완전대혈관 전위의 심방내 교정술 후 추적 관찰

김연우,노정일,허준,윤명자,김호성,최정연,윤용수,양세원,이정렬,김용진,노준량 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

회맹장 및 대장을 침범한 장 결핵에 있어서 바륨을 이용한 방사선 이중조영촬영 소견에 대한 연구

진용현,전혜정,이용근,강철호,조성범,김윤환,박철민,차상훈,김일영,이혜경 건국대학교 의과학연구소 2002 건국의과학학술지 Vol.12 No.-

To determine the characteristic double contrast barium enema findings of ileo-cecal and colonic tuberculosis and to make differential diagnosis from other bowel inflammatory disease. Sixty-seven patients confirmed as ileo-cecal and/or colonic-tuberculosis in six hospitals were evaluated retrospectively. The diagnosis was proven by endoscopic biopsy, surgery, and clinical follow up. Nine of 67 patients were excluded because radiologic findings were normal though endocopic biopsy examinations resulted in tuberculosis. Histopathological diagnosis were madein 58 cases as follows: endoscopic biopsy(n=29), operation(n=12), follow up examination(n=14), tissue culture(n=1), laparoscopic biopsy(n=2). There were 30 men and 28 females. The mean age were 36 yrs(range:16-67), 34 patients were in the second and third decade. The distribution of lesions, morphological characteristics, mucosal changes, ulcer shape and depth, associated with other tuberculous lesion, multiplicity were retrospectively analyzed in the findngs of double contrast barim enema. The commonest clinical symptoms were abdominal pain(n=35, 60%) and diarrhea(n=18, 31%). The chest radiography revealed association of pulmonary tuberculosis in 39 cases. Tuberculous lesions of other organs except chest were present in five cases. Double contrast barium enema findings showed a thickening and irregularity of intestinal mucosal fold(n=29, 50%), bowel contraction and/or shortening(n=26, 45%). There were small, nodular, superficial ulcers in the case of ulcer depth less than 2 mm in the depth. As many as 39 cases(67%) in this series had two or more lesions in the intestinal tuberculosis. The involved segment revealed symmetrical feature(n=21, 36%). Inflammatory pseudopolypoid lesions were noted in 30 cases(52%). The ileo-cecal region was involved in 38 cases(66%). The ascending colon(n=25, 43%) was the second commonest site with or without contiguous cecal involvement. Lesions in terminal ileum, ileo-cecal valve, transverse colon, descending colon and appendix were seen in 19, 18, 18, 12 and seven cases, respectively. Among 18 cases of ileo-cecal valve lesions, there were incompetency in nine cases(16%) and wide gapping in four cases(7%). In 14 cases, tuberculous enterocolitis was diagnosed by clinical follow-up and double contrast barium enema study. 12 out of 14 cases, the findings of double contrast barium enema of tuberculous enterocolitis were normalized after anti-tuberculous medication. However, two cases showed more aggravated state than before due to inappropriate treatment. Double contrast barium enema plays an important role in the diagnosis of tuberculous enterocolitis, determines the type, site and extent of the involvement and helps in treatment guide by using sequential studies.

