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권낙기 ( Nak Ki Kwun ),최명규 ( Myung Gyu Choi ),이인석 ( In Seok Lee ),김세희 ( Se Hee Kim ),조유경 ( Yu Kyung Cho ),김상우 ( Sang Woo Kim ),정인식 ( In Sik Chung ),박두호 ( Doo Ho Park ) 대한소화기기능성질환·운동학회 2002 Journal of Neurogastroenterology and Motility (JNM Vol.8 No.2
Pseudo-obstruction is a clinical syndrome caused by ineffective intestinal propulsion and characterized by symptoms and signs of intestinal obstruction in the absence of an occluding lesion of the intestinal lumen. A 65-year-old male who complained of abdominal pain and obspitation. (not constipation?) was admitted. Simple abdominal radiographs revealed marked colonic dilatation without mechanical obstruction suggesting pseudo-obstruction. Clinical response with conservative care failed to improve the patient. 2.0 mg of neostigmine which was recently reported to be an effective way to decompress the colon in patients with acute colonic pseudo-obstruction, was administered. Immediate clinical response was achieved without complication.(Kor ean J ournal of Gastr ointestinal Motility 2002;8:197-201)
권낙기 ( Nak Ki Kwun ),민준기 ( Jun Ki Min ),박경수 ( Kyung Su Park ),전은정 ( Eun Jung Jun ),조철수 ( Chul Soo Cho ),변재영 ( Jae Young Pyun ),김호연 ( Ho Youn Kim ) 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.2
With varying frequency, systemic sclerosis may involve nearly all parts of the gastrointestinal tract. Pneumatosis cystoides intestinalis(PCI) which is characterized by the presence of multiple gaseous cysts in the intestinal wall of either subserosal or submucosal location rarely occurs in patients with systemic sclerosis. PCI may be asymptomatic, but weight loss, abdominal distension, and nausea are frequent symptoms secondary to sytemic sclerosis. Although the mechanisms responsible for the development of PCI in systemic sclreosis remains unclear, bacterial overgrowth, mucosal damage secondary to ischemic bowel disease are considered to be possible mechanisms. It is a benign condition that often responds to conservative management, however it may be a harbinger of end stage disease particularly in systemic sclerosis. Here, we report a case of PCI accompanying by systemic sclerosis with brief review of literatures.
한혜원,이인석,권낙기,박재명,오정환,조유경,김상우,최명규,정인식 대한소화기내시경학회 2005 Clinical Endoscopy Vol.30 No.6
Background/Aims: Lymphocytic gastritis is characterised by the accumulation of small lymphocytes in the surface and foveolar epithelium. It is a common finding in a subtype of gastritis characterized by the presence of nodules and erosions in the body, relative to which the antrum was spared-'varioliform gastritis'. Lymphocytic gastritis usually follows a chronic course and presents severe clinical symptoms including hypoproteinemia. The aim of this study was to investigate the incidence and clinical manifestations of lymphocytic gastritis in patients who showed endoscopic apprearance of enlarged folds, erosions, and aphthoid nodules in the body. Materials and Methods: The clinical and histological findings of varioliform gastritis with presence of nodules and erosions in the body were analyzed. The ratio of 25 lymphocytes/100 epithelial cell was used as the criteria for the diagnosis of lymphocytic gastritis in the study. Results: Twenty nine cases were classified as varioliform gastritis (there were 20 men/9 women and average age was 48.9 years). Among the 29 varioliform gastritis, 9 corresponded to lymphocytic gastritis. H. pylori infection rate was 44% (4/9) in lymphocytic gastritis and 65% in non lymphocytic gastritis. There was no difference in H. pylori infection rate between the lymphocytic gastritis and non lymphocytic gastritis. Clinical laboratory findings of lymphocytic gastritis were normal. The patients with lymphocytic gastritis had absence of mild degree of symptoms. Among 4 patients with follow-up endoscopy, erosions in body were completely disappreared in 3 patients. Conclusions: Lymphocytic gastritis occurred in about 30% of patients with varioliform gastritis. Most patients with lymphocytic gastritis had no symptoms or only mild symptoms and had no significant abnormality in clinical or laboratory finding. 목적: 림프구성 위염은 위상피 내 림프구의 침윤이 특징인 질환으로 내시경 검사에서 다양한 소견을 보일 수 있으나 주로 위체부와 저부에 분포하는 마마양 위염의 소견을 보인다. 림프구성 위염은 만성적인 경과를 취하고 임상 증상이 현저하며 저단백증을 흔히 동반하는 것으로 알려져 있다. 연구자들은 체부에 주로 분포하는 마마양 미란이 특징적인 내시경 소견을 보인 한국인 환자에서 림프구성 위염의 빈도와 임상상을 알아보고자 하였다. 대상 및 방법: 2001년 7월 1일부터 2002년 6월 21일까지 본원을 방문하여 내시경 검사를 처음 시행 받고 만성 위염으로 진단 받은 5,130명을 대상으로 내시경 검사에서 백태가 붙어 있고 아프타성 결절이 있는 융기형 미란이 주로 체부에 분포한 체부 마마양 위염 환자를 대상으로 임상상과 조직 소견을 조사하였다. 림프구성 위염의 진단 기준은 100개의 상피세포당 25개 이상의 상피세포 내 림프구가 침윤된 경우로 하였다. 결과: 체부 마마양 위염의 내시경 소견을 보인 환자는 남자가 20명, 여자가 9명으로, 평균 나이는 48.9세(23~65)였다. 대상 환자 29명 중 9예(31%)에서 림프구성 위염으로 진단되었다. 림프구성 위염에서의 H. pylori의 감염률은 9예 중 4예(44%)로 전체 대상 환자의 H. pylori의 감염률 65%와 통계적으로 유의한 차이가 없었다. 림프구성 위염 환자는 무증상이거나 경미한 소화 불량증의 증상만을 호소하였으며 빈혈과 저단백증은 없었다. 림프구성 위염 환자 9명 중 4명에서 추적 내시경 검사를 시행하였으며 그 중 3명에서 내시경 소견이 소실되었다. 결론: 체부 마마양 위염의 내시경 진단을 받은 환자 중 림프구성 위염의 빈도는 30%였다. 림프구성 위염의 증상은 보고된 것에 비해 무증상이거나 경미한 증상만 있었으며 검사실 이상 소견을 동반하지 않았다.
대엽성 폐렴의 양상을 보인 폐 Cryptococcosis 1예
박석영,윤영연,오귀염,권낙기 대한화학요법학회 1996 대한화학요법학회지 Vol.14 No.2
A 26 year old lady was admitted due to fever and productive coughing of 10 days duration. She had been working at the office treating stuffs of oriental herb medicine without any problem in her health by then. Chest films revealed consolidative changes involving Lt. lower lobe and she was given systemic antibacterial antibiotics, but her illness was not improved. On 19th hospital day needle biopsy was performed and cryptococcosis was diagnosed involving both alveoli and intertitium. Antifungal agent, itraconazole, was prescribed for 10 weeks and the lesion was resolved completely without remnant change. We discussed this case with review of literatures.