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        원발성 담즙성 경변증 16예의 임상상 : 단일 센터 경험

        박동일(Dong Il Park),고광철(Kwang Cheol Koh),이준혁(Jun Hyek Lee),최문석(Moon Seok Choi),강태욱(Tae Wook Kang),문원(Won Moon),류민규(Min Kyoo Ryu),이용욱(Yong Wook Lee),김지은(Jee Eun Kim),현재근(Jae Geun Hyun),장재권(Jae Kwon Jang) 대한내과학회 2000 대한내과학회지 Vol.59 No.6

        N/A Background : Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease of unknown etiology. The disease is relatively common in western countries, but so far, only about 20 cases have been reported in Korea. Thus, the purpose of our prospective study was to evaluate the clinical characteristics of PBC in Korea. Methods : Between October 1994 and February 1999, 16 patients diagnosed as PBC at our department were enrolled in this study. We analyzed these patients for the distribution of age and sex, initial symptoms and signs, associated disorders, laboratory, endoscopic, and radiologic and histologic findings. Results : Of the 16 patients, the ratio of male to female was 1:7 and the average age was 57.5 years. Pruritus (37.5%) was the most frequent presenting symptom followed by xerostomia and xerophthalmia (12.5%), jaundice (6.3%), chronic fatigue (6.3%), melena (6.3%). Associated disorders were Sj gren's syndrome (25%), arthropathy (12.5%), Raynaud's phenomenon (6.3%) and diabetes (6.3%). Abnormalities of liver function were found frequently. Antimitochondrial antibody (100%), antinuclear antibody (31.25%) and rheumatoid factor (31.25%) were found. Long-term administration of UDCA improved both clinical and biochemical signs in most patients, however, 2 patients experienced exacerbation during UDCA therapy. Conclusions : We experienced 16 cases of PBC within a short period. It is expected that we can find these patients more frequently if we suspect this disease in patients with pruritus and unexplained obstructive pattern of liver function abnormality.(Korean. J. Med 59:634-640, 2000)

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        노인천식에서 천명의 인지

        주재학(Jae Hak Joo),박선혜(Seon Hye Park),서문정(Moon Jeong Seo),박상준(Sang Joon Park),이준혁(Jun Hyek Lee),어수택(Soo Taek Uh),김용훈(Yong Hoon Kim),박춘식(Choon Sik Park) 대한내과학회 2000 대한내과학회지 Vol.59 No.6

        N/A Background : In elderly asthmatics, underdiagnosis is one of the most important feature. The main reason of underdiagnosis is thought to be decreases in complaining of symptoms by reduction of intellectual faculties or physical activity. Among various symptoms, wheezing is the principal clue in diagnosing bronchial asthma, and decreases in wheezing complaints are also noted in elderly asthmatics. The objective of this study is to determine whether decreases in wheezing complaints in elderly asthmatic is due to decrease in the development of wheezing or decrease in the perception of wheezing. Methods : Sixty one young(20-39 years old), 68 middle aged(40-59 years old), and 65 elderly(older than 60 years) stable asthmatic subjects were studied. During methacholine challenge test, lung auscultation and questionnaire survey about presence and perception of wheezing were conducted. Results : One hundred sixty nine patients (87%) developed wheezing during the methacholine challenge test. Development of wheezing during methacholine challenge test was not different between groups. The methacholine concentration, % fall in FEV1, and FEV1% at first detection of wheezing were not different between groups. Among the patients who developed wheezing, 47 patients (90%), 42 patients (74%), and 26 patients (46%) felt wheezing in young, middle, and old age groups, respectively. Conclusion : In conclusion, the perception of wheezing are more decreased in elderly asthmatics compared to those in younger patients.(Korean J Med 59:657-662, 2000)

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