종 설 : 담낭벽 종대 발견시 적절한 대처

박은택 ( Eun Taek Park ) 대한내과학회 2016 대한내과학회지 Vol.90 No.1

Thickening of the gallbladder wall is a relatively frequent finding on diagnostic imaging. Such thickening is also a common but nonspecific finding in many patients with intrinsic gallbladder disease and extracholecystic conditions. Wall thickening may be diagnostically problematic, occurring (as it does) in both symptomatic and asymptomatic patients and in those with and without indications for cholecystectomy. An important first step is to distinguish between the diffuse and focal forms of thickening. Subsequently, identification of ancillary imaging findings and the directed use of additional imaging modalities allow accurate diagnosis. This is of clinical importance. Misinterpretation of the cause of thickening can trigger unnecessary cholecystectomies in patients without intrinsic gallbladder disease. Also, misdiagnosis of patients who do in fact require cholecystectomy may delay treatment, thus increasing morbidity. Although a definitive imaging diagnosis may not be possible, the cause of gallbladder wall thickening can be determined in most instances by correlating the clinical presentation with associated imaging findings. (Korean J Med 2016;90:15-19)

의학강좌-개원의를 위한 모범처방 : 담낭용종의 치료 전략

박은택 ( Eun Taek Park ) 대한내과학회 2015 대한내과학회지 Vol.88 No.5

급성췌장염의 약물, 수액 및 영양요법

박은택 ( Eun Taek Park ) 대한췌장담도학회 2014 대한췌담도학회지 Vol.19 No.4

Acute pancreatitis is an inflammatory disease of the pancreas. Acute abdominal pain is the most common symptom, and increased concentrations of serum amylase and lipase confirm the diagnosis. Pancreatic injury is mild in 80% of patients, who recover without complications. The remaining patients have a severe disease with local and systemic complications. Acute pancreatitis is a hypercatabolic state resulting in rapid loss of body weight, fat and protein. Nutritional support is an integral part of patient care and is started early in the course of disease. Patients with mild to moderate disease (80% of patients) do not require enteral nutrition (EN) or parenteral nutrition(PN), as they will begin oral feeding within 4 days of presentation. Nutritional support is needed for severe disease, EN is preferred over PN, and use PN when EN is contraindicated or not feasible. Most groups have used nasojejunal feeding, which has difficulties in maintenance of the tube position and patency. Nasogastric feeding in severe AP has shown little difference in terms of clinical outcome from nasojejunal feeding. In this review, we review the role, methods, and clinical implications of nutritional supports in acute pancreatitis and also present recently recommended standard guidelines. Korean J Pancreatobiliary 2014;19(4):170-175

특집-급성 췌장염의 최신 지견 : 급성 췌장염의 영양요법

박은택 ( Eun Taek Park ) 대한내과학회 2013 대한내과학회지 Vol.85 No.2

중증 급성 췌장염 환자에서 영양 공급은 치료의 중요한 부분을 차지함에도 불구하고 오랜 기간 동안 소홀히 다룬 측면이 있다. 경증인 경우 현재까지 새롭게 제시된 보존적 치료법은 없지만 영양 공급 면에서 조기 저지방 유동식(lowerfat soft diet)의 시도가 병의 재발이나 복통의 재발 없이 입원 기간 단축을 유도한다. 중증인 경우, 내원 48-72시간 이후 발생하는 영양 부족 및 면역 저하 등으로 인해 발생하는 국소 합병증의 이차 감염증 예방에 영양 공급은 필수적이며 투여 방법에서 경장 영양법이 정맥 주입법보다 우위에 있으나 필요한 만큼의 영양 공급이 이루어지지 않는 경우 정맥 주입법을 보조적으로 사용하는 것이 바람직하다. 경장 영양시 경공장관 영양공급이 유용한 것으로 보고되어 왔으나 최근 비위관 영양공급의 편리성이 부각되어 적극적으로 시도하는 경향이다. Acute pancreatitis is an inflammatory disease of the pancreas. Acute abdominal pain is the most common symptom, and increased concentrations of serum amylase and lipase confirm the diagnosis. Pancreatic injury is mild in 80% of patients, who recover without complications. The remaining patients have a severe disease with local and systemic complications. Acute pancreatitis is a hypercatabolic state resulting in rapid loss of body weight, fat and protein. Nutritional support is an integral part of patient care and is started early in the course of disease. Patients with mild to moderate disease (80% of patients) do not require enteral nutrition (EN) or parenteral nutrition (PN), as they will begin oral feeding within 4 days of presentation. Nutritional support is needed for severe disease, EN is preferred over PN, and use PN when EN is contraindicated or not feasible. Most groups have used nasojejunal feeding, which has difficulties in maintenance of the tube position and patency. Nasogastric feeding in severe acute pancreatitis has shown little difference in terms of clinical outcome from nasojejunal feeding. In this review, we review the role, methods, and clinical implications of nutritional supports in acute pancreatitis and also present recently recommended standard guidelines. (Korean J Med 2013;85:130-134)

