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용혈성 빈혈의 1 치료예

A Case of Hemolytic Anemia Responded to Steroid Therapy

김정일 ( Jung Il Kim )
  • : 대한내과학회
  • : Korean Journal of Medicine(구 대한내과학회지) 12권8호
  • : 연속간행물
  • : 1969년 08월
  • : 599-602(4pages)
Korean Journal of Medicine(구 대한내과학회지)

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A 34-year-old school teacher with idiopathic acquired autoimmune hemolytic anemia who has showed positive Coombs` test was presented. Complete remission was obtained with long-term treatment of prednisolone. An attempt has been made to review the pertinent literature

UCI(KEPA)

I410-ECN-0102-2009-510-004143501

간행물정보

  • : 의약학분야  > 내과학
  • :
  • :
  • : 격월
  • : 1738-9364
  • : 2289-0769
  • : 학술지
  • : 연속간행물
  • : 1949-2021
  • : 12129


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96권4호(2021년 08월) 수록논문
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1만성 신장 질환 환자의 비대면 관리 방법

저자 : 유지호 ( Jiho Yoo ) , 서아론 ( Aaron Su ) , 유승호 ( Seungho Yoo )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 96권 4호 발행 연도 : 2021 페이지 : pp. 253-263 (11 pages)

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22021 대한부정맥학회 심방세동 환자의 특수 임상 상황 환자군에서 ABC Pathway 치료 지침

저자 : 황유미 ( You Mi Hwang ) , 임홍의 ( Hong Euy Lim ) , 이대인 ( Dae In Lee ) , 유희태 ( Hee Tae Yu ) , 박예민 ( Yae Min Park ) , 정보영 ( Boyoung Joung )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 96권 4호 발행 연도 : 2021 페이지 : pp. 264-295 (32 pages)

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Optimized management of atrial fibrillation requires patient-oriented decision making with a multidisciplinary approach. This report incorporates recent authoritative studies to provide detailed recommendations for managing atrial fibrillation in specific clinical settings. The principles of the Atrial fibrillation Better Care (ABC) pathway apply in these clinical settings. In addition, specific considerations are discussed for each of these conditions and populations. (Korean J Med 2021;96:264-295)

32021 대한부정맥학회 심방세동 환자의 뇌졸중 예방 관리 지침

저자 : 이기홍 ( Ki Hong Lee ) , 김진배 ( Jin-bae Kim ) , 신승용 ( Seung Yong Shin ) , 정보영 ( Boyoung Joung )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 96권 4호 발행 연도 : 2021 페이지 : pp. 296-311 (16 pages)

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Atrial fibrillation (AF) is a strong risk factor for ischemic stroke and systemic embolism. To prevent thromboembolic events in patients with AF, anticoagulation therapy is essential. The anticoagulant strategy is determined after stroke and bleeding risk assessments using the CHA2DS2-VASc and HAS-BLED scores, respectively; both consider clinical risk factors. Vitamin K antagonists (VKAs) are the sole anticoagulant option in AF patients with a prosthetic mechanical valve or moderate-severe mitral stenosis; in all other AF patients VKA or non-vitamin K antagonist oral anticoagulants are therapeutic options. However, antiplatelet therapy should not be used for stroke prevention in AF patients. Anticoagulation is not needed in AF patients with low stroke risk but strongly recommended in those with a with low bleeding risk. Left atrial appendage (LAA) occlusion offers an alternative in AF patients in whom long-term anticoagulation is contraindicated. Surgical occlusion or the exclusion of LAA can be considered for stroke prevention in AF patients undergoing cardiac surgery. In this article, we review existing data for stroke prevention and suggest optimal strategies to prevent stroke in AF patients. (Korean J Med 2021;96:296-311)

4마이크로바이옴과 암 면역 치료

저자 : 홍문기 ( Moonki Hong ) , 정민규 ( Minkyu Jung )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 96권 4호 발행 연도 : 2021 페이지 : pp. 312-317 (6 pages)

