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고윤웅,한지숙,오제덕,이선주,이광재,양우익 대한감염학회 1991 감염 Vol.23 No.2
The Aspergilli are among the most common and ubiquitous saprophytic fungi in the environment. Aspergillosis is divided into several cartegories, among which the invasive aspergillsois (IA) causes significant morbidity and mortality in immunocompromized host especially from pulmonary infection. The clinical aspect off 40 cases of aspergillsois were studied. who were admitted Severance Hospital between January, 1985 and June, 1990. The following results were observed. 1) Among these 40 cases, 1 was diagnosed as allergic aspergillsois, 25 as aspergilloma (pulmonary 22, paranasal sinus 3), 11 as IA (pulmonary 5, brain 3, sinus with contiguous invasion 3) and 3 as pleural aspergillsois. 2) Among 22 cases of pulmonary aspergilloma, the most frequently associated underlying diseases were pulmonary tuberculosis in 17 and others were COPD in 3, bronchiectasis in 2 and bronchial asthma in 1. Among 5 cases of invasive pulmonary aspergillsois (IPA), acute lymphocytic leukemia was the underlying disease in 3, acute myelogenous leukemia in 1 and myelodysplastic syndrome in 1. 3) The specific diagnosis of aspergilloma was made by surgical biopsy in 15, transbronchial lung biopsy in 4 and compatible finding of chest X-ray with positive antibody against Aspergillus antigen in 6. Among 3 cases of pleural aspergillsois, 2 were diagnosed by pleural biopsy and 1 by culture of pleural fluid. 4) In cases of IA, the specific diagnosis was made by histopathologic findings in 9. Among 5 cases of IPA, 2 were diagnosed by needle aspiration biopsy, 2 by clinical diagnostic criteria and 1 by open lung biopsy. 5) The severe granulocytopenia (<500/㎣) before pulmonary infiltrates was noted in all cases of IPA. 6) All the 22 cases of pulmonary aspergilloma were improved with surgical resection in 13 and 9 with conservative treatment. In contrast, 3 of 5 IPA were dead inspite of amphotericin B treatment and 2 were recovered with improvement of underlying disease or granulocytopenia. Six cases of invasive sinus or brain aspergillosis were improved with surgical removal and amphotericin B treatment, and 2 pleural aspergillosis with surgical drainage. With the above results, several types of aspergillosis were confirmed and the prognosis seemed to depend on underlying disease. Because of high fatality of IPA, it is more stressed that the pro-phylactic measures, efforts of discernible diagnostic approaches and as early empirical antifungal treatment as possible might give rise to not only the therapeutic success of IPA but also the improvement in prognosis of underlying diseases.
김병철(Byung Chul Kim),오제덕(Jae Duk Oh),이종화(Jong Haw Lee),문영명(Young Myung Moon) 대한내과학회 1989 대한내과학회지 Vol.36 No.6
N/A Pernicious anemia is a rare disease in Korea. Pernicious anemia is the most common vitamin B12 deficiency, in which intrinsic factor secretion ceases owing to atrophy of gastric mucosa, On the basis of incomplete evidence, pernicious anemia in currently thought to be caused by an autoimmune reaction against gastric parietal cells. There is cosiderable evidence for immunologic abnormalities in pernicious anemia. We report a case of pernicious anemia which was diagnosed by bone marrow study, serum level of vitamin B, the Schilling test, Castle's test, gastric juice analysis and fibergastroscopy with biopsy.
정상섭,김동익,허갑범,이현철,임승길,이관우,김경래,김미림,정윤석,이규창,오제덕,서창옥 대한내분비학회 1990 Endocrinology and metabolism Vol.5 No.2
To see prognosis in Korean acromegalics, 15 acromegalic patients who admitted to severance Hospital from 1981 to 1990 were analyzed. The results are as follows: 1) The cure (remission) rate of surgery and/or radiotherapy was 47% (7/15). 2) The remission group was significantly older at the time of diagnosis compared with non- remission group 3) The remission group had significantly lower preoperative basel growth hormone levels compared with non-remission group. 4) The intraseller tumor group had significantly higher remission rate than extraseller tumor group. 5) The group that pituitary tumor was totally removed had significantly higher remission rate than subtotaly removed group. 6) There was no significant difference between remission and non-remission group in sex and preoperative prolactin level. It was suggested that the age at the time of diagnosis, preoperative basel growth hormone level, complete sugical removal of pituitary tumor, and extent of tumor might be important prognostic factors of treatment of acromegary (J Kor Soc Endocrinol 5: 101~107, 1990)
간장 ( 肝腸 ) 및 담도 ( 膽道 ) : Thallium - 201의 경직장 신티그라피를 이용한 문맥순환의 평가
최흥재(Heung Jae Choi),문영명(Young Myung Moon),김경희(Kyung Hee Kim),이관식(Kwan Sik Lee),김병철(Byung Chul Kim),김경철(Kyung Chul Kim),오제덕(Jae Duk Oh) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.3
N/A A new method for evaluating portal systemic circulation by administration of Thallium-201 per rectum was performed in 8 control subjects and in 32 patients with various liver diseases. The heart-to-liver uptake ratio at 20 min after administration (H/L ratio) was used as an index of portal systemic shunting. Also H/L ratios were compared with the results of ICG R15 test and some liver function tests. The results obtained were as follows: 1) The thallium distribution and time-activity curve observed in patients with portal hypertension were clearly distinctive from those in normal control subjects. 2) The H/L ratios obtatined in each group were as, 0.29 +- 0.06 in normal controls, 0.34 +- 0.04 in asymptomatic HBsAg carrier, 0.44 +- 0.10 in patients with CPH, 0.50 +- 0.23 in patients with CAH, and 0.70 +- 0.43 in patients with ]iver cirrhosis. 3) There was a relatively good correlation between the H/L ratio and ICG R15 (indocyanine green retention rate at 15 min) test (r=0.79, p<0.001). 4) No correlation was observed between H/L ratio values and albumin, bilirubin, SGOT, SGPT, but correlations were observed between H/L ratio and prothrombin time (r=-0.70, p<0.001), and platelet counts (r= -0.45, p<0.01). The above results suggest that this noninvasive method seems to be useful in evaluating portal-to- systemic shunting in various liver diseases with portal hypertension.