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김태진,이성미,정재성,옥종한,엄재화,정영기 대한소화기학회 1992 대한소화기학회지 Vol.24 No.6
Hembilia is hemorrhage into the biliary tract that may follow trauma. incluing surgical and needle liver biopsy, aneurysms of the hepatic artery of one of its branches, extra-or intra-hepatic tumors of the biliary tract, gallstone diseases, inflammation of the liver, especially helminthic or pyopgenic, rarely varicose veins related to portal hypertension and sometimes is associated with primary liver cancer. A 55 year-old man was admitted to Maryknoll hospital on November 8th, 1991 due to intermittent right upper quadrant pain for 4 days before admission. Physical examination revealed dry mouth, severe tendemess on RUQ. But there wer no lymphadenopathy, no hepatosplenomegaly and no palpable mass on abdomen. Upon admission, serum transaminase and bilirubin were elevated. All viral markers including HBsAg, anti-HCV, anti-HAV were negative and cs pw skin test were also non-specific findings. Stool occult blood was positive and serum Ca19-9 was elevated. Through ERCP, impacted CBD stone with hemobilia was removed. And repeated ERCP was done. The hemobilia and stone were not seen and normal CBD under 2nd ERCP. And serum transaminase, bilirubin, Hb/Hct, Ca19-9 were within normal limit. We report a case of hemobilia with obstructive jaundice.
활성탄여과 및 Ascorbic Acid 의 투석액 투여로 개선된 혈액투석 환자들에서 발생한 Chloramine에 의한 용혈성 빈혈
정재성,김태준,이성미,공진민,김환곤,엄재화 대한신장학회 1994 Kidney Research and Clinical Practice Vol.13 No.2
Background: Chloramines cause hemolysis in hemodialysis patients both by directly oxidizing red cells and by inhibiting HMP shunt with which red cells defend themselves against oxidant damage. We report here an eposode of chloramine-induced hemolytic anemia in our hemodialysis center, which was managed by the installation of additional charcoal filter and the administration of ascorbic acid into dialysate. Method and Results: The hemoglobin level before chloramines exposure in Nov. 1991 was 7.2±1.5 gm%, which reduced to 6.3±1.5 gm% (P$lt;0.01) in Dec. 1991 when the dialysate was contaminated by chloramines. In Jan. 1992, when additional charcoal filter was installed and ascorbic acid was administered into dialysate, hemoglobin was restored to 6.9±1.3 gm% (p$lt;0.01). Heinz body was positive in 25% of patients in Dec. 1991, all negative in Jan. 1992. Inceased methemoglobin and decreased haptoglobin was also observed in Dee. 1991, which normalized in Jan. 1992. 7 of 41 patients were transfused in Nov. 1991, but patients required transfu- sion in Dec. 1991(p$lt;0.01). 16 and 7 patients had transfusion in Jan. and Feb. 1992, respectively. Chloramines levels in water before and after charcoal filteration in Dec. 1991 was 63.56 and 37.21gm/L, respectively. Those levels before and after charcoal filteration and after ascorbic acid administration in Jan. 1992 were 22.09, 0.04 and less than 0.01mg/L, respectively. Conclusion: Because chloramines are one of the major causes of the aggravation of anemia in hemodialysis patients, physicians should be vigilant for the contamination of dialysate by chloramines. Charcoal filtration and ascorbic acid administration are efficient methods for the removal of chloramines.
