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심미령,조은영,염주진,김용성,김희식,윤기중,유교상,김태현,최석채,나용호 대한소화기내시경학회 2003 Clinical Endoscopy Vol.27 No.1
Primary gastrointestinal lymphomas originating from the mucosa-associated lymphoid tissue (MALT) have been reported with increasing frequency. The stomach is the most frequent site of MALT lymphoma, and a relationship with Helicobacter pylori infection has been studied. However, primary MALT lymphoma arising from the ampulla of Vater is extremely rare, and its relationship with Helicobacter pylori infection is still obscure. We report here a case of a 71-year-old man with marginal zone B cell lymphoma of MALT with large B cell lymphoma of the ampulla of Vater that was not associated with Helicobacter pylori. A pancreaticoduodenectomy was performed, and the pathologic examination of the resected specimen confirmed the diagnosis. The patient tolerated just one course of systemic chemotherapy, but has been doing well for 18 months after surgery. (Korean J Gastrointest Endosc 2003;27:51-55) 점막연관림프조직 림프종은 주로 위에서 발생하며 Helicobacter pylori (H. pylori) 감염과 연관이 있는 것으로 알려져 있다. 바터 팽대부의 점막연관림프조직 림프종은 국내에서 발생된 보고는 없으며, H. pylori와의 연관성도 불분명하다. 저자들은 황달을 주소로 내원한 71세 남자 환자에서 바터 팽대부에 발생한 종괴를 수술 후 조직 검사와 면역 화학염색을 통해 진단된 대세포 림프종을 포함한 점막연관림프조직 변연대 B세포 림프종(marginal zone B cell lymphoma of MALT with large B cell lymphoma) 1예를 경험하였기에 보고하는 바이다.
분절성 호두까기 식도와 비효과적 식도 수축 형태를 동반한 Steakhouse Syndrome 1 예
심미령 ( Mi Ryeong Sim ),최창수 ( Chang Soo Choi ),염주진 ( Joo Jin Yeom ),오효정 ( Hyo Jeong Oh ),임윤혁 ( Yun Hyuk Yim ),서검석 ( Geom Seog Seo ),김태현 ( Tae Hyeon Kim ),최석채 ( Suck Chei Choi ),나용호 ( Yong Ho Nah ) 대한소화기기능성질환·운동학회 2005 Journal of Neurogastroenterology and Motility (JNM Vol.11 No.1
An impacted meat bolus is the most common type of food-related foreign body, and this is usually seen in elderly patients. Acute esophageal obstruction caused by eating poorly chewed meat has been called the Steakhouse syndrome or the Backyard barbecue
내시경적 결찰술로 치유한 직장 내 Dieulafoy 병변 1예
권경희,심미령,이상재,김상욱,서검석,김태현,최석채,나용호 대한소화기내시경학회 2002 Clinical Endoscopy Vol.25 No.2
The Dieulafoy's lesion is an unusual cause of gastrointestinal hemorrhage that results from the erosion of abnormally large submucosal artery. The lesion is usually located in the stomach, although it may occur anywhere in the gastrointestinal tract. Lower GI bleeding from Dieulafoy- like lesion of rectum is very rare. We describe one patient with extragastric Dieulafoy's disease, in the rectum. Diagnosis was made by endoscopy. Recently, endoscopy is important in the treatment of Dieulafoy-like lesion of rectum including epinephrine injection and coagulation therapy. We treated with the endoscopic management using ligation technique. We report a case that the 65-year old women had a extragastric Dieulafoy's lesion on the rectum, treated by endoscopic ligation with O-ring. (Korean J Gastrointest Endosc 2002;25:112-115) Dieulafoy 병변은 위장관 출혈의 드문 원인으로 주로 상부 위장관, 특히 위에서 흔히 발생하나 드물게 소장, 대장에서도 발생하여 하부 위장관 출혈의 원인이 되기도 한다. 특히 직장에서 발생한 Dieulafoy 병변은 매우 드물고 하부 위장관 출혈 발생 시 내시경적 치료와 수술적 치료를 고려할 수 있으나 최근 내시경적 치료가 발달되면서 더 선호되고 있다. 이에 본 저자들은 하부 위장관 출혈을 주소로 내원한 65세 여자 환자에서 대장 내시경을 통해 직장 내의 Dieulafoy 병변을 진단하고 O-ring을 이용한 내시경적 결찰술로 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다.
