욕창 환자에 관한 임상적 고찰

김예흠 中央醫學社 1980 中央醫學 Vol.39 No.2

악성종양 환자 진단의 임상적 연구

김예흠 中央醫學社 1975 中央醫學 Vol.29 No.2

This is a case report of Coarctation of the aorta associated with acute glomerulonephritis. A 8 years old male patient was admitted with chief complaints of hematuria, generalized edema and headache. He was treated under diagnosis of acute glomerulonephritis and unexpectedly he was discovered rib notching on the chest X-ray film and his brachial arterial pressure was (Rt.: 135/85mmHg, Lt. : 115/75 mmHg.) and femoral arterial pressure was 90/ OmmHg respectively. Transaxillary aortography revealed postductal adult type Coarctation of the aorta.

취염에 대한 임상적 연구

김예흠 中央醫學社 1975 中央醫學 Vol.29 No.2

A total of 24 patients with acute hemorrhagic admitted to the Dept. of Surgery, Seoul national University Hospital during the past 5 years (1970-1975) was studied. Thirteen patients of the whole group were 8 less severe cases diagnosed clinically and 5 severe cases of which early diagnosis were definitely made; they were treated conservatively. The remaining 11 patients were severe cases con firmed by laparotomies under the preoperative diagnosis of generalized peritonitis due to such as gastric and duodenal ulcer perforation (5 cases), appendicitis or intestinal perforation (4 cases) and suspected pancreatic (2 cases); They were all treated with conservative (supportive) measures postoperatively besides the given operative procedures. None of mortality or serious complication was noted both in the laparotomied and in the conservativelly treated group. The operative procedures comprised the drainage of the lesser sac and the peritoneal cavity or the diversionary operation on the biliary tract. The conservative (supportive) measures were under following categories, (1) blood volume replacement, including whole blood (1-3 units), plasma, fluid and electrolytes (2) control of pain with Demerol or atropine (3) continuous suction (4) vagolytic drugs (Atropine, Banthine, Diamox) (5) use of steroids (6) Oxygen therapy. From the results obtained it would appear that the prognosis of acute pancreatitis depends on rather the severity of the disease- and the predisposed resistance of the patient than the case is not an extremely severe one, the limited manipulation of the viscera during operation is applied and active conservative treatment is added postoperatively.

Buerger씨병의 임상적 고찰

김예흠 中央醫學社 1980 中央醫學 Vol.38 No.2

장문합 및 기아가 간장에 미치는 변화에 관한 실험적 연구

김예흠 中央醫學社 1976 中央醫學 Vol.31 No.4

The problems of obesity have become discussed increasingly nowadays and many trials such as diet control or surgical attempt of jejuno-colic bypass or ileo-jejunal bypass have been performed to correct obesity by lowering body weight. Those surgical trials are successful in lowering body weight, but they can induce imbalance of metabolism and electrolytes by reduction of surface area of nutritional absorption. It is easily suspected that those imbalance may cause the changes in various organs. A comparative study was made on histological changes of' liver and hematochemical changes by inducing nutritional disturbance and disturbance of absorption of rabbits by various methods. Experimental evaluation was made on a total of 61 of experimental -animals weighing from 1.80kg to 2.45kg, of body weight divided in to 4 groups. 1) Group 1; control group consisted of 15 rabbits, with jejuno-colic adhesion. 2) Group 2; consisted of 15 rabbits, starved completely. 3) Group 3; consisted of 15 rabbits, jejuno-colic anastomosis performed. 4) Group 4; methionine and choline, given intramuscularly in doses of 3mg/kg daily, consisted of 16 rabbits. Among 5 healthy rabbits selected from group 1, 2, and 3, blood sampling was done by 3 days interval and liver biopsy was taken with varying intervals. The results are as follow; 1) There was little difference in comparison with pre-expression with pre-experiments of pathohistological feature of liver cells, body weight, and hematoehemical change of 15 control rabbits performed jejuno-colic adhesion. 2) The fatty degeneration of liver of the rabbit, group of complete starvation state began to be noted 5 days after starvation and there were noted cellular infiltration of liver and hepatic cell necrosis on hepatic tissue sample 8 to 12 days alter starvation. Average life span of rabbits was 9 days and decreasing rate of body weight was 30.3% and this showed prominent reduction in comparison with control group. 3) The average life span of 15 rabbits performed jejuno-colic anastomosis was 14 days and increases in comparison with starvation group. There was gradual reduction of body weight and tissue findings of the liver after 12 days showed fatty infiltration and necrosis like a group 2 of complete starvation. 4) Methionine and choline lipotropic factors was given intramuscularly in doses of 3 mg/kg daily on 8 rabbits of starvation and 8 rabbits performed jejuno-colic anastomosis. The fatty degeneration of these began to be noted after 7 days in comparison with starvation group and after 4 days in comparison with group of bypass procedure, There were prolongation of average life span and gradual reducation of body weight. It may be suspected by the influence of lipotropic agents. 5) Summing up these changes in blood chemistry, blood glucose and calcium level which showed within normal range in control group become to decrease in the group of completely starved and jejuno-colic bypass and potassium level decreased in jejuno-colic bypass group and increased in starved group. Protein and sodium in both groups remained in normal range. To summarize above experiments, it is certain that long termed nutritional deficits and disturbances of absorption of rabbits by starvation and bypass procedure induce fatty degeneration of liver cells, hepatic necrosis and hematological change.