목탄분말 시용량이 양파 생육 및 토양 이화학성에 미치는 영향

윤봉기,박인진,유용권,허원녕,김병운,김용웅 한국국제농업개발학회 2004 韓國國際農業開發學會誌 Vol.16 No.2

양파재배 토양에서 목탄의 적정 사용량 및 토양개량 효과를 구명하기 위하여 참나무 목탄분말을 10a당 0(무처리), 300, 500, 1,000, 1,500, 2,000㎏ 수준의 6처리로 2000년에 시험한 결과는 다음과 같다. 1. 목탄 시용으로 양파생육이 좋아지는 경향이었으며 10a당 300㎏시용에서 초장, 엽수, 줄기직경 등 생육이 좋았다. 2. 목탄 시용에 따른 순량 구성요소는 10a당 300㎏ 시용에서 가장 좋았으며 수량도 300, 500㎏ 시용에서 각각 7%, 2% 증수되었고 1,000㎏ 이상 시용에서는 감수되는 경향 이었다. 3. 목탄 시용으로 토양 pH가 중성 가까이 변화되고 토양 유기물 함량과 양이온 치환용량 이 증가하여 토양 화학성이 개선되었다. 4. 목탄 시용으로 토양의 용적밀도와 고상율이 감소하고 토양 공극율이 증가하여 토양 물 리성이 개선되었다. This experiment was conducted to find out an application amount of wood charcoal pow-der and soil improvement effect of wood charcoal in 2000 year. The wood charcoal was made of a black oak. An application amount of used wood charcoal was 0, 3, 5, 10, 15, 20 Mg/㏊. Effect of soil improvement and application amount of wood charcoal was summerized as follows; Onion growth of plot applied wood charcoal was better than that of plot not applied wood charcoal. The plant height, the number of leaf and diameter of stem of plot applied wood charcoal 3 Mg/㏊ were better than any other that of plot. Yield components of plot applied wood charcoal 3Mg/Bμ were the best. Yied of plot applied wood charcoal 3 and 5 Mg/ha was increased 7% and 2% than that of control. But that of plot applied wood charcoal 10 Mg/㏊ over was trend to decrease.

大邱의 沿革과 關聯된 古代記錄 小考

尹容鎭 慶北大學校 東洋文化硏究所 1975 東洋文化硏究 Vol.2 No.-

In the years prior to the rule of Silla, the Daegu Community had formed a small independent political unit. But when Silla's conquest of the community caused the division of it into two separate administrative units and led to the disunion of indigenous political powers, the community's decline began and went on through the Silla days. Under the rule of Koryo, however, the Daegu Community entered into a new stage of development during which the improvement and enlargement of new irrigation facilities resulted in a remarkable increase of agricultural productivity. At the period, political and economic foundations were built on the basis of which the Daegu Community could grow into one of the most important cities in the Korea after Chosun.