마산만의 수질 개선을 위한 우선순위 하천 선정

배은택 ( Eun-taek Bae ),박종관 ( Jong-kwan Park ),문병현 ( Byung-hyun Moon ) 한국환경기술학회 2022 한국환경기술학회지 Vol.23 No.6

This study aimed to select the priority streams requiring improvement in water quality among the 17 streams flowing into the Masan Bay. Several methods were employed to select the priority streams, including calculation of discharge load and discharge load per unit area, analyses of the impervious rate and road ratio using land cover characteristics, grouping of branch streams, and the calculation of load duration curve excess rate. Watershed data, including flow and water quality data, were collected and monitoring was conducted in the Masan Bay watershed from 2005 to 2021 at the endpoints of the streams. 1) Five and six streams were identified as the subjects of priority management, according to the highest load rates by subwatershed and per unit area, respectively. 2) Two streams appeared to be the subjects of priority management, according to land cover characteristics that indicated an impervious ratio >50 % and a road ratio >10 %. 3) Stream grouping was carried out to identify group A water quality streams with high load and flow rates; six and eight streams were found to be the subjects of priority management, respectively. 4) As a result of selecting streams with an average excess flow >50 % using a flow duration curve, six streams were found to be the subjects of priority management. 5) The analysis of the five indicators revealed that Shinicheon and Samhocheon streams require priority management to improve water quality in the Masan Bay area, particularly management of point-source pollution. Continuous management is also required for Cheoksan, Naedong, and Changwon streams, which were identified as the subjects of priority management based on four indicators.

전환사채 주식전환을 위한 조건부 VaR 최적화

박구현(Koohyun Park),심은택(Eun-Tak Shim) 한국경영과학회 2011 經營 科學 Vol.28 No.2

In this study we suggested two optimization models to answer a question from an investor standpoint:how many convertible bonds should one convert, and how many keep? One model minimizes certain risk to the minimum required expected return, the other maximizes the expected return subject to the maximum acceptable risk. In comparison with Markowitz portfolio models, which use the variance of return, our models used Conditional Value-at-Risk(CVaR) for risk measurement. As a coherent measurement, CVaR overcomes the shortcomings of Value-at-Risk(VaR). But there are still difficulties in solving CVaR including optimization models. For this reason, we adopted Rockafellar and Uryasev’s[18, 19] approach. Then we could approximate the models as linear programming problems with scenarios. We also suggested to extend the models with credit risk, and applied examples of our models to Hynix 207CB, a convertible bond issued by the global semiconductor company Hynix.

