간장 및 담도 : 간세포암 치료에 있어서 간동맥 색전술의 이용 - 임상경험 24예 -

기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이민호(Min Ho Lee),이성구(Sung Koo Lee),이종철(Jong Chul Rhee),유종상(Jong Sang Ryue),최호순(Ho Soon Choi),박민선(Min Sun Park),서흥석(Heung Suk Seo) 대한소화기학회 1986 대한소화기학회지 Vol.18 No.1

N/A 24 patients with unresectable hepatocellular carcinoma were treated with transcatheter arterial embolization. The results were as followings: 1) The serum levels of AFP were decreased in about 80 percent of the patients with elevated AFP. 2) We found the low density areas in the CT after embolization which meant the effect. 3) Side effects were fever, nausea and vomiting in almost of all patients but subsided within several to ten days.

정상 , 양성 및 악성질환에 있어서 혈중 CEA ( Carcinoembryonic Antigen ) 에 관한 연구

기춘석 ( Choon Suhk Kee ),손의석 ( E. Suk Sohn ),이동후 ( Dong Hoo Lee ),박성수 ( Sung Soo Park ),박경남 ( Kyung Nam Park ),김윤호 ( Yun Ho Kim ),남상학 ( Sang Hack Nam ) 대한내과학회 1981 대한내과학회지 Vol.24 No.7

간경변증에 동반된 비기능 항진증의 치료에 있어서 부분적 비동맥 색전술의 장기적 평가

이기창(Kee Chang Lee),함준수(Joon Soo Hahm),이종철(Jong Chul Rhee),이민호(Min Ho Lee),최일영(Il Young Choi),박경남(Kyung Nam Park),기춘석(Choon Suhk Kee),서흥석(Heung Suk Seo) 대한내과학회 1994 대한내과학회지 Vol.46 No.2

Background: Partial splenic embolization (PSE) was performed in ten cirrhotic patients with hypersplenism. Since Maddison first used splenic embolization in the treatment of hypersplenism in 1973, Spigos introduced partial splenic embolization with only few serious complication. Methods: The splenic artery was selectively catheterized via a femoral approach, and the tip of the catheter was placed as distal as possible at intrasplenic artery and gelfoam was infused. In this study, the mean infarcted area of spleen was approximate 60% of spleen. Six cases of ten patients were followed up to 42 months. Results: 1) The platelet and WBC counts increased immediately after P.S.E. Maximal count was observed at one month and then decreased gradually but maintained within normal limit until 42 months. 2) The hemoglobin level was not increased rapidly after P.S.E. but increased gradually and maintained within normal limit for 42 months. 3) The fever, abdominal pain were observed in all cases and transient ascites, pleural effusion ware observed in a few case but no serious complication was observed. Conclusion: P.S.E. is an effective alternative therapy for hypersplenistn in patients with liver cirrhosis.

한국인의 악성고혈압에 관한 임상적 관찰

손의석 ( E Suk Sohn ),기춘석 ( Choon Suhk Kee ),이종순 ( Chong Soon Lee ),임성손 ( Sung Son Lim ),김용신 ( Yong Sin Kim ),김연두 ( Yoon Do Kim ) 대한내과학회 1977 대한내과학회지 Vol.20 No.7

폐쇄성황달을 동반한 간세포암 의 초음파진단

이동후,박찬현,기춘석,박경남 ( Dong Hoo Lee,Chan Hyun Park,Choon Suk Kee,Kyung Nam Park ) 대한소화기학회 1981 대한소화기학회지 Vol.13 No.1

Jaundice in association with hepatocellular carcinoma ordinarily is mild as a result of extensive hepatic infiltration with tumor and underlying cirrhosis. It is not widely recognized that this tumor may involve the extrahepatic biliary tree either by migration of tumor or hemorrhage. In these circumstances obstruction of the common bile duct may produce obstructive jaundice and confuse the clinical picture. A 58 year-old Korean v;oman was admitted to Han Yang University Hospital On December 24. 1980, with 45 day historv of increasing jaundice, intermittent right upper quadrant abdominal pain and indigestion. He noted dark urine and light-coloured stools. On ultrasono- graphy, hepatomegaly with space-occupying lesion of irregularly accentuated macronodular echo on low portion of right lobe was notable. And focal echogenic nodular mass was revealed also around the distal portion of markedly dilatated common bile duct with tree-like appearance of the dilated hepatic radicles near the porta hepatis. Abdominal exploration and microscopic picture revealed an identity. The authors wish to emphasize that the physician should be aware of the presentation with obstructive jaundice as a mechanical complication of hepatocellular carcinoma. Ultrasonographic estimation of this rare manifestation of hepatocellular carcinoma can establish the diagnosis noninvasively before surgery.

