증례 : 쇼그렌 증후군에 병발한 다발성 위유암종 1예

조근종 ( Keun Jong Cho ),김진수 ( Jin Soo Kim ),김창환 ( Chang Whan Kim ),김재광 ( Jae Kwang Kim ),한석원 ( Sok Won Han ),정인식 ( In Sik Chung ),김진아 ( Jean A Kim ) 대한내과학회 2006 대한내과학회지 Vol.71 No.5

유암종은 장크롬친화성 세포에서 발생하는 비교적 드문 내분비 종양으로 그 중 위유암종은 위내시경 검사의 증가로 발생률이 점차 증가하고 있다. 위유암종은 고가스트린혈증을 동반한 만성 자가면역성 위축성 위염이나 가스트린종에 동반된 경우에 대부분 다발성이며, 예후는 고가스트린혈증이 없이 단일 종괴를 형성하는 경우에 비하여 양호하다. 위유암종은 흔히 내분비질환이나 다른 종양에 병발하나 자가면역성 위축성 위염 외에 자가면역성 질환에 동반되는 예는 드물다. 쇼그렌 증후군은 주로 타액선을 침범하는 자가면역성 외분비병증으로 거의 모든 장관을 침범할 수 있으며 만성 위축성 위염은 가장 흔히 동반되는 위장관계 질환으로, 이로 인한 고가스트린혈증과 창자크롬친화세포의 과형성으로 유암종이 발생할 수 있으나 국내외적으로 아직까지 이에 대한 보고는 없다. 저자들은 44세의 여자 환자에서 쇼그렌 증후군에 동반된 다발성 위유암종을 1예 경험하였기에 문헌고찰과 함께 보고하는 바이다. Carcinoid tumors are rare endocrine neoplasms arising from the enterochromaffin or enterochromaffin-like cells. Gastric carcinoids associated with autoimmune atrophic gastritis and hypergastrinemia, are usually multiple and the prognosis are better compared to solotary lesions with out hypergastrinemia. Gastric carcinoids are commonly associated with other endocrine disorders or tumors, but any associations with autoimmune disorders other than autoimmune atrophic gastritis have rarely been reported. Sjogren`s syndrome is an autoimmune exocrinopathy that primarily affects the salivary glands, but it can also involve almost any other part of the gut. The most common form of gastrointestinal involvement in Sjogren`s syndrome is chronic atrophic gastritis, which can lead to hypergastrinemia and the subsequent development of carcinoid. However, gastric carcinoid tumor associated with Sjogren`s syndrome has not yet been reported on. To the best of our knowledge, this is the first such case in the world. We report on this case along with review of the related literature.(Korean J Med 71:551-557, 2006)

운동 후 지연된 근통종과 근손상의 지표에 관한 연구

조근종,최재청,Cho Keun-Jong,Choi Jae-Cheong 대한물리치료학회 1998 대한물리치료학회지 Vol.10 No.1

The purpose of this study was to analyze the delayed muscle soreness after exercise and the indicators of muscle damage. Subjects of this study were 9 male students. Some muscle enzymes and others(GOT, LDH, ALD, CPK in serum, WBC, ESR) that known as the indicators of muscle damage were measured before exercise. After measurements they run on a treadmill ($incline:25\%$, speed;3.5miles/h) for 7 min. on an average. The intensity of this kind of exercise was $90.5\%$ of maximal exercise intensity. After exercise, same indicators were measured at the just after exercise, 24hr after, 48hr after, 72hr after. Also muscle soreness level was evaluated at same intervals by make use of Modified Abraham's scale. The result was as follow: There was no relationships between muscle soreness and the indicators of muscle damage but ALD was the most important indicator that can be explains the muscle soreness very well.