목탄분말의 입자크기가 양파 생육과 토양 이화학성에 미치는 영향

윤봉기,박인진,유영권,허원영,김병운,김용웅 한국국제농업개발학회 2004 韓國國際農業開發學會誌 Vol.16 No.3

토양개량용으로 적합한 목탄의 입자크기를 구명하기 위하여 양파 재배 토양에서 참나무 목탄분말과 소나무 목탄분말의 입자크기를 각각 1 ㎜이하, 1~5㎜, 5~10㎜의 3처리로 하여 목탄분말을 500㎏/10a 수준으로 사용하고 2001년에 시험 한 결과는 다음과 같다. 1) 시험에 사용된 목탄의 화학적 특성은 참나무 목탄은 pH10.1, T-N 0.04%, P₂O_(5) 1.63%, K₂O 0.34%이었으며 소나무 목탄은 pH 9.3, T-N 0.24%, P₂O_(5) 2.18%, K₂O 0.33%이었다. 2) 수확기의 양파 생육은 초장 50.0~62.6㎝, 엽수 6.0~6.5매, 줄기직경 11.2~16.4㎜이었으며 1 ㎜이하 크기의 목탄 시용구에서 초장. 염수, 줄기직경 등 생육이 좋았다. 3) 목탄 입자크기에 따른 수량 구성요소는 1 ㎜이하 시용 구에서 구고. 구 직경, 구중 등이 좋았으며 수량도 목탄 입자크기 1 ㎜이하 시용구에서 많았다. 4) 시험후 토양 화학성은 토양 pH 5.9~6.3, OM 14.7~15.5 g ㎏^(-1), CEC 15.6~16.8 c㏖^(+)㎏^(-1), Avail. P₂O_(5) 147~186㎎ ㎏^(-1), Exch. K 0.35~0.41c㏖^(+) ㎏^(-1)으로 시험전 토양에 비하여 OM, CEC가 증가하고 Avail. P₂O_(5), Exch. K의 축적이 경감되었다. 5) 시험후 토양의 물리성은 용적밀도 1.20~l.24g ㎝^(-3), 고상 45.1~46.6%, 공극율 53.4~54.9% 이었으며 목탄 입자크기 1 ㎜이하 시용구에서 좋아지는 경향이었다. 6) 시험후 토양의 미생물상은 세균 64.3~200.4(×10^(5))cfu g^(-1),방선균 26.4~70.3(×10^(5)), 사상균 16.9~186.2(×10³))이었으며 <1㎜, 1~5㎜ 크기의 목탄 시용구에서 세균, 방선균, 사상균이 많은 경향이었다. This experiment was conduct to find out moderating particle size of wood charcoal powder for soil improvement in 2001 year. The wood charcoal material was a black oak and pine. The particle size of wood charcoal was 1㎜ below, 1~5 ㎜ and 5~10 ㎜. An amount of wood charcoal application was 500 ㎏ l0a^(-1), Chemical properties of a black oak charcoal used experiment was pH 10.1, T-N 0.04%, P₂O_5 1.63% and K₂O 0.34%. That of pine charcoal was pH 93, T-N 0.24%, P₂O_(5) 2.18%, K₂O 033%. At harvest stage of onion, plant height was 50.5~62.6㎝. The number of leaf was 6.0~6.5ea. Stem diameter was 11.2~16.4 ㎜. Plant height, the number of leaf and stem diameter of plot treated 1 ㎜ below wood char-coal were be longer, more or bigger than those of any other particle size. Onion height, diameter and weight of plot treated 1 ㎜ below wood charcoal was higher or bigger than that of any other particle size. Yield was similar to yield component. Soil chemical properties of after experiment was pH 5.9~63, OM 14.7~15.5 g ㎏^(-1), CEC 15.6~16.8 c㏖^+ ㎏^(-1), Avail. P₂O_(5) 147~486 mg ㎏^(-1) and Exch. K 035~0.41 c㏖+ ㎏^(-1). OM and CEC was increased than that of before experiment. Avail. P₂O_5 and Exch. K was decreased than that of before experiment. Soil texture after experiment was bulk density 1.20~4.24 g ㎝^(-1), solid phase 45.1~46.6%, porosity 53.4~54.9%. Soil texture was trend to be improved by l㎜ wood charcoal. Soil microflora after experiment bacteria 64.3~200.4(×10^(5))cfu g^(-1) actinomycete 26.4~70.3(×l0^(5))cfu g^(-1) and fungi 16.9~186.2(×10³)cfu g^(-1) Bacteria, actinomycete and fungi was much at plot treated with <1 ㎜, 1~5 ㎜ wood charcoal with out relation to wood charcoal material.

