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류성혁,배종욱,백현진,이두혁,이상원,최규호,한규형,김세원,김현범,홍구현 대한결핵및호흡기학회 2015 Tuberculosis and Respiratory Diseases Vol.78 No.4
Pulmonary pneumatoceles are air-filled thin-walled spaces within the lung and are rare in adult cases of pneumonia. We report the case of a 74-year-old male who was admitted with a cough and sputum production. He had been treated with oral dexamethasone since a brain tumorectomy 6 months prior. Contrast-enhanced computed tomography (CT) of the chest revealed a large pneumatocele in the right middle lobe and peripheral pneumonic consolidation. Bronchoalveolar lavage was performed; cultures identified extended-spectrum -lactamase (ESBL) producing Proteus mirabilis . A 4-week course of intravenous ertapenem was administered, and the pneumatocele with pneumonia resolved on follow-up chest CT. To the best of our knowledge, this is the first reported case of pulmonary pneumatocele caused by ESBL-producing P. mirabilis associated with pneumonia.
흡입용 스테로이드/지속성 β2 항진제 복합제재 및 지속성 무스카린대항제를 사용하는 만성 폐쇄성 폐질환 환자들에서의 폐렴 및 폐렴과 관련된 합병증에 관한 비교 연구
류성혁,홍구현,김도형,김윤섭,박재석,지영구 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.0
흡입 스테로이드 또는 성분이 다른 각각의 흡입 스테로이드/LABA의 복합제 사용이 COPD 환자의 폐렴 위험성과 어떠한 관계를 가지는지에 대한 연구는 많이 진행되었으나 아직 흡입 스테로이드/LABA의 복합제와 항콜린제를 사용한 환자들 간의 비교 연구는 미미한 실정이다. 따라서 본 연구에서는 성분이 다른 흡입 스테로이드/LABA의 복합제 및 지속성 항콜린제를 사용하는 COPD 환자군에서 흡입제 종류에 따른 폐렴 및 그와 관련된 합병증 간의 상관관계를 알아보고 이를 비교 평가하고자 한다. 2009년 1월 1일부터 2013년 12월 31일까지 5년간 단국대 병원에서 폐렴에 대한 외래진료 및 입원치료를 받은 경력이 있으면서 ICS/LABA (Seretid and Symbicort) 또는 LAMA (Spiriva)를 각각 단독으로 사용한 181명의 COPD 환자의 의무기록을 토대로 이들의 폐렴 및 폐렴 합병증과 관련된 사항에 대해 후향적으로 조사하여 비교하였다. Symbicort군은 46명, Seretide군은 63명, Spiriva군은 72명이 선정되었다. 이들의 외래에서의 평균 폐렴 진단 횟수는 각각 1.3,1.76,0.89회이고 P-value 0.005로 유의한 차이가 있었다. 폐렴 입원 횟수는 0.96,1.63,0.94회였고 폐렴 입원 기간은 10.07,15.9,11.54일로 P-value상 유의한 차이를 보이지는 않았다. 경구 항생제 처방 횟수는 각각 7.3,8.4,4.51회이고 P-value 0.005로 유의한 차이를 보였다. 유의한 차이를 보이는 항목에 대해 사후검정을 하였으며 Seretide군과 Spiriva군에서 유의한 차이를 보였다. 결론적으로 Seretide를 사용하는 군은 Spiriva를 사용하는 군에 비해 폐렴의 유병율이 더 높고 경구 항생제를 더 많이 복용하는 경향이 있었으며 P-value상 유의하지는 않았으나 폐렴으로 인한 입원 횟수, 입원 기간도 Seretide군이 더 높은 양상을 보였다.
