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제인수,허민영,문치숙,이재호,정수룡,조길현,이영민,김대경,김두일,김동수 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.3
Coronary artery aneurysms are detected with increasing frequency because of the routine use of coronary angiography in the diagnosis and management of coronary artery disease. Although some coronary artery aneurysms are congenital or inflammatory, most are atherosclerotic. The prognosis of atherosclerotic coronary artery aneurysm may depend on the morphology of the aneurysm or the presence of coexisting obstructive disease. Coronary artery aneurysms have been also reported to occur after ballon angioplasty, directional athrectomy, laser angioplasty, and stent implantation with a frequency of 2% to 4%. The long-term outcome of post-intervention coronary artery aneurysm is unknown. We report two cases of the development of a coronary aneurysm 6 months after stent implantation as a treatment of severe obsructive coronary artery disease.
크론병과 장결핵의 감별에 있어 특징적인 대장내시경 소견
제인수 ( In Soo Je ),이상혁 ( Sang Hyuk Lee ),정은욱 ( Eun Uk Jung ),강명주 ( Myoung Joo Kang ),박상원 ( Sang Won Park ),최바울 ( Pa Ul Choi ),김지현 ( Ji Hyun Kim ),박성재 ( Sung Jae Park ),지삼룡 ( Sam Ryong Jee ),박은택 ( Eun T 대한장연구학회 2007 Intestinal Research Vol.5 No.2
Background/Aims: The incidence of Crohn``s disease (CD) is on the increase in Korea. The differentiation of Crohn``s disease from intestinal tuberculosis (IT) is difficult. The aim of this study is to determine the characteristics of colonoscopic findings and factors that differentiate CD from IT. Methods: A total of 136 patients who were diagnosed with CD or IT at the Busan Paik Hospital from January 1995 to May 2005 were included in this study. We analyzed endoscopic findings, clinical characteristics and histological findings of 75 patients with CD and 61 patients with IT retrospectively. Results: For patients with IT, 18 (58.1%) of the patients had circular ulcers. For patients with CD, 27 (42.1%) of the patients had transverse ulcers, 18 (28.1%) of the patients had longitudinal ulcer, and 19 (29.6%) of the patients had both types of ulcers. The involvement of the ileocecal valve was noted in 18 (58.0%) of the patients with CD and in 37 (57.8%) of the patients with IT. The involvement of the rectum or anus was noted in 24 (51.5%) of the patients with CD and one (3.2%) patient with IT. Conclusions: According to previous studies, the presence of an ulcer was important to differentiate CD from IT. However, the presence of an ulcer was not a significant differentiating factor in our study. On colonoscopic findings, involved segments, an aphthous ulcer, cobblestone appearance, involvement of the rectum or anus and mucosal bridge should be observed carefully. (Intest Res 2007;5:158-164)
Guillain-Barre Syndrome 환자에서 발생한 항이뇨 호르몬 분비 이상 증후군(SIADH) 1예
김재환,김기훈,제인수,김태희,김양욱,김영훈,김상진 대한내과학회 2004 대한내과학회지 Vol.66 No.4
저자들은 Guillain-Barre syndrome 환자에서 입원 도중 다른 가능한 유발 요인 없이 SIADH가 발생하였고, GBS을 치료하는 동안 수분섭취 제한만으로 회복된 SIADH를 경험하였기에 문헌고찰과 함께 보고하는 바이다. SIADH was first described by Schwartz and colleagues in 2 patients with bronchogenic lung carcinoma as early as 1957. The main features of the syndrome consist of hyponatremia and hypotonicity, absence of fluid volume depletion, inappropriate urinary osmolality, increased urinary sodium excretion while on normal salt and water intake, and absence of thyroid, adrenal, pituitary or renal dysfunction. The Guilain-Barre Syndrome (GBS) is an acute inflammatory demyelinating polyradiculoneuropathy of unknown etiology. It occurs frequently one to three weeks after a banal antecedent respiratory or gastrointestinal infection. SIADH is associated with various condition such as malignant tumors, infection, central nervous system disorders, and different pharmacological agents. SIADH is observed in up 26% of patients with Guillain-Barre Syndrome (GBS). We report a case of GBS with SIADH.
상부 위장관 출혈로 발현된 십이지장 양성 기질 종양 1예
정명교,박은택,이원동,김재환,이상헌,김기훈,배경임,제인수,이상혁,설상영,정정명 白中央醫療院 2004 仁濟醫學 Vol.25 No.1
Small bowel tumors comprise less than 5% of gastrointestinal neoplasm. Because of their rarity, a correct diagnosis is very difficult and often delayed. Gastrointestinal stromal tumors(GIST) are spindle cell tumors occuring mainly in adults with 5-year survivals of 50-56% and 10-year survivals of 35-43%. It is difficult that we concluded clinical manifestation of GIST. At the time of diagnosis, we already consider metastatic lesions as malignancy, which is suggested poor prognosis. Patients frequently complain vague intermittent abdominal pain. Occasionally they experience severe colicky pain because of tumor-induced partial intestinal obstruction. Factors playing a prominent role in predicting their biological behavior are tumor site, size, and degree of mitotic activity. Recently, we experienced one case of duodenal benign GIST in a 23-year-old woman who had epigastric pain and intermittent melena, so we report it with a review of the literature.
급성충수돌기염으로 발견된 위선암에서 전이된 충수돌기 선암 1예
나경준,이재영,백현철,김정훈,배상훈,김동현,제인수,권병표,이태영,김상현,송철수,김민석,이진숙 대한소화기내시경학회 2007 Clinical Endoscopy Vol.34 No.5
Adenocarcinoma of the appendix is a rare neoplasm. Metastatic adenocarcinoma of the appendix from stomach adenocarcinoma is also a very rare finding. A 72-year-old man complained of right lower quadrant abdominal pain for 10 days, and he was diagnosed with acute appendicitis. Appendectomy was performed by a general surgeon. Adenocarcinoma was found on the postoperative biopsy. Subsequently, gastric adenocarcinoma was diagnosed on the gastroscopy with biopsy, and this was proven to be the original site of the appendiceal adenocarcinoma. (Korean J Gastrointest Endosc 2007;34:274-277) 일반적으로 충수돌기의 원발성 선암은 드문 질환으로 알려져 있으며, 다른 장기에서 전이된 충수돌기의 선암도 드물게 보고되는 희귀 질환이다. 저자 등은 급성 충수돌기염으로 진단된 72세 남자의 수술적 방법을 통해 발견된 원발성 위선암에서 전이된 충수돌기 선암의 1예를 경험하여 드문 증례이기에 문헌 고찰과 함께 보고하는 바이다.