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1개월된 소아에서의 Salmonella Group D에 의한 장염 및 패혈증이 동반된 음낭내 농양 1례
최유선,정윤숙,김선일,오성희,Choi, You Sun,Jung, Yoon Suk,Kim, Sun Il,Oh, Sung Hee 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.6
저자들은 salmonella group D로 인한 장염 및 패혈증이 동반된 음낭내 농양을 진단하여 항생제와 절개 및 배농으로 치료한 1례를 경험하였기에 보고하는 바이다. Acute gastroenteritis due to Salmonella species, which usually improves on conservative treatment, can progress to sepsis and extraintestinal focal infection in very young infants. Frequent sites for extraintestinal infections are meninges, bone, joints, spleen and intravascular sites but scrotal abscess due to salmonella in children has been very rare. Literature search revealed only one newborn case of scrotal abscess with bacteremia due to salmonella group D which developed after circumcision. We, herein, report a 42 day old infant who initally presented with diarrhea that progressed to sepsis and scrotal abscess. Despite the use of susceptible antibiotics, the patient improved only after surgical drainage.
채현범 ( Hyun Beom Chae ),정윤숙 ( Yoon Suk Jung ),박동일 ( Dong Il Park ),이창균 ( Chang Kyun Lee ),허규찬 ( Kyu Chan Huh ),신정은 ( Jeong Eun Shin ),김재학 ( Jae Hak Kim ),김유선 ( You Sun Kim ),정윤호 ( Yun Ho Jung ),정성애 ( S 대한소화기학회 2014 대한소화기학회지 Vol.64 No.2
목적: 궤양성 대장염 환자에서 infliximab 사용이 승인된 2006년을 기준으로 infliximab 사용이 증가하면서 그 이전과 이후에 진단된 환자들의 질병의 예후 및 치료약제의 사용이 어떻게 달라졌는지 알아보고자 하였다. 대상 및 방법: 1987년부터 2012년까지 12개 병원에서 궤양성 대장염을 진단받은 1,422명을 대상으로 후향적 연구를 시행하였다. 진단 연도에 따라 두 군(A군: 1987-2005, B군: 2006-2012)으로 나누어 진단 당시 나이, 성별, 추적기간, 이환기간, 질병의 위치, 질병과 관련된 입원과 수술, 약물 사용에 차이를 보이는지 등에 대해 통계적 분석을 시행하였다. 결과: 진단 당시의 평균 연령은 42.2세였고, 평균 추적기간은 4.7년이었다. Infliximab을 사용한 환자는 89명으로 전체의 6.3%였다. 단변량 분석에서 B군에서의 infliximab 사용이 통계적으로 유의하게 많았고(4.5% vs. 7.6%, p=0.016), 경구 스테로이드의 사용은 유의하게 적었다(60.1% vs. 53.3%, p=0.009). 궤양성 대장염에 관련된 입원(45.8% vs. 40.1%, p=0.031)과 수술(6.4% vs. 3.5%, p=0.010)은 B군에서 통계적으로 유의하게 낮았다. 수술적 치료를 받은 환자군과 받지않은 환자군과의 단변량 분석을 시행한 결과, 수술적 치료를 받은 환자군에서 전대장염의 비율이 높았고(p=0.026), 경구 스테로이드의 사용이 많았다(p=0.007). 다변량 분석에서는 경구 스테로이드 사용만이 유의한 차이를 보였다(OR 1.85, 95% CI 1.03-3.30, p=0.039). 결론: 2006년 이후 진단된 궤양성 대장염 환자에서 2006년 이전 진단된 환자들에 비하여 infliximab 의 사용이 유의하게 증가하였고, 수술률도 유의하게 낮은 것으로 나타났다. 또한, 스테로이드 불응성 궤양성 대장염 환자에서 infliximab의 사용이 효과적인 치료로 사용될 수 있을 것으로 생각된다. Background/Aims: Infliximab was approved for the treatment of ulcerative colitis (UC) in 2006 and has recently been used as rescue therapy in steroid-refractory UC. The aim of this study was to investigate the differences of medication use and prognosis in UC patients according to the periods of diagnosis. Methods: From 1987 to 2012, a total of 1,422 patients with UC were retrospectively reviewed in 12 hospitals. The study population was divided into two groups according to the periods of diagnosis as follows, group A: 1987 2005, group B: 2006-2012. Analyzed variables were compared by using chi-square test and logistic regression analysis. Results: Mean age of the subjects was 42.2 years, and the mean follow-up period was 4.7 years. In univariate analysis, the use of infliximab in group B was significantly higher than group A (4.5% vs. 7.6%, p=0.016), and UC related hospitalization (45.8% vs. 40.1%, p=0.031) and UC-related surgery (6.4% vs. 3.5%, p=0.010) in group B was significantly lower than that of group A. The use of oral steroid in surgery group was significantly higher than non-surgery group in multivariate analysis (OR 1.85, 95% CI 1.03-3.30, p=0.039). Conclusions: Infliximab might play an important role for the treatment of steroid-refractory UC. Well designed prospective trials based on the efficacy and safety of infliximab are required in the future. (Korean J Gastroenterol 2014,64:93-97)
위장관 T 세포 림프종에 대한 소화기내과 의사의 초기 진단 정확도
류성호 ( Sung Ho Ryu ),천재희 ( Jae Hee Cheon ),김진영 ( Jin Young Kim ),김보경 ( Bo Kyung Kim ),윤진영 ( Jin Young Yoon ),정윤숙 ( Yoon Suk Jung ),허현미 ( Hyun Mi Heo ),이진하 ( Jin Ha Lee ),전승민 ( Soung Min Jeon ),홍성필 ( Su 대한장연구학회 2011 Intestinal Research Vol.9 No.1
