출혈성 소화성 궤양의 장기 재발률

심기남,정훈용,양석균,홍원선,박의련,박무인,김해련,민영일 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.2

Background/Aims: Bleeding from a peptic ulcer is one of the common and serious complications associated with the rate of reported mortality, which ranges from 5% to 10%. Endoscopic therapy is effective in controlling active bleeding and reducing the emer-gency surgery, the immediate mortality rate and the incidence of early rebleeding. But few recent studies have documented the long-term recurrent bleeding rate after discharge in patients with bleeding peptic ulcers. The aim of this study was to determine the long-term recurrent bleeding rate and factors predisposing to recurrent bleeding. Methods: Eighty-eight patients with bleeding peptic ulcers discharged after medical treatment between Dec. 1990 and Jul. 1992 were included in this study and retrospectively followed up with medical records and telephone interviews. The end point of follow-up was recur-rent hemorrhage, surgery for treatment of ulcer complication, or death. Results: By July 1997, retrospective follow-up was available in 76 patients. Recurrent bleeding occurred in 23 patients (30.3%) with bleeding peptic ulcers and the median follow-up period was 69 months (range, 1 ∼79 months). The estimated cumulative recurrent bleeding rate after 1, 2, 3, 4, 5 and 6 years was 11.8%, 14.5%, 19.9%, 24.2%, 27.2% and 34.2%, respectively. There was no difference between the recurrent bleeding group and the non-recurrent bleed-ing group according to age, sex, prior NSAIDs use, previous history of bleeding or pepticulcer, site of ulcer, stigmata of recent hemorrhage at initial examination, method of treatment and amount of transfusion. Conclusion: Recurrent bleeding occurred in one-third of patients with bleeding peptic ulcers after 6 years of follow-up and one-third of recurrent bleeders rebled within 1 year. The factors predisposing to recurrent bleeding in the long-term follow-up could not be found. Therefore, further studies designed to identify factors predisposing to recurrent bleeding are needed and the evaluation of Helicobacter pylori status in bleeding pepic ulcer is needed because Helicobacter pylori is an important factor of peptic ulcer recurrence.

신우신염으로 오인된 부종양증후군을 동반한 신세포암

한민철,김재헌,박성재,변동원,강덕희,심봉석 이화여자대학교 의과대학 2004 EMJ (Ewha medical journal) Vol.27 No.2

Renal cell carcinoma can presents wide range of signs and symptoms, and commonly associated with paraneoplastic syndrome. Paraneoplastic manifestations are present in up to 20% of patients with renal cell carcinoma. There is convincing evidence that renal cell carcinoma tumor cells elaborate proteins that serve as mediators of endocrine (ex ; ectopic production of parathyroid hormone-related protein or erythropoietin) as well as nonendocrine paraneoplastic syndromes. A paraneoplastic syndrome may be the various clinical presentation of renal cell carcinoma in a significant number of patients, therefore mimicked other general disease. We report a case of renal cell carcinoma associated with paraneoplastic syndrome mimicking pyelonephritis.

이형성 신장과 동반된 이소성 요관

김재헌,한민철,박성재,정준호,심봉석,조민선 이화여자대학교 의과대학 2005 EMJ (Ewha medical journal) Vol.28 No.1

Ectopic ureteral orifice presents predominantly in young girls with duplicated kidneys and ureters, and mostly drains from ectopic ureters were associated with non-duplicated upper urinary systems and it is called a single system ectopic ureter. It is frequently associated with renal dysplasia or agenesis and ureterocele. Compared with ectopic ureter draining from the duplicated kidney, the diagnosis of single system ectopic ureter is often delayed because the ectopic ureter may be associated with a single small dysplastic, poorly functioning kidney. We report a case of single system ectopic ureter associated with dysplastic and poorly functioning kidney.

대구 상인동 가스참사로 본 지역 응급의료체계에 대한 고찰

이삼범,도호석,도병수,이창현,심민철,권굉보 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Disaster may be defined as a sudden calamitous event associated with great damage or destruction. A more common definition, among emergency-preparedness planners, is a medical occurrence that overwhelms medical care systems and facilities. Most regional disaster plans are formulated to respond to disasters of moderate size. At 07:50 A.M. on 28 April 1995, gas explosion was happened at Sangin-Dong where was going to be under construction of subway in Taegu, Korea. 102 victims had died and 178 victims had moderate or minor injuries. Problems in the organization at the scene, triage, field management, transport to the hospital, and the communication contributed to the confusion in the management of victims. An analysis of this disaster allows several lessons to be learn about perimeter control, command functions, crowd control, and transportation priorities. It will benefit disaster planners in other communities.

