국내 복강 내 낭성 림프관종의 임상양상

나운태 ( Woon Tae Na ),이태희 ( Tae Hee Lee ),이병석 ( Byung Seok Lee ),김석현 ( Seok Hyun Kim ),채희복 ( Hee Bok Chae ),김석배 ( Seok Bae Kim ),김용석 ( Yong Seok Kim ),김선문 ( Sun Moon Kim ),임의혁 ( Euyi Hyeog Im ),허규찬 ( Ky 대한소화기학회 2010 대한소화기학회지 Vol.56 No.6

Background/Aims: Cystic lymphangioma is an uncommon disease, and rarely develops in the intraabdomen. The aim of this article was to discuss about clinical characteristics of intraabdominal cystic lymphangioma developed in Korea. Methods: Age, sex, symptoms, locations and size of the lesions, diagnostic methods, treatments, complications and recurrence were analyzed in 13 pathologically confirmed cases of intraabdominal cystic lymphangioma and 18 cases of literature consideration reported in Korea. Results: Intraabdominal cystic lymphangioma commonly developed in adults compared to the other lymphangioma, and frequently located in the mesentery. Abdominal pain was the most common symptom, but it was a non-specific finding. Tenderness and abdominal mass were not significantly associated. The size of mass was diverse. Abdominal ultrasonography and abdominal CT were diagnostic tools most commonly used, but preoperative diagnosis was possible only in 22.6%. All patients were discharged without any complications, and no recurrence was reported. Conclusions: Preoperative diagnosis of intraabdominal cystic lymphangioma is difficult and symptoms and signs are not specific. Intraabdominal cystic lymphangioma should be suspected in patients with non specific abdominal pain and intraabdominal mass and active diagnostic evaluation is mandatory. (Korean J Gastroenterol 2010;56:353-358)

호흡기 ; 만성 폐쇄성폐질환의 폐기능 검사와 운동 검사의 비교

나운태 ( Woon Tae Na ),박주호 ( Joo Ho Park ),이고은 ( Go Eun Lee ),권선중 ( Sun Jung Kwon ),손지웅 ( Ji Woong Son ),나문준 ( Moon Jun Na ),최유진 ( Eu Gene Choi ) 대한내과학회 2009 대한내과학회지 Vol.76 No.5

목적: 일반폐기능 검사만으로는 COPD 환자가 실생활에서 겪는 장애정도와 운동 내성의 한계를 예측하는 데는 한계가 있어, 일반폐기능 검사와 운동부하심폐기능 검사를 이용하여 COPD 환자를 중증도별로 하여 각각 분류하고 그 결과를 비교하여, 운동부하폐기능 검사의 유용성을 알아보고자 하였다. 방법: COPD 환자 105명을 대상으로 안정 시 폐기능 검사와 운동부하심폐기능 검사를 시행하였고, 결과는 표준 의학중증도 분류에 의해 categorical statistical comparison으로 분석하였다. 결과: 두 검사에서 COPD 환자 105명 중 오직 44명(42%)의 환자가 일치된 결과를 보였다. 나머지 환자들 중 21명(20%)은 일반폐기능 검사보다 운동부하심폐기능 검사에서 경한 판정을 받았고, 40명(38%)은 운동부하심폐기능 검사에서 더 심한 판정을 받았다. 운동부하심폐기능 검사에서 더 심한 판정을 받은 환자들은 운동부하 검사 심혈관계 지표들이 보다 감소되어 있었다. 결론: COPD 환자의 운동능력은 일반폐기능 검사만으로는 예측하는 데는 한계가 있으며, 전신질환으로서의 COPD 질환을 이해하고 예측하는데 있어 운동부하폐기능 검사도 일부 도움을 주리라 생각되나, 앞으로 좀 더 많은 연구가 필요하리라 사료된다. Background/Aims: Chronic obstructive pulmonary disease (COPD) is characterized by an incompletely reversible airflow limitation. Pulmonary function test (PFT) has been considered the gold standard test for diagnosis and severity evaluation in COPD. However, PFT by spirometry does not provide information about exercise performance in COPD patients. Therefore, the present study was performed to compare pulmonary function determined by spirometry with exercise function determined by cardiopulmonary exercise test (CPET) for grading of COPD. Methods: A total of 105 patients with airway obstruction were examined. The patients` mean age was 65 years, and the mean smoking history was 27 pack-years. The patients underwent spirometry and CPET. The results were analyzed by categorical statistical comparison, based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and American Thoracic Society guidelines. Results: The two methods agreed on the classification of only 44 patients (42%). Of the remaining patients, 21 (20%) were found to be less severe according to CPET than according to PFT, whereas 40 (38%) were more severe. Those who were more severe according to CPET had significantly low maximal minute ventilation, low anaerobic threshold, low oxygen pulse, and high breathing reserve. Conclusions: The present study revealed the large disagreement between the results of resting and exercise pulmonary function tests, and therefore suggests the need for a novel approach or guideline. Additional cardiological evaluation may be needed in patients classified as more severe according to CPET, who are assumed to have a greater degree of impairment of cardiovascular function. (Korean J Med 76:571-577, 2009)

