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2개의 서로 다른 부전도로를 가진 비후성 심근병증 환자를 전극도자 절제술로 치료한 증례
오치혁 ( Chi Hyuk Oh ),김승민 ( Seung Min Kim ),신재령 ( Jae Ryung Shin ),유정선 ( Jung Sun Yoo ),윤경한 ( Kyung Han Yoon ),김진숙 ( Jin Sug Kim ),박지윤 ( Ji Yoon Park ),김슬기 ( Seul Ki Kim ),김진배 ( Jin Bae Kim ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.1
A 41-year-old man, with WPW syndrome and a hypertrophic cardiomyopathy, was admitted for recurrent palpitation. EPS (Electrophysiological study) identified that manifested bypass tract was an innocent bystander, and another concealed bypass tract was utilized as retrograde conduction, during AVRT (atrioventricular reentrant tachycardia). The multiple accessory pathways could be localized at the right free wall and left posteroseptal area. Both of them were successfully abolished with catheter ablation. Successful catheter ablation provides an evident risk reduction, as a result of a lower incidence of AF(atrial fibrillation) and a complete removal of risk for ventricular tachyarrhythmia.
증례 : 순화기 ; 건강한 성인에서 인플루엔자 A (H1N1)에 감염에 의해 발생한 급성 심장막염 1예
오치혁 ( Chi Hyuk Oh ),김진배 ( Jin Bae Kim ),김유진 ( Yu Jin Kim ),이태인 ( Taein Lee ),변종규 ( Jong Kyu Byun ),김권삼 ( Kwon Sam Kim ),김우식 ( Woo Shik Kim ) 대한내과학회 2014 대한내과학회지 Vol.87 No.4
A 21.year.old male with no any other diseases presented with fever, chills, and chest discomfort. A chest radiography scan and transthoracic echocardiogram revealed a large amount of pericardial effusion. An H1N1 viral real.time PCR test confirmed the presence of H1N1 viral infection. Pericardiocentesis was performed to reduce symptoms, and oseltamivir (Tamiflu TM ) was administered. His symptoms improved during the first 4 days, and there was no relapse of the pericardial effusion. The most common manifestation of influenza A infection is respiratory tract infection. Although a cardiovascular manifestation is possible, it is extremely rare. We have reported here a case of acute pericarditis with a large amount of pericardial effusion in a healthy adult infected with influenza A virus (H1N1, swine.origin). (Korean J Med 2014;87:461-465)
스파이글래스, 담도경 및 일시적 담도배액관 삽입을 통한 난치성 담석의 치료
오치혁 ( Chi Hyuk Oh ) 대한췌장담도학회 2020 대한췌담도학회지 Vol.25 No.1
대부분의 담관결석은 내시경역행담췌관조영술(endoscopic retrograde cholangiopancreatography, ERCP)을 통해서 제거가 가능하다. 하지만 약 10% 내외의 경우에서는 ERCP를 이용한 전통적인 방법으로 제거가 어려운 경우가 있기 때문에 이를 극복하는 여러 방법에 대해서 알아두고 숙지하는 것이 필요하다. 본고에서는 SpyGlass를 이용한 단일시술자 담도 내시경, 직접 경구 담도 내시경 및 일시적인 담관 스텐트 삽입법을 통해서 난치성 담석을 제거하는 방법에 대해서 소개하고자 한다. At least 90% of stones are extracted after conventional endoscopic retrograde cholangiopancreatography. However, some cases are still difficult to manage completely. We describe some methods of removing difficult common bile duct stones through a single-operator cholangioscopy using SpyGlass system, direct peroral cholangioscopy, and temporary biliary stenting.
오치혁 ( Chi Hyuk Oh ),동석호 ( Seok Ho Dong ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.5
Approximately 3-15% of patients who have undergone removal of bile duct stones with endoscopic sphincterotomy have recurrence of stones which often presents as acute cholangitis. Despite better understanding on the factors and mechanisms underlying the recurrence of bile duct stones achieved during the past few decades, endoscopic removal still remains the mainstay of management for recurrent bile duct stones. Recently investigated and suggested management of recurrent bile duct stones are highlighted in this review. (Korean J Gastroenterol 2015;66:251-254)
김승민 ( Seung Min Kim ),김동현 ( Dong Hyun Kim ),신재령 ( Jae Ryung Shin ),오치혁 ( Chi Hyuk Oh ),유정선 ( Jung Sun Yoo ),정명화 ( Myoung Hwa Jung ),박선희 ( Sun Hee Park ),문수연 ( Soo Youn Moon ),손준성 ( Jun Seong Son ),한지상 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.1
Over the last few decades, the incidence and distribution of dengue has increased. Although Korea is not an endemic area, the numbers of imported dengue cases are increasing because of an increasing number of people travelling overseas. Common symptoms of dengue are malaise, fever, musculoskeletal pain and headache. But ocular manifestations have only been reported in one case in Korea. Here, we report a case of imported dengue fever presenting with fever, petechiae and visual disturbance. This case highlights the ocular manifestations of dengue fever. Ophthalmologic evaluation should be performed in patients presenting with severe dengue fever and visual disturbances.
