유입 혈류의 지속적 차단과 간헐적 차단에 의한 흰쥐 간의 허혈-재관류 손상에 대한 비교연구

조남천(Nam Cheon Cho),원달연(Dal Yeon Won),김명수(Myoung Soo Kim),조미연(Mee-Yon Cho),윤갑준(Kap Jun Yoon),김종석(Jong Seok Kim),김익용(Ik Yong Kim),김대성(Dae Sung Kim),노병선(Byoung Seon Rhoe) 한국간담췌외과학회 2001 한국간담췌외과학회지 Vol.5 No.1

Superoxide Dismutase 및 Dimethylthiourea가 허혈-재관류 후 나타나는 흰쥐 간세포의 미세구조 변화에 미치는 영향

조남천(Nam Cheon Cho),백두진(Doo Jin Paik),노병선(Byoung Seon Rhoe) 대한외과학회 2000 Annals of Surgical Treatment and Research Vol.58 No.2

하누소점부위의 결막이완증에서 변형된 방법의 수술적 치료 2 예

조남천(Nam Chun Cho),박천규(Cheon Kyu Park) 대한안과학회 1993 대한안과학회지 Vol.34 No.1

담도계 질환에서 담낭벽 세균배양의 의의

조남천,이연희,윤광수,김대성,유수영,강성준,노병선,김수용 ( Nam Cheon Cho,Yeon Hee Lee,Kwang Soo Yoon,Dae Sung Kim,Soo Young Yoo,Seong Joon Kang,Byoung Seon Rhoe,Soo Yong Kim ) 대한소화기학회 1992 대한소화기학회지 Vol.24 No.4

Many patients with high-risk factors for bactibilia such as acute cholecystitis, do not have bacteria in the bile. Therefore, to evaluate significance of the bacteria in the gallbladder wall, we prospectively performed a culture from the wall and bile of the gallbladder in 129 consecutive patients with biliary operations during the recent 11 month period. The rates of positive cultures were 69.8% in gallbladder wall and 63.6% in gallbladder bile. The number of the isolated organisms in wall and bile of the galbladder were 142 and 148, reepectively. Of the 90 patients with positive cultures from the gallbladder wall, 9(10%) had anaerobic organisms. It was somewhat lower rates than those of the bile (13.4%). The most common aerobic organisms in the bile and the gallbladder wall were E. coli, followed by Klebsiella, Enterobacter and Enterococcus. The most common anaerobes were Bacteroides. Clastridium perfringens were isolated from the both sites in small numbers. Fusobacterium was isolated from the bile in one case but not in the wall of the gallbladder wall. In 12(9. 3%) of the 129 patients, organisms were cultured only from the gallbladder wall. In 4 (3.1%) of tbe 129 patients organisms were cultured only from the bile. The rates of positive cultures in the patients with acute cholecystitis were higher than those in ehronic cholecystitis without statistical significance. The rates of positive cultures for anaerobes were somewhat higher in chronic cholecystitis than those in acute cholecystitis without significance. Patients who had positive. gallbladder wall cultures showed higher rates of postoperative septic complications than patients with negative cultures. Organisms isolated from the infected wound were same in 6 of the 11 patients as in the bile or wall. The results of the cultures in the bile and gallbladder wall were similar. So bile culture would be sufficient to expect the findings of bacteriology of the gallbladder wall.

상 장간막 동맥 폐색증

이흥우,조남천,윤광수,김대성,김수용 ( Heung Woo Lee,Nam Cheon Cho,Kwang Soo Yoon,Dae Sung Kim,Soo Yong Kim ) 대한소화기학회 1992 대한소화기학회지 Vol.24 No.2

