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궤양성 대장염의 Antineutrophil Cytoplasmic Antibody ( ANCA ) 발현율
한상원(Sang Won Hang),오수혁(Soo Hyuk Oh),정현(Hyun Jung),양영상(Young Sang Yang),채현석(Hyun Seok Chae),이봉수(Bong Soo Lee),서정민(Jung Min Suh),김재광(Jae Kwang Kim),백남종(Nam Jong Baeg),최규용(Kyu Yong Choi),정인식(In Sik Jung) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.3
N/A Antineutrophil cytoplasmic antibodies (ANCA) are autoantibodies against various antigens present in the cytoplasmic primary granules of neutrophils detected by standard indirect immunofluorescent technique fixing the neutrophil with alcohol. There are two types of ANCA characterized by immunoreactivity, perinuclear type AACA(P-ANCA) and cytoplasmic type ANCA(C-ANCA). ANCA was demonstrated in the sera of patients with inflammatory bowel disease. We have evaluated the reactivity against human neutrophils of sera from 44 patients with ulcerative colitis, 4 Crohns disease, 3 tuberculous colitis, 2 Behqets disease, 10 simple co- litis and 25 healthy controls. 26/44 (59.1%) sera from patients with ulcerative colitis con- tained ANCA compared with 2/4 (50.0%) from Crohns disease, 1/2 (50.0%) from Behqets disease and 2/25 (8%) from control sera. All ten from patients with simple colitis and all three sera from tuberculous colitis were negative. The presence or titer of ANCA was not cor- related with activity of treatment of ulcerative colitis. The predominant pattern of ANCA was cytoplasmic (30/31) and only one serum gave a perinucleatr pattern. In conclusion, ANCA occurred more commonly in ulcerative colitis than tuberculous colitis or simple colitis.(Korean J Gastroenterol 1994;26: 451 457)
안리숙(Li Suk An),나종순(Jon Soon Na),김상우(Sang Woo Kim),전희경(Hee Kyung Chun),김병수(Byung Soo Kim),정재열(Jae Yeul Jung),오수혁(Soo Hyuk Oh),김재광(Jae Kwang Kim),정인식(In Sik Chung) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.6
Gastrointestinal tract involvement with hepatocellular carcinoma is rarely reponed ei en in the A.,ia and the Africa v;here this carcinoma is one of the relatevely common malignancies. We preserit a case of a 48-year-old man with duodenal bulh metastasis of hepatocellular carcincma, who died because of rnassive hernaternesis, 2 months later. One case v,ith rapicl duoJenal neiastasis ot' hepatocellular carcinorna is reported with the relevant literatures are reviewecl. (Korean J Gastroenterol 1995;27: 888 - 892)
민준기(Jun Ki Min),정우철(Woo Chul Jung),백기현(Gi Hyun Baek),김양리(Yang Ree Kim),오수혁(Soo Hyuk Oh),강문원(Moon Won kang),정인식(In Sik Chung),양우진(Woo Jin Yang),김성훈(Sung Hun Kim) 대한내과학회 1996 대한내과학회지 Vol.51 No.4
N/A Objectives: Tsutsugamushi disease is an acute, febrile illness of humans that is caused by Rickettsia tsutsugamushi. Hypoalbuminemia was reported in some cases of tsutsugamushi disease, but its frequcncy and etiology were not clarified. Therefore we prospectively evaluated fourteen cases of Tsutsugamushi disease patients to idendify intestinal protein loss as a cause of hypoalbuminemia and to assess the value of 99mTc-HSA abdominal scintigraphy for detecting intestinal protein loss. Methods: From November 1994 to December 1994, in fourteen patients with tsutsugamushi disease, serum albumin level and fecal a-1-antitrysin excretion were measured at admission. Anterior abdominal images were obtained at 2, 4, and 24hours after intravenous injection of 30 mCi of Tc-Human serum albumin. Results: 1) The age distribution was mainly in the forties, and fifties. Geographically, 10 cases in the northern part of Kyung-Ki Do and 4 cases in Seoul were occurred. 2) Laboratory findings showed hypoalbuminemia in 5 cases(35.7%), elevated AST and ALT in 11 cases (78.6%), prolonged prothrombin time in 1 cases (7.1%), and proteinuria(30mg/dl) in 9 cases(64.3%). 3) Fecal a-1-antitrypsin concentration was measured in 10 cases of 14 patients with tsutsugamushi disease, of which 8 cases revealed abnormally elevated concentration of fecal a-l-antitrypsin(2.6mg/g dry weight). 4) 99mTc-HSA scintigraphy was positive in 11 of 1478.696) patients with tsutsugamushi disease. 5) In patients with positive 99mTc-HSA scintigraphy, protein loss sites were small bowel(6/11, 54.5%), descending colon(3/14, 27.3%), ascending colon(2/11, 18.1%). Conclusion: Intestinal protein loss was idendified in some patients with tsutsugamushi disease by the measurement of fecal a-1-antitrpysin concentration. 99mTc-HSA scintigraphy is easy and readily available study for detecting intestinal protein loss sites. The comparison of the severity of intestinal protein loss before and after treatment is recommended in patients with tsutsugarnushi disease who have abnormal intestinal protein loss.
