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절단된 Sengstaken-Blakemore 관 위풍선의 내시경적 제거 1예
고동훈,김창환,임창훈,이석주,김정아,김태호,한석원 대한소화기내시경학회 2010 Clinical Endoscopy Vol.40 No.4
A Sengstaken-Blakemore (S-B) tube, when used approximately, still has a place in the management of acute variceal bleeding, and controls bleeding in 40∼90% of the cases. However its use is accompanied by number of complications such as esophageal ulcer, pulmonary aspiration, and malfunction of the tube, which requires replacement. We recently observed a very unusual complication: the remaining gastric balloon of a S-B tube was broken off in the fundus of stomach by the patient’s traction. The gastric balloon was easily and safely removed using an endoscopic snare after deflating the gastric balloon with a needle puncture. 식도 정맥류 출혈 치료 방법 중 하나인 Sengstaken-Blakemore (S-B) 관 삽입은 궤양, 천공, S-B 관의 교환을 요하는 기능 장애 등을 포함한 합병증 때문에 제한된 경우에 한해서 사용하고 있다. S-B 관의 감입(impaction)은 매우 드물게 발생하는 합병증으로 감입된 S-B 관을 내시경 침형 절개도를 이용하여 제거한 1예의 국내 보고가 있다. 최근에 저자들은 토혈로 내원한 간경병증 환자가 자의로 S-B 관을 뽑는 과정에서 완전히 절단되어 위에 남은 위풍선을 내시경적 주사바늘 천자로 풍선의 공기를 뺀 후 올가미로 안전하게 제거한 1예를 경험하여 보고한다.
고동훈,김태호,이석주,김정아,서경진,김창환,한석원 대한내과학회 2011 대한내과학회지 Vol.80 No.-
용종성 낭종성 위염(GCP)은 드문 질환으로 흔히 위 점막과 점막하층에서 다발성 낭성 종물로 나타난다. 주로 과거에 위절제술을 시행받은 사람에서 발병되며 드물게 수술병력 없이 위에서 발병되기도 한다. 육안적으로 점막하 종양, 유경성 또는 무경성 용종, 거대 점막 주름 등 다양한 형태로 나타난다. 최근 저자들은 위절제술의 과거력이 없는 환자에게서 우연히 실시한 상부위장관 내시경 생검결과 과형성 용종을 진단하여 내시경적 점막절제술을 통해 용종성 낭종성 위염으로 확진하여 치료한 증례를 경험하였다. 따라서 위용종 생검에서 과형성 용종으로 진단되더라도 용종성 낭종성 위염의 가능성을 염두에 두어야 하겠다. Gastritis cystica polyposa (GCP) is a rare lesion characterized by hyperplastic and cystic dilatation of the gastric mucosal glands infiltrating into the underlying submucosa. In most cases, it develops in patients who have undergone a gastroenterectomy, but can occasionally be found in an unoperated stomach. GCP may present as a submucosal tumor or polyp, and rarely as a giant gastric mucosal fold. We experienced a case of GCP that presented as a hyperplastic polyp, and it was unrelated to any gastric surgery. Upper endoscopy revealed the presence of a subpedunculated polyp in the posterior wall of the antrum. The lesion was successfully removed by endoscopic mucosal resection and diagnosed as a GCP. (Korean J Med 2011;80:S83-S86)
고동훈,김진범,김홍욱,장영섭,김형준 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.3
Purpose: In this retrospective study, we analyzed the outcomes of prostate cancer patientstreated with the CyberKnife radiotherapy system (Accuray). Materials and Methods: Between 2007 and 2010, 31 patients were treated for prostatecancer by use of the CyberKnife radiotherapy system. After excluding six patients whowere lost to follow-up, data for the remaining 25 patients were analyzed. Patients weredivided into the CyberKnife monotherapy group and a postexternal beam radiotherapyboost group. Clinicopathologic features and treatment outcomes were compared betweenthe groups. The primary endpoint was biochemical recurrence-free survival periodbased on the Phoenix definition. Toxicities were evaluated by using the RadiationTherapy Oncology Group scoring criteria. Results: Of 25 patients, 17 (68%) and 8 (32%) were classified in the monotherapy andboost groups, respectively. With a median follow-up of 29.3 months, most of the toxicitieswere grade 1 or 2 except for one patient in the boost group who experienced lategrade 3 gastrointestinal toxicity. The overall biochemical recurrence rate was 20%(5/25) and the median time to biochemical recurrence was 51.9 months. None of thepatients with low or intermediate risk had experienced biochemical recurrence duringfollow-up. Among D’Amico high-risk populations, 16.7% (1/6) in the monotherapy groupand 50.0% (4/8) in the boost group experienced biochemical recurrence. Conclusions: Our data support that prostate cancer treatment by use of the CyberKniferadiotherapy system is feasible. The procedure can be a viable option for managing prostatecancer either in a monotherapy setting or as a boost after conventional radiotherapyregardless of the patient’s risk stratification.