외과적 보조의 급속상악확장술 : 치험 5예 REPORT OF 5 CASES

박충열,이용욱,송종운,김영운,박홍주,오희균,유선열,이기현,황현식 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.1

Five adults (3 cases of bilateral posterior crossbite, 2 cases of unilateral posterior crossbite) with intermaxillary discrepancy of over 5㎜ due to maxillary transverse deficiency were treated by surgically assisted rapid maxillary expansion (SARME). Bilateral maxillary horizontal osteotomies, osteotomies of pterygomaxillary junction and anterior lateral nasal wall, ans anterior palatal osteotomy were performed in 4 cases, and unilateral osteotomies in 1case, followed by palatal expansion with tooth-borne orthopedic applicance. No significant complication was observed. The mean palatal expansion was 7.2㎜ (5.8∼10.0㎜) in the maxillary first molar region. During the mean follow-up period of 4 years (5 months∼8 years 7 months), no recurrence of crossbite was observed in all cases. The SARME seemed to be a simple, stable, and reliable procedure for achieving a permanent increase of over 5㎜ in skeletal maxillary transverse width of adults.

만성 C형 간염 환자에서 페그인터페론 알파2a와 리바비린 병합 치료중 발생한 벨마비 1예

김일환,장제혁,유충헌,최규남,고정해,김윤정,서광원,김지현,박성재,박은택,이연재,이상혁,설상영 인제대학교 2008 仁濟醫學 Vol.29 No.-

페그인터페론과 리바비린 병합요법은 만성 C형 간염의 일차 치료법이다. 저자들은 만성 C형 간염 환자에서 페그인터페론 과 리바비린 병합 요법 중에 발생한 벨마비 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 5년 전부터 만성 C형 간염을 앓아온 48세 남자이며, PEG-IFN α-2a 135μgm 피하주사 주1회와 하루 1200㎎의 리바비린을 투여하였다. 치료시작 후 9개월째 환자는 오른쪽 안면의 근력약화를 호소하였으며 벨마비로 진단되었다. 페그인터페론과 리바비린 병합요법을 지속하면서 관찰하였다. 환자의 벨마비는 페그인터페론 치료를 중단하지 않았음에도 3개월후 증상이 회복되고 이후 벨마비 재발 없이 현재 경과관찰 중이다. 만성 C형 간염에서 페그인터페론과 리바비린 병합 요법시 벨마비의 발생 가능성을 염두에 두어야 하겠다. A Case of Bell's Palsy Associated with Combination Therapy of Pegylated Interferon Alfa-2a (PEG-IFN) and Ribavirin for Chronic Hepatitis C Virus Infection Pegylated interferon alfa(PEG-IFN α) and ribavirin therapy is the first line treatment for chronic hepatitis C. Mild complications of the therapy are common, but more serious complications are rare. We report here a case of Bell's palsy that occurred in a patient with chronic hepatitis C virus infection during combination therapy of PEG-IFN α-2a and ribavirin. The patient was 49-year-old man with chronic hepatitis C (genotype 1b) for 8 years. He had compensated liver cirrhosis with splenomegaly. Therapy with PEG-IFN α- 2a 135mcg/week and ribavirin 1200mg/day was initiated. After 9 months of the therapy, the patient showed a loss of muscular tone on the right side of his face. A diagnosis of Bell's palsy was made. The Bell's palsy resolved over 3 months despite continuation of the combination therapy.

뇌하수체 종양 제거술 시행 후 뒤늦게 발생한 횡문근 융해증과 동반된 중추성 열

장제혁,최규남,김일환,노은지,김윤정,유충헌,고정해,박봉수,김태균,권민정,이순희,박정현 인제대학교 2008 仁濟醫學 Vol.29 No.-

Body temperature is controlled by thermoregulatory center of the hypothalamus. We report a case of 24 years old man with central fever. He was subjected to a partial excision of pituitary tumor compressing optic chiasm four years ago. He has received hormonal therapy for panhypothyroidism after removal of pituitary tumor. And He received gamma knife operation for partially contrast-enhancing masses in suprasellar and both hypothalamic areas that is probably postoperatively remnant or recurrent tumor of pituitary adenoma. One year after gamma knife operation, he presented with a febrile syndrome of unknown origin including rhabdomyolysis. All usual investigations proved negative. We diagnosed him as central fever with rhabdomyolysis. He received medical ICU care with cooling bed, ice pack. And his symptom improved. Postoperative hyperthermia may result following resection of the pituitary tumor. When central fever is suspected taking note of past history, a quick recognition of course of fever can help reduce the using of unnecessary antibiotics and hospital stay.

