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메티실린 저항성 포도상구균 장염 후 발생한 림프구 장염 1예
배중호 ( Joong Ho Bae ),한동수 ( Dong Soo Han ),박혜선 ( Hye Sun Park ),현일식 ( Yil Sik Hyun ),김태엽 ( Tae Yeob Kim ),은창수 ( Chang Soo Eun ),전용철 ( Yong Cheol Jeon ),손주현 ( Joo Hyun Sohn ) 대한장연구학회 2011 Intestinal Research Vol.9 No.2
Staphylococcus aureus (S. aureus) is occasionally a normal inhabitant of the gastrointestinal tract, and rarely considered a cause of enterocolitis. Methicillin-resistant Staphylococcal enterocolitis may cause persistent diarrhea leading to severe complications and even death, without appropriate treatment. Lymphocytic colitis (LC), a subtype of microscopic colitis, is a relatively common cause of chronic watery diarrhea. We report the case of a 73-year-old woman with profuse watery diarrhea caused by methicillin-resistant S. aureus. Soon after treatment of her enterocolitis with vancomycin the patient`s general condition and symptoms improved, although the diarrhea persisted. Through colonoscopic biopsy and immunohistochemical staining, overt LC was diagnosed, and prompt therapy with budesonide was initiated. (Intest Res 2011;9:139-143)
고영선 ( Young Sun Ko ),유기덕 ( Ki Deok Yoo ),현일식 ( Yil Sik Hyun ),정해룡 ( Hae Ryoung Chung ),박수역 ( Soo Yuk Park ),김선민 ( Sun Min Kim ),전용철 ( Yong Cheol Jeon ) 대한소화기학회 2010 대한소화기학회지 Vol.55 No.3
Hepatitis A virus (HAV) infection is common in developing countries, including Korea. It can be accompanied by extrahepatic complications such as renal failure, arthritis, and vasculitis. Pleural effusion is a very rare complication of HAV infection, which has been reported usually in children, and has benign clinical courses. Here we report a case of pleural effusion with ascites which occurred in an adult hepatitis A patient. A 26-year-old-woman presented generalized myalgia and fever and was diagnosed as acute hepatitis A. Despite of the improvement of laboratory findings, fever and cough persisted. Pleural effusion newly appeared on the serial chest radiologic images. After the fever settled down, the pleural effusion resolved spontaneously at 13th day of admission. (Korean J Gastroenterol 2010;55:198-202)
Clostridium difficile 감염 환자에서의 감염 후 과민성 장 증후군
박혜선 ( Hye Sun Park ),한동수 ( Dong Soo Han ),현일식 ( Yil Sik Hyun ),배중호 ( Joong Ho Bae ),안상봉 ( Sang Bong Ahn ),조현석 ( Hyun Seok Cho ),김태엽 ( Tae Yeob Kim ),은창수 ( Chang Soo Eun ),전용철 ( Yong Cheol Jeon ),손주현 ( 대한장연구학회 2009 Intestinal Research Vol.7 No.2
Background/Aims: Post-infectious irritable bowel syndrome (PI-IBS) frequently follows bacterial enterocolitis, and there are various reported incidences and clinical courses according to different pathogens. However, there have rarely been any reports regarding the PI-IBS caused by Clostridium difficile infection (CDI). The aims of this study were to evaluate the incidence and the risk factors for developing IBS following CDI. Methods: We recruited 86 patients with CDI from January 2005 to October 2007 and also we recruited a comparative control group of 86 patients who had no previous history of any gastroenterological disease. The bowel symptoms were prospectively evaluated by phone through a set questionnaire. Results: Of all the CDI patients, a total of 41 patients (47.6%) completed the questionnaires, and IBS developed in 8 patients (19.5%), of which 7 patients (87.5%) were the diarrhea type. A total of 51 patients (59.3%) from the control group completed the questionnaires, of which 4 patients (7.8%)developed IBS. Although there was no statistically significant difference (p=0.099), there was a tendency towards a higher incidence of developing IBS in the CDI patients group, as compared to that of the control group. Comparing the group that developed IBS with the group that didn’t among the CDI patients, there were no significantly different factors except for a previous admission history before CDI. Conclusions: The incidence of PI-IBS after CDI was 19.5%, and the IBS was predominantly the diarrhea-type. In the future, a large scale study needs to be conducted in order to evaluate the PI-IBS incidence after CDI and the risk factors that predispose patients to such conditions. (Intest Res 2009;7:100-104)
증례 : 소화기 ; 복막암종증으로 오인된 뱀 생식에 의한 스파르가눔증
김윤구 ( Yun Ku Kim ),김명환 ( Myung Hwan Kim ),박한승 ( Han Seoung Park ),장지웅 ( Ji Woong Jang ),현일식 ( Yil Sik Hyun ),김지훈 ( Ji Hun Kim ) 대한내과학회 2012 대한내과학회지 Vol.82 No.3
Sparganosis is a zoonosis caused by sparganum. Humans can be exposed to sparganum by ingesting undercooked snakes or drinking infected copepods harboring sparganum. Sparganosis commonly manifests as migrating subcutaneous masses and may involve multiple organ systems such as the musculoskeletal system, central nervous system, the eyes, and the genitourinary system. We report here a case of laparoscopically confirmed sparganosis caused by ingestion of undercooked snakes. The sparganosis involved the liver and peritoneum and was initially difficult to differentiate from peritoneal carcinomatosis. (Korean J Med 2012;82:331-336)
증례 : 소화기 ; 담낭염 환자에 동반된 간문부에서 기시하는 이중담관 기형 1예
공은정 ( Eun Jeong Gong ),장은경 ( Eun Kyung Jang ),윤용훈 ( Yong Hoon Yoon ),안성희 ( Seong Hee Ahn ),현일식 ( Yil Sik Hyun ),황대욱 ( Dae Wook Hwang ),이성구 ( Sung Koo Lee ) 대한내과학회 2012 대한내과학회지 Vol.82 No.4
Anatomic variation in the hepatobiliary tract is relatively common, although bile duct duplication is rare. Detection of biliary tract variation is important because it is closely related to complications such as cholangitis, cholecystitis, pancreatitis, stone formation, and gastrointestinal tract malignancy. Therefore, preoperative imaging and a high index of suspicion are required to make an accurate diagnosis of a biliary tract anomaly. A 44-year-old woman presented with a 2-year history of epigastric pain after eating a meal and gallbladder sludge with chronic cholecystitis. The presumed diagnosis was gallbladder duplication. However, during surgery it was observed that the tubular structure was parallel with the fissure for the ligamentum venosum and ended at the lesser curvature of the stomach. The pathologic diagnosis was bile duct duplication. We report a case of a unique variant of bile duct duplication arising from the hepatic hilum. (Korean J Med 2012;82:465-469)
변태준,이오영,양선영,박성현,현일식,이항락,한동수,전용철,윤병철,최호순,함준수,이흥우,박문향,임현철 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2
Type I neurofibromatosis (NF-1), first clearly described by von Recklinghausen in 1881, is a dominantly inherited neuroectodermal dysplagia occurring in one of 3,000 births. It is fundamentally characterized by the existence of multiple neurofibromas, 'cafe au lait' spots and Lisch nodules (pigmented hamartomas of the iris). NF-1 may affect the gastrointestinal tract in about 25% of cases. Most NF-1 are located in the jejunum or stomach. In up to 40% of patients, there may be acute or recurrent gastrointestinal bleeding. We report the case of a 36-year-old patient diagnosed as having NF-1 in the stool occult blood test accidentally that was located in ascending colon with a review of literature.