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진춘조,박형석,조화상,유광하,유종길,이경영,임형래,이순일 대한소화기학회 1998 대한소화기학회지 Vol.32 No.1
Cystic disease of the liver is observed with increasing frequency because of the common use of computed tomography and ultrasonography. Hepatic cyst does not present particular symptoms. However, depending on its size and location, symptoms like abdominal distension, or pressure effects on adjacent organs including bile ducts causing intermittent jaundice could appear. Patients with hepatic cyst usually show no elevation of liver enzyme, bilirubin, or liver function tests. Jaundice usually can occur in the patients when the cyst becomes large enough to cause exrtahepatic blocking of bile duct. We receotly experienced a 57-year old female complaining of generalized pruritus, which was diagnosed as non-parasitic liver cyst with obstructive jaundice. The diagnosis was confirmed by abdominal US, CT, ERCP and operation. Unroofing of hepatic cyst was performed, and 3 months later, she was asyrnptomatic and total bilirubin was normalized. We report this case with a review of the relevant literatures.
급성 심근경색증에 동반된 승모판 폐쇄부전증의 임상적 특징
정상만,조영일,조화상,유광하,송기호,인행환 건국대학교 의과학연구소 1997 건국의과학학술지 Vol.7 No.-
The early detection and proper management of mitral regurgitation(MR) associated with acute myocardial infarction(MI) is very important to improve the clinical course and outcome of disease. The change of left ventricular shape and regional function, papillary muscle rupture are major determinant of the existence and severity of MR. We performed 2D and M mode echocardiography of 28 patients at the early stage of acute MI to evaluate the existance and degree of MR and its pathogenetic factor. Significant MR occured in 12 (42.9%) patients. In the group of MI with MR, the inferior MI was frequent (7 case) than anterior MI (5 case) comparing to the patient group of MI without MR (inferior MI : 6 case, anterior MI : 10 case) (p<0.01).The left ventricular end diastolic dimension(LVEDD), end systolic dimension (LVESD) and left atrial dimension (LAD) were significantly increased in MI with MR than MI without MR (LVEDD : 57.3 ±8.6 vs 46.4 ±9.2, p<0.05 ; LVESD : 52.9 ±9.2 vs 38.3 ±7.4, p<0.01 ; LAD : 45.4 ±3.8 vs 37.7 ±3.7, p<0.05).However, the ejection fraction was not different between two group two groups. These datas showed that MR was more frequent in inferior MI and the hemodynamic derangement was more serious in acute MI with MR.
이순일,유광하,임형래,조화상,송종오 대한신장학회 1996 Kidney Research and Clinical Practice Vol.15 No.1
Emphysematous cystitis is characterized by gas collection within the bladder wall and lumen. Persons with diabetes, neurogenic bladder and chronic urinary infection are predisposed to the disease. Treatment consists of urinary drainage, prompt initiation of antibiotic therapy, and strict glucose control. We report a case of emphysematous cystitis in 54 year old male patient with diabetes mellitus.
신부전이 동반된 신실질의 Malakoplakia 1 예
김경수,이현순,이순일,유태석,조화상,조영일,전혜정,유종길,임형래,허원만,유광하 대한내과학회 1996 대한내과학회지 Vol.51 No.6
Malakoplakia is a rare chronic granulomatous disease generally confined to the urinary bladder, but occasionally occuring in other tissue. Since the initial case of Michaelis-Gutmann in 1902, about 200 cases have been reproted. Among these cases, renal parenchymal malakoplakia accounts for only 16M. It is most common in middle-aged females with chronic urinary tract infection. The pathogenesis of malakoplakia is unclear, but defective killing and impaired digestion of phagocytosed bacteria as a result of a low GMP/AMP ratio is believed to contribute to its pathogenesis, Improperly digested bacteria becomes mineralized, leading to the formation of the pathognomonic Michaelis-Gutmann bodies. Renal parenchymal malakoplakia is very rare, and occurs bilateral in about 50% of the cases. Although conservative medical management with an intracellularly active antibiotics, ascorbic acid and a cholinergic agonist has been recommended for unilateral renal malakoplakia, nephrectomy has been advocated as the treatment of choice. Bilateral renal malakoplakia behaves as a progressive, destructive, and fatal disease, and little is known about the satisfactory treatment for it. We experienced a case of renal parenchymal malakoplakia with renal insufficiency in a 66-year-old man. He was admitted for surgery of anal prolapse. On preoperative evaluation, azotemia, pyuria, and an enlarged right kidney were incidentally detected. A percutaneous renal biopsy was performed and the specimen showed the characteristic Michaelis Gutmann bodies, After long-term therapy with antibiotics, renal function was recovered partially, pyuria disappeared and the enlarged kidney decreased in size. Herein, we report this case with a review of the literatures.
진춘조,유태석,성무경,박형석,조화상,유광하,조영일,허원만 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.1
Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.