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반월형 사구체신염이 병발된 T 림프구 기원의 원발성 간림프종 1 예
김용일,정철원,이현순,김홍빈,박동영,이효석,김성권,소영,김노경,김병관,김선미,이기형,허대석 대한내과학회 1997 대한내과학회지 Vol.53 No.1
The primary lymphoma of the liver is a rare disease. We report a case of primary hepatic T-cell lymphoma associated with crescentic glomerulonephritis. The case, a 53-year-old male was presented with a 2-year history of hepatic mass and a 1-month history of foamy urine, rapidly progressive azotemia, and oliguria. The kidney biopsy revealed diffuse crescentic glomerulonephritis. The result of immunohistochemical study of liver biopsy specimen was consistent with non-Hodgkin's lymphoma in T-cell lineage. Because renal function was deteriorated rapidly and there were signs of volume overload, hemodialyses were performed. Although the patient received 2 cycles of combination chemotherapy with CHOP(cyclophosphamide, vincristine, prednisolone, and doxorubicin), he did not respond and died of sepsis.
ORiginal Article : Seroprevalence of Helicobacter pylori Infection in Korean Health Personnel
( Hyun Young Kim ),( Nayoung Kim ),( Seon Mie Kim ),( Ji Hyun Seo ),( Eun Ha Park ),( Dong Ho Lee ) The Editorial Office of Gut and Liver 2013 Gut and Liver Vol.7 No.6
Background/Aims: The aims of this study were to evaluate whether doctors and nurses in a single hospital were at an increased risk of acquiring Helicobacter pylori infection in 2011 and to identify risk factors for H. pylori seroprevalence. Methods: Nurses (n=362), doctors (n=110), health person-nel without patient contact (medical control, n=179), and nonhospital controls (n=359) responded to a questionnaire during a health check-up, which included questions on socio-economic status, education level, working years, and occu-pation in 2011. The prevalence of H. pylori was measured by serology. Results: The seroprevalence rate was 29.8% (nurs-es), 34.5% (doctors), 30.7% (medical control), and 52.9% (nonhospital control). Among younger subjects (<40 years of age), the nonhospital control had a higher seropositivity rate (48.1%) than nurses (29.2%), doctors (29.8%), and the medi-cal control (24.8%), which was not observable in subjects ≥40 years of age. The risk factors for H. pylori seroprevalence were not different for health and nonhealth personnel. A multivariate analysis indicated that seropositivity significantly increased with age, the province of residence, and a gastro-scopic finding of a peptic ulcer. Conclusions: The medical occupation was not associated with H. pylori infection. The seroprevalence of H. pylori in one hospital in 2011 was found to be 38.7%, most likely due to the improvement in socioeco-nomic status and hospital hygiene policy in Korea. (Gut Liver 2013;7:648-654)
비스테로이드성 소염제의 장기 복용후 생긴 교원성 대장염 1 예
이동호,김유선,송인성,정현채,정운태,박동영,최규완,김정룡,김병관,문선희,황진혁,정준오,김찬규,김선미 대한내과학회 1997 대한내과학회지 Vol.53 No.4
Collagenous colitis is characterized clinically by chronic watery diarrhea and pathologically by increased subepithelial collagen deposition associated with an inflammatory infiltrate in the lamina propria. Its etiology is still unclear, although a variety of associated diseases such as rheumatic syndromes, scleroderma, and thyroid diseases have been reported. We report a case of collagenous colitis following the prolonged use of NSAIDs. A 72-year-old woman who has taken NSAIDs for many years due to some dermatologic problems was admitted to the hospital because of chronic watery diarrhea and colicky abdominal pain of 3 months duration. There was no abnormal physical finding except cachectic appearance due to weight loss of 10㎏ during 3 months. Stool examination for ova and parasites and fat was negative, and stool culture for bacterial pathogens was negative. In complete blood count, there were relative eosinophila and mild anemia. Total serum protein and albumin was low, and thyroid function, RA factor, FANA were all normal. Results of upper and lower gastrointestinal contrast radiographs were normal. Sigmoidoscopy revealed normal colonic mucosa but she had a thick subepithelial collagenous deposit and chronic inflammation in lamina propria on colonic biopsy. Based on the above findings, she was diagnosed as collagenous colitis. Diarrhea improved after withdrawing NSAIDs and the treatment with oral prednisolone. In the post-treatment biopsy, the thickness of the collagen hand was diminished. Collagenous colitis is now recognized as one of the common causes of chronic diarrhea of obscure origin and NSAIDs may play an etiological role in some patient with collagenous colitis.
