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내시경적 지혈술로 치료된 결절성 다발 동맥염에 의한 공장 출혈 1예
권혁춘,최정우,최승준,우성일,선주성,원제환,서창희,이기명,함기백,김진홍 대한소화기내시경학회 2006 Clinical Endoscopy Vol.32 No.1
Polyarteritis nodosa is a necrotizing vasculitis of the small and medium-sized arteries of multiple organ systems. The common symptoms of gastrointestinal involvement are abdominal pain, nausea, and vomiting. However, the symptoms at presentation are sometimes non-specific and vague. The well-known complications of gastrointestinal involvement are mucosal ulceration, bowel infarction, perforation, cholecystitis and hepatitis. We describe a case of a 6-year-old male with jejunal bleeding who was diagnosed with polyarteritis nodosa by angiography. After controlling the systemic symptoms with immunosuppressants and steroids, jejunal bleeding occurred. The jejunal bleeding was treated endoscopically with a hemoclip and increasing the immunosuppressant dose. Generally, massive gastrointestinal bleeding in a patient with polyarteritis nodosa is treated surgically. In this case, the jejunal bleeding was controlled with an endoscope because the bleeding site was located within reach of the endoscope, and systemic symptoms subsided with medication. There is no report of gastrointestinal bleeding from the polyarteritis nodosa in a child in Korea. Therefore, we report this case with a review of the relevant literature. (Korean J Gastrointest Endosc 2006;32:48-52) 결절성 다발 동맥염은 다양한 기관에 걸쳐 소형 및 중형 동맥을 침범하는 괴사성 혈관염이다. 위장관 침범은 흔히 복통 및 오심, 구토로 나타나는데, 대개 비특이적이고 다양한 발현양상을 나타내고, 흔히 알려진 합병증에는 궤양 및 장 경색, 천공, 담낭염 및 간염이 있다. 본 증례는 혈관 조영술로 결절성 다발 동맥염을 진단 받고 면역억제제와 스테로이드를 사용하여 전신 증상이 소실된 환아에서 공장 출혈이 발생하여 hemoclip으로 지혈시킨 후 면역억제제의 용량을 증량하여 치료한 경우이다. 결절성 다발 동맥염에 의해 다량의 소화관 출혈이 발생한 경우 수술적 치료가 도움이 되지만, 면역억제제 등으로 전신 증상이 소실되었고, 병변으로 내시경의 접근이 가능한 경우에 선택적으로 내시적 지혈술이 유용함을 경험하였고, 소아 연령의 중증 결절성 다발 동맥염에 의한 위장관 출혈에 대한 국내 보고가 없었기에 문헌 고찰과 함께 보고하는 바이다.
權赫春 大韓齒科保存學會 1980 Restorative Dentistry & Endodontics Vol.6 No.1
Abstract A total of 125 extracted maxillary first molars were used to study the configuration of the^ floor of the pulp chamber. The specimens were ground and the pulp chamber was examined with a magnifying glass and explored with sharp explorer. The study showed the, shape of the pulp chamber, number of root canals, and type of canal orifice.The results were as follows; 1. In so far as observing, the shape of the pulp chamber of the teeth, 50.4% of the teeth were trapezoid, 20.8% were inverted trapezoid, 18.4% were rectangle and 10.4% were triangle shape. 2. 71.2% of the specimens have 3 root canal orifices, and 28.8% have 4 root canal orifices. 3. 71. 2% of the specimens have 1 mesiobuccal canal orifice, 23. 2% have 2 mesio-buccal canal orifices joined, .by a groove, and 5.6% have 2 mesio-buccal canal orifices seperated each other.
신동훈,권혁춘 大韓齒科保存學會 1990 Restorative Dentistry & Endodontics Vol.15 No.2
AbstractTo examine the microleakage of posterior esthetic restorative materials, using 2% methylene blue dye solution, dye penetration was determined with 80 permanent posterior teeth after thermocycling. The following results were obtained. 1. Amalgam group showed the most severe dye penetration of all test groups through the enamel and dentin / cementum margins. 2. Clearfil group showed much more dye penetration than P-50 at the enamel margin and than resin inlay system at the dentin / cementum margin. 3. Through the etched enamel margin, P-50 and resin inlay system groups showed no dye penetration, if any, but through the dentin / cementum margin, all test groups showed dye penetration. 4. Resin inlay system showed the least dye penetration of all test groups through the dentin / cementum margin.