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담즙의 농축화와 산성화가 담석형성에 미치는 영향에 관한 연구
문태훈(Tai Hoon Moon),이기훈(Ki Hoon Lee),이진우(Jin Woo Lee),장동섭(Dong Seob Jang),신용운(Yong Woon shin),김영수(Young Soo Kim),김원곤(Won Gon Kim),김경래(Kyung Rae Kim) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.3
N/A Background/Aims: The most recognized function of the human gallbladder(GB) is to store bile. However, this organ is not a static reservoir. It actively modifies bile by the double process: concentration and acidification. This study was designed to compare solute composition in GB bile between patients with and without gallstones and to evaluate the effects of concentration and acidification of GB bile on cholesterol and calcium solubility. Methods: Bile was sampled directly from the GB of fifteen patients with gallstones(gallstone group) and of fourteen patients undergoing laparotomy for reasons unrelated to hepatobiliary disease(control group). In the bile, we measured electrolytes, pH, pCO, protein, cholesterol, phospholipid, and bile salt. And then, we calculated the cholesterol saturation index(CS1) by using the critical table of Carey and the CaCO saturation index(CaCO Sl) by using metbods of Rege and Moore. Results: The pH was significantly higher in gallstone group. The bile salt concentration was significantly )ower in gallstone group. In between the two groups, total protein concentration were not significantly different. The CSI and CaCO SI were higher in gallstone group, but were not significantly higher than in control group. There was no significant correlation between pH and bile salt concentration, but a significant correlation was found between pH and CaCO Sl. There was also no significant correlation between pH and bile salt concentration, CSI and bile salt concentration, and pH and CSl, respectively. Conclusions: Failure of concentration and acidification of bile was found in patients with gallstones. Concentration and acidification of bile were independent processes. Acidification of bile prevents gallstone formation by increasing calcium salt solubility. (Korean J Gastroenterol 1995;27:338 - 344)
결핵성 복수 환자에 있어서 복수 Adenosine Deaminase 활성도의 진단적 가치에 관한 연구
문태훈(Tai Hoon Moon),박기수(Ki Soo Park),인현호(Hyun Ho In),최민준(Min Joon Choi),이관우(Kwan Woo Lee),김영수(Young Soo Kim),신용운(Yong Woon Shin) 대한내과학회 1995 대한내과학회지 Vol.48 No.5
N/A Objectives: In other to establish the etiology of ascites, routine analysis of fluid, bacteriologic studies, cytolgic tests and peritoneal biopsy are currently being employed. However, even with the above mentioned tests, the exact causes cannot be determined in more than 10% of cases. The purposes of our study are to determine the diagnostic significance of adenosine deaminase (ADA) activity in ascitic fluids which their etiologies have confirmed, and to determine the correlation between ADA activity and other biochemical data in tuberculous ascites. Methods: We have studied 21 cases of tuberculous ascites, 9 cases of malignant ascites, 32 cases of cirrhotic ascites, and 11 cases of miscellaneous etiologies. We have measured the ADA activity and values of routine examinations in ascites in each cases. Results: 1) The mean ascites ADA activity was 115.8±61.1 U/L in tuberculous ascites, 11.3±11.1U/L in cirrhotic ascites, 19.2±16.0 U/L in malignant ascites, and 13.7±12.6 U/L in miscellaneous ascites. 2) At a cutoff value of > 50 U/L, the sensitivity and the specificity for diagnosing tuberculous ascites were 95.2% and 98.4%, respectively. 3) In tuberculous ascites, the ascites ADA activity showed significant correlation with the ascites LDH activity (r=0.60), but other values of routine examination were not showed such correlation. Conclusion: It is suggested that the measurement of ascites ADA activity is simple and useful test in the diagnosis of tuberculous ascites. However, falsenegative results may occur in those in which ascites LDH activity is low.
