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전신성 홍반성 루푸스 환자에서 발병된 크립토코쿠스 뇌막염
이창원 ( Chang Won Lee ),송상헌 ( Sang Heun Song ),배우형 ( Woo Hyung Bae ),안준협 ( Jun Hyup An ),김성일 ( Sung Il Kim ),김명규 ( Myeong Kyu Kim ),이신석 ( Shin Seok Lee ),정대수 ( Dae Soo Jung ),곽임수 ( Ihm Soo Kwak ),나하연 ( 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.4
Cryptococcal meningitis is rare but, often fatal complication of systemic lupus erythematosus(SLE). It is difficult to differentiate cryptococcal meningitis from neuropsychiatric lupus due to similarity of clinical symptoms and laboratory findings of cerebrospinal fluid(CSF). Earlier diagnosis and effective antifungal therapy improve the prognosis of cryptococcal meningitis in SLE patients. We report a case of cryptococcal meningitis in a patient with SLE who had been medicated with low dose steroid.
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Mallory-Weiss syndrome의 내시경적 진단과 치료
송근암(Geun Am Song),김태오(Tae Oh Kim),강대환(Dae Hwan Kang),조몽(Mong Cho),양웅석(Ung Suk Yang),배상문(Sang Moon Bae),류수형(Soo Hyung Ryu),안준협(Jun hyup An),이성훈(Seong Hwun Lee) 대한내과학회 2000 대한내과학회지 Vol.58 No.5
N/A Background : Mallory-Weiss syndrome is a laceration of gastroesophageal junction due to abruptly increased intraabdominal pressure. Bleeding from Mallory-Weiss tears stops spontaneously within 2-3 days without specific therapy in 80-90% of cases, but in some cases, aggressive treatment is required due to massive bleeding. Methods: Among two hundreds and fifteen cases of upper gastrointestinal bleeding from January 1997 to January 1999, twenty three cases (10.7%) were diagnosed as Mallory-Weiss syndrome by endoscopy. We assessed the site, number, coexisting diseases, precipitating factors and bleeding lesion according to the time interval after the tears. After supportive care or specific therapy, we performed follow-up endoscopy to evaluate the healing of the lesions. Results: The mean age was 49.1 years and male:female ratio was 4.8:1. The most common precipitating factors were nausea, vomiting and alcohol drinking. In twenty cases, coexisting diseases such as gastritis and esophageal varix were detected. As for the number of tears, one tear was the most common (69.6%), while two tears were identified in five cases and three were in two cases. Thirteen cases of the Mallory-Weiss tears were located on the gastroesophageal junction, seven cases on the lower esophagus, one case on the cardia and two cases from lower esophagus to cardia. Eighteen cases were diagnosed by endoscopy within 24 hours after bleeding, of whom fourteen cases had active bleeding. Among four cases diagnosed after 24 hours, endoscopic finding revealed active bleeding in two cases and blood clots in the other two cases. We treated thirteen cases with supportive care, one case with hypertonic saline injection and nine cases who had active bleeding or deep and long tears with endoscopic band ligation. One or two weeks later, we performed follow-up endoscopy, and no bleeding was detected in all cases. Conclusion: We diagnosed twenty three cases of Mallory-Weiss syndrome by endoscopy and treated all cases with supportive care or endoscopic band ligation successfully.(Korean J Med 58:542-547, 2000)
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당뇨병성 자율 신경병증에서 99mTc-DISIDA를 이용한 담낭 배출율에 관한 연구
김인주,김용기,유석동,김성장,안준협 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.1
Purpose: We performed this study to evaluate the changes of gallbladder ejection fraction (GBEF) in diabetic patients with or without autonomic neuropathy. Materials and Methods: This study included 37 diabetic patients (25 women, 12 men, mean age 51 years) and 24 normal controls (10 women, 14 men, mean age 38 years). After intravenous injection of 185 MBq of 99mTc-DISIDA, serial anterior abdominal images were acquired before and after fatty meal. Regions of interest were applied on gallbladder and right hepatic lobe on 60 and 90 minute images to calculate GBEF. Results: GBEF was significantly reduced in diabetes with autonomic neuropathy (43±12.3%) and without autonomic neuropathy (57.5±13.2%) compared with normal controls (68±11.6%, p <0.05). And also, GBEF was significantly reduced in diabetes with autonomic neuropathy compared with diabetes without autonomic neuropathy (p <0.05). Fasting blood glucose level, age, sex, hemoglobin A1c, body mass index, serum lipid level were not different in these two ditic patient groups (p>0.05). When 50.2% of GBEF was used as the criteria for diabetic autonomic neuropathy, the sensitivity and specificity were 80%, 76.5%, respectively. The area under receiver operating characteristic curve was 0.846. Conclusion: GBEF of diabetic patients with autonomic neuropathy was significantly reduced than that of diabetic patients without autonomic neuropathy. (Korean J Nucl Med 2000;34:55-61)
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정현철,이우철,김태오,이창원,류수형,이수봉,박순규,안준협,신호진,곽임수,송상헌,배우형,박삼석,나하연 대한내과학회 2000 대한내과학회지 Vol.59 No.5
Scrub typhus is a zoonotic disease, caused by Orientia tsutsugamushi, and characterized by a typical primary lesion(eschar), rash and non-specific symptoms such as fever and chills, headache, myalgia. Although it is an acute febrile illness, severe complications of this disease are very rare since the introduction of specific antibiotic therapy. The authors report two cases of scrub typhus complicating acute respiratory distress syndrome. Although appropriate diagnosis and treatment were performed, all two patients expired. They were diagnosed as scrub typhus by travel history, clinical manifestations, eschars, serologic test and polymerase chain reaction(PCR).(Korean J Med 59:544-549, 2000)
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