• 제목/요약/키워드: Chronic diarrhea

검색결과 168건 처리시간 0.027초

12세 여아에게서 활동성 폐결핵에 동반된 장결핵 1례 (A Case of Tuberculous Enteritis with Active Pulmonary Tuberculosis in a 12-Year-Old Girl)

  • 박가영;박재영;김창휘;곽정자;박재옥
    • Pediatric Infection and Vaccine
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    • 제20권3호
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    • pp.190-196
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    • 2013
  • 결핵은 다양한 임상양상을 보이는 감염병으로 과거에 비해 많이 감소하였고 소아 결핵도 점차 줄어들고 있으나 여전히 중요한 감염병이다. 소아의 결핵은 성인과는 다른 임상적 특징을 가지며 폐외 결핵의 빈도가 성인보다 높고, 청소년의 결핵은 결핵균 감염에서 실제 질병으로 발전될 위험이 크다. 폐외 결핵 중 장결핵은 증상이 비특이적이고 다양하여 진단이 늦어질 경우 사망률 및 이환율이 높아질 수 있다. 크론병 또는 만성적인 소화기 질환과의 감별이 중요하며, 최근 대장 내시경의 발달로 감별 진단이 용이해지고 있다. 저자들은 6개월간 지속된 설사와 복통, 체중 감소와 간헐적이고 반복적인 $37.5-38^{\circ}C$의 발열로 내원한 12세 여아에게서 대장 내시경 검사를 하여 시행한 생검 조직의 PCR 검사와 조직학적 소견으로 장결핵을 진단하였고, 연이어 촬영한 흉부 방사선 상 활동성 폐결핵으로 진단되어 11개월간의 항결핵제 치료로 완치된 증례를 경험하였다.

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급성 출혈성 대장염으로 오인된 궤양성 대장염 1예 (Ulcerative Colitis Mimicking Acute Hemorrhagic Colitis)

  • 문희정;장병익;김승범;이호찬;박재현;은종렬;김태년
    • Journal of Yeungnam Medical Science
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    • 제25권2호
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    • pp.182-186
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    • 2008
  • Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.

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갈근탕의 임상연구 논문 분석 (An analysis of Clinical Studies on Galgeun-tang)

  • 송시영;강유선;변성희;이숭인
    • 대한한의학방제학회지
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    • 제28권1호
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    • pp.91-115
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    • 2020
  • Objective : This study's purpose was to review the clinical studies of Galgeun-tang. Method : We searched papers about Galgeun-tang using KISS, RISS, OASIS, PUBMED and J-stage. The key words we used were "Galgeuntang", "Kakkonto", "Ge gen tang", and "Pueraria Decoction". Papers not matched with inclusion criteria were excluded. Results : Until today, there have been 223 studies on Galgeun-tang. Of these, 25 studies were classified as clinical research papers. There were 4 cases of fever, 5 cases of inflammation on respiratory system, 3 cases of head, neck and shoulder disorder, 2 cases of diarrhea, 6 cases of pharmacokinetics and interaction, 5 cases of side effect. Conclusion : It can be seen that Galgeun-tang has established the basis for application to the purpose of treating fever (common cold, influenza), inflammation on respiratory system (nasal obstruction, maxillary sinus retention cyst, mucoid pseudomonas aeruginosa chronic lower respiratory tract infection), head, neck and shoulder disorder (temporomandibular disorders, shoulder stiffness, tetanus), and diarrhea. On the other hand, considering 4 cases of side effect on drug eruption, caution should be exercised when observing the progress of the patient taking Galgeun-tang.

