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Gastric Cancer and Concomitant Gastric Tuberculosis: A Case Report
강혁조,장유진,이영석,목영재 대한위암학회 2012 Journal of gastric cancer Vol.12 No.4
Gastric tuberculosis is rare even in the endemic areas of tuberculosis, and can mimic neoplasm by causing elevation of the mucosa with or without ulceration. Here, we report a case in which a 54-year-old female patient admitted for resection of early gastric cancer was found to have coexisting histopathologically and bacteriologically confirmed gastric cancer and tuberculosis.
김강혁,조정우,정승환,김진수,박재억,김창현 대한구강악안면병리학회 2016 대한구강악안면병리학회지 Vol.40 No.5
Oral hyperpigmentation is common in patients older 40 years. But lesions in a newborn are unusual and congenital melanotic macule of the tongue has rarely been reported. A 2-month-old infant with 3 pigmented lesion on the right side of the dorsal tongue was evaluated. They were brown black but not homogeneous in color, smooth, nonblanchable, and nonpalpable, with irregular margins. We recommend excisional biopsy under general anesthesia because of possibility of malignancy, but parents refuse invasive procedure. On a following-up examination of the child at the age of 1 year, the pigmented lesions were unchanged. We report a case of congenital melanotic macules on the tongue and a review of literature about the lesion.
김강혁,조비룡,신동욱,황승식,이혜진,안은미,윤재문,정윤희,남유선 대한의학회 2015 Journal of Korean medical science Vol.30 No.8
In order to increase inhaled corticosteroid (ICS) use and to reduce hospitalization, emergency department visits and ultimately the economic burden of asthma, “Korean Asthma Management Guideline for Adults 2007” was developed. To assess the guideline effects on physician’s ICS prescription for asthma, we conducted segmented regression and multilevel logistic regression using National Health Insurance claims database of outpatient visits from 2003 to 2010. We set each quarter of a year as a time unit and compared ICS prescription between before and after guideline dissemination. A total of 624,309 quarterly visits for asthma was observed. The ICS prescription rate before and after guideline dissemination was 13.3% and 16.4% respectively (P < 0.001). In the segmented regression, there was no significant guideline effect on overall ICS prescription rate. In multilevel logistic regression analyses, the effect of guideline on overall ICS prescription was not significant (odds ratio, 1.03; 95% CI, 1.00-1.06). In subgroup analysis, ICS prescription increased in secondary care hospitals (odds ratio, 1.15; 95% CI, 1.02-1.30) and in general hospitals (odds ratio, 1.10; 95% CI, 1.04-1.16). However, in primary clinics, which covered 81.7% of asthma cases, there was no significant change (odds ratio, 0.98; 95% CI, 0.94-1.02). From the in-depth interview, we could identify that the reimbursement criteria of the Health Insurance Review and Assessment Service and patient’s preference for oral drug were barriers for the ICS prescription. The domestic asthma clinical guideline have no significant effect on ICS prescription, especially in primary clinics.
Congenital Melanotic Macules of the Tongue: Case Report and Literature Review
김강혁,조정우,정승환,김진수,박재억,김창현 대한구강악안면병리학회 2016 대한구강악안면병리학회지 Vol.40 No.5
Oral hyperpigmentation is common in patients older 40 years. But lesions in a newborn are unusual and congenital melanotic macule of the tongue has rarely been reported. A 2-month-old infant with 3 pigmented lesion on the right side of the dorsal tongue was evaluated. They were brown black but not homogeneous in color, smooth, nonblanchable, and nonpalpable, with irregular margins. We recommend excisional biopsy under general anesthesia because of possibility of malignancy, but parents refuse invasive procedure. On a following-up examination of the child at the age of 1 year, the pigmented lesions were unchanged. We report a case of congenital melanotic macules on the tongue and a review of literature about the lesion.
이은경,강혁조,임명철,박보영,박수진,정소연,이시연,강한성,박상윤,박보람,주정남,한재홍,공선영,이은숙 대한암학회 2019 Cancer Research and Treatment Vol.51 No.1
Purpose The purpose of this study was to investigate decision patterns to reduce the risks of BRCArelated breast and gynecologic cancers in carriers of BRCA pathogenic variants. We found a change in risk-reducing (RR) management patterns after December 2012, when the National Health Insurance System (NHIS) of Korea began to pay for BRCA testing and riskreducing salpingo-oophorectomy (RRSO) in pathogenic-variant carriers. Materials and Methods The study group consisted of 992 patients, including 705 with breast cancer (BC), 23 with ovarian cancer (OC), 10 with both, and 254 relatives of high-risk patients who underwent BRCA testing at the National Cancer Center of Korea from January 2008 to December 2016.We analyzed patterns of and factors in RR management. Results Of the 992 patients, 220 (22.2%) were carriers of BRCA pathogenic variants. About 92.3% (203/220) had a family history of BC and/or OC, which significantly differed between BRCA1 and BRCA2 carriers (p < 0.001). All 41 male carriers chose surveillance. Of the 179 female carriers, 59 of the 83 carriers (71.1%) with BC and the 39 of 79 unaffected carriers (49.4%) underwent RR management. None of the carriers affected with OC underwent RR management. Of the management types, RRSO had the highest rate (42.5%) of patient choice. The rate of RR surgery was significantly higher after 2013 than before 2013 (46.3% [74/160] vs. 31.6% [6/19], p < 0.001). Conclusion RRSO was the preferred management for carriers of BRCA pathogenic variants. The most important factors in treatment choice were NHIS reimbursement and/or the severity of illness.