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Immune checkpoint inhibitors (ICIs) have achieved promising clinical results in cancer treatment over the past decade. However, the efficacy of ICIs is less than 30% in most tumor types, and studies are underway to identify the predictive factors responsive to ICIs. More than 1,000 species of microorganisms live in the human body, and the second human genome project, The Human Microbiome Project, has been conducted to understand human diseases through interactions with microbes. As the microbiome project has progressed, many studies have reported on the association between microorganisms and human diseases, including preclinical and clinical studies on the relationship between ICIs and the microbiome. Therefore, in this manuscript, the relationship between the microbiome and cancer, especially the effectiveness of ICIs, is reviewed. (Korean J Med 2021;96:312-317)

5내시경적 역행성 췌담도 조영술 연관 천공의 진단과 치료

저자 : 김영중 ( Young Jung Kim ) , 박창환 ( Chang Hwan Park )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 96권 4호 발행 연도 : 2021 페이지 : pp. 318-327 (10 pages)

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Endoscopic retrograde cholangiopancreatography (ERCP)-related iatrogenic perforations are identified when gas or luminal contents exit the gastrointestinal tract during ERCP. Although perforations are rare, mortality is high; prompt diagnosis and appropriate management are essential. A multidisciplinary approach is required. The vast majority of such patients can be safely managed medically and endoscopically but must be carefully selected. Endoscopic closure can be considered, depending on the type of perforation. In patients who are deteriorating or whose iatrogenic perforations are not securely closed endoscopically, surgery is mandatory. (Korean J Med 2021;96:318-327)

6항생제 약물알레르기의 진단과 관리

저자 : 김주희 ( Joo-hee Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 96권 4호 발행 연도 : 2021 페이지 : pp. 328-336 (9 pages)

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Drug allergies encompass a spectrum of immune-mediated hypersensitivity reactions with various mechanisms and clinical presentations. β-lactam drugs are common causes of drug allergies. A detailed clinical history as well as skin and drug provocation tests, are essential to diagnose drug allergies. The key to successful treatment is avoidance or discontinuation of the offending drug, and replacing it with a safe alternative. Cross-reactivities among β-lactam antibiotics should be considered when choosing alternative medications. Proper management of β-lactam allergies is important at the individual and population levels, to reduce the likelihood of drug allergies and prevent antibiotic-related adverse outcomes. (Korean J Med 2021;96:328-336)

7항핵항체의 올바른 해석

저자 : 손창남 ( Chang-nam Son ) , 김상현 ( Sang-hyon Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 96권 4호 발행 연도 : 2021 페이지 : pp. 337-340 (4 pages)

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Anti-nuclear antibodies (ANAs) are autoantibodies against nuclear substances or other cellular components. ANA tests are used in the diagnostic process to screen patients with suspected rheumatic or autoimmune diseases. ANA-associated diseases are characterized by a high titer of antinuclear antibodies and include systemic lupus erythematosus, systemic sclerosis, and mixed connective tissue diseases. ANA test results must be cautiously interpreted as they can be positive not only in infections and oncological diseases but also for the healthy general population. The ANA test mainly uses the indirect immunofluorescence test, and the results are expressed in terms of the final titer and pattern. The ANA test can increase diagnostic value when used in conjunction with the evaluation of disease-related clinical symptoms. (Korean J Med 2021;96:337-340)

8약물이상반응 감시 현황: 단일기관 10년 자료 분석

저자 : 박수빈 ( Soo Been Park ) , 문미라 ( Mira Moon ) , 김현화 ( Hyun Hwa Kim ) , 박가윤 ( Ga-Yoon Park ) , 강동윤 ( Dong Yoon Kang ) , 이주연 ( Ju-yeun Lee ) , 조윤숙 ( Yoon Sook Cho ) , 강혜련 ( Hye-ryun Kang ) , 조상헌 ( Sang-heon Cho )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 96권 4호 발행 연도 : 2021 페이지 : pp. 341-351 (11 pages)

