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      • KCI등재후보

        증례 : 소화기 ; 대장내시경 후 발생한 피하기종, 기종격동 및 기복증

        허정권 ( Jung Kwon Huh ),노희선 ( Hee Sun No ),임희완 ( Hee Hwan Lim ),김정훈 ( Jung Hoon Kim ),김유철 ( You Cheoul Kim ),김철현 ( Cheol Hyeon Kim ),이재철 ( Jae Cheol Lee ) 대한내과학회 2009 대한내과학회지 Vol.77 No.5S

        Colonoscopy is an essential tool to investigate and to manage intraluminal lesions of the colon and has been considered safe although a perforation as a complication of this procedure is often associated with serious morbidity. A 56-year-old woman had a colonoscopic biopsy for a suspicion of colon cancer. After the procedure, the patient complained of neck swelling and abdominal distension and pain. A chest X-ray and abdominal computed tomography scan showed subcutaneous emphysema, pneumomedistinum and pneumoperitoneum. If the colon perforates into the retroperitoneum, air can travel to the mediastinum and subcutaneous tissue as the fascial planes of the cervical soft tissues are in continuity with those of the mediastinum and through the diaphragmatic hiatus with the retorperitoneal soft tissue space. We report here a rare case of subcutaneous emphysema, pneumomediastinum and pneumoperitoneum that developed after a colonoscopic biopsy. (Korean J Med 77:S1153-S1156, 2009)

      • KCI등재

        귀의 특성을 고려한 스피커의 선형 왜곡보상 시스템의 설계 및 구현에 관한 연구

        이원우,허정권,김진영,성굉모 한국음향학회 1993 韓國音響學會誌 Vol.12 No.5

        스피커는 입력이 전기신호이고 출력이 소리인 전기 음향 장치로서, 고유의 전달함수를 갖는 하나의 시스템으로 생각할 수 있다. 일한 스피커 시스템의 전달함수는 여러 가지 원인으로 인해 주파수 영역에서 평탄한 특성을 가지지 못하며 선형위상의 조건을 만족시키기가 힘들다. 음색을 변화시키는 스피커의 전달함수를 선형이라고 가정할 때 스피커의 앞단에서 스피커의 선형 전달함수의 역에 해당하는 선형 필터를 추가함으로쏘, 음색의 왜곡은 보정할 수 있다. 본 연구에서는 이러한 스피커의 선형왜곡을 보상하기 위한 선형필터로서 FIR 필터를 사용하였으나, 2장에 제시되어 있는 기존의 알고리듬과는달리 귀의 청감특성을 이용하여 가청주파수 대역에 대해 몇 개의 대역으로 나눈 후, 각 대역마다 보상 할 주파수 해상도를 달리하는 새로운 알고리듬에 대해 기술하였다. 이러한 다해상도 선형왜곡 보상시스템은 각 대역마다 다른 해상도로 보상한다는점에서는 필터뱅크 보상 시스템과 유사하지만, 대역통과필터가 아닌 저역통과필터만을 이용하여 설계의 복잡서응ㄹ 줄였으며 각 대역마다 독립적으로 보상하는 필터뱅크 보상시스템과는 달리 1차 대역에서 보상하지 ath한 오차를 2차, 3차에서 보상하는 새로운 기법을 이용하였다. 본 알고리듬을 적용한 모의실험을 통하여 성능을 평가한 결과 가청음대역에서 ±6dB의 왜곡을 보인 스피커가 실효 tap수를 272로 했을 때 ±0.5dB의 리플을 보이는 양호한 결과를 얻었다.

