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        정상면역을 가진 성인에서 발생한 식도 방선균증

        김현수 ( Hyun Soo Kim ),천종운 ( Jong Woon Cheon ),김민수 ( Min Su Kim ),정창길 ( Chang Kil Jung ),김경록 ( Kyung Rok Kim ),최재원 ( Jae Won Choi ),강동우 ( Dong Woo Kang ),김선영 ( Sun Young Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.61 No.2

        Hyun Soo Kim, Jong Woon Cheon, Min Su Kim, Chang Kil Jung, Kyung Rok Kim, Jae Won Choi, Dong Woo Kang and Sun Young Kim1 Departments of Internal Medicine and Pathology1, DongKang Medical Center, Ulsan, Korea Actinomycosis is a chronic suppurative disease and caused by Actinomycosis species, principally Actinomyces israelii, which are part of the normal inhabitant on the mucous membrane of the oropharynx, gastrointestinal tract, and urogenital tract. It usually affects cervicofacial, thoracic and abdominal tissue. Cervicofacial type has the highest percentage of occurrence with 50%. Actinomycosis frequently occurs following dental extraction, jaw surgery, chronic infection or poor oral hygiene. It may also be considered as an opportunistic infection in immunocompromised patients such as malignancy, human immunodeficiency virus infection, diabetes mellitus, steroid usage or alcoholism. But, actinomycosis rarely occurs in adults with normal immunity and rare in the esophagus. We report an unusual case of esophageal actinomycosis which was developed in a patient with normal immunity and improved by therapy with intravenous penicillin G followed oral amoxicillin, and we also reviewed the associated literature.

      • KCI등재후보

        재발한 지주막하 포도낭미충증의 Albendazole 치험 1예

        김성범,박대원,이재갑,정혜원,송준영,손장욱,김민자,박승철,제보경,김정혁,이진수 대한감염학회 2003 감염과 화학요법 Vol.35 No.5

        뇌실이나 뇌기조에 발생하는 포도낭미충증은 매우 드물며 유구조충 유충의 머리부분이 변성되면서 발생하는 낭성 막의 비정상적인 성장을 특징으로 한다. 이러한 유형의 병변은 지름술 후에도 진행적인 경과를 보이며 아직까지 항기생충제를 이용한 치료 사례들이 적고, 따라서 가장 적절한 치료 기간도 알려져 있지 않다. 본 증례 보고는 재발한 실비우스 틈새의 포도낭미충증 환자에서 4주간의 albendazole과 스테로이드로 효과적으로 치료하였던 예이다. 환자는 praziquantel과 뇌복막지름술로 치료를 받고도 포도상의 뇌실질외형의 병변이 악화되어, 뇌척수액 투과가 좋은 것으로 알려진 albendazole로 치료제를 바꾼 뒤 병변의 수와 크기가 감소였으며 이후 2년 간의 추척기간동안 다른 발작 없이 잘 지내고 있다. 지주막하의 포도낭미충증은 albendazole과 corticosteroid 치료에 잘 반응하는 것으로 보인다. The so-called racemose cysticercosis, a rare variety of neurocysticercosis occurring in ventricles or basal cisterns, is characterized by abnormal growth of cystic membranes with degeneration of Taenia solium heads (scolex). Although lesions of this type are known to follow a progressive course even after ventricular shunting, there are limitations of case series treated with antiparasitic drugs, and the optimal duration of the treatment is not yet known. We report a case of relapsed racemose cysticercosis in the Sylvian fissure, who has been successfully treated with albendazole and adjunct corticosteroid for 4 weeks. The patient had been previously treated with praziquantel and ventricul-operitoneal shunt, and maintained on the anticonvulsant drug for one year, but returned to the hospital due to seizure recurrence. The patient has been well in seizure-free state for the follow-up 2 years after albendazole therapy. The subarachnoid racemose cysticercosis seems to respond well to treatment of corticosteroid along with prolonged albendazole.