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목적: 의약품의 적절한 사용에도 불구하고 약물이상반응(ADR)은 발생할 수 있으며, 이는 환자의 안전과 직접적으로 관련된 문제를 야기할 수 있다. 이 연구의 목적은 단일 3차 의료기관에서 약물이상반응과 중대한 이상사례의 특성을 분석하는 것이다.
방법: 서울대학교병원 약물안전센터에 2010년 1월 1일부터 2019년 12월 31일까지 보고된 약물이상반응 평가자료를 분석하였다. 약물 사용과 이상사례 발생의 인과성은 세계보건기구 웁살라 모니터링센터(World Health Organization-Uppsala Monitoring Centre, WHO-UMC) 인과성 평가 기준을 기반하여 확실함(certain), 가능성 높음(probable), 가능성 있음(possible)으로 평가된 사례들만 분석에 포함하였다. 연령, 성별, 증상 발생 시기, 중증도 및 위중도 그리고 약물이상반응, 중대한 이상사례의 신체기관계 분류가 분석되었다.
결과: 연구 기간 동안 총 49,955건의 약물이상반응 평가지가 가능성 있음, 가능성 높음, 확실함으로 평가되었다. 위장관계 증상(25.9%)은 전체 보고 건수에 비해 중증(2.6%)의 비율이 낮았던 반면, 혈액학적 질환(6.6%)은 중증(39.2%)의 비율이 상대적으로 높았다. 약물이상반응 중 10.2%가 중대한 이상사례로 평가되었으며, 양 극단의 연령대에서 중대한 이상사례의 비율이 높았다. 신체기관계 분류로 분류하였을 때는 전신 질환이 가장 많이 보고되었으며 그 뒤로 피부와 부속기관 장애가 많았다. 항암제와 항생제가 중대한 유해사례의 의심약제로 가장 많이 보고되었다. 아나필락시스 반응이 가장 흔한 중대한 이상사례였다(6.5%).
결론: 중대한 이상사례의 비율은 신체기관계 분류와 약제 별로 다르게 나타났다. 양 극단의 연령대에서 중대한 유해사례의 비율이 높았으므로 어린이와 노인에서는 잠재적인 중대한 유해사례가 발생할 가능성이 있어 세심한 주의가 필요하다.


Background/Aims: Despite proper use of pharmaceuticals, adverse drug reactions (ADRs) can lead to problems related to patient safety. We analyzed the characteristics of ADRs, particularly serious adverse events (SAEs), in a single tertiary medical institution.
Methods: Spontaneous ADR report data collected from 2010 to 2019 in Seoul National University Hospital were assessed. Causality was evaluated according to the World Health Organization-Uppsala Monitoring Centre criteria. Age, sex, onset, severity, seriousness, and system organ class (SOC) of ADRs and SAEs were analyzed.
Results: During the study period, a total of 49,955 individual case safety reports were assessed as possible, probable, or certain. Although the number of gastrointestinal ADR reports was high (25.9%), severe cases were uncommon (2.6%). By contrast, the number of hematologic disorders was low (6.6%) but 39.2% of them were severe. Among ADRs, 10.2% were assessed as SAEs, the proportion of which was high at extreme ages and in males. Body as a whole-general disorders were the most frequently reported SOC for SAEs, followed by skin and appendage disorders. Antineoplastic agents and antibiotics were the most common causative agents of SAEs and ADRs. Anaphylactic reaction was the most frequent SAE (6.5%).
Conclusions: The proportion of SAE differs according to SOC and drug. Attention should be paid to SAEs in children and older adults because the rate of SAEs is significantly higher at extreme ages. (Korean J Med 2021;96:341-351)

