and mucin phenotype of early gastric cancers (EGCs). Methods: The MS and MV patterns of 160 lesions in 160 patients with EGC who underwent ME-NBI before endoscopic or surgical resection were prospectively collected and analyzed. EGCs were categorized as either differentiated or undifferentiated and as either mucosal or submucosal, and their mucin phenotypes were determined via immunohistochemistry of the tumor specimens. Results: Differentiated tumors mainly displayed an oval and/or tubular MS pattern and a fine network or loop MV pattern, whereas undifferentiated tumors mainly displayed an absent MS pattern and a corkscrew MV pattern. The destructive MS pattern was associated with submucosal invasion, and this association was more prominent in the differentiated tumors than in the undifferentiated tumors. MUC5AC expression was increased in lesions with either a papillary or absent MS pattern and a corkscrew MV pattern, whereas MUC6 expression was increased in lesions with a papillary MS pattern and a loop MV pattern. CD10 expression was more frequent in lesions with a fine network MV pattern. Conclusions: ME-NBI can be useful for predicting the histopathology and mucin phenotype of EGCs.
대장 용종에서 렙틴 발현에 따른 임상병리학적인 특성의 차이
옥경선 ( Kyung Sun Ok ),김유선 ( You Sun Kim ),김형훈 ( Hyung Hun Kim ),류수형 ( Soo Hyung Ryu ),이정환 ( Jung Hwan Lee ),문정섭 ( Jeong Seop Moon ),강윤경 ( Yun Kyung Kang ) 대한소화기학회 2010 대한소화기학회지 Vol.56 No.1
Background/Aims: Colorectal adenoma and cancer are known to be associated with obesity. Leptin, an adipocyte-derived hormone that plays a crucial role in obesity has been suggested as a growth factor in colon cancer. However, the association between adenoma and leptin remains controversial. We evaluated the leptin expression in human colorectal adenoma and its correlation to clinicopathologic factors. Methods: Leptin expression was assessed by immunohistochemistry in 91 samples of colorectal adenoma larger than 5 mm, which were removed by endoscopic polypectomy. All patients underwent colonoscopy for cancer screening at Seoul Paik Hospital from 2007 to 2008 and we only included the patients less than 50 years of age. Leptin expression and its relationship with clinicopathologic features were analyzed. Results: Eighty samples were available for the interpretation of leptin expression and showed positive in 42 (52.5%) cases and negative in 38 (47.5%) cases. As body mass index (BMI) increased based on World Health Organization (WHO) classification the positivity of leptin expression also increased (ptrend=0.02), in leptin positive group, the correlation of leptin expression with adenoma size and histological showed positive tendency without statistical significance. Conclusions: Leptin expression of colorectal adenoma was associated with BMI. The question of whether leptin contributes to colorectal adenoma development is unresolved and will require additional studies. (Korean J Gastroenterol 2010;56:20-26)
Carbamazepine으로 유발된 Bronchiolitis Obliterans Organizing Pneumonia
옥경선 ( Og Gyeong Seon ),박봉건 ( Park Bong Geon ),김희숙 ( Kim Hui Sug ),이혜경 ( Lee Hye Gyeong ),진성림 ( Jin Seong Lim ),진재용 ( Jin Jae Yong ),이혁표 ( Lee Hyeog Pyo ),김주인 ( Kim Ju In ),최수전 ( Choe Su Jeon ),염호기 ( Y 대한결핵 및 호흡기학회 2000 Tuberculosis and Respiratory Diseases Vol.48 No.5
위절제술 후 발생한 거적아구성 빈혈 12예에 대한 고찰
강풍,옥경선,김준희 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Objective: The occurrence of megaloblastic anemia, following gastric cancer surgery depends on the surgical procedures and the duration after operation. In Korea only a few studies of anemia following gastrectomy have been reported. Here we present twelve cases of vitamin B12 deficiency megaloblastic anemias following gastrectomy due to gastric cancer. Methods: We studied twelve megaloblastic anemia patients following gastrectomy from January 1993 to December 1999. Clinical manifestations and laboratory findings were checked. Results: Out of 12 cases two patients received subtotal gastrectomy. The mean duration from surgery to megaloblastic anemia occurrence was 73 months. The mean duration of subtotal gastrectomy patient was 37 months. Conclusion: There was no relationship between the type of gastric surgery and interval of anemia occurrence. No common specific laboratory abnormalities were checked except high LDH.
소장 출혈을 유발한 Peutz-Jeghers 용종의 캡슐내시경 진단 및 이중풍선 소장내시경에 의한 용종절제술 1예
이종성,장원철,옥경선,정태엽,허진국,류수형,이정환,김유선,문정섭 대한소화기내시경학회 2007 Clinical Endoscopy Vol.35 No.6
Peutz-Jeghers syndrome is an autosomal dominant hereditary disease that's characterized by hamartomatous polyps of the gastrointestinal tract and mucocutaneous melanin pigmentation. Hamartomatous polyps can arise anywhere in the gastrointestinal tract, but they are most common in the small intestine. The major symptoms of Peutz-Jeghers syndrome are abdominal pain, intussusception and anemia due to gastrointestinal bleeding, which are all caused by harmatomatous polyp. Capsule endoscopy has been reported to have a higher diagnostic yield than small bowel barium radiography for patients with Peutz-Jeghers syndrome and who have small bowel polyp. Small bowel polyp in patients with Peutz-Jeghers syndrome can be resected by double balloon enteroscopy without laparotomy. We report here on a patient with melena that was caused by small bowel polyps, and this was found by using capsule endoscopy. Polyp in the distal ileum was resected by using colonoscopy and the patient was diagnosed as suffering with Peutz-Jeghers syndrome. The other proximal ileum polyp was resected by using double balloon enteroscopy without complication. (Korean J Gastrointest Endosc 2007;35:424-428) Peutz-Jeghers 증후군은 주로 상염색체 우성유전을 하며 위장관에 다발성 과오종을 형성하고 피부점막에 색소 침착이 특징적인 질환으로 용종은 소화관 어디에서나 생길 수 있으나 소장에서 가장 흔하다. 증상으로 용종에 의한 장폐색과 장중첩증으로 인한 복부 동통이 흔하고 위장관 출혈을 유발할 수 있다. Peutz-Jeghers 증후군에서 발생하는 소장 용종의 진단에서 최근 캡슐내시경 검사가 종래의 바륨 소장조영술보다 민감도가 높다는 보고와 소장 용종을 이중풍선 소장내시경으로 제거한 보고가 있다. 저자들은 반복적인 흑색변을 주소로 내원한 환자에서 캡슐내시경 검사를 통해 발견된 회장 원위부 용종을 대장내시경을 이용하여 절제 후 Peutz-Jeghers 증후군으로 진단하고 남아 있는 소장 용종을 이중풍선 소장내시경으로 합병증 없이 제거하였기에 보고하는 바이다.