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박원우 ( Won Wo Park ),서승철 ( Seung Chul Seo ),이현경 ( Hyun Kyung Lee ),이성순 ( Sung Soon Lee ),이영민 ( Young Min Lee ),이혁표 ( Hyuk Pyo Lee ),김주인 ( Joo In Kim ),최수전 ( Soo Jeon Choi ),염호기 ( Ho Kee Yum ) 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.3
Reactive airway dysfunction syndrome (RADS) is a clinical entity characterized by sudden onset of obstructive airway disorder and nonspecific airway hyperresponsiveness after exposure to a toxic or irritant chemical with negative history of obstructive airway symptoms prior to exposure. After exposure to high concentrations of irritating substances, obstructive symptoms are usually persistent. Causative substances are nonspecific and various. The exact mechanism of this dysfunction remains to be elucidated. We report a case of RADS which presented with dyspnea elicited by smoking insecticide of cockroach containing dichlorvos as a main ingredient. (Korean J Asthma Allergy Clin Immunol 2006;26:246-248)
사람면역결핍바이러스 감염에 동반된 미만성 침윤성 림프구 증가 증후군
권선옥 ( Sun Ok Kwon ),박원우 ( Won Wo Park ),이현경 ( Hyun Kyung Lee ),이성순 ( Sung Soon Lee ),강윤경 ( Youn Kyung Kang ),이영민 ( Young Min Lee ),이혁표 ( Hyuk Pyo Lee ),김주인 ( Joo In Kim ),최수전 ( Soo Jeon Choi ),염호기 ( H 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.3
Diffuse infiltrative lymphocytosis syndrome is an autoimmune syndrome that is characterized by the oligoclonal expansion of CD8+ T-lymphocytes in response to human immunodeficiency virus (HIV) antigens. The clinical manifestations include bilateral enlargement of the parotid glands, lymphocytic interstitial pneumonitis, lymphocytic hepatitis, neurological involvement and systemic lymphadenopathies. In addition to a positive HIV test, the diagnostic histopathological findings are CD8+ T-lymphocytic infiltrations in the lymphnodes, liver, lung, muscle and the salivary or lacrimal glands without granulomatous or neoplastic involvement. We report a case of pulmonary involvement of diffuse infiltrative lymphocytosis syndrome that was associated with a human immunodeficiency virus infection. (Tuberc Respir Dis 2006; 61: 289-293)
수술로 절제한 위장관기질종양에서 Ki-67 발현의 예후적 중요성
정성연 ( Seong Yeon Jeong ),박원우 ( Won Wo Park ),김유선 ( You Sun Kim ),박영일 ( Young Il Park ),김승협 ( Seung Hyup Kim ),윤원재 ( Won Jae Yoon ),문정섭 ( Jeong Seop Moon ),이병모 ( Byung Mo Lee ),홍성우 ( Seong Woo Hong ),강 대한소화기학회 2014 대한소화기학회지 Vol.64 No.2
목적: 현재까지 위장관기질종양(GIST)을 양성과 악성으로 분류할 수 있는 명확한 조직학적 기준은 없지만, 전이나 재발을 일으킬 수 있는 위험도를 종양세포의 유사분열 수와 종양의 크기를 기준으로 나누고 있다. Ki-67은 세포 증식의 표지자로 사용되는 단백질로, GIST의 예후 인자로의 가능성이 주목되고 있다. 이에 저자들은 수술 치료를 시행한 GIST 환자 중 Ki-67 면역조직화학염색을 시행한 32예의 Ki-67 지수와 유사 분열 지수와의 관련성, GIST의 재발률 및 무병 생존율에 대하여 분석 검토하여 보았다. 대상 및 방법: 인제대학교 서울백병원에서 수술 치료를 통하여 GIST를 제거한 32명의 환자를 대상으로 연구를 시행하였고 환자들의 의무기록을 통하여 성별, 연령, 증상 등의 임상적 특징과, 종양의 크기, 위치 등의 조직학적 특징 및 재발률에 대하여 조사하였다. 결과: NIH 진단기준으로 very low risk는 4예, low risk는 9예, intermediate risk는 14예, high risk는 5예였다. Ki-67 지수는 1-18%의 범위 내에 있었고, 평균은 5.56±4.48%였다. 평균 추적관찰 기간은 35.72±29.04개월이었고 관찰 도중 6 예(18.7%)에서 재발 혹은 전이가 발견되었다. Ki-67 지수가 5% 이하인 군의 누적 무병 생존율은 12개월, 24개월, 60개월에 각각 100%, 100%, 86%였다. 반면 Ki-67 지수가 5% 초과인 군의 누적 무병 생존율은 12개월, 24개월, 60개월에 각각 82.1%, 70.3%, 46.9%로 Ki-67 지수가 5% 이하인 환자에 비하여 무병 생존율에 유의한 차이를 보였다(p=0.007) 결론: Ki-67 지수가 5% 초과할 경우 GIST 재발의 고위험성을 시사한다. 