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함준수 ( Joon Soo Hahm ),변태준 ( Tae Jun Byun ),이항락 ( Hang Lak Lee ),최호순 ( Ho Soon Choi ),고용 ( Yong Ko ),이경근 ( Kyeong Geun Lee ),김선일 ( Sun Il Kim ),김태은 ( Tae Eun Kim ),윤지원 ( Ji Won Yun ),박용진 ( Yong Jin Par 대한소화기학회 2004 대한소화기학회지 Vol.43 No.6
Background/Aims: The growth of technology based on internet protocol has affected on the informatics and automatic controls of medical fields. The aim of this study was to establish the telemedical educational system by developing the high quality image transfer using the DVTS (digital video transmission system) on the high-speed internet network. Methods: Using telemedicine, we were able to send surgical images not only to domestic areas but also to international area. Moreover, we could discuss the condition of surgical procedures in the operation room and seminar room. The Korean-Japan cable network (KJCN) was structured in the submarine between Busan and Fukuoka. On the other hand, the Korea advanced research network (KOREN) was used to connect between Busan and Seoul. To link the image between the Hanyang University Hospital in Seoul and Kyushu University Hospital in Japan, we started teleconference system and recorded image-streaming system with DVTS on the circumstance with IPv4 network. Results: Two operative cases were transmitted successfully. We could keep enough bandwidth of 60 Mbps for two-line transmission. The quality of transmitted moving image had no frame loss with the rate 30 per second. The sound was also clear and the time delay was less than 0.3 sec. Conclusions: Our study has demonstrated the feasibility of domestic and international telemedicine. We have established an international medical network with high-quality video trans-mission over internet protocol. It is easy to perform, reliable, and also economical. Thus, it will be a promising tool in remote medicine for worldwide telemedical communication in the future. (Korean J Gastro-enterol 2004;43:370-375)
은창수,함준수,김기찬,조윤주,전용철,이오영,한동수,손주현,최호순,윤병철,이민호,이동후,기춘석,박경남 (Chang Soo Eun,Joon Soo Hahm,Ki Chan Kim,Yoon Joo Cho,Yong Chul Jun,Oh Young Lee,Dong Soo Han,Joo Hyun Sohn,Ho Soon Choi,Byoeng Chul Yoon,Min Ho 대한소화기학회 1999 대한소화기학회지 Vol.33 No.6
Background/Aims: It has been suggested that cholecystectomy can be related with the developmen of colon cancer and altered bile acid metabolism after cholecystectomy may be an important facto in the carcinogenesis. Thus, we have conducted a retrospective case-control study to clarify the relationship between cholecystectomy and subsequent development of colon cancer. Methods: We compared the incidence of previous cholecystectomy in 424 patients with colon cancer who had treated in our clinic during the period of 1983 to 1997 and in 424 age- and sex-matched controls Results: There was no significant difference in a prevalence of cholecystectomy and gallstones between colon cancer patients and controls (Cholecystectomy: odds ratio=1.17, 95% confidence interval=0.39-3.51; Gallstone: odds ratio=1.27, 95% confidence interval=0.73-2.21). The prevalence of cholecystectomy and gallstones was a little high in right-sided colon cancer group, but there was no statistically significant difference between right and left colon. Conclusions: The present study showed that there was no statistically significant association between cholecystectomy and colon cancer. To clarify whether colon cancer is associated with cholecystectomy or gallstones, further study with large sample size and a prospective study of the incidence of colon cancer afte cholecystectomy are proposed. (Kor J Gastroenterol 1999;33:823 - 830)
백상현 ( Sang Hyun Baik ),함준수 ( Jun Soo Hahm ),전용철 ( Young Chul Jeoun ),이오영 ( O Young Lee ),이민호 ( Min Ho Lee ),기춘석 ( Chun Suk Ki ),박준용 ( Jun Yong Park ),은창수 ( Chang Soo Eun ),한동수 ( Dong Su Han ) 대한소화기학회 2002 대한소화기학회 춘계학술대회 Vol.2002 No.-