      • 간문부 담관암 환자에서 경피경관 양측성 금속 배액관의 효과

        김금래,김주형,박원규,장재천,조재호,김태년,김준화,장병익 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

        Background: The purpose of this study was to determine the effectiveness of percutaneously place self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. Materials and Methods: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral self-expanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. Results: There were 4 cased of Bismuth type Ⅱ,21 cases of Bismuth typeⅢa 8 cases of Bismuth type Ⅲb and 15 cases of Bismuth type Ⅳ. Stent placement was technically successful in all patients All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage of 91.9% There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and median survival time were 303 days (range, 60~815) and 338 days (range, 60 ~1175), respectively. Conclusion: Placement of a percutaneous metallic stent is an effective and safe method of palliation of patients with hilar cholangiocarcinoma.

      • KCI등재후보

        필리핀 여행 후 발생한 쯔쯔가무시병 1예

        김계형,김낙현,김문석,김충종,전재현,박완범,장원종,박상원,김익상,오명돈,최강원 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

        Infectious diseases imported from other countries have increased as more and more Koreans are going abroad for various purposes. Tsutsugamushi disease from other endemic area such as Southeast Asia is important, because it can occur in any season and eschar may be absent. We report a case of imported tsutsugamushi disease acquired in the Philippines. A patient presented with fever, headache, and maculopapular skin rash. However, eschar was absent. Polymerase chain reaction (PCR) for 56-kDa gene of Orientia tsutsugamushi using buffy coat was positive. Serum indirect immunofluorescent antibody assay was initially negative but became positive with a titer of 1:320 at follow-up, Sequencing analysis revealed the strain to be 100% identical to the TW73R strain identified in Taiwan. After the patient received doxycycline, body temperature normalized in 12 hours. Tsutsugamushi disease is one of the differential diagnoses that should be included for patients with fever who have recently returned from Southeast Asian countries. PCR for O. tsutsugamushi using patient's buffy coat was useful for early diagnosis.

      • 간세포암과 감별이 어려웠던 악성중피종 치험 1예

        김선문,허원석,채경훈,강윤세,정재훈,김연수,박기오,문희석,이엄석,김석현,성재규,이병석,이헌영,신경숙,조준식,송인상,강대영 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

        Malignant peritoneal mesothelioma is a rare neoplasm that arises from the mesothelium of a serosal cavity and is a rapidly fatal disease with a median survival of 4 to 12 months for untreated cases. Recently, we experienced a case with malignant peritoneal mesothelioma who was suspected hepatocelluar carcioma by abdominal CT scan and was confirmed by biopsy including immunohistochemical stain(calretinin) after surgery. We performed tumor excisions and wedge resection of the liver(segment Ⅷ)and inserted Tencoff catheter in abdominal cavity at 25th day of post-operation. We treated with intraperitoneal paclitaxel(25mg/m^(2)/day for 5 days) six courses monthly. She was well tolerable and is still living without any evidence of recurrence for 14th month of post-operation.

      • 개에서 발생한 폐수종의 치료 증례

        김유수,심재현,김건우,김지용,이병희,송근호,이영원,김덕환 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

        A 9 months intact male American bull dog with chief complaints of dry cough, dyspnea and fever was referred to the Veterinary Teaching Hospital, Chungnam National University. Based on the findings of physical examination, radiological examination, and blood and blood chemical examinations, the present patient was diagnosed into pulmonary edema secondary to primary bacterial and aspiration pneumonia. The patient was hospitalized and treated with buscopan, cephazolin and furosemide for 1 week. His activity and appetite was returned to normal and thoracic radiographs revealed that Jung was recovered to the normal condition after treatment for 7 days. The present patient was a case with pulmonary edema showed favorable therapeutic responses to proper medication.