향후 Ki-67 지수의 표준화와 치료 방향의 결정에 미치는 Ki-67 지수의 역할에 대한 연구가 필요하다. Background/Aims: Assessment of malignant potential in gastrointestinal stromal tumor (GIST) is still problematic. The maximum tumor diameter and the mitotic index are generally used as an index of malignancy of GISTs. The Ki-67 labeling index has recently been used as an index of cell growth. The aim of this study was to investigate the prognostic value of K -67 in GIST. Methods: We retrospectively reviewed the medical records of 32 patients with GIST who underwent surgical resection at Inje University Seoul Paik Hospital. We analyzed their Ki-67 expression, histologic finding, and prognosis. Results: According to the tumor size and mitotic count, 4 patients were classified as very low risk, 9 patients as low risk, 14 patients as intermediate risk and 5 patients as high risk. The average Ki-67 index was 5.56±4.48%. The median follow-up duration was 35.72±29.04 months, and local/distant recurrences were observed in 6 (18.7%) patients. The overall cumulative disease free survival rates in patients with Ki-67 index ≤5% at 1 year, 2 years, and 5 years were 100%, 100%, and 86%, respectively. The overall cumulative disease free survival rates in patients with Ki-67 index >5% were at 1 year, 2 years, and 5 years were 82.1%, 70.3%, and 46.9%, respectively. There was significant relationship between elevated Ki-67 and disease free survival rate (p=0.007). Conclusions: Our study suggests that Ki-67 index >5% confers a higher risk of relapse in patients with GIST. Future work should focus on standardization of Ki-67 assessment and specification of its role in making treatment decisions.(Korean J Gastroenterol 2014,64:87-92)
조주연 ( Joo Yeon Cho ),김유선 ( You Sun Kim ),박원우 ( Won Wo Park ),총배천 ( Tsung Pei Chuan ),김현태 ( Hyun Tae Kim ),이상렬 ( Sang Ryul Lee ),이정환 ( Jung Hwan Lee ),문정섭 ( Jeoung Soep Moon ) 대한장연구학회 2011 Intestinal Research Vol.9 No.1
Background/Aims: Intestinal tuberculosis (ITB) evades early diagnosis due to non-specific clinical manifestations and difficulties in confirming the disease process. In the current study, we determined the diagnostic appearance and clinical manifestations of ITB in recent 10 years according to diagnostic guidelines, as proposed by the IBD Study Group of Korean Association for the Study of the Intestinal Diseases (KASID). Methods: Fifty-six patients with ITB who were diagnosed at Seoul Paik Hospital between January 2001 and August 2010 were retrospectively reviewed. The diagnosis of ITB was defined as definite or probable in accordance with the diagnostic guidelines and the clinical features were analyzed in comparison with previous studies involving ITB in Korea. Results: The mean age at the time of diagnosis was 45±15 years (range, 17-71 years). Definite and probable diagnoses were obtained in 29% and 71% of the patients, respectively. Twenty-three percent of the patients had synchronous active pulmonary TB and 14% of the patients had other forms of abdominal TB, such as TB mesenteric lymphadenitis or peritonitis. The most common symptoms were abdominal pain (43%), followed by diarrhea (30%), weight loss (14%). Twenty-seven percent of the patients (15 cases) were asymptomatic and diagnosed on comprehensive health care or post-operative surveillance. Only 2 patients (3.6%) underwent surgery for complications, such as intestinal obstruction and perforation. Conclusions: ITB is still prevalent in Korea; however, in the recent 10 years the symptoms of ITB have been milder than previously reported. In addition, the complication rates of ITB were remarkably decreased, suggesting that early diagnosis of ITB was increased. (Intest Res 2011;9:0-18)
엄민식,박원우,서승철,이진호,조주연,최혜영,이찬희,임소덕 白中央醫療院 2005 仁濟醫學 Vol.26 No.1
Relapsing polychondritis is an uncommon multisystemic disease which is characterized by recurrent episodes of inflammation and progressive destruction of cartilaginous tissue. The cause of relapsing polychondritis is unclear and suspected to be autoimmune pathophysiology. It involves cartilage of nose, vertebra, trachea, peripheral joint as well as structures of eye, heart, blood vessels or inner ear. Auricular chondritis is present in almost all patients, and multiple arthritis, nasal chondritis, saddle nose, eye involvement, laryngotracheal involvement and skin manifestations are also present. We report a case of relapsing polychondritis presented a arthritis with review of literatures.