Anisakis Type I 유충에 의한 위 아니사키스증 20예

설상영(Sang Yong Seol),옥승철(Sung Cheul Ok),표지수(Ji Soo Pyo),김인호(In Ho Kim),이상혁(Sang Hyuk Lee),정정명(Jung Myung Chung),최하진(Ha Jin Choi),정승진(Seung Jin Jeong),손운목(Woon Mok Sohn) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.1

N/A Twenty cases of the gastric anisakiasis caused by Anisakis type I larva were found by endo- scopic examination during the period from Sep., 1990 to Oct., 1993 in Pusan. The patients chiefly complained of epigastric pain, nausea and vomiting and recalled they had eaten raw flesh of marine fishes. Followings are the summarized clinical features of cases and the mor- phological characteristics of worms detected. Of 20 cases, the sex ratio of male to female was I to 1.5. In terms of age group, the highest rate of incidence was seen at 30's. A total 13 cases(65. 0%) were infected in the winter season, 5 and 2 ones were in the autumn and spring. The main source of infection might be Astroconger myriaster based on the past history of cases. The onset of symptom after eating causative fish occurred within 12 hours in 15 cases(75.0%). The epigastric pain was experienced in all cases. The most frequently detected site of worm in the stomach was the greater curvature(65.0%) of the body. The endoscopical findings of the gastric mucosa adjacent to worms were edematous, sometimes erosive and hemorrhagic. A total 18 out of 22 detected woms were the 3rd stage larvae of Anisakis type I and the others were the 4th stage ones. From the above results, it was confirmed that numerous cases com- plained the epigastric pain after eating raw fish caused by Anisakis type I larva.(Korean J Gastroenterol 1994; 26 : 1 7-24)

간조직내 HBV precore 변이를 동반한 HbeAg 양성 만성 B 형간염 환자에서의 인터페론 치료효과

이연재(Youn Jae Lee),옥승철(Sung Cheul Ok),이상혁(Sang Hyuk Lee),설상영(Sang Young Seol),정정명(Jung Myung Chung),박영홍(Yeong Hong Park),주남영(Nam Young Joo) 대한내과학회 1998 대한내과학회지 Vol.55 No.1

N/A type, Group 2: mixed) were received 3-6 MU INF three times a week for 4-6 months, We did follow-ups for at least six months(mean : Group 1-11.3, Group 2- 13.7 months). A complete responder was defined as persis- tent(>6 months) normalization of transaminase and loss of HBeAg and/or seroconversion. Results : The HBV precore mutants were found in 15 cases(31.2%) among 48 patients: 7 cases(21.2%) in 33 HBeAg-positive patients and 8 cases(53.396) in 15 HBeAg-negative patients. The HBV precore mutants were more frequently found in HBeAg-negative patients(p= 0.043). Differences in severity of hepatic pathology were not observed in the wild-type versus mutant-type chronic hepatitis B patients(p =1.00). Initial response rate was not significantly different between two Groups(p= 0.228), but complete response rate had a lower tendency in Group 2 (p=0.073). Conclusion : There is a tendency for HBV precore mutants to be less responsive to INF therapy than wild type. Therefore the patients with chronic hepatitis B should be treated as early as possible in natural history of their liver disease before the emergence of HBV precore mutants.

식도 정맥류 출혈에 대한 내시경적 결찰요법의 치료효과

이상혁,정정명,설상영,옥승철,정준용,조길현 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.1

Endoscopic injection sclerotheraphy(EIS) was an effective method for treatment of bleeding esophageal varices. However, it might be associated with some undesirable complications. Endoscopic variceal ligation(EVL) is a recently developed method for control of active variceal bleeding and eradicating esophageal varices with similar efficacy and minimal risk of complications compare to EIS. We performed EVL in 40 patients who had recently bled from esophageal varices. Total 198 variceal ligations were performed during 64 separate EVL session. Control rate of acute bleeding was 90%(36 of 40patients) and 4 patients died after EVL because of failure of bleeding control. Rebleeding following initiation of EVL occured in 5 patients-three patients were successfully controlled by EVL, one patient was controlled but eradication was impossible and one patient died. Varices were eradicated or reduced to grade I in 31(86.1% ) of 36 survivors by 1-9 ligation(mean 5.0) in l-4 EVL sessions(mean 1.6). After EVL, there were mild complications-mild substernal discomfort in 4 patients, mild dysphagia in 2 patients and fever in 2 patients. These results suggest that EVL is a safe and effective method for treatment of bleeding and eradication of esophageal varices with less complication.

