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장천공과 Enteritis Cystica Profunda를 동반한 Peutz-Jeghers 증후군
안기성(Ki Sung Ahn),배정동(Jung Dong Bae),김호각(Ho Gak Kim),손호상(Ho Sang Shon),최정윤(Jung Yoon Choe),김지희(Chi Hui Kim),김이근(Ih Geun Kim),김태석(Tae Sug Kim),김채기(Chae Gi Kim) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5
The Peutz-Jeghers syndrome is an autosornal dominant condition characterized by mucocutaneous pigmentation and hamartomatous polyps of the gastrointestinal tract. This syndrome is clinically important because of complications caused by gastrointestinal polyps, such as abdorninal pain, gastrointestinal bleeding and intussusception often leading to intestinal obstruction. The possibility of malignant change in the polyp has been a controversial issue. In the recent reviews of soe cases of Peutz-Jeghers syndrome, the reported lesions of small intestinal adenocarcinoma are regarded as the benign process of enteritis cystica profunda. We present herein a case of Peutz-Jeghers syndrome with small bowel perforation, a previously unreported instance, and enteritis cystica profunda. (Korean J Gastroenterol 1997; 29:677-682)
살모넬라 Group C 감염에 동반된 횡문근융해증 및 급성신부전
안기성(Ki Sung Ahn),박정기(Jeong Ki Park),여동근(Dong Keun Ye),윤원찬(Wern Chan Yoon),김학준(Hak Jun Kim),정의달(Ye Dal Jeong),조선주(Sun Ju Jo) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.2
Rhabdomyolysis is a syndrome characterized by muscle necrosis and release of intracellular muscle constituents into the circulation. Rhabdomylosis can be precipitated by different causes, such as trauma, extraordinary physical exer- tion, metabolic disorder, drugs, toxins, infection, or endocrinopathy. Salmonellosis is another rare cause of rhabdomyolysis. We report a 62-year-old male who developed severe diarrhea and vomitting, one day after boiled pork & raw octopus ingestion. The diagnosis of rhabdomyolysis was established primarily by the elevated serum CPK and myoglobin level. There were no other traumatic, metabolic, toxic, or enzymatic causes for the rhabdomyolysis. Stool cultures received at the first day of hospitalization yielded Salmonella Group C. Salmonella sp. is suggested to cause muscle damage by direct bacterial invasion as well as by decreasing the oxidative and glycolytic enzyme activity of skeletal muscles and by activating lysosomal enzymes. We wish to draw attention to these serious complication of salmonella gastroenteritis, and to institute of prompt measures for preventing the development of ATN. We report a case of acute renal failure associated with rhabdomyolysis and gastroenteritis caused by salmonella Group C with review of literatures.
기존 원발성 막성 신병증에 합병된 반월상 사구체신염 1 예
임상혁(Sang Hyuk Lim),권현희(Hyun Hee Kwon),박경찬(Kyoung Chan Park),류정일(Jung Il Ryu),유성수(Sung Soo You),박민식(Min Sik Park),조창호(Chang Ho Cho),김용진(Yong Jin Kim),안기성(Ki Sung Ahn),이인희(In Hee Lee) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.5
Membranous nephropathy (MGN) is a common cause for nephrotic syndrome in adults. Renal failure usually develops gradually in patients with MGN and rapid deterioration of renal function is a rare complication. Moreover, the development of crescentric glomerulonephritis (CGN) as a cause of acute renal failure (ARF) in patients with preexisting MGN is very rare. We report 20-year-old male patient with MGN who presented with ARF due to superimposed CGN. He had been diagnosed as idiopathic MGN and his renal function was maintained within normal range. After 13 months of conservative treatment, ARF was developed and renal biopsy was performed to differentiate the possible causes of ARF. Renal biopsy revealed diffuse crescents formation on preexisting MGN. Anti-GBM antibody and ANCA were not detected. This patient was treated with combination therapy including methylprednisolone pulse therapy followed by high dose steroid and cyclophosphamide. His renal function was improved significantly 2 weeks after treatment. In conclusion, when unexplained ARF in patient with MGN develops, prompt investigation for superimposed conditions including CGN is necessary and repeat renal biopsy should be considered.