간경변증 환자의 나트륨대사에 있어서 혈장 Renin 및 교감신경활동도의 역할

이진(Jin Lee),최용석(Young Suk Choi),강승식(Seung Sik Kang),정용영(Yong Young Jung),윤석부(Seok Boo Yoon),계세협(Sea Hyub Kae),곽상택(Sang Taek Kwak),주상언(Sang Aun Joo),김호중(Ho Jung Kim),기춘석(Choon Suhk Kee) 대한내과학회 1995 대한내과학회지 Vol.49 No.1

Objectives: We studied to determine the changes of sodium metabolism and to evaluate the role of plasma renin and sympathetic activities in liver cirrhosis with hyponatremia. Methods: We performed measurement of serum sodium, serum albumin and other blood biochemistries, creatinine and creatinine clearance, daily urinary sodium excretion, plasma renin and aldosterone, and plasma norephinephrine level for sympathetic activity in 24 cirrhotic patients with (n;8) and without ascites(n; 16) on day 1 after admisson. We checked body weight, serum sodium and creatinine clearance again on day 10 after admission. Results: 1) The serum sodium level of the ascitic group was lower than that of the non-ascitic group(136±1.0 vs. 138±2.4 mEq/L, p<0.01). There were also significant lower values of serum albumin, creatinine clearance and 24hr urinary sodium excreation in the ascitic group as compared with non-ascitic group. 2) The plasma renin activity and norepinephrine level of the ascitic group were higher than that of the non-ascitic group(renin=3.8±1.1 vs. 557±50 pg/ mL, p<0.05). 3) On day 10 after admission, the serum sodium concentration was decreased more prominently to 132±2.6 mEq/L along with significant reduction of body weight and creatinine clearance in the ascitic group, whereas there was no change of serum sodium level in the non-ascitic group, 4) In total 24 patients, a significant positive correlation between serum sodium and albumin concentration(R=0.6, p=0.004) as well as a significant negative correlation between serum sodium concentration and plasma renin activity(R=0.7, p=0.001). Conclusion: These results suggest that changes of serum sodium concentration in cirrhotic pathents correlate closely with changes of renal function related to the presence or absence of ascites, serum albumin level, changes of body weight, increased plasma renin activity and sympathetic activity, and with alteration of sodium and water delivery to the diluting segment of renal tubules.

위내시경으로 진단된 Gastric Red Spots ( GRS ) 의 병태생리 및 임상적 의의

이종철,양석철,성인경,강인구,함준수,이민호,기춘석,박경남,조석신 ( Jong Chul Rhee,Suk Chul Yang,In Kyung Seong,In Koo Kang,Joon Soo Hahm,Min Ho Lee,Choon Suck Kee,Kyung Nam Park,Suk Shin Cho ) 대한소화기학회 1992 대한소화기학회지 Vol.24 No.5

The incidence of GRS in the proximal part of the stomach was investigated in patients with various liver diseases. 477 patients with biopsy proven chronic liver disease underwent endoscopic study and GRS were obaerved in 38 (20.3%) out of 187 patients with liver cirrhosis, in 21 (16.8%) out of l25 patients with chronic active hepatitis, in 9 (15. 5%) out of 58 patients with chronic persietent hepatitis, and in 12 (14.3%) out of 84 patients with other chronic liver pathologies. There were no statistical differences among the groups. The incidence of chronic liver disease among patients with normal liver function tests and abdominal ultrasonography, but exhibiting GRS upon endoscopic study, was also prospectively studied by liver biopsy. 11 of 23 such patients had chronic liver disease: 2 had liver cirrhosis, 3 with chronic persistent hepatitis, and 6 with chronic reactive hepatitis, while 12 patients with no conclusive pathology in liver biopsy in spite of minimal disarray of hepatic lobular architecture and mild inflammatory cell infiltration into periportal area. The heart to liver radioisotope uptake ratios measured by Thallium-201 scan to estimate the portal pressure were 13+3% (mean+ SD) in 15 control subjects, 22+7% in 20 patients with chronic persistent hepatitis, 28+13% in 15 patients with chronic active hepatitis, 59+41% in 18 patients with liver cirrhosis, and 27+14% in 50 patients with GRS, but with normal liver function test results and normal abdomial ultrasonography. These results showed statistical difference from normal control (p<0.05). It can thus be concluded that GRS in the proximal part of the stomach could be a stigma of chronic liver disease, and would also indicate the presence of high portal pressure.

