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고령의 호흡기 질환 환자에서 상부 위장관 내시경 검사시 폐기능 장애 정도에 따른 산소 포화도의 변화
정윤형(Yun Hung Jung),이진석(Jin Suk Lee),한종학(Jong Hak Han),김재홍(Jae Hong Kim),정동성(Dong Sung Jung),이귀래(Gwi Lae Lee),한창완(Chang Wan Han),박운식(Woon Sik Park),조영삼(Young Sam Cho),주홍돈(Hong Don Joo),두창준(Chang Joon D 대한내과학회 1995 대한내과학회지 Vol.49 No.2
N/A Objectives : We performed following experiment in order to find the relationship between impairment of pulmonary function test (PFT) and oxygen desaturation during upper gastrointestinal endoscopy examination among the elderly patients. Methods : Pulmonary function test and ABGA (arterial blood gas analysis) were performed before endoscopy. Arterial oxygen saturation and pulse rate were monitored with pulse oximeter before endoscopy until 5minutes its completion. We classified the population by control group and patients group by pulmonary function test. we classified patients group by mild group, moderate group and severe group (Table 2). Results : 1) Oxygen saturation was decreased significantly among all of groups, the most decreased within 1 minutes after insertion endoscopy and recovered soon before endoscopic completion. 2) The duration of worst SaO2 did not correlated with the pulmonary function test impairment. 3) The time of endoscopy did not correlated with decrease in SaO2 during endoscopy 4) There is decreased oxygen saturation in mild group, but no significant change from control group. 6) Pulse rate did not correlated with pulonary function test impairment. Conclualon : Oxygen saturation was decreased all groups in elderly populaton during upper gastro-intestinal endoscopy especially moderate or severe groups, therefore, incidence of cardio-pulmonary disease is increased. To prevent cardio-pulmonary complication, we should detect oxygen desaturation early by using pulse oximeter during upper gastrointestinal endoscopic procedure in moderate or severe group. If needed, termination of the procedure, oxygen supplement or assisted ventilation minimize cardiopulmonary complication.
김준현(Joon Hyun Kim),전상교(Sang Kyo Jeon),박정근(Jung Kun Park),김동월(Dong Wol Kim),두창준(Chang Joon Doo),변종훈(Jong Hoon Byun),이성규(Sung Kyu Lee),유선영(Seon Young Yoo),김정례(Jeong Rae Kim) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4
Leiomyosarcoma of duodenum is a rare malignant tumor, only ten percent are found in the duo- denum. The most common symptotns are abdominal pain, melena, weakness, weight loss, and jaundice, fever are rare complants. We reported a case of leiomyosarcoma with abscess formation in 54 year-old man confirmed by exploration and excisional biopsy. His chief complaints were right upper quadrant pain and high fever, a mass lesion combined with air bubbles on computerized tomography, upper gastrointestinal findings showed a duodenal mass hanging on 2nd and 3rd portion of duodenum and mucosal destruction. Excisional biopsy revealed low grade leiomyosar- coma in duodenum combined with necrosis and suppurations. (Korean J Gastroenterol 1996;28: 566 - 570)
전상교(Sang Kyo Jeon),박정근(Jung Kun Park),김동월(Dong Wol Kim),유선영(Seon Young Yoo),김정례(Jeong Rae Kim),김재홍(Jae Hong Kim),이진석(Jin Suk Lee),두창준(Chang Joon Doo),변종훈(Jong Hoon Byun),주재식(Jae Sik Joo) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4
Acinar cell carcinoma of the exocrine pancreas is a rare tumor with reported incidence of 1 to 2 % of pancreatic carcinoma. We reported a case of pancreatic acinar cell carcinoma in 58 year-old woman. Chief complaints were palpable mass and pain in left upper abdomen. Physical exatnination revealed huge aMominal mass in left upper abdomen. Abdominal ultrasonography and computed tomography revealed a huge well demarcated heterogeneous mass at the tail of the pancreas with liver metastasis. Distal pancreatectomy and excision of rnass were carried out. Pathological examination revealed acinar cell carcinoma in pancreatic tail. She died ninth day after operation. (Korean J Gastroenterol 1996;28: 592 - 596)
간경변증 환자에서 Non-01 Vibrio Cholerae에 의한 패혈증 1예
두창준,이명희,한종학,김재홍,변종훈,김준현,노용호,이진석,정동성 대한감염학회 1995 감염 Vol.27 No.1
저자들은 간경병증으로 입원 중인 47세 남자 환자에서 해산물을 생식한 후 발열, 설사, 복통이 발생하고 혈액 배양에서 non -O1 V. cholerae가 분리되었고 조기의 적절한 항생제 투여로 회복되었던 환자 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Non-O1 Vibrio cholerae(V. cholerae) stains represent a diverse group of organisms which are morphologically and biochemically identical to V. cholerae, but do not agglutinate in V. cholerae O-group 1 antiserum. These strains cause a wider range of infections than the other typical cholera vibrio, including watery diarrhea, dysentery, would infection, ear infection, and septicemia. These strains have been isolated from several extraintestinal sites, including bile, gallbladder, blood, wound, ear drainage, sputum, and cerebrospinal fluid. Frequently, patients infected at these sites are afflicted wlth an underlying disease, such as liver cirrhosis, malignancy, diabetes, or any condition resulting in achlorhydria. Since the non-O1 V. cholerae gastroenteritis is self-limited, antibiotics are not recommended. However, septicemia, wound infection, and deep organ infection should be treated with appropriate antibiotics. These strains were susceptible to cephalothin, tetracycline, amikacin, gentamicin, kanamycin, and tobramycin. We report a case of non-O1 V. cholerae septicemia in a patient with liver cirrhosis. A 47-year-old male with liver cirrhosis complained of fever, diarrhea, abdominal pain upon admission. The day before the onset of symptoms, he had Sushi. Two blood cultures yieled non-O1 V. cholerae. He recovered by antibiotics, cefazolin and gentamicin.