9스텐트 플렌지 유발 식도 협착을 경구 스테로이드를 이용하여 치료한 예

저자 : 서준영 ( Junyoung Seo ) , 박주상 ( Ju Sang Park )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 96권 4호 발행 연도 : 2021 페이지 : pp. 352-357 (6 pages)

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Esophageal stent complications include stent migration, tumor ingrowth, perforation, a broncho-esophageal fistula, and gastroesophageal reflux. Development of a new stricture at a flange site after stent removal has been predicted but not yet reported. We experienced the first case of a recurrent esophageal stricture induced by a stent flange after stent removal. A fully covered metallic stent, which had been inserted 2 months ago for treatment of an anastomotic stricture, triggered another stricture at the flange site. Although endoscopic balloon dilatations were repeated several times and then the 2nd stent for rescue therapy was inserted, the stricture was refractory to all treatment. Thus, we prescribed oral prednisolone with repeated endoscopic balloon dilation; the stricture eventually improved. The oral steroid seemed to suppress stricture development. If a stent flange-induced refractory stricture is encountered, an oral steroid combined with endoscopic balloon dilation may be helpful. (Korean J Med 2021;96:352-357)

10장의 급성 이식편대숙주병에서 대변미생물무리이식을 시행한 2예

저자 : 연상훈 ( Sang Hoon Yeon ) , 이명원 ( Myung-won Lee ) , 조덕연 ( Deog-Yeon Jo ) , 허부연 ( Bu-Yeon Heo ) , 권재열 ( Jaeyul Kwon ) , 송익찬 ( Ik-Chan Song )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 96권 4호 발행 연도 : 2021 페이지 : pp. 358-362 (5 pages)

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급성 이식편대숙주병은 동종 조혈모세포이식의 비-재발(non-relapse) 사망률과 연관되어 있는 중요한 합병증 중 하나이다. 대변미생물무리이식을 통해 장의 미생물무리를 복원함으로써 장의 이식편대숙주병을 치료하려는 노력이 시도되고 있다. 저자들은 장의 스테로이드 불응 이식편대숙주병이 있는 환자 2명에게 대변미생물무리이식을 시행한 경험을 문헌고찰과 함께 보고하고자 한다. 첫 번째 증례는 43세 남자로 형제로부터 동종 조혈모세포이식을 받았고, 두 번째는 70세 여자로 아들로부터 사람백혈구항원 반일치 조혈모세포이식을 받았다. 두 환자는 각각 이식 후 7주 및 4주째에 급성 이식편대숙주병이 장에 발생하였다. 두 환자 모두에서 조혈모세포이식의 공여자로부터 대변을 제공받아 대변미생물무리이식을 시행하였다. 이후, 두 환자 모두에서 임상적인 증상의 호전을 보였으며, 첫 번째 환자는 완전 반응을, 두 번째 환자에서는 부분 반응을 보였다. RNA 염기서열 분석을 통해 대변미생물무리이식 전과 후의 대변을 분석하였을 때 대변 미생물무리이식 후 미생물무리의 다양성이 회복되는 것이 관찰되었다. 이로써 동종 조혈모세포이식 후에 발생하는 장의 스테로이드 불응-급성 이식편대숙주병의 치료 방법으로 대변미생물무리이식을 적극적으로 고려해야 하겠다.


Restoring the microbiota via fecal microbiota transplantation (FMT) can be an effective treatment for steroid-refractory acute graft-versus-host disease (GVHD) of the gut. Here, we report two adult patients who underwent FMT to treat steroid-refractory acute GVHD of the gut. The first patient was a 43-year-old man who underwent allogeneic hematopoietic stem cell transplantation (HSCT) with cells from a matched sibling donor. The second patient was a 70-year-old woman who underwent haplo-identical HSCT with cells from her son. Gut GVHD developed at 7 and 4 weeks after HSCT, respectively. After undergoing FMT, the clinical symptoms improved; the first patient had a complete response and the second patient had a partial response. Microbial analyses using RNA gene sequencing showed that a diverse fecal microbiome was recovered by 4 weeks after FMT. FMT should be considered an effective therapeutic option for managing steroid-refractory acute GVHD of the gut. (Korean J Med 2021;96:358-362)

