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증례 : 신세포암의 바터 팽대부 전이에 의한 급성 재발성 췌장염
강종식 ( Jong Sik Kang ),김명환 ( Myung Hwan Kim ),이성구 ( Sung Koo Lee ),이재광 ( Jae Kwang Lee ),이민정 ( Min Jung Lee ),정민정 ( Min Jung Jung ),김진희 ( Jin Hee Kim ) 대한내과학회 2013 대한내과학회지 Vol.84 No.2
신세포암은 드물지만 바터 팽대부로 전이될 수 있으며, 이로 인해 췌액의 흐름을 방해하여 재발성 급성 췌장염을 유발할 수 있다. 수술로 절제가 어려운 경우 내시경 역행성담췌관 조영술 시술을 통한 주췌관 내로의 스텐트 삽입이 췌장염 치료에 도움이 될 수 있다. Metastasis of renal cell carcinoma to the ampulla of Vater is a rare occurrence. We report a case of acute recurrent pancreatitis caused by metastasis of renal cell carcinoma to the ampulla of Vater. The patient manifested acute recurrent pancreatitis 10 years after a nephrectomy for renal cell carcinoma and was presumed to have obstructive pancreatitis secondary to an ampullary mass. Duodenoscopy revealed an ampullary mass, and the patient was finally diagnosed with metastatic renal cell carcinoma. With insertion of a pancreatic stent via endoscopic retrograde cholangiopancreatography, the acute pancreatitis was resolved. When an ampullary mass is observed in a patient with a history of renal cell carcinoma, the possibility of ampullary metastasis of the renal cell carcinoma should be considered, as this is a potential etiology of acute recurrent pancreatitis. (Korean J Med 2013;84:254-258)
간장 ( 肝臟 ) 및 담도 ( 膽道 ) : 특발성 세균성 복막염 환자의 예후 결정 인자에 관한 연구
강종식(Jong Sik Kang),문중갑(Joong Kap Moon),이승주(Seung Ju Lee),이정웅(Jung Woong Lee),정찬수(Chan Su Jeong),이준상(Jun Sang Lee) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2
N/A We examined 34 cases of spontaneous bacterial peritonitis retrospectively to evaluate the factors influencing prognosis in spontaneous bacterial peritonitis. The obtained results were as follows. The groups with higher serum bilirubin, lower ascitic glucose concentration, more abnormal y-GTP, combined hepatic encephalopathy and positive ascitic culture showed poor prognosis significantly. Also, the groups with increased frequency of admission by spontaneous bacterial peritonitis and cultured enteric organism (esp.E.coli) in ascites tended to show poor prognosis. But, fever, serum creatinine level, PMN fraction in ascites or peripheral blood, and postitive blood culture were not related to prognosis statistically.
이준상(Joon Sang Lee),강종식(Jong Sik Kang),임성순(Sung Soon Im),문진훈(Jin Hoon Moon),김재현(Jae Heon Kim),최호정(Ho Jung Choi) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.1
A case of adenocarcinoma at the duodenojejunal junction was encountered recently at W.M.B.H. in Pusan. The patient had complained of epigastric pain and post-prandial vomiting for 40 days. Under the impression of a tumor at the duodenojejunal junction on small bowel series with contrast media, the segmental resection with side-to-end duodenojejunostomy was performed and disclosed small mass at the duodenojejunal junction just below the ligament of Treitz and it was confirmed to be a adenocarcinoma of the jejunum histopathologically. We report this case with the review of the literatures.
이준상(Joon Sang Lee),강종식(Jong Sik Kang),신윤원(Youn Won Shin),문중갑(Joong Kab Moon),이형룡(Heung Ryeong Lee),백옥지(Ok Ji Paik) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.4
A 68-year-old womam, adrnitted with hemoperitoneum due to leiomyoma rupture of the ileum, required emergency operation. After a successful resection for the tumor, the patient was discharged with normal blood values and she has remained we]l. We should consider small bowel tumors in the evidence of chronic or repeated bouts of acute intestinal bleeding in the face of negative conventional X-rays and freedom from symtoms except those due to bleeding. The rarity of this case is emphasized and the literature reviewed.
이준상(Joon Sang Lee),강종식(Jong Sik Kang),김재하(Jae Ha Kim),최호정(Ho Jeong Choi) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.2
N/A The periampullary area is anatomically complex and adenocarcinoma may arise from one of four layers of epitherium: the mucosa of the ampulla of Vater, the pancreatic duct, the distal common bile duct, or the periampullary duodenum. Growths arising from any of these sites have the same over all effect and will be considered as a group. They are often loosely termed Cancer of the head of the pancreas. In the clinical situation, the site of origin can not always be distinguished, and surgical treatment for all resectable carcinoma in the periampullary area is essentially the same. Hovever, carcinoma from each of these sites of origin may exhibit different natural history, diiferent growth patterns, different cure rates, and different nuances of diagnosis. So. It is advantageous to separate tthese four lesions as clearly as possible. Recently, authors experienced a case of adenocarcinoma of the ampulla of Vater at WMBH in Pusan. The patient had complained of abdominal pain and jaundice for four months. Under the impression of a carcinoma of the ampulla of Vater on radiologic and duodenoscopic findigs, the exploratory laparotomy with frozen section biopsy were performed and small mass(1.5 X 2.0 cm) at the ampulla of Vater was seen, and it was confirmed to be a adenocarcinoma of the ampulla of Vater(exposed ulcerationg type, stage III) by histopathologic study. The Whipple's operation was performed and postoperative course was relatively good. Chemotherapy(FAM regimen) was given to her. We report this case with the review of the literatures.
레이노 현상에 의한 수지 괴사로 진단된 원발쓸개관간경화
이우제 ( Woo Je Lee ),강종식 ( Jong Sik Kang ),이기업 ( Ki Up Lee ),박중열 ( Joong Yeol Park ),이상아 ( Sang Ah Lee ),황윤우 ( Yoo Noo Hwang ),윤환 ( Hwang Yoon ) 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.1
Necrosis of the upper extremity occurs rarely in type 2 diabetic patients compared to lower extremity necrosis. We report a 69-year-old woman with type 2 diabetes mellitus who presented with necrosis of the left 5th finger tip. The patient had primary biliary cirrhosis accompanied by necrosis of the fingertip due to severe Raynaud`s phenomenon. Primary biliary cirrhosis (PBC) is a typical autoimmune disease, which can in rare cases be accompanied by autoimmune symptoms including sicca symptom and Raynaud`s phenomenon. Furthermore, autoimmune diseases, such as systemic sclerosis, rheumatoid arthritis and undifferentiated connective tissue disease (UCTD) can be associated. Although every type of vascular etiology should be considered as a cause of digital necrosis, Raynaud`s phenomenon is usually not considered in diabetes. We report this case of finger tip necrosis due to severe Raynaud`s phenomenon accompanied by PBC and UCTD in a diabetic patient.