위암환자의 위절제술 후 식이시도의 시간에 대한 연구

노경빈 청주대학교 보건의료과학연구소 2014 보건의료과학연구 Vol.3 No.1

Since it has been changed to elderly society, with aged person increased, it has shown the cancer patients, specially gastric cancer patients, were gradually increased. This study is about the starting time of the diet after the gastrectomy of the stomach cancer patients was done and their medical records were analyzed retrospectively for the baseline data. In case of no leakage on gastroenterostomy, the subtotal gastrectomy shows no timing difference. When the total gastrectomy was performed, it has shown that the jejunal interposition is faster than Roux-en-y type in the start of soft diet. A upper gastrointestinal series with contrast was performed when the status of patient was uncertain and it also shows faster start of diet. There was no significant difference between the subtotal and total gastrectomy. The healing period of alimentary canal anastomosis is faster compare to skin. For the diet after stomach operation, it should be POD 5 for drinking water, POD 6 for liquid diet, and POD 8 for soft diet, respectively. Since this research was conducted based on relatively small samples, it should give better results if bigger samples are provided.

위암 환자의 병기별 분석과 고찰

노경빈 청주대학교 보건의료과학연구소 2016 보건의료과학연구 Vol.4 No.2

Although the rates of stomach cancer shows decrease trend lately, the mortality is second heighest next to the lung cancer. To investigate the proper therapeutic styles of stomach cancers, a laparotomy data has been analyzed based on age, gender, sites of cancer, gastrotomy, removal of lymph nodes, reconstruction, WHO histopathological classification, Lauren classification, and the clinical stages of T(tumor), N(lymph node), M metastasis), and stomach cancer itself. And this analysis has been in accordance with the 7th edition of AJCC manual of cancer clinical stage. In early gastric cancer, despite the fear of metastasis of lymph nodes, it is found that the conventional subtotal gastrectomy, lymph dissection(D2), and gastroduodenostomy are proper therapeutic styles for the lower and central stomach. On the other hand the total gastrectomy, lymph dissection(D2), and jejunal pouch interposition are proper therapeutic styles for the upper stomach. In advanced gastric cancer, if it is proximal metastasis through the pre-operation evaluation, gastrectomy and lymph dissection(D2, D2a, or D3) are proper therapeutic styles. If it is remote metastasis and splenic artery metastasis of lymph nodes through the pre-operation evaluation, the tail of pancreas preserved splenectomy is the proper therapy for the upper and central stomach. For the lower stomach cancer, in case of lymph node metastasis to the transverse colon mesenteric artery and vein, it is the principle that lymph dissections of arteriovenous of transverse colon and transverse colectomy are proper therapies. In advanced gastric cancer, if it is remote metastasis or distant metastasis of lymph nodes, the distal gastrectomy has not risen the survival rates. In only liver metastasis and localized to the lateral parts of left liver, the left hepatectomy has risen the survival rates. It seems that the preoperative chemotherapy is another strategy for this case. The purpose of this study is to give a good turn for other operations and/or the judgement of operating surgeon through the surgical methods not from the empiricism and at the same time to give the self-reflection opportunities for the surgeon.

총수담관 십이지장문합술 환자의 원격성적

노경빈(Kyung Bin Noh),이봉화(Bong Hwa Lee),이찬영(Chan Young Lee) 대한외과학회 1987 Annals of Surgical Treatment and Research Vol.33 No.5

위암에서 p53단백의 발현

송형근,노경빈,정화숙,장이찬,최재운,이상전,송영진,이동호,윤세진,성노현 충북대학교 의과대학 충북대학교 의학연구소 1993 忠北醫大學術誌 Vol.3 No.1

