한빛대교의 상부 시공 및 사설엔지니어링(C.E)

박용득(Young Deuk Park),원준연(Jun Yeon Won),심웅재(Ung Jae Sim),고준상(Joon Sang Ko),최충현(Chung Heon Choi) 한국강구조학회 2010 韓國鋼構造學會誌 Vol.22 No.3

진균성 심내막염 6예

조정호(Jeong Ho Cho),박윤수(Yoon Soo Park),홍성관(Sung Kwan Hong),고준상(Jun Sang Ko),장경희(Kyung Hee Jang),김효열(Hyo Youl Kim),최영화(Young Hwa Choi),송영구(Young Goo Song),박영환(Young Hwan Park),설준희(Jun Hee Sul),김준명(June M 대한내과학회 2000 대한내과학회지 Vol.59 No.2

Fungal endocarditis is rare but has been reported with increased frequency in the last few decades. Also fungal endocarditis has become an important infection in the aspect of medical progress and predisposing factors such as previous cardiac surgery, antibiotics use and hyperalimentation, immunosuppression, long-term intravenous catheterization, and drug use. We hereby describe six cases which occurred from January 1992 at Severance hospital, Yonsei University College of Medicine. In five cases infection was associated with previous cardiac surgery and in one case associated with subcutaneous central catheterization in a patient who underwent cancer chemotherapy. Only one patient survived after intensive treatment with fluconazole and surgical removal of vegetation. Others were discharged without improvement of disease or expired during therapy. Fungal endocarditis is still a serious disease with high mortality and whenever the diagnosis is suspected, transesophageal echocardiography should be performed with empirical antifungal therapy. Antifungal therapy and surgery would yield the best results. But overall survival in patient with fungal endocarditis is rather poor. Attentions and efforts for early diagnosis are needed in order to improve the prognosis of fungal endocarditis.(Korean J Med 59:203-207, 2000)

자기공명담관조영술에 의한 간외담관담석의 기원분석

박영수(Young Soo Park),서정훈(Jeong Hun Suh),고준상(Jun Sang Ko),정재복(Jae Bock Chung),김명진(Myung Jin Kim),박승우(Seung Woo Park),이세준(Se Joon Lee),정준표(Jun Pyo Chung),송시영(Si Young Song),강진경(Jin Kyung Kang) 대한내과학회 2002 대한내과학회지 Vol.63 No.3

Background : Extrahepatic bile duct stones can be classified into two types. Primary stones are formed de nevo in the bile duct, whereas secondary stones migrate from the gallbladder into the bililary tree. The differentiation between primary and secondary stones is very difficult before operation. The aim of this study is to determine the origin of extrahepatic bile duct stones by analyzing MRC features. Methods : MRC was obtained in 38 patients with stones in both the common duct and gallbladder. MRC findings were compared for gross characteristics and MR signal patterns between common duct stone and gallbladder stone pairs. The gross morphologic characteristics of gallstones on MRC were classified into oval, polygonal, round, rod, sandy and mixed shape. Gallstone patterns seen on heavily T2-weighted images were categorized into one of two patterns: dark, and mixed signal. Results : According to the morphologic characteristics on MRC images, the common duct stones were oval (n=9), polygonal (n=15), round (n=6), sandy (n=4), mixed (n=3) and rod (n=1). The visualized MR signal patterns of common duct stones on heavily T2-weighted images were dark (n=28) and heterogenous (n=10). Conclusion : On MRC, the gross morphologic characteristics and gallstone patterns of common duct stones were similar to those of their paired gallbladder stones in 60.5 to 78.9% of patients. (Korean J Med 63:267-272, 2002)

원발성 간암과 감별이 어려웠던 비전형적인 간혈관종 1예

한광협(Kwang Hyub Han),백용한(Yong Han Paik),전재윤(Chae Yoon Chon),문영명(Young Myoung Moon),김진석(Jin Suk Kim),고준상(Jun Sang Ko),정재연(Jae Youn Cheong),조영준(Young Jun Cho),최병현(Byung Hyun Choi) 대한소화기학회 2000 대한소화기학회지 Vol.35 No.2