응급의학과에서의 인공호흡기 처치

이삼범,도호석,도병수,이창현,심민철,권굉보 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

Study Objectives : To investigate and resolve the problems related with ventilator management in ED(emergency department). At present the ventilator is essential equipment of ED on university hospital and emergency center in Korea. Design : Retrospective consecutive case series. Setting : University teaching hospital Type of participants : All patients admitted and recieved ventilator management in ED of yeungnam university hospital from Jan. 1994 to jul. 1995. Methods and interventions : Charts of all patients were reviewed to determine the frequency, the types and causes of respiratory failure, the death rate, the mean duration of admission, the complications, and CPR(cardiopulmonary resuscitation) related with ventilator management in ED. We also identified the problems related with ventilator management by ED physicians and nurses through the answers to seven questions that suggested by us about ventilator management in ED. Measurements and main result : There were 34,751 admissions through ED during the study period. Of these 160 patients managed with ventilator in ED. The frequency of ventilator management in ED is increased at 1995(0.73%) that compared with 1994(0.32%). Non-trauma(113 cases) and hypoxic respiratory failure(83 cases) patients are more common than trauma(37 cases) and ventilatory failure Total CPR rate related with ventilator management are 25.3%. The mean duration of admission are 12.56±20.28 days, and the death rates are 45.3%. The incidence of complications occurred during ventilator management in ED are 37 cases. About seven questions suggested by us to 30 ED staffs(ED physician, nurses and paramedics), most frequent answer is the difficulty of keeping ventilator in ED because other department rent ventilator from ED and lost a part of ventilator. Conclusion : As the use of ventilator in ED is increased the emergency physician should be well trained for the indications, complications, setting mode and general problems of machine occurred during ventilator management in ED patients.

생약성분 항암제 Tianxian의 흡수동태에 관한 연구

양은정,김원배,심창구,이민화,정석재 서울대학교 1995 藥學論文集 Vol.20 No.-

흡연력을 고려한 궤양성 대장염 발생과 충수 절제술 사이의 상관 관계

남승우,양석균,정훈용,심기남,조병동,김승용,박의련,홍원선,민영일 大韓消化器病學會 1998 大韓消化器病學會誌 Vol.32 No.1

세침 흡입 생검으로 진단된 간의 혈관근지방종 1 예

이경아,유은실,민영일,김해련,심기남,정훈용,양석균,홍원선,박의련,이문규 대한소화기학회 1999 대한소화기학회지 Vol.33 No.6

Hepatic angiomyolipoma is a rare benign tumor of the liver composed of blood vessel, smooth muscle cells, fat and myelocomponent. The preoperative diagnosed of the lesion is important because of its therapeutic implications. Radiologic findings are not specific because the composed elements are variable in proportion and distribution. Thus, the findings at computed tomography, ultrasono graphy and magnetic resonance imaging may be only suggestive and its definitive diagnosed requires histologic confirmation. We experienced a case of hepatic angiomyolipoma in patient with chronic hepatitis diagnosed preoperatively by fine-needle aspiraton biopsy under ultrasound guidance. To our knowledge, this is the first case of hepatic angiomyolipoma diagnosed preoperatively in Korea. We report it with review of literatures.

대장내시경 전처치제로서 Sodium Phosphate 와 Polyethylene Glycol 용액의 전향적 비교 분석

이헌경,김승용,홍원선,민영일,정훈용,김해련,정성애,김석균,심기남,양석균,박의련,조문경 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.3

Background/Aims: Although some authors have suggested that sodium phosphate (NaP) is more effective than polyethylene glycol (PEG) in bowel cleansing, there has been no crossover study proving the superiority of NaP over PEG in bowel cleansing and patients' compliance. The aim of this study was to compare the two solutions for colonoscopy, PEG and NaP, through crossover design with regard to patients' compliance, cleansing ability and side effects. Methods: Thirty patients underwent two separate colonoscopies for colonic polyp(s) with PEG and NaP, respectively. Before and after bowel preparation, blood pressure, body weight, and serum biochemical parameters were measured in all patients. In addition, a detailed questionnaire was used to assess side effects and the patients' preference. The presence of bubbles, types of residual stool, and overall quality of colon cleansing were assessed by one endoscopist blinded to the type of preparation used. In each colonoscopy, two biopsy specimens were taken at rectum. Results: In the NaP group, but not in the PEG group, there were significant changes in several biochemical parameters including sodium (+3.0±3.0 mEq/L), potassium (-0.3±0.3mEq/L), calcium (-0.5±0.5 mg/dL), phosphorus (+3.9±2.2 mg/dL) and osmolarity ( +10.1±9.3 mOsm/kg) after bowel preparation. In addition, the degree of body weight change was greater with NaP (-2.2±2.3 kg) than with PEG (-1.2±2.0 kg) (p=0.06) and the formation of bubbles that disturb luminal observation was more frequently found in the NaP group (p$lt;0.01). There was no difference, however, in the type of residual stool and the overall quality of bowel preparation between the two groups and no significant mucosal change was noted after bowel preparation in both groups. Moreover, PEG was found to be more difficult to take than NaP (p$lt;0.05) and among the 30 patients, 26 (87%) preferred NaP, while only two favored PEG (p$lt;0.01). Conclusions: We conclude that NaP can replace PEG at least in patients with good general condition. Further studies to decrease the incidence of bubbles and to establish subgroups suitable for NaP are needed.

Targeted and Efficient Cancer Therapy Using Functionalized Hollow Gold Nanoparticles

Min Suk SHIM 한국생물공학회 2013 한국생물공학회 학술대회 Vol.2013 No.10