During the past 6 years, 6 cases of superior mesenteric artery occlusion were confirmed by abdominal exploration and treated with operation at Department of General Surgery, Yonsei University Wonju College of Medicine. A clinical analysis was performed and the results were as follows; 1) The patients were between 49 and 76 years old and mean age was 62.2 years old. 2) Male to female ratio was 1:5. 3) All patients were admitted through emergency room due to abdominal pain and 4 cases combined with shock. 4) All patients were admitted within 20 hours, 3 days after onset of symptoms, and operated immediately after admission. 5) All patients had cardiovascular abnormality. Three cases had myocardial ischemia, two cases had atrial fibrillation and one case had only sinus tachycardia. And on past history, three patient had hypertension history. 6) In clinical manifestation, all patients had abdominal pain and distension, three patient had vomiting. Moderate to severe leukocytosis between 15,000-25,000/mm3 was noted in four cases and leukopenia between 2,600-3,100/mm3 in two cases. 7) In 5 cases, massive small bowel resection including right hemicolectomy was performed. And one case was performed resection of right colon with ileum 100 cm, end jejunostomy. 8) Based on pathologic reports, arterial thrombosis was found in three cases, ischemic infarction in two cases, submucosal edema with serosal hyperemia in one case. 9) Survival patients were 3 cases and operative mortality was 3 cases. During follow up, survival patients were satisfactory condition after operation except diarrhea that not easily contralled with conservative management.

간담도 결석에서 총수담관 - 십이지장 문합술과 총수간관 - 공장문합술의 비교

이연희,조남천,윤광수,김대성,노병선 ( Yeon Hee Lee,Nam Cheon Cho,Kwang Soo Yoon,Dae Sung Kim,Byoung Seon Rhoe ) 대한소화기학회 1992 대한소화기학회지 Vol.24 No.5

Over the last ten years, various nanoperative procedures including endoscopic papillotomy reduced the number of patients who underwent surgery for bile duct stones, and the procedure of choledo- choduodenostomy (CD) disappeared from the surgical practice in many centers. Consequently Hepaticojejunostomy (HJ), which has been used in cancer surgery, is preferred more and more, even in benign disease. But some authors still favor the use of CD, because it is less time-consuming than HJ and does not preclude further endoscopic exploration. So the question arises which type of biliary enteric anastomosis is preferable when a choice is possible. We obtained the following results; CD was performed in 27 patients and HJ in 38 patients. The male to female ratio was 1: 2.3, and the age incidence was most commonly distributed in 5th decade. The duration of operation was 168 minutes in CD, 327 minutes in HJ and 261 minutes on the average. The length of hospital stay was 18 days in CD, 25 days in HJ and 22 days on an average. CD was performed for CBD stones (55.6%), CBD & IHD stones (18.5%), IHD stones (14.8%), and GB, CBD & IHD stones (11.1%). HJ was performed for the CBD & IHD stones (42.1%), IBD stones (26.3%), GB, CBD & IHD stones (21.1%) and CBD stones (10.5%), The postoperative complication rate was 38.5% and there was no difference between CD and HJ in early complications. In late camplications, CD revealed the remnant stones (6 cases), recurrent stones (4 cases) and anastomosis site stricture (2 cases), whereas HJ revealed remnant stones (2 cases) and no anastomosis site stricture. There was no operative mortality.

표피포도알균 각막염의 임상양상과 예후

김부기,이동욱,조남천,유인천.Bu Ki Kim. MD. Dong Wook Lee. MD. Nam Chun Cho. MD. In Cheon You. MD 대한안과학회 2011 대한안과학회지 Vol.52 No.1

Purpose: To investigate the predisposing factors, clinical manifestations, treatment results and risk factors for treatment failure in Staphylococcus epidermidis keratitis. Methods: Sixty-one eyes of 61 patients who were diagnosed with Staphylococcus epidermidis keratitis were included in the present study. The past history, location and size of ulceration, hypopyon, treatment results, and antibiotic susceptibility were reviewed retrospectively. A logistic regression analysis was performed to identify the main prognostic risk factors for treatment failure. Results: Twenty-six eyes (42.6%) had previous histories of corneal traumas. Polymicrobial infections were observed in 31 cases (50.8%), including 11 cases (35.5%) combined with the Fusarium species. Twenty-five eyes (41.0%) had lesions located at the corneal center. The average size of ulceration was 7.3 ± 7.2 mm2. Thirteen eyes (21.3%) with lesions that progressed or occurred in the corneal perforation underwent evisceration, penetrating keratoplasty or scleral graft. Risk factors for treatment failure were a history of previous keratitis (P = 0.003) and an ulcer exceeding 5.0 mm2 in size (P = 0.018). Conclusions: Staphylococcus epidermidis keratitis usually has a good prognosis, although a history of previous keratitis and a large ulcer size are risk factors for treatment failure. J Korean Ophthalmol Soc 2011;52(1):14-22