Background/Aims: Primary T-cell lymphoma of the gastrointestinal tract is a very difficult disease entity to diagnose, and has an extremely poor prognosis. The aim of this study was to determine the early diagnostic accuracy for gastrointestinal T-cell lymphoma by gastroenterologists. Methods: Between January 2000 and October 2010, the clinical features of 15 patients with primary gastrointestinal T-cell lymphomas, including endoscopic findings, radiologic diagnosis, endoscopic biopsy findings, and final diagnosis, were retrospectively reviewed. Results: The most common initial presenting symptoms of primary gastrointestinal T-cell lymphomas was abdominal pain (n=11, 73%). The anatomic location of the primary lesion the small bowel (n=8, 53%), colon (n=5, 33%), and stomach (n=3, 20%). There were no cases of T-cell lymphomas diagnosed based on clinical symptoms, radiologic findings, or endoscopic findings without biopsy alone. Pathologic confirmation of T-cell lymphomas by endoscopic examination was achieved in 7 cases (64%) and the remaining cases (n=8, 53%) were diagnosed with T-cell lymphomas based on pathologic examination after surgery. Conclusions: All of the patients with primary T-cell lymphomas of the gastrointestinal tract were diagnosed exclusively by endoscopic or surgical pathologic examainations, suggesting that gastroenterologists should scrutinize and suspect this disease with caution due to atypical gastrointestinal ulcers. (Intest Res 2011;9:6-26)
결핵 환자에서 Rifampin에 의한 Henoch-Shonlein Purpura
김혜련 ( Hye Ryun Kim ),박병훈 ( Byung Hoon Park ),손지영 ( Ji Young Son ),정지예 ( Ji Ye Jung ),안정련 ( Jung Ryun Ahn ),정윤숙 ( Yoon Suk Jung ),임주은 ( Ju Eun Lim ),정주원 ( Ju Won Jung ),문지애 ( Ji Ae Moon ),변민광 ( Min Kwa 대한결핵 및 호흡기학회 2008 Tuberculosis and Respiratory Diseases Vol.65 No.2
Rifampin is one of the first line drugs for treating tuberculosis, but it might be associated with serious adverse effects, including renal failure. We report here on a case of a 57-year-old patient who developed Henoch-Shonlein purpura during antituberculosis therapy that included rifampin. The patient converted to negative on the AFB smear for tuberculosis two weeks after the initial administration of antituberculosis medication. After treatment for 60 days, this patient was diagnosed with Henoch-Shonlein purpura by the purpura lesion on the lower legs, the leukocytoclastic vasculitis, the renal impairment and the pathological examination. After stopping rifampin, the skin lesions disappeared in about 10 days and his renal function gradually improved. This case study showed that Henoch-Schonlein purpura can be caused by rifampin during antituberculosis therapy and we recommend that the use of rifampin should be restrained when clinical symptoms of Henoch-Shonlein purpura are observed. (Tuberc Respir Dis 2008;65:116-120)
염증성 장질환 진단에 있어서 Positron Emission Tomography-computed Tomography의 임상적 유용성
류성호 ( Sung Ho Ryu ),천재희 ( Jae Hee Cheon ),강원준 ( Won Jun Kang ),김진영 ( Jin Young Kim ),김보경 ( Bo Kyung Kim ),윤진영 ( Jin Young Yoon ),정윤숙 ( Yoon Suk Jung ),허현미 ( Hyun Mi Heo ),이진하 ( Jin Ha Lee ),전승민 ( Soun 대한장연구학회 2011 Intestinal Research Vol.9 No.2
Background/Aims: Positron emission tomography-computed tomography (PET-CT) is a nuclear imaging technique that provides noninvasive, three dimensional, quantitative images. Recently, PET-CT has been shown to be valuable in assessing patients with inflammatory diseases; however, the clinical utility of PET-CT in the evaluation of inflammatory bowel disease (IBD) has not been defined. Thus, the aim of this study was to determine the clinical utility of PET-CT in the evaluation of IBD. Methods: Between November 2006 and September 2010, clinical,endoscopic, and radiological data on 14 patients (6 males and 8 females: age range, 33-79 years) with suspected IBD were collected. The standard work-up method for a definite diagnosis of IBD included ileocolonoscopy. Results:The 14 patients were divided into the following five groups: ulcerative colitis (n=4, 29%), intestinal Behcet’s disease (n=3, 21%), intestinal tuberculosis (n=2, 14%), malignancy (n=2, 14%), and no abnormal findings with colonoscopy (n=3, 21%). A PET-CT based-diagnosis of IBD correlated with a colonoscopic diagnosis in nine cases (64.3%),but the matching ratio of the distribution of lesions between PET-CT findings and colonoscopic findings was only 18.1% (2/11). Conclusions: The utility of PET-CT in the diagnosis of IBD requires further evaluation. (Intest Res 2011;9:97-104)