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- 저자 : 이충훤 ( Lee Chung Hwon ) (검색결과 5 건)
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소아용 대장내시경을 이용한 소장내시경 검사로 진단한 원발 공장 선암종 1예
이충훤 ( Chung Hwon Lee ),김범수 ( Pum Soo Kim ),이정일 ( Jung Il Lee ),정석 ( Seok Jeong ),이진우 ( Jin Woo Lee ),권계숙 ( Kye Sook Kwon ),이돈행 ( Don Haeng Lee ),김형길 ( Hyung Gil Kim ),신용운 ( Yong Woon Shin ),김영수 ( Youn 대한소화기학회 2006 대한소화기학회지 Vol.48 No.5
A 39-year-old man presented with dizziness and melena for 2 months. Abdominal CT scan showed constrictive wall thickening with enhancement and proximal loop dilatation of the jejunum. On endoscopic examination, there was large amount of bile stained fluid in duodenum. Enteroscopy using pediatric colonoscope demonstrated an encircling mass with obstruction approximately 20㎝ distal to the ligament of Treitz. Endoscopic jejunal biopsy showed moderately differentiated adenocarcinoma. Small intestinal adenocarcinoma is uncommonly encountered in clinical practice. Because small intestine is relatively inaccessible via routine endoscopy, diagnosis of small intestinal neoplasm is often delayed for several months after the onset of symptoms. Most of the patients are diagnosed in advanced stage. Therefore, when a small bowel neoplasm is suspected, enteroscopy is the most useful study. If enteroscope is not available, enteroscopy using pediatric colonoscope may permit earlier preoperative diagnosis. We report a case of primary jejunal adenocarcinoma diagnosed by endoscopic biopsy using pediatric colonoscope. (Korean J Gastroenterol 2006;48:365-368)
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다발성 결절동맥염 환자에서 경막하 혈종으로 오인된 급성 경수막염
이충훤 ( Chung Hwon Lee ),박인서 ( In Suh Park ),박원 ( Won Park ),박보형 ( Bo Hyoung Park ),임명관 ( Myung Kwan Lim ),김기창 ( Gi Chang Kim ),송정수 ( Jung Soo Song ) 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.4
The pathymeningitis is a very rare neurologic manifestation of PAN. We report a case of pathymeningitis misdiagnosed as subdural hematoma by brain CT in a patient with PAN. A 45-year old man who diagnosed as PAN through arteriography and skin biopsy in the ischemic finger 6 months ago. He complained of sudden headache, nausea, and diplopia 3 days before admission. In emergency room, noncontrast brain CT findings suggested small amount of subdural hematoma. But subsequent MRI findings revealed pachymeningitis of bilateral paratentoria and falx. He was treated with high-dose steroid and cyclophosphamide pulse therapy. Thereafter, his symptoms were gradually resolved. As far as we know, this is the first report of a case of pachymeningitis complicating PAN in Korea.
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박보형 ( Bo Hyoung Park ),송정수 ( Jung Soo Song ),박근호 ( Geun Ho Park ),이충훤 ( Chung Hwon Lee ),박원 ( Won Park ) 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.4
Objective: Ultrasonography (USG) of joints has a unique position for the diagnosis of joint diseases. Bone surface, cartilage, periarticular soft tissue and their pathologic changes can be assessed by USG. This study was aimed to compare the radiographic and ultrasonographic findings in osteoarthritis (OA) of the knee joint and to evaluate the usefulness of each modality to evaluate the disease early and determine the severity of the arthritis. Methods: Fifty osteoarthritis patients classified by the American College of Rheumatology (ACR) clinical criteria from December 2002 to April 2003 were included in the study. Routine radiography (standing anteroposterior, lateral, skyline view) and systemic USG examination of both knee were performed. We compared the incidence of the radiographic and ultrasonographic abnormality related to the pathologic change of the knee OA and suggesting the severity of the OA which would help to decide the therapeutic modality. Results: In patient with knee OA, plain radiography showed abnormal findings in 37/50 (74%) patients, but USG showed at least five abnormal findings in all 50 patients. The abnormal findings detected only by plain radiography were subchondral sclerosis and subchondral cyst (14% and 4% each). But, the thinning of cartilage (94%), Baker`s cyst (94%), cartilage degeneration (54%), meniscal protrusion (44%), meniscal tear (34%), meniscal cyst (32%), and the pannus (22%) were detected only by USG. Among the findings shared by both method, joint space narrowing was detected better by plain radiography than USG, but fluid accumulation, spur, meniscal calcification and osteochondroma were detected more frequently by USG. Conclusion: USG is more sensitive to find the pathologic changes related to the knee OA and to diagnose OA than the plain radiography. But each of the plain radiography and USG have their own unique value for the evaluation of OA in the knee. So the USG supplements the plain radiography in the examination of the knee OA.
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파종성 임균 감염과 급성 C형 바이러스 간염이 동반된 1례
김기창,이충훤,서영환,이진수,정문현,최지호,문연숙 대한감염학회 2004 감염과 화학요법 Vol.36 No.3
임질은 개발도상국에 흔한 질환이며 이 지역으로 여행하는 해외 여행자에서도 성인성질환의 중요 원인이다. 또한 다른 성인성 질환과 동반되어 발생하기도 한다. 임균은 대부분은 점막에 국한되는 감염을 일으키지만 일부 환자에서는 점막외 부위에 감염을 일으키며 파종성임균 감염이 가장 흔한 전신 감염형태이다. 파종성 임균감염은 열과 오한, 피부 병변, 건활막염, 이동형 관절염으로 나타나며, 국내에서는 이에 대해 보고가 없었다. 또한 C형 바이러스 감염이 성접촉 후 발생한다는 것을 직접 증명한 예가 없었다. 필리핀 여행 후 40세 남자 환자가 발열, 다관절통, 출혈성 수포, 농포로 내원하여 활액 검사에서 임균이 관찰되어, 전신성 임균 감염으로 진단되어 ceftriaxone으로 치료하였다. 또한 외래에서 경과 관찰 중 간기능 이상과 anti-HCV 양성전환을 보여 급성 C형 바이러스 간염을 진단하고 interferon-α 2b로 치료 후 증상의 호전을 보인 예를 경험했기에 문헌고찰과 함께 보고하는 바이다. Gonorrhea is endemic in developing countries. Frequent sexual contacts are common among travellers to endemic countries and the risk of sexually transmitted disease as gonorrhea is believed to be high. Disseminated gonococcal infection (DGI) results from blood dissemination of Neisseria gonorrhoeae from the primary mucosal infection and is a common cause of infective arthritis in sexually active adults in the USA. The usual manifestations of DGI are dermatitis, tenosynovitis, and septic arthritis. We experienced a case of DGI concomitant with acute viral hepatitis C, probably acquired by sexual contacts in Philippines. A 40-year-old man took a trip to Philippines and stayed for a week. During his stay in Philippines, a hemorrhagic bulla and several pustules developed on his extrimities. Subsequently he suffered from high fever and arthralgia of several joints, including both knee joints. Neisseria gonorrhoeae was identified by culture of an aspirate from the right knee joint and he was managed with ceftriaxone for 3 weeks under the diagnosis of DGI and gonococcal arthritis. During the follow-up at the outpatient clinic, alanine aminotransferase and aspartate aminotransferase levels began to rise and an anti-HCV antibody became positive. Because HCV viral loads were surging up from 56,703 copies/mL to 538,292 copies/mL during the next 4 weeks, interferon-alpha 2b was administered for 6 months with resultant normal liver function tests and undetectable HCV viral loads.
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