남부 평야지 자운영재배답에서 논유형과 질소수준이 벼 생육 및 토양 화학성에 미치는 영향

윤봉기,김병호,이인,최형국,박인진,김용웅 한국국제농업개발학회 2003 韓國國際農業開發學會誌 Vol.15 No.3

녹비작물로서 자운영을 재배한 논에 벼를 재배할 때 질소비료의 절감기준을 구명하고자 평야지인 전남 나주의 보통답과 사질답에서 관행, 자운영+질소 70%, 자운영+질소 50%, 자운영+질소 30%, 자운영+무질소의 5처리로 1999년부터 2001년까지 3년동안 시험한 결과는 다음과 같다. 1. 자운영의 개화성기 생육은 초장 43.6~43.9㎝, 생초중 21.79~24.99Mg ha^(-1)이였으며 무기성분 함량은 T-N 2.40~2.64%, P₂O_(5) 0.42~0.46%, K₂O 1.83~2.01%였다. 자운영의 생육은 보통답이 사질답에 비하여 생초중이 많았고 T-N, T-C, P₂O_(5), CaO, MgO의 함량도 높았다. 2. 토양중 NH₄-N함량의 경시적 변화는 이앙후 7일에 20.7~47.4㎎ kg^(-1)으로 점차 감소하였는데 처리에 따라서는 자운영+질소 70%, 자운영+질소 50% 시용구에서 높았다. 3. 벼의 생육은 사질답이 보통답에 비하여 초장 및 간장이 크고 ㎡당경수가 많았고 처리에 따라서는 자운영+질소 50%, 자운영+질소 30%시용구에서 생육이 좋았다. 식물체중의 T-N, P₂O_(5), K₂O함량도 자운영+질소 70%, 자운영+질소 50%시용구에서 많은 편이었다. 4. 시험후 토양의 화학성은 관행에 비하여 보통답의 자운영 시용구에서 OM, CEC, Ava, P₂O_(5)함량이 증가하였고 사질답에서는 CEC가 증가하였다. 5. 벼의 수량은 관행(보통답 5.15Mg ha^(-1), 사질답 5.16Mg ha^(-1))에 비하여 보통답에서는 자운영+질소 70%, 50%, 30%시용구에서 각각 3, 6, 4% 증수되었고, 사질답에서는 자운영+질소 70%, 50%시용구에서 각각 3, 5%증수되었다. 6. 남부 평야지에서 자운영을 재배하여 생초 20Mg ha^(-1)를 녹비로 투입하면 벼를 재배시 질수시용 적정량을 보통답에서는 관행시비량의 30%, 사질답에서는 관행시비량의 50%이였다. This study was conducted to find out an amount of N fertilizer for rice culture followed after milk vetch(MV) cultivated at normal and sandy paddy field in Naju which lies to southern plain region from 1999 to 2001. The amounts of N fertilizer were 110(normal paddy) and 130(sandy paddy)㎏ ha^(-1) at control and 0, 30, 50, 70% of control. At flowering stage of MV, Plant height was 43.6~43.9㎝ and fresh weight was more than that of sandy paddy field. Also, the contents of T-N, T-C, P₂O_(5), CaO, MgO in MV plant cultivated normal paddy field were higher than those of sandy paddy field. Content of NH₄-N in soil was 20.7~47.4㎎ ㎏^(-1) at 7days after transplanting and 6.1~8.1㎎ ㎏^(-1) at 70days after transplanting of rice plant. Content of NH₄-N in soil was high at the treatments of MV+N50% and MV+N70%. Rice plant height, culm length and the number of tiller per ㎡ in sandy paddy field were higher than those of normal paddy field. Growth of rice plant in MV+N70% and MV+N50% was higher than that in others. And the content of T-N, P₂O_(5) and K₂O of rice plant in MV+N70% and MV+N50% were higher than those in others. Chemical properties of soil after experiment were pH 5.1~5.9, OM 15.6~20.9g ㎏^(-1). CEC 10.1~13.8cmol ㎏^(-1) and Ava. P₂O_(5) 152~244㎎ ㎏^(-1). The contents of OM. CEC and Ava. P₂O_(5) in soil applied MV at normal paddy field were higher than those of the control, and the content of CEC in soil applied MV at flowering stage, rice yields of MV+N70%, 50%, MV+N30% were increased 3, 6, 4% more than that of control (5.15Mg ha^(-1)) at normal paddy field. Rice yields of MV+N70%, MV+N50% were increased 3, 5% higher than that of control(5.16Mg ha^(-1)) at sandy paddy field. Nitrogen application rate of normal paddy field was 30%, and sandy paddy field was 50% of conventional fertilization rate when 20Mg ha^(-1) MV cultivated paddy field was inputed for rice culture in the southern plains.