선천 긴속눈썹증

조상일(Sang Il Cho),유인천(In Cheon You),조남천(Nam Chun Cho),안 민(Min Ahn) 대한안과학회 2021 대한안과학회지 Vol.62 No.2

목적: 7세 여자아이에서 발생한 긴속눈썹증 1예를 보고하고자 한다. 증례요약: 7세 여자아이가 영유아 검진시 발견된 시력저하를 주소로 내원하였다. 내원 당시 나안시력 우안 0.2, 좌안 0.3이었으며, 양안 상, 하안검 속눈썹의 길이와 수의 증가를 보였다. 양안 속눈썹의 길이는 주변부에서 10 mm, 중심부에서 15 mm였다. 경도의 속눈썹의 각막찌름과 경도의 안검하수가 관찰되었으며 추가로 시행한 안저검사 및 시유발전위검사에서 특이 소견은 발견되지 않았다. 긴속눈썹증의 가족력은 없었으며 긴속눈썹증을 일으킬 만한 특이 소견은 발견되지 않았다. 혈액검사상 이상 소견은 없었으며 특이 약물 복용력 또한 없었다. 현재 긴속눈썹증 진단하에 경도의 시력저하 및 안검하수로 경과 관찰 중이다. 결론: 긴속눈썹증은 가족력 및 다양한 선천성 질환, 후천적 요인에 의하여 발생하는 것으로 알려져 있으나 특별한 원인 없이 선천적으로 발생하는 경우도 있으므로 이에 대하여 주지할 필요가 있다. Purpose: To report a case of congenital trichomegaly. Case summary: A 7-year-old girl visited our clinic with decreased visual acuity. The uncorrected visual acuity was 0.2 in the right eye and 0.3 in the left eye. The length and number of upper and lower eyelashes were increased. The eyelash length was 10 mm on the peripheral edge and 15 mm in the central area. Trichiasis and ptosis were also noted. There were no abnormal findings in the additional fundus examination or visual evoked potential test. There was no family history of trichomegaly, no abnormalities in blood test results, and no medication history. The patient is currently undergoing follow-up treatment for low visual acuity and mild ptosis under the diagnosis of trichomegaly. Conclusions: Trichomegaly is associated with family history, various congenital diseases, and acquired diseases. However, it may occur congenitally, without specific causes.

진균각막염의 임상양상 및 예후 : 20년간의 변화 분석

조상일(Sang Il Cho),박영명(Young Myoung Park),안민(Min Ahn)조남천(Nam Chun Cho),유인천(In Cheon You) 대한안과학회 2021 대한안과학회지 Vol.62 No.7

