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용종성종괴모양을 보인 십이지장 팽대부의 협착성 유두염 1예
박승철,김홍수,이문호,김선주,김대중,윤병옥,박상흠,정일권,오흥석,황헌규,박관석,전 진 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.2
$quot;Stenosing papillitis$quot; is a descriptive term for an anatomic deformity of the Ampulla of Vater due to chronic inflammation and fibrosis, which is characterized by narrowing of the lower end of the bile and pancreatic duct, and by clinical symptoms resembling pancreticobiliary disease. Duodenoscopic finding of stenosing papillitis usually shows edema, erythema, and laceration on Ampulla of Vater, but endoscopic finding such as polypoid mass is rare. We recently experienced one case of polypoid stenosing papillitis and report with a review of relevant literatures A 54-year-old man was admitted to our hospital because of chronic right upper abdominal pain for 2 years. Duodenoscopy revealed a polypoid mass with erythemaous color change on Ampulla of Vater, which was endoscopically resected by using a polypectomy snare, and pathologic examination showed chronic inflammation and fibrosis.
이철우,박규호,강문수,양동호,고봉민,배성한,전기원,박관석,정인섭,홍세용,오종용,오홍석,김명수 대한내과학회 1998 대한내과학회지 Vol.55 No.5
Objectives: Pyrethroids are commonly used pesticides, and acute human poisoning by these insecticides is common in Korea It has a high affinity to the sodium channel on cell membranes causing blockage, which results in neurotoxicity, hyperexcitation, and death. The purpose of this study was to analyze the clinical characteristics of acute pyrethroid poisoning. Methods: To evaluate the clinical characteristics (age, sex, causative agents, cause of ingestion, severity of poisoning and its clinical feature, prognosis, complication and results of the treatment), we analyzed the clinical reports of 30 patients with pyrethroid poisoning who were admitted to Soonchunhyang Chunan hospital from January 1992 to July 1997. Results: 1) 18 out of 30 patients with pyrethroid poisoning were male and the largest age group was above 60 years old. 2) The most common cause of ingestion was suicide, in 24 cases(80%). 3) There were 7 classes of causative agents of poisoning and all of these were classified into 2 grades according to the degree of WHO toxicity. Fenvlaerate and cypermethrin were the most common agents. 4) The degree of severity was classified into three groups-mild, moderate and life-threatened. Of these groups, mild poisoning was the most common. There was no significant difference in the age, type of pyrethoid and interval between pyrethroid ingestion and arriving at the emergency room between the three groups. However, the amount of ingestion was significantly higher in the life-threatened group, 5) The most common symptom of the patients was vomiting, in 19 patients, The classification were of three types (5 type I, 11 type II and 1 intermediate type) according to clinical characteristics. 6) There is no specific antidote, therefore therapy is generally supportive. There were three deaths, and the cause of death was respiratory failure. 7) The most common complication was pneumonia, in 3 cases(10%), which occurred in almost all patients in the life-threatened group. Conclusions: The most common age group of poisoning was over 60 years old, and suicide was the most common cause of ingestion. Treatment is supportive, and most causal exposures require only decontamination. There were three deaths, and the cause of death was respiratory failure in each case. The most common complication was pneumonia.
진단적 내시경적 역행성 담관조영술 중에 발생한 총수담관천공 1예
김은주,김인호,김홍수,이문호,김선주,정일권,박관석,박상홈,은수훈,김상균 대한소화기학회 2001 대한소화기학회지 Vol.37 No.3
Bile duct perforation caused by therapeutic procedures such as endoscopic sphincterotomy, guide-wire, and biliary stent were frequently reported. However, the case of bile duct perforation developed during diagnostic endoscopic retrograde cholangiogram (ERC) was very rare and there has been only one case report until now. A 57-year-old man was admitted for the evaluation of dilated bile duct. During the diagnostic ERC, he suddenly complained of severe right upper quadrant abdominal pain and cholangiogram showed dye leakage from the duodenal side of distal common bile duct where the tip of catheter was closely adhered. He was successfully treated with endoscopic retrograde bililary drainage for 4 weeks.