• Title/Summary/Keyword: 위장관 질환

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Thoracic Actinomycosis - A Case Report - (흉부 방선균증-1례 보고-)

  • 박찬범;최시영;조덕곤;문석환;조규도;조건현;왕영필;이선희
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.914-916
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    • 2002
  • Actinomycosis of the lung is a chronic, suppurative granulomatous infection which is caused by Actinomyces israelii. It is believed to enter the thorax by way of the bronchial tree, by aspiration of contaminated aerosol particles in the upper digestive tract. Symptoms of chronic cough, sputum, hemoptysis, low grade fever, chest pain, and weight loss are common. Chest X-ray shows mass like lesion, pulmonary infiltration, abscess, and tuberculosis like lesion, which makes differential diagnosis from lung cancer very difficult. Surgical intervention is needed for the diagnosis and treatment, and diagnosis of actinomycosis is achieved when histologic examination reveals sulfur granules containing filamentous organisms. Penicillin is the drug of choice. Two or three months of penicillin treatment is recommended to treat the oropharyngeal or dental abscess to avoid recurrences. We present a case of actinomycosis which is suspected to malignant with review of literatures.

A case of acquired acrodermatitis enteropathica with a normal serum zinc level but a low level in the hair (혈중 아연 농도는 정상이나 모발 검사에서는 감소된 아연 농도를 보인 일과성 장병성 선단 피부염 1례)

  • Oh, Kyung Il;Kim, Jung Hee;Lee, Ji Eun;Lim, Dae Hyun;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.50 no.2
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    • pp.209-212
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    • 2007
  • Acrodermatitis enteropathica (AE) is a rare autosomal recessive disorder of early infancy, and is characterized by periorificial dermatitis, alopecia, and intractable diarrhea. Serum zinc levels are usually low in untreated patients and the oral administration of zinc sulfate can clear skin lesions and other symptoms. Although premature and cow's milk-fed infants are at particular risk of developing AE, there have been a few reports about AE in term and breast-fed infants. We report a case of transient AE in a 4-month-old breast-fed infant. This patient suffered from diarrhea and dermatitis for more than a month. Her skin lesions were erythematous, scaly, crusted, psoriasiform, eczematous, with an eruption at the chin, and a periorificial disposition with involvement of the flexural areas of lower extremities. Her serum zinc level was almost normal at $129{\mu}g/dL$ (reference range: $60-121{\mu}g/dL$), but the zinc level in her hair was low: 8 mg percent (reference range: 10-21 mg percent). Skin biopsy findings were consistent with AE. Seven days after zinc supplementation, the skin lesions and diarrhea improved. The authors recommend that a clinical trial of zinc supplementation be considered in cases where there are suspicious of AE, even when the serum zinc level is normal.

The Three Types of Clinical Manifestation of Cow's Milk Allergy with Predominantly Intestinal Symptoms (위장관 증세 위주로 발현하는 영유아기 우유 알레르기 질환의 3가지 임상 유형에 관한 고찰)

  • Lee, Jeong-Jin;Lee, Eun-Joo;Kim, Hyun-Hee;Choi, Eun-Jin;Hwang, Jin-Bok;Han, Chang-Ho;Chung, Hai-Lee;Kwon, Young-Dae;Kim, Yong-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.30-40
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    • 2000
  • Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

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Radiation Exposure Dose Reduction on Upper Gastrointestinal Series (위장조영검사에서 피폭선량 저감)

