포스터 전시 : 위장관 ; Mesalazine에 의해 악화된 궤양성 대장염 1예

박경식 ( Kyung Sik Park ),권두영 ( Du Young Kwon ),조광범 ( Kwang Bum Cho ),황재석,허정욱,안성훈,박승국 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-

<증례> 24세 남자가 혈변으로 내원하였다. 1년전부터 잦은 설사, 하복부 동통, 간헐적인 혈변이 있었으며, 2주전 시행한 대장조영술 및 대장내시경 검사에서 전 대장에 걸친 경미한 궤양성 대장염이 발견되어 Mesalazine 1.5g/day를 1주간 투여하였으나 증상의 호전이 없어 4.0g/day로 증량한 후 혈변(8-10회/day) 및 복통이 악화되어 입원하였다. 과거력, 가족력상 특이할 만한 사항은 없었고 활력징후도 정상이었으며 이학적 검진에서 결막

위장관 폐쇄로 나타난 호산구성 위장관염 1 예

김혜순(Hae Soon Kim),박승국(Soong Kook Park),윤영호(Young Ho Yoon),조광범(Kwang Bum Cho),권두영(Du Young Kwon),전상훈(Sang Hoon Jeon),박혜원(Hae Won Park),황재석(Jae Seok Hwang),허정욱(Jung Wook Hur),안성훈(Sung Hoon Ahn) 대한소화기학회 2002 대한소화기학회지 Vol.39 No.2

Eosinophilic gastroenteritis is a rare disease of unknown etiology characterized by eosinophilic infiltration of the gastrointestinal wall and peripheral eosinophilia. It was first described by Kaijser in 1937. Histologically, it is mainly characterized by infiltration of eosinophilic leukocytes. Clinical features vary according to which layer and location are involved. Its pathogenesis is not clear, but allergic and immunologic etiologies are strongly suggested. In many cases of eosinophilic gastroenteritis, allergic diseases such as seasonal rhinitis, asthma and atopic eczema are often combined. A 52-year-old woman presented with dyspepsia, weight loss and abdominal discomfort. Partial obstruction of the distal jejunum and proximal dilatation confirmed by abdominal computed tomogram and small bowel series. We report this case with the review of relevant literature. (Korean J Gastroenterol 2002;39:119-122)

전신성 홍반성 루푸스 환자에서 발생한 재발성 다발성 연골염

김병상,김현철,권기민,박재호,도주호,권두영 啓明大學校 醫科大學 1999 계명의대학술지 Vol.18 No.4

Relapsing polychondritis is an episodic and often progressive inflammatory disorder of unknown cause affecting predominantly the cartilage of ears, nose and tracheobronchial tree as well as other proteoglycan-rich structures such as eye, heart, blood vessels and inner ear. Relapsing polychondritis can present with many other rheumatic disorders, such as rheumatoid arthritis, systemic lupus eryhematosus, Sjogren's syndrome, Behcet's disease and vasculitis. Recently we have experienced a case of relapsing polychondritis patient who presented with systemic lupus erythematosus. Relapsing polychondritis occuring in a systemic lupus erythematosus patients have never been reported in the Korean literature.

삼출성 늑막액에서 양악성 감별지표로서 CEA, TPA, SCC Ag 측정의 의의

김경찬,김민수,김미정,권두영,한승범,전영준 啓明大學校 醫科大學 1998 계명의대학술지 Vol.17 No.4

상피 세포에서 기원한 대표적인 종양표지자인 carcinoembryonic antigen (이하 CEA로 약함)은 삼출성 늑막액 환자의 양악성 감별에 보고적으로 사용되고 있다. CEA 이외에 혈청에서 양악성감별의 보조적 지표로 알려진 tissue polypeptide antigen (이하 TPA로 약함)과 squamous cell carcinoma antigen (이하 SCC Ag으로 약함)을 혈청과 늑막에서 동시 측정하여 늑막삼출액의 악성 감별에 어느 정도의 임상적인 유용성이 있는지를 알아보기 위하여 이 연구를 시행하였다. 1997년 1월 1일부터 동년 8월 31일까지 계명대학교 동산의료원에 입원한 환자들 중 삼출성늑막액을 가진 61명을 대상으로 하여 혈청과 늑막액에서 CEA, TPA, SCC Ag의 수치를 방사면역법으로 측정하였다. 각각의 조양표지자들은 악성과 양성군으로 구분한 뒤 분석하였으며 악성군이 28례, 양성군이 33례이었다. 그리고 진단양성기준치를 설정한 뒤 종양표지자들의 특이도, 민감도를 산출하였고 상기 지표들을 종양표지자와 늑막액 세포검사르 조합한 경우에도 산출하여 비교 분석하였다. 혈청 CEA 와 TPA는 각각 7.0 ng/ml, 80.0 ng/ml, 늑막액 CEA와 TPA는 각각 50. ng/ml, 4700.0 ng/ml로 진단양성기준치를 설정하였을 때 특이도를 낮추지 않으면서 가장 높은 민감도를 보였다. 늑막액 세포검사와 동시에 혈청 TPA 도는 늑막액 CEA를 측정하였을 때 특이도는 떨어뜨리지 않으면서 민감도를 높이는 좋은 조합인 것으로 나타났으며 혈청 CEA 및 TPA수치를 늑막액 세포검사와 도시에 시행하였을 때 특이도를 떨어뜨리지 않으면서 가장 높은 민감도를 얻었다. 늑막액 세포검사가 음성인 경우에도 혈청 CEA와 TPA를 동시에 측정하여 높은 민감도와 특이도를 얻을 수 있었다. 따라서 CEA와 TPA는 늑막삼출액의 양악성 감별 진단 유용한 보조적 지표로서 사용할 수 있을 것으로 판단된다. Carcinoembryonic antigen(CEA), the most widely used tumor marker was measured in pleural fluid of patients with exudative pleural effusions in order to differentiate malignant from benign effusions. This study was performed to find out if there is any clinical utility in differential diagnosis of malignancy by measuring simultaneously CEA, tissue polypeptide antigen(TPA) and squamous cell carcinoma antigen(SCC Ag) in serum and pleural fluid. The study population was 61 patients with exudative pleural effusions who were admitted to Keimyung University Hospital from January 1 to August 31, 1997. Each CEA, TPA and SCC Ag level in serum and pleural fluid were measured using radioimmunoassay method. These patients were divided to malignant and benign group. Malignant group consists of 28 cases and benign group consists of 33 cases. And the sensitivity and specificity of each tumor marker was obtained using cut-off value and that combining tumor markers and pleural fluid cytology were also obtained and analyzed. When the cut-off value was applied to CEA and TPA in serum using 7.0 ng/ml and 80.0 ng/ml respectively, the highest sensitivity was obtained without specificity being lowered. The same result was obtained when the cut-off value was applied to CEA and TPA in pleural fluid using 5.0 ng/ml and 4700.0 ng/ml respectively. When CEA in pleural fluid or TPA in serum were measured in combining with pleural fluid cytology sensitivity was increased without decreasing specificity than measured in pleural fluid cytology alone. When CEA in serum and TPA in serum were measured in combining with pleural fluid cytology simultaneously, the highest sensitivity was produced without decreasing specificity than measured in any other combinations. In addition, when serum CEA and TPA in serum were measured in the negative group of pleural fluid cytology, high sensitivity and specificity were obtained. These data suggest that CEA and TPA can be used as useful tumor markers for the differential diagnosis of malignancy and benign condition in patients with exudative pleural effusions.

