역행 경정맥 폐색술로 치료된 위정맥류

이주용 ( Jue Yong Lee ),김동준 ( Dong Joon Kim ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.1

춘천 지역의 위식도 역류질환과 역류성 식도염의 특징 -건강 검진자 연구-

이주용 ( Jue Yong Lee ),홍원기 ( Won Ki Hong ),손경민 ( Kyung Min Sohn ),김대용 ( Dae Yong Kim ),김영묵 ( Young Mook Kim ),최현희 ( Hyun Hee Choi ),최창순 ( Chang Soon Choi ),김성중 ( Seong Jung Kim ),백광호 ( Gwang Ho Baik ),김 대한내과학회 2008 대한내과학회지 Vol.74 No.4

목적: 춘천을 중심으로 강원도 북서 지역의 건강 검진자를 대상으로 하여 위식도 역류 증상의 종류별 빈도와 역류식도염, 내시경적으로 의심되는 바렛 식도의 빈도를 알아보고자 하였다. 증상의 종류별로, 내시경적 역류식도염의 유무로 분류하여 각각에서 바렛 식도, 위궤양, 십이지장궤양, 식도 열공, 흡연 및 음주 등의 생활 습관의 차이가 있는지 연구하였다. 방법: 2005년 7월 1일부터 2006년 6월 30일까지 내시경을 포함한 건강검진을 받은 총 1,011명을 연구대상으로 하였다. 설문지를 통하여 증상, 흡연, 음주, 성별, 나이, 과거 HP 치료력을 얻었으며 내시경을 통해 역류식도염, 바렛 식도, 위궤양, 십이지장궤양, 식도 열공 등을 관찰하였다. 증상 종류별로 전형적 증상군, 비전형적 증상군, 증상이 없는 무증상군과 증상의 빈도가 낮아 불편감 없는 군으로 분류하였고, 내시경적 역류식도염의 유무로 분류하여 각 군 간의 임상적 차이를 알아보았다. 결과: 춘천을 중심으로 강원 북서 지역에서 건강 검진자중, 일상 생활에 지장을 주는 정도의 가슴 쓰림과 위산 역류의 증상을 호소하는 경우는 7.5%였으며 내시경적으로 역류 식도염은 9.7%에서 관찰되었다. 바렛 식도는 6.8%에서 내시경적으로 의심되었다. 증상의 유무에 따라 내시경적 역류식도염의 유병률에 통계적 차이를 나타냈으며 성별에 의한 뚜렷한 차이를 관찰할 수 있었다. 내시경적 역류식도염의 성별에 의한 차이가 2.8:1로 남자에서 많은 것으로 관찰되었으며 이와 함께 식도 열공과 음주, 흡연, 기침도 남자에게서 보다 빈번했으며 가슴 쓰림, 속 쓰림, 기타 증상은 여자에게서 빈번히 나타났다. 결론: 증상이 있는 군에서 증상 종류에 따라 연구에 포함된 모든 항목에서 통계적인 차이가 없었고, 증상의 정도 및 빈도는 내시경적 역류식도염과 연관성이 없었다. 그러나 증상의 유무와 역류식도염과는 연관성이 있었다. 이번 연구로 춘천을 중심으로 한 강원 북서 지역의 위식도 역류병의 일면을 보았고 향후 일반 인구집단에 대한 위식도 역류병의 유병률 조사가 필요하겠다. 내시경적 역류식도염에서 지역적 유병률의 차이, 관찰자간 차이 및 실제적 증가가 있는지에 대한 연구가 필요할 것으로 보인다. Background/Aims: The aims of this study were to estimate the frequency of symptoms of gastroesophageal reflux disease and reflux esophagitis, to evaluate the difference in characteristics among groups subdivided by symptoms, and to compare clinical features between a reflux esophagitis group and a non-reflux esophagitis group in Chuncheon City. Methods: A total of 1,011 persons who underwent endoscopy for health check-up were enrolled between July 1, 2005, and June 30, 2006. All persons were given a validated, self-reported questionnaire, which inquired about the presence, frequency, and severity of typical symptoms (heartburn and acid regurgitation) and atypical symptoms. The questionnaire also inquired about smoking, alcohol intake, and Helicobacter pyroli eradication. The subjects were subdivided into typical symptomatic, atypical symptomatic, no discomfort, and asymptomatic groups. Results: The prevalence of heartburn and acid regurgitation occurring at least weekly was 7.5%. Reflux esophagitis, hiatal hernia, smoking, and alcohol intake were more common in males (p<0.05). Ninety-eight cases (9.7%) were endoscopically diagnosed as reflux esophagitis, and sixty-nine cases (6.8%) were endoscopically suspected esophageal metaplasia (ESEM). Subjects in the symptomatic group more frequently manifested reflux esophagitis than subjects in the asymptomatic group (p<0.05). Conclusions: The presence of reflux-induced symptoms is related to reflux esophagitis, but the intensity and frequency of symptoms are poor predictors of the presence or severity of endoscopic mucosal breaks.(Korean J Med 74:385-390, 2008)