갑상선암의 외과적치료에 관한 임상적연구

김예흠 中央醫學社 1982 中央醫學 Vol.42 No.4

기아가 간장 및 부신피질(부신피질) 機能에 미치는 임상적 고찰

金禮欽,鄭謹相 中央醫學社 1976 中央醫學 Vol.31 No.5

The fact that the plasma level of adrenocortical hormone is, significantly influenced by hepatic function has been advocated by many authors. Impaired hepatic function thus leads too increased plasma level of adrenocortical hormone by impairment of clearance of the hormone in plasma. So postoperative increase of plasma adrenocortical hormone should be considered in'-the view of increased production or decreased removal of the hormone due to postoperative impairment of hepatic function. In this review, authors investigated pre- & postoperative adrenocortical function in 10 cases of normal liver function and 10 cases of abnormal liver function. The results obtained are as follows: 1) Control values. of plasma adrenocortical hormone. were not significantly different in both groups (p>0.05). 2) The clearance of adrenocortical hormone in plasma was significantly delayed in patients of abnormal hepatic function(p>0.05). 3) Postoperative increase in plasma adrenocortical hormone- tended to be proportional to the degree of impairment of hepatic function. In allergic respiratory diseases, the incidence of the positive skin reactions to fungal extracts were: 27.1% against Candida albicans, 19.3% against Trichoph-yton species, 8.7% against Rhizopus nigricans and 7.5% against Fusarium species.

[一般演題] 膽道疾患 手術例의 統計的觀察

金禮欽,金宗國,王泳鐘,金子勳,全聖寬,秦柄鎬 대한외과학회 1962 Annals of Surgical Treatment and Research(ASRT) Vol.4 No.1

潰瘍性大腸炎에 關한 臨床的考察

金禮欽,李永殷 中央醫學社 1969 中央醫學 Vol.16 No.3

A tobal of 28 patients with ulcerative colitis treated at the department of Internal Medicine and General Surgery of S.N.U. Hospital from Sept, 1061 to Aug, 1968 was reviewed, The results obtained are as follows: 1) The sex distribution assumed a ratio of 3 to 2 with 17males and 11 females. 2) The majority of the cases was between 3rd and 4th decade (57.1%), while the relatively even distribution of age from 1st to 7th decade of life. 3) The time interval from the onset of symtoms to the first admission was 1 to 20yrs in 18 cases (64%), and less than lyrs in 10 cases (36%). 4) The most diagnostic signs encountered were abdominal pain, diarrhea, gross bleeding, weight loss, tenesmus, fever and vomiting. 5) The Signoidescopic examination showed, positive findings in 25 cases (89.3%), and the colon study in 17 cases (60. 7%). 6) As to the extent of disease determined by sigmoidoscopic examination and the colon study, 18 cases (64.3%) involved rectum or rectosigmoid colon. 7) Significant lab. findings were the tendency of mild leukopenia, eosinophilia, low value of hemoglobin and occult blood. 8) The most common coincidental diseases were neurosis (8 cases) and hypertension (3 cases) 9) Complications were colonic and systemic; hemorrhoid anal fistula, polyp, anemia and arthritis. 10) Three of 4 patients underwent subtotal colectomy without ileostomy showed good result.

치질은 고칠수 있나

김예흠,Kim, Ye-Heum 한국건강관리협회 1975 건강소식 Vol.3 No.5

이른바「질」자가 붙는 병치고 잘 낫는 병이 없다. 그렇다고 죽지도 않는다. 병의 형태도 가지가지 이고, 치료법도 가지가지다-치질도 그런 병의 한 가지. 그러면 치질은 왜 생기며, 완전하게 고칠 수도 있을가.