인터페론 용량에 따른 만성 B형 간염 치료에 대한 유효성 평가

김태호 ( Tae Ho Kim ),김창환 ( Chang Whan Kim ),조근종 ( Keun Jong Cho ),한석원 ( Sok Won Han ),정대영 ( Dae Young Cheong ),김진일 ( Jin Il Kim ),최규용 ( Kyu Yong Choi ) 대한내과학회 2007 대한내과학회지 Vol.73 No.5

목적: 만성 B형 간염은 국내에 그 발생 빈도가 높은 질환으로 만성 간질환, 간경화, 그리고 간암의 주요원인으로 간주되고 있다. 전세계적으로 많은 노력에도 아직까지 완전한 치료법은 없는 상태이다. 4~6개월간의 인터페론 치료로 25~40%의 장기적인 관해를 유도할 수 있으며, 항바이러스 효과뿐 아니라 항증식효과와 면역조절효과가 있는 것으로 알려져 있다. 또한 라미부딘 등 타 약제에서는 관찰되지 않는 HBsAg의 후기소실과 HBeAg에 대한 치료반응 이후 만성 B형 간염의 자연 경과를 향상시키는 효과가 있는 것으로 알려져 있다. 저자들은 만성 B형 간염환자에서 인터페론(Interferon α-2b)의 용량 차이에 따른 치료효과에 차이가 있는지를 보고자 본 연구를 시행하였다. 방법: 만성 B형 간염 환자들 중 HBsAg, HBeAg, hepatitis B virus DNA가 양성이고, 조직생검으로 만성 B형 간염 이외의 다른 간질환이 확인되지 않은 18세 이상 65세 이하의 24명의 환자를 대상으로 하였다. 치료는 이중 맹검법으로 두 군으로 나누어 1주에 3회 각각 인터페론을 500만 Unit과 1000만 Unit을 투여하였다. 16주 또는 24주간의 치료기간과 이후 12개월의 관찰기 동안 환자는 임상적 및 혈청학적으로 추적관찰하였다. 관찰기간이 끝난 후 2차 조직생검을 하였다. 결과: 연구결과 연구 종료시점에 HBeAg 혈청 전환율은 25.0%, HBeAg 음전율은 29.2%, hepatitis B virus DNA 음전율은 29.2%, 조직학적 호전은 50%에서 관찰되었다. 그러나 인터페론의 용량에 따른 치료 효과는 HBeAg의 음전율과 HBV DNA 소실률에서 두 군 간에 의미있는 통계적 차이는 보이지 않았다. 또한 조직학적인 차이도 두 군 간에 의미있는 통계적 차이는 보이지 않았다. 그러나 좋은 치료예측인자로 알려진 낮은 HBV DNA 농도와 높은 ALT (alanine aminotransferase)값에 따른 치료효과도 치료 전 ALT 값이 낮은 경우 조직학적 호전율이 의미있게 높게 나온 것을 제외하고는 두 군 간에 의미있는 차이를 보이지 않았다. 결론: 인터페론 용량에 따른 치료효과의 차이는 유의하지 않았다. 또한 치료 예측인자에 따른 치료효과의 차이도 유의하지 않았다. 다만 치료 전 ALT 값이 낮은 경우 조직학적 호전률이 높았으며 모든 치료군에서 관찰기 동안 반응률이 상승되는 후기 반응을 나타내었다. Background: Infection with hepatitis B virus has been a major health problem. Chronic viral hepatitis B is the principal cause of chronic liver disease, cirrhosis, and hepatoma. A number of studies have showed that a course of interferon (INF) treatment induces a long-term remission in 20~40% of patients. Compared with the use of lamivudine, INF therapy is followed by delayed clearance of HBsAg and the treatment improves the natural history of chronic hepatitis B. The aim of this study is to evaluate the efficacy of the use of different dosages of alpha-interferon treatment in patients with chronic hepatitis B. Methods: We conducted a one-and-a-half year, randomized clinical trial of interferon in 24 Korean chronic hepatitis B patients with a positive HBeAg, and excluded other liver problems with biopsies. The patients were randomly assigned to receive 5 million units (n=10) of interferon-α2b and 10 million units (n=14) of interferon-α2b three times weekly for 16/24 weeks. Patients were followed for 12 months after the cessation of the therapy, and the patients received a second biopsy. Results: After treatment with interferon, 29.2% of the patients became negative for HBeAg and the presence of HBV DNA. Fifty percent of the patients showed histological improvement. The differences of the loss of HBeAg, HBV DNA and histological improvement between the two groups were not significant. HBV DNA and ALT were not valuable as predictive variables in treatment efficacy. However, the rate of histological improvement in patients with a low ALT level was higher. Conclusions: The administration of different doses of interferon-α2b during treatment in patients with chronic hepatitis B did not show a significant difference in efficacy.(Korean J Med 73:464-473, 2007)

