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간세포암종으로 오인된 지방성분이 없는 간혈관근지방종 증례 보고
류수형 ( Yong Moon Woo ),우용문 ( Soo Hyung Ryu ),민정화 ( Jeong Wha Min ),김미령 ( Mi Ryeong Kim ),박태영 ( Tae Young Park ),문정섭 ( Jeong Seop Moon ),강윤경 ( Yun Kyung Kang ) 대한소화기학회 2018 대한소화기학회지 Vol.71 No.1
Angiomyolipoma (AML) is a rare benign mesenchymal tumor in the liver, which is composed of blood vessels, smooth muscle, and adipose cells. The proportion of each component varies, making a diagnosis difficult. This paper reports a case of AML in the liver without adipose tissue, mimicking a hepatocellular carcinoma (HCC), which was diagnosed by a surgical tissue biopsy. A 65-year-old woman was admitted for an evaluation of a hepatic mass that had been detected by ultrasonography. The serologic markers of viral hepatitis B and C were negative. The liver function tests and alpha fetoprotein level were within the normal limits. Magnetic resonance imaging revealed a 1.9 cm sized mass in segment 6 of the liver with early arterial enhancement and washout on the delayed phase accompanied by a rim-like enhancement, which is similar to the imaging findings of HCC. A frozen section examination during surgery indicated a hepatocellular neoplasm and suggested the possibility of HCC. On the other hand, the final pathologic diagnosis was epithelioid myoid type of AML with no adipose tissue component. The tumor cells were positive for human melanocyte B-45 and negative for cytokeratin and hepatocyte paraffin 1. This paper reports a very rare case of AML without adipose tissue in the liver mimicking HCC that was diagnosed by a surgical tissue biopsy. (Korean J Gastroenterol 2018;71:49-53)
전이성 악성 흉수를 동반한 원발이 명확치 않은 선암종 1례
박정석 ( Jung Seok Park ),강석우 ( Seok Woo Kang ),조경표 ( Kyung Pyo Cho ),이재성 ( Jae Sung Lee ),성지석 ( Jee Seok Sung ),우용문 ( Yong Moon Woo ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.1
Primary tumors of the pericardium are extremely rare. Secondary or metastatic malignant pericardial disease is much more common and usually arises from lung and breast tumors, melanoma or lymphoma and etc. A case of metastatic adenocarcinoma of pericardium is reported which had no evidence of primary origin. Only cell-block of pericardial effusion and LN biopsy were positive for metastatic adenocarcinoma.
5-Fluorouracil을 투여한 대장암 환자에서 총정맥영양공급치료 중에 발생한 베르니케 뇌병증 2예
조경표 ( Kyung Pyo Cho ),이재성 ( Jae Sung Lee ),성지석 ( Ji Seok Seong ),우용문 ( Yong Moon Woo ),조영준 ( Young Jun Cho ),정범진 ( Beom Jin Jeong ),손지훈 ( Jee Hoon Sohn ),김수정 ( Su Jung Kim ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.3
Wernicke`s encephalopathy (WE) caused by thiamine deficiency is an acute neurological disorder. Clinically, the classic triad of WE consists of ophthalmoplegia, ataxia, and mental status changes. Thiamine deficiency is known to occur commonly in chronic alcoholic patients. Sometimes, it can occur in patients after gastrointestinal surgery and in those with malabsorption. In addition, patients undergoing renal dialysis, suffering from hyperemesis gravidarum, receiving total parenteral nutrition (TPN), and being treated with chemotherapeutic agents are also prone to develop thiamine deficiency. Herein, we report two cases of WE that developed following simultaneous 5-fluorouracil (5-FU) chemotherapy and TPN in colon cancer patients which was successfully treated with thiamine administration. (Korean J Gastroenterol 2014;64:158-163)
증례 : 류마티스 ; 루푸스 신염 환자에서 항인지질 항체와 연관된 감염 후 대칭적 말초 괴저
이재성 ( Jae Sung Lee ),성지석 ( Jee Seok Seong ),우용문 ( Yong Moon Woo ),조영준 ( Young Jun Cho ),정범진 ( Beom Jin Jeong ),강한나 ( Han Na Kang ),김수정 ( Su Jung Kim ) 대한내과학회 2014 대한내과학회지 Vol.87 No.3