혈액투석 치료를 받는 만성신부전증 환자의 C형간염의 빈도
정재성,김태준,이성미,원대식,공진민,엄재화,옥종환 대한신장학회 1991 Kidney Research and Clinical Practice Vol.10 No.4
To determine the prevalence of anti-HCV in ESRD patients under chronic maintenance hemodialysis, 75 hemodialysis patients in our units and 66 age and sex matched control persons were studied. The mean age of hemodialysis patients was 45 (22-71). The duration of dialysis was 29.5?28.0 (0-120) months. 9 of 75 dialysis patients showed positivity in anti-HCV test and 1 of 66 control persons showed positivity (p $lt;0. 05). All dialysis patients and the control person with anti-HCV (+) had the history of transfusion. The number of transfusion units was significantly higher in the anti-HCV (+) dialysis patients (mean 34.2?25.7; range 2 to 69 units) in comparison with the number in the anti- HCV ( ). (mean 17.9?20.9; range 0 to 72 units; p$lt;0,05). The duration of dialysis was also significantly longer in the anti-HCV (+) dialysis patients (mean 52.4?34.1; range 9 to 120 months) than that of the anti-HCV ( ). (mean 26.4+25.8; range 1 to 96 months; p$lt;0.05). Among 10(13.3%) chronic NANB hepatitis patients, 4 had anCV (+). Among 9 with anti-HCV (+), 4 were chronic NANB hepatitis, 1 was mixed infection by both B and C viruses and 4 were asymptomatic carriers with normal ALT level. We conclude that HCV is prevalent in hemodialysis unit and that HCV infection is significantly related with the number of transfusion units and the duration of hemodialysis.
김태진,이성미,정재성,문성수,최태룡,엄재화,주종은,공진민 대한내과학회 1994 대한내과학회지 Vol.46 No.4
A case of idiopathic crescentic glomerulonephritis type 1 in 23 year-old man with extensive involvement of glomeruli with crescents, linear deposit of IgG along glomerular capillary wall, positive anti-GBM antibody in serum and rapid progressive course of renal insufficiency is reported with a brief review of literatures.
허갑범,이현철,임승길,송영득,차봉수,원영준,김선호,김경래,권석호,정보영,남수연,김태승,엄재화 대한내분비학회 1997 Endocrinology and metabolism Vol.12 No.2
Backgrounds: Pituitary hyperplasia can mimic pituitary adenoma. In MRI, enlarged pituitary gland is enhanced homogenously with upward convexity of the superior margin of the gland .The best definition of hyperplasia in the pituitary hyperplasia seems to be a multiplication of one or more cell types. But definition, etiology and clinical courses of this disease are not clear, Method : We reviewed clinical symptoms, MRI, and pathologic findindings in 6 patients with pituitary hyperplasia. Result: 1. Major clinical symptoms were headache(100%), visual field defect(84%), polyuria/polydipsia (64%), and irregular mensturation(32%). Other symptoms were amenorrhea(16%) and galactorrhea (16%). 2. Three of five cases showed abnormal responses to combined pituitary function test, 3. MRI findings were pituitary hyperplasia(4), macroadenoma(l), and microadenoma(1). 4. In two operated cases, there was no adenoma. One case showed hyperplasia of lactotroph cells, the other was hyperplasia of gonadotroph cells confirmed by the examination of immunocytochemistry. Conclusion : Pituitary hyperplasia should be considered in patients with enlarged pituitary gland without focal mass lesion. (J Kor Soc Endocrinol 12:155-164, 1997)
옥종한(Jong Han Ok),정재성(Jae Sung Chung),김태진(Tae Jin Kim),엄재화(Jae Wha Um),이성미(Sung Mi Lee),정영기(Young Gi Chung) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2
Squamous cell papilloma of esophagus is a very rare benign tumor. It is reported with increasing frequency recently. The lesion is small and diagnosis is often fortuitous. The etiology remains unknown. Grossly, on endoscopy, the papilioma appears as a smooth, round, pink, sharply demarcated, sessile tumor projecting from the esophageal wall. Histologically, the squamous papillomas are benign sessile lesions of surface epithelium, characteristically composed of finger-like projections of tissue, lined by an increased number of squamous cells. The average age range is 6th decade, men outnumber women almost two to one, most are distal in location, and symptoms are diverse. We observed 2 cases of squamous cell patilloma of esophagus. Our purpose here is to report these cases and review the literatures.