유전자 2형인 만성 C형간염 환자에서 페그인터페론과 리바비린의 단기간 치료 효과

정은욱 ( Eun Uk Jung ),박지훈 ( Ji Hun Park ),배경임 ( Kyung Im Pae ),강석우 ( Suk Woo Kang ),박성재 ( Sung Jae Park ),지삼룡 ( Sam Ryong Jee ),박은택 ( Eun Tak Park ),이연재 ( Youn Jae Lee ),이상혁 ( Sang Hyuk Lee ),설상영 ( Sang 대한간학회 2007 Clinical and Molecular Hepatology(대한간학회지) Vol.13 No.3

Analysis of Mutant Line Derived from T-DNA Insertion in Chinese Cabbage

Mi-kyung Lee(이미경),Eun-Taek Woo(우은택),Jae-kyung Yu(유재경),Suk-man Park(박석만),Young-Doo Park(박영두) 한국원예학회 2005 한국원예학회 학술발표요지 Vol.2005 No.10

원발성 유두 장액성 복막암종으로 오인된 급성 췌장염의 합병증

이진욱 ( Jin Wook Lee ),박은택 ( Eun Taek Park ) 대한췌담도학회 2018 대한췌담도학회지 Vol.23 No.2

급성 췌장염은 췌장의 염증성 질환으로 췌장성 복수 및 가성 낭종과 같은 합병증을 일으킬 수 있다. 이러한 합병증은 심할 경우 결장, 복막 및 장간막의 이차성 변화를 일으켜 복막암종과 구별하기 어려울 수 있다. 본 증례의 환자는 타 병원에서 급성 췌장염 및 합병증으로 발생한 가성 낭종을 치료하는 도중 복막암의 가능성이 있어 추가 평가를 위하여 본원으로 전원되었다. 복막암의 가능성을 배제하기 위한 복막 조직검사 없이 순차적인 시술적 접근을 통하여 췌관의 손상으로 발생한 췌장성 복수와 가성 낭종으로 진단할 수 있었다. Acute pancreatitis is an inflammatory disease of pancreas which could lead to a number of complications including pancreatic ascites and pseudocysts. When these complications are severe, the secondary changes in colon, peritoneum or mesentery can make it difficult to distinguish from peritoneal carcinomas. Herein, we report a case of acute pancreatitis that was difficult to differentiate from peritoneal carcinoma. We performed a sequential procedure without peritoneal biopsy to exclude the possibility of peritoneal cancer, and we could diagnose pancreatic ascites and pseudocyst resulting from pancreatic injuries.

총담관결석의 진료 가이드라인: 총담관결석의 내시경 치료

김동욱 ( Dong Uk Kim ),박은택 ( Eun Taeg Park ),최정식 ( Jung Sik Choi ) 대한췌담도학회 2013 대한췌담도학회지 Vol.18 No.4

지난 40년동안 내시경역행담췌관조영술은 총담관결석의 치료에서 널리 사용되는 시술이 되었다. 현재 사용되는 다른 시술방법에는 술중총담관탐색술과 경피경간담석제거술이있다. 개별 병원마다 이용할 수 있는 기구와 이러한 시술방법에 익숙한 전문가가 다르고, 이러한 시술을 시행하는 시기도 임상상황에 따라 다양하다. 결과적으로 임상의사는 총담관결석이 의심되는 환자를 치료할 때 다양한 선택사항에 직면하게 된다. 한국, 타이완, 일본 등의 동아시아 지역은 일차적 총담관결석의 유병률이 서양에 비하여 높아서 총담관결석의 치료에 있어서 내시경 치료가 중요한 역할을 차지한다. 그러나 현재까지 출판된 가이드라인은 서양에 편중되어 있어 본고에서 한국의 실정에 맞는 내시경 치료의 가이드라인을 제시하고자 한다. During last 40 years, endoscopic retrograde cholangiopancreatography(ERCP) has become a widely available and routine procedure in the management of common bile duct (CBD) stones. Other used interventions include intraoperative bile duct exploration, and percutaneous transhepatic stone removal. The availability of equipment and skilled practitioners who are facile with these techniques varies among institutions. The timing of the intervention is often dictated by the clinical situation. As a consequence clinicians are now faced with a number of potentially valid options for managing patients with suspected CBD stones.In East Asia including Korea, Taiwan, and Japan, the prevalence of primary CBD stones without gallbladder stones is higher than that of the Western countries. Under these circumstance, ERCP may be the most important option for the management of CBD stones. However, the currently enacted guidelines is slanting toward the Western countries. This review suggests the guideline of Korean Pancreatobiliary Association for the endoscopic management of CBD stones.