Nicotinamide adenine dinucleotide phosphate oxidase inhibitor induces apoptosis on Epstein-Barr virus positive B lymphoma cells

Choong Heon Ryu,Sung Hyun Kim,Dae Young Hur 대한해부학회 2020 Anatomy & Cell Biology Vol.53 No.4

Over-expression of nicotinamide adenine dinucleotide phosphate oxidase (Nox) isoform enzymes was recently reported in various cancers including Burkitt’s lymphoma (BL). However, the functions of Nox isoform enzymes in BL remain poorly understood. In this study, Nox isoform expression and the effects of a Nox-specific inhibitor were evaluated in Epstein-Barr virus (EBV)-positive Raji BL cells in comparison with EBV-negative Ramos BL cells. To evaluate Nox enzyme expression in Raji and Ramos BL cells, polymerase chain reaction (PCR) and western blot analysis were performed. To verify the intracellular signaling mechanism of the Nox inhibitor-induced apoptosis of Raji cells, WST-1 assay, trypan blue exclusion method, flow cytometry, PCR, western blotting, and bromodeoxyuridine staining were conducted. Experiments using the pan-caspase inhibitor z-VAD, reactive oxygen species scavenger N-acetyl-L-cysteine (NAC), and Bim inhibitor 1 were performed. PCR and western blot results showed that Nox isoform enzymes were highly expressed in EBV-positive BL Raji cells compared with EBV-negative BL Ramos cells. The Nox2 inhibitor induced apoptosis of Raji cells in time- and dose-dependent manners. The Nox2 inhibitor also caused up-regulation of Bim and Noxa, down-regulation of Mcl-1, translocation of Bax, release of cytochrome c, and caspase cascade activation, resulting in apoptosis. Furthermore, z-VAD, NAC, and BI-1 effectively blocked the Nox2 inhibitor-induced apoptosis of Raji cells. Taken together, these results provide a novel insight into the mechanism of Nox inhibitor-induced apoptosis and evidence for Nox as a therapeutic target to treat EBV-positive malignancies.

Review : Biliary Strictures after Liver Transplantation

( Choong Heon Ryu ),( Sung Koo Lee ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2011 Gut and Liver Vol.5 No.2

Biliary strictures are one of the most common complications following liver transplantation, representing an important cause of morbidity and mortality in transplant recipients. The reported incidence of biliary stricture is 5% to 15% following deceased donor liver transplantations and 28% to 32% following living donor liver transplantations. Bile duct strictures following liver transplantation are easily and conveniently classifi ed as anastomotic strictures (AS) or non-anastomotic strictures (NAS). NAS are characterized by a far less favorable response to endoscopic management, higher recurrence rates, graft loss and the need for retransplantation. Current endoscopic strategies to correct biliary strictures following liver transplantation include repeated balloon dilatations and the placement of multiple side-by-side plastic stents. Endoscopic balloon dilatation with stent placement is successful in the majority of AS patients. In patients for whom gaining biliary access is technically diffi cult, a combined endoscopic and percutaneous/surgical approach proves quite useful. Future directions, including novel endoscopic retrograde cholangiopancreatography techniques, advanced endoscopy, and improved stents could allow for a decreased number of interventions, increased intervals before retreatment, and decreased reliance on percutaneous and surgical modalities. The aim of this review is to detail the present status of endoscopy in the diagnosis, treatment, outcome, and future directions of biliary strictures related to orthotopic liver transplantation from the viewpoint of a clinical gastroenterologists. (Gut Liver 2011;5:133-142)

양성 담도협착에서 완전 피막형

류충헌 ( Choong Heon Ryu ),김명환 ( Myung Hwan Kim ),이상수 ( Sang Soo Lee ),박도현 ( Do Hyun Park ),서동완 ( Dong Wan Seo ),이성구 ( Sung Koo Lee ) 대한소화기학회 2013 대한소화기학회지 Vol.62 No.1

Background/Aims: Benign biliary strictures (BBSs) have been endoscopically managed with plastic stent placement. However, data regarding fully covered self-expandable metal stents (FCSEMSs) in BBS patients remain scarce in Korea. Methods: Forty-one patients (21 men, 65.9%) with BBSs underwent FCSEMS placement between February 2007 and July 2010 in Asan Medical Center. Efficacy and safety were evaluated retrospectively. Patients were considered to have resolution if they showed evidence of stricture resolution on cholangiography and if an inflated retrieval balloon easily passed through the strictures at FCSEMS removal. Results: The mean FCSEMS placement time was 3.2 (1.9-6.2) months. Patients were followed for a mean of 10.2 (1.0 32.0) months after FCSEMS removal. The BBS resolution rate was confirmed in 38 of 41 (92.7%) patients who underwent FCSEMS removal. After FCSEMS removal, 6 of 38 (15.8%) patients experienced symptomatic recurrent stricture and repeat stenting was performed. When a breakdown by etiology of stricture was performed, 14 of 15 (93.3%) patients with chronic pancreatitis, 17 of 19 (89.5%) with gall stone-related disease, 4 of 4 (100%) with surgical procedures, and 2 of 2 (100%) with BBSs of other etiology had resolution at FCSEMS removal. Complications related to stent therapy occurred in 12 (29%) patients, including post-ERCP pancreatitis (n=4), proximal migration (n=3), distal migration (n=3), and occlusion (n=2). Conclusions: Temporary FCSEMS placement in BBS patients offers a potential alternative to plastic stenting. However, because of the significant complications and modest resolution rates, the potential benefits and risks should be evaluated in further investigations. (Korean J Gastroenterol 2013; 62:49-54)

