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증례 : 소화기 ; Oseltamivir에 의해 유발된 급성 출혈성 대장염 1예
정덕원 ( Duk Won Chung ),손혁수 ( Hyuk Su Son ),박재형 ( Jae Hyung Park ),정민규 ( Min Kyu Jung ),전성우 ( Seong Woo Jeon ),조창민 ( Chang Min Cho ),김성국 ( Sung Kook Kim ) 대한내과학회 2011 대한내과학회지 Vol.80 No.2S
신종 인플루엔자의 대유행과 함께 치료의 중요성이 인식 되었고 치료제로 널리 처방된 oseltamivir이 드물지만 급성출혈성 장염을 유발할 수 있다. 현재까지 국내 증례보고는 없는 상태로 저자들은 치료 및 화학적 예방요법으로 권장되는 oseltamivir (Tamiflu(R))를 복용한 환자에서 출혈성 장염의 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Oseltamivir is a potent selective neuraminidase enzyme inhibitor and effective against nearly all strains of influenza A and B. The importance of treating influenza has been recognized, and oseltamivir has been prescribed frequently at the onset of the H1N1 influenza A pandemic this year. However, oseltamivir can cause hemorrhagic colitis as a rare adverse effect. Until now, only two cases of hemorrhagic colitis following the use of oseltamivir have been reported in Japan, and none have been reported in Korea. We report a case of acute hemorrhagic colitis in a 15-year-old boy after the oral administration of oseltamivir for swine originating influenza A. (Korean J Med 2011;80:S87-S90)
증례 : 감염 ; 에이즈 환자에서 발생한 위장 카포시 육종 1예
정덕원 ( Duk Won Chung ),장현하 ( Hyun Ha Chang ),황희영 ( Hee Young Hwang ),김혜인 ( Hye In Kim ),박가영 ( Ga Young Park ),김신우 ( Shin Woo Kim ),이종명 ( Jong Myung Lee ) 대한내과학회 2009 대한내과학회지 Vol.77 No.3
AIDS 관련 카포시 육종은 AIDS 및 면역억제 장기이식 환자의 증가와 함께 이전에 비해 드물지 않게 볼 수 있는 질환으로 병기 및 환자의 임상경과에 따라 치료를 선택하게 된다. 저자들은 AIDS 환자에서 발생한 위장 카포시 육종 환자에서 항레트로바이러스 치료 및 인터페론 알파로 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Kaposi sarcoma in acquired immunodeficiency syndrome (AIDS) is rarely seen in Korea and the incidence has declined in the era of highly active antiretroviral therapy (HAART). Visceral involvement in patients having AIDS with Kaposi sarcoma is more common than in patients infected with non-human immunodeficiency virus. Visceral involvement may be asymptomatic and usually does not require specific therapy. Chemotherapy is usually used in symptomatic or rapidly progressive disease, and interferon-alpha can be applied as an alternative treatment option. Compared to cutaneous Kaposi sarcoma in AIDS, only three cases of gastrointestinal Kaposi sarcoma in patients with AIDS have been reported in Korea, and no experience with interferon therapy for AIDS-associated visceral Kaposi sarcoma has been reported. We report a case of gastrointestinal Kaposi sarcoma in a patient with AIDS who had combined treatment with interferon-alpha and HAART. (Korean J Med 77:371-376, 2009)
엄석현 ( Seok Hyeon Eom ),박창환 ( Chang Hwan Park ),정덕원 ( Duk Won Chung ),이상혁 ( Sang Hyeok Lee ),서지영 ( Ji Young Seo ),김영성 ( Yeong Sung Kim ),곽동협 ( Dong Hyup Kwak ),김정희 ( Jung Hee Kim ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.2
Heterotopic bone formation in the gastrointestinal tract is a rare phenomenon. Most reported cases were associated with benign and malignant neoplasms, except for a case in which heterotopic bone formation was found in a patient with Barrett`s esophagus. The exact pathogenesis of the disease has not yet been established. However, most heterotopic bones found in the gastrointestinal tract were associated with mucinproducing tumors of the appendix, colon, and rectum. Inflammation may also play a role in osseous metaplasia in a case with bone formation at the base of an ulcer in Barrett`s esophagus. Here, we report on a patient with heterotopic bone formation in normal gastric cardiac mucosa. A 50-year-old female visited our hospital for a routine health examination. She had no gastrointestinal symptoms, and her physical examination, blood test, X-ray, urine, and stool examination results were normal. A 0.3 cm sized polypoid lesion located just below the squamocolumnar junction was observed on upper gastrointestinal endoscopy. A piece of biopsy was taken. Histologically, a lamella bone trabecula and chronic inflammatory cells were observed in the gastric cardiac mucosa. The follow-up endoscopy performed one month later showed no residual lesion.
