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이창구(Chang Goo lee),김종수(Jong Su Kim),최은석(Eun Suk Choi),전무련(Mu Ryeun Jeun),추성욱(Sung Uk Chu),허충(Chung Hur),이진관(Jin Kwan Lee) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.2
N/A Background/Aims: Parenteral exposure, such as transfusion, drug abuse, needle stick injury, tatooing, hemodialysis and transplantation, is well documented as the major route of transmission. But about half of hepatitis C virus(HCV) carriers have no previous history of parenteral infection. Therefore, other possible routes of the spread should be evaluated. The possibility of intrafomilial transmission of HCV was considered to be low as compared to that of hepatitis B virus(HBV), but recent publications from Japan and Europe elicit the interest in intrafamilial transrmission, especially in spousal transmission. The aim of this study is to investigate the possibility of spousal transmission of HCV. Methods: We analyzed clinical features, serum transaminase and anti-HCV in 56 spouses who got married to anti-HCV positive patients. The mean age in index cases was 44.7 years, 45.6 in male and 43.2 in female and that of spouses was 42.4 yenrs, 45.7 in male and 40.7 in female. The mean duration of marriage was 20,0 years, distributed from 1 to 50. Index cases included 8 asymptomatic carriers, 44 chronic hepatitis, 3 liver cirrhosis and 1 hepatoma. Four of those had previous history of blood transfusion. Results: Among 56 spouses, anti-HCV was detected in 9 cases representing 16.1%. Four of those were clinically asymptomatic carriers and remaining 5 had chronic hepatitis. The mean age in index cases of anti-HCV positive spouses was 56 years old and was older than that of anti-HCV negative spouses 42.6(P<0.01). The mean duration of marriage in index cases of anti-HCV positive spouses was 30,9 years and was longer than that of anti-HCV negative spouses 18.0(P<0.05). Conclusions: This study revealed higher prevalence of anti-HCV in spouses who got married to anti-HCV positive carriers compared to that of general population. As the duration of marriage was getting longer, the frequency of anti-HCV in spouses increased(P<0.01). These results suggest that the spouses of anti-HCV positive carriers could be a high risk group for HCV transmission. (Korean J Gastroenterol 1997; 29:207 - 213)
조삼권(Sam Kwon Cho),정영호(Young Ho Jeung),이창익(Chang Ik Lee),황만근(Man Keun Whang),김정훈(Jeung Hun Kim),김동욱(Dong Wuk Kim),허충(Chung Hur),이진관(Jin Kwan Lee) 대한소화기학회 2001 대한소화기학회지 Vol.38 No.3
Benign and malignant tumors are rarely encountered in the small intestine. Moreover, small bowel metastases arising from the lung carcinoma are very unusual. They often present as intestinal perforation and show a poor prognosis. We report a case of jejunal metastasis from sqamous cell carcinoma of the lung. The patient of this case complained of abrupt epigastric pain and vomiting. On phyical examination, we found whole abdominal tenderness and rebound tenderness. The free air was detected on chest radiography. Abdominal exploration confirmed multiple metastases on the jejunum and the liver, and revealed squamous cell carcinoma on the resection segment of the jejunum. The patient was discharged 9 days after palliative surgery without serious complication and died 2 months later. We report the case of small bowel metastasis from primary squamous cell carcinoma of the lung. (Korean J Gastroenterol 2001;38:211-214)
종합검진상 발견된 C형 간염 항체 양성자의 추적과 HCV RNA 검출율
이진관(Jin Kwan Lee),김정철(Jung Chul Kim),정정희(Jung Hee Jung),이창구(Chang Goo lee),최형경(Hyeong Kyoeng Choi),손석호(Suk Ho Sohn),조욱현(Wook Hyun Cho),허충(Chung Hur) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6
N/A Follow up study and HCV RNA test by PCR was performed on the 26 asymptomatic subjects with anti-HCV found in routine health check. Among the 26 sugjects, 16 have persistently normal ALT level and 10 abnormal ALT level. In 6 subjects, anti-HCV turned to be negative on follow up test and among those, 5 have normal ALT level and one abnormal ALT level. 15 subjects with normal ALT level have HCV RNA and those subjects were assumed to be asymptomatic hepatitis C carrier. HCV RNA was positive in 8 out of 10 subjects with abnormal ALT level. In conclusion, 23 out of 26 asymptomatic subjects with anti-HCV have HCV-RNA and among them 15 with normal ALT level were assumed to be asymptomatic hepatitis C carrier.