손호상(Ho Sang Sohn),안기성(Ki Sung Ahn),박정기(Jeong Ki Park),정의달(Ye Dal Jeong),조선주(Sun Joo Cho),여동근(Dong Geun Yeo),최정윤(Jung Yoon Cheo),이지현(Jee Hyen Lee) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.3
Doxylamine succinate is common over-the-counter sleep medication that is frequently involved in accidental poisonings and suicide attempts. Doxylamine overdose is generally directed at the anticholinergic effect including autonomic,and central nervous system effect and direct cardiac toxicity. Rarely, rhabdo-myolysis has been reported with doxylamine over-dose. We experienced two cases of rhabdomyolysis with overdose of doxylamine in 17-year-old and 31-year-old male. They were diagnosed with high levels of creatine phosphokinase in serum, myoglobin in serum and urine, and increased radionuclide uptake of muscles in (99m)Tc-MDP bone scan. Patients recovered without any complications with hydration and diuresis. Clinicians should be aware of the possibility of rhabdomyolysis in patients with doxylamine overdose.
상부위장관질환 환자에서 H . pylori 감염에 의한 위점막의 조직학적 변화와 혈청 Gastrin 및 혈청 IgG항체가의 상관관계
손호상(Ho Sang Shon),최정윤(Jung Yoon Choe),김지희(Chi Hui Kim),김태석(Tae Sug Kim),김채기(Chae Gi Kim),김이근(Ih Geun Kim),안기성(Ki Sung Ahn),김호각(Ho Gak Kim),오훈규(Hoon Kyu Oh),김용진(Yong Jin Kim),배정동(Jung Dong Bae) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.3
N/A Background/Aims: This study was performed to investigate the relationship between Helicobacter pylori infection and degree of gastric mucosal inflammation, IgG antibody titer against H. pylori, and fasting serum gastrin level. Methods: Patients were divided into 2 groups(H. pylori positive and negative) by identification of H. pylori in biopsied specimens with special staining. In H. pylori positive group, the density of gastric K. pylori colonization was further graded semiquantitatively from 1 to 3. The severity of gastritis in each group was scored according to the Sydney system from 0 to 3. Serum IgG antibody titer against H. pylori was detected by second-generation antigen based enzyme immunoassay(Cobas Core Anti-Helicobacter pylori EIA). Fasting serum gastrin level was measured by standard radioimmunoassay technique. Results: The severity of gastritis in H. pylori positive group was significantly higher than H. pylori negative group in mononuclear cell infiltration(pC0.001), activity of PMNL(pC0.001), and glandular atrophy(pC0.01). In H. pylori positive group, the density of H. pylori colonization was significantly correlated with mononuclear cell infiltration(r=0.67, p0.001), activity of PMNL(r=0.70, p0.001), and grandular atrophy (r=0.38, pC0.001). Neither density of H. pylori colonization nor severity of gastritis was correlated with fasting gastrin level and IgG antibody titer against H. pylori. Conclusions: H. pylori infection results in localized inflammatory reaction in gastric mucosa with relation to density of H. pylori colonization, but serum H. pylori IgG antibody titer does not reflect the severity of gastritis. Fasting serum gastrin level also has no relation with the density of H. pylori colonization and severity of gastritis. These findings suggest that the factor which cause inflammation in gastric mucosa may be different from that cause gastrin secretion or formation of IgG antibody. (Korean J Gastroenterol 1996; 28:311 - 319)
성인 상부위장관 질환군에서의 H . pylori 검출에 이용되는 검사법의 상호비교
한길성(Gil Sung Han),서대규(Dae Gyu Seo),신왕식(Wang Sik Shin),정재군(Jae Gun Jung),손호상(Ho Sang Shon),최정윤(Jung Yoon Choe),안기성(Ki Sung Ahn),배정동(Jung Dong Bae),박재복(Jae Bok Park),강민모(Min Mo Kang) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1