대동맥판막 치환술 환자에서 발생한 아스페르길루스 심내막염 1예
신재령 ( Jae Ryung Shin ),김승민 ( Seung Min Kim ),유정선 ( Jung Sun Yoo ),오치혁 ( Chi Hyuk Oh ),정명화 ( Myoung Hwa Jung ),박지윤 ( Ji Yoon Park ),문수연 ( Soo Youn Moon ),손준성 ( Jun Seoung Son ),이미숙 ( Soo Cheol Kim ),김수 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.1
아스페르길루스 심내막염은 국내에서도 7증례만 보고된 바 있는 드문 질환이며 명확한 치료 방안이 정립되지 못하여 사망률 또한 매우 높은 질환이다. 최근 심장수술의 증가, 장기이식, 광범위 항생제 사용 등으로 입원환자 중에 그 발생빈도가 증가하고 있어 해당 질환에 대한 관심이 필요하겠다. 현재까지 아스페르길루스 심내막염의 치료는 외과적 수술 및 적절한 항균제의 사용이 고려되고 있으나 병합요법의 필요성 및 추후 이차적 예방에 관해 더 많은 연구가 요구되고 있다. 저자들은 대동맥판막 치환술및 관상동맥 우회술을 시행한 환자에서 판막파열 및 가성동맥류가 발생하였고, 수술 후 조직검사에서 A. fumigatus를 확인했던 아스페르길루스 심내막염 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Aspergillus endocarditis is a rare infection that occurs most commonly after heart valve replacement surgery. The outcomes for patients with prosthetic valve endocarditis due to Aspergillus species have been extremely poor. Therapeutic management conventionally consists of combined medical and surgical approaches. However, there was no clear evidence to determine whether or not combination therapy was superior to liposomal amphotericin B alone. And no clear pattern could be determined in relation to the optimal duration of initial antifungal treatment or of long-term secondary prophylaxis. We report a case of aspergillus endocarditis in a patient who underwent aortic valve replacement surgery. The results of repeated blood culture were negative. Aortic root replacement was performed and Aspergillus fumigatus was isolated from aortic valve tissue. Despite of postoperative liposomal amphotericin B therapy, he died of multiple organ failure associated with diffuse brain damage.
유정선 ( Jung Sun Yoo ),황진경 ( Jin Kyung Hwang ),오치혁 ( Chi Hyuk Oh ),김승민 ( Seung Min Kim ),신재령 ( Jae Ryung Shin ),이태인 ( Tae In Lee ),윤경환 ( Kyung Han Yoon ),이철현 ( Cheol Hyun Lee ),김진배 ( Jin Bae Kim ) 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.1
A 24-year-old man was admitted to our institution with implantable cardioverter-defibrillator (ICD) pocket infection. The ICD (single chamber, dual coils) was implanted for aborted sudden cardiac death due to hypertropic cardiomyopathy presenting as ventricular fibrillation. He complained of the redness, pain, skin abrasion at ICD pocket site for 7days. With the impression of pocket infection, ICD lead extraction was performed. The ICD lead was completely removed by percutaneous femoral approach with baseket snare.