가상대장내시경검사를 이용해 진단한 장관포상기종 1예

함주호 ( Joo Ho Ham ),김태호 ( Tae Ho Kim ),한석원 ( Sok Won Han ),조근종 ( Keun Jong Cho ),최선욱 ( Son Ook Choi ),백정선 ( Jung Sun Pack ),양성은 ( Seong Eun Yang ),김상희 ( Sang Hee Kim ),양승아 ( Seung Ah Yang ),이윤정 ( Yune 대한소화기학회 2007 대한소화기학회지 Vol.50 No.5

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple gas filled cysts in the intestinal wall. The diagnosis of PCI is usually made by colonoscopy, histology, or radiologic findings. We report a case of PCI in a 35-year-old man. The patient initially complained of watery diarrhea and abdominal bloating for 2 weeks. Simple abdominal X-ray demonstrated numerous, small, round, air densities on the right upper abdomen along the ascending and proximal transverse colon. Colonoscopy revealed numerous, 5-20 mm sized, sessile poly-poid, balloon-like distended, protruding subepithelial masses covered with normal colonic mucosa from cecum to proximal transverse colon. We performed a CT colonoscopy and confirmed PCI with multiple air-filled cystic masses along the colonic wall from cecum to proximal transverse colon. The patient was treated with antibiotics and oxygen inhalation for 2 weeks. Follow-up CT colonoscopy revealed marked regression in the number and size of the air-filled cystic masses. Herein, we report the first case of the PCI in Korea diagnosed by CT colonoscopy. Follow-up evaluation with CT colonoscopy was performed after the treatment of the PCI. CT colonoscopy is a useful non-invasive diagnostic tool for the diagnosis of pneumatosis cystoides intestinalis. (Korean J Gastroenterol 2007;50:334-339)

내시경적 절제로 완치된 기관지내 섬유상피성 용종

강지영 ( Ji Young Kang ),강지호 ( Ji Ho Kang ),이상학 ( Sang Haak Lee ),전연주 ( Youn Joo Jeon ),조근종 ( Keun Jong Cho ),김의형 ( Eui Hyung Kim ),김관형 ( Kwan Hyoung Kim ),문화식 ( Hwa Sik Moon ),송정섭 ( Jeong Sup Song ),박성학 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.59 No.6

운동 후 지연된 근통증과 근손상의 지표에 관한 연구

조근종,최재청 대한물리치료학회 1998 대한물리치료학회지 Vol.10 No.1

The purpose of this study was to analyze the delayed muscle soreness after exercise and the indicators of muscle damage. Subjects of this study were 9 male students. Some muscle enzymes and others(GOT, LDH, ALD, CPK in serum, WBC, ESR) that known as the indicators of muscle damage were measured before exercise. After measurements they run on a treadmill (incline:25%, speed:3.5miles/h) for 7 min. on an average. The intensity of this kind of exercise was 90.5% of maximal exercise intensity. After exercise, same indicators were measured at the just after exercise, 24hr after, 48hr after, 72hr after. Also muscle soreness level was evaluated at same intervals by make use of Modified Abraham's scale. The result was as follow: There was no relationships between muscle soreness and the indicators of muscle damage but ALD was the most important indicator that can be explains the muscle soreness very well.