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이춘일,김정완,길현교,장연복,박정식,박성우,김병태,최문기,고영박,선덕재 대한내과학회 1990 대한내과학회지 Vol.38 No.3
Heat stroke is a medical emergency and the most important environmental heat illness. It is a disease of high fever, dry warm skin without sweating, and mental disturbances. It commonly involves several organs including the liver, kidney, heart, brain, and the coagulation system. Recently, we experienced 10 cases of heat stroke. The clinical findings of those were as follows: 1) At the time of admission, body temperature in all patients were higher than 39.4℃, and especially in 4 cases, higher than 41.4℃ : pulse rates in all patients were more than 140/min: and systolic blood pressure were less than 100 ㎜Hg except in one case. 2) The clinical manifestations were CNS symptoms including 6 cases of coma, variable skin lesions, G-I hemorrhage, muscle swelling with tenderness and oliguria. 3) On blood chemistry, there were markedly decreased levels of protein, albumin and calcium: markedly inceased level of SGOT, SGPT, CPK, LDH, BUN, and creatinine: one case of hypokalemia and two cases of hyperkalemia: and 4 cases of hyperbilirubinemia greater than 2㎎/㎗. 4) Two cases of myoglobinuria, 3 cases of proteinuria nd 1 cases of hematuria were observed. 5) Complications, such as uremia, ventricular tachycardia, D.I.C., pulmonary edema, pleural effusion, jaundice and acute pancreatitis were observed. 6) Four cases out of 10 were died. The causes of death were pulmonary edema, cerebral edema, D.I.C., hepatic failure and cardiac failure.
Multiple Gastric Diverticula 1예
김우중,이경용,임규성,양재식,최종도,길현교 대한소화기내시경학회 1988 Clinical Endoscopy Vol.8 No.2
Gastric diverticula have been considered to be rave when compored with diverticula in other sites of the gastrointestinal tract. It's prevalence is 0.043% of routine gastrointestinal radiologic examination by Palmer's extensive review. Gastric diverticula almost always occur as a single lesion and approximately 75% of gastric diverticula occur in the juxtacardiac region, high on the posterior wall of the stomach, about 2 cm below the esophagogastric junction and 3 cm from the lesser curvature. We report a case of 75-year-old male patient with multiple gastric diverlicula which was first encountered by endoscopy and confirmed by upper gastrointestinal radiologic examination.
강원도 춘천 인근지역 주민에서의 Rickettsia 에 대한 항체보유 현황과 과거 감염 환자에서의 항체 역가의 변동
김계영(Kae Young Kim),이상조(Sang Jo Lee),백혜진(Hye Jin Baeg),길현교(Hyun Gyo Kil),이영천(Young Chun Lee),최문기,유지소(Ji So Ryu),이종호(Jong Ho Lee),조민기(Min Kee Cho) 대한내과학회 1991 대한내과학회지 Vol.40 No.1
N/A Rickettisal infection is one of the common causes of acute febrile illness occurring every autumn in the rural areas of Korea. The diagnosis of Rickettsiosis is usually made by serologic tests. Diagnostic criteria is based on the seropositive rates and antibody titer of the normal population. In order to determine the serologic criteria of the present infection in the chuncheon area of Kangwondo, we examined the antibody titer of normal residents sera which was collected during July of 1989, just before the epidemic season. We also examined the changing pattern of antibody titer in the patients who had suffered from rickettsial infections one year before. 1) The seropositive rates of R. typhi, R. prowazekii, ad R. tsutsugamushi were 17.6%, 32.3% and 9.2%, respectively. 2) The seropositive rates of R. typhi and R. prowazekii were higher in male, but those of R. tsutsugamushi were higher in females. 3) Rural residents showed higher seropositive rates to all three strains of rickettsia than those of urban residents. 4) Antibody titer of R. typhi and R. prowazekii were less than 1:640 in all positive sera except one which 1:1280 to R. prowazekii. In case of R. tsutsugamushi, antibody titers of all positive sera were less than 1:80. 5) All the five patients who had suffered from murine typhus one year before showed marked decreases in total antibody response to R. typhi (less than or equal to 1:80), but in the case of tsutsugamushi disease four of eight patients with past infections showed lasting total antibody titers of more than 1:640 even though IgM responses were negative in all patients. In conclusion, the serologic diagnosis of present rickettsial infection could be possible with first single serum when total and IgM antibody titers are 1:640 and 1:40 or more, respectively, in murine typhus, and 1:80 and 1:10 or more, respectively, in tsutsugamushi disease.