장형화생 아형에 따른 inducible nitric oxide synthase (iNOS)의 발현

백강우 ( Kang Woo Paik ),민상운 ( Sang Woon Min ),손영해 ( Young Hae Sohn ),박창환 ( Chang Hwan Park ),이완식 ( Wan Sik Lee ),주영은 ( Young Eun Joo ),최성규 ( Sung Kyu Choi ),유종선 ( Jong Sun Rew ),박창수 ( Chang Soo Park ),김 대한내과학회 2003 대한내과학회지 Vol.64 No.2

Background: Intestinal metaplasia (IM) type 3 has been suggested to be associated with gastric cancer of intestinal type. Excess nitric oxide (NO) has been reported to be associated with pathogenesis of various diseases, including gastric cancer. This stu

간에 발생한 염증성 가성종양

한상우(Sang Woo Han),백강우(Kang Woo Paik),김기태(Ki Tae Kim),최성규(Sung Kyu Choi),유종선(Jong Sun Rew),김세종(Sei Jong Kim),윤종만(Chong Mann Yoon) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4

We report a case of inflammatory pseudotumor of the liver that, on imaging studies, may mimic a malignant neoplasm. The fine needle aspiration cytologic features were rnisinterpreted as malignant cells. Under the impression of hepatic malignant neoplasm, the patient underwent hepatic resection. Histologically, the tumor was composed of inflammatory cells, such as lymphocytes, plasma cells, and histiocytes as well as collagen fibrous tissue. (Korean J Gastroenternl 1996;28: 571 - 575)

자궁선근증에서 혈청 CA-125치와 월경곤란증 정도의 병변 깊이와의 관계

장석현 ( Seog Hyun Jang ),안태순 ( Tae Soon Ann ),오은성 ( En Sung Oh ),심재학 ( Jae Hag Sim ),백애란 ( Ae Lan Paik ),원종천 ( Jong Cheon Weon ),정강우 ( Kang Woo Jung ),김용필 ( Yong Pil Kim ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.12

Objective : To evaluate the association of level of CA-125 and severity of dysmenorrhea with lesion depth in adenomyosis. Methods : Sixty-eight women who had undergone hysterectomy and were found to have pure adenomyosis on histopathologic examination wer

출혈을 동반한 만성 췌장염 4예

김세종(Sei Jong Kim),윤종만(Chong Mann Yoon),유종선(Jong Sun Rew),최성규(Sung Kyu Choi),김현종(Hyun Jong Kim),김영진(Young Jin Kim),김현수(Hyun Soo Kim),백강우(Kang Woo Paik),구철(Cheol Koo),박창환(Chang Hwan Park) 대한소화기학회 1997 대한소화기학회지 Vol.29 No.2

Hemorrhage is an uncommon but serious cornplicaticm of pancreatic pseudocysts. When gastrointestinal bleeding or intra-abdominal hemorrhage is associated with a pancreatic pseudocyst and the usual sources of bleeding are not detected by endoscopy, the rupture of a pseudoaneurysm inside the pseudocyst should be suspeeted. We report four cases presenting with major bleeding. Bleeding was massive in two patients and intermittent in two. It resulted from erosion of the gastroduodenal artery in two patients, bleeding into the pancreatic duct in one patient, erosion of the duodenum by a bleeding pseudocyst in one and involvement of the spleen by a bleeding pseudocyst in one. Of the four patients with bleeding pseudocysts, two underwent primary pancreatic reseetion and the other two underwent transcatheter embolization with embolus coiL Bleeding was successfully controlled by the transcatheter arterial embolization in one out of the two patient and pancreatic resection was performed in the rest of three patients. (Korean J Gastroenterol 1997; 29:266-273)