간문맥 혈전증을 동반한 십이지장 게실염의 내시경적 치료
류성혁 ( SungHyeok Ryou ),남광우 ( Kwangwoo Nam ),김진모 ( Jinmo Kim ) 대한소화기학회 2021 대한소화기학회지 Vol.78 No.2
A 44-year-old woman presented with right upper abdominal pain and nausea with a 4-day duration. An abdominopelvic CT scan revealed a 2.3-cm sized cystic lesion in the duodenum with inflammatory changes and partial thrombosis in the distal main portal vein. Empirical antibiotics were initiated considering acute duodenal diverticulitis, but the symptoms worsened. Side-viewing duodenoscopy revealed purulent fluid draining spontaneously from a small diverticular opening. After enlarging the opening using an extraction balloon, sweeping followed by saline irrigation was performed, and pus and food debris gushed out into the duodenal lumen. The patient recovered rapidly and was discharged uneventfully on the 5th day post-hospitalization with oral antibiotics and warfarin. A follow-up CT scan and duodenoscopy 1 month later revealed a normal-appearing duodenal diverticulum and complete resolution of the portal vein thrombosis. This paper reports a rare case of portal vein thrombosis associated with duodenal diverticulitis. Overall, endoscopic therapy can be effective when conservative management fails and might be a viable alternative to surgery for treating duodenal diverticulitis. (Korean J Gastroenterol 2021;78:129-133)
단일 3차 의료기관에 내원한 탈북자 환자들의 임상적 특징
안선영 ( Sun Young Ann ),류성혁 ( Sung Hyeok Ryou ),김석배 ( Suk Bae Kim ) 대한내과학회 2015 대한내과학회지 Vol.89 No.1
Background/Aims: There are increasing numbers of North Korean defectors, and their health status differs from that of the South Korean population. This study was performed to investigate the clinical characteristics of North Korean defectors visiting a single tertiary hospital in South Korea. Methods: The medical records of North Korean defectors who visited Dankook University Hospital, Cheonan, South Korea from 1 February 2006 to 30 April 2014 were retrospectively reviewed. Their comorbidities, main reasons for the visit, and most common diseases were investigated. Results: A total of 169 North Korean defectors (163 females, 6 males) visited our hospital. Sixty-eight patients (40.24%) had comorbidities, the most common of which was tuberculosis (13.60%), followed by chronic hepatitis B (10.06%) and chronic hepatitis C (9.47%). North Korean refugees visited the department of ophthalmology (15.71%) most frequently, followed by gastroenterology (15.18%). Cataracts, chronic hepatitis C, chronic hepatitis B, and pulmonary tuberculosis were the most common reasons for the hospital visit. Chronic hepatitis B and chronic hepatitis C were diagnosed in 19.32% and 17.58% of the patients, respectively. Sixteen patients (9.47%) were diagnosed with tuberculosis, and eight of these patients showed multidrug resistance. Of all 169 patients, 17 underwent colonofibroscopy or stool examination, and parasites (Trichuris trichiura, n = 6; Clonorchis sinensis, n = 1) were found in 7 patients (41.18%). Conclusions: Most North Korean defectors who visited this tertiary hospital in South Korea were female, and they mainly visited the departments of ophthalmology, gastroenterology, and pulmonology. Compared with South Koreans, they showed high rates of chronic hepatitis B, chronic hepatitis C, pulmonary tuberculosis with multidrug resistance, and parasite infection. (Korean J Med 2015;89:54-63)
Tumor necrosis factor-alpha-308G/A의 유전적 다형성과 항결핵제 유발 반구진발진과의 연관성
서원용 ( Won Yong Suh ),김요한 ( Yo Han Kim ),주현돈 ( Hyun Don Joo ),박성준 ( Seong Jun Park ),류성혁 ( Sung Hyeok Ryuo ),최지성 ( Ji Sung Choi ),안선영 ( Sun Young Ann ),박창현 ( Chang Hyun Park ),김상훈 ( Sang Hoon Kim ),김상헌 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.2
Purpose: Adverse cutaneous reactions to antituberculous drugs (ATD), such as maculopapular eruption (MPE), are the most com¬mon causes of discontinuation of scheduled treatment of tuberculosis. We previously reported that tumor necrosis factor (TNF)-α genetic polymorphism -308G/A is significantly associated with ATD-induced hepatitis. This study aimed to investigate associations between TNF-α -308G/A and ATD-induced MPE. Methods: Patients with ATD-induced MPE and controls without any adverse reactions to ATD were recruited from the database of the Adverse Drug Reaction Pharmacogenomic Research Group database of Korea. We compared the genotype frequency of TNF-α -308G/A between patients with ATD-induced MPE and ATD-tolerant controls. Results: A total of 69 patients with ATD-induced MPE and 229 control subjects were enrolled for this study. There were no significant differences in genotype frequency between the patients and the controls, suggesting lack of associations between TNF-α -308G/A and ATD-induced MPE. Conclusion: The TNF-α genetic polymorphism -308G/A may not be related to the development of ATD-induced MPE, in contrast to ATD-induced hepatitis. These findings suggest that associations between TNF-α -308G/A and ATD-induced adverse reactions can be phenotype-specific.(Allergy Asthma Respir Dis 2015;3:124-127)