표면평탄형 조기위암 (EGC IIb) 의 내시경적 소견
이동호,김태헌,송인성,김용태,정현채,김용일,최규완,김정룡,한철주,윤용범,장유현,김선미,신건성,조창락 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.3
Early gastric cancer(EGC) has been proved to be a malignant tumor with favorable prognosis in contrast to the advanced one, thus early diagnosis has always been the emphasis regardless its type. In particular, diagnosis of superficial flat type EGC(IIb) is extremely difficult on gross inspection. The aim of this study is to review the clinical features of the patients with EGC type IIb, with special reference to the endoscopic appearance of tumor. We reviewed the medical records and endoscopic findings of 13 patients which were thereafter surgically resected and pathologically proven EGC type IIb at SNUH from 1989 to 1993. The depressed lesion was observed most frequently in EGC type IIb. The endoscopic suggestion of EGC type IIb were given initially with mucosal bleeding and discoloration. In 3 cases (20%), tumor extended to the submucosa and in only 1 case, lymph node metastasis was found. Four patients(30.9%) had another coincidental EGC or peptic ulcer. Every possible effort is needed not to omit the resectable cancer when the mucosal bleeding and discoloration is observed. Careful observation is recommended not to overlook coincidental lesions.
Fasciola의 간농양에서 Praziquantel 7일 요법의 임상
김정룡,이효석,채종일,김선미,김찬규 대한감염학회 1997 감염 Vol.29 No.5
목 적 : Fasciola hepatica에 의한 간농양으로 진단 받은 환자에게 장기간 praziquantel을 투여하여, fasciola에 의한 간농양에 대한 장기간의 Praziquantel두여 효과를 알아보고자 하였다. 방 법 : F. hepatica에 의한 간농양으로 진단 받은 3명의 환자를 대상으로 하였다. F. hepatica에 의한 간농양으로 진단한 기준은 1) micro-ELISA에 의한 기생충에 대한 항체검사에서 fasciola 항원에 대한 반응이 양성이고 2) 말초 혈액 검사상 호산구증다증 을 보이며 3) 복부초음파 또는 복부컴퓨터단층촬영상 간질에 의한 간농양의특징적 소견을 보이며 4) 간내점 유병소에 대한 조직검사상 호산구성 농양을 보이는 경우로 하였다. Praziquantel의 투여는 하루 70-84mg/kg으로 7일간 투여 하였다. Praziquantel 투여 후 치료 효과 유무의 판정은 3개월 내에 말초혈액 호산구수의 500/㎣ 이하로의 감소 및 1년 이내에 간농양 의 소멸 여부로 결정하였다. 결 과 : 호산구다증은 2-3개월 내에 정상화 되었고, 간농양은 1예에서 치료 5개월 후에 병변의 크기가 90%이하로 감소하였고 나머지 2예에서 1년 이내에 소실되었다. Praziquantel의 투여를 중단할만한 심각한 부작용은 없었다. 결 론 : 7일간의 praziquantel 투여는 간질증에 의한 간농양에 대해 효과가 있으리라 생각되며 안전하다. Background : Fascioliasis is a zoonotic helminthiasis by fasciola species and is occasionally complicated by liver abscess, and the treatment of choice is oral bithionol, which is not available in Korea. Most clinical reports showed that praziquantel given at usual dosage(75mg/kg for 1day) failed to cure Fasciola fepatica infections, however, it has not been investigated whether long term praziquantel(70mg/kg/d for 7 days) would be effective. We evaluated the effectiveness of long term praziquantel therapy in patients with Fasiola liver abscess. Method : There patients were included in the current study who were diagnosed as liver abscess by F. hepatica. The diagnostic criteria for inclusion were 1) hypereosinophilia, 2) positive serologic test for F. hepatica antigen, 3) characteristic findings on CT scan and 4) demonstration of aggregates of eosinophils on ultrasonography-guided aspirates of the abscess. Praziquantel was given orally to patients at the daily does of 70-84mg/kg for 7 days. the effectiveness was assessed by the normalization of count at the end of 3 months and the disappearance of abscess cavity on ultrasonography or CT scam one year after treatment. Results : Blood eosinophil count decreased to less than 500/mm³ in all patient within 2 to 3 months. The liver abscesses reduced in size by 90% in 5 months in one patient and disappeared within a year in two patients. No major adverse effects were observed. Conclusion : We conclude that 7-day praziquantel therapy may be effective and safe in the treatment of liver abscess caused by F. hepatica.
김선미(Seon Mi Kim),이승미(Seung Mie Lee) 한국가정과학회 2000 한국가정과학회지 Vol.3 No.2
We study on the housewives` social contribution through their household labor. By the method of literature review, we discuss about the housewives` social roles, their negative problems and the private and public efforts to solve the problems, and ultimate direction to the solutions. We find their four roles-invisible labors in this capitalist society, consumers without any sovereignty, substitutes for incomplete social welfare system and agents to develop and sustain the social network. A few solutions which they have found out or the Korean society has devised are not enough. The utmost and ultimate solutions should include the housewives` autonomy, subjectivity and community.