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박창현(Chang Hyun Park),박찬웅(Chan Woong Park),심승식(Seung Sig Sim),정만(Mann Jung),이영미(Young Mi Lee),류형선(Hyung Sun Ryeu),김지운(Ji Woon Kim) 대한내과학회 1993 대한내과학회지 Vol.45 No.4
N/A Background: Tsutsugamushi disease is a common febrile illness. For the better understanding it, we need more studies on its clinical and epidemiological characteristics. Methods: We analyzed clinically and epidemiological-ly 218 cases of tsutsugamushi disease which were diagnosed at St. Columban Hospital in 1990 and 1991. Results: Of the 218 cases, the age distribution ranged from teen-agers to the nineties: the 50's, 31.7%: the 60's, 23.4%. and the 40's, 22.5%. Among them. 104 cases were males and 114 cases were females. The ratio of male and female was 1:l.l. The monthly incidence rates were November, 67.4%: October, 24.3%: December, 7.8%: and September, 0.5%. The frequent symptoms and their rates were as follows: fever and chills, 97%: myalgia, 96%: headache, 95%. and fatigue, 83%. Rash, eschar, and lymphadenopathy were observed at the rate of 96%, 85.6%. and 39.4%, respectively. The laboratory findings showed such percentages as elevation of AST, 91.7%: ALT, 68.8%: and alkaline phosphatase, 57.2%. The positive indirect immunofluor-escent antibody test and cross serologic reaction rate of Hantavirus and Tsutsugamushi were observed at the rates of 62.4%, 11.5%, respectively. Increased interstitial markings of the chest X-ray were also observed in 59 cases (27.1%). There were good responses to the treatment of dox-ycycline and chloramphenicol, but no responses to the other antibiotics such as ampicillin and cephapirin. Conclusion: Tsutsugamushi disease is an acute febrile illness which is characterized by fever and chills, head- ache, mylagia, resh, and eachar during autumn and early winter, therefore we make every efforts for the early diagnosis and treatment before serologic examination.
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한국인 산모에서 B형 간염 바이러스의 보유율 변화에 관한 연구
오은아 ( O Eun A ),정숙애 ( Jeong Sug Ae ),정만 ( Jeong Man ),심승식 ( Sim Seung Sig ),양인애 ( Yang In Ae ),최관수 ( Choe Gwan Su ),정남기 ( Jeong Nam Gi ) 대한내과학회 1990 대한내과학회지 Vol.38 No.6
N/A In an attempt to investigate the yearly changes of the HBsAg carrier rate by observing the HBsAg positive rate in full-term pregnant women who are definitely related to the vertical transmission of the hepatitis B virus, as well as to analyze the epidemiologic factors which influence the HBsAg positive rate in pregnant women, we tested HBsAg and checked the histories of about 20 epidemiologic factors in 10,359 prgnant women .who delivered at St. Columban`s Hospital in Mokpo City from April 1, 1985 to June 30, 1989. The results were as follows: 1) Overall HBsAg positivity in all 10,359 pregnant women was 7.9%. 2) The positive rate of HBsAg was unrelated to the frequency or degree of alcohol drinking,smoking, income, nutritional state, hygiene, education, religion, occupation, locality or, injections at home in pregnant women. 3) The positive rates of HBsAg were higher in cases who had acupuncture, venereal disease, who had more than four siblings, and who worked as an institutional worker or hospital staff. The positive rates of HBsAg increased significantly in cases who had blood transfusions(0.025<p<0.05), who had injections at hospitals(p<0.005), who had no hepatitis B vaccination(p<0.005), who had a family history of liver disease(p<0.001) and who were much older(p<0.005). 4) The positive rate of HBsAg was decreased significantly from 9.2% to 7.0% for five years(p<0.001). There were several factors which influence the HBsAg positivity every year. First, the rate of hepatitis B vaccination increased significantly(p<0.001), second, the number of pregnant women who had more than six siblings increased significantly(0.025<p<0.05) and third, the number of pregnant women who had acupuncture decreased significantly(p<0.001). But the number of pregnant women who were over 30 years old increased significantly(p<0.001). 5) The positive rate of HBsAg increased significantly from 7.2% to 13.0% as the age increased(p<0.005). There were several factors which influenced HBsAg positivity by age group. Although the rate of hepatitis B vaccination increased significantly in the older age groups(p<0.001), the positive rate of HBsAg increased more in the older age groups because the numbers of pregnant women who had acupuncture(p<0.001) and a family history of liver disease(p<0.005) increased significantly. The results suggest that the number of HBV carrier pregnant women in Korea decreased progressively every year. Although the rate of hepatitis B vaccination increased significantly, it was not so effective due to the small total number. The number of pregnant women who had acupuncture and a family history of liver disease increased significantly, especially those over 30 years old. So it is important to have a nationwide program of hepatitis B immunization and to educate people on how to interfere with the transmission route in order to eradicate hepatitis B in Korea.
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김지운(Ji Woon Kim),정만(Mann Jung),이영미(Young Mi Lee),류형선(Hyung Sun Ryeu),심승식(Seung Sig Sim),박창현(Chang Hyun Park),박찬웅(Chan Woong Park) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.3
Primaty adenocarcinoma of the duodenum is a uncommon neoplasm, accounting for about 0.3% of all gastrointestinal cancers. Adenocarcinomas tend to metastasize to regional lymph nodes, liver and pancreas, Peritoneal carcinomatosis also occurs and is more common than wide spread metastasis to lungs or bones. But with increasing awareness of its modes of presentation and improved diagnostiic techiques, more cases should be recognized at an earlier stage in the course of the disease. We experienced a case of primary adenocarcinoma of the duodenum associated with pancreatic metastasis, and report it with a review of the literature.
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문용,이영미,박창현,김지운,박찬웅,정만,류형선,심승식,천석배,강상구 대한내과학회 1993 대한내과학회지 Vol.45 No.4
Background: Combined ATCH and GH deficiency is a rare disease, Clinical and laboratory features are variable, non-specific and similar to those seen in adrenocortical insufficiency of any cause. Methods: We have exprienced a case of combined ACTH and GH deficiency without combined disease. The patient, 55 years old female, was admitted because of fatigue, nausea and vomiting on admission. Results: Serum sodium was 112 mmol/L, potassium 3. Hmmol/L, serum osmolarity 237m0sm,Kg and urine osmolarity 531 m0sm/Kg. Basal serum cortisol was 0.68 μg/ml, ACTH 12,7pgjml, GH below 0.1 ng/ml, basal urinary 17-hydroxycorticosteroid(17-OHCS) 0.5 μg/dl and blood glucose was 86 mg/dl. Although cortisol did not respond to rapid ACTH stimulation test, it responded to standard ACTH stimulation test. On combinded stimulation test, the cortis1 did not respond and all anterior pituitary hormone showed normal responses except ACTH and GH. In addition, plasma cortisol and ACTH repond to vasopressin test. There was no abnormalities in sellar CT, and hyponatremia was corrected dramatically with prednisolone replacement. Conclusion: Combined ACTII and GI-I deficiency is rare cause of secondary adrenocortical insufficiency, Its clinical manifestation similar to isolated ACTH deficiency in adult. Patients with isolated ACTFI deficiency due to suprapituitary dysfunction may be distinguished from those with intrinsic pituitary disease by stimulation of cortisol and ACTI-I secretion following vasopressin administration. More study needed to identify the definitive cause and hypothalamic-pituitary system.
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