폐결핵환자의 환기역학

윤덕구 ( Duk Koo Yun ),정태훈 ( Tae Hoon Jung ),박희명 ( Hi Myung Park ) 대한결핵 및 호흡기학회 1986 Tuberculosis and Respiratory Diseases Vol.33 No.4

결핵성 복막염의 복강경검사 성적

박승국(Soong Kook Park),윤덕구(Duk Koo Yun) 대한소화기학회 1988 대한소화기학회지 Vol.20 No.2

N/A Biopsy proven thirty four tuberculous peritonitis patients among of two hundred fifty one patients underwent peritoneoscopy were analyzed. The age was from 19 to 83, average 42. The most prevalent age group was between 30 to 50 and the male to female ratio was 1:2. The major symptoms were increased abdominal girth, anorexia, malaise, and febrile sense. Three most frequent abnormal physical findings were abdominal tenderness, rebound tenderness and palpable mass. White soft granular nodules on peritoneoscopy were most characteristically noted in all of the patients, which were frequently obsereved on parietal peritoneum, liver surface, diaphragm and bowel serosa in order. Fibrous veil and intestinal adhesion were other distinct scopic findings and observed in 10 and 19 patients respectively. In 10 cases of patients, peritoneoscopic findings were similar to tuberculous peritonitis but proved as metastatic adenocarcinoma and chronic inflammation in 8 cases and 2 cases respectively by biopsy afterward. The ascites was single most frequent scopic finding, usually straw in color. 5 patients had ascites too minimal to remove. Ascitis less than 500cc in 12 patients, 500 to 2000cc in 13 patients and over 2000cc in 4 patients were able to be removed. No major complications were noted during and after the procedures. Lower abdominal wall and scrotal edema were seen after procedure in cases of incompletly removed ascitis. The authors concluded that peritoneoscopic examination and biopsy was safe and the most useful method to make differential diagnosis of patients who suspected tuberculous peritonitis.

만성기관지염의 환기역학

박희명 ( Hi Myung Park ),정태훈 ( Tae Hoon Jung ),최창필 ( Chang Pill Choi ),윤덕구 ( Duk Koo Yun ),박경욱 ( Kyung Wook Park ) 대한내과학회 1983 대한내과학회지 Vol.26 No.1

장티푸스와 파라티푸스 30 예에 대한 임상적 고찰 및 Thiamphenicol 의 치료효과

박창호(Chang Ho Park),김종서(Zong Suh Kim),남상숭(Sang Soong Nam),기세길(Se Kil Kee),윤덕구(Duk Koo Yun),송홍석(Hong Suck Song) 대한내과학회 1986 대한내과학회지 Vol.31 No.1

N/A We reviewed 30 cases of bacteriologically con- firmed salmonellosis which performed hone marrow culture from March I984 to August 1985 at the Keimyung University. The results of study were as follows: Among 30 cases, paratyphoid A was 13 cases and group D typhoid fever was 17 case. Age distribution was from 16 to 63 years and most frequent in 2nd decade. Male to female ratio was 1: 3.3 in group A and 1: 1.4 in group D with female predominance. Clinical symptoms were fever, chill, general weakness, headache, anorexia, eneral ache in order of frequency and there was no difference in both group. Physical findings revealed abdominal tenderness in 14 cases(47%) and most common in right lower quadrant area. Splenomegaly was 3 cases(10%) and hepatomegaly was 4 cases(13%). Laboratory findings revealed anemia in 13%, leukopenia in 30%, thrombocytopenis in 10%, positive stool occult blood in 27%, proteinuria in 33% and hypoalbuminemia in 20%. Increased alkaline phosphatase was 20%, increased was 73%, increased SGPT was 80% and positive SGOT widal test above 1: 160 titer was 43%. With blood culture 73% was isolated, 20% with stool culture, 0% with urine culture, 77% with bone marrow culture and 20% isolated with bone marinrow culture only. Mean duration of defervescence was 4.1 days in chloramphenicol-treated group and 5.5 days in thiamphenicol-treated group. Neutropenia after drug therapy was occurred 62% in CP-treated group and 67% in TP-treated group. Complications occurred in 5 cases of typhoid fever: Intestinal hemorrhage in 2 cases and intestinal perforation, pleurisy, 1st degree AU block in 1 case respectively.

