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      • SCOPUSKCI등재

        폐쇄성 황달에서 담도 배액 전후의 Cytokine과 Endotoxin에 대한 연구

        강대환 ( Dae Hwan Kang ),허정 ( Jeong Heo ),김광하 ( Gwang Ha Kim ),문재현 ( Jae Hyeon Moon ),권대식 ( Dae Sik Kwon ),김보석 ( Bo Suk Kim ),안진광 ( Jin Kwang An ),송근암 ( Geun Am Song ),조몽 ( Mong Cho ),양웅석 ( Ung Suk Yang 대한소화기학회 2003 대한소화기학회지 Vol.41 No.6

        Background/Aims: Malignant biliary obstruction are associated with high postoperative morbidity and mortality. This study was performed to determine the effect of external and internal biliary drainage on plasma concentrations of cytokines and endotoxin. Methods: Twenly-one patients with malignant biliary obstruction were enrolled in this study. They were devided into two groups, PTBD (percutaneous transhepatic biliary drainage) and ERBD (endoscopic retrograde biliary drainage)groups. Then, plasma concentrations of TNF-α, sTNFr, interleukin 1α (IL-1α), interleukin 6 (IL-6), and endotoxin were measured before and after 1 week in PTBD and ERBD groups. Results: Total bilirubin decreased significantly from 13.3±8.2 to 6.2±4.4 mg/dL after PTBD and 7.0±11.2 to 5.3±4.0 mg/dL after ERBD (p=0.005, 0.007, respectively). Plasma sTNFr in PTBD group was 5.1±1.4 before drainage and remained unchanged 5.5±1.5 ng/mL at one week after drainage (p=0.155). Plasma sTNFr in the ERBD group was 5.9±1.5 and 5.6±1.0 ng/mL before and after biliary drainage, respectivedly (p=0.333). There was no significant difference of sTNFr changes between the PTBD and ERBD groups (p=0.113). Moreover, there was no significant difference in endotoxin changes between the PTBD and ERBD groups (p=0.477). Other cytokines changed insignificantly. Conclusions: Both PTBD and ERBD did not affect significantly plasma concentrations of sTNFr and endotoxin. Although ERBD provides a better quality of life and physiologic benefit, it dose not decrease cytokines and endotoxin associated with high morbidity and mortality in patients with malignant biliary obstruction. (Korean J Gastroenterol 2003;41:493-498)

      • SCOPUSKCI등재

        Waldenstrom`s Macroglobulinemia 에 의해 유발된 사구체 신염 1 예

        박창근(Chang Keun Park),신태원(Tae Won Sin),권대식(Dae Sik Kwon),김지섭(Ji Sub Kim),정재성(Jae Sung Chung),공진민(Jin Min Kong),김호균(Ho Gun Kim),김병창(Byung Chang Kim),김혜숙(Hae Sook Kim),김용진(Yong Jin Kim) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.5

        Waldenstrom's macroglobulinemia(WM) is a disorder of malignant proliferation of plasmacyoid lymphocytes and monoclonal immunoglobulin M. The renal complications of WM are less common and severe than that of multiple myeloma. We present a case of WM which involved the kidney as massive proteinuria, hematuria and renal failure. A biopy specimen of the kidney reveals the intraglomerular hyaline thrombi of immunoglobulin M paraprotein. Three cycles of plasmapheresis and systemic chemotherapy with chlorambucil and prednisolone show improvement in his renal manifestations. We suppose the glomerulonephritis caused by hyaline thrombi in WM may be reversible, at least in its early stage.

      • KCI등재후보

        충수에서 기원한 지방증식증 1 예

        김혜숙,박승근,박창근,옥종한,박희욱,권대식,신태원 대한내과학회 2001 대한내과학회지 Vol.61 No.4

        $quot;Large intestinal Lipohyperplasia (LPH) is a poorly recognized lesion characterized by adipose tissue infiltration in the submucosal layer of the colon. Most of all, LPH developed at Ileoceal valve, especially upper lip which was called by ileocecal valve syndrome. For endoscopists and radiologists, it has often remained difficult to make a distinction from malignant neoplasia. We report here the case of a mild obese, 51-year-old man who had polypoid lipohyperplasia of the colon associated with extreme hyperplasia of the appendix. His chief complaint was recurrent intermittent abdominal pain. The colonoscopic finding was a submucosal tumor-like polypoid mass originating from appendix with smooth surface, But ileocecal valve was intact. Abdominal CT finding was 2.5㎝ sized round heterogeneous low density mass like lesion with intratumoral fatty density of cecal tip area with enhancement of peripheral portion. In barium enema study, after retrograde filling of contrast, smooth extrinsic indentation of cecal tipwith partial filling of appendix was seen. Histological examination revealed infiltration of mature adipose tissue in the submucosal layer. Because of recurrent abdominal pain, ileocecal resection was performed at operation. We discuss the case and review the literatures on this subject. (Korean J Med 61:449-452, 2001)$quot;

      • KCI등재후보

        여성의 후복강에 생긴 침습성 혈관점액종 1 예

        김경원,최정호,김은영,김혜숙,정규영,박승근,옥종한,구영훈,박희욱,권대식,손창목 대한내과학회 2001 대한내과학회지 Vol.61 No.2

        Aggressive Angiomyxoma is a rare, benign but locally aggressive mesench ymal neoplasm, predominently involving the pelvis and perineum of young omen. We experienced a case of aggressive angiomyxoma in the retroperitoneum. A 47-year-old woman patient visited our hospital because of constipation and an abnormal intraabdominal mass in routine examination. Examination by abdominal ultrasonography and MR imaging indicated that it was a well capsulated large soft tissue tumor in the retroperitoneum. Thus, she underwent excision of the retroperitoneal tumor. A 15 × 10 × 2 cm yellow-whitish mass was noted. The cut surface was homogenous, tannish yellow and mucoid. Microscopic findings represent that a mass was composed of widely scattered spindle-shaped and stallate-shaped cells and variable sized vascular channels within a myxoid matrix. So we report this case with a review of literature.(Korean J Med 61:206-210, 2001)

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