단일 무작위 체취뇨에서 ( Pr / Cr ) 비의 뇨단백 정량검사로서의 의의

곽동협,장대성,박성배,김현철 대한신장학회 1985 학술대회및초록집 Vol.4 No.1

實驗的 肝纖維症에 對한 Colchicine과 Zinc Sulfate의 效果

郭東協,金仁山,曺準承 慶北大學校 醫科大學 1987 慶北醫大誌 Vol.28 No.4

교원질의 합성과 분비를 억제하고 교원질 분해효소의 활성을 증가시키는 작용을 한다고 알려진 colchicine과 교원질의 proline 4-hydroxylation을 방해하여 교원질 형성을 억제한다는 아연의 항섬유화 효과를 알아보기 위하여 실험적으로 간섬유증을 유발시킨 흰쥐에 투여하였다. 간섬유의 유발은 사염화탄소를 반복투여해서 일으켰으며 colchicine과 아연의 효과를 알아보기 위하여 간기능검사와 혈청 NAG 및 PZP 활성도 측정, 그리고 간조직내 교원질함량을 측정하였다. Colchicine을 투여한 경우 사염화탄소 투여로 인한 교원질축적을 현저히 감소시켰으며 혈청 albumin치는 정상대조군과 비슷하였고 혈청 NAG활성도 역시 사염화탄소 투여군보다 현저히 낮은 값을 나타내 보였다. 반면에 아연을 투여한 경우는 실험결과 뚜렷한 효과를 얻을 수 없었다. 결론적으로 colchicine만이 교원질축적 억제효과와 간기능의 보호효과가 있는 것으로 사료된다. Colchicine is a putative antifibrotic agent as it inhibits collagen synthesis and secretion and, also, enhances collagenase activity in vitro. And zinc sulfate has been also known to have an antifibrotic activity in experimental animal models. The aim of this study was to investigate the effects of both high doses of colchicine and zinc sulfate on markers of hepatic fibrosis and on liver function in CCl_4-treated rats. Male Sprague-Dawley rats (100-150g) were divided into 6 groups: control, CCl_4-treated, colchicine treated, colchicine and CCl_4-treated, zinc sulfate treated, zinc sulfate and CCl_4-treated. Colchicine and CCl_4-treated group had significantly lower liver collagen content (0.68±0.13 vs 0.89±0.10mg of hyp./g of wet liver wt., respectively), higher serum albumin level (2.90±0.31 vs 2.47±0.13 g/dl, repectively) and lower serum N-acetyl-β-D-glucos-aminidase activity (22.99±2.76 vs 34.35±9.15 nmole/min/㎖, respectively) than CCl_4-treated group. But zinc sulfate didn't show any remarkable effect in this experiment. In conclusion, high doses of colchicine significantly lowered liver collagen content and improved liver function in CCl_4-treated rats.

복수를 동반한 호산구성 위장염 1례

한승묵,신원승,김민수,김정희,김성종,정재진,이동욱,이동욱,곽동협 啓明大學校 醫科大學 1998 계명의대학술지 Vol.17 No.3

호산구성 위자염은 툭발성으로 위장관 벽의 호산구 침윤과 말초 혈액내 호산구증다증을 동반하고 다양한 위장관 증상을 나타내는 질환으로 복수가 동반된 경우는 매우 드문 것으로 알려져 있다. 이에 저자들은 최근에 말초 혈액에 호산구증다증과 장점막의 호산구 침윤뿐만 아니라 소산구성 복수가 동반되고 스테로이드 요법으로 잘 치료된 호산구성 위장염 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Eosinophilic gastroenteritis is an uncommon disease of uncertain etiology characterized by eosinophilia in the peripheral blood and eosinophilic infiltrates in the bowel wall. Clinical features vary depending on which layers or regions of the gastrointestinal tract are mainly affected. Mucosal involvement causes malabsorption. protein-losing enteropathy and diarrhea. Infiltration of the muscle layer manifests gastric outlet or small bowel obstruction. Serosal involvement causes an exudative ascites rich in eosinophils. Eosinophilic gastroenteritis with ascites is a rare from of eosinophilic gastroenteritis. In this paper, we present a case of eosinophilic gastroenteritis with ascites demonstrating eosinophilia in the peripheral blood and eosinophilic infiltrates in the mucosal wall. The patient was successfully treated with steroid therapy. In addition to this case report, the several literatures on eosinophilic gastroentritis are reviewed.