심낭삼출을 동반한 CREST증후군 1례

윤덕구,박승국,박근용,전영준,이인규,박창호 啓明大學校 醫科大學 1986 계명의대학술지 Vol.5 No.2

CREST syndrome is variant of scleroderma characterized by calcinosis, Raynaud's phenomena, esophageal dysmotility, sclerodactyly & telangiectasia. In the past, it was believed that CREST patients live longer than scleroderma because rare involvement of internal organ, but recently noted that CREST patients may die early by involvement of internal organ. Recently, authors experience one case of CREST syndrome associated with pericardial effusion, herein presenting our experience and literature and reviewed.

혈액배양에서 분리된 병원균과 항생제감수성에 관한 연구

박근용,윤덕구 대한감염학회 1988 감염 Vol.20 No.2

The results of blood cultures in febrile patients who visited or admitted to Keimyung University Hospital during 1981-1986 were analyzed and 349 cases of blood culture positive patients were studied in respect to clinical and antibiotic sensitivity. The results were as follows. The most frequently isolated microorganism was Salmonella and other were S. epidermidis and Pseudomonas in order of frequency. Twenty five percent of all microorganisms were isolated in 1986 and least microorganisms (10%) were isolated in 1982. The Salmonella was most frequently isolated in third decade and Staphylococcus as most frequently isolated below 10 years of age. Salmonella group A and D were isolated in all seasons but Salmonella group A were more freuqently isolated at November, December, May and July. Salmonella group D were more freqently isolated at May, June and December. The most common route of infection was gastrointestinal tract and other important routes of infection were skin, respiratory tract, but in 10% of cases, the routes were not able to identified. Salmonella group D showed 74% sensitivity to chloramphenicol and 68% sensitivity to ampicillin, but 19% resistance to ampicillin and 10% ti chloramphenicol. S. aureus showed 100% and 80% sensitivity to cephalothin and clinidamycin respectiviely but nearly all strains were resistant to ampicillin and pencillin. Gram-negative enteric bacteria showed 61% and 56% sensitivity to amikacin and gentamicin respectively but high resistance to penicillin, kanamycin and cephalothin. P. cepacia showed 83% sensitivity to chloramphenicol but very low sensitivity to other antibiotics.

장티푸스 및 파라티푸스에 대한 Cefoperazone의 치료 효과

이경민,윤덕구 대한감염학회 1989 감염 Vol.21 No.1

Chloramphenicol was drug of choice in the treatment of typhoid fever but its side effects and emergence of resistant strain was considered as problem. Cefoperazone is semisynthetic 3rd generation cephalosporine and noted its activity against Gram negative bacilli including salmonella species. To evaluate the effect of cefoperazone in the treatment of typhoid and paratyphoid fever, authors treated 24 cases of typhoid fever and 8 cases of paratyphoid fever with cefoperazone and chloramphenicol and compaired its efficacy. Fever begin to lysed 4 days after cefoperazone therapy and 6.3 days after chloramphenicol therapy in the paratyphoid fever. In the typhoid fever, fever begin to lysed after 3.6 days both cefoperazone and chloramphenicol therapy. In the paratyphoid fever, Fever became completly lysed 6.0 days after cefoperazone therapy and 7.8 days after chloramphenicol therapy. In the typhoid fever, fever became completely lysed 5.7 days after cefoperazone therapy and 7.4 days after chloramphenicol therapy. In the cefoperazone treated group, 1 case of typhoid fever was relapsed after 2 weeks of treatment and 3 cases of typhoid fever were not responded to therapy. In chloramphenicol treated group, 1 case of typhoid fever was relapsed.

