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종례 : 만성내장질환 환자에서 발생한 십이지장 및 공장의 허혈성 장염 1예
김건민 ( Gun Min Kim ),김용철 ( Yong Cheol Kim ),박진민 ( Jin Min Park ),홍석인 ( Seok In Hong ),김진일 ( Jin Ii Kim ),박수헌 ( Soo Heon Park ),김재광 ( Jae Kwang Kim ) 대한내과학회 2012 대한내과학회지 Vol.82 No.6
위장관 허혈은 내장동맥 협착, 혈전 및 저혈류 상태의 혈관수축에 의해 발생한다. 하지만 상부위장관에 동맥협착이 있다고 해도 풍부한 측부순환으로 허혈성 손상은 드물다. 저자들은 구토, 상복통 및 토혈을 주소로 내원한 92세 여자 환자를 경험하였다. 심전도에서 발작성 심방세동을 가지고 있었다. 환자는 상부위장관 내시경에서 십이지장 제2부에 미만성 분절형태의 점막 부종, 홍반 및 출혈을 보였다. 복부 혈관조영 전산화 단층촬영에서 복강동맥과 상장간막동맥의 협착이 있었고 십이지장 제2부의 근위 부부터 공장의 근위부까지 분절형 동심성 비대가 보였다. 환자는 일주일 동안 양전자 펌프 억제제 및 수액치료를 받았다. 추적 상부위장관 내시경에서 이전 검사에 비해 호전된 점막을 관찰할 수 있었다. 결론적으로 십이지장 및 근위부 공장은 혈액순환이 매우 풍부하여서 허혈성 손상이 발생하는 경우는 매우 드물지만 성내장질환을 가지고 있는 환자에서 유발인자로 인해 발생할 수 있다는 사실에 주의해야 한다. Gastrointestinal ischemia happens by splanchnic artery stenosis, thrombus, or physiological vasoconstriction during a low-blood-stream state. However, even if arterial stenosis exists in the upper gastrointestinal tract, ischemic injury is very rare due to rich collateral circulation. The authors experienced 92-year-old female patient with vomiting, epigastric pain, and hematemesis. An electrocardiogram showed paroxysmal atrial fibrillation. The patient had diffuse and segmental mucosal edema, erythema, and hemorrhage in the second part of the duodenum on esophagogastroduodenoscopy (EGD). On abdomen computed-tomography angiography, stenosis of the celiac and superior mesenteric arteries was observed, and segmental concentric wall thickness was seen from the proximal second portion of the duodenum to the proximal jejunum. The patient was treated with PPI and fluid therapy for one week. At follow-up EGD, the mucosa had improved compared with the previous EGD examination. In conclusion, ischemic injury rarely affects the duodenum and jejunum; however, it can develop in the presence of inducing factors.
증례 : 소화기 ; 다발성 용종으로 발현된 변연부 B세포 위 림프종
박진민 ( Jin Min Park ),전은정 ( Eun Jung Jeon ),김용철 ( Yong Cheol Kim ),김건민 ( Gun Min Kim ),이호상 ( Ho Sang Lee ),정대영 ( Dae Young Cheung ),김진일 ( Jin Il Kim ) 대한내과학회 2011 대한내과학회지 Vol.80 No.2S
변연부 B세포 림프종이 위에서 용종의 형태로 나타나는 경우는 매우 드물며 특히 다발성 용종의 형태로 발현된 경우는 보고되지 않았다. 국내에서는 다발성 용종 형태의 원발성 대장 변연부 B세포 림프종이 보고된 적이 있으나, 위에 국한되어 나타난 증례 보고가 없었다. 이에 저자들은 상부위장관 내시경상 다발성 용종 형태 의원발성 변연부 B세포 위 림프종으로 진단된 후 복합항암화 학요법을 시행하여 완전 관해를 이룬 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Marginal zone B-cell lymphoma of the gastrointestinal tract most commonly affects the stomach. Endoscopic findings of primary gastrointestinal lymphoma are various and heterogeneous. Lesions may appear as ulcers, erosions, or erythemas. Gastrointestinal lymphomas presenting as multiple polyps on endoscopy are rare. No case of marginal zone B-cell lymphoma manifesting as multiple polyps has been reported on the stomach, although a few cases have been reported in the colon. We present a rare case of a 77-year-old female patient diagnosed as primary gastric marginal zone B-cell lymphoma presenting as multiple polyps. She was fully treated by combination chemotherapy. (Korean J Med 2011;80:S73-S77)
김용철 ( Yong Cheol Kim ),김건민 ( Gun Min Kim ),이호상 ( Ho Sang Lee ),홍석인 ( Seok In Hong ),정대영 ( Dae Young Cheung ),김진일 ( Jin Il Kim ),박수헌 ( Soo Heon Park ),김재광 ( Jae Kwang Kim ) 대한소화기학회 2010 대한소화기학회지 Vol.56 No.1
