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자가면역 췌장염의 동반증상 없이 발생한 IgG4 연관 경화성 담관염
천송욱 ( Song Wook Chun ),최자성 ( Ja Sung Choi ),강버들 ( Beo Deul Kang ),김유진 ( Yu Jin Kim ),한기준 ( Ki Jun Han ),조현근 ( Hyeon Geun Cho ),오화은 ( Hwa Eun Oh1 ),조재희 ( Jae Hee Cho ) 대한소화기학회 2013 대한소화기학회지 Vol.62 No.1
IgG4-related systemic diseases are characterized by a diffuse or mass forming inflammatory reaction rich in lymphocytes and IgG4-positive plasma cells (lymphoplasmacytic infiltration), fibrosclerosis of variable organs and obliterative phlebitis. They usually involve various organs including the pancreas, bile duct, gallbladder, salivary gland, retroperitoneum, kidney, lung, and prostate. However, most of them are accompanied by autoimmune pancreatitis, and good response to steroid treatment is one of the hallmarks of this disease. We report a case of an 67-year-old man with IgG4 associated sclerosing cholangitis, who was diagnosed by endoscopic retrograde cholangiopancreatography and successfully treated with steroid therapy. (Korean J Gastroenterol 2013; 62:69-74)
정병하,천송욱,황성하,권혁상,윤건호,차봉연,손호영 대한내과학회 2004 대한내과학회지 Vol.66 No.6
횡문근융해증의 원인으로 알려진 대사성 질환에는 전해질 불균형과 당뇨병성 케톤산증, 고삼투성 혼수, 점액 부종 등 여러 가지가 알려져 있고, 갑상선 중독위기에서 동반되어 발생하는 경우도 드물게 보고 되고 있다. 저자들은 갑상선 중독위기에 동반된 횡문근융해증을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Rhabdomyolysis is defined as skeletal muscle injury with release of muscle cell constituents into the plasma. Trauma and drugs are important causes of rhabdomyolysis and not rarely it is associated with metabolic disorders such as diabetic coma, severe electrolyte disturbances and myxedema coma. There are a few reports about rhabdomyolysis developed in patient with thyroid storm. which is defined as a sudden, life threatening exacerbation of thyrotoxicosis. In this report, we described the case of thyroid storm complicated by rhabdomyolysis.
백정훈,최자성,천송욱,강버들,한기준,정진호,송지선,조재희 대한췌담도학회 2013 대한췌담도학회지 Vol.18 No.1
Anaplastic carcinomas of the pancreas are rare pancreatic tumors, frequently showing various morphologies that include pleomorphic epithelial cells and relatively mononuclear spindle cell. Because they have highly aggressive nature and worse prognosis, it is important to recognize this disease entity. 68- year-old woman admitted for the treatment of epigastric pain and weight loss. Initial CT scan showed that 9 x 5.5 cm sized pancreatic cystic mass in tail and about 1.5 cm sized two cysts in head and neck. Because additional imaging study such as MRI and endoscopic ultrasonography showed large cystic mass had a possibility of malignant mucinous cystadenocarcinoma, we planned to distal pancreatectomy. However, frozen biopsy of each pancreatic cystic wall showed malignant pleomorphic cells, therefore, she underwent total pancreatectomy for the treatment of anaplastic carcinoma. Herein we reported a case of multifocal cyst forming anaplastic carcinoma of the pancreas.