      • KCI등재

        무증상 성인의 대장암 선별검사로서 대장 내시경검사의 유용성

        조현호,이석영,허정권,김정훈,임희환,노희선,조장현,조성인,김덕룡,박수철,김진,한철주,김유철 대한소화기내시경학회 2007 Clinical Endoscopy Vol.34 No.1

        Background/Aims: This study evaluated the prevalence and location of colonic adenomatous polyps in asymptomatic adults. Methods: A total of 2,849 asymptomatic adults underwent colonscopic screening as a part of health evaluation from January 2003 to September 2005. Completed questionnaires as well as the colonoscopic and pathologic findings were analyzed. Results: There were 406 (14.3%) subjects with adenomatous polyps including 78 (2.7%) with advanced polyps. There was a trend toward an increased prevalence of adenomatous polyps with age. The relative risk of a proximal polyp according to the distal findings was 5.7 (95% CI 4.3∼7.4) for adenoma, 4.9 (95% CI 3.0∼7.7) for advanced adenoma compared with that for no adenomatous polyp. There were no index polyps at the distal colon in 30% of the 406 subjects. Conclusions: Though distal polyps are associated with the proximal polyps, 30% of asymptomatic adults with proximal polyps are not associated with any distal index polyps. For those without any contraindication to the procedure, colonoscopy performed by experienced colonoscopists as a screening test is feasible for detecting those patients with colorectal polyps. (Korean J Gastrointest Endosc 2007;34:14-18) 목적: 무증상 성인의 대장암 선별검사로 대장 내시경의 유용성을 알아보고자 한다. 대상 및 방법: 2003년 1월부터 2005년 9월까지 원자력병원 건강검진센터에서 대장암 선별검사를 목적으로 대장 내시경검사를 시행 받은 무증상 성인을 대상으로 하였으며 검사 중 발견된 모든 폴립에 대해 조직학적 검사와 위치, 크기 등을 기록하였다. 결과: 전체 4,629명의 수검자 중 97.0%인 4,491명에서 맹장까지 관찰 가능하였으며, 이 가운데 무증상으로 확인된 2,849명을 분석하였고 406명(14.3%)에서 선종이 발견되었으며 남자의 유병률이 18.4%로 여자의 9.3%에 비해 유의하게 높았다. 선종이 발견된 평균 연령은 남자에서 55.2±10.1세, 여자에서 56.1±10.9세로 차이는 없었으며 연령이 증가할수록 유병률이 증가하는 양상을 보였고 검사에 따른 의미 있는 합병증은 없었다. 선종의 전체적인 분포를 볼 때, 70%가 원위부 대장에 국한해서 또는 원위부 대장과 근위부 대장에서 동시에 발견되었으며 원위부 대장 선종의 존재에 따른 근위부 대장 선종의 상대위험도는 5.5로 나타났다. 결론: 대장 내시경 검사가 선별검사로 심각한 부작용 없이 사용될 수 있으며 원위부 대장 선종의 존재는 동시성 근위부 대장 선종의 예측도를 높이는 것으로 나타났다. 또한, 선종 환자 중 30%에서는 근위부 대장 선종만 있어 선별검사로 대장 내시경검사가 유용할 것으로 생각한다.

      • KCI등재

        Recurrent Mesalazine-Induced Myopericarditis in a Patient with Ulcerative Colitis

        박은혜,김병진,허정권,정은행,이상혁,방기배,설지수,성주욱,김범수,강진호 한국심초음파학회 2012 Journal of Cardiovascular Ultrasound Vol.20 No.3

        Inflammatory bowel disease (IBD) is considered as a dysregulated immune mediated disease. Pericarditis in IBD is a very rare disease both as an extra-intestinal manifestation of IBD and an adverse reaction of therapeutic drug for IBD such as mesalazine or sulfasalazine. A 26-year-old IBD male patient who had been taking mesalazine regularly for about 1 month was referred to our hospital because of fever, chest discomfort, and abnormal electrocardiographic findings. The patients was diagnosed as acute myopericarditis, and recovered after cessation of mesalazine using steroid and aspirin. When mesalazine was re-medicated some days after discharge, he suffered from myopericarditis again. Subsequently, myopericarditis was resolved just after cessation of mesalazine again. These findings suggest that the development of myopericarditis is caused by mesalazine.