목적: 최근 20년간 국내에서 발생된 진균각막염 환자의 임상양상, 원인균, 치료, 예후 등의 변화에 대해 알아보고자 하였다. 대상과 방법: 본원에서 각막염으로 진단받고 시행한 각막찰과 및 배양검사에서 진균이 검출된 177안의 의무기록을 후향적으로 조사하였다. 성별, 연령, 선행 요인, 원인균, 임상양상, 치료 방법, 예후 등을 분석하였다. 또한 배양과 KOH염색 여부에 따라 KOH양성그룹, 배양양성그룹, KOH-배양동시양성그룹으로 나누어 조사하였다. 불량한 임상결과와 관련 있는 위험인자를 로지스틱 회귀분석으로 조사하였다. 결과: 대상 환자의 평균연령은 67.4 ± 11.3세였고, 남자가 107명(60.5%)이었다. 진균각막염 발생의 위험인자는 안외상(57.6%), 특히 식물에 의한 외상(29.4%)이 많았다. 가장 흔한 사상진균은 푸사륨 49균주(31.6%)였고 효모균은 칸디다 17균주(11.0%)였다. 진균과 세균이 함께 배양된 41안 중 사상진균과 그람양성균이 29안(70.7%)으로 많았다. 치료 후 시력이 호전된 경우는 KOH양성그룹이 19명(79.2%), 악화된 경우는 배양양성그룹이 36명(40.4%)으로 흔하였다. 다변량분석에서 불량한 임상결과의 위험인자는 이전의 안질환(odds ratio [OR]: 3.744, p=0.010), 전방축농(OR: 2.941, p=0.030), 수술적 치료를 받은 경우(OR: 24.482, p<0.001)였다. 결론: 진균각막염은 KOH만 양성이면 임상양상이 양호하였고, 배양에서 균이 확인되면 심하였다. 진균이 의심되면 초기에 KOH염색과배양검사를 해야 하고, 불량한 임상결과의 위험인자가 있을 경우 조기에 최대한 약물치료를 시행해야 한다. Purpose: To describe the clinical manifestations, causative organisms, treatment, and prognostic factors of fungal keratitis based on analysis of patients over the past 20 years. Methods: A total of 177 patients (177 eyes) with fungal keratitis, who were diagnosed by smears and cultures, were reviewed retrospectively. Sex, age, predisposing factors, causative organisms, clinical manifestations, treatment, and prognosis were evaluated. The patients were divided into three groups: only potassium hydroxide (KOH)-positive, only culture-positive, and KOH- and culture-positive. Logistic regression was performed to identify the factors associated with a poor clinical outcome. Results: The mean age of the patients was 67.4 ± 11.3 years; 107 (60.5%) patients were men. The most common predisposing factor was ocular trauma (57.6%), especially by plants (29.4%). The most prevalent filamentous fungi were Fusarium species (31.6%, 49 isolates), and the most prevalent yeasts were Candida species (11.0%, 17 isolates). In cases of bacterial and fungal keratitis, filamentous fungus with Gram-positive bacterial infection (70.7%, 29/41) was the most common presentation. Visual improvement after treatment was common in the KOH-positive group (79.2%, 19/24), while visual deterioration after treatment was common in the culture-positive group (40.4%, 36/89). Previous ocular disease (odds ratio [OR]: 3.744, p = 0.010), hypopyon (OR: 2.941, p = 0.030), and surgical treatment (OR: 24.482, p < 0.001) were risk factors for a poor clinical outcome in the multivariate logistic regression model. Conclusions: Clinical prognosis was good in the KOH-positive only group, but poor in the culture-positive group. If fungal keratitis is suspected, diagnostic KOH staining and culture tests should be performed initially. Early intensive antifungal medical treatments are necessary for patients with risk factors for poor clinical outcomes.

나이에 따른 감염각막염 환자의 임상분석: 2병원 연구

김종연,윤경철,박영걸,조남천,유인천.Jong Youn Kim. MD. Kyung Chul Yoon. MD. Yeoung Geol Park. MD. Nam Chun Cho. MD. In Cheon You. MD 대한안과학회 2010 대한안과학회지 Vol.51 No.7

Purpose: To evaluate the age-related risk factors, clinical manifestations, and prognosis in infectious keratitis. Methods: Records of patients with infectious keratitis who visited one of the two tertiary medical centers at Jeolla-do from January 2000 to December 2007 were reviewed. Risk factors depending on patient age distribution standardized over and under the age of 60 were reviewed retrospectively by analyzing sex, age, previous history of trauma, systemic disease, previous ocular disease, causative organism and treatment. Results: A total of 757 patients (757 eyes) visited either one of the two tertiary medical centers. The mean age was 58.2±18.0 (4 to 93) years, and patients included 437 males (57.7%), and 320 females (42.3%). The most common risk factor among all age groups was trauma, especially due to vegetable matter. The second most frequent risk factor among the younger patients was contact lens use (19.2%), and common risk factors among the elderly were previous ocular disease (20.0%), systemic disease (15.5%), and ocular surgery (9.7%). The most prevalent causative organisms among all age groups were Gram-positive bacteria, in particular Staphylococcus epidermidis. Elderly patients had a higher frequency of corneal perforation than did younger patients. In addition, elderly patients had a worse prognosis and more often required surgical treatment. Conclusions: Infectious keratitis has more severe clinical manifestations and complications and a worse prognosis in elderly than in younger patients. Elderly patients have more diverse risk factors. Prevention should aim at avoiding ocular trauma, especially by vegetable matter, and at controlling ocular surface diseases, such as exposure keratitis and bullous keratopathy.