회장 말단부에 궤양을 동반한 혈구탐식증후근 1예

문재현 ( Jae Hyun Moon ),홍성표 ( Sung Pyo Hong ),박필원 ( Pil Won Park ),고광현 ( Kwang Hyun Ko ),황성규 ( Seong Gyu Hwang ),임규성 ( Kyu Sung Rim ),안희정 ( Hee Jung An ),강명서 ( Myung Seo Kang ) 대한소화기학회 2006 대한소화기학회지 Vol.48 No.3

Reactive hemophagocytic syndrome or hemophagocytic lymphohistiocytosis, is characterized by the proliferation of benign histiocytes showing phagocytosis of blood cells in hematopoietic organs including bone marrow, spleen, or lymph nodes, accompanied by fever, hepatosplenomegaly, hepatic dysfunction, pancytopenia, and hypertriglyceridemia. The pathogenesis of reactive hemophagocytic syndrome is unknown. It is often associated with infection, malignant neoplasm, autoimmune disease, drugs and various immunodeficiencies. The prognosis of this syndrome is poor and the causes of death are hemorrhage, infection, or multiorgan failure. We experienced a case of hemophagocytic syndrome with terminal ileal ulcers, not associated with other causes. Thus, we report this case with a review of literatures. (Korean J Gastroenterol 2006;48:205-209)

대장 종양의 진단에서 F18-FDG PET/CT의 유용성

강민경 ( Min Kyung Kang ),홍성표 ( Sung Pyo Hong ),이지은 ( Ji Eun Lee ),전태주 ( Tae Joo Jeon ),김종우 ( Jong Woo Kim ),권창일 ( Chang Il Kwon ),고광현 ( Kwang Hyun Ko ),황성규 ( Seong Gyu Hwang ),박필원 ( Pil Won Park ),임규성 ( 대한장연구학회 2010 Intestinal Research Vol.8 No.1

Background/Aims: The diagnostic value of 2-18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET)/CT in the detection of colon carcinoma and adenoma was evaluated retrospectively. Methods: Between May 2007 and June 2008, 102 patients (42 males and 60 females: age range, 28-89 years) underwent both FDG PET/CT and colonoscopy in < a 3 month interval. FDG uptake on PET/CT was divided into physiologic and pathologic uptake by a nuclear medicine specialist. Pathologic confirmation was obtained in all patients. Results: Forty-three patients had no abnormal findings on both FDG PET/CT and colonoscopy. One hundred five and 59 colonic lesions were detected on FDG PET/CT and colonoscopy, respectively. Eleven of 24 lesions with pathologic FDG uptake were histologically-confirmed to be malignancies. Among 18 lesions with physiologic FDG uptake, 1 carcinoma and 1 adenoma were revealed. One carcinoma, 25 adenomas, and 11 hyperplastic polyps did not reveal FDG uptake. Interpretation of pathologic FDG uptake in the colon had a sensitivity of 84.6% and 28.2%, a specificity of 90.4% and 88.1%, a positive predictive value of 45.8% and 45.8%, and a negative predictive value of 98.4% and 77.8% for carcinomas and adenomas, respectively. Conclusions: FDG PET/CT is a very useful diagnostic method for the detection of colon cancer, but the sensitivity is low for adenomas, which may need further evaluation, such as a screening endoscopy. (Intest Res 2010;8:18-23)

PMV에 의한 보괴스텔의 온열환경 검토

정재훈(Jae -Hoon Jung),강성현(Seong -Hyeon Kang),고광현(Kwang - Hyun Ko) 호서대학교 공업기술연구소 2016 공업기술연구 논문집 Vol.35 No.1

최근 , 하루 중 대부분의 시간을 실내공간에서 보내는 현대인에게 있어 쾌적한 실내 열환경은 필수불가결한 요건 이다 . 본 논문에서는 오피스텔을 대상으로 사무공간과 주거공간에서의 재실자의 활동에 따른 온열감을 예측평균온열감 (PMV; Predicted Mean Vote) 지표를 사용하여 검토하였다 . 또한,오피스텔에 ス}무공간과 주거공간별로 세가지 난방방식 (바닥복사난방, 천정형 시스템에어컨 , 바닥복사난방 겸용 천정형 시스템에어컨)을 적용했을 경우의 온열감에 대하여 PMV를 활용하여 비교,검토하였다 . Recently, comfortable indoor thermal environment is an indispensable requirement ror modem people who spends most of their time in the indoor space. In this paper, thermal comfort was investigated according to the activities of the people of office space and residential space in the officetel using PMV (Predicted Mean Vote) index. In addition, thermal comfort was compared when three heating system (the radiant floor heating, the air conditioning system, the air conditioning system with radiant floor heating) applied in officetel.

정상 간기능 수치를 보이는 비알코올지방간 환자의 임상특징

이소영 ( So Young Lee ),김수경 ( Soo Kyung Kim ),권창일 ( Chang Il Kwon ),김문종 ( Moon Jong Kim ),강명서 ( Myung Seo Kang ),고광현 ( Kwang Hyun Ko ),홍성표 ( Sung Pyo Hong ),황성규 ( Seong Gyu Hwang ),박필원 ( Pil Won Park ),임 대한소화기학회 2008 대한소화기학회지 Vol.52 No.3

Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is known to be closely associated with various metabolic abnormalities including metabolic syndrome. However, there are few data available on the association of metabolic syndrome with the sonographically fatty liver and normal range of liver function test. The purposes of this study were to find the incidence of ultrasonographic fatty liver with normal range of liver function test and to evaluate the association with metabolic syndrome in apparently healthy Korean adults. Methods: We examined 538 men and women, aged 30-80 years, who participated in a health screening test. Among the people with normal ALT level, we compared clinical characteristics and prevalence of metabolic disorders according to the presence of nonalcoholic sonographyally fatty liver, and then they were subdivided into upper normal range and lower normal range of ALT level. Results: Compared to the people without sonographic fatty liver, people with sonographic fatty liver and normal range of ALT level had odds ratios for metabolic syndrome of 4.53, insulin resistance 4.83, hypertension 2.69, dyslipidemia 6.90, and obesity 5.39, respectively. Furthermore, the prevalence of metabolic syndromes and other metabolic disorders were increased in both sonographically fatty liver group or ultrasonographically normal liver group with upper normal range of ALT level compared with lower normal ALT level (p<0.01). Conclusions: The nonalcoholic sonographically fatty liver was strongly associated with metabolic syndrome and common metabolic abnormalities even with normal liver function test. (Korean J Gastroenterol 2008;52:161-170)

간외 담관 결석 환자에서 경피 경간 치료술의 유용성 및 안전성에 대한 연구

선한경 ( Han Gyung Seon ),권창일 ( Chang Il Kwon ),윤상필 ( Sang Pil Yoon ),유광호 ( Kwang Ho Yoo ),옥창수 ( Chang Su Ok ),김원희 ( Won Hee Kim ),고광현 ( Kang Hyun Ko ),홍성표 ( Sung Pyo Hong ),박필원 ( Pil Won Park ) 대한내과학회 2012 대한내과학회지 Vol.83 No.1

목적: ERCP를 이용한 유두 괄약근 절개술은 간외 담관결석 환자에게서 가장 널리 이용되는 치료방법이지만, ERCP가 실패하거나, 위절제술을 받은 경우, 담췌관으로의 접근이 어려운 경우, 환자의 전신상태가 불량한 경우 등에서는 시술하기가 어렵다. 본 연구의 목적은 ERCP를 시행하기 어려운간외 담관 결석을 가진 환자들에게서 PTPBD (percutaenous transhepatic papillary balloon dilatation) 및 폐쇄 풍선 카테터를 이용한 간외 담관 결석 제거술의 안전성 및 유용 유용성을 알아보고자 하였다. 방법: 2001년부터 2010년까지 10년간 간외 담도 결석으로 내원한 509명의 환자 중 PTPBD를 이용하여 간외 담도 결석 제거술을 시행한 17명의 환자를 후향적으로 자료 분석하였다. 모든 환자는 결석을 제거하기 3-4일 전에 PTBD를 시행하였다. 십이지장 유두부를 풍선 확장술로 확장시킨 후, 폐쇄 풍선 카테터(풍선 지름 11.5 mm)를 이용하여 결석을 확장된 유두부를 통해 십이지장 안으로 밀어내어 제거하였다. 크기가 15 mm를 넘는 큰 결석 일부는 부분 쇄석술을 먼저 시행한 후 시술을 시행하였다. 시술결과는 잔류 결석의 유무로 평가하였고, 합병증 및 결석의 크기와 수에 따라서 세부적으로 분석하였다. 결과: 시술을 시행한 17명의 환자들 중 이전에 위절제술을 시행한 환자는 9명, 전신상태가 불량한 환자가 4명, ERCP에 실패한 환자가 4명이었다. 결석의 크기는 직경이 평균 13.6mm (8-25 mm)이었고, 7명은 결석이 1개(41.2%), 5명은 2개 (29.4%), 그리고 남은 5명은 결석이 3개 이상(29.4%)이었다. 17명의 환자 중에 16명(94%)이 잔류 결석 없이 시술에 성공하였다. 이 중 2명의 환자(11.7%)는 시술을 2번 시행하여 성공하였다. 치료에 실패한 1명(6%)의 환자는 랑데뷰 방법을 이용하여 직시 위내시경을 통해 치료에 성공하였다. 시술과연관된 사망 및 합병증의 발생은 없었다. 췌장염의 발생은 없었고, 3명의 환자에게서 경도의 일시적인 아밀라아제 상승소견이 보였다. 결론: 경피 경간 유두부 풍선 확장술 및 폐쇄 풍선 카테터를 이용한 간외 담관 결석 제거술은 ERCP에 부적절하거나 실패한 환자 군에서 안전하고 효과적인 대체 방법으로 이용될 수 있다. Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) occasionally fails due to surgically altered anatomy, difficult cannulation, or poor general condition. This study evaluated the safety and effectiveness of percutaneous transhepatic papillary balloon dilatation (PTPBD) for managing extrahepatic bile duct stones. Methods: Between 2001 and 2010, 17 out of 509 patients with extrahepatic bile duct stones and acute cholangitis were enrolled retrospectively. After PTPBD of the sphincter, the stones were extracted using an occlusion balloon to push the stone over a guidewire into the duodenum. The procedure success was evaluated based on residual stones. In addition, the size and number of stones and complications were analyzed. Results: Of the 17 patients, nine had a previous gastrectomy, four had poor general condition, and four had unsuccessful cannulation, The stone diameter ranged from 8 to 25 mm, Seven, five, and five patients had one, two, or three or more stones, respectively. The results were successful in 16 out of 17 patients, with no residual stones. Treatment failed in one patient, who was then treated with the rendezvous technique with endoscopy. No procedure-related major complication occurred. Three patients had mild transient elevations of the serum amylase levels. Conclusions: PTPBD was safe and effective for managing extrahepatic bile duct stones in patients with unsuccessful or contraindicated ERCP.