정규원(Kyu Won Chung),선희식(Hee Sik Sun),김부성(Boo Sung Kim),정인식(In Sik Chung),이영석(Young Suk Lee),안병민(Byung Min Ahn),오수혁(Soo Hyuk Oh),유진홍(Jin Hong You),정한국(Han Kook Chung) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.1
N/A Percutaneous liver biopsies were performed in 146 patients with acute and chronic liver diseases, including neoplastic diseases. Among 146 patients, 28 patients had undergone liver biopsy under laparoscopic examination and 118 patients by blind intercostal biopsies. Ultrasonographic examination was performed before biopsy and 24 hours after biopsy. Blood pressure and pulse rate were also examined in all 146 hospitalized patients. The following results were obtained. 1) Development of intrahepatic hematoma was found by ultrasound in one case (0.6%) which the biopsy had been done under laparoscopic examination, however there were no significnt hemodynamic changes in blood pressure, hemoglobin level and pulse rate. 2) No significant hemodynamic changes noted between the prebiopsy and six hours after biopsy. 3) No other serious complications encountered in all 146 cases of liver biopsy. It is concluded that routine post-biopsy ultrasonographic examination may be unnecessary in patients undergone percutaneous liver needle biopsy if a skillful personnel and good indications were applied.
쯔쯔가무시병 환자에서 질환의 중증도의 표지자로서의 저알부민혈증의 임상적 의의
김영옥(Young Ok Kim),전희경(Hee Kyung Jeon),조석구(Seok Goo Cho),윤선애(Sun Ae Yoon),손현식(Hyun Sik Son),오수혁(Soo Hyuk Oh),채현석(Hyun Suk Chae),김관형(Kwan Hyoung Kim),채장성(Jang Seong Chae),이창돈(Chang Don Lee),이봉수(Bong Soo 대한내과학회 2000 대한내과학회지 Vol.59 No.5
N/A Background : Although hypoalbuminemia is common in patients with tsutsugamushi disease, acute rickettsial infectious disease, its impact on the severity of disease is not reported. Therefore, we studied the role of hypoalbumiemia as a marker of the severity of disease in patients with tsutsugamushi disease. Methods : We retrospectively reviewed clinical data of 95 patients with tsutsugamushi disease who were admitted between January 1994 and December 1999 at Uijongbu St. Mary's hospital. We compared clinical and laboratory findings, complications, and mortality between hypoalbuminemic group (serum albumin < 3.0 g/dL) and control (serum albumin ≥ 3.0 g/dL). Results : Of the total 95 patients, 50 patients (52.6%) had hypoalbuminemia. In hypoalbuminemic group, the incidence of hypotension was higher (20.0% vs 2.2%, p=0.006) and the duration of admission was longer (12.0±4.5 vs 8.8±2.7 days, p<0.001), compared to control. The degree of thrombocytopenia in hypoalbuminemic group was severer than that in control (84,000±46,000 vs 138,000±75,000/mm3, p<0.001). Hypoalbuminemic group showed higher incidence of interstitial pneumonia (64.0 vs 13.3%, p<0.001), hypoxia (40.0 vs 6.6%, p<0.001), metabolic acidosis (12.0 vs 0%, p=0.018), and acute renal failure (18.0 vs 4,4%, p=0.038), compared to control. Four patients who had hypoalbuminemia died due to septic shock and multiorgan failure. Conclusion : This study shows that hypoalbuminemia could be used as a marker of the severity of disease in patients with tsutsugamushi disease.(Korean J Med 59:516-521, 2000)
내시경적 정맥류 결찰요법후에 생긴 폐쇄성 식도혈종 1예
이봉수,김부성,백남종,오수혁,변병훈,오기원,윤승규,박영민 대한소화기내시경학회 1993 Clinical Endoscopy Vol.13 No.1
Endoscopic variceal ligation(EVL) is an accepted alternatives to endoscopic injection sclero- therapy(EIS) in many patients with bleeding esophageal varices. Esophageal hematoma is rare and an unusual complication after EVL or EIS. We present a patient with liver cirrhosis who developed an obstructive esophageal hematoma after EVL.