      • 性別 및 年齡에 따른 體格과 體力의 特性과 變化에 關한 縱斷的 硏究 Ⅰ : 體育專攻 大學生을 中心으로 Emphasised on College Men of Physical Education

        金尙國,姜東洹,金昇一,徐再均,金耕知,孫斗玉,鮮于攝,崔榮烈,尹宇相,金亨燉,方永鎭,李錫元 慶熙大學校 體育科學大學 1988 體育科學論叢 Vol.- No.1

        The purpose of this study was to compare the characterists and change in physique and physical function by college student of physical education major(287males and 40 females of age groups ranging from 18 to 26). The results were as following; 1) The characteristics of physique and physical function by sex and age. ① The male group of 18yrs old showed higher values in Height, Weight, Upper Limb Length, Strength, Flexibility, and Vital Capacity than any other groups, but female group showed lower values in Height, Weight, Chest Girth, Lower Limb Length, Thigh, Girth, Calf Girth and all of the Physical function. ② The male group of 19yrs old showed high values in power and Agility, then female group showed in Strength and Flexibility. ③ The male group of 20yrs old showed the lower values in Weight, Waist Girth, Upper Limb Length, Fore Arm Girth, Thigh Girh.Calf Girth, Vital Capacity, and female group are very lowed in Upper Arm Lenght, Fore Arm Length, Skin Fold Thickness and 5 minute Run. ④ The male group of 23yrs old showed the high values in Upper Arm Girth, Fore Arm Girth and Balance, and then female group higher in Weight, Chest Girth, Waist Girth, Upper Arm Girth, Fore Arm Girth, Thigh Girth, Power, Shuttle Run, Balance and vital capacity than any other age Groups. ⑤ In male group, Chest Girth, and Blood Pressure were significantly related, and Side Step and Trunk Extension were nagatively related to the age at 0.1% level, and then in female group, Sargent Jump, Standing Long Jump and Vital Capacity were showed a significantly related at 0.5% level. 2) The difference of physique and physical function between male and female by age. ① Everage difference in whole physique items except skinfold thickness was 9.8%, and that 21.1% in all of physical function except Trunk Flextion between male and female group subjects. ② About the ages, the 18yrs old male group showed the 22.8% higher values of 26 items, but 22yrs old male group were about 12.2% in 23 items, thus it is very lower than any other groups. 3) The difference of physique and physical function between General group and physical education group in age-matched. ① In the physique male physical education groups showed about 7% higher in Weight, Chest Girth, Upper Limb Length, Upper Arm Girth, Thigh Girth, and female group showed about 7% higher in Weight and Upper Limb Length. ② In the physical function, Trunk Flextion, 5 minute Run, and Blood Pressure(Diastolic) were about 8% high values in whole group, and female group showed about 8% higher in Standing Long Jump, Shuttle Run, and Trunk Extension. ③ In 22yrs old male and female physical education group were very dominated in physique and physical function than the other age group against the general group.

      • 급성신부전증 이환견에 대한 복막투석 치료 1례

        김건우,이병희,김유수,심재현,김지용,이영원,김덕환,송근호 충남대학교 수의과대학 동물의과학연구소 2004 動物醫科學硏究誌 Vol.12 No.-

        A fourteen-month-old intact female Poodle was referred to the Veterinary Teaching Hospital, College of Veterinary Medicine, Chungnam National University. The patient was presented with history of vomiting, inappetence, ataxia, insomnia, tachypnea and convulsion for 5 days. Biochemical examination revealed BUN (254.2 mg/dl), creatinine (9.22 mg/dl) and phosphate (14 mg/dl). Epithelial cells of urinary tract, neutrophils, macrophages, a large number of gram negative and smaller number of gram positive bacteria were presented on urine test. Ultrasonographic findings show hyperechogenic kidney and indistinguishableness of renal cortex and medulla. Based on the results of examination described above, this case was diagnosed as acute renal failure with interstitial nephritis by urinary tract infection (UTI). Treatments with fluids therapy, diuretics, and peritoneal dialysis during hospitalization showed good results with no clinical signs.

