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- 저자 : 손병관 ( Young Kwon Cho ) (검색결과 4 건)
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증례 : 소화기 ; 알코올 간경변 환자에서 발생한 자발성 동맥 출혈의 3예
조윤주 ( Yun Ju Jo ),이지현 ( Ji Hyun Lee ),조영관 ( Young Kwan Jo ),안상봉 ( Byung Kwan Son ),손병관 ( Young Kwon Cho ),조영권 ( Young Kwon Cho ) 대한내과학회 2014 대한내과학회지 Vol.87 No.4
Spontaneous arterial bleeding has been reported rarely. In a patient consuming heavy amounts of alcohol with alcoholic liver cirrhosis, spontaneous bleeding can be evoked by thrombocytopenia, altered platelet function, and shear stress on fully dilated arteries by portal hypertension. Alcohol consumption itself can also predispose a patient to bleeding by influencing the aggregation and activation of platelets, and altering the coagulation and fibrinolysis pathway. All of these mechanisms could cause patients with alcoholic liver cirrhosis to bleed spontaneously; however, conditions inducing peripheral arterial bleeding are very rare. Here, we report three cases of spontaneous arterial bleeding in patients with liver cirrhosis consuming heavy amounts of alcohol. All of the patients bled without any physical trauma, and the involved arteries were the intercostal arteries in two cases and a gastroduodenal artery in the other case. The patients were treated by angiographic embolization. One expired due to recurrence of arterial bleeding despite repeated angiographic embolization and massive transfusion. (Korean J Med 2014;87:449-454)
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조성대(Sung Dae Cho),강빈(Ben Kang),박소현(So Hyun Park),성현우(Hyun U Sung),전용훈(Yong Hoon Jun),홍영진(Young Jin Hong),손병관(Byong Kwan Son),권영세(Young Se Kwon) 대한소아신경학회 2012 대한소아신경학회지 Vol.20 No.1
Purpose : This study was aimed to evaluate the clinical features of bacterial and aseptic meningitis in neonates. Methods : Seventy seven neonates who diagnosed with meningitis at Inha University Hospital from June 1996 to August 2010 were enrolled in this study. The subjects were classified into either bacterial or aseptic meningitis and their medical records were retrospectively analyzed. Results : Among the 77 cases, 18 cases were bacterial and 59 cases were aseptic. The main symptoms of both groups were fever, moaning in order. In bacterial meningitis, Group B streptococci (GBS) was the most common causative organism (12/18. 75%). In peripheral blood exam, patients with bacterial meningitis were more likely to show leukocytosis (WBC >20,000/㎣) and leukopenia (WBC <5,000/㎣) than those with aseptic meningitis. CRP was also significantly increased in the group of bacterial meningitis. In CSF analysis, 61.2% revealed pleocytosis more than 1,000/㎣ in bacterial meningitis and 8.5% did in aseptic meningitis. CSF glucose were <40 ㎎/㎗ in 72.2% of the group of bacterial meningitis and 35.6% of the group of aseptic meningitis. Mean CSF protein was 289.6±221.2 ㎎/㎗ in bacterial meningitis and 107.6±73.9 ㎎/㎗ in aseptic meningitis. Abnormal radiologic findings were found in 44.4% of bacterial meningitis and 8.4% of aseptic meningitis. The treatments were empirically initiated with ampicillin and cefotaxime in 60 cases, ampicillin and aminoglycosides in 12 cases. Conclusion : Although the clinical features of bacterial and aseptic meningitis are similar, peripheral blood and CSF exams revealed significant differences. Based on these differences, appropriate antibiotic treatment can be selected before the identification of causative agents. 