문맥압 항진증의 혈역학적 특성

김태년(Tae Nyeun Kim),서정일(Jeong Ill Suh),장병익(Byeong Ik Jang),정문관(Moon Kwan Chung),이현우(Hyun Woo Lee) 대한내과학회 1997 대한내과학회지 Vol.53 No.1

N/A Objectives: Hemodynamic measurements of chronic portal hypertension were done to study the mechanisms that maintain high portal pressure despite well developed collateral circulations. Methods: A prehepatic portal hypertensive rat model was produced by partial portal vein ligation. Cardiac output, organ blood flow and porto-systemic shunt were measured by radioisotope labeled microsphere methods, and vascular resistance was calculated by standard equation. Results: There was a significant reduction in the weight of the liver and increase in the weight of the spleen in the portal stenotic rats. Porto-systemic shunting, representing development of the collateral circulations, was 96.7±0.6% in the portal stenosis group compared with 0.9±0.2% in the control group (p<0.01). Portal pressure was significantly increased in the portal stenosis group compared with the control group(12.8±1.4 vs. 6.5±0.6mmHg; p<0.01). Mean arterial pressure was significantly decreased in portal stenosis group compared with control group(101.4±2.5 vs, 129.9±3.9mmHg; p<0.01). In the portal stenosis group, cardiac output(135.7±8.0 vs. 111.0±4.2ml/min; p<0.01) and splanchnic organ blood flow (28.97±2.03 vs. 17.90±1.27ml/min, p<0.01) were significantly increased, with concomitant decrease in total peripheral vascular resistance(58.0±3.3 vs. 88.2±4.8 dyne sec/cm5×105; p<0.01) and splanchnic vascular resistance(2.54±0.20 vs. 5.47±0.33 dyne sec/cm5×105; p<0.01), However, the portal venous resistance was not significantly different in both groups of rats (3.57±0.31 vs. 3.03±0.38 dyne sec/cm5×105; p>0.05). Conclusion: The hemodynamic results of this study indicate that hyperdynamic status of systemic and splanchnic circulation was present in chronic portal hypertension and that the primary factor contributing to the persistently elevated portal venous pressure was the markedly increased portal venous inflow.

비공식투자자의 창업기 투자의사결정요소 연구

김태년(Tae-Nyeun Kim),박선영(Sun-Youmg Park),송영화(Yeong-Wha Sawng) 한국콘텐츠학회 2018 한국콘텐츠학회논문지 Vol.18 No.9

창업은 국가 경제성장에 기여하고 고용창출 효과가 크므로 국가는 창업활성화의 다양한 정책들을 추진하고 있다. 그러나 기술창업은 2016년 현재 2013년 대비 오히려 5.0%p 감소하였다. 정부가 추진하는 창업투자활성화는 벤처캐피탈과 엔젤 펀드들을 통해 창업 이후 성장기 또는 주식상장 2~3년 전의 유망한 벤처기업들에 주로 투자되며, 실제적으로 창업기의 투자와는 투자의 시기적 차이가 있고, 이러한 벤처기업에 투자하는 투자의사결정요소에 관한 연구는 많다. 창업활성화는 민간의 창업투자가 활발하도록 환경조성이 필요하며 창업기에 투자하는 민간 투자금의 현금화 가능성과 수익성에 관해 투자자들의 기대에 대한 연구가 필요하다. 창업기에는 창업자, 가족, 친구, 바보들 등의 비공식투자자들에 의해 투자되고 공식투자자들인 벤처캐피탈 및 엔젤펀드 등의 전문투자에 비해 비정형화된 투자의사결정이 이루어지는 것이 일반적이다. 본 연구는 비공식투자자의 특성과 투자의사결정요소, 그리고 투자금의 현금화 가능성 및 투자수익성이 투자의도에 미치는 영향을 분석하는 것으로서, 현금화 가능성은 자영업창업의 투자의도에 매개효과가 있고, 투자수익성은 기업창업의 투자의도에 매개효과가 있는 것으로 분석되었다. The startup, which is a common noun to start a small business, has been recently one of main targets for policymakers due to its important role for job creation and considerable potential for sustainability of an economy. However, technological entrepreneurship decreased by 5.0% p from 2013 to 2016. The revitalization of entrepreneurial investment promoted by the government is mainly supported in fruitable venture companies at grow stage or 2~3 years before IPO through venture capital firms and angel funds. It is far from an investment at start-up. It is therefore necessary to motivate private investment to be active in the private start-up sector. In addition, the start-up investment requires institutional support and government support to meet the expectations of investors about the possibility of payback and profitability of private investment invested in the founding period. As a small entrepreneur at a comparably early stage in the lifecycle of business, investments for the startup are generally made by informal investors such as family, friends and fools, and their decision making processes are relatively non-programmed compared with ones for listed corporales such as venture capital and angel fund agency. This study focuses on analyzing decision making factors in investment, and verifying an impact of such factors, specifically the possibility of investment payback and investment profitability, in a decision-making process for the startup especially at the very early stage.