간 및 비장을 침범한 결핵성 농양

최정숙(Jeong Sug Choi),류수현(Su Heon Ryu),유대성(Dae Seong Yu),오정열(Jeong Yeol Oh),김영묵(Young Mook Kim),이충원(Choong Won Lee),제영성(Yeong Sung Jae),이준상(Joon Sang Lee) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.3

Hepatosplenic tuberculosis is manifested commonly as miliary form, but the isolated form of hepatosplenic tuberculosisis is extremity rare. The local form of hepatosplenic tuberculosis is trans- ported to liver from intestine through portal vein. Basic pathology is granuloma. We described a patient with tuberculous abscess of liver and spleen proved by computed tomography and microbial identification. Liver specimen obtained by CT-guided fine needle aspiration showed Mycobacterium tuberculosis. After one month of antituberculous medication, the patients condition has been improved. Thus, the local form of hepatic tuberculosis must be differentiated from similar diseases, because it can be cured dramatically by antituberculous medication. (Korean J Gastroenterol 1995;27:363 - 368)

두개골 전이로 진단된 원발성 간암

최정숙(Jeong Sug Choi),류수현(Su Heon Ryu),오정열(Jeong Yeol Oh),이충원(Choong Won Lee),김영묵(Young Mook Kim),임종섭(Jong Sub Lim),제영성(Young Sung Jae),유방현(Band Hyun Liu) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.3

Skull metastases of primary hepatocellular carcinoma are very rare, even in the Orient and the Africa where this carcinoma is one of the common rnalignancies. However, although these skull tnetastases are rare, this diagnosis must be considered when an skull tutnor has a metastatic appearance, especially in cirrhotic patients or heavy alcoholics. This lesion is extremely hypervas- cular, and precautions for hemorrhage must be taken before any procedure, even a biopsy is done. The prognosis remains lethal and average survival time after the time of diagnosis is under 6 months, but appropriate local surgical resection to the skull region and systemic control with chemotheraphy and radiotheraphy can result in improved survival. The patient reported here may be valuable in presenting an unusual occurance of primary hepatocellular carcinoma with metastases to the skull. (Korean J Gastroenterol 1996; 28:415 - 420)

A comparison of the BISAP score and serum procalcitonin for predicting the severity of acute pancreatitis

( Byung Geun Kim ),( Myung Hwan Noh ),( Choong Heon Ryu ),( Hwa Seong Nam ),( Su Mi Woo ),( Seung Hee Ryu ),( Jin Seok Jang ),( Jong Hun Lee ),( Seok Ryeol Choi ),( Byeong Ho Park2 ) 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.3

Background/Aims: The bedside index of severity in acute pancreatitis (BISAP) is a new, convenient, prognostic multifactorial scoring system. As more data are needed before clinical application, we compared BISAP, the serum procalcitonin PCT), and other multifactorial scoring systems simultaneously. Methods: Fifty consecutive acute pancreatitis patients were enrolled prospectively. Blood samples were obtained at admission and after 48 hours and imaging studies were performed within 48 hours of admission. The BISAP score was compared with the serum PCT, Ranson`s score, and the acute physiology and chronic health examination (APACHE)-II, Glasgow, and Balthazar computed tomography severity index (BCTSI) scores. Acute pancreatitis was graded using the Atlanta criteria. The predictive accuracy of the scoring systems was measured using the area under the receiver-operating curve (AUC). Results: The accuracy of BISAP (≥ 2) at predicting severe acute pancreatitis was 84% and was superior to the serum PCT (≥ 3.29 ng/mL, 76%) which was similar to the APACHE-II score. The best cutoff value of BISAP was 2 (AUC, 0.873; 95% con- fidence interval, 0.770 to 0.976; p < 0.001). In logistic regression analysis, BISAP had greater statistical significance than serum PCT. Conclusions: BISAP is more accurate for predicting the severity of acute pancreatitis than the serum PCT, APACHE-II, Glasgow, and BCTSI scores.

두개골 전이로 진단된 원발성 간암 1예

최정숙,오정열,이충원,김영묵,류슈현,임종섭,제영성,유방현 침례병원 1994 浸禮病院學術誌 Vol.11 No.