목적 : 신생아 수막염을 세균성과 무균성으로 나누어 임상 양상을 확인하고자 하였다. 방법 : 1996년 6월부터 2010년 8월까지 인하대병원 신생아 집중치료실에서 수막염으로 진단된 생후 4주 미만의 환아 77명을 대상으로 하였다. 혈액 및 뇌척수액 검사 결과에 따라 세균성과 무균성으로 나누어 의무기록을 후향적으로 분석하였다. 결과 : 대상 환아 77명 중 세균성은 18명, 무균성은 59명이었으며, 발병 시 증상은 두 군에서 모두발열, 끙끙거림 순으로 나타났다. 세균성의 원인균으로는 GBS가 12례(75%)로 가장 많았고, coagulase 음성 포도상 구균, E. coli, H. influenzae, K. pneumoniae가 각각 1례(6%)씩 나타났다. 말초혈액검사에서는 세균성에서 백혈구감소증과 백혈구증가증이 무균성보다 많았으며 CRP는 세균성에서 유의하게 높았다. 뇌척수액검사에서는 백혈구수 1,000/㎣ 이상이 세균성에선 61.2% 무균성에선 8.5%였고, 당 40 ㎎/㎗ 이하가 세균성에서는 72.2%, 무균성에서는 35.6%를 보였으며 단백질은 세균성에선 평균 289.6±221.2 ㎎/㎗, 무균성에선 평균 107.6±73.9 ㎎/㎗로 나타났다. 투여한 항생제는 ampicillin과 cefotaxime이 60례, ampicillin과 aminoglycoside가 12례에서 확인되었다. 뇌 영상학적 검사에서 이상소견은 세균성은 44.4%, 무균성은 8.4%에서 나타났다. 결론 : 세균성 수막염과 무균성 수막염은 증상은 비슷하였으나, CBC, CRP 등의 혈액검사와 뇌척수액 검사 에서 유의한 차이가 있음을 알 수 있었고, 이를 근거로 균동정이 확인되기 전까지 적절한 항생제 투여여부를 결정할 수 있다.
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오성근(Sung Keun Oh),조성대(Sung Dae Cho),홍영진(Young Jin Hong),손병관(Byong Kwan Son),권영세(Young Se Kwon),김은영(Eun Young Kim),임명관(Myung Kwan Lim),최석진(Seok Jin Choi) 대한소아신경학회 2010 대한소아신경학회지 Vol.18 No.2
Intracranial dermoid cyst is a rare congenital disease originating in the embryo. Intracranial dermoid cysts are usually detected before five years of age; however, asymptomatic cysts have been discovered after the third decade of life through various complications. Sometimes, there are neurologic symptoms caused by a cys- tic mass effect and if there is a dermoid sinus, purulent infections can occur. Early diagnosis is important and as such, CT or MR imaging for recognition of the loca- tion, size, and characteristics of the cysts are recommended before surgical resec- tion. Extradural dermoid cysts with an intact occipital dermoid sinus are a rare event. We report a case of intracranial dermoid cyst associated with scalp abscess. In this case, a three-year-old boy was presented with scalp abscess and we per- formed MR imaging, which revealed a cystic region. The prognosis after resection operation was good without any complication.
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장간막 허혈증에서 경피적 혈관성형술의 임상적 유용성 Case Series 6예
정유민 ( Yu Min Jung ),조윤주 ( Yun Ju Jo ),안상봉 ( Sang Bong Ahn ),손병관 ( Byoung Kwan Son ),김성환 ( Seong Hwan Kim ),박영숙 ( Young Sook Park ),배준호 ( June Ho Bae ),조영권 ( Young Kwon Cho ) 대한소화기학회 2011 대한소화기학회지 Vol.57 No.4
Intestinal ischemia is divided into three categories, namely, acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), and colonic ischemia. AMI can result from arterial or venous thrombi, emboli, and vasoconstriction secondary to low-flow states. It is an urgent condition which can result in high mortality rate. The predominant causative factor of CMI is stenosis or occlusion of the mesenteric arterial circulation, and it is characterized by postprandial abdominal pain and weight loss. Surgery is the treatment of choice for intestinal ischemia. However, it has been recently reported that percutaneous transluminal angioplasty with stent placement and/or thrombolysis is an effective therapy in various types of mesenteric ischemia. We report six cases of mesenteric ischemia which were successfully treated by percutaneous angioplasty, and review the literature from South Korea. (Korean J Gastroenterol 2011;57:243-248)
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