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복막투석 환자에서 gadolinium 사용 후 발생한 콩팥성 전신성 섬유증 1예
구태형 ( Tae Hyoung Koo ),이동현 ( Dong Hyun Lee ),백희경 ( Hee Kyung Baek ),김도경 ( Do Kyong Kim ),김보경 ( Bo Kyung Kim ),홍숙희 ( Suk Hee Hong ),안원석 ( Won Suk An ) 대한내과학회 2010 대한내과학회지 Vol.78 No.4
콩팥성 전신성 섬유증은 급성 또는 만성 신부전 환자에서 gadolinium조영제를 사용하였을 경우에 생기는 질환으로 상하지 말단의 부종 후 딱딱해짐, 관절운동 장애 및 전신증상을 일으키는 질환으로 전세계적으로 증례들이 보고되고 있다. 저자들은 복막투석 환자에서 gadolinium을 사용한 자기 공명영상 촬영 후 하지부종 및 통증을 동반한 nephrogenic systemic fibrosis 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Nephrogenic systemic fibrosis is a systemic illness that only affects patients with kidney failure. Exposure to gadolinium-based contrast agents has been associated with the subsequent development of nephrogenic systemic fibrosis in patients with decreased renal function. Nephrogenic systemic fibrosis is characterized by skin induration after swelling and limited joint movement through a loss in flexibility that preferentially affects the extremities. A 58-year-old man in peritoneal dialysis developed swelling and stiffness of the lower limbs following gadolinium exposure for brain magnetic resonance imaging. This patient was diagnosed with nephrogenic systemic fibrosis by CD34 immunoreactivity of subcutaneous fibroblasts in a skin biopsy. We report, for the first time in Korea, that nephrogenic systemic fibrosis developed after gadolinium exposure in a peritoneal dialysis patient. (Korean J Med 78:507-511, 2010)
구태형 ( Tae Hyoung Koo ),최원종 ( Won Jong Choi ),한승희 ( Seung Hee Han ),김수영 ( Su Young Kim ),이종훈 ( Jong Hun Lee ) 대한소화기학회 2015 대한소화기학회지 Vol.65 No.4
A 66-year-old male with dyspepsia and weight loss was referred to our hospital for evaluation. On laboratory examination, anti-saccharomyces cerevisiae (ASCA)-IgA was positive and iron deficiency anemia was present. PET/CT and abdominal CT scan images showed multiple small bowel segmental wall thickening and inflammation. Capsule endoscopy images showed multiple small bowel ulcerative lesions with exudates. Based on laboratory test results and imaging studies, the patient was diagnosed with Crohn’s disease and treated with prednisolone and 5-aminosalicylic acid (5-ASA). However, the patient underwent second operation due to small bowel perforation within 2 month after initiation of treatment. Pathology report of the resected specimen was compatible to primary small bowel diffuse large B cell lymphoma and pertinent treatment was given to the patient after recovery. Herein, we describe a case of primary small bowel diffuse large B cell lymphoma that was mistaken for Crohn’s disease. (Korean J Gastroenterol 2015;65:241-245)
혈중 CA 125 수치가 지속적으로 상승되었던 기관지확장증
신봉철 ( Bong Chul Shin ),구태형 ( Tae Hyoung Koo ),김상옥 ( Sang Ock Kim ),형건덕 ( Hsing Chien Ter ),엄수정 ( Soo Jung Um ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ),김기남 ( Ki Nam Kim ),이기남 ( Ki Nam Lee ),노미숙 ( Me 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.66 No.6
Serum CA 125 is the most useful marker for monitoring patients with epithelial ovarian cancer. However, it can be elevated above normal level in a variety of conditions other than ovarian cancer such as endometriosis, pelvic inflammation disease, and other malignant or nonmalignant disorders, including pulmonary diseases. Recently, we experienced a case of bronchiectasis in which the serum CA 125 level was elevated, changing with the patient`s condition. There was no evidence of underlying malignant disease on positron emission tomography or on gynecologic examination, including transvaginal ultrasonography. During follow-up for 14 months, we could not find any clue of malignant disease that could have been the cause of the elevated levels of serum CA 125. Elevated serum CA 125 level should be interpreted carefully according to the patient`s clinical condition. In addition, our case suggests that CA 125 may be used as a surrogate marker for acute inflammatory status for chronic pulmonary diseases.