대구, 경북지역에서 발생한 쭈쭈가무시병의 임상적 고찰

양창현,윤덕구,박정모,손수호,이준호,김윤년 啓明大學校 醫科大學 1992 계명의대학술지 Vol.11 No.3

Tsutsugamushi disease is acute febrile illness primarily affecting farmer and prevalent in Autumn. The disease is characterized by fever, rash and eschar and sometimes it caused atypical pneumonitis and it should be differentiated by Leptospirosis and Korean hemorrhagic fever. We experienced 38 cases of Tsutsugamushi disease diagnosed by clinical and detection of tsutsugamushi antibody by indirect immunofluorescent technique. Studied subjects were 15 cases of male and 23 cases of female and the victim were primarily farmer(89%). Most cases were occurred in October and September and in 1990. Fever and chills(94%)were the most complaint symptoms and other complaint symptoms were myalgia cough and dyspnea in the order of frequency. Leuhocytosis or leukopenia was detected in 14% and 11% respectively and 83% were detected to have thrombocytopenia. Transaminase was elevated in 57% and BUN and creatinine was elevated in 3%. Physical examination showed eschar(84%), rash(82%) hypatosplenomegaly(24%),conjunctival injection and hyperemia of pharynx. chest X-ray showed interstitial pneumonitis (11%) pulmonary edema(11%) and cardiomegaly(8%). 57% were revealed positive reaction to indirect fluorescent antibody technique. Clinical response was very good in the treatment of tetracycline vibramycin, or chloramphenicol.

복부 방사성균증 1예

이상숙,윤덕구,박영관,김경목,박승국,이경민,권석룡,조원현 대한감염학회 1988 감염 Vol.20 No.3

Actinomycosis is chronic suppurative and granulomatous disease caused by Actinomyces specises and characterized by sulfur granule formation which frequently discharged via draining sinus. Actinomyces can affect cervicofacial, pulmonary, abdominal and pelvic area. Most of abdominal actinomycosis is developed after abdominal operation, trauma or inflammatory bowel disease and it must be differentiated from colon cancer, amaeboma, chronic appendicitis or intestinal tuberculosis. Recently we experienced one case of abdominal actinomycosis developed after peptic ulcer perforation. In this case we noted large secondary and tertiary abscess formation after surgical repairment of primary disese, afterward the abscess was proved as actinomycosis. Herein we presenting our experience and reviewed the literature.

간경화증, 암성 복막염 및 결핵성 복막염 환자의 혈청과 복수내의 Immunoglobulin, 보체 및 Fibronectin치에 관한 연구

박승국,김인산,윤덕구,이두룡,강영우,안성훈,허정욱,조준승 대한감염학회 1989 감염 Vol.21 No.1

Spontaneous bacterial peritonitis is more frequently developed in cirrhotic ascites than noncirrhotic ascites. To evaluate antibacterial activity of cirrhotic ascites, authors analysed immunoglobulin, C3, C4 and fibronectin level in normal ascites, cirrohotic ascites, cancerous and tuberculous ascites and compared its level between cirrhotic ascites and non cirrhotic ascites. The protein content was 1.8gm% in liver cirrhosis and 4.3gm% in normal control and protein content of cirrhotic ascites was significantly lower than normal control, but there was no statistically significant difference in cell count and differential count. Serum Ig G, Ig A and Ig M were 1792 mg%, 485 mg% and 219 mg% respectively in liver cirrhosis and these values were statistically significantly low compare to carcinomatous peritonitis except Ig G but had no statistically significant different compared to tuberculous peritonitis. Ascites Ig G, Ig A and Ig M were 350 mg%, 102 mg% and 37 mg% respectively in liver cirrhosis and statistically significantly low compared to normal and tuberculous ascites but only Ig M was significantly lower than cancerous peritonitis. Ascites to serum ratio of IgG, IgA, IgM, C3 and C4 were 0.20, 0.24, 0.17, 0.09 and 0.19 respectively in liver cirrhosis and statistically significantly lower than cancerous peritonitis and tuberculous peritonitis. Fibronectin level of serum, ascites and ascites to serum ratio in liver cirrhosis were 311μgm/cc, 99μgm/cc and 0.28 respectively, although these values were lower than cancerous peritonitis and tuberculous peritonitis there was no statistically significant means.