적외선 및 원자 흡수 분광법에 의한 담석의 성분 분석과 담석 비중의 유용성에 관한 연구
이진우(Jin Woo Lee),문태훈(Tai Hoon Moon),송준호(Jun Ho Song),장동섭(Dong Seob Jang),박기수(Gi Soo Park),정석(Seok Jeong),조영업(Young Up Cho),김경래(Kyung Rae Kim) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.4
N/A Background/Aims: Recent reports show a tendency of higher incidence of cholesterol gallstones in Korea. 1t is well known that the compositional difference of gallstones is not only affected by the different geographic areas, but also depen<l on dietary and living habits. Measurement of tbe cholesterol content of gallstones facilitates investigations into the etiology, treatment, and prevention of gallstone disease. However, current procedures for determination of gallstone cholesterol content require expensive instrumentation and reagents which may not be readily available. The purpose of this study was to elucidate the influence of regional difference on the incidence of the different types of gallstones and the usefulness of gallstone density for measurement of the cholesterol content of gallstones, especially in satellite cities. Methods: We analyzed the gallstones from 26 gallstone patients who were operated in Inha University Hospital from March 1994 to November 1994. Each stone was evaluated with infrared and atomic absorption spectroscopy, and the gallstones from 20 patients were sampled for the determination of gallstone density. Results: The major type of gallstones was cholesterol stone(46.2%), followed by calcium bilirubinate stone(38.5%), calcium phosphate stone(11.5%) and calcium carbonate stone (3.8%), We obtained a high inverse correlation between the percentage of gallstone cholesterol content and gallstone density(r=-0.91, p -. 0.05). Conclusions: The major type of gallstones in Korea at satellite cities is cholesterol stone. Our results show that significant discrimination between gallstones of varying cholesterol content can be achieved by a simple determination of gallstone density. (Korean J Gastroenterol 1995;27:450 - 456)
황달형 간암 ( Icteric Type Hepatocellular Carcinoma )
이기형(Kee Hyung Lee),문태훈(Tai Hoon Moon),이진우(Jin Woo Lee),이기훈(Ki Hoon Lee),김여주(Yeo Joo Kim),정원재(Won Jai Chung),신용운(Yong Woon shin),김미영(Mi Young Kim),서창해(Chang Hae Suh),김준미(Joon Mee Kim) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.2
Intra-biliary growth of hepatocellular carcinoma(icteric type or cholestatic type hepatoma) is rare disease. In large series, this type of hepatoma has been reported with the incidence of 1.2 1.5%. Hepatocellular carcinoma can induce obstructive jaundice by intrabile duct tumor growth. This findings in most reported cases and, rarely, is recognized ante mortem. The average survival time of the cases was significantly shorter than that of hepatocellular carci- noma patients without intrabile duct tumor growth. There were rare reports in Korea. We present a case of icteric type of hepatocellular carcinoma with literature review.(Korean J Gastroenterol 1994; 26: 373 377)
Helicobactor pylori 의 검출을 위한 Ultrarapid Urease Test 의 유용성에 관한 연구
박기수(Gi Soo Park),정석(Seok Jeong),김여주(Yeo Joo Kim),이기훈(Ki Hoon Lee),김선후(Sun Hoo Kim),장재남(Jae Nam Chang),송준호(Joon Ho Song),문태훈(Tai Hoon Moon),신용운(Yong Woon Shin),김영수(Young Soo Kim),주영채(Yong Chae Joo) 대한내과학회 1996 대한내과학회지 Vol.50 No.5
N/A Objectives: A variety of methods have been developed for the detection of Helicobacter pylori in gastric mucosa. However they have a major disadvantage which is the time required or may be limited by expense. It has been reported that changing the incubation condition permitted ultrarapid diagnosis (ultrarapid urease test). We have examined the diagnostic efficacy of ultrarapid endoscopy room test and compard it with other diagnostic techniques in various gastrointestinal diseases. Methods: 110patients were performed gastroduodenoscopy. Alsco, antral biopsy specimens were taken for ultrarapid endoscopy room test' (1minute and 5minute records), CLO test and histologic test (Hematoxylin & Eosin, Giemsa stain). We have determinde immunoglobulin-G titer for Helicobacter pylori. Results: Using histologic test as the gold standard, ultrarapid urease test produced a sensitivity of 85.7% (1 minute record), 91.4% (5minute record) respectively and a specificity of 92.9% (1minute record), 78.6%(5minute record) respectively. The diagnostic accuracy of the test was 87.8% in 1 minute and 5minute record. Conclusion: Ultrarapid urease test is a rapid, inexpensive, easily available and reliable technique for the detection of Helicobacter pylori in endoscopy room.
Propylthiouracil 에 의한 중증 재생불량성 빈혈 1 예
김인한,김진주,문태훈,송기산,박재후,유혜령 대한내과학회 1996 대한내과학회지 Vol.50 No.5
Antithyroid drugs are usually listed among agents associated with the development of agranulocytosis, but aplastic anemia rarely follows their use. A 34 year-old female was admitted to aur hospital with complaint of easy bruise. Three years before she had been diagnosed as Graves' disease and treated with propylthiouracil(PTU). Investigations were as follows' Hemoglobin 66g/L; hematocrit 19.6%; neutrophils 675/μL; platelets 13,000 /U L; corrected reticulocyte count 0.6%; Bone marrow biopsy showed severe hypocellular marrow. We reported a patient of PTU induced severe aplastic anemia with brief review of the literature.
정상 관동맥을 가진 이형협심증 환자에서 발생한 급성 심근경색증의 혈전용해제 치험
김삼수,김응진,고광곤,문태훈,박태병,이명묵,조상균,방준경 대한내과학회 1994 대한내과학회지 Vol.47 No.6
Coronary vasospasm has been proposed as a mechanism of muocardial infarction, particularly in variant angina pectoris with normal coronary arteries. Plaque rupture or prolonged stasis facilitating thrombus formation has been postulated as the mechanisms of vasospasm induced myocardial infarction, Recently some reports decribed effects of thrombolytic therapy in patients with variant angina and chest pain with long duration to prevent or reduce the amount of myocardial infarction. We report two cases of patients with myocardial infarction in normal coronary artery, who were proved coronary artery spasm and were successfully managed by thrombolytic therapy.