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1본능성 고혈압증의 치료 및 예후

저자 : 박희명 ( H. M. Park ) , 이상계 ( S. K. Lee )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 12권 8호 발행 연도 : 1969 페이지 : pp. 525-528 (4 pages)

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2실험적 복수가토에 있어서의 복수소퇴에 관한 연구

저자 : 김용태 ( Yong Tae Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 12권 8호 발행 연도 : 1969 페이지 : pp. 529-538 (10 pages)

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Ascites was artificially induced by the partial ligation of the supraphrenic portion of the caval vein with success in 27 male rabbits. Of these, 11 animals were the control, 9 were those infected with E. coli, 7 were those infected with Staphylococcus aureus, each 6 days after the operation. The disappearance rates of ascites in these 3 groups were compared Following were the results: l. In the control group, ascites began to appear 2 to 3 days after the operation, which gradually decreased to null in 12 to 16 days. 2. In the group infected with E. coli, the disappearance curve of ascites was almost the same with the control, however, ascites came to null in 15 to 21 days. 3. In the group infected with Staphylococcus aureus, the patterns were essentially the same with above 2 groups, however, ascites came to null in 15 to 18 days, 4. The difference of the disappearance rates of ascites in the control and E. coli infected groups was statistically significant. 5. A statistically significant difference was observed in the disappearance rates of ascites in the control and Staphylococcus aureus infected groups. 6. A statistically significant difference of the disappearance rates of ascites in the E. coli and Staphylococcus aureus infected group was also observed. 7. The mechanism of the production of ascites was discussed. Also the differences in the disappearance rates of ascites in the control and infected groups were discussed in special regards to the changes of capillary permeability, osmotic pressure of the ascitic fluid, lymphatic absorption and dehydration.

3중금속대사에 관한 연구 : 제 1 편 각종질환에 있어서의 혈청 Magnesium 치의 변동

저자 : 안수벽 ( Soo Byuk Ahn )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 12권 8호 발행 연도 : 1969 페이지 : pp. 539-556 (18 pages)

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The purpose of this study is to investigate the change of serum magnesium levels in various diseases. They were determined in 98 cases: 8 normal and 90 patients using Yanagisawa`s method in magnesium determination. 90 patients include 13 patients with renal insufficiency including nephritis, 9 patients with nephrotic syndrome, 8 patients with acute renal failure and E.H.F., 5 patients with hypertension, 5 patients with hepatitis and liver cirrhosis, 6 patients with diabetes mellitus, 13 patients with hyperthyroidism, 11 patients with euthyroidism, 4 patients with hypothyroidism, 8 patients with anemia and 8 patients with leukemia. Following were the results: 1. In normal Koreans, the mean serum magnesium level was 2.04±0.19mEq/L and there was no difference between both sexes. 2. In various renal insufficiency including nephritis and in nephrotic syndrome, the mean serum magnesium levels were 2.18±0.46mEq/L and 2.30±0.35mEq/L respectively. They were high than normal control. 3. In acute renal failure including E.H.F., the mean serum magnesium level was elevated to 3.02±0.34mEq/L and the difference from normal value was statistically signifficant, 4. In hypertension, the mean serum magnesium level was 2.13±0.34mEq/L and there was no differance with normal control. 5. In hepatitis and liver cirrhosis, the mean serum magnesium level was l.82±0.28mEq/L which showed lower value compared with that of normal control. 6. In diabetes mellitus, the mean serum magnesium level was lowed to 1.51±0.41mEq/L and this value was statistically lower than the normal value. 7. In patients with thyroid diseases, the mean serum magnesium levels had tendency to show low value compared with the increase of thyroid function. They were 2.10±0.14mEq/L in hyperthyroidism, 2.37±0.38mEq/L in euthyroidism, and 2.77±0.18mEq/L in hypothyroidism. 8. In various anemias and leukemias, the mean serum magnesium levels were 1.95±0.27mEq/L and l.95±0.55mEq/L. There was no difference with normal control. 9. There was no relation between compound and dialytic form of serum magnesium concentration in neither normal groups nor various diseases.