증례 : 소화기 ; 간세포암 치료로 고주파열치료 시행 후 발생한 간대장누공 1예

강민규 ( Min Gyu Kang ),이태희 ( Tae Hee Lee ),나운태 ( Woon Tae Na ),정지현 ( Ji Hyun Jeong ),임동혁 ( Dong Hyuk Lim ),이만 ( Mahn Lee ),강영우 ( Young Woo Kang ) 대한내과학회 2012 대한내과학회지 Vol.83 No.4

Radiofrequency ablation (RFA) is a relatively safe therapy for patients with hepatocellular carcinoma (HCC); however, complications are not unknown. A hepatocolic fistula is a rare complication after RFA. We report a case of a hepatocolic fistula following a liver abscess after RFA for HCC in a 58-year-old male. The patient was diagnosed with HCC and liver cirrhosis from hepatitis B infection 3 years prior to admission. The HCC was in segment 6 of the liver and was treated with transarterial chemoembolization and RFA. One month after the second RFA, he was diagnosed with a liver abscess, for which he was treated with antibiotics for 2 months, but continued to have intermittent fever and chills. We made a diagnosis of hepatocolic fistula using colonoscopy, fluoroscopy, and liver dynamic computed tomography. The patient underwent a surgical procedure after antibiotic therapy. Although a hepatocolic fistula is a rare complication following RFA, clinicians should be aware of its existence. (Korean JMed 2012;83:480-484)

증례 : 신장 ; Tranexamic Acid 투여 후 발생한 양측성 급성 신피질 괴사 1예

박주호 ( Joo Ho Park ),강민규 ( Min Kyu Kang ),나운태 ( Woon Tae Na ),송인걸 ( In Girl Song ),정장한 ( Jang Han Jung ),윤세희 ( Se Hee Yoon ),윤성로 ( Sung Ro Yun ) 대한내과학회 2011 대한내과학회지 Vol.80 No.6

저자들은 Tranexamic acid 투여 후 갑작스런 혈소판 수 저하를 보이면서 발생한 양측성 급성 신피질 괴사 환자 1예를 경험하였기에 보고하는 바이다. Acute renal cortical necrosis is an anuric form of acute renal failure. We experienced a case of renal cortical necrosis complicated by tranexamic acid administration. To our knowledge, only three cases of renal cortical necrosis have been reported worldwide. A 49-year-old man was referred with hemothorax and multiple bone fractures following a traffic accident. Tranexamic acid, and hemocoagulase were injected three times a day. After the 4th dose of hemostatics, anuria developed abruptly, the platelet count decreased to 84,000 /μL, and the serum creatinine was increased to 2.56 from 1.06 mg/dL. On the 4th Intensive Care Unit (ICU) day, computed tomography (CT) showed bilateral renal cortical necrosis with normal renal arteries and aorta. The oliguria persisted for 14 days and temporary hemodialysis was performed. The serum creatinine had decreased to 2.12 mg/dL 8 months after discharge. (Korean J Med 2011;80:723-728)

급성 A형 간염 이환 후에 만성신장병이 합병된 1예와 막사구체신염이 합병된 1예

송인걸 ( In Geol Song ),강민규 ( Min Gyu Kang ),나운태 ( Woon Tae Na ),김성태 ( Sung Tae Kim ),박문일 ( Moon Il Park ),윤세희 ( Se Hei Yun ),윤성로 ( Sung Ro Yun ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.4

Acute A viral hepatitis is a mild, self-limiting disease of liver and acute renal failure (ARF) is a rare complication. We report two cases of chronic renal failure (CRF) in nonfulminant acute A viral hepatitis and ARF. A 40-year-old man was admitted with ARF and acute A viral hepatitis, and underwent temporary hemodialysis therapy. The renal biopsy showed acute tubular necrosis with tubulointerstitial nephritis. At 13 months after discharge serum creatinine was 1.33 mg/dL and protein-creatinine ratio of spot urine was 0.47 (mg/mg Cr). The second case was a 28-year-old man and was managed conservatively. At discharge the serum creatinine was 3.14 mg/dL and the urinalysis showed hematuria, and protein-creatinine ratio 0.56 (mg/mg Cr). Thirty-nine months after discharge, the creatinine was 1.23 mg/dL, the urinalysis showed persistent nephritis findings and the protein-creatinine ratio 1.28. Kidney biopsy revealed the membranous glomerulopathy with mild tubulointerstitial nephritis, and all of findings suggested the systemic disease-associated secondary glomerulopathy. To our knowledge our case is the first one of chronic glomerulapathy that is confirmed by kidney biopsy.