김병수,정인식,김재광,최종영,오수혁,위성헌 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.2
Foreign bodies in the stomach are usually ingested by children under the age of 5 years, persons with dentures and alcoholics or mentally disturbed individuals. Many patients will be asymptomatic and will be brought in by parents with a history of having swallowed something. The ingested foreign bodies are mainly coins, particles of metal, fish bones and etc. A toothpick in the stomach has been rarely reported in an alert adult. Here, we present a case of a patient with toothpick stuck in the stomach, that she did not realize she had swallowed. It was removed by an endoscopy without any complications. A 57 year-old woman was admitted to Uijoagbu St. Mary's hospital because of epigastric pain for 10 days. The pain persisted constantly in the epigastrium and aggravated after meals. Sbe had an episode of vomiting during these days. A yellowish white, thin, stiff material 1.5 cm long was found by an endoscopic examination stuck at the less curvature of the antrum. It was removed by the endoscopic biopsy forceps and was proved to be an wooden toothpick, sharp at both ends, with a length of 6.6cm and a diameter of 0.2 cm. There was a small ulcer at the site of the removed toothpick and mild bleeding from the ulcer. The epigastric pain was relieved after the removal of the toothpick. She did not realize she had swallowed the toothpick. Four days later, a follow-up endoscopic examination revealed closed ulcer and no bleeding. She was discharged without complications.
이은정,정인식,김재광,김승준,오수혁,민도준,김창섭,위성헌 대한소화기내시경학회 1995 Clinical Endoscopy Vol.15 No.1
Both duodenal ulcer and gastric cancer are common, and it is well known that the pathophysiology of the two is different. The presence of a duodenal ulcer is believed to protect against the development of a gastric malignancy. However gastric cancer may occur in the presence of active or chronic duodenal ulcer disease. Although rare in incidence of coexistence of duodenal ulcer and gastric cancer, physician must be alert to the strange association of duodenal ulcer and gastric cancer. Here, we present 3 cases with coexistence of duodenal ulcer and gastric cancer, diagnosed by endoscopy.
대장균에 의한 다발성 신농양 환자에서 발생한 가역성 단백 상실성 장병증 1례
김영옥,이창돈,송하헌,윤선애,오수혁,방병기,민준기,박재명 대한내과학회 1999 대한내과학회지 Vol.56 No.3
Protein-losing enteropathy is characterized by excessive protein loss into the intestinal tract in association with various disorders. We report a case of reversible protein-losing enteropathy as a cause of severe hypoalbuminemia in a patient with multiple renal abscesses. A 61-year-old woman presented with high fever and left flank pain. Abdominal computed tomography showed multiple abscesses in the left kidney. E. coli was cultured from her blood. Although hypoalbuminemia was severe (1.9 g/dL), the liver function tests including prothrombin time were normal and urine protein was negative. The results of 99mTc-human serum albumin scintigraphy were compatible with protein-losing enteropathy. Alpha-1 -antitrypsin clearence was 89 ml/24 hours (normal range <13 ml/24 hours). After the renal abscess was improved with antibiotic therapy, serum albumin increased to normal range and protein-losing enteropathy disappeared.