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임응훈,김성수,김치홍,추원오,김용수,박인석,구완서,장윤식,방병기,송경섭,박영하 대한내과학회 1992 대한내과학회지 Vol.42 No.2
저자들은 혈액투석을 시행하고 있는 다낭신 환자에서 발생한, 수혈을 요하는 대량혈뇨를 신동맥색전술을 이용하여 성공적으로 치료한 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Polycystic kidney disease is one of the most common inherited autosomal dominant disease with variable clinical prsentations. The disease may manifest abdominal pain, bilateral flank masses, hypertension, hematuria, nephrolithiasis and azotemia. Massive hematuria may occur in polycystic kidney requiring transfusions or rarely surgical intervention. However, renal arterial embolization has been applied for the control of massive hematuria recently. We have experienced two cases of massive hematuria in polycystic kidney disease controlled by percutaneous renal arterial embolization successfully without any serious complications.
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응급실에 내원한 불안정성 발작성 심실상성 빈맥환자에서 정맥내 Adenosine 투여효과
이원재,박규남,채장성,강동헌,임응훈,김세경,황주일,승기배,박승현,오동렬,이기중,최규보 대한응급의학회 1994 대한응급의학회지 Vol.5 No.2
Study purpose : To evaluate the efficacy of adenosione in the treatment of emergency department patients with unstable paroxysmal supraventricular tachycardia. Design : A ten-months prospective outcome study. Population : Patients with 16 or more old with unstable PSVT(systolic blood pressure of less than 90mmHg, chest pain, pulmonary edema, and/or altered mental status) by surface ECG criteria. Measurements : Patient's preadenosine and postadenosine heart rates, symptoms, and blood pressure, complications and recurrence of PSVT. Results : Fourteen patients mets inclusion criteria. After IV adenosine, One patient was found to have atrial flutter. PSVT were diagnosed in remaining thirteen patients. There were five male and eight female patients with a mean age 35.2(range, 16-52). Six patients presents with hypotension(mean systolic blood pressure, 78.6mmHg), four with chest pain, and three with both chest pain and hypotension. There were no patients with altered mental status or pulmonary edema. Eleven patients(85%) converted to sinus rhythm with adenosine therapy (initial 6mg adenosine : eight patients, additional 12mg : three patients). The remaining two patients required electrical cardioversion. Two patients converted to sinus rhythm by electrical cardioversion. In all cases, chest pain and hypotension resolved within minutes of conversion to sinus rythm. There were no clinically significant adverse effects or recurence of PSVT during emergency department observation period. Conclusion : In the unstable patient with PSVT, adenosine appears to be a safe and effective alternative to current advanced cardiac life support-recommended immediate electrical cardioversion.
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한성민,김화영,김재일,박석준,이창후,한상국,김석은,유인환,박주일,임응훈,강정협 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.6
Lipomas are one of the most common benign nonepithelial tumors of the colon and which are often detected incidentally at radiologic investigation or on operation without specific symptoms, Most of them look like submucosal tumor with yellowish-white color, smooth surface and solitary lesion. Sometimes they produce symptoms with large size, bleeding, constipation, diarrhea, abdominal pain, indigestion, intestinal obstruction and intussusception. Diagnosis can be made by colonoscopy, abdominal CT, MRI, barium enema and histologic confirmation achieves by the endoscopic polypectomy. Endoscopic polypectomy or mucosectomy can make it easy to remove them, as therapeutic method. We report 2 cases of lipomas successfully removed by endoseopic polypectomy-the one with two lipomas each at right descending colon and ileocecal valve and the other with one lipoma at the ileocecal valve-with the relevant literatures.
