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Coinfection of Viral Agents in Korean Children with Acute Watery Diarrhea
고홍,백승연,신재일,정기섭,지영미 대한의학회 2008 Journal of Korean medical science Vol.23 No.6
Currently, there are a few reports on viral coinfection that causes an acute watery diarrhea in Korean children. So, to evaluate the features of coinfectious viral agents in children with acute watery diarrhea, we enrolled 155 children with acute watery diarrhea from July 2005 to June 2006. Fecal samples were collected and evaluated for various viral infections such as rotavirus, norovirus, adenovirus and astrovirus. The mean (±standard deviation) age of the children was 2.71±2.37 yr. The detection rate of viral agents was most common in children between the ages of 1 and 3 yr. Rotavirus was detected in 63 children (41.3%), norovirus in 56 (36.2%), adenovirus in 11 (7.1%), and astrovirus in 1 (0.6%). Regarding rotavirus, there were 38 (60.3%) cases with monoinfection and 25 (39.7%) with coinfection. For norovirus, there were 33 (58.9%) cases with monoinfection and 23 (41.1%) with coinfection. Coinfection with rotavirus and norovirus was most common, and occurred in 20/155 cases (12.9%) including coinfection with adenovirus. So, rotavirus and norovirus were the most common coinfectious viral agents in our study population with acute watery diarrhea.
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김세원,채현석,민정요,손혜숙,김진수,김형근,조영석,안창혁 대한소화기내시경학회 2009 Clinical Endoscopy Vol.38 No.1
Malignant duodenocolic fistula is a rare complication of colon cancer, and this usually develops as the right-side colon cancer or colonic hepatic flexure cancer infiltrates into the second portion of the duodenum. Six Korean cases of this malignancy have been previously reported on. The patients usually complain of watery diarrhea, feculant vomiting and weight loss that can be attributed to the altered normal flora. Barium enema has been the diagnostic procedure of choice to demonstrate the fistulous tract, but with the technical development of gastroendoscopy, the primary procedure is also changing. Curative resection is not possible in many cases. Palliative ileotransverse colostomy with gastrodjejunostomy is performed to relieve symptoms, but it cannot completely prevent the vomiting or diarrhea. We herein present a case of malignant duodenocolic fistula in a patient who had been suffering from indigestion, loose stool and feculant vomiting for one year. This case was diagnosed by endoscopy and the patient underwent a palliative operation. 악성 십이지장-결장루는 대장암의 매우 드문 합병증으로 국내에서는 현재까지 6예가 보고되어 있다. 대부분 횡행 결장이나 결장 간만곡부의 종양이 십이지장 후구부를 침범하여 발생한다. 장내 세균총 변화와 관련하여 수양성 설사와 악취가 나는 구토, 현저한 체중감소 등이 주요 증상으로 나타난다. 대장 조영술이 진단에 가장 유용하다고 알려져 있으나 최근에는 상부 위장관 내시경의 일반화 및 기술 발달 추세로 인해 진단 방법이 달라진 양상을 보인다. 치료는 대부분의 경우 국소 침윤이나 전이가 동반되어 있어 증상 호전을 위한 고식적 수술을 시행하게 되며 구토와 설사가 완전히 호전되기는 어렵다. 저자들은 1년 이상 소화불량과 무른변 그리고 악취를 동반한 구토를 주소로 내원한 환자에서 상부 위장관 내시경을 시행하여 십이지장 후구부와 상행 결장간의 누공을 발견한 후 고식적 수술을 시행한 증례를 경험하여 문헌고찰과 함께 보고한다.
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김태영,박성식,Kim, Tae-Yeong,Park, Seong-Sik 사상체질의학회 2020 사상체질의학회지 Vol.32 No.2
Objectives The purpose of this study is to examine the meaning of the Soeumin's Watery diarrhea with little residue(下利淸水). Methods We examined the Watery diarrhea with little residue and Daeseunggi-tang(大承氣湯) in 『Sanghanlun(傷寒論)』, and considered the quotation and the treatment of the Watery diarrhea with little residue in 『Donguisusebowon(東醫壽世保元)』. Afterward, we considered the meaning of the Soeumin's Watery diarrhea with little residue by comparing the view of Junggyeong Jang and Jema Lee. Results and Conclusion 1. Jaricheongsu Saeksuncheong(自利淸水 色純靑) is an expression about the aspect of the Watery diarrhea in 『Sanghanlun』. Especially, Saeksuncheong(色純靑) means there is no residue in Watery diarrhea, and is an expression to distinguish from Haricheonggok(下利淸穀). 2. Haricheongsu(下利淸水) is the Watery diarrhea with little residue in 『Donguisusebowon』. It is caused by the coldness of the Soeumin and should be understood separately from Harihwangsu(下利黃水). 3. Considering the characteristics of the Soeumin, Jema Lee divided the aspects of the Watery diarrhea according to turbidity. Then, he suggested Gwangyebujaijung-tang(官桂附子理中湯) in the warm method(溫法), Seed of Crotonis Fructus(巴豆) in the diarrhea method(下法), and Gangchulgwanjung-tang(薑朮寬中湯) in the warm method after using the diarrhea method as the treatment of the Watery diarrhea with little residue, and aimed to treat the coldness of the Soeumin.
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Pneumatosis intestinalis after adult liver transplantation
김종만,Yulri Park,조재원,권준혁,김성주,Seung Heui Hong,이석구 대한외과학회 2011 Annals of Surgical Treatment and Research(ASRT) Vol.80 No.6
Pneumatosis intestinalis is an uncommon disorder characterized by an accumulation of gas in the bowel wall. We described three cases undertaking liver transplantation. The patients developed diarrhea in three cases and high fever in two. An abdominal X-ray and computed tomography scan demonstrated extensive pneumatosis intestinalis in the colon with pneumoperitoneum mimicking hollow organ perforation. However, the patients had no abdominal symptoms and there was no evidence of peritonitis. The infection work-up was negative except one case with cytomegalovirus antigenemia. After one week of conservative management including bowel rest and antibiotic therapy, their pneumoperitoneum resolved spontaneously without any complication. Pneumatosis intestinalis should be considered as a differential diagnosis after adult liver transplantation with patients suffering from watery diarrhea and fever. Pneumoperitoneum, air-density in mesentery and retroperitoneum in patients with pneumatosis intestinalis without signs of peritonitis improved with conservative management, which included bowel rest and antibiotic therapy.
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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.
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