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증례 : 소화기 ; 이중풍선 소장내시경으로 진단한 회장 해면상 혈관종 1예
윤귀준 ( Gui Jun Yun ),변정식 ( Jeong Sik Byeon ),예병덕 ( Byong Duk Ye ),명승재 ( Seung Jae Myung ),양석균 ( Suk Kyun Yang ) 대한내과학회 2009 대한내과학회지 Vol.77 No.3
소장 혈관종은 매우 드문 질환으로 90% 이상의 환자가 장출혈 등의 증상을 보이나 10%에서는 증상 없이 우연히 발견된다. 복부전산화단층촬영에서 우연히 발견된 소장 종괴의 감별 진단을 위해 이중풍선 소장내시경을 시행하여 혈관종으로 진단한 후 복강경수술로 절제한 증례를 통해 이중풍선 소장내시경이 혈관종을 비롯한 드문 소장 종양의 감별진단 및 치료 방침 결정에 유용함을 경험하였기에 문헌고찰과 함께 보고한다. Hemangiomas of the small intestine are uncommon benign tumors, of which 90% present with symptoms such as acute or chronic recurrent gastrointestinal bleeding, while 10% of the cases are asymptomatic. The preoperative diagnosis is challenging. We report a case of ileal hemangioma detected incidentally on abdominopelvic computed tomography (CT). In this case, we performed double balloon enteroscopy to confirm the diagnosis before surgical resection, which helped with the therapeutic plan. (Korean J Med 77:333-337, 2009)
연구논문 : C형간염바이러스 유전자형 1b에 감염된 한국인 환자에서 인터페론 감수성 결정 영역의 유전자 돌연변이 양상
진영주 ( Young Joo Jin ),박윤경 ( Yoon Kyung Park ),윤귀준 ( Gui Jun Yun ),이한주 ( Han Chu Lee ),정숙향 ( Sook Hyang Jeong ),김강모 ( Gang Mo Kim ),임영석 ( Young Suk Lim ),정영화 ( Young Hwa Chung ),이영상 ( Yung Sang Lee ),서 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.2
Background/Aims: The treatment response to interferon could differ with mutations in the interferon-sensitivity-determining region (ISDR) in patients infected with hepatitis C virus (HCV) genotype-1b (HCV-Ib). We examined the pattern of ISDR mutations and analyzed whether the number of amino acid substitutions influences the treatment response to peginterferon plus ribavirin in chronic hepatitis or cirrhotic patients infected with HCV-Ib. Methods: The study population comprised 52 patients who visited Seoul Asan Medical Center and Seoul National University Bundang Hospital from January 2006 to December 2008 and who received peginterferon alpha-2a (n=37) or -2b (n=15) plus ribavirin, and whose serum was stored. We analyzed the early virologic response, end-of-treatment response, and sustained virologic response (SVR), and examined the ISDR using direct sequencing. Results: The proportions of patients with ISDR mutation types of wild (0mutations), intermediate (1-3 mutations), and mutant (≥4 mutations) were 50.0%, 42.3%, and 7.7%,respectively, and the corresponding SVR rates were 63%, 50%, and 67% (p>0.05). The SVR rates were 59.4% and 50.0% in patients with <2 and ≥2 mutations, respectively (p>0.05). On univariate analysis, age was the only predictive factor for SVR (p=0.016). The pretreatment HCV RNA titer tended to be lower in those with SVR, but without statistical significance (p=0.069). Conclusions: The frequency of ISDR mutations was low in our cohort of Korean patients infected with HCV-Ib. Therefore, ISDR mutations might not contribute to the response to treatment with peginterferon plus ribavirin.
오련,송은희,박기호,조오현,김탁,윤귀준,손병석,성흥섭,김미나,김양수,우준희 대한감염학회 2008 감염과 화학요법 Vol.40 No.5
Cryptococcosis is a disseminated infection caused by Cryptococcus neoformans. It usually causes pulmonary infection and meningitis in immunocompromised patients. However, osteomyelitis due to C. neoformans is extremely rare. It is generally known that cryptococcal osteomyelitis is a complication of disseminated cryptococcosis, appearing in 5-10%. We experienced a case of cryptococcal osteomyelitis with paraspinal abscess in a liver transplant patient.