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김춘직(Chun Jik Kim),김상운(Sang Woon Kim),이수정(Soo Jung Lee),김홍진(Hong Jin Kim),심민철(Min Chul Shim),권굉보(Koing Bo Kwun),정문관(Moon Kwan Chung) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.1
N/A Since operative cholangiography was introduced by Mirizzi in 1932, surgeons have used it routinely during cholecystectomy to find silent CBD stones. However, recent developments in preoperative evaluation techniques have led to debates regarding the routine use of operative cholangiography. The purpose of this study is to evaluate the necessity of the routine use of operative cholangiography. Of the 839 patients who underwent cholecystectomy, 625 patients underwent preexp- loratory cholangiography during the period from June 1983 to December 1991, at the Depart- rnent of Surgery, Yeungnam University Hospital. Unsuspected common duct stones were found in 5 out of 149 patients(5.9%) by preexploratoty cholangiography when emergency cholecystectomy was performed. Of the 448 cholangiography in patients without any abnor- mality in the preoperative test and no operative indication for CBD exploratiOn, the incidence of gall stones was only 1.1%. Of the 82 patients with minor abnormality of LFT or ultrasonogram, 38 cases of elective cholecystectomy were carried out without any other test. The incidence of gall stones in these patients was 28%. The ERCP was attempted on 163 pa- tients with one or more of the following abnormalities: LFT, ultrasonogram and past history of jaundice, pancreatitis or cholangitis. In 117 of these patients, CBD stones were found, in 2 of the patients, stricture were found, and in the rernaining 44, no stones were found. The ERCP performed on 35 patients with normal findings of preopeative LFT or ultrasonogram showed no evidence of CBD stone. Of the 79 whose ERCP was judged normal preoperatively, no stones were found at operative cholangiography. Therefore the following points may be concluded: First, operative cholangiography should be performed when emergency cholecystectomy is indicated. Secondly, it should also be done when the confirmatory test, such as ERCP, PTC and CT was not performed or failed in pa- tients with one or more of the following abnormalities such as LFT, ultrasonogram and past history of jaundice, pancreatitis or cholangitis. Finally, it should also be carried out on patients with dilated duct, small stones in the gallbladder and enlarged cystic duct.(Korean J Gastroenterol 1994; 26: 167-174)
박형윤 ( Hyung Yoon Park ),박태호 ( Tae Ho Park ),정문철 ( Moon Chul Jeong ),유재학 ( Jae Hak You ),김계정 ( Kea Jung Kim ),이규백 ( Kyu Back Lee ) 대한피부과학회 2001 대한피부과학회지 Vol.39 No.9
Chume-Strauss syndrome is a rare systemic vasculitis diagnosed by the presence of any four or more of six criteria which include asthma, eosinophilia>10%. mono- or poly-neuropathy, nonfixed pulmonary infiltrate, paranasal sinus abnormality, extravascular eosinophils. In a 65 year-old-woman, multiple purpura and crusted ulcer with central necrosis were developed on the both extremities and buttocks 1 month ago, She has been suffered from asthma, sinusitis and recurrent pneumonia since ten years ago Laboratory findings showed hematuria, hypereosinophlia and hyperIgE. On the histological examination of ulcerative nodule on the right leg, leukocytoclastic vasculitis and many neutrophils and eusinophils around the cutaneous vessels were seen and the other findings were fibrinoid necrosis and thickening of vessels wall without eosinophilic granulomatous changes. Renal biopsy showed focal segmental glomerulonephritis and sclerosing nephritis. We report a rare case of Chung-Strauss syndrome with acute glomerulonephritis.
After shave lotion 에 의한 색소성 접촉 피부염 1 예
유재학,정문철,박형윤,김계정,정유석 대한피부과학회 2002 大韓皮膚科學會誌 Vol.40 No.1
Pigmented contact dermatitis is characterized by a dark brown pigmentation that results from repeated exposure to small amounts of contact allergen. Histopathologic findings are liquefactive degeneration of the basal layer cells and melanophages in the upper dermis. We report a case of a 73-year-old man with dark brownish mottled hyperpigmented patches on the both cheeks and forehead. Patch tests were positive to isoeugenol, benzyl salicylate and after shave lotion. After shave lotion that the patient used maybe contain these fragrances. Improvement was seen 3 months after ceasing the use of after shave lotion.
박태호,유재학,정문철,박형윤,김계정 대한피부과학회 2001 大韓皮膚科學會誌 Vol.39 No.4
Nodular pseudosarcomatous fasciitis is characterized as rapidly growing benign tumor with microscopically resembling sarcoma in the upper extremities, especially forearms. Most lesions are located in the subcutaneous tissue, although these may also be found intramuscularly, with the involvement of the adjacent fascia or periosteum and dermis.
박태호,유재학,정문철,박형윤,김계정 대한피부과학회 2001 大韓皮膚科學會誌 Vol.39 No.4
Granuloma annulare is a benign granulomatous disease which has an unknown etiology and it is represented by typical annular lesions. Recently various therapeutic modalities have been suggested such as intralesional injections of steroid, chloroquine, dapsone, surgical excision and so on. But any satisfactory result has not been reported yet. In the first case, a 65 year-old-man, Polycyclic, erythematous patches with raised edges were noted on the upper arm spreading to the trunk and both lower extremities for the past 3 years. In the second case, a 63-year-old man, numerous match-head sized skin-colored papules were detected on the sun exposed area such as both shoulders, upper extremities and hands dorsum for the past 3 months. On the histological examination of back, hands dorsum respectively, incomplete degeneration of collagen bundles surrounded by lymphocytes, histiocytes in a palisade pattern and a few giant cells were found in the dermis. Two patients were treated with systemic PUVA, one for 2months and the other, 4months.
종합비경구영양법에 의해 야기된 후천성 아연 결핍증 1예
유재학,김승일,정문철,김계정 대한피부과학회 1999 대한피부과학회지 Vol.37 No.11
Symptomatic Zinc Deficiency occurs due to decreased supplimentation, increased consumption, and decreased bowel absorption of the zinc. We report the typical case of symptomatic zinc deficiency in a patient who received total parenteral nutrition for about 4 weeks due to chronic diarrhea. And after supplementation with oral zinc sulfate, the diarrhea stopped in a day and skin lesions disappeared completely within a week.