1996년도 제35차 대한소화기학회 추계학술대회 / 포스터 발표 : 위장관 ; 한국인 위암환자에 대한 p53 유전자 다형성분석

이오영,김경숙,이춘근,한동수,손주현,최호순,윤병철,권성준,이민호,기춘석,박경남 ( Oh Young Lee,Kyung Suk Kim,Chun Geun Lee,Dong Soo Han,Joo Hyun Sohn,Ho Soon Choi,Byung Chul Yoon,Sung Joon Kwon,Min Ho Lee,Choon Suhk Kee,Kyung Nam Park ) 대한소화기학회 1996 대한소화기학회 추계학술대회 Vol.1996 No.0

급성췌장염의 (急性膵臟炎) 초음파상에 (超音波像) 관한 연구

이동후(Dong Hoo Lee),박경남(Kyung Nam Park),기춘석(Choon Suk Kee),남상학(Sang Hak Nahm),김성윤(Sung Yoon Kim),강종명(Chong Myung kang) 대한소화기학회 1982 대한소화기학회지 Vol.14 No.1

N/A with a special regard of a rapid noninvasive diagnostic modality, the role of ultrasonography in the investigation of pancreatic disorders has become an important primary screening test. Recently available gray-scale ultrasonic technology has greatly improved imaging. We are intended to look for the specific appearance of ultrasonography in 31 patients with acute pancreatitis. All of the patients revealed pancreatic enlargement. Diffusely sonolucent pancreas with more homogeneous texture than hepatic parenchyme, with dilatated pancreatic duct was demonstrable in the most of patients. Three of 31 patients with acute pancreatitis showed gall bladder stones coincidentally. In 3 patients extrahepatic biliary tree was dilated conceivably due to compression of common bile duct by edematous pancreas. Fluid-filled intestines can be occasionally seen as a finding of adynamic ileus associated with acute pancreatitis. In acute pancreatitis subsequent sequencial ultrasonographic examination proved useful in following the progression of the disease to final resolution, or to development of complicating abscess or pseudocyst.

원발성간임의 (原發性肝癌) 초음파상에 (超音波像) 관한 연구

박경남(Kyung Nam Park),이창홍(Chang Hong Lee),기춘석(Choon Suk Kee),최웅환(Oung Whan Choi),이동후(Dontg Hoo Lee),이호채(Ho Chae Lee),김순길(Soon Gill Kim),민영일(Young Il Min) 대한소화기학회 1983 대한소화기학회지 Vol.15 No.1

N/A The gray- cale ultrasonographic app arances of histopathologically proven primary hepatoma in 61 patients were evaluated retrospectively. Our study has revealed four different ultrsonographic patterns of primary hepatoma: echogenic(39.4%), sonolucent(8.2%), mixed(31.0%) and diffuse parenchymal distortion(21.3%). Of 61 primary hepatoma examined, 19 cases exhibited encapsulation. Predominantly, the marginal Contour of mass was irregular rather than smooth. Most of cases represented downward convexity of the lower edge of the liver. Both of hump and marginal irregularity on the hepatic surface were exhibited in 54.1% and 59.0% respectively. Ultrasonography makes it possible to demonstrate not only the extrinsic compression of the vascularity by the tumor mass on intrahepatic vessels, inferior vena cava, and abdominal aorta, but also extrahepatic biliary obstruction. While 40.9% of cases were found to have a cites, splenomegaly was noticed in 31.1% In fact, ultrasonography is a useful screening method for imaging primry hepatorna with pecial regard of its noninva siveness and easy application to assess the nature and extent of the lesions.