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RISS 인기검색어
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- 저자 : 황흥곤(H C Hwang) (검색결과 4 건)
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식도 (食道) 정맥류 (靜脈瘤) 출혈에 있어서 내시경적 (內視鏡的) 경화요법의 (硬化療法) 치료효과
신현성(H S Shin),이동후(D H Lee),기춘석(Chun Suk Ki),박경남(K N Park),황흥곤(H C Hwang),주상언(S U Joo),최일영(I Y Choi) 대한소화기학회 1983 대한소화기학회지 Vol.15 No.1
N/A Bleeding from esophageal varices is the most, severe complication in patients with cinhosis of the liver and portal hyrpertension. There has never been a uniform concept of emergency management of variceal bleeding because of pitfalls in the medical as well as the surgical therapeutic technics. Endoscopic injection sclerotherapy of esophageal varices is being reevaluated by many physicians because of increasing dissatisfaction with shunting procedures. This is to report the result of the EIS of 12 patients with esophageal varix. Who have been admitted to the department of internal medicine at Han Yang Universitv Hospital. The results are as follows: 1. 12 patients with liver cirrhosis who were proven to have esophaveal varices by esophagoscope were treated by EIS. There were 10 males and 2 females in the age range of 37 to 58 years. 2, Severity of liver cirrhosis was classified by Child method revealed cases in grade II and 7 cases in grade III, The varices were classified by the Sesoko method, revealed cases in moderate (B) and 8 cases in severe (C). Intravenous vasopressin was injected within 10 to 12 hours before EIS and b!ood transfusion was performed, if needed. 5.Solution of 5% sodium morrhuate was iniected into varices and Bovine thrombin was spraid around varices. 11 patients with active bleeding had control of their hemorrhage: 7 cases with first shooting, 3cases with second shooting, 1 case with third shooting. In the one patient without bleeding, esophageal varix was significantly decreased in size after EIS. 7. EIS has advantages such as simple, safe, inexpensive, low complication. 8. EIS is proposed as the emergency treatment of choice for patients with proven bleeding Esophageal varices who do not stop bleeding on conservative treatment.
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중증 간경화증환자에 (肝硬化症患者) 동반된 난치성 (難治性) 복수의 (腹水) 초여과에 (超濾果) 의한 치료효과
기춘석(Chun Suk Ki),박경남(K N Park),이호채(H C Lee),황흥곤(H C Hwang),정병천(B C Chung),허동헌(D H Hur),박한철(H C Park) 대한소화기학회 1983 대한소화기학회지 Vol.15 No.1
N/A There had been a considerable trouble in the management of refractory acites combined with liver cirrhosis. Such refractory ascites in advanced liver cirrhosis does not respond to conventicnal therapy such as bed rest, salt restriction, massive diuretics and albumin infnsion. And there are also serious corrplications including hepatic encephalopathy, functicnal renal failure and hyponatremia with massive administration of diuretics. So peritoneovenous shunt(Leveen shunt) had been developed in order to promote effective circulatory volume with increased renal function. But relatively large and serious complications such as DIC, fever, infection, pulmonary edema and pulmonary embolism had limited its widespread use in the magement of refractory ascites. So we have experienced intraperitoneal reinfusion of ultrafiltered ascites for 20 patients with intractable ascites combined with liver cirrhosis. We had performed this procedure via ultrafilter which was usually used in hemodialysis and pump. And the following results werc acquired. 1. About 6200 cc of acites was ultrafiltered for average 4. 5 hrs. and loss of body weight was 6.7kg which was more than the amount of filtered ascites. 2, Increasing tendency in serum albumin concentration after ultrafiltration with peak concentration about 0. 5 gm/dl gain at 3rd after this procedure. There were significant increase in the amount of daily urine output but statisitically nonsignificant increase in creatinine clearance. 4, The complications of this procedure were light headache, hearing disturbance, dizziness and there was no more serious complication such as DIC, variceal rupture, pulmonary edema. There was no recurrence of reaccumulation of ascites within 3 months with one time procedure in a certain case. The repeated with average of 4-6 weeks interval had controlled such refractory ascites. In summary, above results supported that intraperitoneal reinfusion of ultrafiltered ascites have beneficial effect in the control of refractory ascites combined with far advanced liver cirrhosis. The advantages of this procedure are the followings. 1.Low cost. 2. Time saving. 3. Ambulatory control. 4 Less complication. 5. Corresponding effect to intravenous albumin infusion (4-5 bottles)
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복수를 (腹水) 동반한 간경화증에서 (肝鏡化症) 복수내 (腹水內) Albumin 의 전신혈류로 (全身血流) 환류에 (還流) 관한 연구
기춘석(Chun Suk Ki),박경남(K N Park),함준수(J S Hahm),황흥곤(H K Hwang),이종숙(J C Rhee),조석신(S S Cho) 대한소화기학회 1984 대한소화기학회지 Vol.16 No.1
N/A Ascitic ultrafiltration and intraperitoneal reinfusion therapy for intractable ascites in liver cirrhosis removes ascites fluid rapidly and increases urine output, which is thought as a result of increased effective blood volume by inducing gradual backflow of concentrated ascitic albumin into circulation. To demonstrate a net transfer of ascitic albumin to blood by this therapy in cirrhotic intractable ascitic patient, I-181 labeld human serum albumin was administered intraperitoneally after ascitic ultrafiltration, and thereafter blood samples were chawn serially and radioactivity in these sample were measured. The blood levels of I-131-HSA increased gradually over 48 hours with the peak rate of blood uptake achieved at 6 hour and the peak levels is thought to be achieved at 72 hour considering the rate of uptake. At 48 hour, 6.47% of the isotope administered had appeared in the blood when corrections are made for transfer of labeled albumin into ascites and other extracellular space and degradation of labeled albumin, At 72 hour the precentage of ascitic albumin returned to blood appears to be at least 10% By this studies we can provides the therapeutic basis for ascitic ultrafiltration intraperitoneal reinfusion therapy in intractable ascites.
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