외과적으로 절제된 위암에서 양전자방출단층촬영의 수술 전 예후적 가치
김기승 ( Ki Seung Kim ),최석렬 ( Seok Reyol Choi ),박인철 ( In Cheol Park ),구태형 ( Tae Hyoung Koo ),김준모 ( Joon Mo Kim ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.6
Background/Aims: The diagnostic value of PET-CT, in gastric cancer is well known, but the prognostic value of pretreatment PET-CT has not been adequately evaluated. This study aimed to investigate the preoperative prognostic value of PET-CT in gastric cancer patients .Methods: A total of 107 patients underwent surgical treatment for gastric cancer from April 2007 to December 2010 at Dong-A University Medical Center after confirming the presence of F-18 fluorodeoxyglucose (FDG) uptake on preoperative PET-CT. Among these patients, the following subjects were excluded: follow-up loss (13), palliative resection (5), neoadjuvant chemotherapy(1), and unrelated death (1). The remaining 87 patients were included in this study and data were collected by retrospectively reviewing the medical records. The median follow-up duration, defined as the period from operation to last imaging study date, was 34.2±14.8 months. FDG uptake values were represented by maximal standardized uptake value (SUVmax). In order to assess the correlation between SUVmax and recurrence, Kaplan-Meier`s survival analysis with log-rank test and cox proportional hazard model were performed. Receiver operating characteristic (ROC) curve was employed to determine the optimal cutoff value of SUVmax. Results: The result of Kaplan-Meier’s survival analysis with log-rank test were significantly different between high SUVmax group and low SUVmax group (p=0.035), the cutoff value of which was 5.6. However, in multivariate analysis with cox proportional hazard model, T-staging, N-staging and SUVmax did not show statistical significance (p=0.190, p=0.307, and p=0.436, respectively).Conclusions: High SUVmax on PET-CT in gastric cancer can be a useful prognostic factor. (Korean J Gastroenterol 2014;63:348-353)
p16과 RARB2 유전자의 비정상적인 메틸화 검사를 이용한 악성 흉수의 진단
나서희 ( Seo Hee Rha ),이수미 ( Su Mi Lee ),구태형 ( Tae Hyoung Koo ),신봉철 ( Bong Chul Shin ),허정훈 ( Jung Hun Huh ),엄수정 ( Soo Jung Um ),양두경 ( Doo Kyung Yang ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ),노미숙 ( Mee 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.4
혈중 CA19-9이 지속적으로 상승되었던 기관지 확장증 환자
허정훈 ( Jung Hun Huh ),이수미 ( Su Mi Lee ),구태형 ( Tae Hyoung Koo ),신봉철 ( Bong Chul Shin ),엄수정 ( Soo Jung Um ),양두경 ( Doo Kyung Yang ),이수걸 ( Soo Keol Lee ),손춘희 ( Choon Hee Son ),노미숙 ( Mee Sook Roh ),김기남 ( Ki 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.5
An elevated serum CA19-9 level is an indication of pancreatic and biliary tract cancer. However, it has recently become known that nonmalignant gastrointestinal diseases and a variety of nonmalignant respiratory diseases, such as idiopathic interstial pneumonia, collagen vascular disease associated lung diseases, diffuse panbronchiolitis and bronchiectasis, can also show an elevated serum CA19-9 level. We recently encountered a case of bronchiectasis with persistently elevated serum CA19-9, but without any evidence of malignant disease in endoscopic retrograde pancreatocholangiography, abdominal computed tomography, and positron emission tomography. After serial follow-up of 3 years and 10 months, there was still no evidence of cancer. It is believed that the elevated serum CA19-9 level was due to bronchiectasis. An elevated serum CA19-9 level should be interpreted carefully with the patients` clinical condition. (Tuberc Respir Dis 2008;64:383-386)
장길식 ( Gil Sik Jang ),김연희 ( Yun Hee Kim ),최영섭 ( Young Seop Choi ),김승호 ( Seung Ho Kim ),김종민 ( Jong Min Kim ),배석진 ( Seok Jin Bae ),조영관 ( Young Gwan Cho ),구태형 ( Tae Hyoung Koo ) 한국환경농학회 2016 한국환경농학회지 Vol.35 No.2
BACKGROUND: The objective of this study is to evaluate the soil quality to cultivate crops in urban garden. METHODS AND RESULTS: During the period of six month from March to August 2015, measured eight heavy metals, seven Organic items and Fluorine on seventeen urban sites and thirty-one suburban sites in Gwangju city. METHODS AND RESULTS: The average concentration and range of heavy metal in soil are 0.15 mg/kg(ND-0.6) for Cd, 14.9 mg/kg(1.5-33.3) for Cu, 4.4 mg/kg(0.4-71.8) for As, 0.05 mg/kg(ND-1.366) for Hg, 24.7 mg/kg(13.1-62.7) for Pb, 102.5 mg/kg(49.1-276.4) for Zn and 9.2 mg/kg(ND-90.1) for Ni but Cr6+ is not detected. The average value and range of soil fertility items are 253.5mg/kg(76.6-1766.0) for fluorine, 6.4(4.8-7.7) for pH, 20.3 g/kg(5.0-44.0) for orangic matters, 562.7 mg/kg (28.0-1672.0) for available phosphate, 0.6 cmol+/kg (0.1-2.3) for K, 9.7 cmol+/kg (2.7-22.0) for Ca, 3.0 cmol+/kg (0.9-7.4) for Mg, 1.0 ds/m(0.2-2.9) for conductivity. The concentration of Hg in Suburban area is 0.005 mg/kg lower than 0.134 mg/kg in urban area. Also, the concentration of As, Cd, Ni and Zn is lower than urban area as 32%, 37%, 51%, 71% respectively. CONCLUSION: According to SPI index of soil contamination, 39 sites are first degree and 8 sites are second degree and 1 site(41th) is fourth degree. Pb and Cd are not detected and As is detected tiny amounts in plants grown polluted soil, so heavy metals have not moved to plants.