위 MALT 림프종에서 다발성 림프절 전이로 오인된 동시성 림프절 결핵 1예

김성은,김규종,김도현,송준영,문대성,장리라,유찬희,문원,박무인,박선자,김영옥 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

28세 남자가 내시경적 점막절제술을 통해 저등급 위MALT 림프종으로 진단되었다. 병기설정을 위해 18F-FDG PET 검사를 시행하였고 우측 쇄골상부, 우측상/하부 기관주위, AP window 부위에 강한 섭취가 관찰되어 전이성 림프절로 판단하였다. 그러나, 우측 쇄골상부 림프절에서 시행한 절제생검에서 만성육아종성염증소견이 관찰되었고 조직의 결핵 중합효소연쇄반응에서도 양성 반응을 보였다. 2개월간 항결핵제의 사용 후 시행한 추적 컴퓨터단층촬영 검사에서 림프절 크기의 감소를 보여 최종적으로 위 MALT 림프종에서 광범위 림프절 전이로 오인된 동시성 림프절 결핵으로 진단되었다. A 28-year-old man was diagnosed as gastric MALT lymphoma in diagnostic EMR (endoscopic mucosal resection). He subsequently underwent an 18F-FDG PET. 18F-FDG PET showed intense multifocal uptake in right supraclavicular, right upper and lower paratracheal, and AP window areas that was considered radiologically to represent widespread metastatic lymphadenopathy. Excisional biopsy of a supraclavicular lymph node, however, revealed chronic granulomatous lymphadenitis with a positive reaction of Tb-nested PCR. After antituberculosis treatment for 2 months, a follow-up CT scan showed complete resolution of the lesions. Intense 18F-FDG uptake could be due to an infectious process such as synchronous tuberculous lymphadenitis. Therefore, this could mimic a malignant condition such as lymphoma with extensive lymph node metastasis due to a false-positive finding, which may lead to a misdiagnosis.

Impact of body mass index on survival in patients undergoing peritoneal dialysis: Analysis of data from the Insan Memorial End-Stage Renal Disease Registry of Korea (1985-2014)

( Seun Deuk Hwang ),( Jin Ho Lee ),( Jong Hyun Jhee ),( Joon Ho Song ),( Joong Kyung Kim ),( Seoung Woo Lee ) 대한신장학회 2019 Kidney Research and Clinical Practice Vol.38 No.2

Background: Significant increases in the prevalence of obesity have been observed among patients with peritoneal dialysis (PD). The impact of body mass index (BMI) on survival remains unknown in Korean PD patients. Methods: Among data of 80,674 patients on PD acquired from the Insan Memorial ESRD Registry database for the years 1985 to 2014, 6,071 cases were analyzed. Subjects were classified by baseline BMI; < 21.19 kg/m2 (quartile 1, n = 1,518), 21.19 to 23.18 kg/ ㎡ (quartile 2, reference; n = 1,453), 23.19 to 25.71 kg/ ㎡ (quartile 3, n = 1,583), and > 25.71 kg/ ㎡ (quartile 4, n = 1,517). Results: Mean age was 65.8 years, and baseline BMI was 23.57 kg/ ㎡. Numbers of male and diabetic patients were 3,492 (57.5%) and 2,192 (36.1%), respectively. Among 6,071 cases, 2,229 (36.7%) all-cause deaths occurred. As a whole, Kaplan-Meier survival curves according to BMI quartiles was significantly different (P = 0.001). All-cause mortality was significantly higher in quartile 4 than in the reference (hazard ratio [HR] = 1.154, 95% confidence interval [CI], 1.025-1.300; P = 0.018). There was no statistical difference in all-cause mortality among BMI quartiles in diabetic patients on PD. In non-diabetic patients, all-cause mortality of quartiles 1 and 3 was not different from the reference, but the HR was 1.176 times higher in quartile 4 (95% CI, 1.024-1.350; P = 0.022). Conclusion: Baseline BMI > 25.71 kg/ ㎡ seems to be an important risk factor for all-cause mortality in Korean PD patients.