김명환,신규석,변종훈,두창준,소군호,고정석,진교현,김서종 대한소화기내시경학회 2000 Clinical Endoscopy Vol.20 No.2
A choledochal cyst is relatively rare lesion in the biliary system, and a carcinoma arising from such a cyst is rarely reported. Until now, a case of a hepatocellular carcinoma combined with a choledochal cyst had not been reported. A 45-year-old woman was recently admitted due to abdominal pain. An abdominal computed tomography revealed a 5 cm-sized low attenuative mass involving the right anterior and left medial segment of the liver and gallbladder fossa. An endoscopic retrograde cholangiopancreatogram showed fusiform dilatation of the common bile duct, but anomalous union of pancreaticobiliary duct was not observed. Fine-needle aspiration of the liver was conducted and yielded a hepatocellular carcinoma. On celiac arteriography, a hypervascular hepatic mass was also found. Transarterial chemoembolization was performed. It is believed this may be the first case of a choledochal cyst combined with a hepatocellular carcinoma in the literature. Hence, this case is herein reported with a review of related literatures.
악성 복수 및 간 전이를 동반한 췌장의 Mucinous Ductal Ectasia 1예
김미영,김명환,김봉석,신규석,변종훈,두창준,소군호,진교현,김서종,고정석 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.6
A 71-year-old man was admitted due to abdominal distension and periumbilical pain. He was diagnosed as having mucinous ductal ectasia (MDE) of the pancreas three months prior, but refused an operation. Three months later, an abdominal computed tomography revealed more dilated pancreatic duct, newly developed liver metastasis and ascites in comparison with previous findings. Fine-needle aspiration cytology of the cystic lesion in the pancreatic head was conducted and yielded adenocarcinoma. Also, an ascitic fluid cytology determined adenocarcinoma. This patient was diagnosed to be inoperable and received palliative chemotherapy and pain control. The patient expired 5 months after the initial diagnosis.
김미영,최영찬,하상철,서정환,변종훈,박태현,두창준,진원종 대한소화기학회 1998 대한소화기학회지 Vol.31 No.2
Background/Airns: Approximately 30% of all patients who have spinal cord injuries have gastrointestinal symptoms. Gallstone disease is one of the causes. We performed the following study in order to determine the prevalence of gallstone disease among patients with spinal cord injury. Methods: We evaluated male patients who have spinal cord injuries. Abdominal ultrasonography, a detailed history and laboratory data were reviewed. In the study we excluded the patients with a history of obesity, hyperlipidemia, diabetes, gastric surgery, vagotomy, family history, liver cirrhosis, total parental nutrition, or of female sex. We evaluated 80 patients with spinal cord injuries and 82 controls. Results: Gallstone disease was significantly more prevalent in patients with spinal cord injury (18 of 80, 22.5%) compared to the control group (6 of 82, 7.3%). In the patients with spinal cord injury, the prevalence of gallstone disease was related with increasing age, but not the duration of injury, level of injured spinal cord and serum cholesterol. Conclusions: Spinal cord injury appears to be a risk factor for gallstone disease. But additional prospective studies are needed to confirm this association.
최영찬,김명환,서정환,변종훈,박태현,두창준 대한소화기내시경학회 1998 Clinical Endoscopy Vol.18 No.3
A 68-year-old man was admitted due to abdominal pain. He was diagnosed as having recurrent pancreatitis with a pseudocyst, which is communicated through the main pan- creatic duct. An endoscopic pancreatic sphincterotomy and insertion of a nasopancreatic tube into the main pancreatic duct via transpapillary drainage were performed. As a result, the pseudocyst disappeared and the pain was relieved. Thus it was concluded that transpapillary drainage via the main pancreatic duct is a safe and effective treatment for pancreatic pseudocysts, which is communicated through the main pancreatic duct.
김미영,하상철,박정근,한종학,서길준,변종훈,전상교,김동월,두창준 대한소화기내시경학회 1997 Clinical Endoscopy Vol.17 No.1
Hepatie hilar ductal carcinoma is relatively rare, but the prognosis is known to be poor because an early diagnosis is difficult. Because the majority of patients are already infiltrated into adjacent organ by itself at the diagnosis, the rate of resectability is low. The best method of treatment is curative resection, and the range of tumor invasion is very important. The preoperative diagnosis is difficult because the cholangiography may be normal in cases of superficial invasion. Multifocal lesions within the biliary tract may be identified in as many as 10 percent of patients, Especially, the papillary type has the best prognosis and is associated with multiple tumors within the bile duct. We report a case that percutaneous transhepatic cholangiogram showed normal distal common bile duct, but the hepatic hilar confluence and ampulla of Vater lesion was confirmed as adenocarcinoma.