당뇨병성신증 환자에서 Fenoverine에 의해 발생한 횡문근융해증 1예
김기훈,심미령,계영하,이명수,박병현,안선호,오석규,김태현,송주흥,조정구 대한내과학회 2002 대한내과학회지 Vol.62 No.4
Fenoverine is a non-atropine like spasmolytic drug that inhibits calcium channel currents in the smooth muscle. It has been occassionally reported that fenoverine can cause rhabdomyolysis under the certain conditions such as hepatic dysfunction, concomitant use of HMG-CoA reductase, mitochondrial myopathy, lipid storage myopathy or malignant hyperthermia. However, there is no report of fenoverine-induced rhabdomyolysis in type 2 diabetic nephropathy patient. So we describe here a case of fenoverine-induced rhabdomyolysis in type 2 diabetic patient. A 70-year-old man had both lower legs and shoulder pain for 5 days prior to hospital admission. He was a type 2 diabetic patient and had been managed for diabetic nephropathy. He had been consumed common doses of fenoverine for 20 days due to abdominal pain and diarrhea. Results of investigations showed evidence of rhabdomyolysis. Fenoverine therapy was stopped after admission and he was treated supportive care, his condition was recovered. In this case, renal function impairment may have been a predisposing factor for fenoverine-induced rhabdomyolysis. The incidence of muscular complications of fenoverine therapy could be reduced by avoidance of prescription of the drug in patients with diabetic nephropathy.(Korean J Med 62:465-468, 2002) Fenoverine에 의한 횡문근융해증의 발생은 간질환의 존재나 HMG-CoA 환원효소 억제제 계열의 지질강하제 복용시 잘 발생한다고 알려져 있으나 당뇨병성신증 환자에서 fenoverine에 의한 횡문근융해증은 보고된바 없다. 이에 저자들은 당뇨병성신증 환자에서 fenoverine에 의한 횡문근융해증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
조은영,심미령,이상재,김희식,염주진,김용성,김상욱,서검석,손영우,김태현,최석채,김은아,나용호,윤기중 대한소화기내시경학회 2003 Clinical Endoscopy Vol.27 No.4
Gastrointestinal stromal tumors (GIST) form a group of uncommon neoplasms originated from the pleuripotential mesenchymal cell. There is no final conclusion about accurate diagnosis and prognostic factors of GIST. Clinical presentation is not specific and intraperitoneal bleeding is a very rare complication. We report a case of a malignant GIST complicated by intraperitoneal hemorrhage, which was diagnosed by abdominal CT and EUS before operation. A subtotal gastrectomy was perfomed without complication. The patient is still alive without recurrence. (Korean J Gastrointest Endosc 2003;27:220-224) 다능성 간엽 분화를 보이는 종양을 포괄적으로 포함해 위장관 간질종양으로 분류하고 있으나, 아직 분명한 진단기준과 예후인자들에 대한 정확한 결론이 없다. 임상적으로는 증상이 없는 경우가 대부분이며, 비특이적 복통, 위장관 출혈에 의한 증상을 보일 수 있으나, 혈복증이 생기는 경우는 매우 드물다. 저자들은 복통을 주소로 내원한 환자에서 혈복증을 유발한 위의 악성 간질종양을 내시경 초음파와 방사선적 검사로 진단하고, 수술하였던 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
Propylthiouracil에 의한 중증 급성간염 1예
임종주,심미령,이명수,김태현,오석규,안선호,박무림,김남호,박병현,조성구 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2
PTU에 의한 간염의 발생은 매우 드물게 발생하는 것으로 알려져 있으나 저자들은 Graves씨 병으로 진단 받고 propylthiouracil 투여를 받고있던 환자에서 중증의 급성 간염이 발생한 1예를 경험하였기에 보고하는 바이다. Propylthiouracil is widely used to treat patients with hyperthyroidism. This drug has been associated with severe hepatotoxicity rarely. We presented the case of jaundice and profound liver dysfunction from a 23-year old woman treated with propylthiouracil for hyperthyroidism. Viral, metabolic, and autoimmune liver disease could be excluded and liver biopsy revealed a pattern of acute hepatitis. After discontinuing the drug, there was a progressive resolution of hepatic symptoms and decrease in biochemical data of the liver. Despite propylthiouracil induced hepatitis in rare case, patients receiving propylthiouracil are exposed to develope severe hepatotoxicity. Therefore it might be advisable to monitor level of the transaminase on regular base from patients receiving propylthiouracil.