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The purpose of this study is to investigate the changes of serum copper, ceruloplasmin, and zinc concentrations according to the stage of pregnancy and after delivery. Serum copper, ceruloplasmin, and zinc concentrations were determined by Gubler`s, Shimgu`s, and Dithizone method respectively in 132 cases: 14 cases for copper and ceruloplasmin, and 2 cases for zinc in first trimester, 17 cases for copper and ceruloplasmin, and 6 cases for zinc in second trimester, 28 cases for copper and ceruloplasmin, and 25 cases for zinc in third trimester, and 20 cases for copper, ceruloplasmin, and zinc after delivery. The results were as follows: l. In first trimester, the mean serum copper, and zinc concentrations were 127.1±24.1㎍/dl and 140±20㎍/dl which were within normal values, but the mean serum ceruloplasmin activity (27.4±5.26㎎/dl) was significantly elevated compared with that of normal value. 2. In second trimester, the mean serum copper and ceruloplasmin concentrations were 146.8±28.33㎍/dl and 29.1±5.8㎎/dl which were significantly elevated compared with those of normal values, but the mean serum zinc concentration (112±33.82㎍/dl) was similar to normal value. 3. In third trimester, the mean serum copper, ceruloplasmin and zinc concentrations were 165.7±29.4㎍/dl,; 32.6±6.4 ㎎/dl, and 175±74.98㎍/dl, respectively which showed the highest values during the whole period of pregnancy. 4. After delivery, the mean serum copper and zinc concentrations were 111.6±22.83㎍/dl which returned to normal levels, but the mean serum ceruloplasmin activity was 26.8±3.84㎎/dl which showed to be maintained above normal value.

5장티프스 280 예에 대한 임상적 고찰

저자 : 신강연 ( K. Y. Shin ) , 최종오 ( J. O. Choi ) , 최낙상 ( N. S. Choi ) , 김계영 ( K. Y. Kim ) , 김화세 ( H. S. Kim ) , 이재곤 ( J. K. Lee )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 12권 8호 발행 연도 : 1969 페이지 : pp. 569-574 (6 pages)

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A Clinical Study on 280 patients of typhoid fever admitted to the ○○ Evacuation Hospital was carried out during the last 5 months (Nov, 1967 Mar, 1968> and the following results were obtained. 1. Seasonal occurances were insignificant because of short period of clinical observation, but prominent in December. 2. The most common symptoms were fever (82%), headache (66.4%), diarrhea (60%), abdominal pain (45.7%), anorexia (38.6%); the important sign were ileocecal pain (54.6%), anemia (38%), hepatomegaly (31.4%), relative bradycardia (30.4%), rose spots (20%), and splenomegaly (17.9%). 3. At the time of admission leukopenia in 50.2%, normal leukocyte count in 36.6%, leukocytosis in 13.1% were found; hemoglobin level in 38% of case were 10gm %. 4. Widal reaction against somatic (0) antigen showed above 1:160 titer in 130 cases of 180 cases (72.2%) l positive stool culture were in 40 cases (14.3%) 5. S.G.O.T and S.G.P.T. were significant in 27.7%, were above the range of 70~80 S-F units. 6. The duration of febrile stage of patients depended directly upon the date of admission; fever usually dropped to normal level within one week after the start of CM therapy (75%). 7. The most common complication were bronchitis in 52 cases (18.6%) intestinal perforative peritonitis in 32 cases (11.4%), and intestinal hemorrhage in 15 cases (5.4%). 8. The occurances of intestinal perforation were mostly found in 11~12 days after an onset of disease, 9. No typhoid carriers were experienced in the patients who were treated at this hospital. 10. The mortality rate was 2.8% (8 cases) 11. Recurrances in treated typhoid patients were 1.4% (4 cases) and it occured average 15 days after defeveresence and fever was dropped to the normal level within 3 to 4 days after readministration of CM.