First Report of Feline Intestinal Trichomoniasis Caused by Tritrichomonas foetus in Korea

  • Lim, Sun;Park, Sang-Ik;Ahn, Kyu-Sung;Oh, Dae-Sung;Ryu, Jae-Sook;Shin, Sung-Shik
    • Parasites, Hosts and Diseases
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    • 제48권3호
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    • pp.247-251
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    • 2010
  • Feline intestinal tritrichomoniasis by Tritrichomonas foetus was first recognized in USA in 1999 and has so far been reported from UK, Norway, Switzerland, and Australia, but not from the Far East Asian countries. In November 2008, 2 female and male littermate Siamese cats, 6-month old, raised in a household in Korea were referred from a local veterinary clinic with a history of chronic persistent diarrhea. A direct smear examination of fecal specimens revealed numerous trichomonad trophozoites which were isolated by the fecal culture in $InPouch^{TM}$ TF-Feline medium. A PCR testing of the isolate based on the amplification of a conserved portion of the T. foetus internal transcribed spacer (ITS) regions (ITS1 and ITS2) and the 5.8S rRNA gene, and the molecular sequencing of the PCR amplicons confirmed infection with T. foetus. This is the first clinical case of feline intestinal trichomoniasis caused by T. foetus in Korea.

Occurrence of suspected infection of Campylobacter spp and Clostridium spp in dogs with chronic diarrhea

  • Park, Hee-myung;Oh, Tae-ho;Kim, Hyun-uk;Youn, Sin-keun;Lee, Sang-rok;Yoo, Jae-chun;Yoon, Hwa-young;Han, Hong-ryul
    • 대한수의학회지
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    • 제39권4호
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    • pp.819-824
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    • 1999
  • Suspected infections of Campylobacter spp and Clostridium spp were observed in three dogs. The diagnosis was based on fecal cytology, Gram's stain, clinical signs and serum chemistry. The rectal swabs of diarrheic dogs were performed to confirm the enteropathogens. Suspected Campylobacter spp were a sea-gull shape and Clostridium spp had a large, clear endospore in rectal cytology. Treatment with appropriate antibiotics resulted in a complete resolution of all clinical abnormalities in three cases. The source of Campylobacter spp and Clostridium spp could not be found clearly in three cases, but gastrointestinal origin was most likely. When detecting the enteropathogens in feces, fecal smear with Wright's and Gram's stain should be made at first and also, if the patients have canine parvoviral enteritis, attention should be paid to confirm the Campylobacter spp and Clostridium spp. In addition, since Campylobacter spp and Clostridium spp as normal bacterial flora exists in canine intestines, it is thought that microbiological isolation should be performed to confirm the suspected Campylobacter spp and Clostridium spp as primary enteropathogens in subsequent study.

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거대세포 바이러스 간염이 동반된 장성 선단 피부염 1례 (A Case of Acrodermatitis Enteropathica Associated with CMV Hepatitis)

  • 김광렬;박재옥;신상만
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제2권2호
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    • pp.233-239
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    • 1999
  • Acrodermatitis enteropethica (AE) is a rare autosomal recessive disorder of zinc absorption leading to chronic diarrhea and characteristic skin lesion. The term is also applied to any acquired zinc deficiency state resulting in the same clinical pictures. We experienced one case of AE in 1 month old male infant who had bacterial enterocolitis. The skin around mouth, anus, eyes, ears, hands and legs became reddish, vesicular and eczematoid. Serum zinc level was decreased to $51.4\;{\mu}g/dL$ (N=70~150). Endoscopic finding revealed pale gastric mucosa and villous atrophy of small intestine. Biopsy finding of small intestine showed no villi due to mucosal atrophy. On 13 day of admission jaundice with DIC were noted and AST & ALT were elevated to 110 & 36.8 IU/L, respectively. Diarrhea was improved but jaundice and liver function were not recovered until discharge from hospital. After discharge when the patient was 4 months of age serum bilirubin and AST/ALT had not been normalized. CMV shell vial culture of urine and CMV Ig G antibody were positive. So intravenous ganciclovir injection of 7.5 mg/kg, two times a day for 2 weeks and then 10 mg/kg/day for 3 months was done from 4 to 6 months of age. No virus was found in the urine and AST & ALT were normalized at 2 months after stopping ganciclovir treatment.