혈변을 동반한 위막성 대장염 3예

강현준,곽동협,최민호,김호태,곽태영,이현철,김영성,김정희 대한소화기내시경학회 2011 Clinical Endoscopy Vol.42 No.6

Clostridium difficile is the most common nosocomial pathogen of the gastrointestinal tract. Pseudomembranous colitis occurs as a result of a severe inflammatory response to Clostridium difficile toxins. Pseudomembranous colitis is an increasingly frequent cause of morbidity and mortality among elderly hospitalized patients. Diarrhea is the most common manifestation. According to the literature,stools are almost never grossly bloody, and range from soft and unformed to watery or mucoid in consistency. We now report the cases of three patients with pseudomembranous colitis whose main clinical manifestation was hematochezia. Clostridium difficile은 고령의 입원 환자들에게 위장관의 병변을 일으키는 대표적인 원내감염 균주이다. Clostridium difficile과 연관된 질병 중 가장 심한 형태로, Clostridium difficile toxin에 의한 장내의 염증반응으로 발생하는 위막성 대장염은 설사가 주 증상으로 대변은 육안적으로 거의 혈성을 띄지 않는다. 그러나 저자 등은 육안적 혈변을 주 증상으로 하는 위막성 대장염 3예를 경험하여서 문헌고찰과 함께 보고한다.

Cryptococcus 뇌막염 4례

기세길,박근용,곽동협,강영우,윤덕구,박승국 啓明大學校 醫科大學 1987 계명의대학술지 Vol.6 No.1

Four cases of cryptococcal meningitis were experienced in Keimyung University Hospital during 11 years periods. These patients were one pregnant woman, one man who had liver cirrosis and diabetes mellitus and two healthy men. After admission, all four patients were treated with antituberculous agent under the impression of tuberculous meningitis, but no clinical improvement was achieved. Later, Crytococcus neoformans was identified in CSF by India ink preparation or Sabouraud media culture, after then one patient was treated with combination of amphotericin B and 5-fluorocytosine and achieved much clinical and laboratory improvement. Unfortunately other three patients were not followed. The authors experienced four cases of crytococcal meningitis and herein presenting our experience and literature were reviewed.

조직구성림프종에 대한 임상적고찰

김윤년,송홍석,곽동협 대한내과학회 1986 대한내과학회지 Vol.30 No.2

A clinical review was done retrospectively on 105 patients with histiocytic lymphoma who visited to the Dong San Medical Center between Jan. 1974 and Aug, 1984, The results of the this study were as follows: JVIale to female ratio was 1.56:1 with male predorminance and the age distribution was between 4 and 82 with mean age of 44,7 years. Palpable neck mass was the most frequent complaint(52cases: 49.5%). Abdominal pain, fever were observed in 14 cases (13.3%) respectively and abdominal mass in 11 cases(10.5%), weight loss in 9 cases(8.6%), throat pain in 9 cases(8.6%) and abdominal swelling in 8 cases(7.6%). Physical findings revealed lymph node enlargement in 74cases (70.5%) with cervical, inguinal, axillary, mesenteric and supraclavicular in order of frequency. Hepatomegaly was observed in 17.1% splenomegaly in 2.5% and abdominal mass in 20cases(19.0%). Extranodal involvement was observed in 71 cases(67.6%) and organs of involvement were as follows: GIT in 18 cases(17.1%), waldeyer`s ring in 17 cases(16.2%), skin in 16 cases(15.2%) liver in 7 cases(6.7%), bone in 6 cases(5.7%), bone marrow in 5 cases(4.8%), retroperitoneum in 5 cases(4.8%), anterior nasal cavity in 4 cases(3.8%), lung and pleura in 2 cases(l.9%) respectively. Laboratory findings revealed anemia in 47.1%, leukocytosis in 27.5%, leukopenia in 14.7% lymphopenia in 43.4%, hypoalbuminemia in 31.5%, azotemia in 10.4%, increased alkaline phosphatase in 13.9% and hypercalcemia in 8.2%. By Ann Arbor staging, stage I was in 23cases (21.9%), stage g in 34cases(32.4%), stage III in 16cases(15.2%), stage g in 32 cases(30.5) and stage B in 20 cases(27.6%). Treatment was performed as follows: Radiotherapy in 20 cases, combination chemotherapy in 18 cases and combined modality therapy in 8 cases. After treatment, 5 year survival rate was 72.2% in adequately treated patients. 2 year survival rate was 83.4% in complete remission group and 58.6% in partial remission group and there was no long-term survival in patients with partial remission.