  • Lim, Byung-Hak;Chon, Kwon Su
    • Journal of the Korean Society of Radiology
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    • v.11 no.2
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    • pp.109-116
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    • 2017
  • Upper gastrointestinal series is non-invasive examination, and it is useful for patients or elderly patients who have difficulty in endoscopic examination because of absence of any side effects other than temporary constipation or abdominal pain. The entire image of the gastrointestinal tract can be seen and have been widely used in the diagnosis of upper gastrointestinal diseases. However, there is a possibility that radiation dose increases due to improper movement and breath control, when examination is carried out by lack of understanding the overall inspection process for the upper gastrointestinal series. In upper gastrointestinal series to increase understanding of examination, to induce appropriate cooperation during examination, to reduce the number of retakes and shorten examination time, and to reduce dose of the subject, the procedure and precautions of the gastrointestinal test were made as a movie. We investigated the effectiveness of pre-education using the movie to reduce the inspection time, the number of re-shoots, and the reduction of exposure dose by watching the movie during the waiting time before examination. 120 patients that were selected each 20 patients aged from 30s to 80s were evaluated were evaluated for exposure dose, examination time, and the number of retakes before and after the movie training. The radiation dose, the examination time, and the number of retakes were respectively $3171.83{\mu}Gy{\cdot}m^2$ and $2931.73{\mu}Gy{\cdot}m^2$, 8.05 min, and 6.75 min, and 1.68 times and 1.22 times before and after movie training. It can be concluded that the movie training on the gastrointestinal examination influences the reduction of the examination time, the number of retakes and the reduction of the radiation dose.

Growth Rate and Antimicrobial Activity of Lactobacillus plantarum Reacting with Bacterial Culture Supernatant (세균 배양액과 반응한 Lactobacillus plantarum의 생장속도 및 항균 활성에 대한 연구)

  • Ha, Eun-Mi
    • Microbiology and Biotechnology Letters
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    • v.43 no.3
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    • pp.187-194
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    • 2015
  • In this study, L. plantarum, when reacting with the culture media of potential pathogenic bacteria, exhibited an increase in growth rate and antimicrobial activity. In order to examine the characteristics and the nature of the reaction with the bacteria, this study carried out experiments involving culturing the test bacteria in M9 minimal media. Subsequently, the supernatant was incrassated by the decompression-drying method. Through colony forming unit assay, it was confirmed that L. plantarum had the function of growth inhibition to various bacteria. After culturing L. plantarum with bacterial media, the growth rate of L. plantarum was measured by absorbance (OD600), the results showed that the growth rate (E. coli treatment group: OD600 = 0.848, S. typhimurium treatment group: OD600 = 0.848) increased, as compared with the non-treated control group (OD600 = 0.48). In contrast, the concentrate itself did not induce the growth of L. plantarum. These results were observed as a universal phenomenon of the Lactobacillus species. Moreover, the increase in antimicrobial activity was observed in L. plantarum, which reacted with the culture media of E. coli and S. typhimurium, through a disc diffusion assay, and the result of growth inhibition against various bacteria was induced. Finally, based on the analysis results of the characteristics of bacteria culture media, which increased the growth rate of L. plantarum and antibacterial activity, the bacterial media had a tolerance for catabolic enzymes, pH 2−8 and heat. Therefore, this substance can be said to be a small molecule which is highly stable under various conditions.

Pyloric Stenosis in Premature Infants -Report of two cases- (미숙아에서 발생한 유문협착증 2례)

  • Park, Joong-Chae;Kim, Jeong-Nyun;Chang, Cheol-Ho;Chey, Myung-Jae;Kim, Hong-Young;Kim, Jeong-Suk;Chung, Churl-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.120-124
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    • 1998
  • The incidence of Hypertrophic pyloric stenosis (HPS) in premature infants is rare, the presentation is not typical, and the diagnosis delayed due to uncertain diagnostic criteria in abdominal ultrasonography (US). We report two premature infants with HPS diagnosed by US and upper gastrointestinal (UGI) contrast study. Patient 1. A premature female infant (birth weight 1950 gm at 34 week's gestation) with the onset of intermittent vomiting at 9 days of age was evaluated. US was normal at 13 days of life, however, abnormal at 41 days of life (pyloric muscle length 16.5 mm). Patient 2. A premature male infant (birth weight 1470 gm at 29 week's gestation) with the onset of intermittent vomiting at 10 days of age was evaluated. US showed pylorospasm at 11 days of life, however, findings compatible with HPS at 57 days of life (pyloric muscle thickness 11 mm). UGI contrast study at 48 days of life showed similar findings in both cases. Both patients had undergone pyloromyotomy. In conclusion, the diagnosis of HPS in premature infants requires careful follow-up by US and UGI contrast study.

