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증례 : 중심정맥도관 사용과 관련된 Mycobacterium fortuitum에 의한 혈류 감염 1예
하창윤 ( Chang Yoon Ha ),남승현 ( Seung Hyun Nam ),임석아 ( Seok Ah Im ),최희정 ( Hee Jung Choi ),이미애 ( Mi Ae Lee ),윤여준 ( Yeo Jun Yun ),국윤호 ( Yoon Hoh Kook ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-
Atypical mycobacterial infections are increasing, especially such as skin and soft tissue abscess, wound infection, pneumonia, lymphadenitis, and disseminated disease. Atypical mycobacteria could infect immunocompromised patients with more severe bacteremia by central venous catheter. Catheter-related infection often develops due to catheter colonization, hematogenous infection, skin and exit site infection, and infusion-fluid contamination. We experienced a case of catheter-related blood stream infection by Mycobacterium fortuitum. He was 15-year old man with non-Hodgkin`s lymphoma, stage IVb. After 13 days of chemotherapy, he visited our hospital due to fever. M. fortuitum was identified on blood culture, and we used cefoxitin and amikacin for 4 weeks and then change to trimethoprime/sulfamethoxazole. (Korean J Med 69:S994-S998, 2005)
류정화 ( Lyu Jeong Hwa ),하창윤 ( Ha Chang Yun ),오지영 ( O Ji Yeong ),홍영선 ( Hong Yeong Seon ),성연아 ( Seong Yeon A ) 대한내과학회 2003 대한내과학회지 증례 특집호 65-5 부록3 Vol.0 No.-
A 45-year-old woman was admitted with the diagnosis of diabetic ketoacidosis (DKA). During the hospital course, fluctuation of blood pressure accompanying with headache and palpitation was noted. The diagnosis of pheochromocytoma was proven by elevated ur
원발성 비팽대부 십이지장선암: 단일기관에서의 15년간의 경험
유현선 ( Hyun Seon You ),홍정우 ( Jeong Woo Hong ),윤은영 ( Eun Young Yun ),김진주 ( Jin Joo Kim ),이재민 ( Jae Min Lee ),이상수 ( Sang Soo Lee ),김홍준 ( Hong Jun Kim ),하창윤 ( Chang Yoon Ha ),김현진 ( Hyun Jin Kim ),김태효 ( Ta 대한소화기학회 2015 대한소화기학회지 Vol.66 No.4
Background/Aims: Primary non-ampullary duodenal adenocarcinomas (PNADAs) comprise <0.3% of gastrointestinal malignancies. The rarity of PNADA and poorly defined natural history often leads to a delayed correct diagnosis. This study was conducted to evaluate the clinical characteristics of PNADA and to identify its prognostic factors. Methods: Data were collected by retrospectively reviewing the medical records of patients with PNADA managed at Gyeongsang National University Hospital from January 2000 to December 2014. Demographic, clinical, endoscopic, and pathological variables were investigated, and factors related to survival were analyzed. Results: Twenty-seven patients with PNADA were identified, and their median age was 64.9±13.6 years with 16 (59.3%) being male. The majority of patients (25/27, 92.6%) were initially diagnosed during upper endoscopy with biopsies. The tumor was located on the 1st or 2nd portion of duodenum in 92.6% (25/27) of patients. At the time of diagnosis, 85.2% (23/27) had advanced diseases (stage III or IV), 48.2% (13/27) had distant metastasis. Median survival time was 12 months (1-93 months). One and 3-year survival rates were 48.1% and 33.3%, respectively. On multivariable analysis, total bilirubin ≥2 mg/dL (OR, 85.28, 95% CI, 3.77-1,938.79, p=0.005) and distant metastasis (OR, 26.74, 95% CI, 3.13-2,328.14, p=0.003) at the time of diagnosis were independent poor prognostic factors. Conclusions: The majority of patients were diagnosed at an advanced stage. Presence of distant metastasis was independent prognostic factor of PNADA together with elevated total bilirubin. (Korean J Gastroenterol 2015,66:194-201)
증례 : 감염 ; 보존적 치료로 호전된 시력소실을 동반한 급성 A형 간염 1예
임민희 ( Min Hee Lim ),허상택 ( Sang Taek Heo ),김차영 ( Cha Young Kim ),배인규 ( In Gyu Bae ),김재희 ( Jae Hee Kim ),천윤홍 ( Yun Hong Cheon ),하창윤 ( Chang Yoon Ha ) 대한내과학회 2011 대한내과학회지 Vol.80 No.2S
