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대장 선종과 혈중 C-Reactive Protein 농도
박성근 ( Sung Keun Park ),박동일 ( Dong Il Park ),박정호 ( Jung Ho Park ),김홍주 ( Hong Ju Kim ),조용균 ( Yong Kyun Cho ),손정일 ( Chong Il Sohn ),전우규 ( Woo Kyu Jeon ),김병익 ( Byung Ik Kim ),김지은 ( Jee Eun Kim ),손희정 ( Hee 대한소화기학회 2008 대한소화기학회지 Vol.51 No.4
목적: 염증 반응이 대장암의 발생에 관련된다는 여러 연구 결과가 있다. 대장 선종은 대표적인 전암 병변으로서 대장암의 발생에 중요한 역할을 하며 CRP는 염증 반응의 표지자로서 여러 질환에서 임상 의의를 갖는다. 저자들은 대장 선종과 염증 표지자인 CRP와의 연관성에 대해 알아보고자 하였다. 대상 및 방법: 건강검진을 받은 수신자 중 대장내시경을 시행 받은 5,487명을 대상으로 선종이 발견된 1,982명을 대장 선종군으로, 선종이 발견되지 않은 3,505명을 대조군으로 하였다. 이 두 군에서 평균 CRP 농도를 비교하였으며 CRP 농도에 따른 대장 선종의 위험도를 알아보았다. 또한, CRP 농도와 관련된 여러 인자들의 차이에 대해 비교하였으며 대장 선종의 크기와 조직학적인 차이에 따른 CRP 농도의 변화를 알아보았다. 결과: 두 군을 비교했을 때, CRP 농도의 차이는 없었다. 또한, 여러 인자들을 보정했을 때도 CRP 농도는 대장 선종의 발생을 예측하지 못했으며 CRP 농도에 따른 대장 선종의 위험율에서도 차이는 없었다. 대장 선종의 크기와 조직학적인 차이에 따른 CRP 농도 역시 유의한 차이가 없었다. 결론: 염증 반응의 표지자로서 CRP 농도는 대장 선종의 발생 및 특징과 유의한 연관성을 갖지 않는다. Background/Aims: Recent studies implicated inflammation playing an important role in the occurrence and advancement of colorectal cancer. Colorectal adenoma as the representative precursor lesion of colorectal cancer has meaningful association with inflammation. Accordingly, the purpose of this study was to evaluate the association between serum C-reactive protein (CRP) levels and the risk of colorectal adenoma Methods: This study was undertaken on 5,487 subjects (3,478 men and 2,009 women) who underwent colonoscopy at the Health Promotion Center in Kangbuk Samsung Hospital and Samsung Medical Center. The subjects were allocated into 3,505 normal control subjects and 1,982 patients with colorectal adenoma. The mean level of CRP was compared between the two groups, and the correlations with other variables were analyzed by multiple regression analysis. Also, the risk of colorectal adenoma according to CRP level and difference of CRP level according to the characteristics of adenomas were analyzed. Results: There was no significant difference in serum CRP level between normal and colorectal adenoma group. After adjusting for the clinically significant variables of colorectal adenoma, multiple logistic regression analysis of the risk of colorectal adenoma according to the CRP level (<1, 1-3,>3) and the CRP level according to characteristics of adenomas showed no significant difference. Conclusions: An inflammatory marker, CRP is not a risk factor for colorectal adenoma development. (Korean J Gastroenterol 2008; 51:225-231)
증례 : 감염 ; 간경화 환자에서 Non-O1 Vibrio cholerae에 의한 고름근육염 1예
박성근 ( Sung Keun Park ),이지원 ( Ji Won Lee ),김진용 ( Jin Yong Kim ),박윤수 ( Yoon Soo Park ),서일혜 ( Yiel Hae Seo ),조용균 ( Yong Kyun Cho ) 대한내과학회 2011 대한내과학회지 Vol.80 No.3
본 증례는 간경화 환자에서 non-O1 V. cholerae에 의한 고름근육염이 발생한 국내 첫 예이다. 이러한 기저 질환이 있는 환자에서 고름근육염의 원인균으로 non-O1 V. cholerae도 고려하여야 한다. A 63-year-old man with underlying liver cirrhosis was admitted with painful swelling of the right thigh. We identified a non-O1 Vibrio cholerae strain in blood cultures and multiple pyomyositis in the lower limbs. Non-O1 V. cholerae strains have caused several well-studied food-borne outbreaks of gastroenteritis and have been responsible for sporadic cases of otitis media, skin and soft tissue infection, and bacteremia. Skin and soft tissue infection due to non-O1 V. cholerae is rare and is commonly associated with the presence of chronic underlying disease, such as liver cirrhosis, diabetes mellitus, an immunocompromised state, or a hematological malignancy. We report the first case of pyomyositis caused by non-O1 V. cholerae in Korea. Physicians should consider non-O1 V. cholerae strains as a pathogen that can cause pyomyositis. (Korean J Med 2011;80:356-359)
노인에서 대장 내시경 선별 검사의 임상적 효용성: 대한장연구학회 다기관 공동연구
박성근 ( Sung Geun Park ),박동일 ( Dong Il Park ),김영호 ( Young Ho Kim ),김현수 ( Hyun Soo Kim ),김원호 ( Won Ho Kim ),김태일 ( Tae Il Kim ),김효종 ( Hyo Jong Kim ),양석균 ( Suk Kyun Yang ),변정식 ( Jeong Sik Byeon ),이문성 ( Moo 대한장연구학회 2008 Intestinal Research Vol.6 No.1
Background/Aims: Currently, screening colonscopy is widely performed in the medical field. The initial time of screening is recommended at an age of 50 years, but the age to cease screening is unknown. Accordingly, we have investigated the diagnostic yield of colonoscopy according to indications in the elderly, and we evaluated if screening colonoscopy is useful in the elderly. Methods: We recruited asymptomatic individuals undergoing screening colonoscopy according to age (2830 subjects aged 50-74 years and 111 subjects ≥75 years-old), The colonoscopy findings of the study subjects were compared. In addition, colonoscopy findings of asymptomatic subjects more than 75 years-old were compared with the findings of symptomatic subjects with the same age. Results: The yield for overall neoplasia and advanced adenoma was higher in the group of subjects ≥75 years-old than in the 50-74 years age group (overall adenoma: 49.54% versus 24.98%, p<0.001; advanced adenoma: 16.2% versus 8.23%, p=0.003). The overall frequency of neoplasms was higher in asymptomatic subjects ≥75 years-old than in symptomatic subjects ≥75 years-old (49.54% versus 28.19%, p<0.001). Conclusions: The prevalence of advanced adenoma increased with age. Screening colonoscopy was still significantly effective in elderly subjects ≥75 years-old. The lack of a decline in the frequency of adenoma, including advanced adenoma, justifies continuing screening colonoscopy in the elderly. (Intest Res 2008;6:25-30)