〈배경〉 현재까지 담석의 증가와 연관성을 가진 병적인 상태를 찾고자하는 연구가 진행되어 왔다. 대개의 류마치스 관절염환자는 NSAID를 복용하고 있는 자가 많고, 동물 실험을 NSAID가 담석 생성과 관련이 있음이 발표되기도 하였다. 본 연구에서는 류마치수 관절염환자에서의 담석의 빈도를 제시하고 matched control과의 여러 다른 기준척도등의 비교를 통해 이들간의 유의성을 비교하였다. 〈연구대상 및 방법〉 한양대 류마치스 병원에 입원하였던 선별검
호흡부전과 신경학적 이상을 동반한 Acute Intermittent Porphyria
전대원(Dae Won Jun),최춘식(Choon Shik Choi),최호순(Ho Soon Choi),전용철(Yong Chul Jung),손주현(Joo Hyun Sohn),한동수(Dong Soo Han),윤병철(Byung Chul Yoon),함준수(Joon Soo Hahm),이민호(Min Ho Lee),이동후(Dong Hoo Lee),기춘석(Choon Shu 대한소화기학회 2000 대한소화기학회지 Vol.36 No.3
The acute intermittent porphyria (AIP) is characterized biochemically by increased excretion of porphyrins and porphyrin precursors, S-aminolevulinic acid (ALA) and porphobilinogen (PBG). AIP presents with abdominal pain, mental disturbances and neurologic dysfunction. A 24-year-old woman with a medical history of AIP was admitted to our hospital because of abdominal pain and proximal muscle weakness. She was treated by carbohydrate loading with intravenous glucose. Twenty five days later, she developed tachycardia, fluctuation of blood pressure and syndrome of inappropriate secretion of antidiuretic hormore (SIADH). On 90th day, intubation was required to control her breathing. Complete flaccid paralysis developed, and the patient became comatose. The neurologic effects of acute porphyria are generally reversible, but the clinical course of severe case is complicated with respiratory failure, fluid electrolyte imbalance. AIP should be considered in differential diagnosis of patient with unexplained respiratory failure. (Kor J Gastroenterol 2000;36:413 - 418)
담도 . 췌장 / 말기 신질환과 혈액투석 환자의 담석증 유병률에 대한 고찰
이향락(Hang Lak Lee),함준수(Joon Soo Hahm),손병관(Byung Kwan Son),이정익(Jeong Ik Lee),정청일(Chung Il Joung),은창수(Chang Soo Eun),이오영(Oh Young Lee),전용철(Yong Chul Jun),한동수(Dong Soo Han),최호순(Ho Soon Choi),윤병철(Byung Chu 대한소화기학회 2001 대한소화기학회지 Vol.37 No.4
Background/Aims: Gallstone disease is one of the major cause of morbidity in adults. Hemodialysis (HD) has been found to increase risk of gallstone formation following increase in bile cholesterol and biliary saturation index. There are very few data about the prevalence of gallstone in hemodialysis patients and so, we performed this study. Methods: We compared the prevalence of gallstone disease in patients with end-stage renal disease (ESRD) treated with HD with that in 208 age- and sex-matched controls (non-uremic control group). Patients who had chronic liver disease, renal disease, and diabetes were excluded from the control group. Results: In our study, we found a prevalence of gallstone of 18.3% in patients with ESRD treated with HD, which was significantly higher than 5.3% in the non-uremic control group. In most of our HD patients, cholecystolithiasis was asymptomatic. HD patients with cholecystolithiasis were statistically significantly older than patients without gallstones. We did not find a difference in sex, duration of HD treatment between patients with and without gallstones. Conclusions: Our results suggest that the prevalence of gallstone disease is higher in patient with ESRD treated with HD than in non-uremic population in Korea. (Korean J Gastroenterol 2001;37:271-276)
위절제술이 골대사 및 골밀도에 미치는 영향 - 예검법으로서 의미있는 지표
권성준(Sung Joon Kwon),신동일(Donng Ill Shin),원치규(Chi Kyooh Won),전규영(Kyu Young Jun),곽진영(Jin Young Kwak),이광수(Kwang Soo Lee),정파종(Pa Jong Jung),안유헌(Yoo Hern Ahn),함준수(Joon Soo Hahm),김목현(Mok Hyun Kim) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.2