Hepatitis A is usually a mild, self-limiting illness, but in certain cases it can develop into a severe or fatal disease. The most common symptoms of acute hepatitis A virus (HAV) infection are fever, myalgia, nausea, vomiting, jaundice, and abdominal pain. Extrahepatic symptoms are rare, especially neurologic manifestations. We investigated a 34-year-old male who presented after suffering two days of fever, chills and general myalgia. His condition gradually deteriorated and he developed sudden blindness on day nine. This blindness lasted for 20 min and at this point abnormal brain images were observed. Initial tests for immunoglobulin M anti HAV were negative. These tests were repeated, later confirming acute HAV infection. After conservative management, the individual fully recovered. We report this extremely rare acute HAV infection case with metabolic encephalopathy exhibiting transient blindness. (Korean J Med 2011;80:S305-S309)
Sump 증후군에 의한 간농양의 간위루를 통한 자발성 농양배액 1예
황재진,하창윤,장현정,윤은영,주지현,안연정,민현주,김태효,김현진,정운태,이옥재,이선영 이화여자대학교 의과학연구소 2010 EMJ (Ewha medical journal) Vol.33 No.2
A 55-year-old man was admitted to our hospital with symptom of fever, chilling, abdominal discomfort and weight loss for 2months. Abdominal computed tomography(CT) revealed a 5×3.75 cm sized low attenuated lesion in the left lateral segment of liver. Esophagogastrodedodenoscopy showed a fistula with dirty exudates at the fundus and a yellowish stone and food debris at the choledochoduodenostomy site. Endoscopic retrograde cholangiopancreatography (ERCP) was performed and stone and food materials in common bile duct was removed with snare and basket. We experienced a case of liver abscess due to sump syndrome and spontaneous drainage to the stomach.
간세포암종에 대한 간동맥 화학색전술 후 발생한 급성호흡곤란증후군
조윤원,이정미,최자윤,유동훈,차라리,오혜원,김홍준,민현주,김현진,정운태,이옥재,하창윤,이선영 이화여자대학교 의과학연구소 2013 EMJ (Ewha medical journal) Vol.36 No.1
Transcatheter arterial chemoembolization (TACE) has become an effective alternative treatment strategy for patients with inoperable hepatocellular carcinoma (HCC). Although TACE is relatively safe, acute respiratory distress syndrome associated with pulmonary lipiodol embolism is a rare and potentially fatal complication. We report a rare case of acute respiratory distress syndrome after TACE for inoperable HCC. A 75-year-old man, with huge HCC in right lobe, was treated by TACE for the first time. Seven hours after uneventful TACE procedure, he felt dyspneic and his oxygen saturation recorded by pulse oximetry (SpO2) fell to 80% despite of applying non-rebreathing mask. He underwent mechanical ventilation with a protective ventilatory strategy. We experienced a case of acute respiratory distress syndrome after TACE for HCC.
당뇨병 환자의 우울증상과 스트레스 대처방식 : 류마티스 관절염 환자 및 건강 대조군과 비교
심민영,연규월,김하경,김영철,홍영선,이지수,이정희,류정화,하창윤,김지민,성유미,김수인,임원정 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.5
Objectives : This study investigated how diabetes mellitus (DM) and depressive symptoms are related, and differed in terms of coping strategies. In addition, we compared those findings with rheumatoid arthritis (RA) patients. Methods : 80 DM patients, 45 RA patients and 77 healthy subjects completed the Beck depression inventory (BDI) and the Korean version of the ways of coping checklist. Results : BDI scores of depressed DM patients were significantly higher than healthy subjects (p<0.01) but not Significantly with depressed RA patients. Both scores of active (p<0.01) and passive coping (p<0.05) in DM patients were significantly lower than healthy subjects (p<0.01), and the scores of wishful thinking of DM patients were significantly lower than RA patients (p<0.01). BDI scores of DM patients were significantly correlated with the number of complications and the scores of problem-focused coping (p<0.05). In the hierarchical regression analysis, even after controlling for clinical Characteristics, coping strategies altogether could account for 31.0% of the variance of the depressive symptoms in DM patients significantly (p<0.01). Conclusion : DM patients showed significantly higher depression rate than healthy subjects but not than RA patients. In DM patients, insufficient coping strategies could explain substantial portions of depressive symptoms. Therefore, enhancing healthier coping strategies in addition to prevent medical complications might lessen depressive symptoms experienced by DM patients.