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진행성 췌장암을 가진 노인환자에서 Gemcitabine 항암화학요법의 안정성과 효과 - 노인에서 Gemcitabine의 안정성 -
최유이,김동욱,정재훈,이봉은,김광하,송근암,You Ie Choi,Dong Uk Kim,Jae Hoon Cheong,Bong Eun Lee,Gwang Ha Kim,Geun Am Song 대한소화기암연구학회 2013 Journal of digestive cancer reports Vol.1 No.1
Background/Aims: Gemcitabine is regarded as a reference regimen for advanced pancreatic cancer and shows relatively safe toxicity profiles compared with other cytotoxic agents. However, many oncologists are appeared to be still reluctant to treat elderly pancreatic cancer patients with cytotoxic chemotherapy because of predicted low response rate and potential adverse events. Methods: All patients who were received gemcitabine based chemotherapy between 2007 and 2010 were identified and clinical, laboratory, radiographic data were retrospectively reviewed. Patients were divided into two groups based on their ages: less than 65, and equal or more than 65 years old. Gemcitabine, at a dose of 1,000 mg per square meter of body surface area, was administered by intravenously over 30 minutes weekly for 3 weeks followed by 1 week rest, alone or along with other chemotherapeutic agents including cisplatin, capecitabine and erlotinib. Results: A total of 61 patients were identified and all patients were not eligible to receive operation because of advanced stage at diagnosis. Twenty three patients (37.7%) were equal or more than 65 year of age. Mean age was 56 years old and 71 years old in each group. Laboratory data including CA 19-9 were not significantly different. More gemcitabine monotherapy was delivered (56.5% vs. 26.3%, p=0.029) and less second or third line therapy was adminis- tered (17.4% vs. 50.0%, p=0.014) in elderly group. Cholangitis occurred and stent placement were performed similarly in both groups. Conclusion: Gemcitabine based chemotherapy can be administered safely to elderly pancreatic cancer patients and comparable response rate and progression free survival can be expected as young patients.
최유이 ( Yu Yi Choi ),이지원 ( Ji Won Yi ),강동환 ( Dong Hwahn Kahng ),서형일 ( Hyung Il Seo ),김석 ( Suk Kim ),박도윤 ( Do Youn Park ) 대한내과학회 2013 대한내과학회지 Vol.84 No.5
췌장의 AVM은 매우 드문 질환이나 원인이 명확하지 않은 복통, 반복적인 상부위장관 출혈 환자에서 감별 진단으로 고려되어야 하며, 컬러 도플러 초음파나 컴퓨터단층촬영 등의 적극적인 검사로 빠르게 진단하여 치료하는 것이 필요하다. Pancreatic arteriovenous malformations (AVMs) are rare, and most cases occur as congenital anomalies. Many patients with AVM are asymptomatic, but occasionally present with abdominal pain or gastrointestinal bleeding. The increased portal vein flow that forms these malformations can lead to portal hypertension and gastrointestinal bleeding in the absence of primary liver pathology. Early diagnosis can lead to successful surgical resection or percutaneous transarterial embolization. We report a case of a patient with pancreatic AVM in the tail of the pancreas, in which endoscopic ultrasonography was helpful. This patient presented with abdominal pain and was subsequently treated with distal pancreatectomy. (Korean J Med 2013; 84:708-712)
소화기 ; 검진 내시경 상 구불 결장의 상피하 병변으로 관찰된 충수염 1예
최유이 ( Yu Yi Choi ),김수진 ( Su Jin Kim ),강대환 ( Dae Hwan Kang ),김형욱 ( Hyung Wook Kim ),최철웅 ( Cheol Woong Choi ),오숙경 ( Sook Kyoung Oh ),신영신 ( Young Shin Shin ) 대한내과학회 2015 대한내과학회지 Vol.89 No.5
본 증례는 검진 목적의 대장내시경에서 충수돌기 개구부가 정상 소견을 보였지만, 구불결장의 점막하 병변으로 나타난 충수염의 드문 증례이다. 화농성 배액이 보이는 점막하 병변이 구불 결장에서 관찰될 때 충수염의 가능성 또한 감별진단으로 고려해 볼 수 있겠다. Acute appendicitis is common in all age groups. Although many patients with acuteappendicitis present with migrating abdominal pain, the initial presentation can be atypical and nonspecific. Unusual manifestations can lead to diagnostic delay, which is associated with increased morbidity and mortality. Colonoscopic findings suggestinga diagnosis of asymptomatic appendicitis include hyperemia and bulging at the appendiceal orifice area with surrounding mucosal edema, and drainage of pus from the appendiceal orifice. We report a case of asymptomatic perforated appendicitis and periappendiceal abscess that presented as a subepithelial sigmoid colon lesion at screening colonoscopy. On colonoscopy, a subepithelial lesion with pustular drainage surrounded by hyperemic mucosa was seen at the sigmoid colon. Computed tomography revealed appendicitis and a periappendiceal abscess with adjacent sigmoid colon wall thickening. The patient underwent an appendectomy, with a final diagnosis of a perforated appendicitis with a periappendiceal abscess. (Korean J Med 2015,89:548-552)
Acute Ectopic Pancreatitis Occurring after Endoscopic Biopsy in a Gastric Ectopic Pancreas
이성준,김광하,박도윤,최상아,이상희,최유이,전무송,송근암 대한소화기내시경학회 2014 Clinical Endoscopy Vol.47 No.5
Ectopic pancreas is a congenital anomaly and the most common type of ectopic tissue in the gastrointestinal tract. Most patients with an ectopic pancreas are asymptomatic and rarely have complications. Ectopic pancreatitis after an endoscopic biopsy has not been reported. We report a patient who developed acute ectopic pancreatitis in the stomach after an endoscopic biopsy. A 71-year-old male patient presented with a subepithelial tumor (SET) in the stomach and had no symptoms. Endoscopic ultrasonography demonstrated a 30-mm hypoechoic mural mass, lobulated margins, and anechoic duct-like lesions. To obtain proper tissue specimen, endoscopic biopsy was performed through the opening on the surface of the mass. The pathologic results confirmed an ectopic pancreas. One day after the endoscopic biopsy, he developed persistent epigastric pain. His serum amylase and lipase elevated. Computed tomography of the abdomen showed swelling of the SET and diffuse edema of the gastric wall. His condition was diagnosed as acute ectopic pancreatitis occurring after endoscopic biopsy.
이지원,김효정,최영진,설영미,강동환,최유이,박은경 대한암학회 2013 Cancer Research and Treatment Vol.45 No.3
A 37-year-old male presented with a mass measuring 2.5 cm in size in the midbrain and obstructive hydrocephalus, which had manifested as a headache and dizziness. Magnetic resonance (MR) imaging of the brain showed intermediate enhancement on T1-weighted MR imaging and a high intensity of enhancement on T2-weighted MR. Neurosurgeons performed an occipital craniotomy with partial removal of the tumor and the postoperative diagnosis was a pineal parenchymal tumor with intermediate differentiation. He had undergone irradiation with 54 Gy of radiation on 27 fractions for removal of the remaining tumor approximately one month after surgery. However,in follow-up imaging performed four months after radiotherapy, a remnant mass in the superoposterior aspect of the midbrain was found to have extended to the hypothalamus and the third ventricle. He was treated with six cycles of procarbazine,lomustine, vincristine chemotherapy. At five months since the completion of chemotherapy, the brain MR imaging showed no evidence of any remaining tumor and he no longer displayed any of his initial symptoms.
국소성 융모막암종 분화를 동반한 S상결장의 원발성 선암종
오숙경 ( Sook Kyoung Oh ),김형욱 ( Hyung Wook Kim ),강대환 ( Dae Hwan Kang ),최철웅 ( Cheol Woong Choi ),최유이 ( Yu Yi Choi ),임홍규 ( Hong Kyu Lim ),구자준 ( Ja Jun Goo ),최성열 ( Sung Yeol Choi ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.5
Primary colorectal choriocarcinoma is a rare neoplasm. Only 19 cases have been reported worldwide, most of which involved adenocarcinomas. The prognosis is usually poor, and the standard therapy for this tumor has not been established. A 61-year-old woman presented with constipation and lower abdominal discomfort. She was diagnosed with primary adenocarcinoma with focal choriocarcinomatous differentiation in the sigmoid colon and liver metastasis. Because the serum beta-human chorionic gonadotropin level was not significantly elevated, and because only focal choriocarcinomatous differentiation was diagnosed, we selected the chemotherapy regimen that is used for the treatment of metastatic colorectal adenocarcinoma. The patient survived for 13 months after the initial diagnosis. This is the first case in Korea to assess the suppressive effects of the standard chemotherapy for colorectal adenocarcinoma against coexisting colorectal choriocarcinoma and adenocarcinoma. (Korean J Gastroenterol 2015;66:291-296)