1996년도 제35차 대한소화기학회 추계학술대회 / 포스터 발표 : 위장관 ; 염증성 장질환 환자에서 소장통과 시간

김유선,정준오,정현채,송인성,김정룡 ( You Sun Kim,Jun Oh Jung,Hyun Chae Jung,In Sung Song,Chung Yong Kim ) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.1

급성 악화를 보였던 만성 B형 간염 환자에서의 임상 경과

장은정 ( Eun Jeong Jang ),정준오 ( Jun Oh Jung ),김경아 ( Kyung A Kim ),임영석 ( Young Seok Lim ),김윤준 ( Yoon Jun Kim ),윤정환 ( Jung Hwan Yoon ),이효석 ( Hyo Suk Lee ),김정룡 ( Chung Yong Kim ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-

<목적> 만성 B형 간염환자의 자연경과 도중 환자들은 갑작스러운 간기능의 심한 악화를 경험하게되고 심한 경우는 비대상성 간경변증에서 보일 수 있는 합병증들이 동반된 간 부전의 상태가 되게 된다. 최근 그런 상황에서 일부 선택된 환자에서 항 바이러스제를 사용하면서 간 이식을 기다리는 동안에 간 이식이 필요 없게 된 환자들의 증례를 포함한 좋은 경과를 보여주는 논문들이 발표되고 있다. 그러나 이들 논문들은 환자군의 특성상 정확한 대조군을 두기 어려운 점으로

药用茶关于素材的考察 浅析决明子茶的 护肝 功效研究

김효철(Kim,Hyo-chul)(金曉哲);정준오(Chung,Jun-oh)(郑埈旿) 국제차문화학회 2021 차문화ㆍ산업학 Vol.53 No.-

증례 : 만성 호중구성 백혈병 1예

홍순창 ( Sun Chang Hong ),김지훈 ( Ji Hoon Kim ),이정민 ( Jung Min Lee ),정준오 ( Jun Oh Chung ),김윤권 ( Yun Kwon Kim ),김소연 ( So Yon Kim ),이경인 ( Gyeong In Lee ) 대한내과학회 2006 대한내과학회지 Vol.71 No.3

CNL은 매우 드문 골수증식성 질환이며, 이의 진단 및 치료에 대해 많은 경험이 필요할 것으로 생각된다. 이에 저자들은 WHO 진단기준에 맞는 전형적인 CNL 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative disorder characterized by clonal proliferation of mature neutrophils, hepatosplenomegaly, elevated leukocyte alkaline phosphatase score (ALP score) and a negative Philadelphia chromosome. To date, approximately 150 cases have been reported in the literature, including some cases presenting with a "leukemic" state reflected by a neutrophilic reaction. The term "rue" CNL, recently introduced by Reilly, highlights the need for more experience with CNL cases to improve the diagnostic criteria. In Korea, about 10 cases have been reported in the literature and some of those cases did not meet the WHO diagnostic criteria for CNL. We present a typical case of CNL in a 66-year-old man who complained of general weakness and weight loss. On admission, the white blood cell count from the peripheral blood was 175,600/L with 80% segmented neutrophils. The cytogenic study was negative for the Philadelphia chromosome and had a normal karyotype.(Korean J Med 71:328-332, 2006)

내과 전공의가 시행한 초음파 이용 흉수천자를 포함한 흉수의 진단적 접근

이윤영 ( Yun Young Lee ),최원제 ( Won Je Choi ),유창민 ( Chang Min Yu ),서승오 ( Seong O Suh ),김은실 ( Eun Sil Kim ),안석진 ( Seok Jin Ahn ),정준오 ( Jun Oh Chung ),박상준 ( Sang Joon Park ),김윤권 ( Yun Kwon Kim ),김소연 ( So Yo 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.6