증례 : 소화기 ; Propofol을 사용한 수면내시경 후 발생한 아나필락시스 1예
김성국 ( Sung Kook Kim ),김성욱 ( Sung Uk Kim ),정인권 ( In Kwon Chung ),전성우 ( Seong Woo Jeon ),정민규 ( Min Kyu Jung ),손종원 ( Jong Won Sohn ),정덕원 ( Duk Won Jung ) 대한내과학회 2010 대한내과학회지 Vol.79 No.5
프로포폴은 수면내시경 검사 시행 시 진정유도를 위해 널리 쓰이는 약제로 이로 인한 호흡계 및 순환계 억제에 대해서는 잘 알려져 있으나 아나필락시스는 드물다. 저자들은 약제에 대한 알레르기의 병력이 없는 환자에서 프로포폴을 사용한 수면내시경 후 피부발진, 소양감, 호흡곤란 및 저혈압등의 증상이 발생한 1예를 경험하였다. 피부단자시험이나 혈청 특이 IgE 항체를 측정하지 못하였으나, 다른 약제나 라텍스 장갑의 사용 없이 프로포폴 단독 투여 후 발생하여 프로포폴 유발성 아나필락시스로 진단하였고, 이를 문헌고찰과 함께 보고하는 바이다. Propofol is widely used for sedation during endoscopy. Hemodynamic compromise and respiratory depression might occur under propofol sedation, whereas anaphylaxis is rare. We recently experienced this rare side effect. A 71-year-old woman suffering from substernal chest discomfort underwent endoscopic examination under propofol sedation. She denied any history of allergic reaction to drugs or foods such as beans and eggs. After completion of the endoscopic examination, she developed a whole-body rash with pruritus and edema of her face, including the eyelids and lips. Hypotension was seen on physical examination, and her oxygen saturation was decreased on pulse oximetry. She recovered completely after treatment with epinephrine, an antihistamine, and steroids, with supportive care. Anaphylaxis to propofol is a rare side effect, and prompt treatment is mandatory when it develops. (Korean J Med 79:549-552, 2010)
원위부 총담관 결석으로 오인된 결석을 동반한 총담관류 치료
곽태영 ( Tae Young Kwak ),박창환 ( Chang Hwan Park ),엄석현 ( Seok Hyeon Eom ),황홍석 ( Hong Suk Hwang ),정덕원 ( Duk Won Chung ),서지영 ( Ji Young Seo ),김영성 ( Yeong Sung Kim ),곽동협 ( Dong Hyup Kwak ) 영남대학교 의과대학 2015 Yeungnam University Journal of Medicine Vol.32 No.1
A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors’ hospital due to cholangitis and pancreatitis. The patient``s condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.
기관지천식 환자에서 Interleukin (IL)-13 유전자 다형성
김건우 ( Gun Woo Kim ),손자영 ( Ja Young Son ),최은정 ( Eun Jung Choi ),신재대 ( Jae Dae Shin ),이응갑 ( Eung Kab Lee ),정덕원 ( Duk Won Chung ),이종명 ( Jong Myung Lee ),김능수 ( Nung Soo Kim ) 대한천식알레르기학회 2006 천식 및 알레르기 Vol.26 No.4
Background: Asthma is characterized by airway hyperresponsiveness, eosinophilic inflammation, airway mucus hypersecretion, and elevated serum immunoglobulin E (IgE). IL-13 is an important cytokine in the pathogenesis of asthma through the production of IgE, stimulation of bronchial epithelial mucus production, and smooth muscle hyperreactivity. Previous studies have shown that the polymorphisms in IL-13 gene are associated with asthma, atopy, or total IgE. Objective: We investigate whether the polymorphism Arg 110Gln within the IL-13 gene is associated with asthma, atopy, serum total IgE, asthma severity and airway hyperresponsiveness in adult asthma. Method: One hundred fifty-five asthmatic adults and 147 non-asthmatic healthy adults were enrolled. Asthma phenotype and bronchial responsiveness to methacholine were determined by the same physician. IL-13 Arg110Gln polymorphism was genotyped using PCR-RFLP assay. Result: Genotype frequency of IL-13 Arg110Gln polymorphism was significantly different between asthmatic patients (P=0.021), especially between atopic asthma (P=0.024) and controls, and was associated with elevated levels of serum total IgE (P=0.009), asthma severity (P=0.026), pulmonary function (P=0.017), and airway hyperresponsiveness (P=0.025) in patients with asthma. Conclusion: IL-13 Gln110 variant may be an asthma susceptibility gene in Korean adults. In addition, IL-13 Gln110 variant is associated with elevated levels of serum total IgE and severity of asthma. (Korean J Asthma Allergy Clin Immunol 2006;26:302-309)