목탄분말의 원료수종이 양파 생육과 토양 이화학성에 미치는 영향

윤봉기,박인진,유영권,허원영,김병운,김용웅 한국국제농업개발학회 2004 韓國國際農業開發學會誌 Vol.16 No.3

양파재배 토양에서 토양개량용으로 적합한 목탄의 원료 수종을 선발하기 위해서 관행(무처리)과 코코넛피트, 대나무, 참나무, 활엽수 수피, 소나무로 만든 목탄분말의 6처리로 시용량 500㎏· 10a^(-1)으로 하여 2002년에 시험한 결과는 다음과 같다. 1. 시험에 사용한 5종 목탄의 pH는 5.1~10.1, T-N 0.15~0.71%, P₂O_(5) 2.06~2.65%, K₂O 0.20~0.86% 범위였으며 1 ㎜이하 입자의 분포는 9.0~84.8%이었다. 2. 양파의 생육은 목탄시용으로 줄기직경이 크고 주당 엽수가 많은 경향이었으며 참나무, 활엽수 수피, 대나무 목탄처리 구에서 생육이 좋았다. 양파의 수량은 4,631~5,114㎏ 10a^(-1)으로 무처리(4,638㎏)에 비하여 구고가 크고 구중이 무거운 참나무목탄과 활엽수 수피 목탄처리구에서 각각 10%, 소나무 목탄구에서 3% 증수되었으며 유의성이 인정되었다. 3. 시험 후 토양의 물리성은 목탄 시용으로 용적밀도와 토양의 고상비율이 줄어들 고 액상과 기상, 공극율이 증가하는 경향을 보였다. 화학성은 코코넛 피트처리구 를 제외한 처리구에서 토양 pH가 개선되었고, OM, CEC 는 모든 처리구에서 증가하는 경향을 보였다. This experiment was conducted to find out moderating tree kinds of wood charcoal pow-der for soil improvement and onion growth in 2002 year. The wood charcoal materials were coconut peat, bamboo, black oak, pine, and broadleaf tree bark. Wood charcoal application rate was 500 ㎏ 10a^(-1). Results were summerized as follows; Chemical properties of wood charcoal used experiment were pH 5.11~10.1, T-N 0.15~0.71%, P₂O_(5) 2.06~2.65% and K₂O 0.20~0.86%. The particle size of <0.1 ㎜ was 9.0~84.8%. Onion growth of plot applied wood charcoal was better than that of plot not applied wood charcoal. The number of leaf and diameter of stem at plot applied wood charcoal was better than that of plot not applied wood charcoal. Growth of plot applied black oak charcoal, broadleaf tree bark char-coal, and bamboo charcoal was better than that of any other plot. Yield of plot applied wood charcoal was 4,631~5,114 ㎏ 10a^(-1). The yield of plot applied black oak charcoal, broadleaf tree bark charcoal and pine charcoal was increased 10, 10, 3% than that of control(4,638 ㎏ 10a^(-l)), respectively. It was significant at 5% level. Soil physical properties of after experiment was decreased bulk density and solid phase, but liquid phase, air phase and porosity were increased than that of control. Soil chemical properties of after experiment trend to be improved pH. Soil OM and CEC was increased than that of control.