6장티브스 치료에 있어서 펜브리틴에 대한 임상적 관찰

저자 : 이병선 ( B. S. Lee ) , 전영균 ( Y. K. Chun ) , 이재섭 ( J. S. Lee )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 12권 8호 발행 연도 : 1969 페이지 : pp. 575-578 (4 pages)

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The present study was carried out in order to evaluate the therapeutic effect of penbritin (ampicillin) in 32 selected patients with salmonella typhoid fever who were admitted to the department of internal medicine of the Seoul National University Hospital for 6 months from June to November 1968. The series consisted of 19 males and 13 females. The age range was from 11 to 62 years with mean age of 28. 4 years. The criteria for the final diagnosis and inclusion in this trial were positive widal reaction (above 1: 160 in titer) or positive blood culture or positive stool culture of salmonella group. Penbritin was given orally in, the doses of 50~100 mg per kilogram of body weight per day (usually 4~5 Gm in adult) or injected intramuscularly in the doses of 50 mg per Kilogram of body per day (usually 2~3Gm in adult) till pyrexia subsided. thereafter penbritin dosage was reduced to the half f the first amount and this was continued for 7~10 days. Penbritin was effective in 30 (93.8%) of 32 patients with salmonella typhoid fever and the average duration of fever after the start of treatment was 5. 7 days, ranging between 3 and 9 days. of 30 patients responded to penbritin, one relapsed case treated previously with chloramphenicol was included and 4 cases were simultaneously treated with chloramphenicol. A treatment failure was said to occur if the patient was still febrile after 10 days of treatment. There were 2 (6.2%) treatment failures. which were subsequentilly treated with chloramphenicol and fully responded There were no relapses but one drug side effects in this study.

7살모넬라증에 의한 급성위장염의 집단발생보고

저자 : 송장룡 ( Jang Ryong Song ) , 김명정 ( Myong Jung Kim ) , 최종오 ( Jong O Choi ) , 김화세 ( Wha Se Kim ) , 김종순 ( Jong Soon Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 12권 8호 발행 연도 : 1969 페이지 : pp. 579-585 (7 pages)

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22 patients, admitted to the 3rd Army Hospital on 22 Sep, 1968, were confirmed to have suffered from acute gastroenterities due to salmonellois after the clinical observations, and serological and bacteriological studies. 1) Estimated incubation period was 24.3 hours average ranging from 8 to 30 hours. 2) The chief complaints on admission were headache (81. 8%), high fever (59. 1%), generalized bodyaches (50%), general malaise (36. 4%), diarrhea (36. 4%), and abdominal pain (31. 8%), and the signs observed on admission were high body temperature (77. 3%), whitish coated tongue (31. 8%) and abdominal tenderness (13. 6%) 3) On plain abdominal X-ray films, 7 showed reflex ileus pattern of small intestine or enterocolitis pattern. On chest X-ray, 1 showed the pattern of bronchopneumonia and 1 bronchitis. There were no abnormalities noted in 22 cases on X-ray other than mentioned. 4) The leukocyte count on admission resulted in 3 high leukocyte counts, 7 low counts, and 12 normal counts and those on one week later resulted in 7 low counts and 15 normal counts. 5) The Widal tests performed in all cases on admission and one week later, in 8 cases tested 2 weeks later and in 4 cases 3 weeks later, revealed the highest 0 titer of 1:80 in only one out of 8 cases tested 2 weeks after admission and the highest H titer of 1:80 in 6 cases. 6) The blood cultures revealed no growth in all cases tested on admission and in 7 cases cultured one week later. 7) On stool culture, 17 cases (77. 3%) out of all the patients tested on admission, 12 (54. 15%) out of all cases cultured one week later, 7 out of 14 cases cultured 2 weeks later and 3 out of 8 cases cultured 3 weeks later revealed salmonellae species respectively. 8) Urine cultures performed in all cases on admission revealed staphylococci epidermidis in 3 female cases and the cultures of remaining 19 cases revealed no growth. 9) Without specific treatments with the exception of C-M treatment in 14 cases that showed high body temperatures, the defervescence ranged from 1 to 4 days, 14 cases falling in 2 days of defervescence.