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과민성대장증후군의 형상의학적 고찰 -동의보감(東醫寶鑑)을 중심으로- (Hypersensitive Large Intestine Syndrome in Hyungsang Medicine)

  • 최병래;최영현;한진수;이용태
    • 동의생리병리학회지
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    • 제19권5호
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    • pp.1129-1136
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    • 2005
  • The writer reports the conclusions gained from study about the cause of the hypersensitive large intestine syndrome with Dongeuibogam as the central figure through researching the disharmony among Body Essence, Vital Energy, Mentality, and Blood, mutual action of five viscera and six bowels, and external shapes. The hypersensitive large intestine syndrome is generally chronic and recurred in many cases, so it is more efficacious than symptomatic to treat according to find the contradictions of individual shapes. The shapes and cases suffering frequently the hypersensitive large intestine syndrome are Gi-kwa and Sin-kwa, having a long nose, having a bruised spot on Triple warmer, man with inclined mouth, Taeeum type, man with congested fluids, man with colic symptoms. The hypersensitive large intestine syndrome in Oriental medicine is recognized of diarrhea, constipation, abdominal pain, abdominal distention and fullness caused by seven emotions. In Dongeuibogam it can be found out the similarity in depressive symptoms due to disorder of Gi, stagnation of Gi, dysphasia due to disorder of Gi, diarrhea due to disorder of Gi, fullness of due to Gi, diarrhea due to phlegm-retention, retention of undigested food, immoderate drinking, hypo-function of the spleen, or deficiency, abdominal pain from colic symptom, and difficulty in defecation and urination, internal injury, diarrhea due to weakness and fatigue. If the Jung, Gi, Sin, and Hyul composed the human body is broken harmony, the function of large intestinal transmission would be fallen, so similar symptoms like the hypersensitive large intestine syndrome are gotten. Especially Gi-kwa suffers diarrhea, constipation abdominal pain, and abdominal distention and fullness due to depressive symptoms from disorder of Seven emotions or Seven Gi. And Sin-kwa suffers from the hypersensitive large intestine syndrome due to emotional restlessness having an influence on rhythmic movement of abdomen. Examining between five viscera and six bowels and the hypersensitive large intestine syndrome, Liver cannot disperse well having influence on mutual relation of Liver-Large intestine, Heart reduces the function of defecation and urination not to control the seven emotions, Lung having exterior and interior relation with intestine has an influence on primordial energy and let the main symptoms occur, Spleen circulating the body fluid let the main symptoms occur due to malfunction of circulation, Kidney locating in lower part of the body has deep connection with intestine, so let the disorder. Urinary bladder is connected with intestine in moisture metabolism, Stomach is connected in receive and transmission, Small intestine is connected in absorption and excretion, from small intestine pain disturbing the abdominal movement, Samcho managing the catharsis of lower heater if declined its function causes the hypersensitive large intestine syndrome. The colic symptoms of Front private parts which disorder in lower abdomen give rise to abdominal pains, difficulty in defecation and urination due to Cold are similar to the hypersensitive large intestine syndrome. The treatments of applying the shapes of colic syndrome advocated by Master Park can be efficacious cure in clinic. Researching after the clinical cases of Master Park advocating Hyungsang medicine, we came to know that plenty of prescriptions of internal injury are applied and take good effects.

Rifampicin에 의한 위막성 대장염 1예 (A Case of Rifampicin Induced Pseudomembranous Colitis)

  • 윤종욱;황정혜;함형석;이한철;노길환;강수정;서지영;김호중;정만표;권오정;이종헌;손희정
    • Tuberculosis and Respiratory Diseases
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    • 제49권6호
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    • pp.774-779
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    • 2000
  • 저자들은 항결핵제중 rifampicin 사용 후 발생한 위막성 대장염 1예를 경험 하였기에 보고하는 바이며 전신상태가 좋지 않거나 간질환이 있는 고령의 환자에서 항결핵제 사용 중 심한 설사가 있을 때 이의 가능성을 생각해야 되며 필요한 경우 조기에 진단적 검사를 시행해야 한다고 생각된다.

