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복막투석 환자의 복막염 치료 중 발생한 위막성 장염에병발한 단백상실성 장병증 1예
권균홍,허동,이현승,조용건,김봉진,김지연,배용목 대한소화기내시경학회 2008 Clinical Endoscopy Vol.37 No.3
단백상실성 장병증이란 위장관에서 혈청의 단백질이 과다하게 소실되어서 혈중 저단백혈증을 나타내는 모든 질환을 말한다. 단백상실성 장병증은 대변에서 α1-antitrypsin 청소율로 진단할 수 있고 위막성 대장염이 그 원인 중 하나가 된다. 위막성 대장염은 항생제에 연관하여 C. difficile의 이상증식과 독소에 의해 발생하며 대장 점막에 염증을 일으키고 위막을 형성한다. 저자들은 복막염 치료 중 저알부민혈증을 지속적으로 보이며, 설사, 복통, 열감 등을 동반한 단백상실성 장병증을 경험하였고, 위막성 대장염에 병발하여 발생한 예로 문헌고찰과 함께 보고한다.
폐결핵치료 중인 환자에서 Rifampicin에 의해 유발된 위막성 대장염 2예
김봉진,권균홍,임창섭,김자영,홍정범,옥미선,배용목,김지연 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4
Pseudomembranous colitis (PMC) is a disease caused by Clostridium difficile proliferation. The causative drugs are clindamycin, third-generation cephalosporins, flouroquinolone and so on. Rifampicin has been reported as a cause of PMC in the 1980s, and the frequency of PMC is increasing because rifampicin is a first line drug for anti-tuberculosis therapy. Two patients were recently admitted to our hospital due to watery diarrhea for 1 month and they were diagnosed with PMC by sigmoidoscopy. Their onset age were 74, 72 years old and latent period of symptoms were 60, 129 days, respectively. In one case, the patient displayed coexisting hypertension and diabetes. The clinical symptoms improved after discontinuing the rifampicin and then administering oral metronidazole. We report here on two cases presumed to be rifampicin-induced PMC.
체외충격파 쇄석술 시행 후 5년 뒤 발생한 요관 협착 및 농신장 1예
이현승,권균홍,조용건,김봉진,임창섭,김자영,허동,임학 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4
A 40-years-old woman was admitted to this hospital with flank pain and high grade fever for 2 weeks. As a matter of her past history, extracorporeal shock wave lithotripsy (ESWL) was performed for treatment of renal stones 5 years ago. Her abdominal CT findings were hydronephrosis with pyonephrosis and renal stones. Antibiotics administered for 5 days had no effects on her symptom improvement. A right ureteral stricture was noticed by ultrasonography follow up. We inserted double J stent and continued antibiotics therapy for 10 days, and then her fever was disappeared and flank pain was improved. ESWL is one of the most important treatment of renal and ureteral stone. However, its complications should not be negligible including bleeding, pain, ureteral obstruction, infection and so on. Complications of ESWL can be divided into acute and chronic courses. When we treat pyelonephritis patient with past history of ESWL, possibility of ureteral stricture must also be considered. In this study we report a case of pyelonephritis caused by ureteral stricture, possibly as a chronic complication of ESWL performed 5 years earlier
이수형,배용목,권균홍,조용건,이현승,김규종 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.2
A case of pure squamous cell carcinoma of the stomach in a 41-year-old female is reported. Its pathogenesis is still unknown and epidermoid carcinomas of the stomach without a glandular cell component are a rare tumor described in only about 20 patients since 1905. In Korea, six patients have reported to date. In this case upper gastrointestinal endoscopy showed a large ulceroinfiltrating mass with marginal irregularities in the lower body of the stomach. Histologic finding of biopsy specimen was squamous cell carcinoma. Abdominal computerd CT showed metastatic invasions to the spleen, abdominal wall and small bowel loop.
내시경역행성담췌관조영술 후 발생한 종격동기종, 피하공기증, 긴장성 기흉 1예
조용건,이현승,권균홍,김자영,김봉진,김지연,배용목,박선자 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4
However, Endoscopic retrograde cholangiopancreatography (ERCP) is still helpful procedure for the diagonosis of the pancreatobiliary disease and treatment through endoscopic sphinterectomy (EST) is relatively safe, these have possiblity of complications such as hemorrhage, infection, panceatitis, and perforation. ERCP related perforation was rarely reported in 0.3 to 1.1% of previous study, but most serious complication. A report of Pneumomediastinum, Tension Pneumothorax complicating perforation after ERCP and EST is very uncommon. In our hospital, we experienced case of pneumomediastinum, subcutaneous emphysema, and tension pneumothorax after ERCP and EST, and the patient (a 58 years old female with suspicious common bile duct stone) was treated successfully with conservative treatment.