증례 : 양측 부신 전이를 동반한 비소세포폐암에서 발현된 부신피질기능저하증 1예

이주용 ( Jue Yong Lee ),공승진 ( Seung Jin Kong ),전만조 ( Man Jo Jeon ),이성진 ( Seong Jin Lee ),송헌호 ( Hun Ho Song ),최문기 ( Moon Gi Choi ),이명구 ( Myung Goo Lee ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-

전신무력감, 오심, 구토 등의 비특이적 증상을 호소하여 시행한 호르몬검사 및 방사선검사에서 양측 부신 전이를 동반한 비소세포폐암에서 발현된 부신피질기능저하증 증례를 경험하였기에 이를 보고하는 바이다. Metastatic tumor is the most common malignancy in adrenal glands, and high occurrence of adrenal metastasis is closely related to its rich sinusoidal blood supply. Lung is common origin of metastatic tumor, and 42% of non-small cell lung cancer is associated with metastasis to adrenal glands. In spite of high incidence of adrenal metastasis, metastatic tumor very rarely causes adrenocortical insufficiency possibly because adrenal cortex must be almost completely destroyed before development of adrenocortical insufficiency. Symptoms of adrenocortical insufficiency such as fatigue, generalized weakness, anorexia, nausea, vomiting, abdominal pain are usually nonspecific, and insidiously occur. In addition, these symptoms are often overlooked or misdiagnosed as symptoms of cancer progression, thereby adrencortical insufficiency is not properly managed. We report a 68-year-old man who presented with nonspecific symptoms, and was diagnosed as adrenocortical insufficiency associated with bilateral adrenal metastasis of non-small cell lung cancer by hormonal and radiologic studies including rapid ACTH stimuation test and furosemide challenge test. (Korean J Med 69:S846-S850, 2005)

비알코올성 지방간질환과 대장 신생물과의 연관성

이주용 ( Jue Yong Lee ),김자원 ( Ja Won Kim ) 대한내과학회 2013 대한내과학회지 Vol.84 No.3

Background/Aims: Metabolic syndrome is associated with an increased risk of colorectal cancer. Non-alcoholic fatty liver disease (NAFLD) is regarded as a hepatic manifestation of metabolic syndrome. Increased echogenicity suggesting NAFLD is a frequent incidental finding on ultrasound examination. This study examined whether NAFLD is related to colorectal neoplasia. Methods: We reviewed 1,938 consecutive individuals who underwent screening colonoscopy at Changwon Fatima Hospital between Jan 2009 and Sept 2011. The individuals were divided into adenomatous polyp (Group A; n = 494) and control (Group B; n = 1,444) groups. NAFLD was diagnosed by increased echogenicity on abdominal ultrasound. Results: The prevalence of NAFLD was 171 (34.6%) in group A and 336 (23.3%) in group B. Compared with normal subjects, group A subjects were more likely to be men, older, and have a higher body mass index (BMI), blood pressure, waist circumference, fasting glucose, uric acid, triglyceride, HbA1c, Hb and γGT levels, and a higher prevalence of NAFLD, metabolic syndrome, diabetes mellitus, and hypertension. In a multiple logistic regression analysis, older age (≥ 50 years) (OR 2.051; 95% CI 1.647-2.553), male sex (OR 2.419; 95% CI 1.837-3.184), and prevalence of NAFLD (OR 1.289; 95% CI 1.004-1.655) were associated with an increased risk of adenomatous polyps. Conclusions: NAFLD is associated with a high prevalence of colorectal neoplasia. A fatty liver on abdominal ultrasound might predict the development of colorectal adenomatous polyps and cancer. (Korean J Med 2013;84:363-371)

