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이달의 X-선 : 위치에 따라 이동하는 종괴를 포함한 공동으로 진행된 비소세포폐암에 동반된 폐렴
엄태찬 ( Tae Chan Um ),문귀애 ( Kwie Ae Moon ),김필호 ( Phil Ho Kim ),김상현 ( Sang Hyun Kim ),정병오 ( Byung Oh Jeoung ),이혁표 ( Hyuk Pyo Lee ),김주인 ( Joo In Kim ),염호기 ( Ho Kee Yum ),최수전 ( Soo Jeon Choi ),김성준 ( Sung J 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.46 No.4
중추성 요봉증과 단독성 성선자극 호르몬 결핍증을 동반한 공허안증후군 1예
김성준,조남국,엄태찬,문귀애,김필호,김상현,고경수,이병두,박재홍 인제대학교 1998 仁濟醫學 Vol.19 No.2
공허안증후군은 뇌하수체와 내로 거미막하 공간이 내려와 뇌하수체가 편평해지는 질환이다. 공허안증후군 환자의 대부분은 뇌하수체 기능 장애 없이 우연히 발견되는 경우가 많다. 저자들은 이차 성징 발현 소실을 주소로 내원한 30세 남자에서 원발성 공허안증후군과 중추성 요붕증, 단독성 성선자극호르몬 결핍증이 동반되었음을 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Primary empty sella syndrome(PESS) associated wish trophic hormone deficiency is rare. Furthermore, PESS with central type of diabetes insipidus(DI) and isolated anterior pituitary hormone deficiency is extremely rare. We experienced a case of PESS associated with central type of DI and isolated gonadotropin deficiency in a 30-year-old man who had complained of sexual infantilism and polyuria. MRI of pituitary gland showed posteriorly displaced pituitary stalk and CSF-like signal intensity in the sella turcica. We report this case wish review of the relevant literatures.
소화성 궤양의 재출혈 위험인자 및 에탄올 주입치료의 효과에 관한 연구
김상현,이진호,김성준,신원창,김관엽,문귀애,김필호,엄태찬 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.4
Background/Aims: Acute peptic ulcer bleeding is the most common cause of upper gastrointestinal bleeding, and needs urgent management in cases including large amounts of blood loss. Ernergency endoscopy was performed and evaluation was made on the risk factors of rebleeding in peptic ulcer patients and the efficacy of ethanol injection therapy. Methods: The clinical and endoscopic variables were evaluated according to the rebleeding rates and the efficacy of ethanol injection therapy for hemostasis and prevention of rebleeding in 161 cases including gastric ulcers (GU) with bleeding (M: F 134: 27, mean age 56.5 years) and 136 cases including duodenal ulcers (DU) with bleeding (M: F 111: 25, mean age 40.7 years). Background/Aims: Acute peptic ulcer bleeding is the mast common cause of upper gastrointestinal bleeding, and needs urgent managment in cases including large amounts of blood loss. Emergency endoscopy was perform~;d and evaluation was made on the risk factors of rebleeding in peptic ulcer patients and to efficacy of ethanol injection therapy. Methods: The clinical and endascopic variables were evaluated according to the rebleeding rates and the efficacy of ethanol injection therapy for hemostasis and prevention of rebleeding in 161 cases including gastric ulcers (Gj.J) with bleeding (M : F 134 : 27, mean age 56.5 years) and 136 cases including duodenal ulcers (DU) with bleeding (M : F 111 : 25, mean age 40.7 years). Results: 1. There wad no difference in age or gender ratio according to the incidence of rebleeding and shock between GU and DU. In GU, rebleeding was mast common in gastric bodies, failowed by angle and antrum. Posterior wall was the most common rebleeding direction, followed by anterior wall, greater curvature, and lesser curvature. In DU, rebleeding was more common in the bulbar portion than postbulbar portion. Posterior wall was the ghost common rebleeding direction, followed by greater curvature, anterior wall, and lesier curvature. The average size of ulcers with rebleeding was smaller than those without rebleeding. 2. In GU, rebleeding was more common in ulcers with active bleeding and visibly vessels, but without red spots or stigmata. In DU, rebleeding was common in ulcers only with active bleeding, but not with visible vessels, red spots, or stigmata. 3. Ethanol injection therapy (EIT) was successful in controlling bleeding in 91 out of 98 cases in the first trial. The second EIT was performed in 20 rebleeding cases resulting in 15 hemostasis with 92% efficacy. 4. The EIT could not decrease the rebleedng incidence in patiends with active bleeding, visible vessels nor red spots. In the EIT group, the shock incidence transfusion amount and the hospital stay were all noted to be higher than the untreated group. Conclusions: The rebleeding risk should be carefully evaluated and managed diffeently according to clinical and endoscopic findings. The EIT was effective in controlling bleeding peptic ulcers but not in the prevention of rebleeding. The application of the ETT in for prevention of rebleeding should be stratified according to the severity of the first bleeding.
김필호,박연호,남궁준,문귀애,김상현,엄태찬,김성준,고경수,이병두,박미정 인제대학교 1998 仁濟醫學 Vol.19 No.2
다운증후군은 특이한 외모, 지능 발달 저하 등의 임상상으로 나타나는 가장 흔한 상염색체 수 이상 증후군이다. 저자들은 전신 경련을 주소로 내원한 환자에서 염색체 검사를 실시하여 Robertsonian translocation에 의한 부분 삼체성의 다운증후군 및 특발성 부갑상선 기능저하증이 동반된 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Down syndrome is perhaps the oldest condition associated with mental retardation and the most common genetic cause of developmental disability. It is presumed that the additional gene products of the triplicated chromosome 21 cause alterations in the normal processes regulating embryogenesis. Ninety-five percent of cases are caused by trisomy 21, whereas the remainder are translocations. Mainly, the chromosomal translocation is made of Robertsonian translocation. Clinically it consists of cranio-facial abnormality, such as microcephaly, with flattening both of the occiput and face, an upward slant to the eyes with epicanthal folds, and the ears are small. Congenital heart disease, musculoskeletal abnormalities, gastrointestinal disorders, hematologic abnormalities and associated developmental disabilities. And thyroid dysfunction and infertility are the most significant endocrinologic disorders in individuals with Down syndrome. But we could not find any reported case of hypoparathyroidism associated with Down syndrome in worldwide search of literatures. Even though some cases of hereditary hypoparathyroidism, which is not associated with Down syndrome were reported. We experienced a rare case of 15-year-old male diagnosed as hypoparathyroidism associated with Down syndrome, which is diagnosed by cytogenetic chromosomal study and by radioimmunoassay for PTH wish symptoms of seizure disorder due to hypocalcemid and typical cranio-facial abnormalities.
이진호,이성홍,이현경,최태영,신원창,최대식,김필호,김관엽,엄태찬 대한내과학회 1999 대한내과학회지 Vol.56 No.3
Polymyositis is characterized by symmetrical proximal muscle weakness, nonsuppurative inflammation of striated skeletal muscle, elevation of muscle enzyme, and abnormality of electromyographical change, but its pathogenesis is not clear. The incidence of polymyositis is low, and that associated with chronic liver disease is rare. Clinical importance of polymyositis associated with chronic liver disease is that it is a reversible disease which can be treated with glucocorticoid. We experienced three cases of polymyositis associated with chronic liver disease which was treated with prednisolone. And we report these cases with a brief review of literature. So, the further study about the influence of chronic liver disease on the polymyositis is warranted.