N/A Background/Aims: For the evaluation of recent reports that H. pylori infection plays a causative ro1e in the pathogenesis of upper gastrointestinal diseases, we studied the relationship between the presence of H. pylori infection in patient and asymptomatic volunteer groups, using histologic demonstration of the bacteria, CLO test, and serum H. pylori antibody titer. Calculation of sensitivity, specificity, and predictive value of CLO test and antibody detection rate in relation to histologic demonstration were also performed. Methods: We evaluated the detection rate of H. pylori infection by direct demonstration with special stain, CLO test, and IgG antibody titer by EIA method in 80 symptomatiq patients who were categorized by endoscopic findings into 24 patients with chronic gastritis, 22 patients with gastric ulcer, 20 patients with duodenal ulcer, 14 patients with gastric cancer, and 20 asymptomatic volunteers. Four or more biopsy specimens of gastric and duodenal mucosa were taken from each of the total 100 cases with gastrofibroscopy and then blood samples were also taken. Results: In sections stained by Warthin-Starry method, H. pylori was found 62.5% in the 80 patients group and 30.0% in the 20 asymptomatic volunteers group. The prevalence of H. pylori was the highest in gastric cancer group(71.4%). The prevalence of H. pylori in the patients with peptic ulcer and gastric cancer was significantly higher than the asymptomatic volunteer group(p0.05). Positive CLO test in the patient group was 77.5% and 35.0% in the 20 asymptomatic volunteers group. The positive rate was the highest in gastric cancer group. The positive rate of the CLO test in patients with peptic ulcer and gastric cancer groups was significantly higher than the asymptomatic volunteer group(p0.05). The positive rate of IgG antibody test in the patient group was 82.5% and 45% in the 20 asymptomatic volunteer group. The rate of positivity was the highest in duodenal ulcer group. The positive rate of the serum IgG antibody test in all patient groups was significantly higher than asymptomatic volunteer group(p 0.05). Sensitivity and specificity of CLO test and IgG antibody test in relation to direct H. pylori smear was 94.6%, 76.7%, 96.4%, and 53.47o respectively. Conclusions: The positive rate of the H. pylori infection in patients with peptic ulcer and gastric cancer groups was significantly elevated compared with control and chronic gastritis groups for each of the 3 tests. For clinical purpose, CLO test can be used as a single guide for the treatment of H. pylori infection for its rapidity and efficacy. (Korean J Gastroenterol 1996;28: 19 - 27)
홍창우 ( Chang Woo Hong ),노신영 ( Sin Young Nho ),이인희 ( In Hee Lee ),안기성 ( Ki Sung Ahn ),박관규 ( Kwan Kyu Park ),강건우 ( Gun Woo Kang ) 대한내과학회 2014 대한내과학회지 Vol.87 No.3
Ethambutol is commonly used as a first-line drug for the treatment of tuberculosis. The most serious adverse effect of ethambutol therapy is optic neuropathy. However, ethambutol-induced acute kidney injury is extremely rare. We report herein a case of acute kidney injury secondary to ethambutol-associated acute interstitial nephritis. A 65-year-old man with pulmonary tuberculosis presented with a > 7-day history of nausea and vomiting. He had begun antituberculosis medications including ethambutol 3 weeks previously. His laboratory findings showed elevated blood urea nitrogen and serum creatinine levels (32.6 and 3.6 mg/dL, respectively). Examination of percutaneous renal biopsy specimens showed diffuse interstitial mononuclear cell infiltration with mild interstitial edema. The patient was treated by cessation of ethambutol and supportive care. His renal function completely recovered (creatinine, 1.1 mg/dL) and his clinical symptoms improved. (Korean J Med 2014;87:352-356)