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원저 : 기계환기중인 환자에서 기관지내시경 검사에 따른 생리적 변화
편유장 ( Yu Jang Pyun ),서지영 ( Gee Young Suh ),고원중 ( Won Jung Koh ),유창민 ( Chang Min Yu ),전경만 ( Kyeong Man Jeon ),전익수 ( Ik Soo Jeon ),함형석 ( Hyoung Suk Ham ),강은해 ( Eun Hae Kang ),정만표 ( Man Pyo Chung ),김호중 ( 대한결핵 및 호흡기학회 2004 Tuberculosis and Respiratory Diseases Vol.56 No.5
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2003년 경상북도 예천군의 수의사에서 발생한 브루셀라증 1예
임현술,편유장,유영순 東國大學校醫學硏究所 2004 東國醫學 Vol.11 No.2
브루셀라증(brocellosis)은 전 세계적으로 발생하는 인수공통감염증으로 소 등의 가축을 취급하는 직업인에게 주로 발생하는 직업병의 일종으로, 우리나라에서는 2000년부터 제3군 법정전염병으로 분류하여 관리하고 있다. 저자들은 경북 예천군에서 35년간 가축병원을 운영하고 있는 58세 남자 수의사에서2003년 브루셀라증이 발생하였기에 문헌고찰과 함께 보고하는 바이다. 환자는 2003년 5월 10일 발열, 오한, 두통 및 관절통 등이 있어 개인의원을 방문하여 투약을 하였으나 호전이 되지 않았고, 지역 병원에서 입원 치료를 받던 중 6월 29일 서울에 소재한 대학병원으로 후송되었다. 환자의 혈액검체를 국립보건원에 의뢰하여 시행한 표준시험관응집시험에서 브루셀라 항체가는 1:640 역가에서 양성이었고, 혈액배양에서는 그람음성 간균인 Brucella abortus가 분리 동정되었다. 이 환자에서 브루셀라 감염경로는 2003년 4월경 피부에 상처가 있는 상태로 가축을 진료한 적이 있었는데, 제왕절개술을 하는 도중 손에 상처가 생겨도 상처 치료를 하지 않고 분만을 받는 일을 계속 진행하였으므로 가축의 분만을 돕는 일을 하면서 상처나 호흡기를 통하여 감염되었을 것으로 추정하였다. 우리나라에서는 가축 브루셀라증이 간헐적으로 보고되던 것이 1984년 이후 브루셀라 감염이 제주도를 중심으로 소에서 매년 증가하였고 최근 전국적으로 확산되고 있는 추세이므로, 소를 취급하는 수의사나 축산업자에서 브루셀라증이 발생할 가능성이 높다. 따라서 가축과 사람을 대상으로 브루셀라증에 대한 감시체계를 운영하고 고위험군에 대하여 보건 교육을 철저히 하여야 할 것이다. Brucellosis is a zoonosis caused by Brucella. abortus, B. melitensis, B. suis and B. canis. Brucellosis has been an emerging disease since the discovery of B. melitensis by Bruce in 1887. Worldwide, brucellosis remains a major source of disease in humans and domesticated animals. Although reported incidence and prevalence of the disease vary widely from country to country, bovine brucellosis caused mainly by B. abortus is still the most widespread form. In Korea, bovine brucellosis have been occurred. The vaccination for Brucella was done an cows in 1998 after the intervention of the first preventive vaccination. After inoculation, Brucella occurred in a group of cows. And then the first human case occurred in 2002, and then 16 cases in 2003 by B. abortus. We report a case of human brucellosis occurred in a veterinarian. He is a 58-year-old male who has worked for 35 years from 1968 to 2003. We reviewed his clinical features and job contents. Physicians and veterinarians must be concerned about specific environments and clinical patterns of brucellosis. They must make efforts to recognize, evaluate and control the zoonotic diseases.
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박창영,손정일,김명숙,심대중,전우규,이상종,김병익,편유장,정을순 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.6
Collagenous colitis was first described by Lindstrom in 1976. Now this disorder is recognized as one of the more common causes of chronic diarrhea of obscure origin. This disorder is described as a disease of colon associated with chronic watery diarrhea and the typical histologic findings of a thickened subepithelial collagenous band. But in korea a few cases have been reported. We had observed a 52-year-old businessman with chronic watery diarrhea without abdominal pain in the past. And then we had reported previously that case. We also recently observed a 42-year-old housewife with chronic watery diarrhea with lower abdominal discomfort for 10 years. Colonoscopy disclosed no gross abnormalities through the entire colon ineluding the terminal ileum but we could find the pronounced thickening of subepithelial collageous band and chronic inflammation in the lamina propria in the histologic examination. We summarized the above two cases of collagenous colitis with a review of literatures.
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연령과 성별에 따른 대장 및 직장암의 분포 변화에 대한 관찰
박창영,이희무,이만호,조용균,전우규,이상종,김병익,최윤상,김명숙,성기철,편유장 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.6
Background/Aims: Changes in subsite distribution of colorectal cancer have been shown in recent years. The carcinoma tend to shift to more proximal colon and this proximal shift is influenced by age and sex. This study was designed to delineate the relationship of age to subsite incidence of colorectal cancer and to define the role of gender in this difference. Method: We have analyzed the data by patients with colorectal cancer from 1985 to 1995 for elucidate the relationships between age, sex and prinmry location of colorectal cancer. 749 patients(male 454, female 295) were diagnosed of colorectal cancer performed by colonoscopy and/or sigmoidoeopy were divided into three groups by their location of cancer (Right colon: appendix, ascending colon, hepatic flexure, T-colon proximal 2/3 Left colon: T-colon distal 1/3, splenic flexure, descending colon, sigmoid colon Rectum: rectum). Result: 1) The mean age of all patients was 53.84±13.11 (yr). Mean ages of Right colon, Left colon, and Rectal cancer group were 55.54±14.12, 55.32±12.51, 52.22±13.09 (yr), respectively. The mean age of Right colon and Left colon cancer group is significantly older than that of Rectal cancer group (p=0.0040, p=0.0042). 2) In female age group over 56, mean age of Right colon cancer group is shown to be 3.35 and 4.82 years older than Left colon cancer group and Rectal cancer group, respectively (p=0.0062, p=0.0053) and Colon cancer tend to develop on more right side according to increase in age. 3) Above correlation was not observed below 55 of both sexes and male age group over 56. 4) No significant differences in histological differentiation and tumor stage were observed among the three groups. 5) The study was conducted to evaluate the difference in the locator of colorectal cancer between two following groups ; The first group diagnosed from 1985 to 1990 and the second group from 1991 to 199s, yet significant statistical difference was not observed. Conclusion: Age increase seems to show correlation with right shifting of colon cancer, and this correlation was most significant in old women age group. This fording suggests unknown factor strongly linked to age and sex might play important role in carcinogenesis of colorectal cancer.
ScienceON
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