영도대교 보수ㆍ복원 공사

박경호(Kyung-Ho Park),곽동협(Dong-Hyup Kwak),전성용(Sung-Yong Jeon),김선용(sun-Yong Kim),김재근(Jae-Geun Kim) 대한토목학회 2014 대한토목학회지 Vol.62 No.4

교약성 심낭염의 임상적 고찰

서승연,한승범,오영철,곽동협,송홍석,김윤년,김권배 啓明大學校 醫科大學 1986 계명의대학술지 Vol.5 No.1

We experienced fourteen patients with constrictive pericarditis, who were admitted to the Dong San Hospital, Keimyung University and treated by pericardiectiomies during the seven year periods between Jan 1980 and May 1986. The results of our experience were as follows: They were 10 males and 4 females and male to female ratio was 2.5 : 1 and age distribution was between 11 and 66 with mean age 46.4 years. The intervals between initial symtoms for acute pericarditis and the pericarditis were about 123.3 days and intervals between initial treatmetn for acute pericarditis and operation were about 55.4 days. Pleural effusion was noted in 55.7%, enlarged cardiac shadow in 50% and pericardial calcification in 7% on the chest roentgenograms. Regular sinus rhythem was noted in 100%, low voltage in 64%, T wave change in 71% and ST segment changes in 7% on the electrocardigram. The results of pericardial biopsy were tuberculosis in 57%, nonspecific chronic inflammation in 28%, purulent infection in 7% and neoplastic cell infiltration in 14%.

십이지장 선암을 동반한 Peutz-Jeghers 증후군 1 예

김정희,김은영,이동욱,정재진,이원석,한승묵,곽동협 대한내과학회 1998 대한내과학회지 Vol.55 No.2

The Peutz-Jeghers syndrome is an autosomal dominant disease characterized by hamartomatous polyps in the gastrointestinal tract and mucocutaneous melanin pigmentation. Although these polyps are believed to have little potential for malignancy, and the disease was believed to have a relatively benign course, it recently has been recognized that patients with this syndrome are at increased risk for the development of cancer at gastrointestinal and nongastrointestind sites. A 33-year-old male patient was admitted because of vomiting and abdominal pain for 3 months duration. A diagnosis of Peutz Jeghers syndrome was made 3 years ago by multiple hamartomatous polyps confined to the colon and mucocutaneous pigmentation. A barium study showed abrupt string like luminal narrowing at the 4th portion of the duodenum. On laparotomy, there was an annular constricting mass involving the serosa of duodenum with multiple metastasis to liver, so a segmental resection of small bowel followed by chemotherapy was performed. The histologic finding was adenocarcinoma.

양성자 펌프 억제제 투여로 악화된 과증식 위용종 1예

김호태,박종완,엄석현,곽태영,황홍석,김영성,곽동협,김정희 영남대학교 의과대학 2013 Yeungnam University Journal of Medicine Vol.30 No.2

Hyperplastic gastric polyps (HPPs) are the most common type of gastric polyps. They are assumed to be caused by chronic inflammation and regenerative proliferation, although this has not been clearly investigated yet. Many studies suggested the development of fundic gland polyps and carcinoid during long-term proton pump inhibitor (PPI) therapy, but the relationship between PPIs and HPPs is still unclear. We encountered a patient who showed aggravation of HPPs after long-term use of PPIs. A 58-year-old male patient with liver cirrhosis visited our hospital because of hematemesis. We started PPI medication after confirming esophageal variceal bleeding and duodenal ulcer with blood clot in its base via emergency endoscopy. He took PPIs for three years because of an intractable duodenal ulcer. There was a marked increase in the size of the pre-existing polyps and in the development of new polyps. We presumed that the PPIs caused the aggravation of the HPPs, so we stopped their administration. After five months, the HPPs shrank and the polyps were partially degraded. More prospective studies are needed to investigate the relationship between HPPs and PPIs.