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보행성 24시간 식도내압검사로 진단된 미만성 식도경련 1례
최명규(Myung Gyu Choi),추교영(Kyo Young Choo),김재광(Jae Kwang Kim),정규원(Kyu Won Chung),선희식(Hee Sik Sun),박수헌(Soo Heon Park),장데레사(Theresa Jang),김백선(Baek Sun Kim),김선명(Sun Myung Kim),한준열(Jun Yeol Han) 대한소화기기능성질환·운동학회 2000 Journal of Neurogastroenterology and Motility (JNM Vol.6 No.1
Diffuse esophageal spasm (DES) is a motility disorder of the esophagus characterized by symptoms of retrosternal chest pain and intermittent dysphagia. The diagnosis of DES has relied on criteria obtained from a standard esophageal manometry (more than one simultaneous contraction in a series of l0 wet swallows with the rest being peristaltic). Because symptoms and/or typical manometric findings are not always documented during the standard manometry, 24 hour manometry may be more useful in such cases. We recently assessed a 29-year-old male patient who complained of chest pain and dysphagia. He showed nonspecific, findings on the laboratory hiwi manometry, but DES was diagncwed by his typical manometric findings on the 24 hour manometry. Therefore, a 24 hour manometry. should always he performed when the patient's history suggests the presence of DES and the laboratory based manometry failed to detect the symptomatic contractions of DES. Following we report this case with a review of the literature. (Korean Journal of Gastrointestinal Motility 2000;6:63-68)
유진홍,장데레사,엄기성,조승열,김양리,김미영,강문원,유소연 대한감염학회 1998 감염 Vol.30 No.2
목 적 : 남한에서는 1970년대말 후 말라리아 발생이 없다가 1993년 이후 말라리아가 다시 발생하여, 금년에는 토착 말라리아 감염 환자가 폭발적으로 급증하였다. 이에 저자들은 최근 본 병원에서 치료하였던 환자들을 대상으로 말라리아의 역학과 특성, 임상양상 및 치료성적을 분석하고, 토착형 말라리아와 유입형 말라리아간의 차이점을 비교하였다. 방 법 : 저자들은 1991년 3월부터 1997년 11월까지 반복되는 고열을 주소로 강남성모병원에 내원한 환자 중 말라리아로 확진된 40명에 대하여 의무기록을 후향적으로 조사하였다. 결 과 : 토착형 말라리아 감염이 21례였고, 유입형 말라리아 감염이 19례였다. 원인원충은 토착형 말라리아의 경우 전부 삼일열 말라리아였고, 유입형의 경우 열대열 말라리아 13례, 삼일열 말라리아 6례였다. 토착형 말라리아의 감염지역은 연천군(7례)이 가장 많았고, 유입형의 경우는 아프리카와 동남아시아(각 7례)가 가장 많았다. 검사실 소견상 빈혈(혈색소<10g/dL)을 보이는 경우는 유입형 말라리아가 토착형 말라리아보다 많았으나 평균 혈색소는 통계학적인 차이가 없었다(혈색소 각각 9.82±2.0, 10.8±22g/dL, P>0.05). 남미에서 감염된 1명은 primaquine 내성을 보여 치료 용량과 기간을 연장한 후 완치되었다. 결 론 : 토착형 말라리아 감염환자와 발생지역이 급증하므로 지역 주민에게 말라리아의 증상고 예방법을 교육하고, 의료인은 말라리아의 생활환을 끊기 위한 조기진단과 치료에 관심을 기울여야한다. 유입형 말라리아의 경우 말라리아 위험 지역으로 여행을 가거나 거주하는 사람들에 대한 철저한 교육과 예방이 필요하며 치료 내성을 보이는 지역이 증가하고 있으므로 치료제 및 예방약 선택에 주의하여야 하겠다. Background : Endemic malaria has become increasingly rare since the late 1970s, but since the reemergence of indigenous vivax malaria in 1993, the number of cases of malaria have recently increased. We analyzed the cases of malaria who were treated in Kangnam St. Mary's Hospital with regards to epidemiology, clinical manifestations, and treatment outcome, and made a comparison between indigenous and imported cases. Methods : We retropectively analyzed data of 40 comfirmed cases of malaria treated in the same hospital. Results : Twenty-one cases were indigenous and 19 were imported malaria. Peripheral blood smear revealed Plasmodium vivax in all indigenous malaria, whereas in imported cases 13 were P. falciparum and 6 were P. vivax. Yeonchon-gun(7 cases) was the most prevalent area in the indigenous cases; Africa and Southeast Asia(7 cases, respectively) were the most prevalent areas in the imported cases. Anemia(hemoglobin <10g/dL) was found more frequently in the imported cases, but the difference was not statistically significant. One patient, who was infected in South America showed initially resistant to fected in South America showed initially resistant to primaquine, but was cured after extended treatment with increased dosage of primaquine. Conclusion : As cases of indigenous malaria in Korea are increasing, early diagnosis, treatment, and prevention of malaria are important. To prevent imported malaria, anyone who travels to endemic areas should receive proper education and chemoprophylaxis, considering the pattern of drug resistance.
박수현,김재광,정규원,최명규,김선명,선희식,한준열,윤정민,김백선,장데레사,추교영 대한소화기내시경학회 2001 Clinical Endoscopy Vol.22 No.1
A 29-year-old man was admitted because of melena for 5 days. Two years ago, he underwent allogenic bone marrow transplantation for chronic myeloid leukemia and received immunosuppressive agents. Esophago - gastroduodenoscopy showed a picture - multiple scattered deep ulcers and friable pseudomembranes - of highly suggestive of a herpes simplex esophagitis and biopsy revealed multinucleated giant cells and pathognomonic intranuclear inclusion bodies. Esophageal lesions and melena improved after acyclovir therapy.