Antiphospholipid syndrome (APS) is an autoimmune disease that involves vascular thrombosis and pregnancy morbidity associated with elevated titers of antiphospholipid antibodies. APS can affect any organ and has a variety of clinical manifestations. Infections can be associated with thrombotic events in APS, including the potentially fatal subset catastrophic APS. We report a case of extensive symmetrical peripheral gangrene complicating Escherichia coli sepsis associated with antiphospholipid antibodies in a patient with lupus nephritis. (Korean J Med 2014;87:379-382)
우용문,정은정,성지석,정범진,조영준,강영모,이 은 이화여자대학교 의과학연구소 2014 EMJ (Ewha medical journal) Vol.37 No.S
종격동기종은 종격에 공기가 있는 것을 말하며 주로 기저 질환이 없는 건강한 청년기 남자에서 흔하고, 성인에서는 드문 질환이다[1]. 자발성 종격동기종은 흉부손상이나 기관지 내 시술, 식도 내 시술, 인공호흡, 심도자술, 흉부수술 등 이차적인 원인에 의해 발생하는 것이 아니라 명확히 정의된 유발요인 없이 종격에 자유공기(free air)가 누출되는 것을 말한다[2]. 대부분은 무증상이지만 목과 흉부의 통증, 호흡곤란 등을 일으킬 수 있다. 대부분의 환자에서 양호한 임상경과를 보이나 매우 드물게 생명을 위협하는 질병경과를 보일 수 있으므로 세심한 관찰이 필요하다. 천식환자에서 나타나는 자발성 종격동기종은 비교적 드문 합병증으로, 급성 악화 때 발생률은 0.2~0.3%가 보고되고 있으며 [1], 국내외에서 증례 보고가 드물게 되고 있다[3-9]. 최근 저자들은 호흡곤란과 흉통을 주 증상으로 내원한 천식 환자에서 자발성 종격동기종을 보인 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
항응고요법으로 치료된 급성 췌장염에 동반한 간문맥과 비장정맥 혈전증
성지석,송정훈,조경표,이재성,우용문,정범진,조영준,한윤주 이화여자대학교 의과학연구소 2014 EMJ (Ewha medical journal) Vol.37 No.2
Splanchnic vein thrombosis arising from complications of acute pancreatitis is very rare. It usually occurs as a form of portal, splenic and superior mesenteric vein thrombosis, either in combination or separately. It could develop portal hypertension, bowel ischemia and gastrointestinal variceal bleeding. Treatment of splanchnic vein thrombosis includes anticoagulants, thrombolysis, insertion of shunts, bypass surgery and liver transplantation. In some cases, anticoagulation therapy may be considered to prevent complications. However, the standard protocol for anticoagulation in splanchnic vein thrombosis has not been determined yet. We report a case of 43-year-old man who had portal and splenic vein thrombosis in acute pancreatitis. The patient was successfully treated with oral anticoagulants following low molecular weight heparin therapy.
전원 온 환자의 의료기관별 호흡기 검체에서의 균 종류 비교
김태형,조경표,이재성,우용문,성지석,노창석 이화여자대학교 의과학연구소 2013 EMJ (Ewha medical journal) Vol.36 No.2
Objectives: Since the 1990s, drug-resistant bacteria have become common pathogens of hospital-acquired infections. In recent years, healthcare-associated infections have come to the fore, and it is reported that distribution rates of these bacteria are comparable to those of hospital-acquired infections. However, there have been few studies on differences in resistant bacteria depending on the size of hospitals. Thus, the authors studied differences in drug-resistant bacteria between a tertiary hospital and smaller medical institutions. Methods: We retrospectively analyzed the clinical findings and sputum culture results of patients transferred from tertiary hospitals (group A, n=74) and those transferred from smaller medical institutions (group B, n=65). Results: The number of patients with malignancy was higher in group A than in group B. The length of intensive care unit stay was longer in group A than in group B. Antibiotic therapy and mechanical ventilation were more frequently used in group A than in group B. There were no significant differences between the 2 groups in bacterial species (Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa) and their resistance rates to carbapenem, while there were significant differences between the 2 groups in the bacterial species (Acinetobacter baumannii) and its resistance rate to carbapenem. Conclusion: In this study, there were significant differences between the 2 groups in the bacterial species and resistance rates to carbapenem for A. baumannii infection unlike other bacterial infections. Further studies on risk factors and patient classification are needed to confirm our results.