      • RISS 인기논문

        수면량과 집중력의 상관관계

        김병우,류지근,박우진,박계원,김미정,임지은,백대현,최재덕,최윤호,이가현,이관,김덕수 東國大學校醫學硏究所 2002 東國醫學 Vol.9 No.1

        수면, 기억 그리고 학습의 연관성은 실제 매우 복잡하다. 많은 연구에도 불구하고 명확한 연구결과는 아직 없다. 우리는 이 연구에서 평소와는 달리 시험 전날 수면 변화 양상이 집중력에 어느 정도 영향력을 미치는지 알아보고자 하였고, 이를 이용해 효율적인 수면 관리를 할 수 있는 기초자료로 삼고자 하였다. 동국대 의대 본과 1학년생 중 지원자 30명과 본과 2학년생 10명을 대상으로 평상시 상태와 시험 직후 수면이 부족한 상태에서 각각 K-PES TEST를 실시하여 총 8항목에 걸쳐 암기력, 판단력, 단순반응의 변화정도를 검사하였다. 또 설문조사를 병행하여 결과에 영향을 미칠 수 있는 다른 인자들도 파악하였다. 수면량에 대한 부호 숫자 짝짓기(순간 판단력)을 검사한 결과, 인간의 최대 생리학적 기능은 꼭 수면부족에 의해 좌우되는 것은 아니다. 그러나, 수면감소는 피로를 증가시키고, 동기부여를 감소시키나 단, 새로운 사실을 학습하는 데에는 큰 영향을 끼치지 않는다. 즉, 수면부족으로 장시간 깨어있는 것은 정확성과 반응성을 떨어뜨린다. 흡연에 대한 부호 숫자 짝짓기(순간 판단력)을 검사한 결과, 니코틴의 수면에 대한 상호관계는 알려지지 않았고, 인간의 감정이나 의식, 인식에 영향을 주는 것으로 알고있지만, 장기적은 측면에서 흡연이나 알코올은 인식능력과 무관한 것 같다. 카페인에 대한 숫자 외우기(암기력)검사 결과, 카페인은 spacial selective attention에는 특별한 영향을 주지 않지만 지각과정이나 주의 집중에 큰 효과를 주며, 인간의 의식 수행에 긍정적인 효과를 준다. 즉 카페인은 활력, 혼란, 피로상태를 변화시키고 visual analog scales에서 휴식상태에 가까운 양상을 나타낸다. 또 48시간 동안 수면을 취하지 않은 사람에게 카페인은 집중력과 장시간의 좋은 기분을 유지하게 하였다. 그러나 규칙적, 비규칙적으로 먹는 사람간에는 인지수행력의 차이를 보이지 않으며 상용자에서는 상당한 내성이 보인다. 수면패턴에 대한 숫자 더하기(순간 판단력)검사 결과, 집중력은 수면패턴에 의해서도 영향을 받고, 수면패턴이 바뀌게 되면 순간판단력을 저하시킨다. This study was performed to evaluate relationship of sleep and attention, and to control sleep effectively. We conducted a K-PES test of 40 medical students. K-PES contains eight elements, for example, simple response, selective response, color pairing, OddEven discrimination, number addition, number-symbol matching, memory, right-tapping, left tapping. Through these, we tested changes of memory, judgement, simple response. And we conducted a questionnaire survey to exclude bias. Results are as follows. As a results of number-symbol matching test, we know that sleeplessness is not complete responsible for physiologic function for humans. But, decreased sleep increases fatigue and decreases motivation, but no influence on learning new materials. So, long term sleeplessness decreases precision and responsibility. As a results of number-symbol matching test on smoking, a relationship of nicotine and sleep is not certain. A point of view in long term period, smoking and drinking is not related cognition, even if we know that those influence mood, consciousness and cognition. As a results of memory work test on caffeine, caffeine does not influence spacial selective attention, but mainly does perception, attention and consiousness process. Namely caffeine changes energetic activities, chaos, fatigue states and shows resting state in visual analog scales In sleeplessness for 48 hours, caffeine produced attention and good mood for a long time. But, in case of cognitive process no significance shows in regular or irregular diet. Regular diet shows high resistance. As a results of number addition test on sleep patterns, seep patterns influence attention, changes of sleep patterns decrease a moment judgement.

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