홍성훈 ( Seonghun Hong ),장영운 ( Young Woon Chang ),변종규 ( Jong Kyu Byun ),김민제 ( Min Je Kim ),채정민 ( Jung Min Chae ),박선희 ( Sun Hee Park ),오치혁 ( Chi Hyuk Oh ),박용구 ( Yong Koo Park ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.4
Gastric cancer frequently disseminates to the liver, lung, and bone via hematogeneous, lymphatic, or peritoneal routes. However, gastric adenocarcinoma that metastasize to the colon and that shows typical linea platisca pattern on colonofiberscopy has rarely been reported. Recently, the authors experience a case of advanced gastric cancer with colonic metastases in a 55-year-old female patient. Multiple colonic lymphoid hyperplasias were detected on colonofiberscopy and biopsy revealed metastatic gastric cancer to the colonic wall. She was treated with mFOLFOX (5-FU, oxaliplatin, leucovorin) and has achieved stable disease status without disease progression. Herein, we report a rare case of signet ring-cell gastric cancer which metastasized to the colon in the form of multiple colonic lymphoid hyperplasias. (Korean J Gastroenterol 2015,66:221-226)
박선희 ( Sun Hee Park ),장영운 ( Young Woon Chang ),김수정 ( Soo Jung Kim ),이민혜 ( Min Hye Lee ),남지혁 ( Ji Hyeok Nam ),오치혁 ( Chi Hyuk Oh ),김정욱 ( Jung Wook Kim ),장재영 ( Jae Young Jang ),양진오 ( Jin Oh Yang ),유진아 ( J 대한소화기학회 2016 대한소화기학회지 Vol.67 No.1
목적: 유당 제거 우유를 섭취하면 유당불내성으로 인한 소화기 증상을 완화시킬 수 있다고 보고되었다. 그러나 아직까지이에 대한 연구자들의 보고는 일치하지 않는다. 이에 저자들은 유당불내성으로 진단된 한국 성인에서 유당 제거 우유의 유용성에 대해 알아보고자 유당 제거 우유 섭취 전후의 호기수소 검사(HBT) 및 소화기 증상의 변화를 조사하였다.대상 및 방법: 2015년 5월부터 2015년 9월까지 경희대학교병원 내과 방문자 중 평소 유제품 섭취 시 소화기 증상이 있던정상 성인을 모집하였다. 이들 중 유당 25 g이 포함된 일반우유 섭취 후 1차 HBT를 시행하여 호기수소량이 기저치보다20 ppm 이상 상승한 경우를 유당불내성으로 정의하였다(△H2>20 ppm). 유당불내성으로 진단되면 7일 뒤 유당 제거우유 섭취 후 2차 HBT를 시행하여, △H2 값의 변화를 관찰하였고 소화기 증상의 유무 및 중등도를 분석하였다.결과: 35명의 대상자 중 총 31명이 1차 검사에서 유당불내성으로 진단되었고, 이들의 우유 섭취와 연관된 소화기 증상은 복통(30명, 96.8%), 복명(30명, 96.8%), 설사(28명, 90.3%), 방귀(27명, 87.1%)이었다. 유당 제거 우유 섭취 후 시행한 2차검사에서 △H2 값이 모두 20 ppm 이하로 감소하였으며, 유당포함 우유의 △H2 값은 103.7±66.3 ppm에서 유당 제거 우유섭취 후 6.3±4.9 ppm으로 통계적으로 유의한 감소를 보였다(p<0.0001). 유당 제거 우유 섭취 후 총 증상점수 및 개별 증상점수의 유의한 감소를 보였다(p<0.0001).결론: 이번 연구는 한국인 성인에서 유당 제거 우유가 유당포함 우유 섭취 후 발생하는 소화기 증상과 호기수소 생산을 감소시킴을 관찰한 최초의 보고이다. 유당 제거 우유는 유당불내성을 가진 사람에서 일반 우유를 대체하는 데 유효할 것으로 생각한다. Background/Aims: Lactose-free milk (LFM) is available for nutrient supply for those with lactose intolerance (LI). However,there are no consistent results of the efficacy of LFM in LI subjects. We aimed to examine the changes of gastrointestinal (GI) symptoms and hydrogen breath test (HBT) values after ingestion of lactose contained milk (LCM) vs. LFM.Methods: From May 2015 to September 2015, thirty-five healthy adults with history of LCM-induced GI symptoms were recruited at a tertiary hospital. For the diagnosis of LI, HBT with LCM 550 mL (lactose 25 g) was performed every 20 minutes for 3 hours. The test was defined as “positive” when H2 peak exceeded 20 ppm above baseline values (ΔH2>20 ppm). When the subjects are diagnosed as LI, the second HBT using LFM 550 mL (lactose 0 g) was performed 7 days later. Subjects were asked to complete a questionnaire about the occurrence and severity of GI symptoms.Results: Among a total of 35 subjects, 31 were diagnosed with LI at first visit, and their LCM-related symptoms were abdominal pain (98.6%), borborygmus (96.8%), diarrhea (90.3%), and flatus (87.1%). The ΔH2 value in subjects taking LCM (103.7±66.3ppm) significantly decreased to 6.3±4.9 ppm after ingesting LFM (p<0.0001). There were also significant reduction in total symptom scores and the severity of each symptom when LCM was changed to LFM (p<0.0001).Conclusions: This is the first report that LFM reduce LCM-related GI symptoms and H2 production in Korean adults. LFM can be an effective alternative for LCM in adults with LI.(Korean J Gastroenterol 2016;67:22-27)