만성 B형 활동성 간염에 병발한 Guillain-Barre 증후군

도갑석(Gab Suk Doh),박종원(Jong Won Park),서정일(Jeong Ill Suh),이헌주(Heon Ju Lee),하정상(Jeng Sang Hah) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.3

Guillain-Barre syndrorne occur rarely as complications of chronic active hepatitis. Only one case of serologically documented chronic active hepatitis B has been reported with Guillain-Barre syndrorne, in Korea. Guillain-Barre syndrome is characterized as an acute, symetrically progressive, inflammatory polyneuropathy. There is often a history of an antecedent infection, usually from a non specific disease of the upper respiratory tract. Occassionally, the syndrome follows a specific disease, usually Cytomegalovirus and Ebstein-Barr virus, influenza A, B. We present a case of Guillain-Barre syndrome associated with chronic active hepatitis B and treated with interferon a-Iib. Neurological symptoms and liver function tests were improved after inter- feron therapy with Hbe Ag/Anti-Hbe seroconversion. (Korean J Gastroenterol 1996; 28:451 - 456)

전신성 홍반성 낭창의 임상상

전준하 ( Jun Ha Chun ),신경철 ( Kyeong Cheol Shin ),박찬원 ( Chan Won Park ),도갑석 ( Gab Suk Doh ),이충기 ( Choong Ki Lee ),현명수 ( Myung Soo Hyun ),이현우 ( Hyun Woo Lee ),김능수 ( Nung Soo Kim ),김현철 ( Hyun Chul Kim ) 대한류마티스학회 1994 대한류마티스학회지 Vol.1 No.2

Objective: Systemic lupus erythematosus(SLE) is an autoimmune disease and manifests with a variety of clinical and immunologic features in the multisystem SLE occurs worldwide in all ethnic groups but the prevalence and clinical manifestations of SLE may differ depending on ethnic groups and age. Methods: We retrospectively analyzed the clinical and laboratory features of 167 patients with SLE at the Yeungnam University Hospital, Kyungpook National University Hospital and Keimyung University Hospital between January 1984 to February 1993. Results: 1) The male to female ratio was 1:19.8 and the mean age was 28.1. Seventy six patients (42.1%) were diagnosed to have SLE in the third decade. 2) The prevalence of positive ARA criteria for SLE revealed that antinuclear antibody (ANA) was 96.4%, cutaneous disorder 73.6%, hematologic disorder 72.5%, immunologic disorder 71.3%, arthralgia or arthritis 70.1%, renal disorder 55.7%, serositis 40.7%, oral ulcer 28.7%, photosensitivity 25.7% and neuropsychiatric disorder 19.7%. 3) The malar rash was the most common manifestation in mucocutaneous disorder, arthralgia or arthritis in musculoskeletal disorder, proteinuria in renal disorder, pericarditis and pleuritis in cardiopulmonary disorder, psychosis in neuropsychiatric disorder, anemia in hematologic disorder, and hypocomplementemia in immunologic disorder. 4) Renal biopsy was performed in 65 cases among which the most common histologic type was diffuse proliferative glomerulonephritis (53.9%). Conclusion: These data suggested that clinical manifestations of SLE in Korean patients revealed similar to those of Western (Caucasian+Black) except that photosensitivity, serositis, neuropsychiatric disorders were less frequent in Korean.

4기 비소세포폐암 환자에서 복합화학요법군과 보존적치료군의 생존율 비교연구

김병훈 ( Byeong Hun Kim ),이경희 ( Kyung Hee Lee ),도갑석 ( Gab Suk Doh ),이은정 ( Eun Jung Lee ),김성목 ( Seong Mok Kim ),정진홍 ( Jin Hong Chung ),이관호 ( Kwan Ho Lee ),현명수 ( Myung Soo Hyun ) 대한결핵 및 호흡기학회 1996 Tuberculosis and Respiratory Diseases Vol.43 No.4

건강진단자에서 복부초음파검사상 나타난 공간점유간병소에 대한 임상적 고찰

김기윤(Ki Yun Kim),이헌주(Heon Ju Lee),서정일(Jeong Ill Suh),박찬원(Chan Won Back),이동준(Dong Jun Lee),송영두(Young Doo Song),도갑석(Gab Suk Doh),전경진(Kweong Jin Jeon),김준환(Jun Hawn Kim) 대한내과학회 1996 대한내과학회지 Vol.51 No.2

