천공성 충수돌기염 환자의 창상세척과 일차봉합에 대한 고찰

이환봉,이강창 圓光大學校 醫科學硏究所 1999 圓光醫科學 Vol.15 No.1

Background: Under the principle that, the more the removal of pathogens from the contaminated wound, the lesser the chance of wound infection, we tried massive saline irrigation and primary closure in order to compare with the generalized wound management method of delayed primary closure. Methods: From September 1997 to Desember 1998, we operated 318 cases of appendicitis and 64 cases of them presented with perforated appendicitis on operative field. By the same method and the same surgeon, all patients of perforated appendicitis underwent appendectomy and had intraperitoneal closed suction drainage from the peluic cavity and massive (1.0L) saline wound irrigation after peritoneal approximation. A penrose drain was also left in primarily closed operative wound for several days in all patients. Results: Postoperative suppurative wound infection in 5 patients (7.8%) which in eluded 2 cases of wound infections after reoperation due to intraabdominal abscesses appeared as the result of above management. Conclusions: Because of painful time consuming method of delayed primary closure, primary closure of operative wound in perforated appendicitis seems to be acceptable as management method especially in children.

“항상 개혁되어야 할 개혁교회”

이환봉 달구벌기독학술연구회 2007 진리와 학문의 세계 Vol.16 No.-

천공성 충수돌기염 환자의 수술 중 분석 확인의 중요성

이환봉 圓光大學校 醫科學硏究所 1999 圓光醫科學 Vol.15 No.1

Background: Inspite of certainty that lost fecalith would inevitably cause intraabdominal abscess after appendectomy, it has not been emphasized enough to remove any missed fecalith during appendectomy in case of perforated appendicitis. Methods: Through the operations of 64 patients due to perforated appendicitis, under the same method and the same surgeon, any missed fecalith was explored thoroughly if it was not found around the perforation site or in the appendicial lumen. Results: 24 patients had intraluminal fecalithes and 4 patients had spillaged fecalithes into the peritoneal cavity, which could be removed by thorough exploration. Intraabdominal abscess occured in 2 patients (3.1%) of fecalithless perforated appendicitis inspite of full attention about the possibility of missing and remaining of fecalith in peritoneal cavity. Conclusion: The acceptable 3.1% incidence of intra-abdominal infectious complication comparing to other reports on same subjects has been possible by reducing 4 cases of complication inevitale if the fecalith were not removed. This study suggested that full attention and thorough exploration of peritoneal cavity is mandatory if fecalith is not found around the perforated appendix.

천공성 충수돌기염 수술 시 복강 세척 후 감염성 합병증 발생

이환봉,이재규,이병찬 대한외과학회 2003 Annals of Surgical Treatment and Research(ASRT) Vol.65 No.5

Purpose: Until recently, the surgical treatment of perforated appendicitis in South Korea showed a relatively high incidence of postoperative infectious complications compared with centers having protocols for managements. Authors have been performing appendectomies for perforated cases under the principle of massive irrigation of the peritoneal cavity and primary closure of incision wound that leaves a suction drain from pelvic cavity, expecting reducing chance of infective complications and thus reducing the stress faced by operators. Methods: Among 788 cases of appendicitis from September 1997 to December 2002, 172 patients showing perforation and peritonitis in the operative field were reviewed retrospectively. All the operations were performed by the principle mentioned above, and data were collected on various major complications, especially infective wound and intra-abdominal complications. Results: There were 7 cases of suppurative wound infection, and 5 cases of intra-abdominal abscess, representing a total incidence of 7.0% (n=12) in 172 patients. Other major complications such as adhesive ileus (n=3), intestinal fistula (n=1), or remote organ infective event (n=1) were also recognized. Conclusion: Massive saline irrigation during appendectomy of perforated appendicitis-without antibiotic mixture-that leaves a negative suction drain from the pelvic cavity and the primary closure of incision wounds have yielded satisfactory results concerning various aspects, especially in lessening infective postoperative complications. (J Korean Surg Soc 2003;65:425-430)