미만성 대형 B-세포 림프종에서의 예후인자에 관한 연구

김삼용,곽승근,박상은,윤환중,조덕연,김진만 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

미만성 대형 B-세포 림프종은 가장 흔한 악성 림프종의 한 종류로서 우리나라에서는 전체 비호지킨 림프종의 50%를 차지한다. 비호지킨 림프종에서 병기는 호지킨병과는 달리 예후 인자로서의 유용성이 적다. 따라서 병기만을 예후 인자로서 평가하는 한계를 극복하기 위해 국제예후지표(International Prognostic Index)가 도입되었다. 특정 환자에서 IPI 점수와 함께 그 환자의 림프종의 생물학적 특성을 분석한다면 예후 예측에서 정확도가 높아질 것이다. 본 연구에서는 미만성 대형 B-세포 림프종에서 국제예후지표의 유용성을 확인하고자 하였으며, 각종 생물학적 지표의 면역화학염색을 통하여 이들을 배세포 중심 아형(germinal center subgroup : 이하 GC양 아형으로 약함)과 활성화 B-세포 아형(post-germinal center subgroup; 이후 pGC양 아형으로 약함)으로 분류하고 이들의 예후 예측에 대한 적절성을 평가하였다. 결과는 다음과 같다. 1. 연령분포는 37세에서 69세로 중앙치는 56세이었으며, 남자는 17예(65.4%), 여자가 9예(34.6%)였다. 병기는 Ⅰ, Ⅱ, Ⅲ, Ⅳ기가 각각 2예(7.7%), 11예 (42.3%), 5예(19.2%), 8예(30.8%)였다. 'B'증상은 5예(19.2%)에서 양성이었다. 진단 당시 혈청 LDH치가 상승한 경우가 11예(42.3%)였고, 거대종양(직경이 10㎝이상)을 갖는 경우가 5예(19.2%)이었다. ECOG 수행등급은 0이 2예(7.7%), 1이 18예(69.2%), 2가 5예(19.2%), 3이 1예(3.8%)이었다. 2. 면역조직화학염색 상 bcl-2의 양성은 17예(65.4%), bcl-6의 양성이 20예(76.9%)이었다. CD10이 양성인 경우가 5예(19.2%)이었다. IRF-4가 양성인 경우는 8예(30.8%)였다. 26명의 환자에서 bcl-6, CD10과 IRF-4를 이용하여 GC양 아형과 pGC양 아형으로 분류 하였는데, GC양 아형은 14예(53.8%)이었고, pGC양 아형은 7예(26.9%), 분류가 되지 않는 경우가 5예(19.3%)이었다. 3. 평균 48개월 동안 추적한 결과 중앙생존기간은 44개월이었고 생존기간은 1~100+개월에 분포하였다. Kaplan-Meier법에 의한 5년 누적 생존률은 32%이었다. 4. 병기, 'B' 증상, 혈청 LDH 농도, ECOG 수행등급, 거대종양유무가 통계학적으로 의미있는 임상적 예후 인자였다. 5. 면연조직화학염색에서는 bcl-2만이 통계학적으로 유의한 예후인자였다. 6. GC양 아형은 pGC양 아형에 비해 생존기간은 좋았으나, 통계학적 유의성은 없었다. 7. 다변량 분석결과 bcl-2 발현과 혈청 LDH치만이 예후에 영향을 미쳤다. Clinical Significanceof Expression of Biomarkers in Patients with Diffuse Large B-cell Lymphoma Diffuse large B-cell lymphoma(DLBL) is the most common type of lymphoma in Korea, representing about 50% of non-Hodgkin's Lymphomas. Although DLBL is usually considered as a specific category, the diversity in clinical presentation, morphology, genetic and molecular alterations strongly suggest that these tumors represent a heterogeneous group of neoplasia rather than a single clinicopathological entity. Clinical prognostic systems, including the International Prognostic Index (IPI), although useful to assess overall prognosis, embraces patients with heterogeneous prognoses. It is likely that the prognostic assessment of patients with DLBL might be improved by using biological features. During the last decade, most studies dealing with the heterogeneity of DLBL have focused on individual protein expression and molecular alterations. The expression of individual antigens related to different stages of B-cell differentiation, including CD10, bcl-6, and IRF-4, may help to define groups of tumors with different clinical and pathological characteristics. To determine the clinical significance and prognostic value of individual biomarker expression and the biomarker expression patterns according to germinal center subgroup or post-germinal center subgroup of DLBL as defined by a relatively small number of single antigens, we studied 26 patients with de novo DLBL, whose archival pathology specimen were available for immunohistochemistry studies, atChungnam National University Hospital from September 1992 to December 2000. Archival specimens from each patient were immunostained with respective antibodies for CD10, bcl-6, IRF-4, bcl-2 antigens. Two immunophenotyping profiles were distinguished according to the pattern of differentiation; germinal center(GC;CD10/Bcl-6+/IRF-4-) subgroup or postgerminal center (pGC ; CD10/bcl-6/IRF4+) subgroup. The results are as follows; 1) Baseline characteristics of patients were ; median age of patients was 56(range ; 37-69). 17 patients(65.4%) were male. 5 patients(l9.2%) had 'B' symptoms. Stages were as follows ; stage Ⅰ2 patients(7.7%), stage Ⅱ 11 patients(42.3%), stage Ⅲ 5 patients(l9.2%), stage Ⅳ 8 patients(30.8%). 11 patients (42.3%) had elevated LDH levels. 25 patients(96.2%) had ECOG performance grade 0-Ⅱ and 1 patient had grade Ⅲ. 5 patients(l9.2%) bad bulky disease. 2) The results of immunohistochemical study were as follows ; positive bcl-2 staining in 17 patients(65.4%), positive bcl-6 in 20 patients(76.1%), positive CD10 in 5 patients(l9.2%), positive IRF-4 staining in 8 patients (30.8%). 3) After a median follow up duration of 48 months, the median survival duration was 44 months with a range of survival of 1-100+ months. 5-year overall survival rate was 32% by Kaplan-Meier method. 4) The clinical factors affecting survival were elevated serum LDH level, B symptoms, bulky disease, stage at diagnosis and ECOG performance status 5) Among the biomarkers, only bcl-2 expression affected survival of DLBL patients 6) The germinal center like subgroup had superior survival than post-germinal center like subgroup but had no statistical significance. 7) Multivariate analysis showed that bcl-2 and serum LDH level had siginificance on survival Conclusion In addition to the known clinical prognostic factors, immunohistochemically defined characteristics such as bcl-2 expressionin DLBL is important and subgroups(germinal center or post-germinal center subgroup) of DLBL may have importance in predicting prognosis of DLBL patients

