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송정윤,김준식,황진복,Song, Jeong-Yoon,Kim, Jun-Sik,Hwang, Jin-Bok 대한소아소화기영양학회 2007 Pediatric gastroenterology, hepatology & nutrition Vol.10 No.2
저자들은 6세 된 남아에서 4년간의 반복적이고, 발작적인 복통의 원인을 규명하던 중 만성 복통의 타 기질적 질환들이 배제되고, 뇌파 검사의 이상 소견과 함께 항경련제의 사용에 증상의 극적인 소실을 보여 복성 간질로 진단된 1예를 경험하고 문헌 고찰과 함께 보고하는 바이다. Abdominal epilepsy is an uncommon disorder and a rare cause of recurrent abdominal pain of children. Diagnostic criteria of this disorder include otherwise unexplained, paroxysmal gastrointestinal complaints, symptoms of a central nerve system disturbance, an abnormal electroencephalogram with a finding specific for a seizure disorder, and improvement with anticonvulsant medication. We present a case of a 6-year-old boy with abdominal epilepsy presenting with recurrent, paroxysmal abdominal pain for 4 years. This patient had definite electroencephalogram abnormalities and a striking response to administration of an anticonvulsant.
식품 단백질 유발성 직결장염에서 식품 특이 IgE 항체 검사의 임상적 의의
송정윤,강유나,김재룡,황진복,Song, Jeong-Yoon,Kang, Yu-Na,Kim, Jae-Ryong,Hwang, Jin-Bok 대한소아소화기영양학회 2008 Pediatric gastroenterology, hepatology & nutrition Vol.11 No.1
목 적: 식품 단백질 유발성 직결장염(food proteininduced proctocolitis, FPIPC)은 영아기에 모유 수유아에서 호발하는 식품 알레르기 질환으로 식품 알레르기의 비-IgE 매개형으로 분류되고 있다. FPIPC의 유발 원인 식품을 예측할 수 있는 식품 특이 IgE 항체 검사의 임상적 의의를 알아보고자 한다. 방 법: 2006년 2월부터 2007년 5월까지 진단된 16예를 대상으로 하였다. 선홍빛, 소량의 혈변, 정상 배변 및 성장 등의 임상 상황과 직장 조직 생검에서 호산구 침윤이 10개의 고배율시야당 60개 이상일 때 FPIPC로 진단하였다. 진단 후 모체나 환자의 식단에서 5가지 식품(유제품, 계란, 콩 및 견과류, 밀가루, 어패류)을 4일간 제거 후 증상의 호전을 보이면 식단에 단계적으로 유발 시험을 시행하여 증상 유무로 유발 식품을 판단하고, 내원 당시 시행된 알레르기 MAST 및 Uni-CAP 검사와 비교 분석하였다. 결 과: FPIPC 환자는 16예(남:여, 10:6)로 진단 당시 연령은 생후 1~13개월이었다. 알레르기 MAST에서 특정 식품에 양성을 보인 경우는 2예(12.5%)였으며, Uni-CAP에서 양성을 보인 경우는 3예(18.8%)였다. 유발 시험을 통하여 혈변의 원인으로 확인된 식품 건수는 총 33건으로 어패류 7건(21.2%), 계란 6건(18.2%). 밀가루 6건(18.2%), 유제품 4건(12.1%), 콩 3건(9.1%), 돼지고기 3건(9.1%), 견과류 2건(6.1%), 쇠고기 1건(3.0%), 버섯 1건(3.0%)이었다. 알레르기 MAST 양성 혹은 Uni-CAP 양성과 증상 관련 식품이 일치하는 경우는 각각 1예(6.7%)에서 관찰되었다. 결 론: FPIPC에서 식품 특이 IgE 항체 검사인 알레르기 MAST와 Uni-CAP은 관련 식품에 대한 진단적 예측 지표로는 부적합한 것으로 판단되며, 모체 혹은 환자의 식단에서 식품 제거 및 유발 시험이 관련 원인 식품을 추정해 낼 수 있는 임상 수기로 판단된다. Purpose: The aim of this study was to determine the clinical significance of food-specific IgE antibody tests in detecting triggering antigens in food protein-induced proctocolitis (FPIPC). Methods: Between February 2006 and May 2007, data from 16 consecutive FPIPC patients that underwent MAST and Uni-CAP tests on initial visits, were reviewed. The endoscopic criterion used for establishing a diagnosis of FPIPC was an increase in the number of eosinophils in the lamina propria (${\geq}60$ per 10 high power fields). Offending foods were suspected clinically based on elimination and challenge testing to mother or patient diets with the following five highly allergenic foods: dairy products, eggs, nuts and soybean, fish and shellfish, and wheat and buckwheat. We compared the results of initial MAST or Uni-CAP tests with clinically suspected offending foods. Results: For the 16 FPIPC patients, MAST tests showed positive results in 2 patients (12.5%), and Uni-CAP tests showed positive results in 3 patients (18.8%). Through clinical elimination and challenge, the 33 offending foods were identified: 7 fish and shellfish (21.2%), 6 eggs (18.2%), 6 wheat and buckwheat (18.2%), 4 dairy products (12.1%), 3 soybean (9.1%), 3 pork (9.1%), 2 nuts (6.1%), 1 beef (3.0%), and 1 mushroom (3.0%). Clinically suspected offending foods and MAST and Uni-CAP test results were found to be correlated in 1 patient (6.7%) each. Conclusion: Food specific IgE antibody tests are inappropriate for predicting offending foods in FPIPC. Clinical food elimination and challenge testing provide useful means of detecting offending foods.
