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천경아,변재영,이재문,하현권,김현,박영하,김일순,김종우,박용휘,신경섭,Chun, Kyung-Ah,Byun, Jae-Young,Lee, Jae-Mun,Ha, Hyun-Kwon,Kim, Hyun,Park, Young-Ha,Kim, Il-Sun,Kim, Jong-Woo,Bahk, Yong-Whee,Shinn, Kyung-Sub 대한영상의학회 1993 대한영상의학회지 Vol.29 No.2
Adult intussusception is a rare condition, unlike in children. There is an identifiable bowel lesion as a leading point in most of cases. Retrospectively we reviewed 22 patients with adult intussusception, and analyzed CT scans of 13 patients during the last 5 years. Twenty of the 22 patients had various causes of intussusception and 7 patients were as sociated with primary malignancy, 5 patients with benign tumor, and 4 patients with adhesive band. CT scans of 13 cases all showed characteristic target appearance or sausage-like soft tissue mass within the bowel, suggesting intussusception. In eleven of the 13 patients(84.6%) an intussuscepting mass was identified on CT scan as the lead point. Specific diagnosis for the cause of intussusception could be made by CT in four of 13 cases (three lipomas and one mucocle). In conclusion. CT is useful not only for the diagnosis but also for the evaluation of the leading causes of intussusception. Especially, CT could determined the exact causes of intussusception in cases of lipoma and mucocele.
송춘익(Choon Eck Song),심규식(Kyu Sik Shim),구완서(Wan Suk Koo),박동준(dong JUne Park),김철민(chul Min Kim),하현권(Hyun Kwon Ha),허미경(Mi Kyung Hur),강문원(Moon Won Kang) 대한소화기학회 1987 대한소화기학회지 Vol.19 No.2
This is a report of two cases of adenocarcinoma in ileum of the small intestine. Ileal adenocar- cinoma has been noted at its rarity, etiology, distribution, and poor prognosis. Recently we experi- enced two interesting cases. One dveloped in 25 year-old rnan, and the other in 42 year old man, vho had treated by segmental resection and chemotherapy, was followed by development of gastric carcinoma after 8 year-survival.
양우진,하현권,정수교,박용휘 대한핵의학회 1988 핵의학 분자영상 Vol.22 No.2
To Appreciate the value of bone scintigraphy in determination of the bony infection, we performed three phase bone scintigraphy in 34 cases of osteomyelitis of extremities prospectively. They were clinically inactive in 11 and active in 23 cases. We confirmed the active osteomyelitis by operation or aspiration within one week after scintigraphy. Perfusion, blood pool and delayed images were analyzed respectively and compared with the plain roentgenograms. All 23 active lesions showed diffusely increased perfusion in affected limbs. The areas of the increased activities on blood pool images were larger than or similar to those on delayed images in 17 cases (73.9%) with active osteomyelitis and smaller in 6 cases (26.1%). 5 of the latter 6 cases showed definite soft tissue activities on blood pool images. In inactive cases bone scintigrams were completely normal in 4 cases. Two of those were normal on plain films and remaining two showed mild focal bony sclerosis. Among 7 inactive lesions, perfusion was normal in 2 cases, diffusely increased in 4 cases and diffusely decreased in 1 case. 6 of these 7 cases showed increased activities both on blood pool and delayed images and the areas of increased activities on blood pool images didn't exceed those on delayed images. Bony sclerosis was noted on plain films in those 7 inactive lesions and the extent of the sclerosis correlated well to delayed images. Large blood pool activity was characteristics of active osteomyelitis. Normal three phase bone scintigram may indicate the time to terminate the treatment, but increased activity on perfusion and blood pool scans is not absolute indication of active lesion if the extent of the lesion on the blood pool image is smaller than that on delayed image and if no difinite soft tissue activity is noted on perfusion and blood pool images in clinically inactive patient.