Impact of pretransplant rituximab induction on highly sensitized kidney recipients

Young Hae Song,Kyu Ha Huh,Yu Seun Kim,Hyung Soon Lee,Myoung Soo Kim,Soo Jin Kim,Hyun Jung Kim,Soon Il Kim,Dong Jin Joo 대한외과학회 2012 Annals of Surgical Treatment and Research(ASRT) Vol.82 No.6

Purpose: Highly sensitized patients with a high level of panel reactive antibody (PRA) experience more episodes of antibody-mediated rejection (AMR) and poorer graft survival than non-sensitized patients. Rituximab is a well-known monoclonal anti-CD20 antibody that causes the depletion of B lymphocytes. The aim of this study was to compare a rituximab-administered and a non-administered group of highly sensitized recipients. Methods: Forty-three kidney recipients with a PRA level of ≥50% were included. Sixteen (group R) received one dose of rituximab at 2 days prior to transplantation and 27 patients (group NR) did not. Results: Patients’ demographics, such as age, sex, dialysis duration, and type of immunosuppressive agent were not different in the two groups. No side effects due to rituximab administration were observed in group R. Class I PRA of group R (75.6 ± 37.7%) was higher than that of group NR (45.7 ± 35.8%, P = 0.013). More acute rejection episodes occurred within 1 year after transplantation in group NR but the difference between the groups was not significant (18.8% in group R vs. 29.6% in group NR, P = 0.631). However, two AMR episodes occurred only in group NR. Renal functions were not different in the two groups. In group R, CD19 and CD20 rapidly decreased 2 days after rituximab infusion. Furthermore, the administration of rituximab was not linked to acute rejection. Conclusion: To confirm the long-term anti-rejection and beneficial effects of rituximab, further studies should be performed with a larger cohort. In conclusion, rituximab administration 2 days prior to transplantation is both effective and safe.

Gemcitabine/cisplatin 항암치료 후 완전관해가 보고된 전이성 췌장암 환자 2례

조중현 ( Jung Hyun Jo ),정문재 ( Moon Jae Chung,),박정엽 ( Jeong Youp Park ),방승민 ( Seun Gmin Bang ),박승우 ( Seung Woo Park ),정재복 ( Jae Bock Chung ),송시영 ( Si Young Song ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.1

Pancreatic ductal adenocarcinoma has a very poor prognosis. Patients with this type of tumor have a median overall survival of 9 months in locally advanced pancreatic cancer and 3-6 months in metastatic disease. However, there have been rare cases of patients with advanced pancreatic cancer who survived unexpectedly longer without curative surgery. We report two cases of metastatic pancreatic cancer in patients who presented complete remission after receiving gemcitabine/cisplatin chemotherapy and survived for about 10 years. The first case is that of a 51-year-old Korean woman who was diagnosed with pancreatic body cancer with invasion of the celiac artery and supraclavicular lymph node metastasis. The patient received gemcitabine/cisplatin systemic chemotherapy and achieved complete remission after the 12th cycle of chemotherapy. At present, the patient has survived for 10 years and 2 months after diagnosis. The second case is that of a 69-year-old Korean woman who was diagnosed with pancreatic head cancer with liver metastasis. The patient received gemcitabine/cisplatin chemotherapy and achieved complete remission after the 6th cycle of chemotherapy. At present, the patient has survived for 9 years and 2 months after diagnosis. Our study is the first case report of patients who achieved long-term survival with complete remission after receiving chemotherapy alone for metastatic pancreatic cancer.

Case report: Reinterpretation of Follow-Up, High-Resolution Manometry for Esophageal Motility Disorders Based on the Updated Chicago Classification

( Jun Young Song ),( Moo In Park ),( Do Hyun Kim ),( Chan Hui Yoo ),( Seun Ja Park ),( Won Moon ),( Hyung Hun Kim ) The Editorial Office of Gut and Liver 2013 Gut and Liver Vol.7 No.3