N/A Objectives: Ultrasonography(USG) is widely used for the screening and detection of liver SOL in pa- tients with acute and chronic hepatopathy, but the prevalence of liver SOL on a nonselected population by ultrasonographic screening examination is not well know. We experienced some patients with liver SOL in a automated med-screening center visitor by USG and reviewed the prevalence and clinical aspects of liver SOL detected by USG in a view of dynamic relation to hepatoma. Methods: Form March 1983 to April 1994, USG was performed on 27,140 visitors from a urban and suburban area of Taegu city. Initial USG of the liver was followed by follow up USG and other imaging modalities in case it was necessary. Results: 1) Liver SOL was detected in 337 cases(1.24%) of 27140 examinees by initial screening USG. 2) Among 337 cases of liver SOL 226(67.1%) of cyst, 19(5.7%) of hepatoma, 15(4.5%) of hemangioma, 12(3.6%) of polycystic kidney, 2(0.6%) of metastatic cancer, 1(0.3%) of abscess, 22(6.5%) of false positive finding without SOL and 40 cases(11.9%) of nonspecific questionable SOL without confirmation were noted at the end. 3) The sensitivity of USG detecting liver SOL was 93.5% and 100.0%, 93.3% and 94.7 in cyst, hemangioma and hepatoma respectively. False positivity of USG was 6.5%. 4) The incidence rate of hepatoma is presumed to be 8.1 and 3.5 per 100,000 in male nad female, respectively. Coclusion: The prevalence of liver SOL in general population by USG screening was presumed to be 1.24%. USG screening and follow up examination might be needed for the detection of benign and

간경변증 환자에서 간세포암 발생 위험 요인의 분석

이헌주(Heon Ju Lee),이재련(Jae Lyun Lee),이재춘(Jae Chun Lee),이은정(Eun Jung Lee),김기범(Ki Beom Kim),임상우(Sang Woo Lim),이동준(Dong Jun Lee),전경진(Kyeoung Jin Jeon),조영복(Young Bog Cho),도갑석(Gab Suk Doh),서정일(Jeong Ill Suh) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

N/A Objectives: 80-90% of the cases of hepatocellular carcinoma(HCC) are associated with cirrhosis. Hepatitis B virus(HBV) is known as a major etiologic factor of HCC and about 10% of Koreans are HBV carriers. And the prevalence of HCC is high in Korea. Early detection of HCC is important for the better treatment especially in the patients with cirrhosis who usually have the decreased functional hepatic reserve. Risk factors for the hepatocellular carcinoma in the korean patients with cirrhosis were evaluated. Methods: Risk factors for hepatocellular carcinogenisis such as age, sex, ascites, alcohol, HBsAg, anti-HCV, AFP, ICG R(15) and risk score were investigated among the 176 patients with cirrhosis and HCC(group I) and 72 patients with cirrhosis(group II) and compared between the two groups. Results: 1) No age difference was noted between group I and group II. 2) Male to female sex ratio were 5.7: 1 and 2.4: 1 for group I and II in each(p<0.01) and the frequency of HCC among cirrhosis was higher in male than female sex(p<0.01). 3) Both HBsAg and anti-HCV positivity were significantly higher in group I than in group II (p<0.01 and p<0.05 respectively). 4) The frequencies of Child-Pugh A, elevated AFP, elevated ICG R(15) and the frequency of super-high risk patient were higher in group I than in group II(p<0.01). 5) The frequency of alcoholic patients was significantly higher in group II than in group I (p<0.05) but no difference was noted between HBsAg positive group I and group II patients. 6) The frequency of abnormal AST with the level of below 100IU was not significantly different between group I and group II. 7) The frequency of the patients with ascites was higher in group II than in group I (p<0.01). Conclusion: Risk factors for hepatocellular carcinogenesis in korean patients with cirrhosis are male, Child-Pugh A, HBsAg positivity, anti-HCV positivity, absence of ascites, higher AFP, lower ICG R15 and higher platelet count.