대장 흑피증 5례의 임상 분석

김규환,옥승철,이영민,임대건,이상혁,설상영,정정명,최하진 인제대학교 1995 仁濟醫學 Vol.16 No.2

대장 흑피증은 매우 드문 질환으로 anthraquinone 제제의 지속적인 복용과 관련되어 있다고 알려져 있는데 저자 등은 본원에서 대장 내시경을 통한 조직검사나 수술을 통해 확진된 대장 흑피증 환자 5명을 대상으로 그 임상적 특징을 관찰하고 문헌 고찰과 함께 보고하는 바이다. Melanosis coli is the brownish black pigmentation of the colon associated with prolonged ingestion of anthraquinone compounds as laxatives. This condition is so rare that a few cases have been reported in Korea and its pathophysiology has not been understood clearly Many studies have suggested that the brownish discoloration of the colon mucosa is due to accumulation of macrophage containing lipofuscin pigment. We report 5 cases of melanosis coli histologically confirmed by colonoscopic biopsy or by operation from January, 1992 to September, 1994 in this hospital with a review of the literature.

급성 골수성 백혈병에 동반된 심낭삼출 1례

구대식,옥승철,김양욱,김동수,손창학 인제대학교 1993 仁濟醫學 Vol.14 No.4

급성 백혈병에서의 심낭침윤은 국내에서는 비교적 드문질환으로, 급성 골수성 백혈병에서 심낭천자를 통해 백혈병세포 침윤성 심낭삼출을 확인한 1례를 경험하였기에 이에 보고하고자 한다. Leukemic infiltration of heart and its investing membrances were not uncommon among the patients with acute leukemia. But, clinically early detection of such abnormlities is difficult since it would be obscured by symptomatology. So, most studies of leukemic pericardial involvement have been from postmortem period. In addition, the information for adequate management and prognosis is limited. We experienced a case of acute myeloid leukemia with pericardial effusion in 39 years old female patient complaining exertional dyspnea, general weakness and fatigue for one month. Examination showed her to be acutely ill with both engorged neck veins. The chest x-ray and echocardiography showed the pleural effusion and large amount of pericardial effusion. The pericardiocentesis was performed and aspiration cytology of pericardial fluid showed abundant leukemic blast cells. The two cycles of induction chemotherapy with Ara-C, daunorubicin, VP-16 brought out complete remission. But, leukemia and pericardial effusion were relapsed after four months and died due to sepsis despite of aggressive treatment.

십이지장의 Brunner`s Gland 선종 4예

오경석,이상혁,김환태,정정명,설상영,옥승철,구대식,조현대 대한소화기내시경학회 1994 Clinical Endoscopy Vol.14 No.1

Brunners gland adenoma is a benign epithelial tumor of the duodenum originating from submucosal Brunners gland. This is an extremely rare entity that account for only 10.6% of benign duodenal tumor, which are themselves relatively rare, representing 0.008% of all surgical and autopsy specimens. The clinical manifestation are nonspecific gastrointestinal complaints, such as bloating or epigastric pain, and the tumor gives rise to melena or anemia, due to the ulceration or erosion of the tumor. The diagnosis is usually made by radiologic studies and gastroduodenal endoscopy which can also provide definitive treatment. The aim of treatment is complete removal of the lesion and exclude malignancy. We report on 4 cases of Brunners gland adenoma which was confirmed by operation or endoscopic polypectomy.

이식신 제거후 발생한 장모균증 1 예

김호철,김인호,주종수,이연재,주종은,옥승철,김영훈,최봉기 대한내과학회 1996 대한내과학회지 Vol.50 No.2

Mucormycosis is a rare disease caused by fungi of the Group Phycomycetes. The Mucoraceae are ubiquitous fungi and are common inhabitants of decaying matter. They are pathogenic mostly in opportunistic situations, as diabetes, leukemias, chronic renal failure and immunocompromised patients, are acute and rapidly fatal. Intestinal mucormycosis is rare type of mucormycosis. We report an unusual case of a 56-year-old female patient with end stage renal disease complicated by intestinal mucormycosis. The patient presented with peritonitis during CAPD after resection of transplanted kideny by large amount of bleeding and was diagnosed by histopathologic finding of resected colon the fungal hyphe was non-septated with large diameter and branching at right angle in the mesenteric adipose tissue.