연구배경: 일반적으로 고식적 흉수천자가 어렵다고 판단되는 경우 초음파를 이용한 흉수천자를 영상의학과에 의뢰해 왔다. 영상의학과에 의뢰할 경우 검사를 위해 환자가 직접 이동해야 된다는 불편함과 영상의학과 스케줄에 따라 검사가 지연되거나 비용이 많이 드는 단점이 있다. 이에 저자들은 병실에서 내과 전공의들이 직접 초음파를 이용해서 흉수천자를 시행하는 단계를 포함해서 흉수가 있는 환자에게 접근해보았다. 방 법: 2003년 3월부터 2005년 6월까지 입원한 환자중 흉수가 확인된 환자들을 대상으로 하였고, 흉수의 양이 중등도 이상일 경우에는 고식적 천자를, 흉수의 양이 소량 이거나 소방이 형성된 경우 또는 고식적 천자를 실패 하였을 때에는 초음파를 이용한 천자를 시행하였다. 결 과: 총 89예의 연구대상 가운데 소방의 형성이 없으며 흉수의 양이 대량과 중등도의 양인 79예에서 고식적 흉수천자를 시행하여 74예에서 성공하였다. 고식적 흉수 천자가 실패한 5예와 흉수의 양이 소량인 7예 그리고 소방형성이 있는 3예를 합한 15예에서 초음파를 이용해서 흉수천자를 시행하였고 10예에서 성공하였다(66.7%). 소방이 형성된 3예는 모두 실패하였다. 이 3예를 제외하면 12예 중 10예에서 성공하여 83%의 성공률을 보였다. 2예 (기흉 1예, 혈기흉 1예)에서 합병증이 발생하였다(13.3%). 결 론: 고식적 흉수천자가 실패하였거나 흉수의 양이 소량인 경우, 병실에서 내과 전공의가 초음파를 이용하여 흉수천자를 시행하는 것이 비교적 효과적이고 안전할 것으로 사료된다. 그러나 소방이 형성된 경우에는 영상의학과에 먼저 의뢰하는 것이 좋을 것으로 판단된다. Background: A patient with a pleural effusion that is difficult to safely drain by a blind thoracentesis procedure is generally referred to a radiologist for ultrasound-guided thoracentesis. But such a referral increases the cost and the patient``s inconvenience, and it causes delay in the diagnostic procedures. If ultrasound-guided thoracentesis is performed as a bedside procedure by a medical resident, then this will reduce the previously mentioned problems. So these patients with pleural effusions were treated by medical residents at our medical center, and the procedures included bedside ultrasound-guided thoracenteses. Methods: We studied 89 cases of pleural effusions from March 2003 to June 2005. A blind thoracentesis was performed if the amount of pleural effusion was moderate or large. Bedside ultrasound-guided thoracentesis was performed for small or loculated effusions or for the cases that failed with performing a blind thoracentesis. Results: Blind thoracenteses were performed in 79 cases that had a moderate or large amount of uncomplicated pleural effusions and the success rate was 93.7% (74/79 cases). Ultrasound-guided thoracentesis by the medical residents was performed in 15 cases and the success rate was 66.7% (10/15 cases). The 5 failedcases included all 3 cases with loculated effusions and 2 cases with a small amount of pleural effusion. All the failed cases were referred to one radiologist and they were then successfully treated. If we exclude the 3 cases with loculated pleural effusions, the success rate of ultrasound-guided thoracentesis by the medical residents increased up to 83% (10/12cases). Two cases of complications (1 pneumothorax, 1 hydrohemothorax) occurred during ultrasound-guided thoracentesis. Conclusion: Ultrasound-guided thoracentesis performed as a bedside procedure by a medical resident may be relatively effective and safe. If a patient has a loculated effusion, then it would be better to first refer the patient to a radiologist.

성인의 환상췌장 1예

김유선,장윤석,김지원,김찬규,정준오,황진혁,정현채,송인성,이건욱,김정룡 대한내과학회 1997 대한내과학회지 Vol.53 No.3S

성인에서의 환상췌장은 소화성 궤양이나 췌장염, 또는 간외담관 폐쇄등의 합병증이 없을 경우 대부분 무증상인 경우가 많은 매우 드문 성천성 기형이다. 저자들은 환자가 어렸을 때 바둑알을 먹음으로써 환상췌장에 의한 십이지장의 불완전 폐색을 더욱 심화시켜 비교적 일찍 환상췌장을 진단하고 우회술을 시행한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Annular pancreas is a very rare congenital anomaly which consists of a ring of normal pancreatic tissue around the second portion of the duodenum. The majority of annular pancreas in adults are asymptomatic. The symptoms in adults are due to chronic partial duodenal obstruction. We experienced a case of annular pancreas detected in 22-year old male patient who has complained postprandial abdominal pain with fullness, nausea and vomiting for a long time. We suspected upper gastrointestinal partial obstruction and diagnosed as annular pancreas by radiologic and endoscopic findings. After surgical removal of partial obstruction, patient's nutritional status was much improved. Charicteristically, the coin shaped stone in the second portion of the duodenum which was swallowed in the childhood had aggravated duodenal obstruction. Therefore, we could diagnose this case as annular pancreas preoperatively. We report it with review of the literature.

다발성 림프종양 용종증(Multiple Lymphomatous Polyposis)1예

김지원,송인성,정현채,김철우,김정룡,방영주,차성덕,정준오,김찬규,이진혁,나상훈 대한소화기학회 1998 대한소화기학회지 Vol.31 No.6

Multiple lymphomatous polyposis (MLP) is a rare and unique clinical entity that manifest as multiple polyps occurring throughout the gastrointestinal tract. Unlike MALT-type lymphoma, MLP has a high tendency for extra-intestinsl spread and short mean survival time, The malignant cells of MLP share morphological, immunohistologic and cytogenetic similarity with cells of nodal-based mantle cell lympboma. We report a case of MLP that is presented with multiple polyposis affecting stomach, duodenum, small intestine and colon/rectum.