      • KCI등재후보
      • KCI등재

        The Relationship Between Heart Rate Recovery and Brain Natruretic Peptide in Patients With Chest Discomfort

        이재은,김범수,박완,허정권,김병진,성기철,강진호,이만호,박정로 대한심장학회 2010 Korean Circulation Journal Vol.40 No.4

        Background and Objectives: The correlation between brain natruretic peptide (BNP) level and cardiac autonomic function has been studied in type 2 diabetic patients. However, there is limited data from patients with normal systolic function. We evaluated the association between heart rate recovery (HRR) representing autonomic dysfunction and three plasma BNP levels: pre-exercise, post-exercise, and change during exercise in patients with normal systolic function. Subjects and Methods: Subjects included 105 patients with chest pain and normal systolic function. HRR was defined as the difference between the peak heart rate and the rate measured two minutes after completion of a treadmill exercise test. We measured plasma BNP levels before exercise, 5 minutes after completion of exercise, and during exercise (absolute value of difference between pre- and post-exercise BNP levels). Results: Patients with abnormal HRR values (≤24 beats for the first 2 minutes of HRR) had lower high-density lipoprotein, lower peak heart rates, and higher pre- and post-exercise BNP levels than patients with normal HRR values. The patients with coronary artery disease (CAD) had abnormal HRR. However, no significant differences were found between the two groups in terms of history of hypertension (HTN), diabetes, and peak systolic blood pressure (SBP) and diastolic blood pressure (DBP). HRR was significantly associated with pre-exercise BNP (r=-0.36, p=0.004) and post-exercise BNP (r=-0.27, p=0.006), but not BNP changes. Further, pre-exercise BNP levels showed a greater association with HRR than post-exercise BNP levels. Conclusion: HRR is independently associated with pre-exercise and post-exercise BNP levels, even in patients with normal systolic function.

      • KCI등재

        Primary Gastric Choriocarcinoma: Two Case Reports and Review of the Literatures

        윤정호,김민수,국은희,안세환,전세용,한민성,허정권,강혜진,나임일,조수연,김상범,류백렬,양성현 대한암학회 2008 Cancer Research and Treatment Vol.40 No.3

        Primary gastric choriocarcinoma (PGC) is a rare tumor, and its pathogenesis is still uncertain. Most PGCs have been reported to possess an adenocarcinoma component of variable extent, and pure PGC is especially rare. The diagnosis of PGC is confirmed by exhibition of choriocarcinomatous components on biopsy and exhibition of β-hCG positive cell on immunohistochemical stain and elevation of the serum β-hCG. Moreover it must be confirmed that no other site including gonads displays any tumor masses. The PGC tends to be more invasive and to have early metastasis. The median survival is known to be less than several months. We report two cases. The first case was a 62 year-old man who was diagnosed as advanced gastric cancer (AGC) by endoscopic biopsy with hepatic metasasis and received palliative chemotherapy with modified FOLFOX regimen and Genexol plus cisplatin regimen. He underwent subtotal gastrectomy due to perforation of the stomach during chemotherapy. On post-operative biopsy, He was re-diagnosed as PGC and received another palliative chemotherapy modified FOLFIRI, BEP, EMACO, VIP. However, multiple liver metastases were aggravated, and also serum AFP level increased. Ultimately, the paient died 10 months after initial diagnosis. Another case was a 45 year-old man. On endoscopic biopsy, he was diagnosed as AGC of adenocarcinoma. On Chest and Abdomen CT, multiple pulmonary and hepatic metastasis were also confirmed. On liver biopsy, He was diagnosed as PGC. The immunohistochemical stains were performed and the results were cytokeratin positive, EMA negative and β-hCG weak positive. The serum β-hCG level was highly elevated. BEP, VIP and EMA/CO combination therapy were administered, but he died at 12th months after the initial diagnosis.

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