8위내시경검사에 사용한 Hyoscine - N - Butylbromide ( Buscopan ) 작용의 임상적 연구 ( Clinical Study on Buscopan

저자 : 민수홍 ( S. H. Min ) , 김영식 ( Y. S. Kim ) , 정충수 ( C. S. Chung )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 12권 8호 발행 연도 : 1969 페이지 : pp. 587-591 (5 pages)

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During gastric endoscopy favourable pictures can be obtained of the condition of the stomach, when spasms are effectively released and secretion inhibited. In this study the spasmolytic effect of Buscopan during gastric endoscopy was observed. For this purpose the effect of an intramuscular injection of 0.04ml/kg b.w. Buscopan as a premedication for gastric endoscopy was compared with that of 1/150 gr. of atropine sulphate. A control group served for a further comparison. Altogether 95 patients with peptic ulcer, chronic gastritis (atrophic, hypertrophic, superficial and mixed type) and gastric cancer were selected from in- and outpatients of the medical department of the Woo-Sok University Hospital. The gastric endoscope used in this trial was a GASTROCAMERAVA. The results of the gastrocamera finding in each group were as follow: 90.5% of the total pictures taken showed good results with premedication by Buscopan (in 56 patients), while the other two groups exhibited unfavourable results (atropine sulphate group 44.5%, Control group 16.7%), The above mentioned observation reveals that Buscopan can be considered to be a superior antispasmodic and antisecretic. In addition, no specific untoward side effect was seen following Buscopan injection.

9만성위염 , 위하수증 , 위신경증의 etoclopramide ( PRIMPERAN ) 치료에 관한 임상적 관찰

저자 : 김영식 ( Y. S. Kim ) , 정충수 ( C. S. Chung ) , 김승진 ( S. J. Kim ) , 박봉구 ( B. K. Park )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 12권 8호 발행 연도 : 1969 페이지 : pp. 593-597 (5 pages)

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For the purpose of evaluating on the effects of Metoclopramide (PRIMPERAN), a carefully controlled clinical study was carried out in 125 cases; 50 cases of chronic gastritis, 35 cases of gastric ptosis and 40 cases of gastric neurosis. All of the cases were in and out-patients in this hospital and the diagnosis was confirmed by X-ray, endoscopy and the other laboratory examinations. Metoclopramide (PRIMPERAN) was given orally 6~9 tablets (1.5~2.25 gm) divided three times a day for five weeks. The following were the results: The favorable recovery of the subjective symptoms were found in 78.4% of 50 chronic gastritis,. 80.2% of gastric ptosis and 81.5% of gastric neurosis. It is noteworthy that administration of Metoclopramide (PRIMPERAN) improves the clinical situation especially of the symptoms such as anorexia, nausea, vomiting and epigastric fullness.

10용혈성 빈혈의 1 치료예

저자 : 김정일 ( Jung Il Kim )

발행기관 : 대한내과학회 간행물 : Korean Journal of Medicine(구 대한내과학회지) 12권 8호 발행 연도 : 1969 페이지 : pp. 599-602 (4 pages)

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A 34-year-old school teacher with idiopathic acquired autoimmune hemolytic anemia who has showed positive Coombs` test was presented. Complete remission was obtained with long-term treatment of prednisolone. An attempt has been made to review the pertinent literature

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