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선천성 염소성 설사를 가진 환아에서 국소 분절 사구체경화증이 발생하여 만성 신장병으로 발전한 사례 (A Case of Progressive FSGS and Chronic Kidney Disease in Congenital Chloride Diarrhea with SLC26A3 Mutation)

  • 서영준;정한빈;안석민;신우철;배은주;윤종형;정활림;이홍진
    • 대한유전성대사질환학회지
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    • 제18권3호
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    • pp.87-94
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    • 2018
  • 선천성 염소성 설사를 가진 환아에서 국소 분절 사구체경화증이 발생하여 말기 신장병으로 발전한 사례를 보고 하고자 한다. 20세 여자 환자로, 본원에서 출생 전 산전진단에서 양수과다 및 초음파 소견으로 선천성 염소성 설사가 의심되었으며, 출생 직후 확진 되어 신생아기 때부터 KCl 보충을 통하여 증상 조절을 시작하였다. 환아는 이후 특별한 건강의 문제가 없었으나 12세에 단백뇨가 관찰되었고, 16세때 본원에서 국소분절 사구체경과증 과 2기 만성신장병 진단을 받았다. 이후 보존적 치료를 하였으며, 지속적인 단백뇨에 대한 재 평가를 위하여 입원하게 되었다. 입원 후 확인된 검사에서 사구체여과율(GFR)은 4기 신장병으로 악화되어 있었으며 신생검에서도 국소분절 사구체신염으로 인한 만성 신장병이 재 확인 되었다. 환아 및 가족을 대상으로 시행한 유전자 검사(diagnostic exome sequencing)에서는 SLC26A3 유전자의(c.2063-1G>T) 동형 접합체 변이가 각각 부모에서 전달된 것을 확인하였다. 선천성 염소성 설사 환자는 적절한 전해질 보충에도 불구하고 신기능 손상이 되기 쉬운 경향이 있으며, 따라서 조기 진단 및 충분한 전해질 보충이 이루어지는 경우에서도 환자의 신장 기능에 대한 정기적 관찰 및 적절한 보조 치료가 필요할 것으로 사료된다.

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Enterotoxigenic Bacteroides fragilis에 의한 질환과 검출 (Enterotoxigenic Bacteroides fragilis-Associated Diseases and Detection)

  • 권선영;장인호;이기종
    • 대한임상검사과학회지
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    • 제47권4호
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    • pp.161-167
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    • 2015
  • 정상인에서 장내세균은 숙주의 면역이나 영양 흡수를 돕지만, 때로는 기회감염균으로서 그들을 위협하기도 한다. 그 중 절대 혐기성 세균인 Bacteroides fragilis는 분비되는 장독소(enterotoxin)인 Bacteroides fragilis toxin (BFT)의 유무에 따라 non-enterotoxigenic B. fragilis (NTBF)와 enterotoxigenic B. fragilis (ETBF)로 나뉜다. ETBF는 가축 및 사람에서 설사 질환 및 대장 질환을 유발한다 그러나 때때로 ETBF를 가지고 있으나 증상이 없는 사람도 존재한다. ETBF는 염증성 설사 질환, 여행자 설사 환자의 대변에서 검출되어 주목 받고 있다. 또한, 몇몇 연구를 통해 inflammatory bowel disease (IBD)나 대장염 및 대장암 환자에서 ETBF가 증가한다는 것이 밝혀졌다. 일반 C57BL/6 마우스 및 germ-free 마우스, multiple intestinal neoplasia (Min) 마우스, 토끼, Mongolian gerbil 등 여러 동물 모델에서 ETBF가 IBD나 대장염, 대장암을 유발 또는 촉진한다는 것이 발표되었다. ETBF의 유일한 병원성 인자인 BFT는 E-cadherin의 분절을 유도하여 장상피 세포의 투과성을 높인다. 이어서 ${\beta}$-catenin 신호전달계가 활성화하여 장상피세포의 증식이 증가한다. 또한 ETBF의 감염은 일반 마우스에서 급성이나 만성의 대장염을 일으키고 Min 마우스에서 종양 형성을 촉진한다. 이는 Stat3에 의존한 $T_H17$ 면역반응의 활성화를 통해 일어난다. 현재 ETBF의 검출 방법에는 크게 BFT toxin assay와 몇 가지 PCR 방법이 있다. 최근 real-time PCR과 같은 분자진단학적 기법의 발달로 일반적인 PCR보다 더 정확한 ETBF의 검출이 가능하게 되었다. 이것을 이용하여 앞으로 실제 임상에서 ETBF와 대장염 및 대장암의 발달 관계에 대한 심도 깊은 연구가 이뤄질 것으로 본다.