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윤혜경,이정석,이동윤,이지현,홍수희,류인열,윤성준,신원혁,최의혁,유종훈,김영묵,이준상 대한소화기학회 1997 대한소화기학회지 Vol.30 No.3
Background/Aims: Melanosis coli is browinsh or black pigmentation of the colonic mucosa associated with long-term ingestion of anthraquinone compounds as laxatives. The discoloration of the colonic mucosa is due to accumulation of macrophages containing brown lipofuscin pigment in the lamina propria. The purpose of this study was to investigate the clinical characteristics of melanosis coli. Methods: We reviewed the clinical records of 50 cases of melanosis coli, which were confirmed by colonoscopy and tissue biopsy in Wallace Memorial Baptist Hospital from December 1992 to Jannuary 1997, with regard to age and sex of patients, sites of involvement, ingredients of laxatives used, clinical symptoms, and concurrent colorectal diseases. Results: The average age of the patients included in this study was 46.0 years, the lowest was 20, and the highest 74. The ratio of male to female was 1:2.6, suggesting that melanosis coli occurs more frequently in the female than in the male. Considering the combination of the involved segments, melanosis coli was most frequently distributed from the cecum to the recturn. The most frequently used agents were antraquinone derivative laxatives including aloe(74.0%) and the duration of ingestion was variable from 2 months to 20 years. Abdominal pain(82.0%) and constipation (64.0%) were the most frequent synptoms at examination. Concurrent colorectal diseases were he- morrhoid, polyps, and cancer in the order. Conclusions: Melanosis coli itself may not have any clinical significance and may not be associated with any colonic functional impairrnent. However, it may provide a clue to laxative abuse, Considering that anthraquinone laxatives such as aloe are widely used in Korea and and the use of laxatives by the elderly is increasing melanosis coli will be detected more frequently.
당뇨병성 말기신부전증 환자의 유방에 발생한 원발성 모균증 1예
윤성준,이지현,임종섭,류수현,유대성,류인열,신원혁,재영성 대한신장학회 1997 Kidney Research and Clinical Practice Vol.16 No.2
Mucormycosis, caused by Zygomycetes fungi of the order Mucorales, is a rare opportunistic infection which usually develops in immunosuppressed patients, especially in patients with diabetic acidosis. This infection, associated with the presence of broad, nonseparate hyphae in tissue, originates usually in the perinasal sinuses and nose, orbit, central nervous system, lung, skin, soft tissue, or gastrointestinal tract, but is occasionally disseminated from the primary loeation to other areas. Recently we experienced a case of Mucormycosis found in the breast of a 70-year old woman undergoing hemodialysis for diabetic nephropathy. The patients was very poor in her systemic condition. On physical examination, we found the subcutaneous mass in the left breast. Breast ultrasonography showed a mass with a relatively clear boundary in subcutaneous fatty layer and excisional biopsy confirmed infiltration of breast tissue by fungal hyphae. With improvement of patient's malnutrition via an aggressive hemodialysis, control of blood glucose and total parentral nutrition, the mass was slightly reduced in size and maintained without causing any notable symptom. Since Mucormycosis found in the breast tissue has not been reported in the literature yet, we report its case observed in a hemodialysis patient for diabetic nephropathy with the review of the literatures.