내시경역행성담췌관조영술 후 발생한 종격동기종, 피하공기증, 긴장성 기흉 1예

조용건,이현승,권균홍,김자영,김봉진,김지연,배용목,박선자 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

However, Endoscopic retrograde cholangiopancreatography (ERCP) is still helpful procedure for the diagonosis of the pancreatobiliary disease and treatment through endoscopic sphinterectomy (EST) is relatively safe, these have possiblity of complications such as hemorrhage, infection, panceatitis, and perforation. ERCP related perforation was rarely reported in 0.3 to 1.1% of previous study, but most serious complication. A report of Pneumomediastinum, Tension Pneumothorax complicating perforation after ERCP and EST is very uncommon. In our hospital, we experienced case of pneumomediastinum, subcutaneous emphysema, and tension pneumothorax after ERCP and EST, and the patient (a 58 years old female with suspicious common bile duct stone) was treated successfully with conservative treatment.

폐결핵치료 중인 환자에서 Rifampicin에 의해 유발된 위막성 대장염 2예

김봉진,권균홍,임창섭,김자영,홍정범,옥미선,배용목,김지연 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.4

Pseudomembranous colitis (PMC) is a disease caused by Clostridium difficile proliferation. The causative drugs are clindamycin, third-generation cephalosporins, flouroquinolone and so on. Rifampicin has been reported as a cause of PMC in the 1980s, and the frequency of PMC is increasing because rifampicin is a first line drug for anti-tuberculosis therapy. Two patients were recently admitted to our hospital due to watery diarrhea for 1 month and they were diagnosed with PMC by sigmoidoscopy. Their onset age were 74, 72 years old and latent period of symptoms were 60, 129 days, respectively. In one case, the patient displayed coexisting hypertension and diabetes. The clinical symptoms improved after discontinuing the rifampicin and then administering oral metronidazole. We report here on two cases presumed to be rifampicin-induced PMC.