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양석균(Suk Kyun Yang),명승재(Seung Jae Myung),정훈용(Hwoon Yong Jung),홍원선(Weon Seon Hong),김진호(Jin Ho Kim),심기남(Ki Nam Shim),최재원(Jae Won Choe),김해경(Hae Kyung Kim),박무인,이미헌(Mi Hun Lee),김동일(Dong Il Kim),박의련(Eui Ryun 대한내과학회 2001 대한내과학회지 Vol.60 No.6
N/A Background: The current diagnosis of hereditary non-polyposis colorectal cancer (HNPCC) is dependent on a detailed family history based on the Amsterdam criteria proposed by the International Collaborative Group on HNPCC (ICG-HNPCC) in 1990. On recognizing the shortcomings of the ICG-HNPCC criteria, the Korean Hereditary Colorectal Cancer Registry (a subdivision of the Korean Hereditary Tumor Registry) designated the term uspected HNPCC for families who do not fullfill the criteria of the ICG-HNPCC but in whom a genetic basis for colon cancer is strongly suggested. The present study was designed to determine the frequency and define the clinical characteristics of suspected HNPCC. Methods: We analysed the clinical characteristics of 42 suspected HNPCC patients and their family members and compared these characteristics with that of 1,692 non-hereditary colorectal cancer patients. Results : The frequency of suspected HNPCC was 2.4% in our study. The mean age of suspected HNPCC patients at the time of diagnosis was 45.1±9.6 years and that of non-hereditary colorectal cancer patients was 57.4±11.9 years. The incidence of synchronous colorectal cancers in HNPCC was 7.1% and that of non-hereditary colorectal cancers was 0.9%. In suspected HNPCC families, 18 patients had extracolonic malignancies and the stomach cancer was the most common (55.5%). Conclusion : The frequency of suspected HNPCC among total colorectal cancer cases was 2.4% in our study. Tumors in suspected HNPCC differed from non-hereditary colorectal cancers in an early age of onset.(Korean J Med 60:507-513, 2001)
양석균 ( Suk Kyun Yang ) 대한장연구학회 2005 Intestinal Research Vol.3 No.1
Behcet`s disease is a multisystem disease characterized by recurrent oral and genital ulcerations in association with skin and ocular lesions. Gastrointestinal involvement of Behcet`s disease is one of the major causes of morbidity and mortality in this disease, as it often results in serious complications such as perforation and bleeding. However, much remains unknown about the epidemiology, clinical characteristics, treatment, and prognosis of intestinal Behcet`s disease. In this brief review, the author summarized the differences in epidemiology and clinical characteristics of intestinal Behcet`s disease among different regions, the problems in its diagnosis and treatment, and its clinical course and long-term prognosis. (Intest Res 2005;3:1-10)
99mTc - RBC SPECT 를 이용한 간혈관종의 진단
홍기석(Kee Suk Hong),문대혁(Dae Hyuk Moon),이명혜(Myung Hae Lee),조시만(Shee Man Cho),양석균(Suck Kyun Yang),정영화(Young Hwa Chung),이영상(Yung Sang Lee),신성해(Sung Hae Shin) 대한핵의학회 1991 핵의학 분자영상 Vol.25 No.1
N/A The value of 99mTc-RBC scintigraphy and SPECT in the diagnosis of hepatic hemangioma was evaluated in 27 patients with 38 hemangiomas and 13 patients with 15 nonhemangiomas. Twenty four (63.2%) of 38 hemangiomas were detected by planar delayed RBC imaging, whereas 30 (78.9%) hemangiomas were detected by the delayed RBC SPECT. Increase in sensitivity was noted in nodules less than 2 cm in diameter. The smallest hemangioma shown by delayed RBC SPECT was 0.9 cm in diameter. All of nonhemangiomatous lesions show normal or decreased activity in delayed blood pool images. We concluded that 99mTc-RBC SPECT is an accurate method for the detection of hepatic hemangioma and is more sensitive than planar imaging in depicting small lesions.
