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대장내시경에서 궤양의 특성에 따른 베체트 장염의 임상경과
김민철 ( Min Cheul Kim ),신성재 ( Sung Jae Shin ),임선교 ( Sun Gyo Lim ),이경록 ( Kyung Rok Lee ),우학 ( Hak Woo ),최상조 ( Sang Jo Choi ),조정수 ( Jung Soo Jo ),엄중호 ( Jung Ho Eum ),차동엽 ( Dong Youb Cha ),황재철 ( Jae Chul H 대한장연구학회 2010 Intestinal Research Vol.8 No.1
Background/Aims: Intestinal involvement with bleeding and perforation is one of the main causes of morbidity and mortality in patients with Behcet’s disease (BD); however, the clinical course of intestinal BD has not been defined. The aim of this study was to determine the clinical course of intestinal BD based on the characteristics of ulcers visualized during colonoscopy. Methods: We retrospectively reviewed the medical records and colonoscopic findings of 41 patients with intestinal BD. All patients were classified into subgroups according to ulcer depth, size, and number, and we analyzed the clinical manifestations, subset type of BD, medications, surgical procedures, and relapse rate among the subgroups. Results: The median age at the time of diagnosis was 38 years (range, 18-74 years); 25 patients were females (M:F=1:1.56). Abdominal pain (n=40), diarrhea (n=27), and RLQ tenderness (n=21) were common symptoms. The number of complete, incomplete, and suspected types was 3, 17, and 21, respectively. In an analysis according to ulcer depth, the rate of steroid use and intestinal surgeries was more frequent in the deep ulcer group compared with the aphthous and shallow ulcer groups (50.0% vs. 0% vs. 17.6%; P=0.012; 42.9% vs. 0% vs. 23.5%: P=0.013) The rate of steroid use and relapse tended to be higher as the size of the ulcer increased; however, there was no difference in the rates of steroid use, surgeries, and relapse based on the number of intestinal ulcers. Conclusions: The prognosis was worse in patients with intestinal BD who have deeper and larger ulcers. Therefore, we suggest that such patients need to be treated aggressively. (Intest Res 2010;8:40-47)
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고령의 제2형 당뇨병 환자에서 발생한 신장 피막하 농양 1예
권계형,김충현,김성훈,신원용,엄중호,윤진훈,정인수,김병준,안규정 대한당뇨병학회 2001 임상당뇨병 Vol.2 No.2
제2형 당뇨병 환자의 요로 감염 합병증 가운데 드물게 나타나는 신장피막하 농양에 관한 증례를 관찰하였기에 방사선 영상이 진단에 도움이 되고 관혈적 농양 배액술과 항생제의 병합이 치료에 필요하며 추적검사에는 복부 초음파가 효과적이었음을 문헌고찰과 함께 보고하는 바이다. Renal subcapsular abscess is a very rare disease that is defined by a suppurative process localized to a space between the renal capsule and the renal parenchyma. The course and management of subcapsular abscesses have received less attention than those of renal and perlrenal abscesses. We describe a 89-year-old diabetic woman who presented with continuous fever for several days. We initially treated her for urinary tract infection like acute pyelonephritis with secondary generation cephalosporine plus aminoglycoside then recognized abscess formation by ultrasonography. Computed tomography of the abdomen revealed a huge subcapsular abscess. A percutaneous catheter was inserted and left in place for 17 days. Both culture of the pus and urine yielded Klebsiella pneumoniae which was sensitive to used antibiotics. These drugs was administered for 30 days. We changed to Ⅳ antibiotics with oral agent and maintained for 12days. The cystic lesion was disappeared at sonographic follow-up examination. The course and management of this rare disease are presented as a reminder to physicians that renal sucapsular abscess could manifest as fever of unknown origin in a diabetic patient. A high degree of clinical suspicion is required for early diagnosis and treatment in order to achieve a satisfactory outcome.
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박영숙,김성훈,김진욱,이현석,윤진훈,주종은,최일주,신원용,이정돈,권계형,엄중호,한준길 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.6
The survival rate of gastric cancer is mainly affected by lymph node metastasis and depth of invasion. It is now recognized that in early gastric cancer submucosal invasion and lymph node metastasis depend on the size of tumor, A 71-year-old man with epigastric discomfort for 1 month was admitted. Endoscopy showed a huge polypoid tumor with friable and nodular surface occupying the whole lumen of stomach. We suspected a Borrmann type 1 advanced gastric cancer, but we confirmed the gastric cancer confined to only mucosa without lymph node metastasis after operation. So we report a case of huge polypoid early gastric cancer mimicking advanced gastric cancer with a review of relevant literatures.
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