최근 종양억제 유전자가 다양한 종류의 암에서 암발생기전에 중요한 역할을 담당하고 있다고 보고되고 있으며 잘 알려진 p53과 망막아종유전자이외에도 다수의 유전자가 새로운 종양억제 유전자로서 연구되고 있다. 포르말린고정 후 파라핀 포매된 원발성 위암 18예와 주변 림프절에 전이된 전이성 위암 7예를 대상으로 정상 및 돌연변이형의 p53 종양 단백에 대한 단일클론 항체(NCL-p53-DO-7)를 이용하여 면역조직화학 염색을 시행하였다. p53단백의 발현은 핵에 국한되는데, 원발성위암의 50%(9/18)와 주변림프절에 전이된 전이성 위암의 14.7%(1/7)에서 관찰되었다. p53단백의 발현과 종양의 분화도와는 무관하였고, 침윤 깊이와 림프절 전이와는 역상관 관계가 있었다. 이러한 결과는 기존의 문헌에 보고된 p53단백의 발현이 독립적인 예후 결정인자로 적합하다는 가정에 배치되는 소견으로 그 의미에 대해 고찰하였다. Recently tumor suppresor genes(antioncogenes) have been considered as very important roles in oncogenesis of various cancers and besides well known antioncogenes p53 and retinoblastoma gene, numerous new candidates have been searching. Using monoclonal antibody that is monospecific for the normal and mutant p53 oncoprotein, an immunohistochemical study of the expression of p53 protein was performed in formalin fixed, paraffin-embedded tissue sections from 18 primary gastric carcinomas and 7 metastatic gastric carcinomas in regional lymph nodes. p53 expression in which the reaction was localized to the nuclei was observed in 50%(9/18) primary gastric carcinomas and 14.7%(1/7) metastatic gastric carcnomas in regional lymph nodes. There was not a significant association between p53 staining and histological type. In addition, p53 expression was reversely correlated with depth of invasion and lymph nodes metastasis. These results gave us a question whether p53 expression is a real important independent prognostic indicator and is really associated with high potential for lymph node metastasis.

응급실 자료의 구축과 그 활용

홍기천,노경빈,이성웅,장창순,노준양,이두선 대한응급의학회 1993 대한응급의학회지 Vol.4 No.1

It is important work in the department of emergency medicine to manipulating data for the emergency patients. We developed a computer program for effectively managing data of the emergency patients and department on Dec. 1991, and began to build database on Jan. 1992. This program offers the various tools and functions for manipulating data, for quickly finding and displaying the information as you need, and for obtaining the basic results and analyses for quality assurance. The program was coded in a programming mode of FoxPro 2.5, and runs on IBM-PC-compatible computers. The systemic configurations to use properly, requires DOS 5.0 in O.S(operating system), 4 Megabytes or more in RAM(Random Access Memory), 100 Megabytes or more in Hard Disk capacity, at least 10 Megabytes in available disk space, and intel-80386(32 bits) in computer processing chip. The 8 bits combination codes are applied to write "Hangeul"(Korean language character). This program provides the various functions as the followings. 1. Be able to input, output, and search data as you need. 2. Be able to obtain the various reports by analysing the patient data. 3. Be able to retrieve the article data in Journal of Korean Society of Emergency Medicine, American Journal of Emergency Medicine, and Annals of Emergency Medicine as keywords, authors, etc. 4. Be able to manage the departmental data. By examples, manager of the emergency members, scheduler of the department, and collection book of the common senses in emergency medicine. 5. Other programs, which to reset and back up the selected data files for safely maintaining program, are supplied 6. Be able to study and prospectively analyze the clinical data by inserting the predefined optional programs. We expect the more advanced and beneficial program to manage data for the emergency patients and department.