증례 : 문맥염 6예의 임상 양상 및 방사선학적 소견

김태동 ( Tae Dong Kim ),김태년 ( Tae Nyeun Kim ),오희주 ( Hee Ju Oh ),김준환 ( Jun Hwan Kim ),이헌주 ( Hun Ju Lee ),박원규 ( Won Kyu Park ),장재천 ( Jae Chun Jang ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-

문맥염은 드문 질환으로 증상이 모호하여 조기진단이 어렵고 치료시기를 놓치면 높은 치사율을 보인다. 원인으로는 충수돌기염, 게실염, 감염성 췌장 괴사 등의 복강내 감염과 간경변이나 간암, 위암, 췌장암 같은 악성종양 및 골수증식성 질환, 혈액응고인자 결핍증과 같은 상태에서 이차적인 감염이 일어나서 생기기도 한다. 예후에 빠른 진단과 치료가 중요하여 저자들은 본원에서 경험한 6예를 통해 화농성 문맥 혈전증의 임상양상과 방사선학적 소견을 고찰해 보고자 하였다. 6예의 환자 모두 남자였으며 평균 추적관찰기간은 11개월(5~24개월), 평균연령은 54.3세(38~60세)였다. 문맥염의 추정 원인으로는 2예에서 담도염, 1예에서 급성 충수돌기염, 3예에서는 원인이 불분명하였다. 임상양상은 전예에서 발열과 오한, 우상복부 통증과 압통을 보였다. 일반혈액검사에서 6예에서 백혈구 증다증과 빈혈이 있었으며 3예에서 혈소판 감소를 보였다. 역동적 복부 전산화 단층 촬영상 전예에서 문맥혈전증이 보였으며 이 중 4예에서 상장간막 혈전증이 동반되어 있었다. 2예에서 간농양이, 2예에서 담즙종이 동반되어 나타났다. 문맥혈전증은 조영되지 않는 간내 문맥, 혈관내 저음영의 혈전소견, 간실질의 불균일한 조영증강, 변연부에 비해 중심부의 저음영 소견으로 나타났다. 치료는 6예 모두에서 광범위 항생제를 투여하였고, 그 중 1예에서 항응고요법을 병행하였다. 6예 모두 증상이 호전되었으며 항응고요법을 시행한 예에서 추적관찰시 혈전이 사라지고 간엽의 위축이 없이 회복되어 항응고요법이 문맥염의 호전에 도움이 될 것으로 생각되나 이에 대해서는 향후 더 많은 연구가 필요할 것으로 생각된다. Pylephlebitis, a suppurative thrombophlebitis of the portal venous system, is a rare complication of intra-abdominal sepsis usually followed by infection either in the region draining the portal system or in the structure contiguous to the portal vein. Early diagnosis and initiation of adequate antibiotic therapy is important for improving the long-term prognosis of patients suffering from this rare disease, so we retrospectively reviewed 6 cases of pylephlebitis. All patients were males with a mean follow-up of 11 months (range 5~24 months). Clinical symptoms consisted of fever (100%), right upper abdominal pain (100%), jaundice (33.3%), and diarrhea (16.6%). Anemia and leukocytosis were found in 6 patients. Suspected etiology was acute cholangitis in 2 patients, acute appendicitis in 1 patient and idiopathic in 3 patients. All patients were successfully diagnosed with dynamic CT scan which showed the presence of portal vein thrombosis (100%), superior mesenteric vein thrombosis (66.6%), liver abscess (33.3%), and biloma (16.6%). Patients were treated with the systemic administration of a broad spectrum antibiotics and 1 patient was given anticoagulant. Initial symptoms were improved in all patients and some beneficial effects of anticoagulation are expected to achieve the recanalization of thrombosis and prevent atrophic changes in the liver, but further studies on the kind of therapy are needed. (Korean J Med 69:S798-S806, 2005)