대장에 생긴 혈관중심성 T 세포 림프종 2 예

김경아,송인성,김철우,박민정,김정룡,신경한,김주성,차성덕,변정식,정준오,이진혁,정현채 대한소화기학회 1999 대한소화기학회지 Vol.33 No.2

Angiocentric T cell lymphoma is characterized by angiocentric and angioinvasive infiltration. The vascular occlusion is usually associated with prominent ischemic necrosis of both tumor cells and normal tissue. Extranodal sites invariably include nose, palate, skin, lung and gastrointestinal tract. In intestinal angiocentric T cell lymphoma, patients present with acute abdominal pain, bloody stool o bowel perforation resulting from ischemic necrosis and have grave prognosis. We report two cases of angiocentric T cell lymphoma involving the colon. In the first case, the patient had the history o polymorphic reticulosis in left nasal cavity six years ago. In the second case, the patient complained of fever and diarrhea, and had splenomegaly. We assume that this is the first case of angiocentric T cell lymphoma involving the colon in Korea. (Kor J Gastroenterol 1999;33:292 - 297)

비스테로이드성 소염제의 장기 복용후 생긴 교원성 대장염 1 예

이동호,김유선,송인성,정현채,정운태,박동영,최규완,김정룡,김병관,문선희,황진혁,정준오,김찬규,김선미 대한내과학회 1997 대한내과학회지 Vol.53 No.4

Collagenous colitis is characterized clinically by chronic watery diarrhea and pathologically by increased subepithelial collagen deposition associated with an inflammatory infiltrate in the lamina propria. Its etiology is still unclear, although a variety of associated diseases such as rheumatic syndromes, scleroderma, and thyroid diseases have been reported. We report a case of collagenous colitis following the prolonged use of NSAIDs. A 72-year-old woman who has taken NSAIDs for many years due to some dermatologic problems was admitted to the hospital because of chronic watery diarrhea and colicky abdominal pain of 3 months duration. There was no abnormal physical finding except cachectic appearance due to weight loss of 10㎏ during 3 months. Stool examination for ova and parasites and fat was negative, and stool culture for bacterial pathogens was negative. In complete blood count, there were relative eosinophila and mild anemia. Total serum protein and albumin was low, and thyroid function, RA factor, FANA were all normal. Results of upper and lower gastrointestinal contrast radiographs were normal. Sigmoidoscopy revealed normal colonic mucosa but she had a thick subepithelial collagenous deposit and chronic inflammation in lamina propria on colonic biopsy. Based on the above findings, she was diagnosed as collagenous colitis. Diarrhea improved after withdrawing NSAIDs and the treatment with oral prednisolone. In the post-treatment biopsy, the thickness of the collagen hand was diminished. Collagenous colitis is now recognized as one of the common causes of chronic diarrhea of obscure origin and NSAIDs may play an etiological role in some patient with collagenous colitis.

궤양성 대장염 환자 및 위절제술을 받은 환자의 소장 통과시간

김태호,이동호,김유선,송인성,정현채,최규완,김정룡,이국래,장동경,정준오,변정식 대한소화기학회 1998 대한소화기학회지 Vol.31 No.4

Background/Aims: Small bowel transit time (orocecal transit time) is an important parameter of intestinal function. The lactulose hydrogen breath test is a relatively simple, sensitive and noninvasive method for measuring orocecal transit time. The small bowel transit time is known to be influenced by many factors such as psychological stress and menstrual cycle. However, it is not obvious how resection or diseases of the stomach and colon affect on small bowel transit time. We compared orocecal transit time of patients with ulcerative colitis and who had received gastrectomy with that of healthy controls. Methods: We investigated orocecal transit time of 18 healthy persons, 12 patients who had received gastrectomy, 11 patients with active ulcerative colitis and 14 patients with inactive ulcerative colitis. After overnight fasting, lactulose 13 g with water 100 cc was ingested. Then, end-expiratory gas was collected every 15 minutes for 4 hours, The amount of hydrogen in the collected gas samples was measured by Trace Gas Analyzer (Quintron^(R)), Results: For normal Korean adults, the mean of orocecal transit time was 95±18.5 minutes (range: 60-135). The orocecal transit time in patients who had received gastrectomy and patients with ulcerative colitis is longer than that of healthy controls (p$lt;0.01). No statistical difference was found between patients with active and inactive ulcerative colitis. However, the orocecal transit time in active stage patients was prolonged by 35 minutes. Conclusions: The lactulose hydrogen breath test is a valuable rnethod to assess orocecal transit time in patients with variable gastrointestinal diseases. The underlying mechanism for these results are unclear, but it is suggested that some regulating factors of gastrointestinal motility are changed due to gastrectomy and inflammation of the colon. Further investigation is needed to elucidate the mechanism of the change of orocecal transit time.