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A Case of Primary Esophageal Malignant Lymphoma -A Case Report- (식도 림프종 -1례 보고-)

  • Her, Keun;Park, Young-Woo;Kim, Hyun-jo;Heo, Jae-Hak;Jeong, Youn-Seop;Youm, Wook;Jin, So-Young
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.318-321
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    • 2002
  • The esophageal lymphoma is a very rare feature among gastrointestinal lymphoma, and there was no surgical report in Korea. A 62-year-old male patient with submucosal tumor detected on routine esophagoscopy had resection of tumor including the esophageal mucosa, which was confirmed as esophageal lymphoma. As the severe leakage was detected on esophagogram on post-op 7th day, esophagectomy and esophagogastrostomy was followed. Though adjuvant chemotherapy was not performed, there were no evidence of recurrence for 1 year follow up. We experienced a patient with esophageal lymphoma and reported with brief review of literature

The Relationship Between Children's Temperament and Character to Functional Gastrointestinal Disorders (소아의 기능성 위장관 질환과 기질 및 성격과의 관계)

  • Lee, Eun Ju;Kim, Hyung Joong;Lee, Sun Haeng;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.29 no.1
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    • pp.60-68
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    • 2015
  • Objectives The purpose of this study is to establish relationship between functional gastrointestinal disorders in children and Temperament and Character using objective criteria and questionnaires. Methods This study surveyed 3-6 years old 130 children who were attending the kindergarten or daycare center in the vicinity of Gangdong from May 15th, 2014 to November 30th, 2014. The Korean-translated Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III (QPGS-Rome III) and The Junior Temperament and Character Inventory 3-6 (JTCI 3-6) questionnaires were used. Results 1. Between the groups, functional gastrointestinal disorder group scored significantly higher on NS, NS1, NS4, HA4, ST and ST1. 2. As the number of functional gastrointestinal disorders increase, the group scored higher on NS, NS1, NS4, HA4, ST and ST1. Conclusions This study showed functional gastrointestinal disorder group exhibited higher NS, NS1, NS4, HA4, ST and ST1 scores.

A Case of Hypocomplementemic Henoch-Schönlein Purpura Presenting Features of Membranoproliferative Glomerulonephritis (저 보체 혈증 및 막성 증식성 사구체 신염의 임상 상을 보인 Henoch-Schönlein (Purpura) Nephritis 1례)

  • Lee, Kyong-A;Ha, Tae-Sun
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.81-84
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    • 2005
  • Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a systemic disorder characterized by leukocytoclastic vasculitis that can affect multiple organs predominantly the skin, joints, gastrointestinal tract and kidney. Although the specific pathogenesis of HSP is not known, there are several hypotheses. Although the importance of the complement activation in glomerular injury in HSP has been suggested, the complement levels and the blood pressure in those patients are usually normal and massive proteinuria is not common. And pathologic renal changes also have been reported to show a large variety of glomerular changes. However, to our knowledge, a membranoproliferative glomerulo-nephritis (MPGN) is a rare renal clinicopathologic manifestation of HSP. We report a 6-year-old boy with HSP who developed MPGN with hypertension, massive proteinuria, and hypo-complementemia revealed activation of the classical complement pathway, although we could not exclude the possibility of other hypocomplementemic glomerulonephritis including post-streptococcal acute glomerulonephritis.

Detection of Helicobacter Pylori in Saliva of Korean Infant (한국인 소아의 타액에서 Helicobacter pylori의 검출)

  • Ryu, Ji-Won;Lee, Jang-Keun;Lee, Yong-Su;Yoon, Chang-Lyuk;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.33 no.1
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    • pp.9-14
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    • 2008
  • Helicobacter pylori(H. pylori) has been associated with the cause of peptic ulcer and gastric cancer. H. pylori infection occur mostly during childhood and increase by aging. In route of transmission, Oral cavity does important role. So we employed this study to elucidate route of transmission by detection of H. pylori in infant saliva. We investigated 20 infants aged below 10 years and 20 teens aged below 20 years as study group and 71 adults aged 20 and over years as control group. H. pylori DNA was isolated from 5(25%) infants aged below 10 years, 6(30%) teens and 17(23.9%) adults by nested polymerase chain reaction(n-PCR). There was no statistically significant difference(P>0.05). The obtained results suggest that H. pylori infection is relatively common in saliva of Korean infant and oral cavity may be reservoir of H. pylori.