선천성 고립성 거대 간낭종 7예

이봉화,노경빈,송재승,이찬영,윤종현 大韓消化器病學會 1986 大韓消化器病學會誌 Vol.18 No.2

지상발표 : 원발성 담관결석 및 간내결석에서의 측방총수 담관 십이지장 문합술의 효과

이봉화,노경빈,박흥길,이찬영 대한소화기학회 1986 대한소화기학회 추계학술대회 Vol.1986 No.-

담도계 수술 상에서 발견된 십이지장 게실을 동반한 간동맥 게실의 치험 예 보고

이창수,이찬영,노경빈 대한혈관외과학회 1985 Vascular Specialist International Vol.1 No.1

간 손상시 시행한 복부 단층 촬영의 의의

홍윤식,한상원,노경빈 대한외상학회 1995 大韓外傷學會誌 Vol.8 No.1

Surgery is recognized as normal treatment method for liver injuries. However, as the C-T scan is more widely used in cases of blunt abdominal trauma, approximately 20 to 30% of liver injuries are now being treated by means other than surgery. Although generally excellent as a tool for diagnosis of blunt abdominal trauma, C-T scan is still subject to controversy regarding its accuracy. It is true that abdominal C-T scan is valuable particularly for prognosis of the individual damages of solid organs such as liver, however the indications produced by C-T scan are sometimes inconsistent with surgery results or clinically observed symptoms. The purpose of this paper is to suggest guidelines for prognosis of liver injuries resulting from blunt abdominal trauma by analyzing the discrepancy between the surgery findings and the indications shown by C-T scan. For evaluation of this differences, we examined our experience with blunt hepatic trauma patients over the last 5 years. 51 patients who evaluated by cornputed tomography were reviewed. Among them, 19 patients were controlled by nonoperative method but 32 patients required operative management. The mean age was 33. 1 and 66. 7% were male. With using Injury Severity Scale of American Association for the Surgery of Trauma (AAST), 21 were Grade II (41. 2%), 12 were Grad III (23. 5%), 10 were Grade I (19.6%). All nonoperative management group revealed below the Grade K. In 32 patients of operative management group, 20 were below the Grade E. In 20 patients, 7(35.0%) were operatecl due to associated injuries and 13 (65. 0%) were operated due to unstable vital sign and increasing blood transfusion requirement. On the comparison between computed tomographic and operative findings, 10(31. 3%) were corresponding to operative findings, 19(59. 4%) were underestimated and 3(9.4%) were overestimated. 11(58.9%) of underestimated patients showed only one-grade difference, but 4(21.1%) and 4(21.1%) showed two and three-grade differences respectively. In cases where severe damages were found through surgery, the amount of blood transfusion actually required was cosiderably larger than indicated by C-T scan. C-T scan was quite helpful in making the dicision as to perform the surgery or not; however, C-T scan tended to underestimate the degree of liver damages; in particular, C-T scan was not accurate in predicting the requisite amount of blood transfusion. Consequently, we concluded that (1) it is not safe to determine the treatment methods for liver injuries solely on the basis of C-T scan and (2) it is urgently needed to develop a grading system where by C-T scan results can be appropriately evaluated. In addition it may be desirable to use C-T scan together with other types of diagnostic methods.

외상 환자의 기록과 분석

김윤식,홍윤식,노준양,이성웅,노경빈 대한외상학회 1993 大韓外傷學會誌 Vol.6 No.1

Trauma is rapidly becoming one of the most important and serious challenges for the public health in modern societies. In the U.S.A., the trauma is the top ranking cause of death for the age groups younger than 44 and the fourth ranking cause of death for all age groups. In Korea also, trauma is emerging as an exigent social problem due to the significant economic losses caused by the yearly increase in trauma patients and trauma related deaths. Adequate response to the challenge presented by trauma must be based on intensive and scientific analysis of the problem, which require a systemic recording of the data on the trauma patients. Various objective indices designed for the systematic recording and analysis of the trauma data have been developed and are widely in use in the advanced countries; however, not much effort has been made in such area in Korea. In 1985, the Committee on Trauma Research in the U.S.A., proposed the following five areas for trauma: epidemiology, prevention, biomechanics, acute care and rehabilitation. An EMS trauma system includes the facilities, personnel, transportation, communication, education, training and evaluation. An index must be developed for the purpose of accurate recording and effective evaluation of the data. The present article describes an electronic data processing program developed for the purpose of facilitating evaluation of trauma patients by providing a comprehensive system of classification of patient data. Such classification system would exped!te accurate recording and automatic evaluation of data and thereby promote quality assurance and appropriate analysis of data. 1. Classification of data Categories are established for classifying the demographic data, prehospital data, clinical data, laboratory data, trauma outcome data and other data. Demographic data includes patient identification, the date and time of arrival at the emergency room, cause and type of injury, preinjury status of patient and the use of protective gears. Prehospital data includes the time of injury, mode of transportation and emergency care given before the arrival at the hospital. Clinical data includes vital signs, pertinent history, Glasgow Coma scale, results of procedures and clinical impression according to the International Classification of Diseases. Laboratory data includes the results of variable tests; blood alcohol, serum electrolytes, BUN, Creatinine, blood sugar and arterial blood gas analysis. Trauma outcome data includes final deposition, health outcome results, the stay in hospital and ICU, complications and disabilities. 2. Reclassification of basic reference data The basic reference datas: external cause of injury or poisoning code within the International Classification of Diseases frame work, Abbreviated injury scale, Anatomic profile are classified and modified. 3. Menu for recording of data A menu is designed for each category in order to reduce the occurrence of mistakes in the process of the data entry. 4. Evaluation of data analysis and quality assurance. Revised trauma score (RTS), Injury Severity Score (ISS), RRE chart, TRISS metho-dology and ASCOT were evaluated by author designed computerized program, Also, z and W value were evaluated.