Lovastatin의 암세포에 대한 항증식 효과에 관한 연구

이환봉,장정순 圓光大學校 醫科學硏究所 1999 圓光醫科學 Vol.15 No.1

Background: Lovastatin which is a potent inhibitor of HMG-CoA reductase has antiproliferative effect on cancer cells. We investigated the cell cycle regulatory mechanism of anti-proliferative effect of lovastatin and its therapeutic value on cancer treatment. Methods: MDA-MB-231, an ER negative breast cancer cell line and PC-3-M, an androgen independent prostate cancer cell line were grown up to use. We checked expression pattern of cell cycle regulatory proteins such as cyclins, cdk inhibitors including p21, cdks, RB and RB family protein p107 with lovastatin by Western blot analysis and immunoprecipitation. Results: The proliferative tendency of breast cancer and prostate cancer cells was decreased with 10 μM lovastatin. Cyclin D1 was decreased, however p21, a cdk inhibitor was increased with lovastatin. There is no change in the protein level of cyclin E, cdk4 and cdk2. After 36 h incubation with lovastatin, RB and p107 were dephosphorylated and showed increased binding with transcription factor E2F1 and E2F4 respectively. Conclusion: These results show that lovastatin has antiproliferative effects on breast and prostate cancer cells. The cell cycle regulatory effects of lovastatin come to G1 phase and those are mediated by cyclin D1 depression, p21 induction and decreased activity of cdk4. In accordance with them RB dephosphorylation and its sucessive binding with E2F1 seem to have important role in growth inhibitory effect of lovastatin. These data suggest that growth inhibitory activity of lovastatin by way of cell cycle regulation supports the therapeutic value for cancer treatment.

부착포를 이용한 경동맥혈관내 절제술 시 완성 혈관조영술의 의미

이환봉,이병찬,Gregory L. Moneta 대한외과학회 2003 Annals of Surgical Treatment and Research(ASRT) Vol.65 No.4

[권두언] 개혁 교회의 과제 ② - 개혁 교회는 항상 개혁되어야 한다

이환봉 고신대학교 개혁주의학술원 2009 갱신과 부흥 Vol.2 No.1

천공성 충수돌기염 환자의 창상세척과 일차봉합(2)

이환봉,이재규 圓光大學校 醫科學硏究所 1999 圓光醫科學 Vol.15 No.2

Background: Large proportion of patients of perforated appendicitis are still suffering from postoperative infectious complications such as wound infection and intraabdominal abscess. Inspite of various efforts against above complications there leaves much things to be settled for better results of treatment Methods: By one surgeon and by one operative principle throughout the period, 91 cases of perforated appendicitis were underwent surgical intervention from September 1997 to August 1999. all patients of perforated appendicitis had appendectomy and intraperitoneal closed suction drainage from pelvic cavity with massive saline wound irrigation after peritoneal approximation. A penrose drain was also left in primarily closed incision wound for several days in all patients. In case of diffuse peritonitis, saline irrgation of intraperitoneal cavity was made and the presence of fecalith or not was always checked by the operator. Results: Postoperative suppurative wound infection appeared in 6 patients (6.6%) and intraabdomonal abscess appeared in 3 patients (3.3%) Conclusions: Massive saline irrigation in peritoneal cavity and incision wound markedly reduces infective complications in perforated appendicitis patients comparing previous results and shows better results comparing generalized method of delayed primary closure of comtaminated wound.

이종이식과 동종이식에서 ICAM-1의 표현에 관한 연구

이환봉,한덕종,김인구 大韓移植學會 1994 Korean Journal of Transplantation Vol.8 No.1

[권두언] 교회개혁의 과제 ① - 개혁 교회는 항상 개혁되어야 한다

이환봉 고신대학교 개혁주의학술원 2008 갱신과 부흥 Vol.1 No.1