결절다발동맥염에 의한 급성 허혈성 장염으로 소장절제술을 시행한 1예
이경환,박재명,천송욱,백창렬,오정환,조유경,이인석,김상우,최명규,정인식 대한소화기내시경학회 2006 Clinical Endoscopy Vol.33 No.5
Polyarteritis nodosa is a systemic necrotizing vasculitis of the small- and medium-sized arteries with gastrointestinal involvement in more than 50% of cases at some time during the course of the disease. The gastrointestinal manifestations can be diverse and include abdominal pain, nausea and vomiting, ulceration, hemorrhage, occlusion and perforation. Gut involvement is a serious prognostic factor. A 65-year-old man was referred to our department suffering from epigastric pain. A push enteroscopy revealed ischemic enteritis at the proximal small bowel and the CT scan showed a large dilation of the small bowel. His condition deteriorated rapidly and an exploratory laparotomy and total resection of the small bowel was performed. We report a rare case in which the push enteroscopy revealed acute ischemic enteritis of the small bowel and where the pathology specimen showed transmural necrosis of the involved small bowel due to vessel occlusion caused by polyarteritis nodosa. (Korean J Gastrointest Endosc 2006;33:303-306) 결절다발동맥염은 중소동맥의 괴사성 혈관염을 일으키는 전신성 혈관염으로 50% 정도에서 위장관 침범에 의한 증상을 유발한다. 위장관 증상으로는 복통, 구토, 궤양, 출혈, 폐색, 천공 등 다양하며, 위장관 질환을 동반한 경우 예후는 불량한 것으로 되어 있다. 상복부 통증을 호소한 65세 남자의 밀기 소장 내시경 검사에서 근위부 소장의 허혈성 장염을 의심하는 소견이 관찰되었다. 환자는 복부 전산화단층촬영에서 소장 전체에 심한 허혈성 변화가 있었으며 증상이 심해져 소장절제술이 시행되었다. 저자들은 밀기 소장 내시경으로 소장의 급성 허혈성 장염을 의심하였고, 수술로 적출된 소장에서 결절다발동맥염에 의한 혈관 폐색으로 전 소장이 괴사된 증례를 경험하여 보고하는 바이다.
갈색세포종 환자에 병방한 스트레스에 의한 심근병증: 반전된 Takotsubo 심근병증 1예
김태석,추은호,강현희,천송욱,조은주,김재형 한국심초음파학회 2007 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.15 No.2
‘Takotsubo cardiomyopathy’or ‘stress-induced cardiomyopathy’is a newly described clinical entity characterized by transient left ventricular apical ballooning and left ventricular apical dyskinesis in the absence of angiographic feature of significant coronary artery disease. The cause of takotsubo cardiomyopathy is unclear, but catecholamines probably play a role in the takotsubo cardiomyopathy. We report a case of pheochromocytoma-induced takotsubo cardiomyopathy that showed atypical pattern of reversed takotsubo cardiomyopathy with transient significant mitral regurgitation. This is the first case showing the reversal of takotsubo cardiomyopathy due to pheochromocytoma in Korea. 본 증례는 갈색세포종에 의해 유발된 스트레스성 심근병증이 takotsubo 심근병증의 반전 형태로 발현하였으며, 환자가보존적 치료를 받은 후 약 1일 후에 정상 심기능으로 회복된경우로 국내 최초의 갈색세포종에 의한 스트레스성 심근병증이자 반전된 takotsubo 형태를 보이는 스트레스성 심근병증에 대한 보고이다.
조정현,김인태,최진이,천송욱,강버들,배상균,김희만,송지선 영남대학교 의과대학 2013 Yeungnam University Journal of Medicine Vol.30 No.1
Gastrocolic fistula is a fistulous communication between the stomach and the colon. It is a passage between the gastric epithelium and the colonic epithelium. This uncommon complication is caused by benign and malignant diseases of the stomach or the colon. Its clinical manifestations include weight loss, diarrhea and fecal vomiting; occasionally, anemia, poor oral intake, fatigue and dizziness; and very rarely, gastrointestinal bleeding. In this paper, an unusual case of gastrocolic fistula accompanied by hematochezia, which was revealed to have been caused by colon cancer invasion, is described.
아르곤 레이저를 이용한 담관 자가팽창금속스텐트의 트리밍
권정현,이인석,박재명,백창열,서정필,장재혁,박호성,남관우,유찬란,천송욱,조유경,김상우,최명규,정인식 대한소화기내시경학회 2006 Clinical Endoscopy Vol.33 No.6
A self-expanding metal stent is an effective treatment for biliary stenosis, improving obstructive jaundice and maintaining the long term patency of the bile duct. The complications of the metal stent are a perforation, distal migration, restenosis and duodenal mucosa injury from the contralateral wall impaction or trauma. However, the metal stent is a relatively permanent device and its removal is technically challenging. We report a case of protrusion of biliary stents into the duodenal lumen of a distal common bile duct cancer patients that was managed successfully by endoscopic argon plasma laser trimming. (Korean J Gastrointest Endosc 2006;33:385 389)