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RISS 인기검색어
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- 저자 : 최찬주 ( Chan Joo Choi ) (검색결과 9 건)
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김승태(Seung Tae Kim),조항복(Hang Bok Cho),박정종(Jeong Jong Park),이종대(Jong Dae Yee),양종호(Jong Ho Yang),최찬주(Chan Joo choi) 대한소화기학회 1985 대한소화기학회지 Vol.17 No.1
N/A Forty cases of Korean Hemorrhagic Fever who were admitted to Dae Jeon Eul Ji HospitaI from January 1982 to December 1983, were analyzed, based on gastrofiberscopic findings. The results were as follow: 1) The most frequent incidence was found in the age group of 41-50 years old(30% of the total 40 cases studied); the male to female ratio was 1.86:1.2) The location of petechiae in Korean Hemorrhagic Fever could clinically be observed on the soft palate(45%), conjunctiva(32.5%), and axillary portion(20.0%). By using gastrofiberscopy, mucosal and submucosal hemorrhage were found more than twice as often(85% of the total cases) as the above clinical observation. 3) 64.3% of the total Korean Hemorrhagic Fever found on gastrofiberscopy was of the oliguric type. Severe hemorrhage was found in 50% of the oliguric type, but the severe hemorrhage was not found in the non-oliguric type. 4) In the gastrofiberscopic finding for each phase, positive findings were observed throughout all phases. The most frequent incidence and 50% of the severe hemorrhages were found in the oliguric phase. 5) According to the gastrofiberscopic findings, Korean Hemorrhagic Fever occurred most frequently between the 4th and the 9th day after the onset of the incidence, but was generally observed from the first to the 14th day or later. 6) The most frequent bleeding site in the stomach was the fundus(55%) and the body (50%), but bleeding spread to the entire stomach and the esophagus in 8 cases.
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崔燦柱 고려대학교 의과대학 1964 고려대 의대 잡지 Vol.1 No.1
In cases of acute barbiturate poisoning, studies on the ECG changes with references to the alteration in serum transarninase and serum amylase are absent in the literatures, though a few studies have been reported on the ECG changes. So the author investigated ECG findings in 30 cases of acute barbiturate poisoning selected at random, with reference to the change of serum transaninase, serum amylase, grade and duration of coma and liver fution tests. Of the 30 patients, there were 9 males and 21 females ranging in age from 16 to 59 years. The degree of unconsciousness were graded I-V according to Reed, et al. There were 3 cases in grade I, 4 in grade Ⅱ, 10 in grade Ⅲ, 6 in grade Ⅳ and 7 in grade Ⅴ. The duration of coma was 6 to 181 hr. with the average being 37 hr. The serum transaminase (SGOT, SGPT) was determined by the Sigma-Frankel method and the serum amylase by the Somogyi's method. Six liver function tests were performed; serum total protein, A/G ratio, C.C.F., T.T.T., alkaline phosphatase and serum total bilirubin. The results were as follows: 1) Six varieties of ECG changes were regarded abnormal: sinus tachycardia, arrhythmia, prolongation of QT interval, depression of ST segment and T wave changes (flattening, biphasic and inversion). 2)Sinus tachycardia was observed in 43.3% of the cases and the majority were associated with depression of ST segment or T wave changes. They usually lasted for a day or so, but occasionally for 2 to 5 days. In some cases the appearance of depressed S-T segment and T wave changes was heralded by sinus tachycardia. 3) Arrhythmia was seen in 6.6% of the cases. In one case tachycardia developed into auricular fibrillation and in another case intraventricular conduction defect was suspected. 4) Prolongation of QT interval was noted in 13.3% of the cases. It appeared earlier than other ECG abnormalities and returned to normal 1∼2 days later. All cases were with abnormalities of S-T segment (2 of elevation and 2 of depression). 5) In 10% of the cases, elevation of ST segment, more than 1 mm. in L₁-L₃ and V₁-V_(6) was observed. Usually they appeared on the 1st day and returned to normal on the following day. 6) Depression of S-T segment, more than 1 mm. in L₁-L₃ and V₁-V_(6) was noted in 36.3%, lasting for 1 to 3 days. In all cases such depression appeared in combination with T wave changes or some of the other ECG abnormalities such as sinus tachycardia, prolongation of QT interval or arrhythmia. 7) In 33.3% of the cases, T wave changes (flattening, biphasic or inversion) were encountered in L₁,L₂ and V₃-V_(6)They appeared with depressed S-T segment in most cases. In only one case T wave change only occured. 8) Combined depressed S-T segment and T wave changes were observed in 30% of the patients, usually coma of higher grade. 9 ) Among the ECG changes, the elevation of the ST segment was the earliest in onset. It was encountered on the first hospital day in all cases. Prolongation of QT interval and sinus tachycardia were observed exclusively on the first or 2nd hospital day, while the depressed S-T segment and T wave changes appeared later on the 3rd day in some cases of coma of longer duration. The ECG changes found in later period of the poisoning were mostIy depression of S-T segment or T wave changes. 10) The incidence of the ECG changes, particularly, depression of the S-T segment, T wave changes or arrhythmia, were higher in the group of grade IV-V than in the group of grade Ⅰ-Ⅲ. While the ECG changes in former group were as much as 53.8% in sinus tachycardia, 61.5% in depression of S-T segment, 53.8% in T wave changes, 53.8% in depression of S-T segment plus T wave change and 23% in prolongation of QT interval, it was only 35% in sinus tachycardia, 17.6% in depression of S-T segment, 17.6% in T wave changes, 11.7% in depression of S-T segment plus T wave changes, and 5.8% in prolongation of QT interval in latter group. There was no relationship between elevation of S-T segment and grade of coma in the author's series. 