원발성 간세포암종의 척수전이 1례

조광범,손정호,박경식,권두영,이영수,황재석,허정욱,박승국,안성훈 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.2

Hepatocellular carcinoma is one of the most common malignancies reported in Korean adult males. Hepatocellular carcinoma usually spreads to regional lymph nodes around porta hepatis via lymphatics and to distant metastasis via hematogenous spread. The lung is most common distant metastatic site, followed by the adrenal glands, local lymph nodes and bones. But metastasis to the spinal cord of hepatocellular carcinoma is very rare. Recently we experienced a patient with hepatocellular carcinoma who had suffered from lower leg weakness for 10 days. The patient was proved to have hepatocellular carcinoma with metastasis to the spinal cord. MRI showed an ovoid intracordal mass between the twelfth thoracic and first lumbar vertebra level. After emergency irradiation, the patient could recover.(Korean J Hepatol 2002;8:218-222)

만성 B 형 간염에서 HBsAg 및 HBcAg 의 간세포 내 발현양상과 병리조직학적 소견과의 상관관계

박경식,안성훈,김상표,황재석,허정욱,조광범,권두영,박승국,손정호 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.4

Background / Aims : The purpose of this study was to assess the correlation between histologic activity and fibrosis and the distribution of intrahepatic hepatitis B core antigen(HBcAg) and surface antigen(HBcAg ) inpatients with chronic hepatitis B . Methods : 141 patients(M:F=141:27) with biopsy-proven chronic hepatitis B ,abnormal liver function, and a positive HBV viral marker(serum HBeAg , serum HBV DNA) were enrolled. Results : HBcAg was expressed in 96 of 141 patoents(68.1%), n HBcAg in 23(16.3%), c HBcAg in 58(41.25), and n-c HBcAg in 15(10.6%). In the cases of HBsAg, 114 of 141 patients(80.9%) were expressed as c HBsAg, 2(1.4%) as m HBsAg, and 16(11,3%) as m-c HBsAg. The presence of intrahepatic HBcAg and HBsAg according to gudat's calssification was not correlated with activity and fibrosis. But the groups with nuckear expression of HBcAg revealed less inflammatory activity (grade, p=0.003), and less fibrotic stage(p=0.002) than with cytoplasmic or no expression of HBcAg. HBsAg was not. Conclusion : These observations suggest that inflammatory activity and fibrosis of chronic hepatitis B are related to the presence of HBcAg in hepatocytes and the expression of HBcAg. This is a very important finding in hepatocytolysis.

점막하 종양으로 보인 십이지장 결핵에 동반된 결핵성 림프절염 1 예

박경식,안성훈,전상훈,황재석,허정욱,조광범,이석근,권두영,박승국 대한소화기내시경학회 2001 Clinical Endoscopy Vol.23 No.4

In spite of decrease in prevalence, yet tuberculosis is not rare disease in Korea and the morbidity is over one percent. Because extrapulmonary tuberculosis is less common than that of lung, quick and accurate diagnosis is not easy and there may be some problems in selecting the methods and the times to treat it. Especially, each or combination of abdominal lymphadenitis and duodenal tuberculosis are so rare that differential diagnosis from other common or rare diseases is difficult, and much attention is required to diagnose and treat those. Recently we experienced a case of tuberculous lymphadenitis accompanied by duodenal bulbar tuberculosis which had been conceived as submu cosal tumor at endoscopy and diagnosed by explorative operation. So we report this case with review of related literatures.