담관낭종 불완전 절제 후 잔류 낭종에 발생한 거대 췌석

김아림 ( Ah Lim Kim ),김승범 ( Sung Bum Kim ),김국현 ( Kook Hyun Kim ),김태년 ( Tae Nyeun Kim ) 대한췌담도학회 2018 대한췌담도학회지 Vol.23 No.2

췌장암 환자에서 Oxaliplatin 사용 후 발생한 돌발성 난청 1예

김승범 ( Sung Bum Kim ),김소영 ( So Yeong Kim ),김국현 ( Kook Hyun Kim ),김태년 ( Tae Nyeun Kim ) 대한소화기학회 2020 대한소화기학회지 Vol.76 No.5

Oxaliplatin is a new generation of platinum derivatives used frequently to treat solid organ malignancies, including colorectal and ovarian cancer. Recently, an oxaliplatin-based chemotherapeutic regimen was adopted for advanced pancreatic cancer. Although oxaliplatin has extensive therapeutic potential, its use can be limited by significant adverse effects, particularly ototoxicity. This paper reports a rare case of irreversible unilateral hearing loss in a 48-year-old female that developed after the intravenous infusion of oxaliplatin during pancreatic cancer treatment. To the best of the authors’ knowledge, this is the second reported case of oxaliplatin-related ototoxicity in pancreatic cancer. (Korean J Gastroenterol 2020;76:261-264)

염증성 장질환 환자에서 5-Aminosalicylic Acid의 신장기능에 대한 영향

김경옥 ( Kyeong Ok Kim ),장병익 ( Byung Ik Jang ),김태년 ( Tae Nyeun Kim ),이시형 ( Si Hyung Lee ) 대한장연구학회 2008 Intestinal Research Vol.6 No.1

Background/Aims: An increasing number of case reports indicate the potential nephrotoxicity of 5-aminosalicylic acid (ASA). The aim of this study was to investigate the effect of long-term use of 5-ASA on renal function in patients with inflammatory bowel disease (IBD). Methods: The medical records of 318 patients with IBD that were treated with 5-ASA from 2001 to 2007 at Yeungnam University Hospital were reviewed. Changes in creatinine clearance (CCr), as measured by modification of diet with the renal disease study (MDRD) method, and risk factors were analyzed. Results: One-hundred patients were available for analysis. The male to female ratio was 55:45 and the mean age was 35.89±14.1 years. Fifty-eight patients were diagnosed with Crohn’s disease and the other patients were diagnosed with ulcerative colitis. The mean treatment duration with 5-ASA was 2.6±2.5 years and 85 patients were treated with mesalazine and eight patients were treated with sulfasalazine. The mean baseline glomerular filtration rate (GFR) was 112.9±25.3 mL/min. The mean CCr declined to 106.3±28.3 ml/min/m2 with an annual decline of 1.44 ml/min/year/m2, but there was no statistically significant change in the mean CCr. Changes in the CCr were correlated with the pretreatment CCr. Conclusions: There was no statistically significant change in serum CCr. Although 5-ASA therapy in IBD patients resulted in no meaningful effect on renal function, the annual decline was within the normal range (0.4-1 mL/min/m2). Serial follow-up of GFR has significance. A large prospective study with a longer time is needed to confirm these findings. (Intest Res 2008;6:45-49)

췌장후부에서 발생한 원발성 후복막 점액낭샘종

남윤정 ( Yoon Jeong Nam ),김태년 ( Tae Nyeun Kim ),김국현 ( Kook Hyun Kim ),구민근 ( Min Geun Gu ),이재영 ( Jae Young Lee ) 대한소화기학회 2014 대한소화기학회지 Vol.63 No.3