11) Among the average duration of coma in each group of the ECG changes, the group of depressed S-T segment was the longest. The group of depressed S-T segment plus T wave changes and the group of T wave changes were the next in duration in average. In the group of sinus tachycardia, elevated S-T segment and prolongation of QT interval, the average duration was much shorter but stilI longer than the normal ECG group. Thus some relationship seemed to be indicated between the ECG abnormalities and the duration of coma. 12) Among the average value of SGOT and SGPT in each group of the abnormal ECG cases, the highest value was noted in the group of T wave changes. Another three groups, sinus tachycardia, depression of S-T segment plus T wave changes and depression of S-T segment, were lower than the group of T wave changes with similar abnormal levels. The average value of serum amylase was highest in the group of S-T segment depression plus T wave changes. 13) Cases of ECG abnormalities, particularly of depressed S-T segment and T wave changes, were tend to b e associated with abnormalities in many type of liver function tests. 14) As the causes of the ECG changes in acute barbiturate poisoning not only the myocardial anoxia, possibly of importance, but a direct barbiturate effects on cardiae muscels as well, possibly minor in role, are suggested.
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崔燦柱 최신의학사 1959 最新醫學 Vol.2 No.12
Summary To our knowledge, some injected dye, particularly neutral red which is commonly used, disregarded by the achylic stomach Sontrary to the abundant appearance of the dye in acid stomach and this fact appreciated some differential diagnostic value. As for the mechanism of nutral red transfer, there is still controversy, whether it is a simple physicochemical process, i.e. concentration gradient between blood and gastric juice or specific glandular activity is also: involved. I have investigated the behavior of neutral red excretion *in bile as well as in s'romach under various conditions. Material and Method 150 cases, mostly gastroenterological patients, comprised of 90 men and 60 women and age of ranging from 14 to 69, were examined by Katch-Kalk method combined with fractional aspiration over 2hour period. 4m1. of 1% aqueous solution of neutral, red was injected 'intramuscularly immediately after the administration of test meal. Onset of dye appearance, its concentration., duration, free and total acidity, pepsin and total chloride were estimated on each fraction. Basal secretion was also checked. Achlorhydria cases were re-examined by histamine test. In 7 cases the secretion of the dye in bile also examined in detail. In some cases effect of HCl instillation into stomach upon the gastric secretion of the injected dye also observed. Some interesting results were obtained and the tmnsfering mechanism of thy dye was discussed. Results The dye made its appearance in gastric secretion in all cases except achlorhydria and 2 hyperacid cases. The onset of excretion was 10^102 minutes, the average being 27.4 min. Close relationship was shown between average total or free acidity and onset of excretion, so the more the acidity high, the more the onset rapid. Amount of basal secretion and aver-age pepsin concentration also show edthe same tendency, though it was much less clear-cut. Most of 14 cases failed to excrete the dye were of achlorhydria. But 2 hyperacid stomach, gastric carcinoma and peptic ulcer each, excreted no dye claiming significance i for the mechanism of neutral red transfer. Malignancies of stomach, 9 carcinoma and 1 aarcoma, slap refused to excrete the dye or did in trace only. Average onset of excretion in various gastroenterologicai conditions lined up as follows peptic ulcer, intestinal parasites, gastric neurosis, hepato-biliary diseases, chronic gastritis, anacidity syndrome and gastric malignancies from the fastest to the slowest. No significant difference was seen between the on-set of excretion into.the bile and into the gastric. juice. Few cases excreted the dye neither in bile nor in stomach. Duration of gastric excretion outlast that of bile being more than 3^-4 hours vs. 2h. In histamine-proved achlorhydria, 300m]. of N/IO HCI, placed in the stomach, showed no dye against the observation of V.Vallo & T. Javor who have seen the dye in the instilled acid solution into the gastric pouch or isolated Thiry Vella loop of animals. The author holds that the dye concentration gradient between blood and gastric juice is the dominant factor for the mechanism of neutral red transfer. Secretion of endogenous HCl is assumed to be a kind of vehicle by which the dye excreted into stomach. But hyperacid cases, failed to show dye suggest another factor, possibly specific glandular activity is also operating. The possibility of false excretion simulated by regurgitating duodenal fluid into stomach is negligible. These facts in mind, the neutral red injection method, i if combined with conventional gastric analysis such as Katch-Kalk method, will add more diagnostic value to the latter which is less informative than maximal, histamine test but still in use because of its simple procedure.
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