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식도십이지장 림프종과 감별이 곤란하였던 십이지장 결핵 1예
한성민,김화영,박석준,이창후,김석은,강정협,소순찬,김종률,임응훈 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.6
Primary duodenal tuberculosis, duodenal Crohn's disease, duodenal lymphoma, duodenal cancer is extremely rare event. Vague upper abdominal pain, weight loss(10 Kg) had been present for several months in a 52-yeer-old woman. Endoscopy revealed an irregular ulcer in the second part of the duodenum. CT of the abdomen revealed pooly defined hypodense and centrally low density masses along the hepatoduodenal ligament, with poor separation from the head of pancreas. Hypotonic duodenogram showed spiculation and smooth indentation of mucosal fold at medical aspect of sup. portion m descending duodenum. ERCP showed medially displaced distal CBD and main pancreaticduct. At first, lymphoma, cancer, Crohn's disease, duodenal tuberculosis were considered in the differential diagnosis. Endoscopic biopsy sepecimen of duodenal lesion showed atypical lymphocytes. We excluded the diagnosis of the duodenal cancer. We started anti-tubercular drugs because in our country tuberculosis is endemic. After 4 weeks anti-tuberculosis therapy, follow up endoscopy and biopsy specimens showed healing stage of duodenal ulcer and chronic granulomatous inflammation with multinucleated giant cell. Thus we concluded that when duodenal lesion which could not confirmed histopathologically it was wise to start antitubercular therapy than to perform exploraparotomic dianostic procedures.
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신영신,정인식,양진모,김판규,심상인,정규원,김부성,선희식,이교영,채현석,임응훈 대한소화기내시경학회 1991 Clinical Endoscopy Vol.11 No.2
Gastric cancer is the most common malignancy in Korea. Although five years survival rate of gestric cancer has been gradually improved due to advances in the diagnostic technique and therapeutic modalities, the advanced gastric cancer remains a disease with poor pragnosis. At the time of diagnosis, the disease, is usually advanced and longterm survivor is uncommon without a proper surgical treatment or chemotherapy. We experienced a case of advanced gastric cancer who lived for more than 6 years after making a diagnosis, without curative surgical therapy or chemotherapy. The patient at age of 76 year-old, was seen in St. Mary's hospital due to gastroinestinal bleeding in January of l985. A large ulcerating cancer in the diameter of 2.0 cm was found at the posterior wall of body with endoscopy and confirmed the diagnosis of stomach cancer by the endoscopic biopsy. He was recommended the surgical intervention of gastric cancer but he denied the operation due to his age, He had been treated symptomatically with H2 receptor antagonist and antacid with relief of symptoms. Thereafter he had been followed-up clinically at every 2-4 weeks, and the lesion was examined 3-4 times in a year endoscopically, In May l990, an endoscopic esophageal dilation was done due to esophageal stricture with tumor invasion at the lower esophageal sphincter. He was expired in July, 1991 in this hospital. Here we report a case of long term survived advanced gastric cancer who had been followed-up for 6 and half years clinically and endoscopically with review of literatures.
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신조직검사로 진단된 급성백혈병 세포의 침윤에 의한 신부전
이정득(Jeong Deuk Lee),김종률(Jong Yul Kim),김판규(Pan Gyu Kim),임응훈(Eung Hoon Im),한지연(Ji Youn Han),박지원(Ji Won Park),양철우(Chul Woo Yang),김석영(Suk Young Kim),박석영(Suk Young Park),방병기(Byung Kee Bang),서광선(Kwang Sun S 대한내과학회 1993 대한내과학회지 Vol.45 No.5
Infitration of the kidneys in acute 1ymphocytic leukemia is thought to cause rarely functional imparment or lead to renal failure. When renal failure occurs in acute lymphocytic leukemia(ALL), it is secondary to complications such as tumor lysis syndrome, uric acid nephropathy, obstruction, haemolysis and glomerulone-phritis. We report a 56 year-old female patient with ALL who presented with renal failure and was found to have extensive infitration of the kidney with leukemic infiltrates. The absence of other causes of renal failure and the presence of large kidneys with extensive infiltration of the interstitum with tumor cells makes it highly likely that renal failure was caused by leukemic infiltration.
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