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십이지장 및 회장 말단부 궤양으로 발현된 파라티브스 감염증 1예
김태협,명승재,장혜숙,정선미,박상현,박태일,정훈용,양석균,홍원선,김진호,민영일,김미나 대한소화기내시경학회 2002 Clinical Endoscopy Vol.25 No.3
Infection due to Salmonella typhi and Salmonella paratyphi is called enteric fever which is manifested by fever, abdominal pain, and intermittently other gastrointestinal symptoms like vomiting and diarrhea. Although Salmonella species may invade any site of the gastrointestinal tract, it usually invades terminal ileum. The pathologic manifestation of salmonellosis may vary from nonspecific mucosal change (erythema, edema, ulceration etc.) of invaded site to intestinal perforation or hemorrhage. However, the report of upper gastrointestinal invasion by Salmonella species is rare, and confirmation by tissue culture is difficult because gastric acid and the normal propulsive peristaltic flow of the small bowel help to limit the bacterial populations of the upper gastrointestinal tract. We report here a case of Salmonella paratyphi infection proven by tissue culture in a 26-year-old man who presented with fever and watery diarrhea and was found to have multiple duodenal and terminal ileal ulcers. (Korean J Gastrointest Endosc 2002;25:173-177) 살모넬라 감염증의 여러 임상 양상 중 장열은 Salmonella typhi, Salmonella paratyphi에 의하여 야기되는 전신 질환으로, 발열과 복통 등의 임상 증상으로 발현되며 때때로 구토, 설사 등의 위장관 증상을 동반하기도 한다. 살모넬라균은 위장관 어디에도 침범할 수 있지만 일반적으로 회장 말단부를 침범하며, 위장관 병변은 발적, 부종 및 궤양 등의 비특이적인 점막 변화에서부터 장천공이나 장출혈까지 다양하게 나타난다. 하지만 살모넬라 감염증에 있어서 상부 위장관 침범에 대하여는 보고된 바가 매우 드물고, 위산과 소장의 정상적인 연동 운동으로 인해 세균의 정착이 쉽지 않아 병원균의 증명이 어렵다. 저자들은 최근 발열과 수양성 설사를 주소로 내원한 26세 남자 환자에서 십이지장 궤양 및 회장 말단부의 궤양으로 발현하여 조직 배양으로 확진된 Salmonella paratyphi 감염 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
김태협,배지현,임동희,정의상,정태영,Tae Hyup Kim,MD,Ji Hyun Bae,MD,Dong Hui Lim,MD,Eui Sang Chung,MD,PhD,Tae Young Chung,MD,PhD 대한안과학회 2013 대한안과학회지 Vol.54 No.4
Purpose: To report the first case of lattice corneal dystrophy, gelsolin type in Korea. Case summary: A 61-year-old man visited our clinic with severe dry eye symptom in both eyes. Clinical examination revealed in both eyes a visual acuity of 0.7 without correction and intraocular pressure of 18 mm Hg. On slit-lamp examination, both corneas had scattered lattice lines at various depths within the stroma with punctate epithelial erosions. The patient had characteristic features of Meretoja syndrome, including cranial neuropathy characterized by dermatochalasis and facial weakness, and was positive for the gelsolin mutation according to DNA analysis. This is the first description of a patient with lattice corneal dystrophy, gelsolin type in Korea. Conclusions: This is the first description of a patient with lattice corneal dystrophy, gelsolin type in Korea and demonstrates the importance of recognizing the systemic and ophthalmic features for appropriate management of the condition.
김태협,이정혜,안정현,우경인,서연림,김윤덕,Tae Hyup Kim,Jung Hye Lee,Jung Hyun Ahn,Kyung In Woo,Yeon Lim Suh,Yoon Duck Kim 대한안과학회 2013 대한안과학회지 Vol.54 No.4
Purpose: Eccrine ductal carcinoma is an extremely rare tumor that arises in the eccrine sweat glands. The authors of the present study describe a case of an eyelid mass diagnosed as eccrine ductal carcinoma. Case summary: A 74-year-old woman visited our institute with a 3-month history of a mass in the left medial canthus. The lesion appeared as a solitary nodule with central ulceration. A magnetic resonance imaging (MRI) of the orbit showed a relatively well enhanced 0.8 cm x 0.8 cm-sized ovoid soft tissue mass. A mass excision was performed under frozen section control. The tumor was completely excised with margin clearance and medial canthal reconstruction was performed. Histopathological examination revealed a tumor composed of numerous duct-like structures lined with pleomorphic cuboidal epithelium that was diagnosed as eccrine ductal carcinoma of the eyelid. Conclusions: This is the first description of eccrine ductal carcinoma in a patient in Korea. The possibility of the eccrine ductal carcinoma should be considered in the differential diagnosis in an elderly patient with an eyelid mass.
Optic Disc Atrophy in Patient with Posner-Schlossman Syndrome
김태협,김정림,기창원 대한안과학회 2012 Korean Journal of Ophthalmology Vol.26 No.6
A 32-year-old man with blurred vision in the right eye and headache presented with anterior uveitis, an intraocular pressure (IOP) of 60 mmHg, an open angle, no visual field defects, and normal optic nerve. He had a history of five previous similar attacks. In each of the previous instances, his anterior uveitis and high IOP were controlled with antiglaucoma medications and topical steroids. However, at the fifth attack, his optic disc was pale and a superior paracentral visual field defect was shown. Brain magnetic resonance image studies were normal. This case represents that a recurrent Posner-Schlossman syndrome (PSS)-induced optic disc atrophy likely due to ocular ischemia caused by a recurrent, high IOP. Although PSS is a self-limiting syndrome, we should manage high IOP and prevent ischemia of the optic nerve head by treating with ocular antihypertensive medications.
개방성 눈물 배출계를 가진 편측 눈물흘림 환자에서 눈물주머니 조영술 소견
김태협,이정혜,안정현,김정훈,김윤덕,우경인 대한안과학회 2013 대한안과학회지 Vol.54 No.6
Purpose: To evaluate the morphologic change in the lacrimal drainage system using dacryocystography in patients with unilateral epiphora with patent lacrimal drainage system. Methods: Clinical records of patients referred to our clinic for epiphora between October 2007 and August 2011 were reviewed. The study group included 38 patients who had symptoms of unilateral epiphora with patent lacrimal drainage system. The studied patients included 10 males and 28 females with ages varying between 24 and 72 years. Results: Abnormal dacryocystographic findings in the tearing eye were 78.9% and abnormal dacryocystographic findings in the asymptomatic eye were 47.4%. Common abnormal findings included distal nasolacrimal duct stenosis, distal nasolacrimal duct dilatation and nasolacrimal sac dilatation. Conclusions: In many cases, morphologic change in the lacrimal drainage system was observed in patients with unilateral epiphora with patent lacrimal drainage system. Dacryocystographic findings may contribute in devising a treatment plan for these patients.