The aim of this study was to assess changes between primary classification of esophageal motility disease and follow-up classification by high resolution manometry (HRM) and to determine whether previously classified diseases could be recategorized according to the updated Chicago Classification published in 2011. We reviewed individual medical records and HRM findings twice for each of 13 subjects. We analyzed primary and follow-up HRM findings based on the original Chicago Classification. We then reclassified the same HRM findings according to the updated Chicago Classification. This case series revealed the variable course of esophageal motility disorders; some patients experienced improvement, whereas others experienced worsening symptoms. Four cases were reclassified from variant achalasia to peristaltic abnormality, one case from diffuse esophageal spasm to type II achalasia and one case from peristaltic abnormality to variant achalasia. Four unclassified findings were recategorized as variant achalasia. In conclusion, esophageal motility disorders are variable and may not be best conceptualized as an independent group. Original classifications can be recategorized according to the updated Chicago Classification system. More research is needed on this topic. (Gut Liver 2013; 7:377 381)

진행성 대장암 환자에서 FOLFOX4 복합화학약물 치료의 실패 후 2차 요법으로 FOLFIRI 복합화학약물 치료의 효과와 안전성

김재현 ( Jae Hyun Kim ),박선자 ( Seun Ja Park ),박무인 ( Moo In Park ),문원 ( Won Moon ),김성은 ( Sung Eun Kim ),구기환 ( Ki Hwan Ku ),송성은 ( Sung Eun Song ),김제훈 ( Je Hun Kim ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.1

Background/Aims: The incidence of colorectal cancer has been increasing every year in Korea. Irinotecan- or oxaliplatin-based regimens including biologic agents are known to be effective in patients with advanced colorectal cancer. But in practice, FOLFOX (combination of oxaliplatin, 5-fluorouracil, and leucovorin) or FOLFIRI (combination of irinotecan, 5-fluorouracil, and leucovorin) regimens without biologic agents are more commonly used in Korea due to of the high costs of biologic agents. The aim of this study was to evaluate the efficacy and toxicity of FOLFIRI following FOLFOX4 in patients with advanced colorectal cancer. Methods: A total of 54 patients with advanced colorectal cancer who were treated between May 2005 and May 2013 with FOLFOX4 as first-line chemotherapy and with FOLFIRI as second-line chemotherapy at Kosin University Gospel Hospital (Busan, Korea) were reviewed retrospectively. Results: A total of 54 patients received second-line FOLFIRI chemotherapy. Five patients (9.3%) had a partial response, 29 patients (53.7%) had a stable disease. The median overall survival was 8.90 months and the median time to progression was 4.33 months. Toxicities were tolerable. Conclusions: In a Korean population, FOLFIRI as second-line chemotherapy is effective and well tolerated in patients with advanced colorectal cancer after failure of FOLFOX4. Although the efficacy of FOLFIRI in this study was lower than that of second-line FOLFIRI with biologic agents, these results can help in the formulation of a treatment strategy for financially troubled patients. (Korean J Gastroenterol 2014;63:18-24)

열처리 활성탄의 메탄을 흡착특성 연구

유경선,신장원,신성욱,정종현,송광섭,서용석,강순국 한국화학공학회 2003 Korean Chemical Engineering Research(HWAHAK KONGHA Vol.41 No.4

활성탄의 열처리 효과가 메탄을 흡착특성에 미치는 영향을 고찰하기 위하여, 열전도도검출기가 장착된 기체크로마토크라프에서 펄스응답곡선을 측정하고 모멘트 법으로 반응파라메터를 계산하였다. 메탄올의 평형흡착상수와 표면흡착열은 열처리한 활성탄에서 감소하였다. 이것은 열처리 활성탄의 표면산소 기능기들의 감소로 메탄올과의 상호 작용력이 감소하였음을 의미하며 활성탄으로부터 배출되는 C0/CO₂ 농도를 측정한 승온탈착 실험으로 확인하였다. 활성탄의 열처리에 관계없이 큰 세공과 작은 세공 확산계수는 같은 크기규모의 값을 보였으며 표면확산과 Knudsen 확산이 작은 세공과 큰 세공에서 각각 지배적이었다. To investigate the effect of thermal treatment of activated carbon on methanol adsorption, pulse-responses were measured in a gas chromatograph equipped with thermal conductivity detector (TCD), and reaction parameters were calculated by the moment method. Equilibrium adsorption constants and isosteric heat of adsorption of methanol decrease in the thermally treated activated carbon. This shows the decrease in the interaction between activated carbon and methanol due to the decrease of concentration of surface oxygen, which was confirmed by TPD experiment measuring the evolved concentration of CO/CO₂ from the activated carbon. Regardless of thermal treatment of activated carbon, macro- and micro-diffusivities showed the value of same order of magnitude and surface and Knudsen diffusion prevails in micro and macro pore, respectively.