Primary retroperitoneal mucinous cystadenoma is an extremely uncommon tumor, even though mucinous cystadenoma often develops in the ovary and less frequently in the pancreas. A 21-year-old female was admitted to our hospital due to severe abdominal pain. A well-demarcated, oval shaped cystic tumor at the retropancreatic area with displacement of the pancreas and surrounding major vessels was observed on CT and MRI. Exploratory laparotomy was performed, and complete excision of the entire cyst was performed without complication. The pathologic finding was consistent with primary retropancreatic mucinous cystadenoma. To the best of our knowledge, this report is the first to describe a case of retropancreatic mucinous cystadenoma arising from the retropancreatic area in Korea.

5-aminosalicylic Acid 좌약에 의해 급성 췌장염이 유발된 궤양성 대장염 환자 1예

김국현 ( Kook Hyun Kim ),김태년 ( Tae Nyeun Kim ),장병익 ( Byung Ik Jang ) 대한소화기학회 2007 대한소화기학회지 Vol.50 No.6

Oral 5-aminosalicylic acid (5-ASA) has been known as a first-choice drug for ulcerative colitis. However, hypersensitivity reactions, including pancreatitis, hepatitis, and skin rash, have been reported with 5-ASA. Topical formulations of 5-ASA like suppositories have been rarely reported to induce adverse reactions because of their limited absorption rate. We recently experienced a case of acute pancreatitis caused by 5-ASA suppositories in a patient with ulcerative colitis. A 26-year-old male was admitted with abdominal pain and diagnosed as ulcerative colitis. Acute pancreatitis occurred soon after 24 hours of treatment with oral mesalazine. Drug-induced pancreatitis was suspected and administration of mesalazine was discontinued. Then 5-ASA suppositories were started instead of oral mesalazine. Twenty-four hours after taking 5-ASA suppositories, he experienced severe abdominal pain, fever, and elevation of amylase levels. The suppositories were immediately stopped and symptoms resolved over next 48 hours. Herein, we suggest that, in patients treated with 5-ASA suppositories who complain of severe abdominal pain, drug-induced pancreatitis should be suspected. (Korean J Gastroenterol 2007;50:379-383)

성인에서의 환상 췌장

김승범 ( Sung Bum Kim ),김국현 ( Kook Hyun Kim ),김태년 ( Tae Nyeun Kim ) 대한소화기학회 2018 대한소화기학회지 Vol.71 No.5

증례 : 담관결석을 동반한 총간관 막성구조 1예

은종렬 ( Jong Ryul Eun ),김태년 ( Tae Nyeun Kim ),최선택 ( Sun Taek Choi ),이정훈 ( Jung Hoon Lee ),장병익 ( Byung Ik Jang ),이헌주 ( Heon Ju Lee ),배영경 ( Young Kyung Bae ) 대한내과학회 2007 대한내과학회지 Vol.72 No.5

담관의 막성구조는 국내에서 10예 미만이 보고되어 있을 정도로 매우 드문 질환이며 특징적인 내시경적 역행성 담관조영술 소견으로 진단할 수 있는데 원인은 다양하나 일부는 선천적인 것으로 다른 일부는 염증에 의한 후천성 원인이 제시되고 있다. 특징적인 우상복부 통증으로 내원한 31세 여자 환자에서 내시경적 역행성 담관조영술로 담관결석이 동반된 총간관 막성구조로 인한 협착이 진단되어 Roux-en-Y 간공장문합술로 치료한 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Biliary web is a very rare disease and it can be diagnosed by its characteristic findings on endoscopic retrograde cholangiogram. The etiology of biliary web is variable. We were able to diagnose a common hepatic duct web in association with choledocholithiasis by performing endoscopic retrograde cholangiogram and operation. A 31-year-old woman visited our emergency room because of colicky right upper abdominal pain she had experienced for several hours. The endoscopic retrograde cholangiogram showed web-like stricture and stone at the common hepatic duct. She was treated by cholecystectomy with Roux-en-Y hepaticojejunostomy. We report here on this rare case along with a review of the literature. (Korean J Med 72:536-539, 2007)