Vibrio vulnificus 감염증으로 확진된 92예의 임상적 고찰

유종선,문범,지미선,최성규,백강우,김기태,박창환,윤종만 대한감염학회 1995 감염 Vol.27 No.4

목적: V. vulnificus 감염증은 전남지방에서 매년 발생하고 있고 지속적인 계몽과 집중적인 치료에도 불구하고 아직도 높은 치사율을 나타내고 있어 1983년부터 1994년까지의 전남지방의 V. vulnificus 감염증의 임상상과 역학적인 특성을 분석 검토해보았다. 방법:1983년부터 1994년 9월 까지 전남대학병원에 내원한 환자중 균 배양검사로 V. vulnificus 감염증으로 확진된 92예를 대상으로 세균학적 검사소견, 역학적 특성, 임상소견을 분석 검토하였다. 혈액배양은 BACTEC blood culture system(Bekton Dickinson)을 이용하였고, 피부병변 조직배양은 혈액한천배지, MacConkey agar, Thioglycolate broth에 접종 배양한 후 배양된 세균을 ATB 32GN(biome-rieux. France)과 API 20E(biomerieux. France)로 동정하였다. 항생제 감수성은 Kirby-Bauer 디스크(BBL Sensi disc)확산법으로 검사하였다. 결과: 1) V. vulnificus는 혈액배양에서 20예(22%), 조직배양에서 43예(47%), 혈액과 조직에서 27예(29%), 혈액과 복수에서 1예(1%), 혈액과 뇌척수액에서 1예(1%)가 배양되었다. 원판 확산법에 의한 균 감수성검사에서는 tetracycline, chloramphenicol, ampicillin, gentamicin, piperacillin, cefoperazone, cefotaxime, ciprofloxacin등은 100%의 감수성을 나타냈고 amikacin, kanamycin, carbenicillin등은 약 85%, cephalothin은 77%의 감수성을 나타냈으며 colistin은 전 균주에서 내성을 나타냈다. 2) 연도별 발생빈도는 85년에 21예로 가장 많았고, 94년 12예, 89년 10예, 87년 9예, 91년 8예, 93년 8예의 순이었다. 월별로는 5월에서 10월 사이에 발생하였으며 특히 7월에서 9월 사이에 78예(85%)로 집중적으로 발생하였다. 지역별로는 해안지방과 인접 내륙지방에 주로 발생하는 경향을 보였다. 3) 간질환이나 중등도 이상의 음주력이 있는 40-50대의 남자에서 어패류를 생식 또는 불충분하게 조리하여 섭취했을때 많이 발생하였다. 환자 발생시기의 남서해안 근해 평균수온은 16.3℃-28.7℃였으며 특히 22.0℃-23.9℃시기의 발생이 전체의 54%를 차지하였고 해수온도가 상승함에 따라 발생빈도가 증가하는 경향을 보였다(r=0.43 p=0.006). 4) 대부분이 원발성 패혈증 증세를 보였고 하지의 부종과 수포등 피부병변만 나타나고 패혈증 증세가 없었던 창상감염증 1예와 뇌막염 증세를 동반한 패혈증이 1예 관찰되었다. 임상증상으로는 주로 피부병변(96%), 사지통(56%), 저혈압(52%), 발열(47%), 오한(43%), 설사(33%), 복통(26%), 구토(25%)등이 나타났고, 심한 경우에는 핍뇨(9%), 호흡곤란(7%), 혈변(2%)도 나타났다. 피부병변으로는 수포(56%), 부종(52%), 홍반(51%), 괴사(18%), 자반(11%), 구진(7%), 농포(2%), 등이 관찰되었고 주로 하지(73%)에 많이 발생하였다. 5) 사망률은 전체적으로는 57.6%이였고, 점차 감소화 하는 추세를 보였다. 사망군과 생존군간에는 생명징후, 잠복기에 따른 차이는 없었으나 백혈구수와 혈소판수가 감소할수록, AST가 높을수록 사망률이 높았다 결론:V. vulnificus 감염증은 일단 패혈증이 발생하면 병의 진행이 빠르고 감수성 있는 항생제로 집중적인 치료를 해주어도 사망률이 높기때문에 발병후 치료보다 예방이 훨씬 중요하리라 사료된다. Background:V. vulnificus infection is a highly fatal disease prevailing in Chonnam area. To increase understanding of V. vulnificus infection, we investigated clinical and epidemiological characteristics of V. vulnificus infection in Chonnam area. Methods:We retrospectively reviewed the clinical recores of 92 cases with V. vulnificus infection which admitted to Chonnam University Hospital from 1983 to 1994 and bacteriologically were confirmed. Results: 1) V. vulnificus was isolated from blood in 22%, tissue in 47%, blood and tissue in 29%, blood and peritoneal fluid in 1%, and blood and cerebrospinal fluid in 1% of the cases. All the isolates were susceptible to tetracycline, chloramphenicol, ampicillin, gentamicin, piperacillin, cefoperazone and cefotaxime. About eighty-five pervent of the isolates were susceptible to amikacin, kanamycin and carbenicillin and seventy-seven percent to cephalothin. All the isolates were resistant to colistin. 2) The yearly distribution was 21 cases in 1985, followed by 12 in 1994, 10 in 1989, 9 in 1987 in decreasing. The monthly distribution was each 27 cases in July and August, followed by 24 in September, 8 in June, 5 in October, 1 in May. The majority of cases occurred in coastal areas and nearly inlands of Chonnam province. 3) All of V. vulnificus infections occurred in association with ingestion of raw seafoods. The age and sex distribution ranged from the thirties to the eighties and occurred mainly in adult males in the fifties(48%) and the forties(24%). Of ninety-two cases, 73 cases had underlying liver diseases and 67 cases were heavy alcohol consumers. 4) Almost all cases showed primary septicemia except one which had wound infection without septicemia. One case showed septicemia with meningeal symptoms. Clinical manifestations included skin lesion(96%), pain in the extremities or myalgia (56%), hypotension(52%), fever(47%), chills(43%), diarrhea(33%), abdominal pain(26%), oliguria(9%), dyspnea(7%) and melena(2%). Skin lesions included vesicles or bullae(56%), edema(52%), erythema(51%), necrosis(18%), purpura(11%), macules(7%) and pustules(2%). Most of the skin lesions developed in the lower extremities. 5) The average sea water temperature ranged from 16.3℃ to 28.7℃ which was provided by National Fisheries Research & Developement Agency from 1983 to 1994, when V. vulnificus infection occurred. As sea water temperature rose, the incidence of V. vulnificus infection tended to be increased(r=0.43 p=0.006) 6) The overall case fatality rate was 57.6%. There were no significant differences between survivors and non-survivors in vital signs, incubation period, arrival time, and liver function test except aspartate aminotransferase. However, leukocyte and platelet counts were significanty lower in non-survivors (p<0.05). Conclusion:In spite of the susceptible antibiotics therapy and intensive care, V. vulnificus infection was highly fatal. Therefore, we stress that prevention is more important rather than treatment of the disease.