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- 저자 : 강풍 ( Kang Pung ) (검색결과 4 건)
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췌담도 : 자가면역 췌장염의 진단에서 혈청 IgG와 IgG4의 임상 유용성
강풍 ( Pung Kang ),이규택 ( Kyu Taek Lee ),신동현 ( Dong Hyunn Sinn ),김범진 ( Beom Jin Kim ),이재승 ( Jae Seung Lee ),이종균 ( Jong Kyun Lee ),이종철 ( Jong Chul Rhee ) 대한소화기학회 2008 대한소화기학회지 Vol.52 No.5
목적: 혈청 IgG와 IgG4는 자가면역 췌장염 진단을 위한 중요한 검사실 소견이다. 이번 연구는 자가면역 췌장염을 진단하는 데 혈청 IgG와 IgG4의 유용성에 대해서 알아보고자 하였다. 대상 및 방법: 대상 환자를 자가면역 췌장염과 기타 췌장질환의 2개의 군으로 분류하였고, 12명의 자가면역 췌장염과 23명의 다른 췌장질환 환자에서 혈청 IgG와 IgG4 level를 측정하였다. 결과: 일본췌장학회에서 제안한 진단 기준에 따라서 진단된 자가면역 췌장염 환자 중 10명(83%)에서 IgG4가 135 mg/dL 이상 증가하였고, 4명(33%)에서 IgG가 1,800 mg/dL 이상 증가하였다. 1명의 환자는 IgG4가 정상이었지만 IgG가 증가하였다. 혈청 IgG와 IgG4에 대한 자가면역 췌장염의 민감도는 67%와 91%였고, 특이도는 각각 92%였다. ROC curve를 이용하여 자가면역 췌장염의 진단을 위한 최적의 민감도와 특이도를 나타내는 IgG와 IgG4의 값은 각각 1,520, 127 mg/dL이고, 이 때 민감도는 각각 83%였고 특이도는 97%와 87%였다. 결론: 혈청 IgG와 IgG4는 자가면역 췌장염의 진단에 유용하고, 상호 보완적이다. Background/Aims: To diagnose autoimmune pancreatitis (AIP), serum IgG and IgG4 concentration are significant serologic markers. The purpose of this study was to assess the utility of serum IgG and IgG4 for the diagnosis of AIP. Methods: We divided enrolled patients into 2 groups: autoimmune pancreatitis and other pancreatic disease. We measured serum IgG and IgG4 levels in patients including 12 AIP and 23 other pancreatic disease. Results: Among AIP patients, 10 cases (83%) showed elevated IgG4 levels of more than 135 mg/dL and 4 cases (33%) showed elevated IgG levels of more than 1,800 mg/dL, the current cutoff value applied in Japan. Only one patient showed elevated serum IgG level, despite having normal IgG4 level. Sensitivity and specificity for AIP of elevated serum IgG4 (>135 mg/dL) were 91% and 92%, and for elevated serum IgG (>1,800 mg/dL) 67% and 92%, respectively. The optimal cut-off level of IgG4 using receiver operation characteristic (ROC) was 127 mg/dL, at which the sensitivity and specificity were 83% and 96%, respectively, for the diagnosis of AIP. Serum IgG at 1,520 mg/dL showed the sensitivity and specificity of 83% and 87%, respectively. Conclusions: The measurement of serum IgG and IgG4 are helpful to diagnose AIP. Serum IgG and IgG4 are complementary to each other in the diagnosis of AIP. (Korean J Gastroenterol 2008;52:304-309)
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국소성 분절성 사구체 경화증 환자에서 독성 거대결장으로 발현된 거대세포바이러스 대장염 1예
강풍,김유선,정성모,김은순,이정환,문정섭,고행일 대한내과학회 2002 대한내과학회지 Vol.63 No.6
Cytomegalovirus is a frequent opportunistic pathogen in immunosuppressed patients and CMV colitis is one of its major complications. It usually presents as gastrointestinal ulceration with bleeding or perforation, but it can also take less common forms resembling many other entities, including viral gastroenteritis, ischemic colitis, intestinal pseudo-obstuction, toxic megacolon. We experienced a 49-year-old man with symptom of severe constipation and lower abdominal pain. He was diagnosed as having focal segmental glomerulosclerosis by renal biopsy, but he was an immunocompetent state. An abdominal X-ray showed marked dilatation of descending colon without air-fluid level. At colonoscopy and biopsy, he was diagnosed as having CMV colitis with focal stenosis. Treatment for two weeks with ganciclovir resulted in resolution of colitis, but stenosis was remained. We report a case of toxic megacolon and focal stenosis due to CMV colitis in a FSGS patient. It was not certain whether FSGS was related with immunosuppressive state.
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위절제술 후 발생한 거적아구성 빈혈 12예에 대한 고찰
강풍,옥경선,김준희 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Objective: The occurrence of megaloblastic anemia, following gastric cancer surgery depends on the surgical procedures and the duration after operation. In Korea only a few studies of anemia following gastrectomy have been reported. Here we present twelve cases of vitamin B12 deficiency megaloblastic anemias following gastrectomy due to gastric cancer. Methods: We studied twelve megaloblastic anemia patients following gastrectomy from January 1993 to December 1999. Clinical manifestations and laboratory findings were checked. Results: Out of 12 cases two patients received subtotal gastrectomy. The mean duration from surgery to megaloblastic anemia occurrence was 73 months. The mean duration of subtotal gastrectomy patient was 37 months. Conclusion: There was no relationship between the type of gastric surgery and interval of anemia occurrence. No common specific laboratory abnormalities were checked except high LDH.
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