변정식 ( Jeong Sik Byeon ),양석균 ( Suk Kyun Yang ),이윤정 ( Yun Jung Lee ),최재원 ( Jae Won Choe ),이진혁 ( Gin Hyug Lee ),명승재 ( Seung Jae Myung ),정훈용 ( Hwoon Yong Jung ),홍원선 ( Weon Seon Hong ),김진호 ( Jin Ho Kim ),민 대한장연구학회 2003 Intestinal Research Vol.1 No.1
The pathogenesis of ulcerative colitis is complicated and both the genetic and environmental factors contribute to its development. Familial occurrence is an example indicating that both the genetic and environmental factors play some parts in the development of ulcerative colitis because family members have similar genetic characteristics and have been exposed to similar environment. Familial ulcerative colitis is observed in about 10% to 20% of patients. Most such families contain only 2 affected members and families containing more than 2 affected members are relatively rare. We experienced a case of familial ulcerative colitis in which all 4 members (both spouses and their 2 sons) were affected. They had lived together for 29 years before all 4 members were affected. The first patient was diagnosed after 14 years of cohabitation and the rest were affected 13, 14, and 15 years after the first diagnosis. We report this case with a review of literature. (Intestinal Research 2003;1:72-77)
소화기 ; 단일 의료기관에서 경험한 자발성 장벽내 혈종 14예에 대한 임상적 고찰
양동훈 ( Dong Hoon Yang ),김진호 ( Jin Ho Kim ),박성호 ( Seong Ho Park ),양석균 ( Suk Kyun Yang ),변정식 ( Jeong Sik Byeon ),명승재 ( Seung Jae Myung ),김경조 ( Kyung Jo Kim ),예병덕 ( Byong Duk Ye ),고창옥 ( Chang Ok Koh ),윤순민 대한내과학회 2010 대한내과학회지 Vol.79 No.5
목적: 자발성 장벽내 혈종은 대부분 항응고 치료의 드문 합병증으로 발생하며, 최근 항응고제 사용 증가로 이 질환의 빈도도 증가할 것으로 추정된다. 저자들은 자발성 장벽내 혈종의 임상적 특징과 예후에 대해 분석하고자 하였다. 방법: 2001년 3월부터 2009년 2월까지 서울아산병원에서 특징적 CT 소견으로 자발성 장벽내 혈종으로 진단 후 치료받은 14예의 의무기록을 후향적으로 분석하였다. 결과: 환자들의 연령 중앙값은 67세였고, 심방세동, 심장판막 치환술, 허혈성 뇌졸중 등의 동반 질환을 가지고 있었으며, 모두 항응고제를 복용하고 있었다. 발현 증상은 복통(14명), 구역/구토(9명), 흑색변/혈변(8명) 등이었다. 내원 시 international normalized ratio (INR)의 중앙값은 7.7 (1.6~15.1이상)이었고, 13명(93%)에서 INR이 3.5 이상이었다. 하행결장에 발생한 1예를 제외하고 모두 소장에 발생하였는데, 공장 및 회장이 각각 7명, 4명으로 호발 부위였다. 금식 및 항응고제 중단, 신선동결혈장과 비타민 K 투여를 통한 응고장애 교정 등 보존 치료로 모두 호전되었다. 증상 호전과 응고장애 교정 후 12명에서 항응고 치료를 재개하였고, 평균37.4개월의 추적 기간 동안 재출혈 등 합병증은 발생하지 않았다. 결론: 자발성 장벽내 혈종은 주로 항응고제 과다 사용 시발생하였고, 보존 치료로 빠르게 호전되었으며, 항응고 치료재개 후에도 재출혈 등의 합병증은 없었다. 추후 대규모 연구를 통해 항응고 치료 재개의 안전성 및 재개 시점에 대한 확인이 필요하다. Background/Aims: Spontaneous intestinal intramural hematoma is a rare complication occurring most commonly in patients receiving anticoagulant therapy. The present study aimed to analyze the clinical features and prognosis of this condition. Methods: We retrospectively analyzed the medical records of 14 patients who were diagnosed with spontaneous intestinal intramural hematoma based on characteristic computed tomography findings and treated for this condition at Asan Medical Center from March 2001 to February 2009. Results: The median age of patients was 67 years. All patients were receiving anticoagulant therapy. The most common presenting symptoms were abdominal pain (14 patients), nausea/vomiting (9 patients), and melena/hematochezia (8 patients). The median international normalized ratio (INR) was 7.7 (1.6- >15.1). The INR was above 3.5 in 13 patients (93%). Hematomas most commonly involved the jejunum (7 patients), followed by the ileum (4 patients). All patients rapidly recovered without short-term complications after medical treatment, including correction of coagulation abnormalities. Twelve patients resumed anticoagulant therapy after symptomatic resolution and correction of coagulation abnormalities, and no complications, including rebleeding, occurred during the mean 37.4 months of follow-up. Conclusions: Spontaneous intestinal intramural hematoma rapidly improved after medical treatment, and no complications occurred. It may be safe to carefully resume anticoagulant therapy in patients at high risk of thromboembolism. (Korean J Med 79:518-525, 2010)
한국인 크론병 환자에서 Azathioprine/6-Mercaptopurine 치료의 안전성과 유용성
이현주 ( Hyun Ju Lee ),양석균 ( Suk Kyun Yang ),김경조 ( Kyung Jo Kim ),최재원 ( Jae Won Choe ),윤순만 ( Jae Won Choe ),예병덕 ( Byong Duk Ye ),변정식 ( Jeong Sik Byeon ),명승재 ( Seung Jae Myung ),김진호 ( Jin Ho Kim ) 대한장연구학회 2009 Intestinal Research Vol.7 No.1