Hepatocellular carcinoma is one of the major cancers in Korea. Early detection and diagnosis are the most important for the treatment of hepatocellular carcinoma. Ultrasonography combined with the measurement of serum α-fetoprotein is an effective screening method to detect small hepatocellular carcinoma. A 53-year-old man who had chronic hepatitis B was referred to our hospital under the suspicion of having hepatocellular carcinoma. Ultrasonogrphy had revealed a 3 cm diameter hyperechoic mass, suggesting hemangioma. Magnetic resonance (MR) imaging was performed for suspicion of having hepatocellular carcinoma due to elevated serum α-fetoprotein level. Since MR imaging was consistent with possible hepatocellular carcinoma, but not specific for hemangioma, red blood cell scan, needle aspiration biopsy, and angiography were performed. However, those results were not conclusive. Thus, the patient was followed at regular intervals. Since serum α-fetoprotein level became normal, but tumor size was not changed during long term follow-up, we diagnosed the lesion as atypical hemangioma. (Kor J Gastroenterol 2000;35:253 - 257)

위 이소성 췌장의 내시경적 소견

강진경,박인서,문영명,정재복,백용한,박병규,송시영,이용찬,박수진,고준상 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.5

Backgound/Aims: Ectopic pancreas in the stomach is a relatively uncommon abnormality. Although its typical finding on endoscopy was described as a submucosal nodule with central umbilication, it is still difficult to differenciate ectopic pancreas from other pathologies. So we investigated the endoscopic findings of ectopic pancreas in the stomach. Methods: Between Jan. 1987 and Aug. 1998, nineteen patients who underwent gastroendoscopy and were histologically diagnosed as ectopic pancreas by various methods, were encountered at the Department of Internal Medicine, Severance Hospital, Yonsei University. The clinicopathologic records of all the patients were reviewed. Results: The mean age of the patients was 39.3 years old with a male to female ratio of 1:2.8. Endoscopically, seventeen cases (89.5%) were suggestive of submucosal tumors. Submucosal tumors combined with umbilication were in 4 cases (21.1%), with ulceration in 2 cases (10.5%), erosion in 5 cases (26.3%), ulceration and erosion in 1 case (5.3%),and normal mucosa in 5 cases (26.3%) respectively. The size of ectopic pancreas was in the range of 0.8∼3.0 cm, except in one case which measured 6.0 cm. The location of ectopic pancreas was in the antrum in 18 cases (94.7%), and in the angle in 1 case (5.3%). The endoscopic diagnoses were ectopic pancreas in 5 cases (26.3%), submucosal tumor in 12 cases (63.1%), gastric polyp in 2 cases (10.5%). The methods of histologic diagnosis of ectopic pancreas in 3 cases (15.8%) was by endoscopic biopsy, by endoscopic submucosal resection in 10 cases (52.6%), and by operation in 6 cases (31.6%). Conclusions: Ectopic pancreas in the stomach is found in various morphology, presented as submucosal tumors in the antrum. Because histological diagnosis by endoscopic forcep biopsy is difficult in many cases, endoscopic submucosal resection or operation should be considered.

경피골막증과 동반된 비후성 위염 및 조기 위암 1예

조정호,김진석,이준규,강진경,박인서,문영명,이용찬,민진식,고윤웅,전재윤,고준상 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.1

Pachydermoperiostosis is a rare hereditary syndrome characterized by finger clubbing, periosteal new bone formation of tubular bones, and hypertrophic skin changes (pachydermia). This syndrome is known to be associated with a variety of diseases such as cranial suture defect, female escuchen, bone marrow failure and autonomic nervous system symptoms such as facial flushing and hyperhidrosis. There are just a few reports documenting gastric ulcer, hypertrophic gastropathy and Crohn's disease as associated diseases. A case is herein reported of pachydermoperiostosis accompanied by hypertrophic gastropathy and early gastric cancer.