갑상선 결절의 수술 전 세침흡인세포검사 결과에 따라 수술 중 동결절편검사를 생략할 수 있는가?
송정윤(Jeong Yoon Song),한상아(Sang Ah Han),장재훈(Jae Hoon Jang),봉준우(Jun Woo Bong) 대한갑상선-내분비외과학회 2015 The Koreran journal of Endocrine Surgery Vol.15 No.4
Purpose: Fine needle aspiration (FNA) is a useful preoperative diagnostic tool for thyroid nodule because of the high sensitivity and specificity. The aim of this study is to determine the necessity of intraoperative frozen section (IOFS) after fine needle aspiration. Methods: Data of 534 patients with a single thyroid nodule who underwent thyroidectomy from June 2006 to August 2013 were reviewed retrospectively. FNA was performed preoperatively in all patients and IOFS was performed selectively according to the intraoperative findings and FNA results. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNA and IOFS for malignant nodules were analyzed. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNA for malignant nodules were 100%, 95.5%, 99.8%, 100%, and 99.8%, respectively. All nodules diagnosed as benign by FNA were reaffirmed as benign nodules by permanent sections. When the result of FNA was suspicious for malignancy, specific features of preoperative ultrasound, including hypoechoic, size<10 mm showed high positive predictive value and accuracy (98%, 86.9%, and 100%, 78.7% respectively). Conclusion: Performance of IOFS was not necessary when the result of FNA was consistent with malignancy or benign. However when the result of FNA was non-diagnostic or atypia, IOFS should be performed for more accurate detection of malignancy. When the result of FNA is suspicious for malignancy, IOFS is restrictively useful for excluding benign nodules using the features of ultrasound. In addition, IOFS is not useful in finding malignant thyroid nodules when the result of FNA is follicular neoplasm.
좌측 변형 경부 곽청술 후에 흉관손상 없이 발생한 양측성 유미흉 1예
장재훈,최재영,송정윤,박호철,고석환,Jae Hoon Jang,M,D,Jae Young Choi,M,D,Jeong Yoon Song,M,D,Ho Chul Park,M,D,and Suck Hwan Koh,M,D 대한갑상선-내분비외과학회 2006 The Koreran journal of Endocrine Surgery Vol.6 No.1
Bilateral chylothorax as a complication of modified radical neck dissection is extremely rare, but it is potentially serious and sometimes fatal. Early diagnosis and proper management is very important. We report here on a case of bilateral chylothorax following left modified radical neck dissection that was successfully treated with conservative management. (Korean J Endocrine Surg 2006;6:32-34)
장연수(Yeon Soo Chang),송정윤(Jeong Yoon Song),최성일(Sung Il Choi) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.4
Ingestion of foreign bodies is a common clinical problem encountered in early childhood. But ingestion of multiple magnets can cause serious lethal complications. Magnets located within another bowel loop may attract each other across the intestinal walls, resulting pressure necrosis, bowel perforation, fistula formation, intestinal obstruction, and death. Clinicians who care for children should be aware of this unexpected risk of magnetic ingestion. We report a case of ileal perforation caused by ingestion of multiple magnets in a child.
안재현,최재영<SUP>1<.SUP>,박원서,송정윤,김용호,이상목,고석환,Jae Hyun Ahn,M.D.,Jae Young Choi,M.D.<SUP>1<.SUP>,Won Seo Park,M.D.,Jeong Yoon Song,M.D.,Yong Ho Kim,M.D.,Sang Mok Lee,M.D. and Suck Hwan Koh,M.D. 대한갑상선-내분비외과학회 2008 The Koreran journal of Endocrine Surgery Vol.8 No.2
<B>Purpose:</B> PTMC is defined as a papillary thyroid cancer smaller than 10 mm in its greatest diameter. It is the most common form of differentiated thyroid cancer and its prognosis is known to be very favorable. The aim of this study is to identify its biologic behavior and to formulate a reasonable therapeutic strategy for the treatment of PTMC. <B>Methods:</B> 379 patients with papillary thyroid cancer were analyzed. Each patient was diagnosed preoperatively or postoperatively and treated between Jan. 2000 and Dec. 2007. Among these patients, 143 had been identified as having PTMC (37.7%) with a mean tumor size of 0.72 cm in diameter. <B>Results:</B> There were no significant differences of the clinical characteristics such as gender, age, the operative methods, or multicentricity between the PTMC group and the non-PTMC group, except for LN metastases. Also, there were fewer symptoms of palpable neck mass and preoperative findings such as capsular invasion and microcalcification in the PTMC group. We performed unilateral lobectomy with or without central compartment neck node dissection for the early stage diseases, but for the later stages of disease we performed near-total or total thyroidectomy with routine central compartment neck node dissection. And for the patients with lateral node enlargement, we performed ipsilateral modified radical neck dissection (MRND). <B>Conclusion:</B> This study shows that PTMC is quite similar to conventional papillary thyroid cancer in its biological behavior, and we conclude that total thyroidectomy with central compartment neck node dissection is the proper therapeutic strategy to treat PTMC. However, further study is necessary for identifying the low-risk and high-risk patients with PTMC. <B>(Ko</B><B></B><B>rean J Endocrine Surg 2008;8:101-105)</B>