체외생명보조를 이용한 중증 급성호흡곤란증후군 치료

김영묵 ( Young Mook Kim ),이주용 ( Jue Yong Lee ),이명구 ( Myung Goo Lee ),이창률 ( Chang Youl Lee ),김고운 ( Go Woon Kim ),손경민 ( Kyoung Min Sohn ),양하나 ( Ha Na Yang ),김대용 ( Dae Yong Kim ),최현희 ( Hyun Hee Choi ),김형수 ( 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.6

The incidence of acute respiratory distress syndrome (ARDS) has been estimated worldwide to range from 1.7 to 75 cases per 100,000. There are many treatments for ARDS, but only the low tidal volume strategy is based on strong clinical evidence from randomized clinical trials. The efficacy of extracorporeal life support (ECLS) in adults remains controversial. Ongoing clinical trials and research have shown a benefit for its use to salvage severe ARDS patients that are in failure with conventional treatment. We encountered a 41-year-old woman who developed ARDS induced by pneumococcal pneumonia. Despite conventional mechanical ventilation in the emergency room, severe hypoxia remained. We treated the patient immediately with ECLS. The patient has almost fully recovered, and was discharged from a 177-day stay at our hospital. (Tuberc Respir Dis 2007;63:526-530)

일과성 중간 좌심실 풍선 확장 증후군 1예

최현희 ( Hyun Hee Choi ),김영묵 ( Young Mook Kim ),김대용 ( Dea Yong Kim ),이주용 ( Jue Yong Lee ),윤인상 ( In Sang Yun ),한상진 ( Sang Jin Han ),홍경순 ( Kyung Soon Hong ) 대한내과학회 2008 대한내과학회지 Vol.74 No.3

Transient left ventricular apical ballooning syndrome is also known as takotsubo cardiomyopathy, and this is characterized by transient wall-motion abnormalities involving the left ventricular apex without significant stenosis on the coronary angiogram. We report here on a new variant of transient left ventricular ballooning in which only the mid-ventricle was affected. The patient initially presented with dyspnea and she had wall-motion abnormalities involving the mid-ventricle with hypercontractility of the apical and basal segments in the absence of a significant coronary artery stenosis. Emotional or physical stress or other preceding triggering factors might play a key role in this cardiomyopathy, but the precise etiology remains unknown. So far, the cases of this syndrome have been reported only among the North America Caucasian population and the Japanese population. (Korean J Med 74:321-324, 2008)

갑상선기능항진증에 동반된 급성 E형 간염 2예

공승진 ( Seung Jin Kong ),민슬기 ( Seul Ki Min ),김익근 ( Ick Keun Kim ),구현철 ( Hyun Cheol Koo ),박인일 ( In Il Park ),한재필 ( Jae Pil Han ),이주용 ( Jue Yong Lee ),김대용 ( Dae Yong Kim ),이성진 ( Seong Jin Lee ),백광호 ( Gwan 대한소화기학회 2006 대한소화기학회지 Vol.47 No.1

급성 췌장염으로 발견된 췌장의 관내 관유두상 종양

김은영,,신재욱,주연호,이주용,김지훈,박윤정,배명남,배상묵 Ewha Womans University School of Medicine 2013 EMJ (Ewha medical journal) Vol.36 No.S

Intraductal tubulopapillary neoplasm (ITPN) of the pancreas has been recently reported. It is very rare, therefore clinical behavior and prognosis has not yet been characterized. We experienced a case of ITPN of the pancreas which presented with acute pancreatitis and treated with Whipple’s operation. Histopathologic finding showed papillary hyperplasia with carcinomatous change. The tumor recurred after 47 month of operation, and she underwent total pancreatectomy. Pathologic finding revealed tubulopapillary growth with high grade dysplasia. Immunohistochemial staining was not performed, however gross and microscopic findings were compatible with ITPN of the pancreas. We report a case of ITPN of the pancreas.