Python을 이용한 웹 기반 사물인터넷 패킷분석 시스템에 관한 연구

박현철(Park Hyun Cheol),송재승(Song Jae Seun) 한국통신학회 2017 한국통신학회 학술대회논문집 Vol.2017 No.11

대장암 환자에서 복막 전이에 대한 복수내 암태아 항원 (Carcinoembryonic Antigen)의 진단적 가치

송성은 ( Sung Eun Song ),최바울 ( Paul Choi ),김재현 ( Jae Hyun Kim ),정경원 ( Kyoungwon Jung ),김성은 ( Sung Eun Kim ),문원 ( Won Moon ),박무인 ( Moo In Park ),박선자 ( Seun Ja Park ) 대한소화기학회 2018 대한소화기학회지 Vol.71 No.6

Background/Aims: Diagnostic tests for carcinoembryonic antigen (CEA) in ascites have been performed in various malignant cases, but there is only few data on the applicability of CEA for colorectal cancer (CRC) patients with peritoneal carcinomatosis. We aimed to determine the usefulness of CEA in ascites (aCEA) as a diagnostic parameter for CRC with peritoneal carcinomatosis. Methods: Between January 2000 and May 2013, the medical records of 259 patients who underwent paracentesis for the evaluation of ascites were retrospectively reviewed. CRC patients with ascites (n=82) and patients with non-malignant ascites (n=177) were evaluated. Patients who had other malignancies, including gastric or ovarian cancer, with ascites were excluded. The optimal diagnostic cut-off value of aCEA for CRC with peritoneal carcinomatosis was determined using receiver operating characteristic curve analysis. The value of aCEA for predicting the occurrence of peritoneal carcinomatosis was evaluated using a logistic regression model. Results: The optimal cut-off value of aCEA to diagnose CRC with peritoneal carcinomatosis was 3.89 ng/mL, and the area under the curve for aCEA was 0.996 (sensitivity 96.3%, specificity 100%, positive predictive value 100%, negative predictive value 98.3%). Multivariate logistic regression analysis showed that aCEA was an independent factor predicting the occurrence of peritoneal carcinomatosis. Conclusions: In this study, we showed that aCEA may be a useful parameter for diagnosing CRC with peritoneal carcinomatosis, and we propose an optimal aCEA cut-off value of 3.89 ng/mL. Further study that includes patients with other malignant ascites may be necessary to validate these findings. (Korean J Gastroenterol 2018;71:332-337)

급성 구인두 연하곤란으로 발현된 피부근염

송성은 ( Sung Eun Song ),박무인 ( Moo In Park ),문원 ( Won Moon ),박선자 ( Seun Ja Park ),김규종 ( Kyu Jong Kim ),김재현 ( Jae Hyun Kim ),김경미 ( Gyung Mi Kim ),김종국 ( Jong Kuk Kim ),심영주 ( Young Joo Sim ),이정민 ( Jung Min 대한소화기기능성질환·운동학회 2009 Journal of Neurogastroenterology and Motility (JNM Vol.15 No.1

Dermatomyositis is a rare autoimmune disorder afflicting an estimated 6-10 million people worldwide that has a distinct clinical entity identified by a characteristic skin rash and inflammatory myopathy. It can be combined with other connective tissue diseases such as systemic sclerosis or systemic lupus erythematosus. In addition to primary disturbances of limb muscle and skin, extramuscular manifestations include dysphagia, cardiac conduction abnormalities, interstitial lung disease or subcutaneous calcifications. Dysphagia occurs in 12%-54% of those with dermatomyositis, manifests gradually over weeks to months rather than in acutely, and is diagnosed with high-resolution esophageal manometry and video-fluoroscopic monitoring during swallowing. We report a case of dermatomyositis presenting initially with acute oropharyngeal dysphagia and review the available swallowing studies and related literature. (Kor J Neurogastroenterol Motil 2009;15:65-69)