A case of hemophagocytic syndrome associated with ulcerative colitis is very rare. A 32-year-old man visited the hospital complaining of fever and severe abdominal pain for 7 days. He was diagnosed to have ulcerative colitis 2 years ago and had been treated with sulfasalazine. Three months ago, he had abdominal pain, weight loss, and hematochezia, so prednisolone and mercaptopurine were added to the treatment. On admission, the physical examination showed splenomegaly. Peripheral blood counts revealed pancytopenia, and bone marrow aspirate smears showed many histiocytes with active hemophagocytosis. There was no evidence of viral and bacterial infections and other neoplasms, which were commonly associated with hemophagocytic syndrome. He was successfully treated with high dose steroid. We report this case along with a review of the related literatures. (Korean J Gastroenterol 2010;56:45-48)
기관지 흉막루를 통해 대량 객혈을 한 만성 팽창성 혈종 1예
전은경 ( Eun Kyoung Jeon ),정문경 ( Mun Kyung Chung ),김건민 ( Gun Min Kim ),강지영 ( Ji Young Kang ),박현진 ( Hyun Jin Park ),김승준 ( Seung Joon Kim ),이숙영 ( Sook Young Lee ),문화식 ( Hwa Sik Moon ),송정섭 ( Jeong Sup Song 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.64 No.1
Cyclosulfamuron과 Pyribenzoxim의 莖葉處理에 따른 논 雜草 防除效果에 관한 硏究
金健敏,金武成,盧泳德 慶熙大學校 1997 論文集 Vol.26 No.-
Experiments were carried out to evaluate weed control performance of Cyclosulfamuron and Pyribenzoxim by foliar application, especially for direct seeded rice. In addition, the combinations of the herbicides and water managements were tested for the improvement of the herbicidal activity. Herbicidal effect of Cyclosulfamuron was excellent for B. tripartita, B, frondosa, fair or fairly good for A. indica, and C. cerotinus, and good for E. crus-galli, L. prostrata, S. juncoides, and A. keisak. Herbicidal effect of Pyribenzoxim was excellent for B. tripartita, B. fonndosa, A. keisak, and A. indica, fairly good for E. crus-galli, L. prostrata and poor for s. juncoides, and C. cerotinus. The foliar treatment of two herbicides were the most effective when irrigated 3 days after treatments. The herbicidal effects became poor when saturated condition was maintained, especially E. crus-galli and S. jucoides. Both Cyclosulfamuron and Pyribenzoxim were very effective for the control of B. tripartita and frondosa even under very low concentrations. But the higher rates of Pyribenzoxim are to be used for the better control of E. crus-galli and L. prostrata. Combination treatments of the two herbicides could extended the weed control spectrum. In addition the combination treatments had some positive effects in controlling L. prostrata, S. juncoides and A. keisak
간염증 및 신장질환을 대상으로 AST, ALT, ALP가 상승한 혈청과 Creatinine, BUN이 상승한 혈청단백 전기영동 분획 비교
김건민 東國專門大學 1998 金龜論叢 Vol.6 No.1
We compared the serum protein electrophoresis patterns in the sera which increased AST, AST, ALT together with the sera increased creatinine and BUN together. The results showed that the albumin fraction is decreased and γ-globulin fraction is increased in sera with high level of AST, ALT, and ALP together. The sera with high concentration of creatinine and BUN together showed increasing α2-globulin fraction, decreasing β-globulin fraction and increasing γ-globulin fraction. The sera with high level of AST, ALT, ALP, creatinine and BUN showed decreasing albumin fraction, increasing α2-globulin fraction, and increasing γ-globulin fraction. These results show that it so important to analyze the concentration of biochemical components in serum and serum protein electrophoresis for diagnosis of liver or kidney disease.