추성욱(Sung Wook Choo),이재욱(Jae Wook Lee),이장규(Jang Kyu Lee),김성준(Sung Jun Kim),이덕영(Duck Young Lee),박경현(Gyeng Hyen Park),허충(Chung Hur),이진관(Jin Kwan Lee) 대한내과학회 1998 대한내과학회지 Vol.54 No.5
N/A Background: Primary epiploic appendagitis is rarely diagnosed preoperatively and usually results from torsion with subsequent infarction epiploic appendage. Until recent years no diagnostic procedures or clinical symptoms were pathognomic for this disease and the most common pre-operative diagnosis were acute diverticulitis and appendicitis. Rapid advance of imaging technique, especially ultrasound, makes it possible to get image of diseased epiploic appandage. Also primary epiploic appendagitis occurs more frequently than it has been suggested in the literature. Therefore authors analyzed and reviewed clinical features and radiological findings of 15 cases with primary epiploic appen4agitis to give attention to the acute epiploic appendagitis as one of the ways for diagnosing the acute abdominal pain that has unclear diagnosis, thinking that the rapid diagnosis will helpful to escaping the unnecessary operations. Methods: This study included twelve men and three women (aged 20-60years). Surgery was done in two patients, one misdiagnosed for acute appendicitis and another for acute diverticulitis with abscess. Follow up examinations were performed with US and CT (n=3), with US, CT and MHI (n-2) and with clinical course (n=13). Results: All patients had localized abdominal pain and tenderness, mostly in the left lower quadrants (n=12). Duration of pain was 3.3 days (1-15days). Two patients had mild fever and two patients had nausea. Leukocytosis was found in four patients. In all cases US revealed a solid hyperechoic (n=13) or isoechoic (n=2) non-compressible ovoid mass with hypoechoic rim The masses were located under the site of maximum tenderness. CT and MRI finding were compatible with US. Conclusion: Primary epiploic appendagitis can be diagnosed pre-operatively using recent imaging technique, and US finding is fairly characteristic. This disorder is not so rare entity as previously known and must be included in the differential diagnosis of acute unexplained abdominal pain in adults.
상부 위장관 내시경 검사 시 전처치로서의 Propofol의 효과
정영호,최정일,이진관,나인균,허충,조종대,정수룡,조삼권 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.3
Background/Aims: Benzodiazepine is generally used when sedation is required for endoscopy, while propofol, a phenol-derived intravenous anesthetic agent, appears to have a more suitable phamacokinetic profile. The aim of this study was to evaluate the effectiveness and safety of propofol as premedication for upper gastrointestinal endoscopy. Methods: Between July 1998 and October 1998, 44 male patients and 70 female patients were involved in this study. The relative ease of upper gastrointestinal endoscopy, patient's tolerance, and amnestic effects on 64 patients with propofol was compared with 50 patients with non-sedation. Pulse rate and arterial oxygen saturation was monitored. The endoscopist and patients replied to a questionnaire. Results: Patients receiving propofol tolerated endoscopy much more than patients with non-sedation (p<0.01). The change in pulse rate was less variable but arterial oxygen saturation showed a statistically significant decrease in patients receiving propofol (p<0.01). Propofoinduced complete amnesia in 93.7% of the patients and partial anesthesia in 4.7%. Most of the patients receiving propofol accepted the same sedative methods in their next endoscopy (p<0.01). Conclusions: Propofol is highly effective, with a short recovery time and satisfaction of the patients, but careful monitoring is recommended because of its untoward effect of hypoxia. It is recommended that propofol be used as a premedication especially in patients who are apprehensive about a repeated endoscopy.
전혈을 이용한 Helicobacter pylori 검사의 유용성
이진관,허충 대한소화기학회 1998 대한소화기학회지 Vol.32 No.4
Background/Aims: Whole blood test (WBT) was introduced as one of the effective methods for the detection of H. pylori infection in the primary office setting, To evaluate the usefulness of this method in local clinical application, this study was performed. Methods: A prospective trial of WBT using BM-test Helicobacter pylori kit was carried out in 80 cases: 24 patients with duodenal ulcer, 12 patients with gastric ulcer, 7 patients with combined ulcer, 32 patients with gastritis, 1 patient with gastric cancer, 1 patient with gastric polyp, and 3 patients without significant abnormalities. For 51 selected cases among them, rapid blood test (RBT) by chromatographic immunoassay using One-step H. pylori test kit was also conducted. Warthin-Starry silver stain and rapid urease test were conducted as the standard. Results: In 80 patients examined, 46 were H. pylori positive by WBT. However, in urease test, 62 were H. pylori positive. Forty patients out of 51 tested by RBT were H. pylori positive. The sensitivity and specificity of WBT were 63.1% and 73.3%, respectively. On the other hand, those of RBT were 84.4% and 66.7%, respectively. Conclusions: The WBT is a convenient noninvasive method. It is also easy, rapid, and inexpensive. However, this method is not appropriate for the clinical setting of Korea due to its poor sensitivity and specificity.