Background/Aims: This study aimed to evaluate the adverse events and efficacy of azathioprine (AZA) and 6-mercaptopurine (6-MP) in Korean patients with Crohn’s disease (CD). Methods: We retrospectively analyzed 700 patients with CD (male:female=469:231; median age at diagnosis, 22 years; agerange, 9-74 years) who were treated at the Asan Medical Center between January 1997 and January 2006. Results: Of 700 patients, 372 (53.1%) were treated with AZA/6-MP. The cumulative rates of AZA/6-MP treatment at 1, 5, 10, and 20 years were 17.4%, 51.6%, 73.1%, and 94.5%, respectively. Of 372 patients treated with AZA/6-MP, 217 patients (58.3%) experienced 291 adverse events, requiring discontinuation of therapy in 41 patients (11%). Nausea occurred in 120 patients (32.3%) and led to discontinuation of therapy in 11 patients (3.0%). Leukopenia developed in 116 patients (31.2%), requiring dose adjustments in 100 patients (26.9%) and discontinuation of medications in 16 patients (4.3%). Other adverse events included infections (2.7%), abnormal liver function tests (2.7%), fever (0.8%), hair loss (0.8%), arthralgias (0.5%), pancreatitis (0.5%), headaches (0.5%), and skin rashes (0.3%). Complete corticosteroids withdrawal was achieved in 70.9% of the patients based on an intention-to-treat analysis. The remission rate of perianal fistulas was 32.6%. Conclusions: The risk of leukopenia by AZA/6-MP is higher in Korean patients with CD than in Western patients. Although the adverse events of AZA/6-MP are not uncommon in Korean patients with CD, the actual discontinuation rate of the treatment is low. Therefore, AZA/6-MP can be administered to most Korean patients with CD without serious adverse events. (Intest Res 2009;7:22-31)
염증성 장질환에서의 당질 코르티코이드에 대한 불응성 판정을 위한 당질코르티코이드 β 수용체의 유용성
양성연 ( Sung Yeun Yang ),명승재 ( Seung Jae Myung ),양석균 ( Suk Kyun Yang ),장혜숙 ( Hye Sook Chang ),정훈용 ( Hwoon Yong Jung ),홍원선 ( Weon Seon Hong ),김진호 ( Jin Ho Kim ),민영일 ( Young Il Min ),오현주 ( Hyun Ju Oh ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
<목적> 염증성 장질환의 치료에 당질 코르티코이드는 효과적인 약물로 사용되고 있다. 그러나, 증례에 따라서 반응의 정도가 다르며 불응성 증례의 경우 심각한 합병증을 초래할 수 있어 당질 코르티코이드의 투여 전 반응 여부를 미리 예측할 수 있다면 임상적으로 매우 유용한 정보가 될 것이다. 당질 코르티코이드 수용체는 α와 β로 이루어져 있으며 최근 말초 혈액 단핵구에서 β 수용체의 발현이 양성인 경우 당질 코르티코이드의 반응이 저하된다는 보고가 있으나 아직
항결핵제 투여 후 C-reactive Protein 측정을 통한 크론병과 장결핵의 감별진단
박상현 ( Sang Hyun Park ),양석균 ( Suk-kyun Yang ),명승재 ( Seung-jae Myung ),변정식 ( Jeong-sik Byeon ),예병덕 ( Byong Duk Ye ),권승현 ( Seung Hyun Kwon ),김병규 ( Benjamin Kim ),윤순만 ( Soon Man Yoon ),도미영 ( Mi Young Do ) 대한장연구학회 2007 Intestinal Research Vol.5 No.1
Background/Aims: Crohn’s disease (CD) and intestinal tuberculosis (TB) are chronic inflammatory bowel disorders that are difficult to differentiate. Therefore, a therapeutic trial of antimycobacterial drugs is often used to differentiate CD from TB. This study aimed to evaluate the usefulness of C-reactive protein (CRP) level before or during antimycobacterial therapy to differentiate CD from TB. Methods: A total of 26 CD patients and 52 TB patients who received antimycobacterial therapy at the Asan Medical Center were included. CRP levels before or during antimycobacterial therapy were compared between CD and TB patients. A positive response to antimycobacterial therapy was defined as the decrease of CRP level below 50% of its baseline value. Results: The baseline CRP level was normal in only 1 of 26 CD patients (3.8%), while it was in 26 of 52 TB patients (50%). The rate of positive response to antimycobacterial therapy was significantly different between CD and TB patients whose baseline CRP level was abnormal: 28.0% (7/25) vs 88.5% (23/26) in 2 weeks, 34.8% (8/23) vs 84.6% (22/26) in 4 weeks, and 43.5% (10/23) vs 92.3% (24/26) in 8 weeks of antimycobacterial therapy. The rate of normalization in CRP level was also significantly different between the two groups: 0% (0/25) vs 73.1% (19/26) in 2 weeks, 13.0% (3/23) vs 69.2% (18/26) in 4 weeks, and 8.7% (2/23) vs 80.8% (21/26) in 8 weeks of antimycobacterial therapy. Conclusions: The CRP level before and during antimycobacterial therapy may be used as a supplementary tool in the differential diagnosis between CD and TB patients. (Intest Res 2007;5:19-25)