Background/Aims: Abnormalities of bone metabolism occur to gastrectomised patients in the form of a late complication. Nowadays, many biochemical and radiologic measurements are applied to detect these abnormalities. The aim of this study was to determine the parameter for an appropriate screening test during the long-term follow-up period and define the usefulness of new biochemical markers for bone metabo]ism by comparing them with traditional markers. Methods: Among the patients gastrectomised(Billroth II) in the surgica] department of Hanyang University Hospital since 1982, 10 patients were randomly selected with exclusion criteria by measuring several biochemical and radiologic tests. Ten age-matched volunteers who led a healthy normal life were selected with the consent of subjects. Results: Comparing the data with those of a corresponding control group, the ]umbar bone density tneasured by quantitative cornputed tornography(QCT) was statistically significantly lower in the patient group(p0.01). In addition, urinary deoxypyridinoline (DPD), a biochemical marker for bone resorption, was statistica]ly higher in the patient group(p -0.025). Osteocalcin, P1CP, and 1CTP were slightly but not significant]y bigher in the patient group. The serum PTH and 25-hydroxyvitamin D levels were sitnilar in both groups. Conclusiions: Although the nurnber of cases was smal] for data evaluation, we suggest that urinary deoxypyridinoline and QCT were appropriate parameters for tbe screening test for the detection of bone metabolism abnormalities in gastrectomised patients during the long-term follow-up. Furthermore, urinary deoxypyridinoline is a simple and rapid test which can replace cumbersome 24-hour urinary hydroxypro]ine. (Korean J Gastroenterol 1996; 28:172 178)
급성 복통과 상부위장관 출혈을 동반한 물개회충 감염 2예
최춘식(Choon Shik Choi),최호순(Ho Soon Choi),변재원(Jae Won Byun),강문수(Moon Soo Kang),전대원(Dae Won Jun),윤병철(Byeong Chul Yoon),함준수(Joon Soo Hahm),이동후(Dong Hoo Lee),이민호(Min Ho Lee),기춘석(Choon Suhk Kee),박경남(Kyung Na 대한소화기학회 2000 대한소화기학회지 Vol.35 No.4
Human Anisakiasis is caused by the accidental human infestation of larvae of marine mammals. The larvae are usually introduced into human body by the intake of saltwater fish and squid. The common clinical symptoms are colicky pain, diffuse abdominal tenderness, nausea, vomiting, fever, and leukocytosis. Sometimes, they are severe enough to need acute abdominal surgery. The larvae invade the gastrointestinal mucosa, and occasionally result in upper gastrointestinal bleeding. Infestation by Anisakis type I is observed more often than that by Peudoterranova decipiens in Korea. The characteristic intestinal cecum which protrudes towards the ventriculus can be seen in Peudoterranova decipiens. While the characteristics of Anisakis type I and Peudoterranova decipiens are a little different, the clinical manifestation and treatment seem to be the same. We report two cases of gastric Anisakiasis caused by Peudoterranova decipiens larvae, which present acute abdominal pain and upper gastrointestinal bleeding. (Kor J Gastroenterol 2000;35:501 - 506)
간 이식 후 합병된 담관 원주 증후군에 의한 폐쇄성 황달
백상현 ( Sang Hyun Bak ),최호순 ( Ho Soon Choi ),양선영 ( Sun Young Yang ),전대원 ( Dae Won Jun ),한성희 ( Sung Hee Han ),이항락 ( Hang Lak Lee ),이오영 ( Oh Young Lee ),윤병철 ( Byung Chul Yoon ),함준수 ( Jun Soo Hahm ),이민호 ( 대한소화기학회 2006 대한소화기학회지 Vol.48 No.2
Biliary complication occurs in 6-34% of all liver transplant patients. Although bile leaks and strictures are relatively common, other biliary complications such as T-tube leak, choledocholithiasis, and biliary cast syndrome can also be observed. The biliary cast syndrome describes the presence of casts causing obstruction with its resultant sequelae of biliary infection, hepatocyte damage secondary to bile stasis and ductal damage, all contributing to cholangiopathy. Because the exact timing of cast formation after orthotopic liver transplantation is not consistent, it is difficult to define the true incidence of biliary cast syndrome without long-term follow-up data. Proposed etiological mechanisms include acute cellular rejection, prolongation of cold ischemic time, infection, biliary drainage tubes, and biliary obstruction. The diagnosis of biliary cast syndrome is usually confirmed by endoscopic retrograde cholangiopancreatography. There have been few published articles about biliary casts in Korea. Herein, we report a case of biliary cast syndrome followed by orthotopic liver transplantation. (Korean J Gastroenterol 2006;48:119-123)