김진천,홍원선,민영일,정훈용,하현권,양석균,정성애,유창식,이미화,원선영,김해련,최승목,김해경 대한소화기학회 1998 대한소화기학회지 Vol.30 No.4
Background/Aims: In recent years, the pattern of tuberculosis has been changed, demonstrating that extrapulrnonary tuberculosis appears to be increasing. The aim of this study was to investigate the clinical features to predict the factors related to the development of complications in patients with intestinal tuberculosis. Methods: A total of 95 patients with intestinal tuberculosis treated at the Asan Medical Center from June, 1989 to November, 1995 were included. The clinical characteristics of the patients cured by antituberculous medication alone were compared with those of patients who underwent operation due to complications developed during antituberculous medication. Results: Eighty one patients were treated with antituberculous drugs, among whom 66 patients(81%) were cured by antituberculous drugs alone. The reaining 15 patients(19%) received operations for the complications that developed during antituberculous medication. The median period from the beginning of antituberculous medication to the development of complications was 3 months. There was no significant difference in clinical features between the two groups except the location of the disease. Small bowel was evaluated radiologically in only 30 patients, of whom 15 patients revealed small bowel lesions. Six out of 15 patients(40%) with small bowel lesions had the perforation of bowel, while none of 15 patients(0%) without small bowel lesions experienced it(p$lt;0.05). Conclusions: Intestinal tuberculosis patients having small bowel lesions showed a tendency to develop bowel perforation more frequently than in those without small bowel involvement. However, to draw a definite conclusion whether small bowel involvement is the true risk factor for perforation, a prospective study should be performed.
식도Takayasu 동맥염 환자에서 동반된 크론병 1예
김해경,홍원선,민영일,정훈용,김해련,하현권,양석균,이재균,최재원,심기남,신은석 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.6
Vascular manifestations as extraintestinal symptoms of inflammatory bowel diseases have rarely been reported, More than 10 case reports in the worldwide literature have suggested that Takayasu's arteritis be one of the rare vascular complications in inflammatory bowel diseases. We describe herein a 33-year-old woman with Takayasu's arteritis who was subsequently found to have Crohn's disease. Aortic arch angiogram showed typical findings of Takayasu's arteritis, and the diagnosis of Crohn's disease was made by colonoscopic and radiologic findings, clinical course, and the response to medical therapy. To our knowledge, this is the first case report in Korea.
최상욱,양진모,김영옥,서은주,김석찬,최범순,하현권,안리숙,윤인재,노희정 대한내과학회 1995 대한내과학회지 Vol.49 No.5
The etiology of eosinophilic gastroenteritis is unknown, but the history of allergy in patients and their families is often present. And there are arguments that parasite infestation, collagen disease and malignancy attribute to the cause of eosinophilic gastroenteritis, but their correlation are not confirmed. Their have been some reports all over the world that Eustoma rotundum, 5chistosomiasis and Ancylomastoma are the sources of parasites, But the re- port on Ascaris has not presented yet. Clinical presentation has been correlated with the depth of involvement of the bowel wall. Mucosal disease is more likely to be associated with malabsorption, protein losing enteropathy. Muscle layer disease is associated with obstruction, and subserosal disease is associated with ascites. Here we present this case as an example illustrating that it was not clear that eosinophilic gastroenteritis dis not correlate with ascsris.
위내시경 검사상 점막하 종양으로 표현되었던 스파르가눔양 병변 1예
박영환,박주상,유은실,홍원선,민영일,정훈용,김해련,하현권,양석균,최재원,김석균 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.5
Sparganosis in humans is caused by migrating larvae of the cestode Spirometra. Humans are considered the second intermediate host that are incidentally infected. Sparganosis usually infestates the subcutaneous tissues and visceral organs have rarely been reported to be involved. A case is herein reported however, a 67-year old female patient with sparganosis in the gastric wall and perigastric region, presented as a submucosal tumor upon gastrofiberscopy. The diagnosis was made after surgery by the pathologic findings determining a characteristic degenerated Sparganum and multiple tunnel-shape cavities surrounded by many inflammatory cells and necrotic materials.
111In-Pentetreotide 스캔으로 진단 가능했던 가스트린종을 가진 Zollinger-Ellison 증후군 1예
정훈용,문대혁,류진숙,이희경,김재승,하현권,정현조 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.6
In patient with Zollinger-Ellison syndrome, it is difficult to localize gastrinoma because the tumor is frequently small and multiple. However, accurate localization of the tumor is important for the treatment. Among various imaging modalities, somatostatin receptor scintigraphy (SRS) has been recognized to be the most sensitive tool for the detection of neuroendocrine tumors such as gastrinomas based on the presence of high-affinity binding sites for somatostatin. Recently, we experienced a case of Zollinger-Ellison syndrome caused by gastrinomas which was localized by SRS. This is the first case report of gastrinoma detected by SRS in Korea. SRS can facilitate tumor detection in patient with Zollinger-Ellison syndrome and should be considered as the first-line diagnostic method in the early course of the disease.