당뇨병환자에서 무증상세균뇨

도갑석,송영두,원규장,조인호,이충기,이형우,이현우,신경철 대한감염학회 1995 감염 Vol.27 No.3

배경:배뇨곤란, 빈뇨, 잔뇨감 등 현성 요로감염의 증상이 없는 부증상세균뇨의 발생빈도가 여자 당뇨병환자에서 당뇨병이 없는 여자보다 더 높다는 보고가 있으나, 연구자에 따라 그 결과가 다르게 보고되고 있다. 방법:1992년 1월부터 1993년 6월까지 영남대학교 의과대학 부속병원 내과에 입원한 당뇨병환자 279명(남자146명, 여자133명)을 대상으로 무증상세균뇨의 유병률을 조사하고 연령, 당뇨병 이환기간, 당화혈색소(HbAl), QTc간격, CAN score및 당뇨병성 미세혈관합병증 등이 무증상세균뇨 발생빈도에 미치는 영향을 조사하여 다음과 같은 성적을 얻었다. 결과:당뇨병 환자군 전체의 무증상세균뇨 유병률은 9.6%로 대조군의 1.1%보다 높았으며 특히 여자환자군의 유병률은 15.8%로 여자 대조군의 1.5%보다 유의하게 높았으나(p<0.001), 남자환자군은 대조군과 차이가 없었다. 연령에 따른 무증상세균뇨의 유병률은 50대, 60대, 70대에서 각각 13.6%, 10.8%, 13.0%이었으며 50대 이상이 전체 27례중 23례로 대다수를 차지하였다. CAN test중 Valsalva ratio는 세균뇨가 있는 군과 없는 군 사이에 유의한 차이가 있었으며(p<0.05), 여자 환자군의 QTc간격은 무증상세균뇨가 있는 군은 428.3msec, 없는 군은 410.6msec로 두 군간에는 유의한 차이가 있었다(p<0.05). 당뇨관련인자가 무증상세균뇨의 발생빈도에 미치는 영향에 대한 조사에서는 당뇨병 이환기간, HbAl, 당뇨병성신증 및 망막병증 등과는 서로 상관이 없었으나 당뇨병성 자율신경병증과는 유의한 상관관계가 있었다. 무증상세균뇨의 원인균으로 E.coil가 가장 많았으며 그외 Enterococcus, Pseudomonas, Enterobacter, Klebsiella, Staphyiococcus등도 배양되었다. 결론:당뇨병 환자에서 무증상세균뇨의 유병률은 일반인에 비해 높았으며 특히 고령의 여자에서 높은 발생빈도를 나타내었다. 그리고 당뇨관련 인자중 당뇨병성신경증과 자율신경계 손상 등은 무증상세균뇨의 발생빈도와 관계가 있는 것으로 생각된다. Background: The majority of investigators have reported that the prevalence of asymptomatic bacteriuria is higher in diabetic women than in nondiabetic women. Several promoters of bactriruia have been suggested in the diabetic host, such as glycosuria, immune defence defects or autonomic neuropthy, affecting bladder and unethral function. Methods: The prevalence of asymptomatic bacteriuria was studied in 279 diabetic patients and 182 nondiabetic controls. The possible role of host factors such as glycosylated hemoglobin, duration of diabetes mellitus, cardiovascular autonomic reflex, diabetic microangiopathies, was also assessed in diabetic patients with or without bacteriuria. Results: The prevalence of asymptomatic bacteriuria was significantly higher in diabetic women than in nondiabetic controls(15.8 vs 1.5%, p<0.001), but not higher in diabetic men. Escherichia coli was found in 70.3% of urine culture with significant growth from diabetic patients. Risk of asymptomatic becteriruia was not related to the level of glycosylated hemoglobin(HbA₁), eman duration of diabetes mellitus, diabetic nephropathy or retinopathy. Abnormalities of cardiovascular autonomic function and diabetic neuropathy were more common in diabetic patients with bacteriuria than in those without bacteriuria. Conclusions: These results suggest that diabetic patients with abnormal cardiovascular reflex test and autonomic neuropathy appear to be at increased risk of developing bacteriuria. Further study is necessary to determine the relationship between cardiovascular test of autonomic function and autonomic abnormalities in other systems, especially involving bladder innervation.