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당뇨병 환자에서 Tc - 99m - DISIDA Scintigraphy 를 이용한 담낭의 기능분석
황인섭(In shup Hwang),류광현(Kwang Hyun Rhu),김홍남(Hong Nam Kim),노영호(Young Ho Rho),한신(Sin Han),김윤권(Youn Kwon Kim),김소연(So Yon Kim),조민구(Min Koo Cho),이권전(Gwon Jun Lee) 대한내과학회 1998 대한내과학회지 Vol.54 No.4
N/A Objectives : Diabetic autonomic neuropathy is a common complication of long standing diabetes mellitus and is well known to induce the motor dysfunction of cardiovascular system, genitourinary system and digestive system. Although many studies have done to evaluate the diabetic autonomic neuropathy, gallbladder motor function and biliary dynamic study to evaluate the change of gallbladder function in diabetic patients is relatively rare. This study was performed to measure the gallbladder ejection fraction using Tc- 99m-DISIDA with fatty meal in order to evaluate the gallbladder motor function in diabetic patients and to examine the usefulness of it in analyzing diabetic autonomic neuropathy. Methods : 51 diabetic patients(males 31, females 18, mean age 57yr(36-77yr)) and 1H control subjects(males 14, females 4, mean aged 47yr(31-70yr)) without gallstone and impaired liver function were enrolled in our study. Also the diabetic patients were categorized by age, disease duration, body weight and diabetic complications such as retinopathy, peripheral neuropathy and cardiovascular autonomic neuropathy accompanying with or not. Results : 1) Median value and interquartile range of gallbladder ejection fraction(%) were 66%(48-79%) in diabetic patients group and 75%(64-80%) in control subjects. There was no statistically significant difference between the two groups, but the mean value of diabetic patients was slightly lower than that of control subjects. 2) There was no significant difference between the two groups in mean value of gallbladder ejection fraction in every age group(P>0.05). 3) Median value of gallbladder ejection fraction in diabetic groups with less than 10 years of duration (both under 5 years and 5 to 10 years groups) was similar to that of control subjects. However in patients whose diabetic conditions last more than 10 years, the median range of gallbladder ejection fraction was significantly lower than that of control subjects(P<0.05). 4) Median range of gallbladder ejection fraction in obese diabetic patients group was significant lower than those of control subjects and non- obese diabetic patients(p<O.C6). 5) Median value of gallbadder was lower in diabetic patients group with complications like retinopathy, peripheral neuropathy or cardiovascular autonomic neuropathy (p<0.05) in comparison with those of control subjects and diabetic patients group without diabetic complication (p>0.05). Also seven diabetic patients whose gallhladder ejection fraction was reduced under,35% have had at least two diabetic complications. Conclusion : We observed that gallbladder ejection fraction of diabetic patients was reduced compared with that of control subjects. This is due to the reduced gallbladder muscle contractility resulting from diabetic autonomic dysfunction. These results suggest that the assessment of gallbladder ejection fraction using 99m- Tc-DISIDA would be useful to diagnose diabetic autonomic neropathy.
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간 스캔상 공간점유병소의 소견을 보인 Budd-Chiari 증후군
이정해,이윤하,서대원,장태종,황인섭,김영중,김소연,이권전 ( Jeong Hae Lee,Youn Ha Lee,Dae Won Seo,Tae Jong Jang,In Shup Hwang,Young Jung Kim,So Yon Kim,Gwon Jun Lee ) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3
A twenty-one-year old man visited our hospital due to abdominal distension for a month. On the physical examination, there was severe abdominal distension with fluctuation and shifting dullness. The routine laboratory results were within normal range. On the Magnetic Resonace angiography, there wasnt any blood flow within the right and middle hepatic vein. So we concluded that the etiologic disease was Budd Chiari syndrome. On the Iiver scan, there was cold area(absence of radiouptake) on entire right lobe of the liver, increased uptake on the bone marrow and showed spienomegaly. This finding was similar to the liver mass occupying right lobe with underlying chronic liver disease. On the previous reports, it is quite uncommon finding that Budd-Chirari syndrome shows lesion like space occupying one on the liver scan. So we report this case with a review of the lit.erature.
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김영중,유광현,김용일,이윤하,김소연,황인섭,차경석,최병진,조민구 대한내과학회 1996 대한내과학회지 Vol.50 No.3
Focal nodular hyperplasia(FNH) is a rare benign hepatic tumor usually discovered serendipitous]y by an imaging procedure performed for some other reason. FNH is typically asymptomatic, and invariably follows a benign course. Accordingly, the preferred management is conservative, and excision is reserved for large symptomatic and complicated lesion, or when the diagnosis remains uncertain. Although many cases of FNH has been described to date in other countries, only two cases of FNH has been reported in Korean literature. But biopsy proven case have not been reported in Korea. In the present report we describe a 15 cm sized symptomatic lesion of FNH in a 29-year-old woman, that was disclosed by various kinds of imaging procedure. A left lateral segmentectomy was performed. The mass was firm and showed areas of localized growth of mature hepatocytes and septal fibrosis accompanied with marginal ductal proliferation, consistent with FNH. It also displayed an incomplete stellate architectural configuration consisted of a central fibrous scar. We report a case of FNH with a review of the literature.
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김홍남,류광현,김소연,시석,김진욱,최동섭,황인섭,박병익,최병진,김학수,김윤권 대한감염학회 1997 감염 Vol.29 No.3
저자들은 안면부 등의 경화를 주소로 내원한 28세 남자환자에서 당뇨병 등의 동반 질환이 없이 급성 상기도 감염에 속발하여 발생한 경화부종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Scleredema is a rare connective tissue disease of unknown etiology and characterized by nonpitting thickening of subcutaneous tissue of the neck, face, head, upper trunk and arms. We present a 28 year-oldman with extensive skin changes following upper respiratory infection, who have not any concurrent disorders such as diabetes mellitus. Histopathological findings of skin showed normal epidermis with a widening of spaces between collagen bundles by infiltration of acid mucopolysaccharide in the dermis.
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김학수,최병진,차주영,류광현,한신,김소연,황인섭,시석,박병익,조민구 대한내과학회 1998 대한내과학회지 Vol.54 No.4
Eyelid tumors, including metastatic lid tumors, present clinically as recurrent chalazia, multicentric nodules, ulcerated lesions, diffuse swelling, or chronic blepharoconjuntivitis. Lid tumors consist of benign lesions(69%) and malignant lesions(31%). Basal cell carcinoma and squamous cell carcinoma account for 92% of the malignant lesions. Metastatic lid disease was found to be of rare occurence, accounting for 0.1% of all lid lesions and 0.3% of malignant lid lesions. We report a case of metastatic lid carcinoma of stomach cancer. A 60-year-old man developed a painless, slow-growing nodular lesion of his right lower eyelid